Although single thermotherapy has certain curative effect for cancer treatment,it normally leads to the recurrence of tumor in clinical application.Multi-thermotherapy could be an effective approach to solve the problem.Multi-thermotherapy not only kills the tumor cells by heating cells above the physiological temperature,but also induces the anti-tumor immunity of the body to further kill the tumor cells.In order to obrain optimal treatment effect,the time interval of thermotherapy is often set once or twice a week for the consideration of thermotolerance.

Objective To investigate the curative effects of the traditional surgical method of posterior pedicle Schanz screw fixa-tion with partially stripping injured paravertebral muscle in treating thoracolumbar fracture .Methods 52 cases with thoracolumbar fracture underwent posterior pedicle Schanz screw fixation to partially strip injured paravertebral muscle from January ,2010 to Jan-uary ,2012 .The patients were divided into partially stripping injured paravertebral muscle group (32 cases) and traditionally strip-ping injured paravertebral muscle group(20 cases) .The blood loss ,postoperative drainage ,kyphosis postoperative 3 d VAS scores , vertebral height correction rate ,Cobb angle correction ,Oswestry dysfunction indexes were copmared .Results Comparing with tra-ditionally stripping injured paravertebral muscle group ,the partially stripping injured paravertebral muscle group has better effect in transperative blood loss ,postoperative drainage and postoperative 3 d VAS scores ,the differences were statistically significant .But there was no statistical significance between the two groups in vertebral height correction rate ,kyphosis Cobb angle correction ,Os-westry dysfunction indexes .Conclusion Partially strip injured paravertebral muscle has less painful than traditional surgery does , being safe and effective with small invasion and easy to recover .

Objective:To investigate the changes and clinical significance of prothrombin time (PT) during chemotherapy for non-Hodgkin lymphoma (NHL) in high-altitude area and low-altitude area, and understand the relationship between NHL and PT.Methods:From August 2018 to September 2019, data of 68 cases of NHL patients in the Fifth People′s Hospital of Qinghai Province in the high-altitude area (average altitude: 2 261 m) and the Tianjin Fourth Central Hospital in the low-altitude area (average altitude: 1.3 m) were collected and compared with those of 20 subjects from health examination. The patients were divided into groups according to the NHL classification, stage and grade (international prognostic index, IPI score), the PT at initial diagnosis was compared. The PT changes before and after chemotherapy (6 cycles) were compared between high-altitude area and low-altitude area.Results:The PT in healthy subjects and PT at initial diagnosis in NHL patients in low-altitude area were lower than those in high-altitude area: (12.3 ± 1.3) s vs. (13.4 ± 1.9) s, (12.2 ± 0.8) s vs. (13.7 ± 1.1) s, and there was statistical difference ( P<0.05). There was no significant difference between NHL patients and healthy patients in the same area ( P>0.05). In NHL patients in high-altitude area and low-altitude area, PT of different NHL classification, stage and grade were statistically significant ( t = 4.611, 8.202, 6.893, 5.345, 3.121, 5.397, 2.838 and 3.720, P<0.05). In the same altitude area, NHL classification, stage and grade of NHL patients had no significant effect on PT, and there were no statistically significant difference ( P> 0.05); in NHL patients, there were statistically significant differences in PT before and after chemotherapy between high-altitude area and low-altitude area: (13.7 ± 1.1) s vs. (12.2 ± 0.8) s, (13.4 ± 1.4) s vs. (12.0 ± 1.3) s, and there were statistical differences ( P<0.05), and no significant changes in PT before and after chemotherapy in the same altitude area ( t = 1.377 and -1.222, P>0.05). Conclusions:PT of NHL patients in low-altitude area is lower than that in high-altitude area, and there is no significant correlation with NHL classification, stage, grade and chemotherapy in NHL patients.

