Objective To assess whether the Couinaud's segmengtation of the liver in transaxial imaging is an accurate indicator of hepatic segment with 16-slice spiral CT hepatic portography and venography.Methods One hundred healthy subjects underwent 16-slice spiral CT hepatic portography and venography.Three-dimensional maximum intensity projection(MIP) and volume rendering(VR) of the portal and hepatic venous structures were created.The portal and hepatic vein branches were observed and the relationship between portal and hepatic veins was evaluated with tracking the branches of portal vein.Results Segmental branches of portal vein supplied correspondingly hepatic segment,and hepatic vein and its branches located between adjacent hepatic segments.Branches of portal vein could cross the adjacent hepatic vein.The boundaries of hepatic segments were not simple straight lines or flat planes.Conclusion Couinaud's segmengtation of the liver in transaxial imaging has limitations.Three-dimension(3D) angiography of portal and hepatic venous systems can be applied to divide hepatic segment accurately.Hepatic segment analyzed by tracking the branches of portal vein is of more clinical value.

Objective To evaluate the value of contrast enhanced MR imaging (CEMRI)for the diagnosis of focal liver lesions with Meta analysis.Methods Relevant English and Chinese language studies were searched on the Pubmed,EMBASE,EBSCO,OV-ID,CNKI,CBM,VIP,WANFANG databases,respectively.Data were calculated with software of STATA 1 1.0 and Meta Disc 1.4. Results 1 7 of 2836 retrieved studies were included,the pooled sensitivity and specificity for CEMRI with 95% confidence interval (95%CI)were 0.85(0.84-0.87)and 0.86(0.84-0.88),respectively,the AUC of SROC was 0.91 6 8.Conclusion CEMRI can be used as one of the primary examination modalities for focal liver lesions with moderate sensitivity and specificity.

A novel unsaturated polyphosphoester (UPPE) was devised in our previous research, which is a kind of promising scaffold for improving bone regeneration. However, the polymerization process of UPPE scaffolds was unfavorable, which may adversely affect the bioactivity of osteoinductive molecules added if necessary, such as recombinant human bone morphogenetic protein-2 (rhBMP2). The purpose of this study was to build a kind of optimal scaffold named UPPE-PLGA-rhBMP2 (UPB) and to investigate the bioactivity of rhBMP2 in this scaffold. Furthermore, the cytotoxicity and biocompatibility of UPB scaffold was assessed in vitro. A W1/O/W2 method was used to fabricate PLGA-rhBMP2 microspheres, and then the microspheres were added to UPPE for synthesizing UPB scaffold. The morphological characters of PLGA-rhBMP2 microspheres and UPB scaffolds were observed under the scanning electron microscopy and laser scanning confocal microscopy. The cumulative release of UPB scaffolds was detected by using ELISA. The cytotoxicity and biocompatibility of UPB scaffolds were evaluated through examining the adsorption and apoptosis of bone marrow stromal cells (bMSCs) seeded on the surface of UPB scaffolds. The bioactivity of rhBMP2 in UPB scaffolds was assessed through measuring the alkaline phosphates (ALP) activity in bMSCs seeded. The results showed that UPB scaffolds sequentially exhibited burst and sustained release of rhBMP2. The cytotoxicity was greatly reduced when the scaffolds were immersed in buffer solution for 2 h. bMSCs attached and grew on the surface of soaked UPB scaffolds, exerting well biocompatibility. The ALP activity of bMSCs seeded was significantly enhanced, indicating that the bioactivity of rhBMP2 remained and still took effect after the unfavorable polymerization process of scaffolds. It was concluded that UPB scaffolds have low cytotoxicity, good biocompatibility and preserve bioactivity of rhBMP2. UPB scaffolds are promising in improving bone regeneration.

