Objective To validate the gross tumor volume (GTV) delineation in head and neck cancer based on magnetic resonance imaging (MRI) or computed tomography (CT) by cross-sectional autopsy,and to provide a basis for clinical evaluation of the two imaging methods.Methods Ten New Zealand rabbits were selected for transplantation of VX2 carcinoma cells,and a head and neck cancer model was successfully established in six rabbits.Each rabbit was fixed and received MRI scan and CT scan in the same body position.Then,they were sacrificed and fixed in gelatin solution (-70℃) for 72 h; all cryopreserved rabbits underwent cross-sectional autopsy using a jig saw,with the same position and sectional thickness as in MRI scan and CT scan,and cross-sectional autopsy images were obtained using a digital single-lens reflex camera.GTVs were separately delineated based on CT,MRI,and cross-sectional autopsy images.The GTVMRI,GTVCT,GTVSA,and volume difference ratios (VDRs) were calculated;two-way classification ANOVA and paired t-test were used for difference analyses.Results The mean values of GTVMRI,GTVCT,and GTVSA were 8.20 ± 2.56,8.40 ± 2.20,and 8.11 ± 2.88 cm3,respectively,without significant differences among them (F =0.06,P =0.943).The mean values of VDRMRI-SA and VDRCT-SA were 0.180 ± 0.060 and 0.309 ± 0.091,respectively,with a significant difference between them (t =7.49,P =0.001).Conclusion The GTV delineation based on MRI is more accurate than that based on CT in head and neck cancer.

Objective To investigate the feasibility and safety of umbilical single- port laparoscopic surgery in the treatment of children ovarian cysts. Methods The clinical efficacy of umbilical single-port laparoscopic surgery in the treatment of children ovarian cysts of 36 cases was analyzed retrospectively. Results Thirty-six children successfully completed surgery. The operative time was (27.8 ± 8.6) min, the diameter of ovarian cysts was (7.2 ± 2.4) cm, and the blood loss was (6. 5 ± 1.6) ml. All the children were confirmed to have benign ovarian cysts by pathological examination. Thirty-four children retained ovarian tissue after removal of the cyst, and 2 children underwent oophorectomy because of ovarian necrosis. The anus exhaust was recovered (18.4 ± 4.6) h after surgery, and the postoperative hospital stay was (4.2 ± 1.3) d. The children began to diet after anesthesia conscious. All the children recovered well, and no surgical complications occurred. The followed-up time was (24.6 ± 6.3) months, and no recurrence occurred. Conclusions Umbilical single-port laparoscopic surgery in the treatment of children ovarian cysts is easy, minimally invasive, no scar formation, quickly recovered and reliable. It is worth of further clinical application.

Objective To explore the feasibility and safety of single-port laparoscopic surgery in the treatment of incarcerated inguinal hernia in children. Methods The clinical efficacy of single-port laparoscopic and epidural anesthesia needle treatment for incarcerated inguinal hernia in children of 32 cases were analyzed retrospectively. Results Thirty-two children were operated successfully. The operation time was (16.24 ± 4.67) min for unilateral hernia (in 25 cases) and (21.69 ± 5.85) min for bilateral hernia (in 7 cases). The blood loss was (2.50 ± 0.56) ml. The recovery time of intestinal peristalsis was (16.42 ± 4.86) h after surgery, and the postoperative hospital stay was (3.25 ± 0.82) d. Intraoperative exploration found 7 cases had concealed contralateral hernia;incarcerated hernia contents included bowel in 27 cases, ovaries in 3 cases, and greater omentum in 2 cases. All the incarcerations were successfully restored by hand and no-damage clamp assistance. The incarcerated organ had good blood flow in all the 32 cases. The follow-up time was (15.62 ± 5.34) months, and there was no recurrence and atrophy of testis or ovaries. Conclusions The single-port laparoscopic surgery for incarcerated inguinal hernia in children has advantages of preservation of anatomy of the inguinal canal easily to perform high ligation of hernial sac, and reduction under direct visual control. Meanwhile, occult inguinal hernia in the opposite side can be cured. It was a safe, effective, and minimally invasive procedure, being worthy of further clinical application.

