OBJECTIVE: To evaluate the feasibility and accuracy of cone-beam CT (CBCT) images for radiotherapy dose calculation in pelvic tumors. METHODS: An improved volumetric density coverage method was used to establish CT value-relative electron density (RED) curves for CBCT images. The planning CT plans were transferred to the CBCT images, and the constructed density curves were applied to calculate doses for CBCT plans while maintaining the optimization parameters unchanged. Dose calculation deviations between the two plans were analyzed. RESULTS: The mean differences in dosimetric parameters for the target volume and organs at risk (OAR) between the two plans were less than 1% and 1.5%, respectively. The target conformity index (CI), homogeneity index (HI), and gamma passing rates were highly consistent, with no statistically significant differences. CONCLUSION CBCT images corrected by this method can be used for dose calculation in pelvic tumor radiotherapy planning.
Cone-Beam Computed Tomography/methods* ; Humans ; Radiotherapy Planning, Computer-Assisted/methods* ; Radiotherapy Dosage ; Pelvic Neoplasms/diagnostic imaging*

Objective:To investigate the factors influencing the efficacy of etanercept in the treatment of toxic epidermal necrolysis (TEN) across different countries and regions.Methods:A total of 17 articles (case analyses or case reports) were selected through a comprehensive search in 4 Chinese databases (CNKI, Wanfang, VIP, and SinoMed) and 4 English databases (PubMed, Cochrane Library, Embase, and Elsevier SD). Clinical data from 52 patients originating from 7 countries were collected. Independent variables included age, sex, race, culprit drugs, disease severity, presence or absence of complications, initial dose, timing of administration, number of administrations of etanercept, and combination therapy; and the duration of hospitalization served as the dependent variable. Univariate and multiple linear regression analyses were conducted sequentially.Results:Among the 52 patients, 26 were male and 26 were female, with a median age M ( Q1, Q3) of 57.0 (36.0, 71.5) years. The median hospitalization duration was 12.0 (8.0, 17.5) d, and the median severity-of-illness score for TEN (SCORTEN) was 2 (2, 4). A total of 33 patients (63.5%) had at least one comorbidity. The initial etanercept dose was 50 mg in 37 patients (71.2%). The median timing of etanercept administration was 3 (3, 6) days after disease onset. Etanercept was used as monotherapy in 26 patients (50.0%) and as combination therapy in 26 patients (50.0%). Multiple linear regression analysis showed that age (partial regression coefficient β [95% CI]: -0.106 [-0.194, -0.018]), disease severity (2.216 [0.452, 3.980]), timing of administration (1.343 [0.827, 1.858]), and combination therapy (11.993 [4.149, 19.838]) significantly influenced the hospitalization duration of TEN patients (all P < 0.05). However, sex, race, presence of comorbidities, initial dose, and number of administrations did not affect hospitalization duration (all P > 0.05). Based on the standardized regression coefficients, the factors influencing hospitalization duration in TEN patients were ranked from strongest to weakest as follows: timing of administration (0.632), combination therapy (0.595), disease severity (0.337), and age (-0.233) . Conclusions:Early administration of etanercept is the key to achieving clinical benefit in the treatment of TEN. In cases where the response is inadequate or the condition is severe, combination therapy may be considered.

Objective:To investigate the factors influencing the efficacy of etanercept in the treatment of toxic epidermal necrolysis (TEN) across different countries and regions.Methods:A total of 17 articles (case analyses or case reports) were selected through a comprehensive search in 4 Chinese databases (CNKI, Wanfang, VIP, and SinoMed) and 4 English databases (PubMed, Cochrane Library, Embase, and Elsevier SD). Clinical data from 52 patients originating from 7 countries were collected. Independent variables included age, sex, race, culprit drugs, disease severity, presence or absence of complications, initial dose, timing of administration, number of administrations of etanercept, and combination therapy; and the duration of hospitalization served as the dependent variable. Univariate and multiple linear regression analyses were conducted sequentially.Results:Among the 52 patients, 26 were male and 26 were female, with a median age M ( Q1, Q3) of 57.0 (36.0, 71.5) years. The median hospitalization duration was 12.0 (8.0, 17.5) d, and the median severity-of-illness score for TEN (SCORTEN) was 2 (2, 4). A total of 33 patients (63.5%) had at least one comorbidity. The initial etanercept dose was 50 mg in 37 patients (71.2%). The median timing of etanercept administration was 3 (3, 6) days after disease onset. Etanercept was used as monotherapy in 26 patients (50.0%) and as combination therapy in 26 patients (50.0%). Multiple linear regression analysis showed that age (partial regression coefficient β [95% CI]: -0.106 [-0.194, -0.018]), disease severity (2.216 [0.452, 3.980]), timing of administration (1.343 [0.827, 1.858]), and combination therapy (11.993 [4.149, 19.838]) significantly influenced the hospitalization duration of TEN patients (all P < 0.05). However, sex, race, presence of comorbidities, initial dose, and number of administrations did not affect hospitalization duration (all P > 0.05). Based on the standardized regression coefficients, the factors influencing hospitalization duration in TEN patients were ranked from strongest to weakest as follows: timing of administration (0.632), combination therapy (0.595), disease severity (0.337), and age (-0.233) . Conclusions:Early administration of etanercept is the key to achieving clinical benefit in the treatment of TEN. In cases where the response is inadequate or the condition is severe, combination therapy may be considered.

