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Objective:To reconstruct the dose of nasopharyngeal carcinoma and verify the results of the whole-process radiotherapy plan based on log files and cone beam CT (CBCT).Methods:A total of 15 patients with nasopharyngeal carcinoma who received volumetric modulated arc therapy (VMAT) with Halcyon accelerator in the Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February to September 2022 were retrospectively selected. Log files and CBCT for all fractionated radiotherapy were recorded. The errors of monitor unit (MU), gantry angle, and multi-leaf collimator (MLC) leaf position per control point were analyzed. The adaptive CT (aCT) were generated according to CBCT and planned CT (pCT) using a commercial software Velocity TM, and the similarities among aCT, pCT and CBCT were analyzed. The original plan was modified from the log files and imported into the treatment planning system to calculate the delivered dose on the corresponding fractionated aCT to reconstruct the fractionated dose. And all the reconstructed doses were mapped back to pCT to obtain the cumulative dose. Theγpass ratios with criteria of 2 mm/2% and 2 mm/3% and the dose differences between the planned dose and the cumulative dose in the planning target volume (PTV) and organs at risk (OAR) were compared. Results:The root mean square (RMS) and the 95th percentile of the errors of MU, gantry angle and MLC leaf position errors were within an acceptable range. The aCT generated by Velocity TM had the anatomical structure of CBCT and the resolution, contrast, noise characteristics of pCT, which could be directly used for dose calculation. Compared with the planned dose, the changes of V 70 Gy of nasopharyngeal primary tumor (PTV nx), V 68 Gy of cervical glands (PTV nd) and V 60 Gy of planning target volume (PTV1) were -0.88%±1.91%, -2.99%±2.99% and -0.63%±0.93%, respectively, and V 40 Gy of parotid gland was increased to 2.65%±2.63%. Cumulative dose showed different degrees of PTV dose decrease ( P<0.05) and parotid dose was increased ( P<0.05). The γ pass ratio (2 mm/3%) between the cumulative dose and planned dose was 97.3%±2.7% and >95.0% in 86.7% of patients. Conclusions:Based on the log files and CBCT, the whole-process dose reconstruction of nasopharyngeal carcinoma patients can be carried out. According to the results of dose reconstruction, the radiotherapy effect of the target area and OAR can be quantitatively evaluated. In the case of high dose coverage and conformity of the original plan, the reconstruction results show that the cumulative dose coverage of the target area is decreased, whereas that of the parotid gland is increased.
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Organoid is a newly developed cellular there-dimensional culture system in recent years. Organoids have a three-dimensional structure, which is similar to that of the real organs. Together with the characteristics of self-renewal and reproduction of tissue origin, organoids can better simulate the function of real organs. Organoids provide a new platform for the study of organogenesis, regeneration, disease pathogenesis, and drug screening. The digestive system is an essential part of the human body and performs important functions. To date, organoid models of various digestive organs have been successfully established. This review summarizes the latest research progress of organoids of taste buds, esophagi, stomachs, livers and intestines, and prospects future application of organoids.
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Humans , Organoids , Intestines , LiverABSTRACT
The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiplecountries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few caseshave reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computedtomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance,thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, andpneumothorax were also observed during the course of the disease.
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Objective To explore the therapeutic effect of fluorouracil combined with radiotherapy on patients with primary liver cancer and its effect on the levels of serum lipid peroxide (LPO) and malondialdehyde (MDA). Methods From March 2016 to March 2017, a total of 108 patients with primary liver cancer were randomly divided into two groups: radiotherapy group and combined treatment group, with 54 cases in each group. The patients in the radiotherapy group were treated with radiotherapy, while the patients in the combined treatment group were treated with fluorouracil combined with radiotherapy. Biochemical assays were used to detect the levels of aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), fibrinogen (FIB), activated partial thromboplastin time (APTT), and prothrombin time (PT). The enzyme-linked immunosorbent assay was used to detect serum hyaluronidase (HA), laminin (LN), and type III procollagen (PCIII) levels. The flow cytometry was used to detect T lymphocyte subgroup levels. LPO and MDA were detected by immunoturbidimetry. The total effective rate was compared between the two groups. Results The levels of AST, GGT and ALT in the combined treatment group were significantly lower than those in the radiotherapy group (P<0.05). After treatment, the FIB level in the combined treatment group was higher than that in the radiotherapy group, and the APTT and Pt levels were lower than those in the radiotherapy group (P<0.05). The levels of HA, LN and PCIII in the combined treatment group were lower than those in the radiotherapy group (P<0.05). After treatment, the CD8+ level in the combined treatment group was lower than that in the radiotherapy group, while the CD4+ and CD3+ levels were higher than those in the radiotherapy group (P<0.05). The level of LPO and MDA in the combined treatment group was lower than that in the radiotherapy group (P<0.05). The total effective rate of the combined treatment group was higher than that of the radiotherapy group (P<0.05). Conclusion The treatment of primary liver cancer patients with fluorouracil combined with radiotherapy could improve the liver function and coagulation function, improve the immune function, and reduce the severity of liver fibrosis and oxidative stress response of patients. The effect of the combination treatment was significant.
