Pathological scars are the result of excessive wound healing, which can severely impact patients’ quality of life and physical and mental health, which is one of the common intractable diseases in dermatology and orthopedics. Currently there is no specific therapy method avaiable. However, in recent years, the promising efficacy of traditional Chinese medicine (TCM) in treating pathological scars has garnered attention. Through reviewing and analyzing relevant literatures over the past decade, this article reviewed the roles and possible mechanisms of various active components of TCM for pathological scar, in order to provide new ideas for the clinical treatment of related diseases.

Objective:To investigated the safety and efficacy of donor-derived CD19+ or sequential CD19+ CD22+ chimeric antigen receptor T-cell (CAR-T) therapy in patients with B-cell acute lymphoblastic leukemia (B-ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:The data of 22 patients with B-ALL who relapsed after allo-HSCT and who underwent donor-derived CAR-T therapy at the Zhujiang Hospital of Southern Medical University and the 920th Hospital of Joint Logistics Support Force of the People’s Liberation Army of China from September 2015 to December 2022 were retrospectively analyzed. The primary endpoint was overall survival (OS), and the secondary endpoints were event-free survival (EFS), complete remission (CR) rate, and Grade 3-4 adverse events.Results:A total of 81.82% ( n=18) of the 22 patients achieved minimal residual disease-negative CR after CAR-T infusion. The median follow-up time was 1037 (95% CI 546–1509) days, and the median OS and EFS were 287 (95% CI 132-441) days and 212 (95% CI 120-303) days, respectively. The 6-month OS and EFS rates were 67.90% (95% CI 48.30%-84.50%) and 58.70% (95% CI 37.92%-79.48%), respectively, and the 1-year OS and EFS rates were 41.10% (95% CI 19.15%-63.05%) and 34.30% (95% CI 13.92%-54.68%), respectively. Grade 1-2 cytokine release syndrome occurred in 36.36% ( n=8) of the patients, and grade 3-4 occurred in 13.64% of the patients ( n=3). Grade 2 and 4 graft-versus-host disease occurred in two patients. Conclusion:Donor-derived CAR-T therapy is safe and effective in patients with relapsed B-ALL after allo-HSCT.

Pathological scars are the result of excessive wound healing, which can severely impact patients’ quality of life and physical and mental health, which is one of the common intractable diseases in dermatology and orthopedics. Currently there is no specific therapy method avaiable. However, in recent years, the promising efficacy of traditional Chinese medicine (TCM) in treating pathological scars has garnered attention. Through reviewing and analyzing relevant literatures over the past decade, this article reviewed the roles and possible mechanisms of various active components of TCM for pathological scar, in order to provide new ideas for the clinical treatment of related diseases.

Objective To explore the feasibility of quartz glass for radiotherapy dosimetry through the experimental study of the thermoluminescence characteristics of synthetic quartz glass. Methods The thermoluminescence glow curves of quartz glass under different annealing conditions were analyzed, the thermoluminescence characteristics of quartz glass were studied, and the measurement parameters were optimized. Using the Co-60 reference radiation field in the National Secondary Standard Dosimetry Laboratory, the quartz glass samples under different annealing conditions were irradiated following the dose levels of radiotherapy, i.e., 0.5, 1.0, 2.0, 4.0, 6.0, 8.0, and 10.0 Gy, respectively. According to the relationship between the absorbed dose of quartz glass and the relative thermoluminescence signal intensity, the linearity and dispersion of the dose response of quartz glass were obtained, and the feasibility of quartz glass for radiotherapy dosimetry was analyzed. Results The linear correlation coefficient of dose response of quartz glass under annealing condition of 430℃ for 10 min was 0.9984, and the dose response dispersion was 0.97% at the absorbed dose of 2 Gy. The linear correlation coefficient of dose response of quartz glass under annealing condition of 600℃ for 1 h was 0.9911, and the dose response dispersion was 1.4% at the absorbed dose of 2 Gy. Conclusion Preliminary results suggest that quartz glass with annealing condition of 430℃ for 10 min has the potential to be used for radiotherapy dosimetry.

