Objective:To investigate the effect of triply periodic minimal surfaces (TPMS) structure and ceramic volume fraction on the mechanical properties of polymer-infiltrated ceramic network (PICN) composite and reveal its strengthening and toughening mechanism.Methods:In this study, TPMS structures with gyroid (G), primitive (P), diamond (D), and ceramic volume fraction (40%, 55%, 70%, 85%) were designed. Porous zirconia scaffolds were prepared using stereolithography technology, and resin was infiltrated into the scaffolds through a vacuum. Then, the PICN composites were obtained after curing. The bending strength, elastic modulus and fracture toughness of PICN were tested using an electronic universal testing machine, with commercial PICN as the control group. The micromorphology of PICN was observed through stereomicroscope and scanning electron microscope. The cytocompatibility of PICN was verified by using cell counting kit, live/dead cell staining and phalloidin staining.Results:The bending strength values of PICN with different ceramic volume fractions ranged from 82.0 MPa to 376.0 MPa, and they gradually increased as the ceramic volume fraction rised. The elastic modulus values of PICN with different ceramic volume fractions ranged from 12.1 GPa to 56.1 GPa. The fracture toughness values of PICN with different ceramic volume fractions ranged from 1.7 MPa·m 1/2 to 6.5 MPa·m 1/2. The bending strength of 85G PICN reached 306.0 MPa, and it had the highest fracture toughness (6.5 MPa·m 1/2) and an appropriate elastic modulus between that of the control group and that of enamel. Under scanning electron microscopy, it could be observed that the cracks branch and deflect at the interface and eventually terminate within the resin phase. After co-culture with PICN, the survival rate of mouse fibroblasts exceeded 80%, indicating that PICN had no cytotoxicity. Conclusions:The PICN composite with TPMS structure can satisfy the mechanical properties and cytocompatibility of dental prosthesis.

Objective:To investigate the effect of triply periodic minimal surfaces (TPMS) structure and ceramic volume fraction on the mechanical properties of polymer-infiltrated ceramic network (PICN) composite and reveal its strengthening and toughening mechanism.Methods:In this study, TPMS structures with gyroid (G), primitive (P), diamond (D), and ceramic volume fraction (40%, 55%, 70%, 85%) were designed. Porous zirconia scaffolds were prepared using stereolithography technology, and resin was infiltrated into the scaffolds through a vacuum. Then, the PICN composites were obtained after curing. The bending strength, elastic modulus and fracture toughness of PICN were tested using an electronic universal testing machine, with commercial PICN as the control group. The micromorphology of PICN was observed through stereomicroscope and scanning electron microscope. The cytocompatibility of PICN was verified by using cell counting kit, live/dead cell staining and phalloidin staining.Results:The bending strength values of PICN with different ceramic volume fractions ranged from 82.0 MPa to 376.0 MPa, and they gradually increased as the ceramic volume fraction rised. The elastic modulus values of PICN with different ceramic volume fractions ranged from 12.1 GPa to 56.1 GPa. The fracture toughness values of PICN with different ceramic volume fractions ranged from 1.7 MPa·m 1/2 to 6.5 MPa·m 1/2. The bending strength of 85G PICN reached 306.0 MPa, and it had the highest fracture toughness (6.5 MPa·m 1/2) and an appropriate elastic modulus between that of the control group and that of enamel. Under scanning electron microscopy, it could be observed that the cracks branch and deflect at the interface and eventually terminate within the resin phase. After co-culture with PICN, the survival rate of mouse fibroblasts exceeded 80%, indicating that PICN had no cytotoxicity. Conclusions:The PICN composite with TPMS structure can satisfy the mechanical properties and cytocompatibility of dental prosthesis.

Objective:To investigate the effect of peer support education on family function of breast cancer patients with breast reconstruction.Methods:Totally 146 patients who received surgical treatment in the department of plastic surgery for breast cancer from June 2017 to June 2019 were randomly divided into the experimental group and the control group by the method of random number table, 73 cases each. The control group received routine education. Patients in the observation group received regular education and peer support education. The intervention time was from admission to 6 months after discharge, and the control group received routine nursing care. Quality of life questionnaire was used to evaluate the quality of life of the patients at six months after operation, family care index questionnaire was used to evaluate the family function of the patients, and comprehend social support scale was used to evaluate the level of social support, then various indicators of the two groups of patients were compared.Results:6 months after operation, the scores of quality of life function and symptom dimension of the intervention group were 6.43±1.54. 5.83±1.47, while control group were 6.02±1.59; 6.39±1.63. There were statistically significant differences between the two groups ( t values were 4.30, 5.01, P < 0.05); family care scores of the two groups were compared, the intervention group was 8.78±2.04. The control group was 8.43±2.05. There were statistically significant differences between the two groups ( t value was 2.02, P < 0.05); the comprehension support score of the two groups was compared, and that of the intervention group was 62.24±14.81. The control group was 55.74±13.58. There were statistically significant differences between the two groups ( t value was 4.26, P < 0.05). Conclusion:Peer support education can improve the quality of life and family care of breast cancer patients with breast reconstruction.

