ObjectiveTo investigate the effect of porcine large intestine-processed Dahuang （Radix et Rhizoma Rhei） on defecation in constipation model mice and the possible mechanism. MethodsFifty Kunming mice were randomized to blank group （n=10） and model group （n=40）. Loperamide suspension at the dose of 8 mg/（kg·d） was given by gavage for four consecutive days to establish a model of constipation. The 24 successfully modeled mice were randomly divided into model group， processed Dahuang group， lactulose group， raw Dahuang group， with six mice in each group. Moreover， six randomly selected mice were chosen as control group. Since the fifth day， 8 mg/（kg·d） of loperamide suspension by gavage was given to the model group， processed Dahuang group， raw Dahuang group， and lactulose group； two hours later， the processed and raw Dahuang groups were administered with 0.6 g/（kg·d） of processed and raw Dahuang suspension， respectively， while the lactulose group was given 0.6 g/（kg·d） of latulose suspension， and the blank group and the model group were given 0.2 ml/10 g of distilled water by gavage， all for four days. The general condition， body weight after the last gavage， number of fecal particles within six hours， fecal wet weight， fecal water content ratio， intestinal propulsion rate and colonic histology changes by HE staining of each group were detected. ResultsThe body weight of the mice in the raw Dahuang group was significantly lighter than that in the other groups （P＜0.05 or P＜0.01）. The number of fecal particles， fecal wet weight and intestinal propulsion rate of mice significantly decreased in the model group than in the blank group （P＜0.05 or P＜0.01）. Compared to those in the model group， the number of fecal particles and fecal wet weight in the processed Dahuang group， lactulose group and raw Dahuang group significantly increased， and the fecal water content ratio in the raw Dahuang group increased as well （P＜0.05 or P＜0.01）. Compared to those in the processed Dahuang group， the number of fecal particles and fecal wet weight in the raw Dahuang group decreased， while the fecal water content ratio increased （P＜0.05 or P＜0.01）， and the fecal water content ratio in the lactulose group increased significantly （P＜0.05）. The intestinal propulsion rate in the processed Dahuang group was higher than that in the model group， lactulose group and raw Dahuang group （P＜0.05 or P＜0.01）. Histopathological analysis showed that the colonic crypts and goblet cells in the blank group were normal and clear， and the colonic muscular layer was thicker. The colonic crypts of the mice in the model group were damaged， with reduced goblet cells to varying degrees and changed colonic muscularis. In the lactulose group and raw Dahuang group， part of the crypts were broken， and the goblet cells were damaged to varying degrees， while in the processed Dahuang group， still the colonic tissue structure of the mice was relatively clear， and the colonic crypts and goblet cells were relatively normal， with thickened muscular layer of the colon. ConclusionPorcine large intestine-processed Dahuang could improve defecation in constipation model mice， and reduce the drastic purgation function of raw Dahuang， for which the mechanism may be related to the protection of colon histopathological damage.

Objective:To identify the risk factors for functional delayed gastric emptying(FDGE)after retroperitoneal tumor resection.Meth-ods:Sixty-seven patients with postoperative FDGE after retroperitoneal tumor resection from September 2017 to December 2022 admited in Peking University International Hospital were included in the observation group,and 836 normal patients who underwent ret-roperitoneal tumor resection during the same period were included in the control group.Medical histories and clinical treatment data were obtained for each group and compared to identify the risk factors for FDGE after retroperitoneal tumor resection.Results:The overall incid-ence of postoperative FDGE was 7.42%.Factors that were significantly elevated(P<0.05)in the observation group relative to the control group included adverse mental factors(37.31%),preoperative digestive tract obstruction(41.79%),postoperative abdominal cavity complic-ations(79.10%),diabetes(29.86%),average age of(61.85±6.11)years,and blood loss(1 011.94±507.30)mL.Pre-and post-surgery albumin levels[(38.22±3.75)g/L and(30.22±3.36)g/L,respectively]were significantly reduced(P<0.05)in the observation group compared to the control group.Risk factor analyses revealed that advanced age,diabetes,preoperative digestive tract obstruction,intraoperative blood loss,perioperative albumin level,postoperative abdominal cavity complications,and adverse mental factors were correlated with postoperative FDGE.Conclusions:Diverse factors could impact the risk of FDGE after retroperitoneal tumor resection.Patients should be accurately evalu-ated;reasonable and detailed prevention and treatment plans should be developed.

