Minimizing Molecular Misidentification in Imaging Low-Abundance Protein Interactions Using Spectroscopic Single-Molecule Localization Microscopy.

Super-resolution microscopy can capture spatiotemporal organizations of protein interactions with resolution down to 10 nm; however, the analyses of more than two proteins involving low-abundance protein are challenging because spectral crosstalk and heterogeneities of individual fluorescent labels result in molecular misidentification. Here we developed a deep learning-based imaging analysis method for spectroscopic single-molecule localization microscopy to minimize molecular misidentification in three-color super-resolution imaging. We characterized the 3-fold reduction of molecular misidentification in the new imaging method using pure samples of different photoswitchable fluorophores and visualized three distinct subcellular proteins in U2-OS cell lines. We further validated the protein counts and interactions of TOMM20, DRP1, and SUMO1 in a well-studied biological process, Staurosporine-induced apoptosis, by comparing the imaging results with Western-blot analyses of different subcellular portions.

Tunable nonlinear optical responses and carrier dynamics of two-dimensional antimonene nanosheets.

Sb nanosheets, also known as antimonene, have received ever-growing consideration as a promising new type of two-dimensional (2D) material due to their many attractive properties. However, how their nonlinear optical (NLO) properties are affected by their nanosheet structure and measurement conditions remains unclear. Herein, we report a successful size-selective production method for Sb nanosheets, which is based on a combination of lithium ion intercalation, solvent exfoliation and size selection centrifugation. This high-yield and size-selective preparation method enables fundamental investigation on the relation of the intrinsic optical properties of Sb nanosheets. Nanosecond Z-scan measurements revealed a unique size-dependent broadband NLO response. When the average size is reduced from 3 micrometers to 50 nanometers, the Sb nanosheets exhibit a clear transition from saturable absorption to reversed saturable absorption. Ultrafast transient absorption spectroscopic investigation indicated that exciton cooling is significantly faster in a small nanosheet than in large ones, revealing that the different exciton relaxation dynamic plays key roles in the distinct size-tunable nonlinear optical response. This work paves new ways towards the mass production and practical application of antimonene.

[Clinical analysis of surgical procedures and outcomes for corrected transposition of great arteries with heart anomaly].

OBJECTIVE: To determine the outcome of anatomically corrective repair and traditional repair of corrected transposition of great arteries (c-TGA) with heart anomaly. METHODS: From April 2002 to December 2006, nineteen patients including fourteen male and five female with c-TGA, underwent operations, age ranged from 2 to 22 years old and weight ranged from 10 to 48 kg. Fifteen of them received anatomically corrective repair and the other four received traditional repair. Eighteen patients were referred to SLL (segmental anatomy) in situs solitus while fifteen of them with levocardia and three with dextrocardia. One patient was referred to IDD (segmental anatomy) in situs inversus with levocardia. Associated cardiac lesions included ventricular defect in eighteen patients, double outlet of right ventricle in one patient, pulmonary stenosis in seventeen patients and pulmonary hypertension in two patients. The operative procedures to anatomically correct atrioventricular discordance included an atrial switch plus a ventricle-arterial switch. The atrial switch was performed using the modified Senning procedure (n=13), Senning procedure (n=1) and Mustard procedure (n=1). The ventricle-arterial switch was performed using a Rastelli procedure (n=13) or an arterial switch (n=2). The patients underwent Mustard and Rastelli procedure had received bi-direct Gleen shunt due to postoperative high pressure of superior vena cava. Three patients underwent traditional cardiac repair because of small ventricular septal defect and one patient was reoperated to undergo traditional cardiac repair because of left ventricular failure after received anatomically corrective repair. RESULTS: In the patients received anatomically corrective repair, there was one early operative death received a modified Senning atrial switch and an arterial switch. The cause of death was acute myocardial failure due to imperfect coronary transfer. The postoperative complications included severe low cardiac output syndrome (n=1), temporary atrioventricular block (n=1) and thorax cavity fluidify (n=1). The survivors were followed up for 6 months to 4 years. All were sinus cardiac rhythm and in NYHA class I or II. There was no death in the patients received traditional repair. Four patients were followed up for 1 year. Three patients were in NYHA I or II class and one patient in class II. CONCLUSIONS: Anatomically corrective repair of c-TGA can be performed with good operative survival and intermediate-term outcome. The patients with good right ventricular function and well developed tricuspid valve who were difficult to undergo anatomically corrective repair might be fit to receive traditional repair.

