Objectives: The aim of this study was to examine the disease burden of lung cancer attributable to particulate matter (PM2.5) pollution in China from 1990 to 2019. Study design: Data from the Global Burden of Disease Study 2019 were used to estimate the disease burden of tracheal, bronchus and lung cancer attributed to PM2.5 over time in China. Methods: Joinpoint regression models were applied to disability-adjusted life years (DALYs) to assess the time trends and estimate the impact of PM2.5 on the overall disease burden of lung cancer. Furthermore, age-period-cohort models were conducted to assess the relationships between lung cancer DALYs attributed to PM2.5 exposure and age, calendar period and birth cohort trends in China from 1990 to 2019. Results: Lung cancer DALYs attributable to household air pollution from solid fuels decreased with an average annual percent change (AAPC) of 2.9 % per 100,000 population, while those attributable to ambient particular matter pollution (APE) increased (AAPC: -4.7 % per 100,000 population) over the past 30 years. The burden of lung cancer in terms of DALYs in males was higher than in females, and it demonstrated an age-dependent increase. The period and cohort effects also had significant impacts on the DALYs rates of lung cancer attributable to APE, indicating an overall increase in lung cancer DALYs for all age groups in each year. Conclusions: This study highlights the need for effective strategies to reduce PM2.5 exposure in China, particularly from outdoor sources. Gender differences and age, period and cohort effects observed in the study provide valuable insights into long-term trends of lung cancer burden attributed to PM2.5. (c) 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

OBJECTIVE:To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). METHODS:We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January, 2015 and January, 2022 using a convenience sampling method. The patients were divided into a derivation cohort (201 cases) and a validation cohort (101 cases). Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients, based on which a risk prediction model was established in the form of a nomogram. The receiver operator characteristic (ROC) curve, calibration curve and clinical decision curve were used to evaluate the discrimination ability, calibration and clinical validity of this model. RESULTS:The in-hospital mortality risk prediction model was established based the risk factors including hypertension (OR=3.694, 95% CI: 1.582-8.621), continuous renal replacement therapy (OR=9.661, 95%CI: 4.103-22.745), elevated Na2 + level (OR=1.048, 95% CI: 1.003-1.095) and increased hemoglobin level (OR=0.987, 95% CI: 0.977-0.998). In the derivation cohort, the area under the ROC curve (AUC) of this model was 0.829 (95% CI: 0.770-0.889), greater than those of the 4 single factors (all AUC < 0.800), APACHE II Score (AUC=0.777, 95% CI: 0.714-0.840) and the SOFA Score (AUC=0.721, 95% CI: 0.647-0.796). The results of internal validation showed that the AUC of the model was 0.774 (95% CI: 0.679-0.869), and the goodness of fit test showed a good fitting of this model (χ2=4.629, P>0.05). CONCLUSION:The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation, calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system, and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Only 1-2% of non-small cell lung cancer (NSCLC) patients harbor RET fusions. Although selective RET tyrosine kinase inhibitors (RET-TKI), chemotherapy-based combination treatment, and chemotherapy are approved as the standard first-line strategies for stage IV patients, the best option is still undetermined. Here we try to evaluate the clinical efficacy of the above treatment as first-line therapies.

The development of immune-related adverse events (irAEs) has been widely linked to better outcomes in patients receiving immune checkpoint Inhibitors (ICIs) for melanoma, renal cell carcinoma, and non-small cell lung cancer(NSCLC). Here we analyzed the correlation of irAEs to the efficacy and prognosis of patients with small cell lung cancer (SCLC) in China.

