Objective To establish the isodose curves and dose calculation models of()~(125)I seed plane implantation using the three-dimensional treatment planning system(3D-TPS). Methods The isodose cures of 1 000 cGy,3 000 cGy,6 000 cGy,9 000 cGy,12 000 cGy,15 000 cGy,and 20 000 cGy and dose calculation models of triangular,quadrilateral,hexagon,and dodecagon patterns of()~(125)I seed plane implantation were created using the 3D-TPS.The isocenter dose pattern of 0,0.5,1.0,1.5,2.0,2.5,3.0,and 4.0 cm from the plane center was calculated with 3D-CRT. Results The study showed that if doses were less than 10 Gy at 2.0 cm,2.5 cm,3.0 cm and 4.0 cm apart from the center of triangular,quadrilateral,hexagon,and dodecagon patterns and the distance was beyond 1 cm between seeds,there was a low dose region in the centeral point. Conclusions The study showed that the isodose distribution curves and dose calculation models in plane implantation were primarily established using the seed implantation 3D-TPS.

BACKGROUND: It is confirmed that panel reactive antibody (PRA) and its immune level is closely related to rejection activation, renal survival rate and the realization of the renal function. Study addressing the relation PRA level and acute rejection has great clinical significance for forecasting acute rejection and improving the renal survival rate.OBJECTIVE: To analyze the relation of PRA and acute rejection prior to and after transplantation by detecting PRA level combined with patient rejection.DESIGN, TIME AND SETTING: Retrospectively case analysis was performed at the Affiliated Beijing Friendship Hospital of Capital University of Medical Sciences from September 1998 to May 2005.PARTICIPANTS: A total of 633 patients receiving renal transplantation were collected, including 348 males and 285 females, aged 16-67 years.METHODS: Company Lymphocyte Tray produced by One Lambda and Biotest were used for this study, serum PRA level was detected prior to and within 2 months after transplantation.MAIN OUTCOME MEASURES: Pre- and post-transplant PRA level and clinical rejection.RESULTS: Totally 591 patients were PRA negative in pre-transplant assay, and 164 patients were positive, 10.32% (61/591) patients occurred acute rejection; 42 patients were PRA positive in pre-transplant assay, and 71.42% (30/42) patients occurred acute rejection. The difference between PRA negative or positive and acute rejection had significance (P < 0.001). 427 patients were PRA negative in both pre- and post- transplant assay, 5.6% (24/427) patients occurred acute rejection. 164 patients were PRA negative in pre-transplant assay, but positive in post-transplant, 42.7% (70/164) patients occurred acute rejection. The comparison of PRA negative pre-transplant and PRA positive post-transplant combined with acute rejection had difference (P < 0.001). The correlation coefficient of pre-transplant PRA and acute rejection was 0.612, which was 0.658 between post-transplant PRA and acute rejection, there was obvious association when P=0.01.CONCLUSION: PRA plays an important role in forecasting renal rejection. The acute rejection probability is higher in patients with positive PRA; in other hand, the probability is lower in patients with negative PRA.

Objective To study the correlation between transplanted kidney dysfunction and oc-currence of the panel reactive antibody ( PRA, also referred as anti-HLA antibody ) and anti-Major-Histo-compatibility-Complex class Ⅰrelated chain A (MICA) antibody.Methods The tests for detecting PRA and anti-MICA antibody were performed on 679 renal transplant patients from December , 2009 to June, 2010 who received transplantation before 2008 in Beijing Friendship Hospital .Enzyme-Linked Immunosor-bent Assay ( ELISA) was used to detect anti-HLA antibody using LAT-1240 ( OneLambda Inc .) .MICA Ab-Scan Kit was adopted to detect anti-MICA antibody .Continuous observation of graft function was conducted . Results 108 out of 679 patients showed anti-HLA antibody and/or anti-MICA antibody positive results . Among them, 81 patients were positive only for anti-HLA antibody, 18 patients were positive only for anti-MICA antibody and other 9 patients showed anti-HLA and anti-MICA antibodies double positive .Among all of the kidney transplant patients with a failed or decreased renal function , 71 patients were positive for anti-HLA antibody;16 patients were positive for anti-MICA antibody;and other 9 patients were positive for both anti-HLA and anti-MICA antibodies .The results demonstrated that anti-HLA and anti-MICA antibodies af-fected the renal functions in patient with renal transplantation (χ2 =353.92, P <0.001).Conclusion Anti-HLA and MICA antibodies showed significant positive correlations with chronic allograft failure in the patients with renal transplantation .

