摘要
Objective:To evaluate the effect of hyperthermia on radiation pneumonitis (RP) in elderly patients with esophageal cancer undergoing intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 177 elderly esophageal cancer patients (aged ≥60 years) receiving IMRT in the First Affiliated Hospital of Soochow University and Yixing Cancer Hospital from August 1, 2017 to February 6, 2023 were retrospectively analyzed. Patients were divided into the hyperthermia and non-hyperthermia groups based on whether they received hyperthermia treatment. Patients in two groups received IMRT with 6 MV X-rays. Patients in the hyperthermia group underwent high-frequency hyperthermia within 1 h before radiation using the external thermotherapy device HG-2000Ⅲ (heating temperature: 41-43 ℃ for 40 min, twice a week). After adjusting for confounding factors between two groups using propensity score matching (PSM), the short-term effective rates between two groups were compared using Chi-square test. Univariate analysis and logistic multivariate analysis were employed to compare the incidence of RP between two groups. Results:After applying PSM, 42 pairs were successfully matched, and the baseline data and radiotherapy parameters showed no statistically significant differences between two groups (all P>0.05). The objective response rate (ORR) in the hyperthermia group was significantly higher than that in the non-hyperthermia group (83.3% vs. 64.3%, P=0.047). Univariate analysis revealed that the incidence of RP and symptomatic RP (≥ grade 2) in the hyperthermia group was significantly lower than that in the non-hyperthermia group (61.9% vs. 85.7%, P=0.013; 21.4% vs. 47.6%, P=0.012). Logistic multivariate analysis indicated that hyperthermia was an independent protective factor for symptomatic RP ( P=0.011). Conclusions:The incidence and severity of RP in elderly esophageal cancer patients receiving IMRT can be reduced by hyperthermia. Hyperthermia, as a clinically beneficial green treatment, improves efficacy and reduces toxicity for patients with esophageal cancer.
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Objective To investigate the protective and treatment role of ulinastatin(UTI)on con-trast-induced acute kidney injury(CIAKI)in the elderly with coronary heart disease(CHD)and chronic kidney diseases(CKD).Methods A total of 321 elderly CHD inpatients complicated with CKD undergoing coronary angiography admitted in the First Medical Center of Chinese PLA Gen-eral Hospital from November 2021 to November 2022 were enrolled consecutively and then divid-ed into UTI group(n=161)and hydration group(n=160).Their cardiac and renal function pa-rameters were collected and analyzed before and 2 d after intervention.The changes in above pa-rameters and incidence of CIAK were observed and compared between the two groups.Results In 2 d after intervention,the UTI group had significantly lower Scr,urea,CysC,homocysteine and NT-proBNP,but higher eGFR than the hydration group(P＜0.01).There were 62 patients(62/321,19.3％)developing CIAKI,including 17 from the UTI group and 45 from the hydration group,and statistical difference was observed in the incidence(10.6％vs 28.1％,P＜0.01).For the patients with comorbidities of hypertension,diabetes,hyperlipidemia and hyperuricemia,the incidence of CIAKI was obviously lower in the UTI group than the hydration group(P＜0.01).Multivariate logistic regression analysis showed that UTI was an independent protective factor for occurrence of CIAKI(OR=0.348,95％CI:0.180-0.673,P=0.001).Conclusion UTI can im-prove renal function and reduce the risk of CIAKI in elderly CHD patients with CKD.
