At present, nonalcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases in the world. With the development of the bio-psycho-social medical model, the mental health problems of patients with NAFLD are gradually attracting more and more attention. In recent years, more and more studies have been conducted on the association between NAFLD and psychiatric diseases, especially depression. Studies have shown that there is a significant correlation between NAFLD and depression; however, the common pathophysiological mechanism of such correlation is still unclear and further studies are needed to determine their causal relationship and treatment. This article reviews the research advances in the association between NAFLD and depression, common pathophysiological mechanism, and treatment, so as to lay a foundation for further research on these two disease and help with their prevention and treatment in future clinical practice.

With the rapid change in lifestyle in recent years, the prevalence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year and it has gradually become one of the major causes of chronic liver diseases. With the development of the bio-psycho-social medical model, the influence of psychological diseases on physical diseases has attracted the attention of scholars. At present, evidence has shown that anxiety, as one of the most common type of mental disorders, may be associated with the development of NAFLD. This article introduces the current status of research on anxiety and NAFLD and their common influencing factors and predicts the possible pathophysiological mechanism of NAFLD caused by anxiety, so as to lay a foundation for further research on the association between anxiety and NAFLD and provide new directions for the treatment of NAFLD.

Objective To evaluate the safety and effectiveness of ultra-hypofractionated stereotactic body radiotherapy in the treatment of prostate cancer.Methods A total of 26 patients with prostate cancer treated with Cyber-Knife from May 2010 to May 2018 were analyzed retrospectively.The median age of the patients was 69 years old (range,57 to 87).Ultra-hypofractionated radiotherapy was delivered in five fractions of 7.0-7.5 Gy for a total dose of 35.0-37.5 Gy.Androgen deprivation therapy (ADT) was administered in combination with the Cyber-Knife.The primary endpoints were radiation toxicity,PSA-response,local control and symptom alleviation,while the secondary endpoints were progression-free survival and overall survival.Results No graded ≥ 3 acute and late radiation toxicities occurred during follow-up.The acute toxicity of Grades 1 and 2 was 38.4％ and 19.2％,while the late toxicity of Grades 1 and 2 was 30.8％ and 3.8％,respectively.At a median follow-up of 22.44 months,for patients with localized stage,PSA level was decreased significantly after radiotherapy (Z =2.900,2.794,2.510,2.090,P＜0.05).However,there was no statistically significant difference for the metastatic group (P＞ 0.05).Conclusions Ultra-hypofractionated stereotactic body radiotherapy is a safe and effective treatment for patients with prostate cancer.

Objective: To compare the dosimetrics of the plan target volume (PTV) and organs at risk (OARs) between two treatment planning approaches for patients with multiple brain metastases from non-small cell lung cancer on CyberKnife. Methods: 20 patients with multiple metastases from lung carcinoma were reviewed and analyzed, who had been treated by CyberKnife from December 2017 to December 2018. The CyberKnife stereotactic radiotherapy plans of the 20 cases were re-planed with single plan for multiple lesions and multiple plans per lesion. The dosimetry differences of PTV and OARs isodose disribution, conformity index (CI), total beam counts and total monitor units (MUs) were compared in the two types of plans. Results: The two types of plans could satisfy over 95% PTV coverage of the prescription dose. The maximum and mean dose of normal brain adjacent to the PTV were reduced in multiple plan approach effectively. Moreover, the maximum and mean dose of OARs (brainstem) dropped by 1.62% and 5.57% (t=1.09, P<0.01) respectively. The number of treatment nodes and total MU declined by 4.63% (t=1.87, P<0.01)and 1.06% in multiple plan approach, which could significantly shorten the clinical treatment time. The differences in CI index between these two types of plans was of no statistical significance. Conclusions For patients with multiple brain metastases of similar diameter and volume from non-small cell lung cancer to be treated on CyberKnife, multiple plans per lesion could not only reduce dose to normal brain tissue and OARs, but also improve the treatment efficiency.

