BACKGROUND Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic...BACKGROUND Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic characteristics including abnormal drug distribution and clearance.Rocuronium exhibits markedly different distribution patterns in obese patients,with conventional weight correction methods inadequately addressing individual muscle mass variations that critically influence drug distribution.AIM To investigate the quantitative relationship between skeletal muscle index(SMI)and rocuronium distribution volume in obese colorectal cancer patients,establish a population pharmacokinetic model,and develop individualized dosing strategies based on muscle mass.METHODS A retrospective cohort study was conducted,including 100 obese patients(body mass index≥30 kg/m^(2))who underwent elective radical colorectal cancer surgery at our hospital from June 2023 to January 2025.Skeletal muscle mass was measured using InBody 260 body composition analyzer and SMI was calculated to assess muscle mass,with male SMI<7.0 kg/m^(2) and female SMI<5.7 kg/m^(2)as diagnostic criteria for sarcopenia.Plasma rocuronium concentrations were detected by liquid chromatography-tandem mass spectrometry/mass spectrometry,and nonlinear mixed-effect modeling was used to establish population pharmacokinetic modeling.Stepwise regression was used to screen covariates,and dosing regimens were optimized through Monte Carlo simulation.The primary endpoint was targeted plasma concentration achievement rate,and the secondary endpoint was postoperative residual muscle relaxation incidence.RESULTS Among 100 patients,35(35.0%)had sarcopenia and 65(65.0%)did not.Patients in the sarcopenia group were older(64.1±9.8 years vs 54.2±10.9 years,P<0.001)and had significantly lower SMI(6.2±0.8 kg/m^(2)vs 8.4±1.2 kg/m^(2),P<0.001).SMI showed strong positive correlation with rocuronium steady-state distribution volume(r=0.718,P<0.001)and moderate negative correlation with clearance(r=-0.502,P<0.001).A two-compartment population pharmacokinetic model was successfully established,with SMI being the most important covariate affecting central compartment distribution volume(△OFV=-41.2,P<0.001).Model validation showed bootstrap successful convergence rate of 92.3%,and 92.1%of observed values fell within prediction intervals in predicted concentration versus predicted concentration.The SMI-based individualized dosing regimen improved target exposure achievement rate from 82.0%in traditional regimen to 93.5%(P=0.009),and reduced postoperative residual muscle relaxation incidence from 13.0%to 3.5%(P=0.018).The sarcopenia group showed the most significant improvement in achievement rate,from 71.4%to 93.8%(P=0.017).CONCLUSION SMI shows strong correlation with rocuronium distribution volume in obese colorectal cancer patients and is a key factor affecting drug distribution.SMI-based individualized dosing strategies can significantly improve target exposure achievement rate and reduce postoperative residual muscle relaxation incidence,providing scientific evidence for precision anesthesia management in obese patients.展开更多
In this study,the dosimetric characteristics(thickness applicability,preheating time,temperature and humidity dependence,in-batch uniformity,readout reproducibility,dose linearity,self-decay,and electron energy respon...In this study,the dosimetric characteristics(thickness applicability,preheating time,temperature and humidity dependence,in-batch uniformity,readout reproducibility,dose linearity,self-decay,and electron energy response)of engineered polycarbonate films irradiated with an electron beam(0–600 kGy)were investigated using photoluminescence spectroscopy.The results show a linear relationship between photoluminescence intensity and radiation dose when the thickness of the polycarbonate film is 0.3 mm.A higher fluorescence intensity can be obtained by preheating at 60℃ for 180 min before photoluminescence spectrum analysis.As the temperature during spectral testing and the ambient humidity(during and after irradiation)increased,the photoluminescence intensity of the polycarbonate films decreased.The photoluminescence intensity deviation of the polycarbonate films produced within the same batch at 100 kGy is 2.73%.After ten times of repeated excitations and readouts,the coefficients of variation in photoluminescence intensity are less than 8.6%,and the linear correlation coefficient between photoluminescence intensity and irradiation dose is 0.965 in the dose capture range of 20–600 kGy.Within 60 days of irradiation,the photoluminescence intensity of the polycarbonate film decreased to 60%of the initial value.The response of the 0.3 mm polycarbonate films to electron beams with energies exceeding 3.5 MeV does not differ significantly.This comprehensive analysis indicates the potential of polycarbonate films as a high-radiation dose detection material.展开更多
BACKGROUND Primary ciliary dyskinesia(PCD)is a rare condition characterised by dysmotile,immotile,or absent cilia.As a result of the impairment in respiratory mucociliary clearance,patients with PCD typically develop ...BACKGROUND Primary ciliary dyskinesia(PCD)is a rare condition characterised by dysmotile,immotile,or absent cilia.As a result of the impairment in respiratory mucociliary clearance,patients with PCD typically develop neonatal respiratory distress,nasal congestion,otitis media and recurrent respiratory infections leading to bronchiectasis and structural lung changes.These changes have been shown by chest computed tomography(CT)to develop in infancy and early childhood.Recent development and refinement of radiation-reducing CT techniques have allowed significant radiation dose reductions,with chest CT doses now in the range of chest radiography(CR).AIM To evaluate the efficacy of ultra-low dose CT(ULDCT)chest in identifying