3D printing-assisted percutaneous balloon dilatation plasty for treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients / 中华创伤骨科杂志

Objective:To compare the clinical efficacy between 3D printing-assisted percutaneous balloon dilatation calcaneal plasty (3D-PCP) and conventional open reduction and internal fixation (ORIF) via the extended lateral L-shaped approach in the treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients.Methods:Retrospectively analyzed were the data of 36 elderly patients with osteoporotic calcaneal fracture of Sanders type Ⅱ or Ⅲ who had been surgically treated at Department of Orthopaedics, Yixing People's Hospital from June 2012 to June 2018. According to their treatment methods, the patients were divided into a 3D-PCP group [16 cases, 9 males and 7 females with an age of (73.0 ± 3.4) years] and an ORIF group [20 cases, 8 females and 12 females with an age of (71.4 ± 2.6) years]. The 2 groups were compared in terms of hospital stay, operation time, intraoperative fluoroscopy frequency, suture removal time, weight bearing time, fracture healing time, visual analogue scale (VAS) for the surgical site 2 days and one year after surgery, American Foot and Ankle Surgery Association (AOFAS) ankle-hindfoot score, calcaneal imaging parameters (B?hler angle, Gissane angle, and length, width and height of the calcaneus axis) at 2 days and one year after surgery, and postoperative complications.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P > 0.05). All patients were followed up for 14 to 18 months (mean, 15.6 months). Compared with the ORIF group, the 3D-PCP group had significantly shorter hospital stay, significantly shorter operation time, significantly earlier suture removal, significantly earlier weight-bearing, significantly lower VAS scores at 2 days after surgery, significantly higher AOFAS ankle-hindfoot scores at one month after surgery, but significantly more times of intraoperative fluoroscopy (all P < 0.05). In all patients, the VAS scores at 2 days after surgery were significantly lower than those before surgery, and those at one year after surgery significantly lower than those at 2 days after surgery ( P < 0.05). In all patients, the AOFAS ankle-hindfoot scores at one month after surgery were significantly higher than those before surgery ( P < 0.001). In the ORIF group, the AOFAS ankle-hindfoot scores at one year after surgery were significantly higher than those at one month after surgery ( P < 0.05), but in the 3D-PCP group there was no such a significant difference between one year and one month after surgery ( P > 0.05). There was no significant difference in VAS score, AOFAS score, fracture healing time or postoperative imaging parameters between the 2 groups at one year after surgery ( P > 0.05). There was no significant difference either in the incidence of complications between the 2 groups ( P > 0.05). Conclusion:In the treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients, compared with conventional ORIF, 3D-PCP shows advantages of shorter operation time, minimal invasion, quicker incision healing, shorter hospital stay, earlier weight-bearing exercise, and better functional recovery but a disadvantage of increased times of intraoperative fluoroscopy.

Application of 3D printing navigation template in hip arthroplasty / 国际外科学杂志

Hip arthroplasty is a common surgical method with good clinical effect. However, there are many influencing factors, among which the position of prosthesis is the key factor determining the prognosis. At present, 3D printing technology is widely used in hip replacement, which has an important effect in improving the position of hip replacement prosthesis. This paper reviews the application of 3D printing guide plate in hip arthroplasty.

