Objective To achieve efficient compression of on-board radiotherapy projection images using dynamic video encoding algorithms.Methods The on-board radiotherapy imaging system primarily provides 2D X-ray projection images for patient positioning verification and 3D tomographic image reconstruction.Since multiple projection images acquired continuously exhibit strong spatiotemporal correlations,their similarities could be used to eliminate redundant information,thereby improving the image compression ratio.During image compression,the image sets obtained at different times were arranged into an image sequence which was input into a video encoder and output as a video file.During image decompression,the video file was input into a video decoder and output as an image sequence,and the images in the sequence were then assigned back to their original image sets.Three current dynamic video encoding algorithms(AVC,HEVC,and AV1)and the classic static image coding algorithm(JPEG 2000)were tested on a database of 2D projection images.The performance of various compression algorithms was evaluated using indicators such as compression ratio(CR),peak signal-to-noise ratio(PSNR),and structural similarity(SSIM).Moreover,visual comparison of projection images before and after compression was evaluated by clinical radiation oncologists.Results Dynamic video encoding algorithms achieved higher CR than the static image coding algorithm.The average CR of the 3 dynamic video encoding algorithms was as followed:CRAVC=11.50,CRHEVC=30.74,and CRAV1=27.10,while the average CR of the static image coding algorithm(JPEG 2000)was 5.28.For abdominal projection images,well-defined contours and textural details were preserved even when the CR reached 42.37.For head-neck projection images,although mild contour blurring emerged at a CR of 20.71,subsequent evaluation by clinical radiation oncologists confirmed that the reconstructed CBCT images still satisfied clinical requirements.Conclusion These dynamic video encoding algorithms effectively utilize the strong correlation information between multiple projection images,reduce the storage of redundant information,and greatly improve the image CR.

Medical imaging technology plays a crucial role in clinical diagnosis and treatment. Image compression technology provides robust technical support for the storage and transmission of massive medical imaging data, serving as an effective safeguard for hospital data backup and telemedicine. The technology holds broad application prospects in the medical field, enabling the processing of various imaging modalities, multidimensional imaging, and medical video imaging. This study elaborates on general image and video compression algorithms, the application of compression algorithms in the medical field, and the performance metrics of medical image compression, thereby providing critical technical support for enhancing clinical diagnostic efficiency and data management security.

Objective To achieve efficient compression of on-board radiotherapy projection images using dynamic video encoding algorithms.Methods The on-board radiotherapy imaging system primarily provides 2D X-ray projection images for patient positioning verification and 3D tomographic image reconstruction.Since multiple projection images acquired continuously exhibit strong spatiotemporal correlations,their similarities could be used to eliminate redundant information,thereby improving the image compression ratio.During image compression,the image sets obtained at different times were arranged into an image sequence which was input into a video encoder and output as a video file.During image decompression,the video file was input into a video decoder and output as an image sequence,and the images in the sequence were then assigned back to their original image sets.Three current dynamic video encoding algorithms(AVC,HEVC,and AV1)and the classic static image coding algorithm(JPEG 2000)were tested on a database of 2D projection images.The performance of various compression algorithms was evaluated using indicators such as compression ratio(CR),peak signal-to-noise ratio(PSNR),and structural similarity(SSIM).Moreover,visual comparison of projection images before and after compression was evaluated by clinical radiation oncologists.Results Dynamic video encoding algorithms achieved higher CR than the static image coding algorithm.The average CR of the 3 dynamic video encoding algorithms was as followed:CRAVC=11.50,CRHEVC=30.74,and CRAV1=27.10,while the average CR of the static image coding algorithm(JPEG 2000)was 5.28.For abdominal projection images,well-defined contours and textural details were preserved even when the CR reached 42.37.For head-neck projection images,although mild contour blurring emerged at a CR of 20.71,subsequent evaluation by clinical radiation oncologists confirmed that the reconstructed CBCT images still satisfied clinical requirements.Conclusion These dynamic video encoding algorithms effectively utilize the strong correlation information between multiple projection images,reduce the storage of redundant information,and greatly improve the image CR.