Objective To evaluate the value of CT guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of lung ground‐glass opacity (GGO) with a Meta‐analysis .Methods Relevant English and Chinese language studies were searched on the PubMed ,EMBASE ,EBSCO ,OVID ,CNKI ,CBM ,VIP and WANFANG databases ,respectively .Data were calculated with software of Stata 12 .0 and Meta‐Disc 1 .4 .Results 6 of 82 retrieved studies were included (n=341) .The pooled sensitivity ,specifici‐ty ,LR+ ,LR- ,DOR ,AUC and 95% CI were 0 .92(0 .86-0 .95) ,0 .98(0 .85-1 .00) ,49 .03(5 .72-420 .18) ,0 .08(0 .05-0 .15) , 586 .24(65 .18-5 272 .83) and 0 .99(0 .98-1 .00) ,respectively .Conclusion CT guided PTNB can be used as one of the primary examination modalities for lung GGO with moderate sensitivity and specificity .

Objective To assess the clinical effect of oblique lumbar interbody fusion (OLIF) combined with percutaneous pedicle screw fixation on computer navigation for lumbar spondylolisthesis.Methods Total 20 patients (8 males and 12 females with average age of 54.1± 12.3 years) with lumbar spondylolisthesis were enrolled in our study during Oct.2014 and May.2016.All patients were treated with OLIF combined with percutaneous pedicle screw fixation on computer navigation.Operation time,blood loss and complications were all recorded.Clinical and Radiographic evaluation were investigated on 1 week,3 months,6 months,12 months postoperatively and final follow-up.Visual analogue scale (VAS) for low back pain and leg pain,Oswestry disability index (ODI) for low back pain and the MOS item short form health survey (SF-36) were used to evaluate the clinical efficacy of surgery.Disc height,disc angle,lumbar lordosis and degree of upper vertebral slip of patients were investigated with X-ray.Cross-sectional area of intervertebral foramina was measured with three-dimensional CT and MRI.The cross-sectional area and sagittal diameter of the thecal sac were measured on T2-weighted axial and sagittal magnetic resonance images.Accuracy of pedicle screw placement was investigated with three-dimensional CT.Fusion rate was investigated with three-dimensional CT and Xray.Results All patients were followed for 12-30 months (22.9±4.8 months).The mean operation time was (119.0±23.8) min,the mean blood loss was (57.8±20.6) ml.VAS for low back pain,VAS for leg pain,and ODI were significantly improved from (6.7± 2.6),(6.3±2.7) and 50.5％±18.2％ preoperatively to (1.3±1.0),(0.8±1.0) and 14.0％±9.6％ at the latest follow-up.The SF-36 PCS and MCS scores were improved from (27.1 ± 13.9) and (51.0±22.7) preoperatively to (67.3± 18.9) and (81.2±14.1) at the latest follow-up.Disc height,disc angle,lumbar lordosis were significantly increased from (6.0±3.6) mm,1.8°±6.2° and 39.2°±8.4° preoperatively to (10.8± 1.7) mm,6.2°±3.5° and 45.0°±7.8° at the latest follow-up.Degree of upper vertebral slip of patients was reduced from 23.5％±7.4％ preoperatively to 4.2％±3.1％ at the latest follow-up.Cross-sectional area of intervertebral foramina in CT and MRI were significantly increased from (140.6±36.0) mm2 and (78.1±31.2) mm2 before surgery to (179.8±35.6) mm2 and (141.7±29.5) mm2 at 6 months after surgery.Cross-sectional area and sagittal diameter of thecal sac were significantly increased from (73.4±29.3) mm2 and (5.2±3.2) mm before surgery to (124.5±26.6) mm2 and (9.5±2.0) mm at 6 months after surgery.Accuracy of pedicle screw placement was 95％,and fusion rate was 100％ at 6 months after surgery.There were no severe vascular and nerve injuries.Conclusion OLIF combined with percutaneous pedicle screw fixation on computer navigation has good indirect decompression effect on lumbar spondylolisthesis,and was associated with high fusion rate.It can also effectively decrease the surgical trauma,improve the accuracy of pedicle screw placement,and increase disc height,disc angle and lumbar lordosis.