Hemodynamic abnormality in patients with primary trigeminal neuralgia / 中华神经科杂志

Objective:To investigate specificity of neurovascular compression in patients with primary trigeminal neuralgia (PTN) by three-dimension reconstruction and computational fluid dynamics.Methods:Clinical characteristics and preoperative magnetic resonance imaging (MRI) data of 20 patients with both PTN and single artery compression (PTN group) and 10 patients without PTN but having neurovascular contact in MRI images (control group) in the Second Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were collected and analyzed. After three-dimension reconstruction of the MRI images, curvature of the arterial loop, angle between the plane of arterial loop and the trigeminal nerve and location of the compression were observed. Then bidirectional structure-fluid coupling based on the optimized stereolithography models of arterial loop and nerve were processed by ANSYS 19.2 software. In the location of the compression of contact, equivalent stress (ES) of arterial loop on the nerve, shearing stress (SS) of the blood flow and local deformation of the nerve were iteratively computed. All parameters were analyzed and compared between the PTN group and the control group, and the correlation analysis was proceeded between the anatomical parameters and hemodynamical parameters.Results:The curvature of arterial loop [0.21(0.12) mm -1vs 0.13(0.07) mm -1, U=34.00, P<0.05], the angle between vascular loop and nerve [69.70(30.67)° vs 43.40(37.21)°, U=38.00, P<0.05] in the PTN group were significantly greater than those in the control group, and the location of compression was significantly closer to the root of nerve in the PTN group [PTN group: (4.23±1.29) mm vs control group: (5.54±1.85) mm, t=-2.26, P<0.05]. The average SS [15 952.48(5 365.56) Pa vs 12 501.97(6 355.26) Pa, U=53.00, P<0.05], ES [24 965.65(7 693.22) Pa vs 14 992.99(9 824.08) Pa, U=32.00, P<0.05] in the PTN group were significantly greater than those in the control group. The curvature of arterial loop was positively correlated with the SS ( r=0.931, P<0.05) and ES ( r=0.962, P<0.05), and the latter two ( r=0.787, P<0.05; r=0.853, P<0.05) were positively correlated with the local neural deformation. Conclusions:In patients with PTN, offending artery compresses the root of nerve by greater arterial curvature and angle between the arterial loop and nerve. These anatomical differences will cause significantly greater SS, ES and local neural deformation.

The research progress on the structure pharmaceutics and dosage form structures of traditional Chinese medicines / 药学学报

Traditional Chinese medicine (TCM) preparations have made tremendous progresses in modernization, whereas there exist relatively few researches pertaining to preparation structures. As demonstrated by the theory and practice of structure pharmaceutics, the structure properties of dosage forms have significant influences on the quality and efficacy of drugs, which might offer reference for the research and development of TCM dosage forms. With the application of synchrotron radiation X-ray micro-computed tomography (SR-μCT) and other novel technologies in recent years, researches in structure pharmaceutics have made huge advancement, which provide reference and methodology basis for the study of TCM preparations. The article generalized and summarized the recent progresses and methods in the structure researches of pharmaceutics and TCM preparations, and further explored the significance of the researches of structure of TCM preparations. It is expected to provide the basis for the dosage form design, production process improvement, and quality evaluation of TCM and promote the modernization of TCM preparations.

Application of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer / 中国胸心血管外科临床杂志

@#Objective    To evaluate the safety, feasibility and short-term outcomes of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer. Methods    From February 2018 to December 2019, 118 consecutive patients who underwent minimally invasive McKeown esophagectomy for esophageal squamous cell carcinoma in our hospital were included. There were 94 males and 24 females with an average age of 53.7 (41–77) years. They were divided into two groups based on the methods of gastric mobilization: a traditional dissociation (TD) group (n=55) and a single-direction mobilization (MD) group (n=63). The clinical data of the two groups were compared. Results    Enbloc resection and a negative resection margin were obtained in all patients. There was no postoperative mortality or incision complication. The rate of postoperative complications was 22.9%. There was no significant difference in the spleen injury, gastric injury, conversion to open surgery, abdominal reoperation as well as cervical anastomotic leakage between the two groups (P>0.05). It took significantly less time in the MD group compared with the TD group (P<0.05). There was an obvious statistical difference in the incidence of gastric mobilization related complications between the MD group (1.6%, 1/63) and TD group (12.7%, 7/55, P<0.05). Conclusion    Application of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer is safe and easy to perform with a satisfactory short-term outcome.

