Based on a review of the practices of echinococcosis control in China and of the historical experience from the international community in the field,this paper discussed the research achievements and challenges.The author indicated that it is a realistic time to launch a comprehensive control program in western China and there are urgent needs for scientific research integrating into the program.

The sera of 206 cases with hydatid disease diagnosed by B-ultrasound and X-ray in survey scene had been examined by Dot-ELISA and IHA with Qinghai cystic hydatid antigen, ELISA With Xingjiang cystic hydatid antigen and Em18-EliB with alveolar hydatid antigen. The results showed that the sero-positive rates were 90. 37％ and 91.98％ in these cases with cystic hydatid disease by Dot EliSA and IHA with Qinghai cystic hydatid antigen respectively. The sero-positive rate was 75. 94％ in same cases by ELISA with Xingjiang cystic hydatid antigen. The sero-positive rateswere 77.27％ 81. 82％ and 65. 91 ％ in those cases with the whole calcific cystic hydatid disease by above three methods respectively, and the sero-positive rates were lower in whole calcific cystic hydatid than that in other cystic hydatid disease. The sero-negative cases belonged to cystic hydatid disease which located in lungs of livers alone. The results by EM18-ELIB with alveolar hydatid antigen showed that the sero-positive rates were 73. 68％ and 5. 88％ in those cases with alveolar hydatid disease and with cystic hydatid disease diagnosed by B-ultrasound and X-ray respectively,and the sero-positive rate was 15.91 ％ in whole calcific cystic hydatid disease. The ratio of the number of positive seras to that of negative seras was 1 to 7 approximately. The value and mean of different serological methods in diagnosis and judge diagnosis for cystic and alveolar hydatid disease had been discussed.

Objective To analyze the MRI features of rare intracranial germ cell tumors of the pineal region compared with pathologic findings.Methods The MRI and pathologic data of 32 patients with rare intracranial germ cell tumors of the pineal region were reviewed retrospectively.All cases were proved by surgery and pathological examinations.Results Fourteen teratomas with malignant transformations were cyst-solidary which were mixed signals on plain MRI and the solid components showed obvious enhancement.The adiposity signals could be seen in teratomas.The level of serum or CSF AFP was high.Microscopically,many tissue components could be seen.The signal of 6 yolk sac tumors were homogeneous,and they had great enhancement after enhanced scanning.Increasing of preoperative serum AFP level could be seen in all patients.The 5 embryonal carcinomas were well-defined margin masses and heterogeneous with cystoid variation and necrosis and moderate to severe edema.The solid components showed obvious enhance.The signals of 7 mixed germ cell tumors were atypical,which depended on the components of germ cell tumors.Conclusion The MRI findings of the rare intracranial germ cell tumors of the pineal region(teratomas with malignant transformations,yolk sac tumors endodermal sinus tumor,embryonal carcinomas and mixed germ cell tumors)show some feature which are correlated with pathology.Suggestive diagnosis could be made combined with clinical data and MRI features.

As an interstitial brachytherapy,radioactive seed implantation could provide high doses in the local site and minimal doses at surrounding normal tissues.It has become one of the best choice for early stage prostate carcinoma.Radioactive seeds were implanted under the guidance by ultrasound,CT and MRI,featured with surgical and interventional treatment.Based on dosimetry for target and organs at risk,radioactive seed implantation is multiple disciplinary.In order to acquire the accurate and high quality seed implantation,it is necessary to set up a team including surgeons,radiation oncologists,interventional doctors and nuclear medicine doctors.The content of the consensus is as follows:radiation physics and dosimetry,indications,side-effects and 3 D-printing template work-follow.Despite the benefit of radioactive seed implantation for solid carcinoma,there still a compelling need for prospective randomized and stage Ⅲ clinical trials from multiple centers,so as to upgrade the evidencebased level,above all confirm the role of radioactive seed implantation in the comprehensive treatment of tumors.

