1.Manganese porphyrin metal-organic framework nanoparticles loaded with DMXAA combined with sonodynamic therapy for the treatment of triple-negative breast cancer mouse xenografts
LIU Qianhui ; GUI Bin ; PU Huan ; LI Zhouchang ; HUANG Xin ; ZHOU Qing ; DENG Qing
Chinese Journal of Cancer Biotherapy 2026;33(3):262-269
[摘 要] 目的:构建负载STING激动剂DMXAA的锰卟啉金属有机框架纳米颗粒(DPM),探讨其对三阴性乳腺癌(TNBC)细胞4T1及其小鼠移植瘤的治疗效果。方法:通过物理吸附法制备 DPM 纳米颗粒,利用透射电镜、扫描电镜及纳米粒度电位仪表征其形貌与理化性质。常规培养4T1细胞,细胞实验分为对照组、超声辐照组(US组)、DPM治疗组(DPM组)和DPM治疗联合超声辐照组(DPM + US组),用CCK-8法检测细胞活性,免疫荧光法检测高迁移率族蛋白B1(HMGB1)和钙网蛋白(CRT)的表达,WB法检测STING通路相关蛋白的表达。构建4T1细胞移植瘤小鼠模型,分为四组,处理同细胞实验,测量肿瘤体积,免疫荧光法检测移植瘤组织中Ki-67、HMGB1、CRT和缺氧诱导因子-1ɑ(HIF-1ɑ)蛋白的表达,TUNEL法检测细胞凋亡,流式细胞术检测免疫细胞活化情况,对主要器官进行H-E染色,以评估纳米材料的体内安全性。结果:DPM呈梭形,平均粒径(268 ± 3.302)nm,电位(33.1 ± 0.87)mV。细胞实验中,DPM联合超声辐照可明显抑制4T1细胞的增殖(P < 0.001),提高4T1细胞中ROS水平(P < 0.001),诱导4T1细胞CRT表达上调(P < 0.001),HMGB1从细胞核中移至细胞质,激活STING信号通路[p-STING、p-TBK1、p-IRF3蛋白表达均显著增加(均P < 0.001)]。体内实验中,DPM联合超声辐照可显著抑制4T1细胞移植瘤生长(P < 0.001)并促进免疫细胞表型转化(P < 0.001),抑制移植瘤组织中Ki-67、HIF-1α蛋白表达(均P < 0.01),谷胱甘肽(GSH)产生(P < 0.01),促进CRT、HMGB1蛋白表达、ROS产生(P < 0.001),对主要器官结构无明显影响。结论: DPM联合超声辐照可通过激活STING通路显著抑制4T1细胞及其移植瘤的生长,诱导抗肿瘤免疫应答,且对主要器官无明显毒性。
2.Clinical Efficacy and Economic Evaluation of 1293 Non-Severe Adult Patients with Community-Acquired Pneumonia Treated by the Jiangsu Traditional Chinese Medicine Diagnosis and Treatment Protocol for Dominant Diseases:A Multicenter,Retrospective Real-World Cohort Study
Ye MA ; Yeqing JI ; Zhichao WANG ; Fanchao FENG ; Mingzhi PU ; Hong LYU ; Xiaodong HU ; Gaohua FENG ; Xiaoqian FANG ; Guicai ZHANG ; Yanfen TANG ; Yeqing ZHANG ; Yao ZHUFU ; Wenpan PENG ; Hao WANG ; Cheng GU ; Zhichao ZHANG ; Shuang YANG ; Xinyu SUN ; Qi ZHAO ; Aojie GUO ; Xin TONG ; Zhuoyue WU ; Xiaoxiao WANG ; Jia LIU ; Hailang HE ; Xianmei ZHOU
Journal of Traditional Chinese Medicine 2026;67(9):966-974
ObjectiveTo evaluate the clinical efficacy and economic value of the Jiangsu Traditional Chinese Medicine (TCM) Diagnosis and Treatment Protocol for Dominant Diseases (abbreviated as the Diagnosis and Treatment Protocol) in adult patients with non-severe community-acquired pneumonia (CAP) based on real-world clinical data. MethodsA retrospective real-world cohort study was conducted using electronic medical records of adult patients hospitalized for non-severe CAP from September 1st, 2023 to December 31st, 2024 across 10 TCM hospitals in Jiangsu province. Patients were classified into an exposure group and a non-exposure group based on whether they received Chinese herbal medicine (CHM) according to the Diagnosis and Treatment Protocol. The non-exposure group received only conventional western medicine, while the exposure group additionally received differentiated CHM for at least five consecutive days. Outcomes were compared between two patient groups, including cough resolution rate, sputum resolution rate (assessed by volume, color, and consistency), incidence of abnormal C-reactive protein (CRP), incidence of abnormal white blood cell (WBC) count, and radiographic resolution rate of pulmonary infiltrates on chest imaging. Multivariable logistic regression was performed to identify factors influencing clinical efficacy. Subgroup analyses were conducted according to age, gender, smoking status, history of hypertension, and pneumonia severity score (CURB-65), and the efficacy of treatment for cough and sputum was analyzed within each subgroup. Cost-effectiveness analysis was conducted using cough resolution rate as the outcome measure, evaluating the pharmacoeconomics of the two groups. ResultsA total of 1688 patients were included with 1293 in the exposure group and 395 in the non-exposure group. Compared to the non-exposure group, the exposure group demonstrated significantly higher resolution rates of cough, sputum volume, color, and consistency, as well as a significantly lower incidence of abnormal CRP (P<0.05). No statistically significant difference was observed between the groups in terms of abnormal WBC count and radiographic resolution rate of pulmonary infiltrates (P>0.05). Logistic regression analysis showed that the cough resolution rate in the exposure group was 1.83 times that of the non-exposure group, while the probabilities of resolution in sputum volume, color, and consistency were 1.37, 2.09, and 1.56 times those of the non-exposure group, respectively (P<0.05). Subgroup analyses showed that the exposure group achieved significantly higher cough resolution rates across most subgroups except for populations with a CURB-65 score ≥2 or those with a history of hypertension (P<0.05). Specifically, among females, patients aged ≥18 and <65 years, non-smokers, those without hypertension, and those with a CURB-65 score of 0, the exposure group showed a higher cough resolution rate than the non-exposure group (P<0.05). From an economic perspective, total hospitalization cost, length of stay, antibiotic cost, and CHM cost all differed significantly between groups (P<0.05). The cost-effectiveness ratio (CER) was 10,788.80 CNY/case in the exposure group, while 22,513.80 CNY/case in the non-exposure group. This implies that, compared with the exposure group, the non-exposure group incurred an additional 17,302.27 CNY to achieve one case of cough resolution. When the willingness-to-pay threshold ranged from 0 to 50,000 CNY, the probability of economic advantage was consistently higher in the exposure group than in the non-exposure group. ConclusionOn the basis of conventional western medicine, the addition of CHM in accordance with the Diagnosis and Treatment Protocol can effectively improve clinical symptoms, reduce inflammatory markers, promote clinical recovery, and is more cost-effective in treating adults with non-severe CAP.
