[Research Photon Energy Spectrum of Medical Linear Accelerator by Monte Carlo Method].

Objective: The distribution of the photon energy spectrum in isocenter plane of the medical linear accelerator and the influence of secondary collimator on the photon energy spectrum are studied. Methods Use the BEAMnrc program to simulate the transmission of the 6 MeV electrons and photons in 5 cm×5 cm,10 cm×10 cm,15 cm×15 cm and 20 cm×20 cm fields in treatment head of the medical linear accelerator, where a phase space file was set up at the isocenter plane to record the particle information passing through this plane. The BEAMdp program is used to analyze the phase space file, in order to obtain the distribution of the photon energy spectrum in isocenter plane and the influence of secondary collimator on the photon energy spectrum. Results: By analyzing the photon energy spectrum of a medical linear accelerator with a nominal energy of 6 MV, it is found that the secondary collimator has little effect on the photon energy spectrum; different fields have different photon energy spectrum distributions; the photon energy spectrum in different central regions of the same field have the same normalized distribution. Conclusion: In the dose calculation of radiation therapy, the influence of photon energy spectrum should be carefully considered.

Effect of short neuropeptide F signaling on larval feeding in Mythimna separata.

Mythimna separata is a notorious phytophagous pest which poses serious threats to cereal crops owing to the gluttony of the larvae. Because short neuropeptide F (sNPF) and its receptor sNPFR are involved in a diversity of physiological functions, especially in functions related to feeding in insects, it is a molecular target for pest control. Herein, an sNPF and 2 sNPFRs were identified and cloned from M. separata. Bioinformatics analysis revealed that the sNPF and its receptors had a highly conserved RLRFamide C-terminus and 7 transmembrane domains, respectively. The sNPF and its receptor genes were distributed across larval periods and tissues, but 2 receptors had distinct expression patterns. The starvation-induced assay elucidated that sNPF and sNPFR expression levels were downregulated under food deprivation and recovered with subsequent re-feeding. RNA interference knockdown of sNPF, sNPFR1, and sNPFR2 by injection of double-stranded RNA into larvae not only suppressed food consumption and increased body size and weight, but also led to decrease of glycogen and total lipid contents, and increase of trehalose compared with double-stranded green fluorescent protein injection. Furthermore, molecular docking was performed on the interaction mode between sNPFR protein and its ligand sNPF based on the 3-dimensional models constructed by AlphaFold; the results indicated that both receptors were presumably activated by the mature peptide sNPF-2. These results revealed that sNPF signaling played a considerably vital role in the feeding regulation of M. separata and represents a potential control target for this pest.

Feasibility of delta radiomics-based pCR prediction for rectal cancer patients treated with magnetic resonance-guided adaptive radiotherapy.

Magnetic resonance-guided adaptive radiotherapy (MRgART) represents the latest frontier in precision radiotherapy. It is distinguished from other modalities by the possibility of acquiring high-contrast soft tissue images, combined with the ability to recalculate and re-optimize the plan on the daily anatomy. The extensive database of available images offers ample scope for using disciplines such as radiomics to try to correlate features and outcomes. This study aimed to correlate the change of radiomics feature along the treatment to pathological complete response (pCR) for locally advanced rectal cancer (LARC) patients. Twenty-eight LARC patients undergoing neoadjuvant chemoradiotherapy (nCRT) with a short course (25 Gy, 5 Gy × 5f) MRgART at 1.5 Tesla MR-Linac were enrolled. The T2-weighted images acquired at each fraction, corresponding target delineation, pCR result of the surgical specimen, and clinical variables were collected. Seven families of features [First Order, Shape, Gray-level Co-occurrence Matrix (GLCM), Gray-level Dependence Matrix (GLDM), Gray-level Run Length Matrix (GLRLM), Gray-level Size Zone Matrix (GLSZM), and Neighborhood Gray Tone Difference Matrix (NGTDM)] were extracted, and delta features were calculated from the ratio of features of each successive fraction to those of the first fraction. Mann-Whitney U test and LASSO were utilized to reduce the dimension of features and select those features that are most significant to pCR. At last, the radiomics signatures were established by linear regression with the final set of features and their coefficients. A total of 581 radiomics features were extracted, and 2,324 delta features were calculated for each patient. Nineteen features and delta features, and one clinical variable (cN) were significant (p< 0.05) to pCR; seven predictive features were further selected and included in the linear regression to construct the radiomics signature significantly discriminating pCR and non-pCR groups (p< 0.05). Delta features based on MRI images acquired during a short course MRgART could potentially be used to predict treatment response in LARC patients undergoing nCRT.

