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Ulcerative colitis （UC） is a chronic inflammatory bowel disease with complex etiology. The pathogenesis of this disease， due to a combination of factors， is complex and has not yet been elucidated. Among them， intestinal mucosal barrier damage is the basic pathological change of UC. As a non-destructive response of cells， autophagy regulates intestinal mucosal immunity， inflammation， oxidative stress， and bacterial homeostasis through degradation and reabsorption to actively repair damaged intestinal mucosal barrier， exerting a key role in the occurrence and development of UC. The disease is mainly treated clinically with aminosalicylic acid preparations， glucocorticoids， and immunosuppressants. Western medicine treatment of the disease has a fast onset of effect， and the short-term efficacy is definite， but the long-term application is easy to be accompanied by more adverse reactions. Moreover， some drugs are expensive， bringing great physical and mental pain and economic burden to patients. Therefore， it is urgent to explore new therapies with stable efficacy and mild adverse effects. In recent years， a large number of studies have shown that Chinese medicine can regulate autophagy of the intestinal mucosa with multiple targets and effects and repair the intestinal mucosal barrier function， thereby inhibiting the development of UC. Many experiments have shown that the active ingredient or monomers and compound formulas of Chinese medicine can improve the immunity of the intestinal mucosa， inflammation， oxidative stress， and flora by regulating the level of autophagy to maintain the normal function of the intestinal mucosal barrier to effectively intervene in UC， providing a new measure for the prevention and treatment of UC. However， there is a lack of systematic review of Chinese medicine in regulating the level of autophagy in the intestinal mucosa for the prevention and treatment of UC. Therefore， based on the current research on UC， autophagy process， and Chinese medicine treatment， this article reviewed the relationship of autophagy and its key target proteins with UC to clarify the key role of autophagy in UC production and systematically summarized Chinese medicines targeting the regulation of autophagy to treat UC in recent years to provide new ideas for the treatment and drug development of UC.
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Ulcerative colitis （UC） is a chronic， non-specific inflammatory bowel disease. The pathogenesis of this disease is complex and is attributed to multiple factors. Intestinal mucosal barrier damage is the basic pathological change of UC， and intestinal flora disorder is one of the important characteristics of UC. Intestinal flora plays a key role in the pathological process of UC by regulating intestinal mucosal immunity and inflammatory response to repair the damaged intestinal mucosal barrier. At present， western medicine has the advantages of rapid action onset and significant short-term efficacy， but the curative effect of long-term use is not good， accompanied by many adverse reactions， causing great physical and mental pain to patients. Therefore， it is urgent to explore new treatment methods with definite long-term efficacy and mild adverse reactions. A large number of studies have shown that Chinese medicine can regulate intestinal flora through multiple targets in an all-around way， restore the homeostasis of the flora， and repair the damaged intestinal mucosal barrier， thereby inhibiting the progression of UC. Numerous studies have shown that the active components， monomers， and compounds of Chinese medicine can effectively antagonize UC by regulating the intestinal flora to improve the intestinal mucosal immunity， reduce the inflammatory response of the intestinal mucosa， and restore the normal physiological function of the intestinal mucosal barrier， providing a new strategy for UC prevention and treatment. Although there are some studies of the regulation of intestinal flora by Chinese medicine to prevent and treat UC， those studies have the shortcomings of systematic and comprehensive inadequacy. Therefore， based on the research status of UC， intestinal flora， and Chinese medicine treatment， this study reviewed the relationship between intestinal flora and UC and clarified the key role of intestinal flora in the occurrence and development of UC. At the same time， this paper comprehensively summarized the Chinese medicine that targeted the regulation of intestinal flora for the treatment of UC in the past five years to provide new strategies and ideas for UC treatment.
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Objective:To investigate the clinical efficacy of redo rectal resection and coloanal anastomosis.Methods:The retrospective and descriptive study was conducted. The clinicopatholo-gical data of 49 patients who underwent redo rectal resection and coloanal anastomosis for the treatment of local recurrence of tumors and failure of colorectal or coloanal anastomosis after rectal resection in the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to December 2021 were collected. There were 32 males and 17 females, aged 57(range,31-87)years. Redo rectal resection and coloanal anastomosis was performed according to the patient′s situations. Observa-tion indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distri-bution were represented as M( Q1, Q3) or M(range). Count data were described as absolute numbers or percentages. Results:(1) Surgical situations. All 49 patients underwent redo rectal resection and coloanal anastomosis successfully, with the interval between the initial surgery and the reopera-tion as 14.2(7.1,24.3)months. The operation time and volume of intraoperative bold loss of 49 patients in the redo rectal resection and coloanal anastomosis was 313(251,398)minutes and 125(50,400)mL, respectively. Of the 49 patients, there were 38 cases receiving laparoscopic surgery including 12 cases with transanoscopic laparoscopic assisted surgery, 11 cases receiving open surgery including 2 cases as conversion to open surgery, there were 20 cases undergoing Bacon surgery, 14 cases undergoing Dixon surgery, 12 cases undergoing Parks surgery, 2 cases undergoing intersphincter resection and 1 case undergoing Kraske surgery, there were 20 cases undergoing rectum dragging out excision and secondary colonic anastomosis, 13 cases undergoing dragging out excision single anastomosis, 12 cases undergoing rectum dragging out excision double anastomosis, 4 cases undergoing first-stage manual anastomosis, there were 21 cases with enterostomy before surgery, 16 cases with prophylactic enterostomy after surgery, 12 cases without prophylactic enterostomy after surgery. The duration of postoperative hospital stay of 49 patients was (14±7)days. (2) Postoperative situations. Fifteen of 49 patients underwent postoperative complications, including 8 cases with grade Ⅱ Clevien-Dindo complications and 7 cases with ≥grade Ⅲ Clevien-Dindo complications. None of 49 patient underwent postoperative transferring to intensive care unit and no patient died during hospitalization. Results of postoperative histopathological examination in 23 patients with tumor local recurrence showed negative incision margin of the surgical specimen. (3) Follow-up. All 49 patients underwent post-operative follow-up of 90 days. There were 42 cases undergoing redo rectal resection and coloanal anastomosis successfully and 7 cases failed. Of the 37 patients with enterostomy, 20 cases failed in closing fistula, and 17 cases succeed. There were 46 patients receiving follow-up with the median time as 16.1(7.5,34.6)months. The questionnaire response rate for low anterior resection syndrome (LARS) score was 48.3%(14/29). Of the patients who underwent redo coloanal anastomosis and closure of stoma successfully, there were 9 cases with mild-to-moderate LARS.Conclusion:Redo rectal resection and coloanal anastomosis is safe and feasible for patients undergoing local recurr-ence of tumors and failure of colorectal or coloanal anastomosis after rectal resection, which can successfully restore intestinal continuity in patients and avoid permanent enterostomy.
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Objective:To explore the rules of Traditional Chinese Medicine (TCM) prescriptions of gastroesophageal reflux disease based on Ancient and Modern Medical Records Cloud Platform.Method:The relevant medical cases from ancient medical case database, modern medical case database, shared medical case database and famous doctors' medical case database in Ancient and Modern Medical Records Cloud Platform (V2.3.8) were selected, and frequency analysis, attribute analysis, association analysis, cluster analysis and complex network analysis were performed on the herbs.Results:A total of 107 medical records were obtained, including 225 TCMs. The core medicines were Radix et Rhizoma Glycyrrhizae, Pericarpium Citri Reticulatae, Rhizoma Coptidis, Poria, and Fructus Evodiae. The drug property was mainly cold and warm, and the herbal tastes bitter and pungent. The meridian tropism of drugs mainly manifested in the spleen and stomach meridians. The core herbal pairs were Radix et Rhizoma Glycyrrhizae and Pericarpium Citri Reticulatae. The core prescription consisted of 17 herbs including Radix Glycyrrhizae, Pericarpium Citri Reticulatae, Rhizoma Coptidis, Fructus Evodiae, Poria, Endoconcha Sepiae, Herba Taraxaci, Fructus Aurantii, Radix Paeoniae Alba, Radix Bupleuri, Jiang Banxia, Rhizoma Cyperi, Radix Aucklandiae, Caulis Bambusae In Taenia, Fructus Aurantii Immaturus, Fructus Amomi, and Rhizoma Atractylodis Macrocephalae. Conclusions:Chinese medicine treatment of gastroesophageal reflux disease is mainly based on Chaihu Shugan Powder, Zuojin Pill, and Wendan Decoction. Moreover, we need to combine with clinical symptoms to add or subtract herbs.
