FLASH radiotherapy is moving from animal experiments to clinical trials. However, the research on radiation shielding of FLASH radiotherapy rooms has been still in the initial stage. This paper analyses the structural characteristics of the beam pulse of FLASH radiotherapy devices of different technical routes, and discusses the radiation shielding challenges facing the radiotherapy room from FLASH radiotherapy technology based on the current protection standards for the radiotherapy room at home and abroad. The purpose is to provide input to the research on radiation protection of FLASH radiotherapy and to promote the clinical development of FLASH radiotherapy.

FLASH radiotherapy is moving from animal experiments to clinical trials. However, the research on radiation shielding of FLASH radiotherapy rooms has been still in the initial stage. This paper analyses the structural characteristics of the beam pulse of FLASH radiotherapy devices of different technical routes, and discusses the radiation shielding challenges facing the radiotherapy room from FLASH radiotherapy technology based on the current protection standards for the radiotherapy room at home and abroad. The purpose is to provide input to the research on radiation protection of FLASH radiotherapy and to promote the clinical development of FLASH radiotherapy.

Objective Exploring the use of thromboelastography(TEG)to assess the risk of bleeding in patients with acute leukemia(AL)undergoing platelet transfusion refractoriness(PTR).Methods To investigate the differences in TEG parameters between the PTR group and the non-PTR group in adult AL patients,and compare the differences in PLT and TEG parameters between the bleeding group and the non-bleeding group in the PTR group.Results A total of 58 AL patients were positive for platelet-related antibodies,and the proportion of PTR was 48.28%.A total of 20 patients with PTR were transfused with large-dose immunoglobulin,the effective rate was 40%,and 26 patients with PTR were transfused with matching platelets,the effective rate was 42.62%.This study observed the difference of TEG parameters between the PTR group and the non-PTR group,and the results showed that there were no significant differences in PLT,R value,K value,α Angle and MA value before and after platelet transfusion in the PTR group.The PLT and MA values of the non-PTR group were significantly different before and after transfusion(P＜0.05),while the R value,K value and α Angle were not significantly different.The PLT and MA values of the non-PTR group were significantly higher than those in PTR group after transfusion(P＜0.05).Analysis and comparison of PLT and TEG parameters between the bleeding group and the non-bleeding group in patients with PTR showed that there was no significant difference in PLT value,R value,K value and α Angle of TEG,while MA value in the non-bleeding group was higher than that in the bleeding group,with significant difference(P＜0.05).Conclusions Platelet count alone cannot accurately reflect the risk of bleeding in AL patients with PTR.TEG can effectively predict and evaluate the bleeding risk in AL patients,among which the maximum amplitude index has the most significant clinical significance,which is of great significance for disease evaluation and treatment guidance.

Objective To explore the surgical techniques and experiences in the treatment of Peyronie's disease using electric rotary grinding of tunica albuginea plaques followed by graft repair with tunica vaginalis or bovine pericardium under a microscope.Methods A retrospective cohort study was performed on 21 patients with severe penile curvature due to Peyronie's disease admitted in our department from January 2021 and May 2023.All of them underwent microscopic electric rotary grinding of tunica albuginea plaques followed by graft repair surgery.Short-term and mid-term outcomes were observed.Results For the 21 enrolled patients,12(57.1％)underwent repair using unilateral tunica vaginalis,3(14.3％)underwent repair using bilateral tunica vaginalis,and 6(28.6％)underwent repair using bovine pericardium.The operation time was 170～385(average 272±69)min,and the average postoperative follow-up duration was3～24(average 12.1±7.2)months.Seventeen patients(81.0％)had their penis fully extended,while 4 patients(19.0％)had slight dorsal curvature,which was less than 10°.All patients were satisfied with the shape of their penis during erection.The change in penile length was+(1.1±0.5)cm,and 9 patients(42.9％)reported early postoperative penile head numbness,which spontaneously resolved after an average duration of 3.2±1.9 months.All patients were able to successfully engage in sexual activity,with an average penile erection hardness score of 3.8.The overall satisfaction rate was 90.5％post operatively.Conclusion Meticulous dissection of Buck's fascia under a microscope is advantageous in reliably preserving dorsal neurovascular structures.Application of an electric grinding drill for plaque ablation allows for more precise release of the tunica.Graft repair of tunica albuginea defects with testicular tunica vaginalis or bovine pericardium for Peyronie's disease yields overall favorable clinical outcomes and obtains high satisfaction.It is worthy of promotion in clinical practice.

