[Value of Head and Neck CT Angiography in the Clinical Evaluation of Intraoperative Bleeding Volume of Carotid Body Tumours].

Objective To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Methods Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. Results The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(P=0.019),the maximum diameter of tumours on axial images(P=0.003),the maximum upper and lower diameters(P=0.004),Shamblin classification(P=0.012),and number of blood supply arteries(P<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Conclusions Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.

AMP-activated protein kinase regulates cancer cell growth and metabolism via nuclear and mitochondria events.

Adenine monophosphate-activated protein kinase (AMPK) is a fuel sensing enzyme that is activated in shortage of energy and inhibited in its surplus. Cancer is a metabolic disease characteristic of aerobic glycolysis, namely Warburg effect, and possesses heterogeneity featured by spatiotemporal hypoxia and normoxia, where AMPK is deeply implicated. The present study delineates the regulation of mitochondrial functions by AMPK in cancer cells. On the one hand, AMPKα subunit binds to mitochondria independently of ß subunit and targeting AMPK to mitochondria facilitates oxidative phosphorylation and fatty acid oxidation, and inhibits glycolysis. As such, mitochondrial AMPK inhibits the growth of cancer cells and tumorigenesis. On the other hand, ablation of the ß subunits completely abolishes AMPK activity and simultaneously leads to decreases in mitochondria DNA and protein contents. The effect of the ß deletion is rescued by overexpression of the active mutant of bulky AMPKα1 subunit. In conjunction, the transcriptional factors PGC1α and Nrf-1 are up-regulated by LKB1/AMPK, an event that is abolished in the absence of the ß subunits. Intriguingly, the stimulation of mitochondria biogenesis is not achieved by mitochondria-targeted AMPK. Therefore, our study suggests that AMPK inhibits cancer cell growth and tumorigenesis via regulation of mitochondria-mediated metabolism.

Design, synthesis and biological evaluation of 3,5-dimethylisoxazole and pyridone derivatives as BRD4 inhibitors.

Bromodomain-containing protein 4 (BRD4), a member of the bromodomain and extra-terminal (BET) family, has been recognized as an attractive candidate target for the treatment targeting gene transcription in several types of cancers. In this study, two types of novel compounds were designed, synthesized and evaluated as BRD4 inhibitors. Therein, pyridone derivatives were more effective against BRD4 protein and human leukemia cell lines MV4-11. Among them, compounds 11d, 11e and 11f were the most potential ones with IC50 values of 0.55 µM, 0.86 µM and 0.80 µM against BRD4, and exhibited remarkable antiproliferative activities against MV4-11 cells with IC50 values of 0.19 µM, 0.32 µM and 0.12 µM, respectively. Moreover, in western blot assay, compound 11e induced down-regulation of C-Myc, which is a significant downstream gene of BRD4. Cell cycle analysis assay also showed that compound 11e could block MV4-11 cells at G0/G1 phase. Taken together, our results suggested that compound 11e and its derivatives were a class of novel structural potential BRD4 inhibitors and could serve as lead compounds for further exploration.

The fast fabrication of flexible electronic devices of graphene composites.

The rapid production and accurate deposition of graphene composites are first integrated into one process, due to the strong interaction between the polymer bond with sodium dodecyl sulfonate (SDS) and graphene. It is demonstrated that tension-shear exfoliation in high viscosity fluid may get a higher graphene production rate than in N-methyl-pyrrolidone. In addition, the micro-scale patterns of graphene nanomaterials produced by this method show high electrical conductivity and superior sensitivity to pressure due to their porous structure.

MicroRNA-433 inhibits cell proliferation in hepatocellular carcinoma by targeting p21 activated kinase (PAK4).

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. P21-activated kinase 4 (PAK4) has been identified as an oncogenic protein in a variety of cancers. However, the contribution and regulation of PAK4 in HCC remain poorly understood. In the present study, we found that inhibition of PAK4 expression by specific shRNA significantly attenuated HCC cell proliferation. Moreover, we show that microRNA-433 (miRNA-433) could directly target PAK4 through the miRNA-433 binding sequence at the 3'-UTR of PAK4 mRNA, and inhibit PAK4 protein expression. We further show that miRNA-433 expression was downregulated in HCC tissues and cell culture as well, which inversely correlated with PAK4 expression levels. Overexpression of miRNA-433 significantly suppressed the proliferation of HepG2 cells, while this effect was partially rescued by forced expression of PAK4 through restoring PI3K/AKT signaling in HepG2 cells. These findings will shed light on the roles and mechanisms of miRNA-433 in regulating HCC proliferation, and may benefit future development of therapeutics targeting miRNA-433 and PAK4 in HCC.

