With the extensive application of nuclear technology in industry, agriculture, and medicine, the safety issues associated with neutron radiation have become increasingly prominent. Due to their high penetrability and strong ionization effect, neutrons can cause serious health risks by directly damaging DNA or inducing secondary γ radiation. Therefore, the neutron radiation protection has become a core challenge in radiation protection, especially the research and development of neutron shielding materials. To ensure the safe development of nuclear technology, neutron shielding materials are indispensable and constitute a fundamental core technology for radiation protection. This paper reviews the theory of neutron radiation protection and the research progress of neutron shielding materials, with a focus on the current application status and existing problems of neutron shielding materials. This article also discusses the future development trends. This review aims to provide theoretical support and technical references for the safe application and development of nuclear technology.

OBJECTIVE: To evaluate the effectiveness of tibial nerve transection with epineurial suture and division of the common plantar digital nerve branches in the treatment of congenital macrodactyly in children. METHODS: A retrospective analysis was conducted on clinical data from 9 children with congenital macrodactyly who met the selection criteria and were admitted between January 2018 and December 2024. The cohort included 4 boys and 5 girls, aged 1-6 years (median, 3 years). Syndactyly of the second and third toes was present in 2 patients. Hypertrophy distribution was as follows: 1 case of single-ray involvement, 4 of double-ray, 1 of triple-ray, 1 of quadruple-ray, and 2 of quintuple-ray. Preoperatively, 7 cases exhibited limitations in both active and passive flexion and extension of the affected toes; in 2 cases, active movement was restricted while passive motion remained intact. All 9 children were unable to wear standard-sized footwear for the unaffected foot. Six presented with a limp, and 3 had difficulty walking. All 9 cases were moderate to severe progressive macrodactyly, and the growth rate of the affected foot was significantly faster than that of the healthy side. Six cases had undergone prior surgical interventions at other institutions, but disease progression continued postoperatively. All 9 patients underwent tibial nerve transection with epineurial suture and selective division of the common plantar digital nerve branches. At last follow-up, the foot growth rate was calculated (compared with that immediately after operation), and the changes of plantar pain sensation in the affected foot were detected before operation, immediately after operation, and at last follow-up, and the surgical efficacy was evaluated based on improvements in shoe fit and gait function. RESULTS: All 9 children were followed up 6-36 months, with an average of 18 months. All the incisions healed by first intention, and no infection or plantar ulceration occurred. At last follow-up, the growth rate of the affected foot was 0.10 (0.04, 0.14) cm/month, which was significantly slower than that of the healthy foot [0.14 (0.08, 0.18) cm/month] ( Z=3.951, P<0.001). Preoperatively, plantar pain sensation was absent in all cases; it was restored immediately after operation. At last follow-up, 6 patients had absent pain sensation, 2 had partial preservation (involving certain toes and central plantar regions), and 1 patient (with 3-year follow-up) exhibited regained sensation in multiple plantar areas. Gait improved in most cases, in which 8 children achieved normal ambulation, while 1 continued to limp due to leg-length discrepancy. Surgical efficacy were rated as excellent in 1 case, good in 7, and fair in 1. CONCLUSION Tibial nerve transection with epineurial suture combined with selective division of the common plantar digital nerve branches effectively reduces the growth rate of congenital macrodactyly in children, has minimal impact on plantar sensory function, and does not result in plantar ulcers or impaired ambulation.
Humans ; Male ; Female ; Child, Preschool ; Child ; Retrospective Studies ; Infant ; Tibial Nerve/surgery* ; Toes/surgery* ; Treatment Outcome ; Suture Techniques ; Fingers/surgery* ; Foot/innervation* ; Limb Deformities, Congenital

Primary hepatic cancer is one of the major problems that need to be solved urgently in the field of public health, seriously endangering the life and health of Chinese people. Its treatment mode is multidisciplinary participation and synergy of multiple therapeutic methods. Even though there are many common clinical treatments for liver cancer in China, its therapeutic outcome is still unsatisfactory. yttrium-90 has been applied for more than 20 years, and a large amount of foreign clinical data have been accumulated. Combining the latest literature and clinical practice, the authors describe the clinical application and research progress of yttrium-90 micro-sphere selective internal radiation therapy in primary liver cancer.

