With the rapid development of medical technology, radiation therapy in the treatment of liver cancer occupies the important position. According to the biological characteristics of large liver cancer, the development of liver cancer radiotherapy at home and abroad and the technical features of stereotactic radiotherapy, it is concluded that the effect of radiation therapy of liver cancer can be comparable to those of surgery.γ-SABR is a kind of high accuracy of stereotactic radiotherapy. Before the treatment, usually do a rough evaluation according to the patient general condition, tumor size, and the liver function. The potential risk of radiation induced liver disease is very big. Therefore, the evaluation of essential functional liver volume of large liver cancer is particularly important before stereotactic radiotherapy. Draw lessons from the consensus of liver reserve function and the decision tree of liver function, the concept of essential functional liver volume and remaining functional liver volume is applied to theγ-SABR are being studied in clinical trials. This review is intend to outline the evaluation of essential functional liver volume of solitary large hepatocellular carcinoma beforeγ-SABR.

Objective To observe the effectiveness of liver-soothing and spleen-strengthening traditional Chinese medicine combined with intra-arterial infusion of chemical medicine for advanced primary hepatocellular cancer patients.Methods One hundred and twenty primary hepatocellular cancer patients were randomly assigned to treatment group(60 patients) and control group(60 patients).The treatment group was treated by traditional Chinese medicine combined with intra-arterial infusion of chemical medicine,while only intra-arterial chemical medicine was applied to the control group.The intra-arterial chemical medicine was applied every four weeks.Each group received at least two courses of treatment.Aspects such as treatment effectiveness,quality of life,immune function and the condition of blood coagulation were observed.Results Clinical stable rate of the treatment group was 80.8%,higher than the control group obviously(P

Objective To study the characteristics of toe-to-thumb transplantation in a group of infants who completely lacked the thumb.The mean age was 24.6 months,and the youngest was 10 months old,The operative technique and rehabilitation were studied.Methods In two infants with Ⅲ-Ⅳ? defects of the thumb together with multiple injuries of fingers,the wounds were debrided and toe-to-thumb transplantation was done later.In case 3 Ⅲ? defect of the thumb together with palm injury,one-stage toe-to-thumb transplantation and the palm injury was covered with an abdominal flap were done at the same time.Considering the characteristic physiological structure of a dorsalis pedis and the first metatarsal arteries.In the infant,minimally invasive operation under 10? microscope was employed.A series of early functional exercises was given for the reconstructed thumbs.Results The reconstructed thumbs completely survived,hand function was recovered 3-6 months after the operation.With follow-up for longer than 2 years in 2 cases,it was noted that the reconstructed thumb grew consistent with the wounded hand.The appearance and function thumb were satisfactory.Conclusion Toe to thumb transference was successful in infancy,with the combined technique of minimally invasive and plastic surgery.Reconstruction of the thumbs can be completed in two stages on immediately after injury.The appearance and function can be restored.[

Objective To establish an effective technique in reservation and function reconstruction of a leg, in which all the muscles except gastrocnemius necrosed induced by the delayed necrosis of all the intermuscular vessels, the foot was linked only by skin, fascia and tibia. Methods The leg was linked with foot only by the skin, fascia, caput mediale of gastrocnemius and tibia when all the muscles, intermuscular vessels and fibula were removed. The direct island flap of tibialis posterior artery was cut from the healthy limb and used to cover the 4/5 length and 1/3 circumference of bone-fascia raw surface, then to anastomose the both arteries of the flap and the caput lateral gastrocnemius when dividing the pedicles. As soon as the raw surface healed, fuse the ankle in the functional situation and fix the flexor and extensor tendon in the proper situation. Results With sufficient blood supply from the skin and fascia of the flap, the raw surface healed soon, the severe ischemia pain relieved, and the circulation and sensation recovered gradually. The crutching and walking function of the leg reconstructed at last. Conclusion When all the necrotic intermuscular vessels and muscles except caput mediale of gastrocnemius were removed, the necrosis may be delayed by means of reticular collateral circulation among skin, deep and superficial fascia and tibia of the injured limb. However, the blood supply is very little, the severe ischemia wound and ischemia pain can't be healed. Through the tibialis posterior artery direct island skin flap of the healthy leg to cover the dystrophic wounds, the blood supply of the leg can be improved. As a result, the leg survives and its function is reconstructed, and an eternal axial-pattern artery for the wound leg through arteries anastomosis is rebuilt.

Objective To establish an equation between canine and other permanent teeth,and probe a new method to predict the sum of the mesiodistal diameters of unerupted permanent canines.Methods Samples consisted of 118 dental casts were obtained from Chinese patients(50 males,68 females,respectively).Mesiodistal tooth diameters were measured by a vernier caliper.GAS was used to establish the equation between canine and other permanent teeth,and compared with stepwise regression analysis.Those were modelling samples that optimized equations coefficient(112 samples).Others were inspection samples(6 samples).Results The equation between canine and other permanent teeth was established.MU=0.0511U1+0.2164U2+0.2780U4+0.0407U5+0.2853U6+0.8321①;ML=0.2998U1+0.1294U2+0.3912U4+0.0088U5+0.0791U6+0.9839②;FU=0.1419U1+0.1741U2+0.3258U4+0.0412U5+0.093U6+1.7355③;FL=0.2796U1+0.3750U2+0.2968U4+0.0268U5+0.0043U6+0.6030④.Compared with stepwise regression analysis,the mean error of precision by GAS was less(P

