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This article investigates the attitude tracking control problem for a rigid spacecraft without angular velocity feedback, in which external disturbances, parametric uncertainties, and input saturation are considered. Initially, an angular velocity observer is developed incorporated with adaptive technique, which could tackle the unmeasurable angular velocity and system uncertainties simultaneously. By introducing adaptive updating law into the proposed observer, the synchronized uncertainties are handled such that robustness of the observer is enhanced, even in the presence of external disturbances. Further, for solving the input constraints problem, command filter and backstepping method are utilized; thus, a bounded attitude tracking control law is derived. Finally, the attitude tracking performance is evaluated by numerical examples.

Adamantinoma is an extremely rare tumour originating from bone that can be divided into classical and osteofibrous dysplasia (OFD)-like adamantinoma. This low-grade malignancy almost exclusively occurs in long bones, and only few cases of mandibular adamantinoma have been reported. Here, we report the case of a 30-year-old female with a 2-year history of right mandible tenderness. Radiological examinations showed a lytic lesion involving the right mandible without a well-defined margin. Biopsy confirmed the diagnosis of adamantinoma. She underwent a segmental mandibulectomy and reconstruction with a fibula flap. The definitive diagnosis was OFD-like adamantinoma. However, the tumour recurred after 5 years. The residual mandible and fibula flap were widely involved. A total mandibulectomy was performed. Five years later, there is no evidence of recurrence or metastasis. We recommend that adamantinoma be treated by radical resection with clear margins, and long-term surveillance is necessary due to the likely high local recurrence rate and the potential for late tumour metastasis.

BACKGROUND: Though robot-assisted minimally invasive esophagectomy (RAMIE) is demonstrated to offer a better visualization and provide a fine dissection of the mediastinal structures to facilitate the complex thoracoscopic operation, the superiorities of RAMIE over MIE have not been well verified. The aim of this study was to explore the actual superiorities through comparing short-term results of RAMIE with that of MIE. METHODS: PubMed, EMBASE and web of science databases were systematically searched up to September 1, 2020 for case-controlled studies that compared RAMIE with TLMIE. RESULTS: Fourteen studies were identified, with a total of 2,887 patients diagnosed with esophageal cancer, including 1,435 patients subjected to RAMIE group and 1,452 patients subjected to MIE group. The operative time in RAMIE was still significantly longer than that in MIE group (OR =0.785; 95% CI, 0.618–0.952; P

Background Robotic system was recently introduced to assist surgeons in performing thymectomy. However, whether robot-assisted thoracoscopic thymectomy (RATT) could replace video-assisted thoracoscopic thymectomy (VATT) and be considered as a superior treatment for thymic epithelial tumors is still controversial. The aim of this study was to evaluate the progression-free survival (PFS) and short-term clinical outcomes in patients undergoing RATT or VATT by comparing the matched two groups after performing propensity score analysis. Methods We retrospectively reviewed the clinical data of 295 patients diagnosed with thymic epithelial tumors. There were 60 patients in RATT group and 235 in VATT group. Propensity score matching was done between two groups with variables of age, gender, tumor size, organization histologic classification, original Masaoka stages, presence of myasthenia gravis (MG) and adjuvant therapy. Sixty patients from the RATT group and 60 from the VATT group were matched, fitting the model. The PFS and short-term clinical outcomes of matched groups were compared. Results After matching, the surgical time in RATT groups was significant shorter than that in VATT groups (P=0.042). Loco-regional recurrence and distal metastasis were detected in 4 patients with thymoma and 1 patient with thymic carcinoma in RATT group and in 25 patients with thymoma and 3 patients with thymic carcinoma in VATT group before matching. PFS were estimated in only thymoma cases. The PFS in RATT group (n=55) intended to be longer than that in VATT group (n=58) after matching (5-year PFS rate: 81.5% and 75.4%, respectively; log-rank P=0.095). Conclusions RATT has the superiorities over VATT on short-term outcomes due to enabling surgeons to operate in a stable and comfortable environment. Meanwhile, RATT yielded a longer PFS compared with VATT, although the difference was not significant. Therefore, RATT could be considered as a standard approach for the treatment of thymic epithelial tumors.

BACKGROUND: Paravertebral block (PVB) conducted by epidural catheter is a prevalent pain management for patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. The aim of this study was to assess the efficacy and safety of paravertebral block with a modified PVB (MPVB) catheter under surgeon’s direct vision after video-assisted thoracoscopic lobectomy. METHODS: Three hundred fifty-six patients undergoing VATS lobectomy were retrospectively reviewed and divided into two groups consecutively according to the catheter applied in PVB procedure (PVB group and MPVB group). In the MPVB group, a modified catheter with a flexible forepart and more apertures distributing along the forepart than the conventional epidural catheter was introduced. An infusion pump containing of 150 mL mixture was connected to the catheter to provide sustained regional analgesia. Intramuscular dezocine 10 mg was administered as a rescue medication when necessary. Postoperative pain management effect was assessed by visual analog scale (VAS) at rest and on coughing. Spirometry values and blood gas analysis were monitored and recorded for the first 3 postoperative days (PODs). Analgesia-related adverse events, characteristics of PVB procedure and postoperative major complication were also compared between the two groups. RESULTS: There were 172 patients who received PVB with conventional epidural catheter in the PVB group, and 184 patients were performed PVB with modified paravertebral catheter in the MPVB group. Significantly lower pain score at rest was found in MPVB group at 24 h postoperatively (P=0.006). The pain score on coughing in MPVB group was significantly lower than that in PVB group at 12 and 24 h postoperatively (P=0.037 and P

OBJECTIVES According to retrospective studies, oesophageal carcinoma is the second deadliest gastrointestinal cancer after gastric cancer. Enteral immunonutrition (EIN) has been increasingly used to enhance host immunity and relieve the inflammatory response of patients undergoing oesophagectomy; however, conclusions across studies remain unclear. We aimed to evaluate the effect of EIN on the clinical and immunological outcomes of patients undergoing oesophagectomy. METHODS Four electronic databases (MEDLINE, Embase, Web of Science and Cochrane Library) were used to search articles in peer-reviewed, English-language journals. The mean difference, relative risk or standard mean difference with 95% confidence interval were calculated. Heterogeneity was assessed by the Cochran’s Q test and I2 statistic combined with the corresponding P-value. The analysis was carried out with RevMan 5.3. RESULTS Six articles were finally included, with a total of 320 patients with oesophageal cancer. The meta-analysis results showed that EIN did not improve clinical outcomes (such as infectious complications, pneumonia, surgical site infection, anastomotic leak and postoperative hospital stay) or immune indices [referring to C-reactive protein, interleukin (IL)-6, IL-8, tumour necrosis factor-α]. Descriptive analysis suggested that EIN also increased the serum concentrations of IgG and the percentage of the B-cell fraction. Thus, its impact on IL-8 and IL-6 remains inconsistent. CONCLUSIONS The early-stage impact of EIN on immunological status in patients undergoing oesophagectomy is still unclear. According to the results of this meta-analysis, whether EIN could improve the clinical outcomes or biological status after oesophagectomy compared to standard enteral nutrition is uncertain. Since the impact of EIN is unclear, current guidelines that strongly advise the use of EIN should be changed, as the utility of EIN is very uncertain. More appropriately powered clinical studies are warranted to confirm its effectiveness.

