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Objective:To explore the feasibility and accuracy of three-dimensional (3D) modeling methods based on ultrasound imaging data for normal and abnormal fetal cardiac structures, and to construct a methodology system for 3D printing of fetal heart based on ultrasound.Methods:A total of 93 fetuses examined in Tangdu Hospital of Air Force Military Medical University from January to December 2019 were selected. Fetal echocardiography was obtained using spatio-temporal image correlation (STIC). Ninety-three hearts were 3D modeled by blood flow modeling, blood pool modeling and cavity modeling, and printed by stereolithography technique. The data measured on the 3D digital models and 3D printed solid models were compared with the corresponding fetal echocardiographic images respectively in order to evaluate the accuracy of the modeling methods.Results:The fetal cardiac blood flow models based on Doppler flow image data showed the malformation and trend of small blood vessels. The fetal cardiac structure models printed based on blood pool modeling displayed the malformation of heart and large blood vessels. Models printed based on cavity modeling method accurately displayed valve and structural defects.For 83 normal fetal hearts, the long diameters of left and right ventricles measured on echocardiography [(15.3±1.9)mm, (13.2±1.9)mm] were compared with those measured on digital models [(15.1±1.9)mm, (12.9±1.9)mm] and 3D printed models[(15.1±1.9)mm, (13.0±1.9)mm], respectively, and there were no significant differences between any two groups of them ( P>0.05). Bland-Altman showed good consistency for all measurements within and between operators. Conclusions:The three modeling methods, including blood flow modeling, blood pool modeling and cavity modeling, have their own advantages in displaying different types of fetal heart malformations. Appropriate modeling methods should be selected for 3D modeling and printing to make up for the limitations of single modeling method. The consistency between measurements on 3D models and those on echocardiography is high, and the repeatability between operators is good.
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Objective:To investigate clinical efficacy of conformal sphincter preservation operation (CSPO) versus intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 183 patients with low rectal cancer who were admitted to two medical centers (117 in the Changhai Hospital of Naval Medical University and 66 in the Huashan Hospital of Fudan University) from August 2011 to April 2020 were collected. There were 110 males and 73 females, aged (57±11)years. Of 183 patients, 117 cases undergoing CSPO were allocated into CSPO group, and 66 cases undergoing ISR were allocated into ISR group, respectively. Observation indicators: (1) surgical situations of patients with low rectal cancer in the two groups; (2) postoperative complications of patients with low rectal cancer in the two groups; (3) follow-up; (4) influencing factors for prognosis of patients with low rectal cancer; (5) influencing factors for satisfaction with the anal function of patients with low rectal cancer. Follow-up was conducted using outpatient examination, questionnaire and telephone interview to determine local recurrence, distal metastasis, survival, stomal closure, satisfaction with the anal function of patients. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test.The Kaplan-Meier method was used to draw survival curves, and life table method was used to calculate survival rates. Log-rank test was used for survival analysis. Univariate analysis was performed using the linear regression. Variables with P<0.10 in the univariate linear regression analysis were included for multivariate analysis. Multivariate analysis was performed using the COX stepwise regression model and linear regression analysis. Results:(1) Surgical situations of patients with low rectal cancer in the two groups: cases with laparoscopic surgery, operation time, volume of intraoperative blood loss, distance from tumor to distal margin, cases with postoperative chemotherapy, duration of postoperative hospital stay were 44, (165±54)minutes, (142±101)mL, (0.6±0.4)cm, 76, (6.6±2.5)days for the CSPO group, respectively, versus 55, (268±101)minutes, (91±85)mL, (1.9±0.6)cm, 9, (7.9±4.7)days for the ISR group, showing significant differences between the two groups ( χ2=35.531, t=8.995, -3.437, -3.088, χ2=44.681, t=2.267, P<0.05). (2) Postoperative complications of patients with low rectal cancer in the two groups: 19 patients in the CSPO group had complications. There were 6 cases with grade Ⅰ complications, 12 cases with grade Ⅱ complications, 1 case with grade Ⅲb complication. Fourteen patients in the ISR group had complications. There were 4 cases with grade Ⅰ complications, 7 cases with grade Ⅱ complications, 1 case with grade Ⅲa complication, 2 cases with grade Ⅲb complications. There was no significant difference in the postoperative complications between the two groups ( χ2=0.706, P>0.05). Patients with complications in the two groups were improved after symptomatic and supportive treatment. There was no perioperative death in the postoperative 30 days of the two groups. (3) Follow-up: 183 patients received follow-up. Patients of the CSPO group and ISR group were followed up for (41±27)months and (37±19)months, respectively, showing no significant difference between the two groups ( t=-1.104, P>0.05). There were 2 cases with local recurrence and 9 cases with distal metastasis of the CSPO group, respectively, versus 3 cases and 4 cases of the ISR group, showing no significant difference between the two groups ( χ2=1.277, 0.170, P>0.05). The 3-year disease-free survival rate and 3-year total survival rate were 84.0% and 99.0% for the CSPO group, versus 88.6% and 92.8% for the ISR group, showing no significant difference between the two groups ( χ2=0.218, 0.002, P>0.05). The stomal closure rate was 92.16%(94/102) and 96.97%(64/66) for 102 patients of CSPO group and 66 patients of ISR group up to postoperative 12 months,respectively, showing no significant difference between the two groups ( χ2=1.658, P>0.05). Of the 8 cases without stomal closure in the CSPO group, 2 cases refused due to advanced age, 4 cases subjectively refused, and 2 cases were irreducible due to scar caused by radiotherapy. Two cases in the ISR group had no stomal closure including 1 case of postoperative liver metastasis and 1 case of subjective refusal. There were 92 and 61 patients followed up to 12 months after stomal closure, of which 75 cases and 38 cases completed questionnaires of satisfaction with the anal function. The