Objective To evaluate the intensity-modulated radiation therapy(IMRT)for the whole pelvis in the treatment for cervix cancer with the method of ionization chamber verification and fluence map verification.Methods IMRT plan was designed with Pinnacle 7.0 inversed treatment planning system,and the planning parameter was copied to the solid water phantom.The dose of the reference points in the phantom was calibrated with ionization chamber,and compared with those in IMRT plan.Then the gantry angle was set as 0 degree.The solid water phantom was irradiated with film,and the actual fluence maps were obtained 2cm below the phantom surface,and then the delivered films were compared with those fluence maps in plan.Results The error percentage at 4 points was less than 3% in absolute dose calibration,at 2 points was less than 5%,at another 2 points was less than 5%,at 1 point was over 10%,and at another 1 point was over 15%.It was found that the last two calibrated points were set in a region with a high dose gradient,resulting in high error.In fact they were impertinent.So another two points were chosen in uniformity area of dose distribution.The percentage of error were both less than 3%.The fluence maps between films and plan were consistent.Conclusion It is feasible to evaluate IMRT plan for whole pelvis in the treatment of cervix cancer with the method of ionization chamber verification and fluence map verification.The results can meet the clinical requirement.

Objective To measure the phase values of the deep gray nuclei by using susceptibility weighted imaging(SWI) in underage brains,and to investigate the correlation between the phase value and age.Methods A total of 105 healthy juveniles were examined in this study by using MRI conventional sequence and SWI.Their ages ranged from 0 to 18 years(0-＜ 1 year,60 cases; 1-＜3 years,10 cases; 3-7 years,10 cases; 7-12 years,10 cases; 12-18 years,15 cases).Phase values of deep gray nuclei were measured.The correlation between phase value and age was analyzed by Spearman correlation method.Results During 0-3 years,the phase value of caudate nucleus was the lowest within the same age group (0-＜ 1 year:left-0.0433 ± 0.0291,right-0.0369 ± 0.0215 ; 1-＜ 3 years:left-0.0369 ± 0.0215,right-0.0384 ± 0.0259),whereas the phase value of red nucleus was the highest (0-＜ 1 year:left 0.0286-0.0380,right 0.0254 ±0.0361 ; 1-＜3 years:left 0.0325 ±0.0237,right 0.0395 ±0.0270).After 3 years old,the phase value of globus pallidus was the lowest within the same age group (3-＜7 years:left-0.0967 ± 0.0656,right-0.0953 ± 0.0617; 7-＜ 12 years:left-0.1870 ± 0.0531,right-0.1724 ±0.0547; 12-＜ 18 years:left-0.2037 ±0.0492,right-0.1849-±0.0324),whereas the phase value of thalamus was the highest (3-＜ 7 years:left-0.0019 ± 0.0225,right -0.0007 ± 0.0167 ; 7-＜ 12 years:left-0.0067 ± 0.0104,right-0.0064 ± 0.0118 ; 12-＜ 18 years:left-0.0204 ± 0.0181,right-0.0172 ± 0.0133).During 0-18 years,a moderate negative correlation between phase values of bilateral caudate nucleus,globus pallidus,red nucleus,substantia nigra and age were observed (rs =-0.483,-0.497,-0.67,-0.621,-0.489,-0.43,-0.552,-0.58 respectively) A low negative correlation between phase values of bilateral putamen,thalamus and age were observed (rs =-0.272,-0.213,-0.382,-0.366 respectively).Conclusions There is a negative correlation between phase value and age in the deep gray nuclei of underage brains.And the phase value may be a useful index in the diagnosis of iron deposition related diseases.

