Objective:To investigate the influence of contrast-enhanced computed tomography(CECT)on dose calculation in magnetic resonance imaging(MRI)-guided online adaptive radiotherapy(oART)based on the electron density(ED)assignment method for rectal cancer.Methods:A retrospective analysis was conducted on the medical data of 15 patients with locally advanced rectal cancer at middle-low segments,who admitted to the Chinese PLA General Hospital between December 2023 and April 2025.All patients underwent both plain computed tomography(PCT)and CECT scans during location.The average HU and ED value of all organs that were extracted from PCT and CECT images in the treatment plan system were obtained,and the influences of contrast agent of intake on image characteristics of the structure of each organ(small intestine,femoral head,bladder)were analyzed.PCT was used as referred image to design reference plan(Pref).The synthetic CT(sCT)was simulated and generated on the basis of PCT and CECT,respectively.The beam flow field that was same with Pref was used to recalculate dose on sCT,and then,the online plan(PPCT)based on PCT,and the online plan(PCECT)based on CECT were obtained,respectively,which can simulate the online dose calculation of MRI-guided online adaptive radiotherapy(oART).The Pref was used as reference to compare dosimetric parameters for target region and organ at risk(OAR)through dose volume histogram(DVH)and planed evaluation indicators.Additionally,three dimension(3D)slicer software was used to perform γ analysis for the results of dose distribution,and explore the differences among PPCT,PCECT and Pref on dose distribution.Results:In terms of image characteristics,the HU values of soft-tissue organs(intestine,bladder,spinal cord,soft tissue)and planning target volume(PTV)in CECT were higher than those in PCT,and the differences of them were statistically significant(Zintestines=-2.188,Zbladder=-3.196,tspinal cord=-3.767,tsoft tissue=-10.083,tPTV=-4.693,P<0.05),while its influence was less on bone tissue.The statistical results of ED were consistent with those of HU.Regarding to dosimetric parameters,there was no statistically significant difference in target coverage rate between PPCT and Pref(P>0.05),and the D50%of the PPCT[(2724.25±19.91)cGy]was higher than that of the Pref[(2718.99±21.13)cGy],and the difference was statistically significant(t=-3.679,P=0.002).However,the target coverage rate of PCECT was 94.65(94.04,95.27)%,and the difference of that between PCECT and Pref was statistically significant(Z=-2.158,P=0.031).For OAR,the differences of Dmax value of the small intestine,and the V20 of the left femoral head between PPCT and Pref were significant(Z=-2.556,-2.529,P<0.05).The differences of the Dmax of small intestine,and the D50%of bladder between PCECT and Pref were significant(t=-4.821,2.171,P<0.05).The comparative γ passed rates of PPCT,PCECT and Pref under the standards of 3 mm/3%and 2 mm/2%were all above 95%,and the differences were not significant(P>0.05).Conclusions:The influence of CECT on dose calculation in MRI-guided oART based on ED assignment method for rectal cancer is relatively small,which can be directly used in the design of reference plan,but the maximum dose of radiation-sensitive organs such as the small intestine should be paid attention.