3D-printed biodegradable magnesium alloy scaffolds with zoledronic acid-loaded ceramic composite coating promote osteoporotic bone defect repair.

Osteoporotic fracture is one of the most serious complications of osteoporosis. Most fracture sites have bone defects, and restoring the balance between local osteogenesis and bone destruction is difficult during the repair of osteoporotic bone defects. In this study, we successfully fabricated three-dimensional (3D)-printed biodegradable magnesium alloy (Mg-Nd-Zn-Zr) scaffolds and prepared a zoledronic acid-loaded ceramic composite coating on the surface of the scaffolds. The osteogenic effect of Mg and the osteoclast inhibition effect of zoledronic acid were combined to promote osteoporotic bone defect repair. In vitro degradation and drug release experiments showed that the coating significantly reduced the degradation rate of 3D-printed Mg alloy scaffolds and achieved a slow release of loaded drugs. The degradation products of drug-loaded coating scaffolds can promote osteogenic differentiation of bone marrow mesenchymal stem cells as well as inhibit the formation of osteoclasts and the bone resorption by regulating the expression of related genes. Compared with the uncoated scaffolds, the drug-coated scaffolds degraded at a slower rate, and more new bone grew into these scaffolds. The healing rate and quality of the osteoporotic bone defects significantly improved in the drug-coated scaffold group. This study provides a new method for theoretical research and clinical treatment using functional materials for repairing osteoporotic bone defects.

The first 3D-bioprinted personalized active bone to repair bone defects: A case report.

The repair and reconstruction of bone defects are still major problems to be solved in the field of orthopedics. Meanwhile, 3D-bioprinted active bone implants may provide a new and effective solution. In this case, we used bioink prepared from the patient's autologous platelet-rich plasma (PRP) combined with polycaprolactone/ß-tricalcium phosphate (PCL/ß-TCP) composite scaffold material to print personalized PCL/ß-TCP/PRP active scaffolds layer by layer through 3D bioprinting technology. The scaffold was then applied in the patient to repair and reconstruct bone defect after tibial tumor resection. Compared with traditional bone implant materials, 3D-bioprinted personalized active bone will have significant clinical application prospects due to its advantages of biological activity, osteoinductivity, and personalized design.

Evaluation of flattening-filter-free and flattening filter dosimetric and radiobiological criteria for lung SBRT: A volume-based analysis.

Introduction: The use of volumetric modulated arc therapy (VMAT) with flattening-filter-free (FFF) beams is becoming more prevalent in lung cancer stereotactic body radiotherapy (SBRT). The aim in this study was to assess the impact of dosimetric and radiobiological differences between FFF and flattening filter (FF) beams for lung SBRT based on the target volume. Methods: A total of 198 lung stereotactic body radiation therapy treatment plans with FFF beams and FF beams were retrospectively selected for this study. For all plans, the prescribed dose was 50 Gy/5 fractions, and the dose volume histogram (DVH) for the target and organs at risk (OAR) and the normal tissue complication probability (NTCP) of the lung were recorded and compared. Moreover, monitor units (MUs), the beam on-time and the treatment time were evaluated. Results: The study was performed following the Radiation Therapy Oncology Group (RTOG) 0813 and 0915 protocols. No significant differences in D90, coverage rate (CR) or conformity index (CI) of the target were observed between FFF beams and FF beams (p>0.05). The D2, R50% and gradient index (GI) for the target improved with FFF beams compared with FF beams (p<0.05). FFF beams also significantly reduced the dose for the lung, heart, spinal cord, esophagus and NTCP of the lung (p<0.05), compared with FF beams. However, there was no significant difference in sparing of the trachea (p>0.05). The mean MUs, beam on-time and treatment time were 1871 ± 278 MUs, 3.2 ± 0.2 min and 3.9 ± 0.3 min for FFF beams, and 1890 ± 260 MUs, 4.2 ± 0.3 min and 4.8 ± 0.4 min for FF beams, respectively. Discussion: The FFF beam technique for lung SBRT with VMAT results in a better dose fall-off, better dose-sparing of OAR, lower NTCP of the lung and a shorter beam on-time compared with the FF beam technique. Additionally, the improvement in target and OAR-sparing for FFF beams was increased with increasing target volume.

