Objective To explore the effectiveness and precision of 3D printing navigational template in puncturing of foramen rotundum for radiofrequency thermocoagulation to treat primary trigeminal neuralgia (V2).Methods Forty-three patients (27 males,16 females,aged 45-85 years,ASA grade Ⅰ or Ⅱ) with primary trigeminal neuralgia (V2) were included and randomly divided into experimental group (group A,n=21) and control group (group B,n=22).After taking a CT scan and 3D reconstruction of each patient's skull,puncture simulations were carried out,then the final puncture schemes were decided.In group A,puncture was performed under guidance of navigational template but was conducted empirically in group B.In both groups,3D-CT image and electrical stimulation were used in all the procedures to confirm the location of point of needle before radiofrequency thermocoagulation.The cases of successful puncture in one-time,times of CT scanning,radiant quantity,operation time during the operation in both groups were recorded.Furthermore,NRS scores and complications including hypoesthesia,motor function degeneration,hematoma,absence of corneal reflex,cerebrospinal fluid leakage were recorded after procedure.Results The rate of successful puncture in one-time of group A was superior than that of group B (90.4% vs.22.7%).Compared with group B,CT scan times [(1.1±0.3) times vs.(2.8±1.3) times],radiant quantity [(323.1±108.7) mGy*cm vs.(787.8±355.7) mGy*cm],operation time [(15.3±5.5) min vs.(28.5±6.5) min] in group A were significantly reduced (P<0.05).NRS scores of both two groups were obviously reduced after surgery [group A: (3.1±1.7) scores vs.(8.5±0.7) scores;group B: (3.1±1.5)scores vs.(8.5±0.7) scores] (P<0.05),but the effectiveness in group A was not superior than group B.No serious complications occurred in all patients.Conclusion On the basis of sufficient preoperative planning of puncture approach,3D printing template can significantly enhance the effectiveness and precision of puncture of foramen rotundum,improving the efficiency and quality of radiofrequency treatment of primary trigeminal neuralgia (V2).

An untargeted urinary metabonomics method based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry ( UPLC-Q-TOF-MS ) has been established to investigate the mechanism of Schisandra chinensis in treating diabetes and its complications. The urinary biomarkers related to the therapeutic effects of Schisandra chinensis on the diabetes rats were analyzed. In urine, 28 kinds of endogenous metabolites were identified as potential biomarkers, including 13 endogenous metabolites in positive ion mode, 15 endogenous metabolites in negative ion mode, and hippuric acid detected both in positive and negative ion modes. The results revealed that Schisandra chinensis mainly affected the pathways of pentose and glucuronate interconversions, riboflavin metabolism, pantothenate and CoA biosynthesis, arginine and proline metabolism, intestinal bacteria metabolism, ascorbate and aldarate metabolism and tryptophan metabolism in diabetic rats. Combined with biological analysis of these pathways, the therapeutic mechanism of Schisandra chinensis on diabetes and its complications was verified. Based on the biological function of each pathway, the effect of Schisandra chinensis on diabetic nephropathy is stronger. Moreover, it also has the effects of protecting liver, decreasing fat and antioxidant activity.

Objective To study the value of deferred stent implantation in patients with high thrombus burden of acute ST-segment elevation myocardial infarction (STEMI). Methods Select 106 cases with a high thrombus burden within 12 hours of onset in patients with STEMI ,the infarct-related artery thrombus aspiration after antegrade flow of TIMI 2-3 and≤2 points of the thrombus aspiration(TS)patients were randomly divided into immediate stenting group(n = 43)and deferred stenting group(n = 40). Two groups of patients were compared with the myocardial blush grade(MBG),the incidence of slow-/no-reflow ,the incidence of compound endpoints in 6 months and the cardiac function after PCI for 6 months. Results After stenting,the MBG of deferred group was significantly higher than that of immediate group ,the incidence of slow-/no-reflow and the compound endpoints events within 6 months in deferred group was significantly lower than that in the immediate group. After PCI for 6 months,the improvement of LVEF in the deferred group was significantly higher than that in the immediate group, the left ventricular end diastolic dimension(LVEDD)in deferred group was significantly lower than that in immedi-ate group,and the differences were statistically significant(P < 0.05). Conclusions The high thrombus burden in patients with acute STEMI after thrombus aspiration ,deferred stent implantation can significantly reduce the rate of slow-/no-reflow ,improve myocardial perfusion ,reduce the incidence of compound endpoints events ,im-prove cardiac function in patients.

