调强放射治疗的计划优化

本文结合文献、探讨调强放射治疗计划优化中的若干重要问题,包括调强放疗的物理优化和生物优化、优化模型和参数、优化算法、退化、频响和滤波、多目标优化、射野方向和数目优化,以及移动靶区的计划优化.     

子宫内膜癌螺旋断层放疗与静态调强放疗的剂量学比较

背景与目的：螺旋断层放疗（helical tomotherapy,HT）在很多肿瘤治疗中体现了剂量学优势,但目前尚没有子宫内膜癌术后全盆腔HT的报道。本研究通过比较子宫内膜癌术后全盆腔HT与固定机架角静态调强放疗（step-and-shoot intensity-modulated radiation therapy,SaS-IMRT）剂量学的差异,探讨子宫内膜癌术后全盆腔HT是否具有剂量学优势。方法：选择10例接受子宫内膜癌术后全盆腔放疗患者,对每例患者分别设计全盆腔SaS,IMRT和HT计划。比较两组计划的靶区、危及器官和正常组织剂量分布。结果：SaS-IMRT和HT计划的平均PTV100是95．6％和95．8％（P=0．72）。两组计划平均适形指数都是0．87,平均均匀性指数是1．10和1．07（P=0．00）。与SaS-IMRT计划相比,HT计划直肠和膀胱平均剂量分别下降了1.3 Gy和3.0 Gy,小肠加结肠、盆腔骨接受中低剂量照射的体积增加,盆腔骨平均剂量增加1.1 Gy。HT计划正常组织V5、V10、V20分别增加13．0％、18．0％和5．O％（P=0．00）。平均剂量增加2．5Gy（P=0．00）。结论：与SaS-IMRT比较。HT靶区剂量更均匀,能够更好地保护膀胱和直肠。小肠和结肠、盆腔骨及正常组织接受中低剂量照射的体积增加,其临床意义尚需进一步研究。     

Acupuncture in Treating Hepatic Fibrosis: A Review With Recommendation for Future Studies

Hepatic fibrosis, as a major medical problem, is characterized with significant morbidity and mortality. Acupuncture has potential advantages in treating hepatic fibrosis as acupuncture functions well to reduce Qi and Blood stagnation, resolve stasis and enhance body immunity, which are important factors in treating hepatic fibrosis. The aim of this review was to appraise the current limited evidence of acupuncture in treating hepatic fibrosis from both animal experiments and clinical trials by using both Chinese and western databases and to provide recommendations for future studies.     

CQDs/ZnO composites based on waste rice noodles: preparation and photocatalytic capability

To provide a low-cost photocatalyst and new methodology for the utilization of waste rice noodle (WRN), a carbon quantum dots/zinc oxide (CQDs/ZnO) composite using WRN as the raw material was synthesized and characterized. The CQDs/ZnO composite based on WRN exhibited a highly efficient photocatalytic degradation effect on various organic pollutants and could be a good alternative for commercial ZnO. For methylene blue, the CQDs/ZnO composite showed a good degradation rate of 99.58% within 40 min, a high degradation rate constant of 0.2630 min⁻¹, and could be recycled and reused for ten photocatalytic cycles without an appreciable decrease in the degradation effect, which was much better than that of commercial ZnO. The resulting CQDs/ZnO composite also displayed a nice photocatalytic degradation effect on other common organic pollutants, such as malachite green, methyl violet, basic fuchsin, rhodamine B, aniline and tetracycline. In particular, it could achieve excellent photocatalytic degradation on malachite green with an extremely high degradation rate constant of 1.9260 min⁻¹. Besides, the CQDs/ZnO composite could also be used to control the pollution of tetracycline or aniline. The introduction of CQDs based on WRN to ZnO resulted in efficient electron–hole pair separation and enabled more photogenerated electrons to reduce O₂ and more photogenerated holes to oxidize H₂O, which caused stronger abilities in producing radicals (such as O₂˙⁻ and ˙OH) and a better photocatalytic degradation effect to organic pollutants.

A CQDs/ZnO composite based on waste rice noodles displayed a highly efficient photocatalytic degradation effect on various organic pollutants.     

