Objective To evaluate the accuracy of multiparametric imaging on the dual-source CT through acceptance and commissioning testing, and to provide a reference for standardized clinical application. Methods Both the adult and pediatric dual-source CT scanning modes were used to scan the electron density phantom, and identical multiparametric image reconstruction tasks were performed, including the conventional CT images, the mixed CT images, the virtual monoenergetic images, the iodine images, the electron density images, and the effective atomic number images. Results In the adult scanning mode, the virtual monoenergetic CT numbers showed the greatest difference for the cortical bone (1722 HU at 40 keV vs. 30 HU at 80 keV), with smaller differences observed for other materials as their atomic numbers decreased. The pediatric scanning mode exhibited a similar trend, with the largest difference occurring at 40 keV (1393 HU). In the adult scanning mode, the deviations between the theoretical and measured iodine concentration values were all within 5%, whereas in the pediatric scanning mode, the largest deviation was 15% for an iodine concentration of 2.0 mg/mL. For the electron density, the largest deviation between the theoretical and measured values occurred in the LN450 lung (9.18% in the adult scanning mode and 8.96% in the pediatric scanning mode); the deviations for the LN300 lung were all below 7.2%, for aluminum below 6.3%, and for other tissues within 3%. For the effective atomic number, the deviations between the theoretical and measured values were all within 5% in both scanning modes. Conclusion To ensure the accuracy and reproducibility of the dual-source CT applications, a comprehensive acceptance testing protocol should be established to guarantee the safety and precision of the CT localization process.

Objective:To investigate the efficacy of combined pelvic magnetic therapy and pelvic floor electromyographic (EMG) biofeedback therapy in perimenopausal women with pelvic floor dysfunction (PFD), and its effects on bladder function and urodynamic status.Methods:A total of 137 perimenopausal women with PFD treated at Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between February 2022 and May 2024 were enrolled. They were randomly divided into a control group ( n=68) and a study group ( n=69) by random number table method. Both groups received Kegel exercises. The control group additionally received pelvic floor EMG biofeedback therapy. The study group received combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy. The outcomes compared between groups were as follows: Bladder Function: First urge voiding volume (FVS), maximum urge voiding volume (MVS), post-void residual urine volume (PVR), prolapse of pelvic floor organs, urodynamics: Pressure of urethral maximum measurement (PUM), maximum urethral closure pressure (PMUC), bladder compliance (BC), pelvic floor muscle function: Pelvic floor muscle strength grade (PFMT), pelvic floor resting pressure (RP), vaginal dynamic pressure (VDPT). Normally distributed continuous data were presented as xˉ± s and compared by independent samples t-test. Categorical data were presented as case (%) and compared by χ2 test. Ranked data were compared by Kruskal-Wallis H test. A P-value<0.05 was considered statistically significant. Results:Baseline characteristics showed no significant differences between groups ( P>0.05). At post-treatment, the study group had a significantly higher clinical effective rate of 97.10% (67/69) compared to the control group, which was 88.24% (60/68) ( χ2=3.98, P=0.046). At post-treatment, the study group had significantly higher FVS [(238.29±10.22) mL vs. (229.37±10.54) mL, t=5.03, P<0.001] and MVS [(436.57±12.48) mL vs. (428.23±12.75) mL, t=3.87, P<0.001], and significantly lower PVR [(5.14±1.28) mL vs. (6.96±1.21) mL, t=8.55, P<0.001] compared to the control group. At post-treatment, urodynamic parameters were significantly higher in the study group: PUM [(10.08±0.97) kPa vs. (8.54±0.73) kPa, t=10.49, P<0.001], PMUC [(8.71±0.75) kPa vs. (7.68±0.64) kPa, t=8.64, P<0.001], and BC [(396.58±30.49) mL/kPa vs. (378.86±32.91) mL/kPa, t=3.27, P<0.001]. For pelvic organ prolapse (POP-Q), the distribution were as follows: Study Group: Grade 0: 16, Grade Ⅰ: 34, Grade Ⅱ: 18, Grade Ⅲ: 1, Grade Ⅳ: 0, control Group: Grade 0: 9, Grade Ⅰ: 31, Grade Ⅱ: 23, Grade Ⅲ:5, Grade Ⅳ: 0. The difference was statistically significant ( Z=2.08, P=0.037). At post-treatment, pelvic floor muscle function was significantly higher in the study group: PFMT [(4.21±0.29) vs. (3.84±0.23), t=8.27, P<0.001], RP [(9.59±1.26) cmH?O vs. (8.34±1.17) cmH?O, t=6.02, P<0.001], and VDPT [(82.74±3.36) cmH?O vs. (77.45±3.52) cmH?O, t=9.00, P<0.001]. Conclusion:Combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy demonstrates significant efficacy in treating PFD in perimenopausal women. It markedly improves bladder function and urodynamic status.

