Feasibility of a novel type of complex anterior cervical fixation by using Mimics software / 中国骨伤

OBJECTIVE@#To investigate the feasibility of mimics software in analyzing a new type of complex anterior cervical fixation -- anterior transpedicular screw fixation+zero notch internal fixation.@*METHODS@#From January 2021 to September 2022, 50 normal pedestrians who underwent cervical spine CT scanning were selected for C1-C7 segment scanning, including 27 males and 23 females, aged from 25 to 65 years old with an average of (46.0 ± 9.0) years old. The dicom format is exported and engraved into the CD, and use the mimics software to perform 3D reconstruction of each segment. A simulated screw is placed on the image according to the critical value of zero notch screw (head and tail angle 44°, internal angle 29°). The position of zero notch screw in each segment is observed to determine the feasibility of anterior transpedicular screw fixation plus zero notch internal fixation.@*RESULTS@#For the upper zero notch screws the three-dimensional images of the cervical spine across all 50 subjects within the C3-C7 segments demonstrated safe position, with no instances of intersection with ATPS. For the lower zero notch screw, in C3-C4 and C4-C5, 4 out of 50 subjects are in the safe position in the three-dimensional images of cervical vertebrae, and 46 cases could achieve secure screw placement when the maximum caudal angle is(32.3±1.9) ° and (36.1±2.2) °, respectively. In C5-C6 and C6-C7 segments, no lower zero notch screws intersected with ATPS, and all screws are in safe positions.@*CONCLUSION@#Lower cervical anterior pedicle screw fixation plus zero notch internal fixation can achieve successful nail placement through the selected entry point and position.

Clinical application of Mimics software system to three-dimensional reconstruction to guide thoracoscopic anatomic pulmonary segmentectomy / 中国胸心血管外科临床杂志

@#Objective    To investigate the clinical effect of 3D computed tomography bronchial bronchography and angiography (3D-CTBA) and guidance of thoracoscopic anatomic pulmonary segmentectomy by Mimics software system. Methods    A retrospective analysis was performed on patients who underwent thoracoscopic segmentectomy in the Department of Thoracic Surgery of Affiliated People's Hospital of Jiangsu University from June 2020 to December 2022. The patients who underwent preoperative 3D-CTBA using Materiaise's interactive medical image control system (Mimics) were selected as an observation group, and the patients who did not receive 3D-CTBA were selected as a control group. The relevant clinical indicators were compared between the two groups. Results    A total of 59 patients were included, including 29 males and 30 females, aged 25-79 years. There were 37 patients in the observation group, and 22 patients in the control group. The operation time (163.0±48.7 min vs. 188.8±43.0 min, P=0.044), intraoperative blood loss [10.0 (10.0, 20.0) mL vs. 20.0 (20.0, 35.0) mL, P<0.001], and preoperative puncture localization rate (5.4% vs. 31.8%, P=0.019) in the observation group were better than those in the control group. There was no statistically significant difference in the thoracic tube placement time, thoracic fluid drainage volume, number of intraoperative closure nail bin, postoperative hospital stay, or postoperative air leakage incidence (P>0.05) between the two groups. Conclusion    For patients who need to undergo anatomical pulmonary segmentectomy, using Mimics software to produce 3D-CTBA before surgery can help accurately identify pulmonary arteriovenous anatomy, reduce surgical time and intraoperative blood loss, help to determine the location of nodules and reduce invasive localization before surgery, and alleviate patients' pain, which is worthy of clinical promotion.

Exposure to Attractive Toxic Sugar Baits containing Piriproxyfen (ATSB-PPF) in surfaces reduces the number of eggs and larvae produced by Aedes aegypti (Diptera: Culicidae) females

