Objective To study the consistency in the diagnosis of preoperative TNM rectal cancer staging using high resolution magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) combined with carcinoembryonic antigen (CEA) and postoperative pathological TNM.Methods 156 cases pathologically proven were retrospectively analyzed and divided into 4 groups including preoperative MRI group (39 cases),TRUS group (39 cases),MRI and TRUS group (39 cases),MRI and TRUS combined with CEA group (39 cases).The differences between preoperative T,N staging and postoperative pathologic T,N staging were analyzed.Results There were statistically significant differences in the diagnosis of preoperative T and postoperative pathological T in 4 groups (T: Kappa =0.685,P =0.000; N: Kappa =0.544,P =0.000),but there were no significant differences in preoperative N and postoperative pathological N staging in preoperative MRI group,TRUS group,MRI and TRUS group (Kappa =0.142,P =0.329; Kappa =0.154,P =0.645; Kappa =0.154,P=0.229),and significant difference was observed in MRI and TRUS combined with CEA group (Kappa =0.544,P =0.000).There were no significant differences in the accuracy of T staging among the 4 groups (x2 =0.326,P =0.574; x2 =0.562,P =0.719; x2 =0.287,P =0.986),but significant difference in the accuracy of N staging were showed among the 4 groups (x2 =4.643,P =0.026; x2 =6.643,P =0.026; x2 =5.243,P =0.019).Conclusion Preoperative evaluation by the MRI add TRUS combined with CEA can improve the accuracy of preoperative staging,which can provide more reliable basis for decision-making and improve the coincidence rate of operative procedures in line with the estimate.It also provides the basis fur the accurate preoperative diagnosis and individualized treatment.

Objective To study the consistency of preoperative staging by transrectal ultrasonography (TRUS) combined with serum carcinoembryonic antigen (CEA) and the postoperative pathological TNM staging (PTNM).Methods 118 rectal cancer patients pathologically proven were divided into preoperative TRUS combined with CEA group (59 cases) and along TRUS group (59 cases).The consistency of preoperative stag in 2 groups and postoperative pathological stage was analyzed retrospectively.Results In TRUS combined with CEA group,the accuracy of T stage was 79.7 ％ (47/59),and the accuracy of N stage was 77.8 ％ (42/59),compared with the postoperative pTNM.While in along TRUS group,the accuracy of T stage was 86.4 ％ (51/59),and the accuracy of N stage was 57.7 ％ (30/59).The consistencies of T and N stage in TRUS combined with CEA group and postoperative pTNM were better (κ =0.685,P =0.000; κ =0.544,P =0.000).While the consistency of T stage in along TRUS and postoperative pTNM was better (κ =0.755,P =0.000),but that of N stage was poor (κ =0.154,P =0.229).Conclusion Preoperative evaluation by the TRUS combined with CEA can increase the accuracy of preoperative stage which can provide more reliable basis for decision-making and improve the rate of coincidence of operative procedures in line with forecasts.At the same time,it can provide the basis for the accurate preoperative diagnosis and individualized treatment.

Objectives:To observe the influence of PN treatment on the postoperative patients of advanced ovarian cancer. Methods:The patients were divided into two groups.Thirty cases of patients(PN group) were treated with PN after the operation for the ovarian cancer.Thirty five cases of patients(control group) were treated regularly without PN.The biochemical indicators,complications and mortality rate were compared between the two groups. Results:The biochemical indicators in PN group were better than those in control group.The incidence of complications and mortality rate in PN group were significantly lower than those in control group. Conclusions:PN can improve the general status of postoperative patients with advanced ovarian cancer and decrease the complication incidence and motality rate.

A case of lipoblastomatosis occuring in a 1 year and 10 month old boy is described. The tumor was first presented in the left foot at his age of 4 month, and was surgically removed. The tumor was grossly infiltrating skeletal muscle tissue, and was microscopically composed of lobulated fat tissue with prominent myxoid stroma and many immature mesenchymal cells and scattered multivacuolated lipoblasts. The tumor recurred 11/2 years later and was again removed. The tumor was equally lobulated and located inbetween skeletal muscle. However, this time lobulated tumor consisted almost entirely of mature fat tissue with scattered lipoblasts.

Adult ; Humans ; Laparoscopy ; methods ; Male ; Retrocaval Ureter ; surgery ; Ureterostomy ; methods ; Young Adult

BACKGROUND:Prefabricated customized bone flaps have the advantages of few trauma, good vascularization, ossification with predetermined shape, and can be used to restore bone defects with compromised blood bed.
OBJECTIVE:To establish animal models of mandibular reconstruction with prefabricated, customized bone flaps.
METHODS:After computed tomography scanning of nine rhesus’ head, customized meshes were made. After loading with recombinant human bone morphogenetic protein-2-incorporated demineralized freeze-dried bone al ograft (DFDBA) or coral ine hydroxyapatite (CHA), the constructs were implanted in latissimus dorsi muscle. Meanwhile, segmental mandibular defects were created, and the customized meshes loaded with DFDBA, CHA, or recombinant human bone morphogenetic protein-2-incooperated DFDBA and CHA were implanted in situ. At 13 weeks, prefabricated bone flaps with recombinant human bone morphogenetic protein-2-incorporated DFDBA or CHA were transferred to repair segmental mandibular defects. Clinical and histological analyses were used to evaluate the ossification and vascularization of the prefabricated implants in ectopic and orthotopic sites.
RESULTS AND CONCLUSION:Segmental mandibular defects were successful y restored with prefabricated bone flaps and recombinant human bone morphogenetic protein-2-incorporated CHA in situ, but other segmental mandibular defects remained with recombinant human bone morphogenetic protein-2-incorporated DFDBA, DFDBA and CHA in situ. Moreover, mandibles reconstructed with prefabricated bone flaps revealed more regenerated and homogeneous bone formation than other reconstructions. These findings suggest that the animal model of mandibular reconstruction with prefabricated, customized bone in rhesus monkey is applicable.

