Objective:To explore the method of developing a canal-shaped implant template using a combined automatic pre-planning and 3D printing technology, and assess its impact on dose and efficacy improvement.Methods:Retrospective analysis of 15 patients with advanced cervical cancer admitted to the Affiliated Cancer Hospital of Guangxi Medical University from September 2020 to September 2022 was performed. Patients had characteristics such as vaginal stump recurrence, tumor eccentric growth, and previous hysterotomy, etc. Three-dimensional images were obtained by CT scan after automatic pre-planning. The PMT 3D software was used to analyze digital imaging and communications in medicine (DICOM) radiotherapy data, capture the coordinates of the pre-planned stay points to establish the implant channel, and generate the size and shape of the canal-shaped implant template based on patients' physiological structure. Dosimetric parameters, such as conformity index (CI), were evaluated. The changes of tumor size before and after treatment were analyzed by paired t-test. Results:Fifteen patients were treated with the canal-shaped implant template. The CI was 0.74±0.26, the total radiation dose (HR-CTV) D 90% (EQD 2, α/β=10) was (85.5±6.8) Gy, and the D 2 cm3 (EQD 2, α/β=3)for bladder, rectum, small intestine, and colon were (72.2±4.2), (65.8±6.1), (65.2±4.4), and (69.8±3.7) Gy, respectively, meeting clinical needs. After the treatment, the tumor volume was significantly decreased. The template had a good fit with the vaginal cavity, and a small amount of air gap on the sidewall did not affect the dose. Non-parallel needle insertion increased the utilization of the cavity space and implant needles. Conclusion:The method of developing the canal-shaped implant template using automatic pre-planning and 3D printing technology is efficient and effective, meets the requirements of modern precise radiotherapy, and has practical clinical value.

Objective:To explore the characteristics of the changes in risk score for intensive care unit (ICU) patients during hospitalization by the intelligent calculation method, and to provide evidence for the risk prevention.Methods:In this retrospective study, ICU patients of the Fifth Central Hospital in Tianjin from November 3, 2021 to March 28, 2022 were enrolled and divided into ≥ 14 days group, 10-13 days group, 7-9 days group, and 3-6 days group according to the ICU length of stay. Risk scores assessed by the intelligent calculation method of the ICU patients were collected, including nutritional risk screening 2002 (NRS 2002), Caprini score and Padua score. NRS 2002 score for all patients, Caprini score for surgical patients and Padua score for internal medicine patients were selected. Trends in change of each score were compared between patients admitted to ICU 1, 3, 7 (if necessary), 10 (if necessary), and 14 days (if necessary).Results:A total of 138 patients were involved, including 79 males and 59 females, with an average age of (61.71±18.86) years and an average hospital stay of [6.00 (4.00, 9.25)] days. ① in the group with ICU length of stay ≥ 14 days (21 cases): there was no significant change in the NRS 2002 scores of the patients within 10 days, but the NRS 2002 score was significantly decreased in 14 days as compared with 1 day [3.00 (2.50, 3.50) vs. 4.00 (3.00, 5.00), P < 0.05]; both Caprini and Padua score were increased with prolonged hospital stay and compared with 1 day, the scores at the other time points were significantly increased, especially at 14 days [Caprini score: 5.00 (3.25, 7.00) vs. 2.50 (1.25, 5.50), Padua score: 6.00 (6.00, 7.00) vs. 3.00 (1.00, 3.00), both P < 0.05].② in the group with ICU length of stay from 10-13 days (15 cases): with the prolonged hospital stay, there was no significant change in NRS 2002 score, but both Caprini and Padua score were increased at 3, 7, 10 days, especially at 10 days [Caprini score: 3.00 (2.00, 4.75) vs. 2.00 (0.25, 2.75), Padua score: 5.00 (3.50, 6.00) vs. 2.00 (0.50, 4.00), both P < 0.05].③ in the group with ICU length of stay from 7-9 days (23 cases): compared with 1 day, the NRS 2002 score at 3 days and7 days were decreased, but the Caprini and Padua score were increased, especially at 7 days [NRS 2002 score: 2.00 (1.00, 4.00) vs. 2.00 (2.00, 4.00), Caprini score: 3.00 (2.00, 5.50) vs. 2.00 (0.25, 3.00), Padua score: 5.00 (4.00, 6.00) vs. 2.00 (0, 2.00), all P < 0.05]. ④ in the group with ICU length of stay from 3-6 days (79 cases): compared with 1 day, the NRS 2002 score at 3 days was decreased [NRS 2002 score: 2.00 (1.00, 3.00) vs. 2.00 (1.00, 3.00), P < 0.05], Caprini and Padua score were significantly increased [Caprini score: 3.00 (2.00, 4.00) vs. 2.00 (1.00, 3.00), Padua score: 5.00 (4.00, 5.00) vs. 2.00 (1.00, 3.00), both P < 0.05]. Conclusion:Based on dynamic assessment of intelligent calculation methods, the risk of thrombosis in ICU patients increased with hospital length of stay, and the nutritional risk was generally flat or reducing in different hospitalization periods.

