Objective:To assess performance advantages of voxel-less optimization(VoLO)algorithm of CyberKnife-based S7 treatment plan system for the optimization of stereotactic body radiation therapy(SBRT)for liver cancer.Methods:The case data of 20 patients with hepatocellular carcinoma from Chinese PLA General Hospital during June 2022 and April 2023 were retrospectively selected,which included 10 patients with large hepatocellular carcinoma and 10 patients with small hepatocellular carcinoma.All patients adopted respectively sequential optimization(SO)and VoLO to conduct optimization for plan.The optimized quality of plan and execution efficiency of two kinds of algorithms were assessed,and the influences of different tumor volumes also were considered.The planed quality assessment included dosimetric parameters of the target region and organ at risk(OAR).The assessment parameters of execution efficiency included the numbers of monitor units(MUs),nodes and beams,and estimated treatment time.Paired t-test method was adopted to analyze quality of plan and treatment efficiency.Results:On the aspect of the dose of target region,for small hepatocellular carcinoma,the conformity index(CI)value(1.08±0.05)of target region of VoLO algorithm was significantly better than(1.17±0.06)of SO algorithm(t=4.631,P<0.05).The gradient index(GI),coverage rate and dose by 95%(D95%)of VoLO algorithm were better than those of SO algorithm,while the differences were not significant(P>0.05).According to the defined standards of liver surgery,for large hepatocellular carcinoma,the differences in CI,GI,coverage rate and D95%of target region between two kinds of algorithms were significant(t=3.337,4.238,-3.359,-3.311,P<0.05),respectively.On the aspect of dosimetry for OAR,for the target region of large hepatocellular carcinoma,the differences of liver Dmean and D700 cm3 between two kinds of algorithms were significant(t=4.114,3.415,P<0.05).However,for small hepatocellular carcinoma,there was no significant statistical difference in dosimetry parameters of OAR between two kinds of algorithms(P>0.05).The execution efficiency of the plan of VoLO group was obviously higher than that of SO group,and the differences of MU number,node number,beam number and estimated treatment time between two groups were significant(t=12.661,4.423,5.024,9.487,P<0.05).Conclusion:The quality of VoLO plan is significantly better than that of SO,which has a significant improvement in execution efficiency of treatment.For the cases of large hepatocellular carcinoma with more complexity,the VoLO optimization shows better advantages on the aspect of dose on target region,and protection for normal liver.

Objective:To assess performance advantages of voxel-less optimization(VoLO)algorithm of CyberKnife-based S7 treatment plan system for the optimization of stereotactic body radiation therapy(SBRT)for liver cancer.Methods:The case data of 20 patients with hepatocellular carcinoma from Chinese PLA General Hospital during June 2022 and April 2023 were retrospectively selected,which included 10 patients with large hepatocellular carcinoma and 10 patients with small hepatocellular carcinoma.All patients adopted respectively sequential optimization(SO)and VoLO to conduct optimization for plan.The optimized quality of plan and execution efficiency of two kinds of algorithms were assessed,and the influences of different tumor volumes also were considered.The planed quality assessment included dosimetric parameters of the target region and organ at risk(OAR).The assessment parameters of execution efficiency included the numbers of monitor units(MUs),nodes and beams,and estimated treatment time.Paired t-test method was adopted to analyze quality of plan and treatment efficiency.Results:On the aspect of the dose of target region,for small hepatocellular carcinoma,the conformity index(CI)value(1.08±0.05)of target region of VoLO algorithm was significantly better than(1.17±0.06)of SO algorithm(t=4.631,P<0.05).The gradient index(GI),coverage rate and dose by 95%(D95%)of VoLO algorithm were better than those of SO algorithm,while the differences were not significant(P>0.05).According to the defined standards of liver surgery,for large hepatocellular carcinoma,the differences in CI,GI,coverage rate and D95%of target region between two kinds of algorithms were significant(t=3.337,4.238,-3.359,-3.311,P<0.05),respectively.On the aspect of dosimetry for OAR,for the target region of large hepatocellular carcinoma,the differences of liver Dmean and D700 cm3 between two kinds of algorithms were significant(t=4.114,3.415,P<0.05).However,for small hepatocellular carcinoma,there was no significant statistical difference in dosimetry parameters of OAR between two kinds of algorithms(P>0.05).The execution efficiency of the plan of VoLO group was obviously higher than that of SO group,and the differences of MU number,node number,beam number and estimated treatment time between two groups were significant(t=12.661,4.423,5.024,9.487,P<0.05).Conclusion:The quality of VoLO plan is significantly better than that of SO,which has a significant improvement in execution efficiency of treatment.For the cases of large hepatocellular carcinoma with more complexity,the VoLO optimization shows better advantages on the aspect of dose on target region,and protection for normal liver.

