ObjectiveTo realize the current status and hot issues in the field of gastric cancer imaging research, and to provide references for radiologists and gastrointestinal surgeons to grasp the overall overview of gastric cancer imaging.MethodWe downloaded the relevant literatures of gastric cancer imaging published in 2010–2020 in the Web of Science database, and used Citespace 5.7.R3 software for related visual analysis.ResultsA total of 726 articles in the field of gastric cancer imaging research were retrieved and screened. The number of gastric cancer imaging studies published from 2010 to 2020 was on the rise, with the top three countries published in China, Japan, and the United States. The clusters of co-cited literature on gastric cancer imaging: confocal laser microendoscopy, gastric cancer, gastric mucosal intestinal metaplasia, preoperative T staging, convolutional neural network, deep learning, advanced gastric cancer, in vivo differentiation, early stage gastric cancer, surgical treatment, perigastric lymph nodes, nearest neighbor algorithm, and so on. Hot words in recent research fields included: risk factors, characteristics, deep learning, chemotherapy, and neural networks.ConclusionThe imaging diagnosis of early gastric cancer and the application of artificial intelligence are the research hotspots in this field.
To evaluate the safety and efficacy of one-level posterior lumbar interbody fusion(PLIF) combined with Prospace and facet fusion using local autograft. Methods Clinical and radiographic data of 76 patients treated by this technique was reviewed from May 2002 to December 2004. Of them, there were 52 males and 24 females, with an average age of 53.2 years (2381 years), including 60 cases of degenerative disc disease, 9 cases of failed back surgery syndrome and 3 cases of spondylolysis. The disese courses were 1.2-8.7 years (mean 3.6 years). The levels of PLIF were:L 2,3 in 2 cases, L 3,4 in 7, L 4,5 in 54, L 5/S 1 in 10, L 4/S 1 in 1 and L 5,6 in 2. After decompression，Prospace was inserted into interbody space bilaterally，and located in disc space 4 mm beyond the rear edge ofthe vertebral body. Local laminectomy autograft was packed both laterally into and between 2 implants. Then the remanent local autograft was placed over facet bed. Pedicle screws were used after insertion of Prospace. Clinical results wereevaluated by the JOA score. Disc height ratio and lumbar lordosis angles were measured on lateral radiographs. Fusion status was determined by evidence of bridge trabeculae across facet joint and interbody space on CT scan without mobility in lateral dynamic X-rays, and no radiolucent gap between Prospace and endplate. Paired t test was used for statistical analysis. Results Mean blood loss and operative time was 384 ml and 178 minutes, respectively. The average JOA score at final follow-up (26.1±2.7) was significantly improved when compared with that of preoperation (14.5±4.0, P＜0.05), with a mean recovery rate of JOA score 81.1% (37.5%-100.0%). The fusion rate was 974%(74/76). Mean disc height ratio and the involved segmental lordosis angle were increased from preoperative 0.27± 0.07 and 5.8±2.2° to 0.33±0.06 and 11.3±2.0° respectively at the final followup, and the differences were significant (P＜0.05). There were no devicerelated complications. Conclusion This surgical technique combined with Prospace interbody device is a safe and effective surgical option for patients with onelevel lumbar disorders when PLIF is warranted.
Objective To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. Methods The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Results Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow’s space can restore the appearance of midface effectively. Conclusion In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.
The suprachoroidal space is a potential space between the sclera and choroid. Suprachoroidal spacedrug delivery is becoming an applicable method to the ocular posterior segment diseases. Because it targets the choroid, retinal pigment epithelium and retina with high bioavailability and safety, while maintaining low levels elsewhere in the eye. In recent years, new discoveries has been carried out in different areas of interest, such as drug delivery methods, pharmacokinetics and clinical trials. Clinical trials with suprachoroidal space injection of triamcinolone acetonide are executed with promising findings for patients with noninfectious uveitis and diabetic macular edema. Suprachoroidal space triamcinolone acetonide injectable suspension is the first and currently the only agent specifically approved for uveitic macular edema by Food and Drug Administration. Nowadays, many clinical trails with suprachoroidal space drug delivery have been explored, although there are still many risks and uncertainties. With the development of technology in the future, suprachoroidal space drug delivery appears to be a promising treatment modality for ocular posterior segment diseases.