Objective To evaluate the dosimetry accuracy and clinical efficacy of 125I radioactive seed implantation using coplanar template (CPT) in the treatment of metastatic or recurrent chest wall tumor.Methods Thirty-one patients with metastasis or recurrence of chest wall tumor,who had been diagnosed with pathology between July 2005 and July 2015,were retrospectively studied.All patients underwent CPT-assisted 125I radioactive seed implantation.Brachytherapy radiation treatment planning system (BTPS) was used to make preoperative plans,and the prescribed dose (PD) was 110 Gy.CPT was used to assist CT guided 125I radioactive seeds implantation.Dose evaluation was performed immediately after implantation.The difference of dose parameters was compared between preoperation and postoperation,including Dg0,D100,V90,V100 and the numbers of seeds.Postoperative chest CT was conducted regularly to assess the treatment efficacy based on the response evaluation criteria in solid tumors (RECIST Version 1.1).The patients were followed up till July 2016.Results All patients went through implantation procedure successfully and there was no significant statistical difference between preoperative and postoperative dose parameters (P ＞ 0.05).The conformal index (CI) was 0.951 ± 0.13,external index(EI) was 6.5％ ±0.9％.Six months after implantation,CR,PR,SD and PD were 25.8％ (8/31),51.6％ (16/31),6.5％ (2/31) and 16.1％ (5/31),respectively.The effective rate was 77.4％,and local control rate was 83.9％ (26/31).Skin pigmentation occurred in 13 patients during the follow-up period,without any special treatment.Conclusions The auxiliary of CPT in the treatment of metastatic or recurrent chest wall tumor under the guiding of CT could achieve quality control,safety and effectiveness.

Objective To evaluate the clinical effects of CT-guided 125I radioactive seed implantation in treatment of stage Ⅲ non-small cell lung cancer ( NSCLC ) and the influential factors of prognosis.Methods 247 patients of stage Ⅲa/Ⅲb NSCLC underwent CT-guided 125I radioactive seed implantation.The clinical effects and the factors affecting prognosis were analyzed by univariate and multivariate analyses.Results The 1-,3-,and 5- year overall survival rates were 82.8％,23.8％,and 11.5 ％,respectively.The median survival time was 24.8 months,and the local control rate was 92.2 ％,63.8％,and 25.7％,respectively.The 5- year overall survival rate was 14.7％,and the median survival time was 29.7 months of the stage Ⅲ,patients.And the 5- year overall survival rate was 11.2％,and the median survival time was 24.0 months at the stage Ⅲb.Univariate analysis showed that age,course of disease,hemoglobin before treatment,clinical stage,maximum diameter of tumor,prescribed dose (PD),post-operational mean dose,post-operational dose covering 100％ volume (D100),remedial model were the main prognostic factors; however,multivariate analysis revealed that hemoglobin ≥ 120 g/L before treatment,post-operational dose covering 100％ volume (D100) and maximum diameter of tumor were the independent risk factors for predicting the survival.Aerothorax was observed in 37 patients with an incidence rate of 14.9％,and hemothorax was observed in 22 patients with an incidence rate of 9％.Conclusions 125I radioactive seed implantation therapy is effective in the treatment of stage Ⅲ NSCLC.Hemoglobin level before treatment,post-operational dose covering 100％ volume (D100 ),and maximum diameter of tumor are the main prognostic factors for the NSCLC patients treated with radiotherapy for NSCLC.

Objective To evaluate the relationship between aged diabetes mellitus and cognitive impairment in community elders.Method 308 type Ⅱ diabetic patients, including 225 diabetes patients and 164 diabetes with hypertension patients, were random selected in our study. 225 hypertension and 186 healthy elders were random selected as controls. Mini-Mental State Examination (MMSE) was tested on each case. According to DSM-IV, all participants were classified into three groups ( normal, MCI and dementia) .Result MMSE scores in diabetes patients were lower than that in healthy controls(25. 87±3.33 vs 26. 86 ±2. 82, F = 9.62, P < 0. 01), and scores in diabetes with hypertension group (24. 68 ±4. 36 ) were much lower than that in healthy controls ( F =37. 16, P <0.01). Conclusion Senile diabetes were positive correlated with cognitive impairment. Diabetes were a risk factor of dementia in seniles. Diabetes with hypertension can increase cognitive impairment in community elders.

