OBJECTIVE:To explore the difference of genotypes in patients with coronary artery disease(CAD)and different responses to clopidogrel. METHODS:Totally 159 CAD patients were selected from cardiology department of our hospital during Mar. 2013-Nov. 2015. They were given clopidogrel+aspirin for dual antiplatelet therapy for at least 1 year. Turbidimetry method was used to detect the percentage of platelet aggregation induced by adenosine diphosphate (ADP) and arachidonic acid (AA) before and after treatment. The polymorphism of cytochrome P450(CYP)2C19,CYP3A5,wild type leucine 33 allele(PLA1)/proline 33 al-lele(PLA2)were detected by PCR-RFLP. RESULTS:There were 3 kinds of CYP2C19 genotypes(2/2,2/1,1/1),3 kinds of CYP3A5 genotypes (3/3,3/1,1/1) and 3 kinds of PLA1/PLA2 genotypes (A1/A2,A2/A2,A1/A1);the frequency of each genotype was in line with Hardy-Weinberg balance(P>0.05). Among 159 cases,there were 81 cases of clopidogrelsemi-re-sponse,accounting for 50.9%;78 cases of clopidogrelresponse,accounting for 49.1%. The frequencies of CYP2C19 gene dele-tion(2/2 or 2/1 genotype)and 2 allele in clopidogrelsemi-responsepatients were significantly higher than clopidogrelre-sponsepatients,with statistical significance(P<0.05). The frequencies of PLA1/PLA2 gene deletion(A2/A2 or A1/A2 genotype) and A2 allele in clopidogrelsemi-responsepatients were significantly higher than clopidogrelresponsepatients,with statistical significance(P<0.05). The frequencies of CYP3A5 gene deletion(3/3 or 3/1 genotype)and 3 allele in clopidogrelsemi-re-sponsepatients were slightly higher than clopidogrelresponsepatients,without statistical significance (P>0.05). After treat-ment,the percentage of ADP or AA-induced platelet aggregation in different genotypes patients were significantly lowered,com-pared to before treatment;but the percentage of platelet aggregation in CYP2C19 gene deletion and CYP3A5 gene deletion patients were significantly higher than gene expression patients(1/1 genotype),with statistical significance(P<0.05). There was no sta-tistical significance in the percentage of platelet aggregation between PLA1/PLA2 gene deletion patients and gene expression patients (P>0.05). CONCLUSIONS:The incidence of clopidogrelsemi-responsein CAD patients is high. CYP2C19 and PLA1/PLA2 gene polymorphism may be related to clopidogrelsemi-re-sponse,while CYP3A5 gene polymorphism has no relation-ship with it. CYP2C19 and CYP3A5 gene deletion may weaken inhibitory effects of clopidogrel on platelet aggregation of CAD patients.

OBJECTIVE:To observe the effect of rosuvastatin on prognostic of patients with paroxysmal atrial fibrillation (AF) after circumferential pulmonary vein ablation. METHODS:75 patients with paroxysmal AF were divided into observa-tion group(n=39)and control group(n=36)according to the admission single. All patients underwent circumferential pulmo-nary vein ablation antiarrhythmic treatment. Control group orally received warfarin sodium,amiodarone,metoprolol,and sub-cutaneous injected low molecular weight heparin. Observation group additionally received 10 mg Rosuvastatin tablet,qd on the basic of contol group. Changes of cardiac function,inflammatory factors,lipid levels in 2 groups before and after treat-ment were observed,and follow-up results were compared. RESULTS:There was no significant difference in left atrial diame-ter and left ventricular ejection fraction in 2 groups before and after treatment (P>0.05);atrial effective refractory periods (AERP)in 2 groups significantly prolorged,and observation group prolorged more significantly than control group,the differ-ence was statistically significant(P<0.05). Serum high sensitivity C-reactive protein,interleukin-6 48 h and 1 month after op-eration in 2 groups significantly increased,and control group was significantly higher than observation group,the difference was statistically significant (P<0.05);before operation and after 3 months of operation,there was no significant difference in inflammatory cytokine levels(P>0.05). Triglyceride and low density lipoprotein cholesterol in observation group 1 month after operation significantly decreased, HDL-C significantly increased, there were significant differences (P<0.05). Fol-low-up time was (23.91 ± 5.28) months,AF recurrence was 7.8%,which was significantly lower than control group (13.9%),the difference was statistically significant (P<0.05);and there were no significant differences in ablation-related atrial tachycardia (ATa) and the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Rosuvastatin can effectively inhibit the inflammatory reaction and prolong the AERP,thereby reducing the recurrence rate of AF,with good efficacy and safety.

