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Objective:To explore the feasibility and validity of constructing an intensity-modulated radiotherapy gamma pass rate prediction model after combining the SHAP values with the extreme gradient boosting tree (XGBoost) algorithm feature selection technique, and to deliver corresponding model interpretation.Methods:The dose validation results of 196 patients with pelvic tumors receiving fixed-field intensity-modulated radiotherapy using modality-based measurements with a gamma pass rate criterion of 3%/2 mm and 10% dose threshold in Hunan Provincial Tumor Hospital from November 2020 to November 2021 were retrospectively analyzed. Prediction models were constructed by extracting radiomic features based on dose files and using SHAP values combined with the XGBoost algorithm for feature filtering. Four machine learning classification models were constructed when the number of features was 50, 80, 110 and 140, respectively. The area under the receiver operating characteristic curve (AUC), recall rate and F1 score were calculated to assess the classification performance of the prediction models.Results:The AUC of prediction model constructed with 110 features selected based on the SHAP-valued features was 0.81, the recall rate was 0.93 and the F1 score was 0.82, which were all better than the other 3 models.Conclusion:For intensity-modulated radiotherapy of pelvic tumor, SHAP values can be used in combination with the XGBoost algorithm to select the optimal subset of radiomic features to construct predictive models of gamma pass rates, and deliver an interpretation of the model output by SHAP values, which may provide value in understanding the prediction by machine learning-dependent models.
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Objective:To explore the feasibility of a classification prediction model for gamma pass rates (GPRs) under different intensity-modulated radiation therapy techniques for pelvic tumors using a radiomics-based machine learning approach, and compare the classification performance of four integrated tree models.Methods:With a retrospective collection of 409 plans using different IMRT techniques, the three-dimensional dose validation results were adopted based on modality measurements, with a GPR criterion of 3%/2 mm and 10% dose threshold. Then prediction were built models by extracting radiomics features based on dose documentation. Four machine learning algorithms were used, namely random forest (RF), adaptive boosting (AdaBoost), extreme gradient boosting (XGBoost), and light gradient boosting machine (LightGBM). Their classification performance was evaluated by calculating sensitivity, specificity, F1 score, and AUC value. Results:The RF, AdaBoost, XGBoost, and LightGBM models had sensitivities of 0.96, 0.82, 0.93, and 0.89, specificities of 0.38, 0.54, 0.62, and 0.62, F1 scores of 0.86, 0.81, 0.88, and 0.86, and AUC values of 0.81, 0.77, 0.85, and 0.83, respectively. XGBoost model showed the highest sensitivity, specificity, F1 score, and AUC value, outperforming the other three models. Conclusions:To build a GPR classification prediction model using a radiomics-based machine learning approach is feasible for plans using different intensity-modulated radiotherapy techniques for pelvic tumors, providing a basis for future multi-institutional collaborative research on GPR prediction.
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Objective:To develop the minimal clinically important difference (MCID) of Quality of Life Instruments for Cancer Patients-Leukemia (QLICP-LE) (V2.0).Methods:The quality of life of 101 patients with leukemia in First Affiliated Hospital of Kunming Medical University and First People′s Hospital of Yunnan Province from October 2011 to May 2012 were measured. The QLICP-LE (V2.0) was used for data collection, and the MCID for the overall score and scores of various domains of QLICP-LE (V2.0) were established by using the distribution-based approach including indexes of effect size, standard error of measurement (SEM), reliable change index, standardized response mean and responsiveness statistic, and the recommended values of MCID were determined through the consensus method.Results:The MCID formulated by the above five indexes were as follows: the total scale 1.4-9.3, physical functional domain 1.6-15.6, psychological functional domain 2.9-15.6, social functional domain 2.2-18.0, common symptoms and side-effects domain 1.7-17.1, common module 1.8-10.0, and the specific module 1.1-12.1. Through the expert consensus method, it was recommended to use the MCID results calculated by 1.96SEM: the total scale was 4, physical domain was 8, psychological domain was 8, social domain was 9, common symptoms and side-effects domain was 9, common module was 4, and the specific module was 6.Conclusion:Each index of distribution-based approach has its own advantages and disadvantages, which can be selected based on actual conditions. There is clinical significance when the score change of QLICP-LE (V2.0) of leukemia patients after treatment exceeds its MCID.
