OBJECTIVES: To propose a new method for optimizing radiotherapy planning for lung cancer by incorporating prognostic models that take into account individual patient information and assess the feasibility of treatment planning optimization directly guided by minimizing the predicted prognostic risk. METHODS: A mixed fluence map optimization objective was constructed, incorporating the outcome-based objective and the physical dose constraints. The outcome-based objective function was constructed as an equally weighted summation of prognostic prediction models for local control failure, radiation-induced cardiac toxicity, and radiation pneumonitis considering clinical risk factors. These models were derived using Cox regression analysis or Logistic regression. The primary goal was to minimize the outcome-based objective with the physical dose constraints recommended by the clinical guidelines. The efficacy of the proposed method for optimizing treatment plans was tested in 15 cases of non-small cell lung cancer in comparison with the conventional dose-based optimization method (clinical plan), and the dosimetric indicators and predicted prognostic outcomes were compared between different plans. RESULTS: In terms of the dosemetric indicators, D_95% of the planning target volume obtained using the proposed method was basically consistent with that of the clinical plan (100.33% vs 102.57%, P=0.056), and the average dose of the heart and lungs was significantly decreased from 9.83 Gy and 9.50 Gy to 7.02 Gy (t=4.537, P<0.05) and 8.40 Gy (t=4.104, P<0.05), respectively. The predicted probability of local control failure was similar between the proposed plan and the clinical plan (60.05% vs 59.66%), while the probability of radiation-induced cardiac toxicity was reduced by 1.41% in the proposed plan. CONCLUSIONS The proposed optimization method based on a mixed objective function of outcome prediction and physical dose provides effective protection against normal tissue exposure to improve the outcomes of lung cancer patients following radiotherapy.
Humans ; Lung Neoplasms/radiotherapy* ; Radiotherapy Planning, Computer-Assisted/methods* ; Prognosis ; Radiotherapy, Intensity-Modulated/methods* ; Carcinoma, Non-Small-Cell Lung/radiotherapy* ; Radiotherapy Dosage ; Female ; Male ; Middle Aged

BACKGROUND:Superior lower limb mobility is regarded as one of the prerequisites for winning competitions.Wearable resistance training can effectively overcome the deficiency in the transfer efficiency of traditional strength training in enhancing lower limb mobility.Considering that the impact of wearable resistance training based on different body parts on lower limb mobility may have significant differentiated characteristics,it is particularly important to review and summarize the specific application strategies and acute and chronic intervention effects. OBJECTIVE:To comb and analyze acute and chronic intervention effects of wearable resistance training based on different body parts on lower limb mobility,in order to provide insightful and methodological references for optimizing application strategies for lower limb movement ability. METHODS:A literature search was conducted in CNKI,Wanfang,VIP,Web of Science,Medline,SPORTDiscus,and PubMed databases for publications up to October 2023.Chinese and English search terms were"arm,forearm,limb,leg,lower extremity,vest,trunk,resist,weight,load,sprint,agility,change of direction".A total of 60 articles were ultimately included for review after screening the retrieval results. RESULTS AND CONCLUSION:(1)Trunk loading of 6-20%of body mass is suitable for optimizing acceleration in sprinting,while trunk loading of≤6%body mass is suitable for optimizing high-speed running.A trunk load of 5%body mass is applicable for optimizing change-of-direction movement;forearm,calf,or thigh loading often uses 1%or 2%body mass.(2)Trunk loading optimizes the functional performance of the lower limb stretch-shortening cycle by increasing vertical load.This enhances the efficiency of ground reaction force utilization and strengthens the coordinated stability control of the whole body musculature.Forearm loading effectively enhances the driving force of the upper limb swing,improves the propulsive force of the lower limb sprint,and optimizes the efficiency of inter-limb coordination.Calf loading can impose restrictions on the function of the hip joint,thereby leading to localized load stimulation and compensatory functional enhancement in the knee or ankle joint.Thigh loading partially restricts the peak extension angle and speed of the knee joint,creates specific load stimulation at the hip joint,and significantly improves its rotational kinetic energy output.(3)During larger-angle change-of-direction movements,the impact of calf loading is more significant than thigh loading.Thigh loading stimulation helps to enhance power output,while calf loading stimulation aids in improving stability control and directional change.(4)Currently,wearable resistance training has been proven to be an effective way to improve sprint and change-of-direction performance.The methodological strategies to improve sprint performance are relatively mature,but the optimal application scheme to improve change-of-direction performance needs to be further refined and optimized.Further research is recommended to supplement this area.