BACKGROUND:Anterior cervical discectomy and fusion surgery is a good choice for repair of degenerative cervical disc herniation, but it is reported that fusion can affect the exercise of cervical neighboring stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration.
These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P<0.05). In the final fol ow-up, the visual analog scale scores of neck and upper limbs and cervical dysfunction index were al lower than those after one week of treatment, and the Japanese Orthopaedic Association scores were higher than those after one week of treatment (P<0.05). There were no significant differences in the above indicators at each time point between these two groups (P>0.05). The cervical activity and surgical segmental motion after cervical disc replacement were significantly higher than those in the fusion group;the difference was statistical y significant (P<0.05). There were no serious complications in these two groups. There was no significant difference in the incidence of complications between these two groups (P>0.05). These results suggest that the artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single cervical disc herniation have the same effect in terms of patients’ symptoms mitigation. With respect to fusion technique, artificial disc replacement surgery has the advantage of maintaining cervical stability and activities of replacement segments.

BACKGROUND:In recent years, with the continuously improving of the fixation systems and technology, conducting anterior cervical decompression bone graft accompanying with anterior plate fixation have been accepted by most scholars, however, the complications related to this also appeared constantly. In view of this, the zero notch interbody fusion plate (Zero-P) has been approved for the clinical treatment of cervical degenerative disease. OBJECTIVE:To discuss the early application effect of Zero-p on anterior cervical decompression and fusion. METHODS:The study enrol ed 22 patients who underwent anterior cervical decompression and fusion with Zero-P between February and December 2014. The number of Zero-P implanted in the C3-4, C4-5, C5-6 was 1, 3 and 18 respectively. Pain and neurological improvement were evaluated using Visual Analog Scales score and Japanese Orthopaedic Association (JOA) score for al the patients after operation. The X-ray plain of lateral and flexion-extension lateral of cervical vertebra were shot. The degradation degree was judged based on the measurement results from the cervical lateral X-ray films about the ratio of cephalad and caudal adjacent intervertebral space to vertebral body height, and adjacent segments osteoarthritis situation. The abnormal activity at the surgical spaces was observed by the extension and flexion lateral X-ray plain. RESULTS AND CONCLUSION:Twenty-two patients obtained fol ow up for 10-28 months. 2 patients had dysphagia on the fourth day and the fifth day after operation (extremely mild). The symptom disappeared within 2 weeks after treatment. The Visual Analog Scales score was significantly lower compared with preoperation (P<0.05), the JOA score was significantly higher than that before operation (P<0.05) , the cervical Cobb angle was significantly higher than that before operation (P<0.05). There were no significant differences statistical y in comparison of the Visual Analog Scales score, JOA score and cervical Cobb angle at different time points after operation (P>0.05). In cephalad adjacent intervertebral space, 3 cases had developed hyperosteogeny (first level). In caudal adjacent intervertebral space, 1 had developed hyperosteogeny (first level). There was no significant difference in the hyperosteogeny between cephalad adjacent intervertebral space and caudal adjacent intervertebral space (P>0.05). There was no significant difference in the R value in cephalad adjacent intervertebral space and caudal adjacent intervertebral space between preoperation and postoperation (P>0.05). During the fol ow-up, no abnormal activity at the surgical spaces and implant displacement was observed. These results suggest that using Zero-p in the treatment of monosegmental disc disease has significant effect, can effectively improve the cervical curvature and establish good cervical stability. The incidence of postoperative dysphagia is low. The degeneration of adjacent segments after treatment was not increased in early stage.