ABSTRACT The significant role of Aedes aegypti as a vector of several arboviruses has intensified studies on vector control tools, including Attractive Toxic Sugar Baits containing Pyriproxyfen (ATSB-PPF). PPF is an insect growth regulator (IGR) that has been used to control immature mosquitoes, but it also has direct effects on female reproduction. This study evaluated the effect of physical exposure of Ae. aegypti females with ATSB-PPF on fecundity and fertility at different times before and after blood meal. Females were confined in cages impregnated with ATSB-PPF at different concentrations (5, 50, and 500 ppm). One group of females was exposed to the baits 24 and 48 hours Before the Blood Meal (BBM), and in the other group, exposure occurred 24 and 48 hours After the Blood Meal (ABM). The number of eggs laid, larvae, and pupation rate were analyzed. Exposure of Ae. aegypti females to ATSB-PPF bait 24 hours after the blood meal was able to reduce the number of eggs laid, especially at the higher concentrations used, but the number of larvae obtained was reduced regardless of the exposure time to ATSB-PPF, i.e., 24 hours before or after the blood meal, or the concentration of PPF used. No changes were observed in the number of pupae from larvae obtained from eggs laid by mosquitoes exposed to ATSB-PPF. Physical exposure of mosquitoes to sugar baits is sufficient to reduce the investigated reproductive parameters of Ae. aegypti.

Comparison of four methods that remove calcium hydroxide from root canals / 口腔疾病防治

Objective@# To compare the efficiency of four methods that remove calcium hydroxide in root canals and to guide clinical practice. @* Methods @# Sixty-five isolated mandibular single root canal premolars were collected. After crown cutting and root canal preparation, a tooth was randomly selected as the blank control group, and the remaining 64 teeth were equally divided into Groups A and B (n = 32). Group A was injected with water-soluble calcium hydroxide, and Group B was injected with oil-soluble calcium hydroxide. After 2 weeks of drug sealing, Groups A and B were randomly divided into 4 groups (n = 8), including the lateral opening syringe group, sonic vibration group, ultrasonic group, and Er: YAG laser group. Before and after calcium hydroxide removal, the samples were scanned by cone-beam CT, and the data were imported into Mimics for 3D reconstruction. The root canal was divided into the following segments: superior root segment, middle and apical, and the calcium hydroxide volume of each segment of the root canal was calculated. The volumes of calcium hydroxide before and after removal were V1 and V2, respectively, with a clearance rate = (V1-V2)/V1×100%. Three-factor ANOVA was used for statistical analysis. After Groups A and B were reconstructed, the apical region with residual calcium hydroxide was selected, and the blank control was observed by scanning electron microscopy (SEM). @*Results @# Two types of calcium hydroxide could not be completely removed by the four flushing methods. The clearance rate of water-soluble calcium hydroxide was higher than that of oil-soluble calcium hydroxide (P<0.001). Among the three segments of the root canal, the clearance rate of the apical segment was lower (P<0.05). The Er: YAG laser treatment group showed the highest removal efficiency of two kinds of calcium hydroxide, which was higher than that of the other groups, especially in apical of the root. Compared with the sonic wave washing group and the syringe washing group, the ultrasonic wave washing group exhibited significant advantages (P<0.05). The clearance rate of the sonic wave washing group was higher in the oily calcium hydroxide root middle group than in the syringe washing group (P<0.05). SEM showed that the two kinds of calcium hydroxide could not be completely removed, but the residual rate of oil-soluble calcium hydroxide was large.@*Conclusion @# Both types of calcium hydroxide could not be completely removed, and compared to water-soluble calcium hydroxide, oil-soluble calcium hydroxide was more difficult to remove. Among the four cleaning methods, Er:YAG laser swing washing showed the higher cleaning efficiency.

Clinical efficacy of CT modeling and 3D printing in the treatment of ankle fracture / 中国综合临床

