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Objective:To compare the dosimetric differences between the VenusX accelerator with an orthogonal dual-layer multi-leaf collimator (MLC) and the Varian′s CLINAC IX and EDGE accelerators with a single-layer MLC for hippocampus protection in the whole-brain radiotherapy (WBRT).Methods:Forty patients with multiple brain metastases admitted to the Radiotherapy Department of the Shanghai General Hospital from June 2021 to February 2023 were selected in this study. Three whole-brain treatment plans were designed based on the above three accelerators for each patient. Under the same prescription dose, radiation field, and plan constraints, the three plans were compared in terms of the dosimetric differences in target volumes, hippocampi, and adjacent organs at risk (OARs), as well as the execution efficiency.Results:For the planning target volume (PTV), there were statistically significant differences in approximate maximum dose ( D2) between the VenusX and IX plans ( t = 4.94, P < 0.05), in approximate minimum dose ( D98) between the VenusX and EDGE plans ( t = 5.98, P < 0.05), in the target conformity indices (CIs) between VenusX plan and EDGE plans, and between the VenusX and IX plans ( t = -6.84, -14.30; P < 0.05), and dose homogeneity indices (HIs) between the VenusX and IX plans ( t = 3.48, P < 0.05). For OARs, the maximum doses ( Dmax) and average doses ( Dmean) to bilateral hippocampi of the VenusX plan were lower than those of the EDGE and IX plans ( t = 8.59-17.11, P < 0.05); the maximum doses ( Dmax) to bilateral lenses, bilateral optic nerves, and optic chiasma of the VenusX plan were lower than those of the other two plans ( t = 2.10-20.80, P < 0.05); and the differences between the maximum doses ( Dmax) to the brain stem of the VenusX and EDGE plans were statistically significant ( t = 3.86, P < 0.05). In terms of plan execution efficiency, the number of machine jumps (MU) and the treatment time of the VenusX plan were higher than those of the EDGE and IX plans, with statistically significant differences ( t = -56.48, -56.90, P < 0.05). Conclusions:The doses to target volumes of the three treatment plans all meet the prescription requirements, and the VenusX plan outperforms the EDGE and IX plans in the protection of OARs. Despite the reduced execution efficiency, the VenusX plan shortens the actual treatment time by improving the dosage rate, thus meeting the clinical requirements.
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@#<b>Objective</b> To compare the effects of different respiratory signal acquisition methods on the delineation of moving tumor targets. <b>Methods</b> A cube phantom containing a sphere was placed on a motion platform to simulate respiratory movement by setting motion period, frequency, and direction. Respiratory signal was acquired by real-time position management (RPM) method and GE method independently. Target delineation was conducted using the maximum intensity projection (MIP) sequence. The difference between the reconstructed volume and the theoretical moving volume was compared under the two respiratory signal acquisition methods for cube and sphere targets. <b>Results</b> Under the same respiratory signal acquisition method, the same respiratory amplitude, and different respiratory frequencies, reconstructed volume changes were relatively small. For the sphere target, the deviation between the reconstructed volume and the theoretical moving volume was −1.5% to 5.7% with the RPM method and −1.3% to −13.8% with the GE method (both <i>P</i> < 0.05). For the cube target, the deviation between the reconstructed volume and the theoretical moving volume was 0.2% to 0.9% with the RPM method and −2.6% to 0.9% with the GE method, with no statistical significance. <b>Conclusion</b> For small-volume sphere targets, the target volumes obtained from MIP images by the two respiratory signal acquisition methods are both smaller than the actual moving volume. For large-volume cube targets, there is no significant difference between the reconstructed and theoretical results with any respiratory signal acquisition method. The RPM method produces smaller deviation and better image quality when reconstructing small-volume targets.
