Objective:To compare the accuracy of two-dimensional (2D) ultrasound with three-dimensional (3D) reconstruction and conventional 2D ultrasound in measuring bladder volume in pelvic tumor patients, using computed tomography (CT) as the reference.Methods:A set of bladder phantoms were constructed to compare CT and ultrasound measurements with actual injected volumes. Clinical data of 104 pelvic tumor patients who received radiotherapy at the Cancer Hospital, Chinese Academy of Medical Sciences between August and December 2023 were retrospectively analyzed. Portable transabdominal ultrasound was used to obtain the largest bladder cross-section, and the maximum diameters in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions (D LR, D AP, D SI) were measured. The 2D ultrasound volume was calculated as V=0.523 × D LR × D AP × D SI. Full-bladder transverse videos were recorded and processed in Matlab R2016a through frame extraction(60 images), followed by contrast enhancement, edge detection segmentation, cubic spline interpolation, and image smoothing to achieve 3D reconstruction. Paired t-tests, intraclass correlation coefficients (ICC), and Bland-Altman analyses were performed to assess systematic bias and consistency between ultrasound methods and CT. Multivariate linear regression was applied to evaluate the effects of slice thickness, posture, age, and other factors on CT measurements. Results:In the phantom study, deviations of 2D ultrasound and CT from actual injected volumes were (0.73±3.05) ml ( t=-0.48, P=0.667) and (1.52±11.27) ml ( t=0.17, P=0.875), with ICC values>0.999. In the clinical study, mean bladder volumes measured by 3D-reconstructed ultrasound, conventional 2D ultrasound, and CT were (373.5±153.31), (314.89±135.28), (382.82±157.57) ml, respectively. The 3D-reconstructed method showed excellent agreement with CT (ICC=0.98; Bland-Altman mean bias=-9.32 ml, P=0.096), while 2D ultrasound also showed good consistency (ICC=0.91), but significantly underestimated bladder volume (mean bias=-67.93 ml, P<0.001). Subgroup analysis revealed that 2D ultrasound had the best agreement with CT in the medium-volume group (200-500 ml, ICC=0.902), whereas agreement decreased in the small-volume (<200 ml, ICC=0.884) and large-volume (>500 ml, ICC=0.840) groups (all P<0.001). The 3D-reconstructed ultrasound maintained excellent consistency with CT across all subgroups (all ICC>0.95), and the measured bladder volume was not statistically significant. Multivariate regression showed that slice thickness, posture, age, sex, and surgical status had no significant effects on CT measurements. Conclusions:Ultrasound with 3D reconstruction enables accurate bladder volume monitoring through true 3D contour reconstruction, while conventional 2D ultrasound systematically underestimates bladder volume and requires correction.

