Discovery of a Potent Antiosteoporotic Drug Molecular Scaffold Derived from Angelica sinensis and Its Bioinspired Total Synthesis.

Angelica sinensis, commonly known as Dong Quai in Europe and America and as Dang-gui in China, is a medicinal plant widely utilized for the prevention and treatment of osteoporosis. In this study, we report the discovery of a new category of phthalide from Angelica sinensis, namely falcarinphthalides A and B (1 and 2), which contains two fragments, (3R,8S)-falcarindiol (3) and (Z)-ligustilide (4). Falcarinphthalides A and B (1 and 2) represent two unprecedented carbon skeletons of phthalide in natural products, and their antiosteoporotic activities were evaluated. The structures of 1 and 2, including their absolute configurations, were established using extensive analysis of NMR spectra, chemical derivatization, and ECD/VCD calculations. Based on LC-HR-ESI-MS analysis and DFT calculations, a production mechanism for 1 and 2 involving enzyme-catalyzed Diels-Alder/retro-Diels-Alder reactions was proposed. Falcarinphthalide A (1), the most promising lead compound, exhibits potent in vitro antiosteoporotic activity by inhibiting NF-κB and c-Fos signaling-mediated osteoclastogenesis. Moreover, the bioinspired gram-scale total synthesis of 1, guided by intensive DFT study, has paved the way for further biological investigation. The discovery and gram-scale total synthesis of falcarinphthalide A (1) provide a compelling lead compound and a novel molecular scaffold for treating osteoporosis and other metabolic bone diseases.

Using meta-analysis and CNN-NLP to review and classify the medical literature for normal tissue complication probability in head and neck cancer.

PURPOSE: The study aims to enhance the efficiency and accuracy of literature reviews on normal tissue complication probability (NTCP) in head and neck cancer patients using radiation therapy. It employs meta-analysis (MA) and natural language processing (NLP). MATERIAL AND METHODS: The study consists of two parts. First, it employs MA to assess NTCP models for xerostomia, dysphagia, and mucositis after radiation therapy, using Python 3.10.5 for statistical analysis. Second, it integrates NLP with convolutional neural networks (CNN) to optimize literature search, reducing 3256 articles to 12. CNN settings include a batch size of 50, 50-200 epoch range and a 0.001 learning rate. RESULTS: The study's CNN-NLP model achieved a notable accuracy of 0.94 after 200 epochs with Adamax optimization. MA showed an AUC of 0.67 for early-effect xerostomia and 0.74 for late-effect, indicating moderate to high predictive accuracy but with high variability across studies. Initial CNN accuracy of 66.70% improved to 94.87% post-tuning by optimizer and hyperparameters. CONCLUSION: The study successfully merges MA and NLP, confirming high predictive accuracy for specific model-feature combinations. It introduces a time-based metric, words per minute (WPM), for efficiency and highlights the utility of MA and NLP in clinical research.

Base-Controlled Divergent Synthesis of Fluorine-Containing Benzo[4,5]imidazo[2,1-b][1,3]thiazines from 2-Mercaptobenzimidazoles and ß-CF3-1,3-Enynes.

A base-controlled divergent cyclization between 2-mercaptobenzimidazoles and ß-CF3-1,3-enynes providing either trifluoromethylated or fluorinated benzo[4,5]imidazo[2,1-b][1,3]thiazines has been developed. The ß-CF3-1,3-enyne, as a three-carbon synthon, underwent a 1,8-diazabicyclo[5.4.0] undec-7-ene (DBU)-catalyzed tandem hydroamination/intramolecular hydrothiolation to give CF3-substituted 3,4-dihydro-2H-benzo[4,5]imidazo[2,1-b][1,3]thiazine, whereas reaction with KOH afforded fluorinated 4H-benzo[4,5]imidazo[2,1-b][1,3]thiazine exclusively. In addition, the synthetic utility of this methodology was showcased through a variety of downstream derivatizations.

The study of virtual source position with the geometric convergent ratio errors prevention management method of spot scanning beam in carbon ion therapy.

