Early identification value of quick sequential organ failure assessment score in patients with sepsis of different ages / 中华危重病急救医学

Objective:To investigate the value of quick sequential organ failure assessment (qSOFA) score in early identification for sepsis patients of different ages.Methods:A retrospective study was conducted. The clinical data of 1 529 patients with suspected infection in emergency department of Changshu No.2 People's Hospital from September 2017 to March 2020 were collected. All patients were assessed for qSOFA score, and the diagnosis and treatment were recorded. Sepsis-3 was defined as the diagnostic criteria for sepsis. All the patients were divided into five groups according to age, youth group (< 45 years old), middle-aged group (45-59 years old), presenile group (60-74 years old), elderly group (75-89 years old), and longevity group (≥90 years old). The patients' examination results, diagnosis and treatment status were collected. The distribution of different scores of qSOFA was analyzed to calculate the sensitivity, specificity, positive predictive value and negative predictive value of different qSOFA scores for the diagnosis of sepsis in patients with suspected infection of different ages. The receiver operator characteristic curve (ROC curve) was drawn to analyze the diagnostic value of qSOFA score for sepsis in patients with suspected infection at different ages.Results:Of 1 529 suspected infection patients, there were 67 patients in youth group, 129 patients in middle-aged group, 465 patients in presenile group, 778 patients in elderly group and 90 patients in longevity group. There were significant differences in lactic acid (Lac), total bilirubin (TBil), creatinine (Cr), qSOFA score and the increased value of SOFA score compared with the basic value (ΔSOFA) among the suspected infection patients at different ages. Among suspected infection patients at different ages, the patients with qSOFA score ≥ 1 were the most, and the proportion of sepsis patients was larger. Further analysis showed that qSOFA score ≥1 had a high diagnostic sensitivity in patients with suspected infection at different ages. In the youth group, the sensitivity was 84.4%, and the specificity was the highest (74.3%). Although qSOFA score ≥ 2 had a high specificity in the diagnosis of sepsis (all > 97%), its sensitivity was very low (all < 44%). In this study, all patients with a qSOFA score of 3 were sepsis, and the positive predictive value of the diagnosis of sepsis in each group was 100%. ROC curve analysis showed that the area under ROC curve (AUC) of qSOFA score for the diagnosis of sepsis in all suspected infection patients was 0.771 [95% confidence interval (95% CI) was 0.747-0.794], when the best cut-off value was 0.5, the sensitivity was 93.4% and the specificity was 45.6%. Among suspected infection patients of all ages, the accuracy of qSOFA score in the diagnosis of sepsis in the youth group and the longevity group was relatively high, with AUC (95% CI) of 0.825 (0.724-0.927) and 0.837 (0.756-0.917), respectively; when the best cut-off value was 0.5, the sensitivity was 84.4% or 92.2%, and the specificity was 74.3% or 56.4%, respectively. Conclusions:qSOFA score has an early diagnosis value for sepsis, especially in the patients aged < 45 years old or ≥ 90 years old. Using qSOFA score ≥2 to screen patients with suspected infection is likely to cause missed diagnosis.

Magnetic resonance imaging-guided microwave ablation of hepatic malignancies: Feasibility, efficacy, safety, and follow-up

Context: Percutaneous image-guided thermal ablation has emerged as a valuable therapeutic approach for hepatic malignancies. Magnetic resonance imaging (MRI) has shown potential for great soft-tissue resolution and multiplanar capabilities in arbitrary imaging planes, which are also critical for treatment planning, targeting, and evaluation. Aims: The aim of this study was to investigate the feasibility, technical success, safety, and follow-up of hepatic malignancies treated with MRI-guided microwave ablation (MWA). Materials and Methods: MRI-guided MWA was performed in a closed-bore 1.5 T MR system. T1-weighted imaging was used as a monitoring tool during surgery. T2-weighted imaging was performed to obtain an adequate tumor margin, to calculate the tumor size. Multi-b-value diffusion-weighted imaging (DWI) was performed postprocedurally. Enhanced MRI was performed at 4 weeks, to assess the technical success, and every 3–6 months as a follow-up. Results: Twenty-six patients (38 lesions) were enrolled in the study. A primary efficacy rate of 100% was achieved, and no major complications were observed. Two patient cohorts were identified based on lesion size. Six lesions with incomplete circles on reconstructed DWI appeared immediately postprocedure, and persistent hyperintense signals developed into new lesions over the subsequent 6–12 months. Conclusion: MRI-guided ablation is feasible and effective for planning and evaluating MWA in hepatic malignancies. The available clinical data strongly support the advantages of the assessment of tumors through 3D imaging versus routine axial images