Monte Carlo dosimetry of the 60Co sources of a new GZP3 HDR afterloading system.

BACKGROUND: The purpose of this work was to obtain the dosimetric parameters of the new GZP3 60Co high-dose-rate afterloading system launched by the Nuclear Power Institute of China, which is comprised of two different 60Co sources. METHODS: The Monte Carlo software Geant4 and EGSnrc were employed to derive accurate calculations of the dosimetric parameters of the new GZP3 60Co brachytherapy source in the range of 0-10 cm, following the formalism proposed by American Association of Physicists in Medicine reports TG43 and TG43U1. Results of the two Monte Carlo codes were compared to verify the accuracy of the data. The source was located in the center of a 30-cm-radius theoretical sphere water phantom. RESULTS: For channels 1 and 2 of the new GZP3 60Co afterloading system, the results of the dose-rate constant (Λ) were 1.115 cGy h-1 U-1 and 1.112 cGy h-1 U-1, and for channel 3 they were 1.116 cGy h-1 U-1 and 1.113 cGy h-1 U-1 according to the Geant4 and EGSnrc, respectively. The radial dose function in the range of 0.25-10.0 cm in a longitudinal direction was calculated, and the fitting formulas for the function were obtained. The polynomial function for the radial dose function and the anisotropy function (1D and 2D) with a [Formula: see text] of 0°-175° and an r of 0.5-10.0 cm were obtained. The curves of the radial function and the anisotropy function fitted well compared with the two Monte Carlo software. CONCLUSION: These dosimetric data sets can be used as input data for TPS calculations and quality control for the new GZP3 60Co afterloading system.

The ecdysis triggering hormone system is essential for reproductive success in Mythimna separata (Walker).

Ecdysis triggering hormone (ETH) was originally discovered as a key hormone that regulates insect moulting via binding to its receptor, ETH receptor (ETHR). However, the precise role of ETH in moth reproduction remains to be explored in detail. ETH function was verified in vivo using Mythimna separata (Walker), an important cereal crop pest. RT-qPCR analysis revealed that transcriptional expression profiles of MsepETH showed evident sexual dimorphism in the adult stage. MsepETH expression increased in the females on day 3 and persisted thereafter till day 7, consistent with female ovarian maturation, and was merely detectable in males. Meanwhile, MsepETH expression levels were significantly higher in the trachea than in other tissues. MsepETHR-A and MsepETHR-B were expressed in both sexes and were significantly higher in the antennae than in other tissues. MsepETH and MsepETHR knockdown in females by RNA interference significantly reduced the expression of MsepETH, MsepETHR-A, MsepETHR-B, MsepJHAMT, and MsepVG, which delayed egg-laying and significantly reduced egg production. RNAi 20-hydroxyecdysone (20E) receptor (EcR) decreased MsepETH expression whereas injecting 20E restored egg production that had been disrupted by MsepETH interference. Meanwhile, RNAi juvenile hormone (JH) methoprene tolerant protein (Met) also decreased MsepETH expression and smearing JH analog methoprene (Meth) restored egg production. In conclusion, the reproduction roles of ETH, JH, and 20E were investigated in M. separata. These findings will lay the foundation for future research to develop an antagonist that reduces female reproduction and control strategies for pest insects.