Objective:To investigate the efficacy of combined pelvic magnetic therapy and pelvic floor electromyographic (EMG) biofeedback therapy in perimenopausal women with pelvic floor dysfunction (PFD), and its effects on bladder function and urodynamic status.Methods:A total of 137 perimenopausal women with PFD treated at Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between February 2022 and May 2024 were enrolled. They were randomly divided into a control group ( n=68) and a study group ( n=69) by random number table method. Both groups received Kegel exercises. The control group additionally received pelvic floor EMG biofeedback therapy. The study group received combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy. The outcomes compared between groups were as follows: Bladder Function: First urge voiding volume (FVS), maximum urge voiding volume (MVS), post-void residual urine volume (PVR), prolapse of pelvic floor organs, urodynamics: Pressure of urethral maximum measurement (PUM), maximum urethral closure pressure (PMUC), bladder compliance (BC), pelvic floor muscle function: Pelvic floor muscle strength grade (PFMT), pelvic floor resting pressure (RP), vaginal dynamic pressure (VDPT). Normally distributed continuous data were presented as xˉ± s and compared by independent samples t-test. Categorical data were presented as case (%) and compared by χ2 test. Ranked data were compared by Kruskal-Wallis H test. A P-value<0.05 was considered statistically significant. Results:Baseline characteristics showed no significant differences between groups ( P>0.05). At post-treatment, the study group had a significantly higher clinical effective rate of 97.10% (67/69) compared to the control group, which was 88.24% (60/68) ( χ2=3.98, P=0.046). At post-treatment, the study group had significantly higher FVS [(238.29±10.22) mL vs. (229.37±10.54) mL, t=5.03, P<0.001] and MVS [(436.57±12.48) mL vs. (428.23±12.75) mL, t=3.87, P<0.001], and significantly lower PVR [(5.14±1.28) mL vs. (6.96±1.21) mL, t=8.55, P<0.001] compared to the control group. At post-treatment, urodynamic parameters were significantly higher in the study group: PUM [(10.08±0.97) kPa vs. (8.54±0.73) kPa, t=10.49, P<0.001], PMUC [(8.71±0.75) kPa vs. (7.68±0.64) kPa, t=8.64, P<0.001], and BC [(396.58±30.49) mL/kPa vs. (378.86±32.91) mL/kPa, t=3.27, P<0.001]. For pelvic organ prolapse (POP-Q), the distribution were as follows: Study Group: Grade 0: 16, Grade Ⅰ: 34, Grade Ⅱ: 18, Grade Ⅲ: 1, Grade Ⅳ: 0, control Group: Grade 0: 9, Grade Ⅰ: 31, Grade Ⅱ: 23, Grade Ⅲ:5, Grade Ⅳ: 0. The difference was statistically significant ( Z=2.08, P=0.037). At post-treatment, pelvic floor muscle function was significantly higher in the study group: PFMT [(4.21±0.29) vs. (3.84±0.23), t=8.27, P<0.001], RP [(9.59±1.26) cmH?O vs. (8.34±1.17) cmH?O, t=6.02, P<0.001], and VDPT [(82.74±3.36) cmH?O vs. (77.45±3.52) cmH?O, t=9.00, P<0.001]. Conclusion:Combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy demonstrates significant efficacy in treating PFD in perimenopausal women. It markedly improves bladder function and urodynamic status.