摘要
Objective: To compare and analyze the clinical characteristics of acute myeloid leukemia (AML) related to the treatment of hematological tumors and solid tumors. Methods: The laboratory and clinical data of 41 patients with treatment-related AML (t-AML) in the Department of Hematology, Henan Cancer Hospital from January 2014 to December 2021 were retrospectively analyzed, and they were divided into hematological tumor group and solid tumor group. Survival analysis was performed using the Kaplan-Meier method and Log rank test. Results: The median interval from the first tumor diagnosis to t-AML in 41 patients was 21.0 (16.5-46.0) months; 24 (58.5%) had abnormal expression of lymphoid antigen, 28 (68.3%) had abnormal karyotype, 18 cases (43.9%) were positive for fusion gene, and 28 cases (68.3%) were positive for gene mutation; the median recurrence-free survival (RFS) was 11.0 months, and the median overall survival (OS) was 11.5 months. The proportion of acute promyelocytic leukemia ([APL], 0.0, 0/13), complete response ([CR],18.2%, 2/11), median OS (4.5 months) and median RFS (2.5 months) of t-AML patients in the hematological tumor group were significantly lower than those in the solid tumor group (35.7%, 10/28; 68.0%, 17/25; not reach; not reach), but the proportion of M4 /M5 (93.2%,12/13) was significantly higher than that in the solid tumor group (53.6%,15/18; all P values<0.05). Through subgroup analysis, the proportion of patients with positive PML-RARa and good prognosis karyotypes in the solid tumor group (35.7%, 10/28; 46.4%, 13/28) was significantly higher than that in the hematological tumor group (0.0, 0/13; 0.0, 0/13; P<0.05), while the proportion of patients with intermediate karyotypes (42.9%, 12/28) was significantly lower than that in the hematological tumor group (84.6%, 11/13; P<0.05), the difference was statistically significant. The CR rate (90.0%, 9/10), median OS (not reach) and median RFS (not reach) in the t-APL group were higher than those in the t-AML (without t-APL) group (38.5%, 10/26; 6 months; 8 months; P<0.05). After excluding the effect of t-APL patients, there was no significant difference in the CR rate, median OS and median RFS between the solid tumor group (8; 9 months; not reach) and the hematological tumor group (2; 4 months; 2 months; P>0.05). Univariate analysis showed that the primary tumor belongs to hematological tumor was a common risk factor for OS and RFS in t-AML patients (P<0.10). Conclusions: Compared with patients with t-AML secondary to solid tumors, patients with t-AML secondary to hematological tumors have poorer treatment effects and poorer prognosis. After excluding the effect of t-APL patients, there are no significant differences in the treatment efficacy and prognosis between the two types of t-AML patients.
Subject(s)
Humans , Retrospective Studies , Leukemia, Myeloid, Acute/genetics , Hematologic Neoplasms , Mutation , Hematology摘要
Objective: To compare and analyze the clinical characteristics of acute myeloid leukemia (AML) related to the treatment of hematological tumors and solid tumors. Methods: The laboratory and clinical data of 41 patients with treatment-related AML (t-AML) in the Department of Hematology, Henan Cancer Hospital from January 2014 to December 2021 were retrospectively analyzed, and they were divided into hematological tumor group and solid tumor group. Survival analysis was performed using the Kaplan-Meier method and Log rank test. Results: The median interval from the first tumor diagnosis to t-AML in 41 patients was 21.0 (16.5-46.0) months; 24 (58.5%) had abnormal expression of lymphoid antigen, 28 (68.3%) had abnormal karyotype, 18 cases (43.9%) were positive for fusion gene, and 28 cases (68.3%) were positive for gene mutation; the median recurrence-free survival (RFS) was 11.0 months, and the median overall survival (OS) was 11.5 months. The proportion of acute promyelocytic leukemia ([APL], 0.0, 0/13), complete response ([CR],18.2%, 2/11), median OS (4.5 months) and median RFS (2.5 months) of t-AML patients in the hematological tumor group were significantly lower than those in the solid tumor group (35.7%, 10/28; 68.0%, 17/25; not reach; not reach), but the proportion of M4 /M5 (93.2%,12/13) was significantly higher than that in the solid tumor group (53.6%,15/18; all P values<0.05). Through subgroup analysis, the proportion of patients with positive PML-RARa and good prognosis karyotypes in the solid tumor group (35.7%, 10/28; 46.4%, 13/28) was significantly higher than that in the hematological tumor group (0.0, 0/13; 0.0, 0/13; P<0.05), while the proportion of patients with intermediate karyotypes (42.9%, 12/28) was significantly lower than that in the hematological tumor group (84.6%, 11/13; P<0.05), the difference was statistically significant. The CR rate (90.0%, 9/10), median OS (not reach) and median RFS (not reach) in the t-APL group were higher than those in the t-AML (without t-APL) group (38.5%, 10/26; 6 months; 8 months; P<0.05). After excluding the effect of t-APL patients, there was no significant difference in the CR rate, median OS and median RFS between the solid tumor group (8; 9 months; not reach) and the hematological tumor group (2; 4 months; 2 months; P>0.05). Univariate analysis showed that the primary tumor belongs to hematological tumor was a common risk factor for OS and RFS in t-AML patients (P<0.10). Conclusions: Compared with patients with t-AML secondary to solid tumors, patients with t-AML secondary to hematological tumors have poorer treatment effects and poorer prognosis. After excluding the effect of t-APL patients, there are no significant differences in the treatment efficacy and prognosis between the two types of t-AML patients.