Objective To investigate the effects of miR-483-3p on hypoxia/reoxygenation(H/R)-induced apoptosis and pyroptosis of H9c2 cardiomyocytes and its possible mechanism.Methods Rat H9c2 cardiomyocytes were cultured in vitro,adeno-associated virus-infected H9c2 and the H/R model were constructed by triple-air incuba-tor,and the cells were randomly divided into blank control(Sham)group,model(H/R)group,AAV-miR-483-3p mimic+H/R(AAV-miR-483-3p)group,AAV-miR-483-3p negative control+H/R(AAV-NC)group.The growth status of cells in each group was observed using an inverted microscope;cell proliferation activity was detected by cell counting kit-8(CCK-8);LDH release by lactate dehydrogenase(LDH)kit;apoptosis rate by flow cytometry;apoptosis by notched end labeling(TUNEL).Western blot(WB)was used to detect the expression levels of IL-1β and GSDMD proteins in each group.Results Compared with the Sham group,the H/R group showed abnormal cell status and increased cell death,decreased cell activity,increased LDH release,increased apoptosis rate and apopto-sis level,and increased expression levels of IL-1β and GSDMD proteins(P<0.05);compared with the H/R group,the AAV-miR-483-3p group showed improved cell status and less cell death,increased cell proliferation activity,increased LDH release,and increased IL-1β and GSDMD protein expression levels(P<0.05).Compared with the H/R group,the AAV-miR-483-3p group showed improved cell status and less cell death,increased cell proliferation activity,decreased LDH release,decreased apoptosis rate and apoptosis level,and decreased expression of IL-1β and GSDMD proteins(P<0.05).Conclusion Over-expression of miR-483-3p can improve H/R-inducedH9c2 cardiomyocyte injury by enhancing cell activity and cell metabolism,and inhibiting apoptosis and cell charring.

Objective:To investigate the influence of contrast-enhanced computed tomography(CECT)on dose calculation in magnetic resonance imaging(MRI)-guided online adaptive radiotherapy(oART)based on the electron density(ED)assignment method for rectal cancer.Methods:A retrospective analysis was conducted on the medical data of 15 patients with locally advanced rectal cancer at middle-low segments,who admitted to the Chinese PLA General Hospital between December 2023 and April 2025.All patients underwent both plain computed tomography(PCT)and CECT scans during location.The average HU and ED value of all organs that were extracted from PCT and CECT images in the treatment plan system were obtained,and the influences of contrast agent of intake on image characteristics of the structure of each organ(small intestine,femoral head,bladder)were analyzed.PCT was used as referred image to design reference plan(Pref).The synthetic CT(sCT)was simulated and generated on the basis of PCT and CECT,respectively.The beam flow field that was same with Pref was used to recalculate dose on sCT,and then,the online plan(PPCT)based on PCT,and the online plan(PCECT)based on CECT were obtained,respectively,which can simulate the online dose calculation of MRI-guided online adaptive radiotherapy(oART).The Pref was used as reference to compare dosimetric parameters for target region and organ at risk(OAR)through dose volume histogram(DVH)and planed evaluation indicators.Additionally,three dimension(3D)slicer software was used to perform γ analysis for the results of dose distribution,and explore the differences among PPCT,PCECT and Pref on dose distribution.Results:In terms of image characteristics,the HU values of soft-tissue organs(intestine,bladder,spinal cord,soft tissue)and planning target volume(PTV)in CECT were higher than those in PCT,and the differences of them were statistically significant(Zintestines=-2.188,Zbladder=-3.196,tspinal cord=-3.767,tsoft tissue=-10.083,tPTV=-4.693,P<0.05),while its influence was less on bone tissue.The statistical results of ED were consistent with those of HU.Regarding to dosimetric parameters,there was no statistically significant difference in target coverage rate between PPCT and Pref(P>0.05),and the D50%of the PPCT[(2724.25±19.91)cGy]was higher than that of the Pref[(2718.99±21.13)cGy],and the difference was statistically significant(t=-3.679,P=0.002).However,the target coverage rate of PCECT was 94.65(94.04,95.27)%,and the difference of that between PCECT and Pref was statistically significant(Z=-2.158,P=0.031).For OAR,the differences of Dmax value of the small intestine,and the V20 of the left femoral head between PPCT and Pref were significant(Z=-2.556,-2.529,P<0.05).The differences of the Dmax of small intestine,and the D50%of bladder between PCECT and Pref were significant(t=-4.821,2.171,P<0.05).The comparative γ passed rates of PPCT,PCECT and Pref under the standards of 3 mm/3%and 2 mm/2%were all above 95%,and the differences were not significant(P>0.05).Conclusions:The influence of CECT on dose calculation in MRI-guided oART based on ED assignment method for rectal cancer is relatively small,which can be directly used in the design of reference plan,but the maximum dose of radiation-sensitive organs such as the small intestine should be paid attention.