Comparison of three-dimensional printing-assisted pedicle screw placement and traditional surgery for lumbar spondylolisthesis: A meta-analysis / 中国组织工程研究

BACKGROUND: With the development of three-dimensional (3D) printing technology, it has been widely used in spinal surgery. However, whether 3D printing-assisted surgery for lumbar spondylolisthesis has an advantage over traditional surgery is still controversial. OBJECTIVE: To compare the clinical efficacy and safety of 3D printing-assisted versus conventional surgery for the treatment of lumbar spondylolisthesis using system evaluation. METHODS: Randomized controlled trials about 3D printing technology for lumbar spondylolisthesis in CNKI, Wanfang database, CBM, VIP, PubMed, Cochrane Library, Embase, and Web of Science were searched via computer from inception to November 16, 2019. The retrieved literatures were screened according to predefined inclusion and exclusion criteria, and quality evaluation was performed. Then, the available data were extracted and analyzed with the Stata 11. 0 software. RESULTS AND CONCLUSION: (1) Six randomized controlled trials including 394 cases were included. Among them, 201 cases were assigned to the 3D printing-assisted group and 193 cases to the conventional group. (2) Meta-analysis results showed that the 3D printing-assisted group proved significantly superior to the conventional group regrading the operation time [WMD=-38. 17, 95%CI(-43. 93, -32. 41), P=0. 00], intraoperative blood loss [WMD=-61. 61, 95%CI(-69. 19, -54. 03), P=0. 00], the frequency of fluoroscopy [WMD=-4. 89, 95%CI(-6. 38, -3. 41), P=0. 00] and the screw placement accuracy [OR=3. 89, 95%CI(2. 43, 6. 25), P=0. 00]. (3) However, in terms of the postoperative visual analogue scale scores [WMD=-0. 47, 95%CI(-1. 21, 0. 27), P=0. 215], Oswestry disability index [WMD=-1. 41, 95%CI(-2. 87, 0. 05), P=0. 058], Japanese Orthopaedic Association scores [WMD=1. 02, 95%CI(-0. 68, 2. 72), P=0. 240] and the rate of complications [OR=0. 37, 95%CI(0. 12, 1. 11), P=0. 075], no statistically significant differences were found between the two groups. (4) In conclusion, the application of 3D printing technology in the surgical treatment of lumbar spondylolisthesis has the advantage of shortening the operation time, reducing intraoperative blood loss and frequency of fluoroscopy and improving the accuracy of the screw placement.

Three-dimensional chromosome conformation capture and its derived technologies / 生物工程学报

Linear chromatin is compacted into eukaryotic nucleus through a complex and multi-layered architecture. Consequently, chromatin conformation in a local or long-distance manner is strongly correlated with gene expression. Chromosome conformation capture (3C) technology, together with its variants like 4C/5C/Hi-C, has been well developed to study chromatin looping and whole genome structure. In this review, we introduce new technologies including chromosome capture combined with immunoprecipitation, nuclei acid-based hybridization, single cell and genome sequencing, as well as their application.

Application of three-dimensional fast gradient echo sequence in observation of craniocervical junctional ligament / 中南大学学报(医学版)

OBJECTIVES@#To explore the value of three-dimensional fast gradient echo sequence (3D-GRE) in observation of the craniocervical junctional ligament.@*METHODS@#A total of 21 healthy volunteers underwent 3D-GRE imaging. The imaging data was imported into the post-processing workstation. The structures of the ligaments in the craniocervical junctional area were observed and evaluated by multiplanar reconstruction technique.@*RESULTS@#The features of ligaments in the craniocervical junction were shown clearly for all the 21 cases of volunteers. The scan time was 267-294 s. After the treatment with the three-dimensional reconstruction technique, the signal characteristics and the running structure of the transverse ligament, the alar ligament, the serrated ligament and the lamina could be effectively displayed.@*CONCLUSIONS@#The 3D-GRE can evaluate the three-dimensional data of craniocervical junctional ligament in a short period of time. Post-processing reconstruction technique can clearly evaluate the structure characteristics of each ligament, which can lay a foundation for further application in craniocerebral trauma patients.

Application of septoplasty and primary cheiloplasty for complete unilateral cleft lip / 中华整形外科杂志

Objective@#To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction.@*Methods@#Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups.@*Results@#All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group.@*Conclusions@#Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.