1. In a non-cage environment, goose eggs are buried in litter and goose feathers, leading to contamination and discolouration. Such random distribution of goose eggs poses a great challenge to the recognition and location for intelligent picking by robot systems on farm.2. In order to assist in recognition and location of goose eggs in non-cage environments, a novel method was proposed which used three-channel convolutional neural network (T-CNN), composed of improved AlexNet, combined with ‘you only look once’ (YOLOv5), egg contour curve creation and support vector machine (SVM).3. Using this method, the original goose egg images were put into the YOLOv5 model for target detection and segmentation. In parallel, the median filter and maximum interclass variance method (OTSU) were applied to egg segmentation images to obtain the main pixels for each, and the Kirsch operator was used for edge extraction and contour curves fitting by designing the fitting curve equation to obtain segmentation images with goose egg contour curves.4. In order to further enrich the differences between goose eggs and background, the goose egg segmentation images were divided into three colour components: R, G and B, which were put into T-CNN for feature extraction. Then the eggs were classified by vector stitching and SVM, by adding goose egg contour curve images.5. The recognition and location results showed that about 95.65% of the goose egg pixel blocks in the segmented images were recognised correctly. About 3.81% of the pixel blocks in the segmented images were recognised incorrectly, and the centre of mass offset was about 4.45 pixels.6. This study demonstrated accurate goose egg recognition and location using the proposed method in a non-cage environment. This highlighted its application prospect in intelligent goose egg picking as well as a possible method to use in other species laying eggs outside the nest (floor eggs) as for example laying hens in non cage systems.

Pucotenlimab is a novel anti-PD-1 IgG4 monoclonal antibody. Several clinical trials conducted in China have demonstrated its efficacy and safety in various solid tumors including gastric cancer and breast cancer. Here we report a phase II study result of pucotenlimab for nsq-NSCLC without EGFR/ALK mutations. In this open-label phase II study, patients naive to systemic treatment were enrolled with histologically diagnosed stage IIIB or IV nsq-NSCLC. Patients were received intravenous Pucotenlimab 200mg Q3w for up to 35 cycles, combined with platinum + pemetrexed Q3W for 4 cycles and followed by maintenance pemetrexed Q3W (all intravenous). The primary endpoint was overall response rate (ORR) and safety, and the secondary endpoints were progression-free survival (PFS), duration of response (DOR) and overall survival (OS). From September 25th, 2020 to April 15th, 2021, a total of 43 patients were enrolled and followed up with a median of 13.1 months by the cut-off date (August 3th, 2022). 22 patients achieved partial response and 20 remained stable disease, respectively, contributing an ORR of 48.8% (95%CI: 38.9%, 59.2%) and a DCR of 95.3% (95%CI: 88.7%, 98.4%). The median PFS, DOR were 11.1 months (95%CI: 6.8, 14.4) and 13.9 (95%CI: 6.6, NE) months, respectively. The median OS was not reached. The common treatment-related adverse events (TRAEs) of any grade included anemia (79.1%), neutrophil count decreased (72.1%), white blood cell count decreased (67.4%) and platelet count decrease (53.5%). Neutrophil count decreased (32.6%) was the most reported grade 3/4 TRAE. Pucotenlimab combined with pemetrexed plus platinum demonstrated promising efficacy and safety for the 1st line nsq-NSCLC patients without EGFR/ALK mutations.

HER2 alterations are identified in 2-4% of non-small cell lung cancer (NSCLC), indicating poor clinical outcomes. Due to the deficiency of effective targeted therapies in the first-line setting, chemotherapy alone or combined with Bevacizumab, immune checkpoint inhibitors (ICIs) or both are recommended as standard options. However, the optimal therapy is still undetermined. Stage IV NSCLC patients with HER2 alteration were retrospectively analyzed from 6 cancer centers in China between May 2017 and February 2023. All the patients received chemotherapy alone (C), chemotherapy combined with Bevacizumab (BC), chemotherapy combined with ICIs (IC), or chemotherapy combined with Bevacizumab and ICIs (IBC) as first-line strategies. The clinical outcomes were evaluated. Eighty patients with HER2 mutation (75/80) or amplification (5/80) were included, in which 10 patients received chemotherapy alone, 37 received BC, 24 received IC, and 9 received IBC treatment. Compared with chemotherapy, combination therapy significantly improved mPFS (8.47 months VS 4.97 months, p<0.0001). Further analysis based on different combination mode showed that, each of the combination therapeutics, including BC (mPFS 7.27 m, HR=0.31, 95% CI: 0.14-0.68, p<0.001), IC (mPFS 8.47m, HR=0.20, 95% CI:0.08-0.48, p=0.004) and IBC (mPFS 16.3m, HR=0.08, 95% CI: 0.02-0.25, p<0.001), gave beneficial PFS compared with chemotherapy. In our effort to determine the optimal combination strategy, we found IBC treatment gave longer mPFS compared with BC (HR=0.15, 95% CI: 0.04-0.50, p<0.001) and IC (HR=0.43, 95% CI: 0.16-1.18, p=0.092). However, the efficacy of IC and BC schemes are comparable.Table: 1387PGroupsPatient numberORR, % (95% CI)DCR, % (95% CI)mPFS, months (95% CI)Chemotherapyn=1030.0(1.60,58.4)100(100,100)4.97 (4.09, 5.84)Combinationn=7025.7(15.5,36.0)91.4(84.9,98.0)8.47 (7.28, 9.35)ICn=2429.2(11.0,47.4)87.5(74.3,101)8.47 (7.15, 9.78)BCn=3718.9(6.30,31.5)91.9(83.1,101)7.27 (6.27, 8.26)IBCn=944.4(12.0,76.9)100(100,100)16.3 (8.83, 23.8)ALLn=8026.3(16.6,35.9)92.5(86.7,98.3)7.63 (6.35, 8.92) Open table in a new tab . Chemotherapy-based combination strategies improve patient survival compared with chemotherapy in the first-line therapy of HER2-altered NSCLC, while the IBC mode lead to the optimal PFS.

