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Objective:To analyze the application effect of PAD teaching mode in Epidemiology teaching,and to investigate students'suggestions for improving PAD class,so as to provide some thoughts and basis for improving teaching reform.Methods:PAD class was introduced into Epidemiology teaching.Two cross-sectional surveys were conducted after class,and questionnaires about PAD learning interests and suggestions for improvement were anonymously collected.The teaching effect was analyzed and suggestions for rectification were put forward.Results:Among the 134 students majoring in medical laboratory science,the score rate of each learning interest survey item of PAD teaching mode was more than 80% .And 57.46% of the students thought that discussion sessions should be added.The scores of chapter test in PAD mode class was higher than that in traditional mode class(t=2.938,P＜0.01).Conclusions:PAD class can enhance learning interest and knowledge mastery.The time schedule of teaching and discussion should be adjusted in time according to students'wishes,and after-school exercises and counseling should be appropriately increased to promote the application of PAD class in Epidemiology teaching.
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BACKGROUND:Overweight or obesity is the most significant risk factors for knee osteoarthritis.Time-restricted diet shows an effective effect in preventing overweight or obesity.Whether infrapatellar fat pad,an important component of the knee joint,is affected by time-restricted diet and thus influences knee osteoarthritis remains unclear. OBJECTIVE:To employ a high-fat diet-induced rat model to investigate the effect of weight loss by time-restricted diet on infrapatellar fat pad,thereby providing evidence for early prevention and treatment of obesity-related knee osteoarthritis. METHODS:Fifteen male Sprague-Dawley rats were randomly divided into three groups(n=5 per group).Rats in the control group were allowed to eat at will for 24 hours and were fed the defined control diet(12%fat);rats in the high-fat diet group were allowed to eat at will for 24 hours and were fed the high-fat diet(45%fat);and rats in the high-fat diet with time-restricted diet group were fed the high-fat diet only from 9:00(2 hours after the light)to 17:00(2 hours before the dark).After 8 weeks of feeding,mDixon-Quant sequence was used to assess proton density fat fraction in the infrapatellar fat pad and subcutaneous adipose tissue in the right inguinal region.ELISA was used to quantify differences adipokine.Sirius red staining was used to evaluate changes in fibrosis of the infrapatellar fat pad.The expressions of uncoupling protein-1 in the infrapatellar fat pad and subcutaneous adipose tissue in the right inguinal region as well as leptin,adiponectin and tumor necrosis factor-α in the infrapatellar fat pad were detected by immunohistochemistry staining. RESULTS AND CONCLUSION:After 8 weeks of feeding,compared with the high-fat diet group,the body mass of rats in the control group(P=0.036)and the high-fat diet with time-restricted diet group(P=0.003)was significantly reduced.The proton density fat fraction in the infrapatellar fat pad in the high-fat diet group was significantly higher than that in the control group(P<0.001)and the high-fat diet with time-restricted diet group(P=0.004),while there was no significant difference in the proton density fat fraction of the subcutaneous adipose tissue among the three groups.The serum leptin levels of rats in the high-fat diet group were significantly higher than those in the control group(P=0.030)and the high-fat diet with time-restricted diet group(P=0.018).Compared with the high-fat diet group,the infrapatellar fat pad fibrosis characterized by Sirius red staining in the control group(P<0.001)and the time-restricted diet group(P=0.003)was significantly decreased.The expression of leptin in IFP of the high-fat diet group was significantly higher than that of the control group(P<0.001)and the high-fat diet with time-restricted diet group(P<0.001).The expression of adiponectin in the infrapatellar fat pad of the high-fat diet group was significantly lower than that of the control group(P=0.004)and the high-fat diet with time-restricted feeding group(P=0.048).However,there was no positive expression of uncoupling protein-1 in the infrapatellar fat pad and subcutaneous adipose tissue of all the three groups,and no positive expression of tumor necrosis factor-α in the infrapatellar fat pad.To conclude,time-restricted diet could retard the fibrosis of the infrapatellar fat pad,reduce the proton density fat fraction of the infrapatellar fat pad,and affect the level of adipokine in serum and infrapatellar fat pad.Time-restricted diet may become a simple and effective option for the treatment and prevention of obesity-related knee osteoarthritis.
