Objective:To investigate the dosimetric characteristics of intensity modulated proton therapy (IMPT) and intensity modulated radiation therapy (IMRT) for lung cancers.Methods:Three lung cancer patients (central-lower, central, and peripheral types) admitted to Shandong Cancer Hospital and Institute from January 2024 to May 2024 were selected as the research subjects. IMPT and IMRT plans were designed for each case based on the anatomical location of the clinical target volume and the dose constraints for organs at risk (OARs). Dosimetric parameters, including conformity index (CI), homogeneity index (HI), and gradient index (GI) for target coverage, as well as OARs dosimetric parameters were evaluated. The volume of additional dose deposition in the body was compared by assessing regions receiving 10%, 30%, and 50% of the prescription dose.Results:For all three cases, IMRT plans demonstrated higher CI values (0.80, 0.60, and 0.79) compared to IMPT plans (0.61, 0.57, and 0.34). IMPT plans yielded lower HI values (0.07, 0.06, and 0.06) than IMRT plans (0.09, 0.15, and 0.09) and lower GI values (2.84, 2.47, and 4.56 vs. 4.91, 3.09, and 4.99 for IMRT plans). Compared with the IMRT plans, the low-dose region in the ipsilateral lung was significantly reduced in IMPT plans (V 5 of the IMPT plans were 20.59%, 46.29%, 10.94%, respectively; V 5 of the IMRT plans were 48.91%, 60.63%, 19.92%, respectively), but there was no significant advantage in the high-dose region compared to IMRT plans (V 20 of the IMPT plans were 12.88%, 34.75%, 5.21%, respectively; V 20 of the IMRT plans were 21.70%, 36.50%, 5.31%, respectively). The dose to the contralateral lung and heart was significantly reduced in IMPT plans [the D mean of the contralateral lung in the IMPT plans were 0.08, 0.04, and 0.00 Gy (RBE), respectively, and those in the IMRT plans were 3.25, 1.18, and 0.55 Gy, respectively; the heart D mean in the IMPT plans were 6.23, 7.04, and 0.00 Gy (RBE), respectively, while those of the IMRT plans were 18.33, 10.27, and 0.08 Gy, respectively). IMPT plans significantly reduced the volumes receiving 10% of the prescription dose by 65.94%, 25.57% and 72.47%, respectively, compared to IMRT plans. The volumes IMPT plans occupied by 30% of the prescription dose area in the body were reduced by 54.97%, 26.47% and 39.04%, respectively, compared to the IMRT plans. The volumes IMPT plans occupied by 50% of the prescription dose area in the body were reduced by 54.49%, 30.43% and 28.89%, respectively, compared to the IMRT plans. Conclusions:IMPT plan significantly reduces the V 5 of the ipsilateral lung, the D mean of the contralateral lung and the heart, while maintaining target coverage compared with IMRT plan for lung cancers. However, IMPT plan does not show much more advantage than IMRT plan in the ipsilateral lung V 20. IMPT can reduce the additional exposure volume within the body.

Antenatal hydronephrosis（AHN）is the most common congenital anomalies of kidney and urinary tract（CAKUT）detected through prenatal ultrasound screening.Approximately two-thirds of AHN are physiological and can be relieved spontaneously after birth，while AHN may be aggravated in some cases，resulting in deterioration of kidney function or severe complications and requiring surgical intervention.Currently，there is a lack of consensus on the prenatal and postnatal management of AHN，making it crucial to stratify the risk for affected children and establish appropriate follow-up plans.This article reviews the clinical assessment and management of AHN in prenatal and postnatal settings based on domestic and international literature，with the goal of raising AHN awareness among families of high-risk children and alleviating anxiety and excessive intervention for families of low-risk children，ultimately promoting individualized diagnosis and treatment.

Objective:To retrospectively analyze the clinical characteristics and renal involvement in children with neurofibromatosis type 1 (NF1), in order to provide reference for the clinical assessment and management of these patients.Methods:A case series report.Basic information, admission conditions, clinical manifestations, laboratory and renal imaging findings, as well as follow-up data of children diagnosed with NF1 at Wuhan Children′s Hospital of Tongji Medical College, Huazhong University of Science and Technology from January 2019 to December 2023 were retrospectively collected and analyzed.Descriptive statistics were used to summarize the clinical features of renal phenotypes associated with NF1 in this cohort.Results:A total of 102 children with NF1 were included in the study, including 64 males and 38 females, with a male-to-female ratio of approximately 1.7∶1.0, and the median age was 5.6 years.The majority of initial consultations were in the departments of neurology, orthopedics, and general surgery, with 3 cases in the nephrology department.Renal involvement was observed in 8 children (7.8%), including 4 cases with abnormal urine tests (2 cases of proteinuria and 2 cases of microscopic hematuria) and 4 cases with hydronephrosis.All children had normal serum creatinine levels.Blood pressure monitoring was performed in 51 children, including 5 cases(9.8%) with prehypertension and 13 cases(25.5%) with hypertension.Conclusions:NF1 is a multisystem disorder, and children with NF1 are prone to develop glomerular diseases, urinary tract abnormalities and renal vascular lesions.Urological manifestations are often subtle, making them easily overlooked in clinical practice.Therefore, it is recommended to regularly conduct blood pressure, renal function, urine routine, and urinary imaging examinations for NF1 children in order to detect and manage them early and improve their long-term prognosis.

