Objective:To investigate the effects of Juglone on the apoptosis of osteosarcoma(OS)cells(U2OS and MG63 cells)through the cysteinyl aspartate specific proteinase-3(Caspase-3)/gasdermin E(GSDME)-mediated pyroptosis pathway.Methods:The U2OS and MG63 cells were cultured in vitro and divided into control group,different concentrations(5,10 and 20 μmol·L-1)of Juglone groups and Caspase-3 inhibitor Z-DEVD-FMK group(10 μmol·L-1 Juglone+30 μmol·L-1 Z-DEVD-FMK).The survival rates of cells in various groups were assessed by cell counting kit-8(CCK-8)assay,and the apoptotic rates were detected by flow cytometry.Lactate dehydrogenase(LDH)release assay was used to measure the release rates of LDH from the cells.Western blotting method was used to detect the expression levels of apoptosis-related proteins including B-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax),cleaved-Caspase-3 and poly(ADP-ribose)polymerase(PARP)and pyroptosis-related proteins including GSDME full form(GSDME-F)and GSDME N-terminal(GSDME-N).The levels of interleukin-1β(IL-1β)and interleukin-18(IL-18)in the cell supernataut in various groups were measured by enzyme-linked immunosorbent assay(ELISA)method.Results:Compared with control group,the survival rates of cells in 5,10,and 20 μmol·L-1Juglone groups were significantly decreased(P＜0.05 or P＜0.01),and the 50％inhibitory concentration(IC50)values of U2OS cells and MG63 cells were 8.4 and 10.2 μmol·L-1,respectively.Compared with control group,the apoptotic rates and LDH release rates of U2OS and MG63 cells in 5 and 10 μmol·L-1Juglone groups were significantly increased(P＜0.05 or P＜0.01).Compared with control group,the expression levels of Bax,cleaved-Caspase-3,and cleaved-PARP proteins in 5 and 10 μmol·L-1 Juglone groups were significantly increased(P＜0.01),while the expression levels of Bcl-2 protein were significantly decreased(P＜0.01).Compared with control group,the levels of IL-1β and IL-18 in cell supernatant in 5 and 10 μmol·L-1Juglone groups were increased(P＜0.01).Compared with control group,the expression levels of cleaved-Caspase-3 and GSDME-N proteins in 5 and 10 μmol·L-1 Juglone groups were significantly increased(P＜0.01),while there was no difference in the expression level of GSDME-F protein(P＞0.05).Compared with 10 μmol·L-1 Juglone group,the expression levels of cleaved-Caspase-3 and GSDME-N in Z-DEVD-FMK group were significantly decreased(P＜0.01),while there was no difference in the expression level of GSDME-F protein(P＞0.05).Conclusion:Juglone can induce the apoptosis of U2OS and MG63 cells and cause the Caspase-3/GSDME-mediated pyroptosis.

Objective:To achieve the conversion from dual-energy cone-beam CT (DECBCT) at the kilovolt (KV) level to projections at the megavolt (MV) level using an improved CycleGAN network, in order to provide a potential reference benchmark and real-time monitoring of in vivo doses delivered by exit beams for the safe implementation of advanced techniques such as online adaptive radiotherapy. Methods:Simulated patient data were generated using a 4D extended cardiac torso (XCAT) model, and projections were generated based on the geometric parameters of Varian′s onboard cone-beam CT. Furthermore, relative electron density (RED) images were derived from DECBCT images using an iterative dual-energy decomposition algorithm. The SE-CycleGAN and CycleGAN networks were trained to generate MV projection images using DECBCT projections and RED images, respectively. The performance of both methods was evaluated using metrics including structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), and root mean square error (RMSE).Results:SE-CycleGAN significantly outperformed CycleGAN in all evaluation metrics ( Z = -23.92, -26.17, -25.54, -26.80, -11.54, -11.21, P<0.05), particularly in learning global information. Besides, although both methods generated satisfactory MV projections, training using DECBCT projections as input yielded better effects than training using RED images. For all the 3 636 sets of projections in the test set, the SE-CycleGAN and CycleGAN networks using DECBCT projections as input respectively yielded SSIMs of 0.997 7±0.000 7 and 0.997 1±0.001 6, PSNRs of 39.625 0±4.684 4 and 36.272 2±5.566 3, and RMSEs of 0.004 1±0.002 7 and 0.006 3±0.0043, respectively. In contrast, the SE-CycleGAN and CycleGAN networks using RED projections as input respectively yielded SSIMs of 0.996 8±0.001 0 and 0.996 2±0.001 5, PSNRs of 38.548 7±3.637 4 and 36.007 3±4.437 8, and RMSEs of 0.004 3±0.002 2 and 0.006 1±0.0037, respectively. Conclusions:This study proposed a new method to establish reference benchmarks for in vivo dose monitoring based on DECBCT and deep learning technologies. This method is accurate and effective according to the preliminary validation using virtual simulation experiments.

