Objective:To investigate the anti-tumor effect of tetrandrine on human liver cancer cell line 7402 in vitro.Effects of tetrandrine on proliferation and apoptosis of human liver cancer cell 7402 were observed.Methods:The effects of tetrandrine on proliferation of 7402 cells was observed by MTT assay and clonogenic assay.Apoptosis was observed by acridine orange(AO)/ethidium bromide(EB) Fluorescent staining?DNA gel electrophoresis and flow cytometry,and the expression of apoptosis related gene was analyzed by immunohistochemical staining method.Results:Tetrandrine inhibits the proliferation of 7402 cells in a dose dependent manner and induces apoptosis.Immunohistochemical staining showed that the expression of Bcl-2 was decreased and the expression of Bax was increasd in 7402 cells treated with tetrandrine.Conclusion:Tetrandrine inhibits the proliferation of 7402 in the dose dependent manner,and induces apoptosis.The antitumor effect of tetrandrine may be due to the regulation of the expressions of Bcl-2 and Bax.

BACKGROUND: Platelet-rich plasma containing various high-concentration growth factors can promote new bone formation and accelerate bone healing. But its effects on distraction osteogenesis remain unclear. OBJECTIVE: To observe the effects of autologous platelet-dch plasma on premaxillary distraction osteogeaesis in rabbits. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Laboratory of Physiology, North Campus,Sun Yat-sen University between July and August 2007. MATERIALS: Sixteen healthy rabbits, the same number for male and female, aged 3-5 months,weighing 1. 4-1.7 kg,were randomly and evenly divided into an experimental group and a control group. Premaxillary incisor band,outside front distraction mask, and distraction rubber band were self-made.Coagulant was prepared by dissolving 1000 u bovine thrombin in 1 mL of 10% calcium chloride.METHODS: Titanium nails (1.5 mm in diameter) were separately inserted on two sides of left premaxillary suture in rabbits. A self-made distraction device was used. Gelatum-like substance [Vplatelet-rich plasma: V coagulant=9:1] was injected into the left premaxillary suture of experimental group rabbits immediately prior to distraction.In each group, one-week sustained distraction was performed in 4 rabbits,and three-week sustained distraction was performed in another rabbits. MAIN OUTCOME MEASURES: The increase of nail-nail distance on the two sides and histological results following distraction osteogenesis.RESULLTS: Rabbit premaxillary bone moved anterior in the two groups. The experimental group showed greater increase of nail-nail distance, faster bone formation and mineralization, more blood vessels, and thicker and more mature bone trabecula in the distraction interspace in comparison with the control group. CONCLUSION: Platelet-rich plasma will help bone tissue regeneration and promote premaxillary distraction osteogenesis.

Objective: To compare the difference of intensity modulated radiation therapy (IMRT),3-D imensional conformal radiation therapy (3DCRT) for patients with upper esophageal carcinoma. Methods: Ten patients with upper esophageal carcinoma were treated by intensity modulated radiation therapy and 3-D imensional conformal radiation therapy at the same TPS, the difference of exposure dose between target area and critical organ was compared by dose volume histogram(DVH) with the plan target volume (PTV) must reach 95% of the prescription dose. Results: There was significant difference in dose of 95% plan target volume (PTV) (P <0.05) IMRT better than 3D-CRT. For two target conformal index and the prescription dose coverage of GTV percentage IMRT was better than 3DCRT. IMRT reduced maximum dose of spinal cord (P <0.05). There was no difference in the dose of lung and heart (P >0.05). Compared with 3D-CRT, IMRT planning has better dose distribution and protection of normal tissue. Conclusions: IMRT was better than 3DCRT, IMRT is the best radiation therapy.

