Objective To develop the methods for using 0.015 cc pinpoint chambers, 0.007 cc miniature chambers and diode detector to measure Multi-leaf collimator (MLC) small field in IMRT.Methods MAX4000 and Unidos electrometers were connected with different types of small chambers and diode detectors.MLC shaped fields of10 cm×10 cm, 6 cm×6 cm, 4 cm×4 cm, 3 cm×3 cm, 2 cm× 2 cm were defined at 100 cm SSD.The field sizes for the Varian accelerator were defined by the tertiary MLC, while the secondary jaws were kept at 10 cm × 10 cm field, with the monitor units of 250 MU.Each field was measured three times to obtain the average value.The readings of all small fields were normalized to 10 cm × 10 cm field values for comparison of measured and published output factors.Results The relative deviations of the MLC small field output factors from the published outputs are 1.0％ , 1.7％ , 1.5％ and 2.4％, respectively, for Unidos electrometer connected with 0.015 cc pinpoint chamber;0.2％, 0.8％, 0.8％ and 1.4％, respectively, for Unidos electrometer connected with 0.007 cc miniature chamber;and 0.1％, 0.5％, 0.5％ and 0.9％, respectively, for MAX4000 electrometer connected with 0.007 cc miniature chamber.Conclusions The 0.015 cc chamber-measured MLC output factors for 3 cm × 3 cm and 2 cm × 2 cm fields are excellent.As required by IAEA, the relative deviations of the measured output factor from the published output factor are within ± 2％ for 2 cm × 2 cm fields and ± 3％ for larger fields.The results measured using 0.007 cc chamber are better than those measured using 0.015 cc chamber.The measured results using the diode detector, normalized to the 10 cm × 10 cm field, are consistent with the minimum requirements and excellent when being normalized to the 4 cm × 4 cm field.For dosimetric consideration, MLC small field output factor should be measured using small chamber and diode detector.The method is accurate and reliable, therefore, all measured output factors for MLC small fields should be input into radiation treatment plan system.

Knowledge Discovery in Databases is gaining attention and raising new hopes for traditional Chinese medicine (TCM) researchers. It is a useful tool in understanding and deciphering TCM theories. Aiming for a better understanding of Chinese herbal property theory (CHPT), this paper performed an improved association rule learning to analyze semistructured text in the book entitled Shennong's Classic of Materia Medica. The text was firstly annotated and transformed to well-structured multidimensional data. Subsequently, an Apriori algorithm was employed for producing association rules after the sensitivity analysis of parameters. From the confirmed 120 resulting rules that described the intrinsic relationships between herbal property (qi, flavor and their combinations) and herbal efficacy, two novel fundamental principles underlying CHPT were acquired and further elucidated: (1) the many-to-one mapping of herbal efficacy to herbal property; (2) the nonrandom overlap between the related efficacy of qi and flavor. This work provided an innovative knowledge about CHPT, which would be helpful for its modern research.

Objective To develop a methodology for auditing dosimetric parameters using TLD for photon and electron beams in non-reference conditions.Methods The correction experiments have been developed for non-linear dose response,PAAM holder,energy,fading and dispersion using TLD for 60Co γ-ray,high energy X-ray and electron beams.The measuring method was set up for absorbed dose estimation by TLDs in water.3 photon beams and 2 electron beams were selected for research purposes,and 5 photon beams and 4 electron beams for reliability research.Results The research results were evaluated for60Co source,6,10,15 and 18 MV photon beams in non-reference conditions at off-axis,with the relative deviation within-0.1％-7.2％ at-off axis (IAEA's acceptable deviation:± 7.0％).The verification results were evaluated for 5 photon beams in non-reference conditions at on-axis,with the relative deviation are within 0.1％-7.0％.The verification results were evaluated for 4 electron beams in non-reference conditions,with the relative deviation within 0-4.7％ (IAEA's acceptable deviation:±5.0％).Conclusions It is convenient and accurate to use TLD method for quality audits for clinic dosimetry parameters in radiotherapy.Two kinds of IAEA TLD holders are feasible for use in TLD audits.Absorbed doses for high energy electron beam were corrected using plane parallel chambers and verified using TLD,with good results obtained.

Objective To explore the effects of radiofrequency ablation ( RFA) combined with percutaneous vertebroplasty ( PVP) by the injection of artificial bone for metastatic spinal tumor. Methods Fifty-eight patients with metastatic spinal tumors were divided into bone cement group 1 (n=12),bone cement group 2 (n=16), artificial bone group 1 (n=16), artificial bone group 2 (n=14). The patients in bone cement group were arranged RFA combined with PVP by injection of bone cement,and the artificial bone group were treated with RFA combined with PVP by injection of artificial bone. The vertebral body modality,fractures, and visual analogue scale ( VAS) ,spinal ODI score were compared before operation,1 week,1,3,6,9,12 months of after operation. Results There were 12 patients (42. 9%) with vertebral body deformation in bone cement group,which was more than those in artificial group (6. 7%) (χ2 =8. 4768,P=0. 0036). The VAS or DOI score decreased after operation than those pre-operation in the 4 groups (P<0. 01),but increased in bone cement group after operation of 6, 9 and 12 months than those in artificial group (P<0. 05). Conclusion The combination of RFA and PVP by injection of bone cement or artificial bone is effective to metastatic spinal tumors. The effects of PVP injection with artificial bone maintains longer duration compared to bone cement.

