International Journal of Radiation Research
Volume:21 Issue: 4, Oct 2023

Fractionated radiotherapy is widely used for cancer treatment because of its advantages in the preservation of normal tissues; however, it may amplify the radioresistance of cancer cells. In this study, we aimed to understand whether and how fractionated radiation exposure induces radioresistance.

HCT8 human colorectal cancer cells received a total X-ray dose of 5 Gy in either a single treatment (5 Gy administered once) or via fractionated exposure (1 Gy/day treatment for 5 consecutive days). We then examined the radioresistance of cancer cells exposed an additional 2 Gy X-ray by clonogenic assay and Western blot analysis.

Cells receiving fractionated exposure showed significantly greater proliferation and clonogenicity than those that received a single dose. Compared with the levels in the intact cells without radiation exposure, the expression levels of γH2AX, phospho-ATM and PARP were significantly enhanced only in the cells exposed to fractionated radiation. In contrast, the expression of cyclin D1 and cyclin E1 was enhanced only in the cells that received a single dose. In addition, the expression of SOD1 and SOD2 was slightly increased in the cells that received either the fractionated exposure or single exposure treatment.

Fractionated radiation exposure facilitates radioresistance in HCT8 human colorectal cancer cells predominantly by enhancing their DNA repair capacity.

Abdominopelvic radiotherapy (RT) can lead to inflammatory and oxidative changes in non-targeted organs, such as the lungs. This study aimed to investigate the protective effect of probiotic and melatonin administration on the inflammatory and oxidative changes in the lungs after abdominopelvic RT in Wistar albino rats.

Thirty female Wistar albino rats were divided into four groups: Group 1 (Control), Group 2 (RT) receiving a single dose of radiotherapy to the abdominopelvic region, Group 3 (RT + Melatonin) receiving a single dose of melatonin intraperitoneally before radiotherapy, and Group 4 (RT + Probiotic) receiving probiotic containing Lactobacillus rhamnosus GG and BB-12 (1010 CFU) via an orogastric feeding cannula before radiotherapy. After the rats were sacrificed, lung tissue samples were analyzed for the levels of Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Oxidative Stress Index (OSI), Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), and Tumor Necrosis Factor-alpha (TNF-α).

TAS was lower in Group 2 compared to Group 3 or 4 (p<0.001). TOS was higher in Group 2 compared to Group 3 (p=0.007). IL-1β, IL-6, OSI, and TNF-α levels were lower in Group 3 or Group 4 compared to Group 2.

Abdominopelvic RT resulted in increased TOS and inflammatory cytokines and decreased TAS in non-targeted lung tissues. However, administration of melatonin or probiotics improved the antioxidant status and mitigated the increase in inflammatory cytokines and OSI caused by RT. Melatonin exhibited more prominent effects.

To explore computerized tomography (CT) imaging features of pulmonary fungal infection (PFI) in patients with acute leukemia (AL) after chemotherapy.

Totally 116 AL patients who received chemotherapy in our hospital from June 2016 to April 2023 participated into this study, and the pulmonary fungal infection was confirmed by laboratory examination and clinical antifungal treatment. The CT image signs, lesion distribution, CT concomitant signs and main types of fungal infection were analyzed.

CT image signs of two main types, nodule/mass type and mixed type were recorded, with76 cases of nodular/mass type and 40 cases of mixed type. There were 372 lesions in nodules/mass cases, mainly in the upper lung (46.24%). In these 372 lesions, 113 micro-tubercle, 138 small nodules, 115 nodules and 6 masses were included. There were 88 cases of halo sign, 26 cases of cavity, and 25 cases of air crescent sign. Candida albicans was the most common pathogenic fungal strain, followed by aspergillus, candida tropicalis, candida glabrata, candida parapsilosis, cryptococcus, candida dubliniensis, mucor, candida krusei and candida rugosa.

The CT manifestations of AL complicated with pulmonary fungal infection after chemotherapy were various, most of which had no characteristics, but the “halo sign” and “air crescent sign” had certain specificity. The combined CT and clinical manifestations can narrow the range of differential diagnosis. When the diagnosis still cannot be confirmed, diagnostic therapy or early diagnosis by fungal culture and histological examination can be performed.

The impact of doses on the left ventricle (LV) and left anterior descending artery (LAD) in relation to major adverse cardiac events is well documented. Studies performed on breast cancer have shown that LV doses are correlated with cardiac toxicity.

Thirty-two patients with left lung cancer who received radiotherapy at our center were evaluated retrospectively. The left ventricle (LV) and left anterior descending artery (LAD) were contoured as organs at risk on CT simulation images. Seven fields were used in intensity-modulated radiation therapy (IMRT) plans, while two partial arcs were used to create volumetric modulated arc therapy (VMAT) plans. Conventional plans were compared with LV and LAD sparing plans dosimetrically.

When comparing conventional plans to sparing plans, no statistically significant differences were found in target volume parameters and values related to critical structures (p>0.05). However, when evaluating the heart (Dmean and V25) and its substructures (LADmean, V15, V30, and LV V5, V10, V15, V30, V40), the plan with LV and LAD sparing demonstrated significantly better outcomes (p<0.05).

Therefore, it is essential to contour the substructures of the heart as organs at risk, particularly including LAD and LV in the optimization algorithm during radiotherapy planning for central lung tumors located near the heart.

Banxia Xiexin Decoction (BXD) is reported to be effective in the treatment of gastrointestinal diseases. In this work, we evaluated the effects of chemotherapy combined with Banxia Xiexin Decoction on duodenal cancer using Computed tomography (CT) enhanced scanning.

Totally 80 cases diagnosed with duodenal cancer were selected, and the data of patients were retrospectively analyzed. They were randomly allocated into the treatment and control groups with 40 patients in each group. Participants in the treatment group received serotonin blocker (granisetron) combined with chemotherapy drugs, and oral administration of Banxia Xiexin Decoction to prevent nausea, vomiting and other gastrointestinal reactions. Those in the control group received chemotherapy drugs, combined with serotonin blocker (granisetron). CT enhanced scan, magnetic resonance imaging (MRI) and pathological examination were performed, and pathological diagnosis was used as the gold standard for treatment effect evaluation.

