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Objective:To investigate the changes of glutathione peroxidase 4 (GPX4) in retinal photoreceptor cells, and the related mechanism correlated with retinal photoreceptor cell damage.Methods:The posterior segment tissues of 8 age-matched male donors were collected from the Body (Organ) Donation Register and Corneal Receiving Station of Tongji Hospital of Wuhan Red Cross from 2018 to 2021, including 4 non-diabetic donors and 4 diabetic donors.The tissues were divided into diabetes group and control group according to their donors.A total of 14 healthy SPF 8-week-old male C57BL/6 mice were selected and randomly divided into diabetes group and control group by the random number method, with 7 mice in each group.The mice in diabetes group were intraperitoneally injected with streptozotocin at a dose of 50 mg/kg for 5 days, and no intervention was given to mice in control group.Mouse photoreceptor cells 661W were divided into advanced glycation end products (AGEs) group and control group.AGEs group was treated with 100 μg/ml AGEs for 24 hours to simulate diabetic injury, and no intervention was given to control group.The outer segment morphology of retinal photoreceptors in human and mouse retinas was observed by hematoxylin-eosin staining.The expressions of glial fibrillary acidic protein (GFAP), rhodopsin and GPX4 in human and mouse retinas were detected by immunofluorescence staining.The expressions of GFAP, rhodopsin and GPX4 in mouse retina and the expression of GPX4 in 661W cells were determined by Western blot.The activity of 661W cells was detected by cell counting kit-8 (CCK8) method.The concentration of malondialdehyde (MDA) in mouse retina and cells was detected by TBA method.The activity of superoxide dismutase (SOD) in mouse retina and cells was detected by hydroxylamine assay.The use of human tissues was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (No.TJ-C20230301). The animal experiments were conducted with reference to the Standards Guide for the Care and Use of Laboratory Animals of the National Institutes of Health, and the study protocol was approved by the Experimental Animal Ethics Committee of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (No.TJH-2016001).Results:Hematoxylin-eosin staining showed that retinal photoreceptor outer segments were deformed or broken in diabetic donors and diabetic mice compared with control groups.GFAP fluorescent signal mainly appeared in the inner retina of human and mice, and the stained cells were spindle or polygonal, which was consistent with the shape of glial cells.The retinal GFAP fluorescent signal of diabetic tissue and mouse groups was stronger than that of respective control groups.Rhodopsin was only expressed in the outer segment layer of photoreceptors with clear boundaries, and GPX4 was expressed in the whole retina with strong signal in the outer segment layer of photoreceptors.The fluorescent signals of rhodopsin and GPX4 in diabetic tissue and mouse groups were weaker than those in respective control groups.The relative expressions of GFAP were significantly higher and the relative expressions of rhodopsin and GPX4 were significantly lower in diabetic tissue and mouse groups than in respective control groups (all at P<0.05). The cell viability of AGEs group was significantly lower than that of control group ( t=13.490, P<0.001). The relative expression of GPX4 protein in AGEs group was 0.42±0.12, which was significantly lower than 1.00±0.04 in control group ( t=9.041, P<0.001). MDA concentration was higher and SOD activity was lower in retinal tissue of diabetic mice and AGEs group than those in respective control groups, and the differences were statistically significant (all at P<0.05). Conclusions:Diabetes can reduce the GPX4 level in retinal photoreceptor cells and cause the imbalance of oxidation-antioxidant system, which may be the mechanism of the damage to retinal photoreceptor cells caused by diabetes.