Objective:To explore the effect of 3D printing technology on ankle fracture surgery.Methods:This study was a case-control study.Forty five patients with ankle fractures admitted to the Department of Orthopaedics of the Affiliated Hospital of North China University of Science and Technology from January 2017 to May 2022 were selected. Divide into an observation group and a control group using the random number table method. The control group received open reduction and internal fixation of the ankle joint under X-ray assistance, while the observation group used Mimics software modeling and 3D printing models to assist in open reduction and internal fixation of the ankle joint. Compare the surgical time, intraoperative bleeding volume, intraoperative X-ray exposure frequency, postoperative physician fatigue scale 14 (FS-14) score, fracture reduction quality, fracture healing time, and ankle joint function at 6 months after surgery between the two groups of patients. The measurement data is represented by ± s, and the two groups are compared using t-tests with two independent samples; Counting data is represented by examples (%), χ 2 test is used for inter group comparison, and rank sum test is used for inter group comparison of rank data. Results:The observation group had shorter surgical time than the control group [(134.16±25.61) minutes compared to (163.38±41.90) minutes], with less intraoperative bleeding and fewer intraoperative X-ray exposure times than the control group [(46.32±29.29) mL compared to (99.62±77.85) mL, (13.68±3.50) times compared to (18.54±6.09) times], and lower postoperative physician fatigue scores than the control group [(9.77±2.02) points compared to (12.13±1.73) points], The differences between groups were statistically significant (t-values in decibels were 2.69, 3.20, 3.12, and 4.20, all P<0.05). The quality of postoperative fracture reduction in the observation group was excellent in 12 cases, good in 5 cases, and poor in 2 cases; The quality of postoperative fracture reduction in the control group was excellent in 7 cases, good in 16 cases, and poor in 3 cases. Compared between groups, the observation group had better postoperative fracture reduction quality than the control group ( Z=-2.05, P=0.040). At a follow-up of 6 months after surgery, there was no statistically significant difference in bone healing time between the two groups ( P>0.05). The AOFAS score in the observation group was higher than that in the control group (91.63±2.83) compared to (88.92±3.92), and the difference was statistically significant ( t=2.56, P=0.014). Conclusions:Using Mimics software modeling and 3D printing technology to assist ankle fracture surgery can shorten the operation time, reduce the use rate of X-ray, reduce the fatigue of doctors, and improve the quality of joint reduction and ankle function.

Analysis of injury characteristics of peritalar dislocations using ankle models reconstructed with software Mimics / 中华创伤骨科杂志

Objective:To analyze the injury characteristics of peritalar dislocations using ankle models reconstructed with software Mimics.Methods:A retrospective study was conducted to analyze the medical records of 36 patients with peritalar dislocation who had been treated at Department of Orthopaedics, The Fourth Hospital of Wuhan from January 2008 to April 2022. There were 28 males and 8 females with an age of (46.0±14.6) years, and 16 left and 20 right limbs. Their CT data were imported into software Mimics to reconstruct ankle models to observe the fractures of the postero-medial process of the talus, the affiliated injuries to the surrounding bone structures outside the talus, and the complete or incomplete dislocations of the talonavicular articulation.Results:32 patients (88.9%, 32/36) had fracture of the postero-medial process of the talus, and 24 patients (66.7%, 24/36) a total of 33 affiliated injuries to the surrounding bone structures outside the talus, including 12 lateral malleolus ones, 4 medial malleolus ones, 7 scaphoid ones, 6 calcaneus ones, 3 fractures of the cuboid and 1 fracture of the fifth metatarsal. Sixteen patients were complicated with 1 affiliated injury, 7 patients with 2 affiliated injuries, and 1 patient with 3 affiliated injuries. The 8 patients with 2 or more affiliated injuries all had complete dislocation of the talonavicular articulation. Of the 36 patients, 26 had complete dislocation of the talonavicular articulation and 10 incomplete dislocation of the talonavicular articulation. The incidence of affiliated injuries [84.6% (22/26)] in the patients with complete dislocation of the talonavicular articulation was significantly higher than that [20.0% (2/10)] in those with incomplete dislocation of the talonavicular articulation ( P=0.001). Conclusions:Most of the peritalar dislocations are combined with the fracture of the postero-medial process of the talus. The incidence of complete dislocation of the talonavicular articulation is high. Patients with complete dislocation of the talonavicular articulation are more likely to have an affiliated injury, or even more than two injuries.

Stroke Mimics ­ Glioblastoma Presenting with Hemorrhage after Thrombolysis: Case Report / Stroke mimics ­ Glioblastoma apresentando hemorragia após trombólise: Relato de caso

Background Stroke is a clinical syndrome characterized by a sudden-onset neurological deficit of vascular cause. Stroke-like clinical symptoms that are later found to have nonvascular disorders have been termed stroke mimics (MIM), and their incidence ranges from 1.3 to 25% in patients not treated with thrombolytic therapy. Eventually, intravenous thrombolysis of MIM may occur. Case Description We describe a 74-year-old woman with abrupt global aphasia who received thrombolytic therapy after the presumed diagnosis of acute ischemic stroke. She gradually improved despite the finding of an asymptomatic left temporal hematoma on the computed tomography (CT) scan. Two months later, she presented with a new focal neurological deficit and was diagnosed with a glioblastoma in the topography of the previous bleeding. Conclusion This case highlights the rare occurrence of hemorrhage after thrombolysis in patients with MIM.

