PURPOSETo introduce how to reconstruct defects after resection for locally advanced carcinoma of externa-lia in man. METHODS In 11 male patients after radical resection of the primary lesion and clearance of lymph nodes, fascial flap, rectus abdominis myocutaneous flap or combined myocutaneous flap of musculus gluteus max-imus and musculus tensor fasciae latae are used to reconstruct the large defects. Reconstruction with rectus abdominis myocutaneous flap is explained in detail. RESULTS In 11 male patients. 10 were healed by first intention, one was healed by granulation. CONCLUSION The key to successful operation is to select the suitable myocutaneous flap according to the degree of defects. Indication and key points of the operation are explained.

Nowadays,with the introduction of the concept of minimally invasive surgery,laparoscopic surgery which occupied the mainstream operation method,vaginal surgery,and abdominal surgery were three main ways of gynecological surgery.Hysterectomy operation method as the routine operation of gynecology was changed as well.Laparoscopic hysterectomy has replaced transvaginal hysterectomy and transabdominal hysterectomy gradually.Historical development,operation indication,and advantages and disadvantages of hysterectomy are summarized in this article.

Objective To explore the diagnosis and treatment of penile verrucous carcinoma,a distinctive variant of squamous cell carcinoma. Methods The clinical data of 8 patients (mean age,46 years) with penile verrucous carcinoma were analyzed retrospectively.All the tumors showed exophytic,papillary lesions,ranging from 2 to 6 cm in the greatest dimension.The tumors were located at glans in 5 patients and invaded to shafts in the other 3.The diagnosis was established by biopsy of the lesion.Three patients with tumor invading to shafts and 1 patient with large tumor at glans underwent partial penectomy, while the other 4 with the tumors localized at glans were treated by local excision. Results Histopathologic examination of the specimens confirmed tumors-free surgical margins in all the cases.The tumor cells were mostly well-differentiated.Fourteen months postoperatively,local recurrence occurred in 1 patient with local excision and partial penectomy was performed; postoperative follow-up of 9 years showed no recurrence and metastasis. During a follow-up of 4 to 13 years,the other 7 patients were disease-free.The patients with local excision of the tumors reported satisfaction of their sexual lives. Conclusions Verrucous carcinoma of penis is characterized by slow growth and a locally aggressive nature.It seldom develops metastasis to regional lymph nodes or distant areas.The prognosis is favorable after appropriate treatment.

【Objective】 To develop a prognosis model based on CT images using radiomics method for patients with osteonecrosis of the femoral head (ONFH) and to investigate the additional prediction value of the imaging features of the contralateral normal femoral head regions for the prognosis prediction. 【Methods】 A total of 51 patients were included in this retrospective study. All the patients had preoperative CT images. For each patient, two regions of interest (ROIs) were involved, including the osteonecrosis region and the contralateral normal femoral head region. A total of 968 radiomics features were extracted for each patient. We made both the univariate and multivariable analyses. Three models were developed based on the features of osteonecrosis region, contralateral normal femoral head region, and both regions. The 10 times of repeated random experiments were used for model construction and validation. The average performance of the 10 times of experiments was reported as the results. 【Results】 For the features of osteonecrosis region, 37 features showed significant predictive value, with the mean AUC value of 0.708 2±0.029 9. The AUC of the constructed prediction model was 0.911 0±0.029 4 and 0.688 6±0.089 3 for the training set and validation set, respectively. For the features of contralateral normal femoral head region, 14 features showed significant predictive value, with the mean AUC value of 0.703 6±0.006 9. The AUC value of the constructed model for the training set and validation set was 0.867 2±0.039 5 and 0.669 0±0.072 6, respectively. For the models developed based on combined features, the AUC value was higher than that of the models developed based on osteonecrosis region features (training set: 0.935 8±0.016 6 vs. validation set: 0.737 9±0.090 8). 【Conclusion】 We developed a novel CT images-based radiomics method to predict postoperative prognosis in patients with ONFH. Furthermore, the features of contralateral normal femoral head region has additional prediction value. Combining the imaging features of osteonecrosis region and contralateral normal femoral head region can obtain more accurate prediction of prognosis in patients with ONFH.