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Objective To explore the rules of early pregnancy related hormone changes in different pregnancy outcomes.Methods Three hundred and fourteen women at early pregnancy women were selected as our subjects.And they were followed up until 3 months of gestation.chemiluminescence analysis was used to test serum human chorionic gonadotropin (β-HCG),progesterone,estradiol and testosterone levels all pregnant women.According to the pregnancy outcome,clinical symptom and body mass index,all subjects were divided into normal and abnormal group.Results Among 314 cases of early pregnancy women,the normal pregnancy group was 53.18％ (167/314) and the abnormal pregnancy were 46.82％ (147/314).While in abnormal pregnancy group,women with the threatened abortion and continues pregnancy were 102 cases(69.39％),with inevitable abortion group were 29 cases (19.73％),and with embryos diapauses were 16 cases (10.88％).Serum estradiol level of cases in normal pregnancy group was (3104.6 ± 1507.1) pmol/L,higher than that in threatened abortion and continues pregnancy,threatened abortion group and inevitable abortion group((2 361.0 ±1 057.9) pmol/L,(1 250.0 ±624.5) pmol/L,(1 465.7 ±724.4) pmol/L)),and the differences were statistically significant(P ＜ 0.05).In normal pregnancy group,the level of serum β-HCG,estradiol and testosterone were positively correlated with gestational age (r =0.57,0.62 and 0.24 ; P ＜ 0.05).However,progesterone levels had no correlation with gestational age (r =0.15,P =0.06).Conclusion Dynamic detection of early pregnancy can guide clinicians to colytic therapy.
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Objective To investigate the relationship of sermn C-reactive protein(CRP), IL-18 and insu-lin resistance(IR) in women with polycystic ovary syndrome (PCOS). Methods 36 women with PCOS (study group) and 20 healthy women (control group) were recruited. Serum C RP, IL-18 and sex hormone concentration were tested. Oral glucose tolerance tests (OGTT) and insulin release tests (IR) were conducted in all cases. Body mass index (BMI), fasting glucose to insulin ratio(FGIR), 2-hour glucose to insulin ratio(G120/I120) and homeo-markedly higher T level, LH/FSH ratio , logCRP and IL-18 than control group[(2.77±1.30) nmol/L vs (1.21±0.67) nmol/L, (2.31±0.87) vs (0.58±0.32), (0.16±0.20) vs (-0.47±0.38), (0.21±0.08) μg/L vs vs (22.23±2.68 ) kg/m2, P<0.05] and fasting insulin (I0) concentration [(35.76±24.11) mU/L vs (11.90± 5.32) mU/L, P<0.05)], higher serum glucose (G60=(9.77±2.75) mmol/L vs (7.84±2.02) mmol/L, G120= (7.97+2.07 ) mmol/L vs (6.24±1.80) mmol/L, P<0.05), insulin (I60= (228.38±60.16) mU/L vs (132.46±60.15) mU/L,I120= (172.94±48.39) mU/L vs (90.63±39.79) mU/L,P<0.05 for each) after OGTT and IRT than control group. HOMA-IR increased and FGIR decreased more significantly in study group than controls group (HOMA-IR=(9.59±4.72)vs (3.06±0.82), FGIR=(0.11±0.04) vs (0.23±0.02), HOMA-IR (r=0.5 and 0.37,P<0.05), IL-18 was positively correlatrd with BMI and HOMA-IR (r=0.58 and 0.61, P<0.05). Partial correlation showed that logCRP was positively correlated with HOMA-IR (r=0.46, P< 0.05), but negatively correlated with FGIR and G120/I120(r=-0.54 and -0.48,P<0.05 for all) in test group. Conclusion IR exists in women with PCOS, and their increased serum CRP and IL-18 level shows positive correla-tion with IR,demonstrating that chronic inflammation may participate in the pathogenesis of PCOS, and may have correlation with insulin resistance.
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s Objective To investigate the predictive value of maternal serum C reactive protein,IL 6 and glucose concentration for the early intrauterine infection in patients with preterm premature rupture of the membranes(PPROM).Methods Amniotic fluid(AF) was collected from patients with PPROM,IL 6,glucose concentration,anti Chlamycdia trachomatis, anti lytomegalovirus IgM and ureaplasma urealytiaum were detected and cultured.Results The most sensitive test was AF IL 6 determination(P