Objective ToinvestigatethevalueoftheoptimalCNR monoenergeticimagesofportalveininpredictingesophagealGgastric varicealbleeding(EVB).Methods FortypatientswithlivercirrhosisandportalhypertensionunderwentcontrastGenhancedspectral CTscan.TheoptimalCNR monoenergeticimagesand70keV monoenergeticimagesoftheportalveinphasewereselectedtocompare theimagingquality.TheconsistencyoftheoptimalCNR monoenergeticimageswithendoscopyforesophagealGgastricvaricealwas analyzed by Kappa test.A ccording to the E V B history ,the patients w ere divided into bleeding group and nonGbleeding group.T he ROCcurveswerecalculatedtoassessthevaluesofthemainportalvein(MPV)anditstributariesdiameterstopredictingEVB.Results TheCNRandobjectivescoreoftheoptimalCNR monoenergeticimagesweresignificantlyhigherthanthoseofthe70keVimages(P＜0.05).TheoptimalCNR monoenergeticimageshadgoodconsistency withgastroscopeintheclassificationofesophagealGgastric variceal(k＝0.769).ThereweresignificantdifferencesofthediametersofMPV,intrahepaticleftbranchofportalvein(LPV),splenic vein(SV)andleftgastricvein (LGV)betweenthebleedinggroupandnonGbleedinggroup (P＜0.05).ROCcurveanalysisshowed thattheincidenceofEVBwashighestwithasensitivityof76.92%andaspecificityof85.71%,whentheLGVwasgreaterthan6.1mm. Conclusion TheoptimalCNR monoenergeticimagesofportalveincouldimprovetheimagingquality,andLGVdiametershouldbe ariskindicatorforpredictingEVBinlivercirrhosis.

Objective To quantitatively compare the diagnostic capability of 68Ga-NGR and 18F-FDG in well-differentiated hepatocellular carcinoma (HCC) bearing mice by microPET/CT imaging.Methods The in vitro cellular uptake, in vivo microPET/CT imaging and biodistribution studies of 68Ga-NGR and 18F-FDG were quantitatively compared in SMMC-7721-based well-differentiated HCC.The human fibrosarcoma (HT-1080) and human colorectal adenocarcinoma (HT-29) cells/xenografts were respectively used as positive and negative reference groups for CD13.The expression of CD13 was qualitatively verified by immunohistostaining.The levels of CD13 and glucose-6-phosphatase (G6Pase) were semi-quantitatively analyzed by Western blot test for all 3 types of tumors.Two-sample t test was used for data analysis.Results The in vitro cellular uptake showed that the 68Ga-NGR uptake in SMMC-7721 and HT-1080 cells was higher than that in HT-29 cells, and the 68Ga-NGR uptake was higher than 18F-FDG uptake in SMMC-7721 cells.The in vivo microPET/CT imaging results revealed that the uptake of 68Ga-NGR in SMMC-7721 tumor was (2.17±0.21) %ID/g, remarkably higher compared to (0.73±0.26) %ID/g of 18F-FDG uptake (t=8.826, P<0.01).The tumor/liver ratio of 68Ga-NGR was 2.05±0.16, which was 2.03-fold higher than that of 18F-FDG.In the HT-1080 tumors, the uptakes of 68Ga-NGR and 18F-FDG were both high, and the values were (2.46±0.23) %ID/g, (3.47±0.31) %ID/g.The uptake of 68Ga-NGR was significantly lower than that of 18F-FDG in HT-29 tumors: (0.67±0.20) %ID/g vs (3.17±0.29) %ID/g;t=4.221, P<0.01.Western blot and immunohistostaining results were as follows: HT-1080(CD13+, G6Pase-), SMMC-7721(CD13+, G6Pase+), HT-29(CD13-, G6Pase-).Conclusions The uptake of 68Ga-NGR is higher than 18F-FDG uptake in SMMC-7721 tumor bearing mice, therefore it is worthwhile to consider the feasibility of clinical translation for PET/CT in diagnosis of HCC.Furthermore, because of the difference in 68Ga-NGR and 18F-FDG avidities in tumors with different molecular phenotypes of CD13 and G6Pase, there is an underlying potential for molecular imaging in the determination of molecular phenotypes.