pulmonary changes within a PCD paediatric patient cohort.METHODS Paediatric patients with PCD who presented for routine clinical outpatient follow-up within the study period,were eligible for inclusion in the study.ULDCT and CR were performed on these patients and the results compared.Comparison metrics included radiation dose,subjective and objective image quality and disease severity.RESULTS Six paediatric patients(mean age 9 years)underwent clinically indicated ULDCT chest examinations and CR for surveillance of their PCD.The mean effective dose was 0.08±0.02 mSv,a dose that approximates that of a frontal and lateral chest radiograph.The average Brody II score across the entire cohort was 12.92,with excellent interrater reliability and intra-class correlation coefficient(ICC)of 0.98.The average Chrispin-Norman score on CR was 1 with excellent inter-rater reliability and ICC of 0.92.CONCLUSION ULDCT demonstrates superior diagnostic capabilities,minimal radiation dose penalty,and high interobserver reliability in comparison to CR.Thus,we advocate for ULDCT to be the preferred modality for surveillance imaging in paediatric PCD.展开更多
BACKGROUND Current drugs primarily target inflammation control but do not reverse tissue remodeling changes for asthma.Human mesenchymal stem cells are known for their anti-inflammatory and tissue remodeling capabilit...BACKGROUND Current drugs primarily target inflammation control but do not reverse tissue remodeling changes for asthma.Human mesenchymal stem cells are known for their anti-inflammatory and tissue remodeling capabilities.However,limited research has explored the therapeutic impact of varying doses and frequencies of human umbilical cord blood-derived mesenchymal stem cells(HUC-MSCs)on established airway remodeling in experimental asthma.AIM To explore and optimize the dosage and administration frequency of HUC-MSCs in experimental models of ovalbumin(OVA)-induced asthma.METHODS BALB/c mice underwent sensitization and were challenged using OVA.Control animals were administered a saline solution following the same protocol.HUC-MSCs were identified using flow cytometry.HUC-MSCs at incremental dosages(1×105,2×105,4×105)were injected via tail veins on day 30(the second after the final stimulation).After comparing each group and determining the optimal dose,supplement the optimal dose twice on day 30 and day 33(the second and fifth day after the final stimulation).Bronchoalveolar lavage fluid(BALF)and serum were harvested for analysis of concentrations of interleukin-4(IL-4),IL-13,immunoglobulin E and interferon-gamma(IFN-γ)by enzyme-linked immunosorbent assay.Pharmacology of airways and lung functions were also evaluated to identify the optimal group.RESULTS The study shows that HUC-MSC transplantation ameliorates OVA-induced asthma by significantly reducing airway inflammation and obstruction in preclinical models.This effect is associated with decreased Th2 cytokines IL-4 and IL-13,and increased Th1 cytokine IFN-γ.The optimal dose of 2×105 cells/mouse was identified as the most effective in reducing local asthmatic airway inflammation and changing levels of IL-4,IL-13,and IFN-γin serum and BALF compared to other single doses of HUC-MSC.Multiple treatments with the medium dose(2×105 cells)of HUC-MSCs on days 30 and 33 yield the best pathological and lung function outcomes.However,double treatments do not reduce IL-4 and IL-13 expression or enhance IFN-γproduction in serum or BALF more effectively than a single medium dose.CONCLUSION HUC-MSCs effectively regulate pro-inflammatory mediators in serum and BALF,modulating airway remodeling and lung function.In this acute mouse asthma model,a single dosage of 2×105 is optimal,with more significant effects of decreasing airway obstruction requiring repeated administration.展开更多
A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a signifi...A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a significant advancement in personalized radiotherapy by improving accuracy and reducing treatment-related toxicity.The model demonstrated strong predictive performance with R-values above 0.8,indicating its potential to improve treatment consistency.However,concerns arise from the small sample size and exclusion criteria,which may limit generalizability.Future studies should incorporate larger,more diverse patient cohorts,explore potential confounding factors such as tumor characteristics and delivery technique variability,and address the long-term effects of SBRT.展开更多
Objective:To investigate the differential effects of different rivaroxaban dosing regimens on symptom relief,fluctuations in laboratory parameters,and medication safety in patients with stable pulmonary embolism(PE).M...Objective:To investigate the differential effects of different rivaroxaban dosing regimens on symptom relief,fluctuations in laboratory parameters,and medication safety in patients with stable pulmonary embolism(PE).Methods:This study enrolled 100 patients in the maintenance phase of PE who were treated at our hospital between January 2022 and December 2023.They were randomly divided into a control group and an observation group using a random number table,with 50 subjects in each group.The treatment period was uniformly set at 6 months.The control group received oral rivaroxaban 10 mg once daily,while the observation group received oral rivaroxaban 5 mg once daily.The study focused on comparing the two groups regarding the degree of clinical symptom relief,coagulation function parameters(including D-dimer levels,PT,and APTT),cardiac function markers(NT-proBNP),and drug-related adverse events.All data were processed using SPSS 26.0 statistical software.Measurement data are presented as mean±standard deviation,intergroup differences were verified by t-test,categorical variables were analyzed by chi-square test,and the