ObjectiveTo evaluate a third-generation applicator template for intracavitary combined with interstitial brachytherapy （IC-ISBT） suitable for locally advanced cervical cancer， aiming to improve therapeutic outcomes. MethodsA retrospective study was conducted on patients with stage IB3-ⅣB cervical cancer treated at Sun Yat-sen University Cancer Center from January 2023 to October 2023. Magnetic resonance imaging data before and after external beam radiation therapy were collected and analyzed. According to the residual tumor after external beam radiation， high-risk clinical target volumes （HR-CTV） were delineated， based on which a third-generation IC-ISBT applicator template was designed. The dosimetric and therapeutic differences between using this applicator template （template implantation group） and traditional freehand interstitial implantation （freehand implantation group） were further compared. Statistical methods were used to analyze the data from both groups to test the efficacy and safety of the two approaches. ResultsThe third-generation applicator template could accommodate different cervical structures and optimize needle path layout. The tumor volume in the template implantation group was significantly larger than in the freehand implantation group， showing statistical differences. In terms of dosimetric coverage （V_100%）， the template implantation group exhibited significant statistical differences compared with the freehand implantation group， demonstrating superior dose coverage. Additionally， the third-generation template showed advantages in protecting the rectum and sigmoid colon by potentially reducing high-dose points， while there were no significant differences in bladder dosimetry between the two methods. The primary cervical lesion remission rates were similar between the two groups. ConclusionThe third-generation IC-ISBT applicator template is scientifically and rationally designed， especially for patients with larger tumor volumes and later stages. It is easy to operate， highly reproducible， and shows significant advantages in dose distribution and protection of surrounding critical organs. The template has the potential to be widely applied as a routine treatment option.

Objective To investigate the characteristics of body fluid metabolic profile in patients with kidney stones based on surface-enhanced Raman spectroscopy,and to explore its application value and provide a reference for the screening of patients with kidney stones.Methods A total of 25 patients with kidney stones and 25 healthy controls were involved.Urine and blood samples were collected,whose spectra were measured with surface-enhanced Raman spectroscopy.The mean and difference spectra were plotted with origin software.The normalized data were processed with principal component analysis combined with linear discriminant analysis(PCA-LDA).Finally,the performance of the PCA-LDA method was evaluated with the receiver operating characteristic(ROC)curve.Results The levels of phosphatidylinositol,phenylalanine,palmitic acid/fatty acids,etc.in the urine of patients with kidney stones are higher than those in healthy controls,while the levels of components such as uracil and glycogen are lower.The content of methyl bands in the plasma of patients with kidney stones is higher than that of healthy controls,while the contents of glycogen,phosphatidylinositol,protein-tyrosine,phenylalanine,palmitic acid/fatty acid,hydroxyproline/tyrosine,and lipids are lower than those of healthy controls.Conclusion Surface-enhanced Raman spectroscopy can identify the changes in various metabolites in patients with kidney stones,and the combination of PCA-LDA and ROC analysis is helpful for the screening of patients.

Objective:To investigate the impact of serum vitamin A levels on all-cause mortality risk in diabetes patients.Methods:Diabetes patients aged 20 years and above who participated in the US National Health and Nutrition Examination Survey during 2003-2004 and 2005-2006 were enrolled as the study population,with death data up to 2019 as the endpoint.Cox proportional hazards regression models were employed to calculate the hazard ratios of all-cause mortality in diabetes patients with different serum vitamin A levels,both unadjusted and adjusted for confounders.Restricted cubic spline methods were used to analyze the dose-response relationship between serum vitamin A levels and all-cause mortality risk in diabetes patients.Results:A total of 484 diabetes patients were included,with a median follow-up period of 13.7 years,during which 211 deaths occurred.Cox proportional hazards analysis showed that compared to the lowest quartile of serum vitamin A,higher quartiles of serum vitamin A were not associated with all-cause mortality risk in diabetes patients without adjusting for confounders.However,after adjusting for confounders,higher quartiles of serum vitamin A significantly reduced the all-cause mortality risk.The dose-response analysis indicated a significantly increased risk of all-cause mortality in diabetes patients with lower serum vitamin A levels.As the vitamin A levels increased,the mortality risk gradually decreased.A significant reduction in all-cause mortality risk was observed when serum vitamin A levels were between 2.17 and 2.50 μmol/L.Beyond this range,there was a tendency for increased all-cause mortality risk with further increases in vitamin A levels.Conclusion:Lower serum vitamin A levels increase the all-cause mortality risk in diabetes patients,while moderate serum vitamin A levels help reduce the all-cause mortality risk in diabetes patients.