Development Review of Novel Laparoscope Technology / 中国医疗器械杂志

The proportion of laparoscopic surgeries is continuously increasing in general surgeries. Along with the development and application, new image sensor and digital image processing technology accelerated the emergence of novel laparoscope in recent years. Stereoscopic laparoscope (3D) appearing make the space orientation more accurate. new imaging methods and new structure design satisfy more clinical requirements; combination with optical technology (NBI technique, PDD technique, ICG technique) make intraoperative diagnosis possible.

Clinical efficacy of three-dimensional laparoscopic resection for gastric stump cancer / 中华消化外科杂志

Objective To investigate the clinical efficacy of three-dimensional (3D) laparoscopic resection for gastric stump cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 20 patients who underwent 3D laparoscopic resection for gastric stump cancer in the Henan Provincial People's Hospital between January 2015 and January 2018 were collected.All patients were diagnosed as malignant tumors through gastroscopy and pathological examination before operation,and underwent 3D laparoscopic resection for gastric stump cancer and lymph node dissection according to Japanese Classification of Gastric Carcinoma (ver.14).Observation indicators:(1) intra-and post-operative recovery situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival and tumor recurrence up to March 2018.Measurement data with normal distribution were represented as (-x)±s.Measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative recovery situations:of 20 patients with gastric stump cancer,14 underwent 3D laparoscopic radical resection for gastric stump cancer (R0 resection and negative resection margin),4 underwent 3D laparoscopic palliative resection for gastric stump cancer and 2 were converted to open palliative resection for gastric stump cancer.Operation time,volume of intraoperative blood loss,number of lymph node dissected,time for postoperative out-of-bed activity,time to initial anal exsufflation,time for postoperative semi-fluid diet intake,duration of hospital stay and treatment expenses in 18 patients were (195±60) minutes,(105±85) mL,20±8,(1.6±0.8) days,(3.0±1.0) days,(5.5±1.8)days,(8.0±2.8) days and (5.5± 1.5) ×104 yuan,respectively.There was no surgery-related complication.(2) Follow-up and survival situations:of 20 patients,18 were followed up for 2-36 months,with a median time of 18 months.During the follow-up,6 patients died,including 2 dying of liver metastases and 4 dying of peritoneal metastases,12 had good conditions.Conclusion 3D laparoscopic resection for gastric stump cancer is safe and effective.

Chondrogenic Potential of Dedifferentiated Rat Chondrocytes Reevaluated in Two- and Three-Dimensional Culture Conditions

For the cartilage repair, the cell sources currently adopted are primarily chondrocytes or mesenchymal stem cells (MSCs). Due to the fact that chondrocytes dedifferentiate during 2-dimensional (2D) expansion, MSCs are generally more studied and considered to have higher potential for cartilage repair purposes. Here we question if the dedifferentiated chondrocytes can regain the chondrogenic potential, to find potential applications in cartilage repair. For this we chose chondrocytes at passage 12 (considered to have sufficiently dedifferentiated) and the expression of chondrogenic phenotypes and matrix syntheses were examined over 14 days. In particular, the chondrogenic potential of MSCs was also compared. Results showed that the dedifferentiated chondrocytes proliferated actively over 14 days with almost 2.5-fold increase relative to MSCs. Moreover, the chondrogenic ability of chondrocytes was significantly higher than that of MSCs, as confirmed by the expression of a series of mRNA levels and the production of cartilage extracellular matrix molecules in 2D-monolayer and 3-dimensional (3D)-spheroid cultures. Of note, the significance was higher in 3D-culture than in 2D-culture. Although more studies are needed such as the use of different cell passages and human cell source, and the chondrogenic confirmation under in vivo conditions, this study showing that the dedifferentiated chondrocytes can also be a suitable cell source for the cell-based cartilage repair, as a counterpart of MSCs, will encourage further studies regarding this issue.