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Objective:To explore the diagnostic efficacy of ultrasonography and follow-up outcomes of hepatic venous outflow obstruction after liver transplantation(LT)in children.Methods:From July 2017 to January 2022, 32 children diagnosed with outflow tract obstruction post-LT are designated as HVOO group and examined by digital subtraction angiography(DSA).All of them underwent balloon dilation.Thirty cases with no vascular complications are selected as control group.Color Doppler blood flow parameters are recorded, including peak systolic velocity(PSV), peak diastolic velocity(PDV), PSV/PDV(S/D), resistive index(RI), portal vein velocity(PVV), hepatic vein velocity(HVV), hepatic vein waveform, anastomotic velocity and waveform.Intravascular pressure values of DSA within 48h are recorded.The correlations between color Doppler flow parameters and intravascular pressure values are examined before and after tube expansion.The differences of color Doppler flow parameters before tube expansion between HVOO and control groups are compared.And receiver operating characteristic(ROC)curves are plotted for obtaining ultrasonic parameters' cut-off value.Patients with excellent recovery are selected for comparing the difference of color Doppler blood flow parameters before and after tube expansion and detect the trend of hemodynamics.Results:There is a positive correlation between anastomotic velocity of hepatic vein and inferior vena cava and DSA before and after tube expansion in HVOO group(r=0.483, 0.414, all P<0.05); S/D, RI and anastomotic velocity are higher in HVOO group than those in control group( Z=-3.275, P=0.001; t=3.437, P=0.001; Z=-5.677, P<0.01); PV and HVV are lower in HVOO group than those in control group( Z=-2.719, P=0.007; Z=-6.762, P<0.01); The waveforms of hepatic vein and anastomosis in HVOO group are mostly single-phase waves, accounting for 81.25%(26/32)and 53.12%(17/32).Control group is mostly of dual-phase wave.According to ROC curve analysis, area under curve(AUC)of HVV diagnosing HVOO is 0.996 with a critical value of 21.65 cm/s; AUC of hepatic vein anastomosis velocity is 0.92 with a critical value 162 cm/s and AUC of RI 0.76 with a critical value of 0.73.PVV and HVV values after tube expansion are higher than before tube expansion( Z=-2.233, P=0.026; Z=-4.45, P<0.01); Anastomotic velocity after tube expansion is lower than that before tube expansion( t=8.584, P<0.01).The waveforms of hepatic vein and anastomosis are mostly of single-phase waves(76.92%, 61.54%)before tube expansion and dual-phase wave(88.46%, 96.15%)after tube expansion. Conclusions:Color Doppler ultrasound is a preferred imaging modality for diagnosing HVOO and conducting postoperative follow-ups in children after LT because of its non-invasiveness, real-time, simplicity and rapidness.Furthermore, the diagnostic efficiencies of hepatic vein and anastomotic velocity are relatively high.
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Objective:To investigate the role of combinational elastography in the dynamic quantitative evaluation of liver transplantation.Methods:From April to December 2019 in Tianjin First Central Hospital, 27 cases of the liver transplant patients and donors were examined by shear wave elastography and real-time tissue elastography, respectively on donor preoperative within 24 h and postoperative day 1, day 7, in order to obtain liver elastic modulus E, measured average relative strain value (MEAN), the index activity (A) and acoustic attenuation measurement (ATT), and to obtain pathologic specimens during operation, including: hydropic degeneration, inflammation, necrosis, steatosis. AST, ALT, TB, DB were detected by automatic biochemistry analyzeron postoperative day 1, day 7. Correlation analysis was performed for pathological parameters and ultrasonic parameters, E, MEAN, A, ATT were selected to plot ROC curve, to analyze ultrasonic parameters′ cut-off value and area under the curve(AUC). According to the pathological signs donor liver were divided into no or mildhydropic group and moderate-to-severehydropic group, non-inflammation group and inflammation group, non-steatosis group and steatosis group. Ultrasonic parameters of donor liver were compared between the two groups, and differences in liver function and ultrasonic parameters on postoperative day 7 were analyzed between the two groups. The change trends of ultrasonic parameters were analyzed from preoperative donor liver to postoperative day 1, day 7 of recipient. The changes of liver function were analyzed from the first day to 7th days. Correlation analysis was performed for liver function and ultrasonic parameters respectively on postoperative day 1, day 7.Results:①Correlation of the ultrasonic parameters of donor liver preoperative within 24 h and pathological parameters: E value and hydropic degeneration and inflammation of pathological signs were significantly and positively correlated( rs=0.597, 0.497; all P<0.05); MEAN and hydropic degeneration and inflammation of pathological signs were significantly and negatively correlated( rs=-0.601, -0.584; all P<0.05); A and inflammation of pathological signs was significantly and positively correlated( rs=0.452, P=0.016); ATT and steatosis of pathological signs was significantly and positively correlated ( rs=0.564, P=0.006). ②The differences of ultrasonic parameters of donor liver preoperative within 24h: E value of moderate-to-severehydropic group