Objective To explore the application effect of artifact removal technique of Discovery RT (GE Inc) in organ segmentation and radiotherapy planning. Methods Twelve patients with head and neck tumors carrying irremovable metal dentures,who received radiotherapy at the Fourth Affiliated Hospital of Nanjing Medical University from September 2021 to February 2024,were enrolled in the study. AccuContour was used to perform organs-at-risk (OAR) segmentations separately on CT image processed by metal artifact reducing algorithm and conventional CT image. Dice similarity coefficient (DSC),Hausdorff distance (HD) and the mean CT values of OAR with or without metal artifacts were compared. Both the processed CT images and original images were transferred to Monaco planning system. Dose calculation was conducted on the images with metal artifacts,and the calculated plans were mapped to the artifact-free images for analyzing the dosimetric differences of OAR. Results The HD of the throat,oral cavity and mandible were slightly higher. The mean CT values of the tissues in images before and after artifact removal were not statistically different except for the trachea (P<0.05),and the mean oral CT value at the artifact level differed significantly in two groups (P<0.05). The radiation dose of different tissues in the radiotherapy plan before and after artifact removal only showed statistical differences in the superior constrictor musde of pharynx. The percentages of irradiation dose differences for the tissues ranged from 0 to 6.45％,with the largest fluctuation in the left lens (-2.92％±3.95％) and the right lens (1.29％±3.35％). Conclusion Manual delineation is required for the tissues close to metal artifacts due to the remarkable effects on CT values and planned dose,but there is few differences in the other tissues.

Objective To explore the expression of serine/threonine protein kinase 1(AKT1)and Isocho-rismatase Domain-Containing 1(ISOC1)in gastric cancer tissues and evaluate their diagnostic utility.Methods A total of 90 patients with gastric cancer who were diagnosed and treated in our hospital between March 2023 and September 2024 were recruited as the study subjects.The positive expression rates and positive scores of AKT1 and ISOC1 in cancer tissues and adjacent tissues were compared.The AKT1 and ISOC1 positive scores of gastric cancer patients with diverse characteristics were also compared.The Spearman correlation analysis was employed to exam-ine the relationship between the expression of AKT1 and ISOC1 in cancer tissues and the clinical features of gastric cancer patients.A diagnostic model for gastric cancer,integrating AKT1 and ISOC1,was established using the Logistic regression model.Receiver operating characteristic(ROC)curves were plotted to analyze the area under the curve(AUC)value,sensitivity,and specificity of AKT1,ISOC1,and their combined diagnosis for gastric cancer.Results The positive expression rates and positive scores of AKT1 and ISOC1 in cancer tissues were significantly higher than those in paracancerous tissues(P<0.05).In gastric cancer patients,the expressions of AKT1 and ISOC1 were notably higher in patients with low differentiation,clinical stage Ⅰ～Ⅱ,invasion depth T1-2,absence of lymph node metastasis,and no distant metastasis compared to those with moderate differentiation,clinical stage Ⅲ～Ⅳ,invasion depth T3-4,and presence of lymph node metastasis and distant metastasis(P<0.05).Spearman's correlation analysis indicated that AKT1 and ISOC1 were positively correlated with the degree of differ-entiation,clinical stage,lymph node metastasis,invasion degree,and distant metastasis(P<0.05).The area under the curve(AUC)values of AKT1,ISOC1,and their combined diagnosis for gastric cancer were 0.735,0.726,and 0.875 respectively(P<0.05).The sensitivities were 60.00%,56.70%,and 75.60%,while the speci-ficities were 85.60%,83.30%,and 87.80%.The AUC value of the combined detection of AKT1 and ISOC1 in the diagnosis of gastric cancer was higher than that of AKT1 or ISOC1 alone(Z=-3.003,-3.196,P<0.05).Conclusions AKT1 and ISOC1 are highly expressed in gastric cancer tissues,and their expressions are upregu-lated with the progression of the disease.The combined detection of their expression levels holds great significance for the diagnosis and prognosis assessment of gastric cancer.

Objective To explore the application effect of artifact removal technique of Discovery RT (GE Inc) in organ segmentation and radiotherapy planning. Methods Twelve patients with head and neck tumors carrying irremovable metal dentures,who received radiotherapy at the Fourth Affiliated Hospital of Nanjing Medical University from September 2021 to February 2024,were enrolled in the study. AccuContour was used to perform organs-at-risk (OAR) segmentations separately on CT image processed by metal artifact reducing algorithm and conventional CT image. Dice similarity coefficient (DSC),Hausdorff distance (HD) and the mean CT values of OAR with or without metal artifacts were compared. Both the processed CT images and original images were transferred to Monaco planning system. Dose calculation was conducted on the images with metal artifacts,and the calculated plans were mapped to the artifact-free images for analyzing the dosimetric differences of OAR. Results The HD of the throat,oral cavity and mandible were slightly higher. The mean CT values of the tissues in images before and after artifact removal were not statistically different except for the trachea (P<0.05),and the mean oral CT value at the artifact level differed significantly in two groups (P<0.05). The radiation dose of different tissues in the radiotherapy plan before and after artifact removal only showed statistical differences in the superior constrictor musde of pharynx. The percentages of irradiation dose differences for the tissues ranged from 0 to 6.45％,with the largest fluctuation in the left lens (-2.92％±3.95％) and the right lens (1.29％±3.35％). Conclusion Manual delineation is required for the tissues close to metal artifacts due to the remarkable effects on CT values and planned dose,but there is few differences in the other tissues.

