In recent years, the issue of "reproducibility" of scientific research results has become more and more prominent. Radiobiology is a medical science that studies the biological effect of radiation on living organisms, and there is also a serious problem of "reproducibility of findings". Inaccuracy of physical dose or incomplete dosimetric reports is one of the main causes. Use of guidelines, specifications and recommendations for dosimetric measurement, such as the standardized scoring system for dosimetric reports, will help improving the standardization and accuracy of physical dose measurement in radiobiological research. In this article, multiple guidelines and recommends for improving collaboration between radiobiology and radiation physics, as well as for dose standardization of radiobiological research were evaluated, aiming to provide reference for improving the reproducibility of radiobiological research.

Objective: To investigate the epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021, so as to provide insights into the prevention and control of overseas imported arthropod-borne infectious diseases. Methods: The data pertaining to imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 were collected from the Chinese Disease Prevention and Control Information System, and the temporal distribution, regional distribution, population distribution, sources, diagnosis and treatment of imported dengue fever and malaria cases were descriptively analyzed. Results: Totally 4 332 overseas imported dengue fever cases and 2 011 overseas imported malaria cases were reported in Yunnan Province form 2015 to 2021, which accounted for 30.09% of all reported dengue fever cases and 98.53% of all reported malaria cases. The number of overseas imported dengue fever and malaria cases peaked from August to November (83.13% of all imported dengue fever cases) and from April to July (59.08% of all imported malaria cases), and the cases were predominantly reported in Dehong Prefecture (50.99% and 58.88%), with farmers as the predominant occupation (40.21% and 67.93%). The dengue fever and malaria cases were mainly imported from Southeast Asia (99.04% and 88.21%), and the proportions of definitive diagnosis of dengue fever and malaria were 88.33% and 97.80% at township hospitals, respectively. Conclusions The number of overseas imported dengue fever and malaria cases peaked from August to November and from April to July in Yunnan Province from 2015 to 2021, and the cases were predominantly reported in Dehong Prefecture and imported from Southeast Asia, with farmers as the predominant occupation.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Image registration is of great clinical importance in computer aided diagnosis and surgical planning of liver diseases. Deep learning-based registration methods endow liver computed tomography (CT) image registration with characteristics of real-time and high accuracy. However, existing methods in registering images with large displacement and deformation are faced with the challenge of the texture information variation of the registered image, resulting in subsequent erroneous image processing and clinical diagnosis. To this end, a novel unsupervised registration method based on the texture filtering is proposed in this paper to realize liver CT image registration. Firstly, the texture filtering algorithm based on L0 gradient minimization eliminates the texture information of liver surface in CT images, so that the registration process can only refer to the spatial structure information of two images for registration, thus solving the problem of texture variation. Then, we adopt the cascaded network to register images with large displacement and large deformation, and progressively align the fixed image with the moving one in the spatial structure. In addition, a new registration metric, the histogram correlation coefficient, is proposed to measure the degree of texture variation after registration. Experimental results show that our proposed method achieves high registration accuracy, effectively solves the problem of texture variation in the cascaded network, and improves the registration performance in terms of spatial structure correspondence and anti-folding capability. Therefore, our method helps to improve the performance of medical image registration, and make the registration safely and reliably applied in the computer-aided diagnosis and surgical planning of liver diseases.
Algorithms ; Humans ; Image Processing, Computer-Assisted ; Liver Diseases ; Tomography, X-Ray Computed

Further healthcare system reform calls for desirable pathway design. This paper introduced the logical framework of the new healthcare system reform pathway design and typical practical experience in Hangzhou.Known for " Internet+Smart healthcare" forerunner, Hangzhou has pioneered the reform of public hospitals and the construction of smart handy service for the public.With the aim of fully protecting the health rights and interests of urban and rural residents, comprehensive policy has been taken to deepen the reform of public hospitals; with the comprehensive promotion of contracted services and the primary level sharing of resources as a carrier, we will build a hierarchical medical service system of vertical linkage.We will also innovate and practice the governing philosophy of " Medicine has its limitations but we have the courage to overcome, service is boundaryless and we must pursue excellence".Promotion of party building in the industry also ranks high.Deepening the reform of " one visit for all" in the field of medical and health services as a measure to enhance people′s sense of gain; The " public-private partnership" to encourage the development of the social governance system and legalization in healthcare proves successful at this stage. However, there are still many challenges in the information security maintenance of smart healthcare, the balance of stakeholder interests in public hospitals, the all-round advancement of hierarchical medical service, standardizing and streamlining the reform of " one visit for all".

Higher service efficiency and better medical experience are main goals of the healthcare system reform.The article explained the logical framework, main actions, initial results of the " one visit for all" reform, which aims at promoting the efficiency of medical services and management in Hangzhou.Policy suggestions are raised, namely involving more people into the governance mechanism, collaboratively optimizing the working process of medical staff, improving the information security mechanism, and perfecting the effectiveness evaluation system.These measures are designed to accelerate the construction of modern hospital management system, and to build a scientific and orderly hierarchical medical system.

