Objective To analyze the distribution characteristics and trends of occupational exposure types of medical radiation workers in Gansu Province, China, and to provide a basis for administrative departments to formulate and adjust radiation protection policies. Methods According to the radiation health information platform, the data of occupational exposure types of radiation workers in Gansu Province from 2014 to 2023 were obtained. The proportions of occupational exposure types in each physical examination year was statistically analyzed. Results From 2014 to 2023, the number of medical radiation workers accounted for more than 70% of the total number of radiation workers. The proportion of X-ray imaging diagnostic radiation workers in the total number of medical radiation workers gradually decreased but remained the highest, exceeding 68% annually. The proportion of interventional radiology workers in the total number of medical radiation workers increased from 13.8% to 25.5%. The proportions of radiation therapy and nuclear medicine workers in the total number of medical radiation workers increased slowly. The numbers of interventional radiology and radiotherapy workers in tertiary hospitals both accounted for more than 70% of the total number of such workers in the province. The proportion of interventional radiology workers increased and then decreased. The proportion of radiotherapy workers increased significantly from 70.5% to 93.0%. The number of nuclear medicine workers in tertiary hospitals accounted for more than 80% of such workers in the province. Conclusion Radiation protection policies and measures should be adjusted according to the changes in the types of occupational exposure. The focus of these policies and measures should differ depending on the level of healthcare institutions, the type of radiological diagnostic and therapeutic services, and the characteristics of various occupational exposure types .

Objective:To analyze the characteristics and its influencing factors of occupational injury among clinical nuclear medicine staff, and to put forward suggestions for formulating relevant radiation protection intervention measures.Methods:In March 2022, a study was conducted involving 12 medical institutions engaged in nuclear medicine in Gansu Province. The occupational health examination data of 1451 clinical nuclear medicine staff were analyzed. The study subjects were divided into two groups based on the median annual effective dose of external exposure in 2022: Group A (annual effective dose ≤0.2 mSv, n=927) and group B (annual effective dose >0.2 mSv, n=524). The effects of annual effective dose, age, seniority, gender and occupational category on occupational health of clinical nuclear medicine staff were analyzed. Classification variables between groups were compared with Pearson χ2 test. Multivariate logistic regression was used to analyze the influencing factors of the abnormal results. Results:The abnormal rates of white blood cell count (WBC), red blood cell count (RBC) and hemoglobin (HGB) in female clinical nuclear medical staff were higher than those in males, and the differences were statistically significant ( P<0.001). The abnormal rates of WBC and HGB in clinical nuclear medicine staff of different occupational categories were statistically significant ( P<0.05). The abnormal rates of RBC and HGB of clinical nuclear medicine staff in annual effective dose group B were higher than those in group A, and the differences were statistically significant ( P<0.05). Multivariate logistic regression results showed that the abnormal risks of RBC in annual effective dose group B was 2.465 times of that in group A, the abnormal risks of RBC, WBC and HGB in females were 9.354, 2.939 and 6.760 times of those in males, respectively. The abnormal risk of WBC in the radiotherapy group was 2.334 times of that in general radiotherapy group. The abnormal risk of lens in nuclear medicine group was 2.459 times of that in general radiotherapy group. The abnormal risk of ECG and lens in ≥35 years old age group were 1.814 times and 1.969 times of those in <35 years old age group, respectively. The abnormal risk of lens of the ≥10 working years group was 1.899 times of that in the <10 working years group. The risk of lymphocyte micronucleus abnormality in the interventional group was 1.481 times of that in the general radiotherapy group, the risk of lymphocyte micronucleus abnormality in females was 2.215 times of that in males. The risk of lymphocyte micronucleus abnormality and lymphocyte chromosome aberration in ≥35 years old age group were 2.552 and 2.266 times of those in <35 years old age group, respectively. The risk of lymphocyte micronucleus abnormality in the group with≥10 working years was 1.443 times of that in<10 working years group ( P<0.05) . Conclusion:Long-term low-dose ionizing radiation has a certain effect on the lens and genetic indexes of clinical nuclear medicine staff.

