Objective To explore the effects of anti-tumor immunity induced by dendritic cells (DCs) vaccine pulsed with PEP3-KLH (keyhole limpet hemocyanin) on induction of specific immunity against prostate cancers.Methods DCs were propagated from bone marrow of C57BL/6 mice in vitro with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4).On day 5 of culture, DCs were harvested and incubated with PEP3-KLH or KLH.Then the DC vaccine was inoculated into C57BL/6 mice by subcutaneous injection for three times with an interval of two weeks.One week after the last vaccination, the levels of IL-2, IL-12, and interferon (IFN)-γwere measured with enzyme-linked immunosorbent assay (ELISA) kit.The aforementioned immunized mice with DC vaccines were challenged with transgenic adenocarcinoma of mouse prostate (TRAMP)-C2 tumor cells, the tumor growth curve was drawn, and survival rate was checked and compared.The cytotoxic T lymphocyte (CTL) activity induced by DCs was tested with lactate dehydrogenase (LDH) release method.The percentages of CD3 + , CD4+ ,or CD8 + T cells in tumor-infiltrating lymphocytes (TILs) were determined with flow cytometry.Results PEP3-KLH-DC group stimulated the body and induced higher levels of secreted IL-2, IL-12, and IFN-γ compared to DCs control and KLH-DC groups (P ＜ 0.01).The tumor of mice vaccinated with PEP3-KLHDC grew significantly slower than that injected with DCs or KLH-DC (P ＜0.01).Compared to the others, the survival rate in PEP3-KLH-DC group raised remarkably (P ＜ 0.01).PEP3-KLH-DC group induced more outstanding specific CTL activities of killing tumor cells than DCs control group and KLH-DC group (P ＜ 0.01), and the cytotoxicities of TILs in PEP3-KLH-DC group was significantly enhanced (P ＜0.01).The percentages of CD3 + , CD4 + , or CD8 + T cells in TILs (40.9％, 34.1％) in PEP3-KLH-DC group were significantly higher than those in DC-KLH (27.3％, 5.2％) or DCs (26.2％, 5.1％) group.Conclusions PEP3-KLH-DC vaccine can inhibit effectively tumor growth, enhance long-term survival in mice,intensify the local immunologic function of tumor, and elicit and promote profound specific anti-prostate cancer cellular immune responses.

Objective To investigate the significances of monitoring urine neutrophil gelatinase -associated apolipoprotein (NGAL)and kidney injury molecule -1 (KIM-1)levels before and after coronary intervention in early predication of contrast -induced nephropathy.Methods The clinical data of 249 patients with coronary heart disease undergoing percutaneous coronary intervention were collected.All patients were divided into contrast -induced nephropathy group(n =21 )and non -contrast -induced nephropathy group(n =228)according to whether had contrast -induced nephropathy.Before surgery and 4h,12h,24h,48h,72h after surgery,the levels of serum creatinine were tested.Before surgery and 4h,12h,24h,48h after surgery,the levels of urinary NGAL and KIM-1 were detected by using enzyme -linked immunosorbent assay(ELISA).Results Compared with before surgery,the serum creati-nine level of contrast -induced nephropathy patients after surgery 48h[(101.7 ±20.3)μmol/L]was elevated,the difference was statistically significant(t =15.972,P <0.05).Compared with before surgery,the urinary NGAL levels of contrast -induced nephropathy patients after surgery 4h ~48h were (12.3 ±1.6)μg/L,(14.5 ±1.5 )μg/L, (14.1 ±1.2)μg/L and (14.3 ±1.4)μg/L,which were significantly elevated(t =8.672,11.817,15.942 and 17.641,all P <0.05),and the urinary KIM-1 levels after surgery 24h and 48h were (5.1 ±0.9)μg/L and (5.5 ± 1.3)μg/L,which were elevated,the differences were statistically significant(t =9.672,14.381,all P <0.05).The urinary NGAL levels of contrast -induced nephropathy patients after surgery 4h ~48h were higher than non -contrast-induced nephropathy patients,and the urinary KIM-1 levels after surgery 24h and 48h were higher than non -contrast -induced nephropathy patients,the differences were statistically significant(t =17.838,19.370,13.996, 18.172,2.792,3.307,all P <0.05).Pearson correlation analysis showed that the urinary NGAL levels after 4h and urinary KIM-1 levels after 24h were positively correlated with serum creatinine levels after surgery 48h(r =0.698, 0.576,all P <0.05).ROC curve analysis showed that urinary NGAL levels in predicting contrast -induced nephrop-athy,the area under the curve was 0.963 (95% CI:0.931 ~0.995 ),sensitivity was 85.7%,and specificity was 94.3%,for urinary KIM-1 levels,those were 0.839 (95%CI:0.768 ~0.909),81.0% and 72.8%.Conclusion The urinary NGAL levels of contrast -induced nephropathy patients after interventional treatment 4h were increased, and the urinary KIM-1 levels appeared increased after surgery 24h,which were earlier than serum creatinine.They were expected to be early indicators for determining acute kidney injury and predicting contrast -induced nephropathy after intervention treatment.