Objective to study the factors of delaying survival of the ankle and foot which were linked with leg only by skin, fascia and tibia after all the infected and inactivated muscles and intermuscular vessels had been removed, and to study the effect of artery blood supply reconstruction to avoid the necrosis and ischemia contracture of the foot. Methods The leg was linked with ankle and foot by the tibia which was covered only by skin and fascia after all the muscles, interosseous membrance, intermuscular vessels and fibula had been removed. And then the artery blood supply for the injured limb was reconstructed by stages. Results The sense of haphalgesia, with normal temperature and color, recovered in the injured limb 7 months after operation, no contracture and deformity happened in the food muscles and joint, and the patient may smooth stand and walk with a stick freely. Conclusion The necrosis and ischemia contracture of foot was delayed by reticular collateral circulation among skin, deep and superficial fascia and tibia of the injured limb, although the blood supply was very little after all the muscles and intermuscular vessels had been removed because of infection and necrosis. Finally the injured limb was reserved successfully by artery blood supply reconstruction. The clinical effect was satisfactory.

Objective To probe the pathogenesis of long bone defects and damage to epiphysis as the result of postoperative infections following fractures in the childhood of patients, and to look for ideal ways to prevent and repair the defects and damages. Methods The treatment of the infected bone defect of a tibia had been continued for one year following fracture in one four-year old patient, and the treatment of the infected bone defect of a humerus had been continued for ten years following fracture in another seven-year old patient, but all the treatments had failed. The injured limbs developed bone infection, bone defect, bone exposure, shortening, and pseudoarthrosis deformities at last. Then the lesions were completely cleaned, and the deformities of the infected bones were corrected in one stage, with reconstruction of the bone and the repair of the wounds by transplantations of fibular free flaps. Results Both fibular free flaps survived in one stage transplantation. The bones of the injured limbs healed half a year after the operations, and weight-bearing and walking functions of the injured limbs recovered as well. Conclusion Transplantation of fibular free flap was an ideal way to treat a long bone defect as a result of postoperative infection following fracture in the childhood. The early appropriate treatment of postoperative infection following fracture is very important to avoid bone and epiphysis damages.

Objective To investigate the value of dynamic contrast?enhanced MRI (DCE?MRI) in the differential diagnosis of glioblastoma and brain metastases. Methods Twenty patients with high grade gliomas and 20 cases patients with brain metastases proved by surgery and pathology were collected, and patients were examined with conventional MRI and DCE?MRI preoperatively. The ROIs were manually placed in solid parts of the tumors and their surrounding tissues to calculate Ktrans, Kep and Ve values. The Ktrans, Kep and Ve values differences for the solid part and surrounding tissues of the two brain tumors were compared by two independent sample t test. The correlation between Ktrans of the solid parts of the two brain tumors and Ktrans, Kep and Ve values of their surrounding tissues were studied by Pearson correlation analysis. Results The Ktrans, Kep and Ve values of glioblastoma were(0.258 ± 0.063)min-1,(0.398 ± 0.082)min-1, 0.632±0.084, the Ktrans, Kep and Ve values of brain metastases were(0.233±0.053)min-1,(0.357±0.042)min-1, 0.672±0.113. There were no significant differences between the glioblastoma and brain metastases for Ktrans, Kep and Ve values(t=-1.354,-1.982, 1.276, all P>0.05). The Ktrans, Kep and Ve values of surrounding tissues of glioblastoma were(0.093±0.032)min-1,(0.411±0.089)min-1, 0.107±0.021, the Ktrans, Kep and Ve values of surrounding tissues of brain metastases were(0.033±0.010)min-1,(0.204±0.045)min-1, 0.069±0.017. The Ktrans, Kep and Ve values of surrounding tissues between glioblastoma and brain metastases had significant difference (t=-7.978,-9.303,-6.203, all P<0.05). The Ktrans of glioblastoma were correlated with Ktrans, Kep and Ve values of their surrounding tissues (r=0.759, 0.464, 0.651, all P<0.05); The Ktrans values of brain metastases had no relationship with Ktrans, Kep and Ve values of their surrounding tissues (P>0.05). Conclusion The DCE?MRI can quantitatively display the microvascular permeability and accurately evaluate the damage of blood?brain barrier of glioblastoma and brain metastases, which has an important value in studying biological characteristics and differential diagnosis of the two brain tumors.

Objective: To explore the effects of workplace health promotion in a wind power equipment manufacturing factory. Methods: Based on investigation of occupational hazard factors, personal protective equipment (PPE) application, occupational health management and healthy life style, health promotion strategy and intervention were implemented in this factory. The sample size was 56 for monitoring of occupational hazard factors before and after intervention, 283 and 259 for questionnaire before and after intervention. Results: After intervention, the qualified rate of workplace occupational hazard factors increased from 67.9% to 82.1%. The abnormal rate of occupational health surveillance among workers decreased from 24.7% to 11.6%. The rates of correct use of PPE increased from 39.6% to 80.7%. The rates of awareness of occupational health increased from 10.2% to 71.8%. The rates of awareness of chronic disease increased from 10.2% to 77.2%. Two-week consultation rate decreased from 6.4% to 4.2%. Smoking rate decreased from 12.4% to 10.4%. Conclusion Workplace health promotion is effective measures for reducing occupational hazard factors exposure and improving workers’ health.