Objective To describe the anatomical variants of infants’internal cerebral veins and their tributaries with MR suscep-tibility weighted imaging,and to evaluate the capability in the visualization of cerebral deep veins.Methods 80 healthy infants were enrolled in this study.All the brain images were obtained by a 3D gradient-echo sequence (Enhanced T2 ? weighted angiography-ES-WAN)on a 3.0T MR,which were reconstructed with minimal intensity projection.The septal vein,thalamostriate vein,internal cerebral vein and anterior caudate nucleus veins were evaluated.4 types (ⅠA,ⅠB,ⅡA,ⅡB)were classified based on their rela-tionship with the septal vein-internal cerebral vein junction and interventricular foramen,and 3 types (Ⅰ,Ⅱ,Ⅲ)based on the drainage patterns of the anterior caudate nucleus veins.Results The septal vein,thalamostriate vein and internal cerebral vein could be clearly and continuously visualized in 100% infants,and the visualization rate of the anterior caudate nucleus veins was 88.1%. TypeⅠA and TypeⅠ were most common in the two classification patterns.Conclusion Infants’internal cerebral veins and their tributaries are able to be clearly shown with the minimal intensity projection in susceptibility weighted imaging,which is a good method to evaluate the cerebral deep veins in infants.

OBJECTIVERadial corrective osteotomy is an established but challenging treatment for distal radial malunion. There is an ongoing discussion about whether an opening or closing-wedge osteotomy between should employed. The purpose of the present study was to retrospectively compare the clinical and radio graphic results between conventional opening-wedge osteotomy and closing-wedge technique.

METHODSFrom January 2004 and December 2012,42 patients with extra-articular distal radial malunion were managed with corrective osteotomy and were followed for a minimum of one year. Twenty-two patients (5 males and 17 females, ranging in age from 25 to 75 years old) were managed with radial opening-wedge osteotomy and implanting of interpositional bone graft or bone-graft substitute, and twenty patients (4 males and 16 females, ranging in age from 19 to 79 years) were managed with simultaneous radial closing-wedge and ulnar shortening osteotomy without bone graft. The selection of the surgical procedure was determined by the surgeon. Each patient was evaluated on the basis of objective radio graphic measurements, and functional outcomes were determined on the basis of clinical examinations, including range of wrist motion, grip strength, pain-rating score, Mayo wrist score, and Disabilities of the Arm, Shoulder and Hand (DASH) score.

RESULTSThe mean duration of follow-up was 36 months (ranged, 12 to 101 months) for the opening-wedge cohort and 28 months (ranged, 12 to 87 months) for the closing-wedge cohort. The two techniques were comparable in terms of complications. Post-operative volar tilt and ulnar variance were improved significantly in each cohort. The ulnar variance was more frequently restored to within defined criteria (22.5 to 0.5 mm) in the closing-wedge cohort than that in the opening-wedge cohort. The post-operative mean extension-flexion are of the wrist and Mayo wrist score were significantly better in the closing-wedge cohort. Differences in the pronation-supination arc, grip strength, pain-rating score, and DASH scores between these two cohorts were not significant.

CONCLUSIONThe closing wedge osteotomy technique is an effective reconstructive procedure for the treatment of extra-articular distal radial malunion. It is significantly better than the opening-wedge osteotomy technique in terms of the restoration of ulnar variance, the extension-flexion arc of wrist motion, and the Mayo wrist score.

Adult ; Aged ; Bone Nails ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Osteotomy ; Radius Fractures ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Wrist Joint ; surgery ; Young Adult

OBJECTIVETo evaluate the therapeutic effect on pain in the dressing change after perianal abscess surgery treated with warm suspending moxibustion at Changqiang (GV 1).

METHODSOne hundred and sixty patients were randomized into a moxibustion group and a far-infrared therapy group, 80 cases in each one. In the moxibustion group, the warm suspending moxibustion at Changqiang (GV 1) was applied. In the far-infrared therapy group, the infrared ray was radiated at Changqiang (GV 1). The treatment started in 10 min after dressing change in the two groups. Totally, 8 treatments were required. The time requirement being equal to or less than 2 score in the assessment face scale (AFS), the case number of pain relief in 10 min after treatment and the intention of the two therapies after everyday dressing change were observed in the patients of the two groups.