Objective:To apply statistical process control (SPC) techniques to the quality assurance of non-normal radiotherapy plans through Johnson transformation, establishing patient-specific tolerance and action limits based on treatment sites and dose/distance assessment criteria, thereby enhancing the intensity-modulated radiation therapy (IMRT) verification accuracy and dose delivery precision.Methods:In this study, 951 gamma analysis data of patient-specific quality assurance (PSQA) executed on the Halcyon accelerator platform were selected and categorized into six groups based on treatment sites, including brain (102 cases), head and neck (100 cases), breast (229 cases), lung (154 cases), esophagus (223 cases), and pelvic (143 cases) groups. The six groups of data were statistically analyzed through Anderson-Darling normality tests ( α = 0.05) using Minitab 21 software. Non-normal data were transformed into normal data through Johnson transformation and then were used to establish treatment site-specific tolerance and action limits, which were compared with the Shewhart control charts based on normal distributions. Results:The PSQA result of the six groups all exhibited non-normal distributions ( P < 0.05). Through Johnson transformation, the tolerance and action limits for the head and neck, breast, lung, esophagus, and pelvic areas under the 3%/2 mm criterion ranged from 95.13% to 96.16% and 94.19% to 95.91%, respectively. In contrast, the tolerance and action limits ranged from 91.15% to 94.86% and 89.94% to 94.78% under the 2%/2 mm criterion. Directly applying Shewhart control charts without normality assumptions yielded higher tolerance limits compared to the application of Johnson transformation, increasing the false positive rate in the non-normal PSQA process. Conclusions:Applying the SPC techniques directly to a non-normal process can lead to an increased false alarm rate and wrong process interpretation. The SPC techniques combined with Johnson transformation enable more effective monitoring of a non-normal PSQA process, facilitating timely identification of potential factors that may lead to an out-of-control process based on the treatment site-specific limits.

Objective To propose and validate a decomposition method based on half-projection reconstruction for dual-energy cone beam CT(DE CBCT),thereby providing a potentially feasible low-dose imaging solution for anatomical monitoring and dose reconstruction optimization in adaptive radiotherapy.Methods Dual-energy scans were performed on a Gammex phantom using the on-board kilovoltage CBCT system of a VitalBeam accelerator at acquisition frame rates of 15 and 7 frames per second(f/s).Images were reconstructed from the projection data,and dual-energy decomposition was applied to the 7 f/s dual-energy images to derive relative electron density(RED)and stopping power ratio(SPR)using weighted formulas and empirical functions,followed by accuracy evaluation.Additionally,the weighted CT dose index was calculated for different scanning parameters.Results Dual-energy decomposition effectively suppressed image artifacts,with RED and SPR errors remaining below 2.82%and 2.56%,respectively.Compared with the traditional dual-scan method which required high-and low-energy acquisitions,the weighted CT dose index of the half-projection DE CBCT was reduced by 11.60 mGy(a 52.90%reduction).Furthermore,it was 2.58 mGy lower than the dose of the full-projection high-energy CBCT alone(a 19.98%reduction)and only 1.31 mGy higher than that of the low-energy CBCT(a 14.52%increase).Conclusion The proposed method effectively suppresses image artifacts while maintaining high accuracy in RED and SPR under low radiation dose conditions,demonstrating its potential value for scenarios requiring frequent image guidance,such as adaptive radiotherapy.

