Objective To evaluate the short and mid-term effects of fixing comminuted posterior acetabular wall fractures with structural autologous iliac bone graft combined with mini screws.Methods From January 2010 to January 2014,29 patients with comminuted posterior acetabular wall fracture were treated by structural autologous iliac bone graf combined with mini screws.They were 21 males and 8 females,with a mean age of 44.2 years (range,from 22 to 58 years).The mean time form injury to operation was 7.8 days (range,from 1 to 25 days).The operations were performed through the Kocher-Langenbeck approach,with the patients in the lying position on the uninjured side.The fragments were reduced and fixed by mini screws and the ischemic ones were removed.Structural autologous iliac bone graft was used to reconstruct the posterior wall of acetabulum before a reconstruction plate was applied to compress and maintain it.The functional outcomes were evaluated by the modified Merle d'Aubigne and Postel clinical grading system at the last follow-ups.The radiographs were graded according to the Matta criteria.Results By the Matta criteria,10 cases achieved excellent reduction,16 good reduction,and 3 poor reduction,giving a good to excellent rate of 89.7％.Of this series,29 patients were followed up for 31.5 months on average (range,from 12 to 48 months).By the modified Merle d'Aubigne and Postel criteria,the functional recovery was rated as excellent in 16 cases,good in 9,fair in 3 and poor in one,giving a good to excellent rate of 86.2％.Two cases developed femoral head necrosis according to the magnetic resonance imaging 18 months postoperation.Three patients developed traumatic arthritis two years postoperation.Five patients developed heterotopic ossification postoperation,with no obvious clinical symptoms.Two patient with injury to the sciatic nerve recovered 4 months postoperation.Conclusions Structural autologous iliac graft combined with mini screws can reconstruct the integrity and stability of the fractured acetabular posterior wall,avoiding osteonecrosis of the acetabulum.This surgical technique is effective and safe in treatment of comminuted fracture of the acetabular posterior wall.

objective To compare the technical survival between Tenckhoff double-cuffed straight catheter (TC)and swan-neck curled tip catheter (SNC) in peritoneal dialysis (PD). Methods Clinical data of 208 patients received PD in the Peritoneal Dialysis Center of Peking Union Medical College Hospital from January 1999 to December 2007 were analyzed retrospectively. All the patients were divided into two groups according to indwelling catheter. Technical survival and complications associated with the catheter between two groups were compared. Results Demographics and basic information were similar in both groups. The exit-site infection (ESI) rates of TC and SNC were 22.1% and 19.8% (P=0.786), and peritonitis rates of TC and SNC were 31.1% and 22.1% (P=0.159), which were slightly lower in SNC group, but the difference was not significant. Removal of the catheter was found in 27 (13.0%)patients, including 17 cases in TC group (13.9%) and 10 cases in SNC group (11.6%)(P=0.680).The median survival times of catheter in TC group and SNC group were 25 months and 22 months respectively without significant difference (P=0.103). Conclusions There are no significant differences of ESI rate, peritonitis rate and catheter survival between these two catheters in PD. The expensive swan-neck catheter offers no additional advantage. Doctors should choose the catheter according to the economic status of patients.

Objective To analyze the characteristics of lethal peritoneal dialysis related peritonitis and to define the risk factors.Methods All patients who developed PD related peritonitis between Jan.1999 and May 2015 in PUMCH were included.Clinical profiles were collected.Patients were divided into mortality group(n=16) and non-mortality group(n=182) according to whether peritonitis causing mortality.Baseline clinical profiles were compared between two groups.Cox regression analysis was used to define the risk factors for mortality.Results White blood cells [(10.2±6.3)×109/L vs (5.8±1.8)×109/L,P<0.05] increased,but serum albumin[(25.2±8.5)g/L vs (34.0±6.3)g/L,P<0.05] and potassium concentration [(3.5±0.9)mmol/L vs (4.5±1.0)mmol/L,P<0.05] decreased at the time of lethal peritonitis bacteria and fungus cultures were positive in half of the patients as bacteria (31.2%),fungus (12.5%)and mycobacterium tuberculosis (6.25%).Multiple cox regression analysis identified cardiovascular disease as the independent risk factor for peritonitis related mortality (HR 9.318,95% CI 1.875~46.305,P<0.01).Conclusions Peritonitis of patients with cardiovascular disease may cause death.