Objective:To explore the effects of bladder volumes from CT simulation on bladder volume consistency and set-up errors during radiotherapy for prostate cancer, aiming to provide a reference for clinical practice.Methods:A retrospective analysis was conducted for of 66 prostate cancer patients treated with intensity-modulated radiation therapy in the Sun Yat-sen University Cancer Center from August 2015 to November 2020. They underwent CT scan or radiotherapy after voluntarily holding in urine. Cone beam computed tomography (CBCT) scans were performed for them to measure their set-up errors in left-right (L-R), superior-inferior (S-I), and anterior-posterior (A-P) directions before each treatment. The bladder contours of the patients were delineated on CT simulation images and CBCT images. Accordingly, bladder volumes were calculated. Based on the calculated bladder volumes derived from the CT simulation images, the patients were divided into three groups: 18 cases in the 200-300 ml group, 24 cases in the 300-400 ml group, and 24 cases in the >400 ml group. Finally, this study analyzed the effects of bladder volumes derived from CT simulation on set-up errors and the changes of CBCT-derived bladder volumes relative to planned volumes during radiotherapy.Results:The bladder volumes in the 200-300 ml, 300-400 ml, and >400 ml groups during radiotherapy were reduced by 15%, 26%, and 32%, respectively. The pairwise comparison indicates statistically significant differences in the changes of bladder volumes among the three groups ( Z=3.43, 7.97, 4.83, P<0.05). Regarding the three-dimensional set-up errors, there were statistically significant differences in S-I set-up errors among the three groups ( H=26.72, P<0.05), but there was no statistically significant difference in L-R and A-P set-up errors ( P>0.05) among these groups. The 200-300 ml, 300-400 ml, and >400 ml groups exhibited S-I set-up errors of 0.00 (-0.20, 0.20) cm, 0.00 (-0.20, 0.30) cm, and -0.10 (-0.30, 0.20) cm, respectively. Therefore, the >400 ml group displayed larger the S-I set-up errors than other two groups, with statistically significant differences ( Z=4.17, 4.66, P< 0.05), while there was no statistically significant differences in S-I set-up errors between other two groups ( P> 0.05). Conclusions:Controlling the bladder filling volumes at 200-300 ml in CT simulation is beneficial for maintaining bladder volume consistency and reducing set-up errors of patients during radiotherapy.

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 evaluate the preliminary clinical efficacy and safety of stereotactic body radiation therapy (SBRT) in combination with targeted therapy for metastatic renal cell carcinoma (mRCC).Methods:Clinical data of 58 patients with mRCC who were treated with SBRT in combination with targeted therapy in Sun Yat-sen University Cancer Center from June 2013 to December 2018 were retrospectively analyzed. Among them, 79.3% patients were classified as intermediate or high risk according to International Metastatic Renal Cell Carcinoma Database Consortium Criteria. The median biologically equivalent dose (BED) was 147 Gy (67 to 238 Gy).Results:Overall, 32, 13, 7, 5 and 1 patients received SBRT for 1, 2, 3, 4 and 6 metastatic sites (105 lesions) and 71.4% of them were bone lesions. Targeted therapy was continued during SBRT. With a median follow-up of 9.4 months (range 2.7 to 40.1 months), 18 patients died. The 1-year local control rate was 97.4%. The 1-year progression-free survival was 50.3%. The 1-and 2-year overall survival was 72% and 53%. Approximately 85% patients experienced pain relief after SBRT. Patients who achieved complete or partial response after SBRT obtained better overall survival than those with stable disease or disease progression (1-year overall survival: 83% vs. 48%, P=0.021). In the whole cohort, 6 cases developed Grade Ⅲ adverse events, 4 of which were Grade Ⅲ myelosuppression, 1 case of Grade Ⅲ neuropathy and 1 case of radiation-induced skin injury. Conclusion:Preliminary study reveals that combined use of targeted therapy and SBRT is an efficacious and safe treatment of advanced mRCC.

OBJECTIVE： To study the correlation between the color of Moutan Cortex and the contents of effective components before and after carbonized， and to provide reference for identification and quality evaluation of Moutan Cortex and its charcoal piece decoction. METHODS： Using colorimeter determination of Moutan Cortex and Moutan Cortex charcoal decoction pieces powder chroma space parameter [lightness value （L*）， red， green and component values （a*）， yellow and blue component value （b*） and total color difference value （E*ab）]， HPLC method for content determination of 10 effective components （gallic acid， 5-HMF， catechins， oxypaeoniflorin， paeoniflorin， quercetin， benzoyl paeoniflorin， isorhamnetin， paeonol， kaempferide） content in Moutan Cortex and Moutan Cortex charcoal decoction pieces. On this basis， the correlation between the content of effective components and the chromaticity space parameter of a color was studied by SPSS 21.0 software. RESULTS： There was no correlation between gallic acid content and the chromaticity space parameter of a color （P＞0.05）. There was an extremely significant negative correlation between 5-HMF content and L*， b*， E*ab （P＜0.01）， and an extremely significant positive correlation between 5-HMF content and a* （P＜0.01）. The content of paeoniflorin was positively correlated with L*， b* and E*ab， but not with a* （P＞0.05）. The content of oxidized paeoniflorin was positively correlated with L* and E*ab （P＜0.01）， and negatively correlated with a* （P＜0.01）， but not with b* （P＞0.05）. The content of catechins， quercetin， benzoyl paeoniflorin， isorhamnin， paeonol and kaempferol were positively correlated with L*， b* and E*ab （P＞0.05）， and negatively correlated with a* （P＞0.05）. CONCLUSIONS： Chromatic aberration technology can quantify the color of Moutan Cortex and its charcoal decoction pieces， and there is a significant correlation between the color of Moutan Cortex before and after processing and the content of its active ingredients.

