1.Randomized Double-blind Placebo-controlled Trial of Modified Zuojinwan Granules in Treating Reflux Esophagitis and Functional Dyspepsia with Same Syndrome with Disharmony Between Liver and Stomach
Guangming WANG ; Wanli LIU ; Lu YANG ; Hao WU ; Yuzhen HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):112-120
ObjectiveTo observe the clinical efficacy of modified Zuojinwan granules in treating reflux esophagitis (RE) and functional dyspepsia (FD) with the same syndrome with disharmony between liver and stomach). MethodA randomized double-blind placebo-controlled clinical trial was conducted to enroll 144 patients with disharmony between liver and stomach, including 72 patients with RE and 72 patients with FD. These patients were then randomly divided into observation and control groups, with 36 patients in each group. The observation group was given modified Zuojinwan granules orally, and the control group was given placebo granules orally. They both were treated with two packs each time, twice a day, for four weeks. The traditional Chinese medicine (TCM) syndrome scores, cerebrointestinal peptides [calcitonin gene-associated titanium (CGRP), vasoactive intestinal peptide (VIP), 5-hydroxytryptamine (5-HT), and substance P (SP)], inflammatory factors [tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)], common gastrointestinal related hormones [gastrin (GAS) and motilin (MTL)], and other indicators in the two groups were compared before and after treatment, and the curative effect of TCM syndromes and the occurrence of adverse reactions were determined. At the same time, the changes in the above indicators and the curative effect of TCM syndromes in the two groups of patients with the same disease were analyzed. ResultAfter treatment, CGRP, VIP, 5-HT, SP, TNF-α, IL-6, GAS, MTL, and TCM syndrome scores in the observation group and control group were significantly improved (P<0.05). After treatment, the improvement of CGRP, VIP, 5-HT, SP, TNF-α, IL-6, GAS, MTL, and TCM syndrome scores in the observation group was better than that in the control group (P<0.05). After treatment, CGRP, VIP, 5-HT, SP, TNF-α, IL-6, GAS, MTL, and TCM syndrome scores in both groups of RE patients and FD patients were significantly improved (P<0.05). After treatment, the improvement of CGRP, VIP, 5-HT, SP, TNF-α, IL-6, GAS, MTL, and TCM syndrome scores in RE patients and FD patients in the observation group were better than that in the control group (P<0.05). In the observation group and the control group, the incidence of nausea, vomiting, fatigue, dry mouth, and other adverse reactions was lower, and there was no statistical significance. ConclusionModified Zuojinwan granules can effectively improve the TCM syndromes of disharmony between liver and stomach of RE and FD, brain and intestinal peptide, gastrointestinal hormone, and inflammatory factors and provide evidence for the clinical application of TCM theory of "treating different diseases with the same method".
2.A Multicenter, Randomized, Double-blind, and Placebo-parallel Controlled Trial of Tibetan Medicine Ruyi Zhenbaowan in Treatment of Knee Osteoarthritis
Chunquan SUN ; Yanming XIE ; Jinghua GAO ; Weiheng CHEN ; Lianxin WANG ; Shangquan WANG ; Xiangdong TIAN ; Zujian XU ; Yuxin ZHENG ; Mingwang ZHOU ; Chungen LI ; Zhanwang XU ; Jiayi GUO ; Shuangqing DU ; Qigang CHEN ; Quan JI ; Zhiqiang BAI ; Jing XIAO ; Wanli QI ; Weiyi YANG ; Jingxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):57-67
ObjectiveThis study aimed to evaluate the clinical efficacy of Ruyi Zhenbaowan(RYZBW)in the treatment of initial and early knee osteoarthritis (KOA) through a prospective multicenter,randomized,double-blind,and placebo-parallel controlled trial. MethodFrom October 13th, 2021 to December 25th, 2021, 240 KOA subjects meeting the acceptance criteria were enrolled in 15 sub-centers including Wangjing Hospital, Chinese Academy of Chinese Medical Sciences, and they were randomly divided into observation group and control group, with 120 cases in each group. The intervention measures for the observation group were RYZBW + health education, and the intervention measures for the control group were RYZBW placebo + health education. The intervention period in both groups was four weeks, and they were followed up for four weeks after the intervention. The primary outcome measure was the total score of Western Ontario and McMaster University Osteoarthritis Index score (WOMAC score), and the secondary outcome measures were the response rate of