This paper analyzed the causes of peripheral nerve injury induced by acupoint injection, and proposed methods for prevention. These methods included emphasizing the physicochemical properties of medications and strengthening research on medication compatibility, classifying high-risk acupoints and establishing international standards for safe acupoint needling, standardizing clinical procedures for acupoint injection, and incorporating ultrasound technology when necessary to improve the accuracy and safety of the procedure. These strategies aimed to reduce the risk associated with the clinical application of acupoint injection.
Humans ; Peripheral Nerve Injuries/prevention & control* ; Ultrasonography ; Acupuncture Points ; Injections/adverse effects*

Objective:To explore the dosimetry optimization strategy based on filter thickness and shape selection for the bulb superficial X-ray radiotherapy unit.Methods:Monte Carlo code TOPAS was used to model tubular equipment, and the dose distribution from six X-ray energies (50-150 kV) and five conventional aluminum filters (0.5-3.0 mm) with different thickness were simulated in the water model. The percentage depth dose (PDD) curve along the central axis, the center-axis profile dose at different depths, and the lateral dose distribution were analyzed. The dose distribution of three different designs of aluminum filters (conventional cylindrical, conical and oblique cylindrical filters) was compared to evaluate the effect of dosimetric optimization of different filter shapes.Results:Under the same energy, increasing the thickness of the filter can optimize the superficial skin dose, and the optimization effect of depth dose uniformity can be increased by 26% at a depth of 5.5 mm at 70 kV energy. The raised, flat and inclined dose distribution modes can be achieved by using conventional cylindrical, conical and inclined aluminum filters.Conclusions:By selecting the appropriate X-ray energy and filter thickness, an ideal dose distribution matching the tumor depth can be achieved. The application of personalized filters is also of great significance for diverse target areas.

Transmission X-ray tubes are relatively new devices characterized by portability,suitability for miniaturization,and low requirements for shielding,making them ideal radiation sources for kilovoltage X-ray therapy.However,their application in radiotherapy remains underexplored.An electron target model of a transmission X-ray tube is developed using the Monte Carlo toolkit TOPAS 3.8.1.The study investigates the effect of tungsten target thickness on X-ray output efficiency,finding that a tube voltage of 50 kV and a tungsten thickness of 1.4 μm yields the highest emission efficiency.Based on the energy spectrum at this optimal efficiency,polynomial fitting approach is applied to determine the corresponding aluminum filter thickness for mean energies ranging from 20 keV to 35 keV,achieving a mean fitting error of 0.91%.Next,the study simulates dose deposition in a water phantom for spectra with different mean energies and various source-to-surface distances,and plots percent-depth-dose curves,relative normalized dose-depth curves,and relative normalized dose histograms under each treatment condition.Finally,the simulated results are compared with experimental data from the intraoperative radiotherapy system Intrabeam and the superficial X-ray therapy unit SRT-100,obtaining average relative errors of 3.71%and 4.38%,respectively.These findings provide a theoretical foundation for further optimization of transmission X-ray tubes in kilovoltage radiotherapy.

Neoadjuvant therapy for pancreatic cancer is undergoing a paradigm shift from conventional chemotherapy to precision medicine. This expert forum discussed cutting-edge issues in pancreatic cancer neoadjuvant therapy from an evidence-based perspective, incorporating the latest clinical research advances. We focused on innovative directions including immunotherapy combination strategies, liquid biopsy applications, artificial intelligence (AI)-assisted decision making, and individualized precision medicine. We proposed forward-looking concepts such as molecular subtyping-guided individualized treatment strategies, multi-omics integrated efficacy prediction models, and standardized multidisciplinary collaborative care systems. These innovative concepts will drive pancreatic cancer neoadjuvant therapy toward more precise and effective directions.

Objective To investigate the clinical features of patients with China Liver Cancer Staging(CNLC)stage Ⅲhepatocellular carcinoma(HCC)achieving five-year sustained complete remission(CR)after local treatment combined with systemic therapy,as well as potential contributing factors,and to provide a reference for optimizing the treatment of advanced HCC.Methods A retrospective analysis was performed for the clinical data of six patients with CNLC stage Ⅲ HCC who were treated in Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,from January 2016 to December 2019 and achieved five-year sustained CR.Baseline characteristics,treatment modalities,and follow-up data were summarized,and a literature review was performed.Results The six patients had a mean age of 58.3±10.1 years,among whom five had stage Ⅲa HCC and one had stage Ⅲb HCC,and all patients had a history of hepatitis.The mean preoperative MELD score was 8.2±0.8 for the six patients,and there were five patients with Child-Pugh class A liver function and one with Child-Pugh class B liver function.All patients underwent transcatheter arterial chemoembolization,followed by sequential targeted drug therapy after surgery,with sorafenib for four patients and lenvatinib for two patients.Four patients with main portal vein tumor thrombus also received 125I seed implantation,one patient with the single-nodule type underwent radiofrequency ablation,and three patients received immunotherapy with camrelizumab.The median time to AFP normalization was 6 months,the median time from treatment to CR was 5.5 months,and the median follow-up time was 63 months.Conclusion Good liver function at baseline,an early and rapid reduction in AFP,and the combination of local treatment and systemic therapy are key factors for achieving long-term CR in patients with advanced HCC.Multi-center large-scale studies are needed in the future to further explore prognostic factors and optimize treatment regimens.

