Objective To investigate the feasibility and efficacy of ultrasound-guided interstitial implantation of radioactive ~(125)I seed for the treatment of unresectable pancreatic carcinoma.Methods Twenty-one patients with unresectable primary pancreatic carcinoma were treated with interstitial ~(125)I seed implantation under laparotomy.The radioactive activity and the number of implanted seed were determined according to preoperative CT scanning outcomes by using the Treatment Planning System(TPS).The matched peripheral dose(MPD) was 65~110 Gy.The radioactive activity ranged 0.4~0.5 mCi per seed.A total of 10~75 ~(125)I seed were implanted with an 18-gauge seed needle and the Mick applicator under direct visualization or ultrasound guidance.Gastroenterostomy or cholangiojejunostomy were performed in 8 patients before or after the implantation.Postoperative external radiation therapy combined with chemotherapy with gemcitabine was carried out in 2 patients. Stent placement was conducted in 2 patients preoperatively and postoperatively, respectively.Results Out of 15 patients with abdominal pain,complete and partial pain relief were obtained in 7 patients and 7 patients,respectively,at 1~3 postoperative days,the response rate being 93.3%(14/15). Except for 2 cases of loss of follow-up,there were 5 cases of complete response(CR),7 cases of partial response(PR),5 cases of progressive disease(PD),and 2 cases of no change(NC).Of 19 patients,the median survival time was 5 months and the 1-year survival rate was 26.3%.Chylous leakage occurred in 1 patient and seed dislodgement to the liver occurred in 3 patients.No pancreatic fistula or pancreatitis were encountered. Conclusions Radioactive ~(125)I seed implantation for the treatment of pancreatic carcinoma is safe,effective,and micro-invasive,being a good option of remedy.

Objective To investigate the epidemiological characteristics of polyomavirus type BK infection in renal transplant recipients.Method We systematically screened for active BKV infection preoperation and at 0.5,1,3,6,9,12 and 15 months after transplantation in 116 renal transplant recipients.The screening tests included urine cytology (by the Papanicolaou method) and BKV DNA PCR (the kit for testing the BK virus) assay of both urine and plasma,and the results were recorded.Renal biopsy was performed if the graft function was deteriorated gradually or the loads of BKV replication were very high.Routine histopathological examination and immunohistochemistry were performed on renal tissues from partial patients who received the tests of renal biopsy.Result Throughout the follow-up of 15 months,urinary decoy cells (median 8/10 HPF,[1～ 48/10 HPF]),BKV viruria (median 2.63 × 105 copies/mL,[1.78 × 103 ～ 8.54 × 109 copies/mL]),BKV viremia (median 2.70 × 104 copies/mL,[1.95 × 103 ～6.31 × 106 copies/mL]),and BKVAN (4 patients) occurred in 53.46％,24.17％,20.72％ and 3.45％ of renal-transplant recipients,respectively.The positive rate of the decoy cell and BKV DNA in urine reached the peak at the third month to the ninth month after transplantation,and the peak time of the BK viremia was the fifth month post-transplantation throughout the follow-up period.The change in BKV DNA level remained constant in blood and urine throughout the follow-up period.Conclusion The peak time of BKV infection was apparently three to nine months after transplantation,suggesting the importance of monitoring urine cytology and BKV DNA loads in post-transplantation patients closely during this period in order to reduce BKVAN after transplantation.

Objective To obtain the near-infrared fluorescence image in vivo and find the relationship between the detecting depth and fluorescence probe concentration. Methods Signals of fluorescence probe in various depths of vivo and tissue phantom with cooled CCD camera were acquired. Results The fluorescence intensity informations with different fluorescence probe concentrations and depths in vivo and liquid phantom were obtained. Conclusion Relationship between fluorescence intensity,location and depth of detecting probe in vivo is found. The linear relation of fluorescence probe concentration and detecting intensity is simulated,which will be used as a reference for the experiment system.

Objective To develop the fluorescence molecular imaging system and obtain the 3D images of near-infrared fluorescent probe in tissue-like solution.Methods Weak optical signals were acquired with hypothermal cooled CCD camera.The system captured the fluorescent images of different projections at rotating the tissue phantom.The photon propagation in tissue followed the diffusion approximation theory.The 3D image of probe was calculated with a fast reconstruction algorithm based on finite element approach.Results The imaging system could obtain the full-angle dense raw dataset.The reconstruction algorithm had capacity to recover the position and contour of the fluorescent target included in diffusive medium.Conclusion The results from phantom experiments are promising and show the potentials to act as a platform for in vivo fluorescence tomography.