Objective To investigate the application of radiological diagnosis and treatment equipment and distribution of medical radiation levels in medical institutions at various levels in Shijiazhuang, China in 2019, and to lay a sound foundation for further radiation protection and management. Methods A universally designed questionnaire was used to investigate and compile data on the level of the sampled hospitals, the number of radiation workers, equipment information, the number of outpatients and emergency patients, the number of inpatients, and the frequency of radiological diagnosis and treatment; the application frequency of each radiological diagnosis and treatment item was calculated based on the demographic data of Shijiazhuang. Results In Shijiazhuang, there were 390 medical institutions (excluding dental clinics) certified for radiological diagnosis and treatment, with a total of 4262 radiation workers and 1215 radiological diagnosis and treatment devices; 1.11 radiological diagnosis and treatment devices were available per 10 000 people, and 3.89 radiation workers were available per 10 000 people. The number of annual outpatients and emergency patients was 30 208 471, the number of inpatients was 1 981 295, and the total number of people or times receiving radiological diagnosis and treatment was 5 987 230. The application frequency of medical radiation was 546.70 persons/times per 1000 people, with the highest frequency for X-ray diagnosis (534.63 persons/times per 1000 people), followed by diagnosis and treatment with nuclear medicine (6.16 persons/times per 1000 people), and the lowest frequency for radiotherapy (1.17 persons/times per 1000 people). In terms of regional distribution, the highest frequency of medical radiation fell in Yuhua District (1602.97 persons/times per 1000 people), and the lowest frequency fell in Shenze County (203.21 persons/times per 1000 people). Conclusion The development of medical radiation is imbalanced in Shijiazhuang, with high-quality medical resources concentrated mainly in the main urban area, thus resulting in long-term overworking of hospital staff and equipment in some areas. The government and health administration departments should strengthen macro-control and the rational allocation of medical resources; medical institutions at various levels should rationally use radiological diagnosis and treatment equipment, strengthen judgments on the justness of radiation, and strengthen the training of radiation workers on protection knowledge and radiation protection optimization.

This paper introduces the application for National Natural Science Foundation of China (NSFC) projects on mechanical sciences in the year 2021, analyses the characteristics of fund application in all branches of mechanics, especially biomechanics, points out some problems existing in fund application, and proposes several suggestions about the interdisciplinary research and development on biomechanics.

