Objective:To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and helical tomotherapy(HT)in undergoing protective plan for pelvic bones of patients with cervical cancer.Methods:A total of 40 patients with cervical cancer,who underwent radiotherapy at the First Affiliated Hospital of Bengbu Medical University from January 2023 to February 2024,were selected for this study.The target volumes and organs at risk(OARs)were delineated after the information of computed tomography(CT)simulation images were acquired from each patient.The pelvic bone was alone delineated as OAR.Two kinds of bone marrow dose-limiting radiotherapy plans,coplanar dual-arc VMAT and HT,were respectively designed for each patient by using the treatment planning system(TPS)of radiotherapy.A statistical analysis was conducted to compare the dose parameters of target volume,conformity,homogeneity,OAR dose-volume,mean dose,and maximum dose of point between the two kinds of plans.Results:Both the VMAT and HT plans could meet the requirements of target volume and OARs for dose.For general OARs,the dose-volume percentage(V40 Gy)of V40 Gy at bladder,mean dose(Dmean),rectal V40 Gy,maximum dose(Dmax)at small intestine point of HT plan were respectively(38.97±2.29)%,(38.06±0.45)Gy,(61.50±2.51)%and(50.82±0.36)Gy.The differences of them between HT plan and VMAT plan were statistically significant(t=25.46,13.99,1.56,10.93,P<0.05).The V10 Gy,V20 Gy,V30 Gy and Dmean of VMAT plan were respectively(70.76±2.51)%,(60.84±3.29)%,(52.40±2.56)%and(32.02±4.33)Gy for pelvic bones,which were significantly lower than those of HT plan,and the differences of them between two kinds of plans were also statistically significant(t=-20.68,-13.23,-7.73,-10.26,P<0.05).Conclusion:The HT plan can provide the optimal dose distribution for target region in radiotherapy for patients with cervical cancer,which can better protect OAR nearby target region.VMAT plan has a significant advantage in low-dose regions of protecting pelvis.Thus,individualized treatment design should be conducted according to the conditions of each patient in clinical treatment.

Objective:To investigate the diagnostic potential of serum Dickkopf-related protein 3(Dkk3)as a novel biomarker for sarcopenia in an elderly Chinese population by examining its correlation with muscle mass, muscle strength, and physical function.Methods:The study included elderly individuals aged ≥60 years from the Health Examination Center of Jiangsu Provincial Hospital between 2021 and 2022, who had independent mobility and were free from acute diseases.Fat and muscle mass were measured using Dual-energy X-ray Absorptiometry(DXA). Grip strength and chair stand test times were employed to assess upper and lower limb muscle strength, respectively.Physical function was evaluated using the Short Physical Performance Battery(SPPB). Serum Dkk3 concentration was measured using a human Dkk3 enzyme-linked immunosorbent assay(ELISA)kit.Results:A total of 108 elderly participants(83 males)were included in the study, with an age range of 60 to 97 years(mean age: 70.6±10.8). Serum Dkk3 concentration was found to be negatively correlated with the skeletal muscle mass index(SMI)( R=-0.292, P=0.002), lower limb muscle mass( R=-0.320, P<0.001), upper limb muscle mass( R=-0.222, P=0.020), and hip muscle mass( R=-0.261, P=0.006). Functional assessments revealed negative correlations with grip strength( R=-0.204, P=0.035), 4-meter walking speed( R=-0.195, P=0.043), the three-position balance test( R=-0.245, P=0.011), and the SPPB score( R=-0.196, P=0.043). Regression analysis indicated that, after adjusting for age, sex, body mass index(BMI), and comorbidities, Dkk3 remained negatively associated with lower limb muscle mass( β=-0.197, P=0.012), hip muscle mass( β=-0.156, P=0.029), and the SPPB score( β=-0.001, P=0.013). The sarcopenia group exhibited a 55.6% higher serum Dkk3 level compared to the control group(76.68±37.62 ng/ml vs.49.27±25.88 ng/ml, P<0.001). Receiver Operating Characteristic(ROC)curve analysis determined the optimal diagnostic threshold to be 80.08 ng/ml, with an area under the curve of 0.726, a sensitivity of 41.98%, and a specificity of 96.30% for detecting sarcopenia. Conclusions:Serum Dkk3 is closely associated with reduced muscle mass in the lower limbs and hips, as well as a decline in physical function, in elderly individuals with sarcopenia.Given its cost-effectiveness and clinical utility, serum Dkk3 shows potential as a meaningful biomarker for diagnosing sarcopenia in the elderly.