Objective To study the relationship between serum iron, serum ferritin and alcoholic fatty liver(AFL), nonalcoholic fatty liver(NFAL). Methods The liver specimens of 97 patients with fatty liver were obtained by 1 second liver biopsy, and were further stained by haematoxylin eosin(HE) and Perl's Prussian. Meanwhile the serum levels of iron and ferritin were detected by atomic absorption spectrum and radioimmunoassay respectively. Results Compare to the control group ((10.5?5.7)?mol/L, (143.3?71.9)ng/ml),the serum levels of iron and ferritin were obviously high in patients with severe NAFL ((21.5 ?11.1 ) ?mol/L , (199.3?72.1)ng/ml) or moderate AFL((20.9? 9.3 )?mol/L,(217.6.0?71.8)ng/ml) and severe AFL ((29.1?6.5) ?mol/L ,(284.7?77.9)ng/ml) ( P

Objective To investigate the clinical efficacy of BK viremia and BK virus-associated nephropathy (BKVAN) with rescuing therapy in renal-transplant recipients.Methods We systematically screened for active BKV infection at 0.5,1,3,6,9,12 and 15 months after transplantation in 116 renal transplant recipients.The screening tests included BKV DNA PCR (the kit for testing the BK virus) assay of both urine and plasma,and the results were recorded.Renal biopsy was performed if the graft function deteriorated gradually or the loads of BKV replication were very high.According to the existing literature material,preferential therapy was given to the patients with BK viremia and BKVAN after renal transplantation.Results Throughout the follow-up of 15 months,urine BKV viruria (median 2.63 × 105 copies/mL,1.78 × 103 8.54 × 109 copies/mL),blood BKV viremia (median 2.70 × 104 copies/mL,1.95 × 103-6.31 × 106 copies/mL),and BKVAN (4 patients) occurred in 24.17％,20.72％ and 3.45％ renal-transplant recipients,respectively.According to related literature and guide,in 24 cases of BKV viremia including 4 BKVAN patients,the dosages of immunosuppressants were reduced or FK506 was replaced with CsA,the disease conditions were effectively improved,and no acute rejection,allograft dysfunction or graft loss occurred.Conclusion Rescuing therapy of immunosuppression reduction or replacing FK506 with CsA was effective for BKV viremia and BKVAN recipients,and could not increase the risk of acute rejection and graft loss.

Objective To study the impairment and the expression of receptor of advanced glycation endproduct (RAGE) in cultured rat glomerular mesangial cells ( GMC ) induced by constant and intermittent high glucose, and to investigate the pathogenesis of diabetic nephropathy. Methods After being cultured under constant and intermittent high glucose with different concentrations for 24 and 48 hours, the morphological changes of rat mesangial cells were observed, the proliferation of GMC was detected by MTT assay, the activity of superoxide dismutase (SOD)and the level of malondialdehyde (MDA)in supernatant were measured by spectrophotometer,and the expressions of RAGE mRNA were evaluated by RT-PCR. Results ( 1 ) Compared with the control group,the cellular morphology was changed in case of constant and intermittent high glucose. The damage of GMC with intermittent high glucose concentrations was more serious. (2)The activity of SOD was decreased and the level of MDA was raised in case of intermittent high glucose concentrations compared with the constant high glucose concentrations (P＜0.05). (3)The expression of RAGE mRNA with intermittent high glucose concentrations was significantly higher than that with constant high glucose concentrations ( P＜0. 01 ). Conclusions The damaging effects and increased expression of RAGE in cultured rat GMC induced by blood glucose fluctuation was much worse than that with constant high glucose. The blood glucose fluctuation may be one of the causes that induce diabetic nephropathy.

BACKGROUND: With the rapid development of digital orthopaedics, navigational template has been widely used in the field of orthopaedics, but the research status of the technique in China based on bibliometric analysis is never reported. OBJECTIVE: To investigate the application status of navigational template in the orthopaedic field and to explore its tendency and hot spot based on bibliometric analysis, thereby providing reference for the development of digital orthopaedics in China.METHODS: A computer-based retrieval of CBMdisc, CNKI, CSPD, CMCI databases was conducted for articles published before December 1, 2016 using the keywords of navigational template and subject heading orthopaedics and the core orthopaedic journals published in 2016 were searched by manual. The articles were screened according to inclusion and exclusion criteria, and finally were analyzed by bibilometric study.RESULTS AND CONCLUSION: (1) In China, the first paper reporting navigational template was issued in 2008. A total of 199 articles were published in the past 9 years, with more than 10 papers yearly from 2009 to 2014, while there was a rapid increase tendency during 2015 and 2016. (2) The articles were mainly published in the orthopaedic journals and some professional journals closely related to digital orthopaedics, such as biomedical engineering, basic medicine and digital medicine. About 86.9% papers belong to Chinese core journals, including Chinese Journal of Orthopaedic Trauma,Chinese Journal of Orthopaedics, and Chinese Journal of Tissue Engineering Research. (3) There is a 99.5% cooperation rate and 6.15 degree of cooperation. Zhang Yuan-zhi, Ding Huan-wen, Lu Sheng, Chen Yu-bing, Hu Yong,Huang Xuan and Zheng Peng-fei are most productive authors, and core authors contribute to 53.8%, indicating that the group of core authors is being formed. First authors are all from hospitals and universities, mostly from Kunming General Hospital of Chengdu Military Command of PLA, General Hospital of Guangzhou Military Command of PLA, the Affiliated Hospital of Inner Mongolia Medical University and South China University of Technology. The cooperation rate of more than two institutes occupies 54.8%, indicating that the study holds a promising future with the strong support of research institutes in universities. About 59.3% articles are sponsored by funding, the national and provincial foundations accounting for 64.0% in 239 projects, and 57.6% articles were supported by more than two foundations, revealing the high research levels and academic values of this technique. (4) The articles are cited by 763 times; Lu Sheng,Chen Yu-bing, and Zhang Yuan-zhi are the highly cited authors; Kunming General Hospital of Chengdu Military Command of PLA, General Hospital of Guangzhou Military Command of PLA and Nanfang Hospital of Southern Medical University are the highly cited institutes, and Chinese Journal of Orthopaedic Trauma is the highly cited journal. (5) To conclude, based on product design, manufacture and cadaver studies of the navigational template, it has been extensively applied in the spine surgery (especially cervical surgery), orthopaedic traumatology, bone and joint surgery,bone tumor and pediatric orthopaedics, and has obtained satisfactory clinical outcomes in assisting screw placement,osteotomy and precise resection and functional reconstruction. However, there is still a lack of a large-sample,multicenter, and long-term randomized trial.

