Objective To evaluate the feasibility of interstitial implantation of ~(125)I seeds for recurrent or metastatic malignant tumor at the Head and Neck.Methods From January 2003 to July 2007,29 patients received interstitial implantation of ~(125)I seeds in our hospital because of recurrent or metastatic malignant tumors at the head or neck after surgery or chemotherapy.Under local anesthesia and guidance of CT,B-ultrasonography,or endoscopy,~(125)I seeds were implanted into the tumor tissues with intervals of 0.5-1.0 cm.The matched peripheral dose(MPD)was 90-160 Gy,and the radioactive activity was set at 29.6 MBq per seed.Results The operation was completed in all the patients.A median of 23 seeds(12-67)were implanted in each case.No complications,such as hemorrhage,infection,or seed migration,occurred in the patients.The patients were followed up for 3-24 months(mean,16 months).During the period,the rate of local control was 55%(16/29)at 3 months,71%(20/28)at 6 months,45%(10/22)at 12 months,and 36%(5/14)at 2 years.Conclusion Interstitial implantation of ~(125)I seeds is feasible for recurrent or metastatic tumor at the head or neck with a good short-term outcome.

Purpose:To study the diagnosis and management of postoperative chylothosax for resection of lung cancer.Methods:Clinical data of 8 patients with lung cancer who had postoperative chylothorax were analyzed retrospectively. Results:4 cases were treated by conservative treatment, among them 2 cases were cured, the other 2 cases had respiratory failure. The rest were cured by tieing off the ductus thoracicus. Conclusions:It is suggested that in the management of postoperative chylothorax, conservative treatment or tieing off the ductus thoracicus, depending on the patients' condition.

Objective: To observe the biocompatibility of acellular nerve scaffold (ANS) via three sterilization methods, to provide experimental data for tissue engineering industrialization. Methods: Pig sciatic nerves were cut and treated using the NaOH maceration method. ANSs were sterilized by ethylene oxide, ~(60)Co-irradiation and peracetic acid. Evaluated the biocompatibility by MTT, cellular compatibility test, collagenase susceptibility test in vitro and local implantation test. Results: ANS retained the integrity of structure and major components of the basement membrane. The result of MTT test showed that the ANSs via different sterilization methods had statistical differences. There were no overall significant differences in Collagenase susceptibility test. Scanning electron microscope results showed the skin fibroblasts could attach, proliferate and grow well on the surface and holes of ANS with sterilization of PAA and Co~(60),a small quantity of cells adhered on ANS with sterilization of ETO. Tests for local effects after implantation show that different sterilization methods don't effect the ability of ANS to resist the enzyme degradation. In ETO group, rats showed an acute inflammatory response followed by chronic inflammation. In PAA and ~(60)Co group rats showed an acute inflammatory response that diminished such that the graft ultimately became indistinguishable from native tissue, observations that were consistent with graft acceptance. Conclusion: Peracetic acid sterilization offers a convenient alternative protocol for ANS processing. ANS sterilized with PAA shows good compatibility and biologic safety. It is an ideal sterilization method for ANS.

BACKGROUND: Interleukin-1 (IL-1β) and intercellular adhesion molecule-1 (ICAM-1 ) can mediate neutrophilic infiltration, which is closely relevant to cerebral ischemia-reperfusion injury.OBJECTIVE: To investigate the effect of physcion on cerebral inflammatory reaction after ischemia-reperfusion injury.DESIGN: A completely randomized study based on animals.SETTING: Neurological department in a university hospital.MATERIALS: From September to December 2003, the study was conducted in the Animal Laboratory, Hebei Staff and Workers Medical College. Totally 91 healthy male SD rats, supplied by Laboratory Animal Center of Hebei Medical University, were used in the experiments. They were divided into sham operation (SO) group, ischemia-reperfusion group, normal control group, 20 mg/kg physcion group and 40 mg/kg physcion group.Each of the former two groups would be divided into 4 subgroups named as the 6th-hour-after-reperfusion group, the 12th-hour-after-reperfusion group, the 24th-hour-after-reperfusion group and the 48th-hour-after-reperfusion group. Each of the latter two groups were divided into 2 subgroups named as the 12thhour-after-reperfusion group and the 24th-hour-after-reperfusion group. Each subgroup contained 7 rats.INTERVENTIONS: Middle cerebral artery occlusion model (MCAO model) was applied, and IL-1β was measured by radioimmunoassay and ICAM-1 was detected by immunohistochemical staining.MAIN OUTCOME MEASUREMENTS: The IL-1 β level and the positive expression of ICAM-1 in the rats' cerebella were observed.RESULTS: Cerebral ischemia-reperfusion injury in the rats reached its peak 6 hours after reperfusion, and then it decreased gradually. In the 12-hour-after-reperfusion subgroup amd the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group, and the 12-hour-after-reperfusion subgroup of the 20 mg/kg physcion group, IL-1β in the injured parts of the cerebella decreased dramatically, compared with MCAO model controls ( P＜ 0.01 ). In the normal control group and SO group, a small quantity of ICAM-1 was detected in rat' s cerebral cortex, and some fulvous staining substance was observed in the plasma and membrane of cerebral vascular endothelium cells. In the cerebral ischemia-reperfusion injury group, positive staining substance could be observed 24 hours after the reperfusion, then darkened gradually (integral absorbency value: 31.89 ± 4.38, area density value: 0. 018 5 ± 0. 003 1). In the 12-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 13.33 ±6. 12, area density value: 0. 007 6 ± 0. 002 2) and the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 20.04 ±4.65,area density value: 0. 012 9 ±0. 003 6), and in the 24-hour-after-reperfusion subgroup of the 20 mg/kg physcion group (integral absorbency value:23.73 ±4.51 area density value: 0. 014 1 ±0. 003 8), expressions of ICAM-1 around the infarctions significantly decreased as compared with those in the MCAO model controls respectively ( P ＜ 0.01 or P ＜ 0.05).CONCLUSION: Physcion tends to decrease the expressing of IL-1β and ICAM-1 in a cerebellum after ischemia-reperfusion injury, thus, it may help alleviate the ischemia-reperfusion injury.

