Objective:To explore the dosimetric differences of different dose accumulation method for brachytherapy combined with external beam radiation therapy (EBRT) of cervical cancer and establish clinical prediction models for radiation-induced late rectal injury (RLRI) after radiotherapy.Methods:A retrospective analysis was conducted for the clinical data of patients who received radical concurrent chemoradiotherapy (CCRT) for cervical cancer in the Department of Oncology of the Affiliated Hospital of North Sichuan Medical College from January 1, 2020 to November 30, 2021. EBRT combined with brachytherapy was employed for the patients, and dose assessment was performed in two means: the direct accumulation using equivalent dose in 2-Gy fractions (EQD2) and deformable image registration (DIR)-based dose accumulation of 3D planning images. The toxicity criteria of the Radiation Therapy Oncology Group were adopted as the RLRI grading criteria. The prediction models of RLRI using both dose assessment method were constructed. The areas under the receiver operating characteristic (ROC) curves were calculated to assess the predictive accuracy of the different dose assessment method.Results:In the case of brachytherapy, the D95% and D90% EQD2 doses to high-risk clinical target volumes (HR-CTVs) were 2.18 and 2.92 Gy higher respectively and the D2 cm 3, D1 cm 3, and D0.1 cm 3 EQD2 doses to the rectal were 1.74, 2.28, and 2.26 Gy higher, respectively compared to DIR-based dose accumulation ( t = 3.82, 5.21, 4.58, 5.17, 2.05, P < 0.05). For EBRT combined with brachytherapy, the D2 cm 3, D1 cm 3, and D0.1 cm 3 EQD2 doses to the rectal were 6.22, 7.61, 9.56 Gy higher than DIR-based doses, respectively, and the dosimetric differences were statistically significant ( t = 9.40, 10.59, 7.87, P < 0.001). The joint prediction model yielded an area under the ROC curve of 0.788. The sensitivity and specificity of the optimal cut-off value were 0.850 and 0.660, respectively. Furthermore, the Hosmer-Lemeshow goodness-of-fit tests indicated high goodness-of-fit ( P > 0.05). The prediction model for DIR-based dose accumulation of traditional predictors yielded areas under the ROC curves for D2 cm 3 and D1 cm 3 to the rectal of 0.784 and 0.763, respectively. The sensitivities of the optimal cut-off values were 0.850 and 0.750, respectively, and the specificities were 0.679 and 0.717, respectively. Conclusions:There are dosimetric differences between the direct dose accumulation using EQD2 and DIR-based dose accumulation of 3D planning images for brachytherapy combined with EBRT. Both the joint prediction model and the DIR-based dose accumulation of D2 cm 3 and D1 cm 3 to the rectal are effective in predicting RLRI. Given the complex calculation of the joint prediction model, it is recommended that RLRI should be predicted through DIR-based dose accumulation of D2 cm 3 and D1 cm 3 to the rectal clinically.

Objective:To investigate the efficacy of staged treatment of infectious femoral defects of Cierny-Mader type Ⅳ using bone transport combined with locking plating after En-Bloc resection debridement.Methods:A retrospective analysis was conducted of the 10 patients with distal femoral traumatic bone infection who had been treated at Department of Orthopedics, The People's Hospital of Weifang from January 2020 to January 2023. There were 8 males and 2 females with an age of (48.5±11.4) years. All cases were classified as Cierny-Mader type Ⅳ. At the first stage, En-Bloc resection debridement was performed in all cases to remove previous internal fixation devices and fill the defects with antibiotic bone cement. After infection control, the second stage involved removal of bone cement, re-fixation with internal devices, and external fixation support for bone transport. After the bone segments met, freshening of the bone ends, minor bone grafting, and screw locking of the transported bone segments were performed. Outcomes observed included bone defect length, frame carrying time and index, bone healing time, limb function, and complications.Results:After the first stage of debridement, a bone defect of (9.1±2.1) cm was created in 10 patients. All patients were followed up for (19.8±6.6) months. The duration for carrying external fixation frame was (107.2±25.1) days, and the frame index (11.8±0.5) d/cm. No recurrence was observed postoperatively. Bone union was achieved in 9 patients within 8 months, but in 1 patient only after secondary bone grafting due to poor healing at the meeting ends. All patients returned to their previous life or physical labor with no complications like pain or re-fracture. Three patients experienced varying degrees of knee joint stiffness, but were able to meet needs of daily life; one requested joint release surgery which resulted in satisfactory therapeutic efficacy.Conclusion:Staged treatment of infectious femoral defects of Cierny-Mader type Ⅳ using bone transport combined with locking plating after En-Bloc resection debridement is simple and effective.