statistical significance level was set at P<0.05.Results:After six months of treatment intervention,there was no significant difference in the overall relief of core clinical symptoms such as dyspnea and chest pain between the two groups.Regarding laboratory indicators,post-treatment D-dimer levels,prothrombin time,activated partial thromboplastin time,and NT-proBNP values were significantly optimized compared to baseline in both groups(P<0.05),but intergroup comparisons did not reach statistical significance.Notably,the overall incidence of bleeding events in the observation group was significantly lower than that in the control group(P<0.05),while there were no significant differences in the incidence rates of other adverse events between the two groups.Conclusion:In the maintenance phase treatment of pulmonary embolism,rivaroxaban 5 mg and 10 mg doses are equivalent in efficacy regarding improvement of clinical symptoms and blood indicators.However,the 5 mg dose significantly reduces the risk of bleeding,offers better safety,and is more suitable for long-term anticoagulation management in some high-risk populations.展开更多
This study introduces a novel concept,biological in vivo three-dimensional(3D)dose distribution verification,aimed at investigating how respiratory motion affects the efficacy of lung cancer radiotherapy,representing ...This study introduces a novel concept,biological in vivo three-dimensional(3D)dose distribution verification,aimed at investigating how respiratory motion affects the efficacy of lung cancer radiotherapy,representing an evolution from the current standard of rigid-body dose distribution verification.A 3D ex vivo biological lung motion simulation device(3D-BioLungEx)was designed to replicate human respiration.A radiotherapy plan of the patient was copied to the porcine lung,which was driven by 3D-BioLungEx to simulate various respiratory patterns that occur during treatment.To ensure anatomical consistency with the patient’s lung structure,during transmission,skin,skeleton,and organs were adjusted according to CT images of the porcine lung.The patient’s radiotherapy plan was then adapted to the porcine lung using the Monaco treatment planning system(TPS).Next,an iterative optimization and scatter inversion-based dose distribution retro-analysis algorithm(IOSI-BLDose)was developed to calculate the dose distribution during treatment.Gamma passing rates were used to quantify discrepancies between this dose distribution and that of the radiotherapy plan.When respiratory conditions were replicated,the passing rate reached up to 93.61%,while irregular breathing dropped it to 70%-90%,primarily due to amplitude changes.However,cycle variations had minimal impact.Compared to conventional rigid-body dose distribution verification,our method provides real-time biological feedback and more effectively captures motion-induced deviations.Accordingly,our biological in vivo 3D dose distribution verification has potential for improving treatment precision and enabling adaptive radiotherapy in clinical practice.展开更多
The ionization chamber produces significant space-charge and ion recombination effects at ultra-high dose rates,posing achallenge for dose monitoring.In addition,there is no generally accepted ion correction model for...The ionization chamber produces significant space-charge and ion recombination effects at ultra-high dose rates,posing achallenge for dose monitoring.In addition,there is no generally accepted ion correction model for dosimetry in FLASHradiotherapy,making it crucial to monitor the dose at ultra-high dose rates accurately and in real time.In this study,the airpressure of the ionization chamber was reduced to perform real-time beam monitoring,and a Faraday cup was used for calibrationfor active dosimetry.To study the saturation effect of the ionization chamber,the drift,attachment,recombination,anddiffusion processes of the electron-ion pairs were modeled using finite-element analysis based on physical phenomenologicalprinciples,and the correction factor was calculated.The experimental results showed that the FLASH ionization chambermeasures good dose linearity at a dose rate of approximately 0.2 Gy/s.When the air pressure of the chamber was adjustedto 10 mbar,the response of the FLASH ionization chamber was linear at a dose rate of approximately 50 Gy/s,with theresiduals within 2%.Furthermore,by using physical phenomenology to resolve the process of electron-ion pair motion inthe sensitive volume of the ionization chamber,the analytical model better describes the saturation effect of carbon ions atultra-high dose rates.The maximum deviation in the calculated correction factor is less than 10%.We studied the saturationeffect in dose measurement,achieving accurate and fast dose and profile position measurement across different dose ratesin a wide range based on the Heavy Ion Research Facility in Lanzhou.展开更多
Tungsten is considered the most promising plasma-facing material for fusion reactors with exceptional performance.Under certain conditions,activated tungsten dust can be generated through plasma–wall interactions and...Tungsten is considered the most promising plasma-facing material for fusion reactors with exceptional performance.Under certain conditions,activated tungsten dust can be generated through plasma–wall interactions and released into the atmosphere.Activated tungsten migrates downward in the soil after atmospheric deposition.However,effective methods for evaluating the environmental dose of gamma rays emitted by activated tungsten are still lacking.Consequently,a method for evaluating the air-absorbed dose rate of activated tungsten dust was proposed considering soil attenuation.Key parameters including the mass attenuation coefficient and energy absorption build-up factor were determined for the main gamma ray energies of radionuclides within the activated tungsten dust.Additionally,air-absorbed dose rates were calculated by assuming that radioactive sources were located at different soil depths and radii.It was found that a soil depth of 50 cm significantly attenuated the environmental dose by 99.9%,whereas the air-absorbed dose rates within the horizontal distance of 500 cm accounted for 91%of the total dose rate.Therefore,this study underscored the importance of soil attenuation in environmental dose assessments,which must be carefully re-examined for the safety analysis of fusion reactors.展开更多