Identification of the neuropeptide gene family and feeding regulation by neuropeptide Y in Mythimna separata (Lepidoptera: Noctuidae).

Mythimna separata is a crucial agricultural pest with polyphagous characteristic. Neuropeptide signaling, especially neuropeptide Y (NPY) involved in feeding regulation, is considered as a potential pest control target. In this study, we identified 50 neuropeptides including NPY of M. separata using transcriptome sequencing. Bioinformatics analysis showed that NPY had a conserved carboxyterminal motif of RGRYamide and shared very high homology across lepidopteran insects. Spatio-temporal expression profile articulated that NPY was mainly expressed in the larval stage, and with the highest expression in larval midgut and adult alimentary canal. RNAi knockdown by the injection of dsNPY into larvae significantly inhibited food uptake and body weight, delayed developmental duration, and also caused increase of trehalose and decrease of glycogen and total lipid compared to dsGFP. This study identified nearly the entire neuropeptide gene family of M. separata and further indicated that NPY signaling pathway might played a vital role in the feeding regulation and related to energy metabolism. Our results not only laid a preliminary foundation for functional studies on neuropeptide of M. separata, but also provided a potential molecular target for future pesticide development.

Niobium promotes fracture healing in rats by regulating the PI3K-Akt signalling pathway: An in vivo and in vitro study.

Background: Stable fixation is crucial in fracture treatment. Currently, optimal fracture fixation devices with osteoinductivity, mechanical compatibility, and corrosion resistance are urgently needed for clinical practice. Niobium (Nb), whose mechanical properties are similar to those of bone tissue, has excellent biocompatibility and corrosion resistance, so it has the potential to be the most appropriate fixation material for internal fracture treatment. However, not much attention has been paid to the use of Nb in the area of clinical implants. Yet its role and mechanism of promoting fracture healing remain unclear. Hence, this study aims at elucidating on the effectiveness of Nb by systematically evaluating its osteogenic performance via in vivo and ex vivo tests. Methods: Systematic in vivo and in vitro experiments were conducted to evaluate the osteogenic properties of Nb. In vitro experiments, the biocompatibility and osteopromoting activity of Nb were assessed. And the osteoinductive activity of Nb was assessed by alizarin red, ALP staining and PCR test. In vivo experiments, the effectiveness and biosafety of Nb in promoting fracture healing were evaluated using a rat femoral fracture model. Through the analysis of gene sequencing results of bone scab tissues, the upregulation of PI3K-Akt pathway expression was detected and it was verified by histochemical staining and WB experiments. Results: Experiments in this study had proved that Nb had excellent in-vitro cell adhesion and proliferation-promoting effects without cytotoxicity. In addition, ALP activity, alizarin red staining and semi-quantitative analysis in the Nb group had indicated its profound impact on enhancing osteogenic differentiation of MC3T3-E1 cells. We also found that the use of Nb implants can accelerate fracture healing compared to that with Ti6Al4V using an animal model of femur fracture in rats, and the biosafety of Nb was confirmed in vivo via histological evaluation. Furthermore, we found that the osteogenic effects of Nb were achieved through activation of the PIK/Akt3 signalling pathway. Conclusion: As is shown in the present research, Nb possessed excellent biosafety in clinical implants and accelerated fracture healing by activating the PI3K-Akt signalling pathway, which had good prospects for clinical translation, and it can replace titanium alloy as a material for new functional implants.