For patients in the treatment group, 13 were analyzed, 15 were clear, 9 had no effect, and 3 were negative, with a total effect of 93.50%; For patients in the control group, there are 6 patients with control, 16 patients with obvious results, 12 patients with benefits, and 6 with no benefits, with a total results of 87.00%. All the results were significantly different between the two groups (P<0.05).

Banxia Xiexin decoction has the advantages of low cost, obvious benefits, and few side effects in the treatment of nausea and vomiting of duodenal cancer patients, which is suitable for medical treatment.

To investigate the clinical and diagnostic value of X-ray examination and computed tomography (CT) imaging for gastric cancer (GC) and benign gastric tumors.

Totally 160 patients with gastric tumors treated in Baoding First Central Hospital from October 2016 to December 2017 participated in this study and randomized into the control group and observation group (n=80 per group). The control group received X-ray examination and the observation group underwent CT scan. The diagnostic rate was compared between these two modes. Receiver Operating Characteristic (ROC) curve was applied for the evaluation of the diagnostic efficacy of CT quantitative parameters in the observation group. The clinic accordance rate, clinical efficacy and life quality score in the two groups were then compared.

CT scan is more accurate than X-ray examination in diagnosing gastric cancer and benign tumor (P< 0.05). CT quantitative parameters were of diagnostic value in gastric cancer and benign gastric tumor. Their Area under Curve (AUC) was 0.750, 0.696, 0.676, 0.841 and 0.721, respectively. After treatment, the clinical efficacy and functional scales showed improvement in patients examined by CT imaging relative to those examined by X-ray (P<0.05).

CT scan has a higher diagnostic accuracy than X-ray examination for gastric cancer and benign tumor. Selecting appropriate therapy after diagnosing with CT scan is beneficial for the improvement of clinical efficacy.

The purpose of this study was to measure the surface dose in breast cancer patients undergoing supraclavicular irradiation using a thermoluminescent dosimeter (TLD) and compare the measurements to calculated doses determined by the treatment planning system (TPS). The results of in vivo patients’ measurements were verified using a phantom.

The oesophageal surface dose of 30 breast cancer patients undergoing supraclavicular lymph node irradiation was measured by TLD and TPS. For each patient, two TLDs were positioned on the oesophageal surface. The TLD and TPS results were verified using a phantom that covered from the oesophagus to the supraclavicular area. The TLD was positioned within or outside the treatment field on the phantom depending on the patient.

The average oesophagus surface dose was 9.04 ± 5.07 Gy and 8.06 ± 6.17 Gy for TLD and TPS, respectively (p=0.09). Oesophagus surface doses were greater for the left than for the right side. The calculated and measured dose values at the surface for the phantom were 0.78 Gy and 0.96 Gy, respectively, with the TLD placed inside the radiation field (p=0.02). The calculated and measured dose values at the surface for the phantom were 0.024 Gy and 0.10 Gy, respectively, with the TLD placed outside the radiation field (p=0.01).

The results showed a good agreement between TLD measurements and TPS calculations, except when the TLD was placed outside the radiation field. Therefore, dose calculations in peripheral regions should be used with caution.

Minimizing the radiation side effects in cancer therapy has become one of the major challenges in radiotherapy, especially if the cancer is located in vital organs such as the brain. Negative pi-meson-based therapy is one method of radiotherapy that allows cancer to receive a high radiation dose while the surrounding normal tissue receives a low radiation dose. This research aims to analyze negative pi-meson therapy's dose and irradiation time in glioblastoma multiforme.

Simulation-based research is conducted using the PHITS program. The source used is a negative pion beam with an intensity of 2.5 × 108 pions/second with an energy of 30 MeV to 60 MeV with an interval of 1 MeV. The negative pion energy, which has the maximum dose rate in the cancer target area, was optimized to obtain the weighting factors and irradiation time. The irradiation was carried out in 30 fractions with the dose per fraction of 2 Gy.

Irradiation time per fraction obtained was 194.91 seconds. The organ at risks (OARs) analyzed in this research were soft tissue, skin, brain, and cervical spinal cord. The doses received by the OAR are 0.2641 Gy, 0.7645 Gy, 7.3295 Gy, and 0.075 Gy, respectively.

In summary, negative pi-meson therapy has the potential to minimize radiation dose to healthy tissue while cancer still receives high-dose radiation. However, it is necessary to compare negative pi-meson therapy and other radiotherapy methods to determine the strengths and weaknesses of each method.

The "Geant4 Application for Tomography Emission" (GATE) toolkit comprises advanced open-source Monte Carlo (MC) code for use in ‎medical imaging and radiotherapy simulations. This study aimed to verify the GATE toolkit results against a water phantom and then to show the dose calculation capabilities of the GATE for radiotherapy. The results were compared with three dose calculation algorithms using patients' Computerized Tomography (CT) data.‎

A Linac with a 6 MV photon beam was simulated in the GATE code. The ‎code was verified, head CT images of three patients were inserted into the GATE as realistic ‎phantoms‎, and simulations were performed for different field sizes and angles. The Percent ‎Depth Doses (PDDs) and transverse profiles were extracted from the GATE simulation and ‎calculation ‎algorithms. Their results were ‎compared regarding the Dose Difference (DD) and gamma index for the PDDs and the Full Width at Half Maximum (FWHM) for the profiles. ‎

Using the patient CT data for the PDDs, the ‎gamma pass rate with 3%/3 mm criteria in the comparison between the GATE ‎simulation and ‎algorithms for all fields ranged from 89.4% to ‎‎98.8%, with an average of 92.8%. The ‎extracted FWHMs from the GATE and algorithms were in good agreement, and their differences ranged from 0.1 to 1.2 mm.