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Objective@#To investigate the feasibility of myeloid and plasmacytoid dendritic cell combined vaccines loaded with heat-treated Lewis lung cancer cell lysates for treatment of lung cancer in mice.@*Methods@#Bone marrow cells were induced by the recombinant mouse fms-like tyrosine kinase receptor 3 ligand (rmFlt3-L) in vitro, myeloid dendritic cells (mDC) and plasmacytoid dendritic cells (pDC) were separated by magnetic beads. The mDC, pDC, and mDC∶pDC=1∶1 were stimulated with heat-treated Lewis lung cancer cell lysates, respectively. The effects of each group on stimulating of lymphocyte proliferation and inducing of T cell to kill tumor cells in vitro were compared. The alternations of the immunophenotypes of CD80, CD86, CD40 and major histocompatibility complex Ⅱ (MHC-Ⅱ) were detected by flow cytometry. The secretion of cytokines including interlukin-12 (IL-12), interlukin-6 (IL-6), and tumor necrosis factor α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA).@*Results@#The lymphocyte proliferation in mice stimulated with mDC+ pDC group loaded with heat-treated Lewis lung cancer cell lysates was 10.80±0.66, significantly higher than 8.63±0.65 of mDC group and 7.10±0.46 pDC group under the same culture conditions, respectively (P<0.05). When the ratio of effector cells: target cells (E∶T) was 10∶1, the killing rate of the mDC+ pDC group loaded with heat-treated tumor cell lysate was 31.68%±2.93%, significantly higher than 17.44%±0.97% of mDC group and 10.29%±1.33% of pDC group, respectively (P<0.05). When the ratio of E∶T was 20∶1, the killing rate of the mDC+ pDC group loaded with heat-treated tumor cell lysate was 54.77%±3.28%, significantly higher than 35.25%±1.51% of mDC group and 15.52%±0.73% of pDC group, respectively (P<0.05). When the ratio of E∶T was 40∶1, the killing rate of the mDC+ pDC group loaded with heat-treated tumor cell lysate was 73.01%±0.91%, significantly higher than 51.36%±0.58% of mDC group and 22.65%±1.28% of pDC group, respectively (P<0.05). With the rate of E∶T increased, the killing rate also increased. The mean fluorescence intensities of surface molecules including CD80, CD86, CD40 and MHC-Ⅱ of mDC: pDC=1 group pulsed with heat-treated Lewis lung cancer cell lysates were higher than those of mDC group and pDC group. The IL-6 cytokine concentrations of mDC+ pDC group, mDC group and pDC group loaded with heat-treated Lewis lung cancer cell lysates were (586.67±52.52) pg/ml, (323.33±67.14) pg/ml and (166.67±16.07) pg/ml, respectively. The concentrations of IL-12 in each group were (2 568.75±119.24) pg/ml, (2 156.25±120.55) pg/ml and (672.92±31.46) pg/ml, respectively. The concentrations of TNF-α in each group were (789.33±48.08) pg/ml, (584.89±116.49) pg/ml and (291.56±40.73) pg/ml, respectively. The concentrations of IL-6, IL-12 and TNF-α secreted by mDC+ pDC group were much higher than those of mDC group and pDC group under the same culture conditions (P<0.05).@*Conclusions@#The mDCs and pDCs combined vaccines pulsed with heat-treated Lewis lung cancer cell lysates have synergistic effects on inducing of T lymphocyte proliferation and killing tumor cells in vitro. This synergistic anti-tumor effect is related with up-regulation of co-stimulatory molecules and increased secretion of cytokines.
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Objective To compare the quality of life ( QOL) in different family life cycle residents and analyze its influencing factors. Methods Based on the stratified cluster sampling,517 married residents from three communities of Dongguan city were chosen to be investigated by a questionnaire on the general status and the MOS health survey (SF-36).The One-Way ANOVA and Multiple Regression Analysis were used to analyze the data. Result There were significant differences on the seven domains of the SF-36 ex-cept of physical pain in different family life cycle residents (P<0.05) . The scores of different domains at the retirement or senior years were the lowest ( ranging from 37.10-59.81) ,and the scores of different domains at the child-bearing period were highest (ranging from 37.10-59.81). The results of Multiple Linear Stepwise Regression showed that the QOL of different family life cycle residents were influenced by some factors. The influencing factors on PCS at the child-bearing period were income (β=1.51) and life events (β=-6.13), while that at the period of families with adolescents were economic income (β=1.81) and age (β=-0.65);that at the period of empty nest were economic income (β=-3.64) and age (β=-0.65);and that at the re-tirement or senior years were unhealthy living habit (β=-15.06),age (β=-0.56) and income (β=3.06). The influencing factors on MCS at the child-bearing period was medical insurance (β=5.86),while that at the period of families with adolescents were medical insurance (β=6.28),education (β=2.32),life events (β=-4.68) and occupation (β=-5.53);that at the period of the empty nest were age (β=-0.61) ,gender (β=-10.35) and chronic disease (β=-8.35);that at the retirement or senior years were age (β=-0.27) , economic income (β=2.55) and unhealthy living habit (β=-6.95) . Conclusion The influencing factors of QOL for different family cycle residents are not conformity with each other. It suggested that in order to im-prove the QOL of residents, the community health service including health education and health promotion should be based on different family life cycle.
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By analyzing the connotation and research status of life culture, the authors of the article have pointed out that the introduction of life cultural education is a new interpretation of medical humanities education and can give full play to their role as educating people. They have also put for-ward that we should grasp its open and comprehensive characteristics in work, and carry out life cul-tural education comprehensively and by multi-channels. Medical colleges can try to construct scientific cultural education system, design useful education content, set up diversified education platform and carry out the multi-channel and all-round life cultural education from the classroom teaching, practice, campus activities and so on.
