Objective: To develop a modified calculation formula for renal tumor volume and tumor contact surface area (CSA) based on the modeling results of 3D Slicer software, and to create a webpage of the calculation formula for use. Methods: The general information and tumor anatomical data of 98 patients who underwent partial nephrectomy during Jan.2021 and Jul.2023 in the Second Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed.The imaging data were input into 3D Slicer software in the form of Dicom files for tumor and ipsilateral kidney modeling to obtain tumor anatomical data.The relationship between tumor anatomical parameters and tumor volume and CSA was analyzed using multifactorial linear regression.The initial modified formulas (V2, C2) and the optimized modified formulas (V3, C3) for tumor volume over CSA were established, respectively, after insignificant variables were eliminated.The mean square error (MSE) and Akaike information criterion (AIC) of the modified and traditional formulas (V1, C1) were compared, and the formula with the smallest MSE and AIC was selected as the optimal tumor volume and CSA calculation formula.The median tumor volume and CSA obtained from 3D modeling were used as the cutoff values.The optimal formula and conventional formula were applied to calculate tumor volume and CSA for all patients, and risk stratification was performed for all patients based on these cutoff values, and the perioperative indicators of patients in the upper and lower groups were compared.Finally, an online calculation tool was developed based on HTML. Results: Based on multifactorial linear regression analysis, we obtained the modified tumor volume calculation formula: V=0.382abc+2.488a+2.372b－4.146c+1.948（V2）, V=0.469abc－4.586c+13.816（V3）; the modified tumor CSA calculation formula CSA=2.469a －2.262L －19.23a+6.206b+1.212c+18.017L+1.616h－3.97h －2.185h/h －0.388（C2）, CSA=2.376a －2.144L －20.157a+5.024b+1.128c+17.578L+2.525h－2.634（C3）.Both of the modified volume formula (MSE=151.298 vs. 127.807 vs. 104.106) and modified CSA formula (MSE=309.878 vs.23.556 vs.30.388) had smaller errors compared to the conventional formula.The modified volume calculation formula showed that bleeding was more and thermal ischemia time was longer in patients with larger tumor volumes than in patients with smaller tumor volumes (P<0.05); and the modified CSA calculation formula showed that bleeding was more, surgery and thermal ischemia time were longer in patients with high CSA than in patients with low CSA (P＜0.05).Finally, V3 and C3 are selected as the best calculation formula, and a web page (https://lizihao-bot.github.io/RCC-Calculate/) was established for easy use. Conclusion: This study combined data from a medical information technology platform with numerical modeling methods to provide a faster and more accurate method to calculate the renal tumor volume and CSA.Meanwhile, a webpage version of the tool was developed to enhance its practicability.

Objective To investigate the probability and dosimetric risk factors of lung injury after sequential immune checkpoint inhibitors (ICIs) and thoracic radiotherapy. Methods A retrospective analysis was conducted on 139 patients who received sequential ICIs and thoracic radiotherapy in Xuzhou Cancer Hospital and Affiliated Hospital of Xuzhou Medical University between February 2020 and February 2024. The relationships of clinical factors and lung and heart volume dose parameters with grade ≥ 2 acute lung injury (ALI) in patients with thoracic tumors were studied using univariable (χ² test, t test, nonparametric test) and multivariable (binary logistic regression analysis) methods. The thresholds of dosimetric risk factors were determined using the receiver operating characteristic curves. Clinical factors included age, gender, smoking history, type of ICIs, cycle of ICI application, and the interval between ICI application and thoracic radiotherapy. Dose parameters included total radiotherapy dose, single dose, planning target volume, maximum dose of planning target volume, average dose of planning target volume, total lung volume, heart volume, and the V₅, V₁₀, V₁₅, V₂₀, V₂₅, V₃₀, V₃₅, and V₄₀ of lung and heart. Results The incidence of grade ≥ 2 ALI in the included cases was 36% (50/139). The χ² test did not find any statistically significant clinical factors. In the univariable and binary Logistic regression analysis, lung V₁₅ and V₂₀, heart V₁₅ and V₂₀, and lung volume were independent risk factors for the occurrence of grade ≥ 2 ALI in sequential ICIs and thoracic radiotherapy. The thresholds were 18.51% for lung V₁₅, 14.43% for lung V₂₀, 32.41% for heart V₁₅, and 17.74% for heart V₂₀. Conclusion For patients who are going to receive thoracic radiotherapy after ICIs, the thresholds of lung V₁₅ and V₂₀ and heart V₁₅ and V₂₀ in the radiotherapy plan are recommended to be less than 18.51%, 14.43%, 32.41%, and 17.74%, respectively, which can effectively reduce the occurrence of grade ≥ 2 ALI.

