Objective To evaluate effectiveness and safety of electronic choledochoscopy in treatment of intrahepatic bile duct stones. Methods From July 2013 to February 2016, 280 patients with intrahepatic bile duct stones in the Department of General Surgery of the Affiliated Hospital of Shandong Academy of Medical Sciences were selected as the research objects. All the patients were randomly divided into a choledochoscopy treatment group and a conventional treatment group by envelope principle method. There were 140 patients in each group. The safety and short- and long-term effectiveness were compared in these two groups. This study was approved by the ethics committee of the hospital. Results ① The age, gender, body mass index, course of disease, and location of stone had no significant differences in these two groups (P>0.05). ② The operations and the net stones were successfully completed in all the patients. The operative time was shorter, the blood loss was less, the incision length was smaller, the postoperative anal exhaust time was earlier, and the hospitalization time was shorter in the choledochoscopy treatment group as compared with the conventional treatment group (P<0.05). ③ The total postoperative complication rate on day 14 in the choledochoscopy treatment group was 2.9% (4/140), which was significantly lower than that in the conventional treatment group (11.4%, 16/140, P<0.05). ④ The curative excellent and good rates was 97.9% and 85.0% in the choledochoscopy treatment group and conventional treatment group respectively, which was a significant difference in these two groups (P<0.05). ⑤ The postoperative serum ALT and AST values on month 6 in the choledochoscopy treatment group were significantly lower than those in the conventional treatment group (P<0.05). Conclusion Electronic choledochoscopy in treatment of intrahepatic bile duct stones could promote rehabilitation of patient, reduce incidence of postoperative complications, and it is conducive to promoting recovery of liver function and improving follow-up effect.
Cardiac implantable electronic device (CIED) is commonly used to treat arrhythmias. The amount of CIED implantation has increased year by year since its first application in 1958. At the same time, the CIED infection rate also increases significantly. Although the infection rate is very low for the primary implantation, the consequences of CIED infection are serious, and it is often necessary to remove the equipment for treatment. The mortality rate in patients with CIED infections is high, and the economic burden is huge. In this paper, the epidemiology, pathogenesis and pathogen, manifestations and diagnosis, risk factors, treatment and preventive measures of CIED infection were systematically described based on the recently published guidelines and international consensus literature, so as to provide theoretical guidance for the prevention of CIED infections.
We determined superoxide radical in ischemia-reperfu-sion to skin flaps by electron spin resonance and observed itseffect to skin flap survival. The experimental results showthat superoxide radical arise in ischemia-reperfusion. By per-fusion with superoxide dismutase,as free radical scavengers,significantly improved flap survival rate over controls. Basedon experimental date, the pathology mechanisms of skin flapnecrosis is discussed.
ObjectiveTo systematically review the impact of different electronic health technologies on weight loss outcomes in overweight and simple obesity populations. MethodsThe Cochrane Library, Embase, PubMed and WOS databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to May 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 and Stata 18 software. ResultsA total of 9 RCTs involving 2 416 patients with overweight or simple obesity were included. The meta-analysis results showed that body weight (MD=−0.81, 95%CI −1.1 to −0.52, P<0.001), BMI (MD=−0.63, 95%CI −0.89 to −0.37, P<0.001), waist circumference (MD=−1.06, 95%CI −1.70 to −0.42, P<0.001) and energy intake (SMD=−0.44, 95%CI −0.75 to −0.13, P=0.005) in the e-health technology group were significantly improved compared with the control group. But there was no statistically significant difference in physical activity between two groups. ConclusionThe available evidence suggests that e-health technology is an effective tool for weight loss. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Three dimensional (3D) printing is considered as an advanced manufacturing technology because of its additive nature. Electron beam melting (EBM) is a widely used 3D printing processes for the manufacturing of metal components. However, the products printed via this process generally contain micro porosities which affect mechanical properties, especially the fatigue property. In this paper, two types of EBM printed samples of the Ti-6Al-4V alloy, one with a round cross section and the other with a triangle cross section, were employed to investigate the existence of porosities using computed tomography (CT). Statistical analyses were conducted on the number, volume, shape, and distribution of pores. The results show that small pores (less than 0.000 2 mm3) account for 80% of all pores in each type of samples. Additionally, to some extent, the shape of sample has influence on the number of micro porosities in EBM made Ti-6Al-4V. The sphericity of the pores is relatively low and is inversely proportional to pore volume. It is found that re-melting on the free surface effectively reduce pore density near the surface. This study may help produce a medical implant with better fatigue resistance.