Introdução O acidente vascular encefálico (AVC) é uma síndrome clínica caracterizada por déficit neurológico de início súbito. Casos nos quais a sintomatologia é semelhante aos AVCs e que, posteriormente, são identificados como distúrbios não vasculares, foram denominados de stroke mimics, cuja incidência varia entre 1,3 e 25% em pacientes diagnosticados com AVC. Eventualmente, pode ocorrer trombólise intravenosa de stroke mimics. Descrição do caso Descrevemos o caso de uma mulher de 74 anos com afasia global abrupta que recebeu terapia trombolítica após o diagnóstico presumido de AVC isquêmico. A paciente apresentou melhora gradual dos sintomas apesar do achado na tomografia computadorizada (TC) de crânio de um hematoma temporal esquerdo assintomático. Dois meses depois, a paciente apresentou novo déficit neurológico focal e foi diagnosticada com glioblastoma na topografia do sangramento anterior. Conclusão Este caso destaca a rara ocorrência de hemorragia após trombólise em paciente portador de glioblastoma e com diagnóstico inicial de AVC isquêmico.

Bone tunnel positions in anterior cruciate ligament reconstruction evaluated by three-dimensional CT reconstruction based on Mimics software:modified transtibial versus anteromedial portal technique / 中国骨伤

OBJECTIVE@#To compare the femoral and tibial tunnel positions of anterior cruciate ligament reconstruction using the modified transtibial (MTT) technique and anteromedial (AM) portal technique.@*METHODS@#Between January 2017 and September 2020, 78 patients with anterior cruciate ligament rupture underwent single-bundle reconstruction with the modified transtibial technique in 39 cases (group MTT) and through anteromedial approach in 39 cases (group AM). There were 25 males and 14 females in group MTT, with an average age of (37.0±2.3) years old; 27 males and 12 females in group AM, with an average age of (37.5±2.2) years old. CT scan of the affected knee was conducted one week after the surgery to measure and compare the femoral tunnels positioning (Fx, Fy), tibial tunnels positioning in the frontal plane(Tx1), tibial tunnels positioning in the sagittal plane (Ty1), and tibial tunnels positioning in the axial plane (Tx2, Ty2) in patients undergoing anterior cruciate ligament reconstruction through Mimics software.@*RESULTS@#Three-dimensional CT reconstruction after the surgery showed that the average Fx and Fy were(25.2±2.1)% and (34.9±3.0)% respectively and the Tx1 and Ty1 were (45.5±3.3)% and (44.7± 3.0)% respectively, while the Tx2 and Ty2 were (47.0±3.0)% and (39.9±4.2)% respectively in group MTT. In group AM, the average Fx and Fy were (26.0±2.0)% and (36.1±3.9)% respectively and the Tx1 and Ty1 were (46.5±3.1)% and (45.6± 3.1)% respectively, while the Tx2 and Ty2 were (47.4±2.5)% and (39.6±3.9)% respectively. There were no statistically significant differences in the femoral and tibial tunnels between the two groups (@*CONCLUSION@#Both the MTT and AM technique can achieve good anatomical positioning of the femoral and tibial tunnels, without significant differences in the positioning of the bone tunnels.