Objective:To investigate the clinical manifestations and characteristics of tracheobronchial foreign bodies in children, and improve the diagnosis and treatment of foreign bodies.Methods:A retrospective analysis was performed on the clinical data of children with tracheobronchial foreign bodies confirmed by fiberoptic bronchoscopy between January 2010 to December 2019.The children with tracheobronchial foreign body who were treated in the Maternal and Child Health Hospital of Gansu Province.Results:A total of 967 cases were operated by soft electronic bronchoscope, and foreign bodies were removed by means of foreign body forceps or nets.Among them, 19 cases(3 cases with subglottic foreign bodies, one with row of pins, and the rest 15 cases with foreign bodies completely wrapped by granulation)were not removed, two cases were spontaneously coughed, and 946 cases (97.8%)were removed.Bronchial foreign bodies in children were more common in boys, with the ratio of male to female being 2.14∶1.The main age of onset was 1-3 years old(88.8%). The incidence was slightly higher in rural areas than that in urban areas(46.5% in urban areas, 53.5% in rural areas). Foreign bodies were inhaled most in March and least in June.From the perspective of season, winter and spring were more than summer and autumn.The foreign body types inhaled were mainly exogenous plant foreign body, accounting for 93.0%, among which peanut(31.7%)and melon seeds(19.2%)were the most common.The duration of foreign body inhalation was up to 347 cases(35.9%)in 1-3 days.There were 501 cases(51.8%)with endoscopic endobronchial inflammation, and 196 cases of children with varying degrees of granulomatous hyperplasia, accounting for 39.1% and 20.3% of the total.The foreign body in the right bronchus accounted for 50.0% and the left bronchus for 43.7%.There were 793 cases confirmed by imaging, with a positive rate of 81.9%, and 90.9% confirmed by CT.Conclusion:About 88.8% of tracheobronchial foreign bodies occurred in 1 to 3 years of age.The occurrence of foreign bodies had obvious gender, urban-rural and seasonal distribution characteristics, and more cases were male, in rural and winter as well as spring.

Objective To explore the clinical effectiveness of deferasirox, deferiprone and desferrioxamine in the treatment of iron overload in patients with thalassemia major.Methods Among the severe thalassemia patients with iron overload being diagnosis,treated and followed up in Guigang City People′s Hospital,fifty cases were tested by MRI T2 and were detected with cardiac and liver iron overload,the patients were selected and randomly divided into the deferoxamine treatment(DFO)group(18 case),deferiprone treatment(DFP)group(22 cases)and deferasirox treatment(DFX)group(10 case),The baseline data of the three groups were statistically analyzed.the serum ferritin(SF)value,the cardiac MRI T2 value and the liver MRI T2 value before and after treatment were measured.Results The patients completed the treatment,after 1 years of treatment,the serum SF value,cardiac and liver MRI T2 values of the patients were improved than those before the treatment(P<0.05); the differences in serum SF among the three groups were not statistically significant(F=3.089,P>0.05); the differences in liver MRI T2 value among the three groups were not statistically significant(F=0.131,P>0.05),There were significant differences in heart iron load MRI T2 values among the three groups((34.27 ± 6.30)ms vs.(23 ± 2.79)ms vs.(21.8 ± 2.20)ms,F=39.54,P<0.05) .Conclusion Deferoxamine,deferiprone and deferasirox can effectively alleviate the iron load in patients with thalassemia major.in terms of cardiac iron overload,the curative effects of deferiprone treatment in patients with thalassemia is superior than desferrioxamine and deferasirox treatment,it is worthy of clinical promotion.