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Objective:To investigate the preventive and therapeutic effects of compound wild chrysanthemum eye pad on blue light-induced alteration of meibomian gland function in mice and its mechanism.Methods:Sixty-four 15-week-old male C57BL/6J mice were divided into two groups of 32 mice each according to random numbers for the prevention test and the treatment test.The respective 32 mice in the prevention and treatment experiments were randomly divided into normal group, blue light group, solvent group and eye pad group according to random numbers, with eight mice in each group, respectively.In the prevention experiments, mice in each group were exposed to blue light at a wavelength of 460 nm and a light intensity of 2 000 lx for 6 hours per day for 15 consecutive days to establish a mouse model of meibomian gland function changes except for the normal group.The solvent group and the eye pad group were treated with the corresponding eye pad before and after the blue light exposure for 25 minutes daily for the 15 consecutive days.The blue light group was treated with blue light exposure only for 15 days, and the mice were photographed at the edge of the meibomian gland on day 15 to observe the function of the meibomian gland except for the normal group.In the treatment test, all groups of mice except the normal group were induced the altered function of the mouse meibomian gland by the above method.The solvent and eye pad groups were treated with corresponding eye pads for 25 minutes in the morning and afternoon of each day for 15 consecutive days after blue light exposure.The blue light group was kept in a standard environment for 15 days and the changes in meibomian gland function of mice were detected by meibomian gland photographs on day 15.Photography of the eyelid margin in vitro, oil red O staining, and hematoxylin-eosin staining were performed to observe the histologic changes in the meibomian glands of mice after the preventive and experimental treatment.The relative expression of interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) mRNA in mouse meibomian gland tissues was detected by real-time fluorescence quantitative PCR.The expression of nuclear factor-κB (NF-κB) and phosphorylation of NF-κB (p-NF-κB) proteins in mice meibomian gland tissues was detected by Western blot to assess the degree of amelioration of blue light-induced inflammation in mouse meibomian glands by the compound wild chrysanthemum eye pad.This study was conducted in accordance with the Statement of the Association for Research in Vision and Ophthalmology on the Use of Animals in Ophthalmology and Vision Research, and was approved by the Animal Ethics Committee of Xiamen University (No.XMULAC20220258). Results:Compared with the normal group, a gradually increased number of blocked meibomian gland openings, and a gradually decreased remaining area of lower meibomian gland, were observed in the mice after 15 days of blue light group, and all the differences were statistically different (all at P<0.05). In the prevention test, the number of obstructed opening in the eye pad group was 1.833±0.753, which was significantly less than 3.667±1.033 in the solvent group ( P<0.05). The relative remaining area of the lower lid meibomian gland in the eye pad group was 0.718±0.091, which was significantly greater than 0.624±0.130 in the solvent group ( P<0.05). Hematoxylin-eosin staining showed inflammatory cell infiltration in mouse meibomian gland in the blue light and solvent groups.There was no inflammatory cell infiltration in eye pad group, and the morphology of the acini was similar to that of the normal group.Oil red O staining showed that there was no significant lipid deposition in the groups.The relative expressions of IL-1β, IL-6, TNF-α, and IFN-γ mRNA were significantly lower, and the relative expressions of NF-κB and p-NF-κB proteins were significantly lower in the eye pad group than in the solvent group, showing statistically significant differences (all at P<0.05). In the treatment test, the number of obstructed openings in the eye pad group and solvent group was 4.333±1.211 and 4.833±1.722, respectively, and the relative remaining area of the lower meibomian gland was 0.572±0.151 and 0.588±0.154, respectively, showing no statistically significant differences (both at P>0.05). Hematoxylin-eosin staining showed inflammatory cell infiltration in mouse meibomian glands in the blue light and solvent groups, with a similar morphology of acini as in the normal group.There was no inflammatory cell infiltration in eye pad group.Oil red O staining showed that there was no significant lipid deposition in the groups.The relative expressions of IL-1β, IL-6, and IFN-γ mRNA were significantly lower and the relative expressions of NF-κB and p-NF-κB proteins were significantly lower in the eye pad group than in the solvent group (all at P<0.05). Conclusions:Compound wild chrysanthemum eye pad may have preventive and therapeutic effects on blue light-induced changes in meibomian gland function by reducing the inflammatory response of meibomian gland tissue through the inhibition of the NF-κB signaling pathway.
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Prevention and treatment of complications after liver transplantation play a significant role in maintaining liver graft function and improving clinical prognosis of the recipients. Neutrophil extracellular trap (NET) are fibrous net-like structures composed of DNA as the skeleton and histones and granular proteins released by activated neutrophils. Studies have shown that the activation of neutrophils and the release of NET in donor liver after liver transplantation are involved in the incidence of multiple liver transplantation-related complications including ischemia-reperfusion injury, acute rejection, acute liver failure and recurrence of hepatocellular carcinoma, etc. In this article, the effect of NET on the complications after liver transplantation was mainly assessed, and research progress on NET as a potential target for the prevention and treatment of complications after liver transplantation was reviewed, aiming to provide reference for the prevention and treatment of complications after liver transplantation, enhance clinical efficacy of liver transplantation and improve clinical prognosis of the recipients.
