Given the escalating number of cancer patients and the consequent rise in demand for radiation therapy in China, there is an urgent need to establish and improve a talent cultivation system for radiation dosimetrists. The United States, with an early-established cultivation system for radiation dosimetrists, boasts relatively mature and comprehensive systems of academic education and qualification certification. This study summarized and analyzed the educational and certification patterns for radiation dosimetrists in the United States based on public data from relevant institutions, related literature, and interviews with American radiation dosimetrists. Meanwhile, this study delved into and assessed the shortcomings in China′s radiation dosimetry education, examination, certification, and career advancement pathways. Furthermore, this study offered suggestions and recommendations for constructing a novel pattern tailored to the cultivation of radiation dosimetrists in China, in order to facilitate the high-quality development of the medical dosimetry discipline.

OBJECTIVE: To evaluate the early effectiveness of transosseous suture fixation in treating recurrent acute patellar dislocation with patellar osteochondral fractures (OCFs). METHODS: A retrospective analysis was conducted on 19 patients with recurrent acute patellar dislocation and patellar OCFs, who underwent transosseous suture fixation between January 2018 and December 2022 and were followed up 2 years. The cohort included 8 males and 11 females, aged 13-21 years (mean, 16.2 years). Patients experienced 2-5 times of patellar dislocation (mean, 3.2 times). The interval from the last dislocation to operation ranged from 3 to 15 days (mean, 9.6 days). Preoperative imaging revealed the intra-articular osteochondral fragments and medial patellofemoral ligament (MPFL) injury. Clinical outcomes were evaluated using the visual analogue scale (VAS) score for pain, the International Knee Documentation Committee (IKDC) score, the Hospital for Special Surgery (HSS) knee score, the Lysholm score, and the Tegner score. Postoperative complications were recorded. During follow-up, the knee X-ray films, CT, and MRI were taken to evaluate fragment healing, displacement, and the morphology and tension of the MPFL reconstruction graft. RESULTS: All incisions healed primarily, and no complication occurred such as infection, joint stiffness, patellofemoral arthritis, or redislocation. Patients were followed up 24-60 months (mean, 43.5 months). At 12 months postoperatively and the last follow-up, significant improvements ( P<0.05) were observed in VAS, Lysholm, IKDC, HSS, and Tegner scores compared to preoperative values. Further improvements were observed at last follow-up compared with the 12 months postoperatively, and the differences were significant ( P<0.05). Imaging studies demonstrated satisfactory osteochondral fragment positioning with stable fixation. At last follow-up, all fragments had healed, and MPFL reconstruction grafts exhibited optimal morphology and tension. No joint adhesion or fragment displacement occurred. CONCLUSION For recurrent acute patellar dislocation with patellar OCFs, transosseous suture fixation proves to be both safe and effective, achieving satisfactory early effectiveness.
Humans ; Male ; Female ; Patellar Dislocation/surgery* ; Adolescent ; Young Adult ; Retrospective Studies ; Patella/surgery* ; Suture Techniques ; Treatment Outcome ; Recurrence ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Follow-Up Studies

Objective To investigate the diagnostic value of neutrophils CD64(nCD64)index,C reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in viral and bacterial upper respiratory tract infections.Methods Patients with upper respiratory tract infection treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 2023 to January 2024 were selected as study objects.According to the results of etiological examination,they were divided into bacterial infection group(46 cases)and viral infection group(58 cases).The levels of nCD64 index,CRP,IL-6 and PCT before medication were compared between two groups.Receiver operating characteristic(ROC)curve was used to evaluate the value of infection markers in the differential diagnosis of bacterial and viral upper respiratory tract infections.Results The levels of CRP,nCD64 index,IL-6 and PCT in bacterial infection group were significantly higher than those in viral infection group(P＜0.01).ROC curve results showed that the area under the curve(AUC)of nCD64 index,CRP,PCT and IL-6 to distinguish the two types of infection were 0.818,0.776,0.692 and 0.654,respectively,and the combined AUC of four indexes was 0.870.Conclusion nCD64 index,CRP,IL-6 and PCT are closely related to the pathogen types of patients with upper respiratory tract infection,and the combined detection of all indicators can improve the diagnostic efficiency of upper respiratory tract infection types.

