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Wang C, Liu X, Li Y, Liu D, Yang L, Wang Y. Effects of psychological support intervention on patients with nasopharyngeal carcinoma undergoing radiotherapy. Pak J Med Sci 2024; 40:1420-1424. [PMID: 39092052 PMCID: PMC11255788 DOI: 10.12669/pjms.40.7.7875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 08/04/2024] Open
Abstract
Objective To find out the effects of psychological support intervention on patients with nasopharyngeal carcinoma undergoing radiotherapy. Methods This was a retrospective study. Sixty six patients with nasopharyngeal carcinoma who received radiotherapy in the Affiliated Hospital of Hebei University from March 2021 to March 2022 were included and randomly divided into the observation group and the control group, with 33 cases in each group. Patients in the control group were given conventional care measures, while those in the observation group were given psychological support intervention on top of conventional care measures. The nursing effects between the two groups were compared. Results After the intervention, the psychological resilience score of the observation group was significantly higher than that of the control group, with a statistically significant difference (P<0.05). The psychological resilience scores after the intervention were significantly higher in the observation group than before the intervention, and those in the control group were higher than before the intervention, with a statistically significant difference(P<0.05). The overall health score of quality of life in the observation group was significantly higher than that in the control group after the intervention, with a statistically significant difference(P<0.05). Moreover, the skin reaction in the observation group after radiotherapy was significantly better than that of the control group (P<0.01). Conclusion Psychological support intervention is an effective means to treat patients with nasopharyngeal carcinoma, which results in various benefits such as improving patients' mental resilience and quality of life and reducing the incidence of adverse reactions after radiotherapy.
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Affiliation(s)
- Ce Wang
- Ce Wang, Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
| | - Xiaohui Liu
- Xiaohui Liu, Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
| | - Yanhong Li
- Yanhong Li, Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
| | - Dongxue Liu
- Dongxue Liu, Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
| | - Litao Yang
- Litao Yang, Department of Orthopedics, Baoding NO.1 Central Hospital, Baoding, Hebei, 071000, China
| | - Yue Wang
- Yue Wang, Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
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Li X, Tao Y, Li H, Huang Z, Li Y, Gao Z, Zhu W, Li X, Yu Y. Periodontitis is associated with altered brain structure and function in normal cognition middle-aged and elderly individuals. J Periodontal Res 2024; 59:299-310. [PMID: 38014515 DOI: 10.1111/jre.13214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/19/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Numerous studies have proposed that periodontitis is a potential risk factor for Alzheimer's disease. However, the association between periodontitis and brain normal cognition in aged and elderly individuals (NCs) is unclear. Such a link could provide clues to Alzheimer's disease development and strategies for early prevention. OBJECTIVE To explore the associations between periodontal condition and metrics of both brain structure and function among NCs with the help of multimodal magnetic resonance imaging (MRI). METHODS High-resolution T1-weighted structural data, resting-state functional-MRI data, and measures of periodontal condition were collected from 40 NCs. Cortical volume, thickness, and area as well as regional homogeneity were calculated with the aid of DPABISurf software. Correlation analyses were then conducted between each imaging metric and periodontal index. RESULTS Consistent negative correlations were observed between severity of periodontitis (mild, moderate, severe) and cortical volume, area, and thickness, not only in brain regions that took charge of primary function but also in brain regions associated with advanced cognition behavior. Among participants with mild attachment loss (AL) and a shallow periodontal pocket depth (PPD), periodontal index was positively correlated with most measures of brain structure and function, while among participants with severe AL and deep PPD, periodontal index was negatively correlated with measures of brain structure and function (all p < .005 for each hemisphere). CONCLUSIONS Our results demonstrate that periodontitis is associated with widespread changes in brain structure and function among middle-aged and elderly adults without signs of cognitive decline, which might be a potential risk factor for brain damage.