0bjective To study the angular dependence of optically stimulated luminescent dosimeter (OSLD) with solid phantoms under SSDL radiation level ⁶⁰Co radiation field, and to discuss the possibility of OSLD in volumetric modulated arc therapy (VMAT) and other rotating irradiation dose audit. Methods OSLDs were embedded in the two phantoms with the same size and material, respectively. The phantom 1 was set to make the first OSLD perpendicular to the beam, and the phantom 2 was set to make the second OSLD parallel to the beam. The OSLDs were irradiated at 8 angles: 0°, 45°, 90°, 135°, 180°, −45°, −90, −135°. The counts of the OSLSs were read and the response of each angle which normalized to 0° were calculated. Results When the OSLDs are perpendicular to the beam, the angular response is between −6.76% ～ +1.5%, with the maximum angular dependence at 90° and −90°. When the OSLDs are parallel to the beam, the angular response is between −1.74%～+1.67%, below 2%. Conclusion It is better to correct the sensitivity of dosimeters by Element Correction Factors (ECF) for dose audit. Under the condition of rotating irradiation, OSLD shoud be set parallel to the beam, which can better reduce the influence of angular dependence and facilitate further application research of VMAT dose audit.

Objective: To develop the methodology for using TLD and radiochromic film to measure the planned target volume (PTV) and organ at risk (OAR) doses and 2D dose distribution in IMRT, in order to provide technical guidance on the dose quality audit in IMRT at home. Methods: China has participated in the research project launched by the international multi-radiotherapy centre (IMRC). IMRT polystyrene phantom provided by IAEA was scanned by CT scanner and then the scanned images were transmitted to TPS to outline prescribed dose to PTV and to OAR. The former was limited to 400 cGy while the latter limited to 200 cGy. IMRT was implemented with the phantom irradiated using 6 MV X-ray. The irradiated TLDs and films were sent to IAEA dosimerty laboratory for measurement and calculation. Jiangsu, Sichuan, Hubei and Henan provinces were selected to engage with this study for their variety of accelerators and highly skilled physicists. The procedures used were the same as in the IMRC and the irradiated TLDs and films were required to send to external audit group for measurement and calculation. Results: According to IAEA requirement, the relative deviations of the TLD-measured and TPS planned doses are within ±7.0% for PTV and OAR. The China′s research results at the IMRC have shown that the relative deviation of TLD-measured and TPS-planned values for the upper and lower PTV were -0.2% and 0.8%, respectively, consistent with the IAEA requirement, and the values for upper and lower OAR were -0.6% and -1.0%, respectively, consistent with the requirement. As the results have shown in four provinces, the relative deviations of the TLD-measured and TPS-planned were within 0 to 10.6% for upper and lower PTV and -0.6% to 20.9% for upper and lower OAR. According to IAEA requirement, the passing rate should be greater than 90% for 3 mm /3% for 2D dose distribution. China′s result at the IMRC is 100%, being excellent. The four provinces′ results have shown that 2D dose distribution pass rate of 3 mm/3% was in the range of 45.0%-100.0%. Conclusions The uses of TLD in quality audit for PTV and OAR doses and the radiochromic film in 2D dose distribution pass rate in IMRT are characterized by scientific feasibility, strong operability, easy-to-mail and data realibility. They are can be applied to quality assurance and audit in medical institutions in the country to on a large scale.

