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Objective To explore the teaching effect of flipped classroom teaching mode supported by the 3D printing model in the embryology experiment. Methods Totally 76 students from class 2016 were randomly divided into two groups: the experimental group previewed the embryo 3D models before class and taught other students in class, while the control group did not preview the embryo 3D models before class. An embryo knowledge test and a questionnaire survey were carried out before and after the experimental class to compare the differences of knowledge mastery and self-evaluation between the two groups. Results In the aspect of self-evaluation, the self-evaluation of the experimental group students in explaining the causes and explaining the process of development was significantly improved after the lecture (P<0.05), while the self-evaluation of the control group students in identifying the structure, understanding knowledge, telling the causes and explaining the process of development was significantly improved (P< 0.05). In terms of knowledge test scores, the scores of students in the experimental group and the control group after teaching were higher than those before teaching (P < 0.05). The improvement of the knowledge test in the control group was significantly higher than that in the experimental group (P<0.05). The experiment group' s grades of knowledge test were significantly higher than the control group in the second experiment. 70.27% of the students thought that they were still lack of knowledge in the introspection of the causes of wrong answers. The misunderstanding of English nouns (15.54%), psychological factors (5.41%) and other factors (8.78%) also caused the students to lose points in the knowledge tests. Conclusion The combination of the 3D printing model and the flipped classroom teaching mode can effectively improve the teaching effect, which should be paid attention to in the reform of embryology experimental teaching.
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Objective@#To investigate the accuracy and feasibility of individual 3D printing model for pedicle screw placement in treating patients with upper cervical spine fracture.@*Methods@#A retrospective case control study was conducted to analyze the clinical data of 30 patients with upper cervical spine fracture admitted to Ningbo No.6 Hospital from August 2013 to December 2018. There were 19 males and 11 females, aged 45-67 years with an average age of 53.5 years. The 15 patients in the study group were treated with pedicle screw fixation and another 15 patients in the control group were treated with traditional freehand screw fixation. A total of 120 pedicle screws were implanted, with 60 screws in each group. The operation time, intraoperative blood loss, preoperative and postoperative visual analogue score (VAS), Japan Orthopedic Association (JOA) score were recorded. The position and grade of screws were evaluated according to Kawaguchi's evaluation method of screw grade after operation. The patients took monthly reexamination for the first three months after discharge. In the first two months after discharge, the patients took X-ray examination for observation of screw loosening or rupture of internal fixation. At the third month after operation, the patients took CT of cervical spine for observation of bone healing and fusion.@*Results@#The mean follow-up duration was 17.8 months (range, 13-21 months). The study group had shorter operation time (99.13±3.04)minutes compared with the control group (107.00±6.92) minutes (P<0.01). There were no significant differences in intraoperative blood loss, preoperative VAS, JOA scores before operation and 1 year after operation between the two groups (P>0.05), but the VAS in study group was significantly lower than that in control group (P<0.05). In the study group, the VAS score 1 year after operation [(2.3±0.5)points] was lower than that before the operation [(7.7±0.7)points], and the JOA score [(16.8±0.4)points] was significantly higher than that before the operation [(15.9±0.7)points](P<0.01). In the control group, the VAS 1 year after operation [(2.5±0.5)points] was significantly lower than that before operation [(7.5±0.5)points] (P<0.01), and the JOA score [(16.5±0.5)points] was significantly higher than that before operation [(15.9±0.8)points] (P<0.05). In the study group, according to the CT results, there were 28 atlas pedicle screws of grade 0 (93.3%), two of grade 1 (6.7%), 0 of grade 2, 0 of grade 3, and there were 27 axial pedicle screws of grade 0 (90.0%), three of grade 1 (10.0%), 0 of grade 2, and 0 of grade 3. In the control group, there were 25 atlas pedicle screws of grade 0 (83.3%), four of grade 1 (13.3%), one of grade 2 (3.4%), 0 of grade 3, and there were 27 axial pedical screws of grade 0 (90.0%), three of grade 1 (10.0%), 0 of grade 2, and 0 of grade 3. There was no significant difference in the accuracy of pedicle screw placement between the two groups (P>0.05). No serious complications such as spinal cord or vertebral artery injury occurred. At 3 months after operation, CT showed that the fracture of cervical vertebra healed.@*Conclusion@#Individualized 3D printed cervical spine model can guide the pedicle screw placement for upper cervical spine fracture, which can shorten the operation time, reduce the postoperative pain of patients, improve the accuracy of screw placement, and reduce the risks related to operation.