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Affiliation(s)
- Xiaoshu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yufei Tao
- Department of Periodontics, Hefei Stomatological Clinic College, Anhui Medical University & Hefei Stomatological Hospital, Hefei, China
| | - Hui Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ziang Huang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuqing Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ziwen Gao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wanqiu Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Li Y, Gong F, Guo Y, Ng WT, Mejia MBA, Nei WL, Wang C, Jin Z. Predictive accuracy of machine learning for radiation-induced temporal lobe injury in nasopharyngeal carcinoma patients: a systematic review and meta-analysis. Transl Cancer Res 2023; 12:2361-2370. [PMID: 37859745 PMCID: PMC10583015 DOI: 10.21037/tcr-23-859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/18/2023] [Indexed: 10/21/2023]
Abstract
Background Radiotherapy is a common treatment for nasopharyngeal carcinoma (NPC) but can cause radiation-induced temporal lobe injury (RTLI), resulting in irreversible damage. Predicting RTLI at the early stage may help with that issue by personalized adjustment of radiation dose based on the predicted risk. Machine learning (ML) models have recently been used to predict RTLI but their predictive accuracy remains unclear because the reported concordance index (C-index) varied widely from around 0.31 to 0.97. Therefore, a meta-analysis was needed. Methods The PubMed, Web of Science, Embase, and Cochrane Library databases were searched from inception to November 2022. Studies that fully develop one or more ML risk models of RTLI after radiotherapy for NPC were included. The Prediction model Risk Of Bias Assessment Tool (PROBAST) was used to assess the risk of bias in the included research. The primary outcome of this review was the C-index, specificity (Spe), and sensitivity (Sen). Results The meta-analysis included 14 studies with 15,573 NPC patients reporting a total of 72 prediction models. Overall, 94.44% of models were found to have a high risk of bias. Radiomics was included in 57 models, dosimetric predictors in 28, and clinical data in 27. The pooled C-index for ML models predicting RTLI was 0.77 [95% confidence interval (CI): 0.75-0.79] in the training set and 0.78 (95% CI: 0.75-0.81) in the validation set. The pooled Sen was 0.75 (95% CI: 0.69-0.80) in the training set and 0.70 (95% CI: 0.66-0.73) in the validation set and the pooled Spe was 0.78 (95% CI: 0.73-0.82) in the training set and 0.79 (95% CI: 0.75-0.82) in the validation set. Models with radiomics and clinical data achieved the most excellent discriminative performance, with a pooled C-index of 0.895. Conclusions ML models can accurately predict RTLI at an early stage, allowing for timely interventions to prevent further damage. The kind of ML methods and the selection of predictors may influence the predictive accuracy.
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Affiliation(s)
- Yiling Li
- Vertigo Clinic/Research Center of Aerospace Medicine, Air Force Medical Center, PLA, Beijing, China
| | - Fengyuan Gong
- Graduate School, Hebei North University, Zhangjiakou, China
| | - Yangyang Guo
- Vertigo Clinic/Research Center of Aerospace Medicine, Air Force Medical Center, PLA, Beijing, China
| | - Wai Tong Ng
- Clinical Oncology Center and Shenzhen Key Laboratory for Cancer Metastasis and Personalized Therapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Wen-Long Nei
- Division of Radiation Oncology, National Cancer Center Singapore, Singapore, Singapore
| | - Cuicui Wang
- Vertigo Clinic/Research Center of Aerospace Medicine, Air Force Medical Center, PLA, Beijing, China
| | - Zhanguo Jin
- Vertigo Clinic/Research Center of Aerospace Medicine, Air Force Medical Center, PLA, Beijing, China
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Liang X, Wang L, Zhu Y, Wang Y, He T, Wu L, Huang M, Zhou F. Altered neural intrinsic oscillations in patients with multiple sclerosis: effects of cortical thickness. Front Neurol 2023; 14:1143646. [PMID: 37818221 PMCID: PMC10560735 DOI: 10.3389/fneur.2023.1143646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