Objective:To analyze the characteristics and its influencing factors of occupational injury among clinical nuclear medicine staff, and to put forward suggestions for formulating relevant radiation protection intervention measures.Methods:In March 2022, a study was conducted involving 12 medical institutions engaged in nuclear medicine in Gansu Province. The occupational health examination data of 1451 clinical nuclear medicine staff were analyzed. The study subjects were divided into two groups based on the median annual effective dose of external exposure in 2022: Group A (annual effective dose ≤0.2 mSv, n=927) and group B (annual effective dose >0.2 mSv, n=524). The effects of annual effective dose, age, seniority, gender and occupational category on occupational health of clinical nuclear medicine staff were analyzed. Classification variables between groups were compared with Pearson χ2 test. Multivariate logistic regression was used to analyze the influencing factors of the abnormal results. Results:The abnormal rates of white blood cell count (WBC), red blood cell count (RBC) and hemoglobin (HGB) in female clinical nuclear medical staff were higher than those in males, and the differences were statistically significant ( P<0.001). The abnormal rates of WBC and HGB in clinical nuclear medicine staff of different occupational categories were statistically significant ( P<0.05). The abnormal rates of RBC and HGB of clinical nuclear medicine staff in annual effective dose group B were higher than those in group A, and the differences were statistically significant ( P<0.05). Multivariate logistic regression results showed that the abnormal risks of RBC in annual effective dose group B was 2.465 times of that in group A, the abnormal risks of RBC, WBC and HGB in females were 9.354, 2.939 and 6.760 times of those in males, respectively. The abnormal risk of WBC in the radiotherapy group was 2.334 times of that in general radiotherapy group. The abnormal risk of lens in nuclear medicine group was 2.459 times of that in general radiotherapy group. The abnormal risk of ECG and lens in ≥35 years old age group were 1.814 times and 1.969 times of those in <35 years old age group, respectively. The abnormal risk of lens of the ≥10 working years group was 1.899 times of that in the <10 working years group. The risk of lymphocyte micronucleus abnormality in the interventional group was 1.481 times of that in the general radiotherapy group, the risk of lymphocyte micronucleus abnormality in females was 2.215 times of that in males. The risk of lymphocyte micronucleus abnormality and lymphocyte chromosome aberration in ≥35 years old age group were 2.552 and 2.266 times of those in <35 years old age group, respectively. The risk of lymphocyte micronucleus abnormality in the group with≥10 working years was 1.443 times of that in<10 working years group ( P<0.05) . Conclusion:Long-term low-dose ionizing radiation has a certain effect on the lens and genetic indexes of clinical nuclear medicine staff.

Objective:To investigate the incidence, influencing factors, and clinical characteristics during hospitalization of small for gestational age (SGA) infants among very preterm infants (VPIs) in neonatal intensive care units (NICUs).Methods:This study was a multicenter cohort study. Clinical data of VPIs with gestational age<32 weeks admitted to 19 collaborative units from January 1, 2019 to December 31, 2022, were collected from the Neonatal Perinatal Collaborative Network of Suxinyun (SNPN) and analyzed. General characteristics, perinatal conditions, and clinical manifestations during hospitalization of SGA infants among the VPIs were analyzed using Chi-square test, Mann-Whitney U test, and multivariate logistic regression. Clinical characteristics of symmetric and asymmetric SGA infants with hospital stay >7 d were also analyzed. Results:(1) During the study period, a total of 5 045 VPIs were included, among which there were 346 large for gestational age (LGA) infants, 4 475 appropriate for gestational age (AGA) infants, and 224 SGA infants, with a SGA incidence of 4.4%. The incidence of SGA was significantly higher in VPIs born at 30-31 +6 gestational weeks than in those with gestational age<28 weeks and born at 28-29 +6 weeks [6.1% (145/2 380) vs. 3.0% (25/833) and 3.6% (54/1 486), χ 2=11.77 and 11.32, both P<0.001]. No significant difference in SGA incidence was found between VPIs with gestational age<28 weeks and those born at 28-29 +6 weeks ( χ 2=0.65, P=0.248). (2) Multivariate logistic regression analysis showed that multiple pregnancies, hypertensive disorders of pregnancy (HDP) and assisted reproductive technology (ART) were independent risk factors for the occurrence of SGA in VPIs [ OR values (95% CI): 