Objective To analyze the clinical,radiological features and risk factors of diplopia in patients with acute lacunar infarction (ALI).Methods Retrospectively retrieved patients of ALI (lesion diameter was less than 1.5 cm in DWI sequence)diagnosed by MR and clinical.We further summarized 13 ALI patients with diplopia and randomly selected 13 ALI patients without diplopia as the control group. SPSS22.0 statistical software was used for statistical analysis.The general clinical data such as sex and age was compared by Ch-i square test and t-test.The risk factors were primarily analyzed by one-way ANOVA and then the risk factors with statistical significance were brought into the logistic regression model for multivariate analysis.Results The incidence of diplopia in ALI patients was about 2.7%(13/489). The infarct sites were all located in the brain stem of the oculomotor-related brain nucleus and the dorsolateral medulla oblongata.Hypertension and hematocrit were negatively correlated with diplopia after infarction (P＜0.05 ).Conclusion The incidence of diplopia is low in ALI patients.The medial longitudinal tract of the dorsolateral medulla is an important area causing diplopia.Hypertension and hematocrit are non-risk factors for diplopia after ALI.

Objective: To study the different ischemic characteristics of cerebral gray matter and deep white matter in patients with chronic cerebral artery severe stenosis or occlusion. Methods: A retrospective study was conducted on 30 patients with chronic unilateral cerebral artery severe stenosis or occlusion from April 2014 to April 2018 in our hospital. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time of peak time (TTP) and time to delay(TTD) of cerebral cortex gray matter and deep white matter in the blood supply area of the responsible artery (the affected side) and the contralateral hemisphere (the healthy side) were measured. Statistical analysis of the perfusion parameters of cerebral cortex gray matter and deep white matter in the affected side and contralateral side were performed using SPSS13.0 software package. T test was used for variance homogeneity, and t′ test was used for variance discrepancy, and P<0.05 was statistically significant. Results: The average values of CBF and CBV of the ipsilateral and contralateral cerebral cortex were increased than those of ipsilateral and contralateral cerebral deep white matter respectively(P<0.01). MTT, TTP and TTD of the ipsilateral and contralateral cerebral cortex were decreased than that of ipsilateral and contralateral cerebral deep white matter (P<0.01); CBF of ipsilateral cerebral cortex and CBV of ipsilateral cerebral deep white matter were not different from those of the contralateral cerebral cortex and deep white matter respectively, but CBF of ipsilateral cerebral deep white matter is decreased than that of the contralateral deep white matter (P<0.01). CBV of ipsilateral cerebral cortex is increased than that of the contralateral cerebral cortex (P<0.01). MTT, TTP and TTD of ipsilateral cerebral cortex and deep white matter were increased than those of contralateral cerebral cortex and deep white matter respectively(P<0.01). Conclusion Deep cerebral white matter perfusion decreased more significantly than cortical gray matter in the supply region of chronic cerebral artery severe stenosis or occlusion. CT perfusion imaging can quantify the degree of chronic cerebral ischemia and can provide quantitative diagnostic information for clinical treatment and efficacy evaluation.

Objective To investigate the imaging features of the cerebral complications of infective endocarditis (IE)and the evolution process of infective cerebral infarction.Methods The clinical and imaging data from 5 patients diagnosed as IE with neurological complications were retrospectively and comprehensively reviewed,so that the imaging features of cerebral complications and infective cerebral infarctions were summarized.Results Among the 5 cases,3 showed multiple acute infarctions,including 2 massive ones.All the 5 cases showed multiple hemorrhagic lesions at different stages.The infarction and hemorrhage were mostly located at the corticalGmedullary junction.1 case of subarachnoid hemorrhage and 1 case of meningitis were also observed.Two massive infarctions mentioned above showed irregular patchy shape,which evolved into cerebral abscesses after 1 2 and 1 5 days of neurological symptoms showing up,then abscesses started shrinking after 33 and 3 1 days,respectively.Conclusion MRI can accurately reflect the features of cerebral complications of IE and the evolution process of infective cerebral infarctions,which provides evidences for physicians to make correct diagnoses and the treatment plans.