Objective:To realize the automatic evaluation of the target conformity, dose overflow, dose drop and other indicators in stereotactic body radiation therapy (SBRT) plan for the early non-small cell lung cancer (NSCLC) in the Eclipse planning system.Methods:Eclipse Scripting API application development interface and C# programming language were used to develop it with script plug-ins combined with independent programs. According to the requirements of the NSCLC SBRT plan in Radiation Therapy Oncology Group (RTOG) 0915 report, the automatic evaluation of related indicators was realized. A rule of equal interval sampling and double thresholds was designed during the period, which could more accurately and conveniently evaluate the dose drop outside the target area.Results:13 clinical cases of NSCLC SBRT plans were randomly selected, the method in this study and the module equipped with the Eclipse system to were utilized to evaluate and compare the results. It was concluded that the results of the two methods were in line with the clinical requirements, and the former was more efficient ( P<0.05). Conclusions:The NSCLC SBRT plan evaluation software in this article has a friendly interface. It can not only realize the automatic evaluation of target conformity, dose overflow and dose drop, but also effectively improve work efficiency and better serve the clinical and scientific research work of radiotherapy.

Objective:To realize the interactive form evaluation of radiotherapy dose and the automatic calculation of conformity index (CI) and heterogeneity index (HI) in the Eclipse planning system.Methods:The Eclipse Scripting API application development interface and C# programming language were employed to develop it with script plug-ins combined with independent programs. The visual interface programming and call the relevant dose query function in the API were utilized to realize the interactive table dose evaluation and the automatic calculation of HI. The functions of calling dosage structure creation and structure Boolean operation in the API were adopted to realize the automatic calculation of CI.Results:15 clinical radiotherapy cases of nasopharyngeal carcinoma were selected. The dose evaluation results were statistically compared between this method and the module equipped in the Eclipse system. The results showed that the accuracy was consistent between these two methods ( P>0.05), whereas the evaluation efficiency of this method was significantly higher compared with that of the Eclipse system module ( P<0.05). Conclusions:The interactive evaluation form in this article has a friendly interface, which allows users to more conveniently perform dose assessment, multi-plan comparison, and calculation of CI and HI, which effectively improves work efficiency and can better serve the clinical and scientific research work of radiotherapy.

Objective:To explore the feasibility and validity of constructing an intensity-modulated radiotherapy gamma pass rate prediction model after combining the SHAP values with the extreme gradient boosting tree (XGBoost) algorithm feature selection technique, and to deliver corresponding model interpretation.Methods:The dose validation results of 196 patients with pelvic tumors receiving fixed-field intensity-modulated radiotherapy using modality-based measurements with a gamma pass rate criterion of 3%/2 mm and 10% dose threshold in Hunan Provincial Tumor Hospital from November 2020 to November 2021 were retrospectively analyzed. Prediction models were constructed by extracting radiomic features based on dose files and using SHAP values combined with the XGBoost algorithm for feature filtering. Four machine learning classification models were constructed when the number of features was 50, 80, 110 and 140, respectively. The area under the receiver operating characteristic curve (AUC), recall rate and F1 score were calculated to assess the classification performance of the prediction models.Results:The AUC of prediction model constructed with 110 features selected based on the SHAP-valued features was 0.81, the recall rate was 0.93 and the F1 score was 0.82, which were all better than the other 3 models.Conclusion:For intensity-modulated radiotherapy of pelvic tumor, SHAP values can be used in combination with the XGBoost algorithm to select the optimal subset of radiomic features to construct predictive models of gamma pass rates, and deliver an interpretation of the model output by SHAP values, which may provide value in understanding the prediction by machine learning-dependent models.