ObjectiveTo observe the changes of uric acid level and lipid spectrum, and activities lipid metabolism related enzyme as well as uric acid metabolism-related enzymes on quail abdominal obesity model and then investigate the underlying mechanism of abdominal obesity combined with blood lipid spectrum disorder and hyperuricemia model. MethodsThe quail model of abdominal obesity was induced by feeding with high-fat diet.The body weight and abdominal fat content were measured and the abdominal fat index was calculated. The levels of total cholesterol (TC), high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG), glucose, and uric acid in serum were determined. The changes of adenosine deaminase (ADA),xanthine oxidase (XOD), lipoprotein lipase (LPL), hepatic lipase (HL), and total esterase (TE) activities were also determined. ResultsOn the 7th day, the body weight, abdominal fat content, and abdominal fat index were not significantly different between the model group and control group ( all P ＞0.05 ). On the 14th day, the body weight was not significantly different between these two groups ( P ＞ 0.05 ), while the abdominal fat content [(3.91 ±2. 13) vs. (2.40±0.96) g, P=0.0468] and abdominal fat index (1.92％ ±0.97％ vs. 1.22％ ±0.45％, P =0.0447) were significantly higher in the model group. On the 7th and 14th day, the levels ofTC (P =0.0042 and P =0.0006, respectively), LDL-C ( P =0.0045 and P =0.0010, respectively) in the model group were significantly higher than those in control group, while the level of TG significantly decreased ( P =0.0006 and P =0.0024, respectively ). On the 7th day, compare with the control group, the activities of ADA ( P =0.0237 )and XOD (P =0.0142) in the model group significantly increased, while the activities of LPL, HL, and TE had no significant changes. On the 14th day, compared with the control group, the activities of ADA ( P =0.0060),XOD ( P =0.0071 ), and LPL ( P =0.0419) in the model group significantly increased, while the activities of HL and TE had no significant changes. ConclusionsHigh-fat diet can induce disorders in blood lipid profiles in quail model, but also may incur abdominal obesity and multiple metabolic disorders. Changes in the activities of uric acid and lipid metabolism related enzymes may be the underlying mechanism of disorders in blood lipid profile and its associated hyperuricemia and abdominal accumulation.

ObjectiveTo study the cardioprotective effects of ischemic post-conditioning on elderly patients with ST-elevation acute myocardial infarction (STEM1).MethodsConsecutive 215 patients with STEMI undergoing emergency percutaneous coronary intervention(PCI) were randomly assignedto receive ischemicpost-conditioningorconventional PCItreatment.The ischemic postconditioning (n=38) were conducted by 3 episodes of 30-second occlusion followed by 30-second reperfusion, while the control group (n= 46) was without any intervention after PCI.Reperfusion arrhythmias, corrected TIMI frame count (cTFC) and TIMI myocardial perfusion grade (TMPG)were compared between the two groups, respectively.Results The incidence of reperfusion arrythmias was less frequent in ischemic postconditioning group (21.1％ ,8/38) than in control group (45.7％ ,21/46) after PCI (x2 = 5.571, P＜0.05). The TIMI grade 3 flow was similar between two groups [(94.7％(36/38) vs. 82.6％( 38/46), x2= 2.919, P＞0.05], the cTFC levels (23.6±3.7vs. 26.1 ±5.9) and TMPG 3 perfusion [ 89.5％ (34/38) vs.69.6％ (32/46)] were significantly different (t= 5.434, P＜0.05; x2 = 4.899, P＜0.05, respectively) between two groups.ConclusionsIschemic postconditioning may reduce myocardial reperfusion injury in elderly patients with STEMI undergoing emergent PCI.

Objective To analyze CMV DNA stability of 30 EDTA plasma samples in the order of magnitude between 300 and 100 000 copies/mL over a 21 day period. Methods Thirty plasma samples were grouped into three categories according to the CMV DNA loads , including low CMV DNA contents , intermediate CMV DNA loads and high CMV DNA loads. Ten milliliters of whole blood was freshly collected from each patient. Plasma samples without hemolysis were divided into 1-ml aliquots. One aliquot was processed immediately (Day 0) for baseline PCR assays. The remaining aliquots were then processed after one , two, three, seven, 14 or 21 day of storage at 4℃. Results There was no significant difference between the mean of the difference time point in viral loads following storage at 4 ℃ by paired-samples t test, including Day 1 compared to Day 0 (t = 1.654, P =0.109), Day 2 compared to Day 0 (t = 1.487, P = 0.148), Day 3 compared to Day 0 (t = 1.609, P = 0.118), Day 7 compared to Day 0 (t=0.831, P=0.413), Day 14 compared to Day 0 (t=1.721, P=0.096), and Day 21 compared to Day 0 (t=0.244, P=0.810). Conclusion The concentration of CMV DNA in all samples stored at 4 ℃ for 21 days did not differ significantly from the baseline viral load ,and it was not observed the trend in continued degradation in different time point (Day 1, 2, 3, 7 and 14).

