Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study / 中华急诊医学杂志

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Water-equivalence of ZrO2doped polystyrene by Monte Carlo simulation / 中华放射医学与防护杂志

Objective To design water-equivalent plastic scintillator detector for the measurement of absorbed dose in tumor radiotherapy.Methods The concentration of ZrO2to be doped in polystyrene was estimated according to the empirical formula,and then the Monte Carlo program Geant 4(GEometry And Tracking 4)was used to simulate the energy deposition and transport process of X-rays with different energies in water,solid water RW34(composed of 2.1 wt％TiO2doping polystyrene)and different concentrations of ZrO2particles doped in polystyrene.The dose and attenuation coefficients were compared among different materials at different depths of water.Results The doses at different depths and the attenuation coefficient of polystyrene(doped with about 0.4 wt％ZrO2nanoparticles)were much more consistent with those of water and even exhibit much better water-equivalence than RW34.Conclusions The simulation results provide the basis for the development of water-equivalent scintillator.

A community-based survey in awareness of osteoporosis and influence factors in middle-aged and old population in Guangzhou / 实用医学杂志

Objective To investigate the awareness of osteoporosis and its influential factors in middle-aged and older people. Methods By using self-designed questionnaire, 354 middle-aged and old people were investigated as to their awarness of osteoporosis in Chajiao street community in Guangzhou. Among them, 58 people were measured the bone density in the calcaneal bone by Ultrasound. Results The average score of the questionnaire was 9.46 ± 5.13, and the accuracy was 39.4%. In the diagnosis and treatment, the accuracy was just 17.8%. The diet (the accuracy in 54%) and sport (the accuracy in 50.3%) were good. The statistical analyses showed the linear relationship between the T value of bone density and the age (P = 0.021), between the T value and the score (P = 0.047). Wilcoxon rank sum test found that the T value between female and male was significantly different (Z = -3.749, P < 0.000). With multiple linear regression analysis, the T value had a linear correlation with the score (F = 4.224, P = 0.045) positively. Conclusions Currently, the awareness of osteoporosis in the middle-aged and old people was inadequate. To better prevent osteoporosis, the propogation of knowledge and guidance provided by clinicians in osteoporosis should be improved necessarily and emergently.

Analysis of the evolution of esophageal tumor volume in radiotherapy process using a mathematical model / 生物医学工程学杂志

The volume change of tumor during radiotherapy processes indirectly reflects the short-term efficacy and the quality of radiotherapy planning. We analyzed clinical data of radiotherapy using a mathematical model in our study. First, we selected eight esophageal carcinoma patients with only using 3DRT and conventional dose fractionation schemes. And then we observed and measured the change of tumor volume during the radiotherapy. Based on the LQ model, repopulation and re-oxygenation in 4Rs, and the kinetics of doomed tumor disintegration, we established the mathematical model of tumor evolution in radiotherapy. And then we used the model to analyze the clinical trial data about esophageal carcinoma with radiotherapy. It was proved that the results of the model almost coincided with the clinical trial data. According to the analysis results, we could get the related radiobiology parameters to estimate biological effective dose and repopulation of patients. The mathematical model could provide reference for assessment of prognosis and further scheme of treatment.

The quantitative study on high energy photon dose verification by PET imaging / 中华放射医学与防护杂志

Objective To study positron yield quantitatively in different phantoms by means of PET imaging after high energy photon irradiation,and to investigate the feasibility of bio-dose verification by PET in high energy photon radiotherapy.Methods The phantoms (hydrogel,HDPE,inhomogeneous phantom) were scanned with PET 1 min later after exposure to 2,4,6,8 Gy dose with/using 25 and 50 MV photon irradiation.The positron account rates were recorded every minute in PET scanning process and then fitted to get the half-lives of yielded nuclides.Positron distribution in each phantom was compared with dose distribution to investigate the relationship between positron activity and dose delivered.Results The half-lives of nuclides yielded in hydrogel and HDPE were supposed to be 2.23 and 19.47 min,respectively by fitting results,which had negligible difference with half-lives of 11C (20.2 min) and 15O (2.08 min).The positron amounts induced by 50 MV photon in hydrogel and HDPE were 3.88 and 3.86 times that of 25 MV photon,and increased in proportion to dose delivered.Except for build-up region and cavity,activity distributions in depth and off-axis were similar to dose distribution.Conclusions The amount and distribution of positron induced by high energy photon are related to dose delivered,and it is feasible to do dose verification with PET imaging in high energy photon radiotherapy.

Mathematical model of tumor evolution in radiotherapy / 生物医学工程学杂志

The schemes of dose fractionation play an important role in tumor radiotherapy. We used mathematical methods to describe the process of tumor cells evolution during radiotherapy, trying to find how the schemes of dose fractionation affect tumor cells. In clinical radiobiology, linear-quadratic (LQ) model is frequently used to describe radiation effects of tumor cells. We integrated LQ model with effect of oxygen, and with the phenomenon of repopulation and reoxygenation in the theory of radiation biology. While we considered the disappearing progress of doomed cells in tumor, we established the mathematical model of tumor evolution in radiotherapy. We simulated some common treatment schedules, and studied the change role of tumor cells during radiotherapy. These results can serve for the optimization of dose fractionation scheme based on tumor radiobiological characteristics.

Rituximab sensitizes a Burkitt lymphoma cell line to cell killing by X-irradiation.

Clinical trials with rituximab in combination with chemotherapeutic regimens have shown promising results. Data on the effects of rituximab treatment in combination with irradiation are, however, limited and inconsistent. This study aims to investigate the effects of rituximab (R) on cell death induced by X-irradiation in Raji lymphoma cells and to evaluate its mechanisms. We found the cell growth inhibition by irradiation was enhanced by additional rituximab exposure both in cells precultured with rituximab followed by irradiation (R + irradiation) or in cells treated in the reverse sequence (irradiation + R). R + irradiation combination treatment induced more apoptotic cells than irradiation and irradiation + R treatment as early as 12 h after treatment. At 24 h, both combination treatments, R + irradiation and irradiation + R, showed apoptotic cells, which were significantly different from irradiation alone. G2/M cell cycle arrest was observed after irradiation alone and the combination treatment. The combination treatment revealed an elevation in reactive oxygen species (ROS) generation in a radiation dose-dependent manner. In addition, rituximab enhanced the cell growth inhibition and apoptotic cell death induced by the oxidative agent, H(2)O(2). We propose that rituximab mediates a significant in vitro radiosensitizing effect and induces cell cycle changes and apoptosis in Raji cells. ROS probably play an important role in these events.