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 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 describe the relationship status of breast reconstruction after mammary gland surgery, and to explore the changes of sexual and emotional experience in breast reconstruction. Methods A semi-structured in-depth interview was conducted in 19 patients admitted to Hunan Cancer Hospital from October 2015 to December 2017 for reexamination in the hospital from 2 to 26 months after breast reconstruction. The Giorigi method was used to analyze data in the phenomenological analysis of qualitative research. Data collection, transfer and analysis are conducted simultaneously, and the method and content of the next interview were constantly adjusted with the existing data analysis results. Results The sex and emotional experience of breast reconstruction after breast surgery could be summarized into 5 subjects. The first was cognition of sexual life . The second was sexual psychological change.The third was physiological changes. The forth was the desire for sexual information. The fifth was breast reconstruction surgery brings the emotional fluctuation of both husband and wife. Conclusions Understanding of breast cancer postoperative breast reformer sexual and emotional experience can help medical personnel through effective communication and evaluation, provide targeted health education and consultation, improve recovery quality of life of patients.

Objective To review outcome and experience in application of various forms of transverse rectus abdominis musculocutaneous flap in breast reconstruction and chest wall radiation ulcer repairment.Methods From January 2008 to February 2016,61 cases (included 58 female patients and 3 male patients) were admitted,the age ranged from 39 to 57 years old.Among these cases,37 cases received mastectomy and one-staged breast reconstructive operation and multiple chemotherapy preoperatively.The other 24 patients suffered from chest wall radiation ulcer,all occurred after mastectomy and radiotherapy,the course ranged from 12 to 56 months,all received long-time conservative therapy but the patient's condition worsened.Of those patients 8 cases suffered radioactive bone injury,involved clavicle,rib and sterum;3 cases suffered pleura injury;2 cases suffered lung injury;2 cases suffered brachial plexus injury and upper extremity lymphedema,resulted in upper extremity dysfunction.The patients were treated with pure pedicled transverse rectus abdominis musculocutaneous flap (TRAM) musculocutaneous flap in 31 cases,frec TRAM musculocutaneous flap in 3 cases,pedicled TRAM musculocutaneous flap plus superficial inferior epigastric vein anastomosis in 13 cases,and pedicled TRAM musculocutaneous flap combined with contralateral free deep inferior epigastric perforator (DIEP) flap in 14 cases.Results The area of flap for chest wall reconstruction ranged from 22 cm × 10 cm to 38 cm× 15 cm,the size of flap for breast reconstruction ranged from 16 cm × 10 cm to 22 cm× 13 cm.The donor site was closed directly in all cases.Distal part necrosis and fat liquefaction were noted in 3 cases used pure pedicled TRAM musculocutaneous flap,in 1 case the defect was closed directly after radical debridement,in other 2 cases free anterolateral thigh flap was applied after debridement.All other 58 flaps survived uneventfully.All patients were followed up for 12 -108 months with satisfied esthetic and functional results in reconstructed chest wall and breast.No local recurrence or ulcer happened.Only linear scar left in the donor sites,no hernia occurred.Conclusions Transverse rectus abdominis musculocutaneous flap is one of the first choice for breast reconstruction and chest wall radioactive ulcer.To ensure the operation success,it is efficient to apply different forms of transverse rectus abdominis musculocutaneous flap according to the flap size and blood supply.

Objective To explore the therapeutic effect of K8 short wave therapeutic apparatus on facial sensitive skin.Methods 130 patients with facial sensitive skin admitted in our hospital from November 2015 to September 2017 were selected as the subjects.According to the different surgical methods,65 cases in the control group were treated with intensive care cream.On the basis of the control group,65 cases in observation group were given K8 therapeutic apparatus.Then we compared the treatment effect between the two groups.Results K8 shortwave therapeutic apparatus to treat facial sensitive skin can achieve higher total effective rate,reduce the skin area score and and erythema parameters,reduce the skin water loss and improve skin stratum corneum moisture content.After two weeks of treatment,the total effective rate of the observation group (98.46％) was higher than that of the control group (86.15％),the skin area score [(2.28 ± 0.26) piont],the erythema parameter (180.28 ± 29.87) and the epidermis water loss [(9.85 ±2.25)g/(cm2 ×h)] were lower than that in the control group [(4.54 ± 1.14) point,223.87 ± 30.47,(13.02 ± 3.25) g/(cm2 × h)],while the water content of the skin cuticle [(88.75 ± 10.35) ％] was higher than that of the control group [(78.98 ± 9.58) ％] (all P ＜ 0.01).Conclusions K8 short-wave therapeutic apparatus combined with intensive care cream has a better clinical effect and certain advantage in the treatment of facial skin sensitive skin than the use of intensive care cream alone.