3.Efficacy and Economic Evaluation of Weishi Qingjin Formula (苇石清金方)in the Treatment of Adult Community-Acquired Pneumonia with Phlegm-Heat Obstructing the Lung Syndrome:A Multicenter Retrospective Real-World Cohort Study
Yeqing JI ; Ye MA ; Zhichao WANG ; Fanchao FENG ; Mingzhi PU ; Hong LYU ; Xiaodong HU ; Gaohua FENG ; Xiaoqian FANG ; Guicai ZHANG ; Yanfen TANG ; Yeqing ZHANG ; Yao ZHUFU ; Wenpan PENG ; Hao WANG ; Cheng GU ; Zhichao ZHANG ; Shuang YANG ; Xinyu SUN ; Qi ZHAO ; Aojie GUO ; Xin TONG ; Zhuoyue WU ; Xiaoxiao WANG ; Jia LIU ; Hailang HE ; Xianmei ZHOU
Journal of Traditional Chinese Medicine 2026;67(9):975-984
ObjectiveTo observe the real‑world effectiveness and economic outcomes of Weishi Qingjin Formula (苇石清金方, WQF) in the treatment of adult community‑acquired pneumonia (CAP) with phlegm‑heat obstructing the lung syndrome. MethodsBased on a multicenter, real-world retrospective cohort study, clinical data were collected from hospitalized adult patients diagnosed with non‑severe CAP and phlegm‑heat obstructing the lung syndrome in 10 traditional Chinese medicine (TCM) hospitals in Jiangsu province. Patients were divided into an exposure group (those who received oral WQF) and a non‑exposure group (those who did not). The following outcomes were compared between the two groups before and after treatment, which were remission rates of clinical symptoms including cough, expectoration (sputum volume, color, consistency), and chest pain, levels of inflammatory markers including C‑reactive protein (CRP) and white blood cell count (WBC), and the rate of pulmonary inflammatory absorption on chest CT. Subgroup analyses were performed based on age, gender, smoking status, presence of hypertension, and the severity of community-acquired pneumonia (CURB‑65) score, comparing the two groups in terms of cough remission rate, chest pain remission rate, and chest CT absorption rate. For health economic evaluation, cost‑effectiveness analysis was used to calculate the cost‑effectiveness ratio (CER) and incremental cost‑effectiveness ratio (ICER). Univariate sensitivity analysis and probabilistic sensitivity analysis were performed to test the robustness of the results. ResultsA total of 647 patients in the exposure group and 1491 patients in the non-exposure group were included in the final statistical analysis. There was no statistically significant difference in length of hospital stay, gender, marital status, smoking history, bronchoscopy history, and comorbidities between the groups (P>0.05), but age, CURB-65 score, and antibiotic use. The exposure group had significantly higher remission rates of cough and sputum consistency than the non-exposure group (P<0.05). After adjusting for confounders using propensity score matching and logistic regression, the cough remission rate in the exposure group was 1.49 times that of the non-exposure group (P<0.01). No significant difference was observed between groups in the reduction rates of CRP and WBC, and in the rate of pulmonary inflammatory absorption on chest CT (P>0.05). Subgroup analyses revealed that the cough remission rate in the exposure group was significantly better than that in the non-exposure group except for patients aged ≥65 years, smokers, hypertensive patients, those using other type antibiotics or not using antibiotics, and those with a CURB-65 score ≥1 (P<0.05). Among smokers, the chest pain remission rate in the exposure group was 4.38 times that of the non-exposure group (P<0.01). No significant difference in chest CT absorption rate was found between groups across subgroups of gender, age, hypertension status, or antibiotic type (P>0.05). In terms of economic evaluation, CER was 10,877.60 CNY/case in the exposure group and 16,773.10 CNY/case in the non-exposure group. Compared to the exposure group, the non-exposure group incurred an additional 15,034.26 CNY to achieve one case of cough resolution, indicating a more favorable cost-effectiveness profile. Probabilistic sensitivity analysis yielded results consistent with the cost-effectiveness analysis, confirming the robustness of the findings. ConclusionWQF demonstrates significant efficacy in improving cough symptoms in the treatment of adult CAP with phlegm-heat obstructing the lung syndrome, and also exhibits favorable economic benefits.
