Objective To establish a reliable prediction model for radiation pneumonitis(RP)based on multi-regional radiomics analysis of localizable CT images.Methods A retrospective analysis was conducted on 185 patients who received radiotherapy from January 2021 to June 2023 in the Department of Radiotherapy,Xuzhou Cancer Hospital.Patients were classified as having RP or not based on imaging combined with clinical diagnosis.Three regions of interest(ROI)were defined in the localizable CT images:Lung,Lung-PTV and PTV,and their radiomics features were extracted.After feature screening using methods such as Mann-Whitney Utest,recursive feature elimination,and Lasso,a prediction model was established using support vector machine classification algorithm.The model performance was validated using 6 evaluation metrics:the area under the receiver operating characteristic curve(AUC),accuracy,specificity,sensitivity,positive predictive value,and negative predictive value.Results The prediction model consisted of 7 radiomics features.The clinical model of target-to-lung ratio,PTV model,Lung model,and Lung-PTV model achieved AUC values of 0.535,0.801,0.672,and 0.706 in the test set,respectively.The AUC value and accuracy of PTV model reached 0.843 and 0.775 in the training set,while 0.801 and 0.750 in the test set.PTV model was superior to Lung model,Lung-PTV model,and clinical model in predictive performance.The AUC values of the combined PTV+(Lung-PTV)model in the training and test sets were 0.867 and 0.806,respectively,higher than those of PTV model and Lung-PTV model.Conclusion The predictive ability of the prediction models constructed from radiomics features in different ROI for symptomatic RP varies.The radiomics prediction model using PTV as ROI exhibits superior predictive performance,and the combined multi-regional radiomics model can further improve the predictive ability for RP.

Objective To establish a reliable prediction model for radiation pneumonitis(RP)based on multi-regional radiomics analysis of localizable CT images.Methods A retrospective analysis was conducted on 185 patients who received radiotherapy from January 2021 to June 2023 in the Department of Radiotherapy,Xuzhou Cancer Hospital.Patients were classified as having RP or not based on imaging combined with clinical diagnosis.Three regions of interest(ROI)were defined in the localizable CT images:Lung,Lung-PTV and PTV,and their radiomics features were extracted.After feature screening using methods such as Mann-Whitney Utest,recursive feature elimination,and Lasso,a prediction model was established using support vector machine classification algorithm.The model performance was validated using 6 evaluation metrics:the area under the receiver operating characteristic curve(AUC),accuracy,specificity,sensitivity,positive predictive value,and negative predictive value.Results The prediction model consisted of 7 radiomics features.The clinical model of target-to-lung ratio,PTV model,Lung model,and Lung-PTV model achieved AUC values of 0.535,0.801,0.672,and 0.706 in the test set,respectively.The AUC value and accuracy of PTV model reached 0.843 and 0.775 in the training set,while 0.801 and 0.750 in the test set.PTV model was superior to Lung model,Lung-PTV model,and clinical model in predictive performance.The AUC values of the combined PTV+(Lung-PTV)model in the training and test sets were 0.867 and 0.806,respectively,higher than those of PTV model and Lung-PTV model.Conclusion The predictive ability of the prediction models constructed from radiomics features in different ROI for symptomatic RP varies.The radiomics prediction model using PTV as ROI exhibits superior predictive performance,and the combined multi-regional radiomics model can further improve the predictive ability for RP.

Objective:To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS-MS)method for the determination of 2-mercaptobenzothiazole(MBT)genotoxic impurities in cefazoxime sodium for injection and to analyze the detection of domestic samples from 28 manufacturers.Methods:The UPLC analysis was performed on a Phenomenex Luna Omega C18 column,(2.1 mm × 100 mm,1.6 μm)with the column temperature 30 ℃.The mobile phases A was 2 mmol·L-1 ammonium acetate(contai-ning 0.001％formic acid)and the mobile phase B was acetonitrile with gradient elute.The flow rate was 0.3 mL·min-1.The injection volume was 5 μL.The electrospray ionization(ESI)source in positive mode and multiple reaction monitoring(MRM)were used for the detection of MBT,and external standard method for quanti-tative analysis.Results:The linear relationship of MBT was good in the concentration range of 1.4-58.12 ng·mL-1(r=0.999).The limit of detection was 1.453 pg and the limit of quantification was 7.265 pg.The average recoveries of low,medium and high concentrations were 106.8％,107.1％and 109.0％,respectively with the relative standard deviation(RSD)all less than 2.0％.The relative standard deviation(RSD)of repeatability was less than 6.0％.The content of MBT in the samples from 28 domestic enterprises was all less than 10 ppm,but there were obvious differences in the detected amount among all enterprises which is due to different production processes.Conclusion:The established method can be used for the qualitative and quantitative detection of MBT in cefazoxime sodium for injection and the partical enterprises which have been detected MBT impurities need to further raise the warning.