Objective To investigate the effects of miR-483-3p on hypoxia/reoxygenation(H/R)-induced apoptosis and pyroptosis of H9c2 cardiomyocytes and its possible mechanism.Methods Rat H9c2 cardiomyocytes were cultured in vitro,adeno-associated virus-infected H9c2 and the H/R model were constructed by triple-air incuba-tor,and the cells were randomly divided into blank control(Sham)group,model(H/R)group,AAV-miR-483-3p mimic+H/R(AAV-miR-483-3p)group,AAV-miR-483-3p negative control+H/R(AAV-NC)group.The growth status of cells in each group was observed using an inverted microscope;cell proliferation activity was detected by cell counting kit-8(CCK-8);LDH release by lactate dehydrogenase(LDH)kit;apoptosis rate by flow cytometry;apoptosis by notched end labeling(TUNEL).Western blot(WB)was used to detect the expression levels of IL-1β and GSDMD proteins in each group.Results Compared with the Sham group,the H/R group showed abnormal cell status and increased cell death,decreased cell activity,increased LDH release,increased apoptosis rate and apopto-sis level,and increased expression levels of IL-1β and GSDMD proteins(P<0.05);compared with the H/R group,the AAV-miR-483-3p group showed improved cell status and less cell death,increased cell proliferation activity,increased LDH release,and increased IL-1β and GSDMD protein expression levels(P<0.05).Compared with the H/R group,the AAV-miR-483-3p group showed improved cell status and less cell death,increased cell proliferation activity,decreased LDH release,decreased apoptosis rate and apoptosis level,and decreased expression of IL-1β and GSDMD proteins(P<0.05).Conclusion Over-expression of miR-483-3p can improve H/R-inducedH9c2 cardiomyocyte injury by enhancing cell activity and cell metabolism,and inhibiting apoptosis and cell charring.

Objective To analyze the quality of 22 batches of Fritillariae thunbergii bulbus Formula Granules from 12 different manufacturers by using water-extraction reference substance of Fritillariae thunbergii bulbus(ZBM ERS ST)and water-extraction reference substance of Fritillariae hupehensis bulbus(HBBM ERS ST)as references.Methods Ethyl acetate-methanol-triethylamine-water(17∶1∶1∶0.5)was used as the developing solvent for high-performance thin-layer chromatography(HPTLC)fingerprint analysis.The high-performance liquid chromatography(HPLC)fingerprint analysis was performed on a Agilent Eclipse XDB-C18 column(4.6 mm×250 mm,5 μm)with the gradient mobile phase consisted of acetonitrile-0.03%diethylamine solution.The column temperature was set at 25℃and evaporative light-scattering detector was used.The determination was conducted according to standard test method for measurement of Fritillariae thunbergii bulbus Formula Granules(Guangdong PFKL00117).Results The results of HPTLC and HPLC analysis showed that there are significant differences among the 22 batches of Fritillariae thunbergii bulbus Formula Granules.There were 4 batches of Fritillariae thunbergii bulbus Formula Granules from 3 manufacturers among them showed fingerprint characteristics of Fritillariae hupehensis bulbus.The total amount of peimine and peiminine in the remaining 18 batches of Fritillariae thunbergii bulbus Formula Granules was 0.291-3.179 mg·g-1,which were quite different.Conclusion Currently,the quality of Fritillariae thunbergii bulbus Formula Granules on the market varies greatly.Standardized water-extract reference substance has better applicability for the analysis of the quality of Fritillariae thunbergii bulbus Formula Granules than the control medicinal materials.