A Fast 3-Dimensional Magnetic Resonance Imaging Reconstruction for Surgical Planning of Uterine Myomectomy

BACKGROUND: Uterine myoma is the most common benign gynecologic tumor in reproductive-aged women. During myomectomy for women who want to preserve fertility, it is advisable to detect and remove all myomas to decrease the risk of additional surgery. However, finding myomas during surgery is often challenging, especially for deep-seated myomas. Therefore, three-dimensional (3D) preoperative localization of myomas can be helpful for the surgical planning for myomectomy. However, the previously reported manual 3D segmenting method takes too much time and effort for clinical use. The objective of this study was to propose a new method of rapid 3D visualization of uterine myoma using a uterine template. METHODS: Magnetic resonance images were listed according to the slide spacing on each plane of the multiplanar reconstruction, and images that were determined to be myomas were selected by simply scrolling the mouse down. By using the selected images, a 3D grid with a slide spacing interval was constructed and filled on its plane and finally registered to a uterine template. RESULTS: The location of multiple myomas in the uterus was visualized in 3D and this proposed method is over 95% faster than the existing manual-segmentation method. Not only the size and location of the myomas, but also the shortest distance between the uterine surface and the myomas, can be calculated. This technique also enables the surgeon to know the number of total, removed, and remaining myomas on the 3D image. CONCLUSION: This proposed 3D reconstruction method with a uterine template enables faster 3D visualization of myomas.

Evaluation of changes in right ventricular myocardial mechanical properties in breast cancer patients receiving pirarubicin using three-dimensional speckle tracking imaging / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the changes in the mechanical properties of the right ventricular myocardium (RVM) after chemotherapy using three-dimensional speckle tracking echocardiography (3D-STI).</p><p><b>METHODS</b>Thirty-six breast cancer patients receiving chemotherapy with pirarubicin underwent examinations with 3D-STI to test the mechanical properties of the RVM before chemotherapy and at the end of the second, fourth, and sixth cycles of chemotherapy (C2, C4, and C6, respectively). Blood levels of hs-cTnI and NT-proBNP were also examined at the same time points. Thirty-one of these patients also underwent Tc-MIBI and F-FDG myocardial perfusion/metabolism imaging at C6. Myocardial perfusion abnormalities and survival outcomes of the patients were analyzed according to radionuclide imaging results.</p><p><b>RESULTS</b>Compared with that before chemotherapy, RVGLS at C2 was significantly lowered, and both RVGLS and RVGAS were significantly decreased at C4 and further decreased at C6 ( < 0.05) in relation with the cumulative drug dose. The RVGLS and RVGAS differed significantly among patients with different levels of TAPSE, hs-cTnI, and RV-FAC decline after chemotherapy. RVGLS and RVGAS were found to significantly correlate with FAC (=0.37, 0.26), TAPSE (=0.43, 0.51), and S' (=0.21, 0.36) ( < 0.01), and showed a high sensitivity and specificity for identifying RV-FAC decline by > 5%. Myocardial perfusion/metabolic imaging showed normal myocardial perfusion in 17 patients, and abnormal myocardial segments of the RVM were detected in 14 patients, but F-FDG imaging showed that these myocardial segments were all viable; these 14 patients showed significantly decreased RVGLS and RVGAS and significantly increased hs-cTnI level compared with the patients with normal ventricular myocardial perfusion ( < 0.05). ROC curve analysis showed that an absolute value of RVGLS less than 18.2% had a sensitivity of 92.9% for diagnosis of RV impairment with a diagnostic specificity of 88.2% and an area under the curve of 0.87. RVGAS less than 26.8% had a sensitivity of 94.8% and a specificity of 86.6% for diagnosis of RV damage with an area under the curve of 0.86.</p><p><b>CONCLUSIONS</b>3D-STI can provide a reliable new approach to early diagnosis of changes in the mechanical properties of the RVM related with chemotherapy with pirarubicin in breast cancer patients.</p>

The impact of atrial function on mitral regurgitation using three-dimensional transesophageal echocardiography with one-year follow-up / 中华超声影像学杂志