Room temperature phosphorescence (RTP) materials show potential applications in information security and optoelectronic devices, but it is still a challenge to achieve RTP in organic materials under water ambient due to the unstable property of triplet states. Herein, water-induced RTP has been demonstrated in the organic microrod (OMR). Noting that the RTP intensity of the as-prepared OMR is greatly enhanced when water is introduced, and the reason for the enhancement can be attributed to the formation of hydrogen-bonded networks inside the OMR. The hydrogen-bonded networks can confine the molecular motion effectively, leading to the stability of triplet states; thus the lifetime of the OMR can reach 1.64 s after introducing water. By virtue of the long lifetime of the OMR in the presence of water, multilevel data encryption based on the OMR has been demonstrated.

This study aimed to evaluate intraoral anastomosis of a deep circumflex iliac artery (DCIA) flap in combination with computer-assisted techniques for mandibular reconstruction. Between December 2015 and March 2018, 4 patients with mandibular discontinuity defects caused by ablative tumor surgery were included in the study. Mandibular reconstruction was performed with a DCIA flap using computer-assisted and intraoral anastomosis techniques. A computer-aided design-computer-aided manufacturing cutting guide, a reconstruction stereomodel, and a prebent reconstruction plate were used for mandibular reconstruction in each patient. Anastomosis was performed on the facial artery and vein using the deep circumflex iliac vessels through an intraoral approach. The resulting error-grade color map was used to evaluate repeatability between the preoperative design and postoperative results. Mandibular reconstruction with a DCIA flap using computer-assisted and intraoral anastomosis techniques was successful in all 4 patients. All flaps survived with no severe complications. Satisfactory cosmetic outcomes and occlusion with sufficient bone height for implants were achieved postoperatively. Repeatability between the virtual plan and postoperative result was 81.1% ± 8.2% within 1 mm, 85.8% ± 8.1% within 2 mm, and 89.6% ± 6.7% within 3 mm. The use of intraoral anastomosis and computer-assisted techniques with DCIA flaps for mandibular reconstruction without additional facial scarring is feasible and advantageous. However, the findings should be interpreted cautiously owing to the relatively short follow-up time and limited number of patients involved in this study.

Purpose Adenoid cystic carcinoma (ACC) involving the skull base is difficult to treat and sometimes unresectable. The purpose of this study was to evaluate the efficacy and safety of 125I radioactive seed interstitial brachytherapy for treatment of these patients. Materials and Methods Patients with ACC involving the skull base treated by definitive 125I brachytherapy from March 2008 through December 2018 at the Peking University Hospital of Stomatology (Beijing, China) were retrospectively identified. Overall survival (OS), as the primary efficacy indicator, and progression-free survival (PFS) and distant metastasis-free survival (DFS), as the secondary efficacy indicators, were analyzed by Kaplan-Meier survival analysis and Cox regression analysis. Adverse radiotherapy (RT) reactions, as safety indicators, were recorded. Results Thirty-two patients with (r)T4b locally advanced disease were enrolled. The prescription dose (PD) was 60 to 120 Gy. The dose delivered to 90% of the target volume was 99.1 to 145.2 Gy, the percentage of the target volume receiving at least 100% of the PD was at least 88.2%, and the percentage of the target volume receiving at least 150% of the PD was smaller than 74.0%. Mean follow-up was 32 months (median, 21 months; range, 3 to 95 months). The 1- and 3-year OS rates were 93.3 and 62.6%, the 1- and 3-year PFS rates were 90.0 and 46.4%, and the 1- and 3-year DFS rates were 91.7 and 61.1%, respectively. Survival was significantly associated with local recurrence (P = .04) and distant metastasis except in the lung (P = .05). The rate of severe chronic adverse RT reactions was 3.1%; no severe acute adverse RT reactions were observed. Conclusion 125I brachytherapy appears to be an effective and safe treatment in the short-term for ACC involving the skull base and could be the preferred treatment for patients with prior RT. Local control with brachytherapy could provide survival benefit even in patients with lung metastasis.

OBJECTIVES Pulmonary sequestration is a rare congenital pulmonary malformation. The aim of this study was to explore the effect of different therapeutic strategies on the clinical outcome of asymptomatic intralobar pulmonary sequestration. METHODS We retrospectively reviewed the clinical data of 37 patients diagnosed with intralobar sequestration. All the patients were asymptomatic. Seventeen patients underwent video-assisted thoracoscopic surgery (VATS) once diagnosed and 20 patients chose to undergo observation. Of these 20 patients, 16 patients developed symptoms during the observation period and also underwent VATS; 4 patients never showed symptoms and did not have surgery. The 33 patients who had VATS were divided into 2 groups: group 1, patients who underwent VATS once diagnosed; group 2, patients who underwent VATS once symptoms appeared. Postoperative data and respiratory function data were compared between the 2 groups. RESULTS Twenty of the patients were men and 17 were women (mean age 37.05 ± 7.89 years). Results of a comparative analysis of the 2 groups indicated that patients in group 1 had better values for median estimated blood loss, median duration of chest tube insertion, postoperative hospital stay and postoperative hospital stay than those in group 2. Postoperative complications were reported in 1 patient in group 1 and in 3 patients in group 2. Meanwhile, the loss of lung function between group 1 and group 2 was statistically significant, which also suggested that patients benefited from surgery once diagnosed. CONCLUSIONS For asymptomatic intralobar sequestration, VATS could be effective and safe. The surgical intervention should be performed once the condition is diagnosed to avoid manifestations occurring and to preserve patients’ quality of life.

