Objective:To evaluate the clinical effects of invisible bracketless appliance on the upper molar distalization.Methods:15 patients with class Ⅱ malocclusion(at the average age of 25.3 years) were treated by invisible bracketless appliance,the pre and post three-dimensional digital models were superimposed and measured,the effects of molar distalization were analysed.Results:After treatment,the maxillary first molars were distalized by 2.58 mm on both sides.The left and fight second molars were distalized by 2.57 mm and 2.68 mm respectively.Bilateral central incisors were moved mesially by 0.34 mm.There was no significant difference in the horizontal movement of central incisor.But the left and fight first molars were moved buccally by 0.96 mm and 0.97 mm respectively,the left and fight second molars were moved buccally by 1.01 mm and 1.11 mm separately.Bilateral first molars were intruded by 0.26 mm,the left and right second molars were intruded by 0.37 mm and 0.36 mm,respectively.But the central incisors had no significant vertical movement.There was no significant difference in the buccally or palatally rotation of bilateral first and second molars.Conclusion:Invisible bracketless appliance is efficient for distalization of upper molar,but it may result in mild molar intrusion and anterior anchorage loss.

Objective To explore the clinical efficacy of CT-Guided radioactive 125I seed implantation in treating retroperitoneal lymph node metastases. Methods Eighteen patients with retroperitoneal lymph node metastases (20 lesions in total) received CT-guided radioactive 125I seed implantation. Treatment planning system (TPS) was used to formulate the therapeutic protocol. The radioactive activity of 125I particle ranged from 1.11 × 107-2.96 × 107 Bq (0.3-0.8 mCi) and the matched peripheral dose (MPD) was 60 -100 Gy. Postoperative dosimetry was routinely performed for all the patients in one week. Postoperative D90 (90%dose received by target volume) was 53 -107 Gy. The patient’s clinical benefit response (CBR), two-month local tumor control rate and one-year survival rate were evaluated, and the complications were recorded. Results All the patients were followed up for 2 -15 months with a median time of 5 months. The one-year survival rate was 22.2%. The clinical benefit rate, overall effective rate and two-month local tumor control rate were 72.2%, 70.0% and 90.0% respectively. No serious complications occurred in all patients. Conclusion For the treatment of retroperitoneal lymph node metastases, CT-guided radioactive 125I seed implantation is mini-invasive with satisfactory short-term effect and fewer complications. Therefore, this technique is a relatively safe therapeutic means.

Objective To assess the protective effect of rabbit serum paraoxonase-1 (PON-1) on renal injury induced by dichlorvos in rats.Methods Totally 30 healthy S-D rats were randomly divided into 5 groups:control group (group A,n =6),exposure group (group B,n =6),PON-1 pretreatment group (group C,n =6),traditional atropine,pralidoxime treatment group (group D,n =6) and combination therapy group (group E,n =6).The rats of group A were given normal saline in equal volume of dichlorvos injected into abdominal cavity to make a false model of dichlorvos poisoning.In rats of groups B,C,D and E,9 mg/kg dichlorvos was administered.In rats of groups C and E,PON-1 4 500 units/kg was injected into vein of the tails half an hour before dichlorvos administration.After dichlorvos exposure,rats in group D and E were treated with 45 mg/kg iodoprofen and 10 mg/kg atropine by intraperitoneal injection.The activity of blood urea nitrogen (BUN) was assayed with urease.Serum creatinine (Cr) were measured by picric acid colorimetry.Serum Cys-C,KIM-1 and NAG in urine were determined by ELISA.Ultrastructural changes in renal tissues of rats were examined by light microscopy.The differences in laboratory findings between groups were compared.Results The creatinine level in group B was significantly higher than that in other groups (P ＜0.05).The levels of Cys-C,KIM-1 and NAG in group B and group D were significantly higher than those in group A (P ＜ 0.01).But there were no significant differences in above biomarkers among group C,group E and group A.There were no significant differences in above biomarkers between group B and group D.In group B,inflammatory cells infiltrated extensively in renal tissues and,the renal cells were congested and edematous,the lumen was obliterated and the border of the brush disappeared.The tubular structures were not clearly distinct found in group B,but edema and inflammatory cell infiltration with lesser degree were found in group D than those in dichlorvos exposure groups.The clearly distinct structure of the tube without completely occluded lumen in group D,and the most serious lesions were found in distal convoluted tubules.In group C,and group E,there were only mild congestion and edema without significant cell degeneration and necrosis.In group A,the structure of renal tubular epithelium was clearly distinct with brush-shaped margin,and without tubular or necrotic cell debris in the lumen.Conclusion The rabbit serum PON-1 can protect the renal tissue of rats after dichlorvos exposure.