Objective To systematically evaluate the efficacy and safety of 125I seed implantation for treatment of advanced pancreatic cancer.Methods An electronic literatuire search was performed about randomized controlled trials(RCTs) of 125I implantation for treamtent of advanced pancreatic cancer in CNKI,Wanfang Data,CBM,Cochrane Library,PubMed and Embase (from the date of building the database to November 2016).Two investigators independently screened literature,extracted data and assessed the risk bias of included studies,and the Meta-analysis was performed by using Revman 5.3software.Results There were 12 RCTs (n =689) included.Meta-analysis showed that the objective respond rate(ORR) (OR =3.24,95％CI2.33-4.52,P＜0.001),the 6-month survival rate(OR =3.61,95％ CI 1.53-8.52,P =0.003),the 12-month survival rate(OR =4.80,95％ CI 2.40-9.57,P ＜ 0.001) and the relief rate of pain were higher than those in the control group.However,there were no significant differences between both groups in the 2-year survival rate and the adverse reaction rate,which were (OR=2.36,95％ CI 0.47-11.74,P =0.29) and (OR =4.94,95％ CI 1.05-23.23,P =0.04),respectively.Conclusions The limited current evidence showed that 125I implantation for treatment of advanced pancreatic cancer is effective and safety.125I implantation can improve the ORR,short-time survival rate and pain relief rate.In addition,there was no significant increase in the incidence of related adverse events except for seed malposition.Although the quality and quantity of evidences is limited,it merits further study to provide high quality evidences.

Objective To investigate the efficacy and side effects of radioactive seed implantation in the treatment of non-surgical early stage non-small cell lung cancer (NSCLC) based on CT guidance combined with template.Methods Twenty-one patients with inoperable T1 2N0M0 NSCLC who underwent CT-guided radioactive seed implantation therapy were retrospectively analyzed from December 2010 to October 2016 in the Second Hospital of Tianjin Medical University.All patients were diagnosed by histopathology.All seeds,with the activity of 18.5-29.6 MBq and prescription dose of 120-160 Gy,were completed in an operation of the radioactive seed implantation.The preoperative and postoperative TPS treatment plans and quality verification were corducted.In addition,the local control rate of tumors,overall survival (OS),progression free survival time (PFS),satisfaction rate of dose validation and adverse reactions were evaluated.Results The median follow-up was 25.1 months (range 4.4-72.7months).The local control rate of primary tumor in 1-,2-and 3-year was 100％,95.2％ and 95.2％,respectively.Of all patients,the median OS was 48 months with the median PFS 43.4 months.In particular,the 1-,2-and 3-year survival rate was 100％,91.7％ and 72.9％,respectively.Moreover,the rate of 3-year PFS was 70.2％ and the satisfactory rate of postoperative quahty verification was 100％.The treatment-related adverse events included pneumothorax,bronchial hemorrhage,pleural effusion,cough,pulmonary fibrosis and seed shifts.In all,7 (33.3％) patients had grade 1 adverse events and 4 (19％) patients with grade 2,but no grade 3 adverse event.Conclusions CT and template-guided radioactive seed implantation in NSCLC with T1 2 N0 M0 has a high tumor local control rate and low treatment-related adverse reactions,suggesting that it might provide an alternative way for the treatment of inoperable early stage NSCLC.

Objective To compare the planned radiation dose and the actual dose received after 125I radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R,and to evaluate the clinical efficacy.Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014.The mediastinal lymph node metastases were treated by CPT-assisted 125I radioactive seed implantation.Digital imaging and communications in medicine (DICOM) data were acquired by chest CT scan before implantation,brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan,and the prescribed dose(PD) was 120 Gy.CPT was used to control the precision of needle penetration and implantation of radioactive seeds.Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds.Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test.The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1).Results All patients went through implantation procedure successfully.Dose evaluation after implantation was as followed.The average dose received (231.9 ±29.6)Gy,the dose received by 90％ of the target(D90) (150.8 ± 16.6) Gy,the dose received by 100％ of the target(D100) (100.4 ± 12.6)Gy,the volume of 100％PD covering the target(V100)(94.1 ± 2.6) ％,the volume of 200％ PD covering the target(V200) (33.0 ± 5.7) ％,the conformal index (CI) 0.75 ±0.06,the external index(EI) (22.7 ± 5.8)％,the average dose received by the superior vena cava (19.3 ± 7.2)Gy,and the average dose received by aorta (12.1 ± 5.1)Gy.Efficacy was followed for 6 months after implantation and the effective rate was 84.37％.There was no serious complications (such as radioactive lung injury,major vascular injury,bleeding,and et al.) occurred in follow-up period.Conclusions CPT assisted CT guided 125I radioactive seed imnplantation in treating mediastinal node metastases 4R can achieve preoperative BTPS,minimize major vascular or organ injury.It is an accurate,effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases.