Background and purpose:In recent years,deep inspiration breath hold(DIBH)based on surface-guided radiation therapy(SGRT)has emerged as one of the most promising techniques in breast cancer radiotherapy.Conventionally,cone-beam CT(CBCT)is used before treatment to verify and correct patient positioning deviations.However,patient position may change during treatment,and pre-fraction CBCT cannot fully reflect real-time positional deviations.Therefore,this study aimed to introduce intra-fraction CBCT into left-sided breast DIBH radiotherapy to monitor and correct real-time deviations,verify whether patients achieve the desired position during treatment,and evaluate the clinical value of intra-fraction CBCT in left-breast radiotherapy.Methods:Clinical data from postoperative left-sided breast cancer patients treated at Fudan University Shanghai Cancer Center between June 2023 and January 2024 were collected.Patients with satisfactory cardiopulmonary function and stable DIBH compliance were included.Pre-fraction CBCT scans were performed before treatment,and data were recorded.During treatment,the gantry was rotated to-180° to trigger kV-level intra-fraction CBCT scanning.After gantry repositioning to the starting angle of the tangential field,MV beam delivery commenced.Intra-fraction CBCT scans were acquired for positional registration,and deviations were compared with pre-fraction CBCT results.Results:A total of 30 eligible patients were included,with 150 pairs of pre-fraction and intra-fraction CBCT images analyzed per patient.The mean registration deviations for intra-fraction CBCT were 26%,52%,and 51%lower than pre-fraction CBCT in the X,Y,and Z axes,respectively(P＜0.05),demonstrating significantly reduced real-time deviations.The probability of intra-fraction deviations being＜6 mm was 100.0%,100.0%,and 99.3%for the X,Y,and Z axes,respectively.Correlation analysis revealed a weak correlation between intra-fraction and pre-fraction deviations in the X-axis(P＜0.05),while no significant correlation was observed for the Y and Z axes(P＞0.05).Conclusion:Intra-fraction CBCT effectively monitors and corrects real-time positional deviations in left-sided breast DIBH radiotherapy,serving as a valuable supplement to conventional pre-fraction CBCT.It minimally impacts treatment efficiency while significantly improving positional accuracy,offering clinical and practical benefits for left-breast cancer radiotherapy.

Background and purpose:In recent years,deep inspiration breath hold(DIBH)based on surface-guided radiation therapy(SGRT)has emerged as one of the most promising techniques in breast cancer radiotherapy.Conventionally,cone-beam CT(CBCT)is used before treatment to verify and correct patient positioning deviations.However,patient position may change during treatment,and pre-fraction CBCT cannot fully reflect real-time positional deviations.Therefore,this study aimed to introduce intra-fraction CBCT into left-sided breast DIBH radiotherapy to monitor and correct real-time deviations,verify whether patients achieve the desired position during treatment,and evaluate the clinical value of intra-fraction CBCT in left-breast radiotherapy.Methods:Clinical data from postoperative left-sided breast cancer patients treated at Fudan University Shanghai Cancer Center between June 2023 and January 2024 were collected.Patients with satisfactory cardiopulmonary function and stable DIBH compliance were included.Pre-fraction CBCT scans were performed before treatment,and data were recorded.During treatment,the gantry was rotated to-180° to trigger kV-level intra-fraction CBCT scanning.After gantry repositioning to the starting angle of the tangential field,MV beam delivery commenced.Intra-fraction CBCT scans were acquired for positional registration,and deviations were compared with pre-fraction CBCT results.Results:A total of 30 eligible patients were included,with 150 pairs of pre-fraction and intra-fraction CBCT images analyzed per patient.The mean registration deviations for intra-fraction CBCT were 26%,52%,and 51%lower than pre-fraction CBCT in the X,Y,and Z axes,respectively(P＜0.05),demonstrating significantly reduced real-time deviations.The probability of intra-fraction deviations being＜6 mm was 100.0%,100.0%,and 99.3%for the X,Y,and Z axes,respectively.Correlation analysis revealed a weak correlation between intra-fraction and pre-fraction deviations in the X-axis(P＜0.05),while no significant correlation was observed for the Y and Z axes(P＞0.05).Conclusion:Intra-fraction CBCT effectively monitors and corrects real-time positional deviations in left-sided breast DIBH radiotherapy,serving as a valuable supplement to conventional pre-fraction CBCT.It minimally impacts treatment efficiency while significantly improving positional accuracy,offering clinical and practical benefits for left-breast cancer radiotherapy.

Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

Objective To study the clinical value of air-and hone-conduction auditory brainstem responses(ABRs) in children with congenital aural atresia.Methods Air-and bone-conduction clickevoked ABRs in 38 children with congenital external auditory canal atresia were compared to those in 34 normal-hearing children.Results ABR threshold were (65.0 ± 8.7) dBnHL for air conduction and (10.6 ±7.0) dBnHL for bone conduction in children with congenital external auditory canal atresia;and (25.6 ± 1.7) dBnHL and (9.7 ± 6.7) dBnHL respectively in normal hearing children.There was statistically difference between the two groups in air-conduction ABR threshold(t' =21.59,P ＜ 0.01).There was no significance between the two groups in bone-conduction ABR (P ＞ 0.05).While the air-bone ABR threshold gap was greater in children with external auditory canal atresia than in normal hearing children (t' =13.78,P ＜ 0.01),bone-conduction ABR wave latencies were not statistically different between the two groups(all P ＞ 0.05).Conclusion Bone conduction ABR is valuable in assessing fuuction of cochlea,auditory nerve and brainstem in individuals with congenital external auditory canal atresia.It has important clinical value in objective differential diagnosis of conductive deafness with combined application of air-and bone-conduction ABRs.

OBJECTIVETo investigate the appearance and moisture, ash content, extract, volatile oil of Panax ginseng and its processed products from different producing areas of northeast China, and thus provide the useful reference data for its quality standard establishment and standardized cultivation.

METHODBase on the Chinese Pharmacopoeia and literatures relating to P. ginseng, the content of moisture, ash, extract, volatile oil in P. ginseng and its processed products from northeast 10 different producing areas were measured, and data analysis of these various indicators was carried out by DTOPSIS.

RESULTThe samples from Changbai, Jian Kangmei and Fusong reached the standard of Chinese pharmacopoeia and national standard, and in addition comprehensive evaluation indicators of them were higher than others samples.

CONCLUSIONThe quality of ginseng from different producing areas appears very different. Some samples failed to reach the standard of Chinese pharmacopoeia and national standard. Ginseng samples from those 3 producing areas of GAP planting bases showed good quality, which reflects the importance of GAP for ginseng cultivation.

China ; Drugs, Chinese Herbal ; chemistry ; Oils, Volatile ; chemistry ; Panax ; chemistry ; growth & development ; Plant Roots ; chemistry ; growth & development