Liver transplantation is an effective method for the treatment of hepatocellular carcinoma (HCC). In order to reduce the high recurrence rate of tumor after liver transplantation for HCC, some scholars put forward the famous Milan criteria. Since the Milan criteria are too strict, some HCC patients with relatively “good biological behavior” and large lesions or multiple nodules are excluded from the waiting list for liver transplantation, and thus a large number of “expanded versions of the Milan criteria” appeared around the world. As for the histopathology of HCC, microvascular invasion (MVI) and poorly differentiated tumor tissue are significantly associated with the high recurrence rate after liver transplantation for HCC. This article reviews and summarizes the articles on the application of 18F-FDG PET/CT in liver transplantation for HCC in China and foreign countries and points out that the uptake of 18F-FDG in HCC lesions reflects the difference in the biological behavior (i.e., invasion) of tumor tissue. The intense uptake of 18F-FDG is positively correlated with MVI and poor differentiation of HCC. In addition, 18F-FDG can detect extrahepatic metastatic lesions sensitively and accurately. Preoperative 18F-FDG PET/CT findings have a high value in predicting the prognosis of liver transplantation for HCC, and it is a trend to incorporate such findings into the criteria for liver transplantation in HCC. It is also expected to unify the various expanded versions of the Milan criteria. The new criteria for liver transplantation may be defined as follows: the Milan criteria should be followed in general; as for the patients who do not meet the Milan criteria, liver transplantation can be performed for those who have lesions with negative 18F-FDG PET/CT results, without the involvement of major blood vessels or extrahepatic metastasis.

Objective:To compare the effects of anterograde elastic stable intramedullary nailing (ESIN-A), retrograde K-wires fixation (KW-R) and retrograde precision shaping of elastic stable intramedullary nailing (ESIN-RPS) in the treatment of fractures of distal radial metaphyseal diaphyseal junction (DRMDJ) in children.Methods:A retrospective study was conducted to analyze the data of 112 eligible children with DRMDJ fracture who had been treated at Department of Orthopedics, Children's Hospital, Anhui Medical University and Department of Orthopedics, The People's Hospital of Fuyang City,Anhui Medical University, from January 2016 to May 2022. There were 64 males and 48 females, with an age of (8.4±2.3) years. The children were divided into 3 groups according to different surgical fixation methods: group ESIN-A of 36 cases, group KW-R of 52 cases, and group ESIN-RPS of 24 cases. The operation time, intraoperative bleeding, fluoroscopy times, alignment rates and residual angulations by the anteroposterior and lateral X-ray films immediately after reduction were compared among the 3 groups. The Gartland-Werley evaluation of wrist function and complications were compared at the last follow-up.Results:There was no statistically significant difference in the preoperative general data among the 3 groups, indicating comparability ( P>0.05). In the operation time, group KW-R [(71.2±9.2) min] > group ESIN-A [(65.1±13.1) min] > group ESIN-RPS [(51.7±17.1) min]; in the fluoroscopy times, group KW-R [(13.9±6.3) times] > group ESIN-A [(9.0±2.8) times] > group ESIN-RPS [(6.4±2.0) times]; in the alignment rates by the anteroposterior and lateral X-ray films immediately after reduction, group ESIN-RPS (93.1%±4.6% and 95.2%±3.3%) > group KW-R (82.1%±11.0% and 88.1%±7.4%) > group ESIN-A (80.4%±9.9% and 86.7%±6.9%); in the residual angulations by the anteroposterior and lateral X-ray films immediately after reduction, group ESIN-RPS (3.3°±1.8° and 2.9°±2.1°) < group ESIN-A (5.2°±1.0° and 5.0°±3.2°) < group KW-R (6.6°±1.6°and 7.5°±2.7°). Pairwise comparisons in the above items were statistically significant ( P<0.05). In group ESIN-A, the incision length [(1.8±0.3) cm] was significantlylonger than that in group ESIN-RPS [(1.4±0.2) cm], and the intraoperative blood loss [(8.3±2.2) mL] significantly larger than that in group ESIN-RPS [(5.5±1.6) mL] ( P<0.05). One year after operation, the excellent and good rate by the Gartland-Werley evaluation of wrist function in groups ESIN-RPS, ESIN-A and KW-R, respectively, were 95.8% (23/24), 86.5% (31/36) and 86.1% (46/52), showing no statistically significant difference between the 3 group ( P>0.05), and the major incidence of complications in group KW-R (25.0%, 13/52) and in group ESIN-A (25.0%, 9/36) were significantly higher than that in group ESIN-RPS (4.2%, 1/24) ( P<0.05). Conclusion:In the treatment of DRMDJ fractures in children, compared with ESIN-A and KW-R, ESIN-RPS is an effective choice due to its advantages of shorter operation time, less intraoperative blood loss, less radiation, better alignment, and fewer complications.