Percutaneous imaging-guided cryoablation (PICA) is a recently developed technique,which applies extreme hypothermia to destroy tumors guided with CT,MRI or ultrasound images.Compared with other oncologic cryoablation therapies,PICA has some advantages,such as treating under local anesthesia,superior monitoring capability on multimodal imaging,less intraoperative and postoperative pain and preservation of tissue collagenous architecture.In recent years,PICA has been used in treatment of tumors in lung,liver,kidney,breast,prostate and so on.In this article,the principle of cryoablation and the application progresses of PICA in oncotherapy were reviewed.

ObjectiveTo analyze the causes of occupational acute 1,2-dichloroethane (1,2-DCE) poisoning accident during the use of polyurethane grouting materials for waterproof plugging operation in the construction industry. Methods By combining the clinical symptoms of the patient, worksite survey of occupational health and workplace occupational hazards monitoring method, the cause of an occupational acute 1,2-DCE poisoning accident was investigated at a construction site during the use of polyurethane grouting material for waterproofing and plugging operations. Results The patient was engaged in waterproof grouting work using polyurethane grouting material. The main volatile organic components in the raw materials were 1,2-DCE, with traces of dichloromethane, methyl acetate and others. The result of post-incident on-site investigation showed that the short-term exposure concentration of 1,2-DCE in the workplace air was 578.70 mg/m³, which was more than 30 times higher than the national occupational health standard limit. The mass concentration of 1,2-DCE in the patient's blood was 230 μg/L. Combined with the patient's occupational hazard exposure history, clinical manifestations, worksite survey of occupational health, and laboratory test results, according to GBZ 39-2016 Diagnosis of Occupational Acute 1,2-Dichloroethane Poisoning, this incident was diagnosed as a severe occupational acute 1,2-DCE poisoning event caused by the use of inferior polyurethane grouting material. Conclusion The excessive concentration of 1,2-DCE in the workplace air is the main cause of this poisoning accident. Construction sites with confined space operations should improve various occupational health management systems, occupational health engineering protective facilities, and personal protective equipment must be provided for workers.

OBJECTIVETo investigate the curative effect of penile elongation with four differentoperative approaches.

METHODSThrough four different operative approaches (the coronary sulcus ringincision, Y or Z shaped incision or Z shaped incision combined with coronary sulcus ring incision), thepenile skin and fascia were degloved until the penile root. Then the superficial and deep dorsal penilesuspensory ligament were cut off. After electric coagulation of the residue ends, the two-side tissue at thefront of the pubic symphysis was sutured. Then the penile skin and fascia were repositioned and the incisionat the inner and outer plate was closed.

RESULTSThe increased penile static length was (2.9 ± 0.2) cmwith abdominal wall Y incision (12 cases); (3.1 ± 0.3) cm with transabdominal modified Z incision (260 cases); (3.9 ± 0.7) cm with coronary sulcus ring incision (363 cases); (3.4 ± 0.8) cm with combined incision (39 cases). The lengthening effect was significantly different between the coronary ring incision and abdominal wall Y/Z incision (P < 0.05). The postoperative follow-up period was 6 months to 5.5 years without serious complications. Only 3 cases of subcutaneous hematoma occurred with treatment of debridement and drainage. 4 cases with ischemic necrosis at distal penile skin, were treated with debridement, dressing and physiotherapy, leaving no scar.

CONCLUSIONSPenile lengthening surgery are safe and effective through different approaches. The coronal ring incision has the best therapeutic effect.