INTRODUCTION: We developed a technique including preventing errors management method capable of dealing with the virtual source position delivered by different carbon ion energies from the pattern of spot scanning beam in this study. MATERIALS AND METHODS: A homemade large-format complementary metal-oxide-semiconductor (CMOS) sensor and Gaf Chromic EBT3 films were used for the virtual source position measurement. The Gaf films were embedded in a self-designed rectangular plastic frame to tighten the films and set up on a treatment couch for irradiation in the air with the film perpendicular to the carbon ion beam at the nominal source-axis-distance (SAD) as well as upstream and downstream from the SAD. The horizontal carbon ion beam with five energies at a machine opening field size was carried out in this study. The virtual source position was determined mainly with a linear regression by back projecting the full width half maximum (FWHM) to zero at a distance upstream from the various source-film-distance and double checks additionally with a geometric convergent method to avoid any mistakes caused by manual measurement on FWHM. RESULTS: The virtual source position for higher carbon ion energy has an obvious longer distance from the SAD since the more carbon ion beam energy, the less spreading affected by the horizontal and vertical magnetism, therefore, the distance of virtual source positions is decreased from SAD with high to low energy. CONCLUSION: The method for investigating the virtual source position in the carbon ion beam in this study can also be used for electrons and the proton. We have developed a technique capable of dealing with the virtual source position with a geometric convergent method to avoid any mistakes in spot scanning carbon ion beam.

Oxidative aromatization mechanism of ligustilide.

The aromatization mechanisms of ligustilide (1), a versatile monomeric phthalide, were investigated. DFT calculations combined with control experiments prove that the aromatization could result from direct oxidation by triplet oxygen in mild conditions with no catalyst, which is generally thought to be difficult. Moreover, it is predicted that the aromatization could rapidly clear away the harmful-to-organism singlet oxygen, which may be relevant to the general antioxidation activity of phthalides, providing a new point of view to understand the bioactivity from chemical reaction.

Draft genome and transcriptome of Nepenthes mirabilis, a carnivorous plant in China.

OBJECTIVES: Nepenthes belongs to the monotypic family Nepenthaceae, one of the largest carnivorous plant families. Nepenthes species show impressive adaptive radiation and suffer from being overexploited in nature. Nepenthes mirabilis is the most widely distributed species and the only Nepenthes species that is naturally distributed within China. Herein, we reported the genome and transcriptome assemblies of N. mirabilis. The assemblies will be useful resources for comparative genomics, to understand the adaptation and conservation of carnivorous species. DATA DESCRIPTION: This work produced ~ 139.5 Gb N. mirabilis whole genome sequencing reads using leaf tissues, and ~ 21.7 Gb and ~ 27.9 Gb of raw RNA-seq reads for its leaves and flowers, respectively. Transcriptome assembly obtained 339,802 transcripts, in which 79,758 open reading frames (ORFs) were identified. Function analysis indicated that these ORFs were mainly associated with proteolysis and DNA integration. The assembled genome was 691,409,685 bp with 159,555 contigs/scaffolds and an N50 of 10,307 bp. The BUSCO assessment of the assembled genome and transcriptome indicated 91.1% and 93.7% completeness, respectively. A total of 42,961 genes were predicted in the genome identified, coding for 45,461 proteins. The predicted genes were annotated using multiple databases, facilitating future functional analyses of them. This is the first genome report on the Nepenthaceae family.

Colorectal cancer with testicular metastasis: A case report and literature review.

RATIONALE: Colorectal cancer is the second leading cause of cancer-related deaths in the world. About 50% of patients will have metastases during the course of the disease. The common sites of metastasis are the liver, lung, peritoneum, lymph, etc. Metastatic carcinoma to the testes is uncommon. We found a case of ascending colon cancer metastasized to the testis in the clinic. PATIENT CONCERNS: We reported a 50-year-old male patient who was found to have testicular metastases >4 years after intestinal cancer surgery, and multiple metastases in the peritoneum and pelvis were found 1 week later. DIAGNOSES: After enhanced computed tomography and pathological biopsy, the patient was diagnosed with testicular metastasis of colon cancer. INTERVENTIONS: Capecitabine combined with bevacizumab is currently undergoing palliative treatment. OUTCOMES: The patients died of tumor progression on June 28, 2021. LESSONS: The testicular metastasis of colorectal cancer is a sign of peritoneum and multiple metastases. When the testicular metastasis occurs in colorectal cancer patients, it usually indicates that the patient has a poor prognosis.

[Clinical application of special fluoroscopy method in the treatment of distal radius fractures with volar locking plate].

