External beam radiotherapy which is one of the major treatment options for patients with prostate cancer,has entered an accurate radiation era,with the advancement of radiation technology and the consensus of target volume definition recently.Clinical control of prostate cancer has been improved dramatically with the saccurate delivery of dose escalation.Image-guided radiotherapy,proton therapy and hypofractionated radiation therapy are the research direction for better control.

Objective To investigate the effects of Gegenqinlian Decoction on the IL-1β level in the patients with chronic periodontitis.Methods Seventy patients with chronic periodontitis were divided into the observation group and control group,35 cases in each group.The control group was given the periodontal basic treatment.On the basis of the control group,the observation group was given Gegenqinlian Decoction.The probing depth,attachment level and bacterial plaque index level before and after treatment were compared between the two groups.The levels of IL-1β and IL-6 in serum and gingival crevicular fluid were measured before and after treatment in the two groups.Results The total effective rate in the observation group was 94.29%,which was significantly higher than 71.43% in the control group,the difference was statistically significant (χ2=6.437,P<0.05).After treatment,the probing depth,attachment level and bacterial plaque index in the two groups were significantly decreased (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).The levels of IL-1β and IL-6 in serum and gingival crevicular fluid after treatment in the two groups were decreased significantly (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).Conclusion Gegenqinlian decoction can significantly reduce the IL-1β level in the patients with chronic periodontitis,reduces inflammation reaction and improves the therapeutic effect.

Objective To study the characteristics of the head shape and correlations among the shape parameters in infants at the plagiocephaly.Methods One hundred and four infants at the age of 4-12 months from Department of Rehabilitation,Guangzhou Women and Children's Medical Center with plagiocephaly or normal head shape from January to October 2016 were selected for head shape characteristic analysis.Seventy-four males and 30 females were included.Seventy-three infants (53 males and 20 females) with plagiocephaly were plagiocephaly group with age of (7.07 ±2.23) months.Thirty-one infants (21 males and 10 females) with normal head shape were control group with age for (8.29 ± 2.81) months.The Spectra scanner 2.0 was applied to acquire head shape parameters including cephalic ratio (CR),radial symmetry index (RSI),oblique diagonal difference (ODD),and cranial vault asymmetry index (CVAI).The correlation between the head shape characteristics and shape parameters of infants in different month ages and gender with plagiocephaly were analyzed through independent sample t-test and Pearson correlation analysis.Among all the enrolled infants,there were 46 infants in 4-7 months (36 cases with plagiocephaly and 10 cases with normal head shape),34 infants in ＞ 7-10 months (24 cases with plagiocephaly and 10 cases with normal head shape),and 24 infants in ＞ 10-12 months (13 cases with plagiocephaly and 11 cases with normal head shape).Results CR in 4-7 months group and ＞ 7-10 months of plagiocephaly group were all significantly higher than that in control group [(91.32 ± 5.60) ％ vs.(80.73 ± 2.68) ％,(90.31 ± 6.22) ％ vs.(84.14 ± 3.57) ％],and the differences were all statistically significant (t =-5.765,-2.924,all P ＜ 0.05).The difference was not significant of the CR in ＞ 10-12 months plagiocephaly group compared with that in control group (t =-1.917,P =0.060).RSI,ODD,and CVAI of plagiocephaly group in all ages were significantly higher than those in control group [(46.40 ± 13.59) mmvs.(16.13 ±4.18) mm,(11.84±3.58) mmvs.(3.44±1.59) mm,7.92±2.43 vs.2.34± 1.07],and the differences were all statistically significant (t =-17.210,-16.579,-16.304,all P ＜ 0.001).CR,RSI,ODD,and CVAI of males and females in plagiocephaly group were respectively higher than those of control group,and the differences were all statistically significant (all P ＜ 0.001).There was no statistical significance in CR,RSI,ODD,CVAI between males and females in plagiocephaly group or control group (all P ＞ 0.05).Pearson correlation analysis revealed that there was no correlation between CR and RSI,ODD,CVAI in any age of plagiocephaly group (all P ＞ 0.05).There was a positive correlation among RSI,ODD,and CVAI in the plagiocephaly group in any age (r =0.940,0.912,0.973,all P ＜ 0.001).Conclusions In the infants with plagiocephaly may exist asymmetric head shape and the shorter length of head at the same time.When one of the values of RSI,ODD and CVAI increases,the other two values increase too with more serious level of plagiocephaly.

Adjuvant therapy is the supplemental treatment to radical prostatectomy (RP) aiming to decrease the risk of relapse, including adjuvant androgen deprivation therapy, adjuvant radiation therapy (ART) and adjuvant chemotherapy. The 2020 version of the EAU guideline updated with a new RCT of ART to emphasize the importance of ART in high-risk patients, and to recommend that RT should be given to the pelvic lymphatics and the prostatic fossa for the pN 1 patients.