Objective:To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and helical tomotherapy(HT)in undergoing protective plan for pelvic bones of patients with cervical cancer.Methods:A total of 40 patients with cervical cancer,who underwent radiotherapy at the First Affiliated Hospital of Bengbu Medical University from January 2023 to February 2024,were selected for this study.The target volumes and organs at risk(OARs)were delineated after the information of computed tomography(CT)simulation images were acquired from each patient.The pelvic bone was alone delineated as OAR.Two kinds of bone marrow dose-limiting radiotherapy plans,coplanar dual-arc VMAT and HT,were respectively designed for each patient by using the treatment planning system(TPS)of radiotherapy.A statistical analysis was conducted to compare the dose parameters of target volume,conformity,homogeneity,OAR dose-volume,mean dose,and maximum dose of point between the two kinds of plans.Results:Both the VMAT and HT plans could meet the requirements of target volume and OARs for dose.For general OARs,the dose-volume percentage(V40 Gy)of V40 Gy at bladder,mean dose(Dmean),rectal V40 Gy,maximum dose(Dmax)at small intestine point of HT plan were respectively(38.97±2.29)%,(38.06±0.45)Gy,(61.50±2.51)%and(50.82±0.36)Gy.The differences of them between HT plan and VMAT plan were statistically significant(t=25.46,13.99,1.56,10.93,P<0.05).The V10 Gy,V20 Gy,V30 Gy and Dmean of VMAT plan were respectively(70.76±2.51)%,(60.84±3.29)%,(52.40±2.56)%and(32.02±4.33)Gy for pelvic bones,which were significantly lower than those of HT plan,and the differences of them between two kinds of plans were also statistically significant(t=-20.68,-13.23,-7.73,-10.26,P<0.05).Conclusion:The HT plan can provide the optimal dose distribution for target region in radiotherapy for patients with cervical cancer,which can better protect OAR nearby target region.VMAT plan has a significant advantage in low-dose regions of protecting pelvis.Thus,individualized treatment design should be conducted according to the conditions of each patient in clinical treatment.

Objective:To investigate the diagnostic potential of serum Dickkopf-related protein 3(Dkk3)as a novel biomarker for sarcopenia in an elderly Chinese population by examining its correlation with muscle mass, muscle strength, and physical function.Methods:The study included elderly individuals aged ≥60 years from the Health Examination Center of Jiangsu Provincial Hospital between 2021 and 2022, who had independent mobility and were free from acute diseases.Fat and muscle mass were measured using Dual-energy X-ray Absorptiometry(DXA). Grip strength and chair stand test times were employed to assess upper and lower limb muscle strength, respectively.Physical function was evaluated using the Short Physical Performance Battery(SPPB). Serum Dkk3 concentration was measured using a human Dkk3 enzyme-linked immunosorbent assay(ELISA)kit.Results:A total of 108 elderly participants(83 males)were included in the study, with an age range of 60 to 97 years(mean age: 70.6±10.8). Serum Dkk3 concentration was found to be negatively correlated with the skeletal muscle mass index(SMI)( R=-0.292, P=0.002), lower limb muscle mass( R=-0.320, P<0.001), upper limb muscle mass( R=-0.222, P=0.020), and hip muscle mass( R=-0.261, P=0.006). Functional assessments revealed negative correlations with grip strength( R=-0.204, P=0.035), 4-meter walking speed( R=-0.195, P=0.043), the three-position balance test( R=-0.245, P=0.011), and the SPPB score( R=-0.196, P=0.043). Regression analysis indicated that, after adjusting for age, sex, body mass index(BMI), and comorbidities, Dkk3 remained negatively associated with lower limb muscle mass( β=-0.197, P=0.012), hip muscle mass( β=-0.156, P=0.029), and the SPPB score( β=-0.001, P=0.013). The sarcopenia group exhibited a 55.6% higher serum Dkk3 level compared to the control group(76.68±37.62 ng/ml vs.49.27±25.88 ng/ml, P<0.001). Receiver Operating Characteristic(ROC)curve analysis determined the optimal diagnostic threshold to be 80.08 ng/ml, with an area under the curve of 0.726, a sensitivity of 41.98%, and a specificity of 96.30% for detecting sarcopenia. Conclusions:Serum Dkk3 is closely associated with reduced muscle mass in the lower limbs and hips, as well as a decline in physical function, in elderly individuals with sarcopenia.Given its cost-effectiveness and clinical utility, serum Dkk3 shows potential as a meaningful biomarker for diagnosing sarcopenia in the elderly.