Objective To compare the clinical effect of single-port laparoscopic appendectomy and traditional mult-port laparoscopic appendectomy in children with appendicitis. Methods The clinical data of 96 appendicitis children who had underwent laparoscopic appendectomy were retrospectively analyzed. Among the children, 48 children received single- port laparoscopic appendectomy (observation group), and 48 children received mult-port laparoscopic appendectomy (control group). The operation time, blood loss, postoperative exhaust time, postoperative hospital stay, incision length and surgery-related complications between 2 groups were compared. Results All children were operated successfully. There were no statistical differences in blood loss and postoperative hospital stay between 2 groups (P>0.05). The operation time, postoperative exhaust time and incision lengths in observation group were significantly lower than those in control group: (19.8 ± 5.3) min vs. (30.2 ± 8.1) min, (15.6 ± 4.7) h vs. (22.7 ± 6.5) h and (1.1 ± 0.2) cm vs. (2.3 ± 0.4) cm, and there were statistical differences (P<0.01). There was 1 case with incision infection in observation group, and the child was cured after symptomatic treatment. There was no other surgery-related complication in 2 groups, and all children recovered smoothly. Conclusions The single-port laparoscopic appendectomy is safe and feasible in children with appendicitis. It has short operation time, fast recovery of gastrointestinal function, and better cosmetic effect.

OBJECTIVETo evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back".

METHODSFrom January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function.

RESULTSAll patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist.

CONCLUSIONUsing the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

Adolescent ; Child ; Female ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Ulna Fractures ; physiopathology ; surgery

OBJECTIVETo analyze the risk factors for level Ib lymph node enlargement on CT in patients with nasopharyngeal carcinoma (NPC) and provide clinical evidence for defining the indications of prophylactic level Ib irradiation.

METHODSA total of 435 newly diagnosed NPC patients receiving radiotherapy in Nanfang Hospital in the past 2 years were enrolled in this analysis. The correlations were analyzed with Logistic regression between level Ib lymphadenopathy and the clinical risk factors including T stage, N stage, diameter of level II lymph nodes, submandibular gland involvement, nasal cavity involvement, oropharyngeal involvement, and involvement of 4 or more lymphatic drainage regions.

RESULTSUnivariate analysis showed that level Ib lymphadenopathy were positively correlated with N stage (P=0.023), submandibular gland involvement (P=0.045), and level II lymph node diameter (P<0.001). Multivariate Logistic regression analysis suggested a significant correlation only between the diameter of the level II lymph nodes and level Ib lymphadenopathy (P=0.013).

CONCLUSIONLevel Ib lymphadenopathy is positively correlated with the size of ipsilateral level II lymph nodes in NPC patients.

Carcinoma ; Humans ; Lymph Nodes ; pathology ; Lymphatic Diseases ; epidemiology ; Lymphatic Metastasis ; Nasopharyngeal Neoplasms ; epidemiology ; Neck ; Paranasal Sinuses ; Risk Factors ; Submandibular Gland

Objective To investigate the safety and efficiency of laparoscopic gallbladder - preserving chole-lithotomy in the treatment of cholecystolithiasis in children. Methods The clinical data obtained from 18 children with gallstones undergoing laparoscopic gallbladder - preserving cholelithotomy at Dalian Children′s Hospital of Dalian Medi-cal University during July 2010 and December 2016 were retrospectively analyzed. Eight boys and 10 girls of 5 - 14 years old [mean (9. 2 ± 3. 1)years old]were included in the study,of whom 11 cases had a single stone,7 cases with multiple stones. All patients were followed up for 3 - 72 months. Results All of 18 patients without pancreaticobiliary maljunction were diagnosed by Color Doppler ultrasound and magnetic resonance cholangiopancreatography(MRCP). Gallbladder functions were assessed preoperatively and they were all in good condition. Laparoscopic gallbladder - pre-serving cholelithotomy was successfully performed in all patients without conversion to cholecystectomy. Operation time was 28 - 66 min,with mean value of (40. 2 ± 14. 3)min;intraoperative blood loss was 4 - 12 mL,with mean value of (8. 3 ± 2. 8)mL;postoperative hospital stay lasted 3 - 5 d,with mean value of (3. 8 ± 1. 2)d. There were no complica-tions such as bile leakage,postoperative bleeding,biliary duct damage,biliary pancreatitis during therapy. The patients were followed up for 3 - 72 months,and the Color Doppler ultrasound showed no gallstone recurrence after surgery. Conclusions For children with good gallbladder function,laparoscopic gallbladder - preserving cholelithotomy can preserve gallbladder function and the integrity of biliary tract. The operation is easy and reliable,with minimal invasion, quick recovery,and low recurrence rate. It is a feasible method for the treatment of gallstones in children.

