Objective To evaluate the respiration-induced target volume motion in 3D-CRT for mid-thoracic esophageal carcinoma in order to guide the radiation oncologist to choose the expansion marginfor ITV.Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CTsimulator respectively in free breathing(FB),breath.hold after normal inspiration and expiration(IBH and EBH)with the same scanning range.Then the CT images of three series were transfefred to the treatmentplanning system.The target volume was outlined following the same standard.The motion of the centerpoint of GTV,the center point of each slice of GTV and the edge of the GTV in selected slice weremeasured respectively to obtain the comprehensive value of GTV motion。in order to find the appropriate IMvalue according to the 95％confidence interval of the GTV motion.Results①The GTV motion betweenIBH and EBH was(0.19±0.16)cm in the left.right direction,(0.54±0.19)cm in the cranial andcaudal irection.and(0.16±0.14)cm in anterior.posterior directions for the center of GTV,.For thecenter point of each slice of GTV.they ere(0.19±0.15)cm,(0.54±0.16)cm,(0.16±0.13)cm in three directions above.respectively.For the edge of the GTV in selected slice.they were(0.26±0.19)cm,(0.54±0.18)cm,(0.24±0.19)cm,respectively.The comprehensive value of GTV motion between IBH and EBH was(0.23±0.17)cm,(0.54±0.17)cm,(0.21±0.17)cm.respectively.The 95％confidence interval was 0.21-0.25 cm.0.53-0.56 cm and 0.19-0.22 cm in three directions.②The direction of GTV motion：No motion was noticed in 8.2％.while 73.3％to the right side and 18.5％to the left side in the left-right direction when IBH were compared with EBH.100％were moved to caudal in the the cranial and caudal direction[(0.54±0.17)cm].In the anterior-posterior direction,no motion was noticed in 8.2％,while 16.6％to the posterior and 75.2％to the anterior when IBH were compared with EBH.③The GTV motion was correlated with the vafiance of 1ung volumes in IBH-EBH(r=0.683,P=0.032)and not with GTV volume and length.Conclusions Respiration can induce target volume motion in 3 DCRT for mid-thoracic esophageal carcinoma.Compared to EBH.the GTV tends to move to the caudal,the anterior and the ight side in IBH.

Objective To discuss the relationships between qi-arrival and mind-control, qi-arrival and qi-regulation, and to define qi-arrival by tracing the relevant records in Nei Jing (Classic of Internal Medicine) and Nan Jing (Classic of Difficult Issues). Method Thirty-seven relevant ancient books of the two classics were reviewed and the notes by WANG Bing, MA Shi, and YANG Shang-shan were referred. Result Mind-control requires the spirits of the practitioner, patient and environment, as well as observing and waiting for the arrival of qi. Regarding qi-regulation, theories involve that qi-arrival achieves same reinforcing and reducing effect as qi-regulation, qi-regulation is elucidated from the correct location of acupoint, proper needling depth and direction, and to regulate qi by observing the arrival of qi. Besides, the changes of internal and external environments also influence qi-arrival via qi-regulation and mind-control. Conclusion Qi-arrival is closely related to mind-control and qi-regulation in obtaining, differentiation, and adjustment. Mind-control and qi-regulation assist each other through the whole acupuncture process, which is the core of qi-arrival.

