Objective:To conduct a comparative analysis of the radiation damage to zebrafish embryos and the associated biological mechanism after ultra-high dose rate (FLASH) and conventional dose rate irradiation.Methods:Zebrafish embryos at 4 h post-fertilization were exposed to conventional and FLASH irradiation (9 MeV electron beam). The mortality and hatchability of zebrafish after radiation exposure were recorded. Larvae at 96 h post-irradiation underwent morphological scoring, testing of reactive oxygen species (ROS) levels, and analysis of changes in oxidative stress indicators.Results:Electron beam irradiation at doses of 2-12 Gy exerted subtle effects on the mortality and hatchability of zebrafish embryos. However, single high-dose irradiation (≥ 6 Gy) could lead to developmental malformation of larvae, with conventional irradiation showing the most significant effects ( t = 0.87-9.75, P < 0.05). In contrast, after FLASH irradiation (≥ 6 Gy), the ROS levels in zebrafish and its oxidative stress indicators including superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) were significantly reduced ( t = 0.42-15.19, P < 0.05). There was no statistically significant difference in ROS levels in incubating solutions after conventional and FLASH irradiation ( P > 0.05). Conclusions:Compared to conventional irradiation, FLASH irradiation can reduce radiation damage to zebrafish embryos, and this is in a dose-dependent manner. The two irradiation modes lead to different oxidative stress levels in zebrafish, which might be a significant factor in the reduction of radiation damage with FLASH irradiation.

Objective:To compare and analyze the differences in the setup accuracy of different immobilization method in breast cancer radiotherapy after breast-conserving surgery.Methods:A retrospective study was conducted on 60 patients who received radiotherapy after breast-conserving surgery from January to August, 2021. These patients were divided into two groups. One group consisted of 30 cases who were immobilized using a modified body thermoplastic membrane combined with a multifunction body board during the breast cancer radiotherapy and was called the modified body thermoplastic membrane group. The other group comprised 30 cases immobilized using a vacuum cushion during breast cancer radiotherapy and was referred to as the vacuum cushion group. The setup errors, 3D vector errors, the proportion of errors of > 5 mm, and the dosimetric differences in the planning target volume (PTV) and the clinical target volume (CTV) before and after simulated treatment bed moving (including the PTV_ V100, PTV_ V95, and CTV_ V95 before simulated treatment bed moving and the PTV_ V100 S, PTV_ V95 S, and CTV_ V95 S after simulated treatment bed moving) were compared between two groups. Moreover, for the modified body thermoplastic membrane group, the changes in the average setup errors at different radiotherapy stages were also analyzed. Results:A total of 369 cone-beam CT scans were conducted for 60 patients, including 195 CT scans for the modified body thermoplastic membrane group and 174 CT scans for the vacuum cushion group. The setup errors in the x, y, and z directions (right-left, anterior-posterior, and superior-inferior, respectively) of the modified body thermoplastic membrane group were (2.59±1.98) mm, (2.38±2.04) mm, and (1.45±1.16) mm, respectively, while those of the other group were (2.24±1.63) mm, (2.78±2.17) mm, and (2.70±1.88) mm, respectively. The 3D vector errors of both groups were (4.32±2.28) mm and (5.13±2.14) mm, respectively. Therefore, the setup error in direction z and the 3D vector error of the modified body thermoplastic membrane group were less than those of the vacuum cushion group ( t = -7.77, -3.41, P<0.05). Moreover, the proportion of setup errors of > 5 mm in the x direction of the vacuum cushion group was lower than that of the modified body thermoplastic membrane group ( χ2 = 7.13, P<0.05), while such proportion in the z direction of the modified body thermoplastic membrane group was lower than that of the vacuum cushion group ( χ2= 5.90, P<0.05). After the simulated treatment bed moving, the PTV_ V100 S of the modified body thermoplastic membrane group was better than that of the vacuum cushion group ( t = 2.47, P < 0.05). Furthermore, for the modified body thermoplastic membrane group, the setup errors in the x direction in the first week were higher than those in the 2-3 weeks and 4-5 weeks ( P<0.05). Conclusions:The modified body thermoplastic membrane combined with a multifunction body board yield better immobilization effects than a vacuum cushion. However, it produces high setup errors in the x direction in the first week of the radiotherapy, to which special attention should be paid.