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Objective To explore the effects of Roux-en-Y gastric bypass (RYGB) on hepatic autophagy in obese diabetic rats.Methods Sprague-Dawley diabetes rats were randomly divided into three groups:diabetic group(n =8),diabetic sham RYGB group (n =8) and diabetic RYGB group (n =8).Hyperinsulinemic-euglycemic clamps with tracer infusion were completed to assess insulin sensitivity (IS).Triglyceride (TG) levels in liver tissue were tested.The protein expression levels of P62 (sequestosome 1)and the conversion of LC3 (microtubule-associatedprotein 1 light chain 3) in liver were detected by Western blot.The concentration of glucagon-like peptide-1 (GLP-1) in plasma was detected by ELISA and the correlation between GLP-1 and autophagy was analyzed in 2 weeks after operation.Results In comparison with diabetic and diabetic sham RYGB groups,IS increased by 63％ (F =10.87,P ＜ 0.01) and TG content decreased by 91％ (F =146.3,P ＜ 0.01) in the liver in RYGB group.In RYGB group,the conversion of LC3-Ⅰ to LC3-Ⅱ raised(F =17.01,P ＜ 0.01),the protein expression of P62 decreased(F =19.77,P ＜0.01) and the concentration of GLP-1 in plasma increased by 90％ (F =112.8,P ＜ 0.01).The marked increase of autophagy in liver after RYGB correlated with the plasma GLP-1 level (r2 =0.66,P =0.014 3)Conclusions RYGB reduces hepatic lipid toxicity and improves lipid metabolism disorder by increasing autophagy,increased GLP-1 secretion after RYGB may be one of the reasons for activating autophagy.
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Objective: To evaluate the feasibility and effectiveness of proximal femoral nail anti-rotation (PFNA) combined with curettage and bone graft through Watson-Jones approach in the treatment of proximal femur benign tumors and tumor like lesions. Methods: The clinical data of 38 patients with benign tumors and tumor like lesions in the proximal femur who were treated through the Watson-Jones approach with PFNA combined with curettage and bone graft between January 2008 and January 2015 were retrospective analysed. There were 24 males and 14 females with an average age of 28 years (range, 15-57 years). Pathological types included 20 cases of fibrous dysplasia, 7 cases of bone cyst, 5 cases of aneurysmal bone cyst, 3 cases of giant cell tumor of bone, 2 cases of enchondroma, and 1 case of non-ossifying fibroma. Before operation, hip pain occurred in 19 patients, pathological fracture occurred in 12 patients, limb shortening and coxa varus deformity was found in 4 patients, and 3 patients received surgery for the local recurrence. The operation time, intraoperative blood loss, and full-weight bearing time after operation were recorded. Patients were followed up to observe union of bone graft and the position of internal fixator on X-ray films and CT images. Visual analogue scale (VAS) score was used to evaluate the level of pain. The Musculoskeletal Tumor Society (MSTS93) score was used to evaluate lower limb function. Harris hip score was used to evaluate hip joint function. Results: The operation time was 130-280 minutes (mean, 182 minutes) and the intraoperative blood loss was 300-1 500 mL (mean, 764 mL). After operation, 3 cases of fat liquefaction of incision healed successfully by carefully dressing, and the rest incisions healed by first intention. All patients started partially weight-bearing exercise at 2-4 weeks after operation. The total weight-bearing time was 3-6 months (mean, 4.2 months). All the patients were followed up 24-108 months (median, 60 months). Imaging examination showed that the bone graft fused and the fusion time was 8-18 months (mean, 11.4 months). During the follow-up period, there was no complication such as pathological fracture, femoral head ischemic necrosis, hip joint dislocation, internal fixation loosening and fracture, and no tumor recurrence or distant metastasis occurred. At last follow-up, the VAS score, MSTS93 score, and Harris score were significantly improved when compared with preoperative ones ( P<0.05). Conclusion: The treatment of proximal femoral benign lesions by PFNA combined with curettage and bone graft through the Watson-Jones approach is safe and effective, with advantages of better mechanical stability, less residual tumor, and less postoperative complications.
