Objective To investigate the skills and effects of TriVex system and to discuss its indications and complications in the treatment of varicose vein in lower limbs.Methods The TriVex system operation was underwent in 106 lower limbs with varicose vein.Sixteen of them showed thrombophlebitis while 38 of them showed chronic ulcer and pigmentation.The lower limbs with perforating vein were treated with subfascial endoscopic perforator vein surgery(SEPS) and limbs with deep insufficient vein valve underwent endoscopic valve repair.Results The therapeutic effect of TriVex system was satisfactory and none of them had soft tissue infection.Hematoma occurred in 12 lower limbs(11.2%).Pigmentation and skin petechia disappeared in 3 weeks after operation.Chronic ulcer healed and ankle pigment reduced in 38 limbs.Hematoma,petechia and numbness were the common complications in the patients with varicose vein in lower limbs.Conclusion It was effective,cosmetic and micro invasive to use the TriVex system in the treatment of thrombophlebitis and varicose vein with chronic ulcer.Adept operation skill can minimize the postoperative complications but the long-term effects of this new technique still needed follow-up studies.

ObjectiveTo evaluate the feasibility of angioscopically external valve suture repair. MethodAngioscope was introduced through the terminal great sapherous to the first venous valve of superficial femoral vein. With general femoral vein, deep femoral vein, superficial femoral vein blocked, heparin-contained NS was used to establish water column, and video-guided angioscopy demonstrates the valve′s shape and its degree of defect and deformation. Twelve patients with primary deep venous insufficiency underwent video-valvuloplasty.ResultsPostoperative phlebography showed disappearance of reflux in 9 cases, and significantly reduced reflux in 3 cases. There was no morbidity postoperatively. Conclusion Angioscopic external suture valve repair is safe and effective in the treatment of femoral superficial venous insufficiency.

Objective To describe the current situation of oncology nurses' mastery of cancer pain-related knowledge and explore the correlation between the mastery of knowledge and nursing activities.Methods By convenient sampling,323 oncology nurses in four hospitals were recruited in the questionnaire study.Results Among the 40 pain-related knowledge questions assessed,the mean number of correctly answered questions was (19.33±3.96),with a range of 9 to 33,the correct answer rate for entire questionnaire was between 22.5％ to 81.5％,and the pass rate of the questionnaire was 0.62 ％; the score of the questionnaire had a positive correlation with pain assessment dimension and therapeutic communication and health education dimension;the self-rated score of pain-related knowledge had a positive correlation with the four dimensions; the times of nurses participating in cancer pain control study and the times of the department's cancer pain control study had a positive correlation with pain assessment dimension.Conclusions Oncology nurses did not grasp cancer pain-related knowledge well,and showed discrepancy in mastery of knowledge and nursing activities.Nursing management can strengthen nurses training in cancer pain management or increase the times of cancer pain control study to promote the implementation of cancer pain nursing activities,and to advance the quality of cancer pain nursing.

Objective To investigate the relationships between patients′self- management behaviors and self- efficacy with lower extremity arterial disease, and supply evidence for effective management and intervention of lower extremity arterial disease for clinical medical workers. Methods In August 2014 to January 2015,a total of 110 cases of hospitalized patients with lower extremity arterial disease of two hospitals′vascular surgery from Guangzhou completed questionnaires, including the General Information Questionnaire, Chronic Disease Self- management Behavior - Chinese version, Chronic Disease Self- efficacy -Chinese version. Results The total score of self- management behavior of patients with lower extremity arterial disease ranged from 0 to 69, with an average score of 18.93 ± 6.79, the overall level was not high. Self- efficacy score ranged from 6 to 60, with an average score of 32.25 ± 9.65, the overall level was moderate. Self -management behavior was positively correlated with self- efficacy and its dimensions, and negatively correlated with the dimensions of communication with doctors and Common disease management. Conclusions The clinical staff should strengthen education and guidance of self- management behaviors in patients with lower extremity arterial disease, promote the level of self- management behaviors and self- efficacy, improve the confidence of disease treatment and prevention, in order to achieve the purpose of health promotion.

Objectives To explore the relationship between illness perceptions and health behavior in the subjects. Methods Revised illness perception questionnaire and health promoting lifestyle profileⅡ (HPLPⅡ) were used to measure 101 patients′illness perception and health behavior between the groups. Results The HPLPⅡscore of LEAD was(2.17 ± 0.29) with the score of dimension. The course of disease, prognosis and perception of emotion were negatively related to health behaviour; personal control and primaty congtion of drsease were postively related to health behaviour (all P<0.01). Conclusion Medical personnel should pay attention to the relationship between illness perceptions and health behavior in patients with LEAD and effective measures should be taken to improve the patients′illness perceptions, promote their choices and persistence in health behavior and improve the quality of life.