Value of pressure and respiratory rate in predicting success of weaning from mechanical ventilator in patients / 中华急诊医学杂志

Objective:To evaluate the performance of the combinative index-a product of pressure (P) and respiratory rate (RR), to predict the outcome of weaning.Methods:Single-center, case-control study method was used to prospectively collect the data of 76 patients who had been mechanically ventilated for at least 24 h in ICU of the Affiliated Changshu Hospital of Xuzhou Medical University from November 2017 to April 2019, excluding the patients with central respiration repression and primary neuromuscular disease. The spontaneous breath test (SBT) was performed for 1 h after the patient was ready to be weaned. All patients were divided into two groups according to whether they were successfully weaned from the mechanical ventilation: 50 cases in the success group and 26 cases in the failure group. Clinical data and values of peak inspiratory pressure (P peak), driving pressure (DP) and RR of two groups were collected. The independent sample t test and Mann-Whitney U test were used for the comparison between the two groups. The differences between enumeration data were assessed by Chi-square test. Finally, receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of each index. Results:Of the 76 patients studied, 26 patients failed extubation. The values of P peak×RR and DP×RR in the success group were significantly less than those in the failure group; P peak×RR (cmH 2O·breaths/min): 291.8±76.5 vs 519.8±108.8 ( P<0.01), DP×RR (cmH 2O·breaths/min): 131.6±34.2 vs 227.0±47.5 ( P<0.01). The AUC of P peak×RR, DP×RR was 0.960 and 0.941, respectively. A decrease in P peak×RR index less than 362 cmH 2O·breaths/min had a sensitivity of 96.2%, a specificity of 88.0%, a positive predictive value (PPV) of 97.8% and a negative predictive value (NPV) of 80.6%, to predict successful weaning. A decrease in DP×RR index less than 170 cmH 2O·breaths/min had a sensitivity of 88.5%, a specificity of 92.0%, a PPV of 94.0% and a NPV of 88.5%, to predict successful weaning. Conclusion:The combination of pressure and respiratory rate can accurately predict whether the patients can be successfully weaned from mechanical ventilation.

Clinical application value of template-assisted CT-guided radioactive seed implantation for pancreatic carcinoma / 中华放射学杂志