The GATE MC toolkit has good potential for implementation in radiotherapy Treatment Planning Systems (TPS) for dose calculations.

The study aimed to elucidate the clinical application significance of prospective ECG-gated dual-source CT in central venous (CV) imaging.

Eighty patients who took CT imaging of CV (CTV) check using dual-source Force CT were enrolled. The control group (helical pitch, 0.8; rotation speed, 0.5 s) and the experimental group (rotation speed, 0.25 s). For both groups, image quality and radiation dose were computed.

Cases in the experimental group required longer scanning durations than those in the contro lgroup. In respect to the experimental group, the image quality scores of the superior vena cava and left and right brachiocephalic veins of the patients sharply increased relative to those in the control group. Individuals in the experimental group also presented better image quality scores in left and right subclavian veins, left and right jugular veins, however, this difference was not statistically significant. Lastly, no increase in the radiation dose was bited with the application of prospective ECG gating.

The clinical use of prospective ECG-gated technology significantly reduced cardiovascular pulsing artifact interference on the central vein, especially the superior vena cava segment, and remarkably improved the image quality without increasing the radiation dose to patients.

The monocyte-to-lymphocyte ratio (MLR) has been reported as a useful prognosticator in various types of cancers. We studied the usefulness of MLR as a prognosticator for head and neck squamous cell carcinoma (HNSCC) in patients with oropharyngeal, hypopharyngeal, and laryngeal cancer who received radical concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT).

This study included 76 HNSCC patients diagnosed between January 2015 and April 2020. We obtained their haematological records within one month before radiotherapy and calculated the MLR. Kaplan-Meier method and Cox proportional hazard model were performed to evaluate the association of MLR with locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS).

The Kaplan–Meier survival analysis for MLR showed a significant difference (p = 0.0326) in OS. Univariate and multivariate analysis revealed that the lower MLR group was associated with better OS (hazard ratio [HR] = 0.345, 95 % confidence interval [CI] = 0.124–0.960, p = 0.042 and HR = 0.305, 95% CI = 0.102-0.916, p = 0.034, respectively). Multivariate analysis also revealed that N 2-3 was significant independent predictor of LFRS and PFS (HR = 4.47, 95% CI = 1.43–14.0, p = 0.0286 and HR = 4.94, 95% CI = 1.84-13.2, p < 0.01, respectively).

MLR was useful as a prognostic predictor for OS in patients with HNSCC who received radical concurrent CRT or BRT. MLR may be more reflective of OS than of LRFS or PFS.

Aim is to find correlation between 2D-gamma passing rate and 3D-DVH-based pre-treatment patient-specific quality assurance.

21 head and neck and 21 pelvis patients, treated with volumetric modulated arc therapy (VMAT) were selected for this study. All patients were planned with Elekta VersaHD linear accelerator using Monaco (5.11) treatment planning system. 2D-planar dose measurements were performed with IBA-I'matriXX evolution detector-array using My-QA-Patients software. For 2D-Gamma index evaluation, 3%/3mm and 2%/2mm criteria were used. 3D-dose measurements were performed using the IBA-COMPASS system. For 3D measurement, Monaco and COMPASS doses were compared in terms of percentage dose differences to PTV and organs at risk. For PTV D95, D2, and D50 (dose received by 95%, 2%, and 50% volume), similarly for OARs D2 and D50 were noted. 3D Gamma index was also noted. Correlation coefficient and its corresponding two-tailed p-value (≤0.05, for statistically significant) were calculated for 2D-gamma passing rate and 3D Gamma index & percentage dose differences of 3D-DVH based metrics (Monaco calculated versus COMPASS measured).  Strength of correlation will be considered weak or strong based on the r -value.

2D-Gamma index passing rate was 98.6±1.8%, 92.1±7.1% and 98.5±1.3%, 93.5±4.4% for head-neck and pelvis patients (3%/3mm, 2%/2mm criteria) respectively. Percentage dose-differences for PTV D95, D2, D50 for head-neck and pelvis were: 4.22±2.09%, 4.25±2.23%, 3.93±1.59 & 0.60±1.96%, 1.53±1.64%, 1.59±1.20% respectively. Spine and brainstem D2 were -0.84±6.10%, 0.77±2.70%, bladder and rectum D50 were 3.75±3.31%, -2.19±3.60%.

  No strong correlation was observed between the 2D Gamma passing rate and 3D measurements.

The study aims to evaluate the relationship between the maximum standardized uptake value (SUVmax) of fluorodeoxyglucose positron emission tomography (FDG-PET) before radiation therapy (RT) and the further need for re-irradiation (re-RT) in patients with bone metastases (BM), and to predict the complete response using pre-treatment SUVmax.

Fifty-three patients with 133 painful BMs were accepted into the study. Pain scores and SUVmax at painful BM were recorded. Eight Gray in single fraction palliative RT was administered to all of the patients. A total of 7 patients (8 osseous lesions) underwent re-RT.  Factors associated with re-RT were analyzed using Cox regression analysis.

The ideal SUVmax cut-off to predict complete response was 7.95. Median SUVmax was 12.75 (±4.1) and 7 (±3.36) in patients who required re-RT due to pain progression and in those who did not, respectively (p<0.001).

FDG uptake may be predictive of the need for re-RT in patients with painful BM. This may impact decisions with single-fraction RT which is associated with higher rates of partial response and further need for re-RT at the same location in patients with high SUVmax. Pre-treatment FDG uptake also may be useful in predicting a complete response.

The pathogenesis of radiation-induced lung injury (RILI) remains elusive. In this study, we aimed to elucidate the mechanism underlying RILI progression by employing a comprehensive approach, integrating bioinformatics analysis and experimental validation.

Raw transcriptome sequencing data from two Gene Expression Omnibus (GEO) datasets, GSE202586 and GSE14431, were downloaded and overlapping genes were identified. Differential expressions of microRNAs (miRNAs) were analyzed using GEO2R software on the GSE202586 dataset. The miRDB database and miRWalk database were utilized to identify miRNA targets. Specific miRNA inhibitors or protein siRNA were administered to RILI mouse models for experimental confirmation.

