ABSTRACT
【Objective】 To investigate the population data of human immunodeficiency virus (HIV) infections among voluntary blood donors in Guangzhou between 2012 and 2022, and analyze its characteristics and trends, so as to provide valuable data for formulating targeted prevention and ensuring blood safety. 【Methods】 Voluntary blood donors samples from 2012 to 2022 were screened for p24 antigen and anti-HIV by two ELISA diagnostic kits and HIV RNA by nucleic acid test(NAT). The reactive blood samples were sent to the Disease Control and Prevention Center of Guangzhou for anti-HIV confirmatory test by Western blot. The population characteristics of blood donors with confirmed-positive HIV were subsequently analyzed. 【Results】 There were a total of 3 351 596 blood samples from voluntary blood donors in Guangzhou from 2012 to 2022, of which 708 samples were confirmed-positive of anti-HIV, with a total positive rate of 21.12/100 000, showing a decreasing trend (P<0.05). 1) The positive rates of age groups from high to low were 25-34 year old group, 35-44 year old group, 18-24 year old group, and≥45 year old group. The differences among various groups are statistically significant; 2) The anti-HIV positive rate of first-time blood donors (39.23/100 000) was significantly higher than that of repeat blood donors (10.78/100 000) (P<0.05); 3) The anti-HIV positive rate of male blood donors was 30.45/100 000, which was significantly higher than that of female blood donors (3.46/100 000); 4) The anti-HIV positive rate of individual blood donors (32.18/100 000) was higher than that of group blood donors (9.10/100 000) (P<0.05). 【Conclusion】 From 2012 to 2022, the confirmed-positive rate of anti-HIV among voluntary blood donors in Guangzhou showed a downward trend, which was significantly correlated with the implementation of voluntary blood donation and AIDS prevention policies. Young blood donors are of high risk of HIV, and it is necessary to enhance publicity and education on AIDS prevention through multiple channels among young population. Given that the anti-HIV positive rate of first-time blood donors is much higher than that of repeat blood donors, it is recommended to further optimize the health consultation and physical examination process before blood donation, and take multiple measures to screen high-risk behavior groups. Besides, more efforts should be made to promote publicity and education on AIDS prevention among regular blood donors. It is also important to recruit blood donors from low-risk groups and inform the donors about confidential unit exclusion.
ABSTRACT
Objective:To investigate the effect of visceral fat thickness before operation on the operative difficulty and postoperative complications in renal transplantation recipients.Methods:A total of 179 patients diagnosed with end-stage renal disease who underwent kidney transplantation in Beijing Friendship Hospital, Capital Medical University from January 2020 to January 2022 were retrospectively included. According to the visceral fat thickness measured by CT before transplantation (distance from anterior wall of abdominal aorta to parietal peritoneum at 1 cm above umbilicus), patients were divided into two groups, with 103 patients in thin visceral fat group with visceral fat thickness ≤7.5 cm and 76 patients in thick visceral fat group with visceral fat thickness>7.5 cm. The epidemiological data before renal transplantation, operative time, intraoperative blood loss, postoperative complications, renal function after transplantation and patients′ recovery state were analyzed and compared between the two groups. Measurement data were expressed as mean±standard deviation ( ± s), and independent sample t-test was used for comparison between groups. The Chi-square test was used to compare the count data. Results:The mean age and body mass index of patients in thin visceral fat group [(38.70±11.50) years and (21.28±2.93) kg/m 2] were lower than those in thick visceral fat group [(43.14±11.42) years and (24.78±3.37) kg/m 2], and the differences were statistically significant ( P< 0.05). There was no significant difference in other preoperative epidemiological data between the two groups ( P>0.05). In terms of operation difficulty, the mean operation time of thin visceral fat group was (117.16±34.33) min, which was significantly shorter than that of thick visceral fat group (137.11±20.02) min. The mean intraoperative blood loss in the thin visceral fat group was (89.12±45.95) mL, which was lower than that in the thick visceral fat group (125.39±54.88) mL, the differences were statistically significant ( P<0.001). In terms of postoperative complications, 41 patients in the thin visceral fat group had postoperative infection, incision pain and intraoperative effusion, and the incidence was 