Objective:To investigate and validate the performance of a dosiomics model that utilized 3D dose distribution to forecast radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 3578 patients diagnosed with NPC admitted to Jiangsu Cancer Hospital from January 2011 to December 2021 were retrospectively analyzed. According to the inclusion and exclusion criteria, 97 NPC patients who developed RTLI were assigned into the case group. A 1:1 propensity score matching (PSM) method was used to match 97 NPC patients without RTLI as the control group. Patients were assigned into the training cohort ( n=135) and the validation cohort ( n=59) at a 7:3 ratio by simple random method. Dosiomics features were extracted from the patients' three-dimensional dose distribution maps. Spearman rho and the least absolute shrinkage and selection operator regression were used to select dosiomics features. Clinical features were collected and screened by univariate and multivariate analyses. Eight machine learning classifiers were then trained to build dosiomics models and clinical models, respectively. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to compare the predictive performance of the dosiomics and clinical models. Multivariate analysis was conducted using logistic regression to assess the influencing factors, while comparisons of the ROC curves between two different models were performed using the DeLong test. Results:A total of 1130 dosiomics features were extracted from the three-dimensional dose distribution maps, and 14 features were retained for model building after feature selection. The model based on the support vector machine (SVM) classifier achieved the highest AUC value of 0.977 (95% CI: 0.949-1.000) in the validation cohort, with an AUC of 1.000 (95% CI: 1.000-1.000) in the training cohort. By conducting univariate and multivariate analyses of the patients' clinical features, 2 clinical features were retained to build the clinical model. The model based on the SVM classifier achieved the optimal AUC value of 0.667 (95% CI: 0.523-0.810) in the validation cohort, with an AUC of 0.804 (95% CI: 0.730-0.878) in the training cohort. DeLong test showed that the difference between the dosiomics and clinical models was statistically significant ( P<0.05). Conclusion:The dosiomics model based on 3D dose distribution yields high predictive performance for RTLI in NPC patients after IMRT, which surpasses the clinical feature model, providing a new approach for early clinical prediction of RTLI.

Objective:To compare the influence of titanium mesh repair outside and under the temporal muscle on the cerebral hemodynamic status and postoperative brain function of patients with skull defects after decompressive craniectomy (DC).Methods:A retrospective analysis was performed on clinical data of patients with skull defects after DC who underwent titanium mesh cranioplasty at Yibin Sixth People′s Hospital from January 2019 to January 2024. Patients were divided into a control group ( n=35, subgaleal cranioplasty) and an observation group ( n=35, subtemporal cranioplasty). Surgical outcomes, 1-year complication rates, cerebral hemodynamic parameters [mean velocity (Vm) of the middle cerebral artery (MCA), regional cerebral blood flow (CBF) in the cerebral cortex, basal ganglia, and thalamus], and functional scores [National Institutes of Health Stroke Scale (NIHSS), Minimum Mental State Examination (MMSE), and Fugl-Meyer Assessment (FMA)] were compared preoperatively, at 14 days postoperatively, and 3 months postoperatively. Results:The observation group had significantly longer operation time and postoperative swelling duration, as well as higher intraoperative blood loss than the control group (all P<0.05). At 6 months postoperatively, the complication rate in the observation group was significantly lower than that in the control group ( P<0.05). At 14 days postoperatively, MCA Vm and regional CBF in the cortex, basal ganglia, and thalamus increased in both groups, with more significant improvements in the observation group (all P<0.05). At 3 months postoperatively, NIHSS scores decreased while MMSE and FMA scores increased in both groups compared to preoperative levels. The observation group showed significantly lower NIHSS scores and higher MMSE/FMA scores than the control group (all P<0.05). Conclusions:Both surgical approaches are clinically valuable for repairing skull defects after DC. Patients should choose the appropriate procedure based on their individual conditions.