Objective:To study the clinical characteristics and classification of gastric neuroendocrine neoplasm(NEN) and prognostic factors of mixed adenoneuroendocrine carcinoma (MANEC) and gastric neuroendocrine carcinoma(NEC).Methods:A total of 148 gastric NENs were divided into type Ⅰ, type Ⅱ and type Ⅲ based on the classification of European Neuroendocrine Tumor Society (ENETS). Kaplan-Meier test and Cox regression model were used in univariate and multivariate survival analysis in 108 cases with pathological G3 gastric NEN.Results:In this study, the percentages of type Ⅰ, type Ⅱ and type Ⅲ were 25.0%(37), 3.4%(5) and 71.6%(106) respectively. Among type Ⅰ patients, 28(75.7%) lesions were located in gastric fundus or body, 29(78.4%) had bumps. Lymph node involvement was found in 4 (10.8%) patients. Twenty-six (70.3%) patients received endoscopic treatment and 11 (29.7%) with surgery. All 5 type Ⅱ patients presented lesions in gastric fundus or body, including 4 with ulcers, who were all treated by endoscope. Three type Ⅱ patients had gastrinoma, and 2 combined with multiple endocrine neoplasmⅠ. In type Ⅲ patients, 56(52.8%) showed ulcerative lesions. The majority of patients (102, 96.2%) had a single lesion, 94(88.7%) with lymph node or other organ metastasis. In this study, no deaths were reported in gastric NEN with a pathological grade of G1 or G2. The mortality rate was 38.9%(42/108) in patients with G3 NEN. Survival analysis suggested that age, metastasis of tumor were associated with poor prognosis ( P=0.041, 0.025). Conclusions:Patients with gastric NEN have heterogenous clinical presentations according to gender, age, endoscopic features, infiltration and metastasis, and pathological grade. Aging and metastasis are negative prognostic factors of G3 gastric NEN.

Objective:To investigate the symptoms of patients with oral cancer during treatment, and explore the types of symptom groups and their correlation with quality of life.Methods:Totally 201 patients with oral cancer after surgery were selected as the subject from a ClassⅢ Grade A hospital using convenient sampling and investigated with the MD Anderson Symptom Inventory for Head and Neck cancer (MDASI-HN) and University of Washington Quality of Life Questionnaire (UW-QOL) , and explore the relationship between them.Results:Totally 189 patients completed the questionnaire. Patients with oral cancer showed many symptoms during the progression and treatment of the disease. Serious symptoms included swallowing, chewing and speaking. Exploratory factor analysis revealed three symptom groups, namely, oral and throat symptom group, drowsiness-digestive tract symptom group, and fatigue-respiratory symptom group. The scores of different dimensions and the total scores of quality of life were negatively correlated with the total scores of the three symptom groups ( P<0.05) . Conclusions:There are multiple symptom groups in patients with oral cancer during postoperative rehabilitation, which seriously affect their quality of life. Medical workers should grasp this characteristic, evaluate symptoms in time, actively manage symptom groups, and improve the quality of life of patients.

