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Objective:To explore the application value of optical surface monitoring system (OSMS) volume rendering technique (VRT) body surface imaging in intensity-modulated radiotherapy for thoracic tumors.Methods:A retrospective case series study was performed. The clinical data of 65 patients with thoracic tumors treated with intensity-modulated radiotherapy at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from September 2021 to October 2022 were retrospectively analyzed. In the first treatment,after cone-beam computed tomography (CBCT) scan and correction, VRT body surface images were obtained by using OSMS. In subsequent treatment, the VRT image was used as the benchmark and the 6-dimensional bed was automatically positioned to record the 6-dimensional bed positioning value. The CBCT scan was performed to record the translation and rotation errors of left-right direction (X-axis), head-foot direction (Y-axis) and front-rear direction (Z-axis). After the calibration of the 6-dimensional automatic bed shifting, the new real-time deltas (RTD) value of digital imaging and communications in medicine (DICOM) body surface image was recorded, and the new VRT image was obtained. CBCT registration error value was defined as VRT image-guided setup error. The sum of CBCT registration error value and moving bed movement value was defined as the body surface marker line-guided setup error. The sum of CBCT registration error value and the recorded DICOM image RTD value was defined as the theoretical error of DICOM image-guided setup. The advantages and disadvantages of VRT image, body surface marker line and DICOM image-guided setup were compared and analyzed.Results:There were 42 males and 23 females in 65 patients with thoracic tumors, and the age [ M ( Q1, Q3)] was 58 years (51 years, 64 years). The linear errors [ M ( Q1, Q3)] of VRT image-guided setup in X, Y and Z axes were 0.6 mm (0.3 mm, 1.2 mm), 1.2 mm (0.5 mm, 2.4 mm) and 1.1 mm (0.5 mm, 1.9 mm); and the rotational errors were 0.4° (0.1°, 0.7°), 0.4° (0.1°, 0.6°) and 0.4° (0.2°, 0.6°). The linear errors of the marker line-guided setup were 1.6 mm (0.9 mm, 2.6 mm), 2.2 mm (1.1 mm, 3.8 mm) and 1.0 mm (0.4 mm, 1.8 mm); and the rotational errors were 0.7° (0.3°, 1.2°), 0.5° (0.2°, 0.8°) and 0.5° (0.2°, 0.8°). The linear errors of the DICOM image-guided positioning were 1.1 mm (0.6 mm, 1.9 mm), 2.1 mm (1.0 mm, 3.4 mm) and 1.3 mm (0.6 mm, 3.1 mm), and the rotational errors were 0.6° (0.2°, 1.1°), 0.7° (0.3°, 1.1°), 0.7° (0.2°, 1.1°). Compared with the marker line-guided setup, except for Z-axis linear error ( P = 0.218), the VRT-guided setup errors were low (all P < 0.001). Compared with the DICOM imaging-guided setup, the VRT image-guided setup linear error and rotational error in X-, Y- and Z-axis were low (all P < 0.01). Conclusions:VRT image-guided setup is superior to traditional body surface marker setup and DICOM imaging setup; OSMS VRT body surface imaging can effectively improve the setup accuracy and stability of intensity-modulated radiotherapy for thoracic tumors, and reduce the setup errors.