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Objective:To investigate the effect of multi position prone position latex pad in patients with severe acute respiratory distress syndrome undergoing prone position ventilation, aiming to improve the effect of oxygenation therapy and reduce the complications associated with prone ventilation.Methods:A randomized controlled trial was used to select 80 patients with prone ventilation with severe acute respiratory distress syndrome who were admitted to the ICU of Yancheng First People ′s Hospital from February 2020 to February 2022 by convenient sampling method. The random number method was used to divide into experimental group and control group, with 40 cases in each group. The control group used soft pillow cushions for traditional prone ventilation, and the experimental group used homemade multi-site prone latex pads for prone ventilation. The effects of oxygenation therapy (oxygenation index and PaCO 2), the incidence of complications (pressure injury, artificial airway tube slippage, artificial airway tube bending) and nursing workload (length of turning over and total treatment time) were compared between the two groups. Results:After the intervention, the oxygenation index and PaCO 2 in the experimental group was (265.79 ± 21.15), (31.52 ± 3.43) mmHg (1 mmHg=0.133 kPa) respectively, and the control group was (177.43 ± 17.76), (39.73 ± 4.80) mmHg respectively and the differences between the two groups were statistically significant ( t=15.43, 10.17, both P<0.05). The incidence of pressure injury and artificial airway tube bending in the experimental group was 7.5% (3/40) and 0 respectively, and the control group was 37.5% (15/40) and 20.0% (8/40) respectively, and the differences between the two groups were statistically significant ( χ2=10.32, 8.89, both P<0.05). The incidence of artificial airway tube slippage in the experimental group and the control group was 0 and 7.5% (3/40) respectively, and there was no significant difference between the two groups ( χ2=3.12, P>0.05). The duration and total treatment duration of prone turning in the experimental group was (3.56 ± 0.53) min and (34.47 ± 3.72) h respectively, and the control group was (5.18 ± 0.61) min and (50.22 ± 4.60) h respectively, and the differences between the two groups were statistically significant ( t=6.25, 13.55, both P<0.05). Conclusions:The application of multi position prone position latex pad in patients with severe acute respiratory distress syndrome can significantly improve the oxygenation effect, reduce the incidence of complications and reduce the workload of nursing, which is worthy of clinical application.
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【Objective】 To explore the clinical efficacy and safety of pelvic floor magnetic and electrical stimulation combined with Kegel exercise training in the treatment of stress urinary incontinence (SUI) after minimally invasive surgery for benign prostatic hyperplasia (BPH). 【Methods】 A total of 52 patients with SUI after minimally invasive surgery for BPH treated during Jan.2016 and Feb.2022 were randomly divided into test group (n=26) and control group (n=26). The test group received pelvic floor magnetic and electrical stimulation and Kegel exercise training, while the control group received Kegel exercise training only. The treatment lasted for 3 months. The scores of International Consultation on Incontinence Modular Questionnaire Short Form (ICIQ-SF), 1 h pad test, International Prostate Symptom Score (IPSS) and Incontinence Quality of Life Questionnaire (I-QoL) were recorded and compared between the two groups before and after treatment. The adverse reactions were observed. 【Results】 The scores of ICIQ-SF, IPSS and I-QoL and 1 h pad test significantly decreased in both groups after treatment (P0.05), but after treatment, the scores of ICIQ-SF,IPSS,I-QoL and 1 h pad test were significantly lower in the test group than in the control group (P<0.05). No severe adverse reactions were observed. 【Conclusion】 Pelvic floor magnetic stimulation combined with Kegel exercise training is safe and effective for SUI after minimally invasive surgery for BPH.