Background This study aimed to determine the effectiveness and safety of surgery combined with postoperative 125 I seed brachytherapy for treatment of primary mucoepidermoid carcinoma (MEC) of the parotid gland. Methods Retrospective analysis of data of patients with MEC (n = 108) treated with surgery plus postoperative 125 I seed brachytherapy between 2004 and 2016. Overall survival (OS), disease-free survival (DFS), local control rate (LCR), distant metastasis, and radiation-associated toxicities were analyzed, and factors affecting outcomes were evaluated. Results The 5- and 10-year OS were 98.8% and 95.8%, respectively. The DFS and LCR at 5 and 10 years were all 91.4%. Age ≥ 60 years (hazard ratio [HR] = 6.86, 95% confidence interval [CI]: 1.54-30.55) and T4 disease (HR = 7.15, 95% CI: 1.40-36.52) were poor prognostic factors. Acute radiation-associated toxicities were minor. Conclusion Surgery plus 125 I seed brachytherapy appears to be an effective treatment for parotid gland MEC, capable of providing satisfactory outcomes with few complications.

Background: Uterine myoma is a common gynecological disease in women of reproductive age. Owing to surgery and treatment-related complications, many patients opt for alternative therapy, such as traditional Chinese medicine (TCM). However, there is no standard treatment protocol for TCM. This study aimed to investigate the prescription patterns of TCM for uterine myoma and compare differences between the Chang Gung Research Database (CGRD) and the National Health Insurance Research Database (NHIRD). Methods: Data of 217040 patients newly diagnosed with uterine myoma between 2005 and 2014 were retrieved from the CGRD using the International Classification of Diseases, Ninth Revision, Clinical Modification code for myoma and related symptoms. We analyzed patient demographics, frequencies and average daily doses of prescribed Chinese herbal formulas and single herbs, and iron supplementation doses. Associations between Chinese herbal formulas and single herbs commonly used for uterine myoma were analyzed by association rule mining (ARM) and social network analysis (SNA).Results: In total 45,436 patients used TCM. Most participants (49.1%) were aged 30–44 years. Jia-Wei-Xiao-Yao-San (28.2%; average daily dose 4.85 g) and Xiang-Fu (22.0%; average daily dose 1.10 g) were the most frequently prescribed herbal formula and single herb, respectively. Additionally, the Si-Wu-Tang decoction was often used for uterine fibroids. Common prescription patterns and herbal pairs were identified. Western medicine (WM) outpatient visits (12 ± 19.6) and iron supplement prescriptions (prescription code PLB001M, 62.5 ± 115.3 pills; PLB012M, 24.6 ± 78 pills) were more prevalent in the combined therapy group than in the WM-only group (outpatient visits: 5.9 ± 6.7 times; iron supplements: PLB001M, 48.3 ± 98.4 pills; PLB012M, 20.9 ± 67.5) in the CGRD. Conclusions: We characterized the prescription patterns for uterine myoma in the CGRD. Chinese herbal medicine prescriptions may aim to improve anemia related to hypermenorrhea caused by uterine myoma. Ours is the first study of TCM myoma treatment within the CGRD, and we compared our findings to the TCM NHIRD myoma study results. ARM and SNA of TCM prescription patterns provide an evidence base to inform medical education and medical decision-making.

To determine the neck management of tongue cancer, this study attempted to construct an artificial neural network (ANN)-assisted model based on computed tomography (CT) radiomics of primary tumors to predict neck lymph node (LN) status in patients with tongue squamous cell carcinoma (SCC).Three hundred thirteen patients with tongue SCC were retrospectively included and randomly divided into training (60%), validation (20%) and internally independent test (20%) sets. In total, 1673 feature values were extracted after the semiautomatic segmentation of primary tumors and set as input layers of a classical 3-layer ANN incorporated with or without clinical LN (cN) status after dimension reduction. The receiver operating characteristic (ROC) curve, accuracy (ACC), sensitivity (SEN), specificity (SPE), area under curve (AUC) and Net Reclassification Index (NRI), were used to evaluate and compare the models.Four models with different settings were constructed. The ACC, SEN, SPE and AUC reached 84.1%, 93.1%, 76.5% and 0.943 (95% confidence interval: 0.891-0.996, p.001), respectively, in the test set. The NRI of models compared with radiologists reached 40% (p.001). The occult nodal metastasis rate was reduced from 30.9% to a minimum of 12.7% in the T1-2 group.ANN-based models that incorporated CT radiomics of primary tumors with traditional LN evaluation were constructed and validated to more precisely predict neck LN metastasis in patients with tongue SCC than with naked eyes, especially in early-stage cancer.

A young female was referred for a lesion of the right mandible without any symptoms. The lesion is located in the body of the right mandible. The diagnosis of a suspected low-graded malignant tumor was confirmed by pathology before tumor ablation was performed, which resulted in a segmental mandible defect with 6 cm in length (Figs. 45.1, 45.2, 45.3, 45.4, and 45.5).

OBJECTIVES A thymic epithelial tumour is the most common primary tumour in the anterior mediastinum of adults. A few retrospective studies compared the short-term outcomes between robotic-assisted thymectomy (RAT) and video-assisted thymectomy (VAT). So, it is necessary to conduct a meta-analysis to further compare these 2 surgical techniques. METHODS EMBASE, Medline and Web of Science were used. Thesaurus terms and medical subject headings were used in Medline and EMBASE, respectively. The Newcastle-Ottawa scale was used for grading because the included studies were all case-control studies. RESULTS Nine studies were included in the meta-analysis with a total of 723 patients, including 315 patients in the RAT group and 408 patients in the VAT group. The meta-analysis [odds ratio (OR) 0.24, 95% confidence interval (CI) 0.06–0.94; P = 0.041], indicating that RAT yielded a significantly lower rate of conversion compared with VAT. Duration of drainage with RAT was significantly less than that with VAT (weighted mean difference = −1.10; 95% CI −1.98 to −0.22; P = 0.014). The pooled analysis (weighted mean difference = −103.6; 95% CI −199.21 to −7.98; P = 0.034) suggested that patients in the RAT group had less drainage than those in the VAT group. The recurrence rates in both groups were comparable (OR 0.19, 95% CI 0.03–1.20; P = 0.078). CONCLUSIONS RAT has advantages over VAT in terms of short-term outcomes such as shorter duration of drainage, less total drainage and a lower rate of conversion. The recurrence rate was comparable between the 2 techniques. Therefore, RAT could be considered as an alternative treatment for diseases of the thymus.