[Effects and mechanisms of punicosides on acute alcoholic liver damage in mice].

OBJECTIVE: To evaluate the protective effects of punicosides on alcohol induced acute liver injury in mice and its possible mechanisms as well. METHOD: The 60 mice were randomly divided into normal control, model group, three dose groups of punicosides with low, medium and high, then there is silibinin group. Three dose groups of punicosides and silibinin were given in advance by gavage for 4 weeks, then the mouse model of alcoholic acute liver injury was established. The serum levels of ALT, AST and TG were determined, and the mice were killed to calculate somatic index of liver, thymus as well as spleen. MDA, SOD, GSH-Px and GSH-ST were detected in the liver homogenate. Histopathological changes of the liver were observed by HE staining. The expression of MCP-1 and NF-kappaB in the liver tissues were detected by immunohistochemistry. RESULT: Mid and high dose of punicosides reduced the liver index in mice significantly, improved liver steatosis, decreased the level of ALT, AST and TG in serum and the content of MDA in liver homogenate, furthermore the two dose groups increased the activity of SOD, GSH-Px and GSH-ST, inhibited the expression of MCP-1 and NF-kappaB in liver tissue. CONCLUSION: Punicosides can protect the acute liver damage induced by alcohol.

Immunocompetent mouse models revealed that S100A4+ monocytes/macrophages facilitate long-term Zika virus infection in the testes.

During its global epidemic, Zika virus (ZIKV) attracted widespread attention due to its link with various severe neurological symptoms and potential harm to male fertility. However, the understanding of how ZIKV invades and persists in the male reproductive system is limited due to the lack of immunocompetent small animal models. In this study, immunocompetent murine models were generated by using anti-IFNAR antibody blocked C57BL/6 male mice and human STAT2 (hSTAT2) knock in (KI) male mice. After infection, viral RNA could persist in the testes even after the disappearance of viremia. We also found a population of ZIKV-susceptible S100A4+ monocytes/macrophages that were recruited into testes from peripheral blood and played a crucial role for ZIKV infection in the testis. By using single-cell RNA sequencing, we also proved that S100A4+ monocytes/macrophages had a great impact on the microenvironment of ZIKV-infected testes, thus promoting ZIKV-induced testicular lesions. In conclusion, this study proposed a novel mechanism of long-term ZIKV infection in the male reproductive system.

[Primary risk factors of hepatitis E virus infection:a meta-analysis].

OBJECTIVE: To analyze the main risk factors of hepatitis E virus infection. METHODS: Literatures published in China and abroad about the risk factors on the transmission of HEV were searched. HEV, risk factors, epidemiology and case-control were used as keywords to retrieve papers in Chinese literature databases including CNKI, Wanfang and SinoMed databases. The same strategy was used to retrieve English papers in English literature database including EBSCO and PubMed databases, supplemented by literature tracing method. Time range was from January 1994 to December 2012. A total of 258 papers were collected. Stata 11.0 software was used to calculate combined odds ratio (OR) and 95% confidence internals (CI). RESULTS: A total of 21 studies was included in this Meta-analysis, which contained 3566 cases and 14 724 controls. The results of univariate analysis including OR (95%CI) : Dining out: 2.13 (1.62-2.81), consumption of aquatic products: 2.21 (1.76-3.31), unboiled water: 2.04 (1.13-3.71), not washing hands before meals:1.72 (1.07-2.77), common health facilities: 2.53(1.73-3.70), touching animals:2.00 (1.58-2.52), consumption of contaminated food:1.56 (1.18-2.05), contacting with patients: 2.33 (1.92-2.83), drinking alcohol: 2.56 (1.42-4.63) and gender (male):1.64 (1.15-2.33). The results of multivariate analysis including OR (95%CI) : Dining out: 2.04 (1.68-2.48), consumption of aquatic products: 2.31(1.70-3.15), unboiled water: 1.43 (1.10-1.85), not washing hands before meals: 2.01 (1.46-2.77), common health facilities: 2.28 (1.48-3.51), consumption of contaminated food: 2.16 (2.06-2.26), touching animals: 2.17 (1.55-3.04), contacting with patients: 2.32 (1.68-3.21), drinking alcohol: 1.66 (1.31-2.10) and gender (male): 1.67 (1.46-1.92). CONCLUSION: The independent risk factors of HEV infection were dining out, consumption of aquatic products, unboiled water, not washing hands before meals, common health facilities, touching animals, consumption of contaminated food, contacting with patients, drinking alcohol and gender (male).