Objective To study the different ischemic characteristics of cerebral gray matter and deep white matter in patients with chronic cerebral artery severe stenosis or occlusion. Methods A retrospective study was conducted on 30 patients with chronic unilateral cerebral artery severe stenosis or occlusion from April 2014 to April 2018 in our hospital. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time of peak time (TTP) and time to delay(TTD) of cerebral cortex gray matter and deep white matter in the blood supply area of the responsible artery (the affected side) and the contralateral hemisphere (the healthy side) were measured. Statistical analysis of the perfusion parameters of cerebral cortex gray matter and deep white matter in the affected side and contralateral side were performed using SPSS13.0 software package. T test was used for variance homogeneity, and t′test was used for variance discrepancy, and P<0.05 was statistically significant. Results The average values of CBF and CBV of the ipsilateral and contralateral cerebral cortex were increased than those of ipsilateral and contralateral cerebral deep white matter respectively(P<0.01). MTT, TTP and TTD of the ipsilateral and contralateral cerebral cortex were decreased than that of ipsilateral and contralateral cerebral deep white matter (P<0.01); CBF of ipsilateral cerebral cortex and CBV of ipsilateral cerebral deep white matter were not different from those of the contralateral cerebral cortex and deep white matter respectively, but CBF of ipsilateral cerebral deep white matter is decreased than that of the contralateral deep white matter (P<0.01). CBV of ipsilateral cerebral cortex is increased than that of the contralateral cerebral cortex (P<0.01). MTT, TTP and TTD of ipsilateral cerebral cortex and deep white matter were increased than those of contralateral cerebral cortex and deep white matter respectively(P<0.01). Conclusion Deep cerebral white matter perfusion decreased more significantly than cortical gray matter in the supply region of chronic cerebral artery severe stenosis or occlusion. CT perfusion imaging can quantify the degree of chronic cerebral ischemia and can provide quantitative diagnostic information for clinical treatment and efficacy evaluation.

Objective To investigate the value of 3D-TEE,2D-TEE,CTA and X-ray contrast in assessing left atrial appendage (LAA) shape,size and guidance for the choice of occlusion.Methods Forty-three cases of left atrial fibrillation who were referred for LAA closure were performed TEE to measure the opening maximum diameter,and maximum depth of 2D-TEE at 0°,45°,90° and 135°.When LAA showed most clearly,the opening maximum and minimum diameter of LAA were measured by using 3D-ROOM mode,and the results were compared with those measured by CTA and X-ray contrast.Results There was no significant difference for opening maximum diameter of LAA measured by 3D-TEE,2D-TEE and X-ray contrast (all P＞0.05),but that of CTA statistically larger than 3D-TEE,2D-TEE,X-ray contrast (all P＜0.01).There were significant difference between 2D-TEE at 90°,135° and CTA,2D-TEE at 135° and X-ray contrast in assessing maximum depth of LAA (all P＜0.05).Opening maximum diameter of LAA measured by 3D-TEE was significantly correlated with each angle of 2D-TEE,CTA,and X-ray contrast (r=0.70-0.77,0.57,0.58,all P＜0.01),and the opening maximum diameter measured by 2D-TEE also correlated with CTA and X-ray contrast (r =0.57-0.71,0.45-0.51,all P＜0.01).Also the opening maximum diameter measured by 3D-TEE,2D-TEE,CTA and x-ray contrast were correlated with occluder size (r=0.93,0.70-0.77,0.57,0.47,all P＜0.01).Conclusion Compared with 2D-TEE,CTA and X-ray contrast,3D-TEE is more instructive for occluder selection.

Heat shock protein 70 (HSP70) family is one ofthe most conserved proteinin evolutionand plays critical,role in proteostasis.HSP70 is becoming an interesting target for multiple diseases such as cancer and Alzheimer's disease.There are many drugs targeted to HSP70 in preclinical study.In this review,the classification,the structure,the function of HSP70,and the drugs of the HSP70 family are reviewed.