Objective To propose and validate a decomposition method based on half-projection reconstruction for dual-energy cone beam CT(DE CBCT),thereby providing a potentially feasible low-dose imaging solution for anatomical monitoring and dose reconstruction optimization in adaptive radiotherapy.Methods Dual-energy scans were performed on a Gammex phantom using the on-board kilovoltage CBCT system of a VitalBeam accelerator at acquisition frame rates of 15 and 7 frames per second(f/s).Images were reconstructed from the projection data,and dual-energy decomposition was applied to the 7 f/s dual-energy images to derive relative electron density(RED)and stopping power ratio(SPR)using weighted formulas and empirical functions,followed by accuracy evaluation.Additionally,the weighted CT dose index was calculated for different scanning parameters.Results Dual-energy decomposition effectively suppressed image artifacts,with RED and SPR errors remaining below 2.82%and 2.56%,respectively.Compared with the traditional dual-scan method which required high-and low-energy acquisitions,the weighted CT dose index of the half-projection DE CBCT was reduced by 11.60 mGy(a 52.90%reduction).Furthermore,it was 2.58 mGy lower than the dose of the full-projection high-energy CBCT alone(a 19.98%reduction)and only 1.31 mGy higher than that of the low-energy CBCT(a 14.52%increase).Conclusion The proposed method effectively suppresses image artifacts while maintaining high accuracy in RED and SPR under low radiation dose conditions,demonstrating its potential value for scenarios requiring frequent image guidance,such as adaptive radiotherapy.

Objective:To achieve the conversion from dual-energy cone-beam CT (DECBCT) at the kilovolt (KV) level to projections at the megavolt (MV) level using an improved CycleGAN network, in order to provide a potential reference benchmark and real-time monitoring of in vivo doses delivered by exit beams for the safe implementation of advanced techniques such as online adaptive radiotherapy. Methods:Simulated patient data were generated using a 4D extended cardiac torso (XCAT) model, and projections were generated based on the geometric parameters of Varian′s onboard cone-beam CT. Furthermore, relative electron density (RED) images were derived from DECBCT images using an iterative dual-energy decomposition algorithm. The SE-CycleGAN and CycleGAN networks were trained to generate MV projection images using DECBCT projections and RED images, respectively. The performance of both methods was evaluated using metrics including structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), and root mean square error (RMSE).Results:SE-CycleGAN significantly outperformed CycleGAN in all evaluation metrics ( Z = -23.92, -26.17, -25.54, -26.80, -11.54, -11.21, P<0.05), particularly in learning global information. Besides, although both methods generated satisfactory MV projections, training using DECBCT projections as input yielded better effects than training using RED images. For all the 3 636 sets of projections in the test set, the SE-CycleGAN and CycleGAN networks using DECBCT projections as input respectively yielded SSIMs of 0.997 7±0.000 7 and 0.997 1±0.001 6, PSNRs of 39.625 0±4.684 4 and 36.272 2±5.566 3, and RMSEs of 0.004 1±0.002 7 and 0.006 3±0.0043, respectively. In contrast, the SE-CycleGAN and CycleGAN networks using RED projections as input respectively yielded SSIMs of 0.996 8±0.001 0 and 0.996 2±0.001 5, PSNRs of 38.548 7±3.637 4 and 36.007 3±4.437 8, and RMSEs of 0.004 3±0.002 2 and 0.006 1±0.0037, respectively. Conclusions:This study proposed a new method to establish reference benchmarks for in vivo dose monitoring based on DECBCT and deep learning technologies. This method is accurate and effective according to the preliminary validation using virtual simulation experiments.