visual scale (VAS) pain score, WOMAC sub item scores (joint pain, joint stiffness, and joint function), quality of life (SF-12) score, and traditional Chinese medicine (TCM) syndrome score. Result(1) Efficacy evaluation. The marginal model results showed that the observation group was better than the control group in improving the WOMAC total score and WOMAC pain score in the treatment of KOA with RYZBW, and the difference was statistically significant (P<0.05). There was no significant difference between the two groups in improving VAS score response rate, WOMAC function score, WOMAC stiffness score, SF12-PCS (quality of life-physical health) score, SF12-MCS (quality of life-mental health) score, and TCM syndrome score. (2) Subgroup analysis. ① In terms of VAS score response rate, the response rate of the observation group was higher than that of the control group for subjects with baseline VAS score of (4, 5], and the difference was statistically significant (P<0.05). ② In terms of TCM syndrome score, for subjects aged [56, 60] and [61, 65], the decrease in total TCM syndrome score in the observation group was better than that in the control group, and the difference was statistically significant (P<0.05). ConclusionTibetan medicine RYZBW has good clinical efficacy in improving WOMAC total score, VAS score response rate, WOMAC pain score, WOMAC function score, and TCM syndrome score for patients with initial and early KOA, which can fill the lack of Tibetan medicine RYZBW in the treatment of KOA and make a demonstration study for the inheritance and development of ethnic medicine.
3.Mechanisms by which baicalein protects against steriod-induced osteonecrosis of the femoral head in rats
Wanli MA ; Hongsheng YANG ; Bo QU ; Zhengdong ZHANG ; Kai GONG ; Yanshui LIN
Chinese Journal of Tissue Engineering Research 2024;28(23):3661-3668
BACKGROUND:The development of steroid-induced osteonecrosis of the femoral head is a complex process involving multiple mechanisms.There is still no standard therapeutic drug for early intervention of this disease.Current studies have shown that baicalein has various pharmacological activities such as regulating lipid metabolism,bone metabolism,apoptosis and anti-oxidative stress,which provides an idea for the prevention and treatment of steroid-induced osteonecrosis of the femoral head. OBJECTIVE:To observe the preventive effect of baicalein against steroid-induced osteonecrosis of the femoral head and to investigate its possible mechanism. METHODS:Thirty-six 10-week-old male Sprague-Dawley rats were randomly divided into three groups(n=12 per group):blank control group,model group,and baicalein intervention group.In the model group and baicalein intervention group,intraperitoneal lipopolysaccharide and intramuscular injection of methylprednisolone sodium succinate were performed for modeling,while normal saline was used as a substitute for the modeling drug in the blank control group.Baicalein 300 mg/kg was administered by gavage(once a day for 6 weeks)at the time of initial intramuscular glucocorticoid injection in the baicalein intervention group,and baicalein was replaced by normal saline in the other two groups.The serum level of malondialdehyde in rats was detected at 2 weeks of the experiment.Blood lipid indicators and bone formation metabolic markers were detected at 6 weeks of the experiment,the histomorphometric changes of the femoral head were analyzed by hematoxylin-eosin staining,anti-tartaric acid phosphatase staining and TUNEL staining,and the femoral head was subjected to Micro-CT scanning and three-dimensional reconstruction of the bone in order to analyze the alterations of bone tissue structure and parameters. RESULTS AND CONCLUSION:The serum levels of malondialdehyde,triglyceride,β-collagen type Ⅰ carboxy-terminal peptide were increased and the serum levels of bone specific alkaline phosphatase and pre-collagen type Ⅰ amino-terminal peptide were decreased in the model group compared with the blank control group(P<0.05).The serum level of malondialdehyde decreased in the baicalein intervention group compared with the model group(P<0.05),but there was no significant difference between the baicalein intervention group and blank control group(P>0.05).The serum level of triglyceride was higher in the baicalein intervention group than the blank control group(P<0.05),but had no significant difference between the baicalein intervention group and model group(P>0.05).There were also no significant differences in the levels of