Objective To observe the changes of cerebral ultrastructure,and cerebral oxidative damage and inflammation reaction in rats after orthotopic liver autotransplantation. Methods Twenty-four male SD rats were randomly divided into control group (Group C,n=8),6-h-reperfusion group (Group M1,n=8),and 24-h-reperfusion group (Group M2,n=8).Rats in the Group C received sham operation after anesthesia,involving laparotomy and vascular separation; rats in the Group M1 and M2 received orthotopic liver autotransplantation, and their brain tissues were obtained 6 and 24 h after reperfusion.The changes of cerebral morphology were observed by transmission electron microscope; the levels of interleukin-6 (IL-6),IL-10 and tumor necrosis factor-a (TNF-a) were measured; the levels of superoxide dismutase (SOD),malondialdehyde (MDA) and catalase (CAT) were observed. Results As compared with those in Group C,the cerebral ultrastructure of Group M1 and Group M2 showed obvious traumatic changes,including microvascular edema and deformation,neuron edema,nuclear deformation with indentation in the surface,increment of heterochromatin in the nuclear,blurring in the karyolemma and perinuclear space, disappearance of reticulate structure in the nucleolus,mitochondria edema and disappearance ofendoplasmic reticulum; and these changes in Group M2 were more obvious than those in Group M2.The changes of oxidative damage and inflammatory responses were obvious:as compared with that in Group C, the SOD level in M2 decreased significantly (P＜0.05), the CAT level in M1 decreased significantly (P＜0.05),and the levels of MDA,IL-6,IL-10 and TNF-a in Group M1 increased significantly (P＜0.05). Conclusion After orthotopic liver transplantation,the pathology changes of cerebral tissues in these SD rats were significant, with obvious oxidative damage and inflammatory reaction.

OBJECTIVETo evaluate speech outcomes in patients of maxillary reconstruction with free fibula composite flap.

METHODSSpeech measurements of 20 patients of maxillary reconstruction with free fibula composite flap were collected. Palatopharyngeal valve, the symmetry and movement of soft palate, hypernasality and nasal emission were examined by nasoendoscopy. At the same time the speech intelligibility was measured.

RESULTSNo palatopharyngeal valve insufficiency was found and all the soft palates had good symmetry and movement. The average speech intelligibility was 98.4%.

CONCLUSIONSFree fibula composite flap can reconstruct the phonatory structure and support the function of soft palate, which can restorate speech function well. It is a good choice for maxillary reconstruction.

Adult ; Female ; Fibula ; Humans ; Male ; Maxilla ; surgery ; Middle Aged ; Speech Intelligibility ; Surgical Flaps

Objective To discuss the efficacy of surgery combined with intra-operative I125 particles implantation in treatment of intracranial tumor.Methods The data of 25 cases diagnosed with intracranial tumors in general hospital of Shenyang Military Region from January 2015 to November 2016 were retrospectively analyzed.All patients received the combination of surgery and I125 particles intra-operative implantation.The therapeutic effect was observed and evaluated.Results All the patients were followed up for 6 to 18 months and there was no signs of recurrence or adverse reactions in the short term.Conclusion The combination of surgery and I125 particles intra-operative implantation could avoid the pain of postoperative radiotherapy and inhibit the short-term recurrence of multiple intracranial tumors.

Acupuncture-moxibustion theory believes that needling sensation is a crucial factor in influencing acupuncture efficacy. Judgment of occurrence of needling qi (qualitative measurement) and the intensity of needling qi (quantitative measurement) is the key section in studying the relationship between needling qi and efficacy. According to the relevant literatures, the judgment of the occurrence of needling qi mostly depended on the needling sensations, while a small amount of researches mentioned self-determined threshold or range of needling qi; the quantity of needling qi was measured by factor analysis, Massachusetts General Hospital Acupuncture Sensation Scale (MASS) based on exponential smoothing method, weighted average, addition of needling sensation score, etc. This article holds that the needling qi should be divided into two parts: overall needling qi and needling sensation components, the former referring to the occurrence and intensity of needling qi, and the latter for judging the different sensations and intensity. Currently, the studies on needling qi and efficacy should begin with single treatment at single point and multiple treatments at multiple points, to generally estimate the quality and quantity of needling qi, for seeking a qualitative and quantitative measurement in accordance with both acupuncture-moxibustion theory and clinical practice.