Objective:To apply statistical process control (SPC) techniques to the quality assurance of non-normal radiotherapy plans through Johnson transformation, establishing patient-specific tolerance and action limits based on treatment sites and dose/distance assessment criteria, thereby enhancing the intensity-modulated radiation therapy (IMRT) verification accuracy and dose delivery precision.Methods:In this study, 951 gamma analysis data of patient-specific quality assurance (PSQA) executed on the Halcyon accelerator platform were selected and categorized into six groups based on treatment sites, including brain (102 cases), head and neck (100 cases), breast (229 cases), lung (154 cases), esophagus (223 cases), and pelvic (143 cases) groups. The six groups of data were statistically analyzed through Anderson-Darling normality tests ( α = 0.05) using Minitab 21 software. Non-normal data were transformed into normal data through Johnson transformation and then were used to establish treatment site-specific tolerance and action limits, which were compared with the Shewhart control charts based on normal distributions. Results:The PSQA result of the six groups all exhibited non-normal distributions ( P < 0.05). Through Johnson transformation, the tolerance and action limits for the head and neck, breast, lung, esophagus, and pelvic areas under the 3%/2 mm criterion ranged from 95.13% to 96.16% and 94.19% to 95.91%, respectively. In contrast, the tolerance and action limits ranged from 91.15% to 94.86% and 89.94% to 94.78% under the 2%/2 mm criterion. Directly applying Shewhart control charts without normality assumptions yielded higher tolerance limits compared to the application of Johnson transformation, increasing the false positive rate in the non-normal PSQA process. Conclusions:Applying the SPC techniques directly to a non-normal process can lead to an increased false alarm rate and wrong process interpretation. The SPC techniques combined with Johnson transformation enable more effective monitoring of a non-normal PSQA process, facilitating timely identification of potential factors that may lead to an out-of-control process based on the treatment site-specific limits.

Objective To investigate the therapeutic effects of bone marrow mesenchymal stem cells (BMSCs) for radiation-induced lung injury (RILI) and the underlying mechanism. Methods Forty-five healthy adult male C57BL/6 mice were randomly divided into control, model, and BMSCs groups. The model and BMSCs groups received a single irradiation dose of 20 Gy to the chest, while the control group did not receive X-ray irradiation. For the BMSCs group, an injection of 1 × 10⁶ BMSCs cells was administered via the tail vein within 6 h after irradiation. In the 5th week, the lung tissue was taken to observe pathological changes with HE staining; examine the expression of the inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) with immunohistochemical staining; observe the polarization of macrophages with immunofluorescence staining; and measure the expression of the epithelial-mesenchymal transition markers E-cadherin, N-cadherin, and vimentin proteins by Western blot. Results After radiation, the model group developed pulmonary vasodilation and congestion with septal thickening and inflammatory cell infiltration, and these changes were markedly reduced in the BMSCs group. The model group showed significantly down-regulated expression of IL-6 and TNF-α compared with significantly increased levels in the model group (P < 0.01, P < 0.05). Treatment with BMSCs significantly increased the polarization of lung macrophages towards the M2 type, while significantly decreasing the abnormally increased N-cadherin and vimentin levels in RILI mice (P < 0.05, P < 0.01). Conclusion BMSCs have therapeutic effects for RILI mice, which may be through promoting macrophage polarization from M1 to M2.