Objective:To evaluate the efficacy and safety of switch from prednisone (AA+ P) to dexamethasone (AA+ D) in metastatic castration-resistant prostate cancer patients (mCRPC) progressing on abiraterone plus prednisone.Methods:Between November 2016 and December 2019, 46 mCRPC patients were switched to AA+ D after progression on AA+ P at Sun Yet-sen University Cancer center. Median age was 72 years(50 to 89 years), with median androgen deprivation therapy (ADT) duration 14.6 months(2.1 to 168.5 months). PSA level at the time of diagnosis, the initiation of AA+ P treatment, the time of switch were 258.9 ng/ml, 56.6 ng/ml, 25.1 ng/ml, respectively. 42 (91.3%), 12(26.1%), 7(15.2%) patients had bone metastasis, lymph node metastasis, visceral metastasis, respectively. 28 patients had Gleason score ≥8, and 11 patients had Gleason score<8. The primary endpoint was progression free-survival (PFS). Secondary endpoints included PSA response rate of PSA decline ≥50% and ≥30% and safety. Patients were divided into different risk level groups according to PSA level at the time of switch and PFS on AA+ P.Results:The median follow-up of 46 patients was 4.9 months, 40 patients progressed at the last follow-up, the treatment was terminated in 1 patient because of cerebral infarction, 5 patients were still on the treatment of AA+ D. Median PFS on AA+ D of 46 patients was 3.7 (1.6-24.1) months. A total of 12 (26.1%) patients showed a PSA decline≥50% after treatment with AA+ D, and 21 (45.7%) patients showed a PSA decline ≥30%. The median PFS was 8.5 (2.7-24.1) and 3.0 (1.6-17.8) months for patients with PSA decline≥50% and PSA didn’t decline ≥50%, respectively. Four factors below were significantly associated with a longer PFS on AA+ D after steroid switch in univariate analysis: lower PSA level at the time of switch (<30 ng/ml, HR=0.30, 95% CI 0.14-0.64, P=0.002), longer ADT sensitivity duration (≥18 months, HR=0.55, 95% CI 0.28-1.06, P=0.045), longer AA+ P treatment PFS (≥8 months, HR=0.36, 95% CI 0.18-0.72, P=0.004), and greater PSA decline on AA+ D (≥50%, HR=0.30, 95% CI 0.17-0.75, P=0.007). The above mentioned factors were also independent prognostic factors associated with better PFS on AA+ D after steroid switch in multivariate analysis. Treatment with AA+ D was well tolerated in all patients, with no grade 3/4 toxicity reported. Conclusions:Switching from prednisone to dexamethasone is effective and safe in mCRPC patients progressing on abiraterone plus prednisone. Patients with lower PSA level at the time of switch, longer ADT sensitivity duration, longer AA+ P treatment PFS and greater PSA decline on AA+ D might gain better efficacy.

Objective: To investigate the epidemiology and associated factors of deciduous dental caries in 3-5 years old children in Henan Province, and to provide a epidemiological reference for prevention work of deciduous dental caries among children. Methods: According to the basic methods of the Fourth National Oral Health Survey, 12 kindergartens were randomly selected from 2 counties and 2 districts in Henan Province and a total of 1 296 children aged 3-5 years old were randomly selected with stratified multi-stage random sampling method. The deciduous teeth of these children were examined for caries and their guardians were surveyed with questionnaires regarding oral health behavior, knowledge and attitude. Results: Deciduous dental caries occurred in 755 children, accounting for 58.3% and the average decay-missing-filled teeth (dmft) was 2.83. The differences of prevalence of dental caries of boys and girls (60.5%, 56.0%) and mean dmft index (2.88, 2.78) were of no statistical significance(χ2/F=2.64, 0.22, P>0.05). The prevalence of dental caries and mean dmft index for 3, 4 and 5-year-old group was 46.7%, 2.02 and 60.9%, 2.85 and 67.5%, 3.64, respectively. There was statistical significance among three age groups(χ2/F=40.00, 21.68, P<0.01). No significant difference was found in the dental caries prevalence and mean dmft index between urban (58.9%, 2.87) and rural area (57.7%, 2.79)(χ2/F=0.20, 0.16, P>0.05). Multivariate logistic regression showed that age, feeding pattern within the first six months after birth, dental care experience and self-perceived oral health status associated with deciduous caries in 3-5 year-old children in Henan Province(P<0.05). Conclusion Dental caries prevalence is highly prevalent among preschool children in Henan Province. Effective caries precaution measures should be taken to improve oral health level of these children.