Objective To investigate the clinical efficacy of asymmetric osteotomy via posterior adjacent vertebrae in the treatment of traumatic thoracolumbar kyphotic scoliotic deformity.Methods A retrospective case series study was conducted on the clinical data of 16 patients with traumatic thoracolumbar kyphotic scoliotic deformity admitted to our department from January 2012 to January 2017.There were 10 males and six females,aged (42.5 ±7.6) years (range,20-62 years).According to the location of injured vertebrae,there were two patients with T11,five with T12,six with L1,and three with L2,all of which had scoliosis deformity and obvious low back pain.All patients underwent asymmetric osteotomy via posterior adjacent vertebrae.The operation time and intraoperative bleeding were recorded.The imaging parameters such as kyphosis Cobb angle,scoliosis Cobb angle,distance between C7 plumbline and central sacral vertebral line (C7-CSVL),and distance between C7 plumbline and sagittal vertical axis (SVA) were measured before and after operation.At the same time,the visual analogue scale (VAS),Oswestry dysfunction index (ODI),and SRS-22 scale were used to evaluate the clinical efficacy.The AISA score was used to evaluate the neurological function recovery before and after operation.Results All patients were followed up for (26.3 ± 16.8) months (range,15-65 months).The operation time was (6.0 ± 1.4) hours (range,4.5-9.0 hours),and the intraoperative bleeding was (900.5 ± 360.8)ml (range,800-1600 ml).The kyphosis Cobb angle was improved from (70.3 ± 9.8) °before operation to (12.2 ± 2.9) ° after operation (P ＜ 0.01).The scoliosis Cobb angle was improved from (47.6 ± 11.6) ° before operation to (4.0 ± 0.9) ° after operation (P ＜ 0.01).The C7-CSVL decreased from preoperative (3.1 ±0.8)cm to postoperative (1.2 ±0.4)cm (P ＜0.01),and the SVA decreased from preoperative (5.0 ± 0.9) cm to postoperative (2.9 ± 0.5) cm (P ＜ 0.01).No severe complications such as spinal cord and nerve injury occurred.The VAS decreased from preoperative (6.8 ± 1.0) to (1.9 ± 0.9) points at the last follow up.The ODI decreased from (54.6 ± 4.2) ％ before operation to (8.1 ± 2.5) ％ at the last follow up.The SRS-22 score was increased from (64.6 ±7.5) points before operation to (87.4 ± 3.2) points at the last follow-up.In terms of the ASIA classification,two patients were improved from grade C to grade D after operation,and six patients were improved from grade D to grade E.Conclusion Asymmetric osteotomy via posterior adjacent vertebrae is safe and effective in the treatment of traumatic thoracolumbar scoliosis,with high correction rate of scoliosis and kyphosis at the same time.

Objective To explore the accuracy and clinical efficacy of advanced 3D printing navigation templates in assisting placement of atlantoaxial pedicle screw.Methods A retrospective analysis was carried out on 49 cases of patients with atlanto-axial vertebral fractures and dislocations between June 2013 and June 2016,and all of them were given posterior incision,reduction and internal fixation of atlantoaxial pedicle screw.The patients were divided into advanced 3D printing navigation template group (14 cases),early 3D printing navigation template group (16 cases),and routine pedicle screw placement group (19 cases).Atlantoaxial CT data of patients in advanced 3D printing navigation template group and early 3D printing navigation template group were input into Mimics 17.0,then advanced 3D printing navigation template group and early 3D printing navigation which were used in clinic surgery were designed and printed.The relationship between positions of pedicle screw with the pedicle and bone cortex in plain CT image was observed after operation.The quality of the screw position was assessed and the accuracy of three kinds of screwing methods was compared.The accuracy of the screwing angle was assessed by comparing with the differences between the preoperative designed channel inclination angle and postoperative actual screwing angle.Three groups were compared for differences between operation time,intraoperative blood loss,and scores of cervical nerve scale and visual analogue scale (VAS) of neck and shoulder pain by Japanese Orthopaedic Association (JOA).Results All 49 cases of patients successfully completed the surgery.Patients of the routine pedicle screw placement group,early 3D group and advanced 3D group correspond operation time for 141.2±20.7 min,112.5±12.1 min and 103.1±10.4 min,intraoperative blood loss for 314.0±81.4 ml,243.6±71.2 ml and 181.0+59.1 ml;total accuracy of screwing for 75.0％ (54/72),93.75 ％ (60/64) and 96.43 ％ (54/56).There were statistically significant differences among the routine group,3D group and advanced 3D group in the mentioned programs.There were no statistical differences between advanced 3D group and 3D group in the inclination angle and head tilt angle with the pre-designed values,while there was statistically significant difference between the routine group and the pre-designed value.The accuracy of the inclination angle and bead tilt angle screwing angle were obviously superior in the advanced 3D group and early 3D group to that of the routine group.There were statistically significant differences between preoperative with postoperative VAS scores and JOA scores in the same group,while there were no statistically significant differences among groups in JOA.But there was statistically significant difference between the routine group and the advanced 3D in VAS,and there was no statistically significant difference between the routine pedicle screw placement group and the early 3D in VAS.All three groups of patients had bony fusion of atlantoaxial vertebral body,without loosening,dislocation and fracture of the internal fixators.Conelusion Advanced 3D printing templates in assisting the surgical treatment for atlantoaxial fracture and dislocation can improve the accuracy of pedicle screwing and safety of the surgery,reduce the surgery risk,and obtain satisfied clinical curative effects.

