Objective To investigate the technique and method of MSCT in examination of laryngeal. Methods MSCT data of 28 patients with laryngeal carcinoma confirmed pathologically were analyzed retrospectively. Images quality was evaluated and the results obtained with various windows and CT virtual larynscopy were compared. Results All images had good quality,20 cases(69% ) could be displayed with conventional soft tissue windows,24 cases(81% ) could be demonstrated with lung windows,and 27 cases(93% ) could be demonstrated with CT virtual larynscopy. Conclusion The multislice CT could effectively demonstrate laryngeal carcinoma, and could be applied routinely in examination of laryngeal carcinoma.

Objective:To discuss the dosimetric contribution of the ovoid in the cervical cancer brachytherapy through the intracavity combined with interstitial(IC/IS)technique.Methods:The data on 20 patients with FIGO(2009)stageⅡ A, Ⅱ B or Ⅲ Bcervical cancer treated with radical radiotherapy in China-Japan Union Hospital of Jilin University during 2015-2017 was collected. External irradiation treatment was 45 Gy/1.8 Gy× 25 fractions. Brachytherapy was MRI-guided IC/IS brachytherapy with a prescription of 28 Gy/7 Gy× 4 fractions. All of 20 patients developed two kinds of plans, the ovoid group and the non-ovoid group. The original MRI-guided brachytherapy treatment plan was set(80 fractions)to the ovoid group. As contrast model that removed the ovoid and consisted of tandem combined with needles set to the non-ovoid group was built, and the same physicist designed the plan to make the dose of D90% for high-risk clinical target volume(HR-CTV)similar to the ovoid group. The dosimetric differences of the D90% and D98% for HR-CTV, D90% and D98% for intermediate-risk clinical target volume(IR-CTV)and D2 cm 3 for the bladder, rectum, sigmoid colon and small intestines between two groups of plans were analyze by paired t-test. Results:Compared with the ovoid group, the non-ovoid group showed no significant difference on HR-CTV D90%( P>0.05), but the HR-CTV D98%(6.99±0.60 vs. 6.78±0.76), IR-CTV D90%(4.71±0.58 vs. 4.26±0.57) and D98%(3.77±0.58 vs. 3.26±0.59) of the non-ovoid group decreased significantly( t=3.906, 9.860, 8.636, P<0.05). The sigmoid colon showed no significant difference( P>0.05), while the bladder (5.29±0.67 vs. 4.92±0.74), rectum (3.72±0.69 vs. 3.35±0.92) and small intestines (3.05±1.37 vs. 2.98±1.34) D2 cm 3of the non-ovoid group decreased significantly( t=8.758, 7.543, 8.059, P<0.05). Conclusions:Ovoid is very important for IC/IS technique in cervical cancer brachytherapy. Reasonable optimization of the dose weight ratio of the ovoid and the needle can bring better clinical benefits.

Objective To observe the therapeutic effect of intravitreal lucentis injections combined with laser photocoagulation for Coats disease.Methods This was a retrospective case series study.From August 2012 to December 2015,18 cases (18 eyes) were diagnosed as Coats disease with macular edema by FFA and OCT.All patients were treated at baseline using intravitreal lucentis injections.One week later,photocoagulation was performed by the guiding of FFA.Follow-up treatment was performed as necessary.The primary BCVA and central macular thickness (CMT) was measured postoperatively.The follow-up time was 16-24 months (mean 18.8 months).Results The mean number of lucentis injections was 2.6,and the mean number of laser treatment sessions was 1.8.The mean preoperative BCVA was (0.81 ±0.28) LogMAR,while the final visit was (0.76 ± 0.37) LogMAR (P =0.396).In 3 patients (16.7 ％),BCVA had improved by more than 3 lines,and 13 patients (72.2％)showed stable BCVA (changes within 2 lines of visual acuity),while in 2 patients,BCVA decreased by more than 3 lines (11.1％).The mean CMT improved significantly from (341.11 ±67.97) μm preoperatively to (277.83 ±51.59) μm at the fmal visit (P =0.030).Final BCVA was significantly correlated with preoperative BCVA (r =0.817,P ＜0.001).The final BCVA of patients with subfoveal hard exudates preoperatively was significantly worse than that of patients without such exudates (P =0.044).Conclusion Intravitreal lucentis injection combined with laser photocoagulation may be an effective treatment for Coats disease.It may stablize the visual acuity,decrease the CMT of Coats disease.The final BCVA is associated with preoperative BCVA and occurrence of subfoveal hard exudates.