[Cloning, eukaryotic expression and spatial expression patterns of porcine MNSFbeta].

MNSFbeta (Monoclonal nonspecific suppressor factor beta) is a natural immunosuppressive factor which has been reported to be involved in various biological processes, such as immune responses, cell division, stress response, cell apoptosis, and nuclear transport. However, study on porcine MNSFbeta has been rarely reported. In this study, the full-length sequence of porcine MNSFbeta (GenBank accession number: KF77642500) was predicted in silicon and its cDNA sequence was obtained through RT-PCR from porcine spleen. The nucleic acid and protein sequences were analyzed. Then, the gene was subcloned into pEGFP-C1 to construct a recombinant plasmid pEGFP-MNSFbeta which was transfected into swine umbilical vein endothelial cells (SUVECs) using Lipofectamine 2000. The expression of GFP was detected by fluorescence microscopy, Western blot, and laser confocal fluorescence microscopy. The spatial expression patterns of porcine MNSFbeta were detected by real-time qPCR. Results showed that the full length of porcine MNSFbeta was 402 bp encoding 133 amino acids with only one exon. Bioinformatics analysis showed that porcine MNSFbeta protein was a stable protein consisting of a ubiquitin-like domain fused to the ribosomal protein S30 with no signal peptide. The analyses of homology and phylogenetic tree of porcine MNSFbeta and its homologs in other 18 species showed that the identities of MNSFbeta protein sequence were higher than 91% among different species and the evolutionary distance was less than 0.05. It indicates that MNSFbeta is highly conserved in the process of evolution. Fluorescence signal showed that the fusion protein GFP-MNSFbeta was successfully expressed in SUVECs which was then confirmed by Western blot. Laser confocal fluorescence microscopy showed that MNSFbeta was expressed in both nucleus and cytoplasm. Analysis of spatial expression patterns showed that procine MNSFbeta was widely expressed in immune tissues, but not in lung, suggesting that MNSFbeta may play an important role in immune response.

[A prospective study of late preterm infants' physical growth].

OBJECTIVE: To evaluate birth weights (BW) in late preterm infants (LPI) with different gestational ages (GA) and their physical growths at correct ages (CA) 1, 3 and 6 months. METHODS: A total of 287 LPIs were recruited for a cohort study between May 2010 and September 2011. Birth weights (BW) in infants with different gestational ages and their physical growths at CA 1, 3 and 6 months were evaluated. RESULTS: Of the 287 LPIs, mean BW in LPIs with gestational ages of 34-34(+6) and 35-35(+6) weeks was significantly lower than the reference value from a physical growth investigation on newborns of 15 cities of China in 1986 (P<0.05). However, mean BW in singleton LPIs (n=128) with gestational ages of 36-36(+6) weeks was significantly higher than the reference value (P<0.05). At CA 1, 3 and 6 months, more than 90% LPIs reached P(3) level in weights for age, length for age and head circumference for age. At CA 1 and 3 months, weight for age and head circumference for age in the LPIs were statistically higher than the reference values of physical growth in children under 7 years from nine cities of china in 2005 (P<0.05). Mean length for age at CA 1, 3 and 6 months was not significantly different from the reference value. CONCLUSIONS: There are obvious differences in BW in the LPIs compared with the reference value from a physical growth investigation on newborns of 15 cities of China in 1986, suggesting that the reference value of BW at different gestational ages needs to be updated in a certain interval. Before CA 6 months, there is a risk of overweight in LPIs and long-term monitoring is necessary. Growth of length should be followed-up for a long time.

Education and Quality of Life: Does the Internet Matter in China?