BACKGROUND:The patients undergoing lumbar discectomy have a higher risk of recurrence. There are many different ways of reoperation, but there are few studies on spine-pelvis sagittal morphology of patients with recurrent lumbar disc herniation. OBJECTIVE:To compare the effect of discectomy and posterior lumbar interbody fusion on spine-pelvis sagittal morphology of patients with recurrent lumbar disc herniation. METHODS:Sixty-one patients of recurrent lumbar disc herniation after discectomy were divided into discectomy group (n=30) and posterior lumbar interbody fusion group (n=31) according to the re-repair method. The height of intervertebral disc, lumbar lordosis and pelvic projection angle in the two groups before and after treatment were measured and compared based on standing spine lateral X-ray images. RESULTS AND CONCLUSION: After treatment, the height of intervertebral disc, lumbar lordosis and pelvic projection angle of patients in discectomy group were not significantly changed compared with before treatment (P> 0.05). After treatment, the height of intervertebral disc, lumbar lordosis and pelvic projection angle of patients in posterior lumbar interbody fusion group were significantly increased compared with those before treatment (P< 0.05). Before treatment, there were no significant differences in the height of intervertebral disc, lumbar lordosis and pelvic projection angle between discectomy and posterior lumbar interbody fusion groups (P > 0.05).After treatment, the height of intervertebral disc, lumbar lordosis and pelvic pelvic projection angle were significantly increased in the posterior lumbar interbody fusion group compared with the discectomy group (P < 0.05). These results demonstrate that discectomy cannot significantly change the spine-pelvis sagittal morphology of patients subjected to re-operation, but compared with the discectomy treatment, posterior lumbar interbody fusion has a greater impact on spine-pelvis sagittal morphology of patients subjected to re-operation.

OBJECTIVES: To compare the short- and long-term hearing outcomes after successful inlay cartilage tympanoplasty between patients with small (< or =25%) and large (> or =50%) eardrums perforations. METHODS: This is a retrospective case series study conducted in a tertiary referral center. Twenty-five patients who underwent 27 procedures were enrolled. Their mean age was 60.26 years (range, 42 to 76 years). The mean follow-up time was 18.86 months (range, 12.30 to 35.83 months). The preoperative, initial postoperative, and long-term hearing results in patients with total repair of the eardrum were analyzed. RESULTS: In the small size group, the average (+/-standard deviation) air-bone gap (ABG) closure was 1.08+/-7.53 dB in the short-term and 2.33+/-11.56 dB in the long-term hearing examinations. There was no difference between short- and long-term ABG closure (P=0.689). In the large size group, the average ABG closure was 9.77+/-9.40 dB in the short-term and 16.25+/-6.01 dB in the long-term hearing examinations. There was a significant difference between short- and long-term ABG closure (P=0.029). CONCLUSION: Patients with large perforations have continuous hearing improvement and ABG closure for more than one year. In contrast, the short- and long-term postoperative ABGs are almost the same in patients with small perforations. More long-term postoperative follow-up of hearing results is necessary for large perforations.
Cartilage* ; Follow-Up Studies ; Hearing* ; Humans ; Inlays* ; Retrospective Studies ; Tertiary Care Centers ; Tympanic Membrane* ; Tympanoplasty*

We identified the Beijing family strains of multiple drug-resistant tuberculosis and find out the distribution of second-line injectable drugs resistance-associated nucleotide alteration among the MDR strains in Ningbo.The 106 MDR isolates were selected from the first drug resistant survey in Ningbo during 2014 and 2016.The conventional drug susceptibility testing was used to detect the drug-resistant profiles against 3 second-line injectable drugs (kanamycin,amikacin,capreomycin).The RD105 deletion-targeted multiplex PCR method was used to distinguish the genotype among 106 MDR strains.The gene mutations of second-line injectable drugs resistance-associated among MDR-TB strains were detected by direct DNA sequencing.Results showed that out of the 106 MDR isolates,83(78.3％,83/106) belonged to Beijing genotype,while the other 23(21.7％,23/106) were non-Beijing genotype.There were 10 strains with second-line injectable drugs resistance in 83 Beijing genotype MDR strains and there were no strains with second-line injectable drugs resistance in 23 non-Beijing genotype MDR strains.The Beijing MDR strains had significantly higher proportions of second-line injectable drugs resistance than non-Beijing strains.There were 4 with mutations in 10 MDR-TB with second-line injectable drugs resistance and there were 24 with mutations in 96 MDR-TB without second-line injectable drugs resistance (x2=1.048,P＞0.05).Beijing genotype MDR strains revealed a significant association with second-line injectable drugs resistance.The mechanism of second-line injectable drugs resistance in MDR-TB is mainly in no connection with the mutation of the genes.

Abstract: With the rapid development of artificial intelligence technology, small molecule generation models have emerged as a significant research direction in the field of drug discovery. These models, including Generative Adversarial Networks (GANs), Variational Autoencoders (VAEs), and diffusion models, have proven to possess remarkable capabilities in optimizing drug properties and generating complex molecular structures. This article comprehensively analyzes the application of the aforementioned advanced technologies in the drug discovery process, demonstrating how they supplement and enhance traditional drug design methods. At the same time, it addresses the challenges facing current methods in terms of data quality, model complexity, computational cost, and generalization ability, with a prospect of future research directions.