In this paper, a synchronized fault-tolerant attitude control law for multiple spacecraft system under a direct topology is investigated, in which communication delays between formation members and external disturbances are considered simultaneously. Initially, a finite-time observer is proposed for individual spacecraft to estimate the total uncertainties caused by loss-of-effectiveness actuator faults, additive actuator faults and external disturbances. On basis of the observed information, a synchronized attitude control algorithm is constructed with integral sliding mode method, and system stability is analyzed by using Lyapunov-Krasovskii theory. Finally, simulated results show the validness of the designed control scheme.

Summary The long-term outcomes of robotic-assisted McKeown esophagectomy (RAME) compared to thoraco-laparoscopic McKeown esophagectomy (TLME) for the patients with esophageal squamous cell carcinoma (ESCC) remain unclear. The aim of this study was to compare the number of dissected lymph nodes and long-term survival between RAME and TLME using a propensity score-matched (PSM) analysis. A total of 721 patients undergoing minimally invasive McKeown esophagectomy at our department from February 2015 to October 2019 were analyzed, including 310 patients in RAME group and 411 in TLME group. The exact numbers of lymph nodes including those among thoracic and abdominal categories as well as those along the recurrent laryngeal nerve (RLN) were all recorded. PSM analysis was applied to generate matched pairs for further comparison. All patients with R0 resection were followed with a strict follow-up period which range from 1 to 56 months. The effect of lymphadenectomy was compared between all patients in unmatched and matched groups. Long-term outcomes consisting of overall survival (OS), disease-free survival (DFS) and recurrence rate (including regional recurrence rate, systemic recurrence rate and mediastinal lymph nodes recurrence rate) were compared in R0 resection patients. Finally, 292 patients were identified for each cohort after PSM. RAME was found to yield significantly more left RLN lymph nodes (mean: 2.27 ± 0.90 vs. 2.09 ± 0.79; P = 0.011) and more thoracic lymph nodes (mean: 12.60 ± 4.22 vs. 11.83 ± 3.12, P = 0.012) compared with TLME after PSM analysis. There was no significant difference in the OS and DFS between the RAME and TLME group. Besides, total recurrences were recognized in 33 (11.7%) patients in the RAME group and 36 (12.9%) in the TLME group (P = 0.676). The mediastinal lymph nodes recurrence rate in the RAME group was tended to be lower than that in the TLME group (2.5% vs. 5.4%, P = 0.079). Therefore, RAME might be an alternative approach for the treatment of ESCC with more lymph nodes dissected and similar long-term survival outcomes compared to TLME.

The deep circumflex iliac artery perforator flap with iliac crest (DCIAPF) is considered a favourable single-flap option for oromandibular reconstruction. The aim of this study was to evaluate the effectiveness of venous superdrainage using the superficial circumflex iliac vein (SCIV) in the DCIAPF for oromandibular reconstruction. The data of 22 patients (12 female, 10 male) aged 10-76 years (median 53 years) who underwent simultaneous oromandibular reconstruction with a DCIAPF were reviewed retrospectively. Eleven patients received the DCIAPF with SCIV for superdrainage (group A) and another 11 patients received the conventional single-pedicled DCIAPF flap (group B). No flap loss occurred in either group. Venous congestion due to relative venous insufficiency was significantly more frequent in group B (P=0.045). There was no significant difference in the incidence of partial flap necrosis and wound dehiscence, or in the total operation time between the two groups. Superdrainage using the SCIV has the potential to reduce the incidence of venous congestion due to relative venous insufficiency in DCIAPF used for oromandibular reconstruction.

Background In recent years, immunonutrition has been introduced and proposed to have a positive modulatory effect on inflammatory and immune responses and gut function for surgical patients, especially for patients undergoing gastrointestinal cancer resection. We conducted this parallel-group, randomized and double-blind clinical controlled trial to investigate the efficacy of perioperative enteral immunonutrition (EIN) on clinical and immunological outcomes of patients undergoing esophageal resection. Methods A randomized, parallel-group, double-blind, clinical trial was conducted between December 1, 2017 and March 1, 2018. This study enrolled 120 patients with esophageal cancer. And 112 patients were divided into two groups randomly: EIN group and enteral nutrition (EN) group. The EIN contained extra immunonutritional substrates, including a consistent combination of arginine, RNA and the omega-3 fatty acids compared with EN. Immune indicators were measured at preoperative day 7, postoperative day (POD) 1, 3, 7 and post-discharge day (PDD) 30. Results There were 56 participants randomized to each group. Finally, 53 patients in EIN and 50 patients in EN were analyzed. Immune indicator was the primary outcome in this study. EIN yielded a significantly lower rate of CD8/CD3 (%) at POD 3 compared with EN group (P=0.005). The rate of CD4/CD8 (%) in EIN group was higher than that in EN group at POD3 (P=0.004). The serum levels of IgM at POD 3 and 7 were significantly higher in EN group compared with EIN group (P=0.025 and P=0.009, respectively). The rate of NK (%) and the serum level of IgA were significantly higher in EIN group compared with EN group at PDD 30 (P=0.022 and P=0.041, respectively). No significant differences were found in 2-year progressionfree survival and overall survival. Conclusions Immunonutrition is a safe and feasible nutritional treatment, which has a positive modulatory impact on immune responses after esophagectomy. Although no significant difference was found in clinical and survival outcomes between EIN and EN groups, immunonutrition could still have a positive effect on immunological function of patients undergoing esophagectomy.

Background According to previously published studies, esophagectomy with modified Collard anastomosis has been reported to have low incidences of anastomotic leak and stricture. However, the optional anastomotic method after esophagectomy is still controversial. We conducted this study to compare the incidence of postoperative anastomotic stricture formation and dysphagia over three years after an esophagectomy with modified Collard anastomosis (MC) or end‐to‐side (ETS) hand‐sewn anastomosis. Meanwhile, the early postoperative anastomotic leakage and other complications, hospital stay and 30‐ and 90‐day mortality were also evaluated. Methods The clinical data of 905 patients undergoing McKeown esophagectomy were retrospectively reviewed. The rate of postoperative stricture formation after three years was demonstrated by stricture‐free survival which is the primary end‐point of this study. The incidence of dysphagia, first time of onset of stricture and number of dilatations were also recorded during follow‐up. Results The incidence of anastomotic leak tended to be higher in the MC group compared with that in the ETS group (13.0% vs. 8.7%, P = 0.064). The rates of anastomotic stricture in the MC group were significantly less than in the ETS group (P = 0.004). The number of dilatations in the MC group were significantly greater than those in the ETS group (2.34 vs. 2.46, P = 0.011). Conclusions A modified Collard cervical esophagogastric anastomosis was associated with lower rates of anastomotic stricture and dysphagia, compared with ETS hand‐sewn anastomosis. However, the modified Collard anastomosis is accompanied by an increased anastomotic leakage rate., We conducted this study to compare the incidence of postoperative anastomotic stricture formation and dysphagia three years after an esophagectomy with modified Collard anastomosis or end‐to‐side (ETS) hand‐sewn anastomosis.