Objective To observe the MRI imaging manifestations of the ligaments and soft tissues around the atlanto-axial joint in children with atlanto-axial rotation instability.Methods Assigned into observation group were 50 children with atlantoaxial rotatory displacement who had been treated in our hospital from January 2013 to March 2014.Another 50 healthy children were chosen as a control group who underwent health check-ups during the same period in our hospital.Both groups received MRI examinations of the ligaments and soft tissues around the atlantoaxial joint using the same equipment and methods.MRI manifestations and characteristics of the ligaments and soft tissues around the atlantoaxial joint were analyzed and compared between the 2 groups.Results In the observation group,odontoid gap asymmetry appeared on both sides,with left shift in 32 cases and right shift in 18 cases.The MRI imaging PDWI sequence showed a significant better diagnostic sensitivity than the other sequences (T1WI,T2WI and SPAIR) (P ＜ 0.05).The MRI examinations on all the children with different sequences found 50 cases of degree Ⅰ lesion in the observation group and 4 cases of degree Ⅰ lesion in the control group,and 12 cases of degree Ⅱ lesion in the observation group and none degree Ⅱ lesion in the control group,showing a significant difference between the 2 groups regarding the diagnostic sensitivity of lesions of degrees Ⅰ and Ⅱ (P ＜ 0.05).Conclusions MRI can clearly show the rotation displacement of atlanto-axial joint associated with transverse ligament,alar ligament and lesions of the surrounding soft tissues.MRI has a dcfinite diagnostic value for atlanto-axial rotation displacements in children,especially those caused by transverse ligament tear after trauma.

Objective To explore the effect of preoperative antiviral therapy on hepatitis B virus ( HBV ) reactivation and postoperative liver function in perioperative patients with HBV-DNA-negative hepatocellular carcinoma(HCC).Methods 74 patients with preoperative HBV-DNA-negative scheduled which were analyzed.Patients were divided into two groups according to antiviral therapy or not:20 cases in antiviral treatment group received antiviral therapy for three days, 54 cases in non-antiviral teatment group did not receive antiviral therapy, and both groups received antiviral therapy after post-operative resuming to diets.The indicators of liver function and HBV-DNA levels were detected on pre-operative, post-operative 3rd and 7th day in two groups, and HBV-DNA-positive ( HBV-DNA>500 IU/mL) was defined as reactivation, conversely as inactivation.The indicators of liver function on pre-operative, post-operative 3rd and 7th day were compared between reactivation group and inactivation group.Results The reactivative rate was 21.6%(16/74) in all patients;27.7%(15/54) in pre-operative non-antiviral teatment group, 5.0%(1/20) in antiviral teatment group, and there was significant differences in reactivative rate between two groups ( P=0.035 ).The results of Logistic regression showed that pre-operative nonantiviral therapy was an independent risk factor of post-operative HBV reactivation (OR=13.952,95% confidence interval[CI]:1.358-143.379,P=0.027).The recovery of albumin (ALB) on post-operative 3rd, 7th days in antiviral treatment group was faster than those in nonantiviral treatment group, respectively (P=0.035,0.043).The recovery of ALB and alanine aminotransferase (ALT) on post-operative 7th day in reactivation group were slower than those in inactivation group, respectively (P=0.016, 0.048).Conclusion The pre-operative nonantiviral therapy is an independent risk factor of post-operative HBV reactivation in patients with HBV-DNA-negative HCC.The pre-operative antiviral therapy could inhibit post-operative HBV reactivation effectively and accelerate the post-operative recovery of liver function.