was significantly higher than that of the no or mild hydropicgroup ( P<0.001), MEAN value of moderate-to-severehydropic group was significantly lower than that of the no or mildhydropicgroup( P<0.001). E value of inflammation group was higher than that of non-inflammation group ( P=0.012), MEAN value of inflammation group was lower than that of non-inflammation group ( P=0.026). ATT of steatosis group was higher than that of non-steatosis group ( P=0.006). ③The ROC curve indicated that AUCs of E and MEAN diagnosing hydropic degeneration were 0.882, 0.875, and the critical value were respectively 8.72 kPa, 106.62; the AUC of diagnosing inflammation was 0.898, the critical values was 1.26; the AUC of diagnosing steatosis liver was 0.868, the critical value was 0.515 dB·cm -1·MHz -1. ④There were no statistically significant differences in liver function and ultrasonic parameters on postoperative day 7 between no or mildhydropic group and moderate-to-severehydropic group(all P>0.05). There were no statistically significant differences in liver function and ultrasonic parameters on postoperative day 7 between non-inflammation group and inflammation group(all P>0.05). There were no statistically significant differences in liver function and ultrasonic parameters on postoperative day 7 between non-steatosis and steatosis group (all P>0.05). ⑤E and A values of postoperative day 1 were higher than those of preoperative donor liver and postoperative day 7(all P<0.05), MEAN value of postoperative day 1 was lower than those of preoperative donor liver and postoperative day 7(all P<0.05). ATT of postoperative day 1 was lower than that of preoperative donor liver( P=0.027). ⑥ALT, AST, TB, DB of postoperative day 7 were lower than that of postoperative day 1, the difference was statistically significant ( P<0.05). ⑦On postoperative day 1: E value and ALT, AST, TB, DB were significantly and positively correlated( r=0.641, 0.673, 0.601, 0.575; all P<0.05); MEAN value and ALT, AST were significantly and negatively correlated( r=-0.690, -0.703; all P<0.001); A value and ALT, AST were significantly and positively correlated( r=0.459, 0.442; all P<0.05). On postoperative day 7: E value and ALT, AST, TB, DB were significantly and positively correlated ( r=0.616, 0.729, 0.505, 0.640; all P<0.05); MEAN value and ALT, AST were significantly and negatively correlated( r=-0.602, -0.585; all P<0.05); A value and ALT, AST were significantly and positively correlated( r=0.411, 0.495; all P<0.05). Conclusions:Combinational elastography can dynamically and quantitatively assess the hardness, inflammation, steatosis of liver transplantation, and ultrasonic parameters correlate significantly with pathological and liver function, and provides a certain imaging basis for clinical evaluation of liver quality.
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Objective:To investigate the correlation between Doppler ultrasound parameters and pressure gradient of portal vein in pediatric liver transplant patients, and to analyze the diagnostic value of Doppler ultrasound for portal vein stenosis.Methods:This retrospective study involved the data from 92 pediatric liver transplant patients in Tianjin First Central Hospital from June 2014 to September 2021, who underwent pressure gradient measurement. The collected ultrasonic parameters included the diameter and flow velocity of the native portal vein, the portal vein anastomosis, and the donor portal vein. The anastomotic stenosis rate=(the native portal vein diameter–the portal vein anastomosis diameter)/the native portal vein diameter, the velocity ratio=the portal vein anastomosis velocity /the native portal vein velocity, the velocity difference=the portal vein anastomosis velocity–the native portal vein velocity. According to the diagnostic standard of portal vein stenosis, pressure gradient more than 5 mmHg was the portal vein stenosis group, and the pressure gradient less than 5 mmHg was the non-stenosis group. The correlation and differences between ultrasonic parameters and pressure gradient were analyzed. ROC curve was used to evaluate the diagnostic efficiency of each parameter.Results:Firstly, there was a positive correlation between pressure gradient and the portal vein anastomosis velocity, the velocity difference and the velocity ratio ( r=0.521, 0.531, 0.417; all P<0.001). And there was a negative correlation between pressure gradient and the anastomotic diameter ( r=-0.284, P=0.004). Secondly, the portal vein anastomotic velocity, velocity difference and velocity ratio in stenosis group were significantly higher than those in non-stenosis group [135.5(111.0, 169.0)cm/s vs 103.7(72.9, 118.7)cm/s, (112.2±40.3)cm/s vs (67.9±30.5)cm/s, 5.56(3.73, 7.26) vs 3.85(2.78, 4.70); all P≤0.001]; Furthermore, by ROC curve analysis, the cut-off value, the area under the ROC curve, Jordan index, accuracy, sensitivity and specificity of each parameter for the diagnosis of portal vein stenosis were: the anastomotic velocity 124.5 cm/s, 0.814, 0.592, 80.0%, 65.5% and 93.7%; velocity ratio 5.67, 0.760, 0.488, 73.0%, 48.8% and 100%; velocity difference 107.25 cm/s, 0.797, 0.511, 76.0%, 51.9% and 100%. Conclusions:The anastomosis velocity, velocity difference and velocity ratio of portal vein in pediatric liver transplant patients are correlated with the pressure gradient, and there is higher accuracy and specificity of each parameter for diagnosing portal vein stenosis, but the sensitivity is slightly lower.