959 例子宫内膜异位症患者中医体质分布特点

【目的】探讨959例子宫内膜异位症 （EMs） 患者的中医体质分布特点。 【方法】选取2019年1月至2019年11月就诊于中 国中医科学院广安门医院、首都医科大学附属北京妇产医院、北京医院、北京中医药大学东方医院、首都医科大学附属友 谊医院、首都医科大学附属复兴医院的EMs患者959例,记录患者的一般情况,进行中医体质辨识,分析其中医体质分布情 况、兼夹体质的关联关系以及与年龄、合并痛经的关系。 【结果】（1） EMs患者的体质分布占比由多到少依次为阳虚质65.1% （624/959） 、气郁质58.4% （560/959） 、气虚质52.8% （506/959） 、血瘀质44.2% （424/959） 、痰湿质42.5% （408/959） 、湿热质 41.9% （402/959） 、阴虚质39.6% （380/959） 、平和质26.8% （257/959） 、特禀质16.6% （159/959） ;患者中单一体质者较少,占比 为20.2% （194/959） ,兼夹体质者居多,占比为79.8% （765/959） 。 （2） 基于Apriori算法的关联规则挖掘结果发现相关规则33条, 气虚质-阳虚质、血瘀质-阳虚质、血瘀质-气郁质是其中置信度较高的关联规则。 （3） 与35岁及以下患者相比,35岁以上患 者中血瘀质所占比例较大 （P＜0.05） ;与无痛经患者相比,合并痛经患者各偏颇体质占比均增加、平和体质占比减少 （P＜ 0.05或P＜0.01） 。 【结论】阳虚质、气郁质、气虚质、血瘀质是EMs患者的高发体质类型,EMs患者中医体质兼夹现象普遍存 在,较单一偏颇体质更为常见;从温阳、解郁、益气、活血角度管理EMs,及时纠正偏颇体质,防止疾病进展,可有效发挥 中医体质调理的“治未病”效果。     

Structurally diverse biflavonoids from Dysosma versipellis and their bioactivity

Five pairs of new biflavonoid enantiomers, (±)-dysosmabiflavonoids A–E (1–5), two new biflavonoids, dysosmabiflavonoids F–G (6–7), and four biosynthetically related precursors (8–11) were isolated from the roots and rhizomes of Dysosma versipellis. Their structures were elucidated by extensive spectroscopic analysis, including HR-ESI-MS and 2D NMR. Their absolute configurations were determined by comparison of the calculated and experimental ECD spectra. All isolated compounds were evaluated for AChE inhibitory activity. Compounds 6 and 7 exhibited more potent inhibitory activities with IC₅₀ values of 1.42 and 0.73 µM, respectively, than their biosynthetically related precursors kaempferol (8, 17.90 µM) and quercetin (9, 3.96 µM). The preliminary structure–activity relationship study indicated that the connection mode of biflavonoid subunits, oxidation degree of the C ring, and 3,4-dihydroxy group of the B ring were important structural factors for AChE inhibitory activity. Racemates 1–5 and their corresponding levorotatory and dextrorotatory enantiomers were tested for their potential to impede the generation of NO in lipopolysaccharide-stimulated RAW264.7 cells, and their mushroom tyrosinase inhibitory effect. Racemate 1 displayed more potent mushroom tyrosinase inhibitory activity (IC₅₀, 28.27 µM) than the positive control kojic acid (IC₅₀, 32.59 µM). D. versipellis may have therapeutic potential for melanogenesis disorders and neurodegenerative diseases.

Five pairs of new biflavonoid enantiomers, (±)-dysosmabiflavonoids A–E (1–5), two new biflavonoids, dysosmabiflavonoids F–G (6–7), and four biosynthetically related precursors (8–11) were isolated from the roots and rhizomes of Dysosma versipellis.     

Free autologous internal limiting membrane transplantation in the treatment of large macular hole

We evaluated the clinical efficacy of free internal limiting membrane (ILM) flap transplantation for the treatment of large macular hole over 500 μm in 42 consecutive patients. Quantified evaluation of the post-operative macular anatomy restoration was performed by spectral-domain optical coherence tomography in the 12mo follow-up. The results showed 41 eyes achieved successful closure (97.6%). Postoperative best corrected visual acuity, ellipsoid layer, and external limiting membrane disruption were significantly improved at all follow-up time points. The central foveal thickness was significantly higher at 1mo. We concluded that free ILM flap transplantation proves to be effective to achieve anatomical and functional improvement for the treatment of large macular hole.     

显微镜直视下巩膜外冷凝在视网膜脱离手术中的应用

目的：探讨显微镜直视下巩膜外冷凝在视网膜脱离手术中的应用。方法：对42眼在手术显微镜直视下冷凝所有的赤道部和赤道前的裂孔。结果：视网膜完全复位40眼(95％)。除1例放液时穿透视网膜外,其它病例排液顺利。结论：应用手术显微镜直视下巩膜外冷凝具有操作简单且疗效可靠。     

Significant reductions in apoptosis-related proteins (HSPA6, HSPA8, ITGB3, YWHAH,and PRDX6) are involved in immune thrombocytopenia

Journal of Thrombosis and Thrombolysis - To investigate differences in the expression of plasma proteins in immune thrombocytopenia (ITP) and normal control groups, bone marrow samples were...