4.Clinical Efficacy and Economic Evaluation of 1293 Non-Severe Adult Patients with Community-Acquired Pneumonia Treated by the Jiangsu Traditional Chinese Medicine Diagnosis and Treatment Protocol for Dominant Diseases:A Multicenter,Retrospective Real-World Cohort Study
Ye MA ; Yeqing JI ; Zhichao WANG ; Fanchao FENG ; Mingzhi PU ; Hong LYU ; Xiaodong HU ; Gaohua FENG ; Xiaoqian FANG ; Guicai ZHANG ; Yanfen TANG ; Yeqing ZHANG ; Yao ZHUFU ; Wenpan PENG ; Hao WANG ; Cheng GU ; Zhichao ZHANG ; Shuang YANG ; Xinyu SUN ; Qi ZHAO ; Aojie GUO ; Xin TONG ; Zhuoyue WU ; Xiaoxiao WANG ; Jia LIU ; Hailang HE ; Xianmei ZHOU
Journal of Traditional Chinese Medicine 2026;67(9):966-974
ObjectiveTo evaluate the clinical efficacy and economic value of the Jiangsu Traditional Chinese Medicine (TCM) Diagnosis and Treatment Protocol for Dominant Diseases (abbreviated as the Diagnosis and Treatment Protocol) in adult patients with non-severe community-acquired pneumonia (CAP) based on real-world clinical data. MethodsA retrospective real-world cohort study was conducted using electronic medical records of adult patients hospitalized for non-severe CAP from September 1st, 2023 to December 31st, 2024 across 10 TCM hospitals in Jiangsu province. Patients were classified into an exposure group and a non-exposure group based on whether they received Chinese herbal medicine (CHM) according to the Diagnosis and Treatment Protocol. The non-exposure group received only conventional western medicine, while the exposure group additionally received differentiated CHM for at least five consecutive days. Outcomes were compared between two patient groups, including cough resolution rate, sputum resolution rate (assessed by volume, color, and consistency), incidence of abnormal C-reactive protein (CRP), incidence of abnormal white blood cell (WBC) count, and radiographic resolution rate of pulmonary infiltrates on chest imaging. Multivariable logistic regression was performed to identify factors influencing clinical efficacy. Subgroup analyses were conducted according to age, gender, smoking status, history of hypertension, and pneumonia severity score (CURB-65), and the efficacy of treatment for cough and sputum was analyzed within each subgroup. Cost-effectiveness analysis was conducted using cough resolution rate as the outcome measure, evaluating the pharmacoeconomics of the two groups. ResultsA total of 1688 patients were included with 1293 in the exposure group and 395 in the non-exposure group. Compared to the non-exposure group, the exposure group demonstrated significantly higher resolution rates of cough, sputum volume, color, and consistency, as well as a significantly lower incidence of abnormal CRP (P<0.05). No statistically significant difference was observed between the groups in terms of abnormal WBC count and radiographic resolution rate of pulmonary infiltrates (P>0.05). Logistic regression analysis showed that the cough resolution rate in the exposure group was 1.83 times that of the non-exposure group, while the probabilities of resolution in sputum volume, color, and consistency were 1.37, 2.09, and 1.56 times those of the non-exposure group, respectively (P<0.05). Subgroup analyses showed that the exposure group achieved significantly higher cough resolution rates across most subgroups except for populations with a CURB-65 score ≥2 or those with a history of hypertension (P<0.05). Specifically, among females, patients aged ≥18 and <65 years, non-smokers, those without hypertension, and those with a CURB-65 score of 0, the exposure group showed a higher cough resolution rate than the non-exposure group (P<0.05). From an economic perspective, total hospitalization cost, length of stay, antibiotic cost, and CHM cost all differed significantly between groups (P<0.05). The cost-effectiveness ratio (CER) was 10,788.80 CNY/case in the exposure group, while 22,513.80 CNY/case in the non-exposure group. This implies that, compared with the exposure group, the non-exposure group incurred an additional 17,302.27 CNY to achieve one case of cough resolution. When the willingness-to-pay threshold ranged from 0 to 50,000 CNY, the probability of economic advantage was consistently higher in the exposure group than in the non-exposure group. ConclusionOn the basis of conventional western medicine, the addition of CHM in accordance with the Diagnosis and Treatment Protocol can effectively improve clinical symptoms, reduce inflammatory markers, promote clinical recovery, and is more cost-effective in treating adults with non-severe CAP.
