Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

Objective:To analyze the verification of Trilogy Varian linear accelerator system on tumor position of head and neck,chest and abdomen under electronic portal imaging device (EPID) mode and cone beam computed tomography (CBCT) mode of intensity modulated radiotherapy (IMRT),so as to confirm the most suitable body parts of verification plan of tumor position. Methods:The case data of 48 patients with tumor who underwent IMRT treatment on tumor at the Second Affiliated Hospital of Xi'an Jiaotong University from October 2022 to October 2023 were selected,which could be divided into tumor at head and neck (16 cases),tumor at chest (16 cases) and tumor at abdomen (16 cases),and all of them were intervened 5 times per week by IMRT. They received 3 times of verification of EPID and CBCT modes per week. The positioning deviation on three dimensional (3D) axis position included x (left and right),y (up and down) and z (head and foot) was evaluated. The verification of CBCT mode conducted automatic registration of grayscale registration method for receiving irradiation area (target area) with dose through the corresponding registration software of OBI system,and the target area and the adjacent area were registration area,and the diagnostic CT image obtained from the design of radiotherapy plan was used as reference image. The positioning deviations on 3D axis positions (x direction,y direction and z direction) of referred image and collected image were calculated by using statistic method. The application values of two verification plans of EPID and CBCT modes on tumor positions were compared. Results:There was no statistically significant in the verification effect of the position of patients with tumor on head and neck between CBCT and EPID of IMRT (P>0.05). Compared with positioning error of EPID mode,that of CBCT mode on x axis was smaller,but the difference was not statistically significant (P>0.05). In the position verification of patients with tumor on chest,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=4.546,15.445,15.961,P<0.05). In the position verification of patients with tumor on abdomen,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=30.402,11.766,12.047,P<0.05). Conclusion:EPID and CBCT modes have equal positioning errors in position verification of IMRT for tumor of head and neck,and the CBCT verification should be prioritized for tumors of chest and abdomen.

Objective:To analyze the verification of Trilogy Varian linear accelerator system on tumor position of head and neck,chest and abdomen under electronic portal imaging device (EPID) mode and cone beam computed tomography (CBCT) mode of intensity modulated radiotherapy (IMRT),so as to confirm the most suitable body parts of verification plan of tumor position. Methods:The case data of 48 patients with tumor who underwent IMRT treatment on tumor at the Second Affiliated Hospital of Xi'an Jiaotong University from October 2022 to October 2023 were selected,which could be divided into tumor at head and neck (16 cases),tumor at chest (16 cases) and tumor at abdomen (16 cases),and all of them were intervened 5 times per week by IMRT. They received 3 times of verification of EPID and CBCT modes per week. The positioning deviation on three dimensional (3D) axis position included x (left and right),y (up and down) and z (head and foot) was evaluated. The verification of CBCT mode conducted automatic registration of grayscale registration method for receiving irradiation area (target area) with dose through the corresponding registration software of OBI system,and the target area and the adjacent area were registration area,and the diagnostic CT image obtained from the design of radiotherapy plan was used as reference image. The positioning deviations on 3D axis positions (x direction,y direction and z direction) of referred image and collected image were calculated by using statistic method. The application values of two verification plans of EPID and CBCT modes on tumor positions were compared. Results:There was no statistically significant in the verification effect of the position of patients with tumor on head and neck between CBCT and EPID of IMRT (P>0.05). Compared with positioning error of EPID mode,that of CBCT mode on x axis was smaller,but the difference was not statistically significant (P>0.05). In the position verification of patients with tumor on chest,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=4.546,15.445,15.961,P<0.05). In the position verification of patients with tumor on abdomen,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=30.402,11.766,12.047,P<0.05). Conclusion:EPID and CBCT modes have equal positioning errors in position verification of IMRT for tumor of head and neck,and the CBCT verification should be prioritized for tumors of chest and abdomen.

Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.

OBJECTIVETo describe the different sex, age and grade distribution of coping behavior and its psychological effects on weight, and to analyze the correlation between overweight, obesity and unhealthy psycho-behaviors related to weight control in adolescents.