Objective To investigate the effects of cortical thickness on the identification accuracy of fractional amplitude of low-frequency fluctuation (fALFF) in patients with multiple sclerosis (MS). Methods Resting-state functional magnetic resonance imaging data were collected from 31 remitting MS, 20 acute MS, and 42 healthy controls (HCs). After preprocessing, we first calculated two-dimensional fALFF (2d-fALFF) maps using the DPABISurf toolkit, and 2d-fALFF per unit thickness was obtained by dividing 2d-fALFF by cortical thickness. Then, between-group comparison, clinical correlation, and classification analyses were performed in 2d-fALFF and 2d-fALFF per unit thickness maps. Finally, we also examined whether the effect of cortical thickness on 2d-fALFF maps was affected by the subfrequency band. Results In contrast with 2d-fALFF, more changed regions in 2d-fALFF per unit thickness maps were detected in MS patients, such as increased region of the right inferior frontal cortex and faded regions of the right paracentral lobule, middle cingulate cortex, and right medial temporal cortex. There was a significant positive correlation between the disease duration and the 2d-fALFF values in the left early visual cortex in remitting MS patients (r = 0.517, Bonferroni-corrected, p = 0.008 × 4 < 0.05). In contrast with 2d-fALFF, we detected a positive correlation between the 2d-fALFF per unit thickness of the right ventral stream visual cortex and the modified Fatigue Impact Scale (MFIS) scores (r = 0.555, Bonferroni-corrected, p = 0.017 × 4 > 0.05). For detecting MS patients, 2d-fALFF and 2d- fALFF per unit thickness both performed remarkably well in support vector machine (SVM) analysis, especially in the remitting phase (AUC = 86, 83%). Compared with 2d-fALFF, the SVM model of 2d-fALFF per unit thickness had significantly higher classification performance in distinguishing between remitting and acute MS. More changed regions and more clinically relevant 2d-fALFF per unit thickness maps in the subfrequency band were also detected in MS patients. Conclusion By dividing the functional value by the cortical thickness, the identification accuracy of fALFF in MS patients was detected to be potentially influenced by cortical thickness. Additionally, 2d-fALFF per unit thickness is a potential diagnostic marker that can be utilized to distinguish between acute and remitting MS patients. Notably, we observed similar variations in the subfrequency band.
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Affiliation(s)
- Xiao Liang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lei Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanyan Zhu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yao Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ting He
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lin Wu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Medical Imaging, Nanchang University, Nanchang, Jiangxi, China
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Kang YF, Chen RT, Ding H, Li L, Gao JM, Liu LZ, Zhang YM. Structure–Function Decoupling: A Novel Perspective for Understanding the Radiation-Induced Brain Injury in Patients With Nasopharyngeal Carcinoma. Front Neurosci 2022; 16:915164. [PMID: 35860295 PMCID: PMC9289669 DOI: 10.3389/fnins.2022.915164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022] Open
Abstract
Radiation-induced functional and structural brain alterations are well documented in patients with nasopharyngeal carcinoma (NPC), followed by radiotherapy (RT); however, alterations in structure–function coupling remain largely unknown. Herein, we aimed to assess radiation-induced structure–function decoupling and its importance in predicting radiation encephalopathy (RE). We included 62 patients with NPC (22 patients in the pre-RT cohort, 18 patients in the post-RT-RE+ve cohort, and 22 patients in the post-RT-RE–ve cohort). A metric of regional homogeneity (ReHo)/voxel-based morphometry (VBM) was used to detect radiation-induced structure–function decoupling, which was then used as a feature to construct a predictive model for RE. Compared with the pre-RT group, patients in the post-RT group (which included post-RT-RE+ve and post-RT-RE–ve) showed higher ReHo/VBM coupling values in the substantia nigra (SN), the putamen, and the bilateral thalamus and lower values in the brain stem, the cerebellum, the bilateral medial temporal lobes (MTLs), the bilateral insula, the right precentral and postcentral gyri, the medial prefrontal cortex (MPFC), and the left inferior parietal lobule (IPL). In the post-RT group, negative correlations were observed between maximum dosage of RT (MDRT) to the ipsilateral temporal lobe and ReHo/VBM values in the ipsilateral middle temporal gyrus (MTG). Moreover, structure–function decoupling in the bilateral superior temporal gyrus (STG), the bilateral precentral and postcentral gyri, the paracentral lobules, the right precuneus and IPL, and the right MPFC exhibited excellent predictive performance (accuracy = 88.0%) in identifying patients likely to develop RE. These findings show that ReHo/VBM may be a novel effective imaging metric that reflects the neural mechanism underlying RE in patients with NPC.
