OBJECTIVE: To analyze the time characteristics of the Ethos online adaptive radiotherapy (OART) process in clinical practice and provide guidance for the comprehensive optimization of each stage of adaptive radiotherapy. METHODS: The study involved 61 patients with cervical, rectal, gastric, lung, esophageal, and breast cancers who underwent Ethos OART. The mean ± standard deviation of segmental time, total time, and target volume for these patients were tracked. The time characteristics for different cancer types were evaluated, and the average time for target and organ at risk (OAR) modifications was compared with the average target volume for each cancer type. RESULTS: Cervical cancer born the longest total treatment time, while breast cancer had the shortest. For all cancer types except breast cancer, the modification time for target and OAR was the most time-consuming segment. The average time for target and OAR modifications aligned with the trend of the average target volume. CONCLUSION The total treatment time for various cancers ranges from 15 to 35 minutes, indicating room for improvement.
Humans ; Radiotherapy Planning, Computer-Assisted/methods* ; Neoplasms/radiotherapy* ; Female

OBJECTIVES: To investigate the effects of formulated granules of Tianma Gouteng Yin (TGY) on motor deficits in a mouse model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced subacute Parkinson's disease (PD) and explore the possible molecular mechanisms. METHODS: Ninety C57BL/6 mice were randomized equally into 6 groups, including a control group, a PD model group, a NEC-1 (6.5 mg/kg) treatment group, two TGY treatment groups at 5 and 2.5 g/kg, and a Madopar (76 mg/kg) treatment (positive control) group. Mouse models of PD were established by intraperitoneal injection of MPTP (30 mg/kg) for 5 consecutive days with the corresponding treatments for 15 days. The mice were randomly selected for motor function tests. Western blotting was used to detect the changes in expressions of TH, α-syn, RIPK1, RIPK3 and MLKL in the striatum of the mice. Network pharmacology analysis and molecular docking studies were performed to explore TGY-mediated regulation of the necroptosis pathway for PD treatment. RESULTS: Compared with those in the control group, the PD model mice exhibited obvious motor deficits with significantly increased α-syn protein expression and lowered TH protein expression in the striatum. Treatment with NEC-1 obviously improved motor deficits, inhibited the necroptosis pathway, and alleviated the changes in TH and α‑syn proteins in PD mice. Network pharmacology and molecular docking analyses suggested that the therapeutic effect of TGY in PD was associated with the modulation of RIPK1, a key protein in the necroptosis pathway. In PD mouse models, TGY treatment at the two doses significantly improved motor deficits of the mice, increased TH expression, and decreased the expressions of α-syn and necroptosis-related proteins in the striatum. CONCLUSIONS TGY can effectively inhibit the necroptosis pathway, increase TH expression and decrease α-syn expression in the striatum to improve motor deficits in PD mice.
Animals ; Mice, Inbred C57BL ; Mice ; Necroptosis/drug effects* ; Drugs, Chinese Herbal/therapeutic use* ; Parkinson Disease/drug therapy* ; Disease Models, Animal ; Male

Objective To observe the distribution and characteristics of lymphatic vessels in normal and injured mouse spinal cord,and to determine if lymphatic vessels participate in the repair of spinal cord injury.Methods Thirty-nine adult male KM mice were divided randomly into a normal group(n=6)and an injured group(n=33).Mice in the injured group were further divided randomly into mice examined on postoperative days 1,3,5,7,and 14.Three mice in the injury group died after acupuncture injury,and the sample was subsequently supplemented randomly.Spinal cord damage was induced in the injured group by acupuncture,while mice in the normal group had no spinal cord damage.The distribution of lymphatic endothelial cells(LECs)in the spinal cord was detected by immunohistochemistry,and expression levels of the lymphatic endothelial cell markers prospero-related homobox-1(prox-1),lymphatic vessel endothelial cell hyaluronic acid receptor-1(lyve-1),and flat foot protein(podoplanin),and the vascular endothelial cell marker CD34 were observed in the spinal cords in normal and acupuncture-injured mice.Spinal cord samples were examined by immunofluorescence staining,and the source of new LECs was explored by observing the co-expression of lyve-1/prox-1,lyve-1/podoplanin,and CD34/prox-1.Results Lymphangioid structures were present in the spinal cord in normal mice and were distributed in segments,laterally between the white matter and gray matter.Nascent lymphangioid-like structures appeared in the spinal cord at the site of acupuncture injury,and prox-1,podoplanin,lyve-1,and CD34 were expressed simultaneously;however,these nascent lymphangioid-like structures disappeared after scarring during spinal cord injury.Conclusions Segmental,transversely distributed lymphangioid-like structures are present in the spinal cord in normal adult mice,and neonatal lymphangioid-like structures are involved in the reconstruction of spinal cord injury.These nascent LECs may originate from the surrounding existing lymphatic vessels or from vascular endothelial cells.

