With the development of modern technology,X-ray machine has been widely applied for medical diagnosis.The article simply reported the principle of medical X-ray machine and its maintenance,and also illustrated two troubleshooting cases of Siemens'X-ray machine.

objective To evaluate the therapeutic efficacy of endovenous radiofrequency ablation in combination with TriVex for the treatment of chronic venous insufficiency (CVI)of the lower extremity.Methods One hundred and fifty CVI cases(150 limbs)were randomly assigned to Group A(75 limbs)and Group B(75 limbs).Patients in Group A were treated with greater saphenous vein radiofrequency ablation procedures in combination with TriVex.Patients in Grpup B were treated with greater saphenous vein traditional stripping operation in combination with TriVex.The short-term results in hospital and patient self-assessment for the operation at postoperative 4 week were compared with each other:The changes of CEAP classification and venous clinical severity score(VCSS)were compared. Results Operation time was(67±11)min in Group A versus(69-4-9)min in Group B(P＞0.05).Postoperative pain,average hospital stay in Group A were significantly less and shorter than in Group B(P ＜0.05).The scores of selfassessment for the operation were(11.21±2.00)in Group A versus(10.52±2.08)in Group B(P＜0.05).The change of CEAP classification and VCSS were statistically significant after operation in both groups(P＜0.01).The VCSS decreased 4.6 ±2.5 in Group A versus 4.3±2.7 in Grpup B(P＞0.05).Conclusions Endovenous radiofrequency ablation in combination with TriVex for treatment of CVI are effective,less traumatic,of fast recovery.CEAP classification and VCSS are useful tools for assessing outcomes after the operation.

Objective To investigate the diagnosis and treatment of post-transplant lymphoproliferative disease (PTLD) after hematopoietic stem cell transplantation (HSCT).Methods Clinical data of one case of PTLD,including clinical manifestations,diagnosis and treatment,were retrospectively analyzed.And the related literatures were reviewed.Results From January 2007 to November 2012,one case developed PTLD among 196 patients who were followed up after HSCT in the First Affiliated Hospital of Chongqing Medical University.The incidence of PTLD was 0.5％.Clinical manifestations of the patient were not typical,including frequent fever,multiple lymphadenopathy and multiple pulmonary nodules.The patient was diagnosed as diffuse large B-cell lymphoma (B-DLCL) by pathological examination of the swollen lymph node.After withdrawal of immunosuppressants,the temperature returned to normal,and lymphadenopathy and pulmonary nodules disappeared completely.Conclusion PTLD is a severe complication of HSCT with distinctive morphologic and clinical characteristics.The origin of this disease may be associated with Epstein-Barr virus infection and imrnunosuppressive therapy.It needs the pathologic detection to make a definite diagnosis.Several different treatment strategies have been employed,and reduction of immunosuppressive therapy may lead to regression of PTLD.

Objective To assess the efficacy of combination therapy with all-trans-retinoic acid (ATRA ) and arsenic trioxide (ATO) in treating patients with acute promyelocytic leukemia (APL) .Methods A retrospective study was conducted to evaluate the efficacy of combining ATO with ATRA based induction therapy ,followed by 3 courses of consolidation chemotherapy and 2-year sequential ATO/ATRA maintenance therapy in newly diagnosed APL ,and the efficacy between high risk group and low/inter-mediate risk group ,also between different PML-RARa isoform sub-group were compared .Results In high risk group and low/in-termediate risk group ,the complete remission(CR)rates were 70 .0% and 96 .9% (P=0 .04) ,respectively ;the 3 years overall sur-vival rates(OS) and disease free survival rates (DFS) were(70 .0 ± 14 .5)% ,(96 .9 ± 3 .1)% ,P= 0 .01 and(66 .7% ± 19 .2)% , (93 .8 ± 6 .1)% ,P=0 .08 ,respectively .In BCR1 group and BCR3 group ,the CR were 78 .6% and 95 .6% (P=0 .14) ,respectively ;the rates of 3 years OS and DFS were(95 .7 ± 4 .3)% ,(78 .6 ± 11 .0)% ,P=0 .18 ,and(92 .9 ± 6 .9)% ,(87 .5 ± 11 .7)% ,P=0 .24 , respectively .Conclusion The results indicate that ATO based first-line protocol is highly effective for treatment of newly diagnosed APL ,especially for the PML-RARa BCR3 isoform APL .