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Objective To investigate the effects of RYGB on hepatic and peripheral insulin sensitivity in type 2 diabetes rats and the mechanisms.Methods Sprague-Dawley rats were divided into 2 groups:diabetic RYGB group (n =10) and diabetic sham RYGB group (n =10).The hyperinsulinemiceuglycemic clamp with tracer infusion was completed at 2 weeks postoperatively to assess insulin sensitivity.The lipid content in liver tissue was examined.Malondialdehyde (MDA) and superoxide dismutase (SOD) activities in the liver were measured.The protein expressions of PERK and p-PERK in livers were also detected by Western blot.Results RYGB significantly improved hepatic insulin sensitivity index and decreased hepatic triglyceride concentration (P ＜ 0.05),without an improvement in peripheral insulin sensitivity.The ratio of MDA to SOD and the protein expression of p-PERK in the livers were lower in the RYGB group than in the sham RYGB group.Conclusions The increased insulin sensitivity after RYGB occurs earlier in the liver than in the muscle tissue.The amelioration of hepatic tissue lipotoxicity after RYGB decreased the degrees of oxidative stress and endoplasmic reticulum stress,which may contribute to the improved hepatic insulin sensitivity.
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Objective To evaluate the effect of the discrepancy of the dose calculation results of different algorithms upon the CyberKnife lung tumor treatment plan,and assess the impact of tumor volume and location on the dose calculation results. Methods Thirty-two cases of lung tumors were treated with MultiPlan 5.2.1 planning system of CyberKnife VSI.Ray Tracing and Monte Carlo algorithms were adopted to calculate the dose distribution, and then the calculation results were statistically compared between two algorithms. Results For the enrolled cases,the calculation results of these two algorithms demonstrated that the deviation range of prescription dose coverage of planning target volume (PTV),conformal index,new conformal index and uniformity index were 0.93%~68. 80%, 0.87%~17. 21%,-212.38%~8. 27% and 0%~15. 17%, respectively. Conclusions In the CyberKnife treatment of lung tumors, the volume and location of tumors exert significant impact on the discrepancies of the dose calculation results of different algorithms. The smaller tumor volume and longer beam heterogeneity path are likely to generate a greater discrepancy. It is recommended to adopt or refer to the calculation results of Monte Carlo algorithm to deliver corresponding treatment.
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Objective To establish a rapid synchrony tracking precision detection method for the CyberKnife system by comparing the data between experimental measurements and end to end (E2E) result.Methods The auto quality assurance (AQA) phantom was placed on the synchrony motion plat and irradiated by two orthogonal beams.The concentricity of the beam projection center on the film and the wolfram center were analyzed through AQA software to detect tracking precision.The planning implement time of experimental measurements and E2E was then compared.Results No significant difference was found between the measurement and E2E data (P ＞ 0.05).The time for setting up and modeling in two approaches was identical and the average time for planning implement was 144 and 723 s,respectively.Conclusions The method in our analysis could reduce the procedure time and supplement the AQA and synchrony E2E test,which might be conducted in the morning quality assurance (QA) or weekly QA for CyberKnife system.