3D-PCT-assisted CT-guided radioactive particle implantation precision / 中华放射医学与防护杂志

Objective:To study the precision of 3D printing coplanar template (3D-PCT) assisted CT-guided radioactive particle implantation using two types of phantoms, and compare the differences between the phantoms, in order to provide reference for radioactive particle implantation.Methods:The needle inserting path was designed in the brachytherapy treatment planning system (BTPS) and the needle tip coordinates were obtained. Following the needle inserting path, the implant needles were inserted into the custom and the liver phantoms, respectively. Then gold markers were implanted through the needles. Subsequently, the needles were withdrawn by 10 mm, and the cold sources were implanted. The coordinates of needle tips, gold markers, and cold sources were recorded. The precision of implanted needles, first particles, and particles after needle withdrawal were obtained by calculating the distance between two points in the space. Finally, the differences between the two phantoms were compared through independent samples t-test. Results:In the 3D-PCT-assisted CT-guided radioactive particle implantation, the precision of implanted needles, first particles, and particles after needle withdrawal in the custom and the liver phantoms was (1.89±0.72) and (2.14±0.88 ) mm ( P>0.05), (2.03±1.14) and (2.42±1.12) mm ( P>0.05), and (-1.96±1.29) and (-2.82±0.91) mm ( t=2.09, P=0.046), respectively. Conclusions:The 3D-PCT-assisted CT-guided radioactive particle implantation is efficient, stable, and precise, showing slight precision differences between the two phantoms.

Graphene oxide promotes diabetic skin wound healing through regulating adipose-derived mesenchymal stem cells / 中华内分泌代谢杂志

Objective:To study the effect of graphene oxide (GO) on adipose-derived mesenchymal stem cells (Ad-MSCs) to promote diabetic skin wound healing.Methods:Ad-MSCs were cultured with GO at concentration of 100, 200, and 400 μg/mL and with 25 mmol/L of glucose for 48 h. The apoptosis of Ad-MSCs was detected by flow cytometry and Western blotting. Eighteen BALB/c thymus free female nude mice were selected to establish the skin defect model of diabetic nude mice. Then phosphate-buffered saline, Ad-MSCs, and GO+ Ad-MSCs were injected into the damaged skin of nude mice by intradermal injection for treatment, thereby created the control group, Ad-MSCs group, and GO+ Ad-MSCs group, 6 mice each group. The survival of wound cells and skin healing of mice were observed after surgery, and the wound healing was determined by HE staining and Masson staining.The level of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and interleukin 6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA).Results:Compared with the high glucose group without GO(control group), the apoptosis rate of Ad-MSCs co-culture with GO was significantly reduced( P<0.05), and the apoptosis rate decreased with the increase of GO concentration. The expression level of Bax protein decreased, and the expression level of Bcl-2 protein increased ( P<0.05). Diabetic skin defect model showed that the survival rate of Ad-MSCs and wound healing degree in GO+ Ad-MSCs group were significantly increased ( P<0.05), and the degree of epithelialization and thickness of collagen regeneration were better than those in other groups. ELISA results showed that the expressions of EGF and VEGF were significantly increased in GO+ Ad-MSCs group ( P<0.05), while the expressions of TNF-α and IL-6 were significantly decreased ( P<0.05). Conclusion:GO can inhibit the apoptosis of Ad-MSCs in vitro. In vivo, Ad-MSCs treated with GO have higher survival rate, faster wound healing, and better effect than Ad-MSCs treated alone.

Tongxinluo Inhibits Renal Fibrosis in Diabetic Nephropathy: Involvement of the Suppression of Intercellular Transfer of TGF-[Formula: see text]1-Containing Exosomes from GECs to GMCs.

Glomerular mesangial cells (GMCs) activation is implicated in the pathogenesis of diabetic nephropathy (DN). Our previous study revealed that high glucose (HG)-treated glomerular endothelial cells (GECs) produce an increased number of TGF-[Formula: see text]1-containing exosomes to activate GMCs through the TGF-[Formula: see text]1/Smad3 signaling pathway. We also identified that Tongxinluo (TXL), a traditional Chinese medicine, has beneficial effects on the treatment of DN in DN patients and type 2 diabetic mice. However, it remained elusive whether TXL could ameliorate renal structure and function through suppression of intercellular transfer of TGF-[Formula: see text]1-containing exosomes from GECs to GMCs. In this study, we demonstrate that TXL can inhibit the secretion of TGF-[Formula: see text]1-containing exosomes from HG-treated GECs. Furthermore, exosomes produced by HG induced-GECs treated with TXL cannot trigger GMC activation, proliferation and extracellular matrix (ECM) overproduction both in vitro and in vivo. These results suggest that TXL can prevent the transfer of TGF-[Formula: see text]1 from GECs to GMCs via exosomes, which may be one of the mechanisms of TXL in the treatment of DN.