Objective: To explore periodontal health knowledge and behavior among adolescents aged 12-15 years in Henan Province so as to provide scientific basis for oral health care. Methods: According to the basic methods of the Fourth National Oral Health Survey, 3 786 school adolescents, aged 12-15 years, were selected from 12 middle schools in two district and two country in Henan by multi-stage stratified equal capacity random sampling. Oral examination and a questionnaire survey were performed among these students. Results: The rate of periodontal health was 6.08%, the prevalence of gingival bleeding in these adolescents was 93.92%, its calculus existence was 90.99%. The rate of brushing teeth was 77.79%. However, the rate of brushing teeth twice or more per day was 17.56%, the rate of using fluoride toothpaste was 4.57%. The rate of periodontal health of adolescents who brushing teeth, using fluoride toothpaste were higher than adolescents who did not brush teeth, did not use fluoride toothpaste (χ2=10.81, 5.96, P<0.05). The recognition of oral care knowledge was 62.31%; except for "bacteria can cause dental caries", the awareness rate of other related periodontal diseases is more than 50.00%. Conclusion The status of periodontal health among adolescents aged 12-15 in Henan Province was not optimistic. Adolescents are lake of knowledge and health behavior towards periodontal health, The promotion of adolescents’s oral health education should be strengthened.

Objective:To evaluate the efficacy of first-line tyrosine kinase inhibitors (TKI) plus immune checkpoint inhibitors (ICI) in metastatic fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC).Methods:The data of 87 metastatic FH-deficient RCC patients from West China Hospital ( n=44), Renji Hospital ( n=27) and Sun Yat-sen University Cancer Center (n=16) from Mar 2019 to Aug 2022 were retrospectively analyzed. The median age was 37(30, 47) years, the male to female ratio was 1.9∶1. The median size of tumor was 7.5(5.0, 10.0) cm. Sixty-one patients (70.1%) had germline FH mutations, and 26 patients (29.9%) had somatic FH mutations. Forty-nine patients (56.3%) metastasis disease at initial diagnosis, and 38 patients (43.7%) had metachronous metastasis. The most common site of metastasis was lymph node (41/87, 47.1%), followed by bone (33/87, 37.9%), liver (22/87, 25.3%), and lung (14/87, 16.1%). Fifteen patients (17.2%) had weak expression of FH protein and 59 patients (67.8%) had positive PD-L1 expression. The most common treatments were sintilimab plus axitinib (52/87, 59.8%), followed by pembrolizumab plus cabozantinib (7/87, 8.0%), tirelizumab plus axitinib (6/87, 6.9%), pembrolizumab plus axitinib (5/87, 5.7%), and toripalimab plus axitinib (4/87, 4.6%). Thirteen patients (13/87, 14.9%) received other ICI plus TKI combination treatments. Statistical analysis was conducted using R 4.2.3 software. Kaplan Meier survival curve was used to evaluate survival data, and log-rank test was used to compare differences between treatment groups. Results:The overall objective response rate (ORR) and disease control rate (DCR) of first-line TKI + ICI were 39.1% and 89.7%, respectively. The median progression-free survival (PFS) and overall survival (OS) were 16.5 months and 71.0 months, respectively. For first-line sintilimab plus axitinib, the ORR and DCR were 44.2% and 92.3%, respectively. The median PFS was 17.3 months and the median OS was not reached for this combination treatment. The efficacy of first-line tirelizumab plus axitinib was inferior to other treatment strategies (median PFS: 4.0 vs. 16.6 months, P<0.001; median OS: 22.0 vs. 71.0 months, P=0.043). Subgroup analyses further showed that the efficacy of ICI+ TKI combination therapy was consistent in patients with different clinicopathologic and genomic features. However, patients with liver metastasis had shorter OS than those without liver metastasis (median OS: 26.3 vs. 71.0 months, P=0.021). Conclusion:First-line TKI + ICI is effective for metastatic FH-deficient RCC and can significantly prolong the survival of the patients.