Objective To compare the effects of CalliSpheres drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)and conventional TACE(c-TACE)on liver fibrosis and liver function in the treatment of primary hepatocellular carcinoma(HCC).Methods A total of 40 patients diagnosed with HCC at Xuzhou Municipal Cancer Hospital of China between October 2020 and October 2022 were enrolled in this study.According to therapeutic scheme,the patients were divided into DEB-TACE group(n=20)and c-TACE group(n=20).The preoperative,and postoperative 5-day and one-month hyaluronidase(HA),type Ⅲ procollagen peptide(P Ⅲ NP),type Ⅳ collagen(CⅣ)and laminin(LN),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),albumin(Alb),and prothrombin time(PT)were compared between the two groups.Results The technical success rate was 100％in both groups,and tumor staining completely disappeared immediately after TACE in all patients.The postoperative 5-day levels of HA,LN,P Ⅲ NP,and CⅣ in both groups were remarkably higher than the preoperative ones(P＜0.05).One month after TACE,HA level in the DEB-TACE group was prominently higher than its preoperative value(P＜0.05);HA and LN levels in the c-TACE group were obviously higher than their preoperative values(P＜0.05);and the HA and LN levels in c-TACE group were significantly higher than those in DEB-TACE group(P＜0.05).Five days after TACE,in the DEB-TACE group the AST and PT levels were higher than their preoperative values while the Alb level was lower than its preoperative value(P＜0.05);in the c-TACE group the ALT,AST,TBiL and PT were higher than their preoperative values while the Alb level was lower than its preoperative value(P＜0.05);the ALT and AST levels in the c-TACE group were strikingly higher than those in the DEB-TACE group while Alb level was strikingly lower than that in the DEB-TACE group(P＜0.05).Conclusion Both CalliSpheres DEB-TACE and c-TACE can aggravate liver fibrosis and cause liver function damage.However,the degree of liver fibrosis and liver function damage caused by CalliSpheres DEB-TACE is less than that caused by c-TACE.(J Intervent Radiol,2024,33:259-263)

OBJECTIVE To screen out the pharmacodynamic substances of Cistanches Herba aqueous extracts, explore the basis of the pharmacodynamic substances and their mechanism of action in the treatment of diabetic nephropathy(DN), based on the spectral relationship between the mass spectral peak areas of different elution sites of Cistanches Herba aqueous extracts and their anti-DN effects. METHODS UPLC-Orbitrap-MS/MS technique was used to characterise the chromatographic peaks; MTT method was used to detect the effects of different elution sites of Cistanches Herba aqueous extract on the proliferation of high glucose and high fat HK-2 cells; grey correlation analysis and partial least squares method were used to analyse the spectral relationship between mass spectrometry peak area and anti-DN activity. MTT method was used to determine the anti-DN activities of the individual components of Cistanches Herba aqueous extract; biochemical kit and ELISA were used to determine the levels of oxidative indicators(SOD, GSH-P) and inflammatory factors(IL-1β, TNF-α, TGF-β); Western blotting was used to detect the expression of apoptosis-related proteins. RESULTS UPLC-Orbitrap-MS/MS technique speculated and identified 72 common compounds; In Cistanches Herba aqueous extracts, water, 20% ethanol, and 40% ethanol-eluted sites differentially increased the proliferation rate of HK-2 cells in a high-sugar, high-fat environment; Partial least squares and grey correlation analyses showed that the constituents of the aqueous extracts of Cistanches Herba with greater anti-DN contributions were 8-epideoxymatricinic acid, geniposidic acid, pinoresinol, betaine and syringin, et al. MTT assay reveals that 8-epi-deoxystrychnic acid and geniposidic acid had significant proliferative effects on HK-2 cells in a high glucose and high fat environment; Biochemical kit and ELISA showed that 8-epideoxystrychnic acid and geniposidic acid were able to up-regulate the activity of SOD and GSH-Px, and at the same time they had an inhibitory effect on the expression of inflammatory factors IL-1β, TNF-α and TGF-β. Western blotting results showed that 8-epideoxystrychnic acid and geniposidic acid were able to down-regulate and up-regulate the markers of dermal mesenchymal transition: α-SMA, Collagen Ⅰ and E-cadherin, and they could exert anti-DN effects by inhibiting the PI3K-Akt pathway. CONCLUSION The two compounds, 8-epideoxystrychnic acid and geniposidic acid, which are screened by the spectroeffective relationship of anti-DN among the many chemical constituents contained in Cistanches Herba, can affect oxidative stress, inflammation and epithelial-mesenchymal transformation of renal tubular cells by inhibiting the PI3K-Akt signalling pathway, and improve renal pathology, degree of fibrosis and renal function, which will be useful for the in-depth study of aqueous extracts of Cistanches Herba in the treatment of DN.