Ultra-high dose rate flash radiotherapy(FLASH-RT)has attracted wide attention in the field of radiotherapy in recent years.For FLASH-RT,radiation is delivered at a very high dose rate[usually thousands of times compar...Ultra-high dose rate flash radiotherapy(FLASH-RT)has attracted wide attention in the field of radiotherapy in recent years.For FLASH-RT,radiation is delivered at a very high dose rate[usually thousands of times compared with conventional radiotherapy(CONV-RT)]in an extremely short time.This novel irradiation technique shows a protective effect on normal tissues,also known as the flash effect.At the same time,FLASH-RT is comparable to CONV-RT in terms of tumorkilling efficacy.As basic research dedicates to uncover the mechanisms by which FLASH-RT reduces radiation-induced normal tissue damage,clinical trials of FLASH-RT have been gradually conducted worldwide.This article systematically reviews the evidence of the feasibility and safety of FLASH-RT in clinical practice and offers insights into the future translation of this technology in clinic.展开更多
To monitor nuclear and radiation emergencies,it is crucial to obtain accurate in situ measurements of the environmentalγ radiation dose rate from key radionuclides,particularly for large radioactive surface sources.T...To monitor nuclear and radiation emergencies,it is crucial to obtain accurate in situ measurements of the environmentalγ radiation dose rate from key radionuclides,particularly for large radioactive surface sources.The methods currently used for measuring dose rates are inadequate for obtaining the dose rates of key radionuclides and have large angular response errors when monitoring surface sources.To address this practical problem,this study proposes three methods for measuring the dose rate:the weighted peak total ratio,mean value regression,and numerical integration methods.These methods are based on energy-spectrum measurement data,and they were theoretically derived and numerically evaluated.Finally,a 1-m-long hexagonal radioactive surface source was integrated into a larger surface source.In situ measurement experiments were conducted on a large radioactive surface source using a dose-rate meter and a portable HPGespectrometer to analyze the errors of the three aforementioned methods and verify their validity.展开更多
Hepatitis E virus(HEV)represents a significant global cause of acute viral hepatitis.Annually,it is estimated to cause approximately 20.1 million infections worldwide,3.3 million of which result in symptomatic illness...Hepatitis E virus(HEV)represents a significant global cause of acute viral hepatitis.Annually,it is estimated to cause approximately 20.1 million infections worldwide,3.3 million of which result in symptomatic illness.In developing regions,genotypes HEV-1 and HEV-2 are the primary strains responsible for widespread outbreaks and epidemics of acute jaundice(icteric hepatitis),transmitted predominantly through the fecal-oral route via contaminated water and food(Devarbhavi et al.,2023).展开更多
We read with great interest the recent article by Valenzuela et al.1titled“Dose-response effect of pre-exercise carbohydrates under muscle glycogen unavailability:Insights from McArdle disease”published in the Journ...We read with great interest the recent article by Valenzuela et al.1titled“Dose-response effect of pre-exercise carbohydrates under muscle glycogen unavailability:Insights from McArdle disease”published in the Journal of Sport and Health Science The study's exploration of the effects of varying carbohydrate(CHO)doses on exercise capacity in Mc Ardle disease,a condition characterized by complete muscle glycogen unavailability,is a significant contribution to the field of sports science and metabolic disorders.展开更多
Triple-negative bresst canær(TNBC)metastscis is particularly severe due to its aggressive nsture,leading to rapid disease progresion and significantly reduced survival rates.Rujifang(RJF),a traditional Chinese fo...Triple-negative bresst canær(TNBC)metastscis is particularly severe due to its aggressive nsture,leading to rapid disease progresion and significantly reduced survival rates.Rujifang(RJF),a traditional Chinese formula,has demonstrated potential anti-tumor effects and theability to inhibit TNBC metastasis.However,the efects af varying R.IF dors remain undear.This study utilized Laser-based in vino fow cytometry(IVFC)to monitor circulating tumor cells(CTCs)and evaluate the efficacy of R.IF at different doses.The results indicated that R.IF at the high dose inhibited both the number af CTC:and the formaton of metatatic foci more eflectively compared to the lower dose.TUNEL assays revealed that R.IF trentment promotes apoptosis of tumor cells,with a more pronounced effect observed at the higher dose.Immuno-fluorescence experiments demonstrated that administering a higher dose of R.IF suppreses theеxprescion of Kindlin-1 more effectively in the tumor microenvironment.Although higher doses showed enhanced efficacy,they might also lesd to an increase in side efects.These findings underscore the promise and challenges of using R.IF at high doses for anti-tumor therspy.They highlight the criticnl importance of optimizing the dose of R.JP in the treatment of TNBC and provide valuable insights for its dinical application.展开更多