Objective To retrospectively analyze the setup error in radiotherapy of somal tumors and body metastases using the ExacTrac X-ray portal image,and to evaluate the feasibility and effectiveness of 6D setup error correction in body radiotherapy.Methods The translational and rotational setup errors were calculated by registering the bony structures on the ExacTrac X-setup images to that of the digitally reconstructed setup images,and the corresponding residual errors were calculated together.Results The translational and rotational setup errors in the x (left-right),y (superior-inferior),z (anterior-posterior) and Rx (sagittal),Ry (transverse),Rz (coronal) directions were(2.27±2.02) mm,(4.49±2.52) mm,(2.27± 1.37) mm and (1.02 ± 0.73) °,(0.67 ± 0.68) °,(0.76 ± 0.84) °,respectively.The residual translational and rotational setup errors in the x(r),y(r),z(r) and Rx(r),Ry(r),Rz(r) directions were(0.27±0.48)mm,(0.37±0.45)mm,(0.22±0.30)mm and (0.17±0.33)°,(0.14±0.34)°,(0.16± 0.28) ° respectively.Conclusions Besides the translational setup errors,a certain amount of rotational setup errors exist in radiotherapy of somal tumors and body metastases.By using the 6D setup error correction of the ExacTrac system,a translational less than 0.4 mm and rotational setup errors less than 0.2° could be achieved.

Objective To evaluate the effect of the thickness and area of the cavity between bolus and skin upon the dose deposition in the shallow tissues.Methods The linear accelerator head model of 6 MV X ray was constructed using Geant4,which simulated the accelerator working condition of 10 cm× 10 cm field and recorded the information of emergent particles as phase space file.A water phantom of 30 × 30 × 30 cm3 was designed at the SAD level.A 30 cm × 30 cm × 1 cm water film was constructed adjacent to or with different cavities to the upper surface of the phantom.The phase space file was utilized as particle source to simulate the particle transport process.The axis depth dose distribution and lateral dose profiles in the center area of the field at a depth of 1 mm,5 mm,9 mm,15 mm and 21 mm of the phantom were obtained,respectively.The simulated data obtained from water film with different cavities were compared with those of adjacent to the water phantom.Results When the cavity was ≤ 5 mm,the cavity exerted slight effect.When the thickness was increased,the maximum dose depth (Dmax) was increased,the PDD at Dmax (PD Dmax) became less,the depth of influenced lateral dose profiles was increased and the dose in the center area was decreased.Along with the increase of cavity area,the Dmax was initially increased and then decreased,the PD Dmax was at first decreased and subsequently increased,the depth of influenced lateral dose profile was initially increased and then decreased,the dose in the center area was first decreased and subsequently increased.The lateral dose profile distant from the cavity or located at a depth ≥ 15 mm was almost not affected by the cavity.Conclusion The thickness of the cavity between bolus and skin should be less than 5 mm and the cavity area should be small as possible.

Objective To establish a novel method of describing the off-axis ratio (OAR) characteristics of the flattening filter-free (FFF) beam.Methods The OAR curves at a depth of 1.5,5,10 and 20 cm were measured for Varian Edge,Elekta VersaHD and Tomotherapy using the water tank.The second derivatives of the OAR in the positive and negative directions were calculated.The center of the line connecting the maximum and minimum second derivatives was defined as the field edge.The distance between the left and right field edges was defined as the dosimetric field size.The OAR curve within the 80％ of dosimetric field size was fitted using the gaussian function and the fitting parameters were adopted to describe the shape of OAR.Results The calculated field size error was less than 0.11 cm and the central axis position error was less than 0.05 cm.The fitting correlation coefficient was greater than O.998.The fitting maximum error of OAR curve did not significantly alter with the depth,whereas slightly increased over the increased field size.The maximum error for a field size of 10,20,30 and 40 cm was 0.49％,0.67％,1.25％ and 2.52％,respectively.Conclusions A method which can independently and accurately describe the OAR characteristics of FFF photon beam is established for the first time,which can calculate the field size of FFF beam and fit the OAR curve of FFF beam using the gaussian function.

Objective To investigate the effect of cavity thickness, area and distance under the bolus upon the dose in the superficial tissues. Methods An accelerator model was constructed based on Geant4.The model accuracy was validated by the comparison of the calculated data with the measured data. A 30×30×30 cm3 water phantom with the upper surface located at the isocenter level and a 30×30×1 cm3 water film were constructed. Different models with the water film close to or different cavities with the water phantom were established. Under the 10×10 cm2 field with 6 MV X-ray beam,the central axis depth dose distribution and the lateral dose profiles at a depth of 0. 1 cm ( profile1) of the models with different cavities were calculated. The calculated data of different model with the water film close to or different cavities with the water phantom were statistically compared. Results When the cavity thickness was ≤ 0. 5 cm, the cavity exerted slight effect upon the depth of maximum dose ( Dmax ) and superficial dose. As the cavity thickness was increased,the Dmax was also increased,the PDD at 0. 1 cm ( PDD1) was decreased rapidly and the profile1 was increased from the cavity center to the edge. Along with the increase of cavity area,the Dmax was initially increased and then decreased,whereas the PDD1 was first decreased followed by an increase. When the cavity area was small,the profile1 was gradually increased from the cavity center to the edge. When the cavity area was large,the profile1 was initially decreased and subsequently increased. When the distance was ≥0. 2 cm,it was qualified for the clinical requirement and it exerted no effect when the distance was≥1. 0 cm. The profile1 distant from the cavity was not affected. Conclusion The cavity under the bolus should be minimized to reduce the cavity thickness,area and distance as possible.