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 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.

Objective:To compare the effectiveness of proximal femoral nail antirotation (PFNA) with intertrochanteric antegrade nail (InterTAN) in the treatment of intertrochanteric fractures in the elderly. Methods:A retrospective study of 62 elderly patients with intertrochanteric fractures who received two operation methods from Sep 2014 to May 2016 was done. There were 28 patients in PFNA group, and 34 patients in InterTAN group. The operation time, blood loss in operation, hospitalization time, healing time, and Harris hip joint functional score were compared and analyzed. Results:Operation time and the amount of intraoperative blood loss in PFNA group were less than that in InterTAN group. Hospitalization time,fracture healing time and Harris hip joint functional score after ten months had no significant difference between the two groups. And 59 cases in total were followed up with an average of 11.5 months (from 9 to 16 months) . In PFNA group, 27 patients were followed up, and one patient was lost to follow up, who died because of chronic renal insufficiency. The rest 26 patients all achieved bony union (including one case of hip versus) . At follow-up 9 months, hip joint function was excellent in 18 cases, good in 6, fair in 2, bad in 1, and the excellent-good rate was 88.9%. In InterTAN group,32 patients were followed up,and two cases were lost to follow up. In followed-up cases, there was one patient who was no healing of fracture. After hip arthroplasty, this patient got recovery. The hip joint function was excellent in 21 cases, good in 7, fair in 3, and bad in 1. The differences between the two groups were not statisticaly significant. Conclusion:Both PFNA and InterTAN can treat intertrochanteric fractures in the elderly with good result,but PFNA has obvious advantages over InterTAN on less hemorrhage and operation time.

OBJECTlVE To study the effect of eucaIyptus oiI on fetus skeIetaI deveIopment of retin-oic acid( RA)induced teratogenic rats. METHODS Forty-two pregnant SD rats were randomIy and equaIIy divided into 6 groups:eucaIyptus oiI 100,200 and 300 mg·kg-1+RA groups,soIvent group(peanut oiI+RA)group,RA group and normaI group with normaI diet. Three eucaIyptus oiI and soIvent groups were ig given eucaIyptus oiI in 100,200,and 300 mg·kg-1 and peanut oiI 2 mL at the 7th to 14th day of gestation,respectiveIy,and RA 40 mg·kg-1 at the 10th day of gestation. RA group were ig given RA 40 mg·kg-1 at the 10th day of gestation. AII pregnant rats were sacrificed at the 21th day. The Iength of fetus body and taiI as weII as body mass of the embryos were measured. 1/ 2-1/ 3 fetaI rats from each Iitter were randomIy extracted to observe skeIetaI deveIopment under a stereoscope by staining with aIcian bIue and aIizarin red S. The Iength of Iimbs and bone ossification was measured. RESULTS The fetus body mass,body Iength,taiI Iength of normaI group significantIy surpassed those in the other groups(P﹤0.05,P﹤0.01). The fetus body mass and body Iength of each eucaIyptus oiI group were significantIy better than RA group(P﹤0.05,P﹤0.01). The fetus body mass,body Iength and taiI Iength of soIvent group were not significantIy different from those in the RA group. The fetus taiI Iength in eucaIyptus oiI groups had no significant difference compared with RA group. The Iimb and bone ossification of normaI group were Ionger than in RA group(P﹤0.05,P﹤0.01). The Iimb Iength of the eucaIyptus oiI groups was Ionger than in RA group and soIvent controI group(P﹤0.05,P﹤0.01),but there was no difference between the soIvent controI group and RA group. The Iimb ossification of each eucaIyptus oiI group was aIso Ionger than that in RA group and soIvent controI group(P﹤0.05,P﹤0.01),but there was no difference between the soIvent controI group and RA group. CONCLUSlON EucaIyptus oiI can antagonize the retardation of skeIetaI growth and ossification of fetaI rats caused by RA.