Objective:To investigate the prospective association of sleep duration with the development of chronic obstructive pulmonary disease (COPD) in adults in Suzhou.Methods:The study used the data of 53 269 participants aged 30-79 years recruited in the baseline survey from 2004 to 2008 and the follow-up until December 31, 2017 of China Kadoorie Biobank (CKB) conducted in Wuzhong District, Suzhou. After excluding participants with airflow limitation, self-reported chronic bronchitis/emphysema/coronary heart disease history at the baseline survey and abnormal or incomplete data, a total of 45 336 participants were included in the final analysis. The association between daily sleep duration and the risk for developing COPD was analyzed by using a Cox proportional hazard regression model, and the hazard ratio ( HR) values and their 95% CI were calculated. The analysis was stratified by age, gender and lifestyle factors, and cross-analysis was conducted according to smoking status and daily sleep duration. Results:The median follow-up time was 11.12 years, with a total of 515 COPD diagnoses in the follow-up. After adjusting for potential confounders, multifactorial Cox proportional hazard regression analysis showed that daily sleep duration ≥10 hours was associated with higher risk for developing COPD ( HR=1.42, 95% CI: 1.03-1.97). The cross analysis showed that excessive daily sleep duration increased the risk for COPD in smokers ( HR=2.49, 95% CI: 1.35-4.59, interaction P<0.001). Conclusion:Longer daily sleep duration (≥10 hours) might increase the risk for COPD in adults in Suzhou, especially in smokers.

Background and aim:Hepatitis B virus(HBV)-related gestational acute-on-chronic liver failure(ACLF)is a severe condition with limited treatment options.This study aimed to evaluate the efficacy and ideal timing of plasma exchange and continuous renal replacement therapy(CRRT)in managing pregnant women with HBV-related ACLF. Methods:This study retrospectively analyzed 51 eligible patients with HBV-related gestational ACLF between 2009 and 2020.Patients admitted to the study were divided into a conventional treatment group and a new treatment group according to whether they received the new management protocol,which included more aggressive plasma exchange(PE)and CRRT strategies.All 19 pregnant women with hepatic encephalopathy(HE)were divided into an early treatment group and a non-early treatment group according to whether PE therapy was initiated within three days.Our study had two primary objectives.Firstly,we aimed to evaluate the impact of PE and CRRT on puerperal survival.Secondly,we sought to assess the effects of early PE and CRRT regimens on puerperal survival in women with HE. Results:The levels of total bilirubin on the second day postpartum(D3),the third day postpartum(D4),and the fifth day postpartum(D6)were significantly lower in the new treatment group compared to the conventional treatment group(P=0.02,0.01,and 0.02,respectively).The ALT of D3 was significantly elevated in the new treatment group compared to the conventional treatment group(P=0.02).The incidence of HE overall increased from prenatal to postpartum D4,peaked on D4,and then gradually decreased from the fourth day postpartum(D5)(P=0.027).The first week after delivery revealed a significant difference in survival rate between the two groups,the conventional treatment group had statistically higher mortality rates compared to the new treatment group(P=0.002).Similarly,the entire puerperal period mortality rate of the conventional treatment group was statistically higher than the new treatment group(P=0.002).Moreover,among all patients with HE,the non-early treatment group showed significantly higher puerperal mortality rates compared to the early treatment group(P=0.006). Conclusions:Early PE and CRRT conducted within three days post-childbirth,enhance puerperal prog-nosis for HBV-related gestational ACLF.

Polycystic ovary syndrome(PCOS)is one of the most common reproductive and endocrine disorders in women of childbearing age,and the pathogenesis is unknown.Insulin resistance,hyperandrogenism and obesity are important pathophysiological basis.Glucose-dependent insulinotropic peptide(GIP)is a gastrointestinal hormone involved in the regulation of insulin secretion.Literature studies have shown that GIP is correlated with insulin resistance,hyperandrogenism,obesity and other characteristic changes of PCOS,and it may contribute to the onset and progression of PCOS by affecting the function of hypothalamic-pituitary-ovarian axis,suggesting that GIP is associated with PCOS.This paper reviews the research progress of the correlation between GIP and PCOS.