Objective To study the early response and acute/subacute adverse effects after particle radiation therapy for adenoid cystic carcinoma (ACC) of the head and neck.Methods Between May 2015 and March 2016,a total of 8 patients with ACC of the head and neck were treated using proton and/or carbon-ion radiation therapy.Three patients had early stage and 5 had locally advanced disease.Five patients had an R2 and three achieved an R1 resection.Results Seven patients received intensitymodulated proton therapy (IMPT) followed by intensity-modulated carbon-ion therapy (IMCT) boost.One patient received IMPT only.Among the five patients who had an R2 resection,2/3 patients had partial response (PR)/stable disease (SD) at the end of radiation,0/3 achieved PR/complete response (CR) at 1-month follow-up,and 1/2 achieved PR/CR at 3-months' follow-up after the completion of radiation,respectively.Two patients experienced Grade Ⅲ mucositis during radiation therapy.No patient experienced moderate or severe skin reactions.At the time of this analysis,all patients are alive and no patient had disease progression or recurrence.Conclusions The short-term outcomes indicated that particle therapy is safe and potentially efficacious in the management of head and neck ACC.However,longer follow up is needed to assess late toxicities and long-term efficacy.

Background:After deifnitive chemoradiotherapy for non-metastatic nasopharyngeal carcinoma (NPC), more than 10% of patients will experience a local recurrence. Salvage treatments present signiifcant challenges for locally recur-rent NPC. Surgery, stereotactic ablative body radiotherapy, and brachytherapy have been used to treat locally recur-rent NPC. However, only patients with small-volume tumors can beneift from these treatments. Re-irradiation with X-ray—based intensity-modulated radiotherapy (IMXT) has been more widely used for salvage treatment of locally recurrent NPC with a large tumor burden, but over-irradiation to the surrounding normal tissues has been shown to cause frequent and severe toxicities. Furthermore, locally recurrent NPC represents a clinical entity that is more radio-resistant than its primary counterpart. Due to the inherent physical advantages of heavy-particle therapy, precise dose delivery to the target volume(s), without exposing the surrounding organs at risk to extra doses, is highly feasible with carbon-ion radiotherapy (CIRT). In addition, CIRT is a high linear energy transfer (LET) radiation and provides an increased relative biological effectiveness compared with photon and proton radiotherapy. Our prior work showed that CIRT alone to 57.5 GyE (gray equivalent), at 2.5 GyE per daily fraction, was well tolerated in patients who were pre-viously treated for NPC with a deifnitive dose of IMXT. The short-term response rates at 3–6months were also accept-able. However, no patients were treated with concurrent chemotherapy. Whether the addition of concurrent chemo-therapy to CIRT can beneift locally recurrent NPC patients over CIRT alone has never been addressed. It is possible that the beneifts of high-LET CIRT may make radiosensitizing chemotherapy unnecessary. We therefore implemented a phase I/II clinical trial to address these questions and present our methodology and results. Methods and design:The maximal tolerated dose (MTD) of re-treatment using raster-scanning CIRT plus concur-rent cisplatin will be determined in the phase I, dose-escalating stage of this study. CIRT dose escalation from 52.5 to 65 GyE (2.5 GyE×21–26 fractions) will be delivered, with the primary endpoints being acute and subacute toxicities. Effcacy in terms of overall survival (OS) and local progression-free survival of patients after concurrent chemotherapy plus CIRT at the determined MTD will then be studied in the phase II stage of the trial. We hypothesize that CIRT plus chemotherapy can improve the 2-year OS rate from the historical 50% to at least 70%. Conclusions:Re-treatment of locally recurrent NPC using photon radiation techniques, including IMXT, provides moderate effcacy but causes potentially severe toxicities. Improved outcomes in terms of effcacy and toxicity proifle are expected with CIRT plus chemotherapy. However, the MTD of CIRT used concurrently with cisplatin-based chemo-therapy for locally recurrent NPC remains to be determined. In addition, whether the addition of chemotherapy to CIRT is needed remains unknown. These questions will be evaluated in the dose-escalating phase I and randomized phase II trials.