The incidence of acute kidney injury (AKI) in Neonatal Intensive Care Unit (NICU) is about 30%.The morbidity and mortality of AKI are higher in very premature infants, very low birth weight infants and infants with long mechanical ventilation.Serum creatinine (Scr) and urine output are diagnostic indicators for AKI, which usually change within 12-48 hours after the onset of irreversible injury, and cannot be used for early diagnosis and clinical intervention.Therefore, it is necessary to search for indicators of early renal insufficiency, aiming to intervene and prevent early-stage AKI or reduce the occurrence of AKI.Near-infrared spectroscopy (NIRS) is a non-invasive, continuous, real-time monitoring method, which serves as a supplement to conventional biochemical markers.It provides evidence of early-stage renal ischemia and hypoxia, which contributes to prevent or reduce AKI.This study reviews the clinical application of neonatal renal oxygen saturation monitoring, thus providing clinical reference for renal function protection in critically ill neonates to reduce the occurrence of AKI and improve their prognosis.

Objective:To systematically summarize and assess risk prediction models for occurrence of cervical cancer and to provide evidence for selecting the most reliable model for practice, and guide cervical cancer screening.Methods:Two groups of keywords related to cervical cancer and risk prediction model were searched on Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, and Cochrane Library). Original articles that developed or validated risk prediction models and published before November 21, 2019, were selected. Information form was created based on the CHARMS checklist. The PROBAST was used to assess the risk of bias.Results:12 eligible articles were identified, describing 15 prediction models, of which five were established in China. The predicted outcomes included multiple stages from cervical precancerous lesions to cancer occurrence, i.e., abnormal Pap smear (1), occurrence or recurrence of CIN (9), and occurrence of cervical cancer (5), etc. The most frequently used predictors were HPV infection (12), age (7), smoking (5), and education (5). There were two models using machine learning to develop models. In terms of model performance, the discrimination ranged from 0.53 to 0.87, while only two models assessed the calibration correctly. Only two models were externally validated in Taiwan of China, using people in different periods. All of the models were at high risk of bias, especially in the analysis domain. The problems were concentrated in the improper handling of missing data (13), preliminary evaluation of model performance (13), improper use of internal validation (12), and insufficient sample size (11). In addition, the problems of inconsistency measurements of predictors and outcomes (8) and the flawed report of the use of blindness for outcome measures (8) were also severe. Compared with the other models, the Rothberg (2018) model had relatively high quality. Conclusions:There are a certain number of cervical cancer risk prediction models, but the quality is poor. It is urgent to improve the measurement of predictors and outcomes, the statistical analysis details such as handling missing data and evaluation of model performance and externally validate existing models to better guide screening.

Objectives:This study aims to evaluate the reliability and validity of the Chinese version of the 4-item Negative Symptom Assessment (NSA-4) in patients with schizophrenia.Methods:A total of 172 patients with schizophrenia were recruited and assessed with the Chinese version of NSA-4, the Scale for Assessment of Negative Symptoms (SANS), PANSS, and the Calgary Depression Scale for Schizophrenia (CDSS). Cronbach′s α was computed to evaluate internal consistency. Intraclass correlation coefficients (ICCs) were computed to evaluate the inter-rater reliability and Spearman's correlation analysis was used to evaluate the test-retest reliability. Spearman′s correlation analyses were conducted between NSA-4 and SANS, PANSS, and CDSS to evaluate concurrent validity, convergent validity, and discriminant validity, respectively.Results:Cronbach′s α for the Chinese version of the NSA-4 was 0.788. ICCs were 0.661-0.958 and test-retest reliability was 0.860. The Chinese version of the NSA-4 showed satisfactory concurrent validity considering its high correlation with SANS ( r=0.801), excellent convergent validity considering its high correlation with PANSS total score and negative symptom subscale score ( r=0.528-0.834), and good discriminant validity considering its weak correlation with scores of the positive symptom subscale and general psychopathology subscale of PANSS and CDSS ( r=0.069-0.358). Conclusion:The Chinese version of the NSA-4 has good psychometric properties. It is useful for rapid assessment of negative symptoms in patients with schizophrenia.