1.94 (1.43-2.64), 7.06 (5.34-9.33), and 1.59 (1.14-2.23)], and there was a significant gender difference, with the incidence of SGA being significantly lower in males than in females ( OR=0.61, 95% CI: 0.46-0.81). (3) The body temperature of SGA infants on admission was lower than that of AGA infants [36.0 °C (35.5-36.5 °C) vs. 36.0 °C (35.8-36.5 °C), Z=-2.08, P=0.004]. Moreover, the fasting time, the duration of parenteral nutrition, and the length of hospital stay for SGA infants were longer [3 d (1-7 d) vs. 2 d (1-5 d), 24 d (16-34 d) vs. 19 d (13-29 d), and 47 d (37-61 d) vs. 42 d (30-58 d), Z=-4.13,-4.65, and -3.02, all P<0.05]. The incidence of feeding intolerance, hypoglycemia, neonatal parenteral nutrition-associated cholestasis, and extrauterine growth restriction (EUGR), and the rate of treatment withdrawal or death were also higher in SGA infants [69.8% (143/205) vs. 58.9% (2 450/4 157), 17.6% (36/205) vs. 7.0% (292/4 157), 13.7% (28/205) vs. 6.4% (265/4 157), 77.7% (159/205) vs. 55.2% (2 295/4 157), and 7.8% (16/205) vs. 3.9% (162/4 157), χ 2=9.49, 31.19, 16.54, 44.40, and 7.62, all P<0.05]. Among SGA infants with hospital stay >7 d, there were 111 cases (54.1%) of symmetric SGA and 94 cases (45.9%) of asymmetric SGA. Compared with symmetric SGA infants, asymmetric SGA infants had shorter body length [34 cm (32-36 cm) vs. 38 cm (36-40 cm), Z=-8.49] and lower Apgar score at 1 min [7 points (5-8 points) vs. 8 points (5-8 points), Z=-3.05]. Besides, the proportion of multiple pregnancies and the incidence of postnatal hypoglycemia were higher in asymmetric SGA cases [38.3% (36/94) vs. 21.6% (24/111), 24.5% (23/94) vs. 10.8% (12/111), χ 2=6.84 and 6.71, both P<0.05], while the incidence of feeding intolerance and EUGR during hospitalization was lower [61.7% (58/94) vs. 76.6% (85/111), 58.5% (55/94) vs. 79.3% (88/111), χ2=5.34 and 10.41, both P<0.05]. Conclusions:Multiple pregnancies, HDP, and ART can increase the risk of SGA in VPIs. SGA infants may have increased risks of parenteral nutrition-related problems and EUGR during hospitalization. Symmetric SGA infants are more likely to develop EUGR.

Objective:To explore the influencing factors of whole blood cells and genetics of medical radiation workers, and provide technical support for improving occupational health management and strengthening radiation protection.Methods:In January 2022, a total of 4180 medical radiation workers who underwent occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 2020 to December 2021 were collected as the research objects, and the results of demographic characteristics, whole blood cells, chromosome aberrations, lymphocyte micronucleus and other results were collected. The whole blood cells and genetic abnormalities of different demographic characteristics of medical radiation workers were compared. And the influencing factors of whole blood cells and genetic abnormalities were analyzed by multivariate logistic regression.Results:The rates of hemoglobin (HGB), chromosome aberration and lymphocyte micronucleus abnormality were the highest in the nuclear medicine group, and the rate of white blood cell (WBC) abnormality in the radiotherapy group was higher than those in other occupational groups, the differences were statistically significant ( P<0.05). The abnormal rates of WBC, HGB and lymphocyte micronucleus in female radiation workers were significantly higher than those in male radiation workers ( P<0.001). The abnormal rates of HGB and lymphocyte micronucleus were statistically different among different working years and different age radiation workers ( P<0.001). And the abnormal rate of platelet (PLT) was statistically different among different working years radiation workers ( P<0.05). The abnormal rate of HGB in radiation workers of different hospital levels was statistically different ( P<0.001). Logistic regression analysis showed that the risk of abnormal WBC and HGB in females radiation workers were 3.048 times and 13.122 times of those in males, respectively ( P<0.001). The abnormal risks of WBC in the 6-20 working years group and >20 working years group were 1.517 times and 1.874 times of that in the ≤5 working years group, respectively ( P<0.05). The abnormal risk of PLT in the >20 working years group was 2.643 times of that in ≤5 working years group ( P<0.05). The abnormal risk of WBC in radiotherapy group and intervention group were 2.407 times and 1.341 times of that in general radiotherapy group, respectively ( P<0.05) . Conclusion:Ionizing radiation has different effects on the whole blood cells and genetic indexes of workers in the nuclear medicine, interventional group and radiotherapy group. The occupational health protection of female radiation workers should be paid attention to.

