Objective:To reconstruct the three-dimensional (3D) dose distribution in radiotherapy based on the convolutional neural networks (CNN) through multi-perspective scintillation light processing.Methods:First, fluorescence images were captured from three orthogonal perspectives using a complementary metal-oxide-semiconductor (CMOS) imaging sensor. Then, the images were converted into 3D images, which were input to the trained CNN for dose reconstruction. Finally, the reconstructed doses in different fields were evaluated in terms of gamma pass rate, mean-square error (MSE), percentage depth dose (PDD), and cross beam profile (CBP). Additionally, as the CNN model, 3D-Unet was pre-trained on a virtual dataset.Results:With the 50% maximum dose of as the threshold and 3%/3 mm as the standard, the central-plane and stereo-mean gamma pass rates of all field reconstruction distributions were over 90%, with MSEs remained below 1%. Besides, the PDD and CBP curves showed MSEs below 1‰ and below 1%, respectively.Conclusions:The deep learning-based method for 3D dose reconstruction using scintillation light contributes to enhanced verification of instantaneous 3D relative dose based on plastic scintillation detectors.

ObjectiveTo investigate the gastroscopic manifestations of gastric mucosa in portal hypertensive gastropathy (PHG) and the association of PHG with gastroesophageal varices, ulcers, and liver cirrhosis complications. MethodsA retrospective analysis was performed for the clinical data of 867 patients with liver cirrhosis who were treated in Daping Hospital of Army Medical University from August 2012 to June 2018, and the incidence rates of gastroesophageal varices, PHG, and ulcers were recorded. Meanwhile, the data of spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and hepatocellular carcinoma (HCC) were collected. The chi-square test was used for comparison of categorical data between groups, and a Spearman correlation analysis was also performed. ResultsThe incidence rate of PHG in the patients with liver cirrhosis reached 66.2% (574/867), and gastric mucosa abnormalities in mild PHG were mainly red-spot lesions (68.6%) and snakeskin (56.8%), while diffuse erythema (76.5%) was the main gastric mucosa abnormality in severe PHG. There was a significant difference in the incidence rate of PHG between the patients with different severities of esophageal varices (χ2=304712, P＜0.05), and the severity of PHG increased with the aggravation of esophageal varices (r=0.515, P＜0.05). There was a significant difference in the incidence rate of PHG between the patients with different severities of gastric varices (χ2=81.004, P＜0.05), and the severity of PHG was positively correlated with that of gastric varices (r=0.292, P＜0.05). There was a significant difference in the incidence rate of PHG between the patients with varices at different locations (χ2=41.361, P＜0.05); the patients with gastric varices alone had the lowest incidence rate of PHG (34.8%) and only had mild PHG, and those with gastroesophageal varices had the highest incidence rate of PHG (85.6%). Among the patients without PHG, 71 (24.2%) were hospitalized due to hematemesis and/or tarry stool, and among the 574 patients with PHG, 316 (55.1%) were hospitalized, and there was a significant difference between the two groups (χ2=74562, P＜0.05). ConclusionPatients with different severities of PHG have different features of gastric mucosa abnormalities. The development and severity of PHG are closely associated with the severity of gastroesophageal varices and are important causes of gastrointestinal bleeding in liver cirrhosis. PHG should be treated and prevented to reduce the risk and complications of gastrointestinal bleeding.