Objective To determine whether changes in mitral annular spatial conformation and left atrial(LA)volume are closely related to atrial functional mitral regurgitation(AMR)in patients with atrial fibrillation and before or after the sinus rhythm recovery using real-time three-dimensional transesophageal echocardiography(RT-3D TEE).Methods Fifty-five patients with AMR of at least moderate severity who completed one-year of clinical follow-up after ablation were included in this study.Before ablation and after being followed for one year,intercommissural(IC) and anteroposterior(AP) diameter,annular height (AH)and area(MVA),tenting height(TH)and volume(TV),annular spherical index(ASI),fractional area change of MVA(MVA-FAC),and coaptation index(CPI)were defined and measured by mitral valve quantification software(MVQ).Left atrial volume(LAV),left atrial volume index(LAVI),left atrial area (LAA),left atrial diameter(LAD)and effective regurgitant orifice area(EROA)were also recorded. Results After one year of follow-up,AMR decreased significantly in patients with sinus rhythm[EROA:(0.27±0.03)cm2vs(0.21 ±0.04)cm2,P <0.001].LAA,LAV and LAVI were improved in patients with sinus rhythm[LAA:(22.70±3.34)cm2vs(18.80±3.45)cm2,LAV:(52.77±5.41)cm2vs(45.22± 6.49)cm2,LAVI:26.30±3.12 vs 22.98±3.03,all P <0.001].CPI(β=-0.549,P <0.05),MVA-FAC (β=-0.309,P <0.05)and LAV(β=1.712,P <0.05),MVA-FAC)were independently associated with the reduction in EROA.Conclusions AMR can be decreased through the sinus rhythm recovery and maintenance after ablation,which are caused by improvement of left atrial volume load and leaflets coaptation capability.RT-3D TEE may dynamically assess the changes in leaflets/annular configuration during the AMR follow-up.

The Evaluation of Femoral Trochlear Dysplasia Using Imaging Analysis System Based on Three-Dimension Computed Tomography / 中国运动医学杂志

Objective To evaluate the application of imaging analysis system based on three-dimension computed tomography (3D-CT)for the diagnosis of femoral trochlear dysplasia.Methods Between May 2013 and January 2014,30 patients were diagnosed as recurrent patella dislocation and received surgical treatment.All the patients received 3D-CT diagnosis of the knee joints preoperatively,and the data of 3D-CT were transferred to imaging analysis system with MIMICS software that would be used to get the trochlear dysplasia index.The patients were also received knee fluoroscopic detection.A true lateral view was also used for evaluation of the trochlear dysplasia as the classic method.The difference between the two methods was compared.And the sensitivity,specificity,positive and negative predictive value of the imaging analysis system were analyzed.Results The mean trochlear dysplasia index was 5.3 ± 1.8 mm (3.2 to 8.4 mm)using the classic fluoroscopic method,showing no significant difference from the result according to the imaging analysis system,5.2 ± 1.5 mm (3.5 to 8.1 mm).When the fluoroscopic method was set as the golden standard,the sensitivity,specificity,positive and negative predictive value of the imaging analysis system were 89.5％,81.8％,89.4％ and 82.0％ respectively.Conclusion The imaging analysis system based on 3D-CT of knee joints could provide acceptable results without good sensitivity and specificity,without significant differences from the classic fluoroscopic method.So it is a more safer and easier approach worthy of clinical implication.

Clinical efficacy of the three dimensional laparoscopic sleeve gastrectomy in treatment of obesity combined with type 2 diabetes mellitus / 中华消化外科杂志