Objective:To determine a relationship between ultrasound shear wave elastography (SWE) and pathological lessions of renal tissues in children with chronic kidney disease (CKD).Methods:It was a cross-sectional observational study, involving children admitted to the Department of Pediatrics of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to December 2021 with definite pathological diagnosis through kidney biopsy. The SWE was used to determine the Young's modulus (elastic modulus) of the cortex and medulla of the upper, middle, and lower poles of the kidney. The renal histopathology was classified or graded. The statistical method was used to analyze the relationship between Young's modulus of the inferior polar cortex (YM cor) and medulla (YM med) of the right kidney and renal pathology. Results:The study included 110 children with definite pathological diagnosis through renal biopsy, aged (10.1±3.4) years old (2-17 years old), with 55 males (50.0%). The body mass index was (20.6±2.4) kg/m 2, and mean arterial pressure was (95±24) mmHg. There were 94 patients (85.4%) with CKD stage 1, 8 patients (7.3%) with CKD stage 2, and 8 patients (7.3%) with CKD stage 3. There was no significant difference of YM cor and YM med in the upper and middle poles of the right kidneys, and YM med in the lower poles of right kidneys in CKD patients with different stages (all P>0.05). Both YM cor [(15.75±3.36) kPa] and YM med [(13.50±2.43) kPa] of CKD stage 3 patients were significantly higher than those of CKD stage 1 patients [(12.94±2.45) kPa, (11.88±2.23) kPa](both P<0.05). There was no significant difference of YM cor and YM med in the lower poles of right kidneys between stage 1 and stage 2 CKD patients (both P>0.05). YM cor[(17.93±3.23) kPa] and YM med [(15.50±1.48) kPa] in patients with crescentic glomerulonephritis were higher than those in patients with focal segmental glomerulosclerosis [(12.71±2.42) kPa, (11.57±2.63) kPa] and mesangial proliferative glomerulonephritis [(12.73±2.04) kPa, (11.48±2.10) kPa](all P<0.05). There was no significant difference of YM cor and YM med between focal segmental glomerulosclerosis and mesangial proliferative glomerulonephritis (both P>0.05). YM cor [(16.30±2.63) kPa] and YM med [(15.54±1.59) kPa] of Lee's Ⅳ grade of IgA nephropathy were higher than those of Lee's Ⅲ grade [(13.32±2.70) kPa, (12.57±2.50) kPa](both P<0.05), while the International Study of Kidney Disease in Children grade of purpura nephritis had no significant correlation with YM cor and YM med (both P>0.05). YM cor [(15.41±2.37) kPa] and YM med [(13.82±2.59) kPa] of interstitial fibrosis/tubular atrophy (T1/T2) group of IgA nephropathy mixed with purpura nephritis were significantly higher than those of T0 group's [(12.99±2.40) kPa, (11.79±2.05) kPa] (both P<0.05). Moreover, crescent formation (C1) group had a higher YM cor [(14.21±2.77) kPa] and YM med [(12.80±2.47) kPa] than those in C0 group [(12.73±2.15) kPa, (11.59±1.97) kPa] (both P<0.05), while YM cor and YM med were unrelated to the mesangial hypercellularity (M), endocapillary cellularity (E), segmental sclerosis or adhesion (S) indicators (all P>0.05). In lupus nephritis patients, YM cor ( r=0.744, P=0.035) and YM med ( r=0.728, P=0.009) were favorably linked with the chronic index, but not with the activity index (both P>0.05). Conclusions:Renal interstitial fibrosis/tubular atrophy and crescentic development are connected with YM cor and YM med at the lower pole of the kidney as measured by SWE. SWE can be used to assess the chronic renal lesions in children with CKD in the early and middle stages. It may develop into a new noninvasive way to assess renal pathology.

Objective:To evaluate the efficacy and safety of Tyrosine Kinase Inhibitors (TKIs) combined with stereotactic body radiation therapy(SBRT) in the treatment of renal cell carcinoma (RCC) patients with bone metastasis.Methods:The clinical data of 80 RCC patients with bone metastasis in Sun Yat-sen University Cancer Center from April 2010 to April 2020 were analyzed retrospectively. Among them, 64 patients were medium or high risk according to the International Metastatic Renal Cell Carcinoma Database Consortium(IMDC) score. Twenty-four patients received TKI therapy alone(Group A), and the other 56 cases received TKIs combined with SBRT to bone metastastic lesions (Group B).Results:The median follow-up period was 20.7 months (4.8-115.6 months), 70 patients received second or third-line targeted drug therapy, and 4 patients in group A and 15 patients in group B received TKI plus immunotherapy. Fifty-four patients had symptoms of bone pain before radiotherapy, 46 patients were satisfied with the analgesic effect after SBRT treatment. Twelve patients got complete response (CR) after bone lesions, and 32 patients achieved partial response (PR). Forty patients died of disease progression during follow-up. The median OS was: 20.7 months vs not reached(Group A vs. Group B), and the 2-y OS and 5-y OS were 50% vs. 62%, and 19% vs. 56%, respectively ( P=0.006). There were only 2 patients (3.6%) had grade 3 SBRT related adverse events. Conclusions:SBRT combined with TKIs improved the quality of life and prolonged the overall survival of RCC patients with bone metastasis.