Objective:To investigate the application effects of a novel framework: the external septal retention bionic framework in East Asian rhinoplasty.Methods:A retrospective analysis was performed based on the clinical data of the patients who received treatments in Department of Plastic and Aesthetic ( Burn) Surgery, the Second Xiangya Hospital, Central South University from January 2022 to July 2023 using an external septal retention bionic framework with autologous costal cartilage rhinoplasty. The patients were all treated with a V-shaped incision at the nasal columella, which continued to both sides of the nose to form a bird-shaped incision. During the operation, the sixth or seventh costal cartilage was sculpted to form the nasal columella support grafts (sturt), external nasal septal graft, cap grafts, and shield grafts, in which the nasal column support graft and external nasal septal graft were implanted in a mortise-and-tenon joint structure to form a septum bionic retained external stent in order to lengthen the nasal columellar column and strengthen the septum. A capsular graft was used to shape the tip of the nose and the rectus abdominis fascia was covered to soften the tip of the nose, and the shield grafts were used to fill out the subnasal lobules. A bulb was sculpted, shaped and implanted in the dorsal space to elevate the nasal dorsum. To observe the postoperative results and complications, a postoperative satisfaction survey was completed using the rhinoplasty outcome evaluation (ROE) and the visual analogue scale (VAS) with regular follow-up. Comparison of preoperative and postoperative scale scores was performed using paired samples t-test. Nasal stent stability was assessed by measuring the patients’ preoperative and postoperative nasolabial angle and nasal tip protrusion. The comparison of preoperative and postoperative nasolabial angle was performed using the paired-sample t-test, and the comparison of nasal tip protrusion was performed using the Wilcoxon signed rank-sum test, P<0.05 considered a statistically significant difference. Results:A total of 33 patients were enrolled, including 4 males and 29 females, with average age of 23.8 years(15-42 years). The follow-up period is (14.52 ± 4.72) months (3 to 21 months). Thirty-three patients recovered well after surgery, and no short-term complications such as infection or bleeding occurred. The patients' nasal aesthetic problems such as saddle nose, deviated nasal columella, bilateral asymmetry of the nose, bilateral nasal base depression, and rounded shield of the nasal tip were improved after surgery. Satisfaction survey results: ROE and VAS scores were significantly higher than those before surgery, which were [(17.92±2.56) vs.(12.78±3.14)] and [(8.08±1.66)vs(5.15±1.99)], ( P<0.05), 87.9% (27/33)of the patients were satisfied with the aesthetic and functional outcomes of the nose. Comparisons of nasolabial angle [(87.28±2.58)° vs. (97.64±1.95)°] and tip protrusion [1.88 (1.78, 1.95) cm vs. 2.16(2.01, 2.32) cm] measurements between preoperative and postoperative period of the 33 patients, the differences were statistically significant ( P<0.05). Conclusion:Rhinoplasty for East Asians employs an external septal retention bionic framework to retain the nasal septum. This technique can avoid septal cartilage resorption caused by compression of grafts transplanted in the future, and cause less damage to the anatomy and physiology of the nose. The framework is relatively easy to construct, with a stable and strong stent, and good patient satisfaction. It can achieve a more desirable aesthetic effect of the nose.

Objective:To study the diagnostic value of artificial intelligence B-ultrasound image computer-aided diagnosis system (hereinafter referred to as intelligent ultrasound system) in adult goiter.Methods:In June 2022 and March 2023, two phases of thyroid disease survey were carried out in 4 cities in Anhui Province. One village was selected in each city, and 250 adults were selected as survey subjects in each village. Adult bilateral thyroid area was scanned by both intelligent ultrasound system and conventional ultrasound scanning equipment, and the effectiveness of intelligent ultrasound system in the diagnosis of goiter was analyzed based on the results of conventional ultrasound examination. Receiver operating characteristic (ROC) curve was drawn, and Kappa test was used to analyze the consistency between intelligent ultrasound system and conventional ultrasound examination in the diagnosis of goiter. At the same time, Spearman correlation analysis and Bland-Altman method were used to evaluate the consistency of the two methods in measuring thyroid volume.Results:After screening and removing outliers and missing values, a total of 910 adults were included, including 253 males (27.80%) and 657 females (72.20%). The age was (45.92 ± 10.20) years old, ranging from 18 to 60 years old. The sensitivity, specificity, and accuracy of the intelligent ultrasound system for diagnosing adult goiter were 80.00%, 99.67%, and 99.56%, respectively. The area under the ROC curve (AUC) was 0.996, which was consistent with the results of conventional ultrasound examination for diagnosing goiter ( κ = 0.67, P < 0.001). After controlling for variables such as gender, thyroid function, and thyroid nodules, the intelligent ultrasound system showed good consistency with conventional ultrasound examination in the diagnosis of goiter in females, adults with thyroid dysfunction, and adults without thyroid nodules ( κ = 0.66, 0.80, 0.80, P < 0.001). The consistency in the diagnosis of goiter in adults with thyroid nodules was moderate ( κ = 0.56, P < 0.001). Spearman correlation analysis showed a highly positive correlation between the measurement results of adult thyroid volume by intelligent ultrasound system and conventional ultrasound examination ( r = 0.88, P < 0.001). The Bland-Altman method results showed that only 4.62% (42/910) of points in adults were outside the 95% consistency limit, indicating good consistency between intelligent ultrasound system and conventional ultrasound examination in measuring thyroid volume (< 5%). The proportion of points outside the 95% consistency limit in males, adults with thyroid dysfunction, and adults with thyroid nodules was 6.72% (17/253), 5.83% (12/206), and 6.45% (12/186), respectively. Conclusions:The intelligent ultrasound system has certain diagnostic value for adult goiter and has good consistency with conventional ultrasound examination for thyroid volume measurement. However, the accuracy of diagnosis for males and adults with thyroid nodules still needs to be improved.

