Objective The study combined multiple local flaps to repair small or medium-sized area of facial skin and soft tissue defects,and to explore the advantages of the local flap collaboration repair.Methods Following the partition repair principle and depending on the wound size and location of these defects,the appropriate local flap was selected to cover the wound.Therefore,the incision was hidden and conformed to the face natural contour or skin wrinkles.Results 77 patients were treated in this group,74 cases got phase] healing and the other 3 got phase Ⅱ healing; all were followed-up for 1 to 8 months.The repair flap and surrounding skin had good similarity in terms of color,texture and contour,the incisions were hidden and the scars were not obvious; no tumor had recurred.The face contour and visual effects were good,and the aesthetic results were satisfactory.Conclusions The combined application of several different local skin flap to repair facial trauma defects,can not only reduce the overall difficulty and risk,reduce surgical complications,but also improve the repair quality,to maximize the recovery of facial aesthetic appearance.

Objective To investigate whether the bone harvested from Cloward discectomy with trephine could substitute for iliac-crest bone grafts in arthrodesis procedure. Methods We reviewed the 30 patients with cervical spondylotic myelopathy involving a single level, which had been managed with anterior trephination discectomy and arthrodesis by the bone chips harvested from within the trephine. The bone chips harvested with trephine were then trimed and implanted erectedly similar to Robinson arthrodesis procedure. All cases had been followed-up for an average of 4.75 years. The latest results were analyzed according to JOA score system and recovery rate. The fusion outcome were assessed by anteroposterior and flexion and extension lateral radiographs of the cervical spine. Results At the latest followed-up examination, clinical results were excellent in fifteen patients(50％ ), good in eleven(36.7％ ), fair in three(10％ ) and poor in one (3.3％ ). X-ray showed solid fusion in all, and no dislodgment of the grafts. However, the cervical curves had a little loss. There was no significant bone grafts subsidence. Conclusion In cervical anterior decompression the bone chips obtained in trephination could substitute for other type of bone grafts for arthrodesis. The postoperative outcomes were not affected by the loss of the cervical curves.

Objective To investigate the feasibility of the virtual source model in Monte Carlo dose calculation for clinical radiotherapy.Methods The Monte Carlo simulation was used to obtain the phase space files which recorded the physical properties of the particles emitted by a medical linear accelerator, and the information on the type, energy spectrum, and distribution of particles were extracted from these files and analyzed to establish the semi-empirical model of virtual two-photon source.The GMC dose calculation engine was used to obtain the 3 cm×3 cm, 5 cm×5 cm, 10 cm×10 cm, 20 cm×20 cm, and 30 cm×30 cm fields of radiotherapy and the results of Monte Carlo simulation of dose distribution in three-dimensional water phantom in 2 intensity-modulated radiotherapy ( IMRT) plans.These results were compared with the results of water phantom measurement or the results of Elekta Monaco planning system to verify the accuracy of Monte Carlo dose calculation based on a virtual source.Results As for the percentage depth-dose distribution curves of the central axis of the water phantom and the off-axis dose curves at different depths in the five fields for radiotherapy, the difference between the results of Monte Carlo simulation and the results of measurement was within 1%.As for the two IMRT plans, the three-dimensional passing rates of Monaco calculation results and Monte Carlo simulation results were 98.9%and 99.4%, respectively, for 3%/3 mm, and 95.1%and 95.4%, respectively, for 2%/2 mm.Conclusions Monte Carlo simulation based on the virtual source model can obtain accurate results of radiotherapy dose calculation.

Objective To study the impacts of different applicators on dose distribution in 192 Ir brachytherapy. Methods The inner tubes of two cylinder applicators from Nucletron,#101?001 and#084?350, were made of plastic and stainless steel, respectively. The cylinder parts of them were made of plastic, and had four different radiuses:1?00 cm, 1?25 cm, 1?50 cm, and 1?75 cm. EGSnrc program was used to simulate dose distribution when applicators were present in a phantom, and the results calculated by the treatment planning system were compared with the results of EGSnrc. The impacts of applicators on dose distribution were analyzed with different materials, thickness, and numbers of resident source. Results There was no significant relationship between dose deviation and the radius for the two applicators. When an applicator was present, the actual dose delivered to a patient was smaller than the planned dose. The dose deviation of the applicator#101?001 was no more than 1%, while the dose deviation of the applicator#084?350 was close to 3%. The dose deviation remained the same when the number of resident source changed. Conclusions The plastic applicator, if possible, is the best choice for brachytherapy right now. In a long term, in order to promote the accuracy of brachytherapy, current dosimetry algorithm should be improved, and the impacts of the applicator made of metal, such as stainless steel, on dose distribution should be taken into account.