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OBJECTIVE@#To explore the effectiveness of hairpin shaped incision combined with cover-lifting flap in plastic surgery of huge fat pad on nape and back.@*METHODS@#Between March 2019 and March 2023, 10 patients with huge fat pad on the nape and back were treated. There was 1 male and 9 females with an average age of 52 years (range, 39-57 years). All patients had soft tissue bulge on the nape and back. Preoperative MRI showed the subcutaneous fat thickening. The length of the longitudinal axis of the fat pad ranged from 10.0 to 25.0 cm (mean, 14.1 cm), the length of the transverse axis ranged from 6.0 to 15.0 cm (mean, 10.8 cm); the thickness of the fat pad ranged from 2.5 to 5.1 cm (mean, 3.9 cm). Under general anesthesia, the patient was placed in a prone position and a hairpin shaped incision was made. The flap was lifted to remove the fat pad according to the marked area. The dressing was changed every 2 days after operation.@*RESULTS@#The operation time was 35-110 minutes (mean, 72 minutes). The intraoperative blood loss was 35-80 mL (mean, 49.5 mL). The drainage tube was removed at 2-5 days after operation (mean, 3.4 days). All incisions healed by first intention without incision dehiscence, infection, subcutaneous bruising, hematoma, or other related complications. All patients were followed up 2-24 months (mean, 12 months). All patients had a good shape of the nape and back and no noticeable scar on the incision. According to the Vancouver Scar Scale evaluation criteria, the incision scar score was 3-5 (mean, 3.7) at 2 months after operation. Patients had good neck movement with no recurrence.@*CONCLUSION@#For the huge fat pad on the nape and back, the plastic surgery using hairpin shaped incision and cover-lifting flap has the advantages of fully exposing the fat pad, concealed incision, simple operation, and natural shape of the nape and back after operation.
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Female , Humans , Male , Middle Aged , Surgery, Plastic , Cicatrix , Lifting , Plastic Surgery Procedures , Surgical Wound , Adipose TissueABSTRACT
Background:Peripheral arterial disease (PAD) is one of the major macrovascular complications of diabetes mellitus (DM) which is largely neglected by clinicians. DM-associated atherosclerosis can lead to complications in all major of vascular beds, including the coronary arteries, carotid vessels, and lower extremity arteries. Aims and objective were tostudy the prevalence of PAD in patients with type 2 DMand to study the correlation with carotid artery intima-media thicknessMethods:Hospital based cross-sectional study was conducted among the 124 patients admitted with type 2 diabetes (age >25 year) from Dec 2019 to Oct 2021 in the various units of department of medicineor surgery, KPS institute, GSVM medical college Kanpur. Color doppler of limbs and carotid artery was done in study population.Results:In our study based on doppler ultrasound, the prevalence of PAD was found in 31 patients (25%) out of 124 with men having a higher prevalence (24 out of 74; 77.4%), as compared to women (7 out of 50; 22.6%) (p=0.020). The mean Carotid IMT (mm) (Average) was 0.82±0.16 in all diabetics. Patients with PAD have more increase in CIMT (0.95±0.12) as compare to non-PAD (0.77±0.15) p<0.001.Conclusions:By using doppler, we found evidence of PAD in 25% of type 2 diabetics (M>>F). Patients with PAD have more increase in CIMT as compare to non-PAD.
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Background: India accounts for a quarter of the world cervical cancer burden. Cervical cancer is highly preventable. However, low level of participating women in screening is one of the major issues. The aim of this work was to study the factors that influence women to participate in cervical cancer screening by providing menstrual pads for human papillomavirus (HPV) testing. Methods: Menstrual clothes were collected from two different populations from the rural areas of Maharashtra state for HPV testing to screen for cervical cancer. For this study, out of 945 participated women, 557 (58.9%) provided their menstrual pads. Multivariate logistic regression was applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Results: The probability of providing the menstrual pads was high among the women who were highly educated compared to those with less education (OR: 1.4; 95% CI: 1.0–1.9), having mobile phone facilities as compared to those with no mobile phones (OR: 1.4; 95% CI: 1.0–2.0), who were using new cloths as menstrual pads compared to those who did not use the same (OR: 8.5; 95% CI: 5.0–14.3), who did not have tobacco habit as compared to those who had tobacco habit (OR: 1.4; 95% CI: 1.1–1.9) and in the village where health worker was stationed as compared to the village where health worker was not stationed (OR: 1.8; 95% CI: 1.4–2.5). Conclusion: Factors including health worker availability, using mobile phones for communication and high education level facilitate women’s participation. To improve the participation, there is need to apply special strategies for older age group, less educated women and women having tobacco habit.
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Background: A prospective clinical study was conducted to assess the effectiveness of the two -layered closure of recurrent Oroantral Fistula using Buccal Fat Pad and Buccal Advancement Flap. Materials and methods: Twenty patients with persistent OAFs larger than 5 mm were treated with two layered closure using Buccal Fat Pad and Buccal Advancement Flap. They were followed clinically and radiographically for 5 years after surgery to monitor the durability and effectiveness of the two layered closure of the OAF. Result: The procedure was successful in all patients. The healing process was satisfactory,with no breakdown or liquefaction necrosis postoperatively. No complications were observed during the follow-up period. Conclusion: The results of this study support the view that the use of the double-layered closure using BFP with buccal advancement flap is a durable, convenient, and effective method for the treatment of a persistent large OAF.