A sandwiched electrochemical immunoassay based on the AuNPs@GSH-CdTe as a signal label, which formed by GSH-CdTe QDs and AuNPs, with dual signal amplified by reduced graphene oxide and AuNPs was proposed for the sensitive detection of prostate specific antigen(PSA). Through a sandwich immunoreaction, the target PSA and AuNPs@GSH-CdTe labeled Ab1 were captured to rGO/AuNPs-Ab2 surface. After the HNO3-dissolution step, square wave stripping voltammetry(SWSV)analysis of the captured CdTe QDs was used to quantify the concentration of PSA. In this system, AuNPs possessedlarge specific surface and good biocompatibility, which could effectively expand the amount of antigen and GSH-CdTe QDs loading and signals amplifying, while rGO played a synergistic amplification role due to its large specific surface. The proposed method showed good linearity ranging from 0. 5 to 200 ng/mL with the detection limits of 5. 0 pg/mL. It also showed excellent selectivity, good reproducibility, satisfactory stability. In addition, the method was successfully applied to the determination of real samples. The result was satisfactory and the recovery could fall in 98. 20%- 106. 2%, which represented a novel approach for versatile detection of tumor markers.

Objective: Attentional biases toward emotional scenes may represent vulnerability and maintenance factors in depression. Antidepressant therapy may improve cognitive function and reduce depression, and is considered as the mechanism of action of antidepressants. Therefore, we conducted an eye-tracking test to examine whether selective serotonin re-uptake inhibitor (SSRI) antidepressants can reduce negative attentional biases and elicit clinical responses in depression. Methods: Twenty first-episode depressive patients freely viewed three types of pictures that depicted different emotional scenes (i.e., positive-control, neutral-control, and negative-control) for 4,000 ms while their eye movements were monitored. The attentional bias to different emotional scenes was assessed before and after eight weeks of SSRI treatment using the eye-tracking method. The control group included a group of healthy individuals. Results: The results revealed that first-episode depressive patients oriented their gaze more frequently to negative images and less to happy images, compared to controls. Importantly, the attentional bias in depressive patients was regulated after eight weeks of SSRI treatment. Patients showed an increased tendency to fixate on positive images and a decreased tendency to focus on negative images. Conclusion This suggests that SSRI antidepressants decrease vulnerability to negative images, while having an effect on attention in respect to positive images.