Objective: To analyze the distribution and associated factors of high-risk genotypes of HPV in cervical infection among women in Shenzhen. Methods: The information on sociodemographic characteristics and HPV genotypes of HPV-positive women who participated cervical screening test from January 2014 to December 2016 was downloaded from Shenzhen Maternity and Child Healthcare Management Information System. According to the pathogenicity, the high-risk HPV genotypes were divided into 15 types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68; and there were 6 low-risk genotypes including HPV 6, 11, 42, 43, 44, and 81. Chi-square tests were applied to compare the proportions of high-risk HPV infection among women who had different sociodemographic characteristics. A non-conditional logistic regression model was used to analyze the associated factors for high-risk HPV infection. Results: In total, all HIV positives received HPV genotyping, with an average age of (38.08±9.38) years old. There were 9 979 (93.9%) high-risk and 645 (6.1%) low-risk HPV infections. The proportions of HPV infections for high-risk type in each year were 91.5%, 93.8%, and 95.6%, increasing with the screening years (χ²=54.79, P<0.001). Multivariate logistic regression analysis showed that compared with women younger than 25 years old, women in other age groups (at age 26 to 30 years, 31 to 35 years, 36 to 40 years, 41 to 45 years, and 50 years or older) had increased risks of high-risk HPV infection, with OR (95%CI) of 1.67 (1.20-2.31), 1.49 (1.09-2.03), 1.71 (1.23-2.37), 1.65 (1.19-2.31), and 1.84 (1.26-2.67), respectively; compared with the married, single women had a decreased risk of high-risk HPV infection (OR (95%CI): 0.71 (0.50-1.00)); women received HPV testing in 2015 and 2016 showed higher risk of high-risk HPV infection than those in 2014 (OR (95%CI): 1.43 (1.17-1.74) and 2.03 (1.68-2.46)). The 5 most common HPV genotypes were HPV52 (25.1%, 2 670 cases), followed by HPV16 (19.2%, 2 041 cases), HPV58 (13.3%, 1 413 cases), HPV18 (9.9%, 1 048 cases), and HPV51 (9.3%, 993 cases). Conclusion Age, marital status, and screening year were associated with high-risk HPV infections. Besides HPV16 and HPV18, the prevention and control on HPV infections for HPV52, HPV58, and HPV51 should be prioritized in Shenzhen area.

Objective: To analyze the epidemiological genotype features of human papillomavirus (HPV) in cervical infection and their risks for cervical precancers among women in Shenzhen area. Methods: A total of 2 717 individuals ranging in age from 30~59 years were recruited in 18 community health centers of Shenzhen city from March 1 to June 15, 2015 by a cluster sampling method. The results of genotype of HPV, liquid-based cytology (LBC), colposcopy and pathology were analyzed. The clinical sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values of the combination of different HPV genotype in screening the cervical intraepithelial neoplasia (CIN) 2 and above were estimated. Results: The HPV infection rate in Shenzhen area was 15.9% (432/2 717). The most common HPV genotype was HPV52 (22.9%), followed by HPV16 (12.7%), HPV53 (10.0%), HPV51 (8.6%) and HPV58 (8.1%). Compared with HPV16/18 genotyping, HPV33/16 genotyping had a higher sensitivity (57.1% vs. 42.9%, P<0.05) and an analogous specificity (87.3% vs. 86.9%, P>0.05) in predicting CIN2+ . The sensitivity of combination of HPV33/16 genotyping and low grade squamous intraepithelial lesion (LSIL) positive tested by LBC in predicting CIN2+ was 75.0%, significantly higher than 64.3% of atypical squamous cells of undetermined significance (ASC-US) positive tested by LBC alone (P<0.05). The specificities of these two methods mentioned above in predicting CIN2+ were 83.5% and 89.2%, respectively, without statistical difference (P>0.05). Conclusions Women infected by HPV have distinct risks for CIN2+ according to different high-risk HPV genotypes. The top five risks were HPV 33, 16, 58, 56, and 68. HPV-positive women triaged by LBC LSIL+ combined with HPV33/16 genotyping may be a potential strategy for cervical cancer screening in developed urban area.