Objective To measure the setup errors and organ movements of patients with esophagus carcinoma during radiotherapy and find a reasonable margin from the clinic target volume (CTV) to the planning target volume (PTV). Methods (1) Set-up veri cation: Forty-two cases of untreated esophageal cancer were enrolled into this study. The physicist firstly made the planning according to the doctor requests and ensured the best distribution at the target. Thereafter, the 0° and 90° digitally reconstructed radiograph (DRR) was transmitted to the iView GT workshop. Meanwhile, two copies of cross-cut electronic portal image (EPI) were required before radiotherapy. Two doctors confirmed the variance of the osteal mark from the EPI and DRR,and output a 3D direction (left to right, superior to inferior, anterior to posterior) of the setup errors through the iView GT software. (2)Breathing motion:Ten cases of untreated esophageal cancer were enrolled into this study.Three distinct breathing levels were deflned: FB (free breathing), EBH (expiration with breath-held) and IBH (inspiration with breath-held). We gave the treatment planning in FB, then by moving the isocenter to EBH and IBH, we recalculated the dose distribution without changing the field angle, shape and weighing (Mus). Displacements were analyzed at four points (anterior, posterior, right lateral and left lateral) and five levels of target (upper, quarter, isocenter, three-quarter and lower). Results (1) The systematic setup errors were -0.23 cm, -0.02 cm and -0.06 cm, and the random errors were 0.44 cm, 0.45 cm and 0.44 cm at the direction of left to right(LR), superior to inferior (SI), anterior to posterior(AP), respectively. (2) The organ movements were 0.3 cm, 0.6cm and 0.3cm at the LR, SI, AP, respectively. Conclusions As an alternative, the root-sum-of-squares of set-up error and organ motion are suggested by σtot=√ (σITV2+σSM2). The CTV to PTV margins are 0.8cm left to right, 0.78cm superior to inferior, 0.5cm anterior to posterior.

Objective To investigate the HLA antibody incidence and type renal recipients with different age, and to study the echaracteristics in different age patients, for clinical reference to forecast renal rejection in different age patients. Methods With serum dated from January 2006 to June 2008, patients were classified into three groups: young group, with age below 35 years; middle age group, with age from 36 to 50 years; and old group, with age above 50 years. Penel reactive antibody (PRA) were detected using ELISA. Results Pretransplant HLA antibody incidences in the young, middle age, old group were 18.18%, 23.00% and 6.19%, respectively. In young group, HLA antibody incidences were 5.59% and 8.51% in male and female respectively. In middle age group, they were 21.30% and 25.38% in male and female respectively. In old group, they were 11.36% and 25.00% respectively. HLA Ⅰ and HLA Ⅰ + Ⅱ antibodies were mainly found in all the three groups in pretansplant. Conclusion HLA Ⅰ and HLA Ⅰ + Ⅱ antibodies were mainly found in pretransplant. Antibody incidence was higher in patients who had more than once renal transplant than that in transfusion and pregnancy female. Antibody incidence is higher in female than that in male.

Objective To analyze the sensitized factors in urinemia patients who waiting for renal transplantation.Methods 2429 patients with urinemia from April 2002 to December 2008 were subjected to the detection of panel reactive antibody, and classified into 5 groups according to their clinical data:(A) no history disease group (n = 1097) who never experienced transfusion, pregnancy and transplantation; (B) Transfusion group (n = 361) who received transfusion more than 200 ml; (C) Pregnancy group (n = 481) who experienced pregnancy; (D) Transfusion+ pregnancy group (n= 294) who experienced both pregnancy and transfusion; (E) Re-transplantation group (n = 196) who experienced failed transplantation before, and waited for the second renal transplantation.Results All the males in group A were negative for PRA, and females were weakly positive for HLA Ⅱ antibody.The incidence of PRA production in group B was 15.24 % (55/361).Thirty-nine patients were positive for PRA in group C with the incidence being 8.11 % (39/481).The PRA positive rate in groups D and E was 30.61 % (90/294) and 70.92 % (139/196) respectively.PRA intensity was more than 60 % in 72 patients in group E.Conclusion Transfusion and pregnancy caused lower incidence of PRA positive rate.The incidence was much higher in transfusion + pregnancy patients than that in patients with transfusion or pregnancy alone.Graft caused the higher incidence of PRA than by transfusion and pregnancy.