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Affiliation(s)
- Ya-fei Kang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi’an, China
| | - Rui-ting Chen
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Hao Ding
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, China
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jian-ming Gao
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Li-zhi Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - You-ming Zhang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: You-ming Zhang,
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Wan L, Huang RJ, Yang C, Ai JQ, Zhou Q, Gong JE, Li J, Zhang Y, Luo ZH, Tu E, Pan A, Xiao B, Yan XX. Extracranial 125I Seed Implantation Allows Non-invasive Stereotactic Radioablation of Hippocampal Adult Neurogenesis in Guinea Pigs. Front Neurosci 2021; 15:756658. [PMID: 34916901 PMCID: PMC8670234 DOI: 10.3389/fnins.2021.756658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Adult hippocampal neurogenesis (AHN) is important for multiple cognitive functions. We sort to establish a minimal or non-invasive radiation approach to ablate AHN using guinea pigs as an animal model. 125I seeds with different radiation dosages (1.0, 0.8, 0.6, 0.3 mCi) were implanted unilaterally between the scalp and skull above the temporal lobe for 30 and 60 days, with the radiation effect on proliferating cells, immature neurons, and mature neurons in the hippocampal formation determined by assessment of immunolabeled (+) cells for Ki67, doublecortin (DCX), and neuron-specific nuclear antigen (NeuN), as well as Nissl stain cells. Spatially, the ablation effect of radiation occurred across the entire rostrocaudal and largely the dorsoventral dimensions of the hippocampus, evidenced by a loss of DCX+ cells in the subgranular zone (SGZ) of dentate gyrus (DG) in the ipsilateral relative to contralateral hemispheres in reference to the 125I seed implant. Quantitatively, Ki67+ and DCX+ cells at the SGZ in the dorsal hippocampus were reduced in all dosage groups at the two surviving time points, more significant in the ipsilateral than contralateral sides, relative to sham controls. NeuN+ neurons and Nissl-stained cells were reduced in the granule cell layer of DG and the stratum pyramidale of CA1 in the groups with 0.6-mCi radiation for 60 days and 1.0 mCi for 30 and 60 days. Minimal cranial trauma was observed in the groups with 0.3– 1.0-mCi radiation at 60 days. These results suggest that extracranial radiation with 125I seed implantation can be used to deplete HAN in a radioactivity-, duration-, and space-controllable manner, with a “non-invasive” stereotactic ablation achievable by using 125I seeds with relatively low radioactivity dosages.
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Affiliation(s)
- Lily Wan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Anatomy and Neurobiology, Central South University Xiangya School of Medicine, Changsha, China
| | - Rou-Jie Huang
- Medical Doctor Program, Xiangya School of Medicine, Central South University, Changsha, China
| | - Chen Yang
- Department of Anatomy and Neurobiology, Central South University Xiangya School of Medicine, Changsha, China
| | - Jia-Qi Ai
- Department of Anatomy and Neurobiology, Central South University Xiangya School of Medicine, Changsha, China
| | - Qian Zhou
- Medical Doctor Program, Xiangya School of Medicine, Central South University, Changsha, China
| | - Jiao-E Gong
- Department of Neurology, Hunan Children's Hospital, Changsha, China
| | - Jian Li
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Yun Zhang
- Department of Anesthesiology, The 2nd Xiangya Hospital Central South University, Changsha, China
| | - Zhao-Hui Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ewen Tu
- Department of Neurology, Brain Hospital of Hunan Province, Changsha, China
| | - Aihua Pan
- Department of Anatomy and Neurobiology, Central South University Xiangya School of Medicine, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Xin Yan
- Department of Anatomy and Neurobiology, Central South University Xiangya School of Medicine, Changsha, China
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