Definitive treatment of lung cancer with radiotherapy is challenging, as respiratory motion and anatomical changes can increase the risk of severe off-target effects during radiotherapy. Online adaptive radiotherapy (ART) is an evolving approach that enables timely modification of a treatment plan during the interfraction of radiotherapy, in response to physiologic or anatomic variations, aiming to improve the dose distribution for precise targeting and delivery in lung cancer patients. The effectiveness of online ART depends on the seamless integration of multiple components: sufficient quality of linear accelerator-integrated imaging guidance, deformable image registration, automatic recontouring, and efficient quality assurance and workflow. This review summarizes the present status of online ART for lung cancer, including key technologies, as well as the challenges and areas of active research in this field.
Humans ; Lung Neoplasms/radiotherapy* ; Radiotherapy Planning, Computer-Assisted/methods*

Periodontitis is a common oral disease caused by bacteria coupled with an excessive host immune response. Stem cell therapy can be a promising treatment strategy for periodontitis, but the relevant mechanism is complicated. This study aimed to explore the therapeutic potential of mitochondria from human embryonic stem cell-derived mesenchymal stem cells (hESC-MSCs) for the treatment of periodontitis. The gingival tissues of periodontitis patients are characterized by abnormal mitochondrial structure. Human gingival fibroblasts (HGFs) were exposed to 5 μg/mL lipopolysaccharide (LPS) for 24 h to establish a cell injury model. When treated with hESC-MSCs or mitochondria derived from hESC-MSCs, HGFs showed reduced expression of inflammatory genes, increased adenosine triphosphate (ATP) level, decreased reactive oxygen species (ROS) production, and enhanced mitochondrial function compared to the control. The average efficiency of isolated mitochondrial transfer by hESC-MSCs was determined to be 8.93%. Besides, a therapy of local mitochondrial injection in mice with LPS-induced periodontitis showed a reduction in inflammatory gene expression, as well as an increase in both the mitochondrial number and the aspect ratio in gingival tissues. In conclusion, our results indicate that mitochondria derived from hESC-MSCs can reduce the inflammatory response and improve mitochondrial function in HGFs, suggesting that the transfer of mitochondria between hESC-MSCs and HGFs serves as a potential mechanism underlying the therapeutic effect of stem cells.
Humans ; Gingiva/cytology* ; Fibroblasts/metabolism* ; Mitochondria/physiology* ; Mesenchymal Stem Cells/cytology* ; Animals ; Periodontitis/therapy* ; Mice ; Reactive Oxygen Species/metabolism* ; Inflammation ; Lipopolysaccharides ; Human Embryonic Stem Cells/cytology* ; Cells, Cultured ; Adenosine Triphosphate/metabolism* ; Male

Rapid cycle deliberate practice (RCDP) has emerged as an effective teaching method for enhancing skill proficiency. This study introduces the characteristics and theoretical foundations of RCDP, explains key points in instructional design and implementation strategies, and provides a comprehensive analysis of its application in medical education. Additionally, the potential value and development prospects of RCDP in simulation-based medical education in China are explored. This study aims to provide theoretical support and practical guidance for the further promotion and deeper implementation of the RCDP teaching method in China.

Rapid cycle deliberate practice (RCDP) has emerged as an effective teaching method for enhancing skill proficiency. This study introduces the characteristics and theoretical foundations of RCDP, explains key points in instructional design and implementation strategies, and provides a comprehensive analysis of its application in medical education. Additionally, the potential value and development prospects of RCDP in simulation-based medical education in China are explored. This study aims to provide theoretical support and practical guidance for the further promotion and deeper implementation of the RCDP teaching method in China.

