Ultrasound guided percutaneous interventional therapy has been widely used in clinic. Aiming at the problem of soft tissue deformation caused by probe contact force in robot-assisted ultrasound-guided therapy, a real-time non-reference ultrasound image evaluation method considering soft tissue deformation is proposed. On the basis of ultrasound image brightness and sharpness, a multi-dimensional ultrasound image evaluation index was designed, which incorporated the aggregation characteristics of the organization. In order to verify the effectiveness of the proposed method, ultrasound images of four different models were collected for experiments, including prostate phantom, phantom with cyst, pig liver tissue, and pig liver tissue with cyst. In addition, the correlation between subjective and objective evaluations was analyzed based on Spearman's rank correlation coefficient. Experimental results showed that the average evaluation time of a single image was 68.8 milliseconds. The evaluation time could satisfy real-time applications. The proposed method realizes the effective evaluation of real-time ultrasound image quality in robot-assisted therapy, and has good consistency with the evaluation of supervisors.
Animals ; Cysts ; Male ; Phantoms, Imaging ; Swine ; Ultrasonography/methods*

Objective:To examine the feasibility of small drain in transoral endoscopic thyroidectomy vestibular approach (TOETVA).Methods:A prospective research was performed in Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital, from October 2018 to March 2019. Totally 103 patients who met the inclusion and exclusion criteria, signed the operation agreement of TOETVA, had their surgery completed and followed-up over 6 months, were enrolled in analysis. A central venous catheter was used as a drain tube in all cases (outer diameter 1.7 mm, inner diameter 1.0 mm). Visual analogue scale (VAS) was applied for assessing pain scores during the first 24 hours after the operation. Vancouver scar scale (VSS) was used for assessing the scar left by the drainage. The drainage volume (minimum scale:10 ml, approximate read: 1 ml) was recorded every 2 hours during the first postoperative 12 hours, every 4 hours during 12 to 24 hours, every 8 hours during 24 to 48 hours, and once from 48 hours until extubation. The volume of drainage, the cumulative volume and the percentage of cumulative volume accounting for the total volume were calculated. The data of residual volume (subtract the cumulative volume from the total volume) in the postoperative 24, 32 and 40 hours were analyzed, and their upper one-side P 95 was calculated by percentile method. Results:There were 12 males and 91 females. The age was (36.6±9.7) years (range: 18 to 58 years). The intraoperative tube-inserting time was (10.1±2.6) minutes (range: 6 to 18 minutes). The pain score on the first day was 2.7±1.1 (range: 1 to 5). The extubation time was (2.7±0.5) days (range: 2 to 4 days). VSS scores in the postoperative 1 st month and 6 th month were 2.9±1.3 (range: 0 to 7) and 0(2)( M( Q R)), respectively. The size of the scar was 0 (2.5) mm in the postoperative 6 th month. Sixty-four patients had no visible scars. There were 5 patients who had postoperative drain-related complications (1 for air leakage, 1 for tube blockage, 3 for subcutaneous hydrop, 2 for regional infection), who were all cured after proper treatment. The total volume of drainage for 98 patients without postoperative drain-related complications was (80.1±12.2) ml (range: 58 to 131 ml). The cumulative drainage within 8 hours accounted for (53.8±4.2)% (range: 41.0% to 62.9%) of the total drainage. The volume of residual fluids in the postoperative 32 hours was estimated to (5.8±2.7) ml (range: 0 to 12 ml, P 95=10.0 ml). Conclusions:The small drain tubecan be applied in TOETVA, providing a satisfied cosmetic appearance and a reliable drainage. The main exudation period of the wound is within 8 hours after the operation. If a residual volume less than 10 ml is considered to be self-absorbable, the shortest safe extubation point for 95% patients without drain-related complications should be 32 hours after the operation.

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 selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection.Methods:From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget′s disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded.Results:Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients.Conclusions:For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.

