Objective To observe the daily bladder and bowel preparation of patients with prostate cancer by cone-beam computed tomography (CBCT), and analyze its impact on the precise implementation of radiotherapy for prostate cancer and side effects. Methods We retrospectively analyzed 38 patients with prostate cancer who underwent volumetric modulated arc therapy. The number of radiation fractions for each patient ranged from 25 to 35. A CBCT scan was performed before each daily radiation therapy, and the number of scans for each patient ranged from 25 to 40. Setup errors were adjusted to ensure that the tumor was targeted and the rectum wall was not in the high-dose target area of the prostate. There were 93 instances where treatment could not be successfully implemented and re-preparation and re-scanning were required. We calculated the success rate of treatment and setup errors, compared radiotherapist-adjusted error values under different bladder and bowel preparation conditions, and recorded radiotherapy-related side effects. Results The success rate of treatment in the 38 patients was (92.14 ± 5.25)%. Among the 93 instances of seriously inadequate preparation, 48.4% were due to insufficient bladder filling, and 30.1% were due to intestinal bloating. Radiotherapy side effects were negatively correlated with the success rate of treatment (r = −0.393, P = 0.015). When bladder filling was sufficient, there were no significant differences in radiotherapist-adjusted error values in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions between adequate and inadequate bowel preparation (P > 0.05). When the bladder was moderately or insufficiently filled, there were significant differences in radiotherapist-adjusted error values in the LR, SI, and AP directions between adequate and inadequate bowel preparation (P < 0.05). Conclusion Insufficient bladder filling and intestinal bloating are the main factors influencing the successful implementation of radiotherapy for prostate cancer. When the bladder is sufficiently filled, bowel preparation does not affect prostate position change.

Critical care medicine-related treatment is an interdisciplinary and multi-professional process,often leading to secondary or concomitant mental disorders in clinical practice.Currently,there is no consensus on the pharmacological treatment of related mental illnesses in China.The Chinese Society of Psychosomatic Medicine collaborated with the Critical Care Medicine expert group to form a consensus writing expert group.After a systematic review of relevant literature,summarizing published domestic and foreign literature,and extensive discussions,the consensus was developed.The consensus elaborates on the principles and processes of the standardized use of psychotropic drugs in critical care medicine,as well as the clinical indications,precautions,and specific drug selection of various psychiatric medications,providing feasible suggestions and guidance for the clinical application of psychiatric medications in the intensive care unit.

Substantial progress in the use of chemo-photodynamic nano-drug delivery systems (nano-DDS) for the treatment of the malignant breast cancer has been achieved. The inability to customize precise nanostructures, however, has limited the therapeutic efficacy of the prepared nano-DDS to date. Here, we report a structurally defined tandem-responsive chemo-photosensitive co-nanoassembly to eliminate primary breast tumor and prevent lung metastasis. This both-in-one co-nanoassembly is prepared by assembling a biocompatible photosensitive derivative (pheophorbide-diphenylalanine peptide, PPA-DA) with a hypoxia-activated camptothecin (CPT) prodrug [(4-nitrophenyl) formate camptothecin, N-CPT]. According to computational simulations, the co-assembly nanostructure is not the classical core-shell type, but consists of many small microphase regions. Upon exposure to a 660 nm laser, PPA-DA induce high levels of ROS production to effectively achieve the apoptosis of normoxic cancer cells. Subsequently, the hypoxia-activated N-CPT and CPT spatially penetrate deep into the hypoxic region of the tumor and suppress hypoxia-induced tumor metastasis. Benefiting from the rational design of the chemo-photodynamic both-in-one nano-DDS, these nanomedicines exhibit a promising potential in the inhibition of difficult-to-treat breast tumor metastasis in patients with breast cancer.