Objective To study the effect of 125Iodine seed on the rabbit ischiadic nerve at different time point after implantation. Methods Thirty healthy New-Zealand rabbits were randomly assigned into 3 groups( 2-week group, 2-month group and 4-month group) using envelope method. During operation, 10 radioactive 125I seeds were implanted randomly near one of the ischiadic nerve, while 10 non-radioactive seeds were implanted into the contralateral ischiadie nerve. According to treatment plan system(TPS),90% of the prescription dose (PD)was centered in the specific place, where the nerves were chosen to be studied. After 2 weeks, 2 months and 4 months respectively, nerve electro-physiolngy experiment was used to evaluate the bilateral ischiadic nerves, at the same time the morphology of the ischiadic nerve was examined by general observation, light microscope and electron microscope. The electron microscope photo with the same ×4000 amplification was divided into 100( 10 × 10) cages and non-specific changes in one cage account for 1%. The t test and sum rank test were used for statistics. Results Potential leaking point of experimental ischiadic nerves near heart in 2-week group ,2-month group and 4-month group were (0.52± 0.26), (0.60±0.19), (0.48±0.17)V, while that of the control sides were (0.59±0.19), (0.60± 0.15), (0.53±0.13 ) V, there was no statistical significance in the same group respectively (t=0.91, 0.03,0.67,P>0.05). Potential leak point of experimental ischiadic nerves far from heart in 2-week group, 2-month group and 4-month group were (0.51±0.15), (0.52 s0. 11 ), (0. 53±0.15) V,the control sides were (0.52±0.10), (0.56±0.12), (0.54±0.10)V, there was no statistical significance in the same group respectively (t= 0.25,0.74,0.17, P > 0.05 ). Action potential amplitude of experimental ischiadic nerves near heart in 2-week group,2-menth group and 4-month group were (13.18±4.09), (12.78± 4.42), (12.09±1.20) mV, while that of the control sides were (10.55± 4.21 ), ( 10.31±4.22), (12.88±3.54) mV, there was no statistical significance in the same group respectively (t=1.57,1.36, 0.50,P>0.05). Action potential amplitude of experimental ischiadic nerves far from heart in 2-week group,2-month group and 4-month group were (11.18±3.38), (11.68±3.21), ( 12.52±3.09) mV, while that of the control sides were (11.56±4.80), (10.71±3.40), (11.67±2.48) mV ,there was no statistical significance in the same group respectively(t=0.29,1.01,0.55, P>0.05 ). Nerve conduction velocity of experimental ischiadic nerves in 2-week group,2-month group and 4-month group were (40.56± 9.46), (38.79±5.78), (39.44±8.64) m/V, the control sides were (42.56±6.59), (44.64±7.53), (43.33±6.05)m/V, there was no statistical significance in the same group respectively( t = 0.57,1.94, 0.01,P>0.05). There were some changes in general observation and light microscope, in electron microscope, many non-specificity changes were observed. All of these changes included delamination, collapse, disaggregation of the myelinated nerve, mitochondria swelling and vacuolization of neurilemma cell and axon. The ratio of degenerative alterations in nerves was 60% --70% in 2-week group, 50% in 2-month group and 30% in 4-month group, and there was statistical significance among three groups (P<0.05). Conclusion 125I permanent plantation in our test dose has little effect on ischiadic nerve, all these non-specificity changes were observed in electron microscope, and it has no evident impacts on physiological functions.

Objective To observe the MR findings of myxoid-round cell liposarcoma of the lower extremities and to evaluate therelationship between MR findings and pathologic features. Methods MR findings of 6 myxoid-round cell liposarcomas of the lowerextremities confirmed pathologically were retrospectively reviewed,including tumor's location,size,morphology,internal architecture and signal intensity characteristics on T_1WI,T_2WI and SPIR T_2WI and the pattern of enhancement.Results All tumors were located in thedeep space among skeletal muscles of the lower extremities,with unregular shape,sharp borber and thick septal structures.Tumors werehomogeneous or heterogeneous isointense on T_1WI and hyperintense on T_2WI relative to the signal intensity of skeletal muscles and heterogeneous enhancement after the injection of GdDTPA.Conclusion MRI may lead to a correct diagnosis of myxoidround cell liposarcoma of the lower extremities.