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ObjectiveTo understand the internet media information of COVID-19 in Shanghai in 2022， to provide evidence for health administration departments to respond to public health emergencies， and to establish a comprehensive public health media surveillance system. MethodsData on internet media information and the local COVID-19 epidemic data in Shanghai from January 1 to June 30， 2022 were collected and analyzed. ResultsA total of 90.197 3 million pieces of internet media information were monitored. The top four sources of the information were Weibo （36.84%）， short videos （26.19%）， internet media （14.47%）， and forums （13.31%）. The variation trend of daily internet media surveillance information was identified with the number of newly reported cases per day， and a correlation was found （r＝0.770. After the seven-day moving average，r＝0.796）. Frequent keywords included Shanghai， cheer up， nucleic acid， new cases， local， asymptomatic， prevention and control， gratitude， isolation， epidemic prevention， supplies， pandemic response， patient， seeking help， and clearing the cases. Within the information on Weibo， in addition to netizens in Shanghai （7 823 100） who were highly concerned about the pandemic， netizens from Beijing （2 749 100）， Guangdong Province （2 352 300）， Jiangsu Province （2 189 100） and Zhejiang Province（1 532 100） also posted a relatively high amount of information related to COVID-19 in Shanghai. ConclusionThe outbreak of major infectious diseases triggers significant online activity， and platforms such as Weibo and short video platforms play crucial roles in disseminating internet media information. Weibo， short videos etc. are important platforms for current internet media information. Strengthening media information monitoring and analysis， paying close attention to hot events， taking timely response measures and actively engaging in risk communication contribute to the response and management of public health emergencies.
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Ulcerative colitis （UC） mainly occurs in the colon and rectum， with complex pathological mechanism. The occurrence of ulcerative colitis is associated with the uncontrollable inflammatory response of the intestine. The Western medicine therapy of UC mainly uses glucocorticoids and immunosuppressants to reduce intestinal inflammation. While blocking the progress of UC to a certain extent， it causes severe adverse reactions. More and more studies have confirmed that traditional Chinese medicine （TCM） has obvious advantages in the prevention and treatment of UC and can significantly reduce the recurrence of the disease. Pyroptosis， a novel form of cell death， can destroy cell structure， release intracellular pro-inflammatory substances， and mediate intestinal immune response in UC. TCM can promote pyroptosis （removing excess） or inhibit pyroptosis （replenishing deficiency）， which is consistent with the regulation of Yin and Yang. TCM plays a role in the treatment of UC mainly by inhibiting pyroptosis （replenishing deficiency） and reducing intestinal immune response. In recent years， a large number of studies have been carried out to decipher the mechanism of TCM in the treatment of UC via NOD-like receptor protein domain 3 （NLRP3）-mediated pyroptosis pathway. The results have demonstrated that NLRP3 pathway is the key target of TCM in the treatment of UC. However， a comprehensive summary remains to be carried out on the inhibition of NLRP3-mediated pyroptosis pathway by TCM in the treatment of UC. Therefore， we retrieved the articles in this field in recent years with the keywords "pyroptosis"， "NLRP3"， "ulcerative colitis"， and "Chinese medicine". The Chinese medicines regulating NLRP3 pathway mainly have the functions of clearing heat and drying dampness， harmonizing Qi and blood， moving Qi and dredging fu-organs， and invigorating spleen and removing dampness. The findings can help researchers to fully understand the mechanism of TCM in the treatment of UC via the NLRP3 pathway and provide a theoretical basis for the treatment of UC and further drug development.