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Objective:To investigate the protective mechanism of remote ischemic preconditioning (RIPC) on cerebral ischemia-reperfusion (I/R) injury in rats.Methods:Forty-eight SD rats were randomly divided into sham operation group, RIPC group, I/R group, RIPC+I/R group, and compound C group ( n=9 in each group). The neurological function score, cerebral infarction volume (TCC staining) and neuronal apoptosis rate (TUNEL staining) were measured. The activity of superoxide dismutase (SOD) 2 and malondialdehyde level in homogenate of brain tissue were detected. Expression levels of AMP-activated protein kinase (AMPK)/peroxisome proliferator-activated receptor-γ coactivator (PGC)-1α signaling pathway-related proteins in brain tissue were detected by Western blot. Results:The neurological deficit score, cerebral infarction volume and neuron apoptosis rate in the I/R group were significantly higher than those in the sham operation group (all P<0.05). Compared with the I/R group, the neurological deficit score, cerebral infarction volume and neuron apoptosis rate in the RIPC+I/R group were significantly decreased (all P<0.05). Compared with the RIPC+I/R group, the neurological deficit score, cerebral infarction volume and neuron apoptosis rate in the compound C group were significantly increased (all P<0.05). Compared with the sham operation group, the SOD activity in the I/R group was significantly decreased, and the malondialdehyde content was significantly increased (all P<0.05). Compared with the I/R group, the SOD activity in the RIPC+I/R group was significantly increased, and the malondialdehyde content was significantly decreased (all P<0.05). Compared with the RIPC+I/R group, the SOD activity in the compound C group was significantly decreased, and the malondialdehyde content was significantly increased (all P<0.05). Compared with the sham operation group, the expressions of AMPK, p-AMPK, PGC-1α, nuclear respiratory factor (NRF)-1, mitochondrial transcription factor A (TFAM), SOD2, uncoupling protein 2 (UCP2), cytochrome C (CytC), and apoptosis-inducing factor (AIF) in the brain tissue of the I/R group were significantly increased (all P<0.05). Compared with the I/R group, the expressions of AMPK, p-AMPK, PGC-1α, NRF-1, TFAM, SOD2 and UCP2 in the ischemic brain tissue of the RIPC+I/R group were significantly increased, while the expressions of CytC and AIF were significantly decreased (all P<0.05). Compared with the RIPC+I/R group, the expressions of AMPK, p-AMPK, PGC-1α, NRF-1, TFAM, SOD2 and UCP2 in the brain tissue of the compound C group were significantly decreased, while the expressions of CytC and AIF were significantly increased (all P<0.05). Conclusions:RIPC has a protective effect on I/R injury. Its mechanism may be associated with the activation of AMPK/PGC-1α signaling pathway and maintaining mitochondrial biogenesis.
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Objective:To investigate the effect of gap junction protein Cx43 inhibitor carbenoxolone (CBX) on cognitive function and its possible mechanism in epileptic rats.Methods:One hundred and twenty Wistar rats were randomly divided into sham-operated group, epilepsy group, epilepsy+solvent group, and epilepsy+CBX group ( n=30). The models of temporal lobe epilepsy in the later three groups were prepared by injection of kainic acid in the hippocampus. Intraperitoneal injection of CBX (20 mg/kg) or equal amount of normal saline were given to the rats in the epilepsy+CBX group and epilepsy+solvent group 30 min before modeling. Western blotting was used to detect the protein expressions of phosphorylated (p)-Cx43 and microtubule associated protein light chain 3 (LC3) in the hippocampus 6, 12, and 24 h after modeling; the protein localization of p-Cx43 and LC3 in the hippocampus and optical density of their positive cells were detected by immunohistochemistry 24 h after modeling; the learning and memory abilities of rats were tested by Morris water maze experiment 30 d after modeling. Results:Western blotting results showed that as compared with those in the sham-operated group, p-CX43 and LC3 protein expressions in the hippocampal CA3 regions of epilepsy group and epilepsy+solvent group were significantly increased at 6, 12 and 24 h after modeling ( P<0.05); as compared with the epilepsy group and epilepsy+solvent group, the epilepsy+CBX group had statistically decreased p-CX43 and LC3 protein expressions in the hippocampal CA3 regions at each time point ( P<0.05). Immunohistochemical staining showed that p-CX43 was localized at the cell membrane and cytoplasm of hippocampal astrocytes; LC3 was located at the cytoplasm of hippocampal neurons. As compared with those in the sham-operated group, the optical density values of p-CX43 and LC3 positive cells in hippocampal CA3 regions of epilepsy group and epilepsy+solvent group were increased ( P<0.05). As compared with those in the epilepsy group and the epilepsy+solvent group, the optical density values of p-CX43 and LC3 positive cells in the hippocampal CA3 regions of the epilepsy+CBX group were significantly decreased ( P<0.05). Morris water maze test results showed that as compared with that in the sham-operated group, the escape latency in the epilepsy group and epilepsy+solvent group was significantly prolonged ( P<0.05); as compared with that in the epilepsy group and epilepsy+solvent group, the latency in the epilepsy+CBX group was significantly shortened ( P<0.05). Conclusion:CBX can weaken the neuronal autophagy and reduce the damage to cognitive function by inhibiting the p-Cx43 protein expression in the astrocytes of the hippocampal CA3 regions.
