1.Dose distribution prediction in cervical cancer brachytherapy based on 3D U-net
Rui LUO ; Mingzhe LIU ; Aiping WEN ; Chuanjun YAN ; Jingyue LUO ; Pei WANG ; Jie LI ; Xianliang WANG
Chinese Journal of Radiological Medicine and Protection 2022;42(8):611-617
Objective:To establish a three-dimensional (3D) U-net-based deep learning model, and to predict the 3D dose distribution in CT-guided cervical cancer brachytherapy by using the established model.Methods:The brachytherapy plans of 114 cervical cancer cases with a prescription dose of 6 Gy for each case were studied. These cases were divided into training, validation, and testing groups, including 84, 11, and 19 patients, respectively. A total of 500 epochs of training were performed by using a 3D U-net model. Then, the dosimetric parameters of the testing groups were individually evaluated, including the mean dose deviation (MDD) and mean absolute dose deviation (MADD) at the voxel level, the Dice similarity coefficient (DSC) of the volumes enclosed by isodose surfaces, the conformal index (CI) of the prescription dose, the D90 and average dose Dmean delivered to high-risk clinical target volumes (HR-CTVs), and the D1 cm 3 and D2 cm 3 delivered to bladders, recta, intestines, and colons, respectively. Results:The overall MDD and MADD of the 3D dose matrix from 19 cases of the testing group were (-0.01 ± 0.03) and (0.04 ± 0.01) Gy, respectively. The CI of the prescription dose was 0.70 ± 0.04. The DSC of 50%-150% prescription dose was 0.89-0.94. The mean deviation of D90 and Dmean to HR-CTVs were 2.22% and -4.30%, respectively. The maximum deviations of the D1 cm 3 and D2 cm 3 to bladders, recta, intestines, and colons were 2.46% and 2.58%, respectively. The 3D U-net deep learning model took 2.5 s on average to predict a patient′s dose. Conclusions:In this study, a 3D U-net-based deep learning model for predicting 3D dose distribution in the treatment of cervical cancer was established, thus laying a foundation for the automatic design of cervical cancer brachytherapy.
2.Application of meticulous management in safety construction of intravenous infusion
Yanmei DENG ; Meizhu DING ; Qihua HUANG ; Lijuan LUO ; Jingyue FAN ; Dansi MO ; Caimei KUANG ; Qiuting ZHANG
Chinese Journal of Medical Education Research 2018;17(7):718-722
For the safety problems of internal medicine intravenous infusion,we carry out meticulous management,establish quality control system of intravenous infusion safety management,and formulate quality control plan.We collect and analyse the potential unsafety factors in the various departments of internal medicine.We have revised the intravenous infusion system and procedures,formulated standards for safety inspection of intravenous fluids,and standardized the admission system for nurses.We carry out training on intravenous infusion related knowledge for nursing staff,carry out meticulous management of venous transfusion links,and actively carry out learning and communication.All these measures have greatly enhanced the safety awareness of the nursing staff.The safety index of intravenous infusion for liver diseases was preliminarily summarized.The use rate of the safe indwelling needle was increased from 30.60% to 92.30%,the rate of appropriate rate of drop speed increased from 68.45% to 93.20%,the three sign standard rate rose from 75.20% to 95.10%,and the patient's satisfaction with infusion increased from 85.60% to 96.82%.Meticulous management can improve the safety of the internal medicine intravenous infusion as a whole.