Objective To investigate the clinical value of coplanar template-assisted CT guided radioactive seeds implantation in the treatment of pancreatic carcinoma. Methods A total of 22 advanced pancreatic carcinoma patients underwent CT guided radioactive seeds implantation were retrospectively analyzed.Ten patients were treated with coplanar template-assisted with an average age of(65±10)years(48 to 77 years).Tweleve patients were treated without coplanar template assist with an average age of(68±13) years (47 to 84 years). The preoperative planning designs and postoperative dosimetry verifications were performed for all patients.The dose related parameters including D90,MPD,V100,V150and V200were compared between pre and post operation by t test. The operating time were also evaluated between the two groups. Results Overall the 22 patients were treated successfully without serious surgery-related complications. An average of 26 seeds were implanted in the coplanar template assisted implantation group,and 23 seeds were implanted in the non template-assisted implantation group. Preoperative V100in coplanar template group and non template group were(94.45 ± 1.32)% and(93.27 ± 1.37)% separately. Postoperative V100in both groups were(89.31 ± 2.58)% and(85.25 ± 4.35)% separately. Postoperative D90in both groups were (147.32±7.12)Gy and(149.25±4.86)Gy separately.Postoperative V150in both groups were(57.83±7.74)% and(63.97±7.75)% separately.Preoperative D90in both groups were(152.41±6.78)Gy and(153.30±7.79) Gy separately. Preoperative V150in both groups were(58.61 ± 14.11)% and(62.45 ± 6.49)% separately. Postoperative MPD in both groups were(87.64±10.60)Gy and(87.12±7.66)Gy separately.Postoperative V200in both groups were(34.12±7.67)%,(39.42±7.18)% separately.Preoperative MPD in both groups were (82.12±7.81)Gy and(83.43±4.86)Gy separately.Preoperative V200in both groups were(29.04±10.64)%, (36.11 ± 7.22)% separately. Compared with preoperative plans, the mean value of D90and V100decreased while the mean value of MPD and V200increased in postoperative verifications in both coplanar template assist CT guided radioactive seeds implantation group and non template-assisted group.However,there was no significant difference between pre and post operation except for V100(P<0.05). The operating time of coplanar template assist group and non template-assisted group were(44.3±12.4)min and(60.0±12.8)min respectively. The difference of operating time between two groups were statistically significant (P<0.05). Conclusion Compared with the treatment without template assist, coplanar template-assisted brachytherapy could be more accurate in preoperative plans optimization,and shorten the operation time and improve the patients'tolerance.

Preliminary clinical study of biliary tract irradiation stent for hilar cholangiocarcinoma with malignant obstructive jaundice / 中国介入影像与治疗学

Objective To evaluate the efficacy and safety of biliary stent loaded with 125I seeds in treatment of hilar cholangiocarcinoma with malignant obstructive jaundice.Methods Totally 43 patients with malignant obstructive jaundice caused by cholangiocarcinoma were included.All the patients underwent percutaneous transhepatic puncture of the left and right side branch of the bile duct.In the hilar stenosis,the biliary stent with 125I seeds were implanted,and the biliary drainage tube had been kept in 3 to 5 days after procedures.The drainage tube was removed and the puncture road was closed after the patency of stents were confirmed by cholangiography.The changes of liver function before and after procedures were recorded,and the survival time was observed.Results Five biliary stents loaded with 125I seeds were implanted in type I (n=5),36 in type Ⅱ (n=18),8 in type Ⅲ (n=4) and 25 in type Ⅳ (n=16).The serum total bilirubin and direct bilirubin of patients before procedures were (145.54 ± 65.35) μmol/L and (124.73 ± 35.04) μmol/L,respectively,and (65.91±29.43)μmol/L and (35.50±15.12)μmol/L respectively after procedures.Compared with preoperative,the total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,C-reactive protein and gamma glutamic transaminase decreased significantly (all P＜0.05).The lactate dehydrogenase had no significant difference before and after operation (P=1.050).The median survival time was 13 months (3.0 to 22.5 months).The serious complications such as biliary puncture,pancreatitis,severe biliary tract infection or biliary bleeding were not occurred.Conclusion Biliary stent loaded with 125 I seeds is an effective therapy to alleviate symptoms of jaundice and prolong the survival time of patients with malignant obstructive jaundice caused by hilar cholangiocarcinoma.

CT-guided radioactive 125I seeds implantation in treatment of spinal metastatic tumors / 中国介入影像与治疗学

Objective To evaluated the safety and clinical efficacy of CT-guided percutaneous radioactive 125I seeds implantation in treatment of spinal metastatic tumors.Methods Totally 20 cases (23 lesions) of spinal metastatic tumors with spinal compression and severe back pain were treated by CT-guided percutaneous 125I seeds implantation.Intractable pain and nerve function before and after therapy were evaluated.And the postoperative cumulative local tumors control rates and cumulative survival rates were calculated.Results The median follow-up period was 14 months (range 7-32months).There was no patient lost follow-up.And no severe complication occurred.Intractable pain significantly relieved one month after therapy.The neural retention rate of 12 patients with nerve function impairment was 85.00％ (17/20) and the neural function recovery rate was 30.00％ (6/20) three months after 125 I seeds'implantation.The local tumors control rates in 3-,6-,and 12-month were 100％,100％ and 90％,respectively.The survival rates in 6-and 12-month was 100％and 78.81％,respectively.Conclusion CT-guided percutaneous radioactive 125I seeds implantation for spinal metastatic tumors is safe and feasible.It can relief pain and improve neural function effectively.