Immunotherapy combined with chemotherapy have become the standard first-line options in extensive stage small-cell lung cancer (ES-SCLC) in the past years. However, whether patients can benefit from consolidative thoracic radiotherapy (TRT) after first-line immunotherapy is still undetermined. ES-SCLC patients who received standard first-line immunotherapy combined with chemotherapy with/without subsequent TRT were included from 3 cancer centers in China between February 2020 to December 2022. The clinical outcomes and safety were evaluated. 220 ES-SCLC patients were eligible for our analysis, in which 136 received TRT and maintenance immunotherapy after chemotherapy, and 84 received maintenance immunotherapy only. TRT significantly improved the progression-free survival (PFS) (median 10.7 VS 8.5months, HR=0.662 [95% CI: 0.476-0.919], p=0.013), and decreased the intrathoracic lesion progression rate (13.23% VS 40.48%). Further analysis revealed that TRT with different biological effective dose (>60Gy or ≤60Gy), or different dose fractionation mode (conventional fractionation, hypofractionation or hyperfractionation) didn’t impact patient survival. However, addition of TRT in 3-6 weeks after chemotherapy generated significantly superior PFS compared with adding TRT after tumor progression on first-line treatment (median PFS 10.7m VS 8.3m, HR=0.414 [95% CI: 0.207-0.825], p=0.013). In addition, patients without liver metastases or with bone metastases were more likely to benefit from TRT (both p<0.05). TRT slightly increased ≥grade 3 adverse effect (30.88% VS 25%). Notably, the incidence of pneumonia was higher in the TRT group than in the maintenance immunotherapy group (19.9% VS 6%). The addition of TRT after first-line immunotherapy improves PFS and local control in ES-SCLC patients. TRT should be preferential performed in 3-6 weeks after chemotherapy. Patients without liver metastases or with bone metastases benefit more from TRT. The application of TRT is generally safe excepted for increased pneumonia occurrence.

1. The aim of the present study was to identify differentially expressed genes (DEGs) and metabolic pathways involved in this phenotype. Fibromelanosis is the most striking feature of black-bone chickens, such as the Silkie and Dongxiang indigenous breeds. Due to the accumulation of eumelanin in connective tissues, fibromelanosis manifests as black colouration of the skin, muscles, gut, and periosteum. Studies on fibromelanosis can provide useful information pertaining to human diseases and offer commercial value to the poultry industry. However, the genetic basis of fibromelanosis remains unclear.2. Digital gene expression analysis was performed on black and white skin samples collected from the HW1 black-bone chicken line to detect differences in genome-wide expression patterns. A total of >30 billion bp were sequenced, and 2,707,926,466 bp and 2,948,782,964 bp of clean data obtained for creation of libraries for black and white skin, respectively. In total, 252 DEGs from 15,508 mapped genes were identified with 83 up-regulated in white skin and 169 up-regulated in black skin.3. Gene ontology analysis highlighted that genes from the extracellular region and associated components were abundant among the DEGs. Pathway analysis revealed that many DEGs were linked to amino acid metabolism and the immune system. qRT-PCR validation using 14 genes showed good conformity with the sequence analysis of fibromelanosis-related genes.4. The results showed that L-dopachrometautomerase precursor (DCT), tyrosine aminotransferase (TAT), 4-hydroxyphenylpyruvate dioxygenase (HPD) from the tyrosine metabolism pathway, coagulation factor II (F2), fibrinogen beta chain (FGB), plasminogen (PLG) and complement component 7 (C7) from the complement and coagulation cascades were important genes in the fibromelanosis process in black-bone chickens. These candidate genes require further correlation analysis and functional verification.