The internet has influenced human wellbeing through social networking, time-saving, diffusion of knowledge, and access to health information. Health is a key component of human quality of life. This study examines the nexus between education, the internet, and quality of life using data from China spanning the period from 1991 to 2020. The study used ARDL to examine the short and long-term, exploring education and the impact of the internet on quality of life. Education status plays a significant role in promoting quality of life in the short and long term. The empirical findings show the significant positive impact of the internet and ICT on quality of life in the short and long-run. Financial development and FDI improve the quality of life in the long-term in China. Based on these results, policymakers in China should develop the ICT infrastructure and human capital to support increased quality of life.

Do Higher Education and Financial Institutions Improve Health in China? A New Perspective.

The importance of human wellbeing is documented in the literature of development economics because of its intensifying impacts on economic growth and productivity of labor in the long-run. To the best of the authors' knowledge, no empirical study has examined the symmetric association between China's financial institutional development, education, and health outcomes. Thus, our study aims to fill this vacuum by employing an autoregressive distributed lag (ARDL) approach to explore the impact of financial institutional development and education on life expectancy and infant mortality rate from 1990 to 2020. The empirical analysis reveals that financial institutional development and education report a significant increase in life expectancy and meaningful reduction in mortality rate in the long-run. Based on these findings, the study may deliver intuitive policy implications regarding improvement in health conditions that are imperative for promoting economic growth in the long-run.

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI.

Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (109/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (109/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.

AMP-activated protein kinase re-sensitizes A549 to paclitaxel via up-regulating solute carrier organic anion transporter family member 1B3 expression.

Paclitaxel (PTX) is a common antineoplastic drug whose functionality is often restricted by drug resistance. Solute carrier organic anion transporter family member 1B3 (SLCO1B3) is a PTX influx transporter and its low expression has been proved to be relevant with PTX resistance. It has been widely reported that AMP-activated protein kinase (AMPK) could re-sensitize tumor cells to PTX. Our gene array result demonstrates AMPK up-regulated SLCO1B3. In this paper, we have tried to explain the relationships between PTX, SLCO1B3 and AMPK. First, we have verified the proliferative inhibition of PTX on A549 and found that PTX could inhibit A549 cells proliferation. Then, we have explored the relationship between SLCO1B3 and PTX: SLCO1B3 expression significantly decreased when A549 cells were treated with PTX or in A549 PTX resistant cells (A549-PTX) and the intracellular PTX concentration in A549-PTX was also lower. When treated with metformin/LKB1, both SLCO1B3 expression and intracellular PTX concentration have increased. Knockdown of AMPK has induced decreased SLCO1B3 expression. Moreover, in vitro and in vivo experiments have showed that metformin not only obviously inhibited A549-PTX tumor xenograft and A549-PTX proliferation alone, but also enhanced PTX efficacy to A549-PTX and this may be relevant to SLCO1B3. To verify it, we have treated A549 cells with AMPK both activators and an inhibitor, and then found that AMPK activators could weaken the PTX effect in inhibiting SLCO1B3 while its inhibitor has opposite effect. With knockdown of SLCO1B3, the effect of AMPK in re-sensitizing A549 to paclitaxel has decreased. To sum up, activation of AMPK can up-regulate SLCO1B3 expression, enhance the sensitivity of A549 cells to PTX, providing a new way to re-sensitize PTX resistance.

A step towards environmental mitigation: Do tourism, renewable energy and institutions really matter? A QARDL approach.

Adverse changes in environmental conditions due to unprecedented industrialization have been attracting the attention of policymakers, researchers, and activists. For developing nations like Pakistan, sustainability issues become even more severe because of unplanned growth and lack of resources. In this study, we have applied the QARDL model to analyze the impact of renewable energy, institutional quality, tourism, and GDP on the ecological footprint in Pakistan from 1995 to 2017. The results of this study suggest that increased utilization of renewable energy and tourism improve the environment in Pakistan, whereas institutional quality and GDP are positive and significant at all quantiles, revealing that upsurge in GDP and institutional quality are directly related to environmental conditions at all the quantiles. These results also validate the presence of the Environmental Kuznets Curve in Pakistan. The government of Pakistan can play a notable part in attaining sustainability by efficient management of the environment through promoting sustainable tourism, utilization of renewable energy, and enhancement of institutional quality.

A General Hypoxia-Responsive Molecular Container for Tumor-Targeted Therapy.