OBJECTIVE: The relationship between the distal screws and the wrist articular surface was assessed by the additional lateral oblique fluoroscopic view during the operation, and the dorsal tangential view of the wrist was used to observe whether the distal screw penetrated the dorsal cortex, so as to evaluate the clinical efficacy of the volar locking plate in the treatment of distal radius fractures. METHODS: From January 2020 to June 2021, 45 cases of fresh distal radius fractures were treated using the volar Henry's approach, including 20 males and 25 females, aged from 32 to 75 years old with an average of (52.4±8.1) years old. During the operation, they were divided into 2 groups according to the different intraoperative fluoroscopic views:the control group of 20 cases, treated with standard anteroposterior and lateral fluoroscopic view;25 cases in the observation group, additional lateral oblique fluoroscopic view and dorsal tangential view of the wrist were taken. The wrist joint function score and postoperative complications were evaluated at 6 weeks, 3 and 6 months after operation between two groups. RESULTS: All 45 patients were followed up and the duration ranged from 6 to 14 months, with an average of (10.8±1.7) months, all patients achieved bone union and the incision healed well. The incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). In terms of Gartland-Werley score of wrist joint function, the score of wrist function in the observation group was (4.58±1.31) at 6 weeks, (2.98±0.63) at 3 months and (1.95±0.65) at 6 months post-operatively, which were better than those in the control group (6.32±1.96) at 6 weeks, (3.63±0.76) at 3 months and (2.43±0.73) at 6 months. The difference was statistically significant (P<0.05). In the observation group, 7/25 cases(28%) were found to have screw penetration during the operation by additional lateral oblique and dorsal tangential radiograph fluoroscopic views of wrist. CONCLUSION: The addition of lateral oblique and dorsal tangential during the operation could improve the accuracy of distal screw placement, reduce postoperative complications, and achieve early functional exercise.

Determination of virtual source position using back projecting zero and convergent arcTAN method for scanning-passive scatter beam in carbon ion therapy.

OBJECTIVE: This study aims to develop and test a new technique by using the convergent arcTAN (cATAN) method capable of dealing with the virtual source position delivered by different carbon ion energies from the pattern of scanning-passive scatter beam. MATERIALS AND METHODS: A homemade large-format CMOS sensor and Gaf Chromic EBT3 films are used for the virtual source position measurement. The Gaf films are embedded in a self-designed rectangular plastic frame to tighten films and set up on a treatment couch for irradiation in air with the film perpendicular to the carbon ion beam at the nominal source-axis-distance (SAD) as well as upstream and downstream from the SAD. The horizontal carbon ion beam with 5 energies at a machine opening field size is carried out in this study. The virtual source position is determined by using the convergent arcTAN (cATAN) method and compared with a linear regression by back projecting FWHM to zero at a distance upstream from the various source-film-distance. RESULTS: The film FWHM measurement error of 0.5 mm leads to 0.001% deviation of α (cATAN) at every assumed textend. The overall uncertainty for the reproducibility of calculated virtual source position by the assumed textend in the vertical and horizontal directions amounts to 0.1%. The errors of calculated virtual source position by assumed textend with back projecting FWHM to zero methods are within 1.1±0.001, p = 0.033. CONCLUSION: We develop a new technique capable of dealing with the virtual source position with a convergent arcTAN method to avoid any manual measurement mistakes in scanning-passive scatter carbon ion beam. The readers are encouraged to conduct the proposed cATAN method in this study to investigate the virtual source position in the Linac-based external electron beams and the proton beams.

Using deep learning models to analyze the cerebral edema complication caused by radiotherapy in patients with intracranial tumor.

Using deep learning models to analyze patients with intracranial tumors, to study the image segmentation and standard results by clinical depiction complications of cerebral edema after receiving radiotherapy. In this study, patients with intracranial tumors receiving computer knife (CyberKnife M6) stereotactic radiosurgery were followed using the treatment planning system (MultiPlan 5.1.3) to obtain before-treatment and four-month follow-up images of patients. The TensorFlow platform was used as the core architecture for training neural networks. Supervised learning was used to build labels for the cerebral edema dataset by using Mask region-based convolutional neural networks (R-CNN), and region growing algorithms. The three evaluation coefficients DICE, Jaccard (intersection over union, IoU), and volumetric overlap error (VOE) were used to analyze and calculate the algorithms in the image collection for cerebral edema image segmentation and the standard as described by the oncologists. When DICE and IoU indices were 1, and the VOE index was 0, the results were identical to those described by the clinician.The study found using the Mask R-CNN model in the segmentation of cerebral edema, the DICE index was 0.88, the IoU index was 0.79, and the VOE index was 2.0. The DICE, IoU, and VOE indices using region growing were 0.77, 0.64, and 3.2, respectively. Using the evaluated index, the Mask R-CNN model had the best segmentation effect. This method can be implemented in the clinical workflow in the future to achieve good complication segmentation and provide clinical evaluation and guidance suggestions.