Background: Transjugular intrahepatic portasystemic shunt (TIPS) is widely used for reducing portal hypertension. Post-TIPS anticoagulant treatment is controversial because of lack of obligatory evidence. Aims: To systematically review the effect of anticoagulant treatment on patients with liver cirrhosis after TIPS. Methods: Randomized controlled trials (RCTs) of liver cirrhosis patients after TIPS with anticoagulant treatment (anticoagulant treatment group) or without anticoagulant treatment/placebo (control group) were retrieved from PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CBM and VIP databases in March 2020. Meta-analysis was conducted by RevMan 5.3. Results: Three RCTs involving 157 liver cirrhosis patients were enrolled. These studies mainly reported the effects of anticoagulant treatment on gastrointestinal rebleeding, stent patency, mortality and incidence of hepatic encephalopathy (HE). Meta-analysis revealed that no significant differences in total gastrointestinal bleeding rate (OR=1.04, 95% CI: 0.25-4.38, P=0.96), variceal bleeding rate (OR=1.04, 95% CI: 0.14-7.68, P=0.97), stent stenosis (OR=1.88, 95% CI: 0.73-4.79, P=0.19), occlusion (OR=0.07, 95% CI: 0.00-1.44, P=0.09), shunt dysfunction (OR=0.67, 95% CI: 0.10-4.29, P=0.67), mortality (OR=2.12, 95% CI: 0.06-72.77, P=0.68) and incidence of HE (OR=1.18, 95% CI: 0.45-3.06, P=0.74) were found between anticoagulant treatment group and control group. Conclusions: Post-TIPS anticoagulant treatment is safe and without increasing the rate of gastrointestinal rebleeding, mortality and incidence of HE. However, anticoagulant treatment does not further improve the stent patency. Therefore, anticoagulant treatment appears to be unnecessary in patients with liver cirrhosis after TIPS.

Objective:To explore the influence of buccal corridor of Han people on smile esthetics.Methods:An attractive adult male and a adult female were selected as the models.Buccal corridor was altered digitally with slider technology of Adobe Flash CS4 to obtain a continuous range of buccal corridors(0% -25%).96 orthodontists aged 35.1 ±7.2 years and 96 laypersons aged 37.3 ± 5.1 years were chosen as the raters.The minimum tolerable value(A%),the ideal value(B%)and the maximum tolerable value (C%)of buccal corridor of the models were statistically analyzed.Results:In the orthodontist groupA,B and C of the male model were 5.00 ±0.1 7,9.75 ±2.77 and 1 5.00 ±2.84,in layperson group were 4.79 ±1 .00,9.20 ±3.08 and 1 5.05 ±2.91 ,respec-tively;in orthodontist group,A,B and C of the female model were 3.92 ±0.1 7,1 1 .87 ±2.77 and 1 5.82 ±2.84,in layperson group were 4.00 ±1 .00,1 2.05 ±3.08 and 1 5.1 1 ±2.91 ,respectively(all data between groups,P >0.05).The ideal buccal corri-dor value(%)of the male and female models were 9.48 ±2.73 and 1 1 .96 ±1 .99 respectively(P <0.05).Conclusion:There is no difference between orthodontists and laypersons for buccal corridor esthetic judgment.The ideal esthetic buccal corridor size of male and female is different.

Esophagus ; pathology ; Foreign Bodies ; Hoarseness ; diagnosis ; Humans

Objective:To compare the smile characteristics of the subjects with different types of malocclusion.Methods:1 80 sub-jects with classⅠ(n =60),classⅡ(n =60)and class Ⅲ(n =60)malocclusion at the age of 1 8 to 25 years were included.The smile vidioes and posed smile images of the subjects were acquired.Smile quantitative evaluation indexes were measured and analysed.Re-sults:There were statistical differences in smile indexes and the amount of the gingival exposure in classⅡ subjects between the male and female(P <0.05).There were statistical differences in the quantitative evaluation indexes except the smile symmetry rate among the three groups(P <0.05).The buccal corridor and the gingival exposure ordered from larger to smaller:class Ⅱ >classⅠ >classⅢ,smile index of class Ⅲ was greater than that of class Ⅰ and class Ⅱ,the teeth exposure of class Ⅱ was less than that of class Ⅰand class Ⅲ.Conclusion:Malocclusion types may affect smile characteristics.