Measurement of the maximum corridor parameters of infra acetabular screw and evaluation of the feasibility of screw insertion by digital analysis / 中国骨伤

OBJECTIVE@#To measure the maximum corridor parameters of the infra acetabular screw and evaluate the feasibility of screw insertion through digital analysis of the acetabular structure.@*METHODS@#The pelvic CT data of 100 patients who received plain pelvic CT scan from April 2013 to June 2015 were retrospectively analyzed. There were 50 males, aged 20 to 84 years, with an average age of (48.42±17.48) years, and 50 females, aged 18 to 87 years, with an average age of (55.02±19.54) years. Patients with acetabular fractures, hip dysplasia, and metal implants in the acetabulum were excluded. Import CT data into Mimics software in DICOM format to generate a three-dimensional model, and find the axialprojection of the infra-acetabular corridor in the middle of the pubis ramus in the inlet view. A virtual screw was placed in the infra-acetabular space and measure the parameters including the diameter and the length of the maximum corridor, the distance from the insertion point to the pubic symphysis, to the anterosuperior iliac spine and to the medial edge of the pelvis. Then import the pelvic model into 3- matic software, establish the pelvic model anterior pelvic plane and median sagittal plane, and measure the angle between the screw axis and the two planes. A minimum corridor diameter of at least 5 mm was defined as a cutoff for placing a 3.5 mm screw, and calculate the screw insertion rate.@*RESULTS@#In 100 cases, 49% of patients had a infra acetabular corridor with a diameter ≥5 mm, and the rate of screw placement in men was significantly higher than that in women. The average diameter of the maximum corridor of infra-acetabular screw was (4.86±1.72) mm, the average length was (94.04±8.29) mm, the average distance from the insertion point to the pubic symphysis was (60.92±4.84) mm, to the anterosuperior iliac spine was (85.15± 6.85) mm, and to the medial edge of the pelvis was (6.12±3.32) mm. The mean angle between the axis of the screw and the median sagittal plane was (-1.38±4.74)°, and the mean angle between the axis of the screw and the anterior pelvic plane was (56.77±7.93)°. There are significant differences between male and female measured parameters, except for the angle between the screw axis and the anterior pelvic plane. There was no statistically significant difference in the maximum corridor parameters of infra-acetabular screw on both sides of the pelvis.@*CONCLUSION@#This study shows that the insertion rate of infra-acetabular screws is low in local patients, and the feasibility of screw insertion should be fully evaluated before surgery.

Stroke Mimics：report of 3 Cases and Review of Literature / 中风与神经疾病杂志

@#Objective In order to improve the clinicians’ awareness of stroke mimics and to avoid inappropriate therapy，we described the clinical data of 3 patients with stroke mimics and reviewed the literature.Methods We retrospectively gave a description of the medical history，clinical manifestations，imaging data and treatments of three typical cases of stroke mimics from January 2017 to September 2018 in our hospital.Results Case1 The patient complained of inability to speak in the morning and weakness of the right limbs for several hours. Head CT showed old lacunar infarctions.The primary diagnosis was acute ischemic stroke（AIS）. The patient developed with fever and seizures during the following days. The diagnosis of intracranial subdural empyema was confirmed by head MRI and further surgery was performed. The reason why we didn’t make the right diagnosis was that the resident didn’t ask the medical history in detail and we didn’t check the head MRI in time.Case 2 We describe a 70-year-old man who presented to our emergency department（ED）with acute onset of left arm soreness and left leg weakness for 5 hours. The AIS was considered. The patient was admitted to the ward and we knew his first symptom was back pain which lasted about few minutes. Spinal cord MRI revealed spinal epidural hematoma. Acute spinal epidural hematoma rarely presents with unilateral weakness of the limbs，mimicking a stroke. Because inappropriate thrombolysis can lead to devastating symptoms，spinal epidural hematoma should be excluded when evaluating an acute stroke patient with a symptom of pain who is a possible candidate for thrombolytic therapy. Case3 The patient admitted to the ward with a seizure，speech disorder and right limbs paralysis for more than 20 hours. The patient’s head MR angiography showed severe stenosis of the left middle cerebral artery. The diagnosis of AIS was made. But the two head MRI being negative for acute ischemic lesion and three dimensional arterial spin-labeled brain perfusion MRI was normal. The diagnosis of AIS was wavering. Within 5 days from the admission，there was almost a complete remission of the neurological findings. The electroencephalogram examination revealed focal abnormalities and Todd’s paralysis was finally confirmed. The neurological deficits during the postictal seizure phase are usually short lasting，but they may last up to days after the convulsion.Conclusion Stroke mimics term is applied in a clinical evaluation，describing those non-vascular conditions that simulate stroke，namely those presenting with an acute neurological deficit.Careful clinical assessment （clinical history and neurological examination）in association with laboratory evaluation is important for depicting the stroke mimics. Brain imaging is essential for the correct diagnosis of AIS and stroke mimic exclusion. With the use of the clinical，laboratory data and magnetic resonance imaging （MRI） evaluation，the misdiagnosis incidence of stroke mimics will decline to lower degree.