Objective To evaluate the effect of continuous glucose monitoring system(CGMS) in improving the current status of type 1 diabetes mellitus(T1DM) control and reducing the economic burden of the patients.Methods One hundred and fifteen patients with T1DM were randomly assigned to the CGMS group and the self-monitoring of blood glucose(SMBG) group respectively.The patients in CGMS group were on 72 h CGMS every 6 months, while SMBG group only with SMBG to guide the insulin dose adjustment.The levels of blood glucose and the statistics of the number of hypoglycemia and diabetic ketoacidosis were taken as the main observational indexes every 6 months.The chronic complication and the statistics of the number of hospitalizations and the total cost of treatment were made as the secondary observational index every 12 months.Results 2 h postprandial plasma glucose(2hPG) and mean blood glucose(MBG) in the CGMS group were lower than those in the SMBG group [(10.7±1.9 vs 11.5±2.7) mmol/L, (9.7±0.5 vs 10.6±0.7) mmol/L, P<0.05] in the clinical follow-up visit after 6 months.The per capita number of hypoglycaemia in the CGMS group was lower than that in the SMBG group[(7.9±2.6 vs 9.2±3.4) times, P<0.05].In the outpatient follow-up re-visit to the patients after 6 months, fasting plasma glucose(FPG), 2hPG, MBG, and HbA1C of the patients in the CGMS group were lower than those in the SMBG group(t=4.71~9.75, P<0.05), the per capita numbers of hypoglycemia and DKA in the CGMS group were lower than those in the SMBG group(t=3.61~4.37, P<0.05).Conclusion The application of real-time continuous glucose monitoring in T1DM outpatient management may reduce the whole-day blood glucose of the patients, decrease the incidence risk of hypoglycemia, and improve the compliance of the treatment while without increasing the economic burden of the disease.

Objective:To explore the feasibility of predicting complexity of intensity modulated radiotherapy(IMRT)plan through adopted machine learning method to extract planomics features of radiotherapy,so as to provide a new method for comprehensive evaluation of the complexity of IMRT plan.Methods:The medical case data of 3203 patients with pelvic tumor,or abdominal tumor or head and neck tumor,who admitted to The First Affiliated Hospital with Nanjing Medical University from December 2022 to November 2023,were selected.All patients adopted Monaco system to conduct design for plan,and underwent treatment on Precise and Axesse accelerators.The evaluation indicator of complexity of 10 plans was calculated by using Python software,and the planomics features in the files of radiotherapy plans were extracted through format conversion and pyradiomics tool of imaging omics.The planomics features of radiotherapy were selected through data cleaning,filtering method and embedding method of machine learning.The corresponding predictive model of the evaluation indicator of complexity of 10 common plans was respectively constructed through used Gradient Boosting Decision Tree algorithm.The goodness of fit(R2)was adopted to evaluate the prediction performance of the model,and the 5-fold cross-validation method was adopted to detect the generalization ability of the model.Results:There were statistically significant differences between Precise accelerator and Axesse accelerator in average leaf to area(LA),plan irregularity(PI)of beam shape and standard circle,modulation complexity score(MCS)of the variability between shape and area of subfield,and the advantage value of leaf travel(LT)(t=63.894,-63.678,72.582,-48.858,P＜0.01),respectively.A total of 107 planomics features were extracted through pyradiomics tool,and 38 features were remained after filtering method conducted screening,and 4 to 11 features were remained after embedding method conducted screening.The goodness of fits of mean field area(MFA),LA and leaf gap average(LGA)value were better in the validation set,with R2＞0.970,however the goodness of fits of the proportion of small aperture score 20 mm(SAS20)was poor in validation set,with R2=0.917.The 5-fold cross-validation results showed that the average value of prediction accuracy of all indicators of complexity was＞90％.Conclusions:The extracted planomics features of radiotherapy based on radiomics method can accurately predict the complexity of IMRT plan,which are expected to play a greater role in improving the ensure efficiency of individual quality of patient,and screening radiotherapy plan with higher-quality.

Objective To compare the dosimetry and treatment efficiency between a multi-ple partial volumetric-modulated arcs therapy (MP-VMAT)and double-arc volumetric modulated arc therapy (DA-VMAT)for patients with breast cancer mastecomy.Methods 19 patients with breast cancer treated by mastecomy and requiring postoperative radiotherapy were collected.MP-VMAT and DA-VMAT plans were applied for each patient respectively.Dosimetry parameters for target volume and organ of risks (OARs)were compared.Machine unite and delivery times were compared.Results MP-VMAT plans had a more uniform target dose distribution with average Conformation Index (CI )andHomogeneity Index (HI )of0 .5 6 and 1 .0 6 compared to 1 .0 6 and 1.14 of the DA-VMAT plans(P <0.05).MP-VMAT plans predicted a reduction of 5.53% in V20 of contralateral lung,3.74 Gy in mean dose,6.27% in V5 and 5.53% in V20 of ispleratal lung respectively (P <0.05).MP-VMAT plans predicted a reduction of 10.33% and 7.82% in V5 and V10 of heartrespectively (P <0.05),MP-VMAT plans predicted a reduction of 9.14%, 2.72% and 0.06% inV5,V10 and V15 of contralateral breast respectively (P <0.05)plans. However,MP-VMAT plans improved monitor units 7 4 5 .9 MU and treatment time 3 0 4 .6 s compared with DA-VMAT 524.4 MU and 196.7 s (P <0.05).Conclusion MP-VMAT plans generate more uniformity in the target dose and decreased the dose of most of organs of risk com-pared to the DA-VMAT,But improved monitor units and treatment time.In clinical application, different techniqies are chosen based on the situation of every patient.