This article reported a male neonate with lethal mitochondrial trifunctional protein deficiency (MTPD) caused by compound heterozygous variations in the HADHB gene. The patient presented with poor milk intake complicated by abnormal myocardial enzymes within 24 h after birth and was transferred to the Children's Hospital of Nanjing Medical University on day 4. Physical examination revealed no obvious abnormalities on admission. Laboratory examination showed increased creatine kinase isoenzyme and cardiac troponin levels, and electrocardiogram suggested sinus tachycardia and low QRS voltage in limb leads. Blood screening for metabolic abnormalities showed high levels of tetradecenyl carnitine and various 3-hydroxycarnitines. Heterozygous mutations of c.739C>T(p.Arg247Cys) and c.607C>T(p.Arg203Ter,272) were detected in the HADHB gene in the boy, which were pathogenic variants included in the Human Gene Mutation Database. Followed up to three months of age, the boy was readmitted to hospital due to poor milk intake for one week and poor response for 2 d after catching a cold. After admission, he quickly developed multiple organs dysfunction such as heart failure and respiratory failure, and then died. Lethal MTPD is rare with no effective treatment and poor prognosis. Lethal MTPD should be highly suspected when unexplained cardiomyopathy, hypoglycemia, acidosis and other metabolic abnormalities appear in the neonatal period, and an early diagnosis could be confirmed with genetic testing in the neonatal period.

ObjectiveTo study the mechanism of Shenbai Jiedu prescription inhibiting the proliferation of HCT116 colorectal cancer （CRC） cells by regulating the phosphatase and tensin homolog deleted on chromosome ten （PTEN）/phosphatidylinositol 3-kinase （PI3K）/ protein kinase B （Akt） signaling pathway. MethodShenbai Jiedu prescription was extracted by water extraction and alcohol precipitation to prepare freeze-dried powder. HCT116 cells were cultured in vitro， and treated with different concentrations of Shenbai Jiedu prescription （2， 4， 8， 16 g·L^-1）. The inhibitory effect of Shenbai Jiedu prescription on the proliferation of HCT116 cells was tested by methyl thiazolyl tetrazolium （MTT）. Real-time quantitative PCR was used to detect the mRNA expression levels of PTEN， PI3K， Akt， glycogen synthase kinase-3β （GSK-3β）， c-Myc， survivin and Cyclin D₁. Western blot was employed to measure the protein expression levels of PTEN， phosphorylated PTEN （p-PTEN）， PI3K， Akt， phosphorylated Akt （p-Akt）， GSK-3β， phosphorylated GSK-3β （p-GSK-3β）， c-Myc， survivin and Cyclin D₁， β-catenin nuclear import was explored by immunofluorescence assay. ResultCompared with the control group， Shenbai Jiedu prescription inhibited the proliferation of HCT116 cells in a dose-dependent manner （P<0.01）. Compared with the control group， the mRNA expression levels of PTEN and GSK-3β were up-regulated whereas those of PI3K， Akt， c-Myc， survivin and CyclinD₁ were down-regulated after treatment with Shenbai Jiedu prescription （P<0.01）. The protein expression levels of PTEN， p-PTEN and GSK-3β were up-regulated whereas those of PI3K， Akt， p-Akt， GSK-3β， p-GSK-3β， c-Myc， survivin and CyclinD₁ were down-regulated （P<0.05， P<0.01）. Immunofluorescence assay showed that Shenbai Jiedu prescription suppressed β-catenin nuclear import in HCT116 cells. ConclusionShenbai Jiedu prescription inhibited the proliferation of HCT116 cells via the mechanism of regulating the PTEN/PI3K/Akt signaling pathway.

Objective:To investigate the frequency and severity of systemic adverse reactions in children with allergic rhinitis (AR) undergoing subcutaneous immunotherapy (SCIT).Methods:The clinical data of 321 children with allergic rhinitis receiving SCIT at Department of Otorhinolaryngology, Changzhou Third People′s Hospital from January 2016 to January 2020 were retrospectively analyzed. There were 180 boys and 141 girls aged 5 to 14 years. Patients were injected subcutaneously with standardized dust mites allergen extract. The onset time, symptoms and signs and treatment of adverse reactions were documented. The relationship of adverse reactions with gender, age, treatment course and dosage of allergen injection were analyzed.Results:Patients received total 13 053 injections, and 115 adverse reactions (0.88%) occurred in 56 cases (17.45%). The incidence of adverse reactions in children aged 5-9 years was higher than in those aged 10-14 years, for both the number of cases and injections (χ2=4.41, P=0.04; χ2=9.13, P<0.01), but no significant differences were observed in gender of patients. The incidence of adverse reactions in the age group 2-3 years was lower than that in age groups<1 year and 1-<2 years in both of cases and injections (χ2=22.86, P<0.01; χ2=6.43, P=0.01; χ2=12.14, P<0.01; χ2=13.74, P<0.01). The incidence of adverse reactions in the high-dosage phase (100 000 SQ-U) was higher than that in the low-dosage phase (<100 000 SQ-U) (χ2=4.35, P=0.04). Conclusions:The study shows that the incidence of adverse reactions in children with allergic rhinitis receiving subcutaneous immunotherapy is less than 1% in the number of injections and most of them are grade Ⅰ adverse reactions. The study also shows that younger age, the early course of treatment and the high dosage of allergens are risk factors for adverse reactions.

