Objective To quantitatively compare the dosimetric differences among 4 volumetric modulated arc therapy(VMAT)plans by analyzing the number of arcs and collimator angle settings,aiming to establish a standardized planning template for hippocampal-sparing prophylactic cranial irradiation(HS-PCI)in clinic and improve both planning quality and clinical efficiency.Methods Twenty HS-PCI patients were enrolled,with 4 VMAT plans(V2c,V2p,V3,and V4)for each patient.The differences in target dose,organs-at-risk dose,and monitor units were compared.Results V4 plan had the highest PTV D98%and V95%,and the differences of PTV D98%in V2c vs V2p,V2c vs V4,and PTV V95%in V2c vs V4 were statistically significant(P<0.05).Meanwhile,V4 plan had the lowest PTV Dmax and Dmin doses.Specifically,statistically significant differences were observed in PTV Dmax in V4 vs V2c,V4 vs V2p,V4 vs V3,as well as PTV Dmin in V2c vs V2p,V2c vs V3,V2c vs V4,V2p vs V4(P<0.05).The PTV Dmean was the highest in V2p plan,with statistically significant differences observed in V2c vs V2p,V2c vs V4,V2p vs V3,and V3 vs V4(P<0.05).The highest PTV D2%dose was observed in V2p plan,and the differences in V2c vs V2p,V2c vs V4,V2p vs V3,V3 vs V4 were statistically significant(P<0.05).The homogeneity index and conformity index were close in 4 plans(P=0.946,P=0.380).V4 plan had the lowest Dmax,Dmean,and Dmin of the hippocampus,with significant differences in hippocampal Dmax in V4 vs V2c,V4 vs V2p,hippocampal Dmean in V4 vs V2c,V4 vs V2p,V3 vs V2c,and hippocampal Dmin in V2c vs V2p/V3/V4,and V4 vs V2p(P<0.05).V3 plan had the lowest Dmax for bilateral lenses,and V4 plan showed the lowest Dmax for lenses with a 3 mm expansion,with significant differences between V2c and V2p/V3/V4(P<0.05).V4 plan had the lowest dose for the right optic nerve,with significant differences in V4 vs V2p,and V4 vs V3(P<0.05).No significant differences were observed for the left optic nerve and optic chiasm.The monitor units in V2p plan was the lowest.Conclusion When differences in organs-at-risk doses and plan quality parameters are insignificant,V2p plan is recommended as it can ensure treatment quality while reducing delivery time.

Objective:To investigate effects of human umbilical cord mesenchymal stem cell-derived exosomes(hUCMSCs-Exo)on bisphenol AF(BPAF)-induced oxidative damage and inflammatory factor release from endometrial stromal cells(hESCs).Methods:hESCs were divided into Control group,BPAF group(25 μmol/L BPAF treatment),BPAF+Exo group(25 μmol/L BPAF+hUCMSCs-Exo treatment),BPAF+Exo+LY group(25 μmol/L BPAF+hUCMSCs-Exo+10 μmol/L LY294002 treatment).Cell prolifera-tion was detected by MTT assay;apoptosis,intracellular ROS level,and mitochondrial membrane potential level were detected by flow cytometry;protein expressions of Bcl-2,Bax,Cleaved-caspase-3 and PI3K/AKT signaling pathway were detected by Western blot;mRNA expressions of inflammatory factors TNF-α,IL-6 and IL-1β were detected by RT-qPCR.Results:Compared with Control group,hESCs survival rate was gradually decreased(P<0.01),apoptosis rate was gradually increased with the increased concentration of BPAF(≥25 μmol/L).Compared with Control group,BPAF group showed increased ROS level,decreased mitochondrial membrane potential level,increased Bax and Cleaved-caspase-3 protein expressions,and decreased Bcl-2,p-PI3K and p-AKT protein expressions.Compared with BPAF group,cell survival rate of BPAF+Exo group was increased(P<0.01),ROS level decreased,mitochondrial membrane potential level increased,expressions of Bax and Cleaved-caspase-3 proteins decreased,and expressions of Bcl-2,p-PI3K and p-AKT increased.Compared with BPAF+Exo group,expressions of Bax and Cleaved-caspase-3 protein in cells of BPAF+Exo+LY group were increased,while expressions of Bcl-2,p-PI3K and p-AKT protein were decreased.Expressions of inflammatory factors TNF-α,IL-6 and IL-1β mRNA were significantly up-regulated in BPAF group compared with Control group(P<0.01),and expressions of inflammatory factors mRNA were significantly down-regulated in BPAF+Exo group compared with BPAF group(P<0.05).Conclu-sion:BPAF(≥25 μmol/L)inhibits proliferation of hESCs and promoted apoptosis.hUCMSCs-Exo inhibits BPAF-induced oxidative dam-age and inflammatory factors expressions in hESCs through PI3K/AKT signaling pathway.