Prognostic Significance of Clinicopathological Factors Influencing Overall Survival and Event-Free Survival of Patients with Cervical Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND Cervical cancer (CC) is the most frequent type of cancer among women and its poor prognosis is a main concern, while the prognostic factors for CC have still remained controversial. We conducted this systematic review and meta-analysis to identify the prognostic significance of clinicopathological factors, influencing overall survival (OS), and event-free survival (EFS) of CC patients. MATERIAL AND METHODS The electronic databases of PubMed, EmBase, and the Cochrane library were systematically searched for identification of eligible studies published until June 2021. The pooled hazard ratio (HR) with 95% confidence interval (CI) were calculated using the random-effects model. Sensitivity and subgroup analyses and assessment of publication bias were also conducted. RESULTS We selected 140 studies that involved 47 965 patients for the meta-analysis. The results revealed that age, cell type, depth of tumor invasion, the International Federation of Gynecology and Obstetrics stage, hemoglobin level, histological grade, leukocytosis, lymph node involvement, lymph-vascular space invasion, neutrophil-to-lymphocyte ratio, parametrial invasion, platelet-to-lymphocyte ratio, resection margin, squamous cell carcinoma antigen level, thrombocytosis, tumor grade, tumor size, and tumor volume were clinicopathological factors influencing OS and EFS of CC patients (P<0.05). CONCLUSIONS This study comprehensively identified the prognostic significance of clinicopathological factors, influencing OS, and EFS of CC patients. However, further large-scale prospective studies should be conducted to verify our findings and develop more accurate prognostic models for CC.

Additively manufactured biodegradable porous magnesium implants for elimination of implant-related infections: An in vitro and in vivo study.

Magnesium (Mg) alloys that have both antibacterial and osteogenic properties are suitable candidates for orthopedic implants. However, the fabrication of ideal Mg implants suitable for bone repair remains challenging because it requires implants with interconnected pore structures and personalized geometric shapes. In this study, we fabricated a porous 3D-printed Mg-Nd-Zn-Zr (denoted as JDBM) implant with suitable mechanical properties using selective laser melting technology. The 3D-printed JDBM implant exhibited cytocompatibility in MC3T3-E1 and RAW267.4 cells and excellent osteoinductivity in vitro. Furthermore, the implant demonstrated excellent antibacterial ratios of 90.0% and 92.1% for methicillin-resistant S. aureus (MRSA) and Escherichia coli, respectively. The 3D-printed JDBM implant prevented MRSA-induced implant-related infection in a rabbit model and showed good in vivo biocompatibility based on the results of histological evaluation, blood tests, and Mg2+ deposition detection. In addition, enhanced inflammatory response and TNF-α secretion were observed at the bone-implant interface of the 3D-printed JDBM implants during the early implantation stage. The high Mg2+ environment produced by the degradation of 3D-printed JDBM implants could promote M1 phenotype of macrophages (Tnf, iNOS, Ccl3, Ccl4, Ccl5, Cxcl10, and Cxcl2), and enhance the phagocytic ability of macrophages. The enhanced immunoregulatory effect generated by relatively fast Mg2+ release and implant degradation during the early implantation stage is a potential antibacterial mechanism of Mg-based implant. Our findings indicate that 3D-printed porous JDBM implants, having both antibacterial property and osteoinductivity, hold potential for future orthopedic applications.

Functional analysis of the odorant receptor coreceptor in odor detection in Grapholita molesta (lepidoptera: Tortricidae).

The olfactory system must detect and discriminate various semiochemicals in the environment. In response to such diversity, insects have evolved a family of odorant-gated ion channels composed of a common receptor (coreceptor, Orco) and a ligand-binding tuning odorant receptor (OR) that confers odour specificity. This study aims to examine the expression pattern of Orco gene of Grapholita molesta (GmolOrco) and to elucidate the role of GmolOrco in detecting G. molesta sex pheromone and green leaf volatiles by using gene silencing via RNA interference (RNAi) coupled antennal electrophysiological (EAG). Multiple sequence alignment showed that GmolOrco shared high sequence similarities with the Orco ortholog of lepidopterans. The results of real-time quantitative PCR detection demonstrated that GmolOrco was predominantly expressed in adult antennae and had the highest expression quantity in adult period among the different developmental stages. Compared with the noninjected controls, GmolOrco expression in GmolOrcodouble-stranded RNA (dsRNA)-injected males was reduced to 39.92% and that in females was reduced to 40.43%. EAG assays showed that the responses of GmolOrco-dsRNA injected males to sex pheromones (Z)-8-dodecenyl acetate (Z8-12:OAc) and (Z)-8-dodecenyl alcohol (Z8-12:OH) were significantly reduced, and the GmolOrco-dsRNA-injected female to green leaf volatile (Z)-3-hexenyl acetate also significantly declined. We inferred that Orco-mediated olfaction was different in male and female G. molesta adults and was mainly involved in recognizing the sex pheromones released by female moths.