3.Dosimetric analysis of the optimization algorithm for intracavitary/interstitial brachytherapy of cervical cancer
Chuanjun YAN ; Xianliang WANG ; Aiping WEN ; Jingyue LUO ; Pei WANG ; Jie LI
Chinese Journal of Radiological Medicine and Protection 2023;43(7):524-531
Objective:To provide a basis for selecting the optimization method for intracavitary/interstitial brachytherapy (IC/ISBT) of cervical cancer by comparing graphical optimization (GO), inverse planning simulated annealing (IPSA), and hybrid inverse planning optimization (HIPO) using dosimetric and radiobiological models.Methods:This study selected 65 patients with cervical cancer who were treated with image-guided IC/ISBT. The afterloading therapy plans for these patients were optimized using GO, IPSA, and HIPO individually, with a prescription dose high-risk clinical target volume (HRCTV) D90 of 6 Gy. The non-parametric Friedman test and the non-parametric Wilcoxon rank test were employed to analyze the differences in duration, dose-volume parameters, and radiobiology between the three types of optimized plans. Results:Inverse planning optimization (IPSA: 46.53 s; HIPO: 98.36 s) took less time than GO (135.03 s). In terms of gross target volume (GTV) dose, the high-dose irradiation V150% (53.66%) was slightly higher in the HIPO-optimized plans, while the V200% (30.29%) was higher in the GO-optimized plans. The GO-optimized plans had a higher conformity index (CI; 0.91) than other plans, showing statistically significant differences. Compared with other plans, the HIPO-optimized plans showed the lowest doses of D1 cm 3 and D2 cm 3 at bladders and rectums and non-statistically significant doses at small intestines ( P > 0.05). In terms of the equivalent uniform biologically effective dose (EUBED) for HRCTV, the HIPO-optimized plans showed a higher value (12.35 Gy) than the GO-optimized plans (12.23 Gy) and the IPSA-optimized plans (12.13 Gy). Moreover, the EUBED at bladders was the lowest (2.38 Gy) in the GO-optimized plans, the EUBED at rectums was the lowest (3.74 Gy) in the HIPO-optimized plans, and the EUBED at small intestines was non-significantly different among the three types of optimized plans ( P = 0.055). There was no significant difference in the tumor control probability (TCP) predicted using the three types of optimized plans ( P > 0.05). The normal tissue complication probabilities (NTCPs) of bladders and rectums predicted using the HIPO-optimized plans were lower than those predicted using the GO- and IPSA-optimized plans( χ2 = 12.95-38.43, P < 0.01), and the NTCP of small intestines did not show significant differences ( P > 0.05). Conclusions:Among the three types of optimization algorithms, inverse optimization takes less time than GO. GO-optimized plans are more conformal than IPSA- and HIPO-optimized plans. HIPO-optimized plans can increase the biological coverage dose of the target volume and reduce the maximum physical/biological exposure and NTCP at bladders and rectums. Therefore, HIPO is recommended preferentially as an optimization algorithm for IC/ISBT for cervical cancer.
4.Anti-inflammatory Effect and Mechanism of Active Constituents from Lonicerae Japonicae Flos and Lonicerae Flos: A Review
Jingyue WEI ; Shiwen LUO ; Lingran FENG ; Wanjun LIN ; Keqing WU ; Xuhui LIAO ; Qinhui TUO ; Dongmei YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):273-281
Inflammation is involved in the development of various acute and chronic diseases in the body. Sustained inflammatory responses are key driving factors for diseases such as cancer, neurodegenerative diseases, cardiovascular diseases, metabolic syndrome, inflammatory bowel disease, and arthritis. Therefore, finding anti-inflammatory drugs is crucial for the prevention and treatment of various diseases. In recent years, there has been increasing attention to finding natural drugs with minimal toxic side effects. Lonicerae Japonicae Flos and Lonicerae Flos, as traditional Chinese medicines potent in clearing heat and removing toxins, have strong biological activity and multiple pharmacological effects. They are widely distributed in the plant world and have significant medicinal value. With the continuous advancement of the research on Lonicerae Japonicae Flos and Lonicerae Flos, they have been widely used in the medical field and possess great development potential. Currently, research mainly focuses on the anti-inflammatory mechanisms of Lonicerae Japonicae Flos and Lonicerae Flos, while systematic summaries of their anti-inflammatory active ingredients are rare. Therefore, this paper focuses on the differential analysis of the anti-inflammatory active components of Lonicerae Japonicae Flos and Lonicerae Flos. In addition, it reviewed the possible mechanisms by which extracts and active ingredients of Lonicerae Japonicae Flos and Lonicerae Flos may exert anti-inflammatory effects through various pathways, such as influencing the release of cellular inflammatory factors, regulating inflammatory signaling pathways such as nuclear factor-κB (NF-κB), mitogen-activated protein kinase (MAPK), signal transducer and activator of transcription 3 (STAT3), MAPK/extracellular signal-regulated kinase (ERK)/c-Jun N-terminal kinase (JNK), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/NF-κB, and Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling pathways, increasing antioxidant stress capacity, enhancing immune defense capabilities, and improving intestinal microbiota, aiming to provide a theoretical basis for the rational clinical application of Lonicerae Japonicae Flos and Lonicerae Flos.