Objective:To develop the Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)and evaluate its validity and reliability.Methods:Based on literature analysis,interviews with severe bedtime procrastinators,and open-ended surveys with college students,the initial questionnaire was formed.A total of 389 college students were recruited to conduct item analysis and exploratory factor analysis.Additionally,691 college students were selected for confirmatory factor analysis,criterion validity testing,and internal consistency reliability analysis,and 132 of them were retested two weeks later.The subscale of behav-ioral intention from the Theory of Planned Behavior Questionnaire(TPBQ),Bedtime Procrastination Scale(BPS),and a self-made question for the frequency of bedtime procrastination were used as criterion tools.Results:The CS-MBPQ consists of 10 items,encompassing three factors:emotional need,external influence,and behavioral attitude,explaining 63.31％of the variance.Confirmatory factor analysis indicated that the three-factor structure model of CS-MBPQ fitted well(x2/df=4.90,RMSEA=0.07,CFI=0.96,TLI=0.94).The CS-MBPQ total scores and scores for each factor were positively associated with the score of intentions to sleep on time,BPS scores,and bed-time procrastination frequency(ICC=0.14-0.53,Ps＜0.05).The internal consistency reliabilities for CS-MBPQ and the three factors were 0.87,0.89,0.74,and 0.66,respectively,and the test-retest reliabilities(ICC)were 0.74,0.66,0.69,and 0.58,respectively.Conclusion:The Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)demonstrates good validity and reliability,which could be used as a tool to evaluate motivations for bedtime procrastination among Chinese college students.

Objective To quantitatively compare the dosimetric differences among 4 volumetric modulated arc therapy(VMAT)plans by analyzing the number of arcs and collimator angle settings,aiming to establish a standardized planning template for hippocampal-sparing prophylactic cranial irradiation(HS-PCI)in clinic and improve both planning quality and clinical efficiency.Methods Twenty HS-PCI patients were enrolled,with 4 VMAT plans(V2c,V2p,V3,and V4)for each patient.The differences in target dose,organs-at-risk dose,and monitor units were compared.Results V4 plan had the highest PTV D98%and V95%,and the differences of PTV D98%in V2c vs V2p,V2c vs V4,and PTV V95%in V2c vs V4 were statistically significant(P<0.05).Meanwhile,V4 plan had the lowest PTV Dmax and Dmin doses.Specifically,statistically significant differences were observed in PTV Dmax in V4 vs V2c,V4 vs V2p,V4 vs V3,as well as PTV Dmin in V2c vs V2p,V2c vs V3,V2c vs V4,V2p vs V4(P<0.05).The PTV Dmean was the highest in V2p plan,with statistically significant differences observed in V2c vs V2p,V2c vs V4,V2p vs V3,and V3 vs V4(P<0.05).The highest PTV D2%dose was observed in V2p plan,and the differences in V2c vs V2p,V2c vs V4,V2p vs V3,V3 vs V4 were statistically significant(P<0.05).The homogeneity index and conformity index were close in 4 plans(P=0.946,P=0.380).V4 plan had the lowest Dmax,Dmean,and Dmin of the hippocampus,with significant differences in hippocampal Dmax in V4 vs V2c,V4 vs V2p,hippocampal Dmean in V4 vs V2c,V4 vs V2p,V3 vs V2c,and hippocampal Dmin in V2c vs V2p/V3/V4,and V4 vs V2p(P<0.05).V3 plan had the lowest Dmax for bilateral lenses,and V4 plan showed the lowest Dmax for lenses with a 3 mm expansion,with significant differences between V2c and V2p/V3/V4(P<0.05).V4 plan had the lowest dose for the right optic nerve,with significant differences in V4 vs V2p,and V4 vs V3(P<0.05).No significant differences were observed for the left optic nerve and optic chiasm.The monitor units in V2p plan was the lowest.Conclusion When differences in organs-at-risk doses and plan quality parameters are insignificant,V2p plan is recommended as it can ensure treatment quality while reducing delivery time.