Empirical modeling of the percent depth dose for megavoltage photon beams.

INTRODUCTION: This study presents an empirical method to model the high-energy photon beam percent depth dose (PDD) curve by using the home-generated buildup function and tail function (buildup-tail function) in radiation therapy. The modeling parameters n and µ of buildup-tail function can be used to characterize the Collimator Scatter Factor (Sc) either in a square field or in the different individual upper jaw and lower jaw setting separately for individual monitor unit check. METHODS AND MATERIALS: The PDD curves for four high-energy photon beams were modeled by the buildup and tail function in this study. The buildup function was a quadratic function in the form of [Formula: see text] with the main parameter of d (depth in water) and n, while the tail function was in the form of e-µd and was composed by an exponential function with the main parameter of d and µ. The PDD was the product of buildup and tail function, PDD = [Formula: see text]. The PDD of four-photon energies was characterized by the buildup-tail function by adjusting the parameters n and µ. The Sc of 6 MV and 10 MV can then be expressed simply by the modeling parameters n and µ. RESULTS: The main parameters n increases in buildup-tail function when photon energy increased. The physical meaning of the parameter n expresses the beam hardening of photon energy in PDD. The fitting results of parameters n in the buildup function are 0.17, 0.208, 0.495, 1.2 of four-photon energies, 4 MV, 6 MV, 10 MV, 18 MV, respectively. The parameter µ can be treated as attenuation coefficient in tail function and decreases when photon energy increased. The fitting results of parameters µ in the tail function are 0.065, 0.0515, 0.0458, 0.0422 of four-photon energies, 4 MV, 6 MV, 10 MV, 18 MV, respectively. The values of n and µ obtained from the fitted buildup-tail function were applied into an analytical formula of Sc = nE(S)0.63µE to get the collimator to scatter factor Sc for 6 and 10 MV photon beam, while nE, µE, S denotes n, µ at photon energy E of field size S, respectively. The calculated Sc were compared with the measured data and showed agreement at different field sizes to within ±1.5%. CONCLUSIONS: We proposed a model incorporating a two-parameter formula which can improve the fitting accuracy to be better than 1.5% maximum error for describing the PDD in different photon energies used in clinical setting. This model can be used to parameterize the Sc factors for some clinical requirements. The modeling parameters n and µ can be used to predict the Sc in either square field or individual jaws opening asymmetrically for treatment monitor unit double-check in dose calculation. The technique developed in this study can also be used for systematic or random errors in the QA program, thus improves the clinical dose computation accuracy for patient treatment.

Using magnetic material to repulse electrons in Axxent eBT for skin preservation during early-stage breast cancer conservative intra-operative radiotherapy.

A miniature electronic X-ray source was employed in this study to deliver intra-operative radiotherapy (IORT) within breast lesions. A flexible magnetic material was used to reduce breast skin radiation damage. Total prescribed dose was 20 Gy at balloon surface, with breast tumor bed wrapped around balloon applicator. A flexible magnetic material, called 'neodymium-iron boron' (NdFeB) + alloy-49 was applied to cover lesion's surface to preserve the skin and to reduce electron contamination raised from photon-induced low-energy electrons, with tissue less than 1 cm between applicator surface and breast skin. The reduction of electron contamination using NdFeB + alloy-49 with an applicator-skin distance of 20 mm, ranged from 7% to 10%, while with an applicator-skin distance of 10 mm for balloon volumes from 30 to 50 cm3, it ranged from 4% to 6% only. NdFeB + alloy-49 magnetic material was efficient in repulsing photon-induced low-energy electrons for skin preservation to compensate for deficiency of tissue over less than 1 cm gap between the surface of applicator and the breast skin.