INTRODUCTION:Scrub typhus (ST) is an acute febrile infection and remains a significant health problem globally. This study aimed to determine the factors associated with ST infection in Luhe District, China.MATERIAL AND METHODS:The case-control study was conducted among 116 cases identified through passive surveillance systems over three years.The control subjects were 232 living in the same village for more than six months without any history of ST infection were selected by matching to the age (within 5-years) and identified through active surveillance. Statistical analyses were performed using SPSS v. 25.0 for Windows (IBM SPSS, Chicago, IL, USA).RESULTS:The mean age of confirmed persons was 58.1(SD=10.15) years, while control subjects were 56.14 (11.57).There is no significant difference in gender, age, education, and occupations between case and control. Farmers had the most significant number of cases among occupational groups. The three factors that were significantly associated with an increased odds of having ST infection are bundling or moving waste straw (OR: 1.94, 95%CI; 0.99,381), morning exercise in the park or field (OR: 4.74 95%CI; 1.19, 18.95), and working as labourer in the vegetable field (OR:1.02, 95%CI:1.02,3.19).CONCLUSIONS:Our findings suggested establishing a prevention and control strategy for these groups to lower ST development risk.

Neuroendocrine tumours (NETs) are clinical heterogeneous. To date, no studies have focused on the genetic characteristics of NETs at different anatomical sites. We aim to explore the genetic similarities or differences between NETs at different sites. The patients were from a clinical study STEM (from a single institute, NCT03204032, NCT03204019). This cohort included 47 patients, including 14 Pancreatic NETs (pNETs), 11 Rectal NETs, 14 Thoracic NETs, and 8 Others. Whole exome sequencing (WES) was performed. The WES data of pancreatic cancer (PCa), rectal cancer (RC) and lung cancer (LC) from TCGA were used to compare the genetic characteristics with NETs. Somatic mutational analysis showed that there were no differences in tumor mutation burden, intra-tumoral heterogeneity or mutation spectrum between different NETs. We found several specific driver mutations for pNETs (MEN1 et.al), Rectal NETs (APC et.al) and Thoracic NETs (CACNA1A). Compared with cancers, few significantly mutated genes were shared by pNET and PCa; mutations in APC mostly occurred in both Rectal NET and RC; and some common mutations were observed in Thoracic NET and LC. Copy number analysis showed that copy number loss frequently occurred in all NETs. Deletions of chromosomal regions 14q11.2, 19p13.2, 19q13.31 and 1p36.21 were observed in all NETs. Moreover, we found several specific alterations of chromosomal regions for different NETs. Compared with NETs, counterpart cancers harbored copy number gain as well as copy number loss. Some altered chromosomal regions were shared by Thoracic NET and LC, while none were shared by NET and cancer at pancreas or rectum. Furthermore, we investigated the main altered pathways previously reported in pNETs or small intestine NETs. All NETs had frequent alterations in WNT pathway, PI3K/mTOR pathway, DNA repair pathway, chromatin remodeling pathway and cell cycle pathway. However, several differences in pathway alterations were observed between different NETs, indicating that pathway alterations may be achieved through different genetic routes. NETs at different sites had different genetic characteristics, which have the potential to distinguish the primary site of NETs.