Three-dimensional printing-based personalized limb salvage and reconstruction treatment of pelvic tumors.

BACKGROUND AND OBJECTIVES: The treatment of pelvic tumors is widely recognized to be challenging. The purpose of this study was to evaluate the efficacy of personalized three-dimensional (3D) printing-based limb salvage and reconstruction treatment for pelvic tumors. METHODS: Twenty-eight pelvic tumor patients were enrolled. 3D printing lesion models and osteotomy templates were prepared for surgery planning, prosthesis design, and osteotomy assistance during surgery. 3D printing-based personalized pelvic prostheses were manufactured and used in all 28 patients. Follow-up of postoperative survival, prosthesis survival, imaging examinations, and Musculoskeletal Tumor Society (MSTS) lower limb functional scores were carried out. RESULTS: The mean follow-up period was 32.2 months, during which 16 patients had disease-free survival, 3 survived with the disease, and 9 died. The prostheses were stable, and the mean offset of the center of rotation was 5.48 mm. The prosthesis-bone interface showed good integration. For the 19 surviving patients, the mean MSTS lower limb functional score was 23.2. Postoperative complications included superficial infection in six patients and hip dislocation in three patients. CONCLUSIONS: Personalized 3D printing-based limb salvage and reconstruction was an effective treatment for pelvic tumors. Our patients achieved good early postoperative efficacy and functional recovery.

Demography of Mythimna separata (Lepidoptera: Noctuidae) at outdoor fluctuating temperatures.

The oriental armyworm Mythimna separata (Walker) (Lepidoptera: Noctuidae) is a major migratory pest of cereal crops in East Asia, South Asia and Australia. To comprehensively understand the ecological tolerance of M. separata, we collected life table data of individuals from four consecutive generations reared under outdoor natural fluctuating temperatures from 15 April to 17 October 2018 in Yangling, Shaanxi, China. The results showed that the immature stage in early summer and summer were shorter than in spring and autumn. High mortality in late larval instar and pupal stages was observed in the summer generation. The adult pre-oviposition period in autumn was longer than the other seasons. The population in the earlier two seasons had heavier pupae and higher fecundity than the population in the latter two seasons. The intrinsic rate of increase and the finite rate of increase was the highest in early summer (r = 0.1292 day-1, λ = 1.1391 day-1), followed by spring (r = 0.1102 day-1, λ = 1.1165 day-1), and was the lowest in summer (r = 0.0281 day-1, λ = 1.0293 day-1). The results of this study would be useful to predict the population dynamics of M. separata and deepen our standing of the adaptiveness of this migratory pest in natural fluctuating ambient environments.

A clinical study on bone defect reconstruction and functional recovery in benign bone tumors of the lower extremity, treated by bone marrow mesenchymal stem cell rapid screening-enrichment-composite system.