bone specific alkaline phosphatase and β-collagen type Ⅰ carboxy-terminal peptide between the baicalein intervention group and the other two groups(P>0.05).The serum level of the baicalein intervention group was lower in the baicalein intervention group than the blank control group(P<0.05)but had no significant difference between the baicalein intervention group and model group(P>0.05).Histomorphological analysis of the femoral head showed that the rate of bone empty lacuna,osteoclast counting and cell apoptosis rate in the femoral head of model group rats were significantly higher than those of the other two groups(P<0.05).There was a significant increase in the number of adipocytes in the bone marrow cavity of the femoral head,bone trabeculae were thinned and sparsely arranged with more disruptions in the continuity.The incidence of osteonecrosis was higher in the model group(75%)than in the baicalein intervention group(25%;bilateral and unilateral exact significance results were both 0.05).There was also an increase in the number of adipocytes in the bone marrow cavity of the femoral head in the baicalein intervention group,and the trabecular changes were roughly similar to those in the model group.Micro-CT results showed that bone volume fraction,trabecular thickness,trabecular number,and bone mineral density decreased and trabecular separation increased in the model group compared with the blank control group(P<0.05).Overall significant bone mass loss was observed in the model group.Bone tissue parameters in the baicalein intervention group were significantly improved than those in the model group,which were reflected in bone volume fraction,trabecular thickness and trabecular separation(P<0.05),and trabecular number and bone mineral density had no significant difference between the baicalein intervention group and blank control group(P>0.05).Although baicalein failed to significantly ameliorate dyslipidemia and promote bone formation in rats with steroid-induced osteonecrosis of the femoral head,it could reduce the incidence of steroid-induced osteonecrosis of the femoral head by reducing oxidative stress damage,decreasing cell apoptosis,inhibiting osteoclasts,suggesting its effectiveness in the early prevention of steroid-induced osteonecrosis of the femoral head.
4.Effect of the staging comprehensive treatment with acupuncture-moxibustion on Bell's facial palsy in the acute stage.
Jiajie CHEN ; Haiping SHI ; Wanli GAO ; Xiaowei LI ; Yuling SHU ; Yongzhe WANG ; Binjian JIANG ; Jun YANG ; Pin WANG
Chinese Acupuncture & Moxibustion 2024;44(1):51-56
OBJECTIVES:
To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication.
METHODS:
Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups.
RESULTS:
After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05).
CONCLUSIONS
The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.
Humans
;
Facial Paralysis/therapy*
;
Moxibustion
;
Acupuncture Therapy
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Bell Palsy/therapy*
;
Face
5.Establishment of evaluation index system for hospital accreditation data quality based on analytic hier-archy process
Jingyuan XIN ; Yuan YANG ; Wanli MA ; Peifeng LIANG ; Dong ZHU ; Ping SHEN ; Zeqin ZHANG
Modern Hospital 2024;24(8):1182-1185
Objective To establish an index system for assessing the quality of hospital accreditation data and determine the hierarchical weights of indices at different levels,providing a reference for enhancing the governance of such data.Methods A quality assessment system for hospital accreditation data was developed using literature analysis method and Delphi method.The analytic hierarchy process was employed to create a pairwise comparison judgment matrix to determine the weights of indices.Results An evaluation system was constructed with the following levels:"Indicator Screening Quality-Data Reporting Quality-Data Quality Control Quality-Data On-Site Verification Quality."The system includes 4 first-level indicators and 18 second-level indicators.The indicator with the highest weight among the first-level indicators was Data Reporting Quality(0.496 5),followed by Data Quality Control Quality(0.313 2).Among the second-level indicators,Timeliness(0.428 6)and Cooperation(0.428 6)had the highest weights.Conclusion The establishment of the quality evaluation system of hospital accreditation da-ta is a strategy to optimize the control of hospital accreditation data quality and is beneficial for continuous improvement of hospital accreditation data quality.