5.Efficacy and Economic Evaluation of Weishi Qingjin Formula (苇石清金方)in the Treatment of Adult Community-Acquired Pneumonia with Phlegm-Heat Obstructing the Lung Syndrome:A Multicenter Retrospective Real-World Cohort Study
Yeqing JI ; Ye MA ; Zhichao WANG ; Fanchao FENG ; Mingzhi PU ; Hong LYU ; Xiaodong HU ; Gaohua FENG ; Xiaoqian FANG ; Guicai ZHANG ; Yanfen TANG ; Yeqing ZHANG ; Yao ZHUFU ; Wenpan PENG ; Hao WANG ; Cheng GU ; Zhichao ZHANG ; Shuang YANG ; Xinyu SUN ; Qi ZHAO ; Aojie GUO ; Xin TONG ; Zhuoyue WU ; Xiaoxiao WANG ; Jia LIU ; Hailang HE ; Xianmei ZHOU
Journal of Traditional Chinese Medicine 2026;67(9):975-984
ObjectiveTo observe the real‑world effectiveness and economic outcomes of Weishi Qingjin Formula (苇石清金方, WQF) in the treatment of adult community‑acquired pneumonia (CAP) with phlegm‑heat obstructing the lung syndrome. MethodsBased on a multicenter, real-world retrospective cohort study, clinical data were collected from hospitalized adult patients diagnosed with non‑severe CAP and phlegm‑heat obstructing the lung syndrome in 10 traditional Chinese medicine (TCM) hospitals in Jiangsu province. Patients were divided into an exposure group (those who received oral WQF) and a non‑exposure group (those who did not). The following outcomes were compared between the two groups before and after treatment, which were remission rates of clinical symptoms including cough, expectoration (sputum volume, color, consistency), and chest pain, levels of inflammatory markers including C‑reactive protein (CRP) and white blood cell count (WBC), and the rate of pulmonary inflammatory absorption on chest CT. Subgroup analyses were performed based on age, gender, smoking status, presence of hypertension, and the severity of community-acquired pneumonia (CURB‑65) score, comparing the two groups in terms of cough remission rate, chest pain remission rate, and chest CT absorption rate. For health economic evaluation, cost‑effectiveness analysis was used to calculate the cost‑effectiveness ratio (CER) and incremental cost‑effectiveness ratio (ICER). Univariate sensitivity analysis and probabilistic sensitivity analysis were performed to test the robustness of the results. ResultsA total of 647 patients in the exposure group and 1491 patients in the non-exposure group were included in the final statistical analysis. There was no statistically significant difference in length of hospital stay, gender, marital status, smoking history, bronchoscopy history, and comorbidities between the groups (P>0.05), but age, CURB-65 score, and antibiotic use. The exposure group had significantly higher remission rates of cough and sputum consistency than the non-exposure group (P<0.05). After adjusting for confounders using propensity score matching and logistic regression, the cough remission rate in the exposure group was 1.49 times that of the non-exposure group (P<0.01). No significant difference was observed between groups in the reduction rates of CRP and WBC, and in the rate of pulmonary inflammatory absorption on chest CT (P>0.05). Subgroup analyses revealed that the cough remission rate in the exposure group was significantly better than that in the non-exposure group except for patients aged ≥65 years, smokers, hypertensive patients, those using other type antibiotics or not using antibiotics, and those with a CURB-65 score ≥1 (P<0.05). Among smokers, the chest pain remission rate in the exposure group was 4.38 times that of the non-exposure group (P<0.01). No significant difference in chest CT absorption rate was found between groups across subgroups of gender, age, hypertension status, or antibiotic type (P>0.05). In terms of economic evaluation, CER was 10,877.60 CNY/case in the exposure group and 16,773.10 CNY/case in the non-exposure group. Compared to the exposure group, the non-exposure group incurred an additional 15,034.26 CNY to achieve one case of cough resolution, indicating a more favorable cost-effectiveness profile. Probabilistic sensitivity analysis yielded results consistent with the cost-effectiveness analysis, confirming the robustness of the findings. ConclusionWQF demonstrates significant efficacy in improving cough symptoms in the treatment of adult CAP with phlegm-heat obstructing the lung syndrome, and also exhibits favorable economic benefits.
