A comprehensive method for calculating total body irradiation

PurposeTo provide means for calculating the dose received by various tissues of the patient, calculate lung shield, and verify received dose using a phantom as a tool for quality assurance for a planned Total Body Irradiation (TBI) procedure in radiotherapy.MethodUsing Microsoft Visual Basic, MATLAB, and Python, a program for Total Body Irradiation Calculation in Radiotherapy (TBICR) is constructed. It uses patient translation and beam zone method for total body irradiation calculations to compute the proper dose received by the patient and determine the lung shield thickness. There are three main user-friendly interfaces in the application. The first one allows the user to upload the TBI topography and estimate the distances needed for TBI calculations. The second one enables the user to count the number of beam zones needed for each point and estimate the effective area (A_eff) for each level. The third interface estimates the velocity required to deliver the relative dose depending on patient separation, Monitor Units (MU), couch speed and travel distance. It allows the user to compute the required lung shield thickness, read any patient's CT DICOM file and acquire dose in any distinct location using machine learning model to predict the dose.ResultsThe TBICR software has been successfully validated by reproducing all of the manual calculations in an exact and timely manner. TBICR generated more accurate results and confirmed the absorbed dose to patient through measurements on Anderson phantom.ConclusionsA computer program for the calculation of total body irradiation (TBI) is described in full. The dose received at each point on the patient, the calculation of lung shield and the determination of the velocity and time required for the couch movement are all made possible using the software. The ease of use, precision, data storage and printing are some important features of the present software.     

Replantation and Lengthening of a Lower Leg in a 7-Year-Old Child: A Case Report

Replantation of the lower leg has controversial indications, but it may be considered in carefully selected patients. Although the function of prosthetic lower legs has been improved in recent decades, leg salvage remains a laudable goal. We present the case of a 7-year-old child who sustained a traumatic amputation at the level of the middle tibia with loss of the middle portion of the lower leg. We performed successful replantation, and tibia lengthening was performed starting 10 days after replantation and lasted 6 months.     

解剖锁定钢板联合同种异体腓骨治疗肱骨近端骨折疗效的Meta分析

文题释义：肱骨近端骨折：肱骨近端包括肱骨头及大结节、小结节，中老年人骨质疏松及低能量损伤可导致肱骨近端骨折。 同种异体腓骨：取自于人体异体，经过加工处理，去除其免疫原性，保留其骨性结构，可用于移植修复骨缺损，起到支撑作用。 背景：肱骨近端骨折是临床常见骨折，但对肱骨近端内侧柱缺乏支撑的骨折目前仍是治疗难点，并发症常见，失败率较高。 目的：比较解剖锁定钢板联合同种异体腓骨与单纯解剖锁定钢板治疗肱骨近端骨折的疗效。 方法：使用计算机检索PubMed、Embase、Cochrane Library、Google Scholar、中国知网、万方、维普数据库，检索时间均从建库到2020年2月。检索国内外关于对比研究解剖锁定钢板联合同种异体腓骨与单纯解剖锁定钢板治疗肱骨近端骨折疗效的文献。2名研究员根据纳入和排除标准分别独立筛选文献，提取数据，评估文献中的偏倚风险。纳入12篇相关文献使用RevMan 5.2软件将以下指标进行Meta分析，包括影像学数据、功能评分和并发症。结果与结论：①通过文献检索、根据纳入和排除标准，12篇文献纳入研究，其中11篇为回顾性队列研究，1篇为随机对照研究；纳入研究文献质量高，但GRADE证据质量级别较低。②共纳入958例患者，其中解剖锁定钢板联合同种异体腓骨组411例，单纯解剖锁定钢板组547例；③Meta分析结果显示，解剖锁定钢板联合同种异体腓骨组术后1年肱骨头高度差值(MD=-2.40，95%CI：-2.49至-2.31)、颈干角差值(MD= -6.14，95%CI：-6.62至-5.67)、目测类比评分(MD=-0.22，95%CI：-0.35至-0.08)、肩关节功能评分(MD=4.12，95%CI：2.18-6.06)，上肢伤残评分(MD=-10.32，95%CI：-13.44至-7.19)、术后2年的目测类比评分(MD=-0.37，95%CI：-0.55至-0.19)、肩关节功能评分(MD=5.07，95%CI：2.86-7.27)、总体并发症(OR=0.31，95%CI：0.20-0.48)及肱骨头螺钉切出(OR=0.25，95%CI：0.11-0.55)均明显优于单纯解剖锁定钢板组(P < 0.05)，肱骨头坏死(OR=0.94，95%CI：0.47-1.88)，两组间差异无显著性意义(P > 0.05)；④因此，较弱的证据提示，肱骨近端解剖锁定钢板联合同种异体腓骨治疗肱骨近端骨折的短期疗效优于解剖锁定钢板，可减少并发症的发生，促进功能恢复。ORCID: 0000-0002-8486-3932(阳运康) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

N-acetyl-l-cysteine protects porcine oocytes undergoing meiotic resumption from heat stress

Heat stress (HS) is a notable risk factor for female reproductive performance. In particular, impaired oocyte maturation was thought to contribute largely to the HS-induced reproductive dysfunctions. In this study, we confirmed that oocytes undergoing GVBD were much susceptible to HS, and thus compromising subsequent embryonic development. Using N-acetyl-l-cysteine (NAC), we found supplementation of a relatively high dose NAC during in vitro maturation, can protect oocytes from HS-induced complications, and thus rescuing impaired embryonic development. Further analysis indicated that mechanisms responsible for protecting GVBD oocytes from HS by NAC may include: (1) reversing disorganized spindle assembly and inhibited extracellular signal–regulated kinase (ERK) signaling; (2) correcting erroneous H3K27me3 modification and dysregulated expression of imprinted genes; (3) alleviating increased intraoocyte reactive oxygen species accumulation and apoptosis initiation. Our study, focusing on the oocyte meiotic maturation, may provide a safe and promising strategy for protecting reproductive sows under environmental hyperthermal conditions.     

Skipjack tuna (Katsuwonus pelamis) eyeball oil exerts an anti-inflammatory effect by inhibiting NF-κB and MAPK activation in LPS-induced RAW 264.7 cells and croton oil-treated mice

The effect of tuna eyeball oil (TEO) on lipopolysaccharide (LPS)-induced inflammation in macrophage cells was investigated. TEO had no cytotoxicity in cell viability as compared to the control in LPS induced RAW 264.7 cells. TEO reduced the levels of NO and pro-inflammatory cytokines by up to 50% in a dose-dependent manner. The expression of NF-κB and MAPKs as well as iNOS and COX-2 proteins was reduced by TEO, which suggests that its anti-inflammatory activity is related to the suppression of the NF-κB and MAPK signaling pathways. The rate of formation of ear edema was reduced compared to that in the control at the highest dose tested. In an acute toxicity test, no mice were killed by TEO doses of up to 5000 mg/kg body weight during the two week observation period. These results suggested that TEO may have a significant effect on inflammatory factors and be a potential anti-inflammatory therapeutic.