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With the improvement of people's living standards and the increasing aging population， the incidence of cardiovascular diseases has sharply risen， making it the leading cause of death and a major "killer" for humans. The prevention and treatment of cardiovascular diseases still face severe challenges. Shenmai injection （SMI）， a Chinese medicinal preparation， is widely used in the prevention and treatment of cardiovascular diseases because of its individualized advantages in syndrome differentiation and definite efficacy. Meanwhile， its pharmacological effects and related mechanism are becoming increasingly clear. Modern research shows that SMI can exert cardioprotective effects by reducing myocardial inflammatory response， alleviating oxidative stress， inhibiting myocardial cell apoptosis， improving microcirculatory dysfunction after myocardial ischemia-reperfusion， protecting mitochondrial structure and function， inhibiting ventricular remodeling， reducing drug-induced cardiotoxicity， and possessing antiviral properties. Additionally， it can produce cardiovascular protection by relaxing blood vessels， protecting endothelial cells， and promoting angiogenesis. Furthermore， SMI can lower blood viscosity and lipid levels， thus improving blood rheology. In the future， more clinical trials and basic research are needed to clarify its therapeutic efficacy and target mechanism to further confirm the effectiveness and safety of its clinical application.
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Ulcerative colitis （UC） is a clinical chronic intestinal disease， and the damage of the intestinal epithelial mucus barrier is an important pathological mechanism of UC. Mucin 2 （MUC2） is a major component of the intestinal mucus barrier， and goblet cells are the “main force” of MUC2 secretion， maintaining and renewing the intestinal mucus layer to ensure its integrity. Therefore， repairing the intestinal mucus barrier by promoting the synthesis of MUC2 by goblet cells is an important strategy for the treatment of UC. Traditional Chinese medicine scholars believe that there is an inherent layer of “lipid membrane” or “fat paste” in the intestine， and pathological factors such as moisture and heat lead to the thinning of this structure， which is the fundamental pathogenesis of “diarrhea” and “intestinal dysentery”. It coincides with the damage of intestinal mucus barrier leading to UC in modern medicine. Based on this， this paper summarized the mechanism of Chinese herbal compounds or Chinese herbal active components in regulating intestinal mucus barrier to interfere with UC. It was found that Chinese herbal compounds such as Huanglian jiedu decoction， Shaoyao decoction and Compound Kusen decoction， as well as Chinese herbal active ingredients such as volatile oil of Atractylodes lancea， paeoniflorin and papaya triterpenes could promote the synthesis and secretion function of goblet cells， and achieve the purpose of “thickening intestine”， thus relieving UC symptoms.
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Ulcerative colitis （UC） is a disease that affects the mucosal and submucosal layers of the colon and is characterized by inflammation of the intestinal mucosa. The incidence of UC is increasing year by year， and it is complex and refractory， severely impacting the physical and mental health of patients. The pathological mechanism of this disease is complex， with immune responses and uncontrollable inflammatory reactions in the intestine being important physiopathologic mechanisms. Toll-like receptor 4 （TLR4）， as a transmembrane signaling receptor， plays a key role in mediating immune responses and inflammatory reactions in the development of UC. Currently， the treatment of UC mainly relies on salicylic acids， glucocorticoids， and other agents to reduce intestinal inflammation. While these drugs can partially inhibit the progression of the disease， they often come with significant adverse effects and the potential for relapse upon discontinuation. Traditional Chinese medicine （TCM） offers multiple pathways， effects， and targets for regulating the TLR4 pathway， suppressing inflammatory responses， and effectively intervening in the progression of UC. This approach has become a hot topic in the prevention and treatment of UC. Numerous studies have shown that TCM treatment of UC has unique advantages. TCM can enhance immune defenses， suppress inflammatory responses， promote intestinal mucosal healing， and maintain the balance of the intestinal microbiota by regulating the TLR4 signaling pathway， thereby effectively treating UC， with substantial progress achieved. However， there is currently a lack of comprehensive reviews on the role of TCM in regulating the TLR4 signaling pathway for the treatment of UC. Therefore， this article systematically summarized the relationship between the TLR4 signaling pathway and UC， as well as the role of TCM in this context， by reviewing relevant literature from recent years， aiming to provide new insights into the potential treatment and new drug development for UC.