Radical prostatectomy (RP) is the standard treatment for patients with early-stage of prostate cancer,but often causes urinary incontinence and other complications, which harm patients’ quality of life. The protection and reconstruction of urinary continence-related structures during the operation are significant approaches to reduce the incidence of urinary incontinence and restore urinary continence. This article reviewed the surgical approaches of radical prostatectomy, anatomy of urinary continence-related structures (bladder neck, functional urethra, supporting structures, nerves and vessels) and the protective skills,hoping to provide reference for the treatment of early-stage prostate cancer.

ObjectiveThis article aims to investigate the clinical features of portal biliopathy （PB） patients， in order to improve the understanding of PB. MethodsClinical data were collected from 22 patients who were diagnosed with PB in recent years in The First Hospital of Jilin University， and an analysis was performed for their clinical manifestations， liver function， abdominal color Doppler ultrasound， abdominal CT， and hepatobiliary magnetic resonance imaging. The imaging manifestations of biliary tract abnormalities were described， as well as the type of collateral circulation and the location of thrombosis. ResultsAs for the initial symptom in these 22 patients， three were 11 patients with gastrointestinal bleeding， 5 with abdominal distension， 3 with abdominal pain， 1 with fever， 1 with abdominal discomfort， and 1 with gingival bleeding. There were 3 patients with an increase in aspartate aminotransferase， 4 with an increase in alanine aminotransferase， 4 with an increase in gamma-glutamyl transpeptidase， 7 with an increase in alkaline phosphatase， 8 with a reduction in cholinesterase， 9 with a reduction in albumin， 2 with an increase in globulin， and 5 with an increase in total bilirubin. Among the 22 patients， 20 had cavernous transformation of the portal vein， and 2 had portal vein thrombosis without cavernous transformation. All 22 patients had bile duct abnormalities， among whom 2 had extrahepatic bile duct abnormalities alone， 12 had intrahepatic bile duct dilatation alone， and 8 had dilatation of both intrahepatic and extrahepatic bile ducts. Varices at different sites were observed in 20 patients， among whom 19 had esophageal and gastric varices and 1 had peri-gallbladder varices， and no varices was observed in the superior mesenteric vein or the splenic vein. ConclusionThere are no typical clinical symptoms and changes in liver function parameters in patients with PB， but radiological examination may show dilatation， stenosis， or malformation of the bile ducts at different parts. Therefore， it is necessary to expand the sample size to further explore the diagnosis and treatment of PB.

Objective To investigate the effects of multimedia information technologies on precision radiotherapy of head and neck malignant tumors (HNT). Methods A total of 96 patients with HNT recruited from 2016 to 2019 were randomly assignedto group A and group B with the same planning methodand therapists/technicians. Conventional and multimedia information technologies were respectively used in group A and group B for medical science popularization, individualized education, and doctor-patient communication before radiotherapy planning and positioning. Medical compliance, radiotherapy responses, setup errors, and machine occupancy time were investigated. Results Medical compliance was significantly higher (P < 0.05) in group A (96.5%) than in group B (73.8%). Skin acute radiation reaction was significantly lower (P < 0.05) in group A than in group B. Three-dimensional absolute setup errors were 0.69 ± 0.29 mm, 0.97 ± 0.69 mm, and 0.79 ± 0.47 mm in group A, which were significantly lower than 1.39 ± 0.81 mm, 1.87 ± 1.19 mm, and 2.50 ± 0.99 mm in group B(P < 0.05). Traditional three-dimensional setup errors were 0.73 ± 0.39 mm, 0.51 ± 0.69 mm, and 0.74 ± 0.17 mm in group A, which were significantly lower than 1.32 ± 0.76 mm, 1.89 ± 1.21 mm, and 1.37 ± 0.57 mm in group B (P < 0.05). Planning time was 145.15 ± 28.45 sin group A, which was significantly lower than 240.38 ± 50.45 sin group B (P < 0.05). Positioning time was 115.15 ± 18.45 s in group A, which was significantly lower than 173.38 ± 24.45 sin group B (P < 0.05). Conclusion The application of multimedia information technologies inmedical science popularization, individualized education, and doctor-patient communication forpatients who received precision radiotherapy for HNT can significantly increase patient compliance, alleviate acute radiation reactions, reduce setup errors, and shorten the machine occupancy time of planning and positioning.

