Objective To investigate the construction and significance of in vivo pelvis and abdominal-pelvic arterial vascular network in digital three-dimensional (3D) model for uterine artery embolization (UAE) in the application of surgical approach planning based on computerized tomographic angiography(CTA).Methods A series of digital imaging and communications in medicine 3.0 (Dicom 3.0) were obtained from a woman with myoma of uterus by CTA scanning.Then the software Mimics Version 10.01 was used to construct the pelvic and the arterial vascular network 3D model.Results The digital model could clearly display the abdominal aorta,bilateral common iliac arteries,left and right external iliac artery,internal iliac artery and its branches around the stage ; the right uterine artery emitted in the inferior gluteal artery opening below 15.91 mm,the left uterine artery in inferior gluteal artery below the opening of 15.21 mm,the adjacent artery of internal pudendal artery.At the same time,the artery length and angle of bifurcation were accurately measured.The bifurcation angle of abdominal aorta in fifth lumbar vertebral body edge,was 66.58°,the bifurcation angle of right internal iliac artery was 46.23°,the length of right common iliac artery was 51.43 mm,the bifurcation angle between left and external internal iliac artery was 36.45°,the length of left common iliac artery and 67.50 mm.According to the preoperative approach planning,guided wire across the inferior gluteal artery to the lower 15.00 mm and rotating digital subtraction angiography(DSA) tube,could clearly display the uterine artery opening outward by rotating guide wire,which was relatively easy to enter the uterine artery.Conclusion The female pelvic arterial network model in vivo could be successfully constructed by using Mimics Version 10.01 software with database collected through CTA,which may contribute to the materialization of digital models and be used for preoperative surgical simulator.

A H5N2 subtype avian influenza virus isolated from goose belongs to highly pathogenic avian influenza virus, and the intravenous pathogenicity indexes (IVPI) =2.99. But ducks are not sensitive to this isolated influenza virus. The virus can infect mouse but only replicates in lung and has no pathogenicity. HA and NA gene of this isolated strain share 99.4% and 99.8% nucleotide sequence identity to the HA gene of A/chicken/Hubei/ 489/2004 (H5N1) and the NA gene of A/chicken/Jilin/53/01 (H9N2), and share 99.3% and 99.6% amino acid sequence identity to the HA protein of A/chicken/Hubei/489/2004 (H5N1), A/swan/Guangxi/307/2004 (H5N1), A/wild duck/ Guangdong/314/2004(H5N1), A/chicken/Henan/210/2004(H5N1) and the NA protein of A/chicken/ Jilin/53/01 (H9N2). There are several continuous basic amino acids (-RRRKKR-) at the cleavage site of HA protein. Phylogenetic trees analysis of HA and NA gene suggests that the isolated influenza virus probably originated from the reassortment of H5N1 and H9N2 subtype influenza virus.

Objective To compare the difference between modified peroral endoscopic myotomy (Liu?POEM) and conventional POEM for achalasia. Methods Thirty achalasia patients treated with Liu?POEM and 30 with conventional POEM were enrolled. A retrospective study was performed to compare the conventional POEM and Liu?POEM procedures by evaluating total operation time, postoperative complications and symptoms( Eckardt score) . Results The average total operation time of Liu?POEM was 27?13 ±11?42 min and the average myotomy time was 13?20±5?09 min. There was no pneumomediastinum, subcutaneous emphysema or fever. The average total operation time of conventional POEM was 51?22 ± 25?63 min. The average myotomy time was 11?18±7?61 min. There were three cases(10%) of subcutaneous emphysema but recovered after two days without any special treatment. One patient who underwent conventional POEM had fever( the highest temperature was 37?6℃) and his temperature subsided to normal after physical cooling in one day. Postoperative Eckardt scores of patients were all less than 3. After postoperative follow?up of 3 to 12 months, no complications occurred in any patient. Conclusion Liu?POEM is a modified approach to treat achalasia, advantageous over conventional POEM in more simplified operation procedure, shorter operation time and less invasiveness.

Objective:To evaluate the efficacy and safety of interventional treatment of advanced portal vein occlusion indifferent stages after liver transplantation.Methods:The clinical data of 13 patients with advanced portal vein occlusion after liver transplantation in Tianjin First Central Hospital from March 2016 to June 2022 were retrospectively analyzed, including 8 males and 5 females, with a median age of 47 (2 to 68) years. Based on the Yerdel’s Classification of portal vein thrombosis and Department of Radiology, Tianjin First Central Hospital practice experience, the classification of portal vein occlusion was further modified for a classification-base interventional treatment. The changes of portal vein pressure gradient, complications and protal vein after interventional treatment were analyzed.Results:All 13 cases underwent successful interventional treatment. A total of 15 stents were implanted in the 13 patients. The treatment time was (63.1±18.4) min. The pressure gradient at both ends of portal vein occlusion before treatment was [ M ( Q1, Q3)] 14.0 (9.5, 18.0) mmHg (1 mmHg=0.133 kPa), which declined after interventional treatment 1.0 (1.0, 2.5) mmHg ( Z=-3.19, P<0.001). Portal vein and right portal branch thrombosis recurred in one patient six days after interventional treatment, which was managed with re-interventional treatment. One patient underwent intrahepatic portal shunt through jugular vein 111 days after interventional treatment due to recurrent portal vein thrombosis. The other patients recovered uneventfully without recurrent portal vein thrombosis or occlusion during follow-ups. No intervention-related complications such as puncture point and intraperitoneal hemorrhage occurred in the patients. Conclusion:A modified classification-based interventional treatment could be safe and feasible for patients with advanced portal vein occlusion after liver transplantation.