METHODS: 52 prostate cancer patients who had completed radiotherapy were selected and randomly divided into 2 groups with 40 and 12 separately. Then both VMAT and IMRT plans were manually designed for all patients. The total plans in the group with 40 cases as training datasets were added to the knowledge-based planning (KBP) models for learning and finally obtained VMAT and IMRT training models. Another 12 cases were selected as the validation group to be used to generated auto IMRT plans by KBP VMAT and IMRT models. At last, the radiotherapy plans from three groups were obtained: the automated IMRT plan (V-IMRT) predicted by the VMAT model, the automated IMRT plan (I-IMRT) predicted by the IMRT model and the manual IMRT plan (M-IMRT) designed before. The dosimetric parameters of planning target volume (PTV) and organ at risks (OARs) as well as the time parameters (monitor unit, MU) were statistically analyzed.
RESULTS: The dose limit of all plans in the training datasets met the clinical requirements. Compared with the training plans added to VMAT model, the dosimetry parameters have no statistical differences in PTV (P > 0.05); the dose of X% volume (Dx%) with D25% and D35% in rectal and the maximum dose (Dmax) in the right femoral head were lower (P = 0.04, P = 0.01, P = 0.00) while D50% in rectal was higher ( 0.05), but the Dmax in left femoral heard and D15% in the right femoral head were lower and have significant differences (P 0.05).
CONCLUSION: Compared with the manual plan, the IMRT plans generated by the KBP models had a significant advantage in dose control of both OARs and PTV. Compared to the I-IMRT plans, the V-IMRT plans was not only without significant disadvantages, but it also achieved slightly better control of the low-dose region, which meet the clinical requirements and can used in the clinical treatment. This study demonstrates that it is feasible to transfer the KBP VMAT model in the prediction of IMRT plans.
STUDY DESIGN: A cross-sectional survey.
METHODS: A questionnaire was developed for exploring the sociodemographic characteristics of the respondents, their self-medication status, and important considerations. The questionnaire includes several scales including Health Literacy Scale-Short Form (HLS-SF), EQ-5D Visual Analog Scale (EQ-5D-VAS), Big Five Inventary-10 Items (BFI-10), and New General Self Efficacy Scale (NGSES). After carrying out a multi-stage sampling method, the questionnaire was conducted nationwide from July 10 to September 15, 2021. Next, descriptive statistics were conducted to analyze the general features. Logistic regression was then used to analyze the related factors of the possibility that the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs.
RESULTS: Nine thousand two hundred fifty-six qualified questionnaires were received. 99.06% of Chinese adults had self-medication behaviors. The types of OTC drugs purchased most by the respondents were NSAIDs (5,421/9,256 people, 58.57%) and vitamins/minerals (4,851/9,256 people, 52.41%). 86.2% of the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. The results of multi-factor logistic regression showed that women, those living in the central and western regions of China, those suffering from chronic diseases, those with high agreeableness, high conscientiousness, high neuroticism and openness, high health literacy, high EQ-5D-VAS, and those with high self-efficacy are more likely to take medical staff's suggestions as important factors to consider.
CONCLUSION: The vast majority of Chinese adults have self-medication behavior. Important considerations when purchasing OTC drugs include medical staff's suggestions, drug safety and drug efficacy. Whether residents take the suggestions of medical staff as an important consideration is related to their sociological characteristics, agreeableness, conscientiousness, neuroticism, openness, health literacy, self-assessment health status, and self-efficacy. When purchasing and using OTC drugs, residents should carefully listen to the suggestions from medical staff. They should also carefully consider their own conditions before buying OTC drugs.
Objective: In this study, we aimed to examine the effect of MAN on human lung cancer and reveal the underlying molecular mechanism.
Methods: MTT assay was conducted to measure cell viability. Annexin V-FITC/PI staining was used to detect cell apoptosis. Confocal microscope was performed to determine the formation of autophagosomes and autolysosomes. Flow cytometry was performed to quantify cell death. Western blotting was used to determine the related-signaling pathway.
Results: In the present study, we demonstrated for the first time that MAN inhibitd cell proliferation and induced cell apoptosis in human non-small-cell lung carcinoma (NSCLC) cells. We found that MAN treatment dysregulated mitochondrial function and led to mitochondrial apoptosis in A549 and PC9 cells. Meanwhile, MAN enhanced autophagy flux by the increase of autophagosome formation, the fusion of autophagsomes and lysosomes and lysosomal function. Moreover, mTOR signaling pathway, a classical pathway regualting autophagy, was inhibited by MAN in a time- and dose-dependent mannner, resulting in autophagy induction. Interestingly, autophagy inhibition by CQ or Atg5 knockdown attenuated cell apoptosis by MAN, indicating that autophagy serves as cell death. Furthermore, autophagy-mediated cell death by MAN can be blocked by reactive oxygen species (ROS) scavenger NAC, indicating that ROS accumulation is the inducing factor of apoptosis and autophagy. In summary, we revealed the molecular mechanism of MAN against lung cancer through apoptosis and autophagy, suggesting that MAN might be a novel therapeutic agent for NSCLC treatment.