Objective To analyze the quality of 19 batches of Ginseng Formula Granules from 11 different manufacturers by using Ginseng water Extract reference substance(GWERS)as references.Methods Thin layer chromatography(TLC)identification and feature map detection were carried out according to the identification items and characteristic maps of Ginseng Formula Granules standard(YBZ-PFKL-2021186)issued by the National Medical Products Administration.Results The results of TLC analysis showed that the 19 batches of Ginseng Formula Granules-labeled samples could be divided into three categories.The overall pattern of the first type of samples was consistent with that of GWERS,and the similarity was high.Pseudoginsenoside F11,a unique component of American ginseng,was detected in the second type of samples.Four blue fluorescent spots were observed in the third type of samples compared to GWERS.HPLC results indicated that all 19 batches of Ginseng Formula Granules showed eight characteristic peaks at the same retention time as that of GWERS chromatogram.Two more chromatographic peaks were found in the chromatogram of three batches of samples from one manufacturer compared to the chromatogram of other samples,whose similarity to the GWERS chromatogram was less than 0.65.The similarity between the chromatogram of the remaining 16 sample and GWERS chromatogram was higher than 0.94.Conclusion At present,the quality of Ginseng Formula Granules on the market varies greatly.It was suspected that American ginseng might appear among them.The application of GWERS for quality analysis of Ginseng Formula Granules has better applicability to the control medicinal materials.

Objective:To investigate and analyze the risk factors of pulmonary infection in hemodialysis patients with diabetes nephropathy (DN), and explore the effect of different antibiotic application methods on the efficacy of DN patients with pulmonary infection.Methods:337 inpatients with DN who were admitted to Lishui Central Hospital from August 2021 to April 2022 were selected as the study subjects, and the proportion of pathogenic bacteria in patients with pulmonary infection caused by hemodialysis was analyzed, and the influencing factors of pulmonary infection were analyzed by single factor and multiple factor logistic regression models. DN patients with pulmonary infection were treated with single or multiple antibiotics, and their curative effects were analyzed and compared.Results:Among 337 hospitalized patients with DN in this study, the rate of pulmonary infection caused by hemodialysis was 24.04%(81/337). 87 strains of pathogenic bacteria were cultivated, and the main pathogens of the infected individuals were Klebsiella pneumoniae (36.78%, 32/87), Staphylococcus aureus (17.24%, 15/87), and Acinetobacter baumannii (16.09%, 14/87). The results of univariate analysis showed that patient age, dialysis time, hospital stay, hemoglobin, postprandial blood glucose, malnutrition (blood albumin level<35 g/L), renal function, and volume load were the influencing factors for pulmonary infection in DN patients undergoing hemodialysis (all P<0.05). Multivariate logistic regression model analysis showed that dialysis time, hemoglobin, postprandial, blood glucose malnutrition, renal function, and volume load were risk factors for pulmonary infection caused by hemodialysis (all P<0.05). After treatment, the levels of white blood cells, neutrophils, and hypersensitive reactive protein in patients with pulmonary infection were significantly reduced compared to before treatment (all P<0.05). The effective rate of multi antibiotic therapy (97.44%, 38/39) was higher than that of single antibiotic therapy (80.95%, 34/42) (χ 2=5.563, P=0.018). Conclusions:There are many independent risk factors for pulmonary infection during hemodialysis in DN patients. The infection rate should be reduced through adequate dialysis, blood glucose control, nutrition supplementation, anemia correction and other measures, and the infected can be treated timely with antibiotics according to the situation.