Value of ultrasound-measured changes in diaphragmatic excursion in predicting successful weaning from mechanical ventilation during spontaneous breathing trial / 中华麻醉学杂志

Objective To evaluate the value of ultrasound-measured changes in diaphragmatic excursion (DE) in predicting successful weaning from mechanical ventilation during the spontaneous breathing trial (SBT).Methods Sixty-three patients of both sexes,who were mechanically ventilated for more than 24 h and screened for ascertained readiness to wean,aged 45-64 yr,were enrolled in the study.Bilateral DE was measured using ultrasound at 0,10 and 30 min of SBT.The patients who successfully completed 30 min of SBT were extubated.The patients were divided into either success group or failure group according to whether or not weaning was successful.Receiver operating characteristic (ROC) curves were used to evaluate the value of bilateral △DE30-10 in predicting successful weaning.Results There were 48 cases in success group and 15 cases in failure group.Bilateral △DE30-10 was significantly higher in failure group than in success group (P＜0.05).The area under the ROC curves of the right △DE30-10 in predicting successful weaning was 0.958,＜0.175 cm was used to predict successful weaning,and the sensitivity and specificity were 93.3％ and 87.5％,respectively.The area under the ROC curves of the left △DE30-10 in predicting successful weaning was 0.903,＜0.275 cm was used to predict successful weaning,and the sensitivity and specificity were 80.0％ and 89.6％,respectively.Conclusion The fight △DE30-10 measured using ultrasound can serve as an assistant index in predicting successful weaning from mechanical ventilation during SBT.

Percutaneous intraductal radiofrequency ablation for the treatment of biliary stent stenosis：a preliminary study / 介入放射学杂志

Objective To evaluate the feasibility and effectiveness of percutaneous intraductal radiofrequency ablation (RFA) in treating biliary stent stenosis. Methods A total of 43 cases with biliary obstruction caused by biliary stent stenosis were enrolled in this study. Through percutaneous transhepatic pucturing of biliary duct, an EndoHPB catheter was placed in the stenotic site of the biliary stent, which was followed by RFA treatment. After RFA, biliary drainage catheter was reserved. The drainage catheter was removed when angiography confirmed that the stent was patent. Results Cholangiography showed that the biliary stent became patency after RFA in all patients. No procedure-related complications occurred. After RFA, the median patency time of the stenotic biliary stent in survival patients was 107 days (12-180 days). Conclusion The results of this preliminary clinical study indicate that percutaneous intraductal radiofrequency ablation has excellent effect and safety for the treatment of biliary stent stenosis, although more reliable and randomized controlled trials are needed before its effect and safety can be further proved.

Development and Evaluation of a Web-based Education Program for Nursing Students on Control of Vancomycin-resistant Enterococcus Infection / 기본간호학회지

PURPOSE: The purpose of this study was to develop a web-based education program on control vancomycin-resistant enterococci (VRE) infections and to identify the effects of the program on knowledge and performance of nursing students. METHODS: The web-based VRE infection control education program was developed by using the network-based instructional systems design model. The nursing students in the experimental group could access this web-based education program at any time, and as many times as they wanted, during the clinical training period. Effects were evaluated by assessing knowledge and performance of VRE infection control measures during the clinical training period. RESULTS: The contents of the education program included diagnosis, transmission, and treatment of VRE, contact precautions, hand washing, personal protective equipment, environment management, and quizzes. The lecture portion was filmed in a virtual screen studio using flash animation, video, and sound effects, and it was uploaded on an internet site. The knowledge and performance scores of the experimental group after using the education program were significantly higher than those of the control group. CONCLUSION: The results suggest that the web-based VRE infection control education program is an effective educational method to enhance knowledge and performance of VRE infection control measures.

