ObjectiveTo evaluate the clinical efficacy of gelatin sponge particles chemoembolization for liver metastasis of gastric cancer patients. MethodsThe clinical data of 5 cases from December 2009 to July 2010 with gelatin sponge particles chemoembolization for liver metastasis after radical gastrectomy patients was analyzed retrospectively. ResultsVarious degrees of necrotic lesions were observed in all cases, 6 months after operation, 1 case received complete remission (CR),3 cases with partial remission (PR), 1 case with stable condition (SD), the total effective (CR + PR) rate was 80％(4/5). Conclusion Gelatin sponge particles chemoembelization for liver metastasis of gastric cancer has achieved a good shortterm effect,while the long-term efficacy remains to be identified.

Two main impact factors on accuracy of electronic balance are discussed based on its working principle:acceleration of gravity and temperature variation.Through analysis of interacting variables in acceleration of gravity and electronic balance measurement results,the method of builtin standard weight compensation and its shortages are brought forward and attach the compensation method on weight calibration.The impacts on temperature change for the electronic balance measurement are analyzed,which proposes a method to eliminate these factors.

Objective To evaluate the safety and efficacy of combined transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and lobaplatin (GSPs-TACE) and oral Chinese herb medication Huaier granules in patients with hepatocellular carcinoma (HCC).Methods This is a case-control,single-institution clinical trial.31 HCC patients receiving GSPs-TACE (group A) were matched with 31 patients receiving GSPs-TACE and Huaier granules (group B).Tumor response was evaluated by CECT using response evaluation criteria in solid tumors at 1 month after initial GSPs-TACE.The overall survival was calculated from the data of initial GSPs-TACE using the Kaplan-Meier method.Results The overall mean follow-up period was 28.7 (range 12-42) months.The overall 6-and 12-month survival rates in group A and group B were 90.3％ and 80.6％ vs 100％ and 93.5％,respectively.There was statistically significant difference in 12-month survival rates (x2 =5.213,P ＜0.05).Median survival time respectively was 17.1 and 20.6 months(x2 =0.745,P ＞0.05).The average TACE times were (4.1 ±7.3) and (2.9 ±8.7) respectively in group A and group B (P =0.01).Tumor objective response rate was statistically different in 6-and 12-month in two arms(x2 =5.945,6.384,P ＜0.05).There was no statistically significant difference in complications (respectively x2 =0.435,0.485,2.037,0.137,0.325,all P ＞ 0.05).Conclusions Huaier granules combined with transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and carboplatin for HCC is safe and effectively prolongs patients' survival.

Objective To discuss interventional procedures before feeding tube placed in the DSA guidance,influence postoperative enteral nutrition support for the presence of nutritional risk of clinical outcomes in elderly patients with hepatocellular carcinoma. Methods 33 patients acquired with interventional therapy of hepatic carcinoma were selected as the study group.All of patients un-derwent preoperatively the nutritional risk screening and insertion of nasogastric feeding tube under DSA.Enteral nutritional support by the nasogastric feeding tube was used after interventional therapy.33 similar patients underwent parenteral nutritional support af-ter international therapy were selected as the control group.The change of the nutritional indexes,the incidence of the systemic in-flammatory response syndrome,the incidence of infection,and the length of hospital stay after operation were compared between the two groups.Results There were no significant differences in the plasma albumin levels and body weight changes compared between the two groups (P >0.05).However,the incidence of infection and the length of hospital stay were lower significantly in the study group than in the control group (P >0.05).Conclusion The nutritional risk screening before interventional treatment is necessary for the elder patients with hepatic carcinoma.The patients with nutritional risk can be placed the nasogastric feeding tube preopera-tively under DSA,and perform combined nutritional support to promote the recovery of nutritional state after operation.