Objective:To analyze the clinical characteristics of children with 2019 novel coronavirus (2019-nCoV) infection in Putian City, and to provide a reference for the diagnosis and treatment of children with 2019-nCoV infection.Methods:Clinical characteristics, laboratory examination, pulmonary compated tomography findings, treatment, and clinical outcomes of 78 children with 2019-nCoV infection who were admitted to Putian University Affiliated Hospital Medical Group Putian City Children′s Hospital from September 10 to October 20, 2021 were retrospectively collected and analyzed.Results:Of the 78 children included in the analysis, two cases (2.6%) were asymptomatic infection, 36 cases (46.2%) were mild and 40 cases (51.3%) were ordinary. Five children were vaccinated against 2019-nCoV. The main symptoms were fever (24 cases), cough (13 cases), and fatigue (nine cases). A total of 34 cases (43.6%) had neutropenia, 29 cases (37.2%) had lymphopenia, 36 cases (46.2%) had D-dimer increase, 38 cases (48.7%) had hypokalemia, 27 cases (34.6%) had hypoglycemia and 11 cases (14.1%) had elevated creatine kinase isoenzyme. The neutropenia mostly occurred two to four days after admission. Fifty-six cases (71.8%) showed pulmonary computed tomography abnormalities. The cycle threshold of virus open reading frame ( ORF)1 ab was 20.90±7.15 and the cycle threshold of N gene was 20.29±7.78 in the first nucleic acid detection of 78 children after admission. The time of nucleic acid negative conversion of the 78 children was (20.73±6.94) days. IgM antibody titer in five vaccinated children was 0.36 (0.34, 4.89) and IgG antibody was 10.42 (0.50, 19.42). IgM antibody titer was 1.82 (1.66, 8.12) and IgG antibody was 76.63 (16.92, 79.84) in cases with disease duration ≥10 days. Nine children (11.5%) had resurgence of virus and were sent to the isolation site. All the other children were cured and discharged from hospital. Conclusions:Children with 2019-nCoV infection have mild clinical symptoms, and some children have lymphopenia, neutropenia, and D-dimer elevation during the course of the disease. The overall prognosis is good. The children vaccinated against 2019-nCoV have higher antibody levels.

Objective To investigate functional connectivity between the two hemispheres in patients with positive symptoms of schizophrenia using voxel-mirrored homotopic connectivity ( VMHC ) based on resting-state functional magnetic resonance imaging (rs-fMRI). Methods Eighteen patients with positive symptoms of schizophrenia and 22 healthy controls underwent the rs-fMRI. The whole brain VMHC was calculated in order to provide imaging basis for the study of the pathological mechanism of schizophrenia. Results Compared to the controls, VMHC values were decreased in the bilateral orbitofrontal cortex (t=-5.31, P<0.01), fusiform gyrus (t=-5.16, P<0.01), middle occipital gyrus (t=-5.31, P<0.01) in patients with positive symptoms of schizophrenia. Conclusion The functional coordination between homotopic brain regions is impaired in patients with positive symptoms of schizophrenia .

Objective To evaluate the role of 3.0 Tesla magnetic resonance hysterosalpingography (MR?HSG) work?up in the diagnosis of female infertility. Methods Between July 2015 and December 2018, a total of 1 052 infertile women aged from 20 to 40 years in the Affiliated Hospital of Nanjing University of Chinese Medicine were prospectively enrolled in the study. All the patients underwent pelvic plain scanning and X?ray hysterosalpingography (HSG) followed by MR?HSG examination, and the patency of the fallopian tubes as well as the abnormalities of the uterus and ovaries were evaluated. Among which 33 cases were randomly selected. The chi?square test and Kappa test were used to compare the difference and the consistency of the two methods in the evaluation of fallopian tubes. Results MR?HSG and HSG had good consistency in evaluating tubal patency (Kappa=0.88, P<0.01), and there was no statistically significant difference between the two groups (P=0.65). The examination of MR?HSG was successfully completed in 97.1%(1 021/1 052) cases. There were 81.7% (834/1 021) cases had at least one abnormality. Bilateral tubal, uterine and ovarian abnormalitiesoccurred in 42.6% (435/1 021), 34.2% (349/1 021)and 46.8% (478/1 021) cases, respectively. In which tubal abnormalities display the results as follows: bilateral obstructed 4.7% (48/1 021), bilateral poor pass 8.5% (87/1 021), one smooth one obstructed11.7% (119/1 021), one smooth one poor pass 12.6% (129/1 021), and one poor pass one obstructed 5.1% (52/1 021). Conclusion 3.0 T MR?HSG is expected to be a routineexam for evaluating female infertility, which allows a comprehensive assessment of tubal patency and other pelvic abnormalities of infertile women.