Enhanced drug delivery can improve the therapeutic efficacy of drugs and help overcome side effects. However, many reported drug-delivery systems are too complex and irreproducible for practical use. In this work, the design of a hypoxia-responsive molecular container based on calixarene, called CAC4A, which presents a significant advance in practical, hypoxia-targeted drug-delivery, is reported. CAC4A enables a wide variety of clinical drugs to be quantitatively loaded to improve their solubility and stability, as well as enable the administration of reduced doses. Furthermore, as a result of its azo functional groups, which are sensitive to reduction within a hypoxic environment, it is possible to achieve tumor-targeted drug-release with reduced side effects. CAC4A fulfils all essential requirements for a drug-delivery system in addition to multiple advantages, including facile preparation, well-defined molecular weight, and structure, and universal applicability. Such features collectively enable supramolecular prodrugs to be formulated simply and reproducibly, with potential for bench-to-bedside translation. Moreover, CAC4A is amenable to other therapy modalities and can be facilely decorated with functional groups and hybridized with nanomaterials, providing ample possibilities for its role in future drug-delivery systems.

Spontaneous and transient hyperglycemia before sleep in a patient with glaucomatous blindness and diabetes: A case reprt.

RATIONALE: The peak of blood glucose was during 9 PM to 3 AM. There is a stable, spontaneous and short-term abnormal increase of blood glucose. The pathophysiological mechanism is unknown. It is speculated that the cause might be the imbalance of the glucose-regulating hormone that is caused by the disorder of the biological clock system. PATIENT CONCERNS: The case was a 73-year old man with bilateral glaucoma (only mild light perception) and was hospitalized to establish a viable hypoglycemic plan. He received 4 shots of insulin enhancement, oral meditation, pre-mixed insulin treatment during the 22 days. However, his blood glucose had been spontaneously increased from 9 PM to 3 AM which was the highest of the day, and then resumed by itself. Insulin intervention was effective. DIAGNOSIS: Glaucomatous blindness and diabetes, spontaneous and transient hyperglycemia before sleep. INTERVENTIONS: We used insulin aspart 3u when we found hyperglycemia three times at 9 PM and it was effective. Without intervention, blood sugar will automatically improve in the morning. OUTCOMES: During the late night and early morning, there is a stable, spontaneous and short-term transit abnormal increase in blood glucose, which suggests the complexity of blood glucose adjustment. LESSONS: Due to the case specialty, we could not do the systematic review of the study. However, it improves the awareness of the abnormal periodically increase of blood glucose during the special periods, and provides with a reference for clinical research of dawn and dusk phenomenon. Multi-point blood glucose monitoring or dynamic blood glucose monitoring throughout the day is of great significance for the detection of special types of hyperglycemia.

Clinical diagnosis for dusk phenomenon of diabetes.

The diabetes dusk phenomenon (spontaneous and transient pre-dinner hyperglycemia) anecdotally exists but has not been investigated.A total of 80 diabetic patients that received continuous subcutaneous insulin infusions were retrospectively studied. They were grouped into a routine group (R) (consecutive δDG [dusk blood glucose difference] <0 mmol/L) and a classic dusk phenomenon group (CDP, consecutive δDG≥0 mmol/L). δDG represents differences in blood glucose measurements between pre-dinner and post-lunch (δDG: dusk blood glucose difference). Other patients were placed in a suspicious group (S). The suspicious group was further divided into 3 groups based on the frequency at which the δDG occurred: suspicious 1 group (S1), δDG≥0 mmol/L occurred once only; suspicious 3 group (S3), δDG < 0 mmol/L occurred once only, and the remaining patients were grouped in the suspicious 2 group (S2).We identified the CDP and S3 groups as the "clinical dusk phenomenon" group (CLDP). We confirmed that the S1 and R groups to be in the "clinical routine" group. The S2 group was significantly different from the CDP group. In addition, the S2 group had significant differences in δDG measurements and post-lunch blood glucose values compared with the R group, but no differences in other parameters were seen. Multiple comparisons with the other suspicious groups also showed no statistical difference in many parameters. Thus, we placed these patients into the "suspicious clinical dusk phenomenon" group (SDP). The δDG cut-off for the CLDP group was 1.0167 mmol/L. The pre-dinner-pre-lunch blood glucose cut-off for this group was 2.72 mmol/L. The δDG cut-off for the SDP group was -0.95 mmol/L. The pre-dinner-pre-lunch blood glucose cut-off for this group was 0.87 mmol/L. The cut-off points for the post-dinner-post-lunch blood glucose measurements in the CLDP and SDP groups were both 1.2667 mmol/L.A consecutive δDG≥0 or a once only δDG < 0 could be diagnosed as falling into the CLDP group. The CLDP could be excluded when a consecutive δDG < 0 or a once only δDG≥0 was found. Patients falling into other categories were placed into the SDP group.

