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Postoperative radiotherapy is a major treatment for patients with maxillary sinus carcinoma. However, the irregular resection cavity poses a technical difficulty for this treatment, causing uneven dose distribution to target volumes. In this study, we evaluated the dose distribution to target volumes and normal tissues in postoperative intensity-modulated radiotherapy (IMRT) after placing a water-filled balloon into the resection cavity. Three postoperative patients with advanced maxillary sinus carcinoma were selected in this trial. Water-filled balloons and supporting dental stents were fabricated according to the size of the maxillary resection cavity. Simulation CT scans were performed with or without water-filled balloons, IMRT treatment plans were established, and dose distribution to target volumes and organs at risk were evaluated. Compared to those in the treatment plan without balloons, the dose (D98) delivered to 98% of the gross tumor volume (GTV) increased by 2.1 Gy (P = 0.009), homogeneity index (HI) improved by 2.3% (P = 0.001), and target volume conformity index (TCI) of 68 Gy increased by 18.5% (P = 0.011) in the plan with balloons. Dosimetry endpoints of normal tissues around target regions in both plans were not significantly different (P > 0.05) except for the optic chiasm. In the plan without balloons, 68 Gy high-dose regions did not entirely cover target volumes in the ethmoid sinus, posteromedial wall of the maxillary sinus, or surgical margin of the hard palate. In contrast, 68 Gy high-dose regions entirely covered the GTV in the plan with balloons. These results suggest that placing a water-filled balloon in the resection cavity for postoperative IMRT of maxillary sinus carcinoma can reduce low-dose regions and markedly and simultaneously increase dose homogeneity and conformity of target volumes.

With growing human demand for a variety of economic, resources and environment exerting a profound human impact on the environment, in order to deal with economic, resource and environment relationship, life cycle assessment (LCA) and environmental efficiency evaluation are widely used. In order to more accurately conduct the environmental assessment of the product, it is needed to rationally utilize life cycle assessment and environmental efficiency evaluation, put accurate environmental load data into effective use of the evaluation of environmental efficiency, in which environmental efficiency indicators and the performance factor index correctly reflects the value of the product enhancement and mitigation of environmental load.

To evaluate the hair-removal effect of IPL for hairy skin grafts.10 patients with hairy skin grafts were treated with IPL (ELITEplus) for hair removal 3 to 5 times at intervals of 2 months. The patients received IPL(610 - 1 000 nm) with spot size of 10 mm x 50 mm, pulse width of 5 msec with a delay of 2 - 20 msec, fluence of 30 - 38.3 J/cm2 .The treatment was well tolerated with no need of anesthesia in all the patients. The hairs were removed completely after 3 to 5 treatments. The treated site could be washed as usual with no need of dressing. There was no blister, infection, hyperpigmentation and scarring. Only vellus were existed during the follow-up period of 6 - 12 months.IPL is a safe and reliable method to remove unwanted hair on skin grafts. It can be easily performed with a lower complication.

To evaluate the hair-removal effect of intense pulsed light (IPL).The unwanted hairs were removed with ELITE plus IPL. The treatment took 3 - 5 procedures, with an interval of over 2 months. 341 patients underwent the treatment.All the patients were well tolerant without anesthesia. The unwanted hairs were wholly removed after 3 - 5 procedures. After operation, routine cleaning and make-up were allowed and bandaging was not necessary. There were blister in 3 cases and infection in 1 case. No pigmentation and scarring happened. Following-up of 3 - 6 months showed steady results with less regeneration of very thin and soft hair.IPL is an ideal hair-removal method because of the credible effect, simple operation, rapid treatment and no serious complications.

Based on the septocutaneous artery flap concept, the thigh, which is the commonest conventional donor site for split-skin grafts, can also become a donor area for skin flaps. The thigh flap, with its large and long neuro-vascular pedicle, can be used either as a free flap or as an island flap as an alternative to the lower abdominal flap, groin flap, tensor fasciae latae myocutaneous flap, sartorius myocutaneous flap or the gracilis myocutaneous flap. The anatomical basis, operative technique and characteristics of the thigh flap are discussed.