Objective:To investigate the efficacy and safety of black tomato concentrated sauce in the treatment of benign prostatic hyperplasia(BPH) with lower urinary tract symptoms(LUTS).Methods:An open, randomized and controlled trial was conducted, and 150 BPH patients with LUTS were randomly assigned to three groups: experimental group(60 cases), placebo group (45 cases) and positive control group(45 cases) in the Department of Urology, Lanzhou University Second Hospital from December 2018 to September 2020.Inclusion criteria: age≥50 years old; first diagnosis of BPH, or interrupted medical treatment of BPH for more than 1 month; maximum urinary flow rate (Q max) <15ml/s; prostate volume (PV)≥20ml; IPSS≥8, QOL≥2. Exclusion criteria: lower urinary tract obstruction not caused by BPH, post-void residual urine volume(PVR) >250 ml; history of acute urinary retention in the last 3 months; prostate nodules and suspected prostate cancer were revealed by digital rectal examination and transrectal B-ultrasoundor; prostate-specific antigen (PSA)≥10 ng/ml; neurogenic bladder, perivous history of bladder, prostate, or urethra operations; suffering from serious heart, lung, liver, kidney and other diseases. The patients in the experimental group were orally treated with black tomato concentrated sauce(30 g/once, 3 times/day). The patients in the placebo group were orally administrated with placebo. In the positive control group, the patients with PV≤30ml were orally treated with tamsulosin(0.2mg/once, 1 time/day), the patients with PV>30ml were orally administrated with tamsulosin and finasteride(5 mg/once, 1 time/day). All enrolled patients were treated for 3 months. At the end of third month, the IPSS, QOL, PV, PVR, Q max, average urinary flow rate(Q ave), total PSA(tPSA), free PSA (fPSA), testosterone(TST) and the incidence of adverse reaction were assessed. Results:128 of 150 cases, including 52 cases in experimental group, 36 cases in placebo group and 40 cases in positive control group, completed the study, the rest was excluded due to not take medication regularly and fail to follow-up. There were no significant differences in baseline parameters among experimental group, placebo group and positive control group ( P>0.05) in age[(63.21±8.61) vs.(62.36±6.32) vs. (63.94±7.78)years old], body mass index[(23.74±3.17) vs. (23.94±3.09) vs. (24.26±2.91)kg/m 2], IPSS[(17.5±6.6) vs. (15.4±5.8) vs. (17.9±6.8)], QOL[4.0(3.0, 4.0) vs. 4.0(3.0, 4.5) vs. 4.0(3.0, 5.0)], Q max [(8.60±3.04) vs. (9.13±2.92) vs. (9.58±3.26) ml/s], Q ave[(4.39±1.69) vs. (4.66±1.76) vs. (4.88±1.60)ml/s], PV [32.00(25.55, 45.40)vs. 30.00(24.45, 38.35)vs. 34.80(27.65, 56.65)ml], PVR[23.50(8.25, 45.75) vs.5.50(0, 47.75) vs. 29.00(0, 84.00)ml], tPSA [1.53(0.89, 3.00) vs. 1.23(0.69, 1.98) vs. 2.23(0.90, 4.15)ng/ml], fPSA [0.37(0.28, 0.76) vs. 0.37(0.22, 0.52) vs. 0.54(0.30, 0.97) ng/ml] and TST[(443.64±156.32) vs. (493.97±176.16) vs. (450.89±135.08)ng/dl]. After 3 months of treatment, the IPSS in experimental group was(9.9±5.7), QOL score 2.0(2.0, 3.0), Q max(11.78±5.24)ml/s, Q ave(5.86±3.00)ml/s, tPSA 1.64(0.96, 3.32)ng/ml and TST (475.91±177.33)ng/dl, which were significantly different compared with pre-treatment( P<0.05). In positive control group, IPSS was (9.0±6.2), QOL 2.0(2.0, 3.0), Q max(11.73±4.50)ml/s, Q ave(6.11±2.53)ml/s, tPSA 1.57(0.80, 3.09)ng/ml, fPSA 0.37(0.24, 0.63)ng/ml and TST (526.11±126.88)ng/dl, which were statistically different compared with pre-treatment( P<0.01). However, there were no significant differences in all the above indexes in placebo control group compared with the baseline( P>0.05). The numerical changes of IPSS, QOL, Q maxand Q ave between experimental group and placebo group had statistically significant differences ( P<0.05). The changes of IPSS, QOL, Q max, Q ave, PV, tPSA, fPSA and TST between positive control group and placebo group had significant differences ( P<0.05). The changes of PV, tPSA and fPSA between positive control group and experimental group had statistically significant differences ( P<0.05). The incidence of adverse reactions was 5.77% (3/52, including 1 headache and 2 stomach discomfort) in experimental group, 5.56% (2/36, including 1 headache and 1 stomach discomfort) in placebo group, and 10.00%(4/40, including 1 dizzy, 1 nasal obstruction and 2 erectile dysfunction) in positive control group. And there was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:Black tomato concentrated sauce shows an excellent effect on patients with LUTS/BPH, and improves the quality of life with few adverse events.