Subject(s)
Humans , Retrospective Studies , Leukemia, Myeloid, Acute/genetics , Hematologic Neoplasms , Mutation , Hematology摘要
Objective: To analyze the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treating T lymphoblastic leukemia/lymphoma (T-ALL/LBL) . Methods: This study retrospectively evaluated 119 adolescent and adult patients with T-ALL/LBL from January 2006 to January 2020 at Peking University Third Hospital and Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences. Patients were divided into chemotherapy-only, chemotherapy followed by allo-HSCT, and chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) groups according to the consolidation regimen, and the 5-year overall survival (OS) and progression-free survival (PFS) rates of each group were compared. Results: Among 113 patients with effective follow-up, 96 (84.9%) patients achieved overall response (ORR), with 79 (69.9%) having complete response (CR) and 17 (15.0%) having partial response (PR), until July 2022. The analysis of the 96 ORR population revealed that patients without transplantation demonstrated poorer outcomes compared with the allo-HSCT group (5-year OS: 11.4% vs 55.6%, P=0.001; 5-year PFS: 8.9% vs 54.2%, P<0.001). No difference was found in 5-year OS and 5-year PFS between the allo-HSCT and auto-HSCT groups (P=0.271, P=0.197). The same results were achieved in the CR population. Allo-HSCT got better 5-year OS (37.5% vs 0) for the 17 PR cases (P=0.064). Different donor sources did not affect 5-year OS, with sibling of 61.1% vs hap-haploidentical of 63.6% vs unrelated donor of 50.0% (P>0.05). No significant difference was found in the treatment response in the early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP) and non-ETP populations. The ETP group demonstrated lower 5-year OS compared with the non-ETP group in the chemotherapy alone group (0 vs 12.6%, P=0.045), whereas no significant difference was found between the ETP and non-ETP groups in the allo-HSCT group (75.0% vs 62.9%, P=0.852). Multivariate analysis revealed that high serum lactate dehydrogenase level, without transplantation, and no CR after chemotherapy induction were independently associated with inferior outcomes (P<0.05) . Conclusion: Allo-HSCT could be an effective consolidation therapy for adult and adolescent patients with T-ALL/LBL. Different donor sources did not affect survival. Allo-HSCT may overcome the adverse influence of ETP-ALL/LBL on OS.
Subject(s)
Adult , Adolescent , Humans , Prognosis , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma , Retrospective Studies , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Hematopoietic Stem Cell Transplantation , Lymphoma, T-Cell , Unrelated Donors摘要
Objective: To explore the characteristics of viral infections in children with diarrhea in Beijing from 2018 to 2022. Methods: Real-time PCR and enzyme-linked immunosorbent assay were used to detect viral nucleic acid of Norovirus (NoV), Sappovirus (SaV), Astrovirus (AstV), Enteric Adenovirus (AdV) or antigen of Rotavirus (RV) in 748 stool samples collected from Beijing Capital Institute of Pediatrics from January 2018 to December 2021. Subsequently, the reverse transcription PCR or PCR method was used to amplify the target gene of the positive samples after the initial screening, followed by sequencing, genotyping and evolution analysis, so as to obtain the characteristics of these viruses. Phylogenetic analysis was performed using Mega 6.0. Results: From 2018 to 2021, the overall detection rate of the above five common viruses was 37.6%(281/748)in children under 5 years old in Beijing. NoV, Enteric AdV and RV were still the top three diarrhea-related viruses, followed by AstV and SaV, accounting for 41.6%, 29.2%, 27.8%, 8.9% and 7.5%, respectively. The detection rate of co-infections with two or three diarrhea-related viruses was 4.7% (35/748). From the perspective of annual distribution, the detection rate of Enteric AdV was the highest in 2021, while NoV was predominant in the other 4 years. From the perspective of genetic characteristics, NoV was predominant by GⅡ.4, and after the first detection of GⅡ.4[P16] in 2020, it occupied the first two gene groups together with GⅡ.4[P31]. Although the predominant RV was G9P[8], the rare epidemic strain G8P[8] was first detected in 2021. The predominant genotypes of Enteric AdV and AstV were Ad41 and HAstV-1. SaV was sporadic spread with a low detection rate. Conclusion: Among the diarrhea-related viruses infected children under 5 years of age in Beijing, the predominant strains of NoV and RV have changed and new sub-genotypes have been detected for the first time, while the predominant strains of AstV and Enteric AdV are relatively stable.