6.Sequence analysis of whole genome of influenza A(H3N2) virus in Huai′an
Pengfei YANG ; Fang HE ; Wanli YIN ; Tong GAO ; Wang ZHANG ; Mingyue WEI ; Chenglong XIONG ; Wei HU
Chinese Journal of Experimental and Clinical Virology 2024;38(2):156-161
Objective:To study the biological traits and mutations of the influenza A (H3N2) virus in order to produce a vaccine and offer references for controlling and preventing influenza epidemics.Methods:Four strains of the influenza A(H3N2) virus were chosen from the Huai′an surveillance network laboratory. Nucleic acid extraction, library building, and sequencing (CridION x5 MKI Nanopore) were used to produce the whole-genome sequences. Using homologous alignments of whole-genome sequences, phylogenetic tree construction, and amino acid variant screening, bioinformatics analysis was carried out.Results:The nucleotide identity between 8 gene segments ranged from 97.1% to 100.0%. The gene that differed the most from the reference sequences was HA (97.1%-99.9%), and the gene that differed the least was MP (98.6%-99.9%). The HA gene (3.06%) and MP gene (1.43%) were the regions with the greatest and lowest frequencies of nucleotide site change, respectively. The rates of nucleotide change varied significantly between the genes ( χ2=14.293, P=0.046). Four influenza A(H3N2) virus strains′ whole-genome phylogenies from each of the eight gene segments maintained a roughly consistent topological structure. One strain was linked to the 3C.2a1b.1b clade, which was lost at the 142NWT, 149NGT(HA1), and 436NLS(NA). Three strains were linked to the 3C.2a1b.2a.1a clade lineage. Amantadine and NA inhibitors were effective against all Huai′an strains. Conclusions:The antigenicity of one strain of Huai'an strain changed and its matching with the vaccine strain of that year was low. It is suggested that the genetic surveillance of H3N2 influenza virus should be continuously strengthened to provide scientific basis for influenza prevention and control and influenza vaccine screening.
7.Lenvatinib modulates tumor immune microenvironment to synergistical-ly enhance immune checkpoint inhibitor treatment of hepatocellular car-cinoma
Jiamin LI ; Ruimeng YANG ; Ruili WEI ; Wang YAO ; Wanli ZHANG ; Xinqing JIANG
Chinese Journal of Pathophysiology 2024;40(5):786-795
AIM:To explore the efficacy of lenvatinib(Len)in enhancing the therapeutic effects of immune checkpoint inhibitor for hepatocellular carcinoma(HCC)and to delve into its immunomodulatory mechanisms within the tumor microenvironment.METHODS:The effects of various concentrations of Len on the migration of human umbilical vein endothelial cells(HUVECs)and the secretion of CXC chemokine ligand 10(CXCL10)were investigated,and the mechanism by which Len modulates CXCL10 secretion was validated.An orthotopic HCC model was established,and the mice bearing tumors were randomly allocated into 4 groups:PBS group,BMS-202(PD-1/PD-L1 inhibitor)group,Len group,and Len/BMS-202 group.The progression of the orthotopic liver tumors was monitored with small animal in vivo im-aging techniques.On the 13th day after the treatment,mice were sacrificed and tumor tissues were harvested for analysis.Immunofluorescence was employed to identify apoptosis,vascular architecture,and hypoxic status within the tumor tis-sue.The expression levels of proliferation marker Ki67,transforming growth factor-β(TGF-β),and the infiltration de-grees of CD4+T cells and CD8+T cells in the tumor tissue were monitored with immunohistochemistry.The secretion of im-mune factors interferon-γ(IFN-γ),CXCL10 and TGF-α in the mouse serum was quantified with ELISA.Above all data were followed by statistical analysis.RESULTS:(1)Len could facilitate endothelial cell migration within a specific range and potentiated the response of tumor cells to IFN-γ by blocking fibroblast growth factor receptor(FGFR),thereby increasing the secretion of CXCL10 from the tumor cells.(2)Compared with PBS group,tumor growth was slower in all treatment groups,with Len/BMS-202 group showing the most significant inhibition of tumor growth in tumor-bearing mice(P<0.05).(3)Compared with PBS group and monotherapy groups,Len/BMS-202 significantly promoted tumor tissue apoptosis and inhibited tumor cell proliferation(P<0.05).(4)Compared with PBS group and BMS-202 group,both Len group and Len/BMS-202 group manifested a substantial enhancement in pericytes coverage rate(P<0.01),concomitantly showing a marked improvement in hypoxic conditions(P<0.01).(5)Compared with PBS group and monotherapy groups,Len/BMS-202 group showed a significant increase in the infiltration of CD4+T cells and CD8+T cells within the tumor(P<0.01),along with a marked decrease in the expression of TGF-β(P<0.01).(6)Compared with PBS group,all treatment groups collectively induced varying degrees of secretion of IFN-γ,CXCL10 and TGF-α in mouse serum(P<0.05),with Len/BMS-202 group demonstrating the most pronounced effects(P<0.01).CONCLUSION:Lenvatinib may augment the therapeutic efficacy of BMS-202 in HCC by facilitating tumor vascular normalization,alleviating hypoxic conditions,and enhancing the secretion of CXCL10,thereby synergistically activating the tumor immune microenvironment.
