Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Objective To evaluate the clinical efficacy of buccal acupuncture combined with tuina in treating frozen shoulder and explore its potential mechanism of action.Methods Sixty-four patients diagnosed with frozen shoulder were enrolled from the Rehabilitation Department of Qingyuan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine between May 2024 and December 2024.Patients were randomly divided into an observation group and a control group using a random number table,with 32 cases in each group.The control group received traditional Chinese tuina therapy,while the observation group received additional buccal acupuncture treatment.Three treatment sessions constituted one course,with a total of two courses administered.Clinical efficacy was evaluated after treatment,and the Visual Analogue Scale(VAS)scores for shoulder pain,Constant-Murley Shoulder Score(CMS),and Hamilton Anxiety Scale(HAMA)scores were observed before and after intervention.Serum levels of interleukin 6(IL-6)and C-reactive protein(CRP)were also compared.Results(1)After treatment,the total effective rate of the observation group was 93.75%(30/32),and that of the control group was 75.00%(24/32),and the efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the VAS scores of patients in the two groups were significantly reduced(P＜0.05),and the observation group was significantly superior to the control group in improving the patients'VAS scores,with a statistically significant difference(P＜0.05).(3)After treatment,the CMS scores of patients in the two groups were significantly increased(P＜0.05),and the observation group was significantly superior to the control group in improving patients'CMS scores,with statistically significant differences(P＜0.05).(4)After treatment,the HAMA scores of patients in the two groups were significantly increased(P＜0.05),and the observation group was significantly superior to the control group in improving patients'HAMA scores,with statistically significant differences(P＜0.05).(5)After treatment,the IL-6 and CRP levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the IL-6 and CRP levels,and the difference was statistically significant(P＜0.05).Conclusion The combination of buccal acupuncture and traditional Chinese tuina therapy significantly alleviates shoulder pain,improves shoulder joint function,reduces anxiety,and decreases inflammatory markers IL-6 and CRP in patients with frozen shoulder,demonstrating notable clinical efficacy.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Objective:To investigate the mechanism of immunomodulatory effects of umbilical cord mesenchymal stem cells(UC-MSCs)modified by miR-125b-5p on systemic lupus erythematosus(SLE).Methods:The expression level of miR-125b-5p was detected by real-time fluorescence quantitative PCR in UC-MSCs and peripheral blood mononuclear cells(PBMCs)from SLE patients and health checkers.Annexin V-FITC/PI apoptosis detection kit was used to detect the effect of miR-125b-5p on apoptosis of UC-MSCs.MRL/lpr mice in each group were injected with UC-MSCs via tail vein,and T-lymphocyte subsets in the spleen of the MRL/lpr mice were detected by flow cytometry after 5 weeks.The expression levels of interleukin(IL)-4 and IL-17A in serum of MRL/lpr mice were detected by ELISA.Hematoxylin-eosin staining was used to observe the pathological manifestations of the lungs and kidneys of the MRL/lpr mice.Results:miR-125b-5p was significantly down-regulated in PBMCs of SLE patients compared with healthy controls(P＜0.01).Compared with the UC-MSCs group,the expression of miR-125b-5p in UC-MSCs modified by miR-125b-5p group was increased(P＜0.01).The survival rate of UC-MSCs was significantly increased by miR-125b-5p(P＜0.01).Compared with the untreated group of MRL/lpr mice,the expression level of IL-4 in serum was increased(P＜0.05);the expression level of IL-17A was decreased(P＜0.05);the proportion of Th17 cells in the spleen of MRL/lpr mice was decreased(P＜0.05);the inflammatory cells infiltration and micro-thrombosis of lungs and kidneys of MRL/lpr mice were significantly reduced in the UC-MSCs modified by miR-125b-5p treatment group.Conclusion:UC-MSCs modified by miR-125b-5p have immunomodulatory effects on systemic lupus erythematosus.

This paper analyzed and discussed 3 cases of the occupational diseases diagnosis and identification of obstructive ventilation disorder caused by chronic butanedione exposure. 3 patients developed recurrent cough 3 months to 2 years after occupational exposure to butanedione. After the activity, the chest tightness and shortness of breath were the main symptoms. Pulmonary function tests presented with ventilatory dysfunction. And the patients were diagnosed as obstructive pulmonary disease caused by occupational chronic butanedione poisoning. It is suggested that butanedione could cause lung ventilation function injury, and provided a basis for the formulation of butanedione occupational exposure limit value and occupational disease diagnosis standard in China.

