Objective:To evaluate the value of dual-layer spectral detector CT (DLSDCT) in precise radiotherapy for central lung cancer (CLC) complicated with atelectasis.Methods:Clinical and imaging data (including DLSDCT, PET-CT, and radiotherapy simulation CT images) of 26 patients with pathologically confirmed CLC accompanied by atelectasis from the Third Affiliated Hospital of Shandong First Medical University and Shandong Cancer Hospital were analyzed retrospectively. There were 21 males and 5 females, aged 36-82 years. Two physicians assessed CLC identifiability on DLSDCT, PET-CT, and simulation localization CT images, respectively, and outlined the gross tumor volume (GTV) and measured GTV values (GTV DLSDCT, GTV PET-CT, GTV CT). Paired-sample Friedman test was used to compare the differences in GTV of the three images, and the SNK test with Bonferroni correction was used for a two-way comparison. The intra-class correlation coefficient (ICC) was used to compare the agreement of measured GTV between 2 physicians. Results:The differentiation rates on PET-CT, DLSDCT, and simulation CT images were 100% (26/26), 80.77% (21/26), and 11.54% (3/26), respectively. The differentiation rate of CLC on DLSDCT images was significantly higher than that on simulation CT images (χ 2=16.06, P<0.001). GTV CT, GTV PET-CT, and GTV DLSDCT measured on simulation localization CT images, PET-CT images, and DLSDCT images were 58.75 (22.57, 86.17) cm 3, 47.34 (18.13, 69.25) cm 3, and 51.40 (18.87, 71.31) cm 3, respectively, with statistically significant differences (χ 2=44.99, P<0.001). Both GTV DLSDCT and GTV PET-CT were significantly smaller than GTV CT (χ 2=4.23, 6.59, Bonferroni corrected P<0.001), and there was no significant difference between GTV DLSDCT and GTV PET-CT (χ 2=2.36, Bonferroni corrected P=0.055). The agreement between the two physicians was good for GTV values measured on both DLSDCT and PET-CT (ICC=0.86, 0.89). Conclusions:On DLSDCT images, most CLC and atelectasis can be identified. Compared to simulation localization CT, the tumor target areas outlined on DLSDCT are closer to PET-CT, and the tumor volumes outlined by different physicians are more consistent.

Objective:To evaluate the application value of double-layer spectral detector CT (DLSDCT) in differentiating central lung cancer from atelectasis.Methods:Fifty-one patients with central lung cancer accompanied by atelectasis confirmed by pathology in Shandong Cancer Hospital from January to December 2020 were enrolled. The differentiating rates of tumor from atelectasis of the conventional CT, 40 keV virtual monoenergetic imaging (MonoE), iodine density map (ID), and 40 keV MonoE-ID fusion images of unenhanced scan, arterial and venous phase were retrospectively analyzed. Cochran′s Q test was used to compare the differentiating rate (Bonferroni correction afterwards), and Friedman test was used to compare the maximum diameter of the tumor of each imaging method.Results:Of the 51 patients, none of the conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the unenhanced scan could distinguish lung tumors from atelectasis; the number of cases in which the conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the arterial phase could distinguish lung tumors from atelectasis regions was 4, 5, 5 and 6, respectively; the number of cases in which the conventional CT, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the venous phase could distinguish lung tumors from atelectasis regions was 17, 35, 39 and 38, respectively, and the difference was statistically significant (χ 2=52.40, P<0.001). The differentiating rates of the 40 keV MonoE, ID, and 40 keV MonoE-ID fusion image were significantly higher than that of conventional CT image (χ2=-0.35, -0.43, -0.41, P<0.001, Bonferroni correction afterwards); There was no significant difference in the differentiating rate among 40 keV MonoE, ID and MonoE-ID fusion image ( P=1.00). Seventeen tumors could be differentiated in conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images of venous phase, and the maximum diameters of lung tumors were (50±21) mm, (50±23) mm, (50±23) mm, and (50±23) mm, respectively, and the difference was not statistically significant (χ2=3.61, P=0.31). Conclusions:The venous phase spectral images of DLSDCT can differentiate most central lung cancer from atelectasis. Therefore, it has great clinical application value in tumor staging, efficacy evaluation, and radiotherapy.