Objective:To explore the effects of integrated traditional Chinese and western medicine nursing based on emotional nursing on infertile patients with obese polycystic ovary syndrome (ob-PCOS) .Methods:Totally 80 infertile patients with ob-PCOS admitted at the Department of Reproductive Medicine of Affiliated Hospital of Jining Medical University were selected by convenient sampling and divided into a control group and an intervention group according to the random number table, with 40 patients in each group. Patients in the control group received routine nursing, while patients in the intervention group underwent integrated traditional Chinese and western medicine nursing based on emotional nursing. Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to compare the negative emotion between the two groups, and the Generic Quality of Life Inventory-74 (GQOL-74) was utilized to compare the body weight, waist-to-hip ratio, and body fat percentage of the two groups of patients.Results:After the intervention, the SAS and SDS scores of the two groups were lower than those before the intervention ( P<0.05) , and the intervention group was lower than the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of GQOL-74 in the two groups were higher than those before the intervention ( P<0.05) , and the scores in the intervention group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The body weight, waist-to-hip ratio, and body fat percentage of the intervention group were lower than those before the intervention ( P<0.05) , and were lower than those of the control group, with statistically significant difference ( P<0.05) . Conclusions:The integrated traditional Chinese and western medicine nursing based on emotional nursing can amiloride the negative emotion of infertile patients with ob-PCOS and improve their body weight, waist-to-hip ratio, body fat percentage, and quality of life.

Prior to implantation, the blastocyst has to hatch out of its zona pellucida to invade the endometrium .In mammals including humans , failure of blastocyst hatching leads to infertility .Blastocyst hatching is believed to be regulated by a variety of autocrine and paracrine molecules such as proteases , cyclooxygenase-2, p38 mitogen-activated protein ki-nase, activin A and Wnt signal pathway .This article reviews the mechanisms of the key molecular regulators involved in mammalian blastocyst hatching and hatching-assisting methods , which can help clarify the mechanism of blastocyst hatching and the treatment of infertility due to failure in blastocyst hatching .

Objective To investigate the protective effect and the possible mechanism of Wenshen Shengjing Decoction (WSSJD)(including Cornu Cervi Nippon Parvum , Panax ginseng, Cynomorium songaricum, Cistanche deserticola,Radix Astragali, Epimedium brevicornum, Angelica sinensis.) on cyclophosphamide induced testicular oxidative damage in mice . Methods Eight-week-old male Kunming mice were assigned .Mice in normal control group received intraperitoneally nor-mal saline, and mice in Western medicine group ,WSSJD group and model group were injected intraperitoneally with cyclo-phosphamide [80 mg/(kg? d) ]for five days.Then mice in Western medicine group and WSSJD group were gavaged with clomifene citrate or WSSJD for 30 days consecutively .The epididymal sperm count and sperm viability were recorded , and the structure of seminiferous epithelium was observed .The content of malondialdehyde (MDA) and glutathione (GSH), and activities of glutathione peroxidase ( GSH-Px) and catalase ( CAT) in testicular tissue were detected .Immunohisto-chemical technique was used to detect the expression of survivin in spermatogenic cells .The apoptosis of spermatogenic cells in the testes was detected by TUNEL assay .Results Compared with model and Western medicine groups ,the epidid-ymal sperm count and sperm viability rate , the development of seminiferous epithelium , and the activities of GSH-Px and CAT significantly increased , while the MDA content significantly decreased in WSSJD group .The expression of survivin in spermatogenic cells was significantly improved .The apoptotic indexes of seminiferous tubules and spermatogenic cells significantly decreased in WSSJD group .Conclusion These results suggest that WSSJD can significantly improve the impaired reproductive function induced by cyclophospamide in mice by enhancing the antioxidative capability in testes and reducing the apoptosis of spermatogenic cells .

Objective:To discuss application of large aperture 16 row spiral CT in radiotherapy simulation positioning. Methods: To apply CT simulation positioning with large aperture 16 row spiral CT for the breast tangential field by early breast cancer after breast conserving surgery and radical radiotherapy. Compare CT-simulation and X-ray conventional positioning technique and Compare large aperture 16 row spiral CT and single row spiral CT image. Results: The application of large aperture 16 row spiral CT avoided the error because of body limited. Large aperture 16 row spiral CT simulation position validation error is superior to X-ray positioning. Its image quality is better than that of single row spiral CT. Conclusion:The application of large aperture 16 row spiral CT make simulation positioning more accurate, planned and treatment more accurate, it can provide guarantee of accurate simulation positioning for accurate plan and treatment.

Objective To analyze the influence of tumor volume change on intensity modulated radiotherapy(IMRT)for nasopharyngeal carcinoma by analyzing the repeated CT simulation.Methods Twenty nasopharyngeal carcinoma patients undergoing IMRT from July 2011 to November 2012 were selected in the study.The first CT simulation was conducted prior to radiotherapy,and the repeated CT simulation was finished after radiotherapy of 30 Gy.The first and the repeated CT images were fused in treatment planning system and GTV volume shrink rate was calculated.The original plan was used to recalculate the dose distribution on repeated CT.The dose volume histogram was used to calculate the dose difference of organs at risk including the brain stem and spinal cord.Results Compared with the first CT,GTV volume shrink rate of the repeated CT simulation was 28.7％,the maximum dose,1 cm3 volume and the average dose percentage of the brain stem and spinal cord were increased(t=0.83-3.17,P＜0.05).Conclusions GTV volume shrinked significantly after radiotherapy of 30 Gy in IMRT for nasopharyngeal carcinoma.The dose of the organs at risk increased accordingly.

