Objective To evaluate the uniformity of different diagnosis criteria of metabolic syn-drome in patients with type 2 diabetes, especially the criteria that suit for metabolic syndrome in type 2 dia-betes patients.Methods The patients with type 2 diabetes, aged from 20~74 years, who were treated at Department of Endocrinology , the Third Affiliated Hospital , Qiqihar Medical University from January 2008 to November 2009 were enrolled.Four hundred and twenty one patients with integral data were analyzed . Waistline, hip line, height, body mass, blood pressure and so on were surveyed , and according to waistline and hip line the waist-to-hip ratio was calculated .On the basis of body mase/height body mass index ( kg/m2 ) was calculated .The blood sugar was detected with the hexokinase method .The blood cholesterol , tria-cylglycerol , the high density lipoprotein cholesterol were determined with the biochemistry method .Urinates the micro albumin level was determined with chemistry to try the belt technology .Diagnosis standards of WHO (1999), NCEP-ATPⅢ(2001),ACCE(2003),EGIR(1999),the Chinese CDS(2007) suggestion metabolism synthesis drafts , the triacylglycerol-waistline standard of Blackburn P forecast cardiovascular e-vent(2003) were applied to calculate prevalence rate of metabolism synthesis .Results The 421 enrolled testees were involved in the result analysis .⑴Prevalence rates of type 2diabetes and metabolism synthesis in various single component: In the investigation population the differences in body of obesity , hypertension and hypertriacylglycerolemia , the low and high density lipoprotein cholesterol blood sickness between the men and women were insignificant , but the overload (66.1%) in males was remarkably higher than that in females (49.7%).The prevalence rate in abdomen obese in males (74.0%) was remarkably higher than that in females(59.9%).⑵Abnormal distribution of metabolism in patients with type 2 diabetes: Preva-lence rate of one kind of abnormal metabolism was 27.2%.Prevalence rate of two kinds of or above two kinds of above abnormal metabolism was 61.0%.Prevalence rate of three kinds of above abnormal metabo-lism was 26.1%,and the prevalence rate in females was not higher than that of males ( P >0.05 ) .⑶After age and sex lamination ,prevalence rates of metabolism synthesis and it's the correlated disease:The preva-lence rates of the high hypertriacylglycerolemia , hypertension , metabolism synthesis had the tendency of in-creasing along with the age .Prevalence rates of abdominal obesity and the low and high density lipoprotein cholesterol blood sickness had the increased tendency in females , but it was not obvious in males .Except that 35~44 years old of age group prevalence rate of the high hypertriacylglycerolemia in males ( 62.1%) was remarkably higher than that in females ( 29.2%) ( P <0.005 ) , and the 20~35 years old age group prevalence rates of metabolism synthesis in males (41.2%)were remarkably higher than outside the females (20.0%)( P <0.05).In other various age groups ,there was insignificant difference in prevalence rate between males and females .⑷The prevalence rate of WHO diagnosis standard for metabolism synthesis (62.9%) had good concordance with the prevalence rate of the Chinese CDS diagnosis standard for metabo -lism-synthesis ( 66.7%) .The prevalence rate of ACCE diagnosis standard for metabolism synthesis (88.8%) had good concordance with the prevalence rate of the EGIR diagnosis standard for metabolism synthesis (86.6%).The prevalence rate of Blackburn P forecast cardiovascular event (20.9%),which was distanced from the result of the diagnosis standards ( P <0.005 ) .Conclusion ⑴Patients with type 2 di-abetes have high metabolism syndrome proportion rate , and the abnormal metabolism proportion rate in sin-gle group is also higher.⑵WHO (1999) metabolism syndrome diagnosis standard and CDS (2007)sugges-tion standard are suitable for Chinese metabolism -synthesis in type 2 diabetic patients .⑶The metabolism syndrome diagnostic standards of EGIR and ACCE are similar in proportion rate in Chinese patients with type 2 diabetes , which is accorded with the findings of former literatures .Whether that can be used widely deserves further study .⑷The diagnostic criteria of triacylglycerol waistline is not suitable for Chinese type 2diabetic patients.