Objective:To explore the application and effect of scenario simulation teaching in ST-segment elevation myocardial infarction (STEMI) course for emergency training of "5+3" professional master.Methods:A randomized controlled trial was conducted among 48 "5+3" professional masters who would rotate in the emergency department, to compare the test results of the total and three scenes between scenario simulation teaching group ( n=24) and traditional teaching group ( n=24). The STEMI teaching was carried out through simulating the emergency room, standardized patients and first-aid simulators in the simulation teaching group, and the traditional teaching group was taught by conventional classroom teaching. After the class, "Theoretical Examination" and "Questionnaire Survey" were used to evaluate the teaching effect. The former was further divided into "first diagnosis and differential diagnosis of chest pain", "fast identification and processing of STEMI" and "rescue of cardiac arrest" for inter-group and intra-group evaluation. SPSS 20.0 was used to conduct t-test. Results:In the theoretical examination, the scenario simulation teaching group was superior to the traditional teaching group in the test of emergency processing for STEMI course [(82.38±2.41) vs . (68.00±1.95), t=4.64, P<0.001]. In the sub-analysis of scenario simulation teaching group, students in the role-play group had significantly higher scores than others in the non-role-play group [(90.50±3.04) vs . (79.67±2.79), t=2.09, P=0.049]. Scenario simulation teaching group was also superior to traditional teaching group in the "Questionnaire Survey". Conclusion:In the training and teaching of STEMI emergency processing, scenario simulation teaching group proves to be superior to traditional teaching, which deserves further promotion.

Objective:To evaluate the clinical efficacy of modified Qiwei Baizhu Powder combined with conventional therapy in the treatment of type 2 diabetes mellitus (T2DM) with abnormal lipid metabolism.Methods:A total of 96 patients with T2DM and abnormal lipid metabolism from March 2018 to March 2021 in Anhui Integrated Traditional Chinese and Western Medicine Hospital who met the inclusion criteria were divided into 2 groups according to the random number table method, with 48 in each group. The control group was treated with conventional western medicine, while the observation group was treated with modified Qiwei Baizhu Powder and treatment of the control group. Both groups were treated for 3 months. TCM syndrome scores were performed before and after treatment. Fasting blood glucose (FPG) and 2 hPG were detected by glucose oxidase method, HbA1c was detected by HPLC, TC, TG, HDL-C and LDL-C were detected by cholesterol peroxidase method, glycerophosphate oxidase method, direct inhibition method and direct surfactant clearance method. Adverse events during treatment were recorded and clinical efficacy was evaluated.Results:The total effective rate was 93.8% (45/48) in the observation group and 79.2% (38/48) in the control group, with a statistically significant difference between the two groups ( χ2=4.36, P=0.037). After treatment, the scores of dry mouth, fatigue, anorexia, dizziness, tongue, pulse and total scores in the observation group were significantly lower than those in the control group ( t values were 3.58, 3.17, 3.24, 3.59, 3.58, 2.76 and 8.44, respectively, all Ps<0.05); the levels of FPG, 2 hPG and HbA1c in the observation group were significantly lower than those in the control group ( t values were 3.37, 2.05 and 3.73 respectively, all Ps<0.05). After treatment, the levels of TC [(4.30±0.85) mmol/L vs. (4.78±0.94) mmol/L, t=2.62], TG [(3.00±0.37) mmol/L vs. (3.19±0.54) mmol/L, t=2.01], LDL-C [(2.60±0.71) mmol/L vs. (2.95±0.44) mmol/L, t=2.90] were significantly lower than those in the control group ( P<0.05). After treatment, the HDL-C [(2.07±0.63) mmol/L vs. (1.82±0.55) mmol/L, t=2.01] level was significantly higher than that of the control group ( P<0.05). Conclusion:Modified Qiwei Baizhu Powder combined with conventional therapy can improve blood glucose and blood lipid levels in T2DM patients with abnormal lipid metabolism, relieve clinical symptoms and improve curative effect.