Ten genes were consistently upregulated in the RILI groups across both datasets. A series of miRNAs were dysregulated in the RILI group, with miR-34a exhibiting the largest difference. By integrating target exploration and protein-protein interaction (PPI) analysis, we determined that the miR-34a/CDK6 axis may be the key regulator of RILI progression. Notably, miR-34a inhibitor treatment significantly alleviated alveolitis in RILI mice, and this effect was substantially reversed by CDK6 siRNA.

Targeting the miR-34a/CDK6 axis presents a potential therapeutic strategy for RILI.

To explore the impact of head and neck computed tomography (CT) guided nerve interventional therapy in ischemic cerebrovascular disease (ICVD) patients.

Patients with ICVD (n=100) admitted to our hospital from December 2021 to December 2022 were selected and randomly allocated into control group (CG) and observation group (OG). The CG received drug treatment, and the OG drug treatment before surgery and treated with head and neck CT combined with nerve intervention therapy. Interventional therapy was conducted via endovascular stenting. The National Institute Health of Stroke Scale (NIHSS) score, activities of daily living (ADL) score, vascular recanalization rate, blood flow of the diseased vessels along with occurrence of adverse reactions in both groups were compared.

After therapy, NIHSS score in both groups was declined, and lower in the OG relative to the CG (P<0.05), while ADL score in both groups was elevated, and higher in the OG relative to the CG (P<0.05). The vascular recirculation rate of the OG was 86.00%, higher relative to 60.00% in the CG (P<0.05). Vs (peak systolic flow velocity) and Vd (end diastolic flow velocity) in both groups was lessened post treatment, and lower in the OG relative to the CG (P<0.05). The occurrence of adverse reactions in two groups showed no significant difference (P>0.05).

CT guided nerve interventional therapy was effective for the treatment of ICVD patients, which promoted vascular recanalization and nerve function recovery, effectively improve vascular endothelial function and cerebral blood flow of patients, and improve patient life quality.

To determine the therapeutic effect of ultrasound-guided epidermal growth factor (EGF) injection combined with carbon dioxide laser on facial acne scars.

One hundred patients with facial acne scars admitted to the dermatology department from October 2021 to October 2022 were selected as the subjects of this study. The observation group (OG) received ultrasound guided EGF injection combined with carbon dioxide 2 (CO2) laser treatment, and the control group (CG) received CO2 laser treatment alone. The clinical outcomes and the recovery time after treatment were recorded for both groups of patients. Quantitative skin analysis including skin spots, red mass, pores and wrinkles were performed before and after treatment by VISIA skin detector, and inflammatory factors levels were measured.

The pain duration, erythema duration, incrustation time, decrustation time and incidence of adverse reactions in the OG were lower than those in the CG, while the total efficiency of treatment was higher than that in the CG (P<0.05). In addition, the results of quantitative analysis of skin spots, red matter, pores and wrinkles were higher in the OG and inflammatory factors levels were lower in the CG after treatment (P<0.05).

EGF combined with CO2 laser can effectively improve scarring symptoms and shorten the recovery period in patients with facial acne scars.

To investigate the difference in the effect of ultrasound-guided puncture injection of polidocanol (PO) and ethanol (ET) in the treatment of renal and hepatic cysts (RHC), and to analyze the factors related to patients’ prognosis of disease recurrence.

A total of 105 patients with RHC admitted to our hospital from August 2020 to August 2021. Among them, 59 patients received ultrasound-guided puncture injection of ET (control group); the rest 46 received ultrasound-guided puncture injection of PO (observation grou). The success rate of one-time puncture and adverse reactions of the two groups were counted, and the levels of C-reactive protein (CRP), Cortisol (Cor), liver and kidney function. Patients were then followed up for a one-year prognosis, and the prognosis of RHC recurrence was recorded. Logistic regression analysis was performed to analyze the factors associated with the recurrence of cysts.

Postoperative CRP and Cor were observed to be lower than those in the control group, and hepatic and renal function was better than that in the control group (P<0.05). In addition, the incidence of adverse reactions was lower in the observation group than in group B (P<0.05). Cyst diameter, incomplete cyst aspiration, and post-sclerotic segregation were high-risk independent factors affecting prognostic cyst recurrence (P<0.05).

Ultrasound-guided injection of PO puncture sclerosis for RHC has excellent results. At the same time, patients need to be concerned about the diameter of the cyst, incomplete aspiration of the cystic fluid, and whether the cyst is separated after sclerosis.

To evaluate treatment outcomes and toxicity of pulmonary SBRT for intrathoracic recurrence in patients with locally advanced NSCLC treated as a combination of surgery, radiotherapy or chemotherapy.

A total of 46 patients with NSCLC who received thoracic SBRT for local or non local intrapulmonary recurrent lesions in our department from 2009 to 2019 were retrospectively enrolled in this study. The patients received median 43.4 Gy (25 Gy -60 Gy) radiotherapy using the CyberKnife radiosurgery system in median 3.6 fractions (range, 1-8).Univariate and multivariate Cox regression analyses were performed on the factors predicting outcomes.

The median follow up time after SBRT was 23.5 months. Treatment of the primary tumor consisted of surgical resection, radiochemotherapy, and systemic therapy in 25, 8 and 13 patients, respectively. İsolated local recurrence, intrathoracic recurrence and distant metastasis were detected in 5 (10.9%), 12 (26.1%) and 8 (17.4%) patients, respectively. Kaplan-Meier analysis of 2 year OS, PFS and LC for all tumors treated after SBRT were; 51%, 56% and 91%, respectively. In parameters related to patient and treatment; no statistical significance was found affecting local control and survival.(p>0.05). Grade 2 radiation pneumonitis and chest wall pain were observed in 2 (4.3%) and 1 (2.1 %) patients. Grade 3 toxicity was detected in 3 ( 6.5%) cases.