Ancient Chinese medicine books are the foundation of traditional Chinese medicine inheritance,innovation,and development,and the vast amount of knowledge they contain is worthy of in-depth mining.However,if researchers only rely on manual sorting,research progress will inevitably be slow.To overcome this,previous studies have attempted to extract knowledge from ancient Chinese medicine books automatically with natural language processing technology,which has made certain progress in the last decade.In this paper,we first introduce the text data-oriented knowledge extraction technology,then review the research progress of existing technologies in the two tasks of entity recognition and entity relationship extraction of ancient Chinese medicine books.Finally,we analyze the shortcomings of this research field and recommend standardizing data annotation,expanding entity categories,and paying attention to procedural knowledge.This review aims to provide a reference for the mining and utilization of ancient traditional Chinese medicine books in the era of artificial intelligence.

Transmission X-ray tubes are relatively new devices characterized by portability,suitability for miniaturization,and low requirements for shielding,making them ideal radiation sources for kilovoltage X-ray therapy.However,their application in radiotherapy remains underexplored.An electron target model of a transmission X-ray tube is developed using the Monte Carlo toolkit TOPAS 3.8.1.The study investigates the effect of tungsten target thickness on X-ray output efficiency,finding that a tube voltage of 50 kV and a tungsten thickness of 1.4 μm yields the highest emission efficiency.Based on the energy spectrum at this optimal efficiency,polynomial fitting approach is applied to determine the corresponding aluminum filter thickness for mean energies ranging from 20 keV to 35 keV,achieving a mean fitting error of 0.91%.Next,the study simulates dose deposition in a water phantom for spectra with different mean energies and various source-to-surface distances,and plots percent-depth-dose curves,relative normalized dose-depth curves,and relative normalized dose histograms under each treatment condition.Finally,the simulated results are compared with experimental data from the intraoperative radiotherapy system Intrabeam and the superficial X-ray therapy unit SRT-100,obtaining average relative errors of 3.71%and 4.38%,respectively.These findings provide a theoretical foundation for further optimization of transmission X-ray tubes in kilovoltage radiotherapy.

Objective:To explore the dosimetry optimization strategy based on filter thickness and shape selection for the bulb superficial X-ray radiotherapy unit.Methods:Monte Carlo code TOPAS was used to model tubular equipment, and the dose distribution from six X-ray energies (50-150 kV) and five conventional aluminum filters (0.5-3.0 mm) with different thickness were simulated in the water model. The percentage depth dose (PDD) curve along the central axis, the center-axis profile dose at different depths, and the lateral dose distribution were analyzed. The dose distribution of three different designs of aluminum filters (conventional cylindrical, conical and oblique cylindrical filters) was compared to evaluate the effect of dosimetric optimization of different filter shapes.Results:Under the same energy, increasing the thickness of the filter can optimize the superficial skin dose, and the optimization effect of depth dose uniformity can be increased by 26% at a depth of 5.5 mm at 70 kV energy. The raised, flat and inclined dose distribution modes can be achieved by using conventional cylindrical, conical and inclined aluminum filters.Conclusions:By selecting the appropriate X-ray energy and filter thickness, an ideal dose distribution matching the tumor depth can be achieved. The application of personalized filters is also of great significance for diverse target areas.

Acute kidney injury (AKI) usually requires renal replacement therapy (RRT). Common RRT modes include peritoneal dialysis, continuous renal replacement therapy, intermittent hemodialysis and continuous low-efficiency hemodialysis. In clinical practice, there is still controversy over how to select the appropriate RRT mode for AKI patients and when initiating RRT is more beneficial for AKI patients. This article summarizes previous studies on the impact of RRT mode and initiation timing on the prognosis of AKI patients, with the aim of providing assistance for clinical decision-making.

Objective To investigate the clinical features of patients with China Liver Cancer Staging(CNLC)stage Ⅲhepatocellular carcinoma(HCC)achieving five-year sustained complete remission(CR)after local treatment combined with systemic therapy,as well as potential contributing factors,and to provide a reference for optimizing the treatment of advanced HCC.Methods A retrospective analysis was performed for the clinical data of six patients with CNLC stage Ⅲ HCC who were treated in Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,from January 2016 to December 2019 and achieved five-year sustained CR.Baseline characteristics,treatment modalities,and follow-up data were summarized,and a literature review was performed.Results The six patients had a mean age of 58.3±10.1 years,among whom five had stage Ⅲa HCC and one had stage Ⅲb HCC,and all patients had a history of hepatitis.The mean preoperative MELD score was 8.2±0.8 for the six patients,and there were five patients with Child-Pugh class A liver function and one with Child-Pugh class B liver function.All patients underwent transcatheter arterial chemoembolization,followed by sequential targeted drug therapy after surgery,with sorafenib for four patients and lenvatinib for two patients.Four patients with main portal vein tumor thrombus also received 125I seed implantation,one patient with the single-nodule type underwent radiofrequency ablation,and three patients received immunotherapy with camrelizumab.The median time to AFP normalization was 6 months,the median time from treatment to CR was 5.5 months,and the median follow-up time was 63 months.Conclusion Good liver function at baseline,an early and rapid reduction in AFP,and the combination of local treatment and systemic therapy are key factors for achieving long-term CR in patients with advanced HCC.Multi-center large-scale studies are needed in the future to further explore prognostic factors and optimize treatment regimens.