Objective To study the best method of radiation protection shielding calculation for the gamma photon produced in positron annihilation.Methods With 18F as the typical of nuclide,different methods or literature about constant and the calculation of the TVL or recommended values were adopted to calculate and analyze the shielding thickness by lead as block material.Results The shielding thickness by the dose constant was calculated by point source model (0.142 μSv· m2· MBq-1 · h-1) and TVL of lead recommended by NCRP was the biggest:at the control area the unit thickness for lead shield was 7.562 × 10-4 mm· MBq-1 for one patient.While by the dose constant recommended by AAPM TG108 (0.092 μSv·m2 ·MBq-1 ·h-1) and lead TVL recommended by IAEA was the minimum.The unit thickness for lead shield at the control area was 4.982 × 10-4 mm · MBq-1 · patient-1,with difference of 36.2％.Conclusions The dose constant and the TVL value of lead from AAPM.TG 108 are recommended for the calculation.In shielding design attention should be paid to the distance protection,the separate toilet with shielding for patients,and the separate corridors beteen doctors and patients.

BACKGROUND: The relationship between liver cancer recurrence and hepatitis B virus recurrence remains poorly understood and it is considered to be related to application of immunosuppressive agent after liver transplantation. OBJECTIVE: To investigate the effects of tacrolimus (FK506) on the proliferation of HepG2.2.15 cells and the replication of hepatitis B virus in vitro. METHODS: HepG2.2.15 cells were in vitro cultured. After passage 3 HepG2.2.15 cells were cultured for 24 hours, they were interfered with different concentrations of FK506. 0 g/L FK506-interfered group served as control group, 50 g/L FK506-interfered group as low-concentration FK506 group, 100 g/L or 500 g/L FK506-interfered group as medium-concentration FK506 group, and 1 000 g/L or 3 000 g/L FK506-interfered group as high-concentration FK506 group. RESULTS AND CONCLUSION: Moderate- and high-concentration FK506 exhibited inhibitory effects on the proliferation of HepG2.2.15 cells, while low-concentration FK506 exhibited no inhibitory effects with correlation. High-concentration FK506 made HepG2.2.15 cells arresting at G0/G1 stage. FK506 decreased CyclinA expression in HepG2.2.15 cells in a dose-dependent manner. Higher concentration of FK506 leaded to lower expression of CyclinA. FK506 did not produce effects on the replication of hepatitis B virus in HepG2.2.15 cells. These results indicate that FK506 inhibits the proliferation of HepG2.2.15 cells in vitro, which occurs possibly due to Cyclin A, but it would not affect the replication of hepatitis B virus in vitro.

Objective To investigate the clinical effects of tube flushing in donor duodenum to prevent the hematuria post combined pancreas-kidney transplantation(SPK)with pancreatic fluid drainage through bladder.Methods 18 cases of diabetic patients associated with end-stage renal disease were subjected to combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder,within which 12 cases were pre-placed douche tube in donor duodenum,while the other six were not.As for the cases in group with the tube,T tube of No.10 was put in the donor duodenum through the abdominal wall and then bladder.After that the tube was fixed using 5-0 absorbable suture,then the bladder sutured if the tube was smooth confirmed by flushing with saline.After the operation,flushing was maintained using saline consecutively with the speed of 500 ml/h through the douche tubes of these 12 patients.Then the speed was changed to 250 ml/h 3 days later if the flushing fluid was limpid.One week later,changed to rinse intermittently and prolonged the flushing interval gradually.Till 14 days post the operation,flushing was ceased.After 2 days' survey,the urethral catheter was removed.As for the other 6 cases without douche tube,the urethral catheter was removed during 7-10 days after the operation if hematuria didn't occur.Results In the 12 cases with douche tube,there was only one patient(8.3 %,1/12)having slight hematuria on the 7th day after the cessation of the bladder washout.Through strengthening the flushing,the hematuria disappeared.The urethral catheter was removed on the 14th day after the operation and the hematuria never happened again.In the group without the douche tube,4 cases(66.7 %,4/6)had serious hematuria complicated with bladder obturation.The incidence of that was obviously higher than in the group with the douche tube(P＜0.05).Only one patient(1/12,8.3%)in the group of regular insertion of douche tube had urinary system infection,but in the group without the tube,the incidence of urinary system infection was 66.7 %(4/6)(P＜0.05).Conclusion The tube flushing in donor duodenum can significantly reduce the occurrence of hematuria after combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder.