Objective:A dose verification system of two-dimensional semiconductor matrix(SRS MapCHECK)was used to verify the dose of the clinical treatment plan of patients who underwent CyberKnife(CK),which realized rapid verification for individualization of radiotherapy plans of patients through analyzed the γ-passing rates of them.Methods:A total of 253 patients with tumor who received CK clinical treatment in the First Medical Center of Chinese PLA General Hospital from March 2021 to May 2023 were selected.Among of them,121 cases received CK treatment on head,and 30 cases received that on lung,and 102 cases received CK treatment on abdomen and other metastatic tumor.In the MultiPlan treatment plan system,the plan of patient was mapped to the integrated model composed of StereoPHAN model and SRS MapCHECK matrix dose verification system by the means of the plan image center overlap.The dose verification was conducted on the plan of each patient on the basis of ensuring the consistency of the number of beam,direction of beam and the monitor unit.The different γ analysis standards(1%/1 mm,2%/1 mm,3%/1 mm,1%/2 mm,2%/2 mm,3%/2 mm,1%/3 mm,2%/3 mm and 3%/3 mm)were adopted to conduct global analysis of absolute dose for each verification plan,and the threshold(TH)of low dose was set as 10%.Results:The γ passing rates of phantom verification plans of 253 patients were respectively(88.64±5.91)%,(95.43±3.40)%,(97.90±2.06)%,(96.51±2.35)%,(98.15±1.68)%,(99.06±1.12)%,(98.30±1.39)%,(99.09±0.97)%and(99.52±0.63)%under different analysis standards.The γ passing rates of other standards of patients with tumor on different parts were larger than 95%except the analysis result of 1%1 mm standard.The overall analysis result of the deviation of central point dose was(-1.30±2.17)%,among of which the tumor of head,abdominal tumors and other metastatic tumor were about approximately-2%,while that of lung tumors were approximately-3%.The deviation of abdominal and other metastatic tumor was the minimum.The correlation analysis showed that the target volume and the size of the minimum collimator were respectively correlated to the dose deviation of the center.Conclusion:SRS MapCHECK dose verification system can conveniently and quickly realize the individualized verification for the plan of patients who receive CK treatment.

Objective To explore the clinical value of the combined dual-source CT venography(CTV)for the diagnosis of iliac vein compression syndrome(IVCS).Methods 43 patients with clinically suspected IVCS underwent CTV examination.Among them,22 cases were assessed with combined CTV while 21 cases were given conventionally indirect CTV.The lower extremity deep vein was scanned from foot to head.The dual-energy technology was applied for data acquisition.Results Two kinds of CTV methods could be used directly for diagnosing IVCS and checking the asymptomatic mild iliac vein compression.32 IVCS patients were diagnosed by CTV.In 27 cases with deep venous thrombosis(DVT),the average diameter of the left iliac vein was(3.23 ± 1.45)mm and the average compression rate was 67%.The differences were statistically significant in comparisons of the average diameter of left iliac vein between IVCS patients with or without DVT and patients without IVCS.The image quality scores of bidirectional CTV were higher than indirect CTV with statistically significant difference.Conclusion Combined CTV is a feasible technique for lower extremity venography.The image quality of combined CTV is better than conventional indirect CTV with greater clinical value.