Subject(s)
Child, Preschool , Humans , Infant , Beijing/epidemiology , Diarrhea/epidemiology , Feces , Norovirus/genetics , Phylogeny , Rotavirus/genetics , Virus Diseases/epidemiology , Viruses/genetics摘要
Patients with severe or critical coronavirus disease 2019 (COVID-19) are at high risk of death primarily due to respiratory failure caused by the cytokine storm in pulmonary tissues. The treatment response of these patients remains limited. Recently, low-dose radiation therapy (LDRT) has been clinically adopted to treat severe or critical COVID-19 patients in multiple medical centers abroad, indicating high feasibility and effectiveness. However, the mechanism and optimal radiation dose are still incompletely clear. This paper reviews the radiobiological mechanism, effectiveness, adverse reactions, and radiotherapy dose of LDRT in the treatment of severe or critical COVID-19 patients, aiming to better understand the clinical benefits and adverse reactions of LDRT.
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Objective:To analyze the clinical characteristics of chronic Q fever.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, diagnosis, treatment and prognosis of 12 patients with chronic Q fever admitted in Peking Union Medical College Hospital from January 2008 to December 2022 were analyzed retrospectively.Results:Of the12 cases, there were 11 males and 1 female with a median age at diagnosis of 58 years (47-68). The median time interval between the onset of symptoms and diagnosis was 9.5 months (4.0-28.5). Ten patients had fever, and the common symptoms included weakness ( n=6), weight loss ( n=5) and shortness of breath ( n=3). Seven patients presented with hepatomegaly and splenomegaly. Among the 12 patients, 1 patient suffered from cardiac valve and artery involvement at the same time, 8 patients suffered from infective endocarditis, and 1 patient suffered from aneurysm. No definite infection site was found in 2 patients. Seven of the 12 patients (58.3%) had elevated serum creatinine. Rheumatoid factors were detected in 8 patients, all of which were elevated. Nine patients were treated with doxycycline/minocycline plus hydroxylchloroquine and 3 patients were treated with doxycycline/minocycline. Patients were followed up for 3 months to 14 years, 7 patients stopped antibiotics after 12 to 30 months and were in stable condition. One patient died of heart failure 6 months after diagnosis and 1 patient lost follow-up. Three patients diagnosed in 2022 were still under treatment and in stable condition. Conclusions:The clinical manifestations of chronic Q fever lack of specificity and may involve multiple systems. Endocarditis and mycotic aneurysm are common complications. For long-term fever with new heart valve function damage or mycotic aneurysm patients, chronic Q fever should therefore be considered.
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As a highly malignant tumor, the diagnosis of cholangiocarcinoma (CCA) is often late and the prognosis is poor for which the early symptoms are atypical and the lack of accurate biomarkers. Metabolomics is an emerging science that researches the alterations of all endogenous small molecule metabolites in an organism under the influence of pathological, physiological or genetic modification. The development and progress of CCA is closely related to metabolism. Metabolomic is characterized by global analysis, high throughput and reflects real-time alterations in biology system, providing a new avenue for biomarker screening and diseases diagnosis and treatment. The advances of metabolomics studies on CCA in the recent years were reviewed in this paper which could provide the reference for further research.