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Objective:To obtain the normal reference range of ultrasound hemodynamic parameters after liver transplantation through big data query and statistical analysis, and to analyze its influencing factors.Methods:The clinical liver transplantation Ultrasound Image Database Software V1.0 developed by Tianjin First Center Hospital was used to query adult patients after liver transplantation from December 2012 to June 2021. The ultrasonic hemodynamic parameters including the diameter of portal vein (PVD), the flow velocity of portal vein (PVV), the peak flow velocity of hepatic artery (S), the end diastolic flow velocity of hepatic artery (D), the S/D of hepatic artery, the resistance index of hepatic artery (RI), the diameter of middle hepatic vein (MHVD), the flow velocity of middle hepatic vein (MHVV), the diameter of right hepatic vein (RHVD), the flow velocity of right hepatic vein (RHVV), in the first day (1D), the seventh day (7D), the first month (1M), the sixth month (6M), the first year (1Y), the fifth year (5Y) and the tenth year (10Y) after operation were analyzed statistically, and the 95% reference value range of each parameter was obtained.Results:A total of 1 740 patients with 12 242 monitoring results after adult liver transplantation were included, and the longest follow-up time was 22 years. There was no significant change in PVD. PVV decreased slightly from postoperative 1D to long-term follow-up. The S and D of hepatic artery were the highest in group 7D after liver transplantation, and then decreased gradually with the extension of postoperative time. Hepatic artery S/D was the lowest in group 7D after operation, with the extension of monitoring time after liver transplantation, it showed an upward trend, but fluctuated. Hepatic artery RI was the highest in postoperative 1D group, and fluctuated with the extension of monitoring time after liver transplantation. There was no significant change in MHVD and RHVD.MHVV and RHVV were the highest in group 7D after liver transplantation, with the extension of postoperative monitoring time, they showed a decreasing trend and fluctuated. The normal range of each parameter was estimated according to the range of 95% medical reference value. The influencing factors of blood flow monitoring of transplanted liver were analyzed, including the various factors in perioperative period, the surgery, the primary disease before operation, the source of donor, the postoperative infection, rejection, drug damage, individual differences and so on.Conclusions:This study obtains the trend of each parameter with the extension of follow-up time and the reference value range of each parameter after liver transplantation, which is of great clinical significance for early detection and diagnosis of postoperative vascular complications. However, the blood flow after adult liver transplantation is affected by many factors. In clinical monitoring, it is necessary to make judgment combined with the individual state of patients and conduct dynamic follow-up.