Objective To explore the clinical efficacy of three dimensional (3D) laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity combined with type 2 diabetes mellitus.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Qinghai Red Cross Hospital between January 2013 and April 2016 were collected.All the patients underwent 3D LSG.Observation indicators:(1) surgical and postoperative recovery situations;(2) follow-up and metabolic indexes changes.Follow-up using outpatient examination and telephone interview was performed to detect complications of patients after discharge and usages of antidiabetic drugs or insulin up to February 2017.Body mass,body mass index (BMI),hemoglobin (Hb),albumin (Alb),fasting serum C-peptide,fasting blood sugar,2-hours postprandial blood glucose (2HPBG) and glycosylated hemoglobin (GHb) were detected at month 1,3,6 and 12 postoperatively.Measurement data with normal distribution were represented as (x)±s.Repeated measurement data were analyzed by the repeated measures ANOVA.Count data were evaluated by the proportion.Results (1) Surgical and postoperative recovery situations:28 patients underwent successful 3D LSG,without conversion to open surgery.Operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery and time of postoperative drainage tube removal were (133 ± 20) minutes,(45 ± 22) mL,(2.5 ± 1.2) days and (3.4 ± 0.9) days,respectively.There were no postoperative complications and perioperative death.Duration of hospital stay was (7.1 ± 1.5) days.(2) Follow-up and metabolic indexes changes:28 patients were followed up for 6-12 months,with a median time of 8 months.During the follow-up,there was no death or severe complications.Body mass,BMI,Hb,Alb,fasting serum C-peptide,fasting blood sugar,2HPBG and GHb from pre-operation to month 1,3,6 and 12 post-operatively were decreased from (113±26) kg to (78± 14) kg,from (44±6) kg/m2 to (35±5) kg/m2,from (157±19) g/L to (140±13) g/L,from (43±5)g/L to (40±4)g/L,from (2.50±0.37) μg/L to (1.20±0.33) μg/L,from (10.5±2.0)mmol/L to (5.6±0.5)mmol/L,from (16.3±3.1)mmol/L to (7.9±0.9) mmol/L,from 9.2％± 0.9％ to 6.8％ ±0.6％ with statistically significant differences between preoperative and postoperative indicators (F=396.47,328.20,111.10,21.28,161.06,127.80,243.40,234.64,P＜0.05),and showing a downward trend.Of 28 patients,25 had complete remission of type 2 diabetes mellitus at 12 months postoperatively and 3 had partial remission,with an effective rate of 100.0％ (28/28).The excess weight loss was 63％± 16％.Conclusion 3D LSG is safe and effective in the treatment of obesity combined with type 2 diabetes mellitus,with a good shortterm outcome.

Comparison the two dimensional and three dimensional shear wave elasticity imaging in breast cancer diagnosis / 国际生物医学工程杂志

Objective To compare the two-dimensional (2D) and three-dimensional (3D) shear wave elastography (SWE) technology in the diagnosis of early stage breast cancer.Methods 84 patients (94 breast lesions) with breast disease confirmed by pathological examination were enrolled from December 2014 to December 2016.All patients underwent 2D and 3D color Doppler ultrasound and the relevant SWE examinations.The optimal maximum and mean elastic modulus of 2D and 3D SWE for diagnosing the benign and malignant breast lesions were obtained by the receiver operating characteristic curve (ROC).Based on the results of pathological examinations,the sensitivity,specificity and accuracy of 2D SWE and 3D SWE in benign and malignant breast lesions diagnosis were evaluated and compared.Results The optimal maximum and mean elastic modulus of 2D SWE for diagnosing the benign and malignant breast lesions were 98.82 kPa and 43.88 kPa respectively,while the corresponding modulus of 3D SWE were 102.54 kPa and 53.87 kPa.The sensitivity of 2D SWE and 3D SWE in breast cancer diagnosis was 89.5％ and 86.3％ respectively,and the difference was not statistically significant (P＞0.05).The specificity and the accuracy of 2D SWE in breast cancer diagnosis were 95.3％ and 92.7％ respectively,which was significant higher than 83.9％ and 85.1％ of 3D SWE,and the differences were statistically significant (all P＜O.05).Conclusions The efficiency of 2D SWE examination is significantly higher than the 3D SWE in benign and malignant breast lesions diagnosis,which can provide a reliable diagnostic basis and is worthy for clinical application.