8.Deciphering the suppressive effects of CBX8 on prostate cancer cell invasion
Wanli YANG ; Juan SONG ; Bing LI ; Yimin LAO
Journal of Shanghai Jiaotong University(Medical Science) 2023;43(12):1507-1519
Objective·To elucidate the regulatory mechanisms of the chromobox protein homolog 8(CBX8)in prostate cancer metastasis from transcriptome and epigenetic modification perspectives.Methods·The correlation between the expression of CBX proteins and prostate adenocarcinoma(PRAD)in The Cancer Genome Atlas(TCGA)was examined through an analysis based on cBioPortal database.A stable CBX8 knockdown DU 145 prostate cancer cell line was established via short hairpin RNA(shRNA)transfection.Subsequently,the proliferation and invasion of the CBX8 knockdown cells were analyzed by CCK-8 assay and Transwell assay,respectively.Transcriptome changes of the CBX8 knockdown cells were investigated through RNA sequencing(RNA-seq)coupled with Gene Set Enrichment Analysis(GSEA).To further evaluate the functional implications of these transcriptomic alterations,Gene Ontology(GO)for functional analysis was deployed.Moreover,to identify potentially affected signalling pathways,the Kyoto Encyclopedia of Genes and Genomes(KEGG)was utilized for pathway enrichment analysis.Lastly,the levels of H3K27me3,a key histone modification associated with CBX8,in the knockdown cells were determined by chromatin immunoprecipitation sequencing(ChIP-seq).Results·Bioinformatic analysis with cBioPortal database,based on TCGA-PRAD cohorts,unveiled a high CBX8 mRNA expression in PRAD.Knockdown of CBX8 did not significantly affect the proliferation of DU 145 cells(P>0.05),but caused a a significant increase in their invasiveness(P<0.05).The RNA-seq analysis revealed that CBX8 knockdown led to the upregulation of 750 genes and the downregulation of 951 genes.Notably,branched-chain-amino-acid aminotransferase 1(BCAT1),a gene implicated in the metastasis of various types of cancers,showed a significant increase in expression following CBX8 knockdown.GSEA showed that the expression levels were of the affected genes were related to the functions of the polycomb repressive complex 1(PRC1).A further investigation using GO and KEGG analyses identified several enriched pathways in the CBX8 knockdown cells,including transfer RNA(tRNA)aminoacylation,DNA replication,changes in aminoacyl-tRNA ligase activity,and cadherin binding.Interestingly,in terms of cell component of GO functional analysis,cell-substrate junction-related genes associated with tumor metastasis appeared to be enriched.ChIP-seq results showed a global decrease in H3K27me3 levels.Significantly,97 reduced H3K27me3 peaks were found located nearby genes that were upregulated upon CBX8 knockdown,including the transcriptional start site of BCAT1.Conclusion·CBX8 is highly expressed in prostate cancer.CBX8 suppresses prostate cancer cell invasion,possibly by recruiting the transcriptional repressive PRC1 complex to the transcription site of BCAT1,thereby inhibiting BCAT1 transcription and tumor metastasis.