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Objective:To investigate the biological characteristics of Kerstersia gyiorum and to support the rapid and accurate identification of Kerstersia gyiorum on mass spectrometry by using Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS) for self-built libraries. Methods:From November 2020 to February 2022, thirty-eight strains of Kerstersia gyiorum isolated from clinical patients of the General Hospital of Southern Theatre Command were collected and identified by the fully automated microbial analysis system (Vitek-2 Compact), the automatic microbial mass spectrometry detection system (Vitek-MS) and the 16S ribosomal RNA sequencing. Thirteen strains were randomly selected and mass spectra were obtained by using Vitek-MS. The SARAMIS software was used to construct a Kerstersia gyiorum library, and the remaining 25 strains were used to validate the constructed library. Results:The Vitek-2 Compact and Vitek MS were unable to identify Kerstersia gyiorum; 13 strains were successfully built into a self-built library of Kerstersia gyiorum by SARAMIS software, and 25 validated strains were identified as Kerstersia gyiorum with a confidence level of more than 99.0% and 100% (25/25) accuracy. Conclusion:Kerstersia gyiorum has unique mass spectrometry profile, which can be identified as species quickly and accurately by the establishment of the self-constructed library of profiles.
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Objective:To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province.Methods:A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years (except pregnant women) were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions.Results:A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 (69.2%, 95% CI: 66.5%, 72.0%) presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median ( Q1, Q3) arsenic levels were 0.31 (0.14, 0.74) μg/g in hair samples ( n = 1 079), 0.84 (0.67, 1.10) μg/L in blood samples ( n =1 091), and 60.31 (41.71, 91.52) μg/L in urine samples ( n =1 092). Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively). Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively). The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without (adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039) . Conclusion:Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.
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Objective:To analyze the dosimetric differences of volumetric modulated arc therapy (VMAT) plans for lung cancer caused by different dose calculation algorithms and radiation field settings and thus to provide a reference for designing clinical VMAT plans for lung cancer.Methods:This study randomly selected 20 patients with lung cancer and divided them into four groups of VMAT plans, namely, a group adopting two fields and two arcs based on the AAA algorithm (2F2A_AAA), a group employing two fields and two arcs based on the AXB algorithm (2F2A_AXB), a group using two fields and two arcs based on the MC algorithm (2F2A_MC), and a group adopting one field and two arcs based on the MC algorithm (1F2A_MC). Then, this study evaluated the target coverage, high-dose control, dose homogeneity index (HI), conformity index (CI), and organs at risk (OARs) of the plans using different algorithms and radiation field settings.Results:The planning target volume (PTV) results of two fields combined with two arcs (2F2A) of three groups using different algorithms are as follows. 2F2A_MC achieved better results in both D1% and V 95% (the relative volume of the target volume surrounded by 95% of the prescribed dose) of planning gross target volume (PGTV) than 2F2A_AAA (D1%: t=-2.44, P=0.03; V95%:z=-2.04, P=0.04) and 2F2A_AXB (D1%: t=2.34, P=0.03; z=-3.21, P < 0.01). 2F2A_AXB outperformed 2F2A_AAA ( z=-3.66, P < 0.01) and was comparable to 2F2A_MC in terms of the CI of PGTV. Regarding OARs, 2F2A_AXB and 2F2A_MC decreased the V5 Gy of the whole lung by 0.68% ( z=-2.69, P=0.01) and 3.05% ( z=-3.52, P < 0.01), respectively compared to 2F2A_AAA. 2F2A_AXB achieved a whole-lung Dmean of 1776.44 cGy, which was superior to that of 2F2A_MC ( t=2.67, P=0.02) and 2F2A_AAA ( t=8.62, P < 0.01). Compared to 2F2A_AAA and 2F2A_MC, 2F2A_AXB decreased the V20 Gy of Body_5 mm by 1.45% ( z=-3.88, P < 0.01) and 2.01% ( z=-3.66, P < 0.01), respectively. The results of the two groups with different field settings showed that 1F2A_MC was superior to 2F2A_MC in both the CI of PTV1 and the HI of PTV2 (CI: t=2.61, P=0.02; HI: z=-2.20, P=0.03). Moreover, 1F2A_MC increased the Dmean of the whole lung by 26.29 cGy compared to 2F2A_MC ( t=2.28, P=0.04). Conclusions:Regarding the design of VMAT plans for lung cancer, the MC algorithm is suitable for the target priority and the AXB algorithm is suitable for the OAR priority. When only the MC algorithm is available, it is recommended to choose 1F2A in the case of target priority and select 2F2A in the case of OAR priority.