Pulmonary SBRT for recurrent NSCLC is a good treatment option with favourable LC and promising survival. SBRT can be an effective treatment modality in the treatment of patients with local/limited pulmonary relapses with acceptable toxicity rates.

This research aims to evaluate whether polyethylene glycol (PEG), which can immediately repair neuronal membranes, will have a protective effect against radiation-induced brain injury (RIBI).

Whole brain irradiation (RAD) procedure was performed on 14 of 21 rats included in the study for establishing RIBI. Rats were randomly divided into three groups containing equal numbers of animals: control (RAD not established), placebo (RAD applied, and treated with 1 ml/kg/day of saline that was administered intraperitoneally), and treatment (RAD applied, and treated with 30 mg/kg /day of PEG 3350 that was administered intraperitoneally). Following the end of the 22-day treatments, behavioral tests were performed first, and then magnetic resonance spectroscopy (MRS) was applied to measure brain lactate levels. All rats were sacrificed in order to perform biochemical analysis and histopathological examination of brain tissue.

Compared to the control group, MDA, TNF-α, NF-κB and lactate levels were significantly increased, while BDNF levels were decreased in the placebo group; and RAD-induced changes in all these biochemical markers were reversed by PEG. In MRS performed from the corpus striatum, there was an evident decrease in lactate levels after PEG treatment. Impairment in memory and learning was more limited in PEG-treated rats than in the rats receiving saline therapy. Furthermore, histological examinations from hippocampus and cerebellum exhibited that PEG treatment significantly reduces apoptosis, astrogliosis, and oxidative DNA damage in rats.

Our results support that PEG is very effective in preventing RIBI with its secondary effects on the basis of membrane stabilization.

Ultraviolet radiation is the main cause of photoaging, which can induce oxidative stress and cellular senescence in the skin. It has been demonstrated that platelet-rich plasma (PRP) can significantly improve skin photoaging. However, the mechanism by which PRP improves photoaging remains unclear.

In this study, UVA-induced SD rats were used as a skin photoaging model and administered with PRP treatment, aiming to elucidate the potential mechanism of its protection against photoaging.

They showed that PRP injection on the back of rats improved skin photoaging, oxidative stress, and inflammation, and inhibited skin cell apoptosis. In addition, RPR activated autophagy to inhibit NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome signaling pathway-related proteins.

Our experimental results suggest that PRP plays an anti-UVA photoaging role by inhibiting autophagy and NLRP3 signaling pathways. Our study is the first to suggest that PRP anti-skin photoaging is associated with autophagy and NLRP3, providing a potential therapeutic approach for skin photoaging.

To explore the diagnosis and evaluation efficacy of liver iron concentration (LIC) based on magnetic resonance quantitative technique in liver iron overload in patients with long-term transfusion.

From November 2021 to January 2023, 30 chronic aplastic anemia (CAA) patients with long-term blood transfusion admitted to our hospital were included as the study group. Simultaneously, 20 healthy volunteers with matched gender and age were included in the control group. The serum ferritin (SF), serum iron, total iron binding capacity and transferrin saturation (TSAT) between the two groups was calculated and compared. LIC was evaluated using Liver Magnetic resonance imaging (MRI)-R2* map imaging. The correlation between LIC and SF and TSAT was analyzed, and the diagnosis value of LIC in hepatic iron overload was calculated. Low-risk patients (n=22) diagnosed with iron overload received continuous regular iron removal treatment and the SF, TSAT and LIC were measured after 6 months.

SF, TSAT and LIC were higher in CAA patients relative to the healthy controls (P<0.05). LIC was positively correlated with SF (r=0.74, P<0.001) and TSAT (r=0.67, P<0.001). The sensitivity and specificity of LIC in the diagnosis of hepatic iron overload were 80.00% and 100% based on SF, and 76.0% and 100% based on TSAT, respectively. Additionally, SF, TSAT and LIC were all declined after 6 months of treatment (P<0.05).

The detection of LIC based on MRI-R2* is an effective and non-invasive means for the assessment of liver iron load in patients with long-term transfusion.

This paper makes use of Monte Carlo (MC) simulation to verify the dosimetric accuracy lung SBRT treatment plans delivered with an Elekta beam modulator multileaf collimator (MLC) system.

Treatment plans of twenty early stage non-small cell lung carcinoma (NSCLC) patients were retrospectively re-calculated using the collapsed cone convolution (CCC) algorithm of the Pinnacle treatment planning system (TPS). Dose distributions were also calculated using the BEAMnrc and DOSXYZnrc MC user codes. A comparative analysis of target volume and organ at risk (OAR) dosimetry was performed between the TPS and MC dose calculation. A statistical analysis of the two dose distributions and parameters generated by the TPS and MC was performed to examine the significance of any differences.

The results showed that the TPS matched within 6% of the MC calculations for the planning treatment volume (PTV) coverage, mean and maximum PTV doses, and conformity index. The differences over all plans for the PTV were not statistically significant. For the organ at risk, the TPS overestimated the mean dose parameters over all patients but was only statistically significant for some organ at risks including the mean lung dose (MLD), V20Gy to the lung and V30Gy to the chest wall.

The TPS dose calculation of lung SBRT using CCC Pinnacle3 algorithms is relatively closer to the MC calculation, however there may be inaccuracies in the TPS dose calculation for some patients, manifesting in some of the key dosimetric parameters that are used as correlates for irradiation related complications.

To explore the effectiveness of the mixed decoction of Inula cappa and Serissa japonica (IS) on acute liver injury model.

Sixty carbon tetrachloride (CCl4)-induced mice models were divided into bifendate group (0.2 g/kg) and IS (2, 1and 0.5 g/kg) groups, model group, and control group randomly. Liver function biomarkers aspartate aminotransferase (AST), alanine amiotransferase (ALT), and oxidative stress biomarkers superoxide dismutase (SOD), malonic dialdehyde (MDA) were measured in each group. Hematoxylin and eosin (HE) staining was used to detect the liver tissues.