39.8% (41/103), which was significantly lower than that in the thick visceral fat group (78.9%, 60/76), the difference was statistically significant ( P<0.001); However, there was no significant difference in the incidence of Clavien-Dindo grade 3 or higher complications between the two groups ( P> 0.05). There was no significant difference in serum creatinine levels at 3, 5, 7 days and 1, 2 months after surgery among patients with different visceral fat thickness ( P> 0.05). However, the mean serum creatinine level in the thin visceral fat group was (116.06±36.45) μmol/L, which was lower than that in the thick visceral fat group (133.35±72.26) μmol/L, and the difference was statistically significant ( P=0.038). There was no significant difference in the incidence of delayed renal function recovery between the two groups ( P> 0.05). At the same time, there was no significant difference in postoperative drainage tube indwelling time and hospital stay between the two groups ( P> 0.05). Conclusions:The thicker visceral fat in end-stage renal disease patients before transplantation, the higher the incidence of general postoperative complications, but the severity of complications, patients′ recovery after transplantation and the short-term function of the transplanted kidney are not significantly related to the thickness of visceral fat in the recipients. Meanwhile, although the visceral fat thickness of the recipients in this study was correlated with serum creatinine levels at 3 months after transplantation, its correlation with long-term graft renal function and graft survival time remains to be further studied.
ABSTRACT
Objective To investigate the relationship between the expression of long non-coding RNA C-terminal binding protein 1 antisense RNA2(LncRNA CTBP1-AS2)and microRNA-140-5p(miR-140-5p)levels in nasopharyngeal carcinoma tissues and the radiotherapeutic effect and prognosis.Methods A total of 222 nasopharyngeal carcinoma patients diagnosed in Nantong Cancer Hospital from March 2018 to March 2020 were collected as the nasopharyngeal carcinoma group.The clinical data of these patients were recorded,the radiotherapeutic effect and prognosis were evaluated,and they were grouped into the survival group(n=194)and the death group(n=28).Meanwhile,another 219 patients with nasopharyngeal inflammation were collected as the control group.Correlation between LncRNA CTBP1-AS2 and miR-140-5p expression levels in nasopharyngeal carcinoma patients was calculated using Pearson correlation analysis.Kaplan-Meier survival curve was applied to analyze the relationship between the expression levels of LncRNA CTBP1-AS2 and miR-140-5p in nasopharyngeal carcinoma tissue and prognosis.Multivariate analysis was conducted on the prognosis of nasopharyngeal carcinoma patients using Cox proportional risk regression model.Results The expression level of LncRNA CTBP1-AS2 in the tissues of patients in nasopharyngeal carcinoma group(2.25±0.46)was higher than that in the control group(1.02±0.22),while the expression level of miR-140-5p(0.67±0.19)was lower than that in the control group(1.01±0.23),and the differences were statistically significant(t=35.742,16.934,all P<0.001).There was a negative correlation between LncRNA CTBP1-AS2 and miR-140-5p expression levels in nasopharyngeal carcinoma patients(r=-0.624,P<0.001).The total effective rate(74.11%)and 3-year survival rate(77.68%)of nasopharyngeal carcinoma patients with high expression of LncRNA CTBP1-AS2 after radiotherapy were lower than those with low expression(93.64%,97.27%),and the differences were statistically significant(χ2=15.578,19.331,all P<0.001).The total effective rate(93.58%)and 3-year survival rate(96.33%)of patients with high expression of miR-140-5p after radiotherapy were higher than those of patients with low expression(74.34%,78.76%),and the differences were statistically significant(χ2=15.119,15.538,all P<0.001).The magnetic resonance amide proton transfer(APT)value(2.10±0.26),the proportion of patients with radiotherapy failure(85.71%),high expression of LncRNA CTBP1-AS2(89.29%),and low expression of miR-140-5p(85.71%)in the death group were higher than those in the survival group(1.82±0.31,6.19%,44.85%,45.88%),and the differences were statistically significant(t/χ2=4.551,108.127,19.331,15.538,all P<0.001).The level of LncRNA CTBP1-AS2 was a risk factor for mortality within 3 years in nasopharyngeal carcinoma patients(HR=2.762,95%CI:1.510～5.051,P=0.001),while the level of miR-140-5p was a protective factor for mortality within 3 years in nasopharyngeal carcinoma patients(HR=0.817,95%CI:0.718～0.930,P=0.002).Conclusion LncRNA CTBP1-AS2 was highly expressed,while miR-140-5p was lowly expressed in nasopharyngeal carcinoma tissue,indicating the two may be closely related to the radiotherapeutic effect and prognosis.