Perimenopause is a vulnerable stage for emotional disorders such as anxiety and depression,which is the result of a combination of bio-psycho-social factors,and it seriously affect the quality of life of perimenopausal women.Therefore,finding safe and effective treatments is one of the urgent problems in modern medicine.This paper summarises the etiology and treatment of emotional disorder in perimenopause in Chinese and western medicine,and on this basis,this paper discusses the clinical diagnostic and treatment strategies and research ideas of acupuncture in treating emotional disorder in perimenopause,thus providing a new idea for the prevention and treatment of emotional disorder in perimenopause.

Objective To study the effect of performance evaluation based on analytic hierarchy process combined with paperless electronic medical record management system applied in medical record management on the quality of medical records.Methods According to the standard of filling out medical record information in our hospital,100 cases of medical records were selected randomly for quality assessment from January 2023 to January 2024.Medical record management before and after the im-plementation of performance random based on analytic hierarchy process combined with paperless electronic medical record man-agement system was observed,including the quality of medical records,defects in medical records,the time for organizing medi-cal records of the discharged patients,satisfaction of all kinds of personnel and management of medical records.Results The score for quality of medical records after implementation was higher than that before implementation(P＜0.05).The incidence rates of defects in medical records such as insufficient differential diagnosis,delayed recording of special examinations,incom-plete examination forms,omissions in informed consent forms,omissions in special project approval forms,incomplete medication indications,excessive medication for discharged patients,inconsistent medical orders and fee lists,and no registration within 72 hours were reduced(P＜0.05).The accuracy of coding,accuracy of archiving,recovery rate,and qualification rate of homepage were improved(P＜0.05).The time for organizing nursing documents and other medical records was shortened(P＜0.05).Satisfaction of nurses,physicians,staff responsible for transportation,and patients was improved(P＜0.05).Conclu-sion Applying performance evaluation based on analytic hierarchy process combined with paperless electronic medical record management system in medical record management can effectively improve the quality of medical records,reduce defects in medi-cal records,improve the efficiency of medical record management,shorten the time for organizing medical records of discharged patients,and enhance satisfaction of all kinds of personnel,reference can be considered.

When the use of root canal retreatment and apical surgery experiences difficulty in treating endodontic diseases, intentional replantation is an optional clinical technique used to retain the tooth. A 28-year-old female complained of chewing discomfort at the mandibular second molar after undergoing root canal treatment 3 month ago. History record and radiographic examination revealed that a C-shaped root canal system was filled with gutta-percha in the mandibular second molar. A radiolucency area existed at the root furcal area with a thin canal wall in the distal and mesial roots. Intentional replantation was used to treat this tooth. The clinical and radiographic results showed that intentional replantation and nano-biomaterial application facilitated infection control, tooth retention, and periodontal tissue regeneration.
Female ; Humans ; Adult ; Tooth Replantation ; Root Canal Therapy ; Dental Pulp Cavity ; Gutta-Percha/therapeutic use* ; Tooth Root ; Molar/surgery* ; Retreatment

OBJECTIVE: To detect the gene mutations in patients with myeloid malignancies by high-throughput sequencing and explore the correlation between gene mutations and prognosis. METHODS: A retrospective analysis was performed on 56 patients with myeloid malignancies who were hospitalized in the department of hematology, Peking University International Hospital from January 2020 to May 2021. The genetic mutations of the patients were detected by next-generation sequencing technology, and the correlation between the genetic mutations and prognosis of myeloid malignancies was analyzed. RESULTS: In 56 patients, the number of mutated genes detected in a single patient is 0-9, with a median of 3. Sequencing results showed that the most common mutated genes were RUNX1(21.4%), TET2(17.9%), DNMT3A(17.9%), TP53(14.3%) and ASXL1(14.3%), among which the most common mutations occurred in the signaling pathway-related genes (23.3%) and the transcription factor genes (18.3%). 84% of the patients carried multiple mutated genes (≥2), and correlation analysis showed there were obvious co-occurring mutations between WT1 and FLT3, NPM1 and FLT3-ITD, and MYC and FLT3. TP53 mutation was more common in MDS patients.The overall survival time of patients with NRAS mutation was significantly shortened (P =0.049). The prognosis of patients with TP53 mutation was poor compared with those without TP53 mutation, but the difference wasn't statistically significant (P =0.08). CONCLUSION The application of next-generation sequencing technology is of great significance in myeloid malignancies, which is helpful to better understand the pathogenesis of the disease, to judge the prognosis and to find possible therapeutic targets.
Humans ; Leukemia, Myeloid, Acute/genetics* ; Nucleophosmin ; Prognosis ; Retrospective Studies ; High-Throughput Nucleotide Sequencing ; Myeloproliferative Disorders ; Mutation