The ultra-high dose rate (UHDR) radiation has less side effect while keep comparable tumor control effect with conventional dose rate (CONV) radiation, which was named Flash effect. Recently, the Flash effect has been reported in many animal experiments with various types of radiations, animal species and body parts. However, the underlying mechanism of Flash has still been unraveled, making difficulties for the clinical application. This review pointed out the differences between the Flash effect and the UHDR effect in vitro and proposed three key scientific questions of Flash effect based on three well-known hypotheses, i. e., oxygen depletion, peroxyl radical recombination and immune cell protection. Finally, the research progresses and challenges of Flash mechanism study are concluded in order to give a clue for further deep investigation.

Objective:To explore the feasibility of synthetic diamond detector in use for Flash radiation dosimetry by designing a diamond dosimeter and conducting a series of dosimetric characteristic tests.Methods:A diamond detector system prototype with real-time current output was developed using a CIVIDEC? B1HV diamond sensor and designing a large dynamic range current measurement circuit based on the pre-integration method. The dose (dose-rate) response linearity was tested under irradiation from both electron beam and X ray ultra-high dose rate. Dose (dose-rate) calibration was performed against a medical accelerator to gain the charge-dose transfer coefficient.Results:Good linear correlation ( R2 = 0.99) between detector output charge and reference dose per pulse was shown under electron beam irradiation of 0.08-0.50 Gy/pulse. Good linearity ( R2 = 0.99) is also shown under irradiation from electron beam with ultra-high dose rate (400 Gy/s) and conventional dose rate (0.5 Gy/s). Strictly linear correlation ( R2 = 1) was shown between detector output integrated charge and reference dose under X ray irradiation at ultra-high average dose rate (75.5 Gy/s) and conventional average dose rate (0.5 Gy/s). The charge-dose and current-dose rate conversion factors for practical use were 0.751 7 μC/Gy and 0.753 5 μA·Gy·s -1, respectively. Conclusions:Considerable linearity of the diamond detector dose responses were shown under irradiation both from electron beam and X-ray beam, which could provide a relatively rapid and accurate dosimetry for Flash preclinical experiments. Furthermore, diamond detectors have great potential in the quality assurance for Flash radiotherapy.

Objective: To conduct a comparative study on the brain pharmacokinetics of seven ingredients (i. e. senkyunolide A, ferulic acid, formononetin, calycosin, ononin, calycosin-O-β-D-glucopyranoside, and paeoniflorin), which were the compounds of Buyang Huanwu Decoction (BHD), in normal and cerebral ischemia rats administrated intragastrically with BHD. Methods: The samples of normal and permanent middle cerebral artery occlusion (pMCAO) rats were collected by using brain microdialysis technique. The concentrations of seven ingredients were determined by the HPLC-MS/MS method. After the BHD were administrated intragastrically to the rats for seven consecutive days, brain microdialysis probes were inserted into the hippocampus of rats, and then the brain microdialysates were collected at 20 min time intervals for 5 h. The separation of the seven ingredients and internal standard (IS) was carried out on an ACQUITY UPLC BEH C

Objective To study the relationships between pathological grade of Henoch-Schonlein purpura nephritis (HSPN) and levels of serum transforming growth factor-beta 1 (TGF-β1),monocyte chemoattractant protein 1 (MCP-1),interleukin (IL)-17 and prognosis in adults.Methods 98 HSPN patients treated in our hospital from June 2015 to December 2017 were selected as the study group,65 IgA nephritis patients were selected as the IgA nephritis group,and 60 healthy people who came to our hospital for physical examination during the same period were selected as the control group.The levels of TGF-β1,MCP-1 and IL-17 in serum of the three groups were detected,and the Cox regression analysis was used to analyze the risk factors affecting the patient's condition.Results The levels of serum TGF-β1,MCP-1 and IL-17 in the study group were significantly higher than those in IgA nephritis group and control group (P ＜ 0.05).The levels of serum TGF-β1,MCP-1 and IL-17 in IgA nephritis group were significantly higher than those in control group (P ＜ 0.05).There was no significant difference in age,sex,hemoglobin,albumin,urinary protein and renal phenotype among groups (P ＜ 0.05).Platelets of type Ⅲ were significantly lower than those of type Ⅱ (P ＜0.05);C-reactive protein (CRP) level of type Ⅳ,Ⅴ and Ⅵ was significantly higher than that of type Ⅱ (P ＜ 0.05).The degree of glomerulosclerosis in patients with type Ⅲ,Ⅳ,Ⅴ and Ⅵ was significantly higher than that in patients with type Ⅱ,and the degree of glomerulosclerosis in patients with type Ⅴ and Ⅵ was also significantly higher than that in patients with type Ⅲ (P ＜ 0.05).The formation of crescents in patients with type Ⅲ,Ⅳ,Ⅴ and Ⅵ was significantly higher than that in patients with type Ⅱ,and the formation of crescents in patients with type Ⅳ,Ⅴ and Ⅵ was also significantly higher than that in patients with type Ⅲ (P ＜ 0.05).The levels of serum TGF-β1,MCP-1 and IL-17 were the lowest in type Ⅱ patients and the highest in type Ⅴ and Ⅵ patients.The levels of TGF-β1,MCP-1 and IL-17 in type Ⅲ,Ⅳ,Ⅴ and Ⅵ were significantly higher than those in type Ⅱ (P ＜0.05),and the level of TGF-β1 in type Ⅳ,Ⅴ and Ⅵ was significantly higher than that in type Ⅲ (P ＜ 0.05);Serum IL-17 level of type Ⅴ and Ⅵ was significantly higher than that of type Ⅲ (P ＜ 0.05).Cox regression analysis showed that TGF-β1 and IL-17 were risk factors for pathological grading.Conclusions The higher the pathological grade of Henoch-Schonlein purpura nephritis in adults,the higher the levels of serum TGF-β1 and IL-17.TGF-β1 and IL-17 are the risk factors affecting the pathological grade of Henoch-Schonlein purpura nephritis.