Objective:To develop the Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)and evaluate its validity and reliability.Methods:Based on literature analysis,interviews with severe bedtime procrastinators,and open-ended surveys with college students,the initial questionnaire was formed.A total of 389 college students were recruited to conduct item analysis and exploratory factor analysis.Additionally,691 college students were selected for confirmatory factor analysis,criterion validity testing,and internal consistency reliability analysis,and 132 of them were retested two weeks later.The subscale of behav-ioral intention from the Theory of Planned Behavior Questionnaire(TPBQ),Bedtime Procrastination Scale(BPS),and a self-made question for the frequency of bedtime procrastination were used as criterion tools.Results:The CS-MBPQ consists of 10 items,encompassing three factors:emotional need,external influence,and behavioral attitude,explaining 63.31％of the variance.Confirmatory factor analysis indicated that the three-factor structure model of CS-MBPQ fitted well(x2/df=4.90,RMSEA=0.07,CFI=0.96,TLI=0.94).The CS-MBPQ total scores and scores for each factor were positively associated with the score of intentions to sleep on time,BPS scores,and bed-time procrastination frequency(ICC=0.14-0.53,Ps＜0.05).The internal consistency reliabilities for CS-MBPQ and the three factors were 0.87,0.89,0.74,and 0.66,respectively,and the test-retest reliabilities(ICC)were 0.74,0.66,0.69,and 0.58,respectively.Conclusion:The Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)demonstrates good validity and reliability,which could be used as a tool to evaluate motivations for bedtime procrastination among Chinese college students.

Objective:To investigate effects of human umbilical cord mesenchymal stem cell-derived exosomes(hUCMSCs-Exo)on bisphenol AF(BPAF)-induced oxidative damage and inflammatory factor release from endometrial stromal cells(hESCs).Methods:hESCs were divided into Control group,BPAF group(25 μmol/L BPAF treatment),BPAF+Exo group(25 μmol/L BPAF+hUCMSCs-Exo treatment),BPAF+Exo+LY group(25 μmol/L BPAF+hUCMSCs-Exo+10 μmol/L LY294002 treatment).Cell prolifera-tion was detected by MTT assay;apoptosis,intracellular ROS level,and mitochondrial membrane potential level were detected by flow cytometry;protein expressions of Bcl-2,Bax,Cleaved-caspase-3 and PI3K/AKT signaling pathway were detected by Western blot;mRNA expressions of inflammatory factors TNF-α,IL-6 and IL-1β were detected by RT-qPCR.Results:Compared with Control group,hESCs survival rate was gradually decreased(P<0.01),apoptosis rate was gradually increased with the increased concentration of BPAF(≥25 μmol/L).Compared with Control group,BPAF group showed increased ROS level,decreased mitochondrial membrane potential level,increased Bax and Cleaved-caspase-3 protein expressions,and decreased Bcl-2,p-PI3K and p-AKT protein expressions.Compared with BPAF group,cell survival rate of BPAF+Exo group was increased(P<0.01),ROS level decreased,mitochondrial membrane potential level increased,expressions of Bax and Cleaved-caspase-3 proteins decreased,and expressions of Bcl-2,p-PI3K and p-AKT increased.Compared with BPAF+Exo group,expressions of Bax and Cleaved-caspase-3 protein in cells of BPAF+Exo+LY group were increased,while expressions of Bcl-2,p-PI3K and p-AKT protein were decreased.Expressions of inflammatory factors TNF-α,IL-6 and IL-1β mRNA were significantly up-regulated in BPAF group compared with Control group(P<0.01),and expressions of inflammatory factors mRNA were significantly down-regulated in BPAF+Exo group compared with BPAF group(P<0.05).Conclu-sion:BPAF(≥25 μmol/L)inhibits proliferation of hESCs and promoted apoptosis.hUCMSCs-Exo inhibits BPAF-induced oxidative dam-age and inflammatory factors expressions in hESCs through PI3K/AKT signaling pathway.

CT simulator has the functions such as original coordination positioning and radiotherapy resetting,and it can provide image and cooridiate information for radiotherapy.Through electronic density calibration,tissue inhomogeneity correction is carried out for supporting dose calculation in treatment planning system.With reference to relevant national standards,international guidelines,clinical functions of CT simulator and the practical experience of the center,a set of acceptance and commissioning testing scheme suitable for big bore CT simulator is presented,aiming to guide and assist the newly opened department in conducting comprehensive,safe and feasible acceptance and commissioning tests.The scheme includes the reference methods and tolerance standards of CT simulator machinery,image quality,radiation dose,radiotherapy related items and safety,so as to ensure the safety and accuracy of CT simulation and survival benefits.