Summary Although robotic techniques have been used for oesophagectomy for many years, whether robot-assisted minimally invasive oesophagectomy (RAMIE) can actually improve outcomes and surpass thoraco-laparoscopic minimally invasive oesophagectomy (MIE) in the success rate of lymph node dissection remains to be empirically demonstrated. Therefore, we performed this systematic review and meta-analysis of case–control studies to systematically compare the effect of lymph node dissection and the incidence of vocal cord palsy between RAMIE and MIE. The PubMed, EMBASE, and Web of Science databases were systematically searched up to December 1, 2019, for case–control studies that compared RAMIE with MIE. Thirteen articles were included, with a total of 1,749 patients with esophageal cancer, including 866 patients in the RAMIE group and 883 patients in the MIE group. RAMIE yielded significantly larger numbers of total dissected lymph nodes (WMD = 1.985; 95% CI, 0.448–3.523; P = 0.011) and abdominal lymph nodes (WMD = 1.686; 95% CI, 0.420–2.951; P = 0.009) as well as lymph nodes along RLN (WMD = 0.729; 95% CI, 0.348–1.109; P

We report an asymptomatic child who was positive for a coronavirus by reverse transcription PCR in a stool specimen 17 days after the last virus exposure. The child was virus positive in stool specimens for at least an additional 9 days. Respiratory tract specimens were negative by reverse transcription PCR.

A cystadenoma originating in the salivary gland is a rare neoplasm that can originate from the major or minor salivary glands. Although this tumor has the potential to recur if it is incompletely excised, it has been regarded as a benign tumor because it has not been determined to be associated with local tissue destruction or metastasis. This report serves as an update to the current understanding of cystadenoma. The patient in this case study presented with a recurrent painless mass in her left retromolar and submandibular regions that had persisted for more than 2 years. Histologic analysis showed that this lesion was a recurrent cystadenoma of the minor salivary gland, with cervical lymph nodes testing positive for tumor cells. After more than 3 years of clinical follow-up, no signs of recurrence were observed. A case of cystadenoma with cervical metastasis is presented; further attention should be paid to patients with recurrent cystadenoma that also might contain lymph node metastasis.

Purpose The treatment of inoperable parotid gland carcinoma is challenging and controversial. The purpose of this paper was to present our experience in treating this malignancy using 125I interstitial brachytherapy. Methods and Materials Thirteen patients with advanced carcinomas of the parotid gland were included and treated with 125I interstitial brachytherapy in Peking University School and Hospital of Stomatology from January 2003 to December 2015. All patients were treated with 125I interstitial brachytherapy as a sole modality for the primary tumor. Furthermore, all of them were treated with neck dissection with/without adjunctive external beam radiotherapy for the neck, simultaneously. The prescription dose of interstitial brachytherapy was 140–160 Gy. Results Median followup was 56 months (range: 8–105 months). The 2-year and 5-year local control rates were 91.7% and 58.2%, respectively. The 2-year and 5-year overall survival rates were 100% and 61%, respectively. No cervical lymph node metastasis was observed during the followup. No interstitial brachytherapy-related severe complications occurred. Facial nerve function was preserved well. Conclusions 125I interstitial brachytherapy is a feasible and effective treatment for inoperable parotid gland carcinomas without severe complications. And neck dissection with/without external beam radiotherapy is necessary for patients with cervical metastasis or at high risk of cervical metastasis.

An europium functionalized ZnO quantum dots (QDs) ratiometric fluorescent nanoprobe is designed to establish a real time, on-site visual, and highly sensitive probe method for tetracycline (TC). The yellow-emitting ZnO QDs serves as the internal reference, while the Eu3+ chelated on the surface of ZnO QDs is used as the signal reporting unit. This nanoprobe exhibits rapid response, excellent selectivity, and high sensitivity with a detection limit of 4 nM in detecting the levels of TC. In addition, fluorescence of the nanoprobe can change from yellow to red as the concentration of TC increases. Thus, naked eye detection of TC was realized using the test paper processed by nanoprobe, followed by RGB value analysis function on the mobile phone APP.

Background The aim of this study was to evaluate the prognostic value of positron emission tomography (PET) parameters and the PET texture features of fluorine 18-fluorodeoxyglucose ([18F]FDG) uptake on pretreatment PET/computed tomography (CT) in patients with locally advanced salivary gland carcinoma treated with interstitial brachytherapy. Methods Forty-three patients with locally advanced salivary gland carcinoma of the head and neck were treated with 125I interstitial brachytherapy as the sole modality and underwent [18F]FDG PET/CT scanning before treatment. Tumor segmentation and texture analysis were performed using the 3D slicer software. In total, 54 features were extracted and categorized as first-order statistics, morphology and shape, gray-level co-occurrence matrix, and gray-level run length matrix. Up to November 2018, the follow-up time ranged from 6 to 120 months (median 18 months). Cumulative survival was calculated by the Kaplan-Meier method. Factors between groups were compared by the log-rank test. Multivariate Cox regression analysis with a backward conditional method was used to predict progression-free survival (PFS). Results The 3- and 5-year locoregional control (LC) rates were 55.4% and 37.0%, respectively. The 3- and 5-year PFS rates were 51.2% and 34.1%, respectively. The 3- and 5-year overall survival (OS) rates were 77.0% and 77.0%, respectively. Univariate analysis revealed that minimum intensity, mean intensity, median intensity, root mean square, and long run emphasis (LRE) were significant predictors of PFS, whereas clinicopathological factors, conventional PET parameters, and PET texture features failed to show significance. Multivariate Cox regression analysis showed that minimum intensity and LRE were significant predictors of PFS. Conclusions The texture analysis of pretreatment [18F]FDG PET/CT provided more information than conventional PET parameters for predicting patient prognosis of locally advanced salivary gland carcinoma treated with interstitial brachytherapy. The minimum intensity was a risk factor for PFS, and LRE was a favorable factor in prognostic prediction according to the primary results.