Dosimetry evaluation of navigation system-assisted and CT-guided seed implantation in the treatment of recurrent malignant pelvic tumors / 中华放射医学与防护杂志

Objective:To explore the accuracy of CT-guided 125I seed implantation assisted by a navigation system and 3D-printing template in the treatment of recurrent malignant pelvic tumors by comparing pre-plan and intraoperative physical dosimetric parameters. Methods:This study involved 15 patients with recurrent malignant pelvic tumors who received CT-guided radioactive 125I seed implantation assisted by a navigation system and 3D-printing template in the Peking University Third Hospital from Dec 2018 to Feb 2020.Seven of the patients had cervical cancers, seven had rectal cancers, and one had prostate cancer.The median age was 55 years (34-84 years old). The prescription dose was 100-150 Gy.The pre-plan and post-implant data were compared, including the number of implanted seeds, implantation needle number, and some dosimetric parameters such as the minimum prescription doses delivered to 90% and 100% of target volume( D90, D100), mean percentages of volume receiving 100%, 150%, and 200% of the prescription doses( V100, V150, and V200), conformity index(CI), external index(EI), and homogeneity index(HI)of the target volume. Results:The median lesion volume was 29.20 cm 3, the median seed number was 54, and the median D90 was 150 Gy.The post-implant V150 was lower than pre-plan V150 (64.1% vs. 67.1%, t=2.937, P=0.011), and the post-implant mean HI was higher than pre-plan HI (32.01% vs. 26.68%, t=-2.950, P=0.011). There were no significant differences in other dosimetric parameters before and after seed implantation. Conclusions:With CT-guided radioactive seed implantation assisted by a navigation system and 3D-printing template in the treatment of recurrent malignant pelvic tumors, the actual postoperative dose could meet the preoperative plan requirement, ensuring the accuracy and consistency of the dose delivered.

Dosimetric evaluation of 125I seed implantation assisted by an optical navigation system and a 3D-printing template in the treatment of recurrent head and neck cancers / 中华放射医学与防护杂志

Objective:To verify the accuracy and feasibility of radioactive 125I seed implantation assisted by an optical navigation system and a 3D-printing non-coplanar template in the treatment of recurrent head and neck cancers. Methods:A total of 12 patients with recurrent head and neck cancer treated with radioactive 125I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template were enrolled from Dec 2018 to Dec 2019.The pre-plan and post-implant implantation needle number and implanted seed number were recorded.Meanwhile, their dosimetric parameters were compared, including D90, minimum peripheral dose (MPD), V100, V150, V200, conformity index (CI), external index (EI), and the homogeneity index (HI) of the target volume. Results:The median lesion volume was 31.5 cm 3, the median number of seeds was 61.5, and the median prescription dose was 130 Gy.The means of the pre-plan D90, MPD, V100, V150 and V200 were 134.2, 64.6, 93.3, 75.3 and 39.3 Gy, respectively, while those of post-implant D90, MPD, V100, V150, and V200 were 146.7, 68.94, 97.47, 80.40 and 48.30 Gy, respectively, with no statistically significant difference ( P>0.05). Meanwhile, there was no statistically significant difference between the pre-plan and post-implantation needle number, implanted seed number, CI, HI, and EI ( P>0.05). In terms of postoperative dose quality assessment, eight cases were rated excellent (66.6%) and four cases were rated good (33.3%). Conclusions:Radioactive 125I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template can be accurately performed in the treatment of recurrent head and neck cancer, with good consistency between pre-plan and post-implant dosimetric parameters and thus of prospective potential in clinical application.