Objective To discuss the commonly used puncturing approaches in CT-guided 125I seed implantation for lumbar lymph node metastases in order to provide safe and reliable technical guidance for clinical practice.Methods Under CT guidance,125I seed implantation for lumbar lymph node metastases was performed.According to different locations of metastatic lymphadenopathy (left waist,right waist or middle waist),the corresponding puncture route and implantation method were adopted.Meanwhile,different puncturing approach was designed in order to avoid damage to vital organs.Results For the performance of 125I seed implantation for the lymphadenopathy located at the left waist,right waist and middle waist,the commonly used puncturing approaches were percutaneous transthoracic lumboiliac costal muscle method (i.e.back approach),trans-hepatic trans-duodenal method (i.e.lateral approach) or back approach method,and trans-mesenteric approach together with coaxial needle method (i.e.anterior approach) respectively.Conclusion It is clinically feasible to use different puncturing approaches in performing 125I seed implantation for lumbar lymph node metastases,the suitable puncturing approach can ensure a successful and safe operation.

Objective To evaluate the safety and efficacy of CT-guided radioactive 125I seed implantation in treating retroperitoneal lymph node metastasis due to recurrent cervical cancer after radiotherapy.Methods A total of 10 patients with retroperitoneal lymph node metastasis (12 lesions in total)due to recurrent cervical cancer after radiotherapy,who were treated with CT-guided 125I seed implantation during the periodfrom November 2011 to October 2015,were included in this study.The diameters,that were perpendicular to each other,of the involved lymph nodesranged from 1.7 cm×1 cm to 6.5 cm×5 cm,the diameter of 6 involved lymph nodes (50％) was ＜5.0 cm and the diameter of other 6 involved lymph nodes (50％) was ≥5.0 cm.With the help of treatment planning system for brachytherapy,the source distribution was formulated.Under CT guidance,the 125l seedswith the activity of 0.3-0.7 mCi were implanted.Postoperative validation showed that D90 (90％ minimum prescription dose received by the target volume) was 36-110 Gy (median 59 Gy).After the treatment,the changes in lesion size,pain relief and complications were recorded.Results The 10 patients were followed up for 4.3-16.1 months,the median follow-up time was 9.7 months.The 2-month local control rate and the 2-month effective rate were 100％ and 58.3％,respectively.The 2-month,6-month and 12-month survival rates were 100％,66.7％ and 58.3％,respectively.The median survival time was 12.1 months.One patient (10％) died of gastrointestinal bleeding at five months after treatment,six patients (60％) died of distant metastases,three patients (30％) survived withno evidence of local recurrence.No major complications such as massive hemorrhage,intestinal infection,bone marrow suppression or other 125I seed-related complications occurred.Conclusion For the treatment of retroperitoneal lymph node metastasis due to recurrent cervical cancer after radiotherapy,CT-guided radioactive 125I seed implantation has satisfactory short-term curative effect,and this technique is safe and feasible.

Objective:To establish a dosimetric method based on the well-chamber to verify the accuracy of the source positioning and dwelling time for the afterloading machine, aiming to provide a new method for the quality control of afterloading machine.Methods:The principle of this method was explained according to the hardware structure of the well-chamber. Then, the precision of this method was analyzed by the simulation test and data fitting. The feasibility test was also performed. And the advantages and disadvantages of this method were compared with those of the traditional method.Results:The precision of this method for detecting the source positioning was 0.07 mm and the dwelling time was 0.09 s, respectively. In the feasibility test, the standard deviation of the measure value was below 3%.Conclusions:The well-chamber method has high precision and convenient operation. It can be applied in the rapid verification of the relative accuracy of the source positioning and dwelling time of well-chamber.

Objective To explore the relationship between the peripheral dose and radioactive counts of 125I seeds detected by SPECT/CT.Methods Six 125I seeds(1.48×107 Bq, 1.85×107 Bq, 2.22×107 Bq, 2.59×107 Bq, 2.96×107 Bq, 3.33×107 Bq) were put into the solid water phantoms respectively. SPECT/CT was applied to scan the seeds. The radioactive counts (x) at the distance of 1-15 mm from the center of seeds were recorded respectively, while the corresponding doses (y, cGy) were calculated. SPSS 18.0 was used to analyze the relationship between the radioactive counts and peripheral dose. Results There was an exponential relationship between the peripheral dose of 125I seeds and the radioactive counts. The formula was as follow: y=507.849×1.004x. Conclusion SPECT/CT can visualize the peripheral dose of 125I seed, which may provide a method for dosimetric verification after brachytherapy.

Objective: To study the feasibility of using the PTW729 2D array ion-chamber to verify the relative dose distribution calculated with the Acuros BV algorithm. Both advantages and disadvantages of the method were analyzed to provide reference for practical clinical practices. Methods: Based on self-built measurement phantoms, the dose distribution on the same slice of the phantom was measured with PTW729 and film, respectively, under the same measurement condition and plan. The dose distributions obtained by the two method were compared with the result calculated with Acuros BV, separately, by using γ analytical tool. And the stability of the PTW729 was tested. Results: The γ comparison value was 95.9% between the film and Acuros BV, 98.9% between the PTW729 and Acuros BV and 88.0% between the film and PTW729, with 95.0%, 100.0%, and 100.0%, in their stability test respectively. Conclusions PTW729 2D array ion-chamber can be applied to the rapid verification of Acuros BV algorithm-calculated relative dose distribution.