目的:研究设置不同的铅门宽度、螺距、调制因子对双侧乳腺癌(bilateral breast cancer,BBC)螺旋断层放疗(helical tomotherapy,HT)计划的影响。方法:回顾性选取2013年10月至2023年7月间于某院接受放疗的17例BBC患者的资料,分别设计不同...目的:研究设置不同的铅门宽度、螺距、调制因子对双侧乳腺癌(bilateral breast cancer,BBC)螺旋断层放疗(helical tomotherapy,HT)计划的影响。方法:回顾性选取2013年10月至2023年7月间于某院接受放疗的17例BBC患者的资料,分别设计不同铅门宽度(1.0、2.5、5.0 cm)、螺距(0.215、0.287、0.430)、调制因子(2.0、2.5、3.0、3.5、4.0)的HT计划,同时其他参数保持一致,设计比较不同参数组合放疗计划的剂量学参数差异[包括计划靶区最大剂量D2、最小剂量D98、靶区覆盖度D95、V105以及适形度指数(conformity index,CI)和均匀性指数(homogeneity index,HI),危及器官(organs at risk,OAR)的剂量参数(双肺V5、V20、V30、Dmean,心脏V5、V20、V30、Dmean,肝脏Dmean)]以及治疗时间。使用SPSS 20.0软件进行统计学分析。结果:减小铅门宽度能够改善靶区的D98、D95、D2、D105、V105、HI,并且减少OAR的受照剂量,差异有统计学意义(P<0.05),但CI差异无统计学意义(P>0.05)。伴随着铅门宽度的减小,治疗时间成倍地增加,差异有统计学意义(P<0.05)。减小螺距能使靶区和OAR的照射剂量得到小幅改善,差异有统计学意义(P<0.05),但螺距的减小对治疗时间的影响较小。增大调制因子可以改善靶区和OAR的剂量学指标,差异有统计学意义(P<0.05),但调制因子为3.5和4.0的治疗计划剂量学指标差异较小。调制因子每增加0.5,平均治疗时间约增加15%,差异有统计学意义(P<0.05)。结论:在进行BBC HT计划设计时,设置铅门宽度为5.0 cm、螺距为0.215、调制因子为3.5时治疗计划的效果更佳。展开更多
文摘BACKGROUND Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic characteristics including abnormal drug distribution and clearance.Rocuronium exhibits markedly different distribution patterns in obese patients,with conventional weight correction methods inadequately addressing individual muscle mass variations that critically influence drug distribution.AIM To investigate the quantitative relationship between skeletal muscle index(SMI)and rocuronium distribution volume in obese colorectal cancer patients,establish a population pharmacokinetic model,and develop individualized dosing strategies based on muscle mass.METHODS A retrospective cohort study was conducted,including 100 obese patients(body mass index≥30 kg/m^(2))who underwent elective radical colorectal cancer surgery at our hospital from June 2023 to January 2025.Skeletal muscle mass was measured using InBody 260 body composition analyzer and SMI was calculated to assess muscle mass,with male SMI<7.0 kg/m^(2) and female SMI<5.7 kg/m^(2)as diagnostic criteria for sarcopenia.Plasma rocuronium concentrations were detected by liquid chromatography-tandem mass spectrometry/mass spectrometry,and nonlinear mixed-effect modeling was used to establish population pharmacokinetic modeling.Stepwise regression was used to screen covariates,and dosing regimens were optimized through Monte Carlo simulation.The primary endpoint was targeted plasma concentration achievement rate,and the secondary endpoint was postoperative residual muscle relaxation incidence.RESULTS Among 100 patients,35(35.0%)had sarcopenia and 65(65.0%)did not.Patients in the sarcopenia group were older(64.1±9.8 years vs 54.2±10.9 years,P<0.001)and had significantly lower SMI(6.2±0.8 kg/m^(2)vs 8.4±1.2 kg/m^(2),P<0.001).SMI showed strong positive correlation with rocuronium steady-state distribution volume(r=0.718,P<0.001)and moderate negative correlation with clearance(r=-0.502,P<0.001).A two-compartment population pharmacokinetic model was successfully established,with SMI being the most important covariate affecting central compartment distribution volume(△OFV=-41.2,P<0.001).Model validation showed bootstrap successful convergence rate of 92.3%,and 92.1%of observed values fell within prediction intervals in predicted concentration versus predicted concentration.The SMI-based individualized dosing regimen improved target exposure achievement rate from 82.0%in traditional regimen to 93.5%(P=0.009),and reduced postoperative residual muscle relaxation incidence from 13.0%to 3.5%(P=0.018).The sarcopenia group showed the most significant improvement in achievement rate,from 71.4%to 93.8%(P=0.017).CONCLUSION SMI shows strong correlation with rocuronium distribution volume in obese colorectal cancer patients and is a key factor affecting drug distribution.SMI-based individualized dosing strategies can significantly improve target exposure achievement rate and reduce postoperative residual muscle relaxation incidence,providing scientific evidence for precision anesthesia management in obese patients.
基金supported by the National Natural Science Foundation of China(No.12305385)Key Projects of Scientific Research of the Hunan Provincial Department of Education(22A0310)the Research Startup Project of University of South China(220XQD025).
文摘In this study,the dosimetric characteristics(thickness applicability,preheating time,temperature and humidity dependence,in-batch uniformity,readout reproducibility,dose linearity,self-decay,and electron energy response)of engineered polycarbonate films irradiated with an electron beam(0–600 kGy)were investigated using photoluminescence spectroscopy.The results show a linear relationship between photoluminescence intensity and radiation dose when the thickness of the polycarbonate film is 0.3 mm.A higher fluorescence intensity can be obtained by preheating at 60℃ for 180 min before photoluminescence spectrum analysis.As the temperature during spectral testing and the ambient humidity(during and after irradiation)increased,the photoluminescence intensity of the polycarbonate films decreased.The photoluminescence intensity deviation of the polycarbonate films produced within the same batch at 100 kGy is 2.73%.After ten times of repeated excitations and readouts,the coefficients of variation in photoluminescence intensity are less than 8.6%,and the linear correlation coefficient between photoluminescence intensity and irradiation dose is 0.965 in the dose capture range of 20–600 kGy.Within 60 days of irradiation,the photoluminescence intensity of the polycarbonate film decreased to 60%of the initial value.The response of the 0.3 mm polycarbonate films to electron beams with energies exceeding 3.5 MeV does not differ significantly.This comprehensive analysis indicates the potential of polycarbonate films as a high-radiation dose detection material.