Objective To explore the important role of preperitoneal space in laparoscopic transabdominal preperitoneal （TAPP） and totally extraperitoneal （TEP） hernia repair. Methods The clinical data of 66 patients （78 sides） performed laparoscopic TAPP and TEP hernia repair from January 2008 to April 2011 in this hospital were analyzed retrospectively. Results TAPP hernia repair were performed in 16 cases （20 sides），TEP hernia repair were performed in 50 cases （58 sides）. Three cases of TEP hernia repair transferred to TAPP hernia repair. The unilateral operation time was （86.92±36.38） min，intraoperative bleeding was （6.08±3.43） ml. Postoperative complication rate was 16.7% （11/66），including 3 cases of postoperative serum swelling，3 cases of temporary paraesthesia of nerve feeling in the repair area，2 cases of scrotum emphysema，2 cases of urinary retention，and 1 case of intestinal obstruction. There were 2 cases of recurrence. The hospital stay was （4.52±0.99） d. The return to activities and working time was （10.32±1.86） d after discharge. Sixty-six cases were followed up for （18.56±1.96） months （range 1-38 months），the patch infection，chronic pain，and testicular atrophy complications were not been observed. Conclusions Acquainting and mastering laparoscopic preperitoneal space and its important structure are the key to avoid intraoperative and postoperative complications of laparoscopic inguinal hernia repair.
ObjectiveTo explore the differential diagnosis value of airspace consolidation in thoracic CT between organizing pneumonia (OP) and acquired community pneumonia (CAP).MethodsA retrospective study was taken by retrieving the patients CT database from October 2010 to August 2016. Fifty-six consecutive patients with OP and 99 consecutive patients with CAP whose CT showed airspace consolidation were enrolled and their clinical characteristics and radiological characteristics were analyzed.ResultsThe percentage of patients whose CT image showed various amount of air bronchogram (ABG) with different shapes is higher in OP group than that in CAP group (87.5% and 72.7% respectively, χ2=4.558, P=0.033). The median and interquartile range amount of ABG in the OP patients were significantly higher than those in CAP group [4 (ranged from 2 to 8) and 2 (ranged from 0 to 4) respectively, z=3.640, P=0.000]. Morphologically, 58.9% of the OP patients showed entire air bronchogram (EABG) on the thoracic CT, significantly higher than that in CAP group (21.2%) (χ2=22.413, P=0.000). Interrupted ABG was found in 26.3% of CAP patients, while 16.1% of OP patients shared same features and the difference was not statistically significant (χ2=2.125, P=0.148). Traction bronchiectasis and ground glass opacity (GGO) were more likely to be found in the OP patients rather than CAP patients with 26.8% and 39.3% respectively, while they were found in 1.0% and 11.1% in the CAP patients (P<0.05). Reversed halo sign was found only 1.0% of the CAP patients, significantly lower than that in OP group, 26.8% (χ2=25.671, P=0.000). Pleural effusion and bronchial wall thickening were more commonly found in the CAP group with 56.6% and 35.4% respectively. By multivariate logistic analysis, EABG (OR=5.526, P=0.000), traction bronchiectasis (OR=21.564, P=0.010), GGO (OR=4.657, P=0.007) and reversed halo sign (OR=13.304, P=0.023) were significantly associated with OP, while pleural effusion (OR=0.380, P=0.049) and bronchial wall thickening (OR=0.073, P=0.008) were significantly associated with CAP. Other features in thoracic CT coexisting with ABG all reach significance statistically between the OP and CAP group (all P<0.05).ConclusionsAirspace consolidation in thoracic CT may be valuable for the differential diagnosis between OP and CAP. EABG is more commonly found in OP patients than in CAP patients. When EABG exists or ABG coexists with traction bronchiectasis, GGO and reversed halo sign, a diagnose of OP should be considered.
ObjectiveTo investigate the correlation between spread through air space (STAS) of sub-centimeter non-small cell lung cancer and clinical characteristics and radiological features, constructing a nomogram risk prediction model for STAS to provide a reference for the preoperative planning of sub-centimeter non-small cell lung cancer patients. MethodsThe data of patients with sub-centimeter non-small cell lung cancer who underwent surgical treatment in Nanjing Drum Tower Hospital from January 2022 to October 2023 were retrospectively collected. According to the pathological diagnosis of whether the tumor was accompanied with STAS, they were divided into a STAS positive group and a STAS negative group. The clinical and radiological data of the two groups were collected for univariate logistic regression analysis, and the variables with statistical differences were included in the multivariate analysis. Finally, independent risk factors for STAS were screened out and a nomogram model was constructed. The sensitivity and specificity were calculated based on the Youden index, and area under the curve (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the model. ResultsA total of 112 patients were collected, which included 17 patients in the STAS positive group, consisting of 11 males and 6 females, with a mean age of (59.0±10.3) years. The STAS negative group included 95 patients, with 30 males and 65 females, and a mean age of (56.8±10.3) years. Univariate logistic regression analysis showed that male, anti-GAGE7 antibody positive, mean CT value and spiculation were associated with the occurrence of STAS (P＜0.05). Multivariate regression analysis showed that associations between STAS and male (OR=5.974, 95%CI 1.495 to 23.872), anti-GAGE7 antibody positive (OR=11.760, 95%CI 1.619 to 85.408) and mean CT value (OR=1.008, 95%CI 1.004 to 1.013) were still significant (P＜0.05), while the association between STAS and spiculation was not significant anymore (P=0.438). Based on the above three independent predictors, a nomogram model of STAS in sub-centimeter non-small cell lung cancer was constructed. The AUC value of the model was 0.890, the sensitivity was 76.5%, and the specificity was 91.6%. The calibration curve was well fitted, suggesting that the model had a good prediction efficiency for STAS. The DCA plot showed that the model had a good clinically utility. ConclusionMale, anti-GAGE7 antibody positive and mean CT value are independent predictors of STAS positivity of sub-centimeter non-small cell lung cancer, and the nomogram model established in this study has a good predictive value and provides reference for preoperative planning of patients.