Introduction To compare the effects of micropercutaneous nephrolithotomy (micro-PCNL) and retrograde intrarenal surgery (RIRS) in treating 1-2 cm solitary renal stones in pediatric patients aged less than 3 years. Patients and methods A retrospective analysis was performed on data from 57 children younger than 3 years who received micro-PCNL and RIRS surgery in the authors hospital from October 2016 to August 2018. The patients were divided into group 1, the micro-PCNL group, and group 2, the RIRS group. Peri-operative data including surgical time, number of anesthesia sessions, stone-free rate (SFR), and complications were analyzed. Results There were 27 patients in group 1 and 30 patients in group 2, and the patients' mean ages were 19 +/- 9.9 months and 21 +/- 7.8 months, respectively (P = 0.462). The stone size was 1.6 +/- 0.3 cm in group 1 and 1.7 +/- 0.2 cm in group 2 (P = 0.217); the mean surgical time was 52 +/- 7 min in group 1 and 48 +/- 9 min in group 2 (P = 0.163), and the mean lithotripsy time was 21 +/- 4 min in group 1 and 23 +/- 5 min in group 2 (P = 0.148); and the SFR at 1 month after surgery was 88.9% in group 1 and 86.7% in group 2 (P = 0.799). The number of anesthesia sessions for patients was 1.4 +/- 0.5 in group 1 and 2.7 +/- 0.5 in group 2 (P < 0.001). The complication rate was 14.8% and 16.7% in group 1 and group 2, respectively (P = 0.714). None of the patients needed conversion to the 12-14 F mini-PCNL. Conclusions The results of this study showed that the surgical effects and complications from micro-PCNL and RIRS in treating young children with 1-2 cm solitary renal stones were similar. However, micro-PCNL reduced the need to prestent before surgery and allowed lower anesthesia sessions. Therefore, micro-PCNL is an effective alternative method for 1-2 cm solitary renal stones in patients below 3 years of age.

Healthy river ecosystems can provide fundamental ecological services for human survival and social development. However, previous studies that have sought to assess river ecosystem health have primarily focused on individual biological communities rather than on all aquatic communities and have been based on a single-index assessment method, thereby leading to large uncertainties in the results. In this study, we developed a new framework for the integrated assessment of aquatic ecosystem health based on the principal communities of fish, zoobenthos, phytoplankton, and zooplankton in rivers. An index of biotic integrity was used to evaluate the health of fish and zoobenthos communities, and a diversity index was used to evaluate the health of zooplankton and phytoplankton communities. To integrate the health assessment results from these four communities, a quantile normalization method was developed, where uncertainties in assessments obtained using the diversity index were well compensated for by the assessments obtained using the biotic integrity index. The framework was then applied to a pilot city, which is being constructed as a civilized freshwater ecological city in China. The results were then compared with those previously obtained based on the single-community method. Using this new framework, we found that the aquatic ecosystem health changed regularly in space and over time. Large differences were detected among the assessments of the four individual communities based on the single-community method, with the health score determined using phytoplankton being the highest, followed by that of zoobenthos, zooplankton, and fish, which made it difficult to reach a definitive conclusion regarding aquatic health status. The integrated assessment framework presented in this study successfully overcame the narrow perspective of the single-community method, thereby reducing uncertainties in the assessments based only on a single diversity index, and instead provides a comprehensive view of the status of aquatic ecosystem health. Thus, this integrated framework could assist river managers and stakeholders in developing comprehensive strategies for ecological restoration and water resource management and could become a key research tool for the health assessment and rehabilitation of aquatic ecosystems globally.

AIM:To evaluate the clinical usefulness of quantitative dual-energy (DE) computed tomography (CT) iodine enhancement metrics combined with morphological CT features in distinguishing small-cell lung cancer (SCLC) from non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS:One hundred and six untreated lung cancer patients who underwent DECT before biopsy or surgery were prospectively enrolled. Twenty-seven routine CT descriptors, including tumour location, size, shape, margin, enhancement heterogeneity, and internal and surrounding structures, and associated findings were assessed and DECT parameters were measured in all patients. Multiple logistic regression analyses were applied to identify independent predictors of SCLC. The area under the receiver operating characteristic curve was compared between CT features combined with DECT metrics and CT features alone for distinguishing SCLC from NSCLC. RESULTS:Histology revealed NSCLC in 80 and SCLC in 26 patients. In univariate analysis, 12 morphological CT features and two DECT metrics differed significantly between NSCLC and SCLC. When DECT parameters were combined with CT features for multivariate analysis, the independent predictors of SCLC were large tumour size, central location, confluent mediastinal lymphadenopathy, homogeneous enhancement, absence of coarse spiculation, and lower iodine density and iodine ratio (all p<0.05). The area under the receiver operating characteristic curve was improved from 0.908 to 0.981 after adding DECT metrics compared with CT features alone (p=0.007). CONCLUSION:The combination of DECT measures and CT morphological features can be used to distinguish SCLC from NSCLC, with higher diagnostic performance compared with CT morphological features alone.

