Objective:To investigate the effects of CT images reconstructed using different field of view (FOV) sizes on the automatic segmentation of organs at risk and dose calculation accuracy in radiotherapy after radical mastectomy.Methods:Under the same scanning conditions, CT values-electron density conversion curves were established by reconstructing the original CT images of a phantom placed at the isocenter and extended FOV (eFOV) positions using FOV sizes of 50, 60, 70 and 80 cm. Then, these curves were compared. A standard phantom with a known volume was scanned, and the automatic segmentation result of the phantom on CT images reconstructed using different FOV sizes was compared. A total of 30 patients in Guangdong Second Provincial General Hospital from January 2020 to June 2022 with breast cancer were randomly selected. Through simulated positioning, their CT images were reconstructed using different FOV sizes for the purpose of automatic segmentation of organs at risk, followed by comparison between the outcomes of automatic segmentation and physicians′segmentation. The treatment plan established based on CT images reconstructed using a FOV size of 50 cm (FOV 50 images for short) was applied to CT images reconstructed using FOV sizes of 60, 70 and 80 cm (FOV 60, FOV 70 and FOV 80 images for short) for dose calculation, and the dose calculation result were compared. Results:The CT values - electron density conversion curves derived from CT images reconstructed using different FOV sizes were roughly consistent. At the isocenter, the difference between the segmented volume and actual volume of the standard phantom increased up to a maximum of 6 cm 3 (4.8%) with an increase in the FOV size. As indicated by the automatic segmentation result, the segmentation accuracy of the spinal cord, trachea, esophagus, thyroid, healthy mammary gland, and skin decreased with an increase in the FOV size ( t = -28.43-8.23, P < 0.05). The comparison of dose calculated based on CT images reconstructed using different FOV sizes showed that there was no statistically significant differences( P>0.05) in the dose to target volume ( V95) and the maximum and average doses in the supraclavicular lymph node region, as well as the dose to organs at risk. The coverage for planned target volume decreased with an increase in the FOV size, with a maximum difference of 4.06%. Conclusions:It is recommended that, for radiotherapy after radical mastectomy, FOV 50 images should be selected for the automatic segmentation of organs at risk, CT-values-electron density conversion curves should be established based on the electron density phantom images of the eFOV region, and the eFOV 80 images should be preferred for dose calculation.

Objective:To explore the effects of Rougan Huaxian Granules combined with nucleoside antiviral drugs on liver and kidney function, portal hemodynamics, vascular activity, antiviral indexes and aspartate transaminase-platelet ratio index in patients with hepatitis B decompensated cirrhosis.Methods:A case-control study was conducted on 150 patients with hepatitis B decompensated cirrhosis who were hospitalized in Tangshan Infectious Disease Institute and Affiliated Hospital of North China University of Science and Technology from June 2017 to December 2019 were enrolled. The patients were divided into control group and observation group by computer random random number method, with 75 cases in each group. The control group was given routine liver protection and antiviral treatment; the observation group was given Rougan Huaxian granules on the basis of the control group treatment. Observe the changes of liver and kidney function, portal vein system hemodynamics, vascular activity, antiviral index and aspartate transaminase-platelet ratio index in the two groups. Independent sample T test was used to compare the measurement data between the two groups, paired T test was used for comparison between the same groups before and after treatment, and χ2 test was used for counting data. Results:There were no significant differences in gender, age, course of cirrhosis, Child grade of liver function and baseline data of indexes before treatment between 2 groups (ALL P>0.05). After treatment, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen, creatinine,diameter of portal vein (Dpv), diameter of splenic vein (Dsv), endothelin-1, nitric oxide, glucagon (GLA), APRI,were all lower than before treatment. Comparison between groups, observation group ALT (51.60±15.97) U/L, AST (62.65±26.28) U/L, urea nitrogen (10.25±1.65) mmol/L, creatinine (78.54±14.09) μmol/L, Dpv (10.20±1.10) mm, Dsv (8.08±0.68) mm, endothelin-1 (31.93±6.35) ng/L, nitric oxide (41.38±8.06) μg/L, GLA (69.54±12.14) mg/L, APRI (3.14±1.35), were significantly lower than those of control group ((97.49±30.87) U/L, (96.03±25.63) U/L, (17.49±2.55) mmol/L, (116.43±22.77) μmol/L, (13.42±1.26) mm, (10.44±0.83) mm, (44.34+11.88) ng/L, (63.47±15.50) μg/L, (107.11+25.29) mg/L, (5.91±1.93)), the differences were statistically significant ( t values were respectively 11.43, 7.87, 20.64, 12.26, 16.62, 18.99, 7.98, 10.96, 11.60, 10.23, all P<0.05). After treatment, albumin, portal vein velocity (Vpv), and velocity of splenic vein blood flow (Vsv) were all higher in the two groups than before treatment. However, there was no significant difference in Vsv of the control group before and after treatment ( t=0.51, P=0.613). Comparison between groups, albumin (39.42±7.35) g/L, Vpv ((25.72±4.06) cm/s), Vsv ((24.22±6.15) cm/s) in the observation group were significantly higher than those in the control group (34.66±7.95) g/L, (19.38±3.46) cm/s, (19.54±5.88) cm/s ( t values were 3.81, 10.28, 4.76, all P<0.05). After treatment, the total effective rate (96.00%(72/75) vs. 86.67%(65/75), χ2=4.13, P=0.042), HBV DNA negative conversion rate (76.00%(57/75) vs. 58.67%(44/75), χ2=5.12, P=0.024), HBeAg negative conversion rate (50.67%(38/75) vs. 30.67%(23/75), χ2=6.22, P=0.013) and serum HBeAg/HBeAb conversion (28.00%(21/75) vs. 13.33%(10/75), χ2=4.92, P=0.027) in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). HBsAg negative rate (8.00%(6/75) vs. 5.33%(4/75), χ2=0.43, P=0.513) was higher than that of control group, but the difference was not statistically significant ( P>0.05). Conclusion:Rougan Huaxian Granules combined with nucleoside antiviral drugs has significant effect on patients with decompensated liver cirrhosis of hepatitis B, improve liver and kidney function, liver fibrosis and hemodynamics of the portal vein system, increase vascular activity function, and reduce hepatitis B virus (HBV) DNA load, HBV replication, aspartate transaminase-platelet ratio index, APRI, Toll-like receptor (TLR-4) and transforming growth factor β1 (TGF-β1) levels and improves the body′s immune status.