Study on the distribution of necrotic tissue in steroid-induced osteonecrosis of femoral head patients based on three-dimensional reconstruction of CT / 中国修复重建外科杂志

Objective: To observe the volume and distribution of necrotic tissue of femoral head in steroid-induced osteonecrosis of femoral head (SONFH) patients by three-dimensional reconstruction of CT. Methods: A clinical data of 25 patients with SONFH between September 2016 and December 2018 was analyzed. There were 22 males and 3 females, with an average age of 38.8 years (range, 20-63 years). The necrosis of the femoral head was in stage Ⅱ of Association Research Circulation Osseous (ARCO). The disease duration ranged from 3 to 18 months, with an average of 9.2 months. A three-dimensional reconstruction with CT data of SONFH patients were performed by Mimics Research 21.0 software and the femoral head was segmented into eight regions by 3-matic Research 13.0 software. The volume of necrotic tissue of the femoral head and the volume rate of necrotic tissue to femoral head were calculated and the distribution was also analyzed. Results: The three-dimensional digital model of the femoral head showed that the necrotic tissue of the femoral head was located above the anterior superior medial, and the area of the necrotic tissue was in a dome-like shape. The results showed that the necrotic tissue in the femoral head was mainly concentrated on the anterior superior internal area, the anterior superior outer area, and the posterior superior internal area. The volume of femoral head was (48 399.52±9 408.90) mm 3, and the volume of necrotic tissue was (20 917.08±6 566.94) mm 3, and the volume ratio of necrotic tissue to femoral head was 44.75%±15.72%. The proportion of necrotic volume in different regions was different, and the necrotic tissues were mainly distributed in the anterior superior internal area, the anterior superior outer area, and the posterior superior internal area. Conclusion: The volume and distribution of necrotic tissue in femoral head can be evaluated quickly and intuitively by three-dimensional reconstruction of CT in Mimics software.

Intracranial dural arteriovenous fistula mimicking ischemic stroke and treated with intravenous thrombolysis

@#Stroke patients are evaluated with a non-contrasted brain computed tomography (CT) scan for decision-making for intravenous thrombolysis. We report a case of a patient who presented with receptive aphasia, and was administered IV alteplase after the non-contrasted brain CT showed no contraindication. However, a dural arteriovenous fistula (dAVF) was detected on the subsequent CT angiography performed in the consideration for endovascular therapy. The patient developed fatal symptomatic intra-cerebral hemorrhage, despite subsequent cessation and reversal of thrombolysis. This case highlights how early CT angiography can be useful in hyper-acute stroke patients beyond the detection of large vessel occlusions, with its ability in revealing stroke mimics such as dural arteriovenous fistula and other contraindications to thrombolysis, which may be missed on the noncontrasted brain CT.

Emergency multimodal computed tomography for the diagnosis of stroke mimic--epileptic seizure

@#Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

Virtual reduction and personalized additional fixation by Mimics software in treatment of unstable external wall type intertrochanteric fracture with proximal femoral nail antirotation / 中国骨伤

OBJECTIVE@#To explore the effect of Mimics assisted virtual reduction and personalized additional fixation with proximal femoral nail anti rotation in the treatment of unstable intertrochanteric fracture of lateral wall.@*METHODS@#From January 2015 to June 2018, 11 cases of intertrochanteric fracture with unstable lateral wall injury were analyzed retrospectively, including 3 males and 8 females, aged 64 to 81 years old. There were 3 cases of A3.1, 6 cases of A3.2 and 2 cases of A3.3 according to AO classification. All patients underwent CT scanning, according to the CT scanning data, three-dimensional reconstruction of fracture was performed by Mimics soft. Virtual reduction was performed first, and PFNA was implanted after satisfactory reduction. According to the relationship between the fracture characteristics of the lateral wall and the position of the lag screw tail in the lateral wall, 4 cases were treated with PFNA and titanium cable or steel wire, and 7 cases were treated with PFNA and reconstruction locking plate.The quality of reduction and healing were evaluated by follow up, and Harris score of hip joint was performed in the last reexamination.@*RESULTS@#All patients were followed up for 12 to 18 months. No postoperative infection of incision and loosening of internal fixation occurred. The time of fracture healing was 12 to 20 weeks. At the final follow up, Harris score of hip joint was excellent in 6 cases, good in 3 cases and fair in 2 cases.@*CONCLUSION@#The treatment of intertrochanteric fracture of femur with Mimics assisted virtual reduction and PFNA is helpful to preoperative planning and improve the surgical effect.

