Objective To analyze the differences of dosimetry and positioning error between HyperArc and non-coplanar VMAT in patients with brain metastases,provide references for clinical practice.Methods Forty patients with brain metastases were selected.Among them,20 patients who received HyperArc treatment were the observation group,and 20 patients who received non-coplanar VMAT treatment were the control group.Compared the differences in conformal index(CI),gradient index(GI),homogeneity index(HI)of the two groups,as well as the positioning error in the three directions of X(head to foot),Y(left to right),Z(ab-domen to back),and the three rotation angles of Rx(rotation around the X-axis),Ry(rotation around the Y-axis),and Rz(rotation around the Z-axis).Results CI,GI and HI of the observation group were 0.927(0.890,0.950),3.200(2.510,3.730)and 0.220(0.177,0.280),respectively.CI,GI and HI of the control group were 0.888(0.845,0.928),3.340(2.890,4.220)and 0.218(0.180,0.300),respectively.There was sta-tistically significant difference in CI between the two groups(P<0.05),while there was no statistically sig-nificant difference in GI and HI(P>0.05).The positioning error of X,Y,Z,Rx,Ry,and Rz in the control group were 0.118±0.084,0.133±0.112,0.226±0.142,0.930±0.767,1.330±0.869,and 0.910±0.650,respectively,while in the observation group were 0.149±0.113,0.178±0.120,0.172±0.117,1.340±0.758,1.610±0.743,and 1.420±0.832,respectively.There were statistically significant differences in all directions(P<0.05).Conclusion HyperArc performs better in the conformal degree of the target area,but the positio-ning error of Rx,Ry and Rz rotation angles is slightly inferior to that of non-coplanar VMAT.

Objective To observe the new therapeutic effects and mechanisms of baicalin on diabetic foot ulcer(DFU)rats.Methods SD rats were randomly divided into a control group,a model group,a low-dose baicalin group,a high-dose baicalin group,and a high-dose baicalin+YC-1[hypoxia-inducible factor 1α(HIF-1α)inhibitor]group.Except for the normal group,the rats in all other groups were constructed to DFU model.After successful modeling,the medication was performed in each group.After treatment,fasting blood glucose level was measured,and the wound healing rate was calculated.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of interleukin(IL)-10,tumor necrosis factor(TNF)-α,and IL-6 in wound granulation tissue.The hydroxylamine method was used to measure superoxide dismutase(SOD)activity,the ammonium molybdate method was used to measure catalase(CAT)activity,and the thiobarbituric acid method was used to measure malondialdehyde(MDA)content in wound granulation tissue.Hematoxylin-eosin(HE)staining was used to observe the morphology of wound granulation tissue.Immunohistochemistry was used to detect the positive expression of CD31 protein in wound granulation tissue.Western Blot was used to measure the protein expression levels of advanced glycation end products(AGEs),receptor for advanced glycation end products(RAGE),matrix metalloproteinase 2(MMP-2),HIF-1α,vascular endothelial growth factor(VEGF),and vascular endothelial growth factor receptor 2(VEGFR-2)in wound granulation tissue.Results Compared with the control group,the model group showed reduced angiogenesis and obvious inflanmatory cell infiltration in wound granulation tissue,increased fasting blood glucose level,levels of TNF-α and IL-6,MDA content,and protein expressions of AGEs,RAGE,and MMP-2 in wound tissue,as well as decreased wound healing rate,CD31-positive expression rate,IL-10 level,SOD and CAT activities,and protein expressions of HIF-1α,VEGF,and VEGFR-2,with statistically significant differences(P＜0.05).Compared with the model group,the low-and high-dose baicalin groups showed significantly improved wound granulation tissue morphology,reduced fasting blood glucose level,levels of TNF-α and IL-6,MDA content,and protein expressions of AGEs,RAGE,and MMP-2 in wound tissue,as well as increased wound healing rate,CD31-positive expression rate,IL-10 level,SOD and CAT activities,and protein expressions of HIF-1α,VEGF,and VEGFR-2,with statistically significant differences(P＜0.05).YC-1 partially reversed the improvement effects of baicalin on angiogenesis and inflammation in DFU rats(P＜0.05).Conclusion Baicalin can reduce inflammation and oxidative stress,promote angiogenesis,and accelerate wound healing in DFU rats by activating the HIF-1α/VEGF signaling pathway.