Livedoid vasculopathy is a rare chronic ischemic necrotic skin disease caused by microvascular thrombosis in superficial vascular plexuses.Effective treatments are lacking.Efficacy of anticoagulants has been clinically proven in the treatment of this disease,but the administration route and adverse reactions limit their extensive application.The new oral factor Xa inhibitor rivaroxaban,which has many advantages,such as no need for coagulation monitoring,few adverse reactions and convenient oral administration,can be used in the prevention and treatment of thrombosis and post-thrombotic ulcers.In this article,3 patients with livedoid vasculopathy were treated with rivaroxaban alone or in combination,and satisfactory efficacy was obtained.

OBJECTIVE: To train convolutional networks using multi-lead ECG data and classify new data accurately to provide reliable information for clinical diagnosis. METHODS: The data were pre-processed with a bandpass filter, and signal framing was adopted to adjust the data of different lengths to the same size to facilitate network training and prediction. The dataset was expanded by increasing the sample size to improve the detection rate of abnormal samples. A depth-wise separable convolution structure was used for more specific feature extraction for different channels of twelve-lead ECG data. We trained the two classifiers for each label using the improved DenseNet to classify different labels. RESULTS: The propose model showed an accuracy of 80.13% for distinguishing between normal and abnormal ECG with a sensitivity of 80.38%, a specificity of 79.91% and a F1 score of 79.35%. CONCLUSIONS The model proposed herein can rapidly and effectively classify the ECG data. The running time of a single dataset on GPU is 33.59 ms, which allows real-time prediction to meet the clinical requirements.
Algorithms ; Arrhythmias, Cardiac ; diagnosis ; Databases as Topic ; Electrocardiography ; classification ; methods ; Humans ; Neural Networks (Computer) ; Sensitivity and Specificity

Objective To evaluate the clinical efficacy of lymphoplasma exchange (LPE) for the treatment of severe refractory immune-related skin diseases.Methods From May 2013 to October 2015,8 patients with toxic epidermal necrolysis,drug-induced hypersensitivity syndrome (DIHS),pemphigus vulgaris,pemphigoid or paraneoplastic pemphigus were enrolled from Department of Dermatology,Xiangya Hospital,Central South University,who showed no response to conventional therapy or presented with multiple organ dysfunction.After the treatment with LPE,the efficacy was evaluated,and adverse reactions were observed.Results After one session of LPE therapy,6 patients received marked improvement,and were cured at last.In 1 patient with pemphigus vulgaris who was resistant to the treatment with high doses of glucocorticoids and immunosuppressive agents,the rashes regressed during the treatment with LPE,but recurred after the end of treatment.One patient with bullous pemphigoid presented with eruptive blisters on the next day after the treatment with LPE,which were considered as allergic reactions to allogeneic plasma.There were no obvious differences in white blood cell count,lymphocyte count,neutrophil count and blood platelet count in the peripheral blood of 8 patients before and after the treatment with LPE.During the follow-up of 3-5 years,all of the patients were recovered without recurrence,except 1 patient with bullous pemphigoid who died of disseminated tuberculosis after 1 year.Conclusion LPE is effective for the treatment of severe immune-related skin diseases,but attention should be paid to potential transfusion reaction and allergic reactions.

Objective:This work aims to investigate diallyl disulfide (DADS) inhibition of cell migration and invasion in human colon cancer SW480 cells through the Rac1-ADF/cofilin1 pathway. Methods:The potential of cell migration and invasion was examined by scratch healing assay and transwell membrane assay. The expression of Rac1-ADF/cofilin1 pathway was detected by RT-PCR and Western blot. Results:After the SW480 cells were treated with 40 and 50 mg·L-1 of DADS for 24 h, the number of transmembrane cells through the Matrigel obviously decreased by 57.12%and 64.59%, respectively (P<0.05). After cell treatment for 48 h, the cell migration rates were 23.23%and 12.87%, which were significantly lower compared with the control group (75.86%;P<0.05). After the cells were treated with 45 mg·L-1 of DADS for 24 and 48 h, the expression of Rac1, Rock1, PAK1, LIMK1, and destrin mRNA respectively decreased compared with the control group (P<0.05). However, no significant difference was observed in the expression of cofilin1 mRNA (P>0.05). After the treatment with 45 mg·L-1 of DADS for 6, 12, 24, and 48 h, the expression of Rac1, Rock1, PAK1, LIMK1, and Destrin proteins respectively decreased in a time-dependent manner compared with the control group (P<0.05). However, no significant differences were observed in the expression of the cofilin1 protein (P>0.05). Moreover, the expression of p-LIMK1 and p-cofilin1 notably decreased in a time-dependent manner (P<0.05). Conclusion:DADS inhibits cell migration and invasion, which is related to the down-regulation of Rac1, Rock1, PAK1, LIMK1, p-LIMK1, p-cofilin1, and destrin through the Rac1-ADF/cofilin1 pathway.