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Objective@#To investigate the prevalence and influencing factors of suicidal ideation and the effects of daily stress and positive mental health on suicidal ideation among college freshmen in Wuhan. This study aims to provide a scientific basis for mental health improvement and suicide prevention among college students from the perspective of positive psychology.@*Methods@#In December 2020, a convenient sampling method was used to select 2 592 freshmen from three universities in Wuhan. Demographic information, suicidal ideation, positive mental health, and daily stress were assessed. T test and Logistic regression analysis were used to analyze the status and influencing factors of suicidal ideation among college freshmen.@*Results@#The one year prevalence of suicidal ideation was 27.5%. Freshmen with suicidal ideation had higher daily stress scores and daily stress scores in different domains than freshmen without suicidal ideation( t =-13.00--4.68)， the positive mental health scores of freshmen with suicidal ideation were lower than freshmen without suicidal ideation ( t =17.14， P <0.01). Female ( OR=1.72, 95%CI =1.44-2.05), the higher education level of the mother (OR=1.27, 95%CI=1.05-1.53) and total experience of daily stress ( OR=1.11, 95%CI =1.09- 1.13 ) were associated with risk of oneyear suicidal ideation. Positive mental health was negatively associated with suicidal ideation ( OR=0.88, 95%CI=0.87-0.90, P <0.01) and had a moderating effect on the association between daily stress and suicidal ideation.@*Conclusion@#Suicidal ideation among college freshmen is closely related to daily stress and positive mental health. It is necessary to pay close attention to daily stress of freshmen and reduce suicidal ideation by improving positive mental health.
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Objective:To study the drug resistance patterns of Bordetella pertussis in vitro, and to know the clinical characteristics of pediatric pertussis and evaluation the treatment outcomes, which may provide references for experiential diagnosis and treatment of this disease. Methods:Nasopharyngeal swabs of the hospitalized children with suspected pertussis in Children′s Hospital, Zhejiang University School of Medicine in 2017 were collected for culture. And the clinical data of the children were collected. The strains were identified by pertussis-specific antiserum agglutination and finally confirmed by mass spectrometry. The drug sensitivity test was performed using the E-test method. The efficacy of therapy with antibiotic was evaluated after two weeks of treatment. Statistical analysis was performed with Mann-Whitney U test and chi-square test. Results:Of 1 029 children, 211 (20.5%) nasopharyngeal swabs were positive for Bordetella pertussis culture, and the isolation rate of the specimens was highest (31.2%, 45/144) in July. Of the 211 pertussis patients, 105 (49.8%) were male and the age were 3.8 (2.2, 6.9) months, 114 (54.0%) were not vaccinated with pertussis diphtheria tetanus mixed vaccine and 192 (91.0%) were prescribed with previous antibiotics. There were 142 (67.3%) children from families with two or more than two children, and 136 (95.8%) of which were the youngest siblings. One hundred and fifty-nine (75.4%) patients had paroxysmal cough and 61 (28.9%) had whooping. The white blood cell counts were higher than 20×10 9/L in 94 (44.5%) patients, and the lymphocyte counts were higher than 10×10 9/L in 97 (46.0%) of patients. The drug susceptibility results showed that 138 (65.4%) strains were against erythromycin, azithromycin and clindamycin with minimum inhibitory concentration (MIC)>256.000 mg/L. The MIC 90 of the isolates to ampicillin, ceftriaxone, cefoperazone/sulbactam, meropenem and trimethoprim/sulfamethoxazole were 0.190 mg/L, 0.190 mg/L, 0.094 mg/L, 0.094 mg/L and 0.750 mg/L, respectively. All strains had a MIC of <0.016 mg/L for piperacillin/tazobactam. After treatment, symptoms were improved in 195(92.4%) patients when they were discharged from hospital. Seventy-six (57.1%) children whose symptoms did not improve after seven-day treatment with macrolides, were prescribed with other antibiotics or other antibiotic with macrolides in combination. Compared with the patients treated with macrolides, more patients treated with cefoperazone/sulbactam or piperacillin/tazobactam had negative nasopharyngeal culture results after two weeks of therapy (46/48(95.8%) vs 46/57(80.7%)), or on day seven (45/46(97.8%) vs 39/47(83.0%)) and on day 14 (45/45(100.0%) vs 41/47(87.2%)) since discharged. The differences were all statistically significant ( χ2=5.50, 5.86 and 6.15, respectively, P=0.019, 0.015 and 0.013, respectively). Conclusions:The majority of children with pertussis do not have whooping, and the resistant rate of Bordetella pertussis to macrolides is high. Further study is needed to evaluate the feasibility and reasonability of cefoperazone/sulbactam and piperacillin/tazobactam in treating pediatric pertussis caused by macrolides-resistant Bordetella pertussis.