Objective:To study the effect of radiotherapy on the quality of life (QOL) of patients with bone metastasis of hepatocellular carcinoma by analyzing the Function Assessment of Cancer Treatment(FACT), and to analyze the influence of clinical factors on the improvement of the QOL after radiotherapy.Methods:The FACT bone pain scale in 43 patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy was retrospectively analyzed. The changes in QOL score before and after radiotherapy were analyzed by T test from five aspects: overall QOL score, general functional status, pain degree, physical function and social psychology. Further analysis was made on the scores of patients whose QOL had not been improved. Chi-square test was used to analyze the correlation between clinical factors and QOL improvement after radiotherapy. Results:After radiotherapy, the QOL of patients were improved in all aspects compared with those before radiotherapy, and there were statistical differences ( t=7.621, 5.887, 9.407, 7.785, 4.487, P<0.05). In patients whose QOL did not improve after radiotherapy, the scores of overall QOL and psychosocial assessment decreased significantly, and there were significant differences ( t=3.381, 4.982, P<0.05). Among the clinical factors, soft tissue mass at bone metastasis site and radiotherapy prescription dose had significant effects on the improvement of patients′ life after radiotherapy (χ 2=5.180, 7.457, P<0.05). Whether there were soft tissue masses in bone metastases before radiotherapy, the improvement rates of QOL after radiotherapy were 50.00% and 85% respectively. The improvement rates of QOL after radiotherapy were 44.44% and 84% in patients with prescription dose of <40 Gy and≥40 Gy respectively. Multivariate analysis showed that soft tissue mass at bone metastasis site, the dose of radiotherapy prescription and numeric rating scale (NRS) of pain had more significant effects on QOL ( OR=0.296, 0.020, 1.592, P<0.05). Conclusions:Radiotherapy at bone metastasis sites can significantly improve the QOL of liver cancer patients with bone metastasis. Psychosocial status can affect the QOL of patients. In the case of soft tissue mass in bone metastasis site, the prescription dose of radiotherapy (≥40 Gy) can better improve the QOL.

Objective:To explore the effect of closed skills physical activity with additional dynamic visual task on dynamic visual acuity and static visual acuity for pupils with myopia at grade four at primary school. Methods:In September, 2019, 37 pupils with myopia at grade four in Daicheng Experimental Primary School, Suzhou City were selected. In light of mechanism of refractive system, the intervention of closed-skilled physical activity with dynamic visual task was developed. They were intervened for 16 weeks. The dynamic visual acuity and static visual acuity were measured before intervention, and eight and 16 weeks after intervention. Results:Both dynamic visual acuity and static visual acuity improved significantly in all the pupils with myopia after 16 weeks of intervention (F > 15.933, P < 0.001), both pupils with mild and moderate myopia (|t| > 3.353, P < 0.05). The static visual acuity was better in pupils with moderate myopic than with mild myopia (t = -2.830, P < 0.01). Conclusion:Closed skills physical activity with dynamic visual task could improve the visual acuity of puplis with myopia at grade four at primary school.

Objective To discuss the application of 3D laser scanner and computer technology in restoration of the accident scene and reconstruction of the accident process, as well as identification of the driver-passenger relationship. Methods The scene of a traffic accident, the accident vehicle and the vehicle of the same type as accident vehicle were scanned using 3D laser scanner. The accident scene, traces and accident vehicle were integrated using computer technology to restore the accident scene, and the accident process was reconstructed and analyzed by combining the characteristics of the body injuries. Results By restoring the accident scene and reconstructing the accident process with 3D laser scanner, it was determined that Wu was in the driving seat at the time of the accident. Conclusion It is more objective and scientific to use 3D laser scanning technology to restore the accident scene, reconstruct the accident process and analyze the moving track of the driver and passengers in the vehicle. It will help to improve the accuracy of forensic identification of road traffic accidents.
Accidents, Traffic ; Computer Simulation