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Visual behaviorally operant method is one of the main detections for identifying animal models of visual diseases, which is mainly through the optomotor response (OMR) and optokinetic reflex (OKR) stimulated by the virtual operating system (VOS). The automated VOS was commonly used as a powerful tool to control the contrast sensitivity and measure the spatial frequency of the monitoring device by adjusting parameters such as grating fringe width, rotation velocity and light intensity, and also to track the OKR, OMR, and the combined movement of OKR and OMR.Both the optimized measuring methods and evaluation indicators including the search coils, the corneal labeling, OMR-arena system, the OMR index, the staircase protocol tests and the improved stimuli from two-dimensional to three-dimensional helped to ensure the validity of test data.Moreover, the introduction of image recognition technology benefited in extracting the body and head contours of mice.Computer algorithms such as deep learning were also applied to analyze and process the visual behavior of diseased mice, which promoted sensitivity, shortened testing time, reduced detection errors and improved data accuracy.For all the factors mentioned, the VOS could be used as an effective research tool for glaucoma, cataract, retinopathy, hereditary eye disease, optic nerve degeneration and others.This article reviewed the value of VOS for visual behavioral assessment in mice models of visual disease from the visual detection methods and assessment indicators.
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Objective:To investigate the effects and mechanisms of copper transporter 1 (CTR1) in radiation induced intestinal injury in vitro. Methods:Human small intestinal epithelial cells (HIEC) were irradiated with 2, 4, 6, 8 Gy of X-rays and rat intestinal epithelial cells (IEC-6) were irradiated with 5, 10, 15, 20 Gy of X-rays. At 2, 4, 8, 24, and 48 h after irradiation, the expression of CTR1 was detected by Western blot assay. In some experiments, HIEC and IEC-6 cells were transfected with CTR1 shRNA and then exposed to X-rays. Copper levels were detected by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The radiosensitivity of cells was verified by colonogenic assay, the cellular reactive oxygen species (ROS) level and DNA damage were detected to further explore the related mechanism. In addition, Western blot was applied to detect the expressions of antioxidants and cuproptosis associated proteins in enterocytes after silencing CTR1 or irradiation.Results:The expression of CTR1 was increased by X-ray irradiation in a dose-dependent manner ( t=3.53, 3.45, 6.37, 11.11, 11.13, P<0.05). CTR1 expression was successfully diminished by CTR1 shRNA adenovirus vectors. According to the survival curves, the enhancement ratios of the radiosensitivity of HIEC and IEC-6 cells with CTR1 knocking-down were 1.146 and 1.201, respectively. Radiation-induced copper accumulation was alleviated after CTR1 silencing in IEC-6 cells ( t=3.10, P<0.05). At 0.5 h after irradiation, the ROS production in the CTR1 knockdown group was significantly lower than that in the control group ( t=5.23, 2.96, P<0.05). At 1 h after irradiation, the protein expression of γ-H2AX in the CTR1 knockdown group was obviously lower than that in the control group ( t=7.50, 4.29, P<0.05). The expressions of Nrf2 and HO-1 were increased after irradiation, which could be further increased after CTR1 silencing. In addition, cuproptosis associated protein DLAT, LIAS and FDX1 were reduced post-irradiation, which were recovered after CTR1 silencing. Conclusions:The radioresistance of HIEC and IEC-6 cells was enhanced after CTR1 silencing, possibly through the intracellular ROS and cuproptosis pathway.
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N 6-methyladenosine (m 6A) is the most abundant epigenetic modification in eukaryotic messenger RNA (mRNA), which could be catalyzed by m 6A methyltransferase (Writers), recognized by methylation recognition enzymes (Readers), and removed by demethylase (Erasers). RNA splicing, translation, and stability could be modulated by m 6A methylation modification. The m 6A methylation modification is involved in the biological regulation of a variety of important functional genes in cellular activities. Importantly, abnormal m 6A modification affects the occurrence, development, metastasis and recurrence of tumors. Ionizing radiation can affect the level of m 6A and m 6A methylation-related enzymes. Recently, m 6A methylation is reported to regulate the efficacy of tumor radiotherapy by affecting DNA damage and radiosensitivity of tumor cells. In addition, ionizing radiation can also affect the level of m 6A modification in normal cells to regulate the progress of radiation-induced injuries. This review summarizes the research progress on the roles of m 6A methylation in tumor radiosensitivity and radiation-induced injuries, with the aim of providing novel strategies for the development of clinical tumor radiosensitizers and radioprotective agents.
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With the elevating prevalence and comorbidity rate of chronic diseases,the burden of disease treatment for patients is increasing and quality of life is declining. Recently, the minimal disruptive medicine(MDM)has attracted more attention and its positive impact has been recognized. In this article we review the research progress in the clinical effects of MDM on chronic disease patients,which would promote the exploration and implementation of scientific and effective treatment strategies for general practice in China.