Objective To study long-term post-liver-transplantation hyperuricemia (HUA) and the influence of urate-lowering therapyon renal functions of adult patients.Methods Among 428 cases undergoing liver transplantations during March 2011 to December 2013,206 patients,whose followup periods were above 1 year,were selected as the objects of study.Those whose two-time serum uric acid (SUA) levels tested not in the same day one year after operation ＞420 μmol/L (male),or female ＞360 μmol/L (female) were divided into HUA group,and non-HUA group.The serum creatinine (SCr) concentrations and glomerular filtration rate (eGFR) were analyzedin the two groups at their peak SUA to find whether there was any difference between the two groups.Meanwhile,27 HUA patients with abnormal renal function were given urate-lowering therapy and the differences in SCr and eGFR after the therapy were observed.Results 49.5％ patients sufferedlong-term HUA after liver transplantations.As compared with non-HUA group,SCrconcentrations were increased statistically (P＜0.05),and eGFR was reduced statistically in HUA group (P＜0.05).After 8-week uratelowering therapy among 27 patients,SUA level in 24 cases (88.9％,24/27) returned to the normal standard and SCr concentrations in 21 cases (77.8％,21/27) decreased for a certain degree.SUA levels were decreased to (349.93 ± 22.85)μmol/L from (532.94 ± 93.91) μmol/L (P＜0.001).SCr concentrations were decreased to (129.52 ± 19.06)μmol/L from (144.95 ± 13.51) μmol/L (P =0.016).The eGFR increased to (56.30 ± 11.46) ml · min-1 · 1.73 m-2 from (46.46 ± 8.11) ml·min-1 ·1.73 m-2(P =0.012),which showed a certain degree of improvement in their renal functions.Conclusion HUA is a long-term common complication in liver transplanted adult patients,which has a negative influence on patients' renal functions,so we need to pay enough attention to this.Urate-lowing therapy has a positive influence on the improvement of renal function if other factors were excluded from the treatment.

Objective To determine the maximum tolerated dose ( MTD) and dose?limiting toxicity ( DLT) of weekly PTX and DDP concurrent postoperative radiotherapy in Chinese women with high?and intermediate?risk early cervical cancer. Methods Women with high risks postoperative cervical carcinoma, ECOG≤2 were eligible. Pelvis RT (6/10 MV X?ray,3DCRT 40 Gy/20f,para?metrial boost 10?20 Gy/5?10f) was followed by 2?4f brachytherapy applications ( 192 Ir,5 Gy/f) . Concurrent weekly chemotherapy was started at DDP 20 mg/m2 and PTX 10 mg/m2 weekly,and escalated in three?patient cohorts according to 3+3 methods. Results 25 patients were enrolled and treated over seven doses levels until dose?limiting toxicity (DLT) was reached. Median age was 48 years (range,34?66).All of patients finished RT in 7 weeks. Grade 3,4 non?hematologic toxicities were diarrhea and observed in two patients (4 cycles,DLT) at level 7.Grade 3,4 hematologic,principally leukopenia and neutropenia,and occurs late cycles. One grade 4 leukopenia and neutropenia was observed at dose level 6 but not seen in three additional patients. No one was delayed treatment time by concurrent chemotherapy.22 patients finished 6 cycles. Median follow?up is 59. 5 months. Three patients have died of cancer metastasis and recurrence. One patient has died of respiratory failure. Conclusions Combination PTX and DDP administered concurrently with pelvic EBRT can be safely administered at the MTD of DDP 35 mg/m2 and PTX 30 mg/m2 weekly for six cycles in Chinese women with postoperative cervical cancer.