Objective:To investigate the clinical efficacy of ex vivo liver resection and autotransplantation (ELRA) for liver complex space-occupying lesions.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 50 patients with liver complex space-occupying lesions who underwent ELRA in the First Hospital Affiliated to Army Medical University between June 2009 and May 2017 were collected. There were 36 males and 14 females, aged from 13 to 69 years, with a median age of 51 years. All patients underwent ELRA. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview. Patients were followed up according to the individual follow-up plan in the first 6 months after discharge, and then once every 3 to 6 months to detect tumor recurrence and survival up to May 2019. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M (range). Count data were expressed as absolute numbers or percentages. The Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-rank test was used for survival analysis. Results:(1) Surgical situations: all the 50 patients underwent ELRA successfully, and postoperative pathological examination showed the R 0 resection rate was 100%(50/50). The operation time of the 50 patients were (630±186)minutes, of which 9 patients with liver benign occupation had the operation time of (684±168)minutes and 41 patients with liver malignant tumor had the operation time of (618±190)minutes. The operation time of temporary reconstruction of inferior vena cava and portacaval shunt, time of anhepatic phase, volume of intraoperative blood loss of the 50 patients were (35±9)minutes, (256±71)minutes, 2 000 mL(range, 400-10 000 mL), respectively. The remnant liver mass to standard liver mass ratio of the 50 patients was 65%±16%, of which 9 patients with liver benign occupation had the remnant liver mass to standard liver mass ratio of 63%±14% and 41 patients with liver malignant tumor had the remnant liver mass to standard liver mass ratio of 65%±17%. Of the 50 patients, 35 had vascular invasion (7 cases with liver benign occupation, 28 cases with liver malignant tumor), of which 24 (6 cases with liver benign occupation, 18 cases with liver malignant tumor) underwent in vitro vascular reconstruction, 12 (5 cases with liver benign occupation, 7 cases with liver malignant tumor) had bile duct invasion and underwent choledochojejunostomy due to the inability of the common bile duct to anastomose the ends. Two cases with liver metastasis of gastric cancer, one case with liver metastasis of colon cancer and one case with liver metastasis of pancreatic cancer underwent radical gastrectomy, radical resection of colon cancer, and pancreaticoduodenectomy, respectively. (2) Postoperative situations: the duration of postoperative hospital stay of the 50 patients were 25 days (range, 11-169 days). Of the 50 patients, 12 had pleural effusion who were treated with pleural puncture drainage, 10 had bile leakage who were treated with abdominal puncture drainage, 3 had bile duct anastomotic leakage who were treated with endoscopic nasobiliary drainage or biliary stent implantation, 6 underwent reoperation among which 4 underwent exploratory laparotomy due to abdominal hemorrhage, 1 underwent portal vein reconstruction due to abdominal hemorrhage combined with portal vein thrombosis, and 1 underwent salvage liver transplantation due to liver failure. Nine of the 50 patients died within 90 days after surgery, all of whom had liver malignant tumor. Among them, 3 died of multi-organ dysfunction syndrome caused by severe infection, 3 died of acute liver failure, 2 died of abdominal hemorrhage and 1 died pulmonary embolism. (3) Follow-up: all the 50 patients were followed up for 1 to 119 months. The overall survival time, 1-, 3-, 5-year overall and tumor-free survival rates of the 50 patients after operation were 17 months (range, 1-119 months), 68.0%, 45.9%, 41.1% and 41.9%, 33.4%, 30.8%, respectively. The overall survival time, 1-, 3-, 5-year overall and tumor-free survival rates of the 9 patients who with liver benign occupation after operation were 68 months (range, 10-114 months), 88.9%, 88.9%, 88.9% and 88.9%, 88.9%, 88.9%, respectively. The overall survival time, 1-, 3-, 5-year overall and tumor-free survival rates of the 41 patients who with liver malignant tumor after operation were 15 months (range, 1-119 months), 63.4%, 36.6%, 31.0% and 31.5%, 21.0%, 18.0%, respectively. There were significant differences in the overall and tumor-free survival rates between patients who with liver benign occupation and patients who with liver malignant tumor ( χ2=7.626, 11.766, P<0.05). Conclusions:ELRA can be applied in the treatment of liver complex space-occupying lesions. The selection criteria of patients with liver malignant tumor should be more rigorous to reduce perioperative mortality.