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Narrative medicine provides a new perspective on medical humanity and clinical ethics. Recently, the research on narrative medicine in China has gradually developed, involving a wider range of applications, especially in patient health education. This article reviews the basic concept and process of narrative medicine,and its application and implication in patient health education, in order to provide reference of the relevant practice and research in this field for medical professionals.
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Based on ZHU Zhenheng's “six constraints” theory， it is proposed that the formation of pulmonary nodules is closely related to the six constraints， which are constraint of qi， blood， phlegm， fire， dampness and food. All six constraints might lead to pulmonary nodules， among which qi constraint is the dominant one. When qi constraint lasts for a long time， it will turn into fire constraint， resulting in the failure of spleen to transport， which may lead to phlegm constraint， dampness constraint and food constraint； when qi fails to move blood， blood constraint is formulated. Mutual generation of six constraints lead to the disease， and the pathogenesis is interrelated， jointly promoting the occurrence and development of pulmonary nodules. The treatment is mainly to unblock qi， usually using Yueju Pills （越鞠丸）， a classic formula commonly used for six constraints， as the basic formula. And according to the six constraints partiality， it is suggested to flexibly add the medicinals of soothing the liver and rectifying qi， clearing heat and dissipating masses， dissolving phlegm and dissipating masses， fortifying spleen and dissipating dampness， promoting digestion and removing accumulation， invigorating blood and dissolving stasis.
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Puromycin-sensitive aminopeptidase (PSAP) belongs to the M1 family of aminopeptidases, characterized by the N-terminal substrate binding sequence GAMEN, the enzyme activity center HEXXH(X)18E motif, and the C-terminal ERAP-1-like superfamily structural domain. Encoded by the gene NPEPPS located at 17q21.32, PSAP consists of 919 amino acids and is widely distributed throughout the human body, with the highest expression in the brain, followed by the heart and skeletal muscle. It is also found in the liver, renal tubular epithelium, small intestine, large intestine epithelium, and gastric epithelial cells. PSAP primarily relies on its aminopeptidase hydrolytic activity to remove toxic protein aggregates such as Tau, poly Q, and Cu, Zn-superoxide dismutase 1, making it an important factor in the development of diseases such as Alzheimer's disease, Huntington's chorea, and tumors. Existing PSAP inhibitors include bestatin, amastatin, leuhistin, actinonin, and purinomycin, some of which are already available or in clinical trials. This review provides an overview of the structural and biological functions of M1 family aminopeptidases, with a focus on PSAP, to facilitate further research and targeted drug development.
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Taking the current situation and problems of medical humanities education as the background, the concept of narrative medicine was used to sort out and integrate various course materials of medical humanities, explore the multi-link linkage mode of medical humanities education, and organically integrate medical humanities courses scattered in medical education activities such as medical ethics, health law, doctor-patient communication, and health policy science with teaching stages, teaching resources, and teaching methods, forming vivid narrative medical materials throughout the entire process of medical humanities education, and improving teaching efficiency by sharing and optimizing resources. Through questionnaire analysis, it was found that there are many unsatisfactory aspects of medical humanities education. Further analysis of the issues focuses on the contradiction between learning willingness and time allocation, the lack of synchronization between teaching and social development, the lack of integration between courses, and insufficient innovation in teaching methods. Based on these, countermeasures were put forward to integrate narrative medical materials of medical humanities courses and build a platform for the application and communication of narrative medical materials.
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【Objective】 To investigate the correlation between body composition and thyroid function indicators in type 2 diabetic patients with euthyroidism of different genders. 【Methods】 Type 2 diabetic patients with euthyroidism who were hospitalized in the Endocrinology Department of The Second Affiliated Hospital of Xi’an Jiaotong University from February 2016 to September 2018 were enrolled in this study. Bioelectric impedance analysis was used to measure body composition, and the thyroid function indicators (FT3, FT4, and TSH) were tested. The male and female subjects were matched according to the ratio of 2:1 using the propensity score matching method, and the correlation between body composition and thyroid function indicators was studied in different genders by correlation analysis. 【Results】 The basal metabolic rate, trunk fat mass, fat-free mass, fat-free mass index, bone mass, water mass, total body muscle mass, skeletal muscle mass, and skeletal muscle index were positively correlated with FT3 in male patients (P<0.05). The percentage of body fat mass and fat mass index were positively correlated with FT3 and TSH (P<0.05), and the percentages of lean mass, water mass, and total body muscle mass were negatively correlated with FT3 and TSH (P<0.05), and the basal metabolic rate was negatively correlated with FT4 (P<0.05) in female. 【Conclusion】 In euthyroid type 2 diabetic patients, the correlation between body composition and thyroid function indicators are different between males and females. In males, only FT3 is positively correlated with basal metabolic rate, trunk fat mass, and fat free-related composition; while in females, both FT3 and TSH are positively correlated with fat-related composition, but negatively correlated with fat-free-related composition.