Given the escalating number of cancer patients and the consequent rise in demand for radiation therapy in China, there is an urgent need to establish and improve a talent cultivation system for radiation dosimetrists. The United States, with an early-established cultivation system for radiation dosimetrists, boasts relatively mature and comprehensive systems of academic education and qualification certification. This study summarized and analyzed the educational and certification patterns for radiation dosimetrists in the United States based on public data from relevant institutions, related literature, and interviews with American radiation dosimetrists. Meanwhile, this study delved into and assessed the shortcomings in China′s radiation dosimetry education, examination, certification, and career advancement pathways. Furthermore, this study offered suggestions and recommendations for constructing a novel pattern tailored to the cultivation of radiation dosimetrists in China, in order to facilitate the high-quality development of the medical dosimetry discipline.

Objective To investigate the diagnostic value of neutrophils CD64(nCD64)index,C reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in viral and bacterial upper respiratory tract infections.Methods Patients with upper respiratory tract infection treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 2023 to January 2024 were selected as study objects.According to the results of etiological examination,they were divided into bacterial infection group(46 cases)and viral infection group(58 cases).The levels of nCD64 index,CRP,IL-6 and PCT before medication were compared between two groups.Receiver operating characteristic(ROC)curve was used to evaluate the value of infection markers in the differential diagnosis of bacterial and viral upper respiratory tract infections.Results The levels of CRP,nCD64 index,IL-6 and PCT in bacterial infection group were significantly higher than those in viral infection group(P＜0.01).ROC curve results showed that the area under the curve(AUC)of nCD64 index,CRP,PCT and IL-6 to distinguish the two types of infection were 0.818,0.776,0.692 and 0.654,respectively,and the combined AUC of four indexes was 0.870.Conclusion nCD64 index,CRP,IL-6 and PCT are closely related to the pathogen types of patients with upper respiratory tract infection,and the combined detection of all indicators can improve the diagnostic efficiency of upper respiratory tract infection types.

BACKGROUND:Rapid developments in the field of bioinformatics have provided new methods for the diagnosis of osteoarthritis.Artificial neural networks have powerful data computing and classification capabilities,which have shown better performance in disease diagnosis. OBJECTIVE:To establish a new diagnostic predictive model of osteoarthritis based on artificial neural network and to verify the diagnostic value of the model in osteoarthritis with an external dataset. METHODS:The eligible osteoarthritis-related data sets were downloaded through GEO database search and divided into Train group and Test group.The gene expression matrix of the Train group was analyzed to screen the differentially expressed genes.GO and KEGG enrichment analyses were performed on the differentially expressed genes.Through Lasso regression model,support vector machine model and random forest tree model,the key genes of osteoarthritis were further identified from the differentially expressed genes.The R software"Neuralnet"package was then used to construct the osteoarthritis diagnosis model based on artificial neural network,and the model performance was evaluated by the five-fold cross-validation.Two independent data sets in the Test group were used to verify their diagnostic results. RESULTS AND CONCLUSION:A total of 90 differentially expressed genes related to osteoarthritis were obtained by differential analysis,of which 33 were down-regulated and 57 were up-regulated.GO enrichment analysis showed that the differentially expressed genes were mainly involved in the following biological processes,including leukocyte-mediated immunity,leukocyte migration in bone marrow and chemokine production.KEGG enrichment analysis showed that these genes were mainly enriched in rheumatoid arthritis,interleukin-17 signaling pathway and osteoclast differentiation pathway.Five key genes for the diagnosis of osteoarthritis,HMGB2,GADD45A,SLC19A2,TPPP3 and FOLR2,were identified by three machine learning methods.The artificial neural network model of five key genes in the Train group showed that the accuracy was 96.36%and the area under the curve was 0.997.The five-fold cross validation of the neural network model showed that the average area under the curve was greater than 0.9 and the model was of robustness.Two independent data sets in the Test group showed its area under the curve was 0.814 and 0.788 respectively.Therefore,the establishment of an artificial neural network model for the diagnosis of osteoarthritis has a certain diagnostic value.