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Objective To explore the mechanism of resveratrol in alleviating neuroinflammation after cerebral ischemia-reperfusion injury by inhibiting Toll like receptor 4 (TLR4) signaling pathway. MethodsSixty adult male SD rats were randomly divided into sham-operated group, cerebral ischemia-reperfusion injury group, and resveratrol treatment group (n=20). Rat models of transient middle cerebral artery occlusion (MCAO) in the latter two groups were prepared by modified thread embolization method; reperfusion was performed after 2 h of occlusion, and 20 mg/kg normal saline or resveratrol via tail vein injection was given 15 min before model preparation and one min before reperfusion, respectively. At 72 h after MACO, neurological severity scale (NSS) was applied to evaluate the neurological functions of rats. Enzyme linked immunosorbent assay was performed to detect the expressions of pro-inflammatory cytokines interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-αand anti-inflammatory cytokines IL-4, IL-10, and transforming growth factor (TGF)-β. Reverse transcription-polymerase chain reaction was performed to detect the mRNA expressions of M1 signature markersIL-1βandCD32and M2 signature markersCD206andArginase-1. Western blotting was used to detect the expressions of TLR4 signaling molecules TLR4, myeloid differentiation protein 88 (MyD88), tumor necrosis factor receptor-associated factor 6 (TRAF6), IL-1 receptor associated kinase 1 (IRAK1) and nuclear factor (NF)-κB.ResultsAs compared with those in the sham-operated group, rats in the cerebral ischemia-reperfusion injury group had significantly decreased NSS scores, significantly elevated levels of IL-1β, IL-6, TNF-α, IL-4, IL-10, and TGF-βin the damaged brain tissues, significantly elevated mRNA expression levels ofIL-1β,CD32,CD206, andArginase-1, and significantly elevated protein expression levels of TLR4, MyD88, TRAF6, IRAK1 and NF-κB (P<0.05). As compared with rats in the cerebral ischemia-reperfusion injury group, rats in the resveratrol treatment group had significantly decreased NSS scores, significantly decreased levels of IL-1β, IL-6, and TNF-α, significantly elevated levels of IL-4, IL-10, and TGF-βin the damaged brain tissues, significantly deceased mRNA expression levels ofIL-1βandCD32, significantly elevated mRNA expression levels of CD206andArginase-1, and significantly decreased protein expression levels of TLR4, MyD88, TRAF6, IRAK1 and NF-κB (P<0.05).ConclusionResveratrol inhibits microglia M1-type polarization and promotes M2-type polarization after cerebral ischemia reperfusion by inhibiting TLR4 signaling pathway, which further reduces neuroinflammation and neurological deficits.
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Purpose To measure the longitudinal and transverse strain and displacement parameters of each segment of long axis myocardium on cardiac MRI film images of normal young volunteers using feature tracking technique (FT), and to analyze the regularity of left ventricular long axis strain and establish peak and time to peak (TTP) reference range concerning the longitudinal and transverse strain and displacement. Materials and Methods Cardiac film images of 29 healthy volunteers aged 24 to 34 were collected using Philips Multiva 1.5T MRI scanner, including three typical long axis planes of the left ventricular long axis, left ventricular outflow tract, and four-chamber view. The MRI film images were analyzed drawing on myocardial feature tracking software TOMTEC, and the peak value and TTP of longitudinal and transverse strain and displacement of the 16 AHA segments excluding apex cordis were obtained thereby. The regularity of each parameter concerning the plane, layer, and segment was summarized and analyzed. Results The TTP of longitudinal strain, longitudinal displacement and transverse strain were consistent among each myocardial segment, which was a constant indicator in (41.24±12.51) % RR interphase. The peak value of longitudinal displacement was represented by apex cordis (2.56±0.89) mm < middle (6.09±2.03) mm < cardiac base (8.07±2.05) mm, and the peak value of transverse displacement was manifested as apex cordis (4.57±1.18) mm < middle (5.65±0.84) mm < cardiac base (8.48 ±1.18) mm, which was consistent with cardiac geometric deformation visually observed. The longitudinal strain showed consistency on 2CH-3CH-4CH plane, whose peak reference value was (-22.46±13.19)%; while the peak value of transverse strain displayed no consistency on different planes. Conclusion The longitudinal strain of the left ventricular on different planes has consistent peak value and TTP, suggesting good reference value.