BACKGROUND: With the development of medical technology, credible options for defect reconstructions after the resection of benign bone tumors of the lower extremities have become a high priority. As the current reconstructive methods commonly used in clinical practice have some flaws, new methods of reconstruction need to be explored. We aimed to prepare a new kind of bioactive scaffold for the repair of bone defects through a stem cell rapid screening-enrichment-composite technology system developed by our team. Furthermore, we aimed to investigate the curative effects of these bioactive scaffolds. METHODS: Firstly, cell count, trypan blue exclusion rate, and ALP staining were used to evaluate changes in enrichment efficiency, cell activity, and osteogenic ability before and after enrichment. Then, the scaffolds were placed under the skin of nude mice to verify their osteogenic effects in vivo. Finally, the scaffolds were used for the reconstruction of bone defects after operations for benign bone tumors in a patient's lower limb. The healing status of the defect site at 1 and 3 months was assessed by X-ray, and the Musculoskeletal Tumor Society (MSTS) score was applied to reflect the recovery of patient limb function. RESULTS: The system effectively enriched stem cells without affecting the activity and osteogenic abilities of the bone marrow mesenchymal stem cells (BMSCs). Meanwhile, the bioactive scaffolds obtained better osteogenic effects. In patients, the active scaffolds showed better bone integration and healing status, and the patients also obtained higher MSTS scores at 1 and 3 months after surgery. CONCLUSION: As a new technique, the rapid screening-enrichment-composite technology of stem cells demonstrates a better therapeutic effect in the reconstruction of bone defects after surgery for benign bone tumors of the lower extremities, which will further improve patient prognosis.

A novel revision system for complex pelvic defects utilizing 3D-printed custom prosthesis.

BACKGROUND: Thus far, the hip revision surgery has been widely used and promoted, and the technology has been constantly innovated, such as tissue engineering, 3D printing prosthesis, etc. However, traditional standardized prosthesis, allograft, autograft, bone cement and reinforcing ring are still the main treatment methods in the mainstream pelvic defects classification systems for hip revision. In addition, the mainstream classification systems are still mainly focus on the peri-acetabulum, but less on the large-scale complex pelvic defects that widely affecting the regions far away from the acetabulum, which also have a significant impact on the holistic biomechanical properties of pelvis. METHODS: After integrating the design experience of custom prostheses and the understanding of biomechanical properties of pelvis, an innovative pelvic defects classification for custom revision was preliminarily proposed, and was practiced in surgeries. Some typical cases were chosen for elucidation in this study, and two observers each evaluated their CT data independently twice. Intraobserver and interobserver agreement were calculated using the kappa statistic to evaluate the reliability. The pelvis defects were classified into five types and two subtypes. The corresponding reconstruction principles, as the main basis to support the classification, were also described in detail. Prosthesis position examination and Harris hip score were utilized to evaluate the clinical outcome. RESULTS: The installed prostheses resulted in high concordance with preoperative position planning, significantly improved Harris score, low postoperative complication rate and no re-revision case. In addition, The interobserver and intraobserver agreement were both excellent. CONCLUSION: The presenting revision system for complex pelvic defects utilizing 3D-printed custom prosthesis and corresponding classification of pelvic defects can preliminarily guide patients' grouping and prosthesis design, and may potentially provide an innovative, feasible, and efficient basis for complex total hip arthroplasty (THA) revision. TRANSLATIONAL POTENTIAL STATEMENT: This study provides a novel method for prosthetic revision of peri-acetabular pelvic defects, and is expected to systematically improve the efficiency of prosthesis design and surgery in clinical practice.

Dosimetric and delivery comparison of helical tomotherapy with dynamic jaw and fixed jaw for cervical carcinoma.

Context: Recently, the dynamic jaw mode has been introduced in our radiation oncology center second in China. Many studies showed that dynamic jaw mode in helical tomotherapy (HT) has the potential to improve organs at risk avoidance. Aim: This study aimed to evaluate the plan quality and efficiency of dynamic jaw delivery compared to the regular HT delivery mode (fixed jaw mode) for cervical carcinoma. Settings and Design: Plan quality and efficiency were compared among the fixed jaw 2.5 cm mode, the dynamic jaw 2.5 cm mode, and the dynamic jaw 5.0 cm mode. Subjects and Methods A total of 20 patients with cervical carcinoma were chosen to compare the plan quality and treatment efficiency using regular HT mode (fixed jaw 2.5 cm field width) and HT dynamic jaw mode with width 2.5 cm and 5.0 cm field width. The prescribed dose was 50.4 Gy in 28 fractions to planning target volume. Target coverage, homogeneity, conformity, sparing of organs at risk (OARs), monitor unit, and beam-on time were evaluated. Statistical Analysis Used: : The statistical significance of any difference among plans assessed the two-sided paired t-test. The statistical analysis was conducted using SPSS 19.0 software. Results: For each of the 20 patients, the plans were clinically acceptable. The target coverage and sparing of most OARs were measured using the dynamic jaw. Conclusions: Cervical carcinoma should be treated with the dynamic jaw 2.5 cm mode. Considering the risk of long treatment time, the dynamic jaw 5.0 cm mode could be an option.

