ObjectiveTo systematically summarize recent advancements in the application of artificial intelligence (AI) in key components of radiotherapy (RT), explore the integration of technical innovations with clinical practice, and identify current limitations in real-world implementation. MethodsA comprehensive analysis of representative studies from recent years was conducted, focusing on the technical implementation and clinical effectiveness of AI in image reconstruction, automatic delineation of target volumes and organs at risk, intelligent treatment planning, and prediction of RT-related toxicities. Particular attention was given to deep learning models, multimodal data integration, and their roles in enhancing decision-making processes. ResultsAI-based low-dose image enhancement techniques had significantly improved image quality. Automated segmentation methods had increased the efficiency and consistency of contouring. Both knowledge-driven and data-driven planning systems had addressed the limitations of traditional experience-dependent approaches, contributing to higher quality and reproducibility in treatment plans. Additionally, toxicity prediction models that incorporated multimodal data enabled more accurate, personalized risk assessment, supporting safer and more effective individualized RT. ConclusionsRT is a fundamental modality in cancer treatment. However, achieving precise tumor ablation while minimizing damage to surrounding healthy tissues remains a significant challenge. AI has demonstrated considerable value across multiple technical stages of RT, enhancing precision, efficiency, and personalization. Nevertheless, challenges such as limited model generalizability, lack of data standardization, and insufficient clinical validation persist. Future work should emphasize the alignment of algorithmic development with clinical demands to facilitate the standardized, reliable, and practical application of AI in RT.
Objective To evaluate the quality of clinical studies on dentistry from the Chinese Journals. Methods Clinical studies in Chinese Journal of Conservative Dentistry of 2002 were searched. The quality of the clinical studies on assessment of treatments’ efficacy was evaluated. Results Among 204 related studies from 12 issues, there were 93 (45.58%) restrospective intervention studies, 6 randomized controlled blinded trials (2.94%), 42 randomized trials without blindness (20.58%), 20 controlled trials without randomization (9.80%) and 25 clinical observational studies (12.25%). The statistical analysis showed that 20 studies were with inappropriate methods. Conclusions It is necessary to improve the design and statistical analysis of clinical studies on stomatology in China to produce high-quality research evidence.
ObjectiveTo explore the standardized index system of quality control for single disease of day surgery in Shanghai municipal hospitals.MethodsFrom April to November 2020, through literature research and comprehensive analysis of research results, the framework of quality control index system for single disease of day surgery focusing on obstructive sleep apnea hypopnea syndrome surgery and laparoscopic cholecystectomy was constructed; Delphi method was used to evaluate the quality of day surgery in terms of results, objectivity, statistics, sensitivity, accessibility, quantifiability, importance, and guidance. Finally, the final indicators were screened out.ResultsAfter three rounds of Delphi investigation, 18 experts finally formed 14 general indexes and 14 personalized indexes (6 for obstructive sleep apnea hypopnea syndrome and 8 for laparoscopic cholecystectomy) in the single disease of day surgery quality control index system.ConclusionsThe general indexes and personalized indexes quantifying the quality control index for single disease of day surgery are conducive to the standardization and standardized management of day surgery, and can provide a reference for improving the medical quality and safety, and sustainable development of day surgery.
Recently, the increasing risk of drug development has impelled pharmaceutical enterprises to improve ways of research and exploitation. Adaptive design has been proposed for decades. Although the theory of this design is not perfect, it has been recognized and applied worldwide as a decreasing risk of drug development to a certain extent. The traditional fixed design in western medicine isn’t entirely suitable for traditional Chinese medicine (TCM), while the adaptive design with integrity and variability features provides a new idea for TCM development. Hereby the application of adaptive design in TCM is regarded as an important procedure for promoting TCM modernization, and it has a wide prospective.
As one of the standard electrophysiological signals in the human body, the photoplethysmography contains detailed information about the blood microcirculation and has been commonly used in various medical scenarios, where the accurate detection of the pulse waveform and quantification of its morphological characteristics are essential steps. In this paper, a modular pulse wave preprocessing and analysis system is developed based on the principles of design patterns. The system designs each part of the preprocessing and analysis process as independent functional modules to be compatible and reusable. In addition, the detection process of the pulse waveform is improved, and a new waveform detection algorithm composed of screening-checking-deciding is proposed. It is verified that the algorithm has a practical design for each module, high accuracy of waveform recognition and high anti-interference capability. The modular pulse wave preprocessing and analysis software system developed in this paper can meet the individual preprocessing requirements for various pulse wave application studies under different platforms. The proposed novel algorithm with high accuracy also provides a new idea for the pulse wave analysis process.