Diagnosis, Differential ; Humans ; Immunohistochemistry ; Keratins ; analysis ; Male ; Prostatic Hyperplasia ; diagnosis ; Prostatic Intraepithelial Neoplasia ; diagnosis ; Prostatic Neoplasms ; diagnosis ; Racemases and Epimerases ; analysis ; Staining and Labeling ; methods

Objective To evaluate the role of equivalent uniform dose (EUD) in planning optimization of intensity-modulated radiotherapy (IMRT) for prostate cancer.Methods Ten patients with prostate cancer were randomly selected who treated with IMRT.For these patients,the treatment plans were designed with dose-volume objectives.Based on these plans,new plans were designed through replacing the dose-volume objectives with maximum EUD for rectum,bladder and small bowel,while keeping the dosevolume objectives unchanged.Comparison was made between the new plans and the former cones by paired t-test.Results The conformity index of planning target volume was better with EUD optimization compared to dose-volume (1.00 ± 0.04 ∶ 0.94 ± 0.04,t =3.80,P =0.04).The D53,D30 and Dicm3 for rectum was better with EUD optimization compared to dose-volume (24.4 ± 2.7 ∶ 25.5 ± 2.6,t =-3.82,P =0.004,34.1 ±4.3∶39.1±2.1,t=-3.80,P=0.004 and51.4±1.0∶51.8±0.9,t=-2.42,P=0.039),with V10,V20 for bladder and V10,V20,V30,V40 for small bowel also better with EUD optimization (92.2 ±6.2∶99.4±1.1,t=-4.28,P=0.002;70.7±5.7∶78.7±6.3,t=-3.10,P=0.013 and 62.2±30.2∶74.7 ±30.0,t =-4.18,P =0.002;34.3 ±26.3∶46.5 ±30.9,t =-5.46,P =0.000;17.1 ±17.0∶25.1 ±22.6,t=-3.52,P=0.007;10.6± 11.5∶ 15.6± 16.1,t=-2.64,P=0.030).Conclusions The conformity index of planning target volume is better with EUD optimization compared to dose-volume.And the dose to rectum,bladder and small bowel can be reduced through optimization with EUD optimization compared to dose-volume.

Objective To explore the application value of multi-ISO center planning method in intensity-modulated radiotherapy for carniospinal irradiation.Methods Ten patients treated with craniospinal irradiation with helical tomotherapy were selected.For these patients, new plans were designed with multi-ISO centers planning method on the treatment planning system (TPS) named Eclipse 11.0.Dose distribution to the tumor, OARs and normal tissue, the treatment time and the monitor units (MUs) of the two plans were compared.Results The plans designed in two groups satisfied all clinical requirements.For the tumor target (PTV) , the difference of D95％ between two groups was not statistical significant, while D9s ％ , D2 ％ and HI in HT group were superior to M-ISO group (t =2.822,2.333,4.743, P ＜0.05) , D50％ , D and CI in M-ISO group were superior to HT group (t =5.259,3.685,8.835 ,P ＜ 0.05).The dose of OARs such as cochlea, parotid, submandibular gland, thyroid gland and kidney in HT group was lower than M-ISO group (t =4.365,5.416,2.674,3.077,2.782,2.607,4.659,P ＜0.05) , and the dose of pancreas and small bowel was higher than M-ISO group (t =5.265,5.935, P ＜ 0.05).Differences were not significant for V5 of normal tissue between two groups;while V10, V20 and V36 of normal tissue in M-ISO group were lower than HT group (t =3.57,3.701,2.602, P ＜ 0.05).M-ISO group reduced 41.0％ of the treatment time by average and reduced 94.1％ MUs by average.Conclusions Intensity-modulated radiotherapy for carniospinal irradiation with multi-ISO centers planning method not only met the requirements of clinical dosimetry, but also shorten the treatment time, reduced the damage to the machine.Multi-ISO centers planning method might be promoted as a new design scheme.