Objective To investigate the effects of xenogenic bone with chitosan/norvancomycin sustained-release biomaterials in treating infectious bone defects in rabbits.Methods Xenogenic bone with chitosan/norvancomycin sustained-release biomaterials was made by electrospinning technique.Rabbit infectious bone defect models were made by Methicillin-resistant Staphylococcus aureus.A successful model was evaluated with the standard of more than three points in Norden score assessment.All models were divided into two groups by random number table method,with eight models in each.The control group was treated with surgical debridement,and the experimental group was implanted with bone particles of xenogenic bone with chitosan/norvancomycin sustained-release system after debridement.Postoperatively,general conditions,X-ray,histological results of HE staining,and bacteriological examination results of the rabbits were observed.Results X-ray showed significant bone defects,sequestration,periosteal reaction,and soft tissue swelling after one month of modeling,with Norden score of (3.84 ± 0.52) points.The general conditions were good and the sinus tracts were healed in experimental group after two months of treatment.The control group demonstrated generally poor conditions with swollen sinus and purulent discharge.Two rabbits were died of sepsis.The pathological scores of tibial were (0.41 ± 0.08) points in experimental group,and (3.27 ± 0.26) points in control group by gross observation.The pathological score of experimental group was significantly lower than control group(P ＜ 0.05).The bone defects were basically repaired in experimental group.The longest diameter of bone defect in experimental group was (0.11 ± 0.02)cm,significantly smaller than (0.48 ± 0.06) cm in control group (P ＜ 0.05).There were no obvious signs of osteomyelitis and the bone defects were well repaired in experimental group.Periosteal reaction,soft tissue swelling,a substantial number of bone destruction,and sequestration were observed in control group.The Norden score was (1.32 ± 0.23) points in experimental group,lower than (5.21 ± 0.48) points in control group(P ＜ 0.05).HE staining showed a large amount of trabecular bone formation,bone cell formation,and fibrous hyperplasia in experimental group,with no obvious signs of infection.On the other hand,infiltration of inflammatory cells,necrotic tissue,and sequestration were observed in control group.The histological score was(0.61 ± 0.10) points in experimental group,lower than (4.21 ± 0.41) points in control group (P ＜0.05).The negative rate of bacterial culture in experimental group was 33％,lower than 100％ in control group (P ＜ 0.05).Conclusion Xenogenic bone with ehitosan/norvancomycin sustained-release biomaterials has excellent effect in infection clearance and bone defect reparation in treatment of infectious bone defects in rabbits.