Objective To retrospectively investigate the effects of CYP3A5 * 3,CYP3A4 * 18B and CYP3A5-CYP3A4 phenotype on the C0,D and C0/D of tacrolimus (Tac) in renal transplantation recipients.Methods The CYP3A5 * 3 and CYP3A4 * 18B genotypes of the 61 patients were detected by DNA direct sequencing,and the C0 was detected by ELISA.The differences of C0,D and C0/D on the day 14,and month 1,2 and 3 after transplantation were compared among different genotypes of recipients treated with Tac.Results The frequency of the CYP3A5 * 3 and CYP3A4 * 18B was 74.6％ and 26.2％ respectively.When the D of the recipients with CYP3A5 * 1 ( * 1/* 1 + * 1/* 3)was 1.3-1.6 times to theCYP3A5*3/*3,theC0 of *3/*3 group was 1.1-1.5 times to the * 1group,and the C0/D was 1.8 2.4 times to the CYP3A5 * 1.For CYP3A4,the D of CYP3A4 * 18B group ( * 1/* 18B+ * 18B/* 18B) was 1.2-1.5 times to the CYP3A5 * 1/* 1,but the C0 of 1/* 1was 1.2-1.4 times to the * 18B,the C0/D was 1.5-1.8 times to the * 18B.For the CYP3A5 CYP3A4 phenotype,the D of the recipients with AAAA was 1.3-1.7 times to the GG-GG,the C0 of GG-GG was 1.5-2 times to the AA-AA,the C0/D of the recipients with G@GG was 2.5-3 times to the AA-AA.In the recipients with C0/D above or below the median of C0/D,the distribution of CYP3A5,CYP3A4 and CYP3A5-CYP3A4 phenotypes was different significantly.Conclusion There is a significant correlation between the CYP3A5,CYP3A4 and pharmacokinetics of Tac.It's more powerful evaluating the CYP3A5-CYP3A4 phenotype rather than just one genotype of the recipients.So detecting the CYP3A5 * 3 and CYP3A4 * 18B genotypes prior to transplantation is meaningful for us to determine an appropriate initial and long-time dosage of Tac.

Objective To explore the indications of simultaneous pancreas-kidney (SPK) transplantation for type 2 diabetes mellitus (DM) combined with end-stage renal disease by comparing the outcome of patients with type 1 and type 2 DM combined with end-stage renal disease after renal transplantation.Methods 109 patients accepting SPK from January 2008 to July 2016 in our center were divided into two groups according to the types of DM:T1DM (n =36),and T2DM (n =73).The basic characteristics of recipients,outcome,and pancreas and kidney functions after operation were compared between two groups.Results There was no significant difference in 5-year survival rate and surgical complications between two groups although recipients of T2DM group were older and had higher BMI than T1DM group.But rejection rate was higher in T1DM group.Conclusion SPK for T2DM recipients will not increase the surgical risk and can get good long-term outcome.

Objective To analyze the complications,treatments and prognosis of simultaneous pancreas-kidney transplantation,especially on surgical complications and treatments.Method The causes and outcomes of surgical treatment in 70 cases of simultaneous pancreas-kidney transplantation performed between Dec.1999 and June 2012 were retrospectively analyzed in our center.Result Sixteen patients (22.9％) underwent one or more reoperations.The causes for reoperation were as follows:2 cases of hematuria,4 cases of abdominal hemorrhage,4 cases of abdominal infection,4cases of pancreatic thrombosis,2 cases of renal graft's artery rupture,1 case of renal allograft rupture,1 case of intestinal fistula,and 1 case of pancreatic fistula.Eight pancreas grafts were lost in the first year.Pancreatectomy was performed on the other 5 cases:4 cases of pancreatic thrombosis,1 case of intestinal fistula,accounting for 43.8％ of the patients subject to reoperation.The recipients,kidney,pancreas survival rate in reoperation group at 1 year was 87.5％,75％,and 56.3％ respectively; and that in control group at 1 year was 98.1％,98.1 ％,and 98.1 ％ respectively.There was significant difference in kidney survival rate (P＜0.01,chi-square =6.79),and pancreas survival rate (P＜0.01,chi-square =17.47) between two groups.Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with end-stage renal disease,surgical treatment due to complications is still an important factor in short-term survival on the grafts.

Objective To evaluate the role of cytokine levels for prediction of HBV recurrence after liver transplanta- tion.Methods 34 cases of liver transplantation from June 2002 to December 2003 in our hospital were observed.The measurements of cytokine in serum by ELISA method were taken on the 7 days before operation and recurrence after oper- ation and the change rules were studied.Results The serum TNF-?,IL-10和 INF-? levels gradually increased in HBV non-recurrence group,but which in recurrence group had no markedly change and always skept on normal levels after operation.In addition,the serum TNF-?和 IL-10 levels after operation were significantly higher in nonrecur- rence group than in recurrence group.The serum IL-2 levels in recurrence group always kept on higher levels without marked changes after operation.Conclusion TNF-? and IL-10 are better laboratory index in the prediction of HBV recurrence after liver transplantation and which are noninvaded and cheap.