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Objective@#To explore the effect of blended health literacy education combining WeChat and participatory class among college students, and to provide references for enriching the technology of health education in college.@*Methods@#Using cluster random sampling method, 378 freshmen from 10 classes of a non-medical college in Guangzhou were selected as the research objects. The intervention group (193) was given blended health literacy education including WeChat and participatory class education, while the control group (185) recieved no intervention. The other types of health educaiton were not limited in both groups. A survey was conducted among those college students before and after the health education by applying Questionnaire on College Students’ Health Literacy.@*Results@#According to the baseline survey, there were no significant differences between the intervention group and the control group in the level of health literacy and basic situations(P>0.05). But after the intervention, the scores of health literacy and basic health concept and knowledge, health skills of three aspects were (54.34±6.03) (23.91±2.44) (12.39±2.32) respectively, and infectious diseases prevention, chronic diseases prevention, safety and first aid，health information of six health issues were(5.59±1.34) (10.17±1.57) (12.88±1.55) (6.33±1.58), higher than those in the control group, and the differences were statistically significant(t=3.50, 2.50, 3.94, 2.50, 2.79, 2.48, 2.12, P<0.05). The overall health literacy level of the intervention group was 71.5%(138/193) and the control group was 51.9%(96/185), there was significant difference between two groups(χ2=15.40, P<0.01).@*Conclusion@#Blended health literacy education improves college students’ health literacy level sbustantially, which may provide references to the technology of health literacy intervention in college.
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Surfactin has great potential applications in enhancing oil recovery, agriculture, pharmaceuticals, foods and beverages, and cosmetics due to its extraordinary surface activity, biodegradability, anti-bacterial activity and biocompatibility. Enhancing surfactin production by engineering surfactin-producer and optimizing culture conditions is the key of its industrial production and subsequent applications. In this study, the effect of fatty acid synthesis pathway on surfactin synthesis was investigated, and Bacillus subtilis THBS-2 and THBS-8 with high surfactin titer were constructed by overexpressing key genes involved in the fatty acid synthesis pathway. To optimize culture condition, the amount and adding time of isopropyl-beta-D-thiogalactopyranoside (IPTG) and amino acids were studied, and a two-stage culture method was obtained: IPTG (final concentration: 1.25 mmol/L) and leucine (final concentration: 5 g/L) were added at 3 h, leucine (final concentration 5 g/L) and condensed culture medium (5 mL) were added at 24 h. Applying this strategy, the surfactin titer of B. subtilis THBS-2 reached to 24 g/L in shake flask at 48 h and up to 34 g/L after 68 h fermentation in a 30-L fermentor. The results provide basis for large-scale production and broad application of surfactin.
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Aminoácidos , Bacillus subtilis/metabolismo , Medios de Cultivo , Fermentación , Lipopéptidos , Péptidos CíclicosRESUMEN
Objective: The objective of the study is to test whether three-dimensional (3D)-printed template can be used reproducibly for guiding malignant tumors brachytherapy and study the dosimetric consistency and adequacy between pre- and post-plan. Materials and Methods: Between January and December 2016 in our hospital, a total of 14 patients underwent 3D-printed template-guided brachytherapy. All the patients were fixed into position using a vacuum cushion before undertaking a computed tomography (CT) scan. After the preplan was designed, the templates were printed. The tumors were punctured through predesigned needle holes. Following this, another CT scan was used to confirm the locations of needles, and then the 125 I radioactive seeds were implanted into the tumor according to the preplan. Postplan was performed after the operation. Data of the D90 (minimum absorbed dose of 90% target volume), V90 (90% prescription dose coverage volume percentage of target volume), V100, V150, and seed number pre- and post-operation were collected and compared. Results: The mean D90, V90, V100, V150, and seed number preoperation were 94.96 ± 16.43 Gy, 94.64% ± 1.43%, 91.21% ± 1.59%, 65.01% ± 5.78%, and 46.67 ± 21.87, respectively. The mean D90, V90, V100, V150, and seed number postoperation were 91.97 ± 17.54 Gy, 93.35% ± 2.45%, 89.35% ± 3.21%, 63.40% ± 6.36%, and 46.60 ± 22.85, respectively. No significant difference between pre- and post-operation was observed across the data (P >0.05). Conclusion: For immobilized malignant tumors, 3D-printed template can be used reproducibly. The dose parameters in preplan can be achieved easily and satisfactorily by 3D-printed template guided brachytherapy, and it may become an easily reproducible standardized procedure in the future