Objective:To evaluate our novel path based on anatomical division of the anterior lateral wall of calcaneus and the sustentaculum tali for precise sustentacular screw placement in the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ.Methods:The anterior lateral wall of the calcaneus was divided into the anterior-superior zone S 1, the anterior-inferior zone S 2, the posterior-superior zone S 3 and the posterior-inferior zone S 4 for demarcation of the screw insertion points by our method of Four Zones, and into the front, middle and rear sections by our method of Three Sections for demarcation of the screw target points. The specimens were scanned by CT and modeled by Mimics. On the 3D virtual model of the calcaneus, one screw was placed from each zone of the anterior lateral wall of the calcaneus to the sustentaculum tali body. The screw placement target for S 1 and S 2 was the medial intersection point P 1 of the front and middle sections of the sustentaculum tali, and that for S 3 and S 4 was the medial intersection point P 2 of the middle and rear sections of the sustentaculum tali. It was observed whether the screws were placed in the bone channel. A total of 72 patients were included who had been admitted to Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for calcaneal fractures of Sanders types Ⅱ and Ⅲ from January 2017 to January 2021. They were divided into an anatomical division group and a 3D printing group according to their screw placement method for the sustentaculum tali. In the anatomical division group of 32 patients subjected to screw placement based on our anatomical division, there were 25 males and 7 females, aged from 24 to 60 years; in the 3D printing group of 40 patients subjected to screw placement assisted by 3D printing, there were 31 males and 9 females, aged from 25 to 58 years. The disparities between the parameters of sustentacular screw placement and the actual values were compared in the anatomical division group, and the total number of screws, screws on average, distribution of screws, and accuracy of screw placement were compared between the 2 groups. Results:All the screws which were virtually placed in the specimens of the calcaneus from S 1 and S 2 to P 1 and from S 3 and S 4 to P 2 passed through the bony channel, with no perforation into the tarsal sinus. There was no significant difference in the general date between the anatomical division group and the 3D printing group, showing they were comparable ( P > 0.05). In the anatomical division group, a total of 52 screws were placed to the sustentaculum tali with an average of (1.63 ± 0.48) screws per patient, and 2 screws were placed in 20 patients, yielding an accuracy rate of screw placement of 92.3% (48/52). There were no statistically significant differences between the parameters and the actual values of screw placement in the anatomical division group ( P > 0.05). In the 3D printing group, a total of 63 screws were placed to the sustentaculum tali with an average of (1.58 ± 0.49) screws per patient, and 2 screws were placed in 23 patients, yielding an accuracy rate of screw placement of 93.7% (59/63). There were no significant differences in the above comparisons between the anatomical division group and the 3D printing group ( P > 0.05). Conclusion:In the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ, the sustentacular screw placement based on our anatomical division of the anterior lateral wall of the calcaneus and the sustentaculum tali can lead to similar clinical accuracy as 3D printing-assisted screw placement does.

Objective:To construct a three-dimensional calcaneal finite element model and study its biomechanical distribution by finite element analysis.Methods:Four large calcaneal specimens were taken from the Department of Human Anatomy of Kangda College of Nanjing Medical University in the second semester of 2021—2022. Micro CT scans were performed to obtain the image data of these specimens, and then the three-dimensional calcaneal model was reconstructed using the Mimics and Geomagic Wrap software. The obtained data were imported into the finite element analysis software to perform the material assignments and mesh delineation to obtain the three-dimensional finite element model. The boundary constraints were set, and loads were applied to the calcaneal model to perform finite element analysis calculations, and the stresses and displacements of the finite element model were extracted.Results:The three-dimensional calcaneal model had a high simulation quality. The morphology and structure were complete and without defects, and the size was consistent with that of the real calcaneus, which restores the original bony morphology and structure. The geometric appearance of the three-dimensional calcaneal model after meshing was vivid and lifelike, and without defect. The reconstructed morphology and structure of the three-dimensional model were the same as those of the three-dimensional reconstruction, the size was the same, and the main structure was clearly visible. The meshes and nodes of each component of the three-dimensional calcaneal model were uniformly distributed, and their numbers were comparable to those of the real heel bone. The maximum stresses of the three-dimensional calcaneal model were in the cortical bone, and the maximum stresses were in the same position. These two positions were the lowest part of the anterior part of heel bones. The maximum displacements in the three-dimensional calcaneal model were all less than 0.10 mm.Conclusions:A high-precision three-dimensional finite element calcaneal model has been constructed, which is of good mechanical validity.