Objective To analyze the mutation of HBV X region nucleotide sequence in patients with HBV reinfection after liver transplantation. Methods In this study 320 patients received liver transplantation due to HBV-related end stage hver diseases between June 2002 and Dec 2003.Postoperatively polymerase chsin reaction was used to aInplify their serum HBV DNA fragments for direct sequence analysis.Patients that were followed-up for 1.5～3 years were enlisted for analysis.Results All the 11 reinfection recipients showed nucleotide mutations in X region mng4ng from 5 to 39 sites after transplantation.An A to T mutation at nt1762 and G to A mutation at nt1764 were found in 6 cases.The mutations at nucleotide fnt)1636～1741 were found in all 11 cases.Condusions The results indicated that mutations of nt 1762 and nt 1764 are very common and immunosuppressants cannot change the mutations in patients with HBV reinfection after liver transplantation.

Objective To investigate the in vitro effects of bone marrow mesenchymal stem cells (BM MSCs) on the replication of HBV with the participation of lymphocytes and to analyze the possible mechanism.Methods The HBV genomic DNA transfected HepG2.2.15 cell line was used to evaluate the HBV replication.Bone marrow and spleen samples were collected from BN rats for the isolation of BM MSCs and T lymphocyte cells, respectively.Five groups of co-culturing with different cells were designed in this study.The cellular activities of lymphocytes and HepG2.2.15 cells were detected at the time of 24 h, 48 h and 72 h after co-culturing by using MTT method.The levels of HBV DNA and HBV cccDNA were detected by real-time polymerase chain reaction ( PCR) .T cell subsets in co-culture were measured by using fluores-cence labeled antibodies and flow cytometry analysis.ELISA was used to detect the levels of cytokines in the supernatant of cultured cells.Results Compared with HepG2.2.15 cells group, BM MSCs+HepG2.2.15 cells and splenic lymphocytes+HepG2.2.15 cells co-culture groups, the levels of HBV DNA and HBV cccDNA were significantly decreased in splenic lymphocytes+BM MSCs+HepG2.2.15 cells co-culture group after 48 h of culture [ HBV DNA: ( 181.000 ±14.731 ) IU/ml vs ( 6270.000 ±300.450 ) IU/ml, (2564.000±231.058) IU/ml, (2433.300±302.379) IU/ml;HBV cccDNA: (4.330×105 ±0.464×105 ) IU/ml vs (11.100×105±0.375×105) IU/ml, (8.930×105±0.778×105) IU/ml, (9.850×105±0.810× 105) IU/ml;P<0.01].The secretion of IFN-γin the supernatant of co-cultured cells was negatively corre-lated with HBV DNA level, but the levels of IL-10 and IL-22 were positively correlated with HBV DNA.The ratio of CD4+/CD8+cells was increased in splenic lymphocytes+BM MSCs+HepG2.2.15 cells co-culture group.The percentage of CD8+cells showed a positive correlation with HBV DNA.Conclusion BM MSCs could inhibit the expression of HBV DNA to enhance the clearance of HBV strains.It might be possibly due to rebalancing of Tc1/Tc2 cells and regulating the expression of autocrine agents and cytokines.

Objective To study the effects of bone marrow mesenchymal stem cells (BMSCs) transplantation on the ischemia-reperfusion injury of the intestine in rats.Methods BMSCs were isolated from femur of male Wistar rats and cultured,and the phenotypes of third generation cultured cells were identified.B16-F10-Luc-G5 cells were injected into the intestinal submucosa and traced by Luciferin.Intestinal ischemia-reperfusion injury models were established in male Wistar rats,which were divided into the experimental group (1 ml BMSCs suspension which contained 5 × 106 cells was injected into the intestinal submucosa) and the control group (1 ml normal saline was inject into the intestinal submucosa).Then,serum and intestinal tissue samples were collected at 0,2,6,24,72 and 120 h after operation.Diamine oxidase,D-lactate and TNF-α were tested by ELISA,intestinal tissue samples were observed under the Light microscopy and transmission electron microscopy,and tight junction protein-1 (ZO-1) was detected by using Western blotting and immunohistochemistry.Results BMSCs were isolated and cultured successfully and they colonized in the intestine.The pathological changes of the intestine in experimental group were milder than in control group. Intestinal mucosal barrier was more intact in experimental group than in control group.In the experimental group and control group,DAO was (11.36 ± 1.89) and (14.27 ± 2.09)IU/ml (P＜0.05) at 6th h after injection,and that was (5.04 ± 1.04) and (7.35 ± 1.46) IU/ml (P＜0.05) at 24h after injection,respectively.In the experimental group and control group,D-lactate was (1.57 ± 0.25) and ( 1.93 ± 0.19) mmol/L (P＜0.05) at 6th h after injection,and that was ( 1.09 ± 0.13) and ( 1.41 ± 0.07) mmol/L (P＜0.01 ) at 24th h after injection,respectively.In the experimental group and control group,TNF-α was (266.09 ± 8.84) and (286.81 ± 11.54) ng/L (P＜0.01 ) at 6th h after injection,and that was (190.39 ± 4.24) and (218.49 ± 15.51 )ng/L (P＜0.01 ) at 24th h after injection,respectively.The expression of ZO-1 protein was higher in experimental group than in control group. ConclusionInjection of BMSCs into could protect the intestine from ischemia-reperfusion injury in rats.