Objectives:This study aims to evaluate the reliability and validity of the Chinese version of the 4-item Negative Symptom Assessment (NSA-4) in patients with schizophrenia.Methods:A total of 172 patients with schizophrenia were recruited and assessed with the Chinese version of NSA-4, the Scale for Assessment of Negative Symptoms (SANS), PANSS, and the Calgary Depression Scale for Schizophrenia (CDSS). Cronbach′s α was computed to evaluate internal consistency. Intraclass correlation coefficients (ICCs) were computed to evaluate the inter-rater reliability and Spearman's correlation analysis was used to evaluate the test-retest reliability. Spearman′s correlation analyses were conducted between NSA-4 and SANS, PANSS, and CDSS to evaluate concurrent validity, convergent validity, and discriminant validity, respectively.Results:Cronbach′s α for the Chinese version of the NSA-4 was 0.788. ICCs were 0.661-0.958 and test-retest reliability was 0.860. The Chinese version of the NSA-4 showed satisfactory concurrent validity considering its high correlation with SANS ( r=0.801), excellent convergent validity considering its high correlation with PANSS total score and negative symptom subscale score ( r=0.528-0.834), and good discriminant validity considering its weak correlation with scores of the positive symptom subscale and general psychopathology subscale of PANSS and CDSS ( r=0.069-0.358). Conclusion:The Chinese version of the NSA-4 has good psychometric properties. It is useful for rapid assessment of negative symptoms in patients with schizophrenia.

Objective:To explore the characteristics of cognitive function in patients with early onset and adult onset schizophrenia.Methods:In this cross-sectional study, 546 patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were selected.Among them, 62 cases were defined as early onset schizophrenia (EOS, age of onset＜18 years) and 175 patients were defined as adult onset schizophrenia (AOS, age of onset≥25 years).Patients underwent clinical assessments with the Positive and Negative Symptom Scale (PANSS) and the Personal and Social Performance Scale (PSP), and comprehensive neuropsychological assessments.Results:The EOS patients got lower scores in motor function-PEGDOM T score [ (26±12) vs. (30±11), P＜0.01], working memory-average T score of PASAT and WMSSP[ (34±12) vs. (38±10), P＜0.05]and executive function (inhibition) -Stroop T score [ (35±12) vs. (39±10), P＜0.05]than AOS patients.No differences were fund in processing speed, verbal memory and learning, visual memory and learning (Ps＞0.05) between the two groups.Conclusion:It suggests that the EOS patients have worse motor function, working memory and inhibition.

Anti-Bacterial Agents ; chemistry ; pharmacology ; Drug Resistance, Bacterial ; drug effects ; Humans ; Mycobacterium tuberculosis ; chemistry ; drug effects ; Tuberculosis, Multidrug-Resistant ; drug therapy ; microbiology

OBJECTIVETo investigate the association between ambient fine particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and the risk on preterm birth.

METHODSA total of 1 882 pregnant women with local residency of Taiyuan city and underwent delivery at the First Hospital of Shanxi Medical University with the dates of conception between January 1 and December 31, 2013, were enrolled in the study. Information on general demographics, home address and history on pregnancy, lifestyle and related environmental factors were collected through in-person interview. Birth outcomes and maternal complications were abstracted from medical records. Data on the amount of daily average PM2.5 from 8 monitor points in Taiyuan city, between March 1, 2012 and December 31, 2013 were also collected. Individual exposure during pregnancy were calculated using the inverse-distance weighting method, based on home address. Multivariate unconditional logistic regression model was used to examine the associations among PM2.5 exposure, risk of preterm birth and related clinical subtypes.

RESULTSThe overall incidence of preterm birth was 8.21% (151/1 839)in 1 839 pregnant women. Exposure to ambient PM2.5 during the second week prior to delivery was associated with an increased risk of preterm birth (OR=1.087, 95% CI: 1.001-1.182 per 10 μg/m(3) increase) and mild preterm birth (OR=1.099, 95% CI: 1.007-1.200 per 10 μg/m(3)). Compared to data from the China Environmental Air Quality Standard, higher level of exposure (≥75 μg/m(3)) of PM2.5 during the second week before delivery was associated with an increased risk of preterm birth (OR=1.008, 95%CI: 1.000-1.017) but the association was mainly seen for mild preterm birth (OR=1.010, 95%CI: 1.001-1.018).

CONCLUSIONSRESULTS from our study showed that exposure to high level of PM2.5 during late pregnancy would increase the risk of preterm birth. Future large studies are needed to examine the association by preterm clinical subtypes and to elucidate potential underlying mechanisms.

China ; epidemiology ; Environmental Exposure ; adverse effects ; analysis ; Female ; Humans ; Incidence ; Infant, Newborn ; Logistic Models ; Maternal Exposure ; Particle Size ; Particulate Matter ; analysis ; toxicity ; Pregnancy ; Pregnancy Complications ; Premature Birth ; chemically induced ; epidemiology ; Public Health ; statistics & numerical data