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Objective To investigate the accuracy and feasibility of individual 3D printing model for pedicle screw placement in treating patients with upper cervical spine fracture.Methods A retrospective case control study was conducted to analyze the clinical data of 30 patients with upper cervical spine fracture admitted to Ningbo No.6 Hospital from August 2013 to December 2018.There were 19 males and 11 females,aged 45-67 years with an average age of 53.5 years.The 15 patients in the study group were treated with pedicle screw fixation and another 15 patients in the control group were treated with traditional freehand screw fixation.A total of 120 pedicle screws were implanted,with 60 screws in each group.The operation time,intraoperative blood loss,preoperative and postoperative visual analogue score (VAS),Japan Orthopedic Association (JOA) score were recorded.The position and grade of screws were evaluated according to Kawaguchi's evaluation method of screw grade after operation.The patients took monthly reexamination for the first three months after discharge.In the first two months after discharge,the patients took X-ray examination for observation of screw loosening or rupture of internal fixation.At the third month after operation,the patients took CT of cervical spine for observation of bone healing and fusion.Results The mean follow-up duration was 17.8 months (range,13-21 months).The study group had shorter operation time (99.13 ± 3.04)minutes compared with the control group (107.00 ± 6.92) minutes (P ＜ 0.01).There were no significant differences in intraoperative blood loss,preoperative VAS,JOA scores before operation and 1 year after operation between the two groups (P ＞ 0.05),but the VAS in study group was significantly lower than that in control group (P ＜ 0.05).In the study group,the VAS score 1 year after operation [(2.3 ± 0.5) points] was lower than that before the operation [(7.7 ± 0.7) points],and the JOA score [(16.8 ± 0.4) points] was significantly higher than that before the operation [(15.9 ± 0.7) points] (P ＜ 0.01).In the control group,the VAS 1 year after operation [(2.5 ± 0.5) points] was significantly lower than that before operation [(7.5 ±0.5)points] (P ＜0.01),and the JOA score [(16.5 ±0.5)points] was significantly higher than that before operation [(15.9 ± 0.8)points] (P ＜ 0.05).In the study group,according to the CT results,there were 28 atlas pedicle screws of grade 0 (93.3％),two of grade 1 (6.7％),0 of grade 2,0 of grade 3,and there were 27 axial pedicle screws of grade 0 (90.0％),three of grade 1 (10.0％),0 of grade 2,and 0 of grade 3.In the control group,there were 25 atlas pedicle screws of grade 0 (83.3％),four of grade 1 (13.3％),one of grade 2 (3.4％),0 of grade 3,and there were 27 axial pedical screws of grade 0 (90.0％),three of grade 1 (10.0％),0 of grade 2,and 0 of grade 3.There was no significant difference in the accuracy of pedicle screw placement between the two groups (P ＞ 0.05).No serious complications such as spinal cord or vertebral artery injury occurred.At 3 months after operation,CT showed that the fracture of cervical vertebra healed.Conclusion Individualized 3D printed cervical spine model can guide the pedicle screw placement for upper cervical spine fracture,which can shorten the operation time,reduce the postoperative pain of patients,improve the accuracy of screw placement,and reduce the risks related to operation.
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PURPOSE: To evaluate the fit of a crown produced based on a 3D printed model and to investigate its clinical applicability. MATERIALS AND METHODS: A master die was fabricated with epoxy. Stone dies were fabricated from conventional impressions (Conventional stone die group: CS, n=10). Digital virtual dies were fabricated by making digital impressions (Digital Virtual die group: VD, n=10). 3D data obtained from the digital impression was used to fabricate 3D printed models (DLP die group: DD, n=10, PolyJet die group: PD, n=10). A total of 40 crowns were fabricated with a milling machine, based on CS, VD, DD and PD. The inner surface of all crowns was superimposed with the master die files by the “Best-fit alignment” method using the analysis software. One-way and 2-way ANOVA were performed to identify significant differences among the groups and areas and their interactive effects (α=.05). Tukey's HSD was used for post-hoc analysis. RESULTS: One-way ANOVA results revealed a significantly higher RMS value in the 3D printed models (DD and PD) than in the CS and DV. The RMS values of PD were the largest among the four groups. Statistically significant differences among groups (P < .001) and between areas (P < .001) were further revealed by 2-way ANOVA. CONCLUSION: Although the fit of crowns fabricated based on the 3D printed models (DD and PD) was inferior to that of crowns prepared with CS and DV, the values of all four groups were within the clinically acceptable range ( < 120 µm).