A Mathematical Method to Adjust MLC Leaf End Position for Accurate Dose Calculation in Carbon Ion Beam Radiation Therapy Treatment Planning System.

INTRODUCTION: We present a mathematical method to adjust the leaf end position for dose calculation correction in the carbon ion radiation therapy treatment planning system. METHODS AND MATERIALS: A straggling range algorism of 400 MeV/n carbon ion beam in nine different multileaf collimator (MLC) materials was conducted to calculate the dose 50% point to derive the offset corrections in the carbon ion treatment planning system (ciPlan). The visualized light field edge position in the treatment planning system is denoted as X tang.p, and MLC position (X mlc.p) is defined as the source to leaf end midpoint projection on axis for monitor unit calculation. The virtual source position of energy at 400 MeV/n and straggling range in MLC at different field sizes were used to calculate the dose 50% position on axis. On-axis MLC offset (correction) could then be obtained from the position corresponding to 50% of the central axis dose minus the X mlc.p. RESULTS: The exact MLC position in the carbon ion treatment planning system can be used as an offset to do the correction. The offset correction of pure tungsten is the smallest among the others due to its shortest straggling range of carbon ion beam in MLC. The positions of 50% dose of all MLC materials are always located in between X tang.p and X mlc.p under the largest field of 12 cm by 12 cm. CONCLUSIONS: MLC offset should be adjusted carefully at different field sizes in the treatment planning systems especially of its small penumbra characteristic in the carbon ion beam. It is necessary to find out the dose 50% position for adjusting MLC leaf edge on-axis location in the treatment planning system to reduce dose calculation error.

Energy-Related Scatter Analysis for Determining the Effective Point of Measurement of Cylindrical Ion Chamber in Heavy Charged Particle Carbon Ion Beam.

PURPOSE: An experimental and mathematical study for determining the effective point of measurement (P eff) for a Farmer-type cylindrical chamber in a carbon ion passive scatter beam is presented. METHODS: The ionization depth curves measured by the Bragg peak chamber were plotted according to the position of the inner surface of the entrance window, while the Farmer chamber was plotted at the tip of the cylindrical geometric center. The ionization depth curves measured by a cylindrical chamber in the 3D water phantom were then compared with a high-precision parallel-plate PTW Bragg peak chamber for inspecting the upstream shift correction of the cylindrical chamber in the carbon ion beam. A component of the vertical and horizontal integration method and the barrier model, cosφ = 1 - [2αR L /(1 + α - R L )], for analyzing the shift of effective point of measurement in different carbon ion energies and various field sizes, were studied. RESULTS: The shift between the maximum peak of the Bragg peak chamber and the Farmer chamber in a field size of 10 cm × 10 cm with an energy of 330 MeV/u of carbon ion is 2.3 mm. This upstream shift corresponds to (0.744 ± 0.07)r, where r is the Farmer chamber inner radius of 3.05 mm. Carbon ion energy from 120 MeV/u to 400 MeV/u with different field sizes show different shifts of effective point of measurement in a range of (0.649 ± 0.02)r to (0.843 ± 0.06)r of 3 cm × 3 cm at an energy of 400 MeV/u and 10 cm × 10 cm at an energy of 120 MeV/u, respectively. The vertical and horizontal scatter analysis by the barrier model can precisely describe the shift of the effective point of measurement at different carbon ion energies with various field sizes. CONCLUSIONS: We conclude that the Farmer chamber can be used for a patient-specific dose verification check in carbon ion beam treatment if P eff is well calibrated.

The Study of Field Equivalence Determined by the Modeled Percentage Depth Dose in Electron Beam Radiation Therapy.