METHODSA survey was conducted among students of grade 1 and grade 2 at a junior middle school in Hefei. Students completed the anonymous. questionnaire including the demographic characteristics of adolescents and parents, self-assessed weight status and adolescents' psycho-behaviors related to weight control. Anthropometric measures were taken together with body mass index (BMI) calculated. Students were divided into obesity,overweight and control groups by BMI separate criteria and by self reporting, respectively.

RESULTSAmong all the students, 17.4% reported having unhealthy psychological feelings related to weight control including 3.8% reported having unhealthy behaviors related to weight control and 19.1% of them reported having unhealthy psycho-behaviors related to weight control. The rates of unhealthy psychological feelings, unhealthy behaviors and total unhealthy psycho-behaviors related to weight control among girls (20.6%, 4.3%, 22.6%) were all higher than those among boys (14.5%, 3.3%, 15.8%) (P < 0.05). The rates of unhealthy psychological feelings, unhealthy behaviors and total unhealthy psycho-behaviors related to weight control in obese individuals both assessed by BMI and assessed by self reporting appeared to be the highest (P < 0.05). In addition,data showed that obesity and overweight assessed both by BMI separate criteria and by self-reporting appeared positive correlations with the rates of unhealthy psycho-behaviors related to weight control. Moreover, the relationship between obesity or overweight assessed by the two methods and unhealthy psycho-behaviors related to weight control did not alter by other factors.

CONCLUSIONUnhealthy psycho-behaviors related to weight control of girls are more severe than boys. The relationship between obesity and unhealthy psychological feelings and behaviors related to weight control does not alter by other factors such as social factors.

Adolescent ; Adolescent Behavior ; psychology ; Body Mass Index ; Female ; Health Behavior ; Humans ; Male ; Obesity ; psychology ; Overweight ; psychology ; Students ; psychology ; Surveys and Questionnaires

OBJECTIVETo investigate the psychological well-being among adolescents of HIV-positive parents.

METHODSThis study was involving 298 adolescents from 10 to 18 years old, including 54 adolescents of both parents living with AIDS or HIV, 114 adolescents of one parent living with AIDS or HIV and another 130 adolescents from normal families. Only one adolescent was studied per family. All participants completed an anonymous questionnaire. Psychological health, satisfaction on life, self-esteem and coping style were evaluated by SCL-90, Multidimensional Students' Life Satisfaction Scale, Self-esteem Scale and Simplified Coping Style Questionnaire.

RESULTSThe total score and 10 factors of the SCL-90 in the adolescents of parents living with HIV or AIDS was higher than the adolescents from normal families and those scores in the adolescents of both parents living with HIV or AIDS were the highest. There were 27.8% of the adolescents with both HIV-positive parents were having the total score of SCL-90 more than 160 or at lest one of the 10 factors' score more than 3. The detected rate of adolescents with one HIV-positive parent was 16.7%, higher than those adolescents from normal families (8.5%) and with significant difference (chi2 = 11.457, P = 0.003). 50.0% of the adolescents with both HIV-positive parents, were having one or more factor' score between 2.0 and 3.0, compared to the rate (37.0%) of adolescents with one HIV-positive parent. The rate was higher than the adolescents from normal families (29.8%) and with significant difference (chi2 = 7.250, P = 0.027). Among the students from normal families, the total score and the 5 dimensionalities' score of the MSLSS were lower than those adolescents of parents living with AIDS or HIV. In the friend dimensionality, the score of the adolescents from normal families was significantly higher than the adolescents of parents living with AIDS or HIV. The scores of self-esteem, positive coping style and negative coping style were not significantly different in three different subjects.

CONCLUSIONThe psychological status of the adolescents of parents living with AIDS or HIV indicated unoptimistic situation.

Acquired Immunodeficiency Syndrome ; Adaptation, Psychological ; Adolescent ; Child ; Female ; HIV Infections ; Humans ; Male ; Parent-Child Relations ; Parents

OBJECTIVETo understand the tendency of smoking in middle school students during the last 5 years and to identify the relationship between subjective life qualities and different smoking behaviors in order to determine the possible effects on tobacco use.

METHODSSix middle schools were chosen in the city and rural areas of Hefei in 1998 and 2003, respectively. Smoking behaviors such as ever smoking, smoking before 13 years old, current smoking, regular smoking and addictive smoking were surveyed. Emotional symptoms, satisfaction on school life and on general life were chosen to estimate subjective life qualities. Relationship between subjective life qualities and smoking behaviors was analyzed.