Thyroid eye disease (TED) is an orbital disease closely associated with thyroid disorders, with 25%-50% of patients with diffuse toxic goiter (Graves Disease) developing secondary TED, which can lead to blindness and disability and significantly impair patients' visual function and quality of life.Activity staging is a crucial assessment index for TED and is essential for clinical evaluation, treatment planning, and prognosis.The Clinical Activity Score (CAS) is currently the most widely used method for this purpose both domestically and internationally.To improve the accuracy and consistency of CAS evaluations, the European Group of Graves' Orbitopathy (EUGOGO) recommended the use of a CAS scoring atlas in the TED guidelines.However, existing atlases are primarily based on Caucasians.Considering the anatomical differences in the orbit between Chinese and Caucasians and the resulting divergent ocular characteristics, there is a need for a comprehensive interpretation of the CAS scoring details in the current guidelines.This should be followed by further refinement to tailor the CAS scoring criteria to Chinese patients with TED.Such measures will standardize the operational methods and judgment criteria of CAS scoring in China, thereby providing a reliable basis for the accurate diagnosis and treatment of the disease.

Objective:To investigate the feasibility of applying Fetal Intelligent Navigation Echocardiography (FINE) combined with Virtual Intelligent Sonographer Assistance (VIS-Assistance ?) in the prenatal screening of right aortic arch (RAA) with left-sided ductus arteriosus (LDA). Methods:A total of 32 fetuses with RAA and LDA during middle and late pregnancy in Zhejiang University Medical College Affiliated Sir Run Run Shaw Hospital from Jauary 2018 to Jauary 2020 were included in this retrospective study, and the datas about fetal cardiac three-dimensional volume were analyzed. The time-space correlation imaging (STIC) volume data were collected by using FINE by Senior doctor A. The two diagnostic elements of the transverse aortic arch on the right side of the trachea and the "U" -shaped vascular ring, as well as the three-vessel tracheal diagnostic section were obtained by low-aged doctor B and middle-aged doctor C by using VIS-Assistance ? technology. And then the detection rates of diagnostic sections and diagnostic elements for fetuses with RAA and LDA were calculated. The postpartum outcomes of fetuses with RAA and LDA were followed up. Results:Thirty-two fetuses were included in the study after excluding 2 cases due to the poor quality images, and the datas about fetal cardiac three-dimensional volume of the 32 fetuses were analyzed. The detection rate of one diagnostic element (the aortic arch on the right side of the trachea) were 84.4% vs 87.5% before VIS-Assistance ?, and 93.8% vs 93.8% after VIS-Assistance ? for each doctor B and doctor C , respectively. Another diagnostic element ( "U" -shaped vascular ring) were 78.1% vs 87.3% before VIS-Assistance ?, and 90.6% vs 90.6% after VIS-Assistance ? for doctor B and doctor C, respectively. But no significant difference was found before and after VIS-Assistance ? between the two each doctors(all P>0.05). The detection rate of three-vascular tracheal diagnosis view were 65.6% vs 71.9% before VIS-Assistance ? and 84.4% vs 87.5% after VIS-Assistance ? for doctor B and doctor C, respectively. There was significant difference before and after VIS-Assistance ? of doctor C( P<0.05). The scores of image quality after VIS-Assistance ? were significantly higher than that before VIS-Assistance ? for doctor B and doctor C, respectively [3(2.5, 3) vs 3.25(3.0, 3.5), and 3(2.5, 3.5) vs 3.5(3.0, 3.5)]. The agreement between two doctors performing VIS-Assistance ? was investigated using Bland-Altman analysis and the result showed that within 95% of the differences fall in the agreement interval. No obvious clinical symptoms of compression were found in 32 neonates after follow-up. Conclusions:The application of FINE combined with VIS-Assistance ? technology can easily and reliably obtain the key diagnostic view of RAA with LDA (three-vessel and tracheal view), and clearly display all diagnostic elements, having high repeatability and stability. VIS-Assistance ? technology can improve the detection rate and image quality even if the doctor was lack of experience. So it can be used as an effective supplementary means for prenatal screening of RAA and LDA.

Objective To analyze the perioperative outcomes of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection. Methods The perioperative clinical data of patients receiving heart valve replacement in the Department of Cardiovascular Surgery, the First Affiliated Hospital of University of Science and Technology of China from November 2022 to February 2023 were retrospectively analyzed. According to whether the patients were infected with SARS-CoV-2, they were divided into a non-infected group and an asymptomatic group. The perioperative data of the patients were compared between the two groups, and the effect of asymptomatic infection on the result of heart valve replacement surgery was analyzed. Results A total of 66 patients were enrolled including 36 males and 30 females with a mean age of 58.0±11.1 years. There were 51 patients in the non-infected group and 15 patients in the asymtomatic group. There were 2 patients of mitral valve replacement, 20 patients of aortic valve replacement, 1 patient of double valve replacement, 3 patients of aortic valve replacement with tricuspid valvoplasty, 22 patients of mitral valve replacement and tricuspid valvoplasty, 18 patients of double valve replacement and tricuspid valvoplasty. Asymptomatic infected patients received more emergency surgery than uninfected patients (26.7% vs. 0.0%, P<0.01). There was no statistical difference in the duration of extracorporeal circulation, aortic occlusion, mechanical ventilation time after the surgery, ICU stay, postoperative drainage volume, or postoperative complications between the two groups. Conclusion Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection and non-infection are almost the same.