Early therapy monitoring of 125Ⅰ seed interstitial implant in a pancreatic cancer xenograft by 18FFDG Micro-PET/CT / 中华放射医学与防护杂志

Objective To investigate the application value of early evaluation and monitoring of 125Ⅰ interstitial implantation in a pancreatic cancer xeuograft.Methods Xenograft models were created by subcutaneous injection of Sw 1990 human pancreatic cancer cell suspensions into the right hind limbs of the immunodeficient BABL/c nude mice.The tumors size were about 8-10 mm after two weeks.The mice were randomly divided into 3 groups,including control group (n = 4) ,empty seed implantation group (n = 4)and 125Ⅰ implantation group (n = 4).Before treatment and one week after treatment,18F-FDG Micro-PET/CT scan was performed and then maximum standardized uptake values (SUVmax),mean standardized uptake values (SUVmean),tumor size and necrosis rate were measured.HE staining and TK1 immunohistochemistry examination were carried out in the paraffin-embedded sample.Results Before treatment the SUVmax and SUVmean values of three groups did not reach statistical significance.One week after treatment the SUVmax and SUV values of three groups were 3.53 + 1.20 and 0.57±0.26 vs.3.83±2.13 and0.59 ±0.24vs.0.29±0.23 and0.016±0.001,respectively,with a significant difference (F =7.62,P =0.01 ; F = 10.34,P =0.005).The SUVmax and SUVmean values of 125Ⅰ implant group were significantly lower than empty seed implant group and control group and were significantly lower than before treatment.Before treatment,tumor necrosis rate of three groups were not significantly different.Immunohistochemical staining found the TK1 positive staining index of three groups were respectively (64.25±1.71) % ,(62.25±2.22) % and (38.25±1.71) % with statistically significant difference (F =233.67,P < 0.001).The TK1 positive staining index of 125Ⅰ implant group was significantly lower than empty seed implant group and control group.The SUVmax values had some positive correlation with TK1 positive staining index (r = 0.85,P = 0.001).Conclusions 18F-FDG Micro-PET/CT may be useful as a noninvasive imaging modality to assess early response to 125Ⅰ seed brachytherapy in a pancreatic cancer xenograft.

Population pharmacokinetic modeling of flurbiprofen / 药学学报

The paper is to report the establishment of a population pharmacokinetic model for flurbiprofen (FP), an active metabolite of flurbiprofen axetil (FA). 246 FP serum concentration and clinical data were perspectively collected from 23 general anaesthesia patients receiving FA intravenously before operation in Dentofacial Surgery and Otorhinolaryngology Department of the First Affiliated Hospital of Fujian Medical University. Population pharmacokinetic data analysis was performed using NONMEM software. The measure of Bootstrap was applied for internal validation, while Visual Predictive check was adopted for external validation. The data of FP correspond with two-compartment model. The body weight (WT) had conspicuous effect on clearance and volume of central compartment, while sex, age and daily dose of administration had no marked effect on pharmacokinetic parameter of FP. The basic model was described as follows: CL (L x h(-1)) = 1.28x EXP(ETA(1)), V1 (L) = 5.03x EXP(ETA(2)), Q (L x h(-1)) = 8.5 x EXP(ETA(3)), V2 (L) = 4.39 x EXP(ETA(4)). The final model was described as follows: CL (L x h(-1)) = 1.32 x (WT/60) x EXP(ETA(1)), V1 (L) = 5.23 x (WT/60) x EXP(ETA(2)), Q (L x h(-1)) = 8.45 x EXP(ETA(3)), V2 (L) = 4.37 x EXP(ETA(4)). The population typical value of CL, V1, Q and V2 were: 1.32 L x h(-1), 5.23 L, 8.45 L x h(-1) and 4.37 L, respectively. Bootstrap and visual predictive check show that the final model of FP is stable, effective and predictable. A novel population pharmacokinetic model is developed to estimate the individual pharmacokinetic parameter for patients intravenous injecting FA in terms of patients' characteristics and dosing history, and to design a prior dosage regimen.