Assessing and comparing global river ecosystem health in an objective and quantitative way remains a major challenge. In this study the widely-used semi-quantitative methods Rapid Biological assessment Protocols (RBPs) was used to determine the health of rivers. The findings were then compared to the results derived from our new UAV (Unmanned aerial vehicles) orthophotographic imagery method. This method quantitatively and objectively assesses river ecosystem health. As a comparison, our method was used to quantitatively measure distance and areas of a range of hydrological and biological attributes thus improving the accuracy of distance- and area-related indices, consequently avoiding subjective errors in these estimations that is fraught in methods like the RBPs. To strengthen the objectivity of the assessment the weights of these indices were objectively determined using the entropy weighting method. This new method was then tested using 9551 UAV orthophotographs taken over six field campaigns. It performed satisfactorily, showing that in our study area the health status of mountain rivers was the best with the highest score of 0.94 out of 1.0. Temporally, the health of the river was better in summer (0.65) compared with that in autumn (0.40). Changes in river ecosystem health were driven by variations in biology and water quality. In contrast the outputs of RBPs, especially in relation to distance and area indices, had ~ 20% uncertainty due to visual errors and subjectivity in estimations by observers. The UAV orthophotographic imaging method proposed in this study can improve the ability to compare the health of rivers across different periods and regions throughout the globe.

Rectum is a dose-limiting organ in pelvic tumors radiotherapy. The assessing of radiosensitivity is good to improve individualized radiotherapy. Our previous study has shown increased FAK (focal adhesion kinase, PTK2) expression was related with radioresistance of intestinal epithelial cells. However, its molecular mechanism remains unclear. Here, we investigated the effect of FAK in radiation-induced rectal injury. Peripheral blood samples of patients with colorectal cancer were collected prior to radiotherapy. Differentially expressed genes and copy number variations (CNV) were analyzed by microarray in blood samples. The CTCAE version 3.0 toxicity grades was used assess the acute rectal injury. The intestinal epithelial cells are mostly the main targets for radiation damage. A normal human intestinal epithelial crypt cell line (HIEC) was used. The radiosensitivity of HIEC cells were detected by colony formation assay and flow cytometry. Further studies on AKT signaling-related and apoptotic-related proteins were assessed by western blot. The inhibitors (VS-4718 and MK2206 2HCL) or siRNAs of FAK or AKT were used in the process of above detection. The rectum of C57BL/6N mice were X-irradiated locally with a single dose of 25Gy, and following experiments including hematoxylin-eosin (HE) staining, real-time PCR and immunohistochemistry (IHC). In addition, the effect of FAK-AKT on radiation-induced injury was investigated by the administration of AKT inhibitor after irradiation. FAK mRNA was highly expressed in the mild rectal injury patient samples compared with the severe injury patient samples. In addition, the CNV amplification was located on chromosome 8p24.3, which was related closely with FAK. Further study demonstrated FAK-silenced HIEC cells were more radiosensitive by colony survival and apoptosis assay. The expression of γH2AX involved in DNA damage and repair increased either at 6 h or at 24 h after irradiation treatment. Further functional assays revealed that depressed AKT, increased cytochrome C and cleaved caspase-3 in FAK-silenced HIEC cells. In vivo , radiation-induced apoptosis of crypt cells are under analyzed with or without AKT inhibition. The effect of FAK was known in cancer cells. In current study, our data showed that FAK expression was consistent mild radiation-induced rectal injury. These findings demonstrated that FAK reduced the radiosensitivity of intestinal epithelial cells, which may be related with AKT signaling pathway and apoptotic-related proteins. In summary, further studies based on better understanding of FAK may be benefit to predict and prevent radiation-induced normal tissue injury.