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Objective:To study the effect of PAD (presentation-assimilation-discussion) class applied in the standardized residency training of dermatovenereology on improving residents' practical operation ability.Methods:A total of 120 residents taking the standardized residency training of dermatovenereology in the Affiliated Hospital of North Sichuan Medical College from November 2018 to December 2020 were selected as the research objects and divided into two groups according to the time order of admission, among which, 60 residents enrolled from November 2018 to November 2019 were selected as the control group, and 60 residents enrolled from December 2019 to December 2020 were selected as the experimental group. The control group adopted the traditional standardized residency training mode, and the experimental group adopted the teaching mode of PAD class. SPSS 22.0 statistical software was used for data analysis. The results of theoretical knowledge assessment and skill operation assessment were compared between the two groups by t test, the evaluation of teaching effect was compared between the two groups by chi-square test, and the satisfaction of teaching was compared between the two groups by rank sum test. Results:The theoretical knowledge [(45.38±4.14) points], skill operation [(42.35±4.32) points] and total score [(88.74± 7.69) points] of the experimental group were higher than those of the control group [(39.62 ± 4.15) points, (36.25±4.27) points, (77.96±7.52) points, respectively], with statistical significance ( P<0.05). The evaluation of teaching effect in the experimental group showed that 49 residents (81.67%) believed that their learning interest had been stimulated; 51(85.00%) improved their self-learning ability; 47(78.33%)improved their ability of analyzing and solving problems; 50(83.33%) improved their doctor-patient communication ability; 49(81.67%) improved their clinical thinking ability; 52(86.67%) improved their teamwork ability; and 50(83.33%) improved their literature retrieval ability. The results of satisfaction showed that the experimental group was significantly higher than the control group in sense of responsibility, teaching methods, teaching contents and self-evaluation. Conclusion:The application of PAD class in the standardized residency training of dermatovenereology plays a positive role in mobilizing the learning enthusiasm of residents and cultivating their independent learning ability, and can significantly improve the practical operation and theoretical awareness of residents.
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Objective:To analyze the application value of PAD (Presentation-Assimilation-Discussion) class and case teaching combined with brainstorming in the practice teaching of nursing students in the department of cardiovascular surgery.Methods:A total of 81 undergraduate nursing students who practiced in the Department of Cardiovascular Surgery, The First Affiliated Hospital of Air Force Medical University from June 2019 to April 2020 were selected as the research objects. They were randomly divided into the control group ( n=40, brainstorming teaching) and the observation group ( n=41, PAD class combined with case teaching). After one month of intervention, the teaching effect on the two groups of nursing students were evaluated through the nursing students' clinical communication ability scale, Chinese version of self-assessment of clinical reflection and reasoning (SACRR), and competency inventory for registered nurse (CIRN). And the teaching quality was assessed by the clinical nursing teacher teaching behavior assessment scale. SPSS 22.0 was used for t-test. Results:The scores of each dimension and total scores of clinical communication ability scale, Chinese version SACRR and CIRN of nursing students in the observation group were higher than those in the control group ( P<0.05). The scores of nursing teaching behavior evaluation of clinical teachers in the observation group were higher than those in the control group ( P<0.05). Conclusion:The combination of PAD class and case teaching with brainstorming can improve the clinical communication ability of nursing students in cardiovascular surgery practice, help to promote the transformation of their clinical thinking ability, improve their core competences, and play an important role in improving the teaching quality.
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Objective:To explore the setup errors of vacuum pad combined with breast bracket in linear accelerator intensity-modulated radiotherapy for breast cancer.Methods:The clinical data of 72 patients who received linear accelerator intensity-modulated radiotherapy after breast conserving surgery in Hai'an Hospital of Traditional Chinese Medicine from July 2017 to March 2022 were retrospectively analyzed. According to the radiotherapy fixation schemes, they were divided into vacuum pad group (24 patients), breast bracket group (27 patients) and vacuum pad combined with breast bracket group (21 patients). Cone-beam CT was used to analyze the setup errors of the fixation, and the mean value of the overall errors and the standard deviation of the system errors were calculated. The relative factors affecting the fixed setup errors were analyzed.Results:There were statistical differences among vacuum pad group, breast bracket group and vacuum pad combined with breast bracket group in the level of forward and backward (Z) direction translation error (2.11±0.41, 2.67±0.26 and 1.79±0.21) and Z direction rotation error (1.14±0.24, 1.05±0.21 and 0.91±0.22) ( F values were 45.86 and 6.21, both P < 0.05). The level of Z direction translation error in vacuum pad group was higher than that in vacuum pad combined with breast bracket group, and the difference was statistically significant ( t = 12.37, P = 0.001). The level of Z direction rotation error in breast bracket group was higher than that in vacuum pad combined with breast bracket group, and the difference was statistically significant ( t = 3.41, P = 0.001). In the breast bracket group, the planning target volume (PTV) extension boundary values in the left and right (X), up and down (Y), and Z directions were 2.02, 2.09 and 1.97; the PTV release boundary values in X, Y and Z directions of the vacuum pad group were 1.81, 2.07 and 2.25; the external boundary values of PTV in X, Y and Z directions of the vacuum pad combined with breast bracket group were 1.13, 1.51 and 1.49. The result of multifactor analysis showed that body mass index (BMI) ( OR = 4.208, 95% CI 1.438-12.312) and breast volume ( OR = 4.023, 95% CI 1.375-11.769) were the independent influencing factors of fixed setup errors (both P < 0.05). Conclusions:The application of vacuum pad combined with breast bracket in the fixed setup of linear accelerator intensity-modulated radiotherapy of breast cancer is helpful to reduce the fixed setup errors, but at the same time, the fixed setup errors is affected by the patient's BMI, breast volume and other factors.