Objective:To examine the feasibility of small drain in transoral endoscopic thyroidectomy vestibular approach (TOETVA).Methods:A prospective research was performed in Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital, from October 2018 to March 2019. Totally 103 patients who met the inclusion and exclusion criteria, signed the operation agreement of TOETVA, had their surgery completed and followed-up over 6 months, were enrolled in analysis. A central venous catheter was used as a drain tube in all cases (outer diameter 1.7 mm, inner diameter 1.0 mm). Visual analogue scale (VAS) was applied for assessing pain scores during the first 24 hours after the operation. Vancouver scar scale (VSS) was used for assessing the scar left by the drainage. The drainage volume (minimum scale:10 ml, approximate read: 1 ml) was recorded every 2 hours during the first postoperative 12 hours, every 4 hours during 12 to 24 hours, every 8 hours during 24 to 48 hours, and once from 48 hours until extubation. The volume of drainage, the cumulative volume and the percentage of cumulative volume accounting for the total volume were calculated. The data of residual volume (subtract the cumulative volume from the total volume) in the postoperative 24, 32 and 40 hours were analyzed, and their upper one-side P 95 was calculated by percentile method. Results:There were 12 males and 91 females. The age was (36.6±9.7) years (range: 18 to 58 years). The intraoperative tube-inserting time was (10.1±2.6) minutes (range: 6 to 18 minutes). The pain score on the first day was 2.7±1.1 (range: 1 to 5). The extubation time was (2.7±0.5) days (range: 2 to 4 days). VSS scores in the postoperative 1 st month and 6 th month were 2.9±1.3 (range: 0 to 7) and 0(2)( M( Q R)), respectively. The size of the scar was 0 (2.5) mm in the postoperative 6 th month. Sixty-four patients had no visible scars. There were 5 patients who had postoperative drain-related complications (1 for air leakage, 1 for tube blockage, 3 for subcutaneous hydrop, 2 for regional infection), who were all cured after proper treatment. The total volume of drainage for 98 patients without postoperative drain-related complications was (80.1±12.2) ml (range: 58 to 131 ml). The cumulative drainage within 8 hours accounted for (53.8±4.2)% (range: 41.0% to 62.9%) of the total drainage. The volume of residual fluids in the postoperative 32 hours was estimated to (5.8±2.7) ml (range: 0 to 12 ml, P 95=10.0 ml). Conclusions:The small drain tubecan be applied in TOETVA, providing a satisfied cosmetic appearance and a reliable drainage. The main exudation period of the wound is within 8 hours after the operation. If a residual volume less than 10 ml is considered to be self-absorbable, the shortest safe extubation point for 95% patients without drain-related complications should be 32 hours after the operation.

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 safety and feasibility of the modified transoral endoscopic thyroidectomy vestibular approach (TOETVA) by dissection of mental nerve in clinical practice. Methods: Totally 140 patients underwent the modified TOETVA from the Department of Head and Neck Surgery, Hunan Cancer Hospital from July 2016 to June 2018 were analyzed retrospectively. There were 130 females and 10 males, aging (35.4±9.8) years (range: 11 to 56 years). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative suction drainage, postoperative pain score, postoperative cosmetic satisfaction and postoperative complications (recurrent laryngeal nerve palsy, hypoparathyroidism, infection, pneumoderm, seroma and mental nerve injury) were summarized. Results: Of the 140 patients, 1 patient was transferred to open surgery. Fifty-nine patients underwent thyroidectomy with an operation time of (100.8±18.9) minutes. Sixty-three patients underwent thyroidectomy and central lymphadenectomy with an operation time of (112.1±16.6) minutes. Eighteen cases underwent total thyroidectomy and central lymphadenectomy with an operation time of (185.3±25.9) minutes. The postoperative hospital stay was (3.76±0.98) days. The postoperative drainage was (96.8±36.2) ml. The 24-hour postoperative pain score was 2.66±1.23, the postoperative cosmetic satisfaction was 9.65±0.24. Among the postoperative complications, there were 3 cases of temporary recurrent laryngeal nerve palsy, 2 cases of permanent recurrent laryngeal nerve palsy, 4 cases of temporary hypoparathyroidism but no permanent hypoparathyroidism, 2 cases of infection, 1 case of seroma, 3 cases of pneumoderm, and no cases of mental nerve injury. Conclusion The modified TOETVA by dissection of mental nerve is safe and feasible.