Objective: To compare the setup accuracy between Catalyst HD and skin markers in stereotactic body radiotherapy (SBRT) of lung cancer. Methods: A total of 24 cases treated with SBRT were selected and all patients were fixed with vacuum pad in the supine position. Patients in group A were positioned by Catalyst HD and those in group B were positioned by shin markers. All patients were matched with the CT images after CBCT scan by rigid registration and the setup errors in six directions (x-, y-, z-axis, Rtn, Pitch and Roll) were obtained. Results: The mean±SD in group A and B in the six directions were as follows: (0.13±0.12) cm, (0.25± 0.19) cm; (0.26±0.15) cm, (0.13±0.11) cm; (0.23±0.19) cm, (0.35±0.29) cm; (0.43°±0.40°), (0.80°±0.69°); (0.48°±0.47°), (0.79°±0.64°); (0.62°±0.60°) and (0.88°±0.70°), respectively. Except the x-axis data in group B, all the data in the six directions were not normally distributed. The obtained data significantly differed between two groups (all P<0.05). The out-of-tolerance errors (>0.5 cm/2°) also significantly differed between two groups (P<0.05). Conclusions The setup errors of Catalyst HD are less than those of the skin markers (except the y-axis). The setup accuracy of Catalyst HD is superior to that of traditional skin markers, which is worthy of application in clinical practice.

Objective:To develope an automatic volumetric modulated arc therapy (VMAT) planning for rectal cancer based on a dose-prediction model for organs at risk(OARs) and an iterative optimization algorithm for objective parameter optimization.Methods:Totally 165 VMAT plans of rectal cancer patients treated in Peking University Cancer Hospital & Institute from June 2018 to January 2021 were selected to establish automatic VMAT planning. Among them, 145 cases were used for training the deep-learning model and 20 for evaluating the feasibility of the model by comparing the automatic planning with manual plans. The deep learning model was used to predict the essential dose-volume histogram (DVH) index as initial objective parameters(IOPs) and the iterative optimization algorithm can automatically modify the objective parameters according to the result of protocol-based automatic iterative optimization(PBAIO). With the predicted IOPs, the automatic planning model based on the iterative optimization algorithm was achieved using a program mable interface.Results:The IOPs of OARs of 20 cases were effectively predicted using the deep learning model, with no significantly statistical difference in the conformity index(CI) for planning target volume(PTV)and planning gross tumor volume(PGTV)between automatic and manual plans( P>0.05). The homogeneity index (HI) of PGTV in automatic and manual plans was 0.06 and 0.05, respectively( t=-6.92, P< 0.05). Compared with manual plans, the automatic plans significantly decreased the V30 for urinary bladder by 2.7% and decreased the V20 for femoral head sand auxiliary structure(avoidance)by 8.37% and 15.95%, respectively ( t=5.65, 11.24, P< 0.05). Meanwhile, the average doses to bladder, femoral heads, and avoidance decreased by 1.91, 4.01, and 3.88 Gy, respectively( t=9.29, 2.80, 10.23, P< 0.05) using the automatic plans. The time of automatic VMAT planning was (71.49±25.48)min in 20 cases. Conclusions:The proposed automatic planning based on dose prediction and an iterative optimization algorithm is feasible and has great potential for sparing OARs and improving the utilization rate of clinical resources.

Dose verification, as part of the radiotherapy QA chain, is a significant method to ensure the patients' safety and efficacy of treatment. The increasing application of precision radiotherapy techniques in clinic has advanced the need of three-dimensional ( 3D) dose verification. Gel dosimeters, prevailing for its intrinsic 3D high-resolution measurement and good tissue equivalence, can serve as effective supplement to the clinical radiotherapy dosimetric system. This paper reviews the method ology, dose response mechanism, characterizations of the state-of-the-art gel dosimeters. Gel dosimeters, outstanding for 3D dose measurement, have a great potential to explore both for clinical application and academic research.