The high incidence of unplanned readmission of postoperative patients with gynecologic malignancies not only seriously affects the quality of life of patients, but also increases the medical burden. This paper reviews the current situation, common causes, relevant factors and insights of unplanned readmission of postoperative gynecologic malignancy patients, and further explores the unplanned readmission of postoperative gynecologic malignancy patients in China by drawing on existing foreign studies and combining them with the actual situation in China, with the aim of providing a basis for clinical health care professionals to develop targeted intervention plans, so as to effectively reduce the unplanned readmission of postoperative gynecologic malignancy patients.

Objective:To investigate the effect of pretreatment with butorphanol on perineal discomfort caused by intravenous injection of dexamethasone sodium phosphate.Methods:Using the method of prospective study, ninety patients undergoing elective gynecological surgery in Dalian Women And Children′s Medical Group from June to December 2021 were randomly divided into three groups: butorphanol 0.5 mg pretreatment group (group B1), butorphanol 1.0 mg pretreatment group (group B2) and normal saline control group (group C), with 30 cases in each group. Patients in groups B1 and B2 were given butorphanol 0.5 mg and 1.0 mg intravenously, respectively, prior to induction of anesthesia, while those in group C were given 0.9% sodium chloride injection. 3 minutes later, all patients in the three groups were given dexamethasone sodium phosphate injection 10 mg, and the incidence, grade and adverse reactions of their perineal discomfort symptoms were recorded.Results:The incidence of perineal discomfort and moderate perineal discomfort of patients in group B1 and group B2 was lower than that in group C: 20.00%(6/30)and 10.00%(3/30)vs. 60.00%(18/30), 3.33%(1/30)and 3.33(1/30)vs. 30.00%(10/30), with a statistically significant differences ( P<0.05). The incidence of adverse reactions such as dizziness was increased in the group B2:26.67%(8/30)and 10.00%(3/30)vs. 40.00%(12/30), with a statistically significant difference ( χ2 = 7.13, P = 0.028). Conclusions:Butorphanol 0.5 mg and 1.0 mg pretreatments are touted as effective in inhibiting perineal discomfort caused by intravenous injection of dexamethasone sodium phosphate. However, the butorphanol 0.5 mg pretreatment group have fewer adverse reactions.

OBJECTIVETo understand the genetic polymorphism and population difference of locus DYF155S1 on human Y chromosome.

METHODSUsing minisatellite variant repeat mapping-polymerase chain reaction (MVR-PCR), automated fluorescence detection, DNA sequence analysis, the authors studied the locus DYF155S1 of two chimpanzee and 10 human subjects from each of the following 8 groups: Northern China Hans, Southern China Hans, the Zang (Tibetan) nationality, the Uighur nationality, Japanese, Korean, Black African, White African.

RESULTSIn this study, loci DYF155S1 and DYF155S2 have been detected. There is no difference in all of the samples on the locus DYF155S2; each sample contains one type 4 repeat unit, which is the ancestor gene of locus DYF155S1. On locus DYF155S1, each individual has its specific DNA sequence. The arrangement of the repeat units differs greatly in races: arrangement 3134 in the yellow race, arrangement 134 in the white race, and arrangement null3a1a4a4 in the black race were most common. The average number of the type 4 repeat unit in the white race is much higher than that in the yellow race. The authors also found two new types of repeat unit: type 6 and type 7. Type 6 is the result of the T22A substitution on type 1, which was observed in Japanese (3 samples). Type 7 is resulted from the T22A substitution on type 3, which was observed in the Zang nationality (4 samples), Southern China Hans(1 sample), and Korean (1 sample).