Objective:To compare the accuracy of two-dimensional (2D) ultrasound with three-dimensional (3D) reconstruction and conventional 2D ultrasound in measuring bladder volume in pelvic tumor patients, using computed tomography (CT) as the reference.Methods:A set of bladder phantoms were constructed to compare CT and ultrasound measurements with actual injected volumes. Clinical data of 104 pelvic tumor patients who received radiotherapy at the Cancer Hospital, Chinese Academy of Medical Sciences between August and December 2023 were retrospectively analyzed. Portable transabdominal ultrasound was used to obtain the largest bladder cross-section, and the maximum diameters in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions (D LR, D AP, D SI) were measured. The 2D ultrasound volume was calculated as V=0.523 × D LR × D AP × D SI. Full-bladder transverse videos were recorded and processed in Matlab R2016a through frame extraction(60 images), followed by contrast enhancement, edge detection segmentation, cubic spline interpolation, and image smoothing to achieve 3D reconstruction. Paired t-tests, intraclass correlation coefficients (ICC), and Bland-Altman analyses were performed to assess systematic bias and consistency between ultrasound methods and CT. Multivariate linear regression was applied to evaluate the effects of slice thickness, posture, age, and other factors on CT measurements. Results:In the phantom study, deviations of 2D ultrasound and CT from actual injected volumes were (0.73±3.05) ml ( t=-0.48, P=0.667) and (1.52±11.27) ml ( t=0.17, P=0.875), with ICC values>0.999. In the clinical study, mean bladder volumes measured by 3D-reconstructed ultrasound, conventional 2D ultrasound, and CT were (373.5±153.31), (314.89±135.28), (382.82±157.57) ml, respectively. The 3D-reconstructed method showed excellent agreement with CT (ICC=0.98; Bland-Altman mean bias=-9.32 ml, P=0.096), while 2D ultrasound also showed good consistency (ICC=0.91), but significantly underestimated bladder volume (mean bias=-67.93 ml, P<0.001). Subgroup analysis revealed that 2D ultrasound had the best agreement with CT in the medium-volume group (200-500 ml, ICC=0.902), whereas agreement decreased in the small-volume (<200 ml, ICC=0.884) and large-volume (>500 ml, ICC=0.840) groups (all P<0.001). The 3D-reconstructed ultrasound maintained excellent consistency with CT across all subgroups (all ICC>0.95), and the measured bladder volume was not statistically significant. Multivariate regression showed that slice thickness, posture, age, sex, and surgical status had no significant effects on CT measurements. Conclusions:Ultrasound with 3D reconstruction enables accurate bladder volume monitoring through true 3D contour reconstruction, while conventional 2D ultrasound systematically underestimates bladder volume and requires correction.

Background::Magnetic resonance (MR)-guided ultra-hypofractionated radiotherapy with whole-pelvic irradiation (UHF-WPRT) is a novel approach to radiotherapy for patients with high-risk (HR) and very high-risk (VHR) prostate cancer (PCa). However, the inherent complexity of adaptive UHF-WPRT might inevitably result in longer on-couch time. We aimed to estimate the delivered dose, study the feasibility and safety of adaptive UHF-WPRT on a 1.5-Tesla MR-Linac.Methods::Ten patients with clinical stage T3a-4N0-1M0-1c PCa, who consecutively received UHF-WPRT, were enrolled prospectively. The contours of the target and organ-at-risks on the position verification-MR (PV-MR), beam-on 3D-MR(Bn-MR), and post-MR (after radiotherapy delivery) were derived from the pre-MR data by deformable image registration. The physician then manually adjusted them, and dose recalculation was performed accordingly. GraphPad Prism 9 (GraphPad Prism Software Inc.) was utilized for conducting statistical analyses.Results::In total, we collected 188 MR scans (50 pre-MR, 50 PV-MR, 44 Bn-MR, and 44 post-MR scans). With median 59 min, the mean prostate clinical target volume (CTV)-V 100% was 98.59% ± 2.74%, and the mean pelvic CTVp-V 100% relative percentages of all scans was 99.60% ± 1.18%. The median V 29 Gy change in the rectal wall was -2% (-18% to 20%). With a median follow-up of 9 months, no patient had acute Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or more severe genitourinary (GU) or gastrointestinal (GI) toxicities (0%). Conclusion::UHF-RT to the prostate and the whole pelvis with concomitant boost to positive nodes using an Adapt-To-Shape (ATS) workflow was technically feasible for patients with HR and VHR PCa, presenting only mild GU and GI toxicities. The estimated target dose during the beam-on phase was clinically acceptable based on the 3D-MR–based dosimetry analysis.Clinical trial registration::Chinese Clinical Trial Registry ChiCTR2000033382.