Image registration is of great clinical importance in computer aided diagnosis and surgical planning of liver diseases. Deep learning-based registration methods endow liver computed tomography (CT) image registration with characteristics of real-time and high accuracy. However, existing methods in registering images with large displacement and deformation are faced with the challenge of the texture information variation of the registered image, resulting in subsequent erroneous image processing and clinical diagnosis. To this end, a novel unsupervised registration method based on the texture filtering is proposed in this paper to realize liver CT image registration. Firstly, the texture filtering algorithm based on L0 gradient minimization eliminates the texture information of liver surface in CT images, so that the registration process can only refer to the spatial structure information of two images for registration, thus solving the problem of texture variation. Then, we adopt the cascaded network to register images with large displacement and large deformation, and progressively align the fixed image with the moving one in the spatial structure. In addition, a new registration metric, the histogram correlation coefficient, is proposed to measure the degree of texture variation after registration. Experimental results show that our proposed method achieves high registration accuracy, effectively solves the problem of texture variation in the cascaded network, and improves the registration performance in terms of spatial structure correspondence and anti-folding capability. Therefore, our method helps to improve the performance of medical image registration, and make the registration safely and reliably applied in the computer-aided diagnosis and surgical planning of liver diseases.
ObjectiveTo evaluate the clinical feasibility and safety of CT-guided percutaneous microwave ablation for peripheral solitary pulmonary nodules.MethodsThe imaging and clinical data of 33 patients with pulmonary nodule less than 3 cm in diameter treated by CT-guided microwave ablation treatment (PMAT) in our hospital from July 2018 to December 2019 were retrospectively analyzed. There were 21 males and 12 females aged 38-90 (67.6±13.4) years. Among them, 26 patients were confirmed with lung cancer by biopsy and 7 patients were clinically considered as partial malignant lesions. The average diameter of 33 nodules was 0.6-3.0 (1.8±0.6) cm. The 3- and 6-month follow-up CT was performed to evaluate the therapy method by comparing the diameter and enhancement degree of lesions with 1-month CT manifestation. Short-term treatment analysis including complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) was calculated according to the WHO modified response evaluation criteria in solid tumor (mRECIST) for short-term efficacy evaluation. Eventually the result of response rate (RR) was calculated. Progression-free survival was obtained by Kaplan–Meier analysis.ResultsCT-guided percutaneous microwave ablation was successfully conducted in all patients. Three patients suffered slight pneumothorax. There were 18 (54.5%) patients who achieved CR, 9 (27.3%) patients PR, 4 (12.1%) patients SD and 2 (6.1%) patients PD. The short-term follow-up effective rate was 81.8%. Logistic analysis demonstrated that primary and metastatic pulmonary nodules had no difference in progression-free time (log-rank P=0.624).ConclusionPMAT is of high success rate for the treatment of solitary pulmonary nodules without severe complications, which can be used as an effective alternative treatment for nonsurgical candidates.
肺栓塞( PE) 的确诊依赖于肺动脉的影像学检查。电子计算机断层扫描肺动脉造影( CTPA) 诊断PE 的敏感性和特异性高[ 1] , 而且该项检查是无创技术, 患者痛苦小, 并发症少, 已成为诊断PE 的一线技术[ 2,3] 。随着CT 仪器的不断升级和改进以及检查技术的不断研究, CT 在PE 中的应用不再仅限于PE 的定性诊断, 还用于肺动脉栓塞程度的量化、右心室改变的诊断、患者预后判断以及下肢深静脉血栓形成( DVT) 的诊断等。