Objective:To explore the training methods to improve the cosmetic suture technique of junior surgeons.Methods:The training course of cosmetic suture techniques was carried out for junior residents such as plastic surgery professional graduate students and standardized training residents, through the study of the basic knowledge of cosmetic suture and the practical training of minimally invasive principles, to help them master cosmetic suture techniques systematically for the need of future clinical practice. Compared with the level of operation skills before and after cosmetic suture training in different groups (graduate students of plastic surgery and other majors, standardized training residents of plastic surgery and other majors), the residents' performance had been significantly improved. The incisions healing after half a year follow-up in cases they sutured were observed.Results:After cosmetic suture training, the suture skills of the students were significantly improved, and there was a significant correlation with the time of clinical practice. The incidence of incisions inflammation and postoperative scar formation in the cases sutured by the students with practice for 6 months was significantly lower than those for 1 month (6.42% vs 21.67%, 1.13% vs 5.56% respectively).Conclusions:The training of cosmetic suture techniques is very important to improve the professional ability of junior residents in plastic and cosmetic surgery, and it needs a long time practice to master the suture skills.

Objective:To investigate the clinical effect of botulinum toxin type A injection in the prevention and treatment of frontal traumatic scars immediately after operation.Methods:From January 2016 to January 2018, among the 152 patients with frontal trauma admitted to the Department of Plastic Surgery, Daping Hospital, Army Military Medical University, patients with wounds almost perpendicular to the Langer line were selected. Immediately after debridement and suture, botulinum toxin type A was injected with a concentration of 2 U botulinum toxin per 0.10 ml of solution, 0.05 to 0.10 ml (1 to 2 U) per 1 cm was injected into the frontal muscle according to frontal muscle strength.With reference to the observer scar assessment scale and Vancouver scar scale, the color, width, texture, thickness, pain, and itching of the postoperative scar of the frontal wound were evaluated at follow-up.Results:A total of 44 patients were included, 22 males and 22 females, aged (31.5 ± 8.4) years old, with a wound length of 1-12 cm(average, 3.5 cm) and a Botox injection volume around wounds of 0.10-0.90 ml (2-18 U) . The patients were followed up for 6 to 24 months. One patient had mild to moderate ptosis, which completely disappeared within one month. Within 6 weeks after operation, the scars in 44 patients were pink and hard. 3-6 months later, the scars gradually became soft, narrow and flat with similiar skin color, no pain and itching left in 42 patients. The satisfaction rate was 95.5% (42/44). Two patients were dissatisfied because of scar pigmentation and width.Conclusions:Immediate injection of botulinum toxin type A after debridement and suture of the frontal trauma wound can effectively prevent and improve scar appearance with a high rate of satisfaction.

This study introduces that we have established a clinical case database of scar prevention and treatment with medical histories, diagnosis and treatment ideas, and case expansion according to the scar diseases that professional postgraduates of plastic surgery need to master, and applied it to the practical teaching for plastic surgery postgraduates. Through the comprehensive evaluation from three aspects of mastering basic knowledge, applying knowledge and developing discipline, it's suggested that the professional postgraduates can better grasp the knowledge of scar prevention and treatments after learning from the clinical scar database, and the application of the teaching case database has further improved students' teaching and learning participations and innovative thinking abilities.

Objective:To investigate the clinical effect of botulinum toxin type A injection in the prevention and treatment of frontal traumatic scars immediately after operation.Methods:From January 2016 to January 2018, among the 152 patients with frontal trauma admitted to the Department of Plastic Surgery, Daping Hospital, Army Military Medical University, patients with wounds almost perpendicular to the Langer line were selected. Immediately after debridement and suture, botulinum toxin type A was injected with a concentration of 2 U botulinum toxin per 0.10 ml of solution, 0.05 to 0.10 ml (1 to 2 U) per 1 cm was injected into the frontal muscle according to frontal muscle strength.With reference to the observer scar assessment scale and Vancouver scar scale, the color, width, texture, thickness, pain, and itching of the postoperative scar of the frontal wound were evaluated at follow-up.Results:A total of 44 patients were included, 22 males and 22 females, aged (31.5 ± 8.4) years old, with a wound length of 1-12 cm(average, 3.5 cm) and a Botox injection volume around wounds of 0.10-0.90 ml (2-18 U) . The patients were followed up for 6 to 24 months. One patient had mild to moderate ptosis, which completely disappeared within one month. Within 6 weeks after operation, the scars in 44 patients were pink and hard. 3-6 months later, the scars gradually became soft, narrow and flat with similiar skin color, no pain and itching left in 42 patients. The satisfaction rate was 95.5% (42/44). Two patients were dissatisfied because of scar pigmentation and width.Conclusions:Immediate injection of botulinum toxin type A after debridement and suture of the frontal trauma wound can effectively prevent and improve scar appearance with a high rate of satisfaction.