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Objective:To investigate the feasibility of applying the ArcherQA three-dimensional (3D) dosimetric verification system in intensity-modulated radiotherapy (IMRT) plans for nasopharyngeal carcinoma (NPC).Methods:A retrospective analysis was conducted for 105 NPC patients′ IMRT plans developed using the Eclipse treatment planning system (TPS). Dose verification was conducted using the ArcherQA system and through portal dosimetry (PD). Moreover, this study compared γ passing rates (criteria: 3 mm/3%, TH = 10%) between ArcherQA and PD and the doses delivered to the target volume ( Dmean, D90%) and organs at risk (OARs) ( Dmean) between ArcherQA and TPS, and analyzed the 3D γ passing rates of each organ at risk calculated by ArcherQA. Results:The average 3D γ passing rate calculated by ArcherQA was (99.04±1.01)%, and the average 2D γ passing rate measured by PD was (99.49±0.78)%, with statistically significant differences ( t=-3.35, P< 0.05). The dosimetric differences to the target volume between ArcherQA and TPS were as follows: the average difference in Dmean to the gross tumor volume (GTV) was (0.57±0.48)%, and the average difference in D90% was (0.65±0.56)%. For the target volume, the average γ passing rate was (97.67±3.43)% for GTV, (97.80±4.35)% for GTVnd-L, (97.82±4.07)% for GTVnd-R, (97.88±2.44)% for CTV1, and (96.64±4.32)% for CTV2. The mean dose difference of each target volume was CTV1 (0.57±0.46)%, GTVnd-L (0.85±0.55)%, GTVnd-R (0.73±0.55)%, and CTV2 (0.88±0.52)%. For OARs, the mean γ passing rate was (99.93±0.22)% for the brainstem, (99.17±2.82)% for the optic chiasm, (100±0)% for the lens, (99.56±1.05)% for the spinal cord, (99.00±2.06)% for the thyroid, and (87.86±10.42)% for the trachea. Statistically significant differences in the average doses to OARs were observed ( t=-14.62 to 4.82, P<0.05), except for those to the left optic nerve, the right hippocampus, and the right parotid gland. Conclusions:Based on the high-performance GPU platform and the Monte Carlo dose algorithm, ArcherQA can provide accurate 3D dose distribution and 3D γ passing rates inside patients according to CT images and provide the dose volume histogram (DVH) of various regions of interest (ROIs). Therefore, the ArcherQA three-dimensional dose verification system can be applied to IMRT plans for NPC. Moreover, it is inducive to improve the treatment efficiency since it does not occupy the accelerator operation time.
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Objective:To analyze the dosimetric effects on off-center tumour treatment plan resulting from the MR-Linac-based isocenter position radiotherapy plan.Methods:The cases of 19 patients who were treated in Sun Yat-sen University Cancer Center in 2020 were collected in this study. Two different IMRT plans were designed for each patient with off-center tumor both for group A with planned isocenter position as IMRT and group B with planed target center position as geometric center. The conformity index and homogeneity index of target, the dose normal tissue and the number of MU were compared between two plans.Results:The two IMRT plans met clinical dosimetric requirements. No statistical differences were found both in homogeneity index and conformity index ( P>0.05). Also there was no differences found in doses to normal tissues. However, the MU number (1 149±903, t=2.804, P=0.012) in group A was higher than that in group B (970±652). Conclusions:It is feasible to perform MR-Linac-based off-center treatment plan.
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Objective:The medical records collected on the Ancient and Modern Medical Record Cloud Platform were used to explore the medication rules of Traditional Chinese Medicine for the treatment of ulcerative colitis.Methods:By selecting the medical cases of the modern medical database and medical cases of famous doctors in the ancient medical database on the cloud platform to analyze the frequency, attribution, association, and complex network of those medicines.Results:A total of 209 medical records were obtained, including 319 Traditional Chinese Medicines, of which the core medicines were Rhizoma Coptidis, Radix Aucklandiae, Poria, Radix Paeoniae Alba, and Radix Glycyrrhizae. The properties of those medicines were warm, mild, and cold. The main taste is bitter and sweet, and most of them attibute to spleen, stomach, and liver meridians. The core pair medicine is Radix Aucklandiae-Rhizoma Coptidis. The core prescription was composed of nine herbs including Rhizoma Atractylodis Macrocephalae, Radix Paeoniae Alba, Radix Scutellariae, Radix Aucklandiae, Rhizoma Coptidis, Radix Glycyrrhizae, Radix Pulsatillae, Poria, and Radix Codonopsis. Conclusion:The treatment of ulcerative colitis with Traditional Chinese Medicine mainly include Sijunzi Decoction and Xianglian Pill, accompanied with those medicines which could clear heat with detoxication function, cool the blood and stop diarrhea, By doing so, ulcerative colitis could be treated both in the surface and the root.