Objective To investigate the safety and feasibility of the modified transoral endoscopic thyroidectomy vestibular approach (TOETVA) by dissection of mental nerve in clinical practice. Methods Totally 140 patients underwent the modified TOETVA from the Department of Head and Neck Surgery, Hunan Cancer Hospital from July 2016 to June 2018 were analyzed retrospectively. There were 130 females and 10 males, aging (35.4±9.8) years (range: 11 to 56 years). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative suction drainage, postoperative pain score, postoperative cosmetic satisfaction and postoperative complications (recurrent laryngeal nerve palsy, hypoparathyroidism, infection, pneumoderm, seroma and mental nerve injury) were summarized. Results Of the 140 patients, 1 patient was transferred to open surgery. Fifty?nine patients underwent thyroidectomy with an operation time of (100.8 ± 18.9) minutes. Sixty?three patients underwent thyroidectomy and central lymphadenectomy with an operation time of (112.1 ± 16.6) minutes. Eighteen cases underwent total thyroidectomy and central lymphadenectomy with an operation time of (185.3 ± 25.9) minutes. The postoperative hospital stay was (3.76 ± 0.98) days. The postoperative drainage was (96.8 ± 36.2) ml. The 24?hour postoperative pain score was 2.66 ± 1.23, the postoperative cosmetic satisfaction was 9.65 ± 0.24. Among the postoperative complications, there were 3 cases of temporary recurrent laryngeal nerve palsy, 2 cases of permanent recurrent laryngeal nerve palsy, 4 cases of temporary hypoparathyroidism but no permanent hypoparathyroidism, 2 cases of infection, 1 case of seroma, 3 cases of pneumoderm, and no cases of mental nerve injury. Conclusion The modified TOETVA by dissection of mental nerve is safe and feasible.

Objective To investigate the safety and feasibility of the modified transoral endoscopic thyroidectomy vestibular approach (TOETVA) by dissection of mental nerve in clinical practice. Methods Totally 140 patients underwent the modified TOETVA from the Department of Head and Neck Surgery, Hunan Cancer Hospital from July 2016 to June 2018 were analyzed retrospectively. There were 130 females and 10 males, aging (35.4±9.8) years (range: 11 to 56 years). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative suction drainage, postoperative pain score, postoperative cosmetic satisfaction and postoperative complications (recurrent laryngeal nerve palsy, hypoparathyroidism, infection, pneumoderm, seroma and mental nerve injury) were summarized. Results Of the 140 patients, 1 patient was transferred to open surgery. Fifty?nine patients underwent thyroidectomy with an operation time of (100.8 ± 18.9) minutes. Sixty?three patients underwent thyroidectomy and central lymphadenectomy with an operation time of (112.1 ± 16.6) minutes. Eighteen cases underwent total thyroidectomy and central lymphadenectomy with an operation time of (185.3 ± 25.9) minutes. The postoperative hospital stay was (3.76 ± 0.98) days. The postoperative drainage was (96.8 ± 36.2) ml. The 24?hour postoperative pain score was 2.66 ± 1.23, the postoperative cosmetic satisfaction was 9.65 ± 0.24. Among the postoperative complications, there were 3 cases of temporary recurrent laryngeal nerve palsy, 2 cases of permanent recurrent laryngeal nerve palsy, 4 cases of temporary hypoparathyroidism but no permanent hypoparathyroidism, 2 cases of infection, 1 case of seroma, 3 cases of pneumoderm, and no cases of mental nerve injury. Conclusion The modified TOETVA by dissection of mental nerve is safe and feasible.

The polar tube protein is the major component of polar tube, and can specifically locate on the polar tube of microsporidia and plays an important role in invasion host cell. In this study, we analyzed the potential O- and Nglycosylation sites in polar tube protein 1 from Nosema bombycis. NbPTP1 was successfully cloned to eukaryotic expression vector pMT/Bip/V5-His A, involved V5 and His tags. After transfection, NbPTP1 gene could be efficiently expressed in Drosophila S2 cells. In addition, Lectin blotting and beta elimination analysis showed that NbPTP1 expressed in Drosophila S2 cells was O-glycosylation. These studies provided a basis for understanding the relationship between glycosylation and function of NbPTP1, helped us to reveal the infection mechanism of microsporidia and established effective diagnosis and prevention methods for microsporidia.