Objective:To discuss the effect of curcumin on the proliferation,migration,and invasion of the human prostate cancer C4-2 and LNCaP cells,and to clarify its possible mechanism.Methods:The lentiviral transfection system was used to transfect the C4-2 and LNCaP cells,regarded as shCD147-C4-2 group and shCD147-LNCaP group.RNA interference technology was used to prepare the CD147-silenced cells;the cells transfected with an empty vector were regarded as negative control and divided into shNC-C4-2 group(shNC-C4-2 cells)and shNC-LNCaP group(shNC-LNCaP cells).The C4-2 and LNCaP cells at logarithmic growth phase,as well as shCD147-C4-2 and shCD147-LNCaP cells,were treated with 20 μmol·L-1 curcumin.The morphology of the cells in various groups was observed under microscope at 0 and 24 h of treatment;MTT method was used to detect the proliferation activities of the cells in various groups;cell scratch assay was used to detect the migration rates of the cells in various groups;Western blotting method was used to detect the expression levels of apoptosis,invasion,and migration-related proteins in the cells in various groups.Results:Compared with C4-2 group,the expression of CD147 protein in the cells in shCD147-C4-2 group was significantly decreased after CD147 gene silenting.Compared with LNCaP group,the expression level of CD147 protein in the cells in shCD147-LNCaP group was significantly decreased after CD147 gene silenting.Compared with 0 h of treatment,some cells in C4-2 and LNCaP groups after 24 h of treatment with 20 μmol·L-1 curcumin,showed apoptosis signs with the presence of typical apoptotic bodies.The apoptotic phenomena in shCD147-C4-2 and shCD147-LNCaP groups was reduced.The MTT assay results showed that compared with C4-2+0 μmol·L-1 curcumin group,the proliferation activities of the cells in C4-2+20 μmol·L-1 curcumin group,C4-2+40 μmol·L-1 curcumin group,C4-2+60 μmol·L-1 curcumin group,and C4-2+80 μmol·L-1 curcumin group were decreased(P<0.01).Compared with LNCaP+0 μmol·L-1 curcumin group,the proliferation activity of the cells in LNCaP+20 μ mol·L-1 curcumin group,LNCaP+40 μmol·L-1 curcumin group,LNCaP+60 μmol·L-1 curcumin group,and LNCaP+80 μmol·L-1 curcumin group were decreased(P<0.01).Compared with shNC-C4-2 group,the proliferation activity of the cells in shNC-C4-2+20 μmol·L-1 curcumin group was decreased(P<0.01).Compared with shNC-C4-2+20 μmol·L-1 curcumin group,the proliferation activity of the cells in shCD147-C4-2+20 μmol·L-1 curcumin group was increased(P<0.01).Compared with shNC-LNCaP group,the proliferation activity of the cells in shNC-LNCaP+20 μmol·L-1 curcumin group was decreased(P<0.01);compared with shNC-LNCaP+20 μmol·L-1 curcumin group,the proliferation activity of the cells in shCD147-LNCaP+20 μmol·L-1 curcumin group was significantly increased(P<0.01).The cell scratch healing assay results showed that compared with C4-2 group,the migration rates of the cells in C4-2+20 μmol·L-1 curcumin group and C4-2+40 μmol·L-1 curcumin group after 24 h of treatment were decreased(P<0.01);compared with LNCaP group,the migration rates of the cells in LNCaP+20 μmol·L-1 curcumin group and LNCaP+40 μmol·L-1 curcumin group were increased(P<0.01);compared with shNC-C4-2 group,the migration rate of the cells in shNC-C4-2+20 μmol·L-1 curcumin group was decreased(P<0.01);compared with shNC-C4-2+20 μmol·L-1 curcumin group,the migration rate of the cells in shCD147-C4-2+20 μmol·L-1 curcumin group was significantly increased(P<0.05);compared with shNC-LNCaP group,the migration rate of the cells in shNC-LNCaP+20 μmol·L-1 curcumin group was decreased(P<0.01);compared with shNC-LNCaP+20 μmol·L-1 curcumin group,the garation rate of the cells in