Chronic graft-versus-host disease (cGVHD) is the main complication after allogeneic hematopoietic stem cell transplantation, which is also the major cause of non-relapse -related death. Due to its complex pathophysiological process, the response rate of conventional glucocorticoids combined with immunosuppressants is less than 50%. Second-line therapy should be given for patients with glucocorticoid-resistant cGVHD. Nevertheless, no consensus has been reached on current second-line therapy and the therapeutic effect is relatively poor. Mesenchymal stem cell (MSC) is one of the most common adult stem cells. Due to multi-dimensional and multi-target immune regulating function, MSC has been widely applied in the prevention and treatment of cGVHD. In addition, accumulated studies have confirmed the safety and efficacy of MSC in the treatment of cGVHD, which is expected to become a novel strategy for the prevention and management of cGVHD. In this article, research progress, mechanism and existing problems of prevention and treatment of cGVHD by MSC were reviewed, aiming to provide novel ideas for optimizing therapeutic regimens of MSC and enhancing the prevention and treatment effect of cGVHD in subsequent research.

Objective:To evaluate and compare efficacy of intravenous immunoglobulin (IVIG) versus recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR:Fc) in the treatment of toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from patients with TEN treated with IVIG or rhTNFR:Fc in Wuhan No.1 Hospital from 2013 to 2019. There were 11 patients in the IVIG group, including 3 males and 8 females, aged 25-72 years, and the median TEN-specific severity-of-illness score (SCORTEN) was 3 points; there were 10 patients in the rhTNFR:Fc group, including 5 males and 5 females, aged 32-84 years, and the median SCORTEN was 2 points. These patients all showed no response to the 5-day treatment with prednisolone acetate at a dose of 0.6-1.0 mg·kg -1·d -1, and then received IVIG at a dose of 400 mg·kg -1·d -1 for 5 consecutive days, or subcutaneous injection of rhTNFR:Fc at a dose of 25 mg every other day for 4-6 sessions. Changes in skin lesions and adverse events were recorded in the 2 groups. Statistical analysis was carried out by using Mann-Whitney U test. Results:Compared with the rhTNFR:Fc group, the IVIG group showed a significant decrease in the time to onset of reduction of skin lesion exudate (1.73 ± 1.19 days vs. 3.00 ± 1.56 days, P < 0.05) , time to onset of pain relief in the lesion area (1.64 ± 1.28 days vs. 3.70 ± 1.63 days, P < 0.05) , time to lightening of color of the lesion base (2.45 ± 1.12 days vs. 3.90 ± 1.59 days, P < 0.05) , time to onset of new epidermis growth (3.09 ± 1.13 days vs. 5.20 ± 1.22 days, P < 0.05) , and in the time to onset of lesion drying at the intertriginous sites (4.82 ± 2.22 days vs. 7.90 ± 3.14 days, P < 0.05) . However, there was no significant difference in the length of hospital stay between the IVIG group (17.70 ± 8.33 days) and rhTNFR:Fc group (16.70 ± 4.71 days, P > 0.05) . No adverse reactions were observed during the treatment, and no recurrence or complications were found in the 21 patients during the follow-up of 6 months. Conclusion:IVIG and rhTNFR:Fc are both effective in the treatment of TEN, but IVIG is superior to rhTNFR:Fc in terms of the time to onset of pain relief, skin lesion exudate reduction and epidermal growth.

Objective:To create AAPM TG 119 test plans for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in order to evaluate the accuracy of the United Imaging Healthcare′s URT treatment planning system (URT-TPS). The plans were delivered to the phantom using the United Imaging Healthcare′s URT-Linac 506C.Methods:The overall accuracy of IMRT and VMAT planning, measurement, and analysis were evaluated for four test geometries provided by American Association of Physicists in Medicine (AAPM) Task Group Report 119(TG-119) on multi-target, prostate, head and neck and C-shape (easy). The dose distributions were measured in the coronal plane. The point measurements were measured by a Farmer type ion chamber and fluence measurements were completed with film and Delta4 phantom, respectively. Measured planar dose distributions were analyzed using gamma index with criteria 3%/3 mm.Results:For IMRT and VMAT plans, the planning results matched the TG-119 planning results. Measured point doses of IMRT and VMAT were within 2.62% and 3.90% of the planned doses, respectively. Measured film dosimetry gamma values of IMRT and VMAT were> 97.50% and> 93.27%, respectively.Conclusion:Based on these analyses which were performed in line with the TG119 recommendations, it is evident that the URT treatment planning system and URT-Linac 506C have commissioned IMRT and VMAT techniques with adequate accuracy.