文摘BACKGROUND Primary ciliary dyskinesia(PCD)is a rare condition characterised by dysmotile,immotile,or absent cilia.As a result of the impairment in respiratory mucociliary clearance,patients with PCD typically develop neonatal respiratory distress,nasal congestion,otitis media and recurrent respiratory infections leading to bronchiectasis and structural lung changes.These changes have been shown by chest computed tomography(CT)to develop in infancy and early childhood.Recent development and refinement of radiation-reducing CT techniques have allowed significant radiation dose reductions,with chest CT doses now in the range of chest radiography(CR).AIM To evaluate the efficacy of ultra-low dose CT(ULDCT)chest in identifying pulmonary changes within a PCD paediatric patient cohort.METHODS Paediatric patients with PCD who presented for routine clinical outpatient follow-up within the study period,were eligible for inclusion in the study.ULDCT and CR were performed on these patients and the results compared.Comparison metrics included radiation dose,subjective and objective image quality and disease severity.RESULTS Six paediatric patients(mean age 9 years)underwent clinically indicated ULDCT chest examinations and CR for surveillance of their PCD.The mean effective dose was 0.08±0.02 mSv,a dose that approximates that of a frontal and lateral chest radiograph.The average Brody II score across the entire cohort was 12.92,with excellent interrater reliability and intra-class correlation coefficient(ICC)of 0.98.The average Chrispin-Norman score on CR was 1 with excellent inter-rater reliability and ICC of 0.92.CONCLUSION ULDCT demonstrates superior diagnostic capabilities,minimal radiation dose penalty,and high interobserver reliability in comparison to CR.Thus,we advocate for ULDCT to be the preferred modality for surveillance imaging in paediatric PCD.
基金Supported by the Joint Innovation Project Funds of Huaqiao University,No.2022YX001。
文摘BACKGROUND Current drugs primarily target inflammation control but do not reverse tissue remodeling changes for asthma.Human mesenchymal stem cells are known for their anti-inflammatory and tissue remodeling capabilities.However,limited research has explored the therapeutic impact of varying doses and frequencies of human umbilical cord blood-derived mesenchymal stem cells(HUC-MSCs)on established airway remodeling in experimental asthma.AIM To explore and optimize the dosage and administration frequency of HUC-MSCs in experimental models of ovalbumin(OVA)-induced asthma.METHODS BALB/c mice underwent sensitization and were challenged using OVA.Control animals were administered a saline solution following the same protocol.HUC-MSCs were identified using flow cytometry.HUC-MSCs at incremental dosages(1×105,2×105,4×105)were injected via tail veins on day 30(the second after the final stimulation).After comparing each group and determining the optimal dose,supplement the optimal dose twice on day 30 and day 33(the second and fifth day after the final stimulation).Bronchoalveolar lavage fluid(BALF)and serum were harvested for analysis of concentrations of interleukin-4(IL-4),IL-13,immunoglobulin E and interferon-gamma(IFN-γ)by enzyme-linked immunosorbent assay.Pharmacology of airways and lung functions were also evaluated to identify the optimal group.RESULTS The study shows that HUC-MSC transplantation ameliorates OVA-induced asthma by significantly reducing airway inflammation and obstruction in preclinical models.This effect is associated with decreased Th2 cytokines IL-4 and IL-13,and increased Th1 cytokine IFN-γ.The optimal dose of 2×105 cells/mouse was identified as the most effective in reducing local asthmatic airway inflammation and changing levels of IL-4,IL-13,and IFN-γin serum and BALF compared to other single doses of HUC-MSC.Multiple treatments with the medium dose(2×105 cells)of HUC-MSCs on days 30 and 33 yield the best pathological and lung function outcomes.However,double treatments do not reduce IL-4 and IL-13 expression or enhance IFN-γproduction in serum or BALF more effectively than a single medium dose.CONCLUSION HUC-MSCs effectively regulate pro-inflammatory mediators in serum and BALF,modulating airway remodeling and lung function.In this acute mouse asthma model,a single dosage of 2×105 is optimal,with more significant effects of decreasing airway obstruction requiring repeated administration.
文摘A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a significant advancement in personalized radiotherapy by improving accuracy and reducing treatment-related toxicity.The model demonstrated strong predictive performance with R-values above 0.8,indicating its potential to improve treatment consistency.However,concerns arise from the small sample size and exclusion criteria,which may limit generalizability.Future studies should incorporate larger,more diverse patient cohorts,explore potential confounding factors such as tumor characteristics and delivery technique variability,and address the long-term effects of SBRT.
文摘Objective:To investigate the differential effects of different rivaroxaban dosing regimens on symptom relief,fluctuations in laboratory parameters,and medication safety in patients with stable pulmonary embolism(PE).Methods:This study enrolled 100 patients in the maintenance phase of PE who were treated at our hospital between January 2022 and December 2023.They were randomly divided into a control group and an observation group using a random number table,with 50 subjects in each group.The treatment period was uniformly set at 6 months.The control group received oral rivaroxaban 10 mg once daily,while the observation group received oral rivaroxaban 5 mg once daily.The study focused on comparing the two groups regarding the degree of clinical symptom relief,coagulation function parameters(including D-dimer levels,PT,and APTT),cardiac function markers(NT-proBNP),and drug-related adverse events.All data were processed using SPSS 26.0 statistical software.Measurement data are presented as mean±standard deviation,intergroup differences were verified by t-test,categorical variables were analyzed by chi-square test,and the statistical significance level was set at P<0.05.Results:After six months of treatment intervention,there was no significant difference in the overall relief of core clinical symptoms such as dyspnea and chest pain between the two groups.Regarding laboratory indicators,post-treatment D-dimer levels,prothrombin time,activated partial thromboplastin time,and NT-proBNP values were significantly optimized compared to baseline in both groups(P<0.05),but intergroup comparisons did not reach statistical significance.Notably,the overall incidence of bleeding events in the observation group was significantly lower than that in the control group(P<0.05),while there were no significant differences in the incidence rates of other adverse events between the two groups.Conclusion:In the maintenance phase treatment of pulmonary embolism,rivaroxaban 5 mg and 10 mg doses are equivalent in efficacy regarding improvement of clinical symptoms and blood indicators.However,the 5 mg dose significantly reduces the risk of bleeding,offers better safety,and is more suitable for long-term anticoagulation management in some high-risk populations.