Objective To monitor the levels of radioactive contamination due to the Japanese Fukushima nuclear accident in Beijing,so as to provide scientific technical information for government to draw effective controlling strategy and processing mechanism.Methods The system of nuclear emergency nmonitoring was started,then the radioactive contamination levels of atmosphere,rain water,surface water and vegetables in Beijing were detected according to the relative survey regulations and technology criterions.Results During the period from 15 to 41 d after the accident,obvious radioactive contamination was found in the atmosphere of Beijing.The maximum radioactivity concentration of 131I ( 5.89 mBq/m3 ) was detected at 22 d after the accident.The radioactivity concentrations of 137Cs and 134Cs were surveyed forming their corresponding peaks at 20 d after the accident,but they were one magnitude lower than the peak value of 131I at least.In addition,the gross β radioactivity level in the water of Chao Bai-he river was verified to be in the range of 0.314 - 0.602 Bq/L. Conclusions The radioactive contamination due to Fukushima nuclear accident has not done visible harm to the public health in Beijing,but monitoring should be continued to observe the long-term effect of the accident.

Objective: To analyze the clinical data of the elderly peritoneal dialysis (PD) patients in Peking Union Medical College Hospital (PUMCH), and to find the risk factors for the long-term survival. Methods: Baseline data and the outcome of maintenance PD patients from 1996-03 to 2015-09-30 were collected for a retrospective cohort study. Patients were divided into the non-elderly group (<65 years old), the 65-79 years old group and the ≥80 years old group, and were follow to 2016-09-30. The survival rate was calculated by Kaplan-Meier method and the risk factors of outcome were analyzed by the Cox's regression model. Results: Among 577 PD patients, about 243(42.1%) were elderly patients, including 207 patients aged between 65 and 79 years (35.9%) and 36 patients aged 80 or more (6.2%). The most common primary disease causing PD was diabetic nephropathy (DN) for both elderly and non-elderly patients. The 1-year, 3-year, 5-year survival rate of patients aged between 65 and 79 years were 87.0%, 61.9%, 32.4% respectively, and 72.5%, 48.5%, 27.3% for the ≥80 years old group. The dominating reasons of death were cardiovascular events and infection. There was no difference of technical survival rates among three groups, and the most common reason for technical failure was peritonitis. For elderly patients, diabetes (HR=2.193, 95% CI 1.445-3.328, P<0.001) and lower baseline serum albumin (HR=0.968, 95%CI 0.940-0.996, P=0.026) were independent risk factors for death. However, for non-elderly patients, diabetes (HR=3.746, 95%CI 2.149-6.529, P<0.001) was the only independent risk factor for death. Conclusions Cardiovascular diseases and infection are the main reasons for death among the elderly PD patients in PUMCH. Diabetes and lower baseline serum albumin may predict the mortality of elderly PD patients independently. Better management of nutrition might improve survival in elderly PD patients.

Since the accident on March 11th 2011 at the Fukushima Daiichi Nuclear Power Station following the Great East Japan Earthquake,huge amount of radionuclide has been released to the surrounding environment.In this study,the environmental monitoring method,γ-ray dose rates,radioactivity in environmental samples,food,wild animals and plants,health situation of residents were summarized.Through summarizing the accident experience of Fukushima Daiichi Nuclear Power Station,this research discussed and analyzed the accident combining with the situation in China.

Objectives To compare the clinical characteristics, long - term survival and associated risk factors of automated peritoneal dialysis (APD) patients and continuous ambulatory peritoneal dialysis (CAPD) patients. Methods As a retrospectively study, adult patients started peritoneal dialysis in Peking Union Medical College Hospital (PUMCH) from September 1st, 2002 to September 30th, 2016 were enrolled. Baseline information and dialysis associated parameters were collected. The primary outcome was death and the secondary outcome was technical failure. The risk factors of death were analyzed in APD patients by Cox's regression model. Homochromous gender and age matched CAPD patients were analyzed as control. Results The baseline condition of 69 APD patients were similar to those of 138 CAPD patients. The survival rates of APD patients at 1-year、3-year and 5-year were 95.4%, 88.0% and 73.0% respectively, which were superior to CAPD patients. No significant difference in technical survival was found between APD and CAPD patients. Single-factor Cox's regression analysis showed that all-cause mortality of CAPD patients was 2.2 times higher than that of APD patients (95% CI 1.221-3.837). In the multi-factor Cox regression analysis model, adjusted by age, complications (including cardiovascular disease and diabetes), nPCR and serum creatinine, dialysis modality was not an independent risk factor of dialysis patients. Age (HR=1.077, 95%CI 1.016-1.142, P=0.013), diabetes (HR=3.608, 95%CI 1.117-11.660, P=0.032) and serum albumin (HR=0.890, 95%CI 0.808-0.982, P=0.020) were independently associated with all-cause death of APD patients. Conclusions Dialysis modality was not an independent risk factor for the all-cause mortality of peritoneal dialysis patients. Age, diabetic nephropathy and hypoalbuminemia were independently associated with the death of APD patients.