Objective To investigate the relationship between serum adiponectin levels and body composition of perimenopausal and postmenopausal women in central and western Gansu province, and explore the influencing factors of adiponectin levels. Methods The body weight, body mass index(BMI), waist-to-hip, fat mass, percentage of body fat, visceral fat mass and muscle mass of 638 women(317 in perimenopausal period and 321 in postmenopausal period) in central and western Gansu were measured by bioelectrical impedance analyzer. Enzyme linked immunosorbent assay (ELISA)was used to measure serum adiponectin levels. Pearson correlation analysis and multiple liner regression were used to investigate the relationship between adiponectin levels and body composition. Results The body muscle mass of women living in central and western Gansu province showed a downward trend after menopause period compared to those who were in perimenopause. The waist circumference, waist-hip ratio, percentage of body fat, visceral fat mass of postmenopauseal women showed an increasing trend compared to perimenopausal. There were no significant differences in BMI, fat mass and serum adiponectin levels. Overall, serum adiponectin levels were positively correlated with body fat percentage and visceral fat mass, and negatively correlated with muscle mass, and the main influencing factors of serum adiponectin levels were visceral fat mass. Conclusion The main influencing factors of serum adiponectin levels in perimenopausal and postmenopausal women living in central and western Gansu province are the visceral fat mass.

Toxin-antitoxin system (TA) is a genetic element widely found in chromosomes and plasmids of bacteria, archaea and prophages. TA usually consists a toxin that inhibits the growth of bacteria and an antitoxin that neutralizes its toxicity. Since the discovery of the first CcdB / CcdA TA in the 1980s, TA has been proved to exist in almost all sequenced microorganisms and plays an important role in maintaining plasmid stability, anti-phage and promoting biofilm formation. At present, TA is divided into type I-VIII, among which type IITA is the most widely studied. HipBA is a type II TA. The toxin HipA in Escherichia coli HipBA is a serine / threonine kinase, which inhibits protein translation by phosphorylating bacterial Glutamyl tRNA synthetase (GltX), and its toxicity can be specifically neutralized by HipB. Recently, it has been found that Escherichia coli HipA homologous proteins exist widely in microorganisms, and they form a potential novel TA with genes of the same promoter, in which HipBST has been confirmed by experiments. The toxin HipT and the antitoxin HipS in this TA are similar to the C-terminal and N-terminal of E. coli HipA respectively, and the neutralization mechanism and the substrate of the toxin are different from that of E. coli toxin HipA. This study summarizes the recent discovery of special TA, especially the neutralization mechanism of HipBST which widely exists in prokaryotes.

Bunyavirus is widely distributed, highly contagious, and has a high fatality rate. It is a negative- strand RNA virus that has a major impact on public health around the world. The development of vaccines and the search for drugs are the key to prevent bunyavirus infection. The nucleoprotein (NP) of viruses is necessary for the synthesis of viral RNA, which combines with viral RNA to form the nucleocapsid, participates in viral assembly and RNA transcription, and plays an important role in viral proliferation. In addition, NP also has B cell and T cell epitopes, which can induce cellular and humoral immunity, so NP is an ideal target for vaccine design and drug development. Given its abundance and specificity, NP is also commonly used in the detection of viral diseases. More and more bunyavirus NP structures and structures of NP-RNA complexes have been resolved. Researchers have discovered two important antiviral targets through these structures, the terminal arm and the RNA binding cleft. This paper reviews the function and three-dimensional structure of the bunyavirus NP and the research progress of NP as an antiviral target, in order to provide a theoretical basis for the prevention and treatment of the bunyavirus disease.