Objective:The quality of domestic diagnostic accuracy research was evaluated to explore the quality level of domestic diagnostic accuracy research based on Standards for Reporting of Diagnostic Accuracy 2015 (STARD2015).Methods:The Chinese core journals of CNKI and Wanfang Database were searched, and research literature on diagnostic accuracy published from 2017 to 2022 were collected. The main search terms are diagnostic test, sensitivity, specificity, receiver operating characteristic (ROC) curve, etc. The literature was selected according to the inclusion criteria, and the quality of the included literature was evaluated independently by two reviewers, and the conformity rate of the STARD2015 report and the STARD2015 article was calculated. The report quality of the literature was divided into three levels (low, medium and high) according to the conformity rate of the STARD2015 report. The proportion of literature at each level and the proportion of literature at medium and high level in each year were counted. According to quality analysis on the contents of the included articles, articles were divided into standardized reports and unstandardized reports. Intragroup correlation coefficient ( ICC) was used to analyze the consistency of two reviewers. The trend Chi-square test was used to analyze the trend of the proportion of medium and high level literature in each year. One-way analysis of variance was used to compare the coincidence rates evaluated by STARD2015 for each year. Results:A total of 6 771 studies on diagnostic accuracy published from 2017 to 2022 were included. The compliance rate sccording to STARD2015 was 39.56%±4.90%, and the reported compliance rate ranged from 17.65% to 64.71% (the number of reported items ranged from 6 to 22), and 93.53% (6 333/6 771) literatures were in the middle level. Compliance rate of STARD2015 reports varied significantly among different years ( F=25.023, P<0.01), and the compliance rate of 2021 was significantly higher than that of other years ( P<0.01). The proportion of medium and high level literatures according to STARD2015 showed an increasing trend ( χ 2=14.099, P<0.01). The reporting situation of each item varied significantly, and the conformity rate of items raned from 0 to 100%. According to report item, non-standard report rate was 10.34% (569/5 503) for item 6, 4.15% (277/6 677) for item 8, 21.84% (1 447/6 626) for item 20, 66.67% (24/36) for item 22, and 26.03% (877/3 369) for item 26. Conclusions:The overall report quality of published domestic literature on diagnostic accuracy from 2017 to 2022 is at a medium level according to STARD2015, and the reports conformity rate of each item vary significantly, indicating significant knowledge gap on STARD2015 among domestic researchers. The promotion of STARD2015 needs to be strengthened.

Objective:To provide a new morning check method for the output dose stability of the multileaf collimator (MLC) of the CyberKnife M6 (CK-M6) system.Methods:The CT images of a verification phantom with a size of 20 cm × 20 cm × 10 cm were transmitted into the Precision Treatment Plan ning System (ver. 1.1.1.1). The high-precision alignment between the accelerator output front and the fixed position of the phantom surface was achieved using the fiducial tracking method. A 10 cm × 10 cm radiation field was formed by the MLC and a DailyCheck plan with an output of 200 MU was designed. The repeatability, sensitivity, and accuracy of the DailyCheck plan were measured, and the CK-M6 system was continuously tested for one month using the artificial fixed method and the DailyCheck plan designed in this study. Results:The average and the standard deviation of 10 repeated measurements by the DailyCheck plan were 492.28 pC and 0.09, respectively, indicating good stability. There was a linear correlation between the measured values and the output dose, with a correlation coefficient of R2 > 0.999. Moreover, there was a position deviation of 2 mm between the phantom and the accelerator output front, and the result ant effect on the measured values was equivalent to a dose deviation caused by an output of 1.24 MU. The result from the continuous measurement of both the artificial fixed method and the DailyCheck plan fell within permissible limits, showing high consistency. Conclusions:The DailyCheck plan established through the fiducial tracking of a verification phantom can achieve the convenient, quick, and accurate daily detection of the output dose stability of the MLC of CK-M6. Therefore, this method can be widely applied in the clinical quality control of the CK-M6 system.

Objective To analyze the radiation dose to the normal lung tissue of patients with early stage of non-small cell lung cancer treated by Cyberknife. Methods A retrospective analysis was conducted by summarizing the treatment plans of 264 patients with early stage non-small cell lung cancer from January 2011 to December 2013 in Tianjin Medical University Cancer Institute and Hospital. Sorted by the tumor volumes and locations, the Cyberknife plans were evaluated by means of dose volume histograms ( DVH) , homogeneity indexes ( HI) , percentage volumes receiving at least x Gy ( Vx ) of dose, i. e. , V5 , V10 , V20 , and V30 of the ipsilateral and contralateral lungs. For the tumors approximate to the hilus, the contralateral lungs were included in the optimization process, and the dose-volume metrics were analyzed for the contralateral and bilateral lungs. Results For the tumors close to the chest wall, V5≥(15. 21 ± 3. 12)％ in ipsilateral lung tissue and V5≥(1. 34 ± 0. 67)％ in contralateral lung tissue were observed. For the tumors near the hilus, V5≥(39. 4 ± 11. 90) ％ in ipsilateral lung tissue and V5≥(1. 48 ± 0. 34) ％ in contralateral lung tissue were observed. The irradiated volume ratios of both ipsilateral and contralateral lung tissue increased with the enlargement of tumor sizes. After including the contralateral lung tissue into the optimization, the irradiated volume ratios of the contralateral and bilateral lung tissue (V5,V10) decreasedsignificantly(t=2.44,4.81,3.53,3.17,P<0.05). Conclusions Higherriskof radiation injury in both ipsilateral and contralateral lung tissue can be expected for tumors near the hilus than near the chest wall. After including contralateral lung tissue into the planning optimization, lower dose to the contralateral and whole lung tissue was achieved, indicating a better protection of normal lung tissue.