Objective To evaluate the coupling relationship between segmental longitudinal strain and left ventricular volume at different phases of the cardiac cycle by two dimensional speckle tracking imaging. Methods 2D grey scale images of 41 healthy adults were acquired,and time curve of left ventricular volume (LVV),segmental longitudinal strain(LS)and segmental longitudinal strain rate(LSr)were outputed by analysis software.The correlations between LVV and LS or LSr in isovolumic relaxation time(IVRT),the rapid filling time(RFT),the atrial filling time(AFT)and the ejection time(ET)were analyzed respectively. Results ①IVRT:LS in basal segment,middle segment,apical segment of interventricular septum,in apical segment,basal segment of the lateral wall,and in middle segment of inferior wall were low-moderate negatively correlated with LVV;only LSr in middle segment of anterior wall was negatively correlated with LVV(P<0.05).② RFT:LS in middle segment,apical segment of interventricular septum,in apical segment of the lateral wall were negatively correlated with LVV;LSr in basal segment,middle segment, apical segment of interventricular septum,in apical segment,middle segment,basal segment of lateral wall, in middle segment,basal segment of inferior wall were low-moderate negatively correlated with LVV(P <0.05).③AFT:LS in basal segment of inferior wall,in apical segment,basal segment of the anterior wall were low negatively correlated wtih LVV(P <0.05).④ET:LS in basal segment,middle segment,apical segment of interventricular septum,in apical segment,basal segment of the lateral wall were low negatively correlated with LVV(P <0.05);only LSr in apical segment of lateral wall was negatively correlated with LVV(P<0.05).Conclusions LS or LSr in special segments of interventricular septum,lateral wall, anterior wall and posterior wall are actively participate in the volume change of the left ventricle in healthy adults,specific myocardial segments of left ventricular wall are involved in left ventricular volume changes.

OBJECTIVE:To observe the efficacy and safety of Guizhi fuling capsule combined with mifepristone in treatment of uterine fibroids. METHODS:116 patients with uterine fibroids were randomly divided into control group and observation group. Control group was orally given Mifepristone tablet 25 mg,2 h before meal in the first day of menstrual period,once a day,for con-tinuous 10 d;observation group was additionally given Guizhi fuling capsule 3 pills in non-menstrual period,3 times a day. 3 months was regarded as a treatment course,it lasted 2 courses. Clinical efficacy,and E2,FSH,SHBG,uterine volume,menstrual blood volume,uterine fibroid volume and incidence of adverse reactions in 2 groups before and after treatment were observed. RE-SULTS:Total effective rate in observation group was significantly higher than control group,the difference was statistically signifi-cant(P<0.05). After treatment,the FSH,E2,uterine volume,menstrual blood volume and uterine fibroid volume in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically signifi-cant(P<0.05);but there were no significant difference in the SHBG and adverse reactions between 2 groups(P>0.05). CONCLU-SIONS:The clinical efficacy of Guizhi fuling capsule combined with mifepristone in treatment of uterine fibroids is more signifi-cant than mifepristone alone,with good safety.