Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors： A Randomized Controlled Trial

Background： Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up. Methods： A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up （WFU） group or telephone follow-up （TFU） group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method. Results： Time consumption in WFU group for each patient （23.36 ± 6.16 min） was significantly shorter than that in TFU group （42.89 ± 7.15 min） （P 〈 0.001 ）; total economic cost in WFU group （RMB 90 Yuan） was much lower than that in TFU group （RMB 196 Yuan）. Lost-to-follow-up rate in the WFU group was 7.02% （4/57） compared with TFU group, 9.80% （5/51 ）, while no significance was observed （95% confidence interval [CI]： 0.176-2.740; P = 0.732）. The overall satisfaction rate in WFU group was 94.34% （50/53） compared with 80.43% （37/46） in TFU group （95% CI： 0.057-0.067; P = 0.034）. Conclusions： The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.

Laser cladding of high-entropy alloy on H13 steel

High-entropy alloy layer up to 150 lm in thickness was formed on H13 substrate with a metallurgical bonding at the coating/substrate interface. Simple solid solution phases were formed in the coating layer with a typical microstructure composed of both dendrite and interdendrite. The microstructure at the top of the cladding zone consists of equiaxed grains while that at the bottom consists of columnar grains. The coating layer exhibits great enhancement in microhardness and wear resistance compared with the H13 substrate.

Laser Surface Alloying of Low Carbon Steel Using High-entropy Alloy Precursors

The Al0. 5CoCrCuFeNi high-entropy alloy powders with simple face-centered-cubic （FCC） solid solution structure were introduced into the surface layer of a low carbon steel during laser surface alloying. A high performance surface layer with extremely fine martensite as the dominant phase was obtained, resulting in a great improvement in microhardness, wear resistance, and corrosion resistance. The great enhancement of microhardness and wear resistance of the laser alloyed layer is mainly due to the formation of extremely fine martensite hard phase, the solid solution strengthening of the alloying e!.ements in supersaturated a-Fe solid solution, and the existence of size effect and strain effect under rapid solidification. The enhancement of corrosion resistance is due to the alloying of Al, Co, Ni, Cr and Cu in the laser alloyed layer.

Clinical Characteristics and Endoscopic Endonasal Removal of Foreign Bodies within Sinuses, Orbit, and Skull Base

Background：Foreign bodies within the sinuses,orbit,and skull base （FBSOS） are rare;hence,diagnosis and management guidelines are lacking.Endoscopic sinus surgery （ESS） removal is preferred because of the less invasiveness and minimal morbidity.This study was designed to summarize clinical experience with ESS management of FBSOS.Methods：We retrospectively reviewed clinical manifestations,imaging findings,treatment,and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center.The Chi-square test was performed to compare the infection rate between wooden and nonwooden FBSOS.Results：There were 23 male and five female patients,with median age of 11 years.FBSOS were located within the sinuses （86%）,orbit （75%）,and skull base/intracranial region （46%）.Wooden FBSOS had a significantly higher risk of infection （78%） compared with nonwooden FBSOS （5%,P 〈 0.05）.Contrast-enhanced computed tomography （CT） plus three-dimensional reconstruction was sensitive in all cases.Twenty-seven （96%） FBSOS were removed by ESS alone,while 1 （4%） FBSOS was removed using the combined ESS and lateral cervical approach.Four of the nine intracranial penetrating FBSOS patients had intraoperative cerebrospinal fluid （CSF） leak and received endoscopic CSF leak repair.Twelve （43%） patients suffered complications （meningitis,diplopia,and vision loss）.Conclusions：ESS is a minimally invasive,safe,and promising surgical approach for FBSOS removal.Contrast-enhanced CT is effective in preoperative diagnosis and intraoperative guidance.Wooden FBSOS had higher risk of infection,thus antibiotics are recommended.