CT simulator has the functions such as original coordination positioning and radiotherapy resetting,and it can provide image and cooridiate information for radiotherapy.Through electronic density calibration,tissue inhomogeneity correction is carried out for supporting dose calculation in treatment planning system.With reference to relevant national standards,international guidelines,clinical functions of CT simulator and the practical experience of the center,a set of acceptance and commissioning testing scheme suitable for big bore CT simulator is presented,aiming to guide and assist the newly opened department in conducting comprehensive,safe and feasible acceptance and commissioning tests.The scheme includes the reference methods and tolerance standards of CT simulator machinery,image quality,radiation dose,radiotherapy related items and safety,so as to ensure the safety and accuracy of CT simulation and survival benefits.

Objective:To explore the key genes related to the development, progression and prognosis of acute myeloid leukemia (AML) based on bioinformatics, and to analyze their functions.Methods:The chip expression profile GSE84881 data set of AML patients including 19 AML samples and 4 normal tissue samples was downloaded from the gene expression omnibus (GEO) database. GEO online tool GEO2R was used to screen the differentially expressed genes (DEG). The DAVID online database was used to make gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis of DEG. The STRING online database was used to analyze the protein interaction (PPI) network of DEG, and the key genes were screened by using the Cytoscape software. The weighted gene co-expression network analysis (WGCNA) was used to build co-expressed network and obtain the central genes.LC-Bio online platform was used to construct Venn diagram and the key genes and central genes in PPI were crossed to finally obtain the true key genes. RNA-seq datasets GSE2191 and GSE90062 of human tissues were downloaded from GEO database to verify the screened key genes. Kaplan-Meier method was used to analyze the effects of key genes on the overall survival (OS) of AML based on the data of GEPIA database.Results:A total of 247 DEG were identified in GSE84881 data set, including 112 up-regulated genes and 135 down-regulated genes. According to the results of GO enrichment analysis, 247 DEG were mainly enriched in the regulation of signal transduction and cell proliferation in the biological process (BP); the cell composition (CC) revealed that these genes were mainly involved in the cytoplasm and exosomes; the molecular function (MF) analysis showed that these genes were mainly enriched in protein binding and calcium binding. Further KEGG pathway enrichment analysis showed that these 247 DEG were mainly involved in NOD-like receptor signal pathway and interleukin 17 (IL-17) signal pathway. And then the 12 key genes were obtained from PPI. WGCNA software was used to screen 13 central genes from GSE84881 dataset and finally 1 real key gene EGF was obtained after taking intersection. Kaplan-Meier method showed that OS time of AML patients in EGF high expression group was decreased than that in EGF low expression group, and the difference was statistically significant( P = 0.044). Conclusions:EGF may be an important diagnosis and treatment target of AML and may become a potential biomarker for clinical treatment and prognosis prediction of AML.

Objective:To understand the components, performance, acceptance test and quality assurance (QA) protocols of the new Varian Halcyon accelerator through the procedures of installation product acceptance (IPA).Methods:Per Varian IPA protocol, TG-142 for LINAC and TG-148 for tomotherapy QA protocols, the software license, safety interlock, mechanical accuracy, dosimetric performance and imager system were checked thoroughly. Some parameters were benchmarked to the conventional TrueBeam system.Results:The system has been fully licensed. Safety interlock was normal. Mechanical accuracy: The maximum deviation of beam stability per gantry rotation was 1.13%. The size of isocenter was>0.59mm. The offsets of MV imager, collimation rotation and absolute gantry rotation were 0.09mm, -0.21° and 0.11°, respectively. The maximum offsets of couch, virtual-to-isocenter were 0.15mm (vertical) and -0.04mm (vertical), respectively. Beam performance: The depth deviation of maximum dose was 0.1cm. The offset of percentage depth dose at 10cm was 0.5%. The maximum deviations of off-axis-intensity, symmetry, and repeatability were 0.9%, 0.94% and -0.44%, respectively. MV imager: The dark field mean pixel value, noise, corrected pixels, defective lines, sensitivity and linearity disparity of dose were 614, 4.4, 3626, 0, 19177, and 0.47%, respectively. All values were within the range of tolerance. Visual check of contrast resolution and small object detection was all satisfactory.Conclusions:Without Halcyon-specific TG report or guidelines, manufacture-provided IPA manual can be helpful with the installation of acceptance and QA protocols. IPA has been successfully performed for Halcyon at Peking University Cancer Hospital. The automated workflow improves the clinical efficiency by simplifying the operations.