Objective To construct a geometric skull model by using three-dimensional reconstruction, computer tomography scanning and rapid prototyping technology and evaluate its significance in treatment of complex oral and maxillofacial deformities. Methods A cranial and a goldenhar syndrome patient with complex oral and maxillofacial deformities bone received continuous volumetric scanning of skull and the data acquisition was done by an electron computed tomography, by which reconstruction was performed and the obtained images saved as STL files. Then the data were input into rapid prototyping machine to make three-dimensional geometric model. Direct measurement, designation and surgery simulation could be done on this three-dimensional model. Then the mandibular mirror physical model was manufactured using rapid prototyping according to the normal side. Results A computer-aided model according to CT data could represent the three-dimensional anatomic structures and their relationships precisely. The replica exhibited dimensional errors ranging 0.02 mm to 0.53 mm. Which provided strong basis for accurate understanding of disease status and reasonable surgical plans and helped improve the curative effect of surgery. Conclusion Rapid prototyping can help surgeons in many ways for therapy of the complex oral and maxillofacial deformities.

Objective To summarize the changing rules of free portal pressure (FPP) after splenectomy combined with pericardial devascularization and investigate its influencing factors.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 55 patients with portal hypertension who were admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2016 to September 2018 were collected.There were 39 males and 16 females,aged from 17 to 67 years,with a median age of 46 years.FPP was measured using CT portal vein angiography before splenectomy and intraoperative manometry after cantheterization to the right gastroepiploic veins.Observation indicators:(1) comparison between intraoperative and postoperative FPP;(2) dynamic changes of FPP at the seventh postoperative day;(3) comparison of FPP before and after Valsalva manoeuvre;(4) relationship of FPP with mean arterial pressure and heart rate.Measurement data with normal distribution were represented as Mean ±SD.Repeated measurement data were analyzed using repeated ANOVA.Paired data were analyzed by the paired t test.The linear correlation analysis was done for relevance.Results (1) Comparison between intraoperative and postoperative FPP:55 patients underwent open splenectomy combined with pericardial devascularization.The FPP before splenectomy,after splenectomy combined with pericardial devascularization intraoperatively,at the first and the seventh day postoperatively was (34±6)cmH2O (1 cmH2O=0.098 kPa),(28±6)cmH2O,(34±5)cmH2O and (30±5)cmH2O,respectively,showing a statistically significant difference (F=43.23,P＜0.05).The FPP before splenectomy was statistically significant different from the FPP after splenectomy combined with pericardial devascularization intraoperatively,at the first and the seventh day postoperatively,respectively (P ＜ 0.05).The FPP after splenectomy combined with pericardial devascularization intraoperatively was statistically significant different from the FPP at the first and the seventh day postoperatively,respectively (P＜0.05).There was a statistically significant difference between FPP at the first and the seventh day postoperatively (P ＜ 0.05).(2) Dynamic changes of FPP at the seventh postoperative day:the FPP was (30 ± 5) cmH2 O,(29 ± 5) cmH2 O,(29 ± 5) cmH2 O,(29 ± 5) cmH2 O,(28 ± 5) cmH2 O,(28± 5) cmH2 O,(28 ± 5) cmH2 O,(29 ± 5) cmH2 O,(29 ± 5) cmH2 O,(30 ± 5) cmH2 O,(30± 5)cmH2O,(30±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(32±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(31±5)cmH2O,(30± 5) cmH2O,(30±5) cmH2O from 00:00 to 24:00 at the seventh day postoperatively.Level of FPP was higher from 12:00 to 21:00 and lower from 01:00 to 08:00,with a peak value at 17:00 and valley value from 04:00 to 06:00.(3) Comparison of FPP before and after Valsalva maneuvre:the FPP was (30± 5) cmH2O and (32± 5) cmH20 before and after Valsalva manoeuvre,respectively,showing a statistically significant difference (t =82.72,P＜ 0.05).(4) Relationship of FPP with mean arterial pressure and heart rate.Linear correlation analysis showed positive correlations of FPP with mean arterial pressure and heart rate respectively,but the correlation was not significant (r =0.10,0.16,P＜ 0.05).Conclusions FPP can be reduced significantly after splenectomy combined with pericardial devascularization intraoperatively and it rises briefly again after operation.FPP has regularly circadian fluctuations and is significantly increased by Valsalva Manoeuvre.There is a positive correlation of FPP with mean arterial pressure and heart rate respectively,but the correlation is not significant.

Humans ; Models, Molecular ; Repressor Proteins ; chemistry ; metabolism ; Retinoblastoma-Binding Protein 4 ; chemistry ; metabolism

Objective: To investigate the methods for qualitative pathological assessment of dynamic changes in liver fibrosis/cirrhosis after antiviral therapy in patients with chronic hepatitis B (CHB), since antiviral therapy can partially reverse liver fibrosis and cirrhosis caused by hepatitis B and semi-quantitative, rather than qualitative, pathological assessment is often used for the research on liver fibrosis regression. Methods: Previously untreated CHB patients with liver fibrosis and cirrhosis were enrolled, and liver biopsy was performed before treatment and at 78 weeks after the antiviral therapy based on entecavir. The follow-up assessment was performed once every half a year. Based on the proportion of different types of fibrous septum, we put forward the new qualitative criteria called P-I-R classification (predominantly progressive, predominantly regressive, and indeterminate) for evaluating dynamic changes in liver fibrosis. This classification or Ishak fibrosis stage was used to evaluate the change in liver fibrosis after treatment and Ishak liver inflammation score was used to evaluate the change in liver inflammation after treatment. Results: A total of 112 CHB patients who underwent liver biopsy before and after treatment were enrolled, and among these patients, 71 with an Ishak stage of ≥3 and qualified results of live biopsy were included in the final analysis. Based on the P-I-R classification, 58% (41/71) were classified as predominantly progressive, 29% (21/71) were classified as indeterminate, and 13% (9/71) were classified as predominantly regressive; there were no significant differences between the three groups in alanine aminotransferase, aspartate aminotransferase, albumin, HBeAg positive rate, HBV DNA, and liver stiffness (P < 0.05). After treatment, the proportion of predominantly progressive, indeterminate, or predominantly regressive patients changed to 11% (8/71), 11% (8/71), and 78% (55/71), respectively. Among the 35 patients who had no change in Ishak stage after treatment, 72% (25/35) were classified as predominantly regressive and had certain reductions in the Laennec score, percentage of collagen area, and liver stiffness. Conclusion This new P-I-R classification can be used to assess the dynamic changes in liver fibrosis after antiviral therapy in CHB patients.