Objective:To validate the feasibility of a deep learning-based clinical target volume (CTV) auto-segmentation algorithm for cervical cancer in clinical settings.Methods:CT data sets from 535 cervical cancer patients were collected. CTVs were delineated according to RTOG and JCOG guidelines, reviewed by experts, and then used as reference contours for training (definitive 177, post-operative 302) and test (definitive 23, post-operative 33). Four definitive and 6 post-operative cases were randomly selected from the testing cohort to be manually delineated by junior, intermediate, senior doctors, respectively. Dice coefficient (DSC), mean surface distance (MSD) and Hausdorff distance (HD) were used for test and comparison between auto-segmentation and RO delineation. Meantime, auto-segmentation time and manual delineation time were recorded.Results:Auto-segmentation models of dCTV 1, dCTV 2 and pCTV 1 were trained with VB-Net and showed good agreement with reference contours in the testing cohorts (DSC, 0.88, 0.70, 0.86 mm; MSD, 1.32, 2.42, 1.15 mm; HD, 21.6, 22.4, 20.8 mm). For dCTV 1, the difference between auto-segmentation and all three groups of doctors was not significant ( P>0.05). For dCTV 2 and pCTV 1, auto-segmentation was better than the junior and intermediate doctors (both P<0.05). Auto-segmentation time consumption was considerably shorter than that of manual delineation. Conclusions:Deep learning-based CTV auto-segmentation algorithm for cervical cancer achieves comparable accuracy to manual delineation of senior doctors. Clinical application of the algorithm can contribute to shortening doctors′ manual delineation time and improving clinical efficiency. Furthermore, it may serve as a guide for junior doctors to improve the consistency and accuracy of cervical cancer CTV delineation in clinical practice.

Glaucoma is a neurodegenerative disease characterized by progressive and irreversible necrosis and apopto-sis of retinal ganglion cells.The abnormal activation of microglia,astrocytes and Müller cells in the central nervous system of the retina and macrophages,T/B lymphocytes and regulatory T cells in the peripheral immune system is involved in the pathogenesis of glaucoma,and the secretion of inflammatory factors such as interleukin 6 and interleukin 8 is closely relat-ed to the development of glaucoma.In this paper,the role of immune cells of the central nervous system and peripheral im-mune system of the retina and the inflammatory factors they secreted in the development of glaucoma is reviewed,in order to understand the pathogenesis of glaucoma at the cellular and molecular levels and to provide ideas for exploring new treatment methods.