Preoperative dosimetric comparison between non-coplanar and coplanar template-assisted 125I seed implantation for pancreatic cancers / 中华放射医学与防护杂志

Objective:To compare preoperative planning parameters between non-coplanar and coplanar template-assisted radioactive seed implantation in the treatment of pancreatic cancers, in order to guide clinical application.Methods:Patients with pancreatic cancers who received external irradiation in the Peking University Third Hospital from Jan 2017 to May 2019 were selected.Their image information was imported into the brachytherapy planning system, and the non-coplanar plan and coplanar plan were designed individually.Each patient′s prescription dose was set to 110 Gy, and the activity of the radioactive seeds were 0.4 mCi(1 Ci=3.7×10 10Bq), respectively.For the two plans, the dose distribution was optimized and dosimetric parameters were compared, including the implantation needle number, the implanted seed number, the minimum prescription doses delivered to 90% and 100% of the target volume ( D90 and D100), mean percentages of volume receiving 100%, 150% and 200% of the prescription doses ( V100, V150 and V200), conformity index (CI), external index (EI), and homogeneity index (HI) of the target volume, as well as the doses of 2 cm 3 and 5 cm 3 ( D2 cm 3 and D5 cm 3) of the surrounding normal organs such as the small intestines, colon, duodenum, stomach, and spinal cord. Results:The implantation needle number in the coplanar plan was slightly higher than that in the non-coplanar plan, namely 18.63 vs. 16.45 ( t=-3.239, P <0.05). The implanted seed number was equivalent, namely 90.2 vs. 91.01, with no statistical difference ( P>0.05). There was no significant difference between D90, D100, V100, V150, V200, CI, EI, and HI in the target area of the two plans ( P>0.05). Meanwhile, there was no obvious difference in D2 cm 3 and D5 cm 3 of normal organs including the small intestines, colon, duodenum, stomach, and spinal cord ( P>0.05). Conclusions:With both the coplanar plan and the non-coplanar plan, the prescription doses can be achieved and meanwhile, there are very small differences in the doses of normal organs.Given that 3D-printing non-coplanar and coplanar templates have their own characteristics, it is necessary to choose them according to specific situations.

Efficacy of early arthroscopic shoulder treatment of moderate full-thickness tear of the supraspinatus tendon / 中华创伤杂志

Objective:To investigate the clinical effect of early arthroscopic shoulder treatment of moderate full-thickness tear of the supraspinatus tendon.Methods:A retrospective case control study was conducted to analyze the clinical data of 43 patients with moderate full-thickness supraspinatus tendon tear admitted to First Affiliated Hospital of Xi 'an Jiaotong University from January 2018 to June 2020，including 17 males and 26 females，aged from 41 to 68 years［（55.9±8.2）years］. All patients had arthroscopic shoulder supraspinatus tendon suture and acromioplasty，including 22 patients underwent surgery within 1 month after persistent shoulder pain and motion limitation in early group and 21 patients between 1 month and 3 months in late group. The duration of operation and intraoperative blood loss were recorded. The visual analogue scale（VAS），American Shoulder and Elbow Society（ASES）score and Constant-Murley score were assessed before operation and at postoperative 3 weeks，6 weeks，3 months and 6 months. The complications were detected with 6 months after operation. Results:All patients were followed up for 6-7 months［（6.4±0.4）months］. There was no statistical significance in operation duration and intraoperative blood loss between the two groups（ P>0.05）. At 3 weeks，6 weeks，3 months and 6 months after operation，there showed significant decrease of VAS but significant increase of ASES and Constant-Murley scores compared to preoperation（ P<0.05）. At 3 weeks and 6 weeks after operation，the VAS in early group［（4.4±0.9）points，（3.7±0.8）points］was lower than that in late group［（5.5±1.0）points，（4.8±1.1）points］；while the ASES score［（49.1±4.6）points，（56.8±4.1）points］and Constant-Murley score［（54.1±4.8）points，（64.1±4.4）points］in early group were higher than those in late group［ASES score：（45.2±5.4）points，（50.3±5.4）points；Constant-Murley score：（50.5±3.3）points，（58.2±3.9）points］（ P<0.05）. At 3 months and 6 months after operation，the two groups showed no statistical significance in these scores. There were no postoperative complications such as infection or nerve injury in both group within 6 months. Conclusion:For moderate full-thickness tear of the supraspinatus tendon，arthroscopic shoulder surgery performed within 1 month after persistent shoulder pain and motion limitation can achieve better pain relief and faster functional rehabilitation in the short term compared with surgery performed 1-3 months later.