Objective To discover regularities behind critical values in an effort to provide scientific evidences for a better critical value report system.Methods Collection, analysis and statistical assessments for critical value items and ranges appropriate for the hospital Results The occurrence rate of critical values is found to be 0.14%.By means of clinical evaluation, statistic analysis and reference to literature and clinical specialists, the clinical labs revised the ranges of PO2, GLU, PT and APTT, and added ALT, MYO, CTnl and K+ , GLU, BILl for newborns, and canceled AMY.All of these changes were put in practice upon approval of the Medical Department of the hospital Conclusion Regular evaluation and continuous improvement of the critical value report system may help with saving lives, improving quality of care of the labs and doctors" diagnosis as well

Animals ; Entomology ; history ; History, 20th Century ; Insecta

Objective:To explore the effectiveness of deep learning image reconstruction (DLIR) algorithm compared to adaptive statistical iterative reconstruction (ASIR-V) algorithm in improving the quality of low-dose brain CT images.Methods:Retrospective inclusion of patients who underwent brain CT examination in the People's Liberation Army General Hospital from November 2021 to August 2022. Four different algorithms were used to reconstruct low-dose CT scans of all patients to obtain 30% intensity ASIR-V (ASIR-V-30%) images, low intensity DLIR (DLIR-L) images, medium intensity DLIR (DLIR-M) images, and high intensity DLIR (DLIR-H) images. The regions of interest were selected from four sets of images, including superficial white matter, superficial gray matter, deep white matter, and deep gray matter, and their CT values and standard deviations were measured for calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective evaluation of image quality was conducted by three neuroimaging physicians based on the Likert 5-component scale. The objective and subjective scores of the 4 groups of images were analyzed using ANOVA or Kruskal Wallis. If there are overall differences, pairwise comparisons were conducted within the group.Results:A total of 109 patients were enrolled, including 104 males and 5 females, aged 65-110 years (89.16 ± 9.53) years. The radiation exposure of brain CT low-dose scanning was (0.93 ± 0.01)mSv, significantly lower than that of conventional scanning (2.92 ± 0.01) mSv ( t = 56.15, P < 0.05). The differences in objective image quality analysis of ASIR-V-30%, DLIR-L, DLIR-M, and DLIR-H images of low-dose CT in SNR deep gray matter, SNR deep white matter, SNR superficial gray matter, SNR superficial white matter, CNR deep gray white matter, and CNR superficial gray white matter were statistically significant( F =98.23, 72.95, 68.43, 58.24, 241.13, 289.91, P < 0.05). Among them, DLIR-H images had the lowest noise in deep gray matter, deep white matter, superficial gray matter, and superficial white matter, and had statistically significant differences compared to other image groups ( t = 167.43, 275.46, 182.32, 361.54, P < 0.05). The subjective score of DLIR-H image quality was superior to ASIR-V-30%, DLIR-L, and DLIR-M, with the statistically significant difference ( t = 7.25, 8.32, 9.63, P < 0.05). Conclusions:Compared with ASIR-V, DLIR algorithm can effectively reduce image noise and artifacts in low-dose brain CT, and improve SNR and CNR. The subjective and objective image quality evaluation of DLIR-H is the best.

Objective:To explore the influence of pulmonary nodule size, nodule location, fissure, surgical approach, surgical entrance, postoperative pathology, surgical method and other factors on the relevant information of basal segmentectomy under thoracoscopy.Methods:Retrospectively analyze 103 patients who underwent thoracoscopic basal segmentectomy of the lung from January 2023 to February 2024. According to the classification of nodule size, nodule position, development of pulmonary fissure, surgical approach, number of surgical entrance, postoperative pathology, surgical method, tc., the influence of single factor Logistic regression analysis was used to explore the influence of various factors on the relevant information of pulmonary basal segmentectomy under thoracoscopy. Results:When the dependent variable was the surgery duration, single factor analysis showed that CT location( P=0.024), nodule composition( P=0.029), surgical entry( P=0.002), surgical method( P<0.001), and surgical approach( P=0.052) significantly influenced the surgery duration. Variables with P<0.1 in the single factor analysis were included in the multivariate analysis, which showed that surgical entry and surgical method significantly influenced surgery duration( P<0.05). When the dependent variable was the total hospitalization cost, single factor analysis showed that CT location, surgical approach, and surgical method significantly influenced the total hospitalization cost( P<0.1). Multiple factor analysis showed that the surgical method affected the total hospitalization cost, with significantly higher costs when S9 or S10 lung segments were resected( P=0.050). When the dependent variable was postoperative drainage duration, single factor analysis showed that the condition of the lung fissures significantly influenced postoperative drainage duration( P=0.028). Multiple factor regression analysis showed that incomplete lung fissure development significantly increased the possibility of postoperative air leaks( P=0.034). Conclusion:The surgical access may significantly affect the operation time, which is the use of uniport thoracoscopy is shorter than the multi-port operation time, the surgical method does not contain S9/S10 is shorter than that of S9/S10, and the total cost of hospitalization is lower. The completeness of the fissure will significantly decrease the possibility of postoperative pulmonary leakage.

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.
Humans ; White Matter/diagnostic imaging* ; Diffusion Tensor Imaging/methods* ; Alzheimer Disease/complications* ; Reproducibility of Results ; Cognition ; Cognitive Dysfunction/complications* ; Brain/diagnostic imaging*