Objective To compare the diagnostic efficacy of 68Ga-prostate specific membrane antigen (PSMA)-617 PET/CT and multi-parameter MRI for primary prostate cancer.Methods From June 2017 to November 2017,24 patients (age (67.6±7.0) years) with suspected prostate cancer were prospectively enrolled.All patients underwent 68Ga-PSMA-617 PET/CT and multi-parameter MRI.Pathological diagnosis was considered as the gold standard.The diagnostic efficacy of the two methods was analyzed and the difference was evaluated by receiver operating characteristic (ROC) curve analysis(Z test).Results Based on the puncture biopsy and/or excision biopsy,18 patients were diagnosed as prostate cancer and 6 patients were diagnosed as benign diseases.According to the five-zone analysis for the prostate (24 patients with 120 zones),48 and 56 zones were detected accurately in prostate cancer patients by PET/CT and multi-parameter MRI respectively,which was 54 and 41 for benign patients.The cut-off value of maximum standardized uptake value (SUVmax) in 68Ga-PSMA-617 PET/CT for diagnosing prostate cancer was 4.85,the area under curve (AUC),sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index were 0.890,75.00％ (48/64),96.43％ (54/56),96.00％ (48/50),77.14％ (54/70),85.00％(102/120),71.43％ respectively for prostate cancer by PET/CT,and 0.837,87.50％(56/64),73.21％ (41/56),78.87％ (56/71),83.67％ (41/49),80.83％ (97/120) and 60.71％ respectively by multi-parameter MRI.The difference of AUC was statistically significant (Z=2.82,P＜0.01).Conclusions The diagnostic accuracy of 68Ga-PSMA-617 PET/CT imaging for prostate cancer is higher than that of multi-parameter MRI.Both modalities have high diagnostic efficiency and can be used scientifically as complementary.

Objective To quantitatively compare the diagnostic capability of 68Ga-NGR and 18F-FDG in well-differentiated hepatocellular carcinoma (HCC) bearing mice by microPET/CT imaging.Methods The in vitro cellular uptake,in vivo microPET/CT imaging and biodistribution studies of 68Ga-NGR and 18F-FDG were quantitatively compared in SMMC-7721-based well-differentiated HCC.The human fibrosarcoma (HT-1080) and human colorectal adenocarcinoma (HT-29) cells/xenografts were respectively used as positive and negative reference groups for CD13.The expression of CD13 was qualitatively verified by immunohistostaining.The levels of CD13 and glucose-6-phosphatase (G6Pase) were semi-quantitatively analyzed by Western blot test for all 3 types of tumors.Two-sample t test was used for data analysis.Results The in vitro cellular uptake showed that the 68Ga-NGR uptake in SMMC-7721 and HT-1080 cells was higher than that in HT-29 cells,and the 68Ga-NGR uptake was higher than 18F-FDG uptake in SMMC-7721 cells.The in vivo micro-PET/CT imaging results revealed that the uptake of 68Ga-NGR in SMMC-7721 tumor was (2.17±0.21) ％ID/g,remarkably higher compared to (0.73±0.26) ％ID/g of 18F-FDG uptake (t =8.826,P＜0.01).The tumor/liver ratio of 68Ga-NGR was 2.05±0.16,which was 2.03-fold higher than that of 18F-FDG.In the HT-1080 tumors,the uptakes of 68 Ga-NGR and 18F-FDG were both high,and the values were (2.46±0.23) ％ID/g,(3.47±0.31) ％ID/g.The uptake of 68Ga-NGR was significantly lower than that of 18F-FDG in HT-29 tumors:(0.67±0.20) ％ID/g vs (3.17±0.29) ％ID/g;t=4.221,P＜0.01.Western blot and immunohistostaining results were as follows:HT-1080(CD13+,G6Pase-),SMMC-7721(CD13+,G6Pase+),HT-29 (CD13-,G6Pase-).Conclusions The uptake of 68Ga-NGR is higher than 18F-FDG uptake in SMMC-7721 tumor bearing mice,therefore it is worthwhile to consider the feasibility of clinical translation for PET/CT in diagnosis of HCC.Furthermore,because of the difference in 68Ga-NGR and 18F-FDG avidities in tumors with different molecular phenotypes of CD13 and G6Pase,there is an underlying potential for molecular imaging in the determination of molecular phenotypes.