By analyzing the physiological structure and motion characteristics of human ankle joint, a four degree of freedom generalized spherical parallel mechanism is proposed to meet the needs of ankle rehabilitation. Using the spiral theory to analyze the motion characteristics of the mechanism and based on the method of describing the position with spherical coordinates and the posture with Euler Angle, the inverse solution of the closed vector equation of mechanism position is established. The workspace of mechanism is analyzed according to the constraint conditions of inverse solution. The workspace of the moving spherical center of the mechanism is used to match the movement space of the tibiotalar joint, and the workspace of the dynamic platform is used to match the movement space of subtalar joint. Genetic algorithm is used to optimize the key scale parameters of the mechanism. The results show that the workspace of the generalized spherical parallel mechanism can satisfy the actual movement space of human ankle joint rehabilitation. The results of this paper can provide theoretical basis and experimental reference for the design of ankle joint rehabilitation robot with high matching degree.
Objective To evaluate the effects of different inspiratory flow waveforms on the respiratory function of patients with severe exacerbation of asthma during mechanical ventilation. Methods Twenty-one patients with severe exacerbation of asthma were ventilated with square waveform and decelerating waveform respectively for 30 minutes when the tidal volume was set at 6 mL/ kg, 8 mL/ kg and 10 mL/ kg in ICUof Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine fromJanuary 2006 to December 2007. Meanwhile shunt fraction ( Q·S /Q·T ) , dead space value ( VD/VT ) , airway peak pressure ( Ppeak ) , plateau pressure ( Pplat) ,intrinsic positive end-expiratory pressure( PEEPi) and arterial blood gas analysis were measured. Results The Q ·S /Q·T in the decelerating waveformgroup was less than that of the square waveform group( P lt;0. 05) when tidal volume was set at 6 mL/ kg. When tidal volume was set at 10 mL/ kg, PEEPi and VD /VT in the decelerating waveform group were higher than those of the square waveform group. On the contrary, the Ppeak was lower than that of square waveform group( P lt; 0. 05) . Conclusion For patients with severe exacerbation of asthma treated with mechanical ventilation, decelerating waveform is preferable at low tidal volume( 6 mL/ kg) , and square waveform is preferable at high tidal volume( 10 mL/kg) .
It is difficult to distinguish the inferior alveolar nerve (IAN) from other tissues inside the IAN canal due to their similar CT values in the X image which are smaller than that of the bones. The direct reconstruction, therefore, is difficult to achieve the effects. The traditional clinical treatments mainly rely on doctors' manually drawing the X images so that some subjective results could not be avoided. This paper proposes the partition reconstruction of IAN canal based on shape features. According to the anatomical features of the IAN canal, we divided the image into three parts and treated the three parts differently. For the first, the directly part of the mandibular, we used Shape-driven Level-set Algorithm Restrained by Local Information (BSLARLI) segment IAN canal. For the second part, the mandibular body, we used Space B-spline curve fitting IAN canal's center, then along the center curve established the cross section. And for the third part, the mental foramen, we used an adaptive threshold Canny algorithm to extract IAN canal's edge to find center curve, and then along it established the cross section similarly. Finally we used the Visualization Toolkit (VTK) to reconstruct the CT data as mentioned above. The VTK reconstruction result by setting a different opacity and color values of tissues CT data can perspectively display the INA canal clearly. The reconstruction result by using this method is smoother than that using the segmentation results and the anatomical structure of mental foramen position is similar to the real tissues, so it provides an effective method for locating the spatial position of the IAN canal for implant surgeries.