Objective To analyze the clinical characteristics,prognosis and molecular biological changes of tonsillar squamous cell carcinoma(TSCC).Methods Retrospective analysis of 61 TSCC cases treated from January 1999 to December 2012.Demographic data and clinical charts,including histologic grade of tumor,treatment and outcome of the patients,were reviewed.Human papillomavirus (HPV)-DNA were detected using SPF10-DNA enzyme immunoassay and LiPA genotyping method.Expressions of p16 and p53 proteins were examinated by immunohistochemistry.Survival rate was calculated with SPSS 19.0 software using the Kaplan-Meier method.Results There were 55 males and 6 females,with a median age of 57 years.Of the 61 TSCC,21 were with well differentiation,19 with moderate differentiation and 21 with poor differentiation,including 7 patients at stage Ⅱ,10 at stage Ⅲ and 44 at stage Ⅳ.HPV-positive rate of TSCC was 29.5％ (18/61) and high-risk HPV-16 subtype accounted for 72.2％ (13/18).The percentage of famel patients in HPV-positive TSCC was higher than HPV-negative TSCC(22.2％ vs 4.7％).HPV-positive TSCC was more common in non-smoking patients (50.0％ vs 79.1％,x2 =5,155,P =0.023) and non-drinking patients (27.8％ vs 51.2％,x2 =4.346,P =0.037).HPV-positive TSCC mostly presented with high expression of p16 protein (88.9％ vs 16.3％,x2 =28.481,P =0.000),and low expression of p53 protein(72.7％ vs 46.5％,x2 =5.028,P =0.025).The prognosis of patients with HPV-associated TSCC was significantly better than non-HPV-associated TSCC,and The 3-year and 5-year overall survival rates of patients with HPV-positive TSCC were higher than those of patients with HPV-negative TSCC (87.7％ vs 49.5％ and 78.9％ vs 33.0％,respectively).Conclusion HPV-associated TSCC had unique clinicopathological and molecular biological features,showing better prognosis compared to HPV-negative TSCC.

Objective:To compare the efficacy of casting frame and traditional fixed maxillary protraction appliances in the correc-tion of skeletal Ⅲ malocclusion in mixed dentition.Methods:30 cases with Class Ⅲ malocclusion in mixed dentition were random-ly divided into 2 groups.Casting frame maxillary protraction appliance was applied in group 1 (1 5 cases)and traditional fixed maxil-lary protraction appliance in group 2(15 cases).X-ray cephalometric examination results before and after treatment,treatment time, and the number of visit in 2 groups were analyzed with SPSS 1 3.0.Results:The treatment time in group 1 and 2 was (7.03 ±1 .32) and (9.07 ±1 .31 )months(P <0.05),the number of visiting was (8.00 ±1 .46)and (10.47 ±1 .85)(P <0.05),the cephalomet-ric measurement change of △U1 -SN was (3.85 ±0.95)°and (5.25 ±0.95)°(P <0.05),respectively.Conclusion:Casting frame protraction appliance is an efficient and practical intraoral device,which can prevent anterior upper teeth inclined to labial.

Objective To evaluate the morphology and position of condylar processes in skeletal Class Ⅲ adult patients with mandibular deviation.Methods Twenty skeletal Class Ⅲ adult patients with mandibular deviation were selected as the deviated group and twenty adults with normal occlusion were selected as the control group.Cone-beam CT(CBCT) scans of their temporomandibular joints were taken.The original data were reconstructed and rebuilt.A series of measurements of the condylar morphology and location were performed.The collected data were analyzed using paired t-test.Results In the deviated group,the deviated sides were smaller than the contralateral sides in the perpendicular height,volume,maximum area of axial plane and the height of condylar head.The contralateral condyle was positioned more posteriorly and laterally [(0.35 ± 0.10) and (0.58 ± 0.18) mm] than the deviated condyle (P＜0.05).Conclusions Adult skeletal Class Ⅲ patients with mandibular deviation hadsome extent of condyle asymmetry in both morphology and location.

Objective To explore the risk factors in post-polypectomy hemorrhage in rectum and to discuss the appropriate interventions.Methods A total of 313 patients with 373 polypi were included in this study. The clinical data were analyzed by SPSS 16 software. Results There were 313 patients with colorectal polypus curatively resected and 373 polypi in total.There were 11 (3.5％) patients subjected to post-polypectomy hemorrhage in rectum.Regression analysis showed that the independent risk factor of postpolypectomy hemorrhage in rectum was the hypertension of patients (P ＜ 0.01 ) and this hemorrhage had no significant correlations with patientg'ender,age,size of polypus,pathological characteristics and the methods of polypectomy.Conclusions Hypertension of patients is an independent risk factor in post-polypectomy hemorrhage.