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Objective:To study the effect of PAD Class (Presentation-Assimilation-Discussion) combined with micro class in the teaching of standardized training for cardiac surgery residents.Methods:From October 2019 to June 2020, 70 residents of cardiac surgery were randomized into group A and group B, with 35 cases in each group. Group A used conventional teaching method, while group B used PAD Class combined with micro class teaching. The scores of theoretical examination and practical operation examination before and after teaching, the evaluation of self-learning, clinical thinking and professional social ability before and after teaching, and the satisfaction with the teaching methods were compared between the two groups. SPSS 26.0 was used for chi-square test and rank sum test.Results:There was no significant difference in the scores of theoretical assessment, practical assessment, autonomous learning, clinical thinking and professional social ability between the two groups before teaching ( P>0.05). After teaching, the scores of theoretical assessment, practical assessment, autonomous learning, clinical thinking and professional social ability of the two groups increased, and the scores of group B were higher than those of group A. There was a significant difference in the distribution of satisfaction with teaching methods between the two groups ( P<0.05). The total satisfaction rate of group B[97.14%(34/35)] was higher than that of group A[77.14%(27/35)]. Conclusion:For the residents of cardiac surgery, the teaching method of PAD Class combined with micro class teaching can not only improve their examination results, enhance self-learning, clinical thinking and professional social ability, but also improve their satisfaction with teaching methods.
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Objective:To study the inter-fraction setup errors, intra-fraction movement of patients and its influence on dosimetry, position repeatability of the supraclavicular area, and the plastic stability of the vacuum cushion and styrofoam when one of the three fixation method are applied in the clinical radiotherapy of breast cancer. The three fixation method include acuum negative pressure pad (VP), acuum negative pressure pad combined with a breast bracket (VB), and polyurethane styrofoam combined with a breast bracket (PB).Methods:A total of 96 breast cancer patients who received radiotherapy at Jiangsu Cancer Hospital during 2019-2021 were collected prospectively for study. They were randomly divided into three groups (VP, VB, and PB). Cone-Beam CT and a planning system were used to obtain inter-fraction setup errors, intra-fraction movement of patients and its influence on dosimetry, position repeatability of supraclavicular area, and the plastic stability of vacuum pad and polyurethane tyrofoam.Results:In the left-right (LR) direction, there were no statistical differences in the inter-fraction setup errors among the three groups. In the superior-inferior (SI) direction, inter-fraction setup errors of the PB group were smaller than those of the VB group (3.02 ± 2.04, 3.65 ± 2.64, t=2.35, P=0.031). In the anterior-posterior (AP) direction, the inter-fraction setup errors of both the VB and PB groups were smaller than those of the VP group (3.36 ± 2.93, 3.14 ± 0.98, 4.03 ± 2.55, t=2.29, 3.11, P< 0.05). In the AP direction, the intra-fraction movement of patients of the VP and PB groups were less than that of the VB group (1.31 ± 0.95, 1.24 ± 0.89, 1.88 ± 1.33, t=-2.04, -2.31, P< 0.05). Moreover, the intra-fraction movement of patients had no statistical effect on the dosimetric distribution ( P> 0.05), and the breast bracket did not improve the position repeatability of the supraclavicular region ( P>0.05). In addition, the plastic stability of polyurethane styrofoam was significantly better than that of the acuum negative pressure pad ( t=2.43-5.63, P< 0.05). Conclusions:The inter-fraction setup errors and intra-fraction movement of patients with breast cancer can be reduced by using PB. Compared to an acuum negative pressure pad, polyurethane styrofoam can keep plastic stability throughout the treatment of the patients.