CONCLUSIONLocus DYF155S1 has great genetic polymorphism and obvious population difference. Its significance should receive more attention in forensic science and human genetics research.

Objective To study the genetic polymorphism and population diversity of three SNP loci and their haplotypes on human Y Chromosome. Methods Genetic polymorphisms, population diversity and hap-lotypes of these SNP loci, M4, M9 and M122, on human Y chromosome, in 140 wnrelated individuals from Zang Nationality in China, Japanese, Negroes and white men from southern Africa were studied by using PCR-RFLPs and DNA sequencing analysis. Results No polymorphism was found on M4 locus, each sample was M4A. All samples were wild type. 3 haplotypes were found. In all Negroes there was a wild haplotype of M4A/M9C/M122T. A haplotype of M4A/M 9G/M122T were found in 8 white men. No M122C gene was found. The haplotypes of M4A/M9C/M122T were mainly found in both Japanese and Chinese, The haplotype frequencies in Japanese and Zang population in china were 0.5 and 0.65 respectively. The probability of discrimination power (DP) and the excluding probability of paternity (EPP) were 0.6191 and 0.4994 respectively and the haplotype of M4A/M9C/M122C was absent. There was a remarkable difference (P

Objective To investigate the molecular structure, gene expression and detecting methods of some new variant alleles at FUT2 locus. Method We examined four new variant alleles at FUT2 locus using PCR, RFLPs, gene recombination, DNA sequencing and techniques related to gene expression. Results Three missense gene mutations which were C664T, G868A and G760A respectively were found in three New Guinea individuals. Absence of the glycosyltransferase activity in all three enzymes coded by above three missense gene mutations were confirmed by gene expression techniques. Nonsense mutation A660T was found in one Chinese Han individuals. Changing of sequence of endonuclease SacI resulted from C664T and A660T can be detected by RFLP method. Weak peaks of variats might be missed if DNA sequencing was used to detect heterozygotes. RFLP method can't be used to determine specific site of variation within identified sequence of endonuclease. Conclusion All three FUT2 genes resulted from three mutations C664T, G868A, and G760A were non-secretor genes. More than two methods must be used for checking results each other when detect DNA sequence polymorphisms.

The polymorphisms of the TPOX locus in two population were studied by PCR technique followed by the denatured PAGE and silver staining.Seven alleles were detected in each population of 100 unrelated Northern Chinese Han individuals and 93 unrelated African(Xhosa)individuals in South Africa respectively.No deviation from the Hardy Weinberg equilibrium was demonstrated.The power of discrimination(DP)and the exclusion probability(EPP)were 0 7978 and 0 4625;0 9141 and 0 6125 respectively.Comparison of gene frequency distribution showed that there is significant difference between different races.In addition,three rare genes were detected in we Africans(Xhosa)individuals.Sequencing proved that the only difference among them was the number of repeat unit in the region amplified by the specific primer pair.It might be due to the unequal exchange between chromosomes which was resulting in the production of a chimera.Our study showed that the TPOX locus has a high discriminating power which is important for the study of forensic medicine and human genetics\;

Objective To study the genetic polymorphisms of DYF155S1 locus in 107 unrelated individuals both in the Han population, China and the Japanese population. Methods MVR-PCR, automated fluorescence detection and DNA sequence analysis were carried out for studying. Results Five types of repeat unit and one type newly named type 6 which was resulted from the T22A substitution on Type 1 were detected. Type 6 is monopolized by Japanese and may be regarded as a racial characteristic genetic marker. The common arrangement of the repeat units was 3134 which were detected at 73.44 % and 67.44 % in the Han and Japanese populations respectively. The abundance of arrangement of 3134 is the character of yellow race. Next to the arrangement of 3134 was the arrangement of 134 which was detected at 17.19% in the Han population while the arrangement of 6134 was detected at 16.28% in the Japanese population. The average number of type 4 unit at the 3'terminal was 8.8 in the Japanese population much lower than 12.5 in the Han population. Conclusion This study implies that DYF155S1 locus is an important geneticmarker with good genetic polymorphisms. The population difference between the Han and the Janpanes is significant.