Objective To analyze the relationship of miRNA-146a gene polymorphisms and ischemic post-stroke depression(PSD).Methods The SNP rs2910164 in the miRNA-146a gene in 200 ischemic PSD patients(case group)and 200 ischemic non-PSD patients(control group)was analyzed using the SNaPshot technique.The relative expression levels of miRNA-146a in the peripheral blood of two groups were determined.Results The case group showed significantly different allele and genotype frequencies of the SNP rs2910164 as compared with the control group(G vs.C:P=0.003;GG+CG vs.CC:P=0.012).Meanwhile,the case group presented a significantly lower level of miRNA-146a relative expression(P<0.05).Within the control group,additionally,the subgroup of GG+CG genotypes demonstrated a significantly lower level of miRNA-146a relative expression compared with the subgroup of CC genotypes(P<0.05).Conclusion SNP rs2910164 in the miRNA-146a is associated with the susceptibility to ischemic PSD,and G allele may play a role in the ischemic PSD.

Tardive dyskinesia (TD) is a medication-induced hyperkinetic movement disorder, generally manifested as involuntary spasms or choreiform movements of the tongue, lower face and jaw, and limbs (lasting at least several weeks). It occurs after using neuroleptic medication for at least several months, causing irreversible injuries to the nerve system and significantly impacting patients′ daily function. This review summarizes recent research progress regarding TD risk factors, possible pathogenesis, clinical characteristics, assessment and identification, and treatment and management approaches. The goal is to raise awareness of TD to archive early prevention and identification, standardize treatment, and improve patients′ prognosis and quality of life.

Tardive dyskinesia (TD) is a medication-induced hyperkinetic movement disorder, generally manifested as involuntary spasms or choreiform movements of the tongue, lower face and jaw, and limbs (lasting at least several weeks). It occurs after using neuroleptic medication for at least several months, causing irreversible injuries to the nerve system and significantly impacting patients′ daily function. This review summarizes recent research progress regarding TD risk factors, possible pathogenesis, clinical characteristics, assessment and identification, and treatment and management approaches. The goal is to raise awareness of TD to archive early prevention and identification, standardize treatment, and improve patients′ prognosis and quality of life.

Objective:To explore the incidence, clinical characteristics, imaging features, clinical outcome and prognosis of indeterminate pulmonary nodules (IPN) in patients with osteosarcoma.Methods:A total of 69 patients of osteosarcoma with IPN in lung treated in the Bone tumor Center of Eastern Theater General Hospital from January 2011 to January 2021 were collected retrospectively, there were 47 males and 22 females, with a median age of 19 years old (range 7-60 years old). The clinical characteristics including disease-free interval, the chemotherapy response, with recurrence/non-pulmonary, IPN presence before / during / after chemotherapy and imaging features of IPN including number of IPN, location of IPN, density of IPN, boundary clarity of IPN and outcome. The patients were divided into the metastasis pulmonary nodules group and the benign nodules group according to the final outcome of IPN. Further, χ 2 test was performed for comparison of the clinical and imaging characteristics between the two groups. The survival of patients was counted and the correlation between single factor and survival was compared by Kaplan-Meier test, and multivariate survival analyses were performed using Cox proportional hazards regression models. Results:Sixty-nine cases occurred IPN in 211 patients with osteosarcoma, with an incidence of 32.7%. Of the 69 patients, 45 patients (65.2%) with IPN were diagnosed as metastases, and 24 patients (34.8%) with IPN were diagnosed as benign nodules. Follow-up length ranged from 1 to 124 months, with the median follow up time 43 months. To the end of follow-up, 41 patients (59.4%) remained alive and 28 patients (40.6%) had died. The median survival time was 41.0 (20.0, 65.0) months and the median survival time after diagnosis of IPN was 25.0 (10.0, 43.0) months. There were significant differences in lung nodule density ( P<0.001), boundary ( P=0.002), history of recurrence/extra-pulmonary metastasis ( P=0.023) and chemotherapeutic effect ( P<0.001) between the metastasis pulmonary nodules group and the benign nodules group. Multivariate survival analysis showed that chemotherapeutic effect was an independent factor affecting the overall survival of patients [ HR=0.048, 95% CI (0.01, 0.26)]. Boundary definition [ HR=0.12, 95% CI (0.02, 0.93)] and chemotherapeutic effect [ HR=0.06, 95% CI (0.01, 0.29)] were independent factors influencing survival after diagnosis of IPN. Conclusion:Osteosarcoma patients with IPN have a poor prognosis. The poor effect of chemotherapy is an independent risk factor for the overall survival time of those patients and the survival time after diagnosis of IPN. The boundary definition of IPN is an independent risk factor for the survival time after diagnosis of IPN.