Objective To observe the effect of cigarette smoking on cutaneous wound healing in rats.Methods Healthy adult SD rats,weight 200-250 g,were randomly divided into 4 groups:control group (group C),low tar content group (group L),middle tar content group (group M) and high tar content group (group H),ten rats each group.4 full thickness dermal excision wound models with the diameter of 2.0 cm were established on the back of 40 healthy male or female SD rats.The wound spacing was greater than 2 cm.Group C did not do any intervention treatment,Groups L,M and H rats were put,respectively,into homemade smoke box in 0.1,0.5,and 0.8 mg different-grade tar content of cigarettes and smoked,and the time of wound healing was observed.The wound granulation tissue was taken in 3 and 7 days after surgery.The expression of CD68+ macrophages was detected by immunohistochemical method.The wound healing rate was observed on the days 7 and 16.Results Compared with group C,wound healing time in groups L,M and H was extended (P＜ 0.05).Immunohistochemical results showed that macrophage numbers in groups L,M and H wound were significantly less than that of group C.The wound healing rates 7 days and 16 days after surgery in the three group smoked were significantly lower than that of group C.Conclusions Cigarette smoking leads to wound healing delay,and wound healing rate is reduced at fixed time point,with the decrease in the number of macrophages.

Objective To observe the clinical efficacy of comprehensive acupuncture therapy in treating tinnitus in elderly neurosensory deafness. Method Eighty elderly neurosensory deafness patients were randomized into a treatment group and a control group, 40 cases in each group. The control group was intervened by oral administration of Mecobalamin tablets, and the treatment group was intervened by acupuncture plus acupoint injection plus auricular point sticking. The changes of tinnitus intensity after the treatment in the two groups were observed, the clinical efficacies were compared between the two groups, and the correlation between disease duration and therapeutic efficacy was also observed. Result The tinnitus degree was significantly changed after the treatment in both groups (P<0.01). The total effective rate was 83.3% in the treatment group, versus 57.1% in the control group. There was a significant difference in comparing the clinical efficacy between the two groups (P<0.05). In both groups, the clinical efficacy of the patients with a disease duration ≤3 years was significantly different from that of the patients with a disease duration > 3 years in the same groups (P <0.05). Conclusion Comprehensive acupuncture therapy is an effective method in improving tinnitus in elderly neurosensory deafness.

BACKGROUND:Related studies have showed that poly D,L-lactide-co-glycolide can effectively package antisense oligonucleotides, smal interfering RNA, microRNA. Poly D,L-lactide-co-glycolide can better protect them against the destruction of the enzymes in vivo and have slow the drug release. Therefore, the number of drug administration can be reduced to achieve a long-term and effective therapeutic effect. ＜br> OBJECTIVE:To prepare poly D,L-lactide-co-glycolide-CXCR4-miRNA-nano-particles and to research the characteristics of the prepared nanoparticles. ＜br> METHODS:Poly D,L-lactide-co-glycolide-CXCR4-miRNA nanoparticles were prepared by double emulsion-evaporation process. Ultraviolet spectrophotometry was utilized for measurement of encapsulation efficiency and drug-loading rate, observing the shape of nanoparticles by transmission electron microscope, and measuring the size and distribution of nanoparticles by laser particle size analyzer. Sustained-release characteristics of nanoparticle suspension were observed in phosphate buffer. ＜br> RESULTS AND CONCLUSION:The prepared nanoparticles were spherical-shaped, smooth, evently distributed and inadhesive. The particle size was mainly distributed within 143-502 nm, with an average diameter of 280 nm. The average drug loading was (0.515±0.023)%, the average encapsulation ratio was 50.2%and difference between batches was smal . The nanoparticles could slowly release in vitro and the process initial y experienced the fast-release stage, and then reached a basical y stable platform stage at day 14. These finding indicate that the process to prepare poly D,L-lactide-co-glycolide CXCR4-miRNA-nanoparticles by double emulsion-evaporation is simple. The prepared nanoparticles are wel targeted and exhibit sustained-release effects.