Objective To investigate the expression of serum Maresin 1 and pro-platelet basic protein(PPBP)in patients with diabetes nephropathy(DN)and their correlation with long-term prognosis.Methods A total of 83 patients with diabetes nephropathy admitted to Tangshan Central Hospital from May 2018 to May 2020 were selected as the diabetes nephropathy group.In the same period,60 patients with simple type 2 diabetes were selected as the diabetes group and 60 healthy people as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of serum Maresin1 and PPBP.Spearman correlation analysis was used to analyze the correlation between the levels of serum Maresin1 and PPBP and renal pathological damage.COX proportional hazard regression analysis was used to analyze the factors influencing the long-term poor prognosis of patients with diabetes nephropathy.ROC curve was used to evaluate the predictive value of serum Maresin1 and PPBP for the long-term poor prognosis.Results The levels of serum Maresin1(15.90±4.53 ng/ml,12.34±4.29 ng/ml,9.65±4.38 ng/ml)in the control group,diabetes group and diabetes nephropathy group were decreased in turn while the levels of serum PPBP(263.45±85.22 pg/ml,349.28±80.49 pg/ml,435.76±87.21 pg/ml)were increased in turn,and the differences were statistically significant(F=35.159,72.678,all P＜0.05).With the increase of IFTA score,interstitial inflammation score,and glomerular grading,serum Maresin1 level was decreased(F=25.838,25.187,9.751,all P＜0.05),while serum PPBP level was increased(F=56.513,92.702,58.137,all P＜0.05),and the differences were statistically significant,respectively.Serum Maresin1 was negatively correlated with IFTA score,interstitial inflammation score,and glomerular grading(r=-0.637,-0.581,-0.594,all P＜0.05),while serum PPBP was positively correlated with IFTA score,interstitial inflammation score,and glomerular grading(r=0.659,0.664,0.608,all P＜0.05),with significant differences.The course of diabetes nephropathy(HR=1.135,95％CI:1.012～1.370),24-hour urinary protein(HR=1.087,95％CI:1.016～1.164),PPBP(HR=1.208,95％CI:1.119～1.365),and IFTA score(HR=1.139,95％CI:1.024～1.219),interstitial inflammation score(HR=1.122,95％CI:1.006～1.249)and glomerular grading(HR=1.139,95％CI:1.052～1.273)were independent risk factors for long-term prognosis of diabetes nephropathy patients,while eGFR(HR=0.934,95％CI:0.892～0.993)and Maresin1(HR=0.903,95％CI:0.816～0.982)were protective factors for long-term prognosis(all P＜0.05).The areas under the curve(AUC)of serum Maresin1,PPBP and two indicators combined to predict the long-term poor prognosis of patients with diabetes nephropathy were 0.781,0.777 and 0.901,respectively.The AUC of two indicators combined was higher than that,and the differences were significant(Z=3.049,3.258,all P＜0.05).Conclusion In patients with diabetes nephropathy,serum Maresin1 was decreased and PPBP was increased,and the two indexes were closely related to the degree of renal injury.The combined test could effectively predict the long-term poor prognosis of patients.

Objective:To investigate the quality of life(QOL)of patients undergoing maintenance hemodialysis(MHD)in blood purification centers of three hospitals in Shenyang,and analyze its influencing factors,so as to provide reference for improving QOL of MHD patients.Methods:A total of 343 patients undergoing MHD from Mar to Oct,2021 were included,and their general data,laboratory indicators,hemodialysis indicators,etc.were collected.QOL of patients was evaluated by KDQOL-SFTM1.3 scale(SF-36 score and KDTA score).Multivariable linear regression analysis was used to analyze the factors affecting their QOL.Results:The scores of SF-36 and KDTA in MHD patients were 51.22±19.50 and 60.43±14.50,respectively.Age,marital status,family per capita monthly income,vascular access,monocyte count,blood phosphorus and serum albumin were independent influencing factors of SF-36 score(P＜0.05).And age,education level,family per capita monthly income and serum creatinine were independent influencing factors of KDTA score(P＜0.05).Conclusion:Comprehensive intervention of influencing factors should be paid more attention to improve the QOL of MHD patients.