ABSTRACT
Objective To explore the correlation between intestinal dose and acute radiation enteritis(ARE)in patients with cervical cancer received concurrent chemoradiotherapy,and optimize the dose limit of intestinal tissue.Methods 158 cervical cancer patients received concurrent chemoradiotherapy from 2014 to 2019 were selected in this study.According to CTCAE 5.0,patients with ARE≥grade 2 were classified as ARE≥grade 2 group,otherwise classified as ARE<grade 2 group.The intestinal dosimetric parameters of the two groups were recorded from the dose volume histogram.The correlation between ARE≥grade 2 and intestinal dosimetric param-eters were analyzed using univariate and multivariate logistic regression.Results Among the 158 cervical cancer patients received concurrent chemoradiotherapy,26 cases had grade 2 or above ARE(16.46%).The incidence of ARE≥grade 2 in patients with malnutrition and three-dimensional conformal radiotherapy was significantly higher than that in patients with well-nourished and intensity modulated radiotherapy(P<0.05).The bowelbag V5,V40 and the rectal V50 of cervical cancer patients with ARE≥grade 2 were significantly higher than those with ARE<grade 2(P<0.05).ROC curves showed that bowelbag V5 and V40 were significant predictors of ARE≥grade 2(AUC>0.7,P<0.05).Conclusions For patients with cervical cancer received concurrent chemoradiotherapy,the dose of bowelbag V5 and V40 should be considered to rationally optimize the dose of bowelbag in the radiotherapy plan,so as to reduce the incidence of ARE≥grade 2.
ABSTRACT
Objective:To investigate the value of lipid metabolism-related genes (LMRG) for predicting the efficacy of neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC).Methods:GSE46862, a genome-wide expression data of LARC treated with neoadjuvant radiotherapy, was obtained from the Gene Expression Database, and differential expression analysis was performed to obtain differentially expressed genes. The LMRG were collected from the MSigDB database and intersected with differentially expressed genes to obtain differentially expressed LMRG. Candidate LMRG were identified based on three machine learning algorithms including least absolute shrinkage and selection operator (LASSO), support vector machine - recursive feature elimination (SVM-RFE), and random forest (RF). Functional enrichment analysis was performed using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis to obtain potential function and involved pathways. The accuracy of the candidate LMRG in predicting the efficacy of neoadjuvant chemoradiotherapy for LARC was assessed using receiver operating characteristic (ROC) curve analysis.Results:A total of eight candidate LMRG ( ALOX5AP, FADS2, GALC, PLA2G12A, AGPAT1, AACS, DGKG, ACSBG2) were screened which were mainly involved in biological processes related to lipid metabolism and were involved in the regulation of several important lipid metabolism-related signaling pathways. In addition, these eight candidate LMRG possessed high area under the ROC curve (AUC) for predicting the efficacy of neoadjuvant chemoradiotherapy for LARC. Conclusion:The eight LMRG identified based on three machine learning algorithms had high accuracy in predicting the efficacy of neoadjuvant chemoradiotherapy for LARC, providing clues to identify molecular markers and potential therapeutic targets for preoperative neoadjuvant radiotherapy evaluation of LARC.