Objective To observe the therapeutic effects and mechanisms of acupuncture at Renying(ST9)on hypertension.Methods Spontaneously hypertensive rats(SHRs)were randomly divided into a model group and a Renying group 6 rats in each group,with six Wistar-Kyoto(WKY)rats serving as the blank control group.The Renying group received bilateral acupuncture at Renying point once daily for 5 consecutive days,followed by a 2-day rest,for a total of 4 weeks.Systolic and diastolic blood pressures were measured via tail-cuff plethysmography before intervention and at weeks 1,2,3,and 4 after intervention.After the intervention,fecal and plasma samples were collected.16S rDNA high-throughput sequencing was used to analyze gut microbiota composition,and 1H NMR spectroscopy was employed to detect plasma metabolite differences.Results(1)Before intervention,systolic and diastolic blood pressures in the model and Renying groups were significantly higher than those in the blank group(P＜0.05).After acupuncture intervention,the Renying group exhibited significantly lower systolic and diastolic blood pressures than the model group at weeks 2,3,and 4(P＜0.05).After 4 weeks,the model group showed significantly increased systolic and diastolic blood pressures compared with baseline(P＜0.05),whereas the Renying group exhibited significantly decreased pressures(P＜0.05).Throughout the intervention,the Renying group demonstrated smaller blood pressure fluctuations and more stable control than the model group.(2)Microbiota analysis:Compared with the blank group,the model group had 39 fewer unique operational taxonomic units(OTUs),whereas the Renying group showed increased unique OTUs,approaching levels observed in the blank group.(3)NMDS analysis of β-diversity revealed that acupuncture significantly altered gut microbial diversity in SHRs.At the phylum level,Firmicutes,Bacteroidetes,Verrucomicrobia,and Patescibacteria dominated gut microbiota composition.Patescibacteria abundance was significantly increased in the model group but decreased in the Renying group(P＜0.05).At the genus level,Bacteroides and Faecalibacterium abundances were reduced in the model group but higher in the Renying group(P＜0.05).(4)LEfSe analysis indicated significant enrichment of Clostridia_vadinBB60_group and Alistipes_sp_CHKCI003 in the Renying group,whereas unclassified_Clostridia_UCG_014 was more prevalent in the model group.(5)OSC-PLS analysis of 1H NMR-detected plasma metabolites revealed significant intergroup differences,with Renying acupuncture altering acetate and trimethylamine N-oxide(TMAO)levels.Conclusion Acupuncture at Renying points significantly reduces systolic and diastolic blood pressures in SHRs,possibly by modulating gut microbiota structure,ameliorating microbial dysbiosis,promoting beneficial bacterial growth,suppressing harmful bacteria,and regulating acetate-and TMAO-related metabolic pathways.

Objective To analyze the evaluation value of the standard deviation of erythrocyte volume distribution width(RDW-SD),erythrocyte volume distribution width standard deviation and platelet ratio(RPR)and erythrocyte volume distribution width standard deviation and lymphocyte ratio(RLR)in the de-compensation stage of cirrhosis in primary biliary cholangitis(PBC).Methods The blood routine indexes of 68 patients with PBC admitted and treated in this hospital from January 2019 to June 2021 were retrospective-ly analyzed and divided into the compensation stage(n=36)and decompensation stage(n=32)according to the diagnostic standard.2 mL venous blood was extracted from the patient on an empty stomach in the early morning.The red blood cell(RBC),mean corpuscular volume(MCV),hemoglobin(Hb),hematocrit(HCT),mean erythrocyte hemoglobin content(MCHC),RDW-SD,white blood cell(WBC),neutrophil absolute value(N#),lymphocyte absolute value(L#),platelet count(PLT),mean platelet volume(MPV),platelet volume distribution width(PDW),etc.were detected.The platelet to lymphocyte ratio(PLR),RPR and RLR were calculated.The influencing factors of decompensation stage of PBC cirrhosis were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of different indicators in the decompensation stage of PBC cirrhosis.Results There were statistically significant differences in age,RBC,Hb,HCT,RDW-SD,L #,PLT,RPR and RLR between the compensation group and decompensation group in PBC cirrhosis(P＜0.05).The binary logistic regression analysis showed that the age[odds ratios(OR)=1.087,95％confidence intervals(CI):1.015-1.165,P＜0.05],RDW-SD(OR=1.144,95％CI:1.030-1.270,P＜0.05)and RLR(OR=1.041,95％CI:1.007-1.075,P＜0.05)were the independent risk factors for progressing to the decompensation stage in the patients with PBC cirrhosis com-pensation stage.The ROC curve analysis showed that the areas under ROC curve(AUC)of RDW-SD,RPR and RLR for the diagnosis alone of decompensation stage of PBC cirrhosis were 0.726,0.778 and 0.798,re-spectively,and the differences were not statistically significant(P＞0.05).Conclusion Combined with the age factor,regular monitoring of RDW-SD,RPR and RLR levels has a high predictive value for the develop-ment of PBC cirrhosis compensation stage to decompensation stage.