Objective:To analyze the activity of lithium chloride (LiCl) against influenza virus A (H3N2) in human non-small cell lung cancer cells (A549).Methods:Different concentrations of LiCl were incubated with A549 cells, and the cytopathic effect (CPE) was observed after 24 hours, and the effect of LiCl on cell activity was determined by CCK-8 method. After H3N2 (MOI=1) infected A549 cells, different concentrations of LiCl were added and incubated for 24 hours, and the viral load was measured by real time/reverse transcription quantitative polymerase chain reaction (RT-qPCR), and the CPE was observed, and the viral titer was determined. Different concentrations of LiCl were incubated with A549 at 37 ℃ and 5% CO 2 for 2 hours, virus was added and incubated for 24 hours, and the viral load was determined by RT-qPCR. LiCl, H3N2 and A549 were incubated at 4 ℃ for 1 hour, 35 ℃, 5% CO 2 for 24 hours, and viral load was determined by RT-qPCR. H3N2 and A549 were incubated at 4 ℃for 1 hour, then different concentrations of LiCl were added, incubated at 35 ℃ with 5% CO 2 for 24 hours, and the viral load was determined by RT-qPCR. After H3N2 infected A549 cells, different concentrations of LiCl were added and incubated for 24 hours, and the viral RNA load and viral titer of the supernatant and cells were measured, respectively, and then the corresponding ratios of the supernatant and the cells were calculated. After H3N2 (MOI=10) and BV (MOI=1) infected A549 cells, different concentrations of LiCl were added for 24 h, and the viral load was determined by RT-qPCR. Results:When the concentration of LiCl was<50 mmol/L, the cell viability of A549>90%. Different concentrations of LiCl could significantly reduce the viral load of H3N2 ( P<0.000 1), and the CPE of the LiCl treatment group was more dose-dependent than that of the control group. LiCl did not inhibit viral replication by affecting the cell itself; Different concentrations of LiCl significantly inhibited the entry of H3N2 into A549 ( P<0.000 1), and also had a certain inhibitory effect on the adsorption of A549 cells ( P<0.1). LiCl did not affect the assembly and release of H3N2 ( P>0.05), and it was also found that LiCl had a broad spectrum of antiviral effects against multiple influenza virus strains ( P<0.000 1). Conclusions:LiCl may exert antiviral effect by inhibiting the adsorption and entry of H3N2 into A549 cells and the replication of H3N2 in A549 cells, which provides a data reference for the prevention and treatment of viral infection by LiCl.

Background::Magnetic resonance (MR)-guided ultra-hypofractionated radiotherapy with whole-pelvic irradiation (UHF-WPRT) is a novel approach to radiotherapy for patients with high-risk (HR) and very high-risk (VHR) prostate cancer (PCa). However, the inherent complexity of adaptive UHF-WPRT might inevitably result in longer on-couch time. We aimed to estimate the delivered dose, study the feasibility and safety of adaptive UHF-WPRT on a 1.5-Tesla MR-Linac.Methods::Ten patients with clinical stage T3a-4N0-1M0-1c PCa, who consecutively received UHF-WPRT, were enrolled prospectively. The contours of the target and organ-at-risks on the position verification-MR (PV-MR), beam-on 3D-MR(Bn-MR), and post-MR (after radiotherapy delivery) were derived from the pre-MR data by deformable image registration. The physician then manually adjusted them, and dose recalculation was performed accordingly. GraphPad Prism 9 (GraphPad Prism Software Inc.) was utilized for conducting statistical analyses.Results::In total, we collected 188 MR scans (50 pre-MR, 50 PV-MR, 44 Bn-MR, and 44 post-MR scans). With median 59 min, the mean prostate clinical target volume (CTV)-V 100% was 98.59% ± 2.74%, and the mean pelvic CTVp-V 100% relative percentages of all scans was 99.60% ± 1.18%. The median V 29 Gy change in the rectal wall was -2% (-18% to 20%). With a median follow-up of 9 months, no patient had acute Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or more severe genitourinary (GU) or gastrointestinal (GI) toxicities (0%). Conclusion::UHF-RT to the prostate and the whole pelvis with concomitant boost to positive nodes using an Adapt-To-Shape (ATS) workflow was technically feasible for patients with HR and VHR PCa, presenting only mild GU and GI toxicities. The estimated target dose during the beam-on phase was clinically acceptable based on the 3D-MR–based dosimetry analysis.Clinical trial registration::Chinese Clinical Trial Registry ChiCTR2000033382.

