ObjectiveTo study the types of anatomical variations of hepatic arteries. Methods Hepatic arteries of 64-slice spiral CT scanning data were three-dimensional constructed by using self-designed software. The types of anatomical variations were analyzed and classified with Michels' classification criteria. Results The model presented with realistic profile of hepatic arteries which allowed vivid three-dimensional observation. Of these patients, 40 had normal hepatic arteries (60.61%), 26 had variations (39.39%), and 5 had infrequent aberrant hepatic arteries that was not included in Michels' classification (7.58%). Conclusion Three-dimensional model of hepatic arteries can volumetricly display the anatomical variations of hepatic arteries.

Objective To study the image segmentation, three-dimensional (3D) reconstruction and simulation operation of choledocholithotomy and T-tube drainage based on the computed tomagraphy (CT) data of patient with choledocholithiasis. Methods Patient with choledocholithiasis underwent 64-slice spiral CT imaging. The images segmentation and 3D reconstruction were performed by Medical Image Process System (MIPS) to construct the 3D model of the hepatobiliary system. The model was modified by FreeForm Modeling System. The virtual surgical instruments were developed by GHOST SDK software, and were imported to the virtual surgery. Results The data of plain, arterial phase, venous phase and portal venous phase scanning were collected, and the data stored in DICOM format were transformed to BMP format. A model of the hepatobiliary system was constructed after the data was segmented by MIPS, and then the model was exported in the STL format. The data in STL format were imported to FreeForm Modeling System for smoothing the model. Different structures were assigned different colors to make the model more vivid. The self-developed virtual surgical instruments were imported to the system, and the virtual surgery for choledocholithiasis was performed with PHANToM. Conclusions With the help of MIPS, the image segmentation and 3D reconstruction of the model are finished rapidly and effectively. After the virtual surgical instruments are developed in FreeForm Modeling System, the virtual surgery can be achieved in the 3D model with the assistance of PHANToM.

Objective To analyze epidemiological characteristics and changing trends of common respiratory infectious diseases among 6-19 year-old population in Shenzhen from 2013 to 2021, and to provide a reference for prevention and control. Methods Data of influenza, mumps and varicella reported cases among the population aged 6-19 years in Shenzhen from 2013 to 2021 were collected, and descriptive methods and Joinpoint regression model were used to analyze epidemiological characteristics and trends of incidences. Results Between 2013 and 2022 in Shenzhen, the average annual incidence rates of influenza, mumps, and varicella among the population aged 6-19 years were 961.44/100 000, 157.70/100 000, and 664.34/100 000 respectively. The incidence of influenza showed an upward trend in 10 years, with an annual percent change (APC) of 52.88% (P<0.05). The incidence of mumps and varicella both showed an 'up-down' trend, with an inflection point in 2019. The incidence APC of mumps were 11.51% and -43.49%, respectively (P>0.05), while the incidence APC of varicella were 28.88% and -50.03%, respectively (P<0.05), respectively. From the point of seasonal distribution, the incidence of three infectious diseases all showed bimodal distribution, with peaks in winter (December to January of the following year) and at the turn from spring to summer (April to June). The proportion of reported cases of three infectious diseases among people aged 6-<10 years old exceeded 60%. The proportion of varicella cases among people aged 10-<15 and 15-19 was on the rise. The incidence rate of influenza and varicella in people aged 15-19 years increased fastest, with APCs of 77.89% and 33.00%, respectively (both P<0.05). Conclusions The trend analysis based on Joinpoint regression model displayed that the reported incidence of influenza among people aged 6-19 years in Shenzhen during 2013-2022 showed an upward trend, and the incidence of varicella had an 'up-down' trend. Children aged 6-<10 years old are the main incidence group, and the prevention and control of infectious diseases in primary schools should be further promoted. Meanwhile, the rapid rise in the incidence of respiratory infectious diseases among people aged 15-19 years old and the increase in the proportion of varicella cases among people aged 10-19 years old suggest that intervention should be carried out to address the influential factors such as immunization gaps and concentrated accommodation in the older age group of minors.

Objective To establish an animal model of rapid eye movement (REM) sleep deprivation (SD) and an animal model for perifornical nucleus microdialysis and investigate the change of cognition, hypocretinergic system and GABAergic system in rats' hypothalamus after various degrees of REM sleep deprivation and sleep revival and two GABAergic drugs intervention. Methods The modified multiple platform method (MMPM)was used to establish sleep deprivation model and the cognitive function was assessed by Morris' water maze. Immunofluorescence technique was used to analyze the number of Hypocretin (Hcrt) immunoreactive neurons, total Fos immunoreactive neurons, Hcrt and Fos colabeled neurons, and the integrated optical density ( IA ) of GABAA Rαl immunoreactive area in rats' hypothalamus.High performance liquid chromatograph (HPLC) was used to quantitatively analyze the level of GABA and Gluin in the rats' hypothalamus. Two GABAergic drugs, a selective GABAA R antagonist, SR-95531, and a selective blocker of type 1 GABA transporter (uptake blocker), NO-711, were used for perifornical nucleus microdialysis. Results There was no statistically significant difference in tests between CC and TC ( Define CC and TC). There was a significant decrease (P ＜ 0. 05 ) of cognitive function measured by Morris maze test in SD 3 d, SD 5 d and RS 6 h of SD groups compared with CC and TC groups. Number of Fos immunoreactive, F+ &H+ immunoreactive neuronsand IA of GABAA Rαl immunoreactive area were all significantly increased ( P ＜ 0. 05 ). Content of GABA measured by HPLC was also increased ( P ＜ 0. 05 ). However, all these changes were partly reversed by sleep revival SR-95531 and NO-711 had different effect on these changes. Conclusions Sleep deprivation, no matter mild or severe, has adverse effects on cognitive function. Activities of both GABAergic and Hcrtergic system are increased during REMSD. These two neurons system could be regulated by each other and the relationship between them is positive correlation. GABAergic system also had self-regulation during REMSD, but microdialysision of either SR-95531 or NO-711 acquired adverse effects on cognitive function of rats. So GABAergic system is not an optimal therapeutic target. Because GABAergic and Hcrtergic system has inhibitory effect on each other,suppressing activity of Hcrtergic system might be a promising therapeutic target.

Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.

The clinical data of rare hemiaxial limb skeletal Ollier disease in a child admitted to the Affiliated Hospital of Zunyi Medical University in July 2020 were analyzed retrospectively.The literature was reviewed and the methods of diagnosis and treatment of Ollier disease in children were summarized.The patient is a 3-year-old boy, who was hospitalized for 2 days of claudication of the right lower limb.Imaging examination showed hemiaxial limb ske-letal disease and suggested the possibility of histiocytosis.Curettage, bone graft and plaster external fixation were performed on the lesions of the right femoral neck and greater trochanter.The postoperative pathological results indicated endogenous chondroma.The follow-up results revealed that the bone graft healed well, the symptoms of claudication were improved, and there were no complications such as infections and femoral head necrosis.Long tubular bones are the main site of children′s Ollier disease, but multiple lesions in hemiaxial limbs are extremely rare.It is difficult to diagnose this rare case, which is easily misdiagnosed.At present, it′s diagnosis still needs to be confirmed by pathological examination.Surgical treatment and long-term follow-up are needed for children with a wide range of lesions, seriously impaired limb function and obvious limb deformity.

Objective:To investigate the clinical features, diagnosis and treatment of oblique vaginal septum syndrome (OVSS).Methods:The clinical data of 80 patients with OVSS admitted to The Second Hospital of Hebei Medical University from July 2005 to July 2023 were retrospectively analyzed. According to the classification system of OVSS proposed by Female Genital Anomalies Study Group, Chinese Obstetricians and Gynecologists Association in 2021, the patients were divided into four groups. The clinical manifestations, accompanied urinary system abnormalities, diagnosis and treatment methods and treatment outcomes were observed.Results:According to the above classification system, among the 80 patients with OVSS, 35 patients (44%, 35/80) were categorized as type Ⅰ, 33 patients (41%, 33/80) were categorized as type Ⅱ, 2 patients (3%, 2/80) were categorized as type Ⅲ and 10 patients (13%, 10/80) were categorized as type Ⅳ. The main onset symptom of patients was periodic abdominal pain (70%, 56/80), vaginal bleeding (20%, 16/80), dysuria or fecal impaction (15%, 12/80), vaginal mucopurulent discharge (10%, 8/80). The morbidity of combined urinary system abnormalities was 88% (70/80), and the most common urinary system abnormality was ipsilateral renal agenesis (81%, 65/80). Bilateral kidneys were normal in 13% (10/80) patients, and 6% (5/80) were combined with other urinary system abnormalities. A total of 74 patients underwent vaginal oblique septectomy or septum excision. Five of the 10 patients with type Ⅳ underwent hysterectomy on the cervical atresia side, 4 patients received hysteroscopy combined with cervicoplasty+oblique septotomy or septum excision, and one patient selected delayed menstruation. Two patients underwent laparoscopic resection of the dysplasia kidney and ectopic ureter which opening to the vagina. Eleven patients with endometriosis cyst, hydrosalpinx or empyema underwent laparoscopic surgery.Conclusions:The main symptom of type Ⅰ and Ⅳ patients is abdominal pain, while the main symptom of type Ⅱ and Ⅲ patients is bleeding. Magnetic resonance imaging (MRI) has advantages in the evaluation of complex OVSS, and MRI is recommended before operation to exclude other axial reproductive tract dysplasia and complex urinary system dysplasia. If there is leakage of urine, vaginal discharge or complex deformity, it is necessary to multidisciplinary discussion and formulate a reasonable surgical plan. The first treatment is related to the prognosis of patients especially children, and should be highly valued.

Objective:To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft.Methods:A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up.Results:The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5).Conclusion:Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness.

Objective To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients.Methods We conducted a cross-sectional study in two HIV clinics,affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional.A face-to-face interview,with questionnaire was conducted to collect information on socio-demographic characteristics,drug use,and sexual behavior.Blood samples were used to test HBsAg.x2 test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors.Results The prevalence of HBV and HIV co-infection was 13.85％ (113/816).Results from multivariate logistic regression analyses showed that age (25-45),family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection,with OR (95％ CI) as 1.738 (1.031-2.931),2.898 (1.678-5.005) and 1.744 (1.052-2.892),respectively.Conclusion The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population.HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV,while HepB vaccination was associated with the reduction of HIV/HBV coinfection.Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.