Objective To study the effects of lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization.Methods The clinical data of 70 patients (70 eyes) underwent vitrectomy for diabetic retinopathy combined with iris neovascularization during 2009 to 2015 in our hospital were retrospectively analyzed.The control group (30 eyes) accepted panretinal photocoagulation (PRP),re-vitrectomy,cyclocryotherapy,and the study group (40 eyes) had the 0.5mg lucentis in addition.The follow-up time was 3 months,and the visual acuity,IOP,vitreous hemorrhage,INV regression and complication were observed.Results At 1 month,2 months in the follow-up,the visual acuity of study group was better than the control group,but there was no significant difference along with the follow up.The average preoperative IOP was (26.312 ±4.566) mmHg (1 kPa =7.5 mmHg) in the study group and (24.586 ±5.783) mmHg in the control group,and at the end of the follow up,IOP was (18.576 ±4.762) mmHg in the study group and (28.587 ±7.786) mmHg in the control group,there was statistical difference between the two groups (P =0.041).The intraoperative and postoperative anterior chamber or vitreous hemorrhage occurred in 15 cases,5 cases of the control group,and 3 cases,1 case of the control group,there were significant differences (all P =0.000).At the end of the follow up,3 eyes (7.5％) developed to NVG in the study group and 10 eyes (33.3％) in the control group,there was statistical difference (P ＜ 0.05).Conclusion Lucentis can effectively eliminate the new vessels,reduce the incidence of neovascularization glaucoma and vitreous hemorrhage for patients after vitrectomy for diabetic retinopathy combined with iris neovascularization,and improve the visual acuity in a short time.

Objective T o observe the expression changes of hypoxia inducible factor-1α (H IF-1α) and vascular endothelial grow th factor-A (V E G F-A ) in rats w ith arrhythm ias, and to explore the differences of the expression pattern in the tw o indicators of acute m yocardial ischem ia caused by arrhythm ias and coronary insufficiency. Methods T he arrhythm ia w as induced by C aC l2, and the expression changes of H IF-1α and V E G F-A w ere detected by im m unohistochem istry, W estern blotting and real-tim e PC R w ithin 6 h after the arrhythm ia in rats. Results T he expression of H IF-1α and V E G F-A show ed diffuse in the m yocardial tissue of rats died from arrhythm ias. B oth of them increased in the early arrhythm ia, then decreased. E xtensive m yocardial ischem ia happened at the beginning of arrhythm ia occurrence and its range didn't expand w ith tim e. Conclusion T he expressions of H IF-1α and V E G F-A in m yocardium of the rats w ith arrhythm ia can provide evidence for the differential diagnosis of acute m yocardial is-chem ia caused by fatal arrhythm ia and coronary insufficiency.

We analyzed the epidemiological investigation results of the first case of human infected with avian influenza (H5N6) ,and summarized epidemiological characteristics of this case to provide reference to H 5N6 case screening and investiga‐tion in future works .We retrospectively described and analyzed the investigation progress ,specimen detection results of epi‐demic spot and intimate contact people ,and summarize epidemiological characteristics of this case .Result showed that the first case of human infected with H5N6 in Yunnan was a single case ,and did not showed human‐to‐human transmission .This case had contacts with wild bird and had birds’ market activity before diagnoses ;some environment specimen of birds market near patient’s home has detection results of H5N6 positive .This is a cases of local infection and did not show human‐to‐human transmission .From the investigation ,we could deduced that the transmission route is from birds to human or from birds to en‐vironment and then to human .

Objective To investigate the clinical effects of minimally invasive vitrectomy combined with cataract surgery for myopic foveoschisis in young and middle-aged. Methods Sixty myopic eyes with myopic fo-veoschisis diagnosed from September 2013 to October 2015 in our hospital were included in the study. According to different surgical methods ,patients were divided into two groups:combined operation group(vitrectomy combined with lens replacement surgery,30 eyes)and staged operation group(simple vitrectomy group,30 eyes). Cataract surgery were performed according to the opacity of lens. All the patients were followed up for 6~12 months. Reop-eration rate of staged operation group ,the best corrected visual acuity(BCVA),the distant and near visual acuity and retinal reattachment rate of each group were observed. Every patient was interviewed with a questionnaire about visual quality at 6th month after surgery. Results 27 eyes developed lens opacity after operation(90%)in staged operation group,among them,21 eyes underwent secondary cataract surgery(70%). The BCVA recovery,postop-erative distant vision,and preoperative and postoperative distant vision difference in the combined operation group were significantly higher than those in the staged group(P<0.05). There were no significant differences in macu-lar retinal condition and retinal reattachment rate between the two groups(P > 0.05). Six months after operation, the visual quality of the combined operation group was significantly better than that of the staged group(t=-3.95, P = 0.00). In the combined surgery group,the scores of distant vision,stereopsis and visual fatigue were higher than those of staged operation group. The score of dry eye and night glare in staged operation group was higher than that in combined operation group(all P<0.05). Conclusions Vitrectomy combined with intraocular lens replace-ment for myopic foveoschisis in young and middle-aged people can avoid second operations and improves the visual function,proving to be a feasible operation in clinic.