Objective To explore the expression of serine/threonine protein kinase 1(AKT1)and Isocho-rismatase Domain-Containing 1(ISOC1)in gastric cancer tissues and evaluate their diagnostic utility.Methods A total of 90 patients with gastric cancer who were diagnosed and treated in our hospital between March 2023 and September 2024 were recruited as the study subjects.The positive expression rates and positive scores of AKT1 and ISOC1 in cancer tissues and adjacent tissues were compared.The AKT1 and ISOC1 positive scores of gastric cancer patients with diverse characteristics were also compared.The Spearman correlation analysis was employed to exam-ine the relationship between the expression of AKT1 and ISOC1 in cancer tissues and the clinical features of gastric cancer patients.A diagnostic model for gastric cancer,integrating AKT1 and ISOC1,was established using the Logistic regression model.Receiver operating characteristic(ROC)curves were plotted to analyze the area under the curve(AUC)value,sensitivity,and specificity of AKT1,ISOC1,and their combined diagnosis for gastric cancer.Results The positive expression rates and positive scores of AKT1 and ISOC1 in cancer tissues were significantly higher than those in paracancerous tissues(P<0.05).In gastric cancer patients,the expressions of AKT1 and ISOC1 were notably higher in patients with low differentiation,clinical stage Ⅰ～Ⅱ,invasion depth T1-2,absence of lymph node metastasis,and no distant metastasis compared to those with moderate differentiation,clinical stage Ⅲ～Ⅳ,invasion depth T3-4,and presence of lymph node metastasis and distant metastasis(P<0.05).Spearman's correlation analysis indicated that AKT1 and ISOC1 were positively correlated with the degree of differ-entiation,clinical stage,lymph node metastasis,invasion degree,and distant metastasis(P<0.05).The area under the curve(AUC)values of AKT1,ISOC1,and their combined diagnosis for gastric cancer were 0.735,0.726,and 0.875 respectively(P<0.05).The sensitivities were 60.00%,56.70%,and 75.60%,while the speci-ficities were 85.60%,83.30%,and 87.80%.The AUC value of the combined detection of AKT1 and ISOC1 in the diagnosis of gastric cancer was higher than that of AKT1 or ISOC1 alone(Z=-3.003,-3.196,P<0.05).Conclusions AKT1 and ISOC1 are highly expressed in gastric cancer tissues,and their expressions are upregu-lated with the progression of the disease.The combined detection of their expression levels holds great significance for the diagnosis and prognosis assessment of gastric cancer.

Objective Matrix metalloproteinase-10 (MMP-10) has been shown to be highly associated with atherosclerosis.Recent studies showed that levels of MMP-10 were elevated in infarcted tissues in acute ischemic stoke.However,serum levels of MMP-10 in patients with acute ischemic stroke have never been studied previously.This study aims to investigate the serum levels of MMP-10 in patients with acute ischemic stroke,and evaluate the association of serum levels of MMP-10 with stroke subtypes based on Trial of Org 10 172 in acute stroke treatment classifications,the severity of stroke,risk factors and carotid artery plaque.Methods The circulating levels of MMP-10 were measured by enzyme linked immunosorbent assay in 194 subjects,including 109 patients who were diagnosed as acute ischemic stroke in the Department of Neurology,Shengjing Hospital,China Medical University from April to December 2012,and the 85 healthy controls.Results Patients with acute ischemic stroke had higher serum levels of MMP-10 compared with healthy controls (6.59 (6.07,7.31) μg/L vs 5.16 (3.87,5.94) μg/L,Z =8.33,P ＜ 0.01).NIHSS score had positive correlation with serum levels of MMP-10 (r =0.204,P =0.037).Classified by risk factors,we compared the MMP-10 levels of subsets,and results displayed that statistically significant difference existed between dyslipidemia subset and non-dyslipidemia subset (Z =2.07,P =0.042).MMP-10 levels had positive correlation with serum levels of LDL-cholesterol (r =0.248,P =0.040),but negative correlation with thrombin-activatable fibrinolysis inhibitor (TAFI;r =-0.208,P =0.030).The subset with unstable plaques had higher MMP-10 levels than that with stable plaque (6.62 (6.13,7.36) μg/L) vs 6.10 (6.00,6.46) μg/L,Z =2.12,P =0.034),implying the relationship of MMP-10 and atherosclerosis.Conclusions Patients with acute ischemic stroke have higher serum levels of MMP-10 compared with the healthy controls,and MMP-10 levels have positive correlation with the severity of stroke.MMP-10 is associated with the subtypes of stroke classified by risk factors,and dyslipidemia subset has higher levels of MMP-10 than that of non-dyslipidemia subset.MMP-10 has positive correlation with LDL-cholesterol,but negative correlation with TAFI.MMP-10 may be involved in the process of formation and disruption of unstable plaques,which contribute to the stenosis of arteries and onset of acute ischemic stroke.