This paper analyzed and discussed 3 cases of the occupational diseases diagnosis and identification of obstructive ventilation disorder caused by chronic butanedione exposure. 3 patients developed recurrent cough 3 months to 2 years after occupational exposure to butanedione. After the activity, the chest tightness and shortness of breath were the main symptoms. Pulmonary function tests presented with ventilatory dysfunction. And the patients were diagnosed as obstructive pulmonary disease caused by occupational chronic butanedione poisoning. It is suggested that butanedione could cause lung ventilation function injury, and provided a basis for the formulation of butanedione occupational exposure limit value and occupational disease diagnosis standard in China.

Objective:To preliminarily evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic tumors from head and neck carcinoma.Methods:Clinical data of 24 patients with pulmonary oligometastasis from head and neck carcinoma undergoing SBRT in Zhejiang Cancer Hospital from January 2014 to May 2019 were retrospectively analyzed. Survival analysis was performed by Kaplan- Meier method. Results:Among the 24 patients, 12 cases were diagnosed with nasopharyngeal origin and 12 cases of non-nasopharyngeal origin. A total of 34 pulmonary metastatic lesions were treated with SBRT. The median follow-up time was 19.5 months. Thirteen cases developed new lesions after SBRT, and 9 of them occurred within 1 year after SBRT treatment. The actual 1-year local control rate was 95%. The median progression-free survival was 15.2 months, and the 1-and 2-year progression-free survival were 59% and 46%, respectively. The 2-and 3-years overall survival rate at were 71% and 51% fter lung metastasis, respectively. Univariate analysis showed that the patients with primary lesions located in nasopharynx and disease-free interval of more than 1 year had survival advantage. No more than grade 3 radiation-induced injury was observed in the whole cohort after SBRT, and the incidence of mild radiation-induced injury was 13%.Conclusions:SBRT is safe and effective in the treatment of pulmonary oligometastatsis from head and neck carcinoma, and it may be more effective for patients with primary tumors located in nasopharynx.

Objective:To study the correlation between occupational radiation exposure and chronic metabolic diseases.Methods:The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure.Results:Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group.Conclusion:Long-term exposure to IR increases the risk of chronic metabolic diseases.

Objective:To study the correlation between occupational radiation exposure and chronic metabolic diseases.Methods:The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure.Results:Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group.Conclusion:Long-term exposure to IR increases the risk of chronic metabolic diseases.

Objective: To evaluate the value of two oral mucosal contouring methods for predicting acute radiation-induced oral mucositis (A-ROM) in nasopharyngeal carcinoma (NPC) patients. Methods: A total of 150 AJCC 7^th stage Ⅱ-IVB NPCs receiving radical tomotherapy (TOMO) in Zhejiang Cancer Hospital from 2017 to 2019 were included in this prospective observational study. Oral cavity contour (OCC) and mucosal surface contour (MSC) were applied to delineate the oral mucosal structure. A-ROM grade was prospectively assessed and recorded weekly according to RTOG scoring criteria. The prediction value of two methods for A-ROM was statistically compared. Results: The incidence rate of ≥3 grade A-ROM was 33.3%. In univariate analysis, V₅, V₁₀, V₁₅, V₄₅, V₅₀, V₅₅, V₆₀, V₆₅ and V₇₀ of OCC and V₅, V₁₀, V₅₀, V₅₅, V₆₀, V₆₅, V₇₀ and D_mean of MSC were significantly correlated with the risk of ≥3 grade A-ROM (all P<0.05). In binary logistic regression analysis, gender and smoking were significantly associated with the incidence of ≥3 grade A-ROM by using OCC (male vs. female: OR=0.141, 95%CI=0.037-0.538, P=0.004; smoking vs.non-smoking: OR=5.109, 95%CI=1.413-18.470, P=0.013). For MSC, gender, smoking, N stage and MSC- V₅₅ were the independent predictors (male vs. female: OR=0.129, 95%CI=0.032-0.519, P=0.004; smoking vs.non-smoking: OR=4.448, 95%CI=1.224-16.164, P=0.023; N stage: OR=2.291, 95%CI=1.268-4.137, P=0.006; MSC-V₅₅: OR=1.432, 95%CI=1.008-2.033, P=0.045). The cutoff value of MSC-V₅₅ was 7.70%, the area under ROC curve was 0.754, the sensitivity and specificity were 0.680 and 0.740, retrospectively (all P<0.001). Conclusions Compared with OCC, MSC yields a higher prediction accuracy for the severity of A-ROM in nasopharyngeal carcinoma patients receiving TOMO treatment.