INTRODUCTION: This study presents an empirical method to model the curve of electron beam percent depth dose (PDD) by using the primary-tail function in electron beam radiation therapy. The modeling parameters N and n can be used to predict the minimal side length when the field size is reduced below that required for lateral scatter equilibrium (LSE) in electron radiation therapy. METHODS AND MATERIALS: The electrons' PDD curves were modeled by the primary-tail function in this study. The primary function included the exponential function and the main parameters of N and µ, while the tail function was composed of a sigmoid function with the main parameter of n. The PDD of five electron energies was modeled by the primary and tail function by adjusting the parameters of N, µ, and n. The R 50 and R p can be derived from the modeled straight line of 80% to 20% region of PDD. The same electron energy with different cone sizes was also modeled by the primary-tail function. The stopping power of different electron energies in different depths can also be derived from the parameters N, µ, and n. RESULTS: The main parameters N and n increase but µ decreases in the primary-tail function for characterizing the electron beam PDD when the electron energy increased. The relationship of parameter n, N, and ln(-µ) with electron energy are n = 31.667E 0 - 88, N = 0.9975E 0 - 2.8535, and ln(-µ) = -0.1355E 0 - 6.0986, respectively. Percent depth dose was derived from the percent reading curve by multiplying the stopping power relevant to the depth in water at a certain electron energy. The stopping power of different electron energies can be derived from n and N with the following equation: stopping power = (-0.042ln(N E 0 ) + 1.072)e (-nE0 · 5 · 10-5 + 0.0381)·x , where x is the depth in water. The lateral scatter equivalence (LSE) of the clinical electron beam can be described by the parameters E 0, n, and N in the equation of Seq = (n E 0 - N E 0 )0.288/(E 0/n E 0 )0.0195. The LSE was compared with the root mean square scatter angular distribution method and shows the agreement of depth dose distributions within ±2%. CONCLUSIONS: The PDD of the electron beam at different energies and cone sizes can be modeled with an empirical model to deal with what is the minimal field size without changing the percent depth dose when approximate LSE is given in centimeters of water.

Pre-screening for osteoporosis with calcaneus quantitative ultrasound and dual-energy X-ray absorptiometry bone density.

Calcaneal quantitative ultrasonography (QUS) is a useful prescreening tool for osteoporosis, while the dual-energy X-ray absorptiometry (DXA) is the mainstream in clinical practice. We evaluated the correlation between QUS and DXA in a Taiwanese population. A total of 772 patients were enrolled and demographic data were recorded with the QUS and DXA T-score over the hip and spine. The correlation coefficient of QUS with the DXA-hip was 0.171. For DXA-spine, it was 0.135 overall, 0.237 in females, and 0.255 in males. The logistic regression model using DXA-spine as a dependent variable was established, and the classification table showed 66.2% accuracy. A receiver operating characteristic (ROC) analyses with Youden's Index revealed the optimal cut-off point of QUS for predicting osteoporosis to be 2.72. This study showed a meaningful correlation between QUS and DXA in a Taiwanese population. Thus, it is important to pre-screen for osteoporosis with calcaneus QUS.

Ablation Therapy Combined with EGFR TKIs in the Treatment of Advanced Non-Small Cell Lung Cancer: A Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: Systematically evaluate the efficacy of physical ablation combined with TKI in the treatment of advanced non-small cell lung cancer (NSCLC). METHODS: We performed a comprehensive search of databases including OVID, PubMed, EMBASE, the Cochrane Library, and three Chinese databases (China National Knowledge Infrastructure, Wanfang Database, and Chongqing Weipu Database). The aim was to identify randomized controlled trials (RCT) investigating physical ablation as the treatment for advanced NSCLC. We also evaluated the methodological quality of the included studies and summarized the data extracted for meta-analysis with Review Manager 5.3. RESULTS: A total of 9 studies, including 752 patients, were evaluable. The meta-analysis results show that the complete response rate (CRR) (RR: 2.23, 95% CI: 1. 46 to 3.40, P 0.01), partial response rate (PRR) (RR: -2.25, 95% CI: 1.41 to 3.59, P 0.01), and disease control rate (DCR) (RR: -2.80, 95% CI: 1.64 to 4.80, P< 0.01) of patients with advanced NSCLC who received physical ablation combined with TKI therapy were higher than those who did not receive physical ablation therapy. The control groups from seven of the studies had a total of 606 patients with targeted therapies and chemotherapy. The complete response rate was (CRR) (RR: 2.48, 2.4895% CI: 1.55 to 2.47, P 0.01), partial response rate (PRR) (RR: -1.66, 95% CI: 1.20 to 2.31, P< 0.01), and disease control rate (DCR) (RR: -2.68, 95% CI: 1.41 to 5.06, P< 0.01) for patients with advanced NSCLC who had received physical ablation combined with targeted therapies and chemotherapy, compared to patients who had not received physical ablation therapy. This difference was statistically significant. Above all, these results showed that the clinical efficacy of physical ablation combined EGFR-TKIs therapy (regardless of whether it was combined with chemotherapy) was better than that of EGFR-TKIs therapy alone. CONCLUSION: Physical ablation combined with TKI treatment in patients with advanced NSCLC can improve efficacy.