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 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 explore the clinical application of the transverse upper gracilis flap (TUG) in breast reconstruction for breast cancer patients. Methods: From March 2010 to September 2016, 15 breast cancer patients received radical or modified radical mastectomy in Hunan Cancer Hospital, 8 cases of breast cancer were in stage Ⅰ and 7 cases was in stage Ⅱ. The age of patients ranged from 37 to 62 years old, (39.5±4.7) years. The TUG flap was used to reconstruct breast at the same time.The donor leg is placed in frog-leg position. Free TUG flap was harvested with gracilis muscular branch of profunda artery as pedicle. To keep tight connection between skin paddle and gracilis muscle, the perforators are not visualized. The flap was transferred to reconstruct breast, and the donor site was directly closed. Results: Mean operative time of unilateral reconstruction was 5 hours and (35± 44) minutes (with the range from 4 hours and 17 minutes to 6 hours and 5 minutes). Mean ischemia time was (52± 9 )minutes (with the range from 40 minutes to 1 hour and 16 minutes). The length of flap was (27.1±0.1) cm. The width of flap was (7.8±0.5) cm. The thickness of flap was (3.4±0.2) cm. The length of pedicle was( 6.8±0.5) cm.The average weight of flap was 350 g (ranged from 285 g to 525 g). All TUG flaps were survived. The shape, texture and elasticity of all reconstructed breasts were satisfactory, and there is no flap contracture deformation happened. Only linear scar left in the donor sites, without sacrifice of the function of thighs. All 15 patients were followed for 9-36 months (16.5 months on average). No local recurrence happened. Conclusion TUG flap can be safely harvested. It is reliable, with good texture. It is an alternative method for breast reconstruction after radical or modified radical mastectomy.

Objective: To understand HIV infection status and characteristics of non-remunerated blood donors in Hangzhou. Methods: HIV antibody test were conducted for non-remunerated blood donors in Hangzhou and their demographic and epidemiological information were collected from 2008-2017. χ² test for trend (liner by liner association chi square test) was used for the comparison of the HIV infection trends in each year. Results: A total of 1 461 129 non-remunerated blood donors were surveyed in Hangzhou during 2008-2017, and 260 blood donors were HIV positive. Most HIV infected blood donors were males (96.5%, 251/260) and aged 18-34 years (72.7%, 189/260). Among 260 HIV positive blood donors, those reporting repeated non-remunerated blood donation accounted for 36.9% (96/260), those reporting homosexual transmission accounted for 53.5% (139/260) and those reporting heterosexual transmission accounted for 44.6% (116/260). The HIV infected persons reporting homosexual behaviors were mainly aged 18-34 years (82.0%, 114/139) and unmarried (71.2%, 99/139). Most HIV infected students reported homosexual transmission (88.4%, 23/26). The crude HIV positive rate was 0.8/10 000-2.5/10 000, the differences in annual HIV positive rate had no significance (trend χ²=2.355, P=0.125). The crude HIV positive rate in male blood donors aged 18-24 years increased from 1.1/10 000 in 2008 to 3.7/10 000 in 2017, the difference was significant (trend χ²=5.175, P=0.023). Standardized HIV positive rate was 0.9/10 000-2.4/10 000. Conclusions HIV infection rate was low in non-remunerated blood donors in Hangzhou during 2008-2017. Most HIV infected persons were males and aged 18-34 years. Heterosexual and homosexual contacts were the major transmission routes. The HIV positive rate in males aged 18-24 years showed an increase trend.

Objective: The aim of this study is to investigate the variation tendency of coagulation and fibrinolysis biomarkers in cancer patients and to explore the effect of these biomarkers for the diagnosis of thrombosis in cancer patients. Methods: 171 cancer patients admitted to hospital from September 2017 to July 2019 were enrolled in the study, including 40 cancer patients undergoing surgery, 108 cancer patients without surgery in control group and 23 cancer patients with thrombus. New coagulation and fibrinolysis biomarkers, TM (Thrombomodulin), TAT (Thrombin -antithrombin complex), PIC (Plasmin alpha 2-plasmin inhibitor complex) and t-PAI·C (Tissue plasminogen activator-plasminogen activator inhibitor-1 complex), were tested in every patient. In addition, these new biomarkers are compared with D-dimer. Results: A statistically difference was available on the value of TAT, TM, PIC, t-PAIC, between postoperative cancer patients group and control group (P<0.05, respectively). TAT, TM and PIC in thrombosis cancer group were higher than those in non-thrombosis cancer group (P<0.05; respectively). ROC was used to evaluate the performance of D-dimer, TAT and PIC on thrombosis in cancer patients. The results showed that the AUC of PIC and TAT were both higher than D-dimer (0.871 vs. 0.619; 0.788 vs. 0.619). The specificity of PIC alone was higher than that of D-dimer (91.9% vs. 82.4%), and the sensitivity of PIC and TAT alone was higher than that of D-dimer (73.9% vs. 47.8%, 73.9% vs. 47.8%, respectively). Conclusions The activity of coagulation and fibrinolysis in cancer patients was abnormally enhanced. TAT and PIC were better than D-dimer for the diagnosis of thrombosis in cancer patients.