Methyltransferase like 13 (METTL13), a kind of methyltransferase, is implicated in protein binding and synthesis. The upregulation of METTL13 has been reported in a variety of tumors. However, little was known about its potential function in head and neck squamous cell carcinoma (HNSCC) so far. In this study, we found that METTL13 was significantly upregulated in HNSCC at both mRNA and protein level. Increased METTL13 was negatively associated with clinical prognosis. And METTL13 markedly affected HNSCC cellular phenotypes in vivo and vitro. Further mechanism study revealed that METTL13 could regulate EMT signaling pathway by mediating enhancing translation efficiency of Snail, the key transcription factor in EMT, hence regulating the progression of EMT. Furthermore, Snail was verified to mediate METTL13-induced HNSCC cell malignant phenotypes. Altogether, our study had revealed the oncogenic role of METTL13 in HNSCC, and provided a potential therapeutic strategy.
Head and Neck Neoplasms ; Humans ; Squamous Cell Carcinoma of Head and Neck/genetics*

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

Objective:To analyze the value of shear wave velocity (SWV) combined with thyroid stimulating hormone (TSH) in the diagnosis of hyperthyroidism.Methods:Thirty-five patients with hyperthyroidism who were treated and confirmed in the Fuyang Affiliated Hospital of Anhui Medical University from December 2017 to September 2019 were selected as hyperthyroidism group, and 30 cases of normal health check-up patients in the outpatient department were selected as control group. All of the patients and medical persons were checked by conventional two-dimensional ultrasound and SWV, and the SWV and serum TSH, thyrotrophin receptor antibody(TRAb), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) expression levels of two groups were tested and compared. The correlation relationship in SWV value and serum TSH, TRAb, TGAb, TPOAb levels of hyperthyroidism patients was analyzed by Pearson methods. The receiver operating characteristic curve (ROC curve) method was used to analyze the value of SWV, serum TSH and SWV combined with serum in diagnosis of hyperthyroidism.Results:The SWV values of upper pole, middle pole and lower pole in the hyperthyroidism group had no significant differences ( P>0.05). The SWV values of upper hole, middle pole and lower pole of the left and right lobe of thyroid in the hyperthyroidism group were significantly higher than those in the control group [left lobe: (2.41 ± 0.34) m/s vs. (2.07 ± 0.28) m/s, (2.44 ± 0.39) m/s vs. (2.08 ± 0.25) m/s, (2.46 ± 0.43) m/s vs. (2.04 ± 0.30) m/s; right lobe: (2.47 ± 0.42) m/s vs.(2.01 ± 0.25) m/s, (2.41 ± 0.40) m/s vs. (1.95 ± 0.23) m/s, (2.43 ± 0.35) m/s vs. (2.06 ± 0.24) m/s] ( P<0.01). The serum TSH level in the hyperthyroidism group were significantly lower than that in the control group [(0.05 ± 0.03) kU/L vs. (2.74 ± 1.17) kU/L], while serum TRAb, TGAb and TPOAb levels were significantly higher than those in the control group [(15.82 ± 5.54) U/L vs. (0.55 ± 0.13) U/L, (290.63 ± 145.03) kU/L vs. (25.63 ± 7.12) kU/L, (627.17 ± 250.33) kU/L vs. (34.32 ± 5.95) kU/L], and the differences were statistically significant ( P<0.01). In the hyperthyroidism group, the SWV was negatively correlated with serum TSH ( r=- 0.862, P<0.05), but positively correlated with serum TRAb, TGAb and TPOAb ( r=0.763, 0.837, 0.804, P<0.05). The area under curve(AUC), sensitivity and specificity of combined diagnosis of hyperthyroidism with SWV value and serum TSH were 0.936, 94.29% and 91.43%, which was better than that of SWV (0.803, 80.00%, 74.29%) and serum TSH (0.842, 82.86%, 77.14%). Conclusions:SWV combined with TSH has a high clinical value in the diagnosis of hyperthyroidism.