Histomorphological study of prostatic adenocarcinoma and its mimics

Context: Prostate adenocarcinoma (PC) is one of the common cancers in India and world over. Numerous prostatic, nonprostatic lesions, and normal structures can be very similar to adenocarcinoma. A pathologist's awareness of the benign mimics is important for the diagnosis of PC. Aim: The aim of this study was to determine the prevalence, clinical, and histopathological features of PC, and its common mimics, and to study the criteria for their distinction from PC. Materials and Methods: A prospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology in a medical college, for a period of 2 years was done. A brief clinical history followed by a clinical examination, including per-rectal findings and serum prostate-specific antigen (PSA) levels, was noted. Results: After excluding all the cases of benign hyperplasia of prostate without any associated findings, 50 cases of operated surgical specimens of prostate were studied. PC was the most frequent diagnosis in 28 patients of 50 cases (56.0%). Basal cell hyperplasia formed the predominant mimic (26.0%), followed by prostatic intraepithelial neoplasia (8%), prostate atrophy (4%), clear-cell cribriform hyperplasia(4%),, and one case of atypical adenomatous hyperplasia (2%). Serum PSA was >4 ng/mL in all the cases of PC. In three of the mimics, PSA was >4 ng/mL and in the rest it was <4 ng/mL. Immunohistochemistry (IHC) was not applied in our study. Conclusion: Biopsy still remains a gold standard for diagnosis of PC and its mimics. All the lesions in the above study were diagnosed on routine hematoxylin and eosin staining. IHC is useful especially for lesions in the grey zone but not in routine histopathological study and should not be used as a screening test but should be applied in specific selected cases only.

Preoperative Evaluation of the Texture of Pituitary Adenoma by MRI-Based Three-Dimensional Reconstruction / 中国医科大学学报

Objective To investigate the usefulness of three-dimensional reconstruction in the preoperative evaluation of the texture of pituitary tumors. Methods Seventy patients with pituitary tumors admitted to our hospital between January 2015 and July 2018 were enrolled in the study. All patients underwent enhanced MRI scanning before surgery. They were classified into the soft group, medium group, and tough group according to the tumor texture. The patient's clinical data, MRI images, and surgery conditions were collected.The Mimics software was used to reconstruct the three-dimensional models of pituitary adenomas. The volume and surface area of different tumor signal groups were calculated and analyzed. In addition, the relationships between tumor size, tumor resection, and postoperative complications were analyzed. Results The three-dimensionally reconstructed model of the pituitary adenoma had a clear outline and was consistent with the tumor area in the MRI images. The calculated average threshold accurately segmented the images. Grouped by the classification of texture, the differences of the proportions of each part were statistically significant (P ＜ 0.01). According to the ordinal polytomous logistics regression analysis, the proportion of the volume of the higher part positively correlated with the tumor texture (P ＜0.05), and the ratio of the surface area of the medium part to the overall surface area positively correlated with the tumor texture (P ＜ 0.05).Conclusion The use of Mimics software for 3 D reconstruction of preoperative MRI images can accurately predict the tumor texture in pituitary tumors and can provide a basis for the choice of surgical methods.

Subacute sclerosing panencephalitis: Hyper acute variant

@#Subacute sclerosing panencephalitis (SSPE) usually presents insidiously. Acute presentations with a fulminant course can occur. However hyper acute presentations with a non-progressive course have not been reported. Here we describe two cases that had hyper acute presentation with occipital involvement misdiagnosed initially as ischemic infarct. One case remained stable for 4 years and then had a fulminant course and patient succumbed; the other patient continued to remain stable at 2 year follow up. In countries where SSPE is prevalent, it is important to be aware of such a variant of SSPE.