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Objective To compare the characteristics in initial sandplay of college students with high and low gregarious personality,to validate the psychological assessment function of the initial sandplay.Methods Used the 16-PF as the tool to selected the 56 students as the high gregarious group,and 36 students as the low gregarious group.Results On selection of toys,the proportions of high gregarious group were significantly higher than those in low gregarious group in total numbers,plants and daily necessities ((27.77 ± 11.01)vs (20.94 ± 8.76),(7.30 ±6.43)vs(3.25 ±2.85),(3.66 ±2.86)vs(2.25 ±2.57)),and significantly lower in religion toys (0.30 ± 0.47) vs (0.86 ± 1.09).On operation process,the proportion of starting with toys in high gregarious group was significantly higher than that in low gregarious group (94.6% vs 25%).Their attitudes towards sand were random touch(28.6% vs 5.6%) and indifference(62.5% vs 41.7%).They used more grass(55.4% vs 27.8%),more real characters(83.9% vs 50%),fewer virtual characters(55.4% vs 83.3%) and more dynamic changes in creation(14.3% vs 0%),more applied by the social scene (39.3% vs 0%).On the theme of sandplay,the high gregarious group was fewer appear by the empty,neglect,injury ((3.6% vs 19.4%),(0% vs 8.3%),(0% vs 8.3%) respectively,P < 0.05).Conclusion The results show that the high and low gregarious personality have significantly characteristics in initial sandplay.Sandplay is valuable to be a personality assessment tool.
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ObjectiveTo summarize the characteristics in initial sandplay of the interpersonal sensitivity (IS) in college students,and validate the psychological assessment function of the initial sandplay.MethodsThe research selected the 32 IS college students and 36 healthy students by the symptom checklist 90(SCL-90).All the 68 students applied the initial sandplay operation.The initial sandplay encoding of information was collected by coding table,and analyzed by t test,Chi-square test.ResultsOn selection of toys,the IS group was significantly lower in total,buildings,plants ( ( 18.63 ± 10.93 ) vs ( 29.81 ± 12.25 ),( 1.47 ± 1.52 ) vs ( 2.39 ± 1.68 ),( 3.41 ±4.39) vs(9.72 ±6.67) ),and significantly more in the others( (0.13 ±0.33) vs(0.00 ± 0.00) ).On space utilization,the IS group was lower than the non-IS group in all fields except the left middle and the middle.On operation process,the IS group on attitude to the sand was untouch(59.4% vs 22.2% ),less exposed the blue bottom (71.9% vs 30.6% ),less use the bridge(68.8% vs 38.9% ),more dissatisfaction with the own sandbox(43.8%vs 2.8% ),more warfare and abstract scene( ( 18.8% vs 0% ),(21.9% vs 2.8% ) ),and less family and society scene( ( 12.5% vs 27.8% ),(25% vs 41.7% ) ).On the theme of sandplay,the is group was more appeared by the confusion,empty,split,limit,neglect,injury,threat theme( (25% vs 5.6% ),(37.5% vs 0% ),(31.3% vs 0% ),(40.6% vs 5.6% ),(37.5% vs 2.8% ),( 15.6% vs 0% ),(50% vs 5.6% ) ),and less appeared by the integrate,flow and energy theme ((12.5% vs 38.9%),(3.1% vs 50%),(28.1% vs 58.3%)).ConclusionThe results show that the IS group has significantly characteristics in initial sandplay.Sandplay is valuable to be a clinical psychological assessment.
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ObjectiveTo study the relationship between subjective well-being and family care degree of medical college students.Methods2695 medical college students were tested by Family APGAR index and Oxford Happiness Test-Revised.The data was analyzed by independent-sample t test,pearson correlations and linear regression.Results ( 1 ) The subjective well-being and family care degree and its factors of college students were above average.The score of subjective well-being was 43.08 ± 11.16,and the score of family care degree was 6.48 ±2.39.(2)The family care degree( t=3.462,P<0.01) and its adaptation( t=2.718,P<0.01),partnership( t =4.178,P<0.01),and growth( t=4.484,P<0.01 ) of female students were higher than male students.The family care degree ( t =3.939,P < 0.01 )and its adaptation ( t =4.683,P < 0.01 ),partner-ship ( t =3.306,P< 0.01 ),and growth ( t =2.796,P < 0.01 ) and subjective well-being( t =3.508,P< 0.01 ) of the students who came from cities and towns were higher than the students who came from rural.(3)There was a significant relation between subjective well-being and family care degree and its factors( r=0.197 ~ 0.357,all P<0.05 ).The partner-ship,resolve,growth and affection can forecast together the 13.2% variance of subjective well-being.ConclusionEnhancing family care degree is contribute to the subjective well-being and psychological health of medical college students.