9.Application of EPID-based in vivo dose verification in dynamic intensity-modulated radiotherapy for lung and esophageal cancers
Jia FANG ; Wanli ZHU ; Chunyan DAI ; Xin YANG ; Hongjuan SUN ; Yingjie MEI ; Yanfang LIU ; Shubo DING
Chinese Journal of Radiological Medicine and Protection 2023;43(9):705-711
Objective:To investigate the factors affecting the accuracy of electronic portal imaging device (EPID)-based in vivo dose verification in radiotherapy for patients with lung and esophageal cancers, and to recommend the workflow and specifications for the application of the in vivo dose verification. Methods:This study randomly selected 32 patients who received radiotherapy for esophageal and lung cancers at the Department of Radiation Oncology, Jinhua Municipal Central Hospital from May to August 2022, including 14 lung cancer cases and 18 esophageal cancer cases. Using a uRT-linac 506c linear accelerator, these patients were treated according to the dynamic intensity-modulated radiotherapy (dIMRT) and EPID-based In vivo dose verification ( In vivo EPID) plans developed with the uRT-TPOIS planning system. The In vivo dose verification performed during the treatment included 238 fractions of In vivo EPID and 80 fractions of image-guided radiotherapy (IGRT) for the lung cancer cases, as well as 414 fractions of In vivo EPID and 105 fractions of IGRT for the esophageal cancer cases. The 2D γ passing rate for each irradiation field was obtained according to the set threshold value. Furthermore, fractioned irradiation fields with γ-passing rates below the threshold value were analyzed, and primary factors decreasing the γ-passing rate were further analyzed by combining the online CT images and 3D reconstruction-derived dose. Results:For lung and esophageal cancers, the mean γ-passing rates were 95.1% ± 5.7% and 96.5% ± 4.5%, respectively at 3 mm/5%; 91.5% ± 8.4% and 92.2% ± 4.9%, respectively at 3 mm/3%, and 79.1% ± 14.7% and 83.7% ± 8.2%, respectively at 2 mm/2%, indicating no statistically significant differences between two cancers ( P > 0.05). The average γ passing rate for beam orientations near 0°/180° (Group A) was higher than those near 90°/270° (Group B) 3 mm/5%: Z = -25.4, P < 0.05; 3 mm/3%: Z = -26.8, P < 0.05). The IGRT correction of setup errors significantly improved the γ passing rates (96.3% ± 5.1% and 96.4% ± 4.9%, respectively at 3 mm/5%, Z = -5.50, P < 0.05; 92.3% ± 8.0% and 91.3% ± 7.7%, respectively at 3 mm/3%, Z = -9.54, P < 0.05). The results of In vivo dose verification were affected by changes in the volumes and motion of tumors and normal tissues, radiotherapy positioning, and adequacy of pre-treatment preparation. Conclusions:EPID-based In vivo dose verification during radiotherapy can avoid incorrect irradiation. However, it is necessary to standardize the workflow of the EPID-based In vivo dose verification to avoid the decrease in the γ passing rate caused by artificial factors.
10.Analysis of key genes and targeted protection methods affecting the survival of human islets
Wanli LI ; Yingying ZHANG ; Ting ZHANG ; Yuwei YANG ; Shanshan GU ; Lingling WU ; Shuangqin CHEN ; Jibing CHEN ; Hongjun GAO
Organ Transplantation 2023;14(2):273-
Objective To identify the key genes and targeted protection methods affecting the survival of human islets. Methods Using bioinformatics method, the gene expression profile (GSE53454) was selected through screening and comparison from Gene Expression Omnibus(GEO) database. GEO2R tool was employed to screen the differentially expressed gene(DEG) between the human islets exposed (exposure group) and non-exposed (non-exposure group) to interleukin (IL)-1β and interferon (IFN)-γ for 24, 48 and 72 h, respectively. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed by DAVID. Protein-protein interaction (PPI) network was constructed by STRING and Cytoscape apps. Results A total of 69 up-regulated DEGs and 2 down-regulated DEGs were identified. GO analysis showed that during the biological process, DEGs were enriched in the aspects of virus defense and inflammatory response. In cellular components, DEGs were significantly enriched in extracellular space, outside plasma membrane and extracellular regions. Regarding molecular functions, DEGs were significantly enriched in chemokine activity and cytokine activity. KEGG analysis revealed that DEGs were mainly enriched in multiple signaling pathways, such as cytokine-cytokine receptor interaction, virus protein-cytokine and cytokine-receptor interaction,

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