Objective:To analyze the efficacy and feasibility of performing a new surgical procedure, tunnel esophagogastrostomy, to perform proximal gastrectomy.Methods:The study cohort comprised 10 consecutive patients who had undergone esophagogastrostomy by the tunnel technique in Jiangsu Cancer Hospital between October 2019 and July 2022. All patients were male. Their average age was (64.2±8.1) years and body mass index (25.5±3.2) kg/m2. Nine had upper gastric body adenocarcinoma, the remaining one having signet ring cell carcinoma. TNM staging of the tumors showed that seven were Stage IA, one Stage IB, one Stage IIA, and one Stage IIIA. Briefly, tunnel esophagogastrostomy is performed as follows: After performing a proximal gastrectomy, a rectangular seromuscular flap (3.0 cm × 3.5 cm) is created. The posterior esophageal wall is sutured to the gastric wall at the orad end of the seromuscular flap 5 cm from the stump with three to four stitches. Next, the stump of the esophagus is opened, the posterior esophageal wall is sutured to the gastric mucosa and submucosa, and the anterior esophageal wall is sutured to the full layer of the stomach. Finally, the caudad end of the seromuscular flap is closed. Data on surgical safety, postoperative morbidity, and postoperative reflux esophagitis were analyzed. All enrolled patients completed endoscopic follow-up 1 year and 2 years after surgery.Results:All procedures were completed. They comprised four cases of laparoscopic assisted surgery, four of DaVinci robotic surgery, and two of open surgery. The mean operation time was 212.7±33.2 mins, mean anastomosis time (51.6±5.3) minutes, mean tunnel preparation time (20.0±3.5) minutes, and mean operative blood loss (90.0±51.6) mL. The time to first postoperative passage of flatus was (64.8±11.5) hours. The mean hospital stay after surgery was (9.2±1.7) days. There were no postoperative complications above Clavien-Dindo Grade II. The mean preoperative Reflux Disease Questionnaire score was (3.3± 0.4) before the surgery, (3.8±1.0) 1 month postoperatively, and (3.3±0.4) 12 months postoperatively. All patients underwent endoscopic follow-up; no anastomotic stenoses were found. However, one patient had Grade A reflux esophagitis 1 year after surgery and another Grade B reflux esophagitis 2 years after surgery.Conclusion:Esophagogastrostomy by the tunnel technique is a safe and feasible means of performing proximal gastrectomy.