ABSTRACT
Objective:To summarize the clinical and neurophysiological characteristics of epilepsy with blink inducing.Methods:The patients with epilepsy with blink test positive who received 24 h-video-electroencephalography (24 h-VEEG) monitoring from May 2017 to May 2022 in the Xijing Hospital, the Air Force Military Medical University were enrolled. Their clinical and electrophysiological characteristics were studied and they were followed up to observe their prognosis.Results:A total of 42 patients with epilepsy with blink test positive were collected, 1 of whom was lost to follow-up. The remaining 41 patients included 18 males (44%) and 23 females (56%), whose age was 3 to 12 (8.1±2.6) years. Self-limited epilepsy with centrotemporal spikes (SeLECTS) was diagnosed in 35 patients, self-limited epilepsy with autonomic seizures in 3, and developmental epileptic encephalopathy with spike-and-wave activation in sleep in 3, respectively. The electrical status epilepticus during sleep (ESES) was found in 31 patients (76%), whereas 10 (24%) without ESES. Thirty-two patients experienced 24 h-VEEG monitoring more than twice, and 23 of them were seizure free, of whom blink inducing disappeared in 14 patients and existed in 9 in the last 24 h-VEEG monitoring. Among the 9 patients who were not seizure free, blink inducing disappeared in 3 patients and remained in 6. There was no statistically significant difference between the two groups ( P>0.05). The age of the patients whose blink inducing disappeared in the last 24 h-VEEG monitoring after treatment was (11.3±3.1) years. Meanwhile the age of the patients whose blink inducing remained was (9.1±2.3) years, and the difference between the two groups was statistically significant ( t=2.254, P=0.030). Conclusions:Blink inducing is highly age-dependent and common in self-limited focal epilepsy and developmental epileptic encephalopathy, especially in SeLECTS. Moreover, patients with ESES are more likely to be blink test positive. There was no correlation between blink inducing and seizure outcome.
ABSTRACT
@#【Objective】 To provide a new idea for the treatment of depression by summarizing the antidepressant effect and mechanism of active ingredients in functional food, and medicine and food homologous products. 【Methods】 The literature related to the antidepressant of functional food or medicine and food homologous products from September 25, 1996 to September 5, 2022 was collected through PubMed, Google Academic, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. After that, their antidepressant active ingredients and mechanism of action were systematically summarized and analyzed. 【Results】 A total of 146 pieces of literature were involved in the study, including 67 plant-derived functional foods or medicine and food homologous products, 32 antidepressant extracts (including 8 flavonoid extracts), and 87 antidepressant active ingredients. The 87 antidepressant active ingredients include 7 terpenes, 22 saponins, 15 flavonoids, 11 phenylpropanoids, 7 phenols, 6 sugars, 8 alkaloids, and 11 others. 【Conclusion】 The study summarized and analyzed the active ingredients and mechanisms of antidepressants in functional foods and medicine and food homologous products, which provides a new vision for the development of new antidepressants and a potential alternative treatment for patients with depression.
ABSTRACT
The vascular endothelial cells (VECs) hypoxia/reoxygenation(H/R) model is a classic cell model that simulates vascular endothelial ischemia/reperfusion (I/R) injury and related diseases. It has the advantages of convenient operation, intuitive image, and good stability, and can accurately reflect pathological changes at the cellular level of diseases. It is widely used in the study of molecular mechanisms of drugs and diseases.There are many similarities in the mechanism and formation between the H/R model and the I/R injury model, but the I/R model is more complex. Therefore, in recent years, many scholars have used the H/R model to simulate the I/R model for experimental research, and believe that the H/R model is also an ideal model for studying I/R. By implementing intervention measures on the established H/R model of VECs, the potential effects of the intervention measures in clinical practice can be verified, which has guiding significance for how to prevent, treat, and how to exacerbate I/R injury in clinical practice. This article introduces the different methods used by scholars in recent years, such as medium deoxygenation and mixed gas culture method, to construct H/R models using VECs cultured in vitro to simulate I/R models. The differences in methods used and the subtle differences between the same methods are also discussed. At the same time, due to the relatively single method of constructing H/R models at present, how to find new, more efficient and affordable methods based on scientific and reasonable experiments has also become a focus of attention.
