Objective:To compare the impact of the AlignRT-based optical guidance method with the traditional marker line method on the accuracy of positioning, and explore the effect of patient′s different thoracic characteristic parameters on the precision of optical guidance positioning.Methods:A total of sixty breast cancer patients who received post breast-conserving radiotherapy at Anhui Cancer Hospital from July 2022 to September 2023 were retrospectively selected. Then these patients were equally divided into traditional cross hairs set-up (marker line group) and surface-guided set-up (SGRT group). The cone-beam CT scanning results were used as the gold standard, the three-dimensional set-up errors and the CTV-PTV target area external radiotherapy boundaries of two groups were studied comparatively. Multiple patient′s thoracic characteristic parameters were defined and the correction between each parameter and set-up error of SGRT was analyzed.Results:The mean value of three-dimensional set-up errors in the SGRT group and the marker line group was within 0.2 cm and 0.5 cm, respectively. The differences in three-dimensional set-up errors and total displacements between two groups were statistically significant ( z=-2.93, -3.21, -2.59, -4.76, P<0.05). The SGRT group reduced the CTV-PTV boundary from 0.5 cm of conventional marker line group to 0.3 cm. The thoracic aspect ratio H/W, the affected side pinch angle α1, and the healthy side pinch angle α2 were positively correlated with the x-direction posing error ( r=0.49, 0.59, 0.71, P<0.05); whereas, the affected side and the healthy side mammary gland heights D1 and D2 were negatively correlated with the z-direction posing error ( r=-0.46, -0.49, P<0.05). Conclusions:For breast-conserving postoperative radiotherapy patients, SGRT can obtain a more accurate radiotherapy set-up than the traditional marker line method, and can effectively reduce the target area externally expanded range. Meanwhile, the monitoring accuracy of SGRT is affected by the patient′s thoracic characteristic parameters, and clinical attention should be paid to breast-conserving radiotherapy patients with thick body shape, narrow body width, and small breast glands.

Objective:To compare the impact of the AlignRT-based optical guidance method with the traditional marker line method on the accuracy of positioning, and explore the effect of patient′s different thoracic characteristic parameters on the precision of optical guidance positioning.Methods:A total of sixty breast cancer patients who received post breast-conserving radiotherapy at Anhui Cancer Hospital from July 2022 to September 2023 were retrospectively selected. Then these patients were equally divided into traditional cross hairs set-up (marker line group) and surface-guided set-up (SGRT group). The cone-beam CT scanning results were used as the gold standard, the three-dimensional set-up errors and the CTV-PTV target area external radiotherapy boundaries of two groups were studied comparatively. Multiple patient′s thoracic characteristic parameters were defined and the correction between each parameter and set-up error of SGRT was analyzed.Results:The mean value of three-dimensional set-up errors in the SGRT group and the marker line group was within 0.2 cm and 0.5 cm, respectively. The differences in three-dimensional set-up errors and total displacements between two groups were statistically significant ( z=-2.93, -3.21, -2.59, -4.76, P<0.05). The SGRT group reduced the CTV-PTV boundary from 0.5 cm of conventional marker line group to 0.3 cm. The thoracic aspect ratio H/W, the affected side pinch angle α1, and the healthy side pinch angle α2 were positively correlated with the x-direction posing error ( r=0.49, 0.59, 0.71, P<0.05); whereas, the affected side and the healthy side mammary gland heights D1 and D2 were negatively correlated with the z-direction posing error ( r=-0.46, -0.49, P<0.05). Conclusions:For breast-conserving postoperative radiotherapy patients, SGRT can obtain a more accurate radiotherapy set-up than the traditional marker line method, and can effectively reduce the target area externally expanded range. Meanwhile, the monitoring accuracy of SGRT is affected by the patient′s thoracic characteristic parameters, and clinical attention should be paid to breast-conserving radiotherapy patients with thick body shape, narrow body width, and small breast glands.

Creutzfeldt-Jakob disease is an extremely rare neurodegenerative disease. Due to the lack of specificity of its clinical symptoms, early diagnosis is difficult; Some patients often initially visit the mental health department because they may present psychological symptoms, that are easy misdiagnosed as a mental disorder. This article reports a case with emotional disturbance as the initial symptoms, the early diagnosis as a mental disorder, and the final diagnosis as probable sporadic Creutzfeldt-Jakob disease to improve awareness of this disease.

Creutzfeldt-Jakob disease is an extremely rare neurodegenerative disease. Due to the lack of specificity of its clinical symptoms, early diagnosis is difficult; Some patients often initially visit the mental health department because they may present psychological symptoms, that are easy misdiagnosed as a mental disorder. This article reports a case with emotional disturbance as the initial symptoms, the early diagnosis as a mental disorder, and the final diagnosis as probable sporadic Creutzfeldt-Jakob disease to improve awareness of this disease.

Objective To explore the relationship of miR-34b/c gene polymorphisms and event-related potential P300 in major depressive disorder.Methods The design of case-control research was used,and 302 major depressive patients and 327 normal controls who were in age and gender matched with patients were measured auditory event-related potential P300 on the day when two groups were collected.Polymerase chain reaction(PCR) and direct DNA sequencing technology were used to detect miR-34b/c gene polymorphisms.Results (1) In the single locus analysis,the rs4938723,rs2187473 and rs28757623 had no significant difference in allele frequency and genotype frequency between depressive patients and controls (P＞ 0.05);Haplotype C-C-C in rs4938723-rs2187473-rs28757623 was statistically significant different in depressive patients and controls(x2 =3.96,P=0.046).The odds ratio (OR) was 1.322(95％CI=1.004-1.740).(2) Compared with normal controls,P300 of the patients with major depressive disorder had longer latency of N2 (P＜0.01),P3a (P＜0.01) and P3b (P＜0.05).(3) The P300 targets of major depressive disorder had statistical difference(P＜0.05)in rs28757623 between the individuals with the G allele genotype and C/C genotype.The latency of N1 ((90.80±28.62) ms),P3a((281.79±37.89) ms),P3b((323.87±41.17) ms) were longer thanC/C genotype ((77.40 ± 20.96) ms,(253.00 ± 34.36) ms,(297.30± 23.70) ms).Conclusion Rs4938723-rs2187473-rs28757623 haplotype CCC in miR-34b/c gene might be risk factor for the onset of depression,miR-34b/c gene rs28757623 polymorphism is associated with the principal component of P300 latency in patients with Major depressive disorder which suggest that genetic factors may have a certain impact on cognitive function in the patients with major depressive disorder.

Objective To investigate the clinical features and the prognosis after surgical treatment for hilar cholangiocarcinoma (HCC).Methods The surgical therapy and follow-up result were retrospectively analyzed on 98 cases of hilar cholangiocarcinoma admitted into our hospital from January 1995 to January 2005.Differences between groups were evaluated using Chi-square analysis or Student t-test according to the data type.Survival rate was calculated with Kaplan-Meier method,and using the log-rank test.Results Among 98 patients,83 patients underwent surgical treatment (radical resection in 33,palliative resection in 16,and nonresectional internal or external bile duct drainage in 34),15 patients underwent conservative therapy.The 1-,3-,5-year survival rates were 79％,42％,and 17％ in the resection group and 88％,54％,and 24％ in the radical resection group,respectively.The 1-,3-year survival rates were 55％,and 9％ in palliative resection group,respectively,and none of the patient survived for over 5 years.There were significant differences in the survival rate among the radical resection group and the palliative resection group (log-rank test,P ＜ 0.001).Conclusions Radical resection improves the prognosis of hilar cholangiocarcinoma.