125I seed implantation for early stage non-small cell lung cancer—analysis of clinical efficacy and prognosis factors / 中华放射医学与防护杂志

Objective:To analyze the efficacy and safety of radioactive 125I seed implantation in the treatment of unresectable early-stage non-small cell lung cancer (NSCLC), in order to provide data for clinical practice and relevant research. Methods:A retrospective study was conducted on the data of 39 patients with early-stage NSCLC who received CT-guided radioactive 125I seed implantation from Dec 2010 to Dec 2018 in multiple hospitals.The seed implantation process consisted of preoperative planning and design, CT-guided puncture, seed implantation, and postoperative evaluation and dose verification.The efficacy and complications of the treatment were analyzed.The clinical efficacy was evaluated by adopting the Response Evaluation Criteria in Solid Tumors (RECIST) (v1.1) and the adverse reactions were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE v4.0). Results:All the patients were 70 years old on average (51-85). The median lesion diameter was 2.7 cm (1.1-6.0 cm), the median seed activity was 0.7 mCi (0.6-0.8 mCi), while the median follow-up duration was 29 months (3-97 months). Meanwhile, the 1-, 3-, and 5-year overall local control rates were 89.5%, 79%, and 79%, respectively, and the 1-, 3-, and 5-year overall survival rates were 100%, 74.8%, and 49.9%, respectively.Local recurrence and distant metastasis were the main causes of failure, accounting for 17.9% (7 cases) each.The incidence of pneumothorax was 56.4% (22 cases), among which nine cases (23.1%) required invasive closed thoracic drainage.Only 1 case of grade-2 radiation pneumonia (2.6%) was observed, with no other adverse reactions such as dermatoses, esophagitis, or myelitis being discovered.As indicated by univariate analysis, the patients with KPS scores of 80-90, pathological type of adenocarcinoma, T stage of T 1-2, and D90>180 Gy exhibited better local control ( χ2=6.202, P<0.05). Meanwhile, high D90 was also associated with a higher survival rate ( χ2=6.907, P<0.05). Conclusions:Radioactive 125I seed implantation is a safe and effective treatment for unresectable early-stage NSCLC.In cases where external beam radiotherapy is not available, radioactive 125I seed implantation can be considered as one of the treatment options.Pneumothorax is the most common complication of radioactive 125I seed implantation, and adenocarcinoma (pathological type) and higher values of D90 are predictors of better local control.

Dosimetry evaluation of three-dimensional-printing template guided radioactive seeds implantation assisted by navigation system in malignant tumors / 中华核医学与分子影像杂志

Objective:To compare the difference of preoperative and postoperative plans of navigation-assisted three-dimensional (3D)-printing template combined with CT-guided radioactive 125I seeds implantation for malignant tumors, and verify preliminarily the plan quality of optical navigation-assisted seeds implantation. Methods:From December 2018 to November 2019, a total of 20 patients (10 males, 10 females, median age: 60.5 years) with malignant tumors received navigation-assisted 3D-printing template combined with CT-guided radioactive 125I seeds implantation in Peking University Third Hospital. Eight cases were implanted in the head and neck, 1 case in the chest wall, 9 cases in the pelvis and 2 cases in the paravertebral and/or retroperitoneal region. The median prescription dose was 150 Gy. The data in the preoperative and postoperative plans was compared, including seeds number, needles number, and some dosimetry parameters. Dosimetry parameters including dose delivered to 90% gross tumor volume (GTV) ( D90), percentage of GTV received 100%, 150%, and 200% of the prescribed dose ( V100, V150, V200), minimum peripheral dose (MPD), conformal index (CI), external index (EI), homogeneity index (HI) of target volume, and 2 cm 3 range of spinal cord receiving dose ( D2 cm 3). Paired t test and Wilcoxon signed rank test were used to analyze the data. Results:The needles number of preoperative and postoperative plans was the same (both 12 (9, 19)), and the seeds number of postoperative plan was more than preoperative plan with no significant difference (51(35, 68) vs 49(35, 63); z=1.859, P>0.05). The MPD of postoperative plans was higher than preoperative plans ((80.52±14.89) vs (67.22±20.56) Gy, t=-3.769, P=0.001). There were no significant differences in other dosimetry parameters between the two plans ( t values: -0.533, -0.423, z values: from -0.849 to 1.416, all P>0.05). Postoperative dose quality assessment was excellent in 17 cases (17/20), good in 2 cases (2/20) and middle in 1 case (1/20). Conclusions:The quality of the implantation is good under the guidance of combined mode. The actual target dose after operation can meet the requirements of preoperative planning.