The Effect of Sulfonated Graphene on the Rheological Properties of Cement Paste.

With unique 2D nanostructures and excellent properties, graphene and its derivatives are a class of advanced nanosized reinforcements for cementitious materials. Sulfonated graphene (SG), one of the most important modified graphene materials, possesses sulfonate groups on the surface and significantly improves the mechanical and thermal properties of cement-based composites. It is important to investigate the influence of SG on cement-based materials as it is a prerequisite for practical applications. Herein, SG was prepared and introduced into cement paste to investigate its influence on the rheological properties of cement paste. With the increased addition of SG, a stable slurry was gradually obtained with low fluidity and high rheological parameters. The mechanism of the SG effect on the rheological properties of cement paste was also illustrated. Because of the high specific surface area and sulfonate groups of SG nanosheets, a large amount of flocculated structure was created by the complexing effect, chemical interaction, physical interaction and mechanical interlocking between SG and hydrated/unhydrated cement particles. Furthermore, polycarboxylate ether (PCE) superplasticizer was introduced to ensure fluidity and transportability in the practical application of SG. The results in this work lay a foundation for the practical application of modified graphene in cementitious materials.

An Empirical Model for Describing the Small Field Penumbra in Radiation Therapy.

PURPOSE: We developed a mathematic empirical model for describing the small field penumbra in order to analyze the potential dose perturbation caused by overlapping field to avoid the dose calculation errors in linear accelerator-based radiosurgery. MATERIALS AND METHODS: A ball phantom was fabricated for measuring penumbra at 4 different gantry angles in the coplanar plane. A least square root estimation (LSRE) Model was created to fit the measured penumbra dose profile and to predict the penumbra dose profile at any gantry angles. The Sum of Squared Errors (SSE) was used for finding the parameters n and t for the best fitting of the LSRE model. Geometric and mathematical methods were used to derive the model parameters. RESULTS: The results showed that the larger the gantry angle of the field, the more the expansion of the penumbra dose profile. The least square root estimation model for describing small field penumbra is as follows: Penumbra D s = T · 1 / 2 · 1 - s / n + s 2 + t where Penumbra D(s) denotes the dose profile D(s) at the penumbra region, T is the penumbra height (usually in scalar 100), n is the parameter for curvature, s = x - W d /2 (x and s are the values in cm on x-axis), and t is the radiation transmission of the collimator. Geometric analysis establishes the correlation between the penetration depth of the exposure and its effect on the penumbra region in ball phantom. The penumbra caused by an exposure at any arbitrary angles can be geometrically derived by using a one-variable quadratic equation. CONCLUSION: The dose distribution in penumbra region of small field can be created by the LSRE model and the potential overdosage or underdosage owing to overlapping field perturbation can be estimated.

Dose distribution characteristic study of the Rotating Gamma Knife (RGK) by using the geometry analytic method.

The purpose of this study was to realize the processing of dose distribution of RGK at the treatment isocenter at any gantry rotational angle by using an analytic geometry method to avoid inadequate arc therapy angles when implementing the treatment plan. Gaf chromic film was used for dose evaluation. A calibration curve was first obtained using linear accelerator irradiation. The 50% dose relative to the central axis at fixed gantry angles at the x-, y- and z-axes was obtained using Gaf chromic film and was compared to the analytic geometry method. The full width half maximum (FWHM) on the x-, y- and z-axes was predicted for the RGK dose distribution characteristic analysis. The FWHM on the x-, y-, and z-axes varies with different gantry and rotational plate angles. The most dramatic intersection variation appeared at a static gantry angle of 25°. The ratio of the FWHM of the y- and z-axes to that of the x-axis was up to 9 and 10. The geometric analytic method can be used for an accurate analysis of dose distribution in RGK replacing the actual film exposure experiment. It is essential to select the best arc irradiation angle to prescribe the dose to avoid excess irradiation of normal tissue. The geometric method used in this study can also be applied for rotational arc therapy dose analysis such as tomotherapy, linear-based stereotactic radiotherapy, or volume matrices arc therapy.