OBJECTIVE: To evaluate the efficacy and safety of Wuda Granule (WDG) on recovery of gastrointestinal function after laparoscopic bowel resection in the setting of enhanced recovery after surgery (ERAS)-based perioperative care. METHODS: A total of 108 patients aged 18 years or older undergoing laparoscopic bowel resection with a surgical duration of 2 to 4.5 h were randomly assigned (1:1) to receive either WDG or placebo (10 g/bag) twice a day from postoperative days 1-3, combining with ERAS-based perioperative care. The primary outcome was time to first defecation. Secondary outcomes were time to first flatus, time to first tolerance of liquid or semi-liquid food, gastrointestinal-related symptoms and length of stay. Subgroup analysis of the primary outcome according to sex, age, tumor site, surgical time, histories of underlying disease or history of abdominal surgery was undertaken. Adverse events were observed and recorded. RESULTS: A total of 107 patients [53 in the WDG group and 54 in the placebo group; 61.7 ± 12.1 years; 50 males (46.7%)] were included in the intention-to-treat analysis. The patients in the WDG group had a significantly shorter time to first defecation and flatus [between-group difference -11.01 h (95% CI -20.75 to -1.28 h), P=0.012 for defecation; -5.41 h (-11.10 to 0.27 h), P=0.040 for flatus] than the placebo group. Moreover, the extent of improvement in postoperative gastrointestinal-related symptoms in the WDG group was significantly better than that in the placebo group (P<0.05). Subgroup analyses revealed that the benefits of WDG were significantly superior in patients who were male, or under 60 years old, or surgical time less than 3 h, or having no history of basic disease or no history of abdominal surgery. There were no serious adverse events. CONCLUSION The addition of WDG to an ERAS postoperative care may be a viable strategy to enhance gastrointestinal function recovery after laparoscopic bowel resection surgery. (Registry No. ChiCTR2100046242).
Humans ; Laparoscopy/adverse effects* ; Male ; Female ; Middle Aged ; Double-Blind Method ; Recovery of Function ; Drugs, Chinese Herbal/adverse effects* ; Treatment Outcome ; Gastrointestinal Tract/physiopathology* ; Defecation ; Aged ; Intestines/physiopathology*

Objective To evaluate the effect of sodium hyaluronate combined with recombinant human epidermal growth factor(rhEGF)in the treatment of dry eye after cataract surgery.Methods Patients with dry eye after cataract surgery were divided into treatment group and control group.The control group was treated with sodium hyaluronate eye drops via dropping into the conjunctival sac,a drop per dose,tid,for 4 weeks.On this basis,the treatment group was treated with rhEGF eye drops via dropping into the conjunctival sac,1-2 drops per dose,tid,for 4 weeks.The two groups were compared on overall clinical efficacy,dry eye symptoms before treatment and after 4 weeks of treatment.Tear-film breakup time(BUT),basic tear secretion test(schirmer Ⅰ test,SⅠT),corneal fluorescein staining(CFS)score,meibomian gland yield secretion score(MGYSS),and the levels of tear inflammatory factors were compared between two groups before treatment and after 4 weeks of treatment.The safety was evaluated.Results Finally,41 cases and 39 cases were included in the treatment group and the control group,respectively.After treatment,the total effective rates in the treatment group and the control group were 95.12％and 79.49％,with statistically significant difference(P＜0.05).After 4 weeks of treatment,dry eye symptom scores of the treatment group and control group were 1.42±0.18 and 2.31±0.26;BUT were(11.89±1.26)and(10.46±1.27)s;SⅠT were(10.12±1.35)and(8.45±0.87)mm;CFS scores were 0.83±0.11 and 1.94±0.25;MGYSS scores were 10.85±1.17 and 12.43±1.56;interleukin-1β levels in tears were(35.26±3.53)and(74.12±7.55)ng·L-1;interleukin-6 levels were(8.35±0.86)and(12.41±12.56)pg·mL-1.Compared with the control group,the above indexes in the treatment group were statistically significant(all P＜0.05).The incidence rates of adverse drug reactions in the treatment group and the control group were 12.20％and 10.26％,without statistically significant difference between the groups(P＞0.05).Conclusion Sodium hyaluronate combined with rhEGF can significantly improve dry eye symptoms after cataract surgery,enhance the stability of tear film,reduce tear inflammatory factors,and protect the integrity of meibomian gland.