Child, Preschool ; Cochlear Implantation ; adverse effects ; Foreign-Body Reaction ; diagnosis ; etiology ; Humans ; Male ; Postoperative Complications ; diagnosis

ObjectiveTo investigate the effect of entecavir (ETV) alone or combined with interferon (IFN) on the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). MethodsA retrospective analysis was performed for 409 patients with CHB who were admitted to Beijing Ditan Hospital from January 2008 to December 2014, and according to their antiviral therapy, they were divided into ETV+IFN group with 169 patients (IFN treatment for ≥6 months) and ETV group with 240 patients (ETV treatment for ≥12 months). The patients were followed up to June 2019, and the development of HCC was the outcome event. The Mann-Whitney U test was used for comparison of continuous variables between two groups, and the chi-square test was used for comparison of categorical variables between two groups. The propensity score matching (PSM) method was used to eliminate baseline differences between groups, the Kaplan-Meier method and the log-rank test were used to compare the incidence rate of HCC between groups, and the Cox proportional-hazards regression model analysis was used to investigate the risk factors for the development of HCC. ResultsThe median follow-up time in this study was 5.4 years (IQR: 4.9-7.9). There was no significant difference in the cumulative incidence rate of HCC between the two groups before and after PSM (before PSM: 1.2% vs 2.8%, χ2=1.423, P=0.233; after PSM: 1.7% vs 4.1%, χ2=1.676, P=0.195), and the subgroup analysis also showed no significant difference in the cumulative incidence rate of HCC between the two groups in the non-high risk population (1.3% vs 1.5%, χ2=0.335, P=0.563). The Cox proportional-hazards regression model showed that age was an independent risk factor for HCC (hazard ratio=1.107, 95% confidence interval: 1.005-1.219, P=0.038). ConclusionFor CHB patients without a high risk of cancer, compared with ETV monotherapy, ETV combined with IFN for at least 6 months does not significantly reduce the risk of HCC.

OBJECTIVETo discuss the influence of factors related organic on deqi in acupuncture treatment and provide scientific evidence for further research on the influencing factors of deqi sensation.

METHODSChina National Knowledge Infrastructure (CNKI) database, VIP-Chinese scientific and technological journal database, Chinese biological medical (CBM) database and PubMed database were retrieved. There were 30 articles about the organic influencing factors of deqi and they were analyzed.

RESULTSThe organic related factors which includes individual constitution, syndrome classification, physical condition, specificity of acupoint function, tolerance and psychological factors play an important part in deqi in acupancture treatment, which should be brought to the forefront for acupuncture practitioners and researchers.

CONCLUSIONThe organic factors are influencing the deqi sensation in many ways but most of the present studies are resting on the affirmation of the phenomenon. Further studies about organic related influencing factors on deqi should be carried out and scientific, objective indices of deqi sensation should be explored which may improve the clinical and research level of acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Qi ; Sensation

The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function.Maxillary defects,resulting from tumor resection,can cause severe functional and cosmetic deformities.Furthermore,maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons.Nowadays,vascularized composite bone flap transfer has been widely used for functional maxillary reconstruction.In the last decade,we have performed a comprehensive research on functional maxillary reconstruction with free fibula flap and reported excellent functional and acceptable esthetic results.However,this experience based clinical procedure still remainssome problems in accuracy and efficiency.In recent years,computer assisted techniques are now widely used in oral and maxillofacial surgery.We have performed a series of study on maxillary reconstruction with computer assisted techniques.The computer assisted techniques used for maxillary reconstruction mainly include:(1) Three dimensional (3 D) reconstruction and tumor mapping:providing a 3 D view of maxillary tumor and adjacent structures and helping to make the diagnosis of maxillary tumor accurate and objective;(2) Virtual planning:simulating tumor resection and maxillectomy as well as fibula reconstruction on the computer,so that to make an ideal surgical plan;(3) 3D printing:producing a 3D stereo model for prebending individualized titanium mesh and also providing template or cutting guide for the surgery;(4) Surgical navigation:the bridge between virtual plan and real surgery,confirming the virtual plan during the surgery and guarantee the accuracy;(5) Computer assisted analyzing and evaluating:making a quantitative and objective of the final result and evaluating the outcome.We also performed a series of studies to evaluate the application of computer assisted techniques used for maxillary reconstruction,including:(1)3D tumor mapping technique for accurate diagnosis and treatment of maxillary tumor;(2) Maxillary reconstruction with free fibula flap used computer assisted techniques;(3) Computer assisted orbital floor reconstruction after maxillectomy.The results suggested that computer assisted techniques could significantly improve the clinical outcome of maxillary reconstruction.