Objective To explore the feasibility of inter-laboratory comparison and trueness evaluation among clinical laboratories, and assess the quality of participants′measurement, by measuring the activity of alanine aminotransferase ( ALT ) in patient serum samples.Methods Method comparison study was used.Five patients serum samples, whose target values were assigned by two international candidate reference laboratory with reference method of ALT without pyridoxal phosphate, were measured by 23 routine laboratories.The bias between measurement result of each participant and the mean of reference laboratories was calculated, and then compared to allowable bias 6%.Calculate the mean value and the relative bias.Results Compared with the mean of reference laboratories, the maximum absolute value of bias among the 23 routine laboratories was 31.27%.The rate range which bias was less than the allowable bias was 26.09%-73.91 %.The bias acceptability of 8 participants were more than or equal to 80%;15 participants were less than or equal to 60%; and 3 participants were 0%.Conclusions Using patient serum samples and values assigned by reference method is an effective way to carry out inter-laboratory comparison and trueness evaluation.It can reflect the quality of measurement more truly.

BACKGROUND:Intertrochanteric fracture is one of the common fracture, and accompanied by osteoporosis and high energy injury. The fracture line often descended, and induced A3 intertrochanteric fracture. This type of fracture is difficult to treat. Common intramedulary fixation includes proximal femoral nail anti-rotation and InterTan, which have high stability, are minimaly invasive, and have been extensively used. OBJECTIVE: To compare the biomechanical stability of A3 intertrochanteric fracture fixed with proximal femoral nail anti-rotation and InterTan by finite element analysis. METHODS:Three three-dimensional finite element models of the AO3.1, AO3.2 and AO3.3 intertrochanteric fracture fixed with proximal femoral nail anti-rotation and InterTan were established. Fixation was completed according to the requirement of Department of Orthopedics. Stress distribution of femur and fixator of different models was observed. Stress peak at different areas was compared in femur and fixation models. Biomechanical stability was analyzed. RESULTS AND CONCLUSION: The maximum pressure concentration area in AO3.1 intertrochanteric fracture with proximal femoral nail anti-rotation was located in the lateral proximal femur, and with Intertan was located in the medial proximal femur. The AO3.2 had little differences between two types of nails. The AO3.3 intertrochanteric fracture with proximal femoral nail anti-rotation was located in the medial proximal femur and the medial distal implant. There was no significant pressure concentration with InterTan. The von Mises pressure of six models was concentrated in the medial distal implant, and higher maximum von Mises pressure was found in the proximal femoral nail anti-rotation. There was significant difference of von Mises distribution between the lateral and medial implant with proximal femoral nail anti-rotation. Except the AO3.3 intertrochanteric fracture with proximal femoral nail anti-rotation, the maximum pressures of remaining models were located in the main nail and interlocking nail infal. These results concluded that the fracture fixed with InterTan exhibited fine fixation stability in the AO3.1 and AO3.3 intertrochanteric fracture. There was no significant difference of fixation stability between proximal femoral nail anti-rotation and InterTan in AO3.2. The von Mises distribution of InterTan for intertrochanteric fracture is more reasonable.

Objective To investigate the safety , feasibility , and clinical application value of digital sub-traction angiography ( DSA) -guided insertion of totally implantable venous access port ( TIVAP) in patients with digestive system cancer .Methods We retrospectively analyzed the data of 15 digestive system cancer patients who were inserted with TIVAP under DSA guidance between April 2013 and January 2016, recorded the TIVAP-related complications and indwelling time, and investigated the patients’satisfaction about TIVAP.Paired rank sum test was used for the differences in patients’quality of life before and after the insertion of TIVAP.Results Of the 15 digestive system cancer patients , operation success rate of TIVAP insertion was 100%, with the success rate of venipuncture on first attempt being 100%.The incidence of complication was 6.67% ( 1/15 ) , which was manifested as pull feeling at the neck occurring in the eighth month after insertion .The indwelling time of TIVAP was from 2 to 28 months, with a median value of 9 months.Patients’satisfaction rate of TIVAP was 86.67%(13/15).The proportion of patients with a good quality of life was 100%(15/15), statically signifi-cantly higher than that before the insertion [46.67%(7/15), Z=-3.416, P=0.000).Conclusions TIVAP insertion under DSA guidance in digestive system cancer patients is safe and feasible , with few complications and fair patient satisfaction .It may improve the patient ’s quality of life , worthy of clinical application .