Clinical application of CT-guided ~(125)I seed interstitial implantation for recurrent rectum carcinoma / 介入放射学杂志

Objective to explore the safety and clinical efficacy of CT-guided radioactive seed implantation in treating recurrent rectum carcinoma. Methods CT-guided ~(125)I radioactive seed implantation was carried out in 20 patients with recurrent rectal carcinoma. Treatment planning system was used preoperatively to reconstruct three dimensional image of the tumor and to calculate the estimated seed number and distribution. The tumor matched peripheral dose (MPD) of the radioactive seeds was 80-130 Gy. The radioactivity of the seeds was 0.5-0.8 mCi/seed and the median implanted seeds was 48 (range 25-95) in number. CT scan was made immediately after the implantation to check the quality of the seeds. Change of pain score, tumor size and complications were recorded during the follow-up period. Results Twenty cases composed of 12 males and 8 females, aged 38 to 78 years (median age of 62 years). The follow-up period lasted 2-28 months. On an average, 3 to 7 days after the procedure patients experienced significant pain relief. CT scan performed 2 months after the procedure revealed that complete relief (CR) of the tumor was seen in 2 cases, partial relief (PR) in 13 cases, no change (NC) in 3 cases and progression (PD) in 2 cases. The total effective rate (CR + PR) was 75%. The median survival time was 18.8 months. The survival rate of 1 and 2 years was 75% and 25% respectively. Two cases died of tumor deterioration and 3 cases died of extensive metastases. No complications such as frequent micturation, pain on urination and hematuria occurred during the follow-up period. Conclusion CT-guided ~(125)I radioactive seed implantation is a safe and effective interventional treatment for recurrent rectal carcinoma with reliable short-term efficacy and excellent anti-pain effect.

Clinical efficacy of CT-guided ~(125)I seed implantation therapy for advanced lung cancer / 介入放射学杂志

Objective To investigate the safety and clinical efficacy of CT-guided radioactive ~(125)I seed implantation treatment for advanced lung cancer. Methods The clinical data of thirty cases with lung cancer, which was proved by puncture biopsy, histology or cytology, were retrospectively analyzed. The pathologic diagnoses included squamous cell carcinoma (n= 13), adenocarcinoma (n= 8) and metastatic lung cancer (n= 9). Using treatment planning system (TPS) 3D images of the tumor were reconstructed, the number and the dose rate distribution of ~(125)I seeds were calculated. The matched peripheral dose (MPD) of ~(125)I seed implantation was 80-130 Gy. The median amount of implanted ~(125)I seeds was 35 (8-83) in number. Results Follow-up observation was made at 1, 3, 6 and 12 months after the treatment in all patients. The median survival time was 12 months (7-18 months). The cumulative survival rate at 6, 9 and 12 months was 100.0%, 80.0% and 23.3%, respectively. Follow-up CT images 12 months after the therapy showed that complete relief (CR) was seen in 9 cases, partial relief (PR) in 14 cases, no change (NC) in 4 cases and progression (PD) in 3 cases. The overall effective rate (CR + PR) of 1-month, 3-month, 6-month and 12-month was 83%, 80%, 80% and 77%, respectively. During following-up period, pneumothorax occurred in 3 cases and bloody sputum occurred in 7 cases. Conclusion CT-guided radioactive ~(125)I seed implantation treatment is a safe, effective and minimally-invasive treatment for lung cancer.