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Objective To measure the actual absorbed dose of the target in the QUASAR Respiratory Motion Phantom using the CyberKnife Synchrony Respiratory Tracking System, and to evaluate the effect of density heterogeneity on the absorbed dose of tumor gross target volume ( GTV ) . Methods Nine groups were obtained by making different patterns of QUASAR phantom:rib thickness of 0, 20, and 50 mm, and motion amplitudes of 0, 10, and 15 mm. The nine groups were treated with static computed tomography (CT) in different time phases of four-dimensional CT (4DCT) plan, with the same beam and number of monitor units, and the 4D accumulated dose was calculated. The doses of static and 4D plans were calculated using Ray-tracing and Monte Carlo algorithms, and the absorbed doses of GTV in the nine groups were measured at the same time. Results There were a decrease in calculated absorbed dose of GTV and an increase in deviation between the planned and actual dose, with the increases in simulated rib thickness and motion amplitude. Conclusions The density heterogeneity has an impact on the absorbed dose of GTV. Both static CT and 4DCT plan can evaluate the absorbed dose of GTV in case of small rib thickness and motion amplitude, and 4DCT plan with Monte Carlo algorithm may be the optimal method for evaluation of the absorbed dose of GTV in case of large rib thickness and motion amplitude ( deviation<3%)
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Objective To measure the actual absorbed dose of the target in the QUASAR Respiratory Motion Phantom using the CyberKnife Synchrony Respiratory Tracking System, and to evaluate the effect of density heterogeneity on the absorbed dose of tumor gross target volume ( GTV ) . Methods Nine groups were obtained by making different patterns of QUASAR phantom:rib thickness of 0, 20, and 50 mm, and motion amplitudes of 0, 10, and 15 mm. The nine groups were treated with static computed tomography (CT) in different time phases of four-dimensional CT (4DCT) plan, with the same beam and number of monitor units, and the 4D accumulated dose was calculated. The doses of static and 4D plans were calculated using Ray-tracing and Monte Carlo algorithms, and the absorbed doses of GTV in the nine groups were measured at the same time. Results There were a decrease in calculated absorbed dose of GTV and an increase in deviation between the planned and actual dose, with the increases in simulated rib thickness and motion amplitude. Conclusions The density heterogeneity has an impact on the absorbed dose of GTV. Both static CT and 4DCT plan can evaluate the absorbed dose of GTV in case of small rib thickness and motion amplitude, and 4DCT plan with Monte Carlo algorithm may be the optimal method for evaluation of the absorbed dose of GTV in case of large rib thickness and motion amplitude ( deviation<3%)
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Objective To investigate the effects of Roux-en-Y gastric bypass (RYGB) on hepatic and peripheral insulin sensitivity in rats with type 2 diabetes and their possible mechanisms.Methods 5-6 week old SPF male Sprague-Dawley rats were divided into 2 groups: diabetic RYGB group (n=21) and diabetic RYGB sham group (n=7).The hyperinsulinemic-euglycemic clamp with tracer infusion was completed at 2,4,and 8 weeks postoperatively to assess the insulin sensitivity.The lipid content in liver and muscle tissue was examined.Results Postoperatively,the diabetic RYGB group had significant decreases in weight,fat mass,and RYGB had a profound effect on the plasma lipid profile.Two weeks after surgery,the hepatic insulin sensitivity index was significantly improved and the hepatic triglyceride was decreased in the RYGB group (P<0.05).The significant increased insulin sensitivity was not detected until four weeks after RYGB surgery,the M value was significantly increased and the TG content in the muscle tissue was significantly decreased (P<0.05).Conclusions The increased insulin sensitivity after RYGB occurs earlier in the liver than in the muscle and both may contribute to the long-term remission of type 2 diabetes.Reduced lipid content in hepatocytes and skeletal muscle cells after RYGB may contribute to the improved insulin sensitivity in these cells.
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Objective To screen the optimal medium formula for obtaining high proliferation rate and differentiation rate of protocorm-like body ( PLB) of Dendrobium officinale Kimura et Migo ( D.officinale) . Methods We observed the effect of different concentrations of phytohormones such as 6-benzylaminopurine (6-BA) , 1-naphthaleneacetic acid ( NAA) , 2,4-dichlorophenoxyacetic acid ( 2,4-D) and kinetin ( KT) , or their combinations together with organic additives such as potato extractive ( PE) , banana extractive ( BE) , apple extractive ( AE) and coconut milk ( CM) on the proliferation and differentiation of PLB of Dendrobium officinale Kimura et Migo. Results 6-BA, NAA and KT at certain concentrations were beneficial to the proliferation and growth of PLB, and when the concentration of KT was 1.0 mg/L, 50-d PLB proliferation times reached to 7.20. 2,4-D had obvious inhibitory effect on PLB proliferation and growth. The combination of 6-BA, NAA and KT showed stronger effect on PLB proliferation than the phytohormones used alone, and the combination of 0.5 mg/L 6-BA, 1.0 mg/L KT and 1.0 mg/L NAA had the best effect on PLB proliferation, 50-d PLB proliferation times reaching to 9.52. Certain concentrations of PE and AE could promote PLB differentiation, and 100 g/L PE brought well-grown seedling in test tube and the highest differentiation rate, being up to 92.6% . Conclusion The optimal hormone matching and additives concentration on proliferation and differentiation of PLB of Dendrobium officinale Kimura et Migo have been obtained, which can lay a foundation for its rapid propagation and artificial seed preparation.