RESULTSIn the moxibustion group, the time of pain relief was shorter than that of the far-infrared therapy group [(11.5 +/- 3.9) min vs (17.8 +/- 3.8) min on the 1st day; (9.4 +/- 3.6) min vs (15.2 +/- 4.3) min on the 2nd day; (7.8 +/- 2.7) min vs (14.3 +/- 3.2) min on the 3rd day; (6.4 +/- 3.3) min vs (10.5 +/- 2.9) min on the 4th day; (5.9 +/- 2.9) min vs (11.2 +/- 1.9) min on the 5th day; (5.3 +/- 2.2) min vs (8.8 +/- 2.3) min on the 6th day; (5.4 +/- 1.8) min vs (9.2 +/- 2.1) min on the 7th day; (5.1 +/- 1.4) min vs (9.5 +/- 2.6) min on the 8th day, all P < 0.05]. The case numbers of pain relief in 10 min after treatment were 74 cases, 75 cases, 77 cases and 78 cases from the 1st to the 4th day separately in the moxibustion group, which were much more than 63 cases, 65 cases, 68 cases and 69 cases in the far-infrared therapy group (all P < 0.05). The treatment intention scores in the moxibustion group were better than those in the far-infrared therapy group (all P < 0.05).

CONCLUSIONThe warm suspending moxibustion at Changqiang (GV 1) relieves pain rapidly in the dressing change of much more patients after perianal abscess surgery in much shorter time as compared with the far-infrared therapy. Moreover, the patients have more expectation to be treated with moxibustion therapy.

Abscess ; surgery ; Adolescent ; Adult ; Aged ; Anus Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Pain, Postoperative ; therapy ; Young Adult

Objective To investigate the association between (beta-parvin) PARVB gene rs5764455 polymorphism and susceptibility to non-alcoholic fatty liver disease (NAFLD). Methods A total of 230 patients with NAFLD (NAFLD, n = 230) and 230 control subjects (control, n = 330) were genotyped by PCR and direct sequencing. Clinical information was detected and compared in different groups. Genotypic frequency and gene frequency distribution in the two groups and relative risks to NAFLD susceptibility were assessed statistically , respectively. Results No statistical differences were observed between PARVB gene rs5764455 genotypic frequency with gene frequency distribution and the two groups, respectively (Genotypic frequency χ2 = 0.182, P = 0.913; gene frequency χ2 = 0.180, P = 0.672). Comparing C/T + T/T genotype carrier with C/C genotype carrier, there were no differences concerning the relative risks to NAFLD susceptibility (OR = 1.266, P =0.178;adjusted OR =1.631, P =0.096) before and after adjusting body mass, BMI and so on. In the latter group, there are significant differences in the increases of body mass, BMI, TG, ALT and AST (P < 0.05). Conclusion Non-relationship was observed between PARVB gene rs5764455 polymorphism and the risk of NAFLD in Qingdao Han Chinese.

Objective To investigate the clinical features of malignant conversion of oral submucous fibrosis (OSF) and the application value of polyflaps perforator flaps in its surgical treatment.Methodis Ten patients who suffered from malignant conversion of OSF underwent simultaneous multiple defects reconstruction using polyflaps perforator flaps after radical tumor resection from August 2012 to October 2014.The fibrous bands leading to severe trismus near the pterygomandibular ligament as well as other intraoral lesions with malignant tendency were also resected besides from the known carcinoma.Patients with synchronous multiple primary cancers underwent radical resection and neck dissection of all other malignant lesions.The flaps were cut and tailored between adjacent perforators according to the amount and size of defects,forming several independent paddles for each defect reconstruction.Results Twenty-two defects were formed in 10 patients with malignant conversion of OSF.All of them were repaired with polyflaps anterolateral thigh (ALT) perforator flaps,including 8 cases of bipaddled ALT flaps and 2 cases of tripaddled ALT flaps.The total size of the flaps ranges from 3 cm ～ 8 cm × 6 cm ～ 24 cm,and the pedicle length ranges from 5 ～ 12 (9.7 ± 2.1)cm.Thirty-five perforator vessels were dissected,and each paddle included 1.6 perforators on average.All flaps survived after transplantation,and only 1 patient had infection of the neck incision.Post-operative adjuvant radio-chemotherapy was applied in 2 patients.All patients showed satisfactory accepting-site morphology with good speech function and swallowing recovery,and their trismus was improved during 6 to 30 (11.6 ± 3.7) months.One patient died from lung metastasis 10 months after the surgery while local recurrent or metastasis did not occur in others.The donor sites were closed primarily without skin-grafting,leaving no obvious surgical donor-site complications.Conclusions Polyflaps perforator flaps can reconstruct multiple and sizable complicate defects,increase month opening by one stage operation.They are worth being applied in surgical treatment of malignant conversion of OSF.