Dosimetric analysis of 3D-printing non-coplanar template combined with CT-guided125I seed implantation for the treatment of spinal metastasis / 中华放射肿瘤学杂志

Objective@#To compare the preoperative and postoperative dosimetric parameters in the treatment of spinal metastasis, and to verify the accuracy of 3D-printing non-coplanar template (3D-PNCT) combined with CT-guided 125I seed implantation for the treatment of spinal metastasis.@*Methods@#The treatment plans of 7 patients with spinal metastasis (9 lesions) from 2016 to 2018 receiving 3D-PNCT in combination with CT-guided 125I seed implantation were retrospectively analyzed. The dosimetric parameters including homogeneity index (HI), conformal index (CI), external index (EI), dose of 90% target volume(D90), mPD, volume percent of 100%, 150%, and 200% prescribed dose V100、V150、V200 and D2cm3 of spinal cord were compared before and after operation. The british columbia cancer ageny particle implantation quality evaluation standard was applied to evaluate the quality of implantation.@*Results@#The HI, EI and CI, D90, mPD, V100, V150, V200 and D2cm3 of spinal cord did not significantly differ before and after the plan (all P>0.05). Five were evaluated as excellent and 4 were assessed as good.@*Conclusion@#The postoperative dosimetric parameters of 3D-PNCT combined with CT guided 125I seed implantation of spinal metastasis are basically consistent with preoperative dosimetric parameters. The postoperative plans are evaluated as excellent or good, suggesting that the technology has a good therapeutic accuracy in the treatment of spinal metastasis.

Dosimetric analysis of 3D-printing non-coplanar template combined with CT-guided 125I seed implantation for the treatment of spinal metastasis / 中华放射肿瘤学杂志

Objective To compare the preoperative and postoperative dosimetric parameters in the treatment of spinal metastasis,and to verify the accuracy of 3D-printing non-coplanar template (3D-PNCT)combined with CT-guided 125I seed implantation for the treatment of spinal metastasis.Methods The treatment plans of 7 patients with spinal metastasis (9 lesions) from 2016 to 2018 receiving 3D-PNCT in combination with CT-guided 125I seed implantation were retrospectively analyzed.The dosimetric parameters including homogeneity index (HI),conformal index (CI),external index (EI),dose of 90％ target volume (Dg0),mPD,volume percent of 100％,150％,and 200％ prescribed dose V100、V150、V200 and D2cm3 of spinal cord were compared before and after operation.The british columbia cancer ageny particle implantation quality evaluation standard was applied to evaluate the quality of implantation.Results The HI,EI and CI,Dg0,mPD,V100,V150,V200 and D2cm3 of spinal cord did not significantly differ before and after the plan (all P＞0.05).Five were evaluated as excellent and 4 were assessed as good.Conclusion The postoperative dosimetric parameters of 3D-PNCT combined with CT guided 125I seed implantation of spinal metastasis are basically consistent with preoperative dosimetric parameters.The postoperative plans are evaluated as excellent or good,suggesting that the technology has a good therapeutic accuracy in the treatment of spinal metastasis.

Dosimetry verification of radioactive seed implantation for recurrent malignant tumor of head and neck assisted by 3D printing individual guide plate / 中华放射医学与防护杂志

Objective To compare the dose distributions of postoperative plans with preoperative plans for 3D printing guide plate assist radioactive seeds implantations, explore the effects of the technology for seeds implantations in dosimetry level. Methods From January 2016 to December 2016, a total of 42 patients of local recurrent malignant tumor of head and neck received 3D printing guide plate assist radioactive seeds implantations in in Peking University Third Hospital, and included in the retrospective study. The prescribed dose was 110 -160 Gy. All patients carried out preoperative planning design, individual guide plate production, and compared the dose distribution of postoperative plan with preoperative plan. Dose parameters include D90 , mPD, V100 , V150 , V200 , CI, EI and HI. Statistical method was paired t-test. Results A total of 423D printing individual templates were produced. The mean GTV volume of all patients was 28. 6 cm3 , and mean D90 of postoperative target area ( GTV) was 142. 6 Gy. For postoperative plans, the mean D90 , mPD, V100 , V150, V200 was 142. 6 Gy, 77. 3 Gy, 92. 48％, 68. 40％and 42. 98％, respectively, and 144. 5 Gy, 70. 2 Gy, 91. 45％, 63. 12％ and 34. 74％, respectively, in preoperative plans. Except mPD, V150, V200(t= -2. 166, -2. 863, -4. 778, P<0. 05), there was no significant difference between the two groups. Conclusions 3D printing guide plate could provide good accuracy for positioning and direction. For local recurrent malignant tumor of head and neck, the actual dose distributions in postoperative validations were close to the expectations of preoperative plans which mean the improvement of accuracy in treatment.