satisfaction score with the anal function was 6.8±2.8 and 5.4±3.0 for CSPO group and ISR group, respectively, showing a significant difference between the two groups ( t=-2.542, P<0.05). Fifty-four cases in the CSPO group and 21 cases in the ISR group had satisfaction score with the anal function >5, showing no significant difference between the two groups ( χ2=3.165, P>0.05). (4) Influencing factors for prognosis of patients with low rectal cancer: results of COX stepwise regression analysis showed that gender and pT staging were independent influencing factors for disease-free survival rate of patients with low rectal cancer ( hazard ratio=2.883, 1.963, 95% confidence interval as 1.090 to 7.622, 1.129 to 3.413, P<0.05). Gender and pT staging were independent influencing factors for total survival rate of patients with low rectal cancer ( hazard ratio=10.963,3.187, 95% confidence interval as 1.292 to 93.063, 1.240 to 8.188, P<0.05). (5) Influencing factors for satisfaction with the anal function of patients with low rectal cancer: results of univariate analysis showed that surgical method and tumor differentiation degree were related factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.464, -1.580, 95% confidence interval as 0.323 to 2.605, -2.950 to -0.209, P<0.05). Results of multivariate analysis showed that surgical method, tumor differentiation degree and preoperative radiotherapy were independent influencing factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.637, -1.456, -1.668, 95% confidence interval as 0.485 to 2.788, -2.796 to -0.116, -2.888 to -0.447, P<0.05). Conclusion:Compared with ISR, CSPO can safely preserve the anus in the treatment of low rectal cancer, without increasing the incidence of postoperative complications, which can also guarantee the oncological safety and improve the postoperative anal function.
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Objective:To investigate the accuracy of parents′ self-assessment of dental caries status of their children and to explore the relevant factors affecting accuracy.Methods:A total of 329 children in kindergarten of Science and Technology Research Institute of China Petroleum Corporation and their parents were recruited by convenience sampling method. The parents assessed their children's dental caries status and completed a questionnaire, and then children were examined by the dentists. The difference between parents and dentists′ the assessment of children's dental caries status and relevant influencing factors were analyzed.Results:51.06%(168/329) of the parents did not agree with the doctor's diagnosis in the assessment of children's caries. The rate of parents' missed diagnosis was 94.12%. Logistic regression analysis showed that 'children brush teeth everyday' ( OR value was 2.919), 'parents can help children brush their teeth' ( OR value was 2.670), 'parents can check results after children brushing their teeth '( OR value was 4.508), and 'children received the treatment of dental caries' ( OR value was 1.768) were significant influencing factors of parents' assessment accuracy ( P<0.01). Conclusions:The accuracy of parents' assessment of children′s dental caries status is low, and it is related to many factors. Attention should be paid to the implementation of oral heath behavior during oral health education, and parents' capacity of assessing children caries should be improved.
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Objective@#To investigate the accuracy of parents′ self-assessment of dental caries status of their children and to explore the relevant factors affecting accuracy.@*Methods@#A total of 329 children in kindergarten of Science and Technology Research Institute of China Petroleum Corporation and their parents were recruited by convenience sampling method. The parents assessed their children's dental caries status and completed a questionnaire, and then children were examined by the dentists. The difference between parents and dentists′ the assessment of children's dental caries status and relevant influencing factors were analyzed.@*Results@#51.06%(168/329) of the parents did not agree with the doctor's diagnosis in the assessment of children's caries. The rate of parents' missed diagnosis was 94.12%. Logistic regression analysis showed that 'children brush teeth everyday' (OR value was 2.919), 'parents can help children brush their teeth' (OR value was 2.670), 'parents can check results after children brushing their teeth '(OR value was 4.508), and 'children received the treatment of dental caries' (OR value was 1.768) were significant influencing factors of parents' assessment accuracy (P<0.01).@*Conclusions@#The accuracy of parents' assessment of children′s dental caries status is low, and it is related to many factors. Attention should be paid to the implementation of oral heath behavior during oral health education, and parents' capacity of assessing children caries should be improved.
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Objective To investigate use of magnetic resonance diffusion tensor imaging (MR-DTI) for quantitatively evaluating the efficacy of Mailuoning Injection on non-compressive lumbar radiculitis.Methods Nine Bama mini pigs were selected and divided into group A,B and C,3 cases in each group.The non-compressive lumbar radiculitis model was established under CT-guiding.The corresponding therapeutic drugs (group A:10 mL Mailuoning;group B:10 mL normal saline;group C:10 mL diminishing inflammation fluid) were given by epidural injection on 14 d after constructing model.MR-DTI was performed before model construction,14 d after model construction and before treatment.One experimental pig in each group was taken on 3,7,14 d after treatment,performed MR-DTI and killed for taking the nerve root sample to conduct the immunohistochemical detection.The fractional anisotropy (FA) values of nerve root in MR-DTI imaging were measured.The FA values and immunohistochemical detection results were statistically analyzed.Results MR-DTI:the FA values after model construction in each group was decreased (P0.05),but the FA values increase in the group C was earlier and more rapid than other two groups (P0.05),while the FA values had statistical difference between the group B and C (P<0.05).The immunohistochemical results:TNF-α integral absorbency value(IA value) on 7 d after treatment in the group A began to decline;the TNF-α IA value on 14 d after treatment in the group A and C was significantly decreased compared to group B,the difference was statistically significant (P<0.05).Conclusion Mailuoning Injection has a certain effect on non-compressive lumbar radiculitis,which can be evaluated by using DTI.