ABSTRACT
Congenital insensitivity to pain with anhidrosis (CIPA) is associated with Charcot arthropathy and is a rare clinical syndrome, with limited treatment options. Through a decade-long follow-up of a single case, we aim to provide new insights for clinicians regarding the choice of surgical strategies and postoperative complications. The diagnosed patient exhibited congenital insensitivity to pain and anhidrosis, accompanied by severe Charcot arthropathy affecting the spine. Multiple postoperative complications, including implant displacement, adjacent segment pathology, and pedicle screw loosening, occurred after surgical intervention, leading to five subsequent revision surgeries. Considering the limited experience in managing CIPA-related Charcot spinal arthropathy in the literature, surgical correction remains the preferred treatment. Among the 16 cases reviewed, common postoperative complications included implant displacement, adjacent segment pathology, and pedicle screw loosening. Based on current experience, we do not recommend extensive resection and reconstruction after removing the affected vertebral body, as this may increase the risk of implant displacement. Instead, a 360° long-segment fusion may help reduce the risk of adjacent segment degeneration. Additionally, we discuss potential reasons for revision surgery after Charcot spinal arthropathy surgery and perioperative management strategies for such cases. Meticulous care, appropriate rehabilitation exercises, and metabolic therapy for bone mineralization are crucial components of the treatment for this condition.
ABSTRACT
Lower extremity atherosclerotic occlusive disease is a common vascular disease, mainly peripheral arterial disease caused by atherosclerotic plaque formation of lower extremity arterial stenosis, occlusion, resulting in chronic ischemia of the limbs. In recent years, endovascular therapy has made remarkable progress and has become the treatment of choice for atherosclerotic occlusive disease of the lower extremities. With the continuous improvement of surgical methods, the success rate of endovascular treatment has increased dramatically, but there are some differences between different interventional modalities, and the adaptive population may be different, this paper provides a review of the current progress of endovascular treatment and combines the relevant literature at domestic and international.
ABSTRACT
Establishing appropriate animal models of diabetes is of great importance for gaining in-depth understanding of the pathogenesis of diabetes, conducting diagnosis, and developing novel therapeutic interventions. Exploring methods for treating limb ischemia and comprehending its clinical pathophysiological progression is a significant approach achieved through the use of animal models of lower limb ischemia. In recent years, with the rapid advancements of various techniques, the establishment of lower limb arterial ischemia models and diabetes models has made considerable progress. The establishment of these models carries vital implications for researching and comprehending the mechanisms underlying lower limb arterial ischemia and the impact of diabetes. Successfully and reliably preparing these two models is crucial for elucidating the pathogenesis, pathophysiology, and treatment of lower limb vascular lesions associated with diabetes. This paper provides an overview of the research on the establishment methods of a diabetic rat model of lower limb ischemia, covering the principles, methods, and relevant parameters of establishing a diabetic rat model and a lower limb ischemia model in diabetes.
ABSTRACT
Objective:To explore the application value of 3D-slicer software in measuring renal volume parameters of renal transplant donors in evaluating renal function.Methods:The data of 31 renal donors admitted to Beijing Friendship Hospital, Capital Medical University from October 2019 to September 2022 were retrospectively analyzed. Glomerular filtration rate (GFR) were measured by SPECT radioactive dynamic imaging, and renal cortex volume (RCV), renal parenchymal volume (RPV) were measured after 3D reconstruction of urinary enhanced CT based on 3D slicer software. The estimated GFR(eGFR) predicted by creatinine-based GFR estimation equations (C-G equation, modified and simplified MDRD equation) and volume-based GFR estimation equations (Herts equation, Choi equation). Different eGFR were calculated, and the correlation between kidney volume parameters, eGFR equations and measured GFR was analyzed. The deviation, accuracy and consistency between different equations eGFR and measured GFR were analyzed and compared. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter-group comparison. Measurement data with non-normal distribution were represented by M( Q1, Q3), and non-parametric test was used for comparison between groups. Results:The correlation between different eGFR and measured GFR is poor, and the deviation is small, and with good accuracy and consistency. Except for the weak correlation between the Choi equation eGFR and measured GFR ( r=0.382, P=0.034), there was no significant correlation between eGFR by other equations and measured GFR ( P>0.05). Among them, the deviation between the Herts equation-eGFR and measured GFR was the smallest (0.30 mL·min -1·1.73 m -2), with a 10% coincidence rate (61.29%) and a 30% coincidence rate (96.77%), and the best consistency with measured GFR, with a consistency limit of -28.75 to 29.34 mL·min -1·1.73 m -2. Conclusion:Compared with the laboratory index formula method, the Herts equation has better prediction efficiency in estimating GFR, The measurement of renal volume parameters by 3D slicer software has a certain clinical value in evaluating the renal function of renal donors, which is worthy of further application.