Objective:To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS-MS)method for the determination of 2-mercaptobenzothiazole(MBT)genotoxic impurities in cefazoxime sodium for injection and to analyze the detection of domestic samples from 28 manufacturers.Methods:The UPLC analysis was performed on a Phenomenex Luna Omega C18 column,(2.1 mm × 100 mm,1.6 μm)with the column temperature 30 ℃.The mobile phases A was 2 mmol·L-1 ammonium acetate(contai-ning 0.001％formic acid)and the mobile phase B was acetonitrile with gradient elute.The flow rate was 0.3 mL·min-1.The injection volume was 5 μL.The electrospray ionization(ESI)source in positive mode and multiple reaction monitoring(MRM)were used for the detection of MBT,and external standard method for quanti-tative analysis.Results:The linear relationship of MBT was good in the concentration range of 1.4-58.12 ng·mL-1(r=0.999).The limit of detection was 1.453 pg and the limit of quantification was 7.265 pg.The average recoveries of low,medium and high concentrations were 106.8％,107.1％and 109.0％,respectively with the relative standard deviation(RSD)all less than 2.0％.The relative standard deviation(RSD)of repeatability was less than 6.0％.The content of MBT in the samples from 28 domestic enterprises was all less than 10 ppm,but there were obvious differences in the detected amount among all enterprises which is due to different production processes.Conclusion:The established method can be used for the qualitative and quantitative detection of MBT in cefazoxime sodium for injection and the partical enterprises which have been detected MBT impurities need to further raise the warning.

OBJECTIVE: To investigate the value of hand-held retinal optometer and optical coherence tomography (OCT) in predicting postoperative visual acuity in patients with age-related cataract and idiopathic macular epiretinal membrane. METHODS: We retrospectively analyzed the data of patients undergoing phacoemulsification combined with intraocular lens implantation for age-related cataract in our hospital from January, 2019 to April, 2020.Preoperative examination detected idiopathic macular epiretinal membrane in 45 of the patients (52 eyes) with lens opacity grade C2N2P1 according to LOCSⅡ lens opacity classification criteria.Based on the thickness of the macular fovea, the eyes were divided into group A (9 eyes) with macular thickness < 300 μm by OCT examination, group B (25 eyes) with macular thickness of 300 to 400 μm, and group C (18 eyes) with macular thickness >400 μm.The best corrected visual acuity and retinal visual acuity before operation and the best corrected visual acuity on the first day and at 3 months after the surgery were compared among the 3 groups.The consistency between the preoperative retinal vision and the best corrected vision at 3 months after the surgery was analyzed. RESULTS: The best corrected visual acuity at one day and 3 months after the surgery differed significantly from that before the surgery in all the 3 groups ( CONCLUSIONS For patients with cataract and idiopathic macular epiretinal membrane, phacoemulsification combined with intraocular lens implantation can improve postoperative vision.Hand-held retinal optometer can accurately assess postoperative vision in patients with stage C2N2P1 cataract.Patients with a macular thickness >400 μm caused by idiopathic macular epiretinal membrane are likely to have poor postoperative visual outcomes.
Cataract/diagnostic imaging* ; Epiretinal Membrane/surgery* ; Humans ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

Objective To study the relationship between the ratio of target volume to lung volume and the prescription dose in intensity modulated radiation therapy (IMRT) for esophageal cancer, so as to help clinicians to choose the appropriate prescription dose according to the target situation. Methods 80 patients with esophageal cancer were randomly selected. The lesion range included all types of esophageal cancer, and the target area was outlined according to ICRU (International Commission Radiological Units) 50 and ICRU62. Set statistical parameters and plan objectives. Statistical analysis was performed according to the statistical results of the parameters. The critical value of volume ratio is obtained by fitting calculation. Results there was a positive linear correlation between volume ratio and lung V₅, V₂₀, V₃₀ and average lung dose. The critical value of volume ratio is 10% for 60 Gy and 13% for 50 Gy. Conclusion according to the research results, it can be predicted that when the ratio of target volume to lung volume is more than 10%, the prescribed dose should not be higher than 60 Gy; when the ratio of target volume to lung volume is more than 13%, the prescribed dose should be selected cautiously, meanwhile in the condition of whose target volume exceeds lung segment the prescribed dose. This provides a reference for clinicians when choose the prescription dose and target range while making the target delineation.

Objective To discuss the clinical effect of Sky bone expander percutaneous ky-pbeplasty (Sky-PKP) in treatment of old osteoperotic vertebral compression fractures. Methods The study involved 27 patients (27 vertebrae) with old osteoporotic vertebral compression fractures treated by Sky-PKP from March 2005 to June 2007. Normotopia, lateral and dynamia radiographs, CT scanning and MRI were performed preoperatively to verify fluid collection in the vertebral body, vacuum phenomenon and open-close phenomenon. Visual analog scale (VAS), Oswestry disability index (ODI), anterior body height, middle line body height, posterior body height and kyphotic angle changes were measured on a lateral radiograph before and after treatment. Results All patients were followed up for mean 6.2 months, which showed no severe complications. VAS score was decresed from preoperative 7.8 to postop-erative 3.1 and ODI from 65% to 37%. However, The anterior vertebral height and middle line vertebral height were recovered for 4.6 nun and 5.7 mm respectively compared with preoperation. Correction of ky-photic angle was mean 5.6°postoperatively. There was no sitatistical changes in regard to posterior body height before and after operation. Conclusions Sky-PKP is a reasonable procedure for treatment of old osteoporotic vertebral compression fractures under strict control of indications, especially with vacuum phenomenon, open-close phenomenon and fluid collection. While high degree of difficulty in puncturation results in insignificant correction of kyphotic angle and body height.