基金supported by the National Natural Science Foundation of China(No.62371243)National Key Research and Development Program of China(No.2025YFC2427600)+4 种基金the Jiangsu Provincial Key Research and Development Program Social Development Project(No.BE2022720)the Natural Science Foundation of Jiangsu Province(No.BK20231190)Jiangsu Provincial Medical Key Discipline Cultivation Unit of Oncology Therapeutics(Radiotherapy)(No.JSDW202237)Changzhou Social Development Program(Nos.CE20235063 and CJ20244020)Postgraduate Research&Practice Innovation Program of Jiangsu Province(No.JX13614239).
文摘This study introduces a novel concept,biological in vivo three-dimensional(3D)dose distribution verification,aimed at investigating how respiratory motion affects the efficacy of lung cancer radiotherapy,representing an evolution from the current standard of rigid-body dose distribution verification.A 3D ex vivo biological lung motion simulation device(3D-BioLungEx)was designed to replicate human respiration.A radiotherapy plan of the patient was copied to the porcine lung,which was driven by 3D-BioLungEx to simulate various respiratory patterns that occur during treatment.To ensure anatomical consistency with the patient’s lung structure,during transmission,skin,skeleton,and organs were adjusted according to CT images of the porcine lung.The patient’s radiotherapy plan was then adapted to the porcine lung using the Monaco treatment planning system(TPS).Next,an iterative optimization and scatter inversion-based dose distribution retro-analysis algorithm(IOSI-BLDose)was developed to calculate the dose distribution during treatment.Gamma passing rates were used to quantify discrepancies between this dose distribution and that of the radiotherapy plan.When respiratory conditions were replicated,the passing rate reached up to 93.61%,while irregular breathing dropped it to 70%-90%,primarily due to amplitude changes.However,cycle variations had minimal impact.Compared to conventional rigid-body dose distribution verification,our method provides real-time biological feedback and more effectively captures motion-induced deviations.Accordingly,our biological in vivo 3D dose distribution verification has potential for improving treatment precision and enabling adaptive radiotherapy in clinical practice.
文摘The ionization chamber produces significant space-charge and ion recombination effects at ultra-high dose rates,posing achallenge for dose monitoring.In addition,there is no generally accepted ion correction model for dosimetry in FLASHradiotherapy,making it crucial to monitor the dose at ultra-high dose rates accurately and in real time.In this study,the airpressure of the ionization chamber was reduced to perform real-time beam monitoring,and a Faraday cup was used for calibrationfor active dosimetry.To study the saturation effect of the ionization chamber,the drift,attachment,recombination,anddiffusion processes of the electron-ion pairs were modeled using finite-element analysis based on physical phenomenologicalprinciples,and the correction factor was calculated.The experimental results showed that the FLASH ionization chambermeasures good dose linearity at a dose rate of approximately 0.2 Gy/s.When the air pressure of the chamber was adjustedto 10 mbar,the response of the FLASH ionization chamber was linear at a dose rate of approximately 50 Gy/s,with theresiduals within 2%.Furthermore,by using physical phenomenology to resolve the process of electron-ion pair motion inthe sensitive volume of the ionization chamber,the analytical model better describes the saturation effect of carbon ions atultra-high dose rates.The maximum deviation in the calculated correction factor is less than 10%.We studied the saturationeffect in dose measurement,achieving accurate and fast dose and profile position measurement across different dose ratesin a wide range based on the Heavy Ion Research Facility in Lanzhou.
基金supported by the National Natural Science Foundation of China(No.12375314)。
文摘Tungsten is considered the most promising plasma-facing material for fusion reactors with exceptional performance.Under certain conditions,activated tungsten dust can be generated through plasma–wall interactions and released into the atmosphere.Activated tungsten migrates downward in the soil after atmospheric deposition.However,effective methods for evaluating the environmental dose of gamma rays emitted by activated tungsten are still lacking.Consequently,a method for evaluating the air-absorbed dose rate of activated tungsten dust was proposed considering soil attenuation.Key parameters including the mass attenuation coefficient and energy absorption build-up factor were determined for the main gamma ray energies of radionuclides within the activated tungsten dust.Additionally,air-absorbed dose rates were calculated by assuming that radioactive sources were located at different soil depths and radii.It was found that a soil depth of 50 cm significantly attenuated the environmental dose by 99.9%,whereas the air-absorbed dose rates within the horizontal distance of 500 cm accounted for 91%of the total dose rate.Therefore,this study underscored the importance of soil attenuation in environmental dose assessments,which must be carefully re-examined for the safety analysis of fusion reactors.