Objective:To analyze the efficacy and feasibility of performing a new surgical procedure, tunnel esophagogastrostomy, to perform proximal gastrectomy.Methods:The study cohort comprised 10 consecutive patients who had undergone esophagogastrostomy by the tunnel technique in Jiangsu Cancer Hospital between October 2019 and July 2022. All patients were male. Their average age was (64.2±8.1) years and body mass index (25.5±3.2) kg/m2. Nine had upper gastric body adenocarcinoma, the remaining one having signet ring cell carcinoma. TNM staging of the tumors showed that seven were Stage IA, one Stage IB, one Stage IIA, and one Stage IIIA. Briefly, tunnel esophagogastrostomy is performed as follows: After performing a proximal gastrectomy, a rectangular seromuscular flap (3.0 cm × 3.5 cm) is created. The posterior esophageal wall is sutured to the gastric wall at the orad end of the seromuscular flap 5 cm from the stump with three to four stitches. Next, the stump of the esophagus is opened, the posterior esophageal wall is sutured to the gastric mucosa and submucosa, and the anterior esophageal wall is sutured to the full layer of the stomach. Finally, the caudad end of the seromuscular flap is closed. Data on surgical safety, postoperative morbidity, and postoperative reflux esophagitis were analyzed. All enrolled patients completed endoscopic follow-up 1 year and 2 years after surgery.Results:All procedures were completed. They comprised four cases of laparoscopic assisted surgery, four of DaVinci robotic surgery, and two of open surgery. The mean operation time was 212.7±33.2 mins, mean anastomosis time (51.6±5.3) minutes, mean tunnel preparation time (20.0±3.5) minutes, and mean operative blood loss (90.0±51.6) mL. The time to first postoperative passage of flatus was (64.8±11.5) hours. The mean hospital stay after surgery was (9.2±1.7) days. There were no postoperative complications above Clavien-Dindo Grade II. The mean preoperative Reflux Disease Questionnaire score was (3.3± 0.4) before the surgery, (3.8±1.0) 1 month postoperatively, and (3.3±0.4) 12 months postoperatively. All patients underwent endoscopic follow-up; no anastomotic stenoses were found. However, one patient had Grade A reflux esophagitis 1 year after surgery and another Grade B reflux esophagitis 2 years after surgery.Conclusion:Esophagogastrostomy by the tunnel technique is a safe and feasible means of performing proximal gastrectomy.

As an important functional material for water treatment,ion exchange resin is widely used in medicine,chemical industry,nuclear industry and other fields.Due to its high efficiency and reliability,it is also widely used in the water circulation system of China Space Station,such as urine treatment subsystem,water treatment subsystem,and electrolytic oxygen production subsystem,which effectively guarantees the normal operation of the equipment and the safe use of water resources.Considering its renewability,the development of ion exchange resin regeneration technology for manned space missions can further reduce the supply demand of long-term missions,which is of great significance for the development of manned space flight to deep space.This paper focuses on the application characteristics and research progress of three kinds of ion exchange resin electro-regeneration technology,and the potential auxiliary regeneration technologies such as thermal regeneration,biological regeneration,ultrasonic regeneration and carbon dioxide regeneration are introduced,and the application prospect analysis of ion exchange regeneration technology is given according to the application characteristics of manned spaceflight.

Objective To develop the volume adjustable vegetable facilities and meet the demands of research on the growing technique of vegetables.Methods Three series of adjustable volume vegetable facilities were developed with light and ventilation module,growth module,cultivation tray module and measurement module.Telescopic structure was adopted in the facilities and the performance testing and characteristics analyses were carried out.Results The facilities could be adjusted at the height range of 250-700 mm.Three kinds of LED lights and replaceable cultivation tray and matrix were installed in the facilities.The parameters including water content,electric conductivity and temperature in the matrix,CO2 concentration in the atmosphere of facilities were monitored.The test results showed that the performances and the indexes of facilities met the subsequent experimental demands.Conclusion Light weight,small volume,and adjustable volume vegetable facilities were developed.The production efficiency of lettuce(12 plants/0.12 m2)grown in the facilities was 49.7 g(FW)plant-1.The development of facilities laid the foundation of construction of on-orbit vegetable facility.

Image registration is critical for clinical medical diagnosis and assisting surgical procedure.Using simulated X-ray and digital subtraction angiography(DSA)to generate digitally reconstructed radiograph(DRR)would improve the accuracy and speed of medical image registration.Herein an approach of using shading language to simultaneously generate the 3D render image and DRR from simulated X-ray or DSA is presented.The complex optimization and registration calculations are completed using the parallel calculation language(OpenCL),and the image processing unit(GPU)is used for DRR generation and 2D/3D registration.Experimental results show that the proposed method which relies on simulated X-ray or DSA for image registration can provide rapid and accurate visual guiding for surgical procedure.

The key pathogenesis of endometriosis is blood stasis,often mixed with phlegm turbidity,qi stagnation,and kidney deficiency.In clinical practice,qi,phlegm,and blood stasis are commonly seen,and the ascending and descending of the triple energizer qi movement are imbalanced.Based on its syndrome characteristics,it can be classified as"Zheng Jia"or"infertility"in the TCM.Based on the TCM theory and clinical experience,combined with modern medical research results,this article believed that the dysfunction of the triple energizer is an important pathogenesis of endometriosis,and explore the physiological and pathological aspects,pathogenesis mechanism,and relationship with endometriosis of the triple energizer,providing reference for clinical treatment of endometriosis.