Objective:To evaluate the safety and effectiveness of pecto-intercostal fascial plane (PIFP) block and erector spinae plane (ESP) block for postoperative analgesia in median open heart surgery.Methods:A total of 158 patients who underwent elective midline open heart surgery at the Nanjing First Hospital, Nanjing Medical University from October 2022 to October 2023 were randomly divided into a PIFP block group (P group) and ESP block group (E group) using a random number table method, with 79 patients in each group. Before anesthesia surgery, the group P underwent ultrasound-guided bilateral PIFP block, while the group E underwent ultrasound-guided bilateral ESP block. Both groups received sufentanil intravenous patient-controlled analgesia after surgery. The resting and activity Visual Analog Scale (VAS) scores of two groups of patients at 6, 12, 18, and 24 hours after surgery were recorded; The first press time of the patient′s postoperative patient-controlled analgesia pump, the cumulative dose of sufentanil within 24 hours, the number of effective presses, and the rate of salvage analgesia were recorded; and extubation time, intensive care unit (ICU) stay, and adverse reactions; the time of nerve block operation, clarity score of puncture needle imaging under ultrasound, and patient satisfaction with nerve block were also recorded.Results:There was no statistically significant difference in resting VAS scores and activity VAS scores between the two groups at 6, 12, 18, and 24 hours after surgery (all P>0.05). The activity VAS scores of the group P were lower than those of the group E at 6 and 12 hours after surgery (all P<0.05); Compared with the group E, patients in the group P had significantly longer first press time of postoperative analgesia pump (all P<0.05), lower salvage analgesia rate, cumulative dose of sufentanil 24 hours after surgery, and fewer effective presses of analgesia pump (all P<0.05); There was no statistically significant difference in extubation time, ICU stay, and incidence rate of nausea between the two groups of patients (all P>0.05); Compared with the group E, the group P had shorter nerve block operation time, higher clarity score of puncture needle imaging under ultrasound, and higher patient satisfaction (all P<0.05). Conclusions:Compared with ESP block, PIFP block can provide better perioperative analgesia for cardiac surgery patients, reduce the use of opioid drugs, and the operation of PIFP block is simpler, with good safety and effectiveness.

The facultative anaerobic and strict anaerobic microorganisms enriched and acclimated during the anaerobic digestion process are crucial for the efficiency of the anaerobic digestion system. Most of the problems encountered during running anaerobic digestion processes could be effectively improved via stimulation of microbial metabolic activity. Benefited from the rapid development of microbiome techniques, deeper insights into the microbial diversity in anaerobic digestion systems, e.g. the microbe-microbe interactions and microbe-environment interactions, have been gained. A complex and intricate metabolic network exists in the anaerobic digestion system of solid organic wastes. However, little is known about these interactions and the underlying mechanisms. This review briefly summarized the representative interactions between microbial communities during anaerobic digestion process discovered to date. In addition, typical issues encountered during the anaerobic digestion of solid organic wastes and how microbes can tackle and alleviate these issues were discussed. Finally, future priorities on microbiome research were proposed based on present contribution of microbiome analysis in anaerobic digestion system.
Anaerobiosis ; Bioreactors ; Methane ; Microbial Interactions ; Microbiota ; Solid Waste

