Objective To explore the effects of reconstruction and shaping of thumb or finger defects by free second-toe transfer and one stage appearance remodeling.Methods From October,2007 to August,2013,128 thumb or finger Ⅴ degree defect of 109 cases were reconstruct with free second-toe transfer,and one stage shape remodeling at the same time.Among them,20 fingers by nail bed expand one stage; 23 fingers were nail bed expand added on toe pulp splayed resection on both sides; 29 fingers were added on embedded the philp island flap of great toe to the section of plantar side narrow part in the second digit,19 fingers were added on embedded the abdominal phil chamfered-edge-shape flap to that narrow part in the second digit,and 37 fingers added on toe pulp resection and embedded the philp island flap of great toe to that narrow part.Results All reconstructed thumb or fingers survived and appearance were good.The nail shape of reconstructed thumb or fingers were improved obviously,the shape of narrow part in middle segment was recovered satisfactorily.Seventy-nine cases (72.5％) were followed-up from 3 months to 5 years,and the other 30 cases (27.5％) were lost.The function of the reconstructed thumb or finger and hand feeling was ideal recovered.There were no claudication,no pain and no other sequelaes for donor foot.According to the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of Chinese Medical Association,43 cases excellent,26 cases good,10 cases approve.The rate of excellent and good was 87％.Conclusion Second-toe transfer and shape remodeling is a good method of thumb or finger reconstructing.The appearance of the thumb reconstruction can be improved obviously.Preoperative carefully design and the combination of the above several kinds of operation,for draw up an personalized surgical program is necessary.

Objective To explore the elementary properties of LiF (Mg,Cu,and P) thermoluminescent dosimeter (TLD) in dosimetry for tumor radiotherapy,and to provide a reliable basis for thermoluminescent dosimetry in clinical radiotherapy.Methods 60Coγ-ray and 6 MV X-ray were used for evaluation of the dispersion,repeatability,and dose response of LiF TLD.To meet the requirement of clinical radiotherapy,the effects of energy,dose (50-600 cGy),radiation dose rate (50-600 MU/min),and the angle of incidence for accelerator gantry (0°-± 90°) on TLD were determined and the respective correction factors were calculated.Results The errors of repeatability and dispersion of TLD were less than ±3％.There was a linear relationship between readout and irradiation dose within a certain range of irradiation dose.The minimal relative deviation of 0.3％ was obtained when 6 MV X-ray was used with a dose rate of 300 MU/min and an angle of incidence of 0°.Conclusions LiF TLD shows excellent repeatability,low dispersion,high stability,and strong linear correlation.It meets the international criteria and can be used for dose measurement in tumor radiotherapy.

Objective To investigate influence on dose distribution due to cavity and inhomogeneous structures using thermoluminescence dosimeters (TLD) and Chengdu phantoms.Methods A cavity 4 cm × 4 cm × 3 cm was made by a head and neck phantom and a lung phantom was cut into slices which were got a CT scanning and setup in a digital simulator.The TLD were pasted on edge and in the center of cavity structure and inhomogeneous structures.Treatment plans of different radiotherapy technologies were made generated and delivered on a linear accelerator.Then the TLD were read and analyzed.Results There were remarkable cavity effects of conventional single field,opposite fields and IMRT plans with 7 fields for head and neck phantom.There is similar effect in lung phantom.The more complexity the radiotherapy technology was the less cavity effect.Conclusions It is necessary to consider using more advanced radiotherapy technology or applying more fields to make treatment plans in order to decrease the cavity effect or similar effect when there are inhomogeneous structures.

Objective To understand the status of the radiation therapy in sichuan province, analysis the development level of radiotherapy in the past five years in sichuan province,provide reference for the rational allocation of radiotherapy resources in the province, promote the healthy development of radiotherapy. Methods With reference to the surveys carried out by other provinces and the survey of sichuan province in 2009,to determine the survey schemes,survey projects. The survey covers all medical units of radiation therapy in the province, adopt the way of combination of questionnaire and on?the?spot visiting. Results There is a big progress in basic condition, treatment equipment, auxiliary equipment, verification equipment,personnel and application of new technologies. Compared with 2009 survey,multiple projects achieve a 50% or even more than 100% growth. Conclusions The rapid development of radiation oncology in sichuan province will ultimately benefit a large number of tumor patients in sichuan province. Patients will be treated with better environment,treatment technology and quality. At the same time,higher requirement of quality control for the entire province is put forward to us.