Dosimetry evaluation for CT guided 125I seeds implantation assisted by three-dimensional-printing coplanar coordinate template in chest malignant tumor / 中华核医学与分子影像杂志

Objective To verify the accuracy of three-dimensional printing coplanar coordinate template (3D-PCCT) technology for 125I seeds implantations in chest tumor at dosimetry level.Methods From January 2016 to June 2017,a total of 22 patients (15 males,7 females;median age 62 years) with chest tumors who received 3D-PCCT assisted 125I seeds implantation in Peking University Third Hospital were enrolled in this retrospective study.There were 8 patients with primary lung cancer and 14 with metastatic carcinoma.The sites for implantation included lung (12 cases),mediastinum (2 cases) and chest wall (8 cases).The prescribed dose was 110-180 Gy.The preoperative plan design,puncture and seeds implantation guided by template were carried out and the dose distribution of postoperative plan was compared with that of preoperative plan.Dose parameters included dose delivered to 90％ gross tumor volume (D90),minimum peripheral dose,the percentage of GTV receiving 100％ prescription dose (V100),the percentage of GTV receiving 150％ prescription dose (V150),conformity index,external index of target volume,uniformity index,D2 cm3 of spinal cord and aorta,and V20 of affected side lung.Wilcoxon signed rank test was used to analyze the data.Results The median D90 was 150.4(125.6,187.0) Gy.Postoperative D90 was higher than the prescribed dose in 68％ (15/22) cases.For median value of most parameters,there were no significant differences between the postoperative plans and preoperative plans (all P＞0.05) except for the actual V100,which was lower than the preplanned (95.5％ vs 97.2％;P=O.040).Conclusion 3D-PCCT could provide good accuracy in 125I seeds implantation for chest tumor.

[Short-term curative effects of Tantalum rod treatment in early avascular necrosis].

OBJECTIVE: To explore the recent clinical curative effect of Tantalum rod in treating the early avascular necrosis. METHODS: From January 2008 to November 2008, the 25 patients (39 hips) with early avascular necrosis accepted tantalum rod placement and included 9 males (11 hips) and 16 females (28 hips) with an average age of 37 years old ranging from 18 to 74 years old. Four patients (6 hips) caused by Alcoholic, 6 patients (8 hips) by hormone, 2 cases (2 hips) by traumatic, 13 cases (23 hips) by idiopathic. Steinberg preoperative stage involved 7 hips in period I, 24 hips in period II, 8 hips in period III. Curative effect analysis included preoperative and postoperative Harris score, radiographic changes and hip replacement for follow-up to accept the end of the femoral head survival rate. RESULTS: All patients were followed up for 6 to 47 months (averaged 37.4 months). All 12 hips imaging appeard progress,including tantalum rod exit in 1 hip, hip hemiarthroplasty collapse in 3 hips, the area increased to avascular necrosis in 8 hips. Six hips accepted total hip replacement, including imaging progress in 5 hips (41.7%, 5/12), no imaging progress in 1 hip (3.7%,1/27). All hips' Kaplan-Meier survival curves showed 6-month survival rate was (97.4 +/- 2.5)% after tantalum stick insertion, 1-year survival rate was (94.7 +/- 3.6), and 2-year survival rate was (88.6 +/- 5.4)%, 3-year survival rate was (72.5 +/- 11.2). CONCLUSION: It is effective for treatment of avascular necrosis of femoral head in Steinberg I and II by Tantalum rod, and it can effectively relieve femoral head replacement time.

Dosimetric analysis of 3D-printing template assisted and CT-guided 125I seed implantation for treatment of soft tissue sarcoma / 中华放射医学与防护杂志

Objective To compare the dose distribution of postoperative plans with preoperative plans of 3D-printing template (coplanar and non-coplanar) assisted and CT-guided 125I seed implantation for the treatment of soft tissue sarcoma,and to explore the accuracy of treatment at dosimetry level.Methods From December 2015 to July 2017,19 patients with soft tissue sarcoma (a total of 25 lesions)were treated with 3D printing template assisted and CT-guided 125I seed implantation in Peking University Third Hospital.All patients underwent preoperative assessment,CT simulation orientation,preoperative planning,3D-template printing,3D-template reduction,needle and seed implantation,postoperative dosimetry assessment,postoperative care and follow-up.The preoperative and postoperative dosimetric parameters were conpared.Ten cases of soft tissue sarcoma in superficial trunk or limbs were screened.Preoperative planning of coplanar template and non-coplanar template were designed respectively.The dosimetric parameters of preoperative planning guided of two templates were compared.Results Twentyfive 3D-printing templates were designed and constructed,and 25 lesions were totalled.There was no statistical difference between preoperative and postoperative dosimetric parameters.There was no statistical difference of the preoperative plan's dosimetric parameters between coplanar and non-coplanar in soft tissue sarcoma of superficial trunk/limbs.Conclusions The validation of actual dose distribution in postoperative plans assisted by 3D-printing template in 125I seed implantation showed that most of parameters could meet the expectation of preoperative plans,which indicated the improvement in accuracy for this new modality.For soft tissue sarcoma located in the superficial trunk/limbs,it was recommended to select the 3D-printing coplanar template firstly.

