Radiation therapy is one of the main treatment methods for cancer. Machine learning can be used in all aspects of clinical practice in radiation therapy, including clinical decision support, automatic segmentation of target volumes, prediction of treatment efficacy and side effects. Despite the challenges of lacking structured data and poor interpretability of models, the application of machine learning in radiotherapy will become increasingly profound and extensive. This review contains three aspects: introduction of machine learning, the clinical application of machine learning in radiotherapy, challenges and solutions.

A method was developed to assay α-Hydroxyltriazolam and α-Hydroxyalprazolam,　which are the major metabolites of triazolam and alprazolam respectively,in human urine.　After addition of 2-hydroxyflurazepam　(interal standard) and hydrolysis with β-glucuronidase, the hydroxy-metabolites were extracted with hexane-dichloromethane (1∶1) at pH　10.8, then were derivated with (BSTFA). The analysis was performed on a HP-5 capillary column with electron-capture detector.The detection limits of analysis in urine were about 1μg/L.The method was successfully applied to urine specimens collected from healthy human volunteers who ingested 0.5 mg of triazolam or 0.8 mg alprazolam. The method was enough sensitive to assay urine specimen excreted at 24 h by volunteers after taking the medicine.

Objective To analyze the clinical features and summarize diagnosis and therapeutic efficacy for ureteropelvic junction obstruction(UPJO). Methods Two hundred and twenty-two patients with UPJO were treated from 2000 to 2008,including 155 males and 67 females:the age rangeed from 13 to 75 and mean age was 29 years.One hundred and seventy-three cases presented with back pain;19 cases with urine infection;12 cases with abdomen bump;7 cases with macroscopic hematuria;11 cases found by B-ultrasound examine.Etiological factors included 185 patients of ureteropelvic junction stenosis;18 cases of high location of the junction;19 cases which were diagnosed UPJO due to benign oppression,including fiber cords and peculiar vessels.A total of 222 cases of surgical procedures were conducted,of them Anderson-Hynes dismembered pyeloplasty was conducted for 191 cases,fiber cords and peculiar vessels were relieved for 19,nephrectomy for 12 cases because of nonfunction. Results One hundred and ninety-one cases who underwent Anderson-Hynes dismembered pyeloplasty were all succeeded with operation.They were followed up for 6 months to 8years with a mean of 38 months.B-ultrasound and IVU showed that hydronephrosis was obviously relieved.The clinical symptoms disappeared in all cases.The levels of serum creatinine of 7 cases who had higher ereatinine recovered. Conclusion Anderson-Hynes dismembered pyeloplasty could be a good choice and effective method for the treatment of UPJO.

Objective To evaluate the efficacy of combination solifenacin and tamsulosin for the treatment of distal ureteral calculi after extracorporeal shock wave lithotripsy. Methods 120 patients (male:100 female:20 age:18-67 yrs) randomly assigned to 4 groups (each group 30) with the calculi diameter range from 0.5 to 1.1 cm.All patients performed extracorporeal shock wave lithotripsy (X ray oriented).The control group did not accept any medical treatment.The solifenacin group were administered solifenacin 5 mg,once per day.The tamsulosin group were administered tamsulosin 0.2 mg,once per day.The combination group were administered solifenacin 5mg,plus tamsulosin 0.2 mg,each per day.The observation duration was set at 2 weeks. Results The stone-free rate (according to KUB) within 2 weeks were 80.0％,83.3％,93.3％ and 96.7％ in the control group,solifenacin group,tamsulosin group and combination group respectively.Statistical differences were significant among the tamsulosin group,the combination group and the control group.The stone expulsion times were (7.6 + 3.7) d,(6.3 ± 2.5) d,(4.4 + 2.3) d and (3.5 ± 2.2) d in the 4 groups respectively.Statistical differences were significant among the tamsulosin group,the combination group and the control group.The uses of analgesics were 13,5,9 and 3 in the 4 groups respectively.The bladder irrtative symptoms were 12,6,4 and 4 in the 4 groups respectively.Statistical differences were also significant for the use of analgesics and relief of bladder irritation between the solifenacin group,the combination group and the control group. Conclusions Tamsulosin and solifenacin could be safe and effective for the treatment of distal ureteral calculi after extracorporeal shock wave lithotripsy.It could significantly improve the stone expulsion rate,relief the pain and improve bladder irrtative symptoms.

Objective To discuss the diagnosis and treatment of normotensive pheochromocyto-ma. Methods The clinical data of 22 patients with normotensive pheochromocytoma were reviewed. Inclusion criteria for normotensive pheochromocytoma were no previous history of hypertension and episode of symptoms suggesting high blood pressure. The blood pressure on admission was 90-130/ 60-90 mm Hg with an average of 113/72 mm Hg. Seven patients were found adrenal mass by routine ultrasonic examination. Twelve patients presented with superior abdominal or flank pain. Four pa-tients were present with fatigue, and 2 patients had fever. Headache and palpitation were found in 1 patient. Most of patients were present with large and round mass with low density area in the center of the tumor by uhrosonography and CT. Four patients had elevated level of plasma epinephrine and nor-epinephrine. 24 hours urine CA and VMA were elevated in 5 and 4 patients respectively. Seven pa-tients were prepared with infusion preoperatively to expand intravascular volume, and 2 patients were given prazosin 1.5 mg/d for 5 to 7 days. Results During the operation, seventeen patients had ele-vated blood pressure and 5 patients had no changed. One of seven patients with preoperative prepara-tion had obvious hypertension during operation, and 11 of 15 patients without preoperative preparation had obvious hypertension. The tumors were removed successfully in 21 patients. All the patients were diagnosed pheochromocytoma pathologically. Twenty-one patients had normal blood pressure with no recurrence during the follow-up from 1 month to 7 years. Conclusions The patients with normotensive pheochromocytomas may have lower catecholamine in their plasma and urine. The application of α-blockers and the expanding intravascular volume before operation could be important for the patients safe.

OBJECTIVES: To analyze the clinicopathological features of maxillofacial granular cell tumors (GCT) with the aid of immunohistochemical staining. METHODS: Seven cases of maxillofacial GCT were retrospectively collated, and the microscopic morphology of maxillofacial GCT was analyzed. The expression of S-100, neuron-specific enolase (NSE), SOX-10, CD68, actin, desmin, and Ki-67 in GCT was detected by immunohistochemical staining. The cases were observed in the follow-ups after clinical treatment. RESULTS: All seven GCT tumors lacked envelopes and were poorly defined. Microscopically, the sizes of the tumor cells were large and appeared with inconspicuous cell membranes, forming a syncytium-like appearance. The cytoplasm was filled with characteristic eosinophilic granules. The immunohistochemical results showed that six cases were NSE-positive, five cases were S-100-positive, seven cases were CD68-positive, five cases were SOX-10-positive, one case was actin-positive, and seven cases were desmin-negative. The Ki-67 index did not exceed 5% in all cases. In the follow-up sessions, none of the six cases presented a recurrence. CONCLUSIONS Maxillofacial GCT has a characteristic histological structure. Immunohistochemical S-100, CD68, and other indicators can assist in diagnosis, and the prognosis is good after clinical resection.
Humans ; Ki-67 Antigen/metabolism* ; Granular Cell Tumor/surgery* ; Retrospective Studies ; Actins/metabolism* ; Desmin/metabolism* ; S100 Proteins/metabolism*