Objective:To compare the influence of titanium mesh repair outside and under the temporal muscle on the cerebral hemodynamic status and postoperative brain function of patients with skull defects after decompressive craniectomy (DC).Methods:A retrospective analysis was performed on clinical data of patients with skull defects after DC who underwent titanium mesh cranioplasty at Yibin Sixth People′s Hospital from January 2019 to January 2024. Patients were divided into a control group ( n=35, subgaleal cranioplasty) and an observation group ( n=35, subtemporal cranioplasty). Surgical outcomes, 1-year complication rates, cerebral hemodynamic parameters [mean velocity (Vm) of the middle cerebral artery (MCA), regional cerebral blood flow (CBF) in the cerebral cortex, basal ganglia, and thalamus], and functional scores [National Institutes of Health Stroke Scale (NIHSS), Minimum Mental State Examination (MMSE), and Fugl-Meyer Assessment (FMA)] were compared preoperatively, at 14 days postoperatively, and 3 months postoperatively. Results:The observation group had significantly longer operation time and postoperative swelling duration, as well as higher intraoperative blood loss than the control group (all P<0.05). At 6 months postoperatively, the complication rate in the observation group was significantly lower than that in the control group ( P<0.05). At 14 days postoperatively, MCA Vm and regional CBF in the cortex, basal ganglia, and thalamus increased in both groups, with more significant improvements in the observation group (all P<0.05). At 3 months postoperatively, NIHSS scores decreased while MMSE and FMA scores increased in both groups compared to preoperative levels. The observation group showed significantly lower NIHSS scores and higher MMSE/FMA scores than the control group (all P<0.05). Conclusions:Both surgical approaches are clinically valuable for repairing skull defects after DC. Patients should choose the appropriate procedure based on their individual conditions.

Objective:To investigate and validate the performance of a dosiomics model that utilized 3D dose distribution to forecast radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 3578 patients diagnosed with NPC admitted to Jiangsu Cancer Hospital from January 2011 to December 2021 were retrospectively analyzed. According to the inclusion and exclusion criteria, 97 NPC patients who developed RTLI were assigned into the case group. A 1:1 propensity score matching (PSM) method was used to match 97 NPC patients without RTLI as the control group. Patients were assigned into the training cohort ( n=135) and the validation cohort ( n=59) at a 7:3 ratio by simple random method. Dosiomics features were extracted from the patients' three-dimensional dose distribution maps. Spearman rho and the least absolute shrinkage and selection operator regression were used to select dosiomics features. Clinical features were collected and screened by univariate and multivariate analyses. Eight machine learning classifiers were then trained to build dosiomics models and clinical models, respectively. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to compare the predictive performance of the dosiomics and clinical models. Multivariate analysis was conducted using logistic regression to assess the influencing factors, while comparisons of the ROC curves between two different models were performed using the DeLong test. Results:A total of 1130 dosiomics features were extracted from the three-dimensional dose distribution maps, and 14 features were retained for model building after feature selection. The model based on the support vector machine (SVM) classifier achieved the highest AUC value of 0.977 (95% CI: 0.949-1.000) in the validation cohort, with an AUC of 1.000 (95% CI: 1.000-1.000) in the training cohort. By conducting univariate and multivariate analyses of the patients' clinical features, 2 clinical features were retained to build the clinical model. The model based on the SVM classifier achieved the optimal AUC value of 0.667 (95% CI: 0.523-0.810) in the validation cohort, with an AUC of 0.804 (95% CI: 0.730-0.878) in the training cohort. DeLong test showed that the difference between the dosiomics and clinical models was statistically significant ( P<0.05). Conclusion:The dosiomics model based on 3D dose distribution yields high predictive performance for RTLI in NPC patients after IMRT, which surpasses the clinical feature model, providing a new approach for early clinical prediction of RTLI.

Objective:To explore the effect of clinical target volume (CTV) optimization on long-term survival and late xerostomia of patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 763 patients with NPC treated with intensity-modulated radiotherapy (IMRT) in the Jiangsu Cancer Hospital from January 2015 to November 2018 were retrospectively analyzed. All patients were divided into the modified and conventional CTV groups. Propensity score matching (PSM) was applied to balance the distribution of baseline features. The degree of xerostomia was evaluated by Radiation Therapy Oncology Group (RTOG) / European Organisation for Research and Treatment of Cancer (EORTC) standard and Jiangsu Cancer Hospital Multi-dimensional Radiotherapy-Induced Xerostomia scale. Survival analysis was performed by Kaplan-Meier method. The difference of xerostomia between two groups was compared by rank-sum test. The dose parameters of salivary glands were compared by independent sample t-test. Prognostic factors of survival and xerostomia were assessed by univariate / multivariate regression analyses. Results:There were no significant differences in overall survival, local recurrence-free survival, distant metastasis-free survival and progression-free survival between conventional and modified CTV groups before and after PSM. There were no significant differences in the incidence of late xerostomia above grade 2 of RTOG/EORTC standard between two groups. Using multi-dimensional scale criteria, NPC patients in the modified CTV group developed less late xerostomia than those in the conventional CTV group ( P<0.05). D mean and V 26 Gy of bilateral parotid glands, D mean and V 39 Gy of bilateral submandibular glands, and D mean of sublingual glands and mouths were reduced after optimization of CTV (all P<0.001). Univariate analysis showed that clinical staging, T staging and N staging were the independent prognostic factors of overall survival. Multivariate analysis demonstrated that clinical staging was the independent prognostic factor of overall survival. The risk factor for xerostomia during night sleep was the D mean of sublingual glands. Conclusion:The optimization of CTV in IIb region in NPC treated with IMRT can better protect salivary glands and reduce the incidence of late radiation-induced xerostomia on the premise of ensuring long-term survival.