Objective To explore the feasibility and effectiveness of vertebroplasty with reverse designed unilateral targeted puncture in treatment of osteoporotic vertebral compression fracture (OVCF) by comparing with curved unilateral puncture. Methods A total of 52 patients with OVCF met selection criteria and were admitted between January 2019 and June 2021 were selected as the research objects. According to the random number table method, they were divided into two groups (n=26). In trial group, the reverse designed unilateral targeted puncture was used in the percutaneous vertebroplasty (PVP); while the control group used the curved unilateral puncture. There was no significant difference in gender, age, bone mineral density (T value), cause of injury, time from injury to operation, the level of responsible vertebral body, pedicle diameter of the planned puncture vertebral body, and preoperative visual analogue scale (VAS) score, anterior vertebral height, and Cobb angle between the two groups (P>0.05). The operation time, bone cement injection volume and leakage, intraoperative radiation exposure times, and hospitalization costs in the two groups were recorded. VAS score was used to evaluate the relief degree of low back pain after operation. X-ray film was used to review the diffusion degree of bone cement in the responsible vertebral body, and Cobb angle and anterior vertebral height were measured. Results The operation was successfully completed in the two groups. Patients in the two groups were followed up 12-18 months, with an average of 13.6 months. The operation time, volume of injected bone cement, intraoperative radiation exposure times, and hospitalization costs in the trial group were significantly lower than those in the control group (P<0.05). With the prolongation of time, the low back pain of the two groups gradually relieved, and the VAS score significantly decreased (P<0.05). And there was no significant difference in VAS score between the two groups at each time point (P>0.05). There were 2 cases (7.6%) of bone cement leakage in the trial group and 3 cases (11.5%) in the control group, and no significant difference was found in the incidence of bone cement leakage and the diffusion degree of bone cement between the two groups (P>0.05). Imaging examination showed that compared with pre-operation, the anterior vertebral height of the two groups significantly increased and Cobb angle significantly decreased at 2 days and 1 year after operation (P<0.05); while compared with 2 days before operation, the anterior vertebral height of the two groups significantly decreased and Cobb angle significantly increased at 1 year after operation (P<0.05). There was no significant difference in the above indexes between the two groups at different time points after operation (P>0.05). Conclusion Compared with curved unilateral puncture, the use of reverse designed unilateral targeted puncture during PVP in the treatment of OVCF can not only achieve similar effectiveness, but also has the advantages of less radiation exposure, shorter operation time, and less hospitalization costs.
In order to promote the effective development of hospital day surgery mode, a construction method of information management platform that meets the characteristics of day surgery mode is presented. By analyzing the business process of the day surgery mode, the system architecture of the information platform is given; according to the difficulty of the surgical scheduling, the two-stage surgical scheduling algorithm based on the ranking theory is given; by analyzing the day surgery data statistically, a multi-angle surgical index analysis module is provided. The information management of the day surgery mode has been realized, and the work efficiency has been improved. A reasonable day surgery information platform construction can help to optimize the daytime surgical procedure and promote the smooth development of day surgery.
ObjectiveTo explore the clinical value of computer-assisted surgical planning in the treatment of ankle fractures. MethodsBetween January 2012 and January 2014, open reduction and internal fixation were performed on 42 patients with ankle fractures. There were 22 males and 20 females with an average age of 52 years (range, 19-72 years). The causes were spraining injury (20 cases), traffic accident injury (14 cases), and falling from height injury (8 cases). The time from injury to operation was 5 hours to 12 days (mean, 2.5 days). All fractures were closed trimalleolar fractures. According to Lauge-Hansen classification, 25 cases were rated as supination extorsion type IV, 13 as pronation extorsion type IV, and 4 as pronation abduction type Ⅲ. The preoperative planning was made by virtual reduction and internal fixation using Superimage software. ResultsThe mean operation time was 93.7 minutes (range, 76-120 minutes). Delayed wound healing occurred in 1 case, and secondary healing was obtained after treatment; primary healing of incision was achieved in the other patients. Postoperative X-ray films and CT images showed anatomic reduction of fracture and good position of internal fixation. All patients were followed up 14.6 months on average (range, 9-27 months). The range of motion of the affected ankle was close to the normal side at 6-8 weeks. The mean fracture healing time was 13.1 weeks (range, 11-17 weeks). Degenerative change of the ankle joint was observed in 3 cases (7.1%) with manifestation of mild narrowing of joint space on the X-ray films at last follow-up. According to Baird-Jackson score system, the results were excellent in 24 cases, good in 13 cases, and fair in 5 cases, with an excellent and good rate of 88%. ConclusionComputer-assisted surgical planning for ankle fractures can help surgeons identify type of ankle fractures and improve surgical scheme for guiding fracture reduction and selecting and placing implants, so good effectiveness can be obtained.
A good cushion can not only provide the sitter with a high comfort, but also control the distribution of the hip pressure to reduce the incidence of diseases. The purpose of this study is to introduce a computer-aided design (CAD) modeling method of the buttocks-cushion using numerical finite element (FE) simulation to predict the pressure distribution on the buttocks-cushion interface. The buttock and the cushion model geometrics were acquired from a laser scanner, and the CAD software was used to create the solid model. The FE model of a true seated individual was developed using ANSYS software (ANSYS Inc, Canonsburg, PA). The model is divided into two parts, i.e. the cushion model made of foam and the buttock model represented by the pelvis covered with a soft tissue layer. Loading simulations consisted of imposing a vertical force of 520N on the pelvis, corresponding to the weight of the user upper extremity, and then solving iteratively the system.