Clinical efficacy of CT-guided ~(125)I seed implantation therapy for advanced pancreatic cancer / 介入放射学杂志

Objective To discuss the clinical efficacy of CT-guided radioactive ~(125)I seed implantation treatment for unresectable pancreatic cancer. Methods Forty patients with inoperable pancreatic cancer were enrolled in this study, including 25 males and 15 females with an median age of 69 years (38-89 years). Treatment planning system (TPS) was used to reconstruct 3-dimensional images of pancreatic tumor and to define the quantity and distribution of ~(125)I seeds. The radioactivity of ~(125)I seeds was 0.5-0.8 mCi/seed. The seeds were implanted into pancreatic tumor under CT guidance at intervals of 1 cm and were kept away from vessels, pancreatic duct and other adjacent important organs. The tumor matched peripheral dose (MPD) was 60-140 Gy. The median amount of implanted ~(125)I seeds was 36 (18-68) in number. CT scan was performed immediately after the procedure to check the quality of the seeds. In addition, 10 patients received concurrent chemotherapy with arterial infusion of gemcitabin and 5-fluororacil (5-Fu) for 3 to 4 therapeutic courses. Results The median diameter of the tumors was 4.9 cm. The follow-up period was 2 to 28 months. After the treatment the refractory pain was significantly relieved (P < 0.05), and Karnofsky score was dramatically increased (P < 0.05). Most patients experienced relief of pain within 2-5 days after implantation. Two months after treatment, on CT scans the tumors showed completed relief (CR) in 3 cases, partial relief (PR) in 20 cases, no change (NC) in 14 cases and progression (PD) in 3 cases. The overall effective rate (CR+PR) was 57.5%. The median survival time for all patients was 10.2 months, while it was 14.7 months, 10.9 months and 7.1 months for patients in stage Ⅱ, stage Ⅲ and stage IV respectively. For patients in stage Ⅱ, stage Ⅲ and stage Ⅳ, the 6-month cumulative survival rate was 100%, 88% and 62% respectively, while the 12-month cumulative survival rate was 70% , 41% and 0% respectively. After the therapy, liver metastasis occurred in 5 cases and chemoembolization was employed. In three patients, immigration of four radioactive seeds to the liver was found. No serious complications, such as upper GI bleeding, pancreatitis, pancreatic fistula formation and radiation colitis, occurred during the follow-up period. Conclusion CT-guided radioactive ~(125)I seed implantation is a safe, effective and minimally-invasive brachytherapy for unresectable pancreatic cancer with reliable short-term efficacy. It has an excellent anti-pain effect. The curative results can be further improved when chemotherapy is employed together. However, its long-term efficacy needs to be observed.

NK/T cell infiltration and prognosis in primary squamous cell carcinoma of the lung / 中国癌症杂志

Background and purpose:Both nature killer cells(NK)and cytoxic T lymphocytes in the body tissues of human are the dominant components of cellular immunity,This study was done to explore the degree of infiltration of NK/T in lung squamous cell carcinoma and its relation to patient survival and prognosis.Methods: CCD8 as the markers cytoxic T lymphocyte(CTL)and CD56 as the markers natural killer(NK)were stained immunohistochemically to detect the distribution and infiltration in the lung squamous cell carcinoma specimens. Results:In 39 of 68 lung neoplasm,whose CTL infiltration was zero or mild,the five-year survival rate was 18%, while in 29 with marked CTL infiltration,the five-year survival rate was 42%.In 46 of 68 lung neoplasm,whose NK infiltration was zero or mild,the five-year survival rate was 14%,while in 22 with marked NK infiltration,the five-year survival rate was 45%.In 48 of 68 lung neoplasm,both the NK and T cells were zero or mild,the five-year survival rate was 33%,while in 20 with marked NK and T cell infiltration,the five-year survival rate was 54%.The five-year survival difference among the patients with NK,T infiltration either marked or zero/mild infiltration were significant(x~2=18.62, P=0.00).Conclusions:The degree of NK and T infiltration is positively correlated with the prognosis and survival time of lung squamous cell carcinoma patients.