Objective:To explore the influencing factors of whole blood cells and genetics of medical radiation workers, and provide technical support for improving occupational health management and strengthening radiation protection.Methods:In January 2022, a total of 4180 medical radiation workers who underwent occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 2020 to December 2021 were collected as the research objects, and the results of demographic characteristics, whole blood cells, chromosome aberrations, lymphocyte micronucleus and other results were collected. The whole blood cells and genetic abnormalities of different demographic characteristics of medical radiation workers were compared. And the influencing factors of whole blood cells and genetic abnormalities were analyzed by multivariate logistic regression.Results:The rates of hemoglobin (HGB), chromosome aberration and lymphocyte micronucleus abnormality were the highest in the nuclear medicine group, and the rate of white blood cell (WBC) abnormality in the radiotherapy group was higher than those in other occupational groups, the differences were statistically significant ( P<0.05). The abnormal rates of WBC, HGB and lymphocyte micronucleus in female radiation workers were significantly higher than those in male radiation workers ( P<0.001). The abnormal rates of HGB and lymphocyte micronucleus were statistically different among different working years and different age radiation workers ( P<0.001). And the abnormal rate of platelet (PLT) was statistically different among different working years radiation workers ( P<0.05). The abnormal rate of HGB in radiation workers of different hospital levels was statistically different ( P<0.001). Logistic regression analysis showed that the risk of abnormal WBC and HGB in females radiation workers were 3.048 times and 13.122 times of those in males, respectively ( P<0.001). The abnormal risks of WBC in the 6-20 working years group and >20 working years group were 1.517 times and 1.874 times of that in the ≤5 working years group, respectively ( P<0.05). The abnormal risk of PLT in the >20 working years group was 2.643 times of that in ≤5 working years group ( P<0.05). The abnormal risk of WBC in radiotherapy group and intervention group were 2.407 times and 1.341 times of that in general radiotherapy group, respectively ( P<0.05) . Conclusion:Ionizing radiation has different effects on the whole blood cells and genetic indexes of workers in the nuclear medicine, interventional group and radiotherapy group. The occupational health protection of female radiation workers should be paid attention to.

Objective:To explore the effect of mind mapping combined with continuous quality improvement in the teaching of interns in gastroenterology department.Methods:The 55 students who interned in the gastroenterology department of our hospital from September 2019 to January 2020 were set as the control group and adopted traditional teaching methods; the other 54 students who interned in the gastroenterology department of our hospital from February 2020 to June 2020 were set as the control group; 55 students who interned in the gastroenterology department of our hospital from July 2020 to November 2020 were set as a combined group, and received mind mapping combined with continuous quality improvement teaching. The gastroenterology knowledge and theory assessment results, practical skills operation assessment results and learning initiative, self-study ability, comprehensive thinking ability, teamwork ability, analysis and problem-solving ability, induction and summary ability and so on were compared between the two groups, and the teaching satisfaction rate at the time of leaving the department were also compared. SPSS 20.0 was used for t test and chi-square test. Results:Before the training, there was no statistically significant difference in the three groups of theoretical assessment scores, practical skills operation assessment scores and various ability scores. When leaving the department, the theoretical assessment scores of the combined group and the mind mapping group were (89.74±4.18) points and (86.52±3.72) points, and the performance evaluation scores of practical skills were (90.04±4.86) points and (87.46±4.52) points, respectively. The theoretical evaluation scores and practical skills evaluation scores of the two groups were higher than those of the control group, and the combined group was higher than the mind mapping group, with statistically significant differences ( P<0.05). The scores of various abilities of the combined group and the mind mapping group were higher than those of the control group, and the scores of all indicators in the combined group were higher than those of the mind mapping group, with statistical significance ( P<0.05). The total teaching satisfaction of combined group and mind mapping group was higher than that of the control group, and the total teaching satisfaction of the combined group was higher than that of the mind mapping group. Conclusion:Mind mapping combined with continuous quality improvement has a significant effect on the teaching of gastroenterology interns, which can improve students' abilities and the teaching satisfaction.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.