Objective:To construct a finite element analysis model for the application of sustentaculum tail sustentacular screw in the treatment of calcaneal fracture of Sanders type Ⅱ. The finite element analysis method was used to study the effectiveness of the simulation treatment of Sanders type Ⅱ calcaneal fracture.Methods:A complete adult calcaneal specimen that was not affecting the normal quality of bone after teaching in the Department of Human Anatomy, Kangda College of Nanjing Medical University from 2021 to 2022 second semester was selected. A micro CT scan was performed to obtain data. The three-dimensional model of the calcaneus was reconstructed by the software of Mimics and Geomagic Wrap. The internal fixation and fracutre model were drawn using SolidWorks software. The obtained data were imported into the finite element analysis software for material assignment and meshing to obtain a three-dimensional finite element model. The load and boundary constraints were applied to each model to perform finite element analysis and calculation, and the stress and displacement of the model were extracted. Finally, the experimental screw placement of the calcaneus loading process was verified.Results:The three-dimensional model of calcaneal fracture had a high degree of appearance simulation, complete morphological structure, no defect, and was consistent with the size of the solid calcaneus. After surgical treatment, the anatomical reduction of each fracture model was good, the steel plate fit to the bone surface, and the screw did not protrude outside the model. There was no deformation or damage to the whole internal fixation, the grid division was clear, and the number was relatively uniform and consistent. The maximum stress in each type of calcaneal fracture model was in the internal fixation, and the overall stress was uniformly distributed in each component. The maximum displacement distance of each type of calcaneal fracture was less than 0.13 mm, and the angles and lengths of nails were accurate. The tip of the Kirschner wires was located in the sustentaculum tail. There was no rupture of the sustentaculum tali and no protrusion of the Kirschner wires.Conclusions:The internal fixation is an effective method to treat the Sanders type Ⅱ calcaneal fractures by using sustentaculum tail sustentacular screws.

Objective To evaluate the efficacy,bleeding profile and safety of low-dose levonorgestrel-releasing intrauterine system (LNG-IUS 8) in Chinese healthy women of childbearing age.Methods A multi-center,open-label,single-arm clinical trial conducted at 16 centres in China enrolled 773 healthy women of childbearing age (mean age 31.6 years old,range 18 to 40 years old),who demanded contraception,from April 2006 to June 2013.All women placed LNG-IUS 8 for 3 years and then been followed up at 3,6,9,12,18,24,30,36 months.The efficacy variables including pregnancy rate and expulsion rate were analyzed using life table,while observing adverse events (AE) to evaluate the safety.The bleeding profile happened during the study was assessed using 90-day reference intervals (World Health Organization criteria).Results Eight pregnancies occurred among 773 women,resulting in a overall Pearl index of 0.42 per 100 women years.The 3-year cumulative pregnancy rate was 0.37 per 100 women years and the 3-year cumulative expulsion rate was 1.99 per 100 women years.The number of women with bleeding/spotting reduced and the bleeding/spotting days declined over time.Totally 219 AE were reported related to LNG-IUS 8 placements.The most common AE were vaginal bleeding (8.2％,63/773)and the ovarian cyst (6.2％,52/773).LNG-IUS 8 had an improving effect on dysmenorrhea that the percentage of women with dysmenorrhea as well as the days of dysmenorrhea decreased over time.The percentage of women satisfied or very satisfied with LNG-IUS 8 was 87.2％ (622/713).Conclusion LNG-IUS 8 is highly effective and safe for Chinese healthy women of childbearing age.