Colorimetric Detection of Iodine Ion Based on Its Inhibition Effect on Peroxidase-Like Activity of Platinum Nanoparticles / 分析化学

As an important inorganic element, iodine not only plays an important role in human growth and metabolism, but also has an irreplaceable role in the chemical engineering, medicine, food and other fields.Thus the detection of iodine ion is of important significance.In this work, colorimetric recognition and sensing of iodine ion with high sensitivity was proposed based on target induced shielding of the peroxidase-like activity of bare platinum nanoparticles ( PtNPs ).This assay exhibited simplicity and cost-effectiveness.The recognition of iodine ion by bare PtNPs could be fulfilled in a few seconds and the assay could be accomplished within 10 min.The detection range for iodine ion was 20 nmol/L-5.0 μmol/L and the detection limit was 8 nmol/L ( S/N = 3 ).Furthermore, the new assay system did not require surface modification of nanoparticles, nor complex organic synthesis.This assay was successfully applied to detection of iodine concentration in real salt and water samples, exhibiting promising application prospects.

Exosomes as potential drug delivery tools for treatment of cardiovascular diseases / 中国药理学与毒理学杂志

Exosomes serve as vesicles to deliver protein, lipids, nucleic acids or other cellular components, to neighboring or distant cells. Recent studies have highlighted the potential therapeutic effects of stem cell-derived exosomes on cancer and cardiovascular diseases. Our previous studie-shave investigated the role of stem cell-derived exosomes in cardiac protection. Mesenchymalstem cells released miR-22-enriched exosomes after ischemic preconditioning and these exosomes showed protective effects oncardiomyocytes.MiR-21-conaining exosomes were secreted by H2O2-treated cardiac progenitor cells and protected cardiomyocytes from H2O2-induced apoptosis. Heat-shock lead to the production ofheat shock factor 1-enriched exosomes from cardiac stem cells, which reducedapoptosis of cardiomyocytes. Given these important effects of exosomes in intercellular communications, exosomes have been proposed as a vector for drug delivery or other therapeutic purposes. However, cells secretea limited number of exosomes, which has hampered the development of exosomes for research and clinical application.Synthetic exosome-mimics by cellextrusion or cell membrane-cloaked nanoparticles, which canbe fabricated on a large-scale, provide novel platforms fordrug delivery. Two Korean groups fabricated exosome-mimetic nanovesicles by extruding monocytes or macrophages through a serial of filters and utilized these exosome-mimetics for the delivery of anti-tumor drug. Recently,cell membrane-cloaked nanoparticles have emergedas a potential tool for drug delivery with the advantages ofimmunocompatibility, stability and targeting capabilityfor the treatment of cancer. In summary, exosomes or exosome-mimics may serve as potential therapeutic tools for the treatment of cardiovascular diseases.

An Enzyme Cascade Strategy for Sensitive Detection of Acid Phosphatase / 分析化学

An enzyme cascade strategy was introduced for sensitive detection of acid phosphatase ( ACP) . Pyrophosphate ions ( PPi ) can strongly bound Fe3+and thus hinders the production of Prussian blue nanoparticles (PBNPs). ACP can hydrolyze PPi to form phosphate ions, and the released Fe3+reacts with potassium ferrocyanide ( K4[ Fe ( CN )6] ) to form PBNPs. The formed PBNPs have high peroxidase-like activity, which can decompose hydrogen peroxide ( H2O2) to produce hydroxyl radical (·OH) for oxidizing the typical substrate of 3,3′,5,5′-tetramethylbenzidine ( TMB). Therefore, a novel sensing strategy for detecting ACP based on the high signal amplification of enzyme cascade was constructed. The results showed that there was a good linear relationship between the absorbance of oxidized TMB ( oxTMB ) and the concentration of ACP in the range of 3-20 U/L, with a detection limit of 0. 8 U/L. Different from the conventional enzyme cascades in which the product of one enzyme is the substrate of the other, this study opens up a new way to construct novel enzyme cascade system.