Objective To explore whether the use of purified rabbit serum paraoxonase 1 (PON1) for the treatment of dichlorvos-induced liver injury in rats is superior to traditional method.Methods Thirty male SD rats were randomly divided into the followint 5 groups,with 6 rats in each group:control group (A group),dichlorvos group (B group),traditional treatment group (C group),PON 1 treatment group (D group),combined treatment group (E group).Rats in groups B,C,D and E were adminstered dichlorvos by intraperitoneal injection 9 mg/kg.In group C,atropine 10 mg/kg and iodine solution 45 mg/kg were injected intraperitoneally within 2 min after dichlorvos administration.In group D,PON1 was injected intravenously at a dose of 9 600 U/kg,30 min prior to poisoning.In group E,PON1 was injected intravenously at a dose of 9 600 U/kg,30 min prior to poisoning,followed by in travenous injection of atropine 10 mg/kg and iodine solution 45 rng/kg within 2 min after poisoning.Rats in A group received normal saline.Blood was collected at different time points to examine the acetyl cholinesterase (AChE)-levels by ELISA method.Liver tissue were collected at 12 hours after model establishment to observe the pathological changes.The expression of 4 hydroxy 2-nonenal (4-HNE) in the liver tissue was detected by immunohistochemistry and Western blotting.Results In group B,AChE levels decreased significantly,liver cells showed severn fatty degeneration,karyopyknosis and other pathological changes,and 4-HNE expression increased.The pathological changes of group D and group E were less obvious than those of group C,and the 4-HNE expression in the group D and group E were significantly different from that in the group C (P＜ 0.05).Conclusion PON1 plays a protective role in dichlorvos-induced liver injury in rats,and this protection is better than that offered by traditional treatment.

Colorectal cancer is one of the leading causes of morbidity and mortality around the world. Although the staging and classification systems, such as tumor/node/metastasis (TNM) staging, are widely used in clinic, there are some limitations. For example, the patients with the same pathological type, TNM stage and treatment regimen show a completely different prognosis and outcome. In the present, molecular subtyping was concerned for a more precise and accurate staging of colorectal cancer. Herein, we reviewed the literature of the molecular subtypes of colorectal cancer in the past decades. The clinical significance of various molecular subtyping systems was evaluated and compared. It will provide reference for the precision medicine of colorectal cancer in the future.

Objective: To investigate the safety and feasibility of the modified transoral endoscopic thyroidectomy vestibular approach (TOETVA) by dissection of mental nerve in clinical practice. Methods: Totally 140 patients underwent the modified TOETVA from the Department of Head and Neck Surgery, Hunan Cancer Hospital from July 2016 to June 2018 were analyzed retrospectively. There were 130 females and 10 males, aging (35.4±9.8) years (range: 11 to 56 years). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative suction drainage, postoperative pain score, postoperative cosmetic satisfaction and postoperative complications (recurrent laryngeal nerve palsy, hypoparathyroidism, infection, pneumoderm, seroma and mental nerve injury) were summarized. Results: Of the 140 patients, 1 patient was transferred to open surgery. Fifty-nine patients underwent thyroidectomy with an operation time of (100.8±18.9) minutes. Sixty-three patients underwent thyroidectomy and central lymphadenectomy with an operation time of (112.1±16.6) minutes. Eighteen cases underwent total thyroidectomy and central lymphadenectomy with an operation time of (185.3±25.9) minutes. The postoperative hospital stay was (3.76±0.98) days. The postoperative drainage was (96.8±36.2) ml. The 24-hour postoperative pain score was 2.66±1.23, the postoperative cosmetic satisfaction was 9.65±0.24. Among the postoperative complications, there were 3 cases of temporary recurrent laryngeal nerve palsy, 2 cases of permanent recurrent laryngeal nerve palsy, 4 cases of temporary hypoparathyroidism but no permanent hypoparathyroidism, 2 cases of infection, 1 case of seroma, 3 cases of pneumoderm, and no cases of mental nerve injury. Conclusion The modified TOETVA by dissection of mental nerve is safe and feasible.