ABSTRACT
The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
ABSTRACT
Objective:To evaluate the effects of whole brain irradiation (WBI) and fecal microbiota transplantation (FMT) on hippocampal neurogenesis and the composition of gut microbiota in mice.Methods:Forty specific pathogen free ICR male mice (8-week-old, weighed 30 g) were divided into four groups by simple random sample method: control group (group C), radiation group (group R), group C+FMT and group R+FMT, 10 in each group. Animal models were established by WBI at a dose of 10 Gy by 4 MeV electron beam. In group C+FMT and group R+FMT, mice were gavaged with normal fecal bacteria suspension on day 2 post-irradiation, while those in group C and group R were gavaged with phosphate buffered saline as alternative. Hippocampal tissues and feces in four groups were collected on day 15 post-irradiation. 16S rRNA sequencing was used to detect the species and abundance of fecal flora. BrdU +/NeuN + immunofluorescence staining was performed to observe the neurogenesis in hippocampus of mice. Results:WBI and FMT had no effect on survival rate and body weight of mice. WBI induced the inhibition of hippocampal neurogenesis and flora disorder. The quantity of Bacteroideae and Rumen bacteria was increased by 28.6% and 102.9%, whereas that of Lactobacillus was significantly decreased by 70.6% ( P<0.05). FMT regulated the abundance of bacteria. The abundance of Enterobacteriaceae was significantly declined by 65.1% ( P=0.028), while that of Lactobacillus was increased by 58.2% ( P=0.015). FMT also promoted hippocampal neurogenesis to some extent after WBI. Conclusions:This preliminary study demonstrates that FMT alleviates the inhibition of hippocampal neurogenesis and flora disorder induced by WBI in mice. Ionizing radiation directly acting on the whole brain of mice indirectly disturbs the composition of gut microbiota, which in turn affects the degree of hippocampal neurogenesis in the brain of mice. There is a bidirectional interaction between gut microbiota and brain.
ABSTRACT
Although the use of postmastectomy radiation therapy (PMRT) has been proven to bring survival benefit to breast cancer patients, the use of chest wall tissue equivalent filler (bolus) remains controversial. In recent years, a large number of studies have shown that the use of bolus in PMRT does not significantly improve the local control rate, while it can significantly increase the acute skin toxicity, and even leads to more frequent and longer treatment interruption. Existing retrospective studies have indicated that for breast cancer patients undergoing mastectomy and systemic therapy, if there is no skin invasion, it is recommended not to routinely use bolus during radiotherapy. However, higher-level clinical studies are needed for further confirmation.
ABSTRACT
In recent years, the issue of "reproducibility" of scientific research results has become more and more prominent. Radiobiology is a medical science that studies the biological effect of radiation on living organisms, and there is also a serious problem of "reproducibility of findings". Inaccuracy of physical dose or incomplete dosimetric reports is one of the main causes. Use of guidelines, specifications and recommendations for dosimetric measurement, such as the standardized scoring system for dosimetric reports, will help improving the standardization and accuracy of physical dose measurement in radiobiological research. In this article, multiple guidelines and recommends for improving collaboration between radiobiology and radiation physics, as well as for dose standardization of radiobiological research were evaluated, aiming to provide reference for improving the reproducibility of radiobiological research.