Objective: To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. Methods: A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. Results: In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all P<0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). Conclusion: The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.
Male ; Female ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Hearing Loss, Sudden/therapy* ; Tinnitus/therapy* ; Retrospective Studies ; Deafness/complications* ; Audiometry

Objective: To verify the effectiveness of adolescent peer education on psychological resilience of adolescents, so as to provide a scientific reference for preventing adolescents physical and mental health problems. Methods: The non equivalent comparison group design method was conducted involving 2 towns which were divided into an intervention group(n=732) and a control group(n=881). The intervention group received 1 year peer education. Their resilience and basic information was assessed by using a adolescent psychological resilience scale and a self-designed basic situation questionnaire. Results: After the intervention, in the control group, target concentration, emotional control, family support, interpersonal assistance, and total psychological resilience were reduced by 0.96, 0.72, 0.63, 1.16 and 3.31, respectively(t=5.75, 3.91, 3.52, 5.86, 6.29, P<0.05); in the intervention group, emotional control, interpersonal assistance, and total psychological resilience were increased by 1.05, 0.54 and 1.72, respectively(t=-4.89, -2.46, -2.76, P<0.05). Multiple linear regression showed that the intervention group s target concentration(B=0.38), emotional control (B=0.85), family support(B=0.29), interpersonal assistance(B=0.83), and total psychological resilience(B=2.40) increased higher than the control group(P<0.05). Conclusion Adolescent peer education is effective in improving the target concentration, emotional control, family support, interpersonal assistance, and total psychological resilience.

Objective: To assess the application effect of peer education in mental health education for adolescent primary and middle school students and to provide evidence for promoting the mental health of adolescent primary and middle school students in application. Methods: The non-randomized controlled trial was performed, 4-5 th grade students of two primary and 7-8 th grade students of two middle schools in a district of Chongqing were chosen as peer-education experimental group, and students in the same grade of another two school were chosen as the blank control group. The Mental Health Inventory of Middle School Students scale and self-made questionnaire were used to exam in mental health status of the subjects before and after intervention. Results: The detection rates after intervention of the mental health, compulsion, paranoia, hostility, interpersonal relationship, depression, anxiety, academic stress, emotional imbalance and psychological imbalance (36.8%, 46.1%, 36.6%, 33.3%, 37.2%, 38.8%, 40.9%, 45.7%, 49.2%, 30.3%) in experimental group were lower than those before intervention (39.9%, 55.3%, 38.8%, 37.9%, 43.9%, 40.5%, 42.7%, 48.0%, 52.5%, 32.1%). The detection rate after intervention of maladjustment(39.8%)was higher than that before intervention(37.7%)(P<0.05). Logistic regression analysis showed that the detection rate after intervention of the mental health, compulsion, paranoia, hostility, interpersonal relationship, depression, anxiety and academic stress status of adolescent primary and middle school students in experimental group was 0.63 times more than the rate of the control group(95%CI=0.49-0.81),0.73(95%CI=0.58-0.91),0.68(95%CI=0.54-0.86),0.71(95%CI=0.56-0.91)(P<0.05). Conclusion Peer education is an effective measure and method to improve compulsion,paranoia,hostility,interpersonal relationship,depression,anxiety and intervention effect of adolescent primary and middle school students.

Objective: To learn the status of internet addiction and its influencing factors among junior high school students in Shapingba District of Chongqing,providing basis for intervention measures. Methods: From December 2018 to January 2019,all the students in four middle schools in Shapingba District of Chongqing were selected by cluster sampling method,and investigated the status of internet addiction,family background and so on by a designed questionnaire. The influencing factors for internet addiction were analyzed by multivariate logistic regression model. Results: A total of 2 922 questionnaires were sent out and 2 825 valid ones （96.68%） were recovered. The prevalence rate of internet addiction was 9.49% （268 cases）. The Results of multivariate logistic regression analysis showed that senior students （Grade 8,OR=1.764,95%CI：1.284-2.438;Grade 9,OR=1.822,95%CI：1.301-2.561）,living on campus （OR=1.550, 95%CI： 1.170-2.042）,authoritarian parenting style （OR=2.180,95%CI： 1.624-2.914）,neglecting parenting style （OR=3.974,95%CI：2.308-6.619）,watching TV more than two hours per day （OR=1.880,95%CI：1.432-2.458） and unlimited time on watching electronic screen （OR=1.952,95%CI：1.498-2.539） were risk factors for internet addiction. Conclusions The prevalence rate of internet addiction was 9.49% among junior high school students in Shapingba District. Grade,accommodation,parenting style,time spent daily on watching TV and restriction on watching electronic screen were the influencing factors.