Objective:To investigate the dosimetric impact of tumor treating fields (TTF) transducer arrays on concurrent radiotherapy for patients with glioblastoma (GBM).Methods:A strategy was developed to accurately simulate the dosimetric impact of TTF arrays on radiotherapy, including the establishment of accurate auto-segmentation technique for TTF arrays, determination of the relative electron density (RED) of the transducer arrays and validation of the dose calculation accuracy in the treatment planning system (TPS) for TTF arrays. Based on this strategy, the dosimetric impact of TTF arrays on clinical treatment plans of 10 patients with GBM was evaluated. Furthermore, the dosimetric comparison between the clinical plans with different beam energies were investigated when TTF arrays were used. The methods of analysis of variance were paired t-test or Wilcoxon signed-rank test based on whether the differences followed a normal distribution. Results:The auto-segmentation technique for TTF arrays was established by designing a workflow in Mim software and achieved a Dice coefficient of 0.93 and a Jaccard index of 0.87 compared to the standard contours. The RED of TTF arrays was 3.3 which was derived from the comparison between the measured and simulated percentage depth dose (PDD) with and without TTF arrays on phantom. Measured and calculated dose distributions were compared using the 2D gamma analysis. The gamma passing rates on the coronal plane of 4 mm and 5.1 cm depth were 96.64% and 94.55% at the criteria of 3% /3 mm, indicating that the calculation accuracy of algorithm in TPS for TTF arrays could meet clinical requirements. In the clinical treatment plans of patients with GBM, the presence of TTF arrays caused a mean reduction of planning target volume (PTV) dose of approximately 1%, and an increase in scalp dose of approximately 5%, with minimal impact on other organs at risk (OAR). The 10 MV plans resulted in a higher dose of PTV by 0.3% and lower dose of scalp by approximately 3% compared to the 6 MV plans, when considering TTF arrays.Conclusions:The accurate simulation strategy for the dosimetric impact of TTF arrays on radiotherapy established in this study ensures the accuracy and precision of the calculations. In TTF therapy combined with concurrent radiotherapy for GBM, TTF arrays have slight effect on PTV dose, but significantly increase scalp dose. High-energy beam can reduce the impact of TTF arrays.

Objective:To compare the plan quality between coplanar and non-coplanar volumetric modulated arc therapy (co-VMAT and nco-VMAT) techniques for the whole brain radiotherapy with hippocampus and hypothalamic-pituitary (HT-P) axis sparing.Methods:A total of 15 patients who underwent prophylactic cranial irradiation in Tianjin Medical University General Hospital from November 2021 to August 2023 were retrospectively selected. The hippocampus and HT-P axis were delineated according to Radiation Therapy Oncology Group (RTOG) 0933 and contouring guidelines for hypothalamus. Co-VMAT and nco-VMAT plans were generated for each patient with a prescription dose of 30 Gy in 10 fractions. Then, dosimetric parameters, plan robustness, plan complexity, and delivery efficiency for both plans were compared using paired t-test. Results:Both co-VMAT and nco-VMAT plans could achieve dosimetric objectives. There were no significant differences in D 2%, D 95% and conformity index (CI) of planning target volume (PTV) between the two plans. The D 98% and homogeneity index (HI) of PTV in co-VMAT showed a slight inferiority compared to that in nco-VMAT (D 98%: 26.37 Gy vs. 26.96 Gy, P=0.001; HI: 0.25 vs. 0.24, P=0.002). The D min of bilateral hippocampus in co-VMAT were 8.55 Gy (left) and 8.32 Gy (right), which were lower than 9.31 Gy (left) and 9.26 Gy (right) in nco-VMAT. In addition, the D mean of the hypothalamus and pituitary in the co-VMAT plan were lower than those in the nco-VMAT plan (hypothalamus: 11.54 Gy vs. 12.27 Gy; pituitary: 11.72 Gy vs.12.1 Gy, both P<0.001). The doses to the hippocampus and HT-P axis were highly sensitive to errors in both co-VMAT and nco-VMAT plans, while the sensitivity of dose to errors in the PTV and other organs at risk was low. The co-VMAT plan had lower complexity compared to the nco-VMAT plan, with γ passing rate at 3%/3 mm criteria of 99.06%±0.60% and 98.05%±2.89%, respectively. The average beam-on time of the co-VMAT plan was 4.8 min, approximately 2/3 of the time for nco-VMAT, while the average treatment time was 6.3 min, approximately half of the treatment time for nco-VMAT. Conclusions:Both co-VMAT and nco-VMAT can achieve hippocampus and HT-P axis sparing in the whole brain radiotherapy. In the co-VMAT plan, the D 98% of the PTV is slightly smaller, but it provides better protection for the hippocampus and HT-P axis. The doses to the hippocampus and HT-P axis are sensitive to errors in both plans. However, the co-VMAT plan has lower complexity, higher delivery efficiency, and is more suitable for clinical treatment.

Objective To explore a method of forensic identification work in the non-linear length of the plane. Methods 10 soldering tin wires with different lengths were cut out accurately and the results were read as a control (direct reading method of steel ruler). Then the ten soldering tin wires with different lengths were randomly bent and then calculated by the method studied in this paper The length as a Pixel group, and two sets of data for statistical analysis. Results The difference between the results obtained by the Pixel method and those directly read by the ruler direct reading method was not statistically significant. Conclusion The Pixel method has obvious advantages over the traditional cotton method in measuring the non-linear length of the plane (such as scars and wounds). The calculated length is more accurate and easy to operate, making the forensic identification more accurate and convincing Adapt to the requirements of litigation, forensic identification in the good prospects.