ABSTRACT
Objective:To identify dose-volume parameters to predict the incidence of acute intestinal toxicity in cervical cancer patients after postoperative adjuvant radiotherapy.Methods:Clinical data of 93 cervical cancer patients who underwent postoperative adjuvant intensity-modulated radiotherapy (IMRT) were retrospectively evaluated. The dose-volume parameters comprised the absolute volume of the bowel receiving 5-45 Gy (5 Gy interval) radiation dose and the total volume of the bowel. The acute radiation-induced intestinal toxicity was evaluated by Radiation Therapy Oncology Group (RTOG) criteria. The association between the irradiated bowel volume and acute intestinal toxicity was analyzed.Results:A total of 26 (28%) patients experienced grade ≥2 acute intestinal toxicity. A strong relationship between grade ≥2 acute intestinal toxicity and the irradiated small bowel volume was observed at the total volume of small bowel, small bowel V 5 Gy, V 10 Gy and V 15 Gy (all P<0.05). Small bowel V 10 Gy ( HR=1.028, 95% CI, 0.993-1.062, P=0.029) and small bowel ?V 15 Gy( HR=0.991, 95% CI, 0.969-1.013, P=0.034)were the independent risk factors for evident acute intestinal toxicity. Conclusion:Dose-volume parameters of the small bowel can be used as predictors for the occurrence of grade ≥2 acute intestinal toxicity in cervical cancer patients undergoing postoperative adjuvant radiotherapy.
ABSTRACT
Objective:To evaluate the dose calculation accuracy of cone-beam CT (CBCT) image by actual measurement method.Methods:CBCT images of 60 patients in the Second Affiliated Hospital of Soochow University from September, 2021 to May, 2022 were retrospectively analyzed. CBCT images of full-fan and half-fan scanning of the head, half-fan scanning of the chest and pelvis were obtained by the Varian OBI system. Hounsfield unit - electron density (HU-ED) curves corresponding to the scanning conditions were established with CIRS electron density phantom. The radiotherapy plans were designed on the CBCT images, and the dose calculation results of the detection point were compared with the ionization chamber measurement results to analyze the dose error. Then, three-dimensional dose verification system was adopted to detect the accuracy of the CBCT image radiotherapy plans implementation process in 60 patients, and the accuracy of dose calculation was verified according to the D 99%, D mean, D 1% of target volume, D mean and D 1% of organs at risk (OAR), and the γ pass rate. Results:In point dose detection in phantom, the dose calculation errors of CBCT images in the above four scanning patterns were -1.06%±0.87%、-1.67%±0.86%, 0.91%±0.73%, -1.54%±0.90%, respectively. In dosimetric verification based on patients' CBCT image treatment plan, the mean difference of D mean, D 99%, and D 1% of planning target volume (PTV) in all scanning modes were not higher than 2%, and the D mean and D 1% differences of other OAR were not higher than 3%, except for the lens of patients in the head. The average γ values of target volume and OAR were less than 0.5 under the criteria of 3%/2 mm. Conclusions:Under the condition of correctly establishing HU-ED curves, intensity-modulated radiation therapy (IMRT) / volumetric-modulated arc therapy (VMAT) planning based on CBCT images can be employed to estimate and monitor the actual dose to target volume and OAR in adaptive radiotherapy. Full-fan scanning patterns can further improve the accuracy of dose calculation for the head of patients.
ABSTRACT
Hemorrhage after prostate biopsy is common, but hemorrhagic shock is rare. We reported a case of sudden severe hematuria on the third day after prostate biopsy, which was considered to be bleeding at the puncture site. Conservative treatment was ineffective, and interventional embolization was performed. Bilateral bulbar urethral arteries were embolized, and the bleeding was stopped successfully. On the 4th day after embolization, the patient developed hypovolemic shock. Angiography showed bilateral prostatic artery bleeding, and the bleeding site and its superior branch arteries were embolized immediately. At 4 months after embolization, no bleeding related events occurred.
ABSTRACT
The clinical data of 10 patients with prostate abscess admitted to our hospital were retrospectively analyzed. Summarize its diagnosis and treatment characteristics and its clinical efficacy. Prostatic abscess can generally be effectively controlled by timely, adequate and effective antibiotic treatment and active control of comorbidities. Prostate abscess deroofing might be an effective treatment for patients with the failure of conservative antibiotic treatment.