OBJECTIVE:To study the absorption features of Silymarin enteric coated-polyllactic-co-glycolic acid (PLGA) nanoparticles in rat in situ intestine perfusion model and colonic adenoma Caco-2 cell model. METHODS:HPLC method was used to determine the content of silymarin. The absorption rate constant(Ka)and apparent absorption coefficient(Kapp)of Silymarin sus-pension,Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were investigated in duodenum,jejunum, ileum and colon of rat in situ intestine perfusion model;the apparent permeability coefficient (Papp) of those drugs containing low-concentration,medium-concentration and high-concentration(20,40,60 μg/mL)of silymarin in Caco-2 cell model were also investigated. RESULTS:Compared with Silymarin suspension,Ka and Kapp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were all increased in duodenum,jejunum,ileum and colon(P<0.05);compared with the correspond-ing concentration Silymarin suspension,two-way Papp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanopar-ticles containing low-concentration,medium-concentration and high-concentration of silymarin were all increased in Caco-2 cell model (P<0.05);there was no statistical significance between Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles (P>0.05). CONCLUSIONS:Silymarin enteric coated-PLGA nanoparticles can effectively increase the intestinal ab-sorption,cellular uptake and transmembrane transport rate of silymarin.

Objective To investigate the inhibitory effect of IFN-γ on acute allergic airway inflammation induced by IL-33 in mice.Methods Twenty-four female C57BL/6 mice (6-8 weeks) were randomly divided into four groups: IL-33 model group, IFN-γ treatment group, IL-33+IFN-γ treatment group and PBS control group.A mouse model of acute allergic airway inflammation was induced by IL-33.Samples of bronchial alveolar lavage fluid (BALF) and lung tissues were collected.Group 2 innate lymphoid cells (ILC2s) and eosinophils were analyzed by flow cytometry.Levels of IL-5 and IL-13 in the supernatants of lung homogenate and BALF were measured by ELISA.Expression of IL-5, IL-13 and ST2 at mRNA level was detected by real-time PCR.Pathological changes in lung tissues were observed following hematoxylin and eosin (HE) and periodic acid-Schiff (PAS) staining.Results Compared with the PBS control group, no infiltration with inflammatory cells, goblet cell hyperplasia or mucus secretion was observed in the IFN-γ group;the numbers of ILC2s and eosinophils were not affected by IFN-γ;the levels of IL-5 and IL-13 in the supernatants of BALF and lung homogenate, and the expression of IL-5, IL-13 and ST2 at mRNA level in lung tissues were not significantly changed by IFN-γ (P>0.05).Compared with the PBS control group, massive infiltration with inflammatory cells, excessive mucus secretion, increased numbers of ILC2s and eosinophils, up-regulated levels of IL-5 and IL-13 in the supernatants of BALF and lung homogenate, and enhanced expression of IL-5, IL-13 and ST2 at mRNA level in lung tissues were detected in the IL-33 model group (P<0.05).Compared with the IL-33 model group, the combined treatment with IL-33 and IFN-γ significantly alleviated inflammatory cell infiltration, inhibited mucus secretion, reduced the numbers of ILC2s and eosinophils, down-regulated the levels of IL-5 and IL-13 in the supernatants of BALF and lung homogenate, and suppressed the expression of IL-5, IL-13 and ST2 at mRNA in lung tissues (P<0.05).Conclusion IFN-γ can inhibit the proliferation of eosinophils and ILC2s induced by IL-33, and reduce the secretion of IL-5 and IL-13, which indicates that IFN-γ has an inhibitory effect on acute allergic airway inflammation induced by IL-33 in mice.

Objective To investigate the mechanism of small-dose cisplatin in enhancing photodynamic therapy sensitivity and apoptosis in human cervical carcinoma cell lines.Methods The Hela and Siha cells were divided into four groups(blank control group,photodynamic therapy only,cisplatin only,photodynamic therapy and cisplatin).The effects on proliferation of Hela and Siha cells in the four groups were examined by MTT assay.The expression of P185c-erbB-2 in Hela and Siha cells affected was detected by immunocytochemistry.Results The degree of apoptosis caused by the joint application of cisplatin and photodynamic therapy was greater than that caused by cisplatin or photodynamic therapy alone.The expression of P185c-erbB-2 in cells declined correspondingly.However,the order of cisplatin and photodynamic therapy did not cause obvious differences in the effect.Conclusion The in vitro proliferation of Hela and Siha cells is restrained obviously by cisplatin combined with photodynamic therapy;the effect is greater than that of cisplatin or photodynamic therapy only.The mechanism of cispatin's enhancement of photodynamic therapy sensitivity may be related to inhibiting P185c-erbB-2 expression.