Objective To explore the curative effect of tirofiban treatment on high-risk acute coronary syndromes (ACS) in elderly patients receiving an early percutaneous coronary intervention (PCI) treatment. Methods The 162 elderly cases including unstable angina pectoris and non-ST -segment elevation myocardial infarction (NSTEMI) undergoing early PCI were enrolled in this study.And they were assigned to early treatment group (n=82) and deferred selective group (n=80)according to the time of using tirofiban (Gp Ⅱ b/Ⅲ a inhibitor) treatment. The effectiveness of either strategic option on tissue-level perfusion was evaluated using the TIMI myocardial perfusion grade (TMPG) before and immediately after PCI. The corrected TIMI frame count (cTFC) was also used to assess coronary artery flow and myocardial perfusion. Bleeding complications and the composite end point events at 30 days were also evaluated. Results Of all the 162 patients, the TMPG 0-1 perfusion was observed in 65 patients (40.1%). The TMPG 0-1 perfusion was significantly less frequent in early treatment group (32.9%) than in deferred selective group (47.5%) before PCI (x2=3.58, P＜0.05); while the results of TIMI grade 0-1 flow (26.8% vs. 25.0%) and cTFC levels (34.2±11.8 vs. 34. 9±12. 7) before PCI were similar between the two groups (x2 =0. 07, P=0.47; t= 0.13, P=0.71, respectively). No differences were seen both in composite end point events at 30 days and bleeding complications (x2 = 0.31, P＞0.05; x2=0.004, P＞0. 05). Conclusions High -risk ACS patients treated with an early invasive strategy, routine upstream use of tirofiban are associated with improved tissue-level perfusion before PCI and does not increase bleeding complications when bleeding risks are carefully evaluated before enrollment.

Traditional Chinese medicine (TCM) property theory is believed to be a key and difficult point of basic theory studies of TCM. Complex concepts, components and characteristics of TCM property have long puzzled researchers and urged them to develop new angles and approaches. In the view of cognitive science, TCM property theory is a cognitive process of storing, extracting, rebuilding and summarizing the sensory information about TCMs and their effects during the medical practice struggling against diseases under the guidance of traditional Chinese philosophical thinking. The cognitive process of TCM property has particular cognitive elements and strategies. Taking into account clinical application characteristics of TCMs, this study defines the particular cognitive elements. In the combination of research methods of modern chemistry, biology and mathematics, and on the basis early-stage work for five years, we have built a TCM property cognition model based on three elements and practiced with drugs with pungent and hot properties as example, in the hope of interpreting TCM properties with modern science and providing thoughts for the nature of medical properties and instruction for rational clinical prescription.
Animals ; Cognition ; Drug Therapy ; psychology ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional ; psychology ; Models, Theoretical

Objective Triple-negative breast cancer(TNBC)poses a significant challenge for treatment efficacy.CD8+T cells,which are pivotal immune cells,can be effectively analyzed for differential gene expression across diverse cell populations owing to rapid advancements in sequencing technology.By leveraging these genes,our objective was to develop a prognostic model that accurately predicts the prognosis of patients with TNBC and their responsiveness to immunotherapy. Methods Sample information and clinical data of TNBC were sourced from The Cancer Genome Atlas and METABRIC databases.In the initial stage,we identified 67 differentially expressed genes associated with immune response in CD8+T cells.Subsequently,we narrowed our focus to three key genes,namely CXCL13,GBP2,and GZMB,which were used to construct a prognostic model.The accuracy of the model was assessed using the validation set data and receiver operating characteristic(ROC)curves.Furthermore,we employed various methods,including Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway,immune infiltration,and correlation analyses with CD274(PD-L1)to explore the model's predictive efficacy in immunotherapeutic responses.Additionally,we investigated the potential underlying biological pathways that contribute to divergent treatment responses. Results We successfully developed a model capable of predicting the prognosis of patients with TNBC.The areas under the curve(AUC)values for the 1-,3-,and 5-year survival predictions were 0.618,0.652,and 0.826,respectively.Employing this risk model,we stratified the samples into high-and low-risk groups.Through KEGG enrichment analysis,we observed that the high-risk group predominantly exhibited enrichment in metabolism-related pathways such as drug and chlorophyll metabolism,whereas the low-risk group demonstrated significant enrichment in cytokine pathways.Furthermore,immune landscape analysis revealed noteworthy variations between(PD-L1)expression and risk scores, Conclusion Our study demonstrates the potential of CXCL13,GBP2,and GZMB as prognostic indicators of clinical outcomes and immunotherapy responses in patients with TNBC.These findings provide valuable insights and novel avenues for developing immunotherapeutic approaches targeting TNBC.