Impact of positioning errors in the dosimetry of VMAT left-sided post mastectomy irradiation.

BACKGROUND: Volumetric modulated arc therapy (VMAT) adopted in post-mastectomy radiation therapy (PMRT) has the capacity to achieve highly conformal dose distributions. The research aims to evaluate the impact of positioning errors in the dosimetry of VMAT left-sided PMRT. METHODS: A total of 18 perturbations where introduced in 11 VMAT treatment plans that shifted the isocenter from its reference position of 3, 5, 10 mm in six directions. The thoracic wall and supraclavicular clinical target volumes (CTVs), the heart and the left lung dose volume histograms (DVHs) of 198 perturbed plans were calculated. The absolute differences (∆) of the mean dose (Dm) and DVH endpoints Vx and Dy (percentage volume receiving x Gy, and dose covering y% of the volume, respectively) were used to compare the dosimetry of the reference vs perturbed plans. RESULTS: Isocenter shifts in the anterior and lateral directions lead to maximum disagreement between the CTVs dosimetry of perturbed vs reference plans. Isocenter shifts of 10 mm shown a decrease of D95, D98 and Dm of 12.8, 18.0, and 2.9% respectively, for the CTVs. For 5 mm isocenter shifts, these differences decreased to 3.2, 5.2, and 0.9%, respectively, and for 3 mm shifts to 1.0, 1.7, and 0.6%, respectively. For the organs at risk (OARs), only isocenter shifts in the right, posterior and inferior directions worsen the plan dosimetry, nevertheless not negligible lung ∆ V20 of + 2.6%, and heart ∆ V25 of + 1.6% persist for 3 mm shifts. CONCLUSIONS: Inaccuracy in isocenter positioning for VMAT left-sided PMRT irradiation may impact the dosimetry of the CTVs and OARs to a different extent, depending on the directions and magnitude of the perturbation. The acquired information could be useful for planning strategies to guarantee the accuracy of the treatment delivered.

Expanding the strong absorption band by impedance matched mosquito-coil-like acoustic metamaterials.

A mosquito-coil-like acoustic artificial structure consisting of a spiral channel and a perforated plate with excellent impedance matching is proposed, which can realize strong sound absorption within a certain frequency range. Due to the difficulty in matching the impedance of the single-hole structure with that of the sound propagation medium, the sound absorption should be poor. To overcome this shortcoming caused by the mismatched impedance, some multi-hole microstructures are designed. Moreover, since single-chamber labyrinth can only achieve single-frequency perfect sound absorption, a labyrinthine channel is divided into several chambers with each length distributing by an arithmetic progression gradient. The sound absorption bandwidth can be extended by synergetic coupling resonance among multiple chambers. By selecting different structural parameters including the number of holes, the width of the labyrinthine channel, and the depth of labyrinthine channel, sound absorption of these mosquito-coil-like structures is investigated. The results suggest that the multi-hole structures are helpful in improving the impedance matching, while the synergetic coupling resonance among multiple chambers ensures that the sound absorption coefficient of the structure can be maintained at a high level within a certain frequency range. In addition, some mosquito-coil-like sound absorption structures are fabricated by 3D printing, then the sound absorptions under vertical sound incident conditions are measured, and the strong sound absorption ability in a wide band is experimentally demonstrated. Finally, a method is proposed for adjusting the sound absorptions by proportionally zooming in or out the structure, by which the sound absorptions of the acoustic structure can be effectively shifted to lower or higher frequencies.