Objective: To explore the clinical effects of split-thickness scalp and allogenic acellular dermal matrix (ADM) in repairing deep wounds of hands in patients with extremely extensive burns. Methods: Six patients with extremely extensive burns complicated by deep burn in hands were admitted to our department from December 2014 to December 2017, including 4 males and 2 females, aged 21 to 58 years. Their total burn areas were from 85% to 95% total body surface area (TBSA), and the sum of deep-partial thickness and full-thickness wounds was larger than 50% TBSA. Under general anesthesia, deep wounds of 10 dorsal hands were repaired by combined transplantation of split-thickness scalp and allogenic ADM in 4 to 6 weeks after injury. The skin grafting range was beyond the metacarpophalangeal joint, including partial dorsal digital deep wounds. Survival of skin grafts on dorsal hands, follow-up of hand shape and functional recovery were observed and recorded. Results: Six patients were successfully treated. There was no infection on the dorsal deep wounds of 10 hands after surgery, and the grafts survived well. During follow-up of 1 to 2 years after operation, there were no recurrent tension blisters or dorsal extension deformity of the metacarpophalangeal joints in 10 hands, the shape and function of hands recovered well, and hand Carroll scores were from 90 to 99 points, with functional levels of Ⅴ and Ⅵ. Conclusions The combined transplantation of split-thickness scalp and allogenic ADM is a good method for repairing deep hand wounds in patients with extremely extensive burns, which can alleviate the cicatrix hyperplasia and contracture of healed hand wounds, and improve the shape and function of hands.

Objective: To investigate the clinicopathological characteristics and prognosis of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD). Methods: The clinicopathological data of patients of renal cell carcinoma arising in end-stage renal disease were collected from the Affiliated Hospital of Qingdao University (ten cases) and 971 Hospital of PLA Navy (five cases) from January 2009 to August 2018. Results: Among 15 patients, 14 were male and 1 was female, and the age ranged from 38 to 78 years (mean 51 years, median 49 years). All patients had history of chronic renal failure (7-192 months), including 9 patients treated with hemodialysis for 6 to 132 months. In 12 cases the tumor border was distinct and the tumor size ranged from 1.8 to 11.0 cm. Two cases were multifocal and one case showed extensive renal hemorrhage with an inconspicuous tumor mass. Microscopically, 9 cases were clear cell reanl cell carcinoma including one with sarcomatoid differentiation, 4 were acquired cystic kidney disease-associated(ACKD-RCC) and two were papillary renal cell carcinoma. All patients had a follow-up of 3 to 120 months. Four patients died during a follow-up of 6 to 60 months (mean 30 months) as a result of extensive distant metastases (two cases) and renal failure (two cases), while other eleven patients were alive without tumor recurrence or metastasis (median 40.8 months of follow-up ranging from 3 to 120 months). Conclusions ESRD-RCC is more often seen in younger male patients. The time intervals from the onset of chronic renal failure to the diagnosis of renal cell carcinoma differ and tumors are frequently incidental findings. The histological types can be sporadic renal cell carcinoma or unique ACKD-RCC. Tumors are often hemorrhagic and necrotic. Routine physical examination and early detection could benefit ESRD-RCC patients. ESRD-RCC may have a favorable prognosis despite of a large tumor size or the presence of sarcomatoid differentiation.