OBJECTIVETo compare the curative effect of imatinib and allogeneic hematopoietic stem cell transplant (allo-HSCT) in the treatment of chronic myeloid leukemia (CML).

METHODS292 CML patients received imatinib, and 141 patients underwent allo-HSCT. The clinical data of these patients were retrospectively analyzed to compare event- free survival (EFS) and overall survival (OS) between these two groups of patients in chronic and advanced (including accelerate and blast) phases.

RESULTS(1) EFS, OS, expected 5- year EFS and OS of imatinib group (278 patients in chronic phase) were all statistically higher than of allo-HSCT group (120 patients in chronic phase) (88.5% vs 70.0%, 93.2% vs 80.0%, 84.0% vs 75.0% and 92.0% vs 79.0%, respectively, all P values < 0.01). (2) EFS and OS of imatinib group (14 patients in accelerate and blast phases) were 42.9% and 42.9%, respectively. Meanwhile EFS and OS of allo-HSCT group (21 patients in accelerate and blast phases) were 47.6% and 57.1%, respectively. There were no significant differences in terms of EFS and OS between the two groups (P values>0.05).

CONCLUSIONEFS and OS of imatinib group were significantly higher than of allo-HSCT group for CML patients of in chronic phase. Imatinib and allo-HSCT had the similar efficacy for CML patients in accelerate and blast phases.

Adolescent ; Adult ; Aged ; Benzamides ; therapeutic use ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; therapy ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Protein Kinase Inhibitors ; therapeutic use ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Transplantation, Homologous ; Young Adult

As a core curriculum of forensic medicine,it is of great importance to improve the quality of forensic toxicological education for cultivating high-quality forensic professionals.Basing on the rich experiences of forensic teaching and expertise,well teaching effects were achieved by the reform and explorations in teaching contents and methods,development of curriculum and teachers as well as other aspects aimed to improving the quality of forensic toxicological teaching.

ObjectiveTo explore clinical,histopathological and genetic features in a case of fatal familial insomnia (FFI) and related literatures were reviewed. Methods The clinical features in one patient with FFI were analyzed,and the dead patient was examined at autopsy and histopathological studies were performed on the brain tissues; and the blood samples from the patient and some of her familial members were collected for the sequencing of prion protein gene (PRNP). Results The main clinical features included intractable insomnia,psychiatric symptoms and abnormal night sleep behavior,unsteady gait,difficulty swallowing,sudden death,and positive family history. The pathological studies showed multiple neuronal loss and gliosis of brain tissues from the proband,predominated in thalamus; and analysis of PRNP revealed gene D178N mutation,and linkage with 129 methionine (Met) allele in the proband and a relative.ConclusionsFFI patients may manifest as sudden death,and may have prominent psychiatric symptoms; the corresponding gene mutation could occur in the asymptomatic carriers; the data of autopsy and brain tissue pathology is helpful for further understanding of this disease.

Talent introduction is of great significance for the development of universities and for the raising of the academic standards.Talent introduction in general includes three links,namely,planning,the policy supporting and the concrete implementation.In the supporting policies of the talent introduction various relations should be properly handled,such as the new talents and the old talents relations,the relationship between the introduction and cultivation and the relationship between the high-level personnel and the conventional talents.

Quantity evaluation is one of inspiring means, whose essence is to put into practice the effective external stimulation for inner motivation.Its purpose is to inspire potential, to bring all people's best into full play and to raise the performance of employees. The process of quantity evaluation is also the process of developing employee's potential.Besides quantity evaluation is good for judgement and examination of the title of technical post, in favor of outstanding personnel shaping, optimization and collocation of human resources. This will make personnel management work more scientific and standardized.

Forensic autopsy is an important link in the medicolegal expertise and the foundation and prerequisite to ensure the quality of the medicolegal expertise.Although there is a rarticularity for each au- topsy case,it is the basic requirement to make great effort to do comprehensive and systcmatic autopsy. The limited definition of comprehensive and systemic autopsy is referred to the examination not only in the cranial,thoracic and abdominal cavitv,but also in special sites such as spinal cavity and peripheral nerve if necessary.The general definition of it includes both the aforementioned examination and the collection and preservation of the proper,adequate and reliable samples and material evidences.The common failures are as follows:①The detail of a case is not clear that leads to wrong plan of autopsy.②The blind autopsy be- cause insufficient preparation.③The examination is lopsided as the partial autopsy.④The operation of autopsy is not conformed to the operational standard.⑤A careless observation causes the omission of intop- sy and pathological changes.⑥The examinational description is not accurate and the records and pictures of autopsy are not clear.⑦Material evidences and samples collected are not suitable to show the truth of the autopsied case.

Objective Study the expression of endothelin(ET) of ischaemic myocardium in rat. Method Sixty Wistar rats were randomly divided into 5 groups: coronary artery simply-ligated group,drug-pre-treated group(Isoproterenol,Pituitrin),coronary atherosclerotic group,sham-operated group(as control group). The samples were cut at 15min,30min,45min,60min,90min,120min after coronary (left anterior descending) ligation, and stained with HE and strept avidin-biotin enzyme complex(SABC)method. Results The expression of endothelin was observed with light microscope. Ischaemic myocardium showed ET-positive staining at the early stage of acute myocardial ischaemia in different groups and more in the pre-treated group. Conclusion the SABC-ET method may provide a new marker for diagnosing early myocardial ischaemia, which will be helpful in confirming the cause of sudden coronary death(SCD).