Objective To compare the errors of final isocenter marking method and reference point marking method for CT simulation positioning in intensity-modulated radiotherapy (IMRT).Methods From 2009 to 2012,327 patients with head and neck cancer for IMRT underwent CT simulation positioning using the Philips Brilliance CT Big Bore scanner and Philips Tumor LOC workstation and were divided into final isocenter marking group (n =208) and reference point marking group (n =119) according to positioning methods.Target volume delineation and treatment plan design were performed on the Varian Eclipse treatment planning system (TPS).Before treatment,kilovoltage cone-beam CT scans and registration were performed with the Varian EX on-board imager system to obtain beam position errors in the right-left (RL),superior-inferior (SI),and anterior-posterior (AP) directions,and then comparisons of errors between the two groups were made by independent-samples t test.Finally,the TPS was used to measure the changes in the doses to the organs at risk after moving isocenters in the RL,SI,and AP directions among 5 patients with nasopharyngeal carcinoma.Results The mean beam position errors in the three directions were less in the final isocenter marking group than in the reference point marking group (P =0.02,0.01,0.03).After moving isocenters in the three directions,the target dose was reduced and the dose to the normal tissue around the target tumor was increased significantly.The error in the AP direction had the maximum influence on the spinal cord and brainstem.Conclusions Final isocenter marking method leads to less beam position error than reference point marking method in CT simulation positioning.Small isocenter motion can cause large changes in the doses to the organs at risk.

ObjectiveTo evaluate setup errors of image guided radiation therapy (IGRT) for body tumors immbilized with vacuum cushions and localized with final isocenter marked method using kilovoltage cone beam CT (KVCBCT).MethodsA retrospective study has been carried out for 223 patients from March 2009 to April 2011.All patients were immobilized with vacuum cushions and localized with final isocenter marked method in Philips PQS CT or Philips Brilliance CT Big Bore scanner,which were equipped with LAP movable laser systems. The CT images were transferred to a Varian Eclipse workstation for contouring and treatment planning.Before irradiation,a KVCBCT scan was performed and image registration was done on a Varian iX linear accelerator via OBI system.Each set of setup errors in right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were gathered.An independent-samples t-test statistical analysis was conducted with the 758 sets of data using SPSS 16.0.Results The statistical analysis showed that setup errors from the 758 datasets were depicted a Gaussian distribution.The system errors ± random errors in RL,SI and AP were ( -0.5 ±2.8) mm,(0.0±3.0) mm and (0.4±3.4)mm,respectively.Referring to the formula for planning target volume margin calculation,M =2.5Σ + 0.7δ,the margins were calculated as 3.2,2.1 and 3.4 mm,respectively.ConclusionsThe margins derived from this retrospective study have confirmed the premise that the treatment plans were executed in patients with high reliability,thereby created a high sense of confidence for the clinicians.

Objective To evaluate the setup errors of image guided radiation therapy (IGRT) for head-and-neck cancer using kilovoltage cone beam CT( kV CBCT).Methods 256 patients with head-and-neck cancer were treated with intensity modulated radiation therapy (IMRT) from March 2009 to October 2011.All patients were immobilized with head-and-neck mask and localized with final isocenter marking method using the Philips PQS CT or Philips Brilliance CT Big Bore scanners,which were equipped with LAP movable laser systems.The CT images were transferred to a Varian Eclipse V8.6 workstation for contouring and planning.A kV cone-beam CT scans was acquired,and registered before the treatment for every patient on a Varian iX linear accelerator via OBI system.The setup errors in the right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were recorded.Results The setup errors for the 473 datasets followed a Gaussian distribution.The systematic errors ± random errors in the RL,SI and AP were(-0.6 ± 1.3 ),(0.5 ± 1.6) and (0.9 ± 1.7 ) mm,respectively.The planning target volume (PTV) margins were calculated respectively as 2.4,2.4 and 3.4 mm according to the formula of M =2.5∑ +0.7δ The margins of 288 sets of data using the Big Bore CT scanner were calculated as 2.0,2.1 and 1.7 mm,respectively.Conclusions The setup errors using final isocenter marking method are smaller than those using reference point marking method.The result derived from this retrospective study could be used to set the margin between CTV and PTV.