6.Rapid quality control method for automated organ-at-risk contouring in head and neck radiotherapy
Xiaoyu YANG ; Kaining YAO ; Yichen PU ; Shun ZHOU ; Ruoxi WANG ; Haizhen YUE ; Hao WU
Chinese Journal of Radiological Health 2026;35(2):193-199
Objective To address the need for rapid review of automated organ-at-risk (OAR) contouring for head-and-neck cancer in online adaptive radiotherapy, this study used dosimetric indices as the reference standard to evaluate the suitability of geometric similarity metrics and to develop a rapid screening model that balances the risk of missed errors with review efficiency. Methods This retrospective study included 29 patients with head-and-neck radiotherapy, yielding 243 pairs of OAR contours (auto-generated vs. manual). Geometric similarity metrics, including the Dice similarity coefficient (Dice), the 95th percentile Hausdorff distance (HD95), and the maximum Hausdorff distance (HD100), were computed between the two contour sets. Using the dose distributions from clinical treatment plans, dosimetric differences between the two contour sets were calculated for key indices, including mean dose (Dmean) and maximum dose (Dmax). Correlations between geometric metrics and dosimetric differences were analyzed. Dosimetric discrepancy events were defined as Y3Gy using a threshold of 3 Gy. Within a univariable logistic regression triage framework, each geometric metric was used as an independent variable to estimate the probability of Y3Gy. Discriminative performance was assessed using receiver operating characteristic (ROC) curves and precision-recall (PR) curves, with the area under the curve (AUC) including ROC-AUC and PR-AUC. Practical operating thresholds were determined via threshold sweeping. Results Geometric similarity metrics showed weak-to-moderate correlations with dosimetric differences; compared with maximum dose, correlations with mean dose differences were more consistent. Among the evaluated metrics, HD95 achieved the best classification performance for Y3Gy. Threshold sweeping suggested that an HD95 threshold in the range of 4-9 mm can balance the risk of missed discrepancies with the efficiency of automated contour quality assurance (QA). Conclusion Several geometric similarity metrics demonstrated only weak-to-moderate associations with dosimetric differences. For head-and-neck OAR contour QA in this study, HD95 provided the best discriminative performance and can support rapid triage of automated contours, with a practical operating threshold range of 4-9 mm, potentially improving the efficiency of adaptive radiotherapy workflows.
7.Rapid quality control method for automated organ-at-risk contouring in head and neck radiotherapy
Xiaoyu YANG ; Kaining YAO ; Yichen PU ; Shun ZHOU ; Ruoxi WANG ; Haizhen YUE ; Hao WU
Chinese Journal of Radiological Health 2026;35(2):193-199
Objective To address the need for rapid review of automated organ-at-risk (OAR) contouring for head-and-neck cancer in online adaptive radiotherapy, this study used dosimetric indices as the reference standard to evaluate the suitability of geometric similarity metrics and to develop a rapid screening model that balances the risk of missed errors with review efficiency. Methods This retrospective study included 29 patients with head-and-neck radiotherapy, yielding 243 pairs of OAR contours (auto-generated vs. manual). Geometric similarity metrics, including the Dice similarity coefficient (Dice), the 95th percentile Hausdorff distance (HD95), and the maximum Hausdorff distance (HD100), were computed between the two contour sets. Using the dose distributions from clinical treatment plans, dosimetric differences between the two contour sets were calculated for key indices, including mean dose (Dmean) and maximum dose (Dmax). Correlations between geometric metrics and dosimetric differences were analyzed. Dosimetric discrepancy events were defined as Y3Gy using a threshold of 3 Gy. Within a univariable logistic regression triage framework, each geometric metric was used as an independent variable to estimate the probability of Y3Gy. Discriminative performance was assessed using receiver operating characteristic (ROC) curves and precision-recall (PR) curves, with the area under the curve (AUC) including ROC-AUC and PR-AUC. Practical operating thresholds were determined via threshold sweeping. Results Geometric similarity metrics showed weak-to-moderate correlations with dosimetric differences; compared with maximum dose, correlations with mean dose differences were more consistent. Among the evaluated metrics, HD95 achieved the best classification performance for Y3Gy. Threshold sweeping suggested that an HD95 threshold in the range of 4-9 mm can balance the risk of missed discrepancies with the efficiency of automated contour quality assurance (QA). Conclusion Several geometric similarity metrics demonstrated only weak-to-moderate associations with dosimetric differences. For head-and-neck OAR contour QA in this study, HD95 provided the best discriminative performance and can support rapid triage of automated contours, with a practical operating threshold range of 4-9 mm, potentially improving the efficiency of adaptive radiotherapy workflows.