The necrosis degree and scope, and the structural damage of hepatocyte were significantly ameliorated in the bifendate, IS (2 g/kg) and IS (1 g/kg), compare to model group. IS and bifendate could significantly inhibit the liver index, reduce liver function biomarkers levels and the content of MDA in the liver of acute liver injury mice, and improve the activity of SOD. The serum level of AST was 147.162 (Control), 736.023 (Model), 370.285 (Bifendate), 325.589 (High-dose IS), 407.205 (Middle-dose IS), and 438.631 U/L (Low-dose IS) while the level of ALT was 44.804 (Control), 474.825 (Model), 156.812 (Bifendate), 157.02 (High-dose IS), 217.399 (Middle-dose IS), and 255.649 U/L (Low-dose IS). The content of MDA increased in model and treatment groups compared to control, while the activity of SOD was 69.362 (Control), 53.208 (Model), 64.77 (Bifendate), 73.389 (High-dose IS), 65.173 (Middle-dose IS), and 61.755 (Low-dose IS). Compared to the model group, high-dose IS group exerted significant hepatoprotective effect (p<0.05).

The mixed decoction of Inula cappa and Serissa japonica was able to protect acute liver injury.

Brain tumors like intracranial metastases, meningioma, gliomas, etc are the most prevalent brain tumors. Magnetic Resonance Spectroscopy (MRS) helps in the differentiation of high grade, low grade brain tumors, brain neoplasms, etc.

This study was conducted in the Radiology Department of one of the major tertiary health care centers in South Kerala. Patients suspected of brain tumors were subjected to both MRS and histopathological examinations after the surgery. A total of 69 patients were included. Histopathological findings were evaluated and grouped as benign, atypical, and anaplastic tumors and correlated with MRS findings. Statistical analysis was done by SPSS version 16. Friedman test was used for comparison.

In this study, MRS images of 69 brain tumor lesions were studied and compared for metabolic ratios and pathogenesis. MRS spectrum gives different peaks of specific metabolites of brain tumors like lipid, alanine, lactate, glycine, glutamate /glutamine, myoinositol, etc. Histopathological results also show different pathological findings.

  Magnetic Resonance Spectroscopy has a wide range of sensitivity to and is evaluate the different metabolites of brain lesions. The quantification of tissue metabolites can potentially identify the pathological change, at the biochemical level which creates further therapeutic interventions.

Drinking water from deep wells and boreholes is anticipated to have high concentrations of natural radioactivity from the decay of uranium, thorium, and potassium-40 isotopes. Ingestion of water containing radioactive matter for the long term dispenses potential health risks. This study sought to assess radiological quality in groundwater from selected boreholes used for domestic purposes in Osino, Ghana.

The analysis was done using gamma-ray spectrometry to determine the activity of radionuclides 226Ra, 228Ra and 40K in fifteen water samples collected from five selected boreholes. The samples were prepared into 1 litre Marinelli beaker, firmly closed and stored for 30 days to attain secular equilibrium between the long-lived radionuclides and their short-lived offspring.

The mean activity concentrations for 226Ra, 228Ra and 40K were 5.34 BqL-1±1.1 BqL-1, 9.21 BqL-1±2.0 BqL-1, and 35.64 BqL-1±5.6 BqL-1 respectively. The estimated radiological risks for cancer mortality and morbidity for 226Ra and 228Ra in the drinking water samples were below the WHO set screening level of 10-3. The mean hazard quotient estimated for 226Ra was 9.7 µgkg-1day-1. The total annual committed effective dose ranged from 5.27 x 10-2 mSvy-1 to 8.25 x 10-2 mSvy-1 with a mean of 6.87 x 10-2 mSvy-1 which was within the WHO set guidance level of 0.1 mSvy-1.

The radiological quality of the water is within the individual dose criterion and may not pose a health risk. It is paramount to monitor the radiological quality of the groundwater to provide relevant information to protect public health.

The present study aimed to evaluate the accuracy of the pencil beam algorithm (PBA) dose calculations with modified binomial lateral spreading function for oblique electron beams compared with Monte Carlo simulations (MCs), as a standard method.

The oblique pencil beams were simulated using MC code, and lateral dose distributions of oblique (10 and 12 MeV) electron beams were calculated in homogeneous water and heterogeneous slab phantoms (different materials of paraffin, carbon, and RW3). The MC dose calculations were used to modify the parameters of the binomial Gaussian lateral spreading function of PBA. The dose profiles of oblique electron beams were calculated by modified PBA and compared with MCs in both phantoms using gamma analysis with a 2% dose difference (DD) and 2 mm distance to agreement (DTA) constraints.

The average difference in dose profiles between PBA and MC calculations was 0.88% and 0.76% for water and slab phantoms, respectively. The mean gamma pass rate was 97.4% and 97.8% for water and slab phantoms, respectively. The gamma pass rates were above 95%, except for the dose profile of the water phantom irradiated with 10 MeV at a depth of 1 cm.

The modified PBA dose calculation results showed an excellent agreement with MCs in the two phantoms irradiated with oblique 10 MeV and 12 MeV electron beams. Our approach of modifying the PBA can be used for other charged particle dosimetry and clinical applications, especially electron and proton dosimetry.

Through combustion, a coal-fired power plant produces by-products, such as fly ash and bottom ash, which contain significant concentrations of radionuclides that cause environmental contamination, leading to health problems.

This study investigated the specific activity and radiological impacts of naturally occurring radioactive materials (NORMs) in the coal, fly ash, and bottom ash at a coal-fired power plant. Samples were collected from a coal-fired power plant in Malaysia.