ObjectiveTo investigate the expressions of matrix metalloproteinase-2 (MMP2) and tissue inhibitor of MMP2 (TIMP2) in human malignant melanoma transplanted subcutaneously in nude mice.Methods A non-sense oligonucleotide (N-ODN) and an antisense oligodeoxynucleotide (ASODN)against heparanase mRNA were designed and synthesized.Cultured human A375 malignant melanoma cells were classified into 4 groups to be transfected with the N-ODN,ASODN of 10,20,30 μmol/L,respectively,via liposomes.The cells receiving no treatment served as the blank control group.Then,the transfected or untransfected cells were subcutaneously inoculated into nude mice.Six weeks after the transplantation,transplanted tumors were removed from the nude mice and subjected to immunohistochemical staining for the detection of MMP2 and TIMP2 protein expressions.ResultsThe protein expressions of MMP2 and TIMP2 were significantly lower in tumor tissue specimens from nude mice inoculated with ASODN-transfected A375 cells than in those with N-ODN-transfected cells and in those with untransfected cells(P ＜ 0.05),significantly different between the tumor tissue specimens from mice inoculated with A375 cells transfected with 10,20 and 30 μmol/L of ASODN (all P ＜ 0.05 ).ConclusionThe ASODN against heparinase displays a marked inhibitory effect on the expressions of MMP2 and TIMP2 proteins in malignant melanoma transplanted in nude mice.

Objective To compare the dosimetric differences of three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT) and volumetric modulated arc radiotherapy(V-MAT) for external beam partial breast irradiation.Methods Twelve patients with breast cancer receiving breast-conserving surgery and external beam partial breast irradiation were enrolled.Three different techniques including 3D-CRT,IMRT and V-MAT were designed for each patient.The dosimetry in the target,the dose to the organs at risk(OAR),the MU and delivery time were compared.Results All three plans met the clinical requirement. 3D-CRT showed the worst conformity in target. V-MAT provided the lowest target coverage and homogeneity in target.3D-CRT plans showed the lowest values for the V5,V10,mean dose and the highest values for V30 in the ipsilateral lung.No statistically significant differences were observed in V20 of the ipsilateral lung among three plans.V-MAT showed the lowest values in ipsilateral normal breast volume 15,20 and 25 Gy post-irradiation.For V5,the mean and max dose in heart,the mean dose in contralateral lung and the mean,max dose in thyroid,IMRT and 3D-CRT showed the highest and lowest value respectively(z =-2.94 - -2.09,P ＜ 0.05 ).The MUs in 3D-CRT,IMRT and V-MAT were 417.6 ± 34.4,772.8 ± 54.4 and 631.0 ± 109.0,respectively (z =- 2.93, - 2.76,-2.93,P ＜ 0.05 ). V-MAT significantly reduced the delivery time. Conclusions V-MAT shows significant advantages in reducing the dose in the ipsilateral normal breast and the delivery time compared with 3D-CRT and IMRT.

Objective To study the effects of thymus transplantation(TT)combined with CD4--DLI on T cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods BALB/c mice were randomly divided into three groups:hematopoietic stem cell transplantation (HSCT group),hematopoietic stem cell transplantation combined with thymus transplantation(TT group)and hematopoietic stem cell transplanta-tion combined with thymus transplantation plus CD4+ T cell-depleted lymphocyte infusion(CD4--DLI group). On day-1,the mice were treated with the lethal dose of radiotherapy. On day 0,C57BL/6 mice were used as donor for hematopoietic stem cell transplantation. The mice were sacrificed on 5 days,2 weeks,4 weeks and 3 months after transplantation,respectively. The peripheral blood and spleen cells of mice were collected for determinations of T cell surface antigen,T cell receptor,naive T cells and intracellular cytokines. HE staining was used to assess the development of donor thymus. Results TT and CD4--DLI did not impair each other′s effects on T cell reconstitu-tion. TT combined with CD4--DLI increased the number of T cell reconstruction. CD4--DLI promoted the effect of TT on enlargement naive CD4+and CD8+T cell pool. Combination of TT and CD4--DLI enhanced the cytokine pro-duction of T cells. Conclusion TT combined with CD4--DLI had no side effects on TCR repertoire and thymus. Conclusion TT combined with CD4--DLI can enhance the reconstitution of T cell number and function via thymus dependent and thymus independent mechanism.