RESULTSPrevalence rates of smoking before 13 years old, current smoking, regular smoking and addictive smoking in 2003 (8.8%, 12.0%, 5.6% and 1.7%, respectively) were higher in 1998 (3.1%, 3.0%, 1.7% and 0.6%, respectively). The prevalence rates of depression and anxiety were high among students with ever smoking, current smoking, regular smoking, addictive smoking, smoking before 13 years old and no attempt to quit cigarette smoking. Lower school life satisfaction and general estimation of life were found among these students. Higher satisfaction on school life (OR = 0.657) and on ordinary life (OR = 0.766) were protecting factors of current smoking but comorbid depression and anxiety were risk factors (OR = 2.181). Higher school life satisfaction (OR = 0.388) seemed to be protecting factor of addictive smoking while depression was risk factor of addictive smoking (OR = 2.753) and regular smoking (OR = 1.676).

CONCLUSIONSmoking behaviors were common in middle school students and affected by several emotional and cognitive factors of subjective life qualities. Longitudinal designs are required to clarify the causal relationship between these factors and smoking behaviors in adolescents.

Adolescent ; Adolescent Behavior ; Anxiety ; epidemiology ; China ; epidemiology ; Depression ; epidemiology ; Health Surveys ; Humans ; Prevalence ; Psychology, Adolescent ; Quality of Life ; Risk Factors ; Rural Population ; statistics & numerical data ; Schools ; Smoking ; epidemiology ; Students ; psychology ; statistics & numerical data

OBJECTIVETo study possible relationship between psychopathological symptoms, positive and negative coping styles in adolescents who experienced repeated serious childhood physical abuse (CPA), moderate CPA, and childhood emotional abuse (CEA).

METHODSA total of 5453 students were recruited as subjects from 9 middle schools at grades 7, 8, 10, and 11. They provided informed consent and participated in the self-administered anonymous survey on their frequencies of serious or moderate physical abuse and emotional abuse by his/her parents or other caregivers about average times of experiencing maltreatment every year during primary school. The Symptoms Checklist 90 (SCL-90) was used to rate general mental problem and 9 special psychopathological symptoms. The trait positive and negative coping styles were assessed with the Trait Coping Style Questionnaire (TCSQ). Totally 5141 respondents substantially completed surveys. It was defined as repeating childhood maltreatment that the adolescent reported he/she had suffered 3 or more episodes of one or more forms of serious CPA, moderate CPA, and CEA. Multinomial logistic regression model was used to analyze the effect of the types and quantities of repeating childhood experiences on mental health when the positive, negative coping styles, and both of them entered the statistics model, taking the demographic variables as covariates.

RESULTSOf respondents, 9.1 percent were rated as having general mental health problem. The rates of somatization, obsession, interpersonal susceptivity, depression, anxiety, phobia, paranoia, and psychotic symptoms were 1.3%, 3.6%, 3.6%, 2.8%, 2.2%, 4.0%, 2.1%, 2.8% and 1.6%, respectively. Dose-response trend existed between the number of items of repeating serious CPA, moderate CPA, CEA, and rates of general mental problems, 9 kinds of psychopathological symptoms, number of positive items of psychopathological symptoms. Compared with the respondents without serious CPA, moderate CPA or CEA, those with repeating childhood maltreatment had higher scores of negative coping styles. In the respondents with repeating childhood maltreatments, the prevalence of general mental problems and number of positive psychopathological symptoms increased with the rising of scores of negative coping styles. The results from multinomial logistic regression analysis showed that negative coping style decreased the odds ratio (OR) of repeating serious CPA, moderate CPA, and CEA with general mental health problems, but positive coping style did not.

CONCLUSIONSThe experiences of repeating childhood physical or emotional maltreatment are associated with a wide variety of psychopathological symptoms and general mental health problems. Negative coping strategies may moderate the links of childhood abusive experiences and mental problems.

Adaptation, Psychological ; Adolescent ; Adolescent Behavior ; psychology ; Age Factors ; Child ; Child Abuse ; psychology ; Child Behavior ; psychology ; China ; Female ; Humans ; Logistic Models ; Male ; Psychology, Adolescent ; Schools ; Severity of Illness Index ; Students ; psychology ; Surveys and Questionnaires