BACKGROUND: Esophagogastric anastomotic leak (AL) is a severe complication following esophageal resection. This study aims to explore preliminarily whether the ratio of the gastric conduit length to the thorax length can be regarded as a potential prognostic variable for AL, and if so, a cut-off value can be found to divide the patients into distinct risk groups. METHODS: We retrospectively reviewed the clinical data of 273 patients who underwent esophagectomy. The gastric conduit length, the thorax length, and other covariates were collected. Logistic regression was first conducted to probe the rationality of the ratio as a risk indicator of AL. Then the dichotomizing analysis was applied to find the optimal cut-off value. RESULTS: The incidence of AL was 12.5% (34/273). The coefficient of the ratio in the logistic regression equation was –7.901 with P

This study aimed to identify the specimen type that has high positivity and its proper sampling time for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to promote diagnostic efficiency. All SARS-CoV-2-infected patients with a laboratory-confirmed diagnosis in Zhoushan City were followed up for viral shedding in respiratory tract specimens and faecal samples. Positivity was analysed both qualitatively and quantitatively by proper statistical approaches with strong testing power. Viral shedding in respiratory tract and faecal specimens was prolonged to 45 and 40 days after the last exposure, respectively. The overall positive rate in respiratory tract specimens was low and relatively unstable, being higher in the early-to-mid stage than in the mid-to-late stage of the disease course. Compared with respiratory tract specimens, faecal samples had a higher viral load, higher overall positive rate, and more stable positivity in different disease courses and varied symptomatic status. Faecal specimens have the potential ability to surpass respiratory tract specimens in virus detection. Testing of faecal specimens in diagnosis, especially for identifying asymptomatic carriers, is recommended. Simultaneously, testing respiratory tract specimens at the early-to-mid stage is better than testing at the mid-to-late stage of the disease course. A relatively small sample size was noted, and statistical approaches were used to address it. Information was missing for both specimen types at different stages of the disease course due to censored data. Our research extends the observed viral shedding in both specimen types and highlights the importance of faecal specimen testing in SARS-CoV-2 diagnosis. Healthcare workers, patients, and the general public may all benefit from our study findings. Disposal of sewage from hospitals and residential areas should be performed cautiously because the virus sheds in faeces and can last for a long time.

Background The purpose of this study was to present our preliminary exploration of safety and efficacy of postoperative low-dose-rate brachytherapy for the early clinical stages of minor salivary gland carcinomas of the lip and buccal mucosa. Methods Twenty-seven patients with the early stages of minor salivary gland carcinomas of the lip and buccal mucosa received postoperative 125I seed interstitial brachytherapy from March 2005 to May 2015. Actuarial likelihood estimates for local control, overall survival, and disease-free survival were calculated by Kaplan–Meier method. Results The actuarial 3-year, 5-year, and 10-year local control rates were 94.7%, 82.9%, and 82.9%, respectively. The actuarial 3-year, 5-year, and 10-year overall survival rates were 93.3%, 93.3%, and 77.8%, respectively. No patient experienced toxicity above grade 2. Conclusion Postoperative 125I seed interstitial brachytherapy is an alternative to radical surgery for early stages of minor salivary gland carcinomas of the lip and buccal mucosa, which offers satisfactory cosmetic and functional outcomes. © 2017 Wiley Periodicals, Inc. Head Neck 39: 572–577, 2017

Introduction : Home enteral nutrition (HEN) was adopted as a feasible and safe way which might be beneficial to patients undergoing esophagectomy in recent years. The aim of this study was to compare the effects of four weeks home enteral nutrition with standard enteral nutrition on immune function, nutritional status and survival in patients undergoing esophagectomy. Methods : A parallel-group, randomized, single-blind, clinical trial was conducted between April 1, 2017 and August 1, 2017. Eighty patients were enrolled in this study and 62 patients were eligible for analysis. An enteral feeding pump was used to infuse enteral nutrition via jejunostomy tube postoperatively. Patients in HEN group were instructed to independently administer jejunostomy feeds at home. Immune parameters and nutritional indicators were measured at preoperative day 7 and at postoperative day 30. Results : There were no significant differences in baseline characteristics between the two groups. The levels of IgA and IgG which can reflect the patients’ immune function significantly increased in HEN group compared with SEN group (P = 0.042 and P = 0.003, respectively). Comparing the two groups, 2-year progression-free survival and overall survival had no significant differences in survival curves (P = 0.36 and P = 0.29, respectively). Conclusion : Four weeks home enteral nutrition is a safe and feasible nutritional strategy to improve immune function and nutritional status after esophagectomy. Although there was no significant difference in survival between the two groups, home enteral nutrition could still be more effective and beneficial to patients with defective nutritional and immune status than standard enteral nutrition.

Maxillary reconstruction is one of the most challenging areas of reconstructive surgery. This report describes a case of a 33-year-old male with osteoblastic osteosarcoma of the maxillary. The patient received radical resection and reconstruction with a deep circumflex iliac artery perforator flap (DCIAPF). The flap was harvested with a 4 × 2 cm osseous flap and a 6 × 8 cm skin island supplied by terminal perforators from the deep circumflex iliac artery. Anastomosis was accomplished on the ipsilateral facial vessels with deep circumflex iliac vessels through an intraoral approach. The donor site and the flap were observed to have completed primary healing 2 weeks after the surgery. The DCIAPF may be a satisfactory single-flap option for maxillary reconstruction with less donor-site complications.

Although life cycle assessment (LCA) has been employed to analyze the environmental impacts of bridges, the uncertainties associated to LCA have not been studied, which have a profound effect on the LCA results. This paper is intended to provide a comprehensive environmental impact assessment of bridge with data uncertainty, by assigning probability distributions on the considered parameters, assessing the variability in the acquisition of inventory and identifying the key parameters with significant environmental impacts. A life cycle assessment of a bridge in Shanxi Province of China was conducted in a cradle-to-grave manner, by considering the source of the uncertainty of LCA. A statistical method was applied to quantify the uncertainty of measured inventory data and to calculate the probability distribution of the data. The uncertainty propagation was conducted through using a Monte Carlo simulation. Finally, the factor which is of vital importance to the assessment result was identified by sensitivity analysis. For the case of bridge, normal distribution can be adopted to fit environmental substances and environmental impact in steel production. The distributions of the weighted value of human health damage, ecological system damage, and resource and energy consumption can be represented by an approximate similar normal distribution function. The coefficient of variance (COV) of each weighted value is about 40, 30 to 40, and about 6 %, respectively. The COV for the total environmental impact is about 10 % in all stages of the bridge’s life cycle, except the operation stage, which is up to 22.67 %. By conducting sensitivity analysis, PM10, NOx, and oil consumption was found to have a great influence on the result of human health damage, ecological system damage, and resource and energy consumption, respectively. The COV for the total environmental impact is 22.67 % in the bridge’s operation stage; it is important to establish a reasonable maintenance strategy to decrease the uncertainty of the bridge’s environmental impact. The COVs of the weighted value for human health damage and resource and energy consumption have a quite modest difference among the four stages of the bridge’s life cycle. However, The COV of the weighted value for ecological system damage shows large difference among the four stages of the bridge’s life cycle; construction stage has the greatest uncertainty. In addition, different values of PM10, NOx, and oil consumption have a profound influence on the result of human health damage, ecological system damage, and resource and energy consumption, respectively.