Objective To evaluate non-enhancement magnetic resonance venography (MRV) of iliac vein in diagnosing Cockett syndrome.Methods Magnetic resonance iliac venography was performed with Ingenia 3.0 T superconducting type MRI system.Abdominal surface coil was employed.The scanning sequences included M2DIPEAR (TR/TE=45/5.8 ms,flip angle=60°),THRIVE (TR/TE=6.8/3.5 ms,flip angle=10°),BTFESPAIR (TR/TE=3.4/1.7 ms,flip angle=80°) and FLAIR (TR/TE=9 000/120 ms,flip angle 90°).The layer thickness of 3 mm was used in all scanning,and the average number of acquisition was 3 times.Results On MRV imaging,Cockett syndrome was characterized by narrowed anteroposterior diameter and broadened transverse diameter of the compressed iliac vein,and curved impression could be seen on its anterior border,and collateral vessel formation could be observed.The mean diameters of the left iliac veins in the light,mnedium and severe patients with Cockett syndrome were 7.52,4.83 and 2.76 mm respectively,with the average compression ratios being 37％,69％ and 83％ respectively.Conclusion Non-enhanced MRV is a feasible method for the diagnosis of iliac vein stenosis,this examination is especially suitable for the checking needs of specific population.

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease is characterized by bilateral granulomatous uveitis with neurologic, auditory, and dermatologic manifestations. However, acute myelitis complicating VKH disease has rarely been reported. CASE REPORT: A 50-year-old Chinese Han woman presented with difficulty walking, numbness on the left side of the body, and difficulty with urination. The patient was diagnosed with incomplete VKH disease and received corticosteroid treatment prior to the neurological presentation. Acute myelitis was diagnosed based on both clinical and spinal-cord MRI findings. CONCLUSIONS: Clinicians should consider acute myelitis as a rare possible neurological manifestation in VKH disease patients, and early systemic administration of corticosteroids will suppress the acute inflammatory process and prevent recurrences. This report raises the possibility that VKH disease and acute myelitis share common pathogenic pathways.
Adrenal Cortex Hormones ; Asian Continental Ancestry Group ; Female ; Humans ; Hypesthesia ; Mobility Limitation ; Myelitis ; Neurologic Manifestations ; Recurrence ; Urination ; Uveitis ; Uveomeningoencephalitic Syndrome

OBJECTIVE: To determine the effect of Parkinson's disease-weight bearing exercise for better balance (PD-WEBB) exercise on balance impairment and falls in people with Parkinson's disease (PD). METHODS: A single-blind, randomized controlled clinical trial was conducted. The falls efficacy scale score, unified Parkinson disease rating scale (UPDRS) score and Mini-BESTest score were measured and compared between a PD-WEBB group and a control group. RESULTS: The falls efficacy scale score, UPDRS-2 score, UPDRS-3 score and Mini-BESTest score were improved in the PD-WEBB group compared with the control group (P<0.05), with no significant change in UPDRS-1 score between the two groups. CONCLUSION PD-WEBB training can significantly improve the balance impairment and quality of life to prevent falls. PD-WEBB training is suitable for PD patients in China, and is a reasonable, effective and sustainable training of family and community assessment model.
Accidental Falls ; prevention & control ; China ; Humans ; Parkinson Disease ; therapy ; Postural Balance ; Quality of Life ; Resistance Training ; Single-Blind Method

Objective To investigate the expressions and its relationship of vascular interleukin-6(IL-6) and signal transducer and activator of transcription 3(STAT3) protein in giant cell arteritis patients.Methods The expressions of IL-6 and STAT3 protein were detected by immunohistochemistry in the temporal artery biopsy specimens of 20 patients with giant cell arteritis and 6 patients with other nerve system diseases(control group).Six indexs related to inflammation in giant cell arteritis patients were recorded.Giant cell arteritis patients were divided into the group that ≥3 positive indexs(7 cases) and the group that ≤2 positive indexs(13 cases).The relationship between expressions of IL-6 and STAT3 protein was analysed.Results Compared with control group[(2.00?0.63)score,(30.73?10.84)cell/H],the expressions of IL-6 and STAT3 protein in temporal artery were significantly increased in giant cell arteritis group[(2.85?0.75)score,(40.71?9.90)cell/H](all P