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Objective To analyze the differences of three design methods of hybrid boost(HB)plan based on Monaco in radiotherapy for nasopharyngeal carcinoma.Methods Ten patients who underwent intensity-modulated radiotherapy(IMRT)for nasopharyngeal carcinoma in some hospital from January to December 2021 were selected,and Monaco planning system was used to design a simultaneous integrated boost(SIB)IMRT plan SIB-IMRT33f with a prescription fraction of 33f for each patient,keeping the fraction dose unchanged and modifying the prescription fraction to 28f to obtain a SIB-IMRT28f plan.SIB-IMRT5f1,SIB-IMRT5f2 and SIB-IMRT5f3 plans were formed based on the SIB-IMRT28f plan respectively by using the Bias Plan function,adding a prescription with a prescription fraction of 5f or copying the SIB-IMRT33f plan,modifying the prescription fraction to 5f and executing re-optimization after deleting PTV2 optimization function,then Plan_HB1,Plan_HB2 and Plan_HB3 were got by fusing SIB-IMRT28f with SIB-IMRT5e,SIB-IMRT5f2 and SIB-IM RT5f3 plans.Differences in dosimetric and therapeutic parameters were compared among the three HB plans and statistically analyzed using SPSS 20.0 software.Results The dose distributions of the three HB plans all met clinical treatment requirements,and the dose distribution of Plan_HB2 was roughly equivalent to that of Plan_HB3.Plan-HB1 behaved better significantly than Plan_HB2 and Plan_HB3 in D2％of planning gross tumor volume(PGTV)and PGTV1 target area and D2％,Dmean homogeneity index and VPTV2,56 of PTV2 target area(P＜0.05);Plan_HB2 and Plan_HB3 both had Dmean of parotid gland,V55 of cochlea,Dmean of oral cavity,Dmean of larynx and Vbody-PTV outside the target area increased significantly when compared with Plan_HB1 plan(P＜0.05);SIB-IMRT5f2 and SIB-IMRT5G had the number of segments,number of monitor units and delivery time decreased when com-pared with SIB-IMRT5f1(P＜0.05).Conclusion All the three HB plan design methods based on Monaco planning system are feasible in nasopharyngeal cancer radiotherapy.In terms of dosimetric and therapeutic parameters,Plan_HB2 is roughly equivalent to Plan_HB3,with some dosimetric parameters inferior to while some therapeutic parameters superior to those of Plan_HB1.[Chinese Medical Equipment Journal,2023,44(11):50-55]
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About 10% of children with congenital heart disease (CHD) have pulmonary arterial hypertension (PAH). In this study,we explored the diagnostic values of neutrophil-to-lymphocyte ratio (NLR) and Tei index for CHD-PAH in children. Inorder to complete the study, two hundred CHD children treated in our hospital from January 2015 to January 2017 wereenrolled and divided into postoperative-PAH group (n=29) and no postoperative-PAH group (n=171) according to follow-upresults. The peripheral blood was drawn after surgery, neutrophils and lymphocytes were measured by routine blood test,and NLR was calculated. Ventricular Tei index was determined by pulse Doppler, and the other basic data were compared.Factors affecting postoperative PAH were explored by multivariate analysis. The correlations of NLR and Tei index withN-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac output/pulmonary blood flow (CO/Qp), were analyzed.The structural equation model of PAH was constructed. According to receiver operating characteristic (ROC) curves, the optimalcutoff values of NLR and Tei index for evaluating postoperative PAH were investigated. It has been found that NLR and Tei indexare closely related to CHD-PAH in children, which indirectly reflect the severity and have high diagnostic values.