· AIM: To study the in situ relative intraocular position of the iris-claw phakic intraocular lens (PIOL)for high myopia using an anterior chamber optical coherence tomography (AC OCT)prototype.· METHODS: Six PIOLs (11.50 to 22.00D lens powers) were implanted in phakic myopic eyes. Using AC OCT, tomography was taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens.· RESULTS: Preoperative anterior chamber depth ranged from 3.27 to 3.91 mm and the postoperative endothelial-optic distance measured 2,07 to 2,24 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.82 to 1.32 mm. Several tomography revealed the position of the PIOL on the iris, The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL.· CONCLUSION, The original anterior chamber depths were reduced by 36,1% to 44.6% after implantation. This study of 6 eyes revealed that tomography taken by AC OCT are useful in verifying the intraocular position of the PIOL within the anterior chamber. Adequate space was maintained between the iris-fixated phakic intraocular lens and the corneal endothelium, angle, and crystalline lens.

Pancreatic cancer is malignant with a poor prognosis,and its incidence is rising worldwide in recent years.Multiple slices spiral computed tomography and computed angiography are the first choice for the diagnosis of pancreatic cancer,while misdiagnosis of pancreatic cancer still exists.From August 2009 to October 2011,80 patients with pancreatic or periampullary cancer were diagnosed using the medical image three dimensional visualization system (MI-3DVS).The threedimensional models of the liver,pancreas,vascular system and tumors were reconstructed successfully based on the 64-slice spiral computed tomography data.According to the analysis of the three dimensional models,4 patients underwent standard pancreaticoduodenectomy,1 received palliative surgery.MI3DVS plays an important role in the diagnosis and assessement of resectability of pancreatic and periampullary cancer.

Objective To investigate the values of three-dimensional visualization technology in the diagnosis and surgical treatment of hepatic hemangioma. Methods Thirty two patients with hepatic hemangioma who had been hospitalized during the period from July 2010 to January 2014 in our hospital were scanned by 64-slice spiral computerized tomography (CT) before surgical treatment. Three-dimensional (3D) reconstruction based on the CT data was carried out to achieve dignosis and surgical planning. Assisted with the 3D model , we chose the best surgical procedure for liver resection, protecting the major blood vessels near hemangioma and retaining normal liver tissue as far as possible. Results The location, size and shape of hepatic hemangioma, vascular variation, and spatial relationship with intrahepatic vessel were shown factually by three-dimensional reconstruction. All the hemangiomas were preoperatively assessed to be resectable. The compliance rate for preoperative surgical planning to actual surgery was 100%. Under assistance of the 3D model during surgery , 14 patients received laparoscopic hepatectomy and 18 underwent hepatectomy. Pringle′s maneuver was applied in 18 patients , with blocking time of (15.32 ± 7.12) min and blood loss of (188.63 ± 66.37) mL. The postoperative complications included pleural effusion in 5 patients and incision infection in one patients. Conclusions Three-dimensional visualization technology for the individualized diagnosis and treatment of hepatic hemangioma helps reduce surgical trauma and incidence of postoperative complications.