Objective To evaluate the short-term efficacy and adverse events of pencil beam scanning proton and carbon ion therapy in the treatment of chordoma and chondrosarcoma of the head and neck.Methods Between July 2014 and July 31,2017,61 patients with chordoma and chondrosarcoma of the head and neck receiving proton and heavy ion therapy as the first course of radiotherapy were enrolled.Among them,45 patients were diagnosed with chordoma and 16 cases of chondrosarcoma,39 male and 22 female.The median age was 38 years old (range:14-70 years).The median maximum tumor diameter was 4.1 cm (range:0-8.6 cm).The clivus and the cervical spine were the primary tumor sites.Results Eight patients received proton therapy,21 patients were treated with proton combined with carbon ion therapy and 32 patients received carbon ion therapy.All patients successfully completed the planned radiotherapy.The medial follow-up time was 21 months (range:7-47 months).No grade 3-4 acute toxicity was observed.Only one patient suffered from radiation-induced temporal lobe injury.The 2-year progression-free survival (PFS)and overall survival (OS) were 91％ and 100％.Conclusions Pencil beam scanning proton and heavy ion therapy yields relatively favorable short-term outcomes in the treatment of chordoma and chondrosarcoma of the head and neck.Nevertheless,the long-term clinical efficacy and safety remain to be investigated during follow-up.

Objective:To evaluate the clinical value of 5.0 T ultra-high filed MRI system in assessing intracranial arteries segments and vessel branchers.Methods:This study was a prospective study. Totally 40 consecutive healthy volunteers were recruited from Zhongshan Hospital, Fudan University from September 1, 2021 to November 30, and all participants who underwent either 3.0 T or 5.0 T time-of-flight MR angiography (TOF-MRA) in random order were divided into 3.0 T MR group and 5.0 T MR group with 20 volunteers for each group. Image quality was assessed by Likert 5 scoring systems and signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR),and score in visualization of intracranial arteries [middle cerebral artery (MCA) and its segments, anterior cerebral artery (ACA) and its segments, posterior cerebral artery (PCA) and its segments, lenticulostriate arteries (LA) and pontine artery (PA)] were assessed from 0 to 3 (≥2: good depiction of vessel segment). Quantitative indicators were compared between 2 groups using independent t test or Mann-Whitney U test. Results:Among the 40 subjects, there were 29 males and 11 females, aged 20-69 (50±12) years. SNR and CNR were both significantly higher in 5.0 T MR group than those in 3.0 T MR group (SNR: 187±9 vs 91±4, t=31.59, P<0.001; CNR: 156±7 vs 70±4, t=31.45, P<0.001), but there was no significant difference in subjective scores of image quality between the 5.0 T MR and 3.0 T MR groups [5.0 (4.0, 5.0), 5.0 (5.0, 5.0) points, respectively, Z=-1.23, P=0.218]. In the evaluation of cerebral arteries, the visualizations of the proximal and middle segments of MCA, ACA and PCA was better than those in the 3.0 T MR group, and there was no significant difference in the scores ( P>0.05), while the visualizations of proximal arteries in the 5.0 T MR group were significantly better than those in the 3.0 T MR group ( P<0.05). Furthermore, small vessel branches such as LA and PA in 5.0 T MR group were visualized better than those in 3.0 T MR group ( P<0.001). Conclusion:TOF-MRA by ultra-high filed 5.0-T provides an optimal choice in visualization of distal large arteries and small vessel branches, which could be useful for the diagnosis on cerebral vascular disease.

Objective To observe the value of 5.0T MR susceptibility weighted imaging(SWI)for displaying cerebral small veins and detecting cerebral microbleeds(CMB).Methods Head MR examinations were prospectively performed using both 3.0T and 5.0T MR scanner in 30 stroke patients suspected caused by cerebral small vessel disease.The image quality,effect of displaying cerebral small veins and detecting CMB were compared between 3.0T and 5.0T SWI.Results The image quality scores,signal-to-noise ratios,contrast-to-noise ratios,scores of displaying deep cerebral veins and subcortical veins,the counts of detecting CMB and iron deposition on cortical surface of 5.0T SWI were all higher than those of 3.0T SWI(all P＜0.05).High consistency of CMB positions was found between 3.0T and 5.0T SWI(Kappa=1.0).Conclusion The effect of 5.0T MR SWI for displaying cerebral small veins and detecting cerebral microbleeds were better than 3.0T MR SWI,which could be used to assess stroke caused by cerebral small vascular disease.