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Objective:Based on the National Patent Database, this paper analyzes the medication rule of Traditional Chinese Medicine (TCM) compound patents for the treatment of colorectal cancer in the past 10 years.Methods:By searching for and extracted screening out TCM compound patents for the treatment of colorectal cancer and after the dada selection, data entry , data specifications, the compound patents database for the treatment of colorectal cancer was established. then used IBM SPSS Modeler and IBM SPSS Statistics software to perform frequency analysis, attribute analysis, association analysis and cluster analysis of TCM.Results:A total of 97 compound patents were included, including 411 TCM, among which the core medicines are Atractylodis macrocephalae rhizoma, Hedyotis diffusa, Astragali radix, Glycyrrhizae radix et rhizoma, Scutellariae barbatae herba, Poria, etc. The medicine is mainly cold and warm; The medicine mainly tastes bitter and sweet; The spleen meridian is the main meridian. The cluster analysis result shows there are 7 categories, and the paired TCM with strong correlation includes Hedyotis diffusa- Scutellariae barbatae herba, Atractylodis macrocephalae rhizoma- Curcumae rhizoma, Astragali radix- Codonopsis radix and so on. Conclusions:Treating colorectal cancer should take those medicine which could invigorate the spleen and nurture the deficiency, such as Atractylodis macrocephalae rhizoma, Astragali radix, Codonopsis radix, while for clearing away heat, detoxifying, promoting blood circulation and removing blood stasis, such as Hedyotis diffusa, Scutellariae barbatae herba, and Curcumae rhizoma. At the same time, it can be combined as appropriate, attacking and replenishing simultaneously, regulating qi and blood.
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ObjectiveTo determine the current status and characteristics of tuberculosis （TB） registration and treatment in Kashgar， and to provide scientific evidence for targeted prevention and control measures in future. MethodsKashgar registered TB cases information in 2011 to 2020 was exported from the National Tuberculosis Management Information System. Descriptive epidemiological analysis was conducted using Stata 12.0. ResultsFrom 2011 to 2020， number of Kashgar registered TB patients showed rising trend， followed by a falling one. Average proportion of annual decline in registered TB incidence was 40.48% from 2018 to 2020. From 2011 to 2016， number of registered TB patients in women was always higher than that in men， with a gender ratio （male ： female） of about 0.90. In 2017， the gender ratio was 1.00. From 2018 to 2020， the gender ratios were 1.05， 1.20， and 1.12， respectively. Moreover， number of registered TB cases increased with age （χ2=547.79， P<0.001）. Proportion of registered TB cases was relatively large in Shache County （16.43%‒23.64%）， Yengisar County （9.51%‒13.87%） ， Kashgar City （8.11%‒11.40%）， Yecheng County （6.98%‒13.40%） and Bachu County（4.92%‒16.65%）. Proportion of recurrent TB cases in Kashgar had increased to 27.29%， 20.77% and 28.39% in 2018， 2019 and 2020， respectively. Multivariate analysis showed that age， drug resistance， calendar year and etiological diagnosis were significantly correlated with the proportion of recurrent cases （all P<0.05）. ConclusionSince 2018， TB incidence has decreased significantly due to the increasing efforts for identification and treatment of TB cases. However， Kashgar remains facing a high TB incidence. TB cases that are elderly， drug-resistant and positive for pathogen are susceptible to recurrent treatment. In future， targeted prevention and control measures should be improved for these groups.