Dosimetric study of 125I seed implantation by 3D-printing coplanar template for pelvic wall recurrent cervical cancer after radiotherapy / 中华放射医学与防护杂志

Objective To investigate the feasibility of 3D-printing coplanar coordinate template (3D-PCT) for guiding 125I radioactive seed implantation in the treatment of pelvic wall recurrence of cervical cancer on ensuring the accuracy of dose.Methods From Oct 2016 to Dec 2017 in Peking University Third Hospital,totally 10 patients with pelvic wall recurrent cervical cancer after radiotherapy were treated with 125I radioactive seed implantation assisted by 3D-PCT.The median age was 53.5 years old (37-71 years old).KPS score of the cohort were more than 70.All patients had received pelvic radiation therapy previously.The median volume of the lesion was 31.9 cm3 (3.5-58.0 cm3).The prescription dose was 120-180 Gy.The activity of seeds was 0.55-0.67 mCi(1 Ci =3.7 × 1010Bq),while the number of seeds was 12-81 (median 50) on preoperative plan.Radioactive seeds implantation was performed under 3D-PCT guidance according to the preoperative plan.The actual number of implanted seeds was 53 (10-82).Dosimetry parameters of preoperative plan and postoperative plan including D90,D100,V100,V150,V200,external index (EI),conformal index (CI),heterogeneity index (HI),and organat-risk doses of D2 cm3,D1 cm3 and D0.1 cm3 were compared using the nonparametric test.Results The seed number of postoperative plan was more than that of preoperative plan (Z =-2.255,P ＜ 0.05),but all of the dosimetric parameters showed no significant difference (P ＞ 0.05).D2 cm3 and D1 cm3 of rectum for postoperative plan were lower than that of preoperative plan (Z =-2.100,-2.240,P ＜ 0.05),while other dose parameters of normal tisssues showed no statistically significant difference (P ＞ 0.05).Conclusions Assisted by 3D-PCT for 125I radioactive seed implantation in pelvic wall recurrence of cervical cancer,the actual postoperative dose could meet the requirement of the preoperatie plan through the intraoperative optimization of dose.3D-PCT could ensure the precise of delivered dose of 125I radioactive seed implantation.

Clinical efficacy of CT-guided iodine-125 seed implantation for recurrent head and neck carcinoma after external beam radiotherapy / 中华放射肿瘤学杂志

Objective To evaluate the clinical efficacy and safety of CT-guided 125 I seed implantation in the treatment of recurrent head and neck tumors after radiotherapy. Methods Clinical data of 101 patients who received CT-guided radioactive 125 I seed implantation for recurrent head and neck cancer after radiotherapy from 2007 to 2015 were retrospectively analyzed. The median accumulated dose of external radiotherapy was 66 Gy and the median dose after seed implantation (D90) was 117 Gy. The local progression-free survival and overall survival were analyzed by Kaplan-Meier method. Univariate analysis was performed by log-rank test and multivariate analysis was conducted by using Cox regression model. Results The median follow-up time was 12. 2 months. The 5-year local progression-free survival rate was 26. 6％.The 5-year overall survival rate was 15. 5％. Univariate analysis demonstrated that age,pathological type,implantation site,lesion volume,D90 and short-term efficacy were correlated with local control,and KPS score,lesion volume ,D90,and short-term efficacy were associated with survival (all P<0. 05). Multivariate analysis revealed that pathological type,lesion volume ,D90 and short-term efficacy were independent factors related to local control (P= 0. 000, 0. 002,0. 003 and 0. 014).In terms of the adverse events,skin/ mucosal ulceration was observed in 25. 7％ and pain occurred in 13. 9％ of all patients. No correlation was noted between the adverse events and dose.Conclusions CT-guided radioactive 125 I seed implantation is an efficacious and safe treatment of recurrent head and neck tumors after radiotherapy. Non-squamous carcinoma,small lesion volume and high dose (D90) indicate excellent local control.