8.Rapid quality control method for automated organ-at-risk contouring in head and neck radiotherapy
Xiaoyu YANG ; Kaining YAO ; Yichen PU ; Shun ZHOU ; Ruoxi WANG ; Haizhen YUE ; Hao WU
Chinese Journal of Radiological Health 2026;35(2):193-199
Objective To address the need for rapid review of automated organ-at-risk (OAR) contouring for head-and-neck cancer in online adaptive radiotherapy, this study used dosimetric indices as the reference standard to evaluate the suitability of geometric similarity metrics and to develop a rapid screening model that balances the risk of missed errors with review efficiency. Methods This retrospective study included 29 patients with head-and-neck radiotherapy, yielding 243 pairs of OAR contours (auto-generated vs. manual). Geometric similarity metrics, including the Dice similarity coefficient (Dice), the 95th percentile Hausdorff distance (HD95), and the maximum Hausdorff distance (HD100), were computed between the two contour sets. Using the dose distributions from clinical treatment plans, dosimetric differences between the two contour sets were calculated for key indices, including mean dose (Dmean) and maximum dose (Dmax). Correlations between geometric metrics and dosimetric differences were analyzed. Dosimetric discrepancy events were defined as Y3Gy using a threshold of 3 Gy. Within a univariable logistic regression triage framework, each geometric metric was used as an independent variable to estimate the probability of Y3Gy. Discriminative performance was assessed using receiver operating characteristic (ROC) curves and precision-recall (PR) curves, with the area under the curve (AUC) including ROC-AUC and PR-AUC. Practical operating thresholds were determined via threshold sweeping. Results Geometric similarity metrics showed weak-to-moderate correlations with dosimetric differences; compared with maximum dose, correlations with mean dose differences were more consistent. Among the evaluated metrics, HD95 achieved the best classification performance for Y3Gy. Threshold sweeping suggested that an HD95 threshold in the range of 4-9 mm can balance the risk of missed discrepancies with the efficiency of automated contour quality assurance (QA). Conclusion Several geometric similarity metrics demonstrated only weak-to-moderate associations with dosimetric differences. For head-and-neck OAR contour QA in this study, HD95 provided the best discriminative performance and can support rapid triage of automated contours, with a practical operating threshold range of 4-9 mm, potentially improving the efficiency of adaptive radiotherapy workflows.
9.Pharmacokinetic Differences of Seven Components in Different Phases of Banxia Xiexintang in Rats
Chao HE ; Siyi LIU ; Mingyun WANG ; Qi WANG ; Jingwen ZHOU ; Tong ZHANG ; Yiqiong PU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):215-222
ObjectiveTo evaluate the effects of phases on the pharmacokinetic behavior of seven components from Banxia Xiexintang(BXT) in normal rats by investigating and comparing their pharmacokinetic profiles in different phase samples. MethodsThe phase separation of BXT was carried out by centrifugation-dialysis method, and three phase samples were obtained, including the precipitated phase(PP), colloidal phase(CP) and true solution phase(TP). A total of 24 male SD rats were randomly divided into BXT, PP, CP and TP groups(n=6). The BXT group was gavaged at a dose of 24.1 g·kg-1(calculated by the dosage of raw materials). After proper treatments, PP, CP and TP groups were administrated at the same dose as that of BXT group, respectively. Blood was collected from each group at set time points after gavage of BXT and the phase samples. The contents of 7 components(baicalin, wogonoside, wogonin, berberine, palmatine, ammonium glycyrrhizinate and isoliquiritin) in rat plasma were determined by ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS), and the pharmacokinetic parameters of each component were analyzed by DAS 2.0. ResultsThe peak concentration of baicalin was the highest among the blood-entered components in each group, followed by wogonoside. The results of the concentration-time curves and pharmacokinetic parameters of the 7 components showed that the area under the concentration-time curve(AUC) of isoliquiritin in the BXT group was the highest, followed by that in the CP group. AUC values of baicalin, wogonoside, wogonin and ammonium glycyrrhizinate in the BXT group were similar to those of the CP group, and AUC of palmatine in the BXT group was similar to that of the PP group. The elimination half-life(t1/2) values of baicalin and wogonoside in the BXT group was the longest, the t1/2 values of ammonium glycyrrhizinate and berberine were similar to those of the CP group, and the t1/2 of palmatine was similar to that of the PP group. The t1/2 of wogonin was the longest in the PP group, and the t1/2 of isoliquiritin was the longest in the TP group was the longest, which was similar to that in the PP group. Except for isoliquiritin, the other 6 components showed double peaks in the concentration-time curve of the PP group, indicating that the above components might be reabsorbed through the enterohepatic circulation in vivo, which resulted in the maintenance of high plasma concentrations for a long time, and consequently exhibited sustained-release properties. ConclusionThe pharmacokinetic characteristics of the components in different phases were different, and the CP phase may be the effective phase from the perspective of the pharmacological action of BXT. Compared with the BXT group, the in vivo action times of some components in the CP and PP groups were prolonged. The study explores the phase differences of traditional Chinese medicine(TCM) compound decoction in the aspect of pharmacokinetics, and verifies that the phase states from TCM compound decoction will affect the pharmacokinetic behaviors of the active components, which may consequently lead to the difference in in vivo effects.