Ultrasound guided percutaneous interventional therapy has been widely used in clinic. Aiming at the problem of soft tissue deformation caused by probe contact force in robot-assisted ultrasound-guided therapy, a real-time non-reference ultrasound image evaluation method considering soft tissue deformation is proposed. On the basis of ultrasound image brightness and sharpness, a multi-dimensional ultrasound image evaluation index was designed, which incorporated the aggregation characteristics of the organization. In order to verify the effectiveness of the proposed method, ultrasound images of four different models were collected for experiments, including prostate phantom, phantom with cyst, pig liver tissue, and pig liver tissue with cyst. In addition, the correlation between subjective and objective evaluations was analyzed based on Spearman's rank correlation coefficient. Experimental results showed that the average evaluation time of a single image was 68.8 milliseconds. The evaluation time could satisfy real-time applications. The proposed method realizes the effective evaluation of real-time ultrasound image quality in robot-assisted therapy, and has good consistency with the evaluation of supervisors.
Animals ; Cysts ; Male ; Phantoms, Imaging ; Swine ; Ultrasonography/methods*

Objective:To investigate the relationship between satisfaction and quality of life of patients with breast reconstruction after mastectomy, and analyze the influencing factors of satisfaction.Methods:In this study, 157 female breast reconstruction patients who were treated in Hunan Cancer Hospital from January 2016 to June 2019 were selected as the object of this study. The BRECON-31 and QLQ-BR23 were used to assess satisfaction and quality of life respectively, and the clinical and demographic data were collected, Pearson correlation test was applied to analyze the correlation between satisfaction and quality of life, univariate analysis and multiple linear regression analysis were performed to investigate the influence factors of satisfaction.Results:A total of 157 patients, whose age was (41.8±8.3) years and median follow-up time was 11 months were included and 147 valid questionnaires were collected. The satisfaction score was 74.44±6.29, which meant patients with breast reconstruction after mastectomy had high satisfaction. There was a significant correlation between intimacy and body image ( r=-0.183, P=0.043), sexual function ( r=0.201, P=0.026), sexual interest ( r=0.204, P=0.029), breast symptoms ( r=-0.247, P=0.006) and arm symptoms ( r=-0.246, P=0.006) in patients with breast reconstruction after mastectomy, the patient’s self-awareness was significantly influenced by factors such as body shape ( r=-0.228, P=0.006), sexual function ( r=-0.293, P<0.001), sexual interest ( r=-0.258, P=0.003), breast symptoms ( r=-0.183, P=0.029), hair loss-induced annoyance ( r=-0.187, P=0.027). The result of univariate analysis showed that age ( P=0.047), tumor stage ( P=0.004), reconstruction method ( P<0.001), chemoradiotherapy ( P=0.043) were the influencing factors of total satisfaction score, multiple linear regression result showed that the reconstruction method ( P<0.001) was an independent influence factor of satisfaction score. The total satisfaction score of patients with autologous tissue reconstruction (75.99±5.94) was better than that of patients with autologous tissue combined prosthesis (71.08±4.99) and patients with simple prosthesis implantation (70.81±8.54). Conclusions:Mutual impact was identified for life quality and satisfaction among patients with breast reconstruction after mastectomy. In addition, age, tumor stage, reconstruction method and chemoradiotherapy are the influence factor of satisfaction. Among them, the reconstruction method is independent influence factor, and the breast reconstruction with autologous tissue is a better choice.