Objective To study the dosimetric effect of two source patterns, including equal spacing and peripheral dense intermediate sparse by assuming a tumor shrinking speed of 20%per month after 125 I seed implantation. Methods A virtual cylindrical tumor with 4 cm in height and 5 cm in diameter was contoured on a three-dimensional treatment planning system ( TPS ) . Two groups of preoperative plans were made with 1. 85 × 107 Bq 125 I seeds using two source patterns respectively. It was assumed that the tumor height was unchanged, while the diameter of tumor would decrease at a speed of 20%per month, and the locations of seeds would concentrate towards the tumor core. The 90%target volume dose ( D90 ) , the ratio of 90%isodose volume over the target volume ( V90 ) , and the ratio of 150%isodose volume over the target volume (V150) were calculated at 0, 1, 2, 3 months after 125I implantation respectively. Results In equal spacing group, 85 seeds were implanted. The values of D90 were 126. 20, 130. 41, 133. 82 and 139. 48 Gy after 0, 1, 2 and 3 months respectively. The values of V90 were 97. 0%, 98. 1%, 99. 3%and 100%, while those of V150 were 70. 2%, 69. 9%, 71. 1% and 71. 5%. The dense in-periphery and sparse-in the middle group was loaded with 75 seeds. The D90 values were 126. 46, 125. 41, 123. 50 and 128. 83 Gy, the V9095. 2%, 95. 7%, 94. 9%and 97. 6%, and the V15052. 8%, 60. 4%, 62. 7%and 59. 3%after 0, 1, 2 and 3 months, respectiviely. Conclusions When the tumor diameter reduces at a rate of 20%per month after 125 I seed implantation, the expected tumor dose absorption will gradually increase using the equal spacing sources pattern. However, the expected dose does not vary withsource distribution of dense-in the-surrounding and sparse-in-middle, which also reduces high dose volume more than the equal spacing pattern.

As a standard method for early stage prostate cancer, 125Ⅰ seed implantations are used widely in America. Although there are guidelines from American Brachytherapy Society and American Association of Physicists in Medicine, some hospitals still cannot implant the seeds properly according to the guidelines. Complications were observed inevitably. The medical events about seeds implantation in America from 2002 were investigated and the reasons were analyzed in this paper. Additionally, some solutions were given to avoid the medical events, so that the practitioners in China can learn from it and make sure the 125Ⅰ seeds implantation can be developed healthily and smoothly.

Objective: To compare the clinical application of three-dimensional laparoscopic pancreatoduodenectomy (3D-LPD) with that of two-dimensional laparoscopic pancreatoduodenectomy (2D-LPD), and to explore the safety and feasibility of 3D-LPD. Methods: A retrospective analysis was made from the data of 45 patients with 3D-LPD and 45 patients with 2D-LPD who underwent total laparoscopic pancreatoduodenectomy from March 2017 to August 2018 at Department of Hepato-Pancreato-Biliary Surgery, the First People′s Hospital of Changzhou.The differences of intraoperative conditions, postoperative complications and postoperative pathological findings between the two methods were compared.Measurement data were compared with independent sample t-test, enumeration data were statistically analyzed with Chi-square test or Fisher exact probability. Results: The operation time of 3D-LPD group was shorter than that of 2D-LPD group ((335±95) min vs. (419±113) min, t=-3.817, P=0.000), which mainly showed that the time of digestive tract reconstruction was reduced ((92±26) min vs. (131±46) min, t=-4.951, P=0.000). The intraoperative blood loss in the 3D-LPD group was significantly less than that in the 2D-LPD group ((242±124) ml vs. (350±176) ml, t=-3.365, P=0.001), and the perioperative blood transfusion in the 3D-LPD group was significantly less than that in the 2D-LPD group (χ²=4.444, P=0.035). Postoperative hospitalization days and ICU stay time were not significantly different between the two groups(both P>0.05). Postoperative complications such as pancreatic fistula, biliary fistula, postoperative bleeding, gastric emptying disorders, abdominal infection, were not significantly different between the two groups(all P>0.05). Conclusions The operation time of 3D-LPD is shorter than that of 2D-LPD, and the amount of bleeding is less. Short-term clinical data showed that, 3D-LPD is effective, safe and worth popularizing.