文摘Ultra-high dose rate flash radiotherapy(FLASH-RT)has attracted wide attention in the field of radiotherapy in recent years.For FLASH-RT,radiation is delivered at a very high dose rate[usually thousands of times compared with conventional radiotherapy(CONV-RT)]in an extremely short time.This novel irradiation technique shows a protective effect on normal tissues,also known as the flash effect.At the same time,FLASH-RT is comparable to CONV-RT in terms of tumorkilling efficacy.As basic research dedicates to uncover the mechanisms by which FLASH-RT reduces radiation-induced normal tissue damage,clinical trials of FLASH-RT have been gradually conducted worldwide.This article systematically reviews the evidence of the feasibility and safety of FLASH-RT in clinical practice and offers insights into the future translation of this technology in clinic.
文摘To monitor nuclear and radiation emergencies,it is crucial to obtain accurate in situ measurements of the environmentalγ radiation dose rate from key radionuclides,particularly for large radioactive surface sources.The methods currently used for measuring dose rates are inadequate for obtaining the dose rates of key radionuclides and have large angular response errors when monitoring surface sources.To address this practical problem,this study proposes three methods for measuring the dose rate:the weighted peak total ratio,mean value regression,and numerical integration methods.These methods are based on energy-spectrum measurement data,and they were theoretically derived and numerically evaluated.Finally,a 1-m-long hexagonal radioactive surface source was integrated into a larger surface source.In situ measurement experiments were conducted on a large radioactive surface source using a dose-rate meter and a portable HPGespectrometer to analyze the errors of the three aforementioned methods and verify their validity.
文摘Hepatitis E virus(HEV)represents a significant global cause of acute viral hepatitis.Annually,it is estimated to cause approximately 20.1 million infections worldwide,3.3 million of which result in symptomatic illness.In developing regions,genotypes HEV-1 and HEV-2 are the primary strains responsible for widespread outbreaks and epidemics of acute jaundice(icteric hepatitis),transmitted predominantly through the fecal-oral route via contaminated water and food(Devarbhavi et al.,2023).
文摘We read with great interest the recent article by Valenzuela et al.1titled“Dose-response effect of pre-exercise carbohydrates under muscle glycogen unavailability:Insights from McArdle disease”published in the Journal of Sport and Health Science The study's exploration of the effects of varying carbohydrate(CHO)doses on exercise capacity in Mc Ardle disease,a condition characterized by complete muscle glycogen unavailability,is a significant contribution to the field of sports science and metabolic disorders.
基金supported by the National Key Re-search and Development Program of China(2021YFF0502900,2019YFC1604604)the grant of Peak Climbing Project of Foshan Hospital of Tra-ditional Chinese Medicine,Traditional Chinese Medicine Bureat of Guangdong Province Project(No.20213018)+2 种基金the Special Fund for Research on National Major Research Instruuments of China(Grant No.62027824)Scientific Research Fund of Education Department of Yunnan Province(2023Y0619)Biomedical Projects of Yun-nan Key Science and Technology Program(202302AA310046).
文摘Triple-negative bresst canær(TNBC)metastscis is particularly severe due to its aggressive nsture,leading to rapid disease progresion and significantly reduced survival rates.Rujifang(RJF),a traditional Chinese formula,has demonstrated potential anti-tumor effects and theability to inhibit TNBC metastasis.However,the efects af varying R.IF dors remain undear.This study utilized Laser-based in vino fow cytometry(IVFC)to monitor circulating tumor cells(CTCs)and evaluate the efficacy of R.IF at different doses.The results indicated that R.IF at the high dose inhibited both the number af CTC:and the formaton of metatatic foci more eflectively compared to the lower dose.TUNEL assays revealed that R.IF trentment promotes apoptosis of tumor cells,with a more pronounced effect observed at the higher dose.Immuno-fluorescence experiments demonstrated that administering a higher dose of R.IF suppreses theеxprescion of Kindlin-1 more effectively in the tumor microenvironment.Although higher doses showed enhanced efficacy,they might also lesd to an increase in side efects.These findings underscore the promise and challenges of using R.IF at high doses for anti-tumor therspy.They highlight the criticnl importance of optimizing the dose of R.JP in the treatment of TNBC and provide valuable insights for its dinical application.
文摘目的:探讨在新生儿胸部CT检查中,结合使用低管电压、固定管电流以及不同权重的iDose4重建技术对图像质量的影响,并评估其可行性。方法:搜集80例行CT检查的新生儿,随机分到A、B两组,A组采用自动曝光控制技术,B组采用固定管电流扫描(33 mA),采用iDose^(4)重建法重建出1~7级不同权重的肺窗和纵隔窗图像,并对比分析图像质量。记录患儿的CTDIVOL,后依据回归模型计算出体型特异性剂量估算值(size specific dose estimate,SSDE),并对比分析。结果:A、B两组患儿iDose^(4)重建算法的最佳权重肺窗为3级,纵隔窗为4级;A、B组患儿CTDIVOL分别为(1.04±0.21)mGy和(0.91±0.18)mGy,A组较B组高12.5%(t=2.17,P=0.04);A、B组患儿的SSDE分别为(2.41±0.36)mGy和(2.07±0.32)mGy,A组较B组高15.4%(t=3.19,P<0.05);A、B组患儿CTDIVOL离散度分别为20.2%(0.21/1.04)和19.8%(0.18/0.91),A、B组患儿SSDE离散度分别为14.5%(0.36/2.41)和15.5%(0.32/2.07)。结论:在新生儿CT检查时推荐使用低管电压、低固定管电流及适当的重建算法权重相结合的方法进行扫描,同时,推荐采用SSDE评估新生儿的辐射剂量。