Objective:To understand the occurrence of systemic adverse reactions in patients with simple allergic rhinitis (AR) after receiving subcutaneous immunotherapy (SCIT) with standardized dicid allergen injection.Methods:The clinical data of AR patients who completed the whole course of SCIT with standardized mite allergen injection in AR Diagnosis and Treatment Center in Department of Otolaryngology, the Third People′s Hospital of Changzhou from August 1st, 2015 to July 31st, 2020 were analyzed retrospectively. The course of SCIT was 156 weeks, comprising 4 stages. The first 14 weeks was the dose increase phase, in which standardized mite allergen injection was given once a week and the dose was gradually increased from 5 TU in the 1st week to 5 000 TU in the 14th week; the weeks 15-52, 53-104, and 105-156 were the dose maintenance phase, in which the injection was given once every 5 weeks at the dose of 5 000 TU. According to the number of injections, the incidence of systemic adverse reactions in patients of different gender and age at different stages of the course of treatment and after injection at different doses were counted, and the types [according to the time of occurrence, the adverse reactions were divided into immediate type(≤30 min) and delayed type(>30 min)], classification (grade 1-5), clinical manifestations, and outcome of adverse reactions were analyzed.Results:A total of 302 patients were enrolled in the study, including 175 males and 127 females, aged from 5 to 60 years. Of them, 187 patients were ≤14 years old and 115 were>14 years old. Three hundred and two patients received 13 687 subcutaneous injections totally and 46 patients in 120 times of injection had systemic adverse reactions. The incidence of adverse reactions was 15.23% (46/302) according to the number of cases and 0.88% (120/13 687) according to the number of injections. Among the 120 times of systemic adverse reactions, 55 (45.83%) were immediate type and 65 (54.17%) were delayed type. The adverse reactions belonged to grade 1 in 94 times of injections (78.33%, mainly manifested as nasal itching, eye itching, cough, pruritus, etc), grade 2 in 23 times of injections (19.17%, mainly manifested as asthma, diarrhea, etc), and grade 3 in 3 times of injections (2.50%, 2 mainly manifested as no response to inhaled bronchodilator and 1 as laryngeal edema). There was no significant difference in the incidences of systemic adverse reactions between the male and female patients [0.94% (76/8 091) vs. 0.79% (44/5 596), χ2=0.89, P=0.35]. The incidence of systemic adverse reactions in patients ≤14 years old was higher than that in patients >14 years old [1.14% (97/8 536) vs. 0.45% (23/5 151), χ2=17.59, P<0.01]. The incidence of systemic adverse reactions in weeks 16-52 [1.86% (40/2 153) ] was higher than those in the first 14 weeks [0.99% (51/5 169)], weeks 53-104 [0.72% (23/3 194) ], and weeks 105-156 [0.19% (6/3 171) ], and the differences were statistically significant ( χ2=9.40, P<0.01; χ2=14.30, P<0.01; χ2=41.69, P<0.01). The incidence of systemic adverse reactions at the injection dose o f <5 000 TU was higher than that at the injection dose of 5 000 TU [1.11% (51/4 579) vs. 0.76% (69/9 108) , χ2=4.45, P=0.04]. The systemic adverse reactions were self-relieved or could be relieved after the intervention and the outcome was good. Conclusions:The incidence of systemic adverse reactions in AR patients who completed the whole course of SCIT with standardized dicid allergen injection was 0.88%, which mainly belonged to grade 1 adverse reactions. Children of ≤14 years old, during the week 16 to 52 of treatment, at the injection dose of <5 000 TU were more likely to have systemic adverse reactions.