Bottom blowing has a significant influence on the stirring of molten steel in a combined blown converter. The effects of flow rate and configuration of bottom blowing tuyeres on the flow of molten steel inside the converter were studied with Eulerian multiphase model by using commercial software Fluent6.3, then the bottom blowing system was optimized based on the numerical simulation. The results show that the shape of the flow field of gas-steel phase zone is like an inverted cone, forming a strong center circulation and a weak circulation near the wall on both sides of the gas column because of bottom blowing. The average velocity of molten steel increases with the increase of bottom blowing flow rate. The flow pattern of molten steel changes little when the pitch circle diameter of bottom blowing tuyeres configuration changes. The molten steel has a good dynamic condition when the bottom blowing tuyeres are distributed at 0.55D (D is the diameter of the converter bottom) of the converter bottom. The simulation results were verified by industrial experiments.

Over the past several decades with significant technological advances there has been continuous increase in plastic manufacturing in China, which has contributed to the production of a great deal of plastics worldwide every year, and at the same time it has resulted in a large amount of plastic solid waste (PSW). It has great potential values for waste plastics to reuse as secondary materials, which may lessen pressure on resource and environment. The paper studies the status of waste plastics in recycling, reusing and reducing on management countering on the increase in the flow of waste plastics in Shanghai. In light of the methodology of life cycle, the study analyzes the environmental impacts associating with the alternatives in a ‘cradle to grave’ approve to PSW technological recycling systems. We will choose regenerating and energy recovery processes based on site investigation and literatures data in Shanghai to analyze recycling options and how various processes affect the environment. Life-cycle methodology was very suitable for evaluating the overall environmental consequences, and could be used for making decisions and planning strategies with the rapid increase of plastic solid waste generation for Shanghai.

A rapid and highly accurate diagnostic tool for distinguishing benign tumors from malignant ones is required owing to the high incidence of breast cancer. Although various computer-aided diagnosis (CAD) systems have been developed to interpret ultrasound images of breast tumors, feature selection and the setting of parameters are still essential to classification accuracy and the minimization of computational complexity. This work develops a highly accurate CAD system that is based on a support vector machine (SVM) and the artificial immune system (AIS) algorithm for evaluating breast tumors. Experiments demonstrate that the accuracy of the proposed CAD system for classifying breast tumors is 96.67 %. The sensitivity, specificity, PPV, and NPV of the proposed CAD system are 96.67, 96.67, 95.60, and 97.48 %, respectively. The receiver operator characteristic (ROC) area index A z is 0.9827. Hence, the proposed CAD system can reduce the number of biopsies and yield useful results that assist physicians in diagnosing breast tumors.

BACKGROUND The aim of the study was to present long-term results of mandibular growth in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. PROCEDURE Twenty-five survivors of pediatric parotid gland carcinoma treated with iodine-125 seed interstitial brachytherapy were included for quantitative analysis, including three dimensional (3D) cephalometry and measurement of mandibular volume. RESULTS 3D cephalometry showed that the median fore-and-aft increments of the lengths of the condyle, the ramus, and the body of the mandible were 1.23, 0.19, and 1.66 mm for the affected side, respectively, and were 1.37, 1.95, and 3.42 mm for the unaffected side, respectively. The difference in increments of the ramus was statistically significant between the affected side and the unaffected side (P = 0.003; P

The influence of the device structure on the electroluminescence (EL) properties of fluorescent–phosphorescent organic light emitting diodes (OLEDs) was demonstrated. Four devices with regular-, inverted-, compensated- and symmetrical-emission layers (EMLs) were prepared. In regular-EML device, DCJTB emission increased when the phosphorescent sensitized EML was thickened. In inverted-EML device, low electron energy barrier at the Bphen/BCzVB interface resulted in weakened blue emission. The compensated-EML device, prepared with a red color-compensated layer, showed a color-tunable broadband white emission. Conversely, device with a quantum-like symmetrical-EML showed a narrow color-temperature range. Stable EL efficiency was obtained from regular, compensated, and symmetrical-EML devices. In contrast, EL efficiency of inverted-EML device rolled off significantly, though it had the highest EL efficiency of 11.4 cd/A.

BACKGROUND CONTEXT The incidence of cervical tuberculosis is not high, and only accounts for 3%–5% of spinal tuberculosis. However, the cervical anatomy is complicated, with many of the lesions being adjacent to important structures. The disease has a high risk and high disability rate, which seriously affects the prognosis and quality of life of the patients. Some scholars reported the incidence of paralysis in cervical tuberculosis to be as high as 42.5%. In recent years, anti-tuberculosis drugs in the treatment of spinal tuberculosis are more standardized, and also achieve a good therapeutic effect, but the spinal instability, kyphosis, nerve dysfunction and other complications often occur at follow-up. PURPOSE To observe the clinical effect of anterior debridement, decompression, bone grafting, and instrumentation for cervical spinal tuberculosis in four hospitals. STUDY DESIGN/SETTING A retrospective cohort study. PATIENT SAMPLE One hundred fourty-six patients. OUTCOME MEASURES Clinical outcome, laboratory indexes and radiological results METHODS This research retrospectively analyzed 146 patients with cervical spinal tuberculosis who were treated by anterior debridement, decompression, bone grafting, and instrumentation in four institutions between January 2000 and January 2015. There were 68 males and 78 females with an average age of 31.32±11.69years. All patients received chemotherapy for 18 months after surgery, and fixed by brace for 3 months. Clinical outcome, laboratory indexes and radiological results were analyzed to evaluate the efficacy of anterior approach surgery in the treatment of cervical spinal tuberculosis. RESULTS All cases were followed up about 18-52 months later (average 24 months). At the last follow-up, all patients obtained bone fusion, pain relief and neurological recovery. There was no recurrence in any of the patients, and no internal fixation related complications. There were statistically significant differences before and after treatment in terms of Visual analog scale (VAS), Neck disability index (NDI) and Japanese Orthopedic Association (JOA) (P CONCLUSIONS One stage anterior-only approach surgery for the treatment of cervical spinal tuberculosis showed excellent efficacy andthe complication rate of anterior approach surgery was 12%., so it is a recommendable surgical method.