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ObjectiveBased on the investigation of the core capacity development of health emergency response of Shanghai disease prevention and control institutions after the COVID-19 pandemic， to analyze the shortcomings of health emergency response capacity of Shanghai disease prevention and control institutions， and to put forward suggestions to improve the core capacity of Shanghai's disease prevention and control system in the face of public health emergencies. MethodsUsing questionnaire surveys， investigations and evaluations were conducted on the emergency system development， epidemic monitoring and risk assessment， emergency team manpower and equipment， and actual response to COVID-19 in 16 district-level disease prevention and control institutions in Shanghai. ResultsThe overall public health emergency response capacity building of the district-level disease control agencies in Shanghai is relatively good， and the effect of capacity building has been proven during the handling of the new coronavirus. But at the same time， it also exposed some specific problems such as imperfect system construction， lack of emergency personnel and materials， insufficient on-site handling capabilities of personnel， and uneven allocation of emergency personnel and materials among different agencies. ConclusionShanghai district-level disease control should focus on the specific problems， such as strengthening the development of health emergency system， improving the human resources and material reserves of the emergency teams， and optimizing the laboratory testing ability， to further improve the core health emergency capacity of Shanghai disease control system.
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ObjectiveTo determine the epidemiological characteristics of infectious disease related public health bud-events in Shanghai and assess the effects of bud-event surveillance， so as to provide scientific evidence for improving the surveillance system. MethodsSurveillance data of infectious disease related public health bud-events were collected from 16 districts of Shanghai from 2017 through 2020. Then the data were analyzed and compared with infectious disease related public health emergencies during the same period. ResultsA total of 6 376 infectious disease related public health bud-events were documented in Shanghai in 2017‒2020， which involved 29 792 cases. There were two seasonal peaks， April through June and November through December. Clustered events accounted for 38.85%， mainly caused by chickenpox （14.10%）， hand，foot and mouth disease （11.17%） and norovirus-associated infectious diarrhea （6.54%）. The 36.73% of the bud-events occurred in school settings， which involved 24 718 cases （accounting for 83.00% of all cases）. Median time duration between onset date of the first cases and report date of the events was 4 days， and median duration of the events was 14 days， demonstrating positive correlation. In addition， all the infectious disease related public health emergencies（n=77） from 2017 through 2020 were classified as common events or unclassified. The proportion of infectious disease related public health emergencies in the bud-events during the same period was 1.21%， and that of infectious disease related public health emergencies in the bud-events in school settings was 2.48%. ConclusionTwo peaks of infectious disease related public health bud-events are observed in spring as well as autumn and winter in Shanghai from 2017 through 2020. Schools should be prioritized for control and prevention of infectious diseases. Bud-event surveillance system has been contributable to the prevention and control of public health emergencies， especially in the early detection， reporting and control of clustered events in schools. Bud-event surveillance system should be further improved and assessed comprehensively.
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Objective:Based on the AAPM TG-263, a Content-Based Standardizing Nomenclatures (CBSN) was proposed to explore the feasibility of its standardization verification for organs at risk (OAR) of nasopharyngeal carcinoma (NPC).Methods:The radiotherapy structure files of 855 patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT) from 2017 to 2019(15 of whom showed clinical anomalous structures) were retrospectively collected and processed. The Matlab self-developed software was used to obtain the image position, geometric features, first-order gray histogram, and the Gray-level Co-occurrence Matrix′s texture features of the OAR contour outlined by the doctor to establish the CBSN Location Verification model and CBSN Knowledge Library. Fisher discriminant analysis was employed to establish a CBSN OAR classification model, which was evaluated using self-validation, cross-validation, and external validation, respectively.Results:99%(69/70) of the simulated anomalous structures were outside the 90% reference range of the CBSN Knowledge Library and the characteristic parameters significantly differed among different OARs (all P<0.001). The accuracy rates of self-validation, cross-validation and external verification of the CBSN OAR classification model were 92.1%, 92.0% and 91.8%, respectively. Fourteen cases of clinical abnormal structures were successfully detected by CBSN with an accuracy rate of 93%(14/15). In the simulation test, the accuracy of the left and right location verification reached 100%, such as detecting the right eye lens named Len_L. Conclusion:CBSN can be used for OAR verification of NPC, providing reference for multi-center cooperation and standardized radiotherapy of NPC patients.