ABSTRACT:Objective To study the expressions of adrenomedullin (ADM)andβ-catenin in human osteosarcoma of different differentiation grading and their clinical significance.Methods We chose 33 cases of human osteosarcoma with different pathological grading (14 cases of high differentiation grading and 1 9 cases of low grading)and 10 cases of human osteochondroma to detect the expressions of ADM protein,total (T)β-catenin and phosphorylated (P)β-catenin using immunohistochemical method. Results The expression of ADM was detected in the cytoplasm.In osteosarcomas of higher and lower differentiation grading,the positive rate of ADM was 57.1% (8/14)and 100% (1 9/1 9),respectively,with significant differences (P =0.003<0.05).The expression of T-β-catenin was observed in both the cytoplasm and the nucleus in higher differentiation grading and in only cytoplasm in lower grading.In osteosarcomas of higher and lower differentiation grading,the positive rate of T-β-catenin was 85.7%(12/14)and 94.7% (18/1 9),with no significant difference (P =0.561>0.05).The expression of P-β-catenin was detected in the cytoplasm.In osteosarcomas of higher and lower differentiation grading,the positive rate of P-β-catenin was 35.7% (5/14)and 78.9% (1 5/1 9),with a significant difference (P =0.029 <0.05).There was a significant correlation between ADM and P-β-catenin (r =0.424,P =0.025<0.05),but no significant correlation between ADM and T-β-catenin (P = 0.078 > 0.05 )or between T-β-catenin and P-β-catenin (P = 0.052 > 0.05 ).Conclusion The expressions of ADM and P-β-catenin proteins and the different distributions of expression of T-β-catenin protein in cytoplasm and/or nucleus are important indicators for judging the pathological grading of osteo-sarcoma.

Objective To study the value of three-dimensional (3D) visualization and virtual surgery system in piggyback liver transplantation. Methods Two patients who suffered from choledocholithiasis were scanned by 64-slice spiral CT and the data were collected. The segmentation of the hepatic CT images was carried out. The 3D model of the liver and the intrahepatic vessels was reconstructed, and was imported to the FreeForm Modeling System in STL format for smoothing and modifying. Piggyback liver transplantation was simulated with the force-feedback equipment (PHANToM). Results The reconstructed 3D model of the liver was vivid, and the process of the virtual piggyback liver transplantation was verisimilar. Conclusions The 3D model of the liver enables the simulation of piggyback liver transplantation. It can reduce the risk and complications of the surgery, and enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery. Virtual liver transplantation is also helpful during the training of medical workers.

Objective To assess the feasibility of semi-quantitative scoring system for contrast-enhanced ultrasound (CEUS)quantitative analysis's color images in the differential diagnosis of breast nodules.Methods Totally 244 BI-RADS 4 breast solid lesions received CEUS before core needle biopsy or surgical resection were included.A semi-quantitative scoring system for color images of CEUS quantitative analysis were built.The scores were given as follows:1 )Color type and its distribution (0 to 4);2)Color scope (0 to 1 );3)Color margin (0 to 1 );4)Color shape (0 to1 ).The total score for each lesion would be from 0 to 7.And the differenital value between benign and malignant lesions were assessed.Results The total semi-quantitative scores of 102 malignant tumors (5.1 ±1 .7)was significant higher than that of benign lesions (3.34±0.7)(P < 0.05 ).In 102 malignant lesions,the total scores of 81 lesions (79.41 %)were more than 4 points,and in 142 benign lesions,the total scores of 89 lesions (62.67%)were less than 4 points.Depending on the Wilcox rank sum test (Mann-Whitney)analysis,the distribution of total scores between benign and malignant lesions was significant different (P <0.000 1).Total score 4 was selected as the best cutoff,the area under ROC curve was 0.749,on which the sensitivity,specificity and accuracy were 79.4%,62.7% and 69.67%,respectively.Conclusions The semi-quantitative scoring system of CEUS quantitative analysis color images showed good sensitivity but not satisfied specificity and accuracy in differential diagnosis between malignant and benign breast lesions.