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Objective@# To investigate the clinical effect of buccal fat pad flaps on the restoration of maxillary defects.@*Methods@# Nineteen cases with oral-nasal communications and maxillary soft and hard tissue defects ranging from 3.0 cm×2.0 cm-5.0 cm×4.0 cm after resection of the primary tumor foci were repaired with a pedicled buccal fat pad flap, and the maxillary sinus cavity and oral-nasal communication were closed. The survival, healing and complications of the flap were observed during the 3-month follow-up. @*Results @#The buccal fat pad flaps of 19 patients all survived. Five days after the operation, the buccal fat pad flap was dark red with slight edema, and the maxillary defect area collapsed. Ten days after the operation, most of the buccal fat pad flap turned pink, and the collapse was alleviated. One month after the operation, the buccal fat pad flap had no obvious collapse, and its surface was epithelialized, with a shape and color close to those of the normal mucosa. The opening was slightly limited. Three months after the operation, the buccal fat pad flap was completely epithelialized, with no difference from the surrounding tissue, and the opening was approximately 3 transverse fingers. No complications, such as swelling and necrosis of the buccal fat pad flap, limitation of mouth opening, maxillary sinus fistulas, oral-nasal communications and facial changes occurred in 19 patients within 3 months after the operation.@*Conclusion @#The application of a buccal fat pad flap has a good effect to repair maxillary tissue defects and close oral maxillary sinus communication with diameters less than 5 cm, so it can be widely used in the clinic.
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Background:In transfusion service,it is very important to carry out blood group with perfection. Blood grouping is a fast and easy way to ensure that you receive the right kind of blood for right patient.There are many methods we usefor blood grouping like Slide method,test tube method,column agglutination method anderythrocyte magnetic technique. Test tube method is gold standard method for blood grouping. We need to verify donor blood groupin blood bank or at camp site, for patients at bed side, at the time of issue of blood unit or at the time of dire emergency so to verifythe blood group in Blood centres we require the results of blood grouping urgently. ABD PAD® is a new device for the quick confirmation of the ABO blood group. Materials And Methods:In this Pilot study,200 samples were taken of which 100 were donor samples and 100 were patient samples. Blood grouping was performed on the ABD PAD, and results were compared with conventional tube technique and automate platform, Qwalys 3 (Diagast) EMT technique.Results:All 200 tests performed on the ABD PAD were concordant with other standard methods, namely the Test Tube technique and automated platform, Qwalys 3 (Diagast).The results of ABD PAD were quicker(within 30 seconds) and easy to interpret.Discussion:The manual confirmation of the ABO group and RH-rhesus is a repetitive and time consuming task. It requiresfollowing a procedure handling several reagents. In this context, the ABD pad is a ready to use device using the latex technology M-TRAP, facilitating the procedure intendedfor the confirmation of ABO/Rh. The only drawback is that we are not able to perform reverse grouping. Conclusion:ABD PAD is very useful for blood grouping in donors in the blood bank as well as in outdoor blood donation camp and at the time of issue of blood unit when we want to re-check the blood group of the issue bag. It is easy to interpret, fast, reliable and results are comparable with standard methods.
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A novel paper-based analytical device(PAD)was prepared and applied to determine the xanthine oxi-dase(XOD)inhibitory activity of Salvia miltiorrhiza extracts(SME).First,polycaprolactone was 3D printed on filter paper and heated to form hydrophobic barriers.Then the modified paper was cut according to the specific design.Necessary reagents including XOD for the colorimetric assay were immobilized on two separate pieces of paper.By simply adding phosphate buffer,the reaction was performed on the double-layer PAD.Quantitative results were obtained by analyzing the color intensity with the specialized device system(consisting of a smartphone,a detection box and sandwich plates).The 3D-printed detection box was small,with a size of 9.0 cm x 7.0 cm x 11.5 cm.Color component G performed well in terms of linearity and detection limits and thus was identified as the index.The reaction con-ditions were optimized using a definitive screening design.Moreover,a 10％glycerol solution was found to be a suitable stabilizer.When the stabilizer was added,the activity of XOD could be maintained for at least 15 days under 4℃or-20℃storage conditions.The inhibitory activity of SME was investigated and compared to that of allopurinol.The results obtained with the PAD showed agreement with those ob-tained with the microplate method.In conclusion,the proposed PAD method is simple,accurate and has a potential for point-of-care testing.It also holds promise for use in rapid quality testing of medicinal herbs,intermediate products,and preparations of traditional Chinese medicines.