Gamma spectrometry was used to determine the specific concentrations of NORMs, namely 40K, 232Th, 238U, in each sample. The radioactivity ranges for 238U, 232Th, and 40K in the soil were 22.7–150.7 Bq/kg, 20.7–153.6 Bq/kg, and 68.6–1594.4 Bq/kg, respectively. The coal, fly, and bottom ash samples contained 67.54–189.18 Bq/kg of 238U, 50.2–134.57 Bq/kg of 232Th, and 327.54–1114.40 Bq/kg of 40K. The radium equivalent activities (Raeq) in the samples were 164.55, 467.42, and 429.09 Bq/kg, respectively. Meanwhile, the absorbed dose rate (ADR) in the air ranged from 76.04 to 217.44 nGy/h. Internal and external hazards ranged from 0.44 to 1.26 and 0.63 to 1.77, respectively. The annual gonadal dose equivalent (AGDE) value fluctuated between 521.28 and 1,496.99 μSv.

The excess lifetime cancer risk (ELCR) oscillated from 1.30×10–3 to 3.75×10–3 indoors and 0.32×10–3 to 0.95×10–3 outdoors.

To investigate the effect of DIRAS2 on the response to ionizing radiation (IR) and the related potential molecular mechanism in human ccRCC cells.

In this paper, the expression levels of DIRAS2 in human ccRCC and paired normal tissues were obtained from the Oncomine platform and The Cancer Genome Atlas (TCGA) database, which was further validated by immunohistochemistry. DIRAS2-overexpression cell lines were constructed using a lentivirus-mediated gene expression system. A clonogenic assay was performed to evaluate cell radiation resistance. The effect of DIRAS2 on autophagy was determined by immunoblotting and immunofluorescence analysis. The expression of DIRAS2 and related signalling molecules was evaluated by immunoblotting.

Here, we found that the expression of DIRAS2 was upregulated in human ccRCC. Overexpression of DIRAS2 promoted radiation resistance in ccRCC cells and enhanced the levels of radiation-induced autophagy. Moreover, inhibition of autophagy by chloroquine (CQ) pretreatment largely eliminated the effect of DIRAS2 overexpression on radiation resistance. Finally, molecular mechanism investigation showed that DIRAS2 activated the mitogen-activated protein kinase (MAPK) kinase 4 (MKK4)-c-Jun NH2-terminal kinase 1 (JNK1)-Bcl-2 pathway.

Taken together, these results indicated that DIRAS2 may confer radiation resistance to human RCC via autophagy induction through the MKK4-JNK1-Bcl-2 signalling pathway.

The assessment of central lymph node metastasis before operation guides the surgical plan for patients with papillary thyroid carcinoma (PTC). The aim of this study was to investigate the predictive value of the ultrasonography (US) features and American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) category in central lymph node metastasis in papillary thyroid carcinoma patients.

The retrospective study of 346 papillary thyroid carcinoma patients who received diagnosis and treatment at the authors’ institution from May 2016 to December 2021 was performed. The tumors were categorized based on the US features as well as the Kwak-TIRADS or ACR-TIRADS respectively. Correlation between US features and cervical lymph node metastasis (CLNM), as well as the effects of different TI-RADS categories on the prediction of CLNM were evaluated.

A total of 164 PTC patients (47.4%) were identified with CLNM. In univariable analysis, age (P<0.001), maximum diameter (P<0.001), clinging to the capsule (P<0.001), shape (P=0.003), and ACR-TIRADS score (P<0.001) exhibited significant association with cervical lymph node metastasis in PTC patients. In multivariable analysis, age, maximum diameter, taller-than-wide shape, and clinging to the capsule were the independent factors for CLNM (P<0.05). ACR-TIRADS score was also the independent factor for CLNM (OR=1.230, 95%CI 1.016-1.488, P=0.033).

The study indicated that preoperative ultrasonography features and the ACR-TIRADS category based thereon are effective to evaluate the CLNM risk and of diagnostic value for PTC patients.

To investigate the use of uniportal video-assisted thoracoscopic surgery (U-VATS) in the treatment of non-small cell lung cancer (NSCLC).

A total of 82 patients with early NSCLC in our hospital from May 2019 to January 2021 were enrolled to this study. Forty-one patients treated with spontaneous breathing U-VATS were the research group (RG), and 41 with conventional thoracoscopy were the control group (CG). Fasting peripheral blood was drawn from patients before (T0), one (T1) and three days after surgery (T2), respectively. White blood cells (WBC), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-9 (MMP-9) and T-lymphocyte subsets were measured in the blood. In addition, we counted the conversion rate to open chest and tracheal intubation in the RG, and compared the operation time, intraoperative bleeding, chest drainage, chest tube retention time, antibiotic application time, postoperative hospital stays and complications between groups. Finally, a 1-year prognostic follow-up was performed to record overall survival, chemotherapy rate, and recurrent metastasis rate.

At T1, WBC, IL-6, TNF-α, and MMP-9 were lower in the RG than in the CG, while immune function was better in the RG at T1 and T2 (P<0.05). Complication rates were lower in the RG than in the CG when compared (P>0.05). The prognosis of 1-year overall survival, chemotherapy rate, and recurrence rate were not different between the two groups (P>0.05).

Spontaneous breathing U-VATS can effectively reduce the inflammation and enhance the stability of immune function in NSCLC patients undergoing surgery.

To explore the application of intravoxel incoherent motion (IVIM) parameters based on mono- and bi-exponential models for diagnosing breast cancer (BC).

43 patients underwent breast magnetic resonance (MR) scanned before operation and the images were transferred to AW Volume Share 5 post-processing workstation. The mono-exponential and bi-exponential model was used to measure the slow diffusion coefficient (DC) (D), fast DC (D*) and fraction of perfusion (f). And the association between different parameter values and BC grading was analyzed via Spearman’s rank correlation coefficient.

The D mono value of 13 patients with benign breast diseases was higher than that of 30 patients with BC (4.04 ± 0.23 vs 2.59 ± 0.64，p<0.05) while there was no statistical significance on the value of D* mono, f mono, D bi, D* bi and f bi. Additionally, the parameter differences of D mono, D* mono, D bi and D* bi had statistical significance between the different BC grades. And the grades of BC had a negative correlation with D mono and D bi while were positively related to D* mono and D* bi. It was most closely related to D* bi than D bi. D mono value in ER-positive were higher than that in ER-negative group (3.09±0.37 vs 1.03±0.09, p=.0095).