10.Pharmacokinetic Differences of Seven Components in Different Phases of Banxia Xiexintang in Rats
Chao HE ; Siyi LIU ; Mingyun WANG ; Qi WANG ; Jingwen ZHOU ; Tong ZHANG ; Yiqiong PU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):215-222
ObjectiveTo evaluate the effects of phases on the pharmacokinetic behavior of seven components from Banxia Xiexintang(BXT) in normal rats by investigating and comparing their pharmacokinetic profiles in different phase samples. MethodsThe phase separation of BXT was carried out by centrifugation-dialysis method, and three phase samples were obtained, including the precipitated phase(PP), colloidal phase(CP) and true solution phase(TP). A total of 24 male SD rats were randomly divided into BXT, PP, CP and TP groups(n=6). The BXT group was gavaged at a dose of 24.1 g·kg-1(calculated by the dosage of raw materials). After proper treatments, PP, CP and TP groups were administrated at the same dose as that of BXT group, respectively. Blood was collected from each group at set time points after gavage of BXT and the phase samples. The contents of 7 components(baicalin, wogonoside, wogonin, berberine, palmatine, ammonium glycyrrhizinate and isoliquiritin) in rat plasma were determined by ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS), and the pharmacokinetic parameters of each component were analyzed by DAS 2.0. ResultsThe peak concentration of baicalin was the highest among the blood-entered components in each group, followed by wogonoside. The results of the concentration-time curves and pharmacokinetic parameters of the 7 components showed that the area under the concentration-time curve(AUC) of isoliquiritin in the BXT group was the highest, followed by that in the CP group. AUC values of baicalin, wogonoside, wogonin and ammonium glycyrrhizinate in the BXT group were similar to those of the CP group, and AUC of palmatine in the BXT group was similar to that of the PP group. The elimination half-life(t1/2) values of baicalin and wogonoside in the BXT group was the longest, the t1/2 values of ammonium glycyrrhizinate and berberine were similar to those of the CP group, and the t1/2 of palmatine was similar to that of the PP group. The t1/2 of wogonin was the longest in the PP group, and the t1/2 of isoliquiritin was the longest in the TP group was the longest, which was similar to that in the PP group. Except for isoliquiritin, the other 6 components showed double peaks in the concentration-time curve of the PP group, indicating that the above components might be reabsorbed through the enterohepatic circulation in vivo, which resulted in the maintenance of high plasma concentrations for a long time, and consequently exhibited sustained-release properties. ConclusionThe pharmacokinetic characteristics of the components in different phases were different, and the CP phase may be the effective phase from the perspective of the pharmacological action of BXT. Compared with the BXT group, the in vivo action times of some components in the CP and PP groups were prolonged. The study explores the phase differences of traditional Chinese medicine(TCM) compound decoction in the aspect of pharmacokinetics, and verifies that the phase states from TCM compound decoction will affect the pharmacokinetic behaviors of the active components, which may consequently lead to the difference in in vivo effects.

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