ABSTRACT
Objective:To compare the positioning errors of individual head-rest combined with thermoplastic fixation mask versus thermoplastic fixation mask alone in patients with head and neck tumors. Methods:Twenty-eight patients who received irradiation with helical tomotherapy in Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) between October 2019 and April 2020 were included in this study. They were randomly assigned to receive position fixation with either individual head-rest combined with thermoplastic fixation mask (N1 group, n = 14) or thermoplastic fixation mask alone (N2 group, n = 14). Megavoltage computed tomography (MVCT) scanning registration was used to obtain the positioning errors in translation and rotation (ROLL) in the left-right (X), head-food (Y), and belly-back (Z) directions. There were a total of 841 CT scans, consisting of 425 scans in group N1 and 416 scans in group N2. Results:The positioning errors in X, Y, Z and ROLL directions in the N1 group were (1.37 ± 1.04) mm, (1.38 ± 1.12) mm, (1.47 ± 1.62) mm and (1.47 ± 1.62) ° respectively, and they were (1.57 ± 1.21) mm, (2.10 ± 1.51) mm, (1.61 ± 1.50) mm and (1.40 ± 1.30) ° respectively in the N2 group. There was significant difference in positioning errors in the Y direction between N1 and N2 groups ( P = 0.013). In the N1 group, the outward expansion boundaries in X, Y and Z directions was 4.15 mm, 4.23 mm and 4.81 mm respectively, and it was 4.77, 6.31 and 5.08 mm, respectively in the N2 group. In the X direction, there was significant difference in positioning errors taking 3 mm as the dividing point between N1 and N2 groups ( χ2 = 10.516, P < 0.001). In the Y direction, there was significant difference in positioning errors taking 1, 2 and 3 mm as the dividing points between N1 and N2 groups ( χ2 = 24.889, P < 0.001; χ2 = 42.202, P < 0.001; χ2 = 46.204, P < 0.001). In the Z direction, there was significant difference in positioning errors taking 2 mm as the dividing point between N1 and N2 groups ( χ2 = 7.335, P = 0.007). In the N1 group, the percentage of positioning errors < 3 mm in the X, Y and Z directions was 92%, 90% and 92%, respectively. Conclusion:Compared with thermoplastic fixation mask alone, individual head-rest combined with thermoplastic fixation mask can better effectively improve the positioning stability and reduce positioning errors in patients receiving irradiation with helical tomotherapy for head and neck tumors. The combined method is of certain innovation.
ABSTRACT
Objective:To retrospectively analyze the setup errors of thermoplastic head and shoulder molds alone or combined with vacuum pad in hypofractionated stereotactic radiotherapy (HFSRT) for non-small cell lung cancer (NSCLC) with brain metastases.Methods:Fifty-four NSCLC patients with brain metastases who received HFSRT from 2017 to 2019 were enrolled in this study. Twenty-four patients were fixed with thermoplastic head and shoulder molds (group A), and 30 patients were fixed with thermoplastic head and shoulder molds plus vacuum pad (group B). The interfraction and intrafraction setup errors were acquired from cone-beam CT online image registration before and after the HFSRT. Optical surface system was applied in monitoring the intrafraction setup errors. The setup errors in each direction between two groups were analyzed by independent samples t-test. Results:For the interfraction setup errors of the whole group, the proportion of the horizontal setup errors of ≥3mm was 7.0% to 15.4% and 7.0% to 12.6% for the rotation setup errors of ≥2°. In group A, the anteroposterior setup error was (1.035±1.180)mm, significantly less than (1.512±0.955)mm in group B ( P=0.009). In group A, the sagittal rotation setup error was 0.665°±0.582°, significantly less than 0.921°±0.682° in group B ( P=0.021). For the intrafraction setup errors of the whole group, the proportion of horizontal setup errors of ≥1mm was 0% to 0.7%, whereas no rotation setup error of ≥1° were observed. In group B, bilateral, anteroposterior and sagittal rotation setup errors were (0.047±0.212)mm, (0.023±0.152)mm and 0.091°±0.090°, significantly less compared with (0.246±0.474)mm, (0.140±0.350)mm and 0.181°±0.210° in group A ( P=0.004, P=0.020, P=0.001), respectively. Optical surface monitoring data were consistent with the obtained results. Conclusions:Thermoplastic head and shoulder molds (with or without vacuum pad) combined with online image registration and six-dimensional robotic couch correction can be applied in HFSRT for brain metastases from NSCLC. The intrafraction setup errors in group B are smaller than those in group A. Optical surface system has certain value in monitoring the intrafractional movement.