Objective To compare the dosimetry and treatment efficiency between a multi-ple partial volumetric-modulated arcs therapy (MP-VMAT)and double-arc volumetric modulated arc therapy (DA-VMAT)for patients with breast cancer mastecomy.Methods 19 patients with breast cancer treated by mastecomy and requiring postoperative radiotherapy were collected.MP-VMAT and DA-VMAT plans were applied for each patient respectively.Dosimetry parameters for target volume and organ of risks (OARs)were compared.Machine unite and delivery times were compared.Results MP-VMAT plans had a more uniform target dose distribution with average Conformation Index (CI )andHomogeneity Index (HI )of0 .5 6 and 1 .0 6 compared to 1 .0 6 and 1.14 of the DA-VMAT plans(P <0.05).MP-VMAT plans predicted a reduction of 5.53% in V20 of contralateral lung,3.74 Gy in mean dose,6.27% in V5 and 5.53% in V20 of ispleratal lung respectively (P <0.05).MP-VMAT plans predicted a reduction of 10.33% and 7.82% in V5 and V10 of heartrespectively (P <0.05),MP-VMAT plans predicted a reduction of 9.14%, 2.72% and 0.06% inV5,V10 and V15 of contralateral breast respectively (P <0.05)plans. However,MP-VMAT plans improved monitor units 7 4 5 .9 MU and treatment time 3 0 4 .6 s compared with DA-VMAT 524.4 MU and 196.7 s (P <0.05).Conclusion MP-VMAT plans generate more uniformity in the target dose and decreased the dose of most of organs of risk com-pared to the DA-VMAT,But improved monitor units and treatment time.In clinical application, different techniqies are chosen based on the situation of every patient.

Objective To standardize the selection of clinical research outcome indicators,which can objectively evaluate the clinical efficacy or effect of traditional Chinese medicine in the treatment of myasthenia gravis.This study aims to standardize the construction of the core outcome set of clinical research of traditional Chinese medicine in the treatment of myasthenia gravis.Methods We followed the core outcome set development specification(COS-STAD)to carry out research,established a research working group,which set up a Delphi-method advisory group.Two graduate students of working group conducted a document research and meetings of patients to establishe an outcome set item pool of myasthenia gravis in clinical trials of Chinese medicine under the instruction of other members.With the questionnaire based on the content of item pool,we then carried out Delphi-method expert consultations and a consensus meeting.Results The core outcome set of clinical research on myasthenia gravis treated with traditional Chinese medicine included five outcome domains:endpoint outcome,myasthenia gravis symptom evaluation,medication evaluation,quality of life evaluation and safety outcome;Nine outcome measures:recurrence rate,incidence of hormone complications,incidence of crisis,QMGS scale(MGFA quantitative myasthenia gravis score),daily activity scale of MG patients(ADL),analysis of immunosuppressant dosage,analysis of glucocorticoid dosage,analysis of cholinesterase inhibitor dosage,and incidence of adverse events.Conclusion The five outcome domains and nine outcome measures included in the core outcome set can be used as outcome options for the efficacy evaluation of myasthenia gravis clinical research.