Previously, we reported that Y, a new epigallocatechin gallate derivative, is efficacious in reversing doxorubicin (DOX)--mediated resistance in hepatocellular carcinoma BEL-7404/DOX cells. In this study, we evaluated the efficacy of Y in reversing drug resistance both and by determining its effect on the adenosine triphosphate-binding cassette protein B1 transporter (ABCB1 or P-glycoprotein, P-gp). Our results showed that Y significantly sensitized cells overexpressing the ABCB1 transporter to anticancer drugs that are ABCB1 substrates. Y significantly stimulated the adenosine triphosphatase activity of ABCB1. Furthermore, Y exhibited a higher docking score as compared with epigallocatechin gallate inside the transmembrane domain of ABCB1. In addition, in the nude mouse tumor xenograft model, Y (110 mg/kg, intragastric administration), in combination with doxorubicin (2 mg/kg, intraperitoneal injection), significantly inhibited the growth of BEL-7404/DOX cell xenograft tumors, compared to equivalent epigallocatechin gallate. In conclusion, Y significantly reversed ABCB1-mediated multidrug resistance and its mechanisms of action may result from its competitive inhibition of the ABCB1 drug efflux function.

Objective To measure the parameters of bronchus and peripheral pulmonary small vessel in the early simple pulmonary contusion, and to explore the changes of bronchial and pulmonary small blood vessels after pulmonary contusion.Methods The chest CT images of 30 patients with early simple pulmonary contusion were collected retrospectively,images were then automatically segmented using FACT-Digital lung TM software.Ipsilateral,contralateral bronchial parameters (luminal cross-sectional area,wall thickness,internal and external diameter,inner and outer circumference and luminal density)and pulmonary small vessel parameters (number of vessels in the visual area,total blood vessel area)for 33 pulmonary contusion cases were measured respectively,finally,correlation between lung contusion area and bronchial and small vessel parameters were analyzed.Results Ipsilateral bronchial parameters (luminal cross-sectional area, wall thickness,internal and external diameter,inner and outer circumference and luminal density)and pulmonary small vessel parameters (number of vessels in the visual area,total blood vessel area)were greater than those in the contralateral(P<0.05).The area of pulmonary contusion was not associated with bronchial parameters nor pulmonary small vessel parameters.Conclusion Quantitative CT analysis can intuitively show the changes of bronchial and pulmonary small blood vessels in patients with early simple pulmonary contusion.

OBJECTIVETo observe the effect difference betweendecoction combined with acupuncture at back-points and simpledecoction for chronic fatigue syndrome.

METHODSSixty patients were randomly assigned into an herbal group and a combination group, 30 cases in each one. Simpledecoction was used in the herbal group for continuous one month, one decoction a day. Based on that in the herbal group, 30 min acupuncture was used in the combination group at bilateral Xinshu (BL 15), Feishu (BL 13), Pishu (BL 20), Ganshu (BL 18) and Shenshu (BL 23), with acupoints according to syndrome differentiation. Acupuncture was given for 3 courses, 10 times as a course with 3 days between two courses, once a day. Fatigue status was evaluated before and after treatment by fatigue scale 14 (FS-14) and self-rating anxiety scale (SAS).

RESULTSThe FS-14 scores, including body fatigue scores, mental fatigue scores and total scores, and SAS scores after treatment were lower than those before treatment in the two groups (all<0.01), with better improvements in the combination group (all<0.01).

CONCLUSION decoction combined with acupuncture at back-points can improve chronic fatigue syndrome, which are better than simpledecoction.

Objective To investigate the clinical application and effect of pick-stab skill in eyebrow embroidery.Methods From July 2015 to January 2016,36 cases were selected to receive eyebrow embroidery with pick-stab skill in our department,including 1 male and 35 females.The cosmetic outcomes,complications and satisfaction rate were observed in these cases.Results In these 36 cases,14 cases were colored in one time,19 cases were colored twice,and 3 cases were more than 3 times.All patients were followed up for 6 months.The color of the eyebrow was natural,and the blue color was not existed.Conclusions The pick-stab skill in eyebrow embroidery is worthy in clinic with better cosmetic effect,higher success rate and safety.