Objective:To develop a new method to set up patients using optical surface monitoring system and to compare it with the conventional method in head radiotherapy.Methods:A total of 358 set-ups (130 with the conventional method and 228 with the new method ), which were from 99 head tumor patients in Beijing Cancer Hospital treated between May 2018 to April 2019, obtained by using Image Guided Radiotherapy were retrospectively analyzed. The distributions of set-up errors, the number of abnormal positions, and the set-up time were compared to evaluate the potential advantages of the new method .Results:The mean (± standard deviation) absolute values of setup errors of the new method were (0.07±0.07) , (0.08±0.06) and (0.06±0.06) cm for the vertical, lateral, and longitudinal, (0.53±0.41)°, (0.59±0.44)° and (0.59±0.46)° for the rotation, pitch and roll, respectively. In the new method , the setup accuracy was improved( t=3.24-6.10, P<0.001)and the number of abnormal positions was greatly reduced(χ 2=60.66, P<0.001). Compared with the conventional method, the patient setup time was slightly reduced by the new method , but the difference was not statistically significant ( P>0.05). Conclusions:The new high-precision method to set up patients using optical surface monitoring system improves the accuracy of patients′ position, decreases the corrections applied by 6DoF couch, reduces the probability of abnormal positions, and suggests the potential benefit in head radiotherapy.

Objective:To build patient setup workflow based on the optical surface monitoring system (OSMS) in postoperative radiotherapy for breast cancer, and compare the setup accuracy and PTV margin between OSMS based setup and conventional skin marker based method.Methods:The setup data of 20 cases of postoperative radiotherapy for breast cancer were retrospectively analyzed and divided into two groups: OSMS setup group and conventional skin marker setup group with 10 patients in each group. All CBCT rigid registration values in six dimensions ( x, y, z, Rtn, Pitch, Roll) were obtained, and the absolute value and distribution of errors were statistically analyzed by single sample t-test and χ2-test respectively. Finally, the CTV-PTV margins were compared using the extension formula. Results:The mean values in OSMS setup group and conventional skin marker setup group in sixdirections were 0.18 and 0.18 cm, 0.12 and 0.13 cm, 0.13 and 0.23 cm, 0.55° and 0.74°, 0.63° and 0.99°, 0.67° and 0.68°, respectively, while the standard deviations were 0.13 and 0.12 cm, 0.09 and 0.09 cm, 0.11 and 0.16 cm, 0.37° and 0.55°, 0.53° and 0.65°, 0.42° and 0.55°, respectively. The setup error differed in both z and Pitch directions( t=3.53, 2.98, P<0.05), while the error distribution rate difference was statistically significant between two groups in z direction( χ2=11.090, P<0.05). The CTV-PTV margins in OSMS setup group and conventional skin marker setup group were 0.28 and 0.26 cm, 0.21 and 0.20 cm, 0.24 and 0.35 cm, respectively. Conclusions:The proposed OSMS-based patient setup work flow is better than the conventional skin marker based method in setup accuracy, with significant setup error differences in z and Pitch directions. The proposed OSMS workflow is of potential clinical benefit.

Objective:To characterize the key dose response properties of the novel presage sheet dosimeters for radiotherapy dose verification, including absorption spectra, linearity, dose range and stability.Methods:The same batch of presage sheet dosimeters were irradiated by a radiotherapy linac. The absorption spectra within 400-700 nm were read out with a spectrophotometer, and the R-G-B3 absorption changes read out with a film flatbed scanner was compared before and after irradiation.Results:An absorption peak was clearly identified at 628 nm, where absorptions change in high linearity with delivered doses ( R2=0.9999). A flat valley region is identified around 490 nm, where dose induced absorption changes were negligible. The readout sensitivity of the R-channel of the flatbed scanner was higher than both in green and blue channels. In the dose range below 10 Gy, the R-channel absorptions are in significant linearity with doses ( R2=0.9999), with absorptions change in an obvious quadratic trend in the range beyond 10 Gy ( R2=0.9999). The dose range of presage sheets was more than 94.6 Gy. The absorptions were well preserved within 1 h post-irradation, and then are shown to increase gradually, where the increase speeds are dose-related. The post-irradiation integrity of dose falloff gradients are shown with negligible gradient blurring. Conclusions:The novel presage sheets shown to have reasonable dose response linearity, large dose range, desirable post-irradiation dose gradient integrity and negligible fractionation effect, which indicates its great potentials in integral dose verification of high-dose and multiple target radiotherapy deliveries.