Dental hard tissues lack the ability to self-heal. In dentin and cementum, hydroxyapatite (HA) can exist outside and/or inside collagen fibers. It is difficult to repair or regenerate HA with a highly ordered orientation in the presence of collagen fibers. At present, the biomimetic mineralization of dentin and cementum, mainly carried out by imitating its biological formation process and its physiological structure, can be divided into those originating from the fiber mineralization mechanism and those with HA as the main component. The materials used include natural materials such as demineralized dentin matrix (DDM) and calcined bovine hydroxyapatite (BHA), and synthetic materials such as polymer-induced liquid precursor (PILP) and synthetic HA. In the future, natural materials and synthetic materials should be combined for the restoration and regeneration of dentin and cementum by means of biomimetic mineralization of calcium phosphate released by remineralization solution-HA.

Objective:To observe the effect of narrow band ultraviolet B (NB-UVB) treatment of patients with psoriasis vulgaris on the expression of Wnt5a and Frizzled2 signaling molecules and its relationship with skin lesions so as to explore the mechanism of treating psoriasis vulgaris with NB-UVB.Methods:Thirty-two patients with psoriasis vulgaris and 30 healthy volunteers were selected into a case group and a healthy control group. The case group was treated with NB-UVB irradiation for 8 weeks. The mRNA and protein associated with Wnt5a and Frizzled2 signaling molecules in the skin tissues of both groups were detected before and after the phototherapy using a reverse transcription-polymerase chain reaction and western blotting respectively. Psoriasis area and severity index(PASI) scores were recorded before and after the treatment for the case group, and the correlation between Wnt5a and Frizzled2 protein content and PASI score was analyzed.Results:Before the treatment the expression of Wnt5a and Frizzled2 molecular mRNA and protein in the lesioned area of the case group was significantly higher than in the healthy area of the case group and in the healthy group. It had decreased significantly after the treatment. Before the treatment, the expression of Wnt5a and Frizzled2 protein in the lesioned area was significantly and positively correlated with the severity of the disease. However, after the NB-UVB treatment, the average PASI score was significantly decreased. The expression of Wnt5a and Frizzled2 protein in the lesioned area was still significantly and positively correlated with the severity of the disease.Conclusion:NB-UVB irradiation can significantly reduce the mRNA and protein expression levels of Wnt5a/Frizzled2 signaling molecules in the lesions of patients with psoriasis vulgaris, which may be one of the mechanisms of NB-UVB in treating psoriasis.

OBJECTIVE: To investigate the effect of obstructive sleep apnea (OSA) on different sleep stages, and the relationship between N3 stage of non-rapid eye movement sleep and respiratory abnormal events. METHODS: A total of 188 adult patients who underwent overnight polysomnography(PSG)monitoring in Sir Run Run shaw Hospital of Zhejiang University from June 24th to December 26th 2019 were enrolled in the study. OSA patients were classified into 3 groups (mild, moderate and severe) according to the apnea-hypopnea index (AHI). PSG data, AHI and the lowest SPO in each stage of sleep were compared among three groups. RESULTS: There was no significant difference in total sleep time and sleep efficiency among patients with different severity of OSA (all >0.05). The proportion of N3 stage in moderate and severe OSA groups were significantly smaller than that in mild OSA group (all <0.05). The proportion of N3 stage in severe OSA group was also smaller than that in moderate OSA group (<0.05). In addition, severe OSA group had a longer latency of N3 stage than mild and moderate OSA groups (all <0.05). The latency of N3 stage in moderate OSA group was longer than that in mild OSA group (<0.05). The AHI in N3 stage was markedly lower than that in other sleep stages (all <0.01), regardless of the severity of OSA. Supine AHI in N3 stage in mild and moderate groups was significantly lower than that in N1, N2 and rapid eye movement (REM) stages (all <0.01). Supine AHI in N3 stage in severe group was also lower than that in N2 and REM stages (<0.05 or <0.01). The lowest SPO in N3 stage was significantly higher than that in N1, N2 and REM stages (<0.05 or <0.01), regardless of the severity of OSA. CONCLUSIONS s The proportion of N3 stage is lower in OSA patients, and N3 stage has less sleep respiratory events than non-N3 stages. The results suggest that the increased N3 stage proportion may indicate less severity of OSA.