IVIM could be used to diagnose BC, predict histological grading and ER expression and provide valuable imaging for the clinical treatment and prognosis of BC patients.

This study aimed to evaluate the capability of a novel non-Lead composite shield with a lower density compared to commercial Lead shield to protect against 10-100 keV X-ray.

In the present study, Monte Carlo calculations were performed to study the attenuation properties of a composite designed shield. For this reason, the attenuation rate of 8-material alloy including Tungsten, Bismuth, Barium, Gadolinium, Cesium, Cerium, Tin, and Antimony elements was compared to the 8-layers combination of these elements. Tungsten, Gadolinium, Cerium, and Bismuth were selected to simulate 4-layer and an alloy shields. The resulting X-ray fluence spectra attenuated by the designed shields were calculated.

Preliminary results showed that at the energy of 68 keV, the attenuation value by the 8-layer composition was 2.6 times higher than the value achievable by the alloy. It should be noted that the attenuation of 4-layer shield combined from Tungsten, Gadolinium, Cerium and Bismuth in the energy range of 72-100 keV, was 3.5 times higher than that of the alloy shield built from these elements.

According to the results, a combination of Tungsten, Gadolinium, Cerium, and Bismuth materials can be effectively used to create non-Lead shields. The four-layer shield with higher density offers better attenuation compared to the alloy shield.

To explore the diagnosis and evaluation efficacy of liver iron concentration (LIC) based on magnetic resonance quantitative technique in liver iron overload in patients with long-term transfusion.

From November 2021 to January 2023, 30 chronic aplastic anemia (CAA) patients with long-term blood transfusion admitted to our hospital were included as the study group. Simultaneously, 20 healthy volunteers with matched gender and age were included in the control group. The serum ferritin (SF), serum iron, total iron binding capacity and transferrin saturation (TSAT) between the two groups was calculated and compared. LIC was evaluated using Liver Magnetic resonance imaging (MRI)-T2* map imaging. The correlation between LIC and SF and TSAT was analyzed, and the diagnosis value of LIC in hepatic iron overload was calculated. Low-risk patients (n=22) diagnosed with iron overload received continuous regular iron removal treatment and the SF, TSAT and LIC were measured after 6 months.

SF, TSAT and LIC were higher in CAA patients relative to the healthy controls (P<0.05). LIC was positively correlated with SF (r=0.74, P<0.001) and TSAT (r=0.67, P<0.001). The sensitivity and specificity of LIC in the diagnosis of hepatic iron overload were 80.00% and 100% based on SF, and 76.0% and 100% based on TSAT, respectively. Additionally, SF, TSAT and LIC were all declined after 6 months of treatment (P<0.05).

The detection of LIC based on MRI-T2* is an effective and non-invasive means for the assessment of liver iron load in patients with long-term transfusion.

Juvenile fibroadenoma of the breast is a rare benign tumor, which mostly occur in young women. It is often manifested as a huge tumor with obvious enlargement of the breast, regular shape and clear boundary in the breast. This study reported an 18-year-old female, whose physical examination revealed a tough and mobile mass approximately 1.5 cm in diameter on her right breast, the patient had no clinical symptoms. MRI showed a irregular nodules with radial burrs, equisignal on T1WI, slightly high signal density on T2WI, high signal density on DWI, and heterogeneous signal on apparent diffusion coefficient (ADC) images, Enhanced scan showed margin enhancement, and the time-signal intensity curve (TIC) showed plateau and wash-out types. The mass was surgically excised, and histopathological examination revealed that it was a juvenile fibroadenoma tumor.

Pulmonary cryptococcosis (PC) of the lungs is a fungal infection often occurring in immunocompromised patients, which is most commonly contracted by inhalation. Here, we report the case of a 44-year-old woman who had undergone modified radical surgery for stage I intraductal carcinoma of the left breast one year earlier and had been undergoing endocrine therapy with tamoxifen. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) findings indicated multiple pulmonary nodules, which was highly suspicious of lung metastasis from breast cancer. However, the pathological results suggested cryptococcus infection. The patient was subsequently treated with itraconazole antifungal therapy. However, a chest computed tomography (CT) examination one month later revealed that both lung lesions were still present. Her clinician suspected they were due to her intake of the estrogen receptor inhibitor tamoxifen and asked her to stop temporarily taking the drug. One month later, chest CT reexamination revealed that the lung lesions had disappeared. So far, there have been no reports of pulmonary cryptococcosis caused by tamoxifen after breast cancer surgery. Our case study suggests that PC infection may be one of the rare side effects of tamoxifen and should be considered in the differential diagnosis of multiple nodules in both lungs in patients with a history of cancer surgery and taking estrogen receptor inhibitors. Therefore, the etiology of infections should be considered in the differential diagnosis, especially in patients taking estrogen receptor inhibitors after tumor surgery.

Brachytherapy is often used to treat oral cancer, as it generally yields a good outcome with little oral function loss. In particular, mold brachytherapy is ideally suited for superficial oral cases, such as cancers developing on the gingiva, palate, or buccal mucosa, with little to no bone involvement and thin tissue thickness. Mold brachytherapy including that at a high-dose-rate (HDR) is used to treat gingival cancer, though hospitalization is the typical treatment setting. Reported here are details of HDR mold brachytherapy performed in an outpatient setting for a mandibular gingival case of squamous cell carcinoma (SCC). Mandibular gingival SCC in a 71-year-old man was treated as an outpatient using HDR mold brachytherapy (54 Gy in 9 fractions, 5 days). After receiving mold treatment for thirty months, there was no sign of recurrence or metastasis. To our knowledge, this is the first report of HDR mold brachytherapy in an outpatient setting for treating mandibular gingival cancer.