The present status and future prospects of application of digital medical technology in general surgery in China / 中华外科杂志

It has been almost 10 years since digital medical technology has started to becommonly used in general surgery in China.Led by advances in three dimensional(3D) visualization technology, virtual reality, simulation surgery, and 3D printing, digital medical technology have played important roles in changing the current practice of general surgery in China to become more effective by improving diagnostic accuracy and a better choice of therapeutic procedure with a resultant increased surgical success rate and a decreased surgical risks.Furthermore, education of medical students and young doctors become better and easier.

Dynamic Characteristic Mechanism of Atrial Septal Defect Using Real-Time Three-Dimensional Echocardiography and Evaluation of Right Ventricular Functions / 华中科技大学学报（医学）（英德文版）

The dynamic characteristics of the area of the atrial septal defect (ASD) were evaluated using the technique of real-time three-dimensional echocardiography (RT 3DE),the potential factors re sponsible for the dynamic characteristics of the area of ASD were observed,and the overall and local volume and functions of the patients with ASD were measured,RT 3DE was performed on the 27 normal controls and 28 patients with ASD.Based on the three-dimensional data workstations,the area of ASD was measured at P wave vertex,R wave vertex,T wave starting point,and T wave terminal point and in the T-P section.The right atrial volume in the same time phase of the cardiac cycle and the motion displacement distance of the tricuspid annulus in the corresponding period were measured.The measured value of the area of ASD was analyzed.The changes in the right atrial volume and the motion displacement distance of the tricuspid annulus in the normal control group and the ASD group were compared.The right ventricular ejection fractions in the normal control group and the ASD group were compared using the RT 3DE long-axis eight-plane (LA 8-plane) method.Real-time three-dimensional volume imaging was performed in the normal control group and ASD group (n=30).The right ventricular inflow tract,outflow tract,cardiac apex muscular trabecula dilatation,end-systolic volume,overall dilatation,end-systolic volume,and appropriate local and overall ejection fractions in both two groups were measured with the four-dimensional right ventricular quantitative analysis method (4D RVQ) and compared.The overall right ventricular volume and the ejection fraction measured by the LA 8-plane method and 4D RVQ were subjected to a related analysis.Dynamic changes occurred to the area of ASD in the cardiac cycle.The rules for dynamic changes in the area of ASD and the rules for changes in the right atrial volume in the cardiac cycle were consistent.The maximum value of the changes in the right atrial volume occurred in the end-systolic period when the peak of the curve appeared.The minimum value of the changes occurred in the end-systolic period and was located at the lowest point of the volume variation curve.The area variation curve for ASD and the motion variation curve for the tricuspid annulus in the cardiac cycle were the same.The displacement of the tricuspid annulus exhibited directionality.The measured values of the area of ASD at P wave vertex,R wave vertex,T wave starting point,T wave terminal point and in the T-P section were properly correlated with the right atrial volume (P＜0.001).The area of ASD and the motion displacement distance of the tricuspid annulus were negatively correlated (P＜0.05).The right atrial volumes in the ASD group in the cardiac cycle in various time phases increased significantly as compared with those in the normal control group (P=0.0001).The motion displacement distance of the tricuspid annulus decreased significantly in the ASD group as compared with that in the normal control group (P=0.043).The right ventricular ejection fraction in the ASD group was lower than that in the normal control group (P=0.032).The ejection fraction of the cardiac apex trabecula of the ASD patients was significantly lower than the ejection fractions of the right ventricular outflow tract and inflow tract and overall ejection fraction.The difference was statistically significant (P=0.005).The right ventricular local and overall dilatation and end-systolic volumes in the ASD group increased significantly as compared with those in the normal control group (P=0.031).The aRVEF and the overall ejection fraction decreased in the ASD group as compared with those in the normal control group (P=0.0005).The dynamic changes in the area of ASD and the motion curves for the right atrial volume and tricuspid annulus have the same dynamic characteristics.RT 3DE can be used to accurately evaluate the local and overall volume and functions of the right ventricle.The local and overall volume loads of the right ventricle in the ASD patients increase significantly as compared with those of the normal people.The right ventricular cardiac apex and the overall systolic function decrease.