Bandages ; Debridement ; Drainage ; Electrocoagulation ; Fasciotomy ; Follow-Up Studies ; Humans ; Ligaments ; surgery ; Male ; Necrosis ; surgery ; Organ Size ; Penis ; anatomy & histology ; pathology ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Skin ; Time Factors

A novel unsaturated polyphosphoester (UPPE) was devised in our previous research, which is a kind of promising scaffold for improving bone regeneration. However, the polymerization process of UPPE scaffolds was unfavorable, which may adversely affect the bioactivity of osteoinductive molecules added if necessary, such as recombinant human bone morphogenetic protein-2 (rhBMP2). The purpose of this study was to build a kind of optimal scaffold named UPPE-PLGA-rhBMP2 (UPB) and to investigate the bioactivity of rhBMP2 in this scaffold. Furthermore, the cytotoxicity and biocompatibility of UPB scaffold was assessed in vitro. A W1/O/W2 method was used to fabricate PLGA-rhBMP2 microspheres, and then the microspheres were added to UPPE for synthesizing UPB scaffold. The morphological characters of PLGA-rhBMP2 microspheres and UPB scaffolds were observed under the scanning electron microscopy and laser scanning confocal microscopy. The cumulative release of UPB scaffolds was detected by using ELISA. The cytotoxicity and biocompatibility of UPB scaffolds were evaluated through examining the adsorption and apoptosis of bone marrow stromal cells (bMSCs) seeded on the surface of UPB scaffolds. The bioactivity of rhBMP2 in UPB scaffolds was assessed through measuring the alkaline phosphates (ALP) activity in bMSCs seeded. The results showed that UPB scaffolds sequentially exhibited burst and sustained release of rhBMP2. The cytotoxicity was greatly reduced when the scaffolds were immersed in buffer solution for 2 h. bMSCs attached and grew on the surface of soaked UPB scaffolds, exerting well biocompatibility. The ALP activity of bMSCs seeded was significantly enhanced, indicating that the bioactivity of rhBMP2 remained and still took effect after the unfavorable polymerization process of scaffolds. It was concluded that UPB scaffolds have low cytotoxicity, good biocompatibility and preserve bioactivity of rhBMP2. UPB scaffolds are promising in improving bone regeneration.
Bone Morphogenetic Protein 2 ; chemistry ; pharmacology ; Bone Regeneration ; drug effects ; Humans ; Lactic Acid ; chemistry ; pharmacology ; Phosphatidylinositol Phosphates ; chemistry ; pharmacology ; Polyglycolic Acid ; chemistry ; pharmacology ; Tissue Scaffolds

Purpose To synthetically evaluate MR diffusion kurtosis imaging (DKI) using Meta-analysis to differentiate diagnostic value of benign and malignant breast lesions and quantitatively analyze mean kurtosis (MK) values of benign and malignant breast lesions in an attempt to provide evidence-based facts for clinical decision making. Materials and Methods Computer-based retrieval of Chinese and English literatures concerning differential diagnosis of benign and malignant breast lesions with application of DKI publicly published at home and abroad in PubMed, Ebsco, Embase, CNKI, Cochrane Library, CBM, VIP Data database from January. 1, 2006 to September. 30, 2017. Two valuators independently screened and extracted data according to inclusion and exclusion criteria, and drew on QUADAS for quality assessment, Stata 12.0 and Meta-Disc 1.4 software for Meta analysis and extraction of relevant parameters. Results Totally 8 up-to-standard literatures were included, including 3 in English and 5 in Chinese. The total number of focus was 689. Corresponding effect model analysis revealed that MK value in malignant breast lesion group was higher than that in benign lesion group, the difference of which was statistically significant. The optimal diagnostic threshold was determined by the maximum Youden index, which was approximately 0.71 in size,with combined sensitivity of 0.907(95% CI 0.860-0.939),specificity of 0.910(95% CI 0.856-0.945),positive likelihood ratio of 10.053(95% CI 6.293-16.059),negative likelihood ratio of 0.102(95% CI 0.068-0.154),and diagnostic test odds ratio of 98.203(95% CI 55.014-175.296).The area under receiver operating characteristic curve was 0.96.MK value suggested 94% posterior malignant rate of malignant breast lesions, and 13% malignant rate of benign breast lesions. Conclusion MK value has high diagnostic value for benign and malignant breast lesions with good sensitivity and specificity.