BACKGROUND CONTEXT Despite significant advances in antibiotic treatments, spinal infections are still a serious challenge for surgeons. This is particularly relevant for surgeons selecting an appropriate bone graft after debridement in spinal infectious diseases. Different scholars have different views. Some scholars believe that the autogenous bone is the best choice, while other scholars think that cage is the most suitable materials. Due to the particularity of infection and the allografts, surgeons usually faced a dilemma in the application of allografts as bone grafting. For example, aggravating infection, iatrogenic infection, nonunion and other adverse consequences. Until now, there is still no consensus in academia. PURPOSE We evaluated the clinical efficacy and fusion characteristics of allografts in spinal infectious diseases. STUDY DESIGN/SETTING A retrospective cohort study. PATIENT SAMPLE A total of 731 patients. OUTCOME MEASURES Clinical outcome, laboratory indices and radiological results. METHODS This study reviewed 1,196 patients with spinal infection who were treated at six institutions, from January 2000 to January 2016. A total of 731 patients were enrolled in this research; all patients underwent debridement, decompression, allograft bone grafting and instrumentation. Among these, 624 patients had spinal tuberculosis, 50 had brucellosis, 43 had spinal osteomyelitis and 14 had spinal fungal or cryptococcus infection. All patients received anti-inflammatory therapy and were fixed by a brace for 3-9 months postoperatively. Clinical outcome, laboratory indices and radiological results were analyzed. RESULTS All cases were followed up for 12–60 months. Erythrocyte sedimentation rate returned to normal levels at the final follow-up. Pain was relieved in all patients and 87.6% of cases were painless. At the 9 and 12 month follow-up, the fusion rate of allografts was 34.2% and 97.9%, respectively. At the final follow-up, the fusion rate was 100%. CONCLUSIONS The clinical efficacy and safety of allografts for the treatment of spinal infection was satisfactory. Allografts can replace autografts in surgeries for spinal infection.

Industrial solid waste refers to all solid waste derived from industrial processes. Industrial solid waste, on the one hand, may lead to environmental risk and safety issue; on the other hand, contains valuable recyclable resources. Taking copper slag as a case study, the life cycle environmental and economic performance of recycling process were analyzed by using life cycle assessment and life cycle costing approaches. The functional unit was defined as the recycling of 1 ton of copper slag. The results showed that the process of production of cement after floatation was the optimal scenario for copper slag recycling, and its life cycle impact and life cycle cost were-67.22 Pt and-479.28 yuan, respectively. Specifically, the dominant environmental impact category of copper recycling process was respiratory (inorganic). In addition, raw material, fuel and power, equipment depreciation and transportation contributed to the life cycle cost in descending order of their proportion.

With the fast growing of printing supplies industry in Shanghai, it creates a large waste stream of obsolete printing supplies and causes great pressure on the environment. The information of remanufacturing printing supplies in Shanghai is gathered and waste stream is analyzed. As a case study of original toner cartridge and remanufacturing toner cartridge is compared in the context of life cycle methodology. The results show raw materials, energy consumption and pollution emission of the remanufactured toner cartridge are less than these of original toner cartridge. Environmental loads equitant including global warming potential, acidification potential, photo-oxidant formation potential, solid waste and fume from remanufacturing toner cartridge are cut 3.61%, 3.84%, 15.24% and 22.52% comparing to original toner cartridge. Its significance is that remanufacturing printing supplies can be more profitable and less harmful to the external environment than conventional manufacturing process. It also discusses strategies for lowering the environmental burden to promote the remanufacturing printing supplies in Shanghai.

White organic light emitting diodes (OLEDs) were fabricated for color-tunable lighting applications. Fluorescent and phosphorescent hybrid emission layers (EMLs) were used to enhance the luminance and stability of the devices, which have blue-EML/CBP interlayer/green-EML/phosphorescent-sensitized-EML/red-EML structures. The influence of the composition and structure of the EMLs on the electroluminescence properties of the devices were investigated from the viewpoint of their emission spectra. The possible exciton harvesting, diffusion, transport, and annihilation processes occurring in the EMLs were also evaluated. A maximum luminance intensity of 7400 cd/m2 and a highly stable current efficiency of 3.2 cd/A were obtained. Good color tunability was achieved for the white OLEDs; the chromatic coordinates linearly shifted from pure white (0.300, 0.398) to cold white (0.261, 0.367) when the applied voltage was varied from 10 to 14 V.

Facing with the high energy consumption in Chinas building sector, it is of great significance to understand the accurate building energy consumption. Therefore, this paper investigated the different analysis methods of building energy consumption mainly applied in China, trying to understand the status of building energy consumption. Field survey and statistics, models, and computer simulation analysis, employing as major instruments currently for analyzing building energy consumption in China, were introduced briefly.

There is a huge impact of railway projects on the regional environment. A life cycle assessment (LCA) framework using quantitative methodwas developed to evaluate the environment impact of railway projects quantitatively. The railway life cycle was divided into 5 phases: survey and design, raw materials processing, construction, operation, and demolition. The life cycle environmental impact for railway project was categorized into 5 grades: great negative influence, little negative influence, no influence, little positive influence, and great positive influence. Based on the improved AHP method, a quantitative method was introduced to evaluate comprehensive environmental impact of railway projects. A railway project was analyzed as a case study. The results show that the major environment impact is occurred during the phases of operation and demolition. It is demonstrated that the method is applicable to assess the life-cycle environmental impact of railway projects.

Desmoid-type fibromatosis (DF) is a locally aggressive benign soft tissue tumor. It is rarely observed in the head and neck region and is particularly uncommon in the parotid gland. This report describes the case of a 32-month-old girl with DF of the head and neck. The tumor was resected with gross residual tumors. Recurrence occurred 3 months later and then the patient was treated with iodine-125 interstitial brachytherapy. The tumor was completely absent 6 months after brachytherapy. No recurrence was found 60 months after brachytherapy during follow-up. No severe toxicities or growth abnormalities were observed. Very-low-dose rate brachytherapy as the sole modality could be a reasonable alternative for the treatment of inoperable DF of the head and neck, which avoids the risk of cosmetic deformity caused by surgery, especially in pediatric patients. In addition, long-term follow-up is recommended.