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma.

PURPOSE: To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in treating early T-stage nasopharyngeal carcinoma (NPC). METHOD: Ten patients with early T-stage NPC who received tomotherapy using simultaneously integrated boost (SIB) strategies were replanned with VMAT (RapidArc of Varian, dual-arc). Dosimetric comparisons between the RapidArc plan and the HT plan included the following: (1) D98, homogeneity, and conformity of PTVs; (2) sparing of organs at risk (OARs); (3) delivery time and monitor units (MUs). RESULTS: (1) Compared with RapidArc, HT achieved better dose conformity (CI of PGTVnx + nd: 0.861 versus 0.818, P = 0.004). (2) In terms of OAR protection, RapidArc exhibited significant superiority in sparing ipsilateral optic nerve (Dmax: 27.5Gy versus 49.1Gy, P < 0.001; D2: 23.5Gy versus 48.2Gy, P < 0.001), contralateral optic nerve (Dmax: 30.4Gy versus 49.2Gy, P < 0.001; D2: 26.2Gy versus 48.1Gy, P < 0.001), and optic chiasm (Dmax: 32.8Gy versus 48.3Gy, P < 0.001; D2: 30Gy versus 47.6Gy, P < 0.001). HT demonstrated a superior ability to protect the brain stem (D1cc: 43.0Gy versus 45.2Gy, P = 0.012), ipsilateral temporal lobe (Dmax 64.5Gy versus 66.4 Gy, P = 0.015), contralateral temporal lobe (Dmax: 62.8Gy versus 65.1Gy, P = 0.001), ipsilateral lens (Dmax: 4.27Gy versus 5.24Gy, P = 0.009; D2: 4.00Gy versus 5.05Gy, P = 0.002; Dmean: 2.99Gy versus 4.31Gy, P < 0.001), contralateral lens (Dmax: 4.25Gy versus 5.09Gy, P = 0.047; D2: 3.91Gy versus 4.92Gy, P = 0.005; Dmean: 2.91Gy versus 4.18Gy, P < 0.001), ipsilateral parotid (Dmean: 36.4Gy versus 41.1Gy, P = 0.002; V30Gy: 54.8% versus 70.4%, P = 0.009), and contralateral parotid (Dmean: 33.4Gy versus 39.1Gy, P < 0.001; V30Gy: 48.2% versus 67.3%, P = 0.005). There were no statistically significant differences in spinal cord or pituitary protection between the RapidArc plan and the HT plan. (3) RapidArc achieved a much shorter delivery time (3.8 min versus 7.5 min, P < 0.001) and a lower MU (618MUs versus 5646MUs, P < 0.001). CONCLUSION: Our results show that RapidArc and HT are comparable in D98, dose homogeneity, and protection of the spinal cord and pituitary gland. RapidArc performs better in shortening delivery time, lowering MUs, and sparing the optic nerve and optic chiasm. HT is superior in dose conformity and protection of the brain stem, temporal lobe, lens, and parotid.

Study of Thermal Electrical Modified Etching for Glass and Its Application in Structure Etching.

In this work, an accelerating etching method for glass named thermal electrical modified etching (TEM etching) is investigated. Based on the identification of the effect in anodic bonding, a novel method for glass structure micromachining is proposed using TEM etching. To validate the method, TEM-etched glasses are prepared and their morphology is tested, revealing the feasibility of the new method for micro/nano structure micromachining. Furthermore, two kinds of edge effect in the TEM and etching processes are analyzed. Additionally, a parameter study of TEM etching involving transferred charge, applied pressure, and etching roughness is conducted to evaluate this method. The study shows that TEM etching is a promising manufacture method for glass with low process temperature, three-dimensional self-control ability, and low equipment requirement.