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 investigate the perinatal clinical phenotype and genetic characteristics of two fetuses with ring chromosome 21 mosaicisms. METHODS: Two fetuses who were diagnosed at the Xiamen Maternal and Child Health Care Hospital in November 2021 were selected as the study subjects. Clinical data of the two fetuses were collected. Conventional G-banded karyotyping and chromosomal microarray analysis (CMA) were carried out for the fetuses and their parents. RESULTS: Prenatal ultrasonography of fetus 1 has revealed absence of nasal bone, ventricular septal defect, persistent left superior vena cava, and mild tricuspid regurgitation. Chromosomal karyotyping was 46,X?,dic r(21;21)(p12q22;q22p12)[41]/45,X?,-21[9]. CMA has revealed a 30.00 Mb quadruplication at 21q11.2q22.3 and a 3.00 Mb deletion at 21q22.3. For fetus 2, ultrasonography has revealed pointed echo of the nasal bone. The fetus was found to have a karyotype of 46,X?,r(21)(p12q22)[83]/45,X?,-21[14]/46,X?,dic r(21;21)(p12q22;q22p12)[3]. CMA has revealed a 5.10 Mb quadruplication at 21q22.12q22.3 and a 2.30 Mb deletion at 21q22.3. CONCLUSION The perinatal phenotype of the two fetuses with ring chromosome 21 mosaicisms is related to the duplication of chromosomal segments near the breakpoints of the chromosomal deletions. The combined chromosomal karyotyping and CMA has enabled prenatal diagnosis and genetic counseling for these families.
Pregnancy ; Female ; Humans ; Mosaicism ; Ring Chromosomes ; Vena Cava, Superior ; Chromosome Aberrations ; Prenatal Diagnosis ; Microarray Analysis ; Fetus/diagnostic imaging*

Objective:To investigate the performance of chromosome karyotype, chromosomal microarray analysis (CMA) and fluorescence in situ hybridization (FISH) in prenatal diagnosis of true fetal chromosome mosaicism. Methods:This retrospective study enrolled 40 women with true fetal chromosome mosaicism from 4 071 singleton pregnant women who were indicated for and underwent amniocentesis or/and cordocentesis in the the First Affiliated Hospital of Sun Yat-sen University from April 2018 to August 2021. The results of chromosome karyotyping, CMA and FISH, the types of chromosomal mosaicism, mosaicism ratio and pregnancy outcomes were analyzed using Chi-square test. Results:(1) The detection rate of true fetal mosaicism was 0.98% (40/4 071). (2) Sex chromosome mosaicism accounted for 42.5% (17/40). Other chromosomal mosaicism involved chromosomes 21, 22, 18, 16, 7, 12, 15, 17 and 20, as well as balanced chromosomal translocation. (3) The detection rate of true fetal mosaicism by chromosome karyotyping was 77.4% (24/31) from amniotic fluid samples and 10/19 from umbilical cord blood samples, while that data by CMA was 76.7% (23/30) and 7/11,respectively. (4) Of the 40 pregnant women with fetal chromosome mosaicism, FISH test was performed on 20 cases (14 cases were verified with both amniotic fluid and umbilical cord blood samples, five with amniotic fluid samples and one with umbilical cord blood sample), and all of the diagnosis of mosaicism were confirmed. For those with mosaicism ratio <30%, the detection rate by FISH was higher than that by CMA among amniotic fluid samples [14/19 vs 43.5% (10/23), χ2=3.88, P=0.049]. (5) Among the 40 pregnant women, five were lost to follow-up; 18 chose to terminate the pregnancy; and 17 continued the pregnancy to delivery. No abnormalities in mental or physical development were reported in the 17 neonates after birth or during on-line follow-up between 6 to 24 months old. Of the 14 pregnant women with mosaicism ratio <30% which confirmed by FISH, eight chose to continue the pregnancy, and no abnormalities in mental development or growth were found in the neonates. Conclusions:In prenatal diagnosis of true fetal choromosome mosaicism, the incidence of sex chromosome mosaicism is the highest. FISH may improve the prenatal diagnosis rate of mosaicism and is more accurate in determining the mosaicism ratio. The combination of FISH, CMA and chromosome karyotyping would significantly improve the detection rate of chromosomal mosaicism and assess the mosaicism ratio more accurately, which is of great value in clinical consultation and evaluation of fetal prognosis.