Objective To compare the response capability of active personal dosimeters (APDs) in the pulse radiation field of interventional radiology, and to find APDs that can be used for dose optimization monitoring for interventional radiology staff. Methods Seven models of APDs and dose monitoring systems were tested in the following four types of radiation fields: continuous radiation field (Cs-137), single-pulse radiation field (80 kV, 10 mA, 10～1000 ms), multi-pulse standard radiation field (70 kV, 20～500 mA, 1～20 ms/pulse, frames per second 1～20), and multi-pulse scattering field (angiography machine, irradiation field: 15 cm × 15 cm, 22 cm × 22 cm, 27 cm × 27 cm, angiography: 65～74 kV, 6.2～8.2 mA; photography: 65 kV, 343～479 mA). Results All APDs showed good dose responses in the continuous radiation field. The ratio of the results obtained with and without phantom was 1～1.1. In the single-pulse radiation field, DMC3000 and TruDose showed good dose response, linearity, and repeatability. Under the main ray of the multi-pulse radiation field, DMC3000 and TruDose showed good dose response, linearity, and repeatability as the dose rate increased, and there were 5%～13% differences in the response ability between the two models. In angiography machine scattering field, the ratios of the results obtained from DMC3000, TruDose, and RaySafei3 to those from thermoluminescence dosimeter were 1.08 ± 0.09, 0.95 ± 0.11, and 1.13 ± 0.11, respectively. Conclusion DMC3000, TruDose, and RaySafei3 can be used in clinics as auxiliary dosimeters to optimize radiation dose monitoring and radiation protection measures for people at high risk of occupational diseases. Interventional radiology workers can implement actions to reduce the cumulative dose based on real-time dose information, thereby reducing the radiation dose.

Objective To establish typical values for interventional diagnosis and treatment at our institution, use these values as a tool to evaluate patient medical exposure doses, and optimize radiation protection measures. Methods From June to December 2023, we collected information on 593 adult cardiovascular interventional diagnosis and treatment surgeries, including surgery type, equipment model, air kerma-area product (KAP), incident reference point air kerma (K_a,r), perspective time (FT), and exposure mode. Results The typical value of cardiovascular interventional diagnosis at our institution in 2023 was 27.5 Gy·cm². The typical value of cardiovascular interventional treatment was 70.0 Gy·cm². The FT, KAP, and K_a,r of interventional surgeries were significantly higher than those of interventional diagnosis (P < 0.01). There were significant correlations between FT, KAP, and K_a,r (P < 0.01). Conclusion The results of this study were slightly different from those of other studies. They provide typical data and reference values for cardiovascular interventional diagnosis and treatment dose levels in Beijing and are helpful for dose optimization between different medical institutions.

Objective To understand the types, proportions, and radiation dose levels of pediatric cardiac interventional procedures. Methods A retrospective analysis was conducted using the basic information and radiation dose data from all cases of pediatric cardiac interventional procedures performed at two tertiary medical institutions in Beijing from July 2023 to August 2024. The data included air kerma-area product, reference point air kerma, and fluoroscopy time. Descriptive statistical analysis was conducted to evaluate the basic information and dosimetric indicators of the procedures. Non-parametric tests were employed to examine the differences between variables, and Spearman’s correlation coefficient was utilized to investigate the relationships among various factors. All cases were categorized into the diagnostic group and the therapeutic group. In the diagnostic group, the majority of procedures involved catheter examinations and angiography for identifying the type of disease. In the therapeutic group, the primary procedures included patent ductus arteriosus, atrial septal defect, ventricular septal defect, patent foramen ovale, pulmonary stenosis, radiofrequency catheter ablation, major aortopulmonary collateral arteries, complex congenital heart diseases, and other interventional procedures. Results The survey comprised 1008 cardiac interventional procedures involving 476 males and 532 females. The ages of the participants ranged from 0 to 15 years and the body weights from 4.5 to 105 kg. Among these participants, 92 and 916 were classified in the diagnostic and therapeutic groups, respectively. The proportions of interventional procedures were in the order of atrial septal defect (36.9%), radiofrequency catheter ablation (22.3%), patent ductus arteriosus (15.1%), complex congenital heart disease (4.8%), patent foramen ovale (3.1%), pulmonary stenosis (3.1%), ventricular septal defect (2.2%), other procedures (2.0%), and major aortopulmonary collateral arteries (1.5%). The radiation doses of different interventional procedures were statistically different (P < 0.05), with air kerma-area product ranging from 0.02 to 658.4 Gy·cm², reference point air kerma from 0.1 to 2524 mGy, and fluoroscopy time from 0.2 to 62 min. Conclusion In pediatric cardiac interventional procedures, there is considerable variability in radiation doses for the same type of procedure. Additionally, radiation doses for identical procedures vary between different medical institutions, and a few cases carry a risk of deterministic effects.