OBJECTIVE: To examine the level of occupational exposure to whole body vibration( WBV) in a hydroelectric power station,and evaluate its effects on workers' health. METHODS: A hydroelectric power station in Hangzhou City was chosen as study subject by using judgment sampling method. The level of WBV exposure to workers and high vibration level areas were measured,and the vibration frequency was analyzed. The comfort and allowing duration of occupational exposure in WBV exposed workers was evaluated. RESULTS: The median root-mean-square of accelerometer acceleration of WBV exposure in generator floor,turbines-floor,middle-floor,hydraulic floor of the hydroelectric power station were 0. 894,0. 995,1. 095 and 0. 904 m/s~2,respectively. The central frequency of WBV in this station was 1. 25 Hz. Among the 105 monitoring spots,8. 6% of WBV exposed workers of the spots did not perceive or feel uncomfortable,but 91. 4%of them felt uncomfortable or very uncomfortable. Only 12. 4% of the WBV exposed workers tolerated more than 8 hours of WBV occupational exposure. CONCLUSION: There is an occupational hazard of WBV in this hydroelectric power station.The low frequency vibration with central frequency below 1. 25 Hz is the key control point of the WBV of this hydroelectric power station.

Objective To study the dosimetric characteristics of flattened and flattening filter free (FFF) beams with 6 MV and 10 MV photon energy using a novel dual-energy medical linear accelerator (Elekta Versa HDTM),to identify the dosimetric characteristics and advantages of FFF beams,and to provide a basis for their clinical application.Methods The percentage depth dose (PDD),profiles/dose rate of off-axis ratio (OAR),field size,penumbral width,dose out of the fields,collimator scatter factor (Sc),and total scatter factor (Sc,p) were compared between flattened and FFF beams.Results (1) After beam energy matching,the FFF beams had the same beam energy with the flattened beams.The matching error of PDD at a depth of 10 cm was less than 1％ between fields.(2) The FFF beams had a smaller variation in dose rate of OAR with the depth than the flattened beams.(3) The FFF beams had smaller variations in field size and penumbral width than the flattened beams.Moreover,the penumbral width of the FFF beams increased with the increasing field size or depth.The FFF beams had a lower dose out of the fields than the flattened beams.(4) The FFF beams had smaller variations in Sc and Sc,p with the field size and depth than the flattened beams.Conclusions Removal of the flattening filter can substantially improve the dose rate,shorten radiotherapy time,and reduce leakage and scattering of the head.The dosimetric advantages make the FFF beams appropriate for clinical treatment.

Objective To study the effects of fat grafting on partial jaw deformity.Methods A total of 19 cases of partial jaw deformity.were used fat grafting in past 2.5 years,from January 2012 to June 2015.All analyses were to find suitable fat grafting method for partial jaw deformiw.Fat graft was obtained by low pressure suction and low speed centrifugation.Results A lot of 15 patients in this group had been followed up for 6 months to 2 years.9 patients was satisfied with once fat grafting and 6 with twice.Conclusions Fat grafting provides a useful alternative to partial jaw deformity with normal occlusion.But it also remains to be seen what the forward effects of fat grafting on partial jaw deformity are.

Objective To develop a MOSAIQ Integration PlatformCHN (MIP) based on the workflow of radiotherapy (RT) and to meet the actual requirements in China and the special needs for the radiotherapy department.Methods MIP used C/S (client-server) structure mode running on the local network in the hospital and its database was based on the Treatment Planning System (TPS) and MOSAIQ database.Five network servers,as the core hardware,supplied data storage and network service based on cloud services.The core software was developed based on Microsoft Visual Studio Platform using C# network programming language.The MIP server could simultaneously offer network service for about 200 workstations,including entry,query,statistics,and print of data.Results MIP had 15 core function modules,such as Notice,Appointment,Billing,Document Management (application/execution),and System Management,which almost covered the whole workflow of radiotherapy.Up to June 2016,the recorded data in the MIP were as follows:13546 patients,13533 plan application forms,15475 RT records,14656 RT summaries,567048 billing records,and 506612 workload records.Conclusions The MIP based on the RT workflow has been successfully developed and used in clinical practice.It is an important part of radiotherapy information system construction with the advantages of intuitive operation,real-time performance,data security,and stable operation.It is digital,paperless,user-friendly,and convenient for the retrieval and statistics of data as well as information sharing and department management,and can significantly improve the efficiency of the department.More functions can be added or modified to enhance its potentials in research and clinical practice.