Objective:To propose a markless patient setup workflow based on the optical surface monitoring system (AlignRT) and open-face mask immobilization for whole-course head tumor radiotherapy, assess the setup time and repositioning frequency of the proposed workflow, and conduct a comparative analysis of the differences, correlation, and consistency of the setup errors of the AlignRT and cone beam CT (CBCT) systems.Methods:A retrospective analysis was conducted for the data on the errors of 132 fractionated setup based on open-face mask immobilization of 33 head tumor patients. AlignRT-guided markless patient setup workflow was applied throughout the radiotherapy. Meanwhile, the body structures automatically generated by the treatment planning system were used as body references. The 6-degree-of-freedom (6DoF) setup errors (lateral, vertical, longitudinal, rotation, pitch, roll, and yaw directions), setup time, and repositioning frequency of the AlignRT and CBCT systems were recorded and analyzed. The Wilcoxon and Spearman analyses were used to statistically assess the differences and correlation of the setup errors of the two systems. Moreover, the Bland-Altman analysis was employed to evaluate the consistency of the two systems.Results:The 6DoF setup errors of CBCT were within the clinical tolerance (linear motions: -0.30 to 0.30 cm; rotational motions: -2.0° to 2.0°). The setup time and repositioning frequency of CBCT were (98 ± 31) s and 1.51% (2/132), respectively. There was no significant difference in setup errors between the two systems except those in x-axis ( Z = -3.11, P= 0.002), y-axis ( Z = -7.40, P<0.001), and Pitch ( Z= -4.48, P<0.001). There was a significant positive correlation between the setup errors along lateral ( rs = 0.47, P<0.001) and vertical ( rs = 0.29, P = 0.001) directions, rotation (Rtn; rs = 0.47, P<0.001), pitch (Pitch; rs = 0.28, P = 0.001) and roll (Roll; rs = 0.45, P<0.001) of the two systems. The 95% limits of agreement (95% LoA) of 6DoF setup errors were -0.12 to 0.09 cm, -0.07 to 0.17 cm, -0.19 to 0.20 cm, -1.0° to 0.9 °, -1.0° to 1.5°, and -0.9° to 1.0°, respectively. The 95% confidence interval (95% CI) of 95% LoA was -0.14 to 0.11 cm, -0.09 to 0.19 cm, -0.23 to 0.23 cm, -1.2° to 1.1°, -1.2° to 1.7°, and-1.0° to 1.1°, respectively, all of which were within the permissible error ranges. The 6DoF setup error difference of 3.41% (27/792< 5%) was beyond the 95% LoA. The maximum absolute differences of 6DoF setup errors within the 95% LoA were 0.12, 0.16, 0.19 cm, 0.9°, 1.5°, and 1.0°, respectively. Conclusions:The proposed markless setup workflow based on AlignRT combined with open-face mask immobilization for whole-course head tumor radiotherapy exhibits reasonable agreement and consistency with the patient setup using CBCT, with acceptable clinical efficiency. It can be applied to the first radiotherapy and the real-time monitoring of therapy to improve the safety and thus is of value in clinical applications.

Traditional Chinese Medicine (TCM) has certain advantages in the treatment of precancerous lesions of gastric cancer (PLGC) based on the holistic concept and the thought of syndrome differentiation. Currently, it is generally divided into 6 kinds of syndromes: liver and stomach qi stagnation syndrome, liver and stomach heat stagnation syndrome, spleen and stomach weakness syndrome (including spleen and stomach qi deficiency syndrome with coldness), spleen and stomach damp heat syndrome, stomach yin deficiency syndrome and blood stasis in stomach collateral syndrome. Clinically, the doctor should treat PLGC patients according to different syndrome types by using Chinese medicine prescription, which could improve the gastric mucosal pathological state, gastroscopy and clinical symptoms, to rehibit the development of precancerous lesions, reduce the incidence rate of gastric cancer. In the future, the doctors shouldreach the consensus of treating PLGC with TCM diagnosis, and focus on the research of TCM compounds or monomers with obvious curative effect, increase the times of follow-up, and evaluate the long-term curative effect.

Objective:To investigate the performance of W2 plastic scintillator in megavolt photon and electron beams.Methods:The photon and electron beam energy provided by linear accelerator was used to collect data of the W2 scintillator. The parameters include the electrometer reading stability, W2 dose and dose rate linearity, and angular response. And the dose uncertainty of the W2 correction factors was also investigated.Results:The standard deviation of the electrometer reading stability was between 0.03 and 0.47. The linear regression factors of W2 dose were all 1.0; the maximum deviation of the dose rates was 0.61%. The Cerenkov light radiation correction factor(CLR) for 6 and 10 MV were 0.741 and 0.746, respectively, and the CLR for 6, 9, 12 and 15 MeV were 0.750, 0.753, 0.757 and 0.757, respectively. The maximum deviation of dose uncertainty for 15 MeV was 3.15%.Conclusions:The signal obtained by the blue and green channel was no angular dependence, the same as the high-energy electron beam, which verified that the Cerenkov radiation correction factor has good linearity. W2 plastic scintillator can be applied to non-coplanar radiotherapy dosimetry.