Objective:To assess the predictive value of dosiomics in predicting the occurrence of bone marrow suppression (BMS) in patients with pelvic tumors during radiotherapy.Methods:A retrospective analysis was conducted on the clinical data and radiotherapy planning documents of 129 patients with pelvic region tumors who underwent radiotherapy at the First Affiliated Hospital of Nanjing Medical University from January 2019 to January 2023. The region of interest (ROI) was outlined for bone marrow in the pelvic region by Accu Contour software in planning CT, and the ROI was exported together with the dose distribution file. According to a stratified randomization grouping method, the patients were divided into the training set and test set in an 8 vs. 2 ratio. The dosiomic features were extracted from the ROI, and the two independent samples t-test and the least absolute shrinkage and selection operator (LASSO) algorithm was employed to identify the best predictive characteristics. Subsequently, the dosiomic scores were calculated. Clinical predictors were identified through both univariant and multivariate logistic regression analyses. Predictive models were constructed by using clinical predictors alone and combining clinical predictors and dosiomic scores. The efficacy of predictive model was assessed by plotting the receiver operating characteristic (ROC) curve and evaluating its performance through the area under the ROC curve (AUC), the calibration curve, and decision curve analysis (DCA). Results:Fourteen dosiomic features that showed a strong correlation with the occurrence of BMS were screened and utilized to calculate the dosiomic scores. Based on both univariant and multivariate logistic regression analyses, chemotherapy, planning target volume (PTV) and V 5 Gy were identified as clinical predictors. According to the combined model, the AUC values for the training set and test set were 0.911 and 0.868, surpassing those of the clinical model (AUC=0.878 and 0.824). Furthermore, the analysis of both the calibration curve and DCA suggested that the combined model had higher calibration and net clinical benefit. Conclusion:The combined model has a high diagnostic value for predicting BMS in patients with pelvic tumors during radiotherapy.

Objective:To analyze the role of dandelion and mulberry leaf in the progression of acute myeloid leukemia(AML)by network pharmacology,and to clarify the active components and their mechanisms in treating AML.Methods:The active components of dandelion and mulberry leaf were screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).The targets were predicted by SwissTargetPrediction Database.The AML-related genes and protein targets were retrieved from the SymMap Database,the GeneCards Human Gene Database,the DisGeNET Database,and the Online Mendelian Inheritance in Man(OMIM)Database.The AML-related genes and target genes of dandelion and mulberry leaf were compared by comparative analysis and were identify by the enrichment genes,followed by Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis.The drug-active component-target network and protein-protein interaction(PPI)network were constructed by Cytoscape 3.8.0 software,and the core genes were selected by CytoNCA plugin;the molecular docking was conducted by AutoDock software.Results:After filtering by databases,39 active components were identified,and 148 common targets between dandelion-mulberry leaf and AML were collected.The GO functional enrichment analysis mainly involved cytokine-mediated signaling pathways,positive regulation of kinase activity,and oxidative stress responses.The KEGG signaling pathway enrichment analysis focused on the phosphatidylinositol 3 kinase/protein kinase B(PI3K-AKT)signaling pathway,the tumor necrosis factor(TNF)signaling pathway,and the Janus kinase/signal transducer and activator of transcription(JAK-STAT)signaling pathway.The key targets were identified by topological analysis including signal transducer and activator of transcription 3(STAT3),epidermal growth factor receptor(EGFR),protein kinase B1(AKT1),recombinant human epidermal growth factor(EGF),vascular endothelial growth factor A(VEGFA),oncogene MYC,tumor protein P53(TP53),mitogen-activated protein kinase 3(MAPK3),cysteiny asparate specific protease-3(CASP3),oncogene SRC,heat shock protein 90 alpha family class A member 1(HSP90AA1),tenascin XB1(CTNNB1),phosphoinositide kinase-3 catalytic subunit alpha(PIK3CA),interleukin 6(IL-6),TNF,mitogen-activated protein kinase 1(MAPK1),and phosphatidylinositide kinase-3 regulatory subunit 1(PIK3R1).The molecular docking results showed the highest affinity pairing to be taraxerol with MYC(-8.74 kcal·mol-1),and quercetin,kaempferol,luteolin,and artemetin demonstrated good binding affinities with various targets.Conclusion:The main active components of dandelion-mulberry leaf,such as quercetin,taraxerol,kaempferol,luteolin,and artemetin,may exert the anti-AML effect by regulating AKT1,STAT3,HSP90AA1,IL-6,and MAPK1;regulation the PI3K-AKT signaling pathway may be the critical mechanism of anti-AML effect by dandelion-mulberry leaf.