Objective:To observe the effect of combined operation of internal and external surgery for intraocular hemorrhage of polypoidal choroidal vascular disease (PCV).Methods:Retrospective clinical research. From January to August 2018, 14 eyes of 14 patients with PCV combined with vitreous hemorrhage (VH) with hemorrhagic retinal detachment confirmed by eye examination at the Second Affiliated Hospital of Nanchang University were enrolled in this study. The average disease course was 1.12±0.68 months. The visual acuity decreased from 2 to 14 days. The average time from hemorrhagic retinal detachment to surgery was 6.32±2.82 d. There were 9 eyes with BCVA of light sensing, 3 eyes of hand movement, and 2 eyes of counting fingers. The average macular foveal thickness (CFT) was 564.6±102.2 μm. The range of retinal detachment involves equal or greater than 2 quadrants. 23G vitrectomy surgery was used to remove VH, and subretinal hemorrhage was drained through external scleral drainage to reset the retina. One week and 1 and 2 months after the operation, the eyes were injected with 0.05 ml of ranibizumab in the vitreous cavity. The average follow-up time after surgery was 6.24±1.16 months. One week after the operation, 1, 3, and 6 patients were examined with the same equipment and methods before the operation to observe the condition of BCVA, CFT, intraocular pressure and retinal reattachment. Non-parametric tests were used to compare BCVA before and after surgery.Results:VH was completely cleared in all eyes, and no iatrogenic retinal hole appeared during the operation. Six months after the operation, there were 1 eye with BCVA of hand movement, 1 eye of counting fingers, 8 eyes of 0.1, 2 eyes of 0.2 and 2 eyes of over than 0.2; the average CFT was 336.4±54.8 μm. Compared with before surgery, the BCVA was significantly improved ( Z=-3.711, P=0.000), the CFT was significantly decreased ( t=3.212, P=0.006). OCT examination showed that the macular morphology and structure were clearly visible. Of the 14 eyes, 13 eyes were reattached, 1 eye was detached again after silicone oil removal. Intraocular pressure increased in 3 eyes within 1 week after surgery, including 1 eye with a small amount of blood in the anterior chamber. No recurrent VH was found in all eyes during follow-up. Conclusions:Combined internal and external surgery for PCV combined with VH with hemorrhagic retinal detachment is safe and effective.

Objective:To explore the application of 3D printing technology-assisted standardized applicator in the image-guided adaptive brachytherapy (IGABT) for cervical cancer.Methods:Twenty-three patients with stage Ⅲ B cervical cancer with extensive paracervical invasion after external irradiation (45 Gy/25f) were treated with IGABT, and the prescription dose was 7 Gy/f×4f. According to the regression of tumor on MRI before and after external irradiation, the range of brachytherapy was determined, and the under dose area of standard intracavitary/interstitial applicator (IC+ IS) was estimated. The virtual transperineal needle channel was inserted in the under dose area, the angle, spacing and depth of implantation were optimized. The auxiliary templates were designed with graphic design software, and 3D printing technology was utilized to print the auxiliary templates. The auxiliary templates were closely combined with the standardized applicator. Under the anesthesia condition, ultrasound-guided applicator was completed, and patients were scanned with MRI image after operation. The MRI images were introduced into treatment planning system (TPS) to delineate the target area and organs at risk, and the treatment plans were optimized to complete the plan evaluation and treatment. Results:The average printing time of templates was (3.5±1.0) h, 382 implant needles were inserted guided by auxiliary templates, (4.2±1.5) template-guided implant needles were used in each fraction and the weight ratio was (16.49±9.50)%. The total dose of HR-CTV D 90% EQD 2Gy, α/ β=10 was (90.45±3.03) Gy, and IR-CTV D 90% EQD 2Gy, α/ β=10 was (66.46±3.68) Gy. The D 2cm 3 EQD 2Gy, α/ β=3 of the bladder, rectum, small intestine and sigmoid colon were (82.69±2.60) Gy, (73.20±2.52) Gy, (69.35±3.32) Gy and (69.39±3.27) Gy, respectively, all of which met the clinical dose requirements. The 1-and 2-year local control rates were 96% and 87%, 87% and 70% for the distant metastasis-free survival rates, and 96% and 78% for thea overall survival rates, respectively. Conclusion:The auxiliary applicators made by 3D printing technology can effectively compensate for the dose insufficiency of the standard applicator in the paracervical and other areas during the clinical brachytherapy in patients with stage Ⅲ B cervical cancer, providing an effective method for the brachytherapy of advanced cervical cancer.

In China, COVID-19 epidemic is currently showing a sporadic state, and the task of epidemic prevention is still arduous. Brachytherapy (BT) plays a critical role in the treatment of cancer. For some cancer receiving radiotherapy, use of BT can not be replaced or excessively delayed. Nevertheless, the recommendations or guidelines regarding the application of BT during COVID-19 epidemic have been rarely reported. In this article, a few recommendations on the application of BT during COVID-19 epidemic were retrieved and the work experience of Department of Radiation Oncology, China-Japan Union Hospital of Jilin University in the early epidemic period was summarized, aiming to provide relevant reference for the use of high-dose-rate BT for malignant tumor patients during COVID-19 epidemic.