Objective To investigate the safety and feasibility of the modified transoral endoscopic thyroidectomy vestibular approach (TOETVA) by dissection of mental nerve in clinical practice. Methods Totally 140 patients underwent the modified TOETVA from the Department of Head and Neck Surgery, Hunan Cancer Hospital from July 2016 to June 2018 were analyzed retrospectively. There were 130 females and 10 males, aging (35.4±9.8) years (range: 11 to 56 years). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative suction drainage, postoperative pain score, postoperative cosmetic satisfaction and postoperative complications (recurrent laryngeal nerve palsy, hypoparathyroidism, infection, pneumoderm, seroma and mental nerve injury) were summarized. Results Of the 140 patients, 1 patient was transferred to open surgery. Fifty?nine patients underwent thyroidectomy with an operation time of (100.8 ± 18.9) minutes. Sixty?three patients underwent thyroidectomy and central lymphadenectomy with an operation time of (112.1 ± 16.6) minutes. Eighteen cases underwent total thyroidectomy and central lymphadenectomy with an operation time of (185.3 ± 25.9) minutes. The postoperative hospital stay was (3.76 ± 0.98) days. The postoperative drainage was (96.8 ± 36.2) ml. The 24?hour postoperative pain score was 2.66 ± 1.23, the postoperative cosmetic satisfaction was 9.65 ± 0.24. Among the postoperative complications, there were 3 cases of temporary recurrent laryngeal nerve palsy, 2 cases of permanent recurrent laryngeal nerve palsy, 4 cases of temporary hypoparathyroidism but no permanent hypoparathyroidism, 2 cases of infection, 1 case of seroma, 3 cases of pneumoderm, and no cases of mental nerve injury. Conclusion The modified TOETVA by dissection of mental nerve is safe and feasible.

Objective:To examine the feasibility of small drain in transoral endoscopic thyroidectomy vestibular approach (TOETVA).Methods:A prospective research was performed in Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital, from October 2018 to March 2019. Totally 103 patients who met the inclusion and exclusion criteria, signed the operation agreement of TOETVA, had their surgery completed and followed-up over 6 months, were enrolled in analysis. A central venous catheter was used as a drain tube in all cases (outer diameter 1.7 mm, inner diameter 1.0 mm). Visual analogue scale (VAS) was applied for assessing pain scores during the first 24 hours after the operation. Vancouver scar scale (VSS) was used for assessing the scar left by the drainage. The drainage volume (minimum scale:10 ml, approximate read: 1 ml) was recorded every 2 hours during the first postoperative 12 hours, every 4 hours during 12 to 24 hours, every 8 hours during 24 to 48 hours, and once from 48 hours until extubation. The volume of drainage, the cumulative volume and the percentage of cumulative volume accounting for the total volume were calculated. The data of residual volume (subtract the cumulative volume from the total volume) in the postoperative 24, 32 and 40 hours were analyzed, and their upper one-side P 95 was calculated by percentile method. Results:There were 12 males and 91 females. The age was (36.6±9.7) years (range: 18 to 58 years). The intraoperative tube-inserting time was (10.1±2.6) minutes (range: 6 to 18 minutes). The pain score on the first day was 2.7±1.1 (range: 1 to 5). The extubation time was (2.7±0.5) days (range: 2 to 4 days). VSS scores in the postoperative 1 st month and 6 th month were 2.9±1.3 (range: 0 to 7) and 0(2)( M( Q R)), respectively. The size of the scar was 0 (2.5) mm in the postoperative 6 th month. Sixty-four patients had no visible scars. There were 5 patients who had postoperative drain-related complications (1 for air leakage, 1 for tube blockage, 3 for subcutaneous hydrop, 2 for regional infection), who were all cured after proper treatment. The total volume of drainage for 98 patients without postoperative drain-related complications was (80.1±12.2) ml (range: 58 to 131 ml). The cumulative drainage within 8 hours accounted for (53.8±4.2)% (range: 41.0% to 62.9%) of the total drainage. The volume of residual fluids in the postoperative 32 hours was estimated to (5.8±2.7) ml (range: 0 to 12 ml, P 95=10.0 ml). Conclusions:The small drain tubecan be applied in TOETVA, providing a satisfied cosmetic appearance and a reliable drainage. The main exudation period of the wound is within 8 hours after the operation. If a residual volume less than 10 ml is considered to be self-absorbable, the shortest safe extubation point for 95% patients without drain-related complications should be 32 hours after the operation.