The emergence and evolution of digital intelligent technology has profoundly influenced the development of minimally invasive research-oriented hepatobiliary and pancreatic surgery discipline. Over various periods, our team has always adhered to the principle of "being oriented by clinical issues and driven by clinical needs", continuously carried out innovative research across interdisciplinary boundaries, propelling the evolution of digital intelligent technology. Spanning over two decades, this journey includes the progression from digital virtual human, three-dimensional visualization, molecular fluorescence imaging, augmented reality and mixed reality, artificial intelligence, to the realm of human visualization meta-universe. This evolution facilitates the shift from two-dimensional empirical diagnoses of hepatobiliary and pancreatic surgical diseases to deep learning intelligent diagnostics, the transition from morphology-based tumor diagnoses to molecular imaging-based diagnostics, and from conventional empirical surgery to intelligent navigation surgery. The authors provide a comprehensive review of our developmental process and achievements within the realm of digital intelligent diagnostic and therapeutic technologies, with the aims to promote the development and application of digital intelligent medicine.

OBJECTIVETo observe the prognostic value of Medical Image Three-dimensional (3D) Visualization System (MI-3DVS) in evaluation of the distribution and blood supply of gastroesophageal varices (EGV).

METHODS3D reconstruction was played by MI-3DVS and CT-maximum intensity projection (CT-MIP) respectively on multi slice computed tomography (MSCT) date of 51 patients with EGV from February 2010 to October 2012. The demonstration rate of collateral vessels in spleen and stomach area, EGV typing and the blood supply between the two methods were observed and compared.

RESULTSThe demonstration rates of LGV, gastro-renal shunt, splenorenal shunt and PGV showed a high coincidence between the MI-3DVS and CT-MIP (κ = 0.882-1.000), and moderate agreements in SGV and paraesophageal varices (κ = 0.646 and 0.757). The outcome of EGV classification (MI-3DVS vs. CT-MIP) were typeIfor 31 vs. 28 cases, type II for 6 vs. 4 cases, type III for 4 vs. 4 cases and type IV for 6 vs.10 cases, the 2 methods show high agreements (weighted Kappa value of 0.848 and P < 0.01).Significant differences were found in the blood supply distribution among the four types of EGV (χ(2) = 36.647, P < 0.01); and the blood supply of the EGV tended to be a strong correlation with EGV classification (C = 0.769 and 0.744, P = 0.000). There were 12 patients with gastro-renal shunt and 5 patients with Spleno-renal shunt.

CONCLUSIONSMI-3DVS can explicitly determine the location, blood vessel diameter and blood supply of the EGV, which is helpful for us to grab the formation of collateral circulation completely. The 3D reconstruction of MI-3DVS has guidance and current significance in optimizing therapeutic schedule or preoperative planning.

Adult ; Aged ; Esophageal and Gastric Varices ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, X-Ray Computed

As 2021 is known as the “first year of the metaverse”, the concept of metaverse is promoting a multi-field innovation revolution on a global scale. The new experiences and technologies it brings are expected to provide solutions for the difficulties in the field of human visualization surgery in disease diagnosis, preoperative planning, surgical treatment, medical education, health management and patient experience. This opens up opportunities for the next wave of disruptive technology innovation. This paper proposes a new concept of “human visualization metaverse”, and summarizes its innovative application, future development direction and challenges to promote the research and development of human visualization metaverse,and to explore the application potential of metaverse technology in the field of surgery to advance the research and development of the metaverse for human visualization.

As 2021 is known as the “first year of the metaverse”, the concept of metaverse is promoting a multi-field innovation revolution on a global scale. The new experiences and technologies it brings are expected to provide solutions for the difficulties in the field of human visualization surgery in disease diagnosis, preoperative planning, surgical treatment, medical education, health management and patient experience. This opens up opportunities for the next wave of disruptive technology innovation. This paper proposes a new concept of “human visualization metaverse”, and summarizes its innovative application, future development direction and challenges to promote the research and development of human visualization metaverse,and to explore the application potential of metaverse technology in the field of surgery to advance the research and development of the metaverse for human visualization.