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Objective To learn the endocardial strain patterns of the left ventricles on the short-axis views in normal youth volunteers using feature tracking techniques on cine cardiac MR imaging,and to build up the reference ranges of strain peak and time to peak (TTP) for endocardial strain analysis.Methods Twenty-nine normal youth volunteers aged from 24-34 years old were enrolled in the study in march 2015.The Cine MR imaging were acquired using balance FFE sequence with 24 phases for each cardiac cycle.The standard short-axis imaging planes were basal,mid-cavity and apical levels and divided into 16 segments.The peaks and TTPs of myocardial displacement and its velocity,radial and circumferential strain and strain rate and its velocity in each segment were calculated using feature tracking techniques.The data with normal distribution were analyzed by ANOVA and Student-Newman-Keuls (SNK) method,and Kruskal-Wallis and Wilcoxon rank sum test were used for the data without normal distribution.Results The peaks and TTPs of radial strain and strain rate differed in 16-segmental levels and basal,middle and apical plane levels and had no concordant reference ranges.The circumferential strain and strain rate were homogeneous at basal and middle plane levels [(-27.09 ±9.51)%,(1.94 ±0.98)/s,respectively].Their TTPs were homogenous [0.38 (0.08)RR,0.54 (0.08)RR,respectively],and there were no significant differences in planar-segments or inter-segment level.Except for middle level,the peaks of radial displacement and velocity differed in basal and apical levels and had no concordant reference ranges.But radial velocity TTPs were homogeneous in all 16 segments [0.21 (0.04)RR].Except for the radial strain rate,TTPs showed no significant difference between basal level and middle level.The measurements at apical level revealed high variance.No regular pattern could be found on individual peak and TTP curves of velocity and strain rate.Conclusion The peaks and TTPs of radial strain are different in segmental and planar levels without a concordant reference range.The peaks and TFPs of circumferential strain and the radial velocity rTTPs are homogeneous in middle and apical plane level and have homogeneous reference range.
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Objective To investigate the differences in the survival time and the occurrence of complications between esophageal cancer patients treated with fully-covered segmented esophageal internal irradiation stent and esophageal cancer patients treated with conventional esophageal internal irradiation stent.Methods The clinical data of 66 esophageal cancer patients,who had received esophageal internal irradiation stents placement,were retrospectively analyzed.The patients were divided into the study group (using fullycovered segmented esophageal internal irradiation stent,n=30) and the control group (using conventional esophageal internal irradiation stent,n=36).The postoperative complications,including restenosis,stent migration,chest pain,etc.,and the survival time of the two groups were recorded.The results were analyzed,and P<0.05 was considered to be statistically significant.Results No statistically significant difference in the restenosis rate existed between the study group and the control group (20.0% vs.30.6%,P=0.403);although the median time of restenosis in the study group was longer than that in the control group (161.5 d vs.138 d,P=0.025).The stent migration rate in the study group was higher than that in the control group (33.3% vs.8.3%,P=0.014).The difference in the median time of stent migration between the two groups was not statistically significant (91.5 d vs.166 d,P=0.236).No statistically significant difference in the median survival time existed between the two groups (186 d vs.178 d,P=0.486).No statistically significantly differences in the incidence of other stent-related complications existed between the two groups.Conclusion Fully-covered segmented esophageal internal irradiation stent can delay the occurrence of restenosis,although it can increase the stent migration rate to a certain degree.