In recent years, molecular diagnostics has been the most promising branch of
Humans ; Microfluidics ; Molecular Diagnostic Techniques/instrumentation* ; Pathology, Molecular/instrumentation*

Objective To investigate the correlation between CT manifestations of intramural vascular abnormalities and pathological subtypes,ground glass types in ground-glass opacity (GGO) lung adenocarcinoma.Methods CT data of 50 patients (55 lesions) with GGO lung adenocarcinoma confirmed by operative pathology were analyzed.The vascular morphology was observed.Correlation between vascular abnormalities (vascular thickening and hyperplasia) and pathological subtypes,ground glass types in GGO lung adenocarcinoma were analyzed.Results Among 55 GGO lung adenocarcinoma lesions,5 were pre-invasive lesions,no vascular thickening was observed,whereas vascular increasing was noticed in 1 lesion.Among 16 minimally invasive adenocarcinomas (MIA),vascular thickening and vascular increasing were observed in 11 and 16 lesions,respectively.All 34 invasive adenocarcinomas (IAC) were found with vascular thickening and increasing.The overall difference of vascular thickening and vascular increasing among pre-invasive lesions,MIA and IAC was statistically significant (x2 =27.67,20.08,both P＜0.05).There was positive correlation between pathological subtypes and vascular thickening and vascular increasing (r=0.61,0.66,P＜0.01).Significant differences of vascular thickening were found between pre-invasive lesions and MIA (x2=9.19,P=0.01),pre-invasive lesions and IAC (x2 =29.87,P＜0.01),as well as MIA and IAC (x2 =12.63,P＜0.01).There were significant differences of vascular increasing between pre-invasive lesions and MIA,pre-invasive lesions and IAC (x2 =15.45,20.79,both P＜0.01).Of all 55 GGO lung adenocarcinoma lesions,25 were pGGO,17 with vascular thickening and 21 vascular increasing;30 were mGGO,28 with vascular thickening and 30 vascular increasing.There were significant differences of vascular thickening and increasing in pGGO and mGGO (x2=6.12,6.69,both P＜0.05).Conclusion Vascular abnormalities in GGO lung adenocarcinoma suggest increasing of invasion.Vascular thickening and increasing can occur independently.

High dose grid radiotherapy ( GRID ) refers to a single fraction of high-dose radiation ( 10-25 Gy) in which, beams are divided into multiple small beam lets through a grid collimator or MLC, resulting in non-uniform dose distribution of high and low dose area ("peak-to-valley" effect) in the target volume. Recently, as 3D radiotherapy ( 3DRT) technology emerged, the 2D GRID has been reconfigured into 3D dose LATTICE whereby high doses are concentrated at each lattice vertex within the radiation target volume with drastically lower dose between vertices through multiple focused non-coplanar beams with different radiation techniques. Compared with 2D GRID therapy, 3D LATTICE shows significant effect on"peak-to-valley" and minimizes radiation to surrounding tissues. Experimental and clinical data have shown that LATTICE therapies can reduce toxicity to normal tissue while stimulating bystander effects, endothelial cell death and immunogenic abscopal effects leading to enhanced killing of tumor cells and further improve the control of the local and distant disease. The clinic experience with LATTICE, although limited, has demonstrated favorable outcomes, especially for treating bulky tumors and palliative intend. The exact mechanism of the clinical advantages by LATTICE is not explicitly known and a more comprehensive biological study and clinical trials are called should be carried out.

Objective To study the characteristics of Chinese ischemic stroke subclassification (CISS) in relation with migration to different climatic zones in autumn and winter.Methods Ninety-six subjects who travelled from northeast China,northwest China and north China to Hainan Province from September 2012 to February 2017 and were admitted to our hospital due to cerebral infarction occurred within 3 weeks after they arrived at Hainan were included in this study.Their demographic data,risk factors for cerebrovascular disease,laboratory blood test and imaging parameters were recorded.The patients were classified according to their medical history,auxiliary examination findings and CISS.The recorded data were statistically analyzed.Results CISS showed that penetrating artery disease,large artery atherosclerosis,cardiogenic stroke,and undetermined etiology accounted for 50.0％,38.5％,4.2％,7.3％ respectively.Hypertension (70.8 ％) and abnormal glucose metabolism (61.5％) were the major risk factors for cerebral in farction.Conclusion The incidence of penetrating artery disease is the highest,followed by that of large artery atherosclerosis in cerebral infarction patients.Alert to cerebral infarction should thus be stressed for those with hypertension and abnormal glucose metabolism who are going to travel in autumn and winter.