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Objective To explore the feasibility of 3D printing technique combined with intra-operative ultrasound for locating completely endophytic renal tumor in lapamscopic nephron-sparing surgery.Methods Fifteen patients with completely endophytic renal tumor,who undervwent 3D printing technique combined with intra-operative ultrasound assisted localization of laparoscopic partial nephrectomy from Mar.2014 to Mar.2016,received CT image 3D reconstruction and 3D printing kidney model using Fommlab Form1 + 3D printer before operation.Among 15 patients aging (55.7±10.5) years,11 patients were male and 4 were female;the tumor diameter was (2.8±1.0) cm;and 3 cases were ventral and 12 were dorsal,all had solitary tumors.The clinical data,including intra-operative blood loss,warm ischemia time,post-operative pathology and surgical margins,and post-operative renal function,were statistically analyzed in this study.Resuits Laparoscopic partial nephrectomy was successfully carried out in all cases:the average operation time was (105.0± 20.6) min,the average warm ischemia time was (22.8 ± 3.5) min,and the mean intra-operative blood loss was (87.3±15.8) mL.No case received blood transfusion during or after operation,and the average post-operative hospital stay was (6.7 ± 1.0) days.No obvious complication occurred after operation.The surgical margins were all negative.Post-operative pathology confirmed that 13 patients were with clear cell renal cell carcinoma,and 2 with papillary renal cell carcinoma.Patients were followed up for (23.7± 11.8) months,and nocontinuous deterioration of renal function or tumor recurrence was found.Conclusion Pre-operative 3D printing technique for patients with completely endophytic renal tumor can help to determine the tumor location and adjacent relationship,reducing the risk of surgery by guiding operation scheme.Meanwhile,propaganda and education using 3Dprinting kidney model can improve patients ' cognition to surgery and simplify pre-operative conversation process.Furthermore,utilizing intra-operative ultrasound to optimize tumor resection scheme can reduce the damage to the renalvessels and collection system,maximizing the clinical benefit by ensuring negative margin and renal function reservation.
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Objective To explore the feasibility of 3D printing technique combined with intra-operative ultrasound for locating completely endophytic renal tumor in laparoscopic nephron-sparing surgery. Methods Fifteen patients with completely endophytic renal tumor, who underwent 3D printing technique combined with intra-operative ultrasound assisted localization of laparoscopic partial nephrectomy from Mar. 2014 to Mar. 2016, received CT image 3D reconstruction and 3D printing kidney model using Formlab Form1+ 3D printer before operation. Among 15 patients aging (55.7±10.5) years, 11 patients were male and 4 were female; the tumor diameter was (2.8±1.0) cm; and 3 cases were ventral and 12 were dorsal, all had solitary tumors. The clinical data, including intra-operative blood loss, warm ischemia time, post-operative pathology and surgical margins, and post-operative renal function, were statistically analyzed in this study. Results Laparoscopic partial nephrectomy was successfully carried out in all cases:the average operation time was (105.0±20.6) min, the average warm ischemia time was (22.8±3.5) min, and the mean intra-operative blood loss was (87.3±15.8) mL. No case received blood transfusion during or after operation, and the average post-operative hospital stay was (6.7±1.0) days. No obvious complication occurred after operation. The surgical margins were all negative. Post-operative pathology confirmed that 1 3 patients were with clear cell renal cell carcinoma, and 2 with papillary renal cell carcinoma. Patients were followed up for (23.7±11.8) months, and no continuous deterioration of renal function or tumor recurrence was found. Conclusion Pre-operative 3D printing technique for patients with completely endophytic renal tumor can help to determine the tumor location and adjacent relationship, reducing the risk of surgery by guiding operation scheme. Meanwhile, propaganda and education using 3D printing kidney model can improve patients’ cognition to surgery and simplify pre-operative conversation process. Furthermore, utilizing intra-operative ultrasound to optimize tumor resection scheme can reduce the damage to the renal vessels and collection system, maximizing the clinical benefit by ensuring negative margin and renal function reservation.
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Objective To evaluate the safety,efficiency of retroperitoneal laparoscopic partial nephrectomy combined with four points location in 3D model or 3Dimensional CT for completely endophytic tumors,and summarize the surgical experience.Methods From Jan 2015 to Jan 2016,5 patients with completely endophytic tumors,who underwent retroperitoneal laparoscopic partial nephrectomy were recruited.one patient underwent 3D printing kidney model,and another 4 patients underwent 3Dimensional CT and locating four projection positions of the tumor on the surface,in order to guide the tumor resection in laparoscopic partial nephrectomy.Perioperative,operative,and postoperative,as well as oncological outcomes were analyzed.Results In all 5patients,preoperative four points location in 3D model or 3Dimensional CT for completely endophytic tumors is feasible and accurate in term of locating the tumor.The mean operative time was(129.0 ± 19.5) min,mean warm ischaemia time was (19.6 ± 5.4) min and mean estimated blood loss was(100 ± 83) ml.Pathological examination showed cell renal cell carcinoma.All the patients had a negative surgical margin,and no tumor recurrence or metastasis during 6-18months of follow up.Conclusions In experienced institutes,retroperitoneal laparoscopic partial nephrectomy combined with four points location in 3D model or 3Dimensional CT for completely endophytic tumors is a feasible and safe procedure in terms of accurate locations,low complication rates,reasonable functional and oncologic outcomes after an intermediate-term follow-up