Traditional Chinese medicine (TCM) is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer (NSCLC) are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM. Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC.

Transcription factor cyclic AMP response element-binding protein (CREB) in embryonic cortical neurons is an important modulator of Brain-derived neurotrophic factor (BDNF) induced gene expression. Meanwhile, our early researches have indicated that BDNF possesses neuroprotective role for hypoxic neurons against hypoxia. In order todisclose whether the neuroprotective role of BDNF for embryonic rat cortical neurons against hypoxia is fulfilled via nucleoprotein CREB phosphorylation, we used western blotting method to detect the expression of CREB and phosphorylated CREB in experimental groups (with BDNF) and hypoxic control group (without BDNF) with the time changes of exposure to hypoxia. Results indicated that hypoxia and BDNF both could induce phosphorylation of CREB in embryonic cortical neurons. Phosphorylation of CREB in experimental group (with BDNF) was much higher than that in hypoxic control group at the same time points (P<0.01). The expression of phosphorylated CREB reached the highest level at the first hour after being exposed to hypoxia in experimental groups, then phosphorylated CREB decreased slowly and remained at the level for much longer time in experimental groups than in control group. The total amount of CREB in embryonic cortical neurons at the first 0-3 hours after being exposed to hypoxia in experimental groups were the same as that in hypoxic control group. CREB decreased more quickly in hypoxic control group at 5-6 hours after hypoxia. This in vitro research demonstrates that BDNF plays its neuroprotective role for embryonic rat cortical neurons against hypoxia via CREB phosphorylation.
Animals ; Brain-Derived Neurotrophic Factor ; chemistry ; pharmacology ; Cell Hypoxia ; Cells, Cultured ; Cerebral Cortex ; cytology ; Cyclic AMP Response Element-Binding Protein ; chemistry ; Embryo, Mammalian ; Neurons ; cytology ; Neuroprotective Agents ; chemistry ; pharmacology ; Phosphorylation ; Rats

Objective To study the clinical effect and safety of Yishen Wendu Compound in treatment of ankylosing spondylitis (AS) of kidney deficiency and cold governor vessel type. Methods The diversification of the clinical symptoms, signs and laboratory indicators of ankylosing spondylitis patients in Yishen Wendu Compound 30 cases of treatment group and sulfasalazine (SASP) 30 cases of control group before and after treatment were observed. Results After treatment, the percentage of ASAS20 standard cases number (%) and the efficacy of TCM syndrome total effective rates of treatment group were 95.83% and 93.3% respectively, superior to sulfasalazine control group 82.5% and 66.7% (P

Objectives:Dose-response effect of nicorandil cardioplegia at various concentrations was studied to optimize its myocardial protective effect.Methods:Forty-eight isolated working rat hearts were divided into 6 groups randomly.They were group A:control (depolarized cardiac arrest with St.Thomas solution No.2),group B,C,E,F and G:hyperpolarized cardiac arrest (nicorandil concentration were 25,50,100,125 and 150μmol/L respectively).The hearts underwent a 120-minute hypothermic arrest (15±1)℃ with cardioplegia (40 ml/kg) and reinfused with cardioplegia (40 ml/kg) at interval of 30 minutes.Mechanical arrest time,cardiac functional recoveries,myocardial content of malondialdehyde (MDA) and ultrastructure were measured.Results:The protective effect of nicorandil cardioplegia was dose-related.Conclusions:The optimal concentration of nicorandil in cardiplegia may be 100μmol/L for myocardial protection.