shCD147-LNCaP+20 μmol·L-1 curcumin group was significantly increased(P<0.05).The Western blotting results showed that compared with C4-2 group,the expression levels of Bcl-2-associated X protein(Bax),cleaved Caspase-3,and poly ADP-ribose polymerase 1(PARP1)proteins in the cells in C4-2+20 μmol·L-1 curcumin group and C4-2+40 μmol·L-1 curcumin group were significantly increased(P<0.01),and the expression levels of Bcl-2 protein was significantly decreased(P<0.05 or P<0.01);compared with LNCaP group,the expression levels of Bax,cleaved Caspase-3,and PARP1 proteins in the cells in LNCaP+20 μmol·L-1 curcumin group and LNCaP+40 μmol·L-1 curcumin group were significantly increased(P<0.01),and the expression level of Bcl-2 protein in the cells in LNCaP+40 μmol·L-1 curcumin group was decreased(P<0.01);compared with shNC-C4-2 group,the expression levels of Bax,cleaved Caspase-3,and PARP1 proteins in the cells in shNC-C4-2+20 μmol·L-1 curcumin group were significantly increased(P<0.05 or P<0.01),and the expression level of Bcl-2 protein was significantly decreased(P<0.05);compared with shNC-C4-2+20 μmol·L-1 curcumin group,the expression levels of Bax and cleaved Caspase-3 proteins in the cells in shCD147-C4-2+20 μmol·L-1 curcumin group were significantly decreased(P<0.01);compared with shNC-LNCaP group,the expression levels of Bax,cleaved Caspase-3,and PARP1 proteins in the cells in shNC-LNCaP+20 μmol·L-1 curcumin group were significantly increased(P<0.05 or P<0.01),and the expression level of Bcl-2 protein was significantly decreased(P<0.05);compared with shNC-LNCaP+20 μmol·L-1 curcumin group,the expression levels of Bax,cleaved Caspase-3,and PARP1 proteins in the cells in shCD147-LNCaP+20 μmol·L-1 curcumin group were significantly decreased(P<0.05 or P<0.01),and the expression level of Bcl-2 protein was significantly increased(P<0.05).Compared with C4-2 group,the expression levels of E-cadherin protein in the cells in C4-2+20 μmol·L-1 curcumin group and C4-2+40 μ mol·L-1 curcumin group were significantly increased(P<0.01),and the expression levels of N-cadherin and Vimentin proteins were significantly decreased(P<0.01);compared with LNCaP group,the expression levels of E-cadherin protein in the cells in LNCaP+20 μmol·L-1 curcumin group and LNCaP+40 μmol·L-1 curcumin group were significantly increased(P<0.01),and the expression levels of N-cadherin and Vimentin proteins in the cells in LNCaP+40 μmol·L-1 curcumin group were significantly decreased(P<0.01);compared with shNC-C4-2 group,the expression levels of N-cadherin and Vimentin proteins in the cells in shNC-C4-2+20 μmol·L-1 curcumin group were significantly decreased(P<0.01);compared with shNC-C4-2+20 μmol·L-1 curcumin group,the expression level of E-cadherin protein in the cells in shCD147-C4-2+20 μmol·L-1 curcumin group was significantly decreased(P<0.01),and the expression levels of N-cadherin and Vimentin proteins were significantly increased(P<0.01);compared with shNC-LNCaP group,the expression level of E-cadherin protein in the cells in shNC-LNCaP+20 μmol·L-1 curcumin group was significantly increased(P<0.01),and the expression levels of N-cadherin and Vimentin proteins were significantly decreased(P<0.01);compared with shNC-LNCaP+20 μmol·L-1 curcumin group,the expression level of E-cadherin protein in the cells in shCD147-LNCaP+20 μmol·L-1 curcumin group was significantly decreased(P<0.01),and the expression level of N-cadherin was significantly increased(P<0.05).Conclusion:Curcumin inhibits the proliferation,migration,and invasion of the prostate cancer cells in vitro and induces the apoptosis;silencing the CD147 gene partially reduces its inhibitory effect and its ability to induce the apoptosis.