Objective:To investigate the application effects of a novel framework: the external septal retention bionic framework in East Asian rhinoplasty.Methods:A retrospective analysis was performed based on the clinical data of the patients who received treatments in Department of Plastic and Aesthetic ( Burn) Surgery, the Second Xiangya Hospital, Central South University from January 2022 to July 2023 using an external septal retention bionic framework with autologous costal cartilage rhinoplasty. The patients were all treated with a V-shaped incision at the nasal columella, which continued to both sides of the nose to form a bird-shaped incision. During the operation, the sixth or seventh costal cartilage was sculpted to form the nasal columella support grafts (sturt), external nasal septal graft, cap grafts, and shield grafts, in which the nasal column support graft and external nasal septal graft were implanted in a mortise-and-tenon joint structure to form a septum bionic retained external stent in order to lengthen the nasal columellar column and strengthen the septum. A capsular graft was used to shape the tip of the nose and the rectus abdominis fascia was covered to soften the tip of the nose, and the shield grafts were used to fill out the subnasal lobules. A bulb was sculpted, shaped and implanted in the dorsal space to elevate the nasal dorsum. To observe the postoperative results and complications, a postoperative satisfaction survey was completed using the rhinoplasty outcome evaluation (ROE) and the visual analogue scale (VAS) with regular follow-up. Comparison of preoperative and postoperative scale scores was performed using paired samples t-test. Nasal stent stability was assessed by measuring the patients’ preoperative and postoperative nasolabial angle and nasal tip protrusion. The comparison of preoperative and postoperative nasolabial angle was performed using the paired-sample t-test, and the comparison of nasal tip protrusion was performed using the Wilcoxon signed rank-sum test, P<0.05 considered a statistically significant difference. Results:A total of 33 patients were enrolled, including 4 males and 29 females, with average age of 23.8 years(15-42 years). The follow-up period is (14.52 ± 4.72) months (3 to 21 months). Thirty-three patients recovered well after surgery, and no short-term complications such as infection or bleeding occurred. The patients' nasal aesthetic problems such as saddle nose, deviated nasal columella, bilateral asymmetry of the nose, bilateral nasal base depression, and rounded shield of the nasal tip were improved after surgery. Satisfaction survey results: ROE and VAS scores were significantly higher than those before surgery, which were [(17.92±2.56) vs.(12.78±3.14)] and [(8.08±1.66)vs(5.15±1.99)], ( P<0.05), 87.9% (27/33)of the patients were satisfied with the aesthetic and functional outcomes of the nose. Comparisons of nasolabial angle [(87.28±2.58)° vs. (97.64±1.95)°] and tip protrusion [1.88 (1.78, 1.95) cm vs. 2.16(2.01, 2.32) cm] measurements between preoperative and postoperative period of the 33 patients, the differences were statistically significant ( P<0.05). Conclusion:Rhinoplasty for East Asians employs an external septal retention bionic framework to retain the nasal septum. This technique can avoid septal cartilage resorption caused by compression of grafts transplanted in the future, and cause less damage to the anatomy and physiology of the nose. The framework is relatively easy to construct, with a stable and strong stent, and good patient satisfaction. It can achieve a more desirable aesthetic effect of the nose.

Objective To investigate the influencing factors of treatment decision dilemma in the pa-tients with intracranial aneurysm.Methods A total of 210 patients with intracranial aneurysms hospitalized in the neurosurgery department of this hospital from January to December 2022 were selected as the research subjects.The questionnaire survey on the patients was conducted by using the general data questionnaire,De-cision Dilemma Scale (DDS),Perceptive Social Support Scale (PSSS) and Hospital Anxiety and Depression Scale (HADS).Results The scores of decisional dilemma,perceived social support,anxiety and depression of the patients with intracranial aneurysm were (38.08±14.05) points,(50.59±3.38) points,(11.12±3.46) points and (9.56±2.11) points respectively.The multiple linear regression analysis showed that the age,fam-ily per capita monthly income,aneurysm diameter,social support and anxiety were the main influencing fac-tors of treatment decision dilemma in the patients with intracranial aneurysm (P<0.05).Conclusion The de-cision-making dilemma in the patients with intracranial aneurysms is in a moderate level.Medical care staff should for-mulate the targeted decision support measures according to the patient' s age,economic status,aneurysm size,patient's social support and anxiety situation to help the patients to improve their decision-making level.