investigate the clinicopathological characteristics and prognosis of renal cell carcinoma (RCC) in patients with end?stage renal disease (ESRD). Methods The clinicopathological data of patients of renal cell carcinoma arising in end?stage renal disease were collected from the Affiliated Hospital of Qingdao University (ten cases) and 971 Hospital of PLA Navy (five cases) from January 2009 to August 2018. Results Among 15 patients, 14 were male and 1 was female, and the age ranged from 38 to 78 years (mean 51 years, median 49 years). All patients had history of chronic renal failure (7-192 months), including 9 patients treated with hemodialysis for 6 to 132 months. In 12 cases the tumor border was distinct and the tumor size ranged from 1.8 to 11.0 cm. Two cases were multifocal and one case showed extensive renal hemorrhage with an inconspicuous tumor mass. Microscopically, 9 cases were clear cell reanl cell carcinoma including one with sarcomatoid differentiation, 4 were acquired cystic kidney disease?associated(ACKD?RCC) and two were papillary renal cell carcinoma. All patients had a follow?up of 3 to 120 months. Four patients died during a follow?up of 6 to 60 months (mean 30 months) as a result of extensive distant metastases (two cases) and renal failure (two cases), while other eleven patients were alive without tumor recurrence or metastasis (median 40.8 months of follow?up ranging from 3 to 120 months). Conclusions ESRD?RCC is more often seen in younger male patients. The time intervals from the onset of chronic renal failure to the diagnosis of renal cell carcinoma differ and tumors are frequently incidental findings. The histological types can be sporadic renal cell carcinoma or unique ACKD?RCC. Tumors are often hemorrhagic and necrotic. Routine physical examination and early detection could benefit ESRD?RCC patients. ESRD?RCC may have a favorable prognosis despite of a large tumor size or the presence of sarcomatoid differentiation.

Objective To evaluate the clinical efficacy stapledtransanal in the treatment of severe rectal obstructive constipation. Methods Eighty patients with rectal obstructive constipation and hospitalized in Tangshan City Hospital of TCM were enrolled in the study and randomly divided into the treatment group and control group,40 cases in each group. The treatment group was treated with stapledtransanal and the control group was treated with transvaginal repair of longitudinally cut transverse suture operation. The clinical symptoms of two groups were observed and quantified. The operation time,intraoperative blood loss and wound healing time were recorded, Wexner constipation scores were collected at 1, 3, 6 and 12 months after the operation; Postoperative bleeding,pain,infection,anal distention,rectovaginal fistula and other complications were observed. The clinical efficacy of the two groups was compared. Results The total effective rate in the treatment group was 100% (40/ 40),which was significantly higher than that in the control group (90. 00%(36/ 40)) (χ2 = 0. 60,P= 0. 027). There were significant differences in the clinical symptom scores of the two groups at 7 days (treatment group(3. 58±1. 61) points,control group(4. 12±1. 52)points))and 3 months after treatment(treatment group (4. 23±2. 13)points,control group (5. 33±1. 12)points) compared with those before treatment (treatment group (13. 23±3. 08)points,control group (14. 45±3. 01) points ) (P<0. 05);There was a statistically significant difference in clinical symptom quantification score between the treatment group and the control group at 3 months after treatment (P<0. 01). In the treatment group,the operation time ((15. 65±1. 61) min),intraoperative bleeding ((10. 77±5. 23) ml) and wound healing time ((9. 28±1. 41)) d were better than those of the control group ((25. 89±3. 71) min,(43. 31±8. 11) ml,(14. 87±1. 92) d) (t = 15. 632,14. 266,15. 518,P<0. 01). The scores of Wexner in the two groups were lower than those of the same group at 1,3,6 and 12 months after operation. The scores of Wexner in the treatment group were lower than those of the control group at 1,3,6 and 12 months after operation (P<0. 05). In terms of postoperative complications,the pain and anal distention in the treatment group were better than those in the control group ( P < 0. 05) . Conclusion Stapledtransanal is effective for the treatment of outlet obstructive constipation.