Objective To develop the methodology for using TLDs and films to measure absorbed dose and 2D dose distribution produced by the multi-leaf collimator (MLC) in intensity modulated radiotherapy (IMRT),in order to provide the guidance on dose quality audit in IMRT.Methods A total of 30 different-typed accelerators were selected from 27 hospitals in Jiangsu,Sichuan,Hubei and Henan provinces,including 17 Varian accelerators,10 Elektas and 3 Simens.The same batch of films and TLDs were put in a 2 cm-thick solid plate for fixation and then loaded in a 15 cm × 15 cm × 15 cm polysyrene solid phantom supplied by International Atomic Energy Agency(IAEA) in terms of 90 cm SSD,19 cm depth,10 cm × 10 cm field at different doses.The standard dose curves wcrc established for film and TLD,respectively.The irradiated film was measured and then sent to the External Audit Group (EAG) in China.The TLD-and film-absorbed doses were compared with TPS-calculated doses.The 2D dose distribution on the IRMT MLC field was measured using films.The homogeneous phanton of 30 cn × 30 cm was scanned by CT and the image was transferred to the TPS.The IMRT was implemented with 6 Gy fractionated irradiation by placing a 25 cm × 25 cm film on the phantom surface at 95 cm SSD and at 5 cm depth.The irradiated film was sent to the IAEA dosimetry laboratory for measurement and calculation.2D dose distribution verification was conducted in thc same way consistent with the procedure of international multi-radiotherapy center.The 3 mm/3％ passing rate was calculated for 2D dose distribution and compared with the film-measured and TPS calculated result.Results IAEA requires the relative deviation of TLD and film measured absorbed dose are with in ± 5％.The relative deviation of TLD-and filmmeasured to TPS-calculated absorbed dose was within the range of ±0.7％-± 8.5％ and within ±0.3％ ±7.8％ in Jiangsu,Sichuan,Hubei and Henan provinces,respectively.IAEA requires the 3 mm/3％ passing rate of film-measured 2D distribution to be 90％.The result of the present study were up to 94.0％.The verification result of 2D dose distribution were within 70.0％-99.9％ in Sichuan,Jiangsu,Hubei and Henan provinces.Conclusions The adsorbed dose and 2D distribution can be audited using TLDs and films for MLC in IRMT.The method is scientific and applicable,economical and convenient for development of dose quality audit for a wide range of IRMT.

Objective To measure the doses to eye lens and hands of workers,using thermo luminescent dosimeter (TLD) and optically stimulated luminescence dosimeter (OSLD).Methods TLDs in the same batch were annealed,packed and stuck to the flat abdomen of Alderson-Phantom at a distance of about 15 cm from 125I seed source,while irradiated at different doses:1.0,1.5,3.0,5.0,10.0,12.0,20.0,25.0,30.0,50.0 and 60.0 μ Gy.And then TLDs were measured by dosimeters to establish a dose calibration curve.By implanting seed source into the selected lung for 14 cases,belly for 10 cases,pelvic for 5 case and neck for 6 cases while placing calibrated TLDs on the left,middle and right above eyes,left and right hands of the workers to obtain the location-specific kerma values.Finally,the conversion factors Hp (3) and Hp (0.07) were used to calculate the values of dose equivalent to eye lens and hands.Additionally,OSLDs were used to measure the doses to workers in the same way.Results The TLD-measured eye lens dses to the operator and his assistant were 0.8 and 1.6 mSv in lungs,1.3 and 1.2 mSv in bellies,0.9 and 0.6 mSv in pelves,0.3 mSv in necks,respectively.Meanwhile,hand doses to the operator and his assistant were 1.4 and 2.1 mSv in lungs,1.2 and 1.0 mSv in bellies,0.5 and 0.9 mSv in pelves,0.1 mSv in necks,respectively.The maximum doses to eye lens and hands were 1.2 and 1.0 mSv,respectively in a single treatment.OSLD-measured dose equivalents from lung therapy were 0.2 and 0.1 mSv for eye lens of the operator and his assistant and 0.4 and 0.6 mSv for hands.For belly therapy,the accumulated dose equivalent to hands of the operator was 0.1 mSv while those for other types of therapy were 0 mSv.Conclusions TLDs have the capability to measure not only accumulated dose but also dose equivalent from a single therapy According to ICRP 118 publication and as estimated in the present study,the number of therapy should be not more than 17 every year.OSLDs only give the accumulated dose,the accuracy of which needs to be studied in low-dose measurement.