Objective To investigate the impact of daidzein(DAI)on the pyroptosis of renal tubular epithelial cells induced by high glucose by regulating NOD-like receptor protein 3(NLRP3)/caspase-1 signal pathway.Methods HK-2 cells were divided into control group(NC group)(5.5 mmol/L D-glucose),HG group(30 mmol/L D-glucose),DAI-L,DAI-M,DAI-H groups(HK-2 cells were incubated with 30 mmol/L D-glucose and 25,50,100 μmol/L DAI,respectively),and DAI-H+LPS group(HK-2 cells were incubated with 30 mmol/L D-glucose,100 μmol/L DAI and 1 μg/mL LPS).MTT assay was applied to detect the cytotoxicity and proliferation of HK-2 cells;the apoptosis of HK-2 cells was detected by flow cytometry.The level of interleukin-1β(IL-1β)and inter-leukin-18(IL-18)in HK-2 cells was detected by ELISA.The morphology of pyroptosis cells was ob-served by scanning electron microscope.Immunofluorescence staining was applied to detect pyroptosis related pro-teins.The expression of NLRP3,cleaved casase-1 and GSDMD-N was detected by Western blot.Results In NC group,the cells were spherical with regular boundaries,while in HG group,the cells swelled and became larger with irregular boundaries;the OD value(490 nm)of HK-2 cells in HG group was obviously lower than that in NC group(P＜0.05),the apoptosis rate,IL-1β,IL-18 contents,NLRP3,cleaved casase-1,GSDMD-N protein level of HK-2 cells were obviously higher(P＜0.05);After DAI treatment,the swelling of cells was alleviated,the A value(490 nm)of HK-2 cells increased significantly(P＜0.05),the apoptosis rate of HK-2 cells,IL-1 β,IL-18 content,NLRP3,cleaved-caspase-1 and GSDMD-N protein levels were significantly decreased(P＜0.05)and the therapeutic effect of DAI was dose-dependent;LPS eliminated the beneficial effect of DAI-H on high glucose in-duced apoptosis of renal tubular epithelial cells.Conclusions DAI may alleviate pyroptosis of renal tubular epithe-lial cells induced by high glucose through inhibition of NLRP3/caspase-1 signaling pathway.

Carcinoid is a rare clinical disease, especially primary carcinoid of testis. On December 11, 2019, a patient with primary testicular carcinoid was admitted to the Fourth Hospital of Hebei Medical University. The physical examination, color Doppler ultrasound and scrotal CT showed that left testicular tumor. The patient underwent radical orchiectomy and sent for pathology examination on December 14, 2019. Gastroscopy, enteroscopy and CT examination of pelvic and abdominal cavity showed no obvious abnormalities. Postoperative pathology combined with immunohistochemistry was diagnosed as primary carcinoid of testis. The patient was followed up for 23 months with no recurrence.

Objective To investigate the efficiency and safety as well as the effect of chronic intravenous iron supplementation on the improvement of anemia in the patients with maintain hemodialysis (MHD). Methods Fifty-six patients with MHD were involved in the six-month, controlled trail and randomly divided into two groups: intravenous iron group (IV group) and oral iron group (oral group). The patients of IV group (n=28) were intravenously pumped 100 mg iron dextran during each hemodialysis session for the total amount of 1000 mg,after that,100 mg iron dextrin each two weeks. Patients in the oral group took 525 mg ferrous sulfate a day during the first three months and received iron dextran on the above methods under stopping oral iron supplement during the second three months. The efficacy was assessed by determining the change of hemoglobin (Hb), hematocrit (Hct), serum ferritin (SF) and transferring saturation (TSAT). Results The levels of Hb, Hct, SF, TSAT were increasing in the IV group after trail and there were evidently difference in those markers in the first three months, compared to the oral group, P