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<p><b>OBJECTIVE</b>To evaluate the value of 640-slice 3D CT angiography (3D-CTA) plus 3D printing for improving the outcomes of surgeries for intracranial aneurysms.</p><p><b>METHODS</b>Sixty patients with intracranial aneurysm were randomly divided into trial group (n=30) and control group (n=30). The control group received routine surgery, and the simulation models of the intracranial aneurysm in trial group was printed using a 3D printer using the imaging data from 3D-CTA. Using the simulation model, the surgery was designed and planned before operation (including surgical approaches and placement of clips) and simulation surgery was also conducted. The coincidence rates between preoperative and intraoperative findings of the intracranial aneurysms on 3D-CTA were compared. CT scan was performed at 1 and 3 days after the operation to detect potential cerebral infarction or bleeding associated with the operation; CTA was performed both at the same time and at 3-6 months after the operation to detect stenosis, occlusion and aneurysm clipping. The patients were followed up for 3-6 months to assess the outcomes using Glasgow Outcome Scale (GOS).</p><p><b>RESULTS</b>The preoperative 3D-CTA findings were basically consistent with the intraoperative findings in all the 60 patients. Nine patients in the control group and 2 patients in the trial group had short-term adverse operation events; 11 patients in control group and 4 patients in trial group had long-term adverse events; 18 patients in control group and 25 patients in trial group had good neurologic function. The incidences of short-term and long-term adverse events associated with the operation was significantly lower in the trial group than in the control group (χ=5.364, P=0.021; χ=4.841, P=0.028), and the outcomes were significantly better in the trial group than in the control group (χ=4.633, P=0.031).</p><p><b>CONCLUSION</b>The simulation model of intracranial aneurysm is helpful to improve the quality of surgery and patients outcomes.</p>
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Objective: To develop a scoring system for estimating advanced colorectal neoplasm risk in average-risk population in southern Jiangsu province, and to evaluate its screening efficiency. Methods: An average-risk population of colorectal neoplasm in southern Jiangsu province, who underwent colonoscopy, was included in this study. All participants were asked to complete a questionnaire on demographic characteristics, medical history, smoking, alcohol consumption, dietary intake, and other factors that may be associated with advanced neoplasms. A multivariable logistic regression method was used to identify independent predictors of advanced neoplasms. A scoring system was developed from the logistic regression model by using a regression coefficient-based scoring method, and then was internally validated. The screening efficiency of the scoring system was assessed by its calibration, discrimination, and accuracy. Results: A total of 905 average-risk participants were included in this study. The scoring system comprised 5 variables (age, sex, coronary artery disease, egg intake, and defecation frequency), with scores ranging from 0 to 10. The system had good calibration (P= 0.205) and good discrimination (area under the receiver operating characteristic curve = 0.75, 95% confidence interval: 0.69-0.82). If score 2.5 was used as the screening cut-off value, the sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 93.8%, 47.6%, 50.1%, 9.1%, 99.3%, 1.79, and 0.13, respectively. Among the participants with low-risk (0-2) or high-risk (>2) scores, the risks of advanced neoplasms were 0.7% and 9.1% (P<0.001), respectively. If colonoscopy was used only for persons with high risk, 93.8% of persons with advanced neoplasms would be detected while the number of colonoscopies would be reduced by 45.4%. Conclusion: The scoring system in this study has satisfactory screening efficiency and can be used for preliminary screening of advanced colorectal neoplasms in average-risk population in southern Jiangsu Province.
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Objective To analyze the risk factors on type 2 diabetic with foot ulcer.Methods 69diabetic foot patients were involved in the study.According to ulcer,patients were divided into the ulcer group(n=25)and the no-ulcer group (n=44).FBG,2h PBG,HbA1c,TC,TG,HDL,LDL,BUN,Cr.CRP were examined.T-test and chi-square test were used to assess the risk factors on diabetic foot patients with clure.Results Compared with the no-ulce group,the ulcer grou were associated with HDL and CRP.Chi-square-test demonstrated a statistically significant difference between the groups with ulcer and no-ulcer grou on incidence of hypertension and ulcer in diabetic foot patients(P
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Objective To investigate the relationship between atherosclerotic lesions of arteries of lower extremities and metabolic disorders in patients with diabetic foot. Methods Three hundreds and sixty two patients with type 2 diabetes were selected, including 232 males and 130 females, with average age of (64.9?11.2) years and the average diabetic duration of (9.2?7.5) years. Atherosclerotic lesions of the arteries were detected by type B ultrasound. According to severity of lesions of femoral, popliteal and tibial arteries, the patients were classified into four groups: A-control group, B-plague formation (plague), C-arterial stenosis (stenosis) (luminal narrowing≥50%) and D-arterial occlusion (occlusion). Fasting blood glucose, GHbAlc and lipid levels (Total cholesteral, TC; Triglyceride, TG; Low density iipoprotein, LDL) were tested in all patients. Results (1)GHbAlc levels in group B and group C were significantly different from that in group A respectively[(8.4?2.2%)vs(7.8?2.2%),P