Moschus chrysogaster (sifanicus) viral hemorrhagic disease (McVHD) is an acute and highly lethal infectious disease caused by Moschus chrysogaster hemorrhagic disease virus (McHDV) whose genome sequence is highly homologous with rabbit hemorrhagic disease virus. To screen the protective antigen of McHDV and set the basis for study of McVHD vaccine, the antigen epitope of major structural protein VP60 of McHDV was analyzed, and the specific primers were designed to obtain three amplified DNA sequences encoding the main antigen epitope of VP60 from McHDV by using RT-PCR. Then the three DNA fragments were sequenced and cloned to prokaryotic expression vector with pET-28a(+) by using overlap extension PCR, and finally the prokaryotic expression plasmid pET-truncated-VP60 was constructed. Subsequently, the pET-truncated-VP60 was transformed into Escherichia coli BL21(DE3), and the recombinant proteins were expressed by IPTG induction. Finally, the expressed protein was purified and applied to immunize that without immunizing with RHD vaccine, then the antiserum titers were evaluated by the hemagglutination inhibition test, and the immune-protective efficacy of the recombinant proteins was observed and analyzed through animal challenge test. The results showed that the multi-epitope DNA fragments of VP60 of McHDV was successfully expressed in the form of inclusion bodies in E. coli, and the relative molecular weight of recombinant proteins is about 45 kDa. After immunized with the recombinant proteins, 100% of New Zealand white rabbits were resistant to attack of McHDV, which indicates efficient immune-protective efficacy of chosen epitope recombinant protein. The study laid a foundation for the development of the new subunit vaccines of McVHD.

Objective To investigate the characteristics,treatment and prognosis of Rowell's syndrome.Methods Clinical data were collected from 6 inpatients with Rowell's syndrome from July 2009 to July 2015,and retrospectively analyzed.Results All the patients were female,of them,2 developed skin lesions after sun exposure,2 had medication history,1 had Staphylococcus aureus infection before occurrence of skin lesions,and 1 had no obvious precipitating factor.Skin lesions spread from the face to the whole body in 4 cases,from the dorsal hauds to the whole body in 1 case,and were confined to the face,both hands and feet in 1 case.All the 6 patients had chilblain-like lesions in the digit tips,and 5 patients had fever.Among these patients,6 were positive for antinuclear antibodies (granular pattern),4 for anti-Sm antibodies,5 for anti-U 1RNP antibodies,4 for anti-SSA antibodies,2 for anti-dsDNA antibodies,and 1 was positive for both anti-SSA and anti-SSB antibodies.Histopathological examination revealed hyperkeratinization,mild hyperplasia,partial necrosis,many dyskeratocytes,liquifaction degeneration of basal cells in the epidermis,and perivascular infiltration of lymphocytes in the superficial dermis.After admission,1 patient was finally diagnosed with subacute cutaneous lupus erythematosus (SCLE),and 5 with systemic lupus erythematosus (SLE).All the 6 patients were treated with prednisone at a dose of 0.6-1.0 mg·kg-1 ·d-1,and 1 was also treated with gamma globulin (200 mg/d).During the process of glucocorticoid tapering,hydroxychloroquine was administered at 0.2 g twice a day.During 1-year follow-up,neither erythema multiform nor chilblain-like lesions recurred in 5 patients,and 1 patient was lost to follow-up.Conclusions Rowell's syndrome frequently occurs in women.Glucocorticoids are a mainstay of its treatment,and their tapering should be slower in patients with Rowell's syndrome than in those with lupus erythematosus.

tRNA-derived RNA fragments (tRFs) are an emerging class of non-coding RNAs (ncRNAs). A growing number of reports have shown that tRFs are not random degradation products but are functional ncRNAs made of specific tRNA cleavage. They play regulatory roles in several biological contexts such as cancer, innate immunity, stress responses, and neurological disorders. In this review, we summarize the biogenesis and functions of tRFs.
Organelle Biogenesis* ; Humans* ; Immunity, Innate ; Nervous System Diseases ; Neurodegenerative Diseases ; RNA* ; RNA, Transfer ; RNA, Untranslated

OBJECTIVETo investigate the cause and related risk factors of an outbreak caused by Brucellosis.

METHODSEpidemiological investigation and laboratory test were carried out among occupationally invloved population including sheep slaughters and sellers in the village.

RESULTS18 people were serology positive among the 129 occupationally involved persons under survey. Seven of them were confirmed cases, 11 were latent infection, to make the overall attack rate as 14%. 90% of the sheep were from high-risk areas of Brucella. Among the occupationally involved persons, 89% of them never wore face masks, 84% never wear overalls and 70% never wear gloves. Factors as:work but wearing no gloves (RR = 7.4, 95%CI:1.1-53.0), with hand wound (RR = 3.4, 95%CI:1.1-11.0) could increase the risk of Brucella infection.

CONCLUSIONThe cause of this outbreak was due to the plentiful influx of unchecked sheep from the northern part of China and the employees in the process of sheep slaughtering or trading were lack of effective prevention programs.

Abattoirs ; Animals ; Brucella ; isolation & purification ; Brucellosis ; epidemiology ; China ; epidemiology ; Commerce ; Disease Outbreaks ; Humans ; Incidence ; Occupational Diseases ; epidemiology ; Risk Factors ; Sheep ; microbiology