ObjectiveTo study the using of cerrobase as the compensation material in the intensitymodulated radiation therapy (IMRT) implementation and impact factors.MethodsWith therapy planning system (TPS) exported the radiation field intensity file (Dicom RT),through measuring the attenuation coefficient of cerrobase,to calculate the processing depth of AUTIMO 3D CNC corresponding for Dicom RT files at each pixel,then using the processed foam casting of Cerrobase,produced the required IMRT compensator.Through the MATRIXX testing the IMRT compensator in clinical implementation.At the same time we compared the MU of using multi-leaf collimator (MLC) and Cerrobase IMRT compensator for 10patients.ResultsWith cerrobase compensation IMRT can get similar dose or dose distribution to dose produced by TPS for point or plane dose,error is within 5％.To comparison with MLC,using cerrobase compensator has fewer treatment times ( (4.44±0.39) min:(5.71±0.57) min (t =10.82,P =0.000) )and fewer MU (462.5 ± 65.8) MU:(524.5±99.6) MU(t=3.14,P=0.012) ).Conclusions Comparison with MLC IMRT,the cerrobase compensation technique has an important application value with its unique advantages.This research provides an implemented method of IMRT radiotherapy for the primaryhospital.

Objective:To screen the kinase genes related to radioresistance by high-throughput method and provide a theoretical basis for clinical treatment strategy of oral squamous cell carcinoma.Methods:The tongue squamous carcinoma cell line Cal-27 was infected with lentivirus shRNA kinase library that contains 4 675 different shRNAs regulating 709 human kinase genes. The uninfected cells were removed by puromycin screening. Then, the cells were irradiated with different doses (0, 10, 15 cGy) and continued to culture for 3 d to enrich the differences among groups. Afterwards, the cell genomic DNA was extracted and the complete shRNA sequences were obtained by PCR.Different tags were labeled in shRNAs of each group. An illumina platform was used for next generation sequencing to acquire the shRNA abundance, and then the differentiated expressed genes among different groups were identified.Results:A total of 5 kinase genes (PKLR, IPMK, AURKB, ITPKB and DLG2) were screened out from irradiated cells. Knockdown of PKLR and IPMK increased radiation resistance, while knockdown of AURKB, ITPKB and DLG2 increased radiation sensitivity, and the high expression of these genes would lead to radiotherapy tolerance.Conclusions:In this study, 3 genes relative to radioresistance of oral squamous cell carcinoma were identified by using shRNA lentivirus library combined with next generation sequencing, but the underlying mechanism requires further exploration.

Objective To investigate if the positive postnatal environment could modify the schizo-phrenia-related behaviors caused by early maternal immune activation,and the interaction of this two pre-and postnatal factors.Methods The pregnant mice were randomly divided into experimental and control groups.The experimental groups were injected with polynosinic-polycytidylic acid(Poly I : C)(5mg/kg),via intra-venous route,at gestational day 9.The control groups were injected with the same volume of normal saline (NS)at the same gestational day.All offspring were housed in groups of littermates until postnatal day (PND)21 when they were weaned.Between PND22-PND60,offspring were divided into dull or enriched en-vironment(DE or EE)groups by sex and treatment.Different toys were put into the cages of enriched envi-ronment group every week,such as running wheels,climbing materials,swings and rollers.The dull environ-ment(DE)groups were kept the normal housing environment only with sawdust.At PND60,behavioral tests were conducted,such as prepulse inhibition(PPI),open field test,novel object/location recognition,social interaction test,as well as water maze test,were conducted to evaluate the performance of all offspring.After behavioral tests,all offspring were killed and the hippocampus were dissected.The western blot was used to analyze the expression of myelin basic protein in the hippocampus.Results (1)The percentage of PPI with early maternal immune activation of Poly I : C were significantly reduced when compared with control groups (female offspring:F=28.12,P<0.001;male offspring:F=14.76,P<0.01),suggesting the schizophrenia-like behavioral deficit in the offspring induced by early prenatal Poly I : C challenge.(2)In open field test,early maternal immune activation increased the moved distance and speed of the offspring compared with the con-trol groups(female offspring:distances,F=5.10,P<0.05,speed:F=5.19,P<0.05;male offspring:distances:F=6.76,P<0.05,velocity:F=6.85,P<0.05,vs each corresponding control).(3)Enriched environment in-creased the social interaction time of offspring with strange mouse in the social interaction test(female off-spring:EE group(101.30±6.83)s,DE group(76.50±5.59)s,F=9.41,P<0.01;male offspring:EE group(98. 52±6.82)s,DE group(75.82±3.95)s,F=7.95,P<0.01).(4)Enriched environment decreased the time for offspring to find the platform in water maze test(P<0.05).(5)The expression of myelin basic protein in hip-pocampus in offspring which received early maternal immune activation by Poly I : C was lower than that in the control groups(P<0.05).Conclusion The postnatal enriched environment increased the social interac-tion and the learning abilities of the offspring with early maternal immune activation by Poly I : C in water maze,and even more improved the perseveration behavior of the offspring induced by the early maternal im-mune activation.