Objective:To investigate the curative effect and safety of Stoppa approach combined with iliac fossa approach in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture, and to provide a scientific evidence for its application in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture.Methods:Sixty-three patients with coxafossa anterior column or coxafossa dual column bone fracture were selected;among them 32 cases were treated with stoppa approach combined iliac fossa approach(Stoppa group),and 31 patients were treated with ilioinguinal approach(control group).The intraoperative blood loss volume,the operaton time,the reset quality of fracture and hip joint function after operation of the patients in two groups were evaluated.Results:The intraoperative blood loss volume of the patients in Stoppa group was lower than that in control group, and the difference was statistically significant (P<0.05).The operation time of the patients in Stoppa group was shorter than that in control group, and the difference was statistically significant (P<0.05).The reset quality of fracture of the patients in stoppa group was higher than that in control group, and the difference was statistically significant (P<0.05).The hip joint function of the patients in Stoppa group was higher than that in control group, and the difference was statistically significant (P<0.05).Conclusion:Stoppa approach combined with iliac fossa approach is an effective method in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture with sufficient exposure and tiny tissue damage.Stoppa approach combined with iliac fossa approach in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture has the advantages of shorter operative time,less blood loss, higher rate of anatomic reduction,and good joint function.

Objective To study the correlation of human cytomegalovirus infection with carotid atherosclerosis.Methods A total of 120 patients with carotid atherosclerosis and 140 healthy control patients were recruited for HCMV-PP65 antigen detection and Ultrasound examination.Results In carotid atherosclerosis and healthy patients,58.20％(71 cases)and 6.43％(9 cases)of the subjects were positive for HCMV-PP65 antigen(x2 =32.98,P ＜ 0.05).In carotid atherosclerosis group,69.01％(49 cases)of the patients with positive HCMV-PP65 antigen had instable plaques,while it was 47.06％(24 cases)in the patients with negative HCMV-PP65 antigen.The difference in the positivity of HCMV-PP65 between the two groups were significant(x2 =8.22,P ＜ 0.05).Conclusion Active infection of HCMV may be associated with Carotid Atherosclerosis and the plaques will be more instable.

Objective To detect the meshwork of tiny lymphatic channels at bilateral vertebral body and ventral aorta at 3.0 Tesla and to probe the relationship between its detective ratio and some diseases.Methods Fat-suppressed T2-weighted imaging in 91 patients was performed at the upper abdomen. The meshworks of tiny lymphatic channels at bilateral vertebral body and ventral aorta on contiguous axial and coronal images were reviewed. The classifications of the lymphatic meshwork were made according to its width and length on coronal images. The differences in the detective ratios of the lymphatic meshwork between control group and the risk ones including portal hypertension group, choledochus obstruction group and malignant tumour group were analyzed.Results Right- or left-sided lymphatic meshwork at vertebral body or ventral aorta were 34.07%(31/91),32.97%(30/91),32.97%(30/91) and 43.96%(40/91) respectively. The detective ratio of the lymphatic meshwork on the side of the ventral aorta was higher significantly in the portal hypertension group than that in the control or malignant tumour one (P0.05). Conclusion Meshwork of tiny lymphatic channels at bilateral vertebral body and ventral aorta allows to be detected on fat-suppressed T2-weighted imaging at 3.0 Tesla, and the portal hypertension may influence the detective ratio of the lymphatic meshwork on the side of the ventral aorta.

Objective To evaluate the safety and efficacy of 125I seed strands cavity brachytherapy for ureteral carcinoma.Methods To tally 10 patients with ureteral carcinoma underwent Carm CT and DSA guided percutaneous nephrostomy with 125I seed strands cavity brachytherapy.The technical success rate,complications,tumor local control rate,ureteral patency andsurvival time,and compared the Karnofsky scores,Girignon grade,pain score before and after treatment were evaluated.The dose related parameters were compared between pre-and post-treatment.Results 125I seed strands implantation was successfully completed in all patients with technical success rate of 100％.The mean procedure time was (12.3 ±3.8) min.No severe complications such as ureteral perforation,infection,severe bleeding occurred.Local tumor response was CR in 4 cases and PR in 6 cases,showing local control efficiency (CR + PR) 100％ after 2-3 months.Ureteral patency rate was 50％ (5/10).Postprocedure Karnofsky scores,Girignon grades,and pain scores were significantly improved (Z =-2.72,-2.88,-2.83,P＜0.01).The average follow-up time was (14.6 ±6.5) months (5-25 months),tumor progression was observed in 3 cases,stable disease in 7 cases.Nine cases were alive and one died due to multiple organ failure.The differences of D90％,mPD,V100％,V150％,V200％,CI,EI,HI between the preand post-treatment were not statistically significant (P ＞ 0.05).Conclusions 125I seed strands cavity brachytherapy for ureteral carcinoma is an effective and safe procedure without serious complications,and an effective alternative treatment for patients who are unable to undergoor refuse surgery.