Objective To evaluate the clinical indication,research value and surgical techniques of retroperitoneal laparoscopic ureter lithotomy for ureteral calculi.Methods Clinical data of 98 cases were retrospectively analyzed.All the patients underwent RLU,KWB,IVP,CTU or MRU examination and diagnosed with ureteral calculi,with 42 cases of upper ureteral calculi,35 cases of middle ureteral calculi,and 21 cases of low ureteral calculi.Laparoscopic ureter lithotomy was performed on all the patients.Results All the 98 cases underwent laparoscopic ureter lithotomy (RLU) successfully,with the sizes of stones ranging from 1.5 to 3.0cm,the mean operative time 60 minutes (from 45 to 100 minutes),and mean blood loss 30 mL (from 20 to 60ml).Complication had not been observed in 85 cases for 3-38 months follow-up.Conclusions The treatment of ureteral calculi with lapa-endo-scopic ureter lithotomy shows its unique superiority on the basis of skilled operative technology.Lapa-endo-scopic ureter lithotomy can be a preferred method to be performed or be a compensation method in some cases.

Objective Cataract surgery is also considered as a type of refractive surgery , but there is few research on the change of preoperative and postoperative ocular biometry measurements .The aim of the study was to compare the A-scan ultrasound biom-etry measurements before and after phacoemulsification with intraocular lens implantation , followed by the analysis on its clinical signifi-cance . Methods Dynamic observation was conducted in 188 eyes of 155 cataract patients who received cataract operation from January 2011 to January 2013 in the department of ophthalmology in Nanjing Gernal Hospital .Measurements were made before surgery and 14 days after surgery by Ultrascan Digital 2000 contact ultraound A-scan (Alcon), including anterior chamber depth (ACD), vitreous cham-ber depth ( V) and axial length ( AL) .Simultaneously , a prospective comparison of measurements was made by A-scan ultrasound in sit-ting and decubitus position .Measurements were also conducted in preoperative and postoperative visual acuity and intraocular pressure of the patients. Results visual acuity and intraocular pressure: The difference between preoperative and postoperative visual acuity [(0.17 ±0.19) vs (0.61 ±0.27)] and intraocular pressure [(15.09 ±8.50) mmHg vs (12.99 ±4.44) mmHg] was of statistical sig-nificance ( P<0.05) .ACD:The difference between peroperative and postoperative ACDs measured by A-scan ultrasound was of statisti-cal significance (P<0.05).No significant difference existed between ACDs in sitting and decubitus positions before and after the opera -tion (P>0.05).V:The difference between peroperative and postoperative Vs was of significant difference (P<0.05).No significant difference existed between Vs in sitting and decubitus position before the operation [(16.568 ±2.406) mm vs (16.524 ±5.544) mm,with intraocular lens implantation can get better operation result. In addition, different measuring positions have no influence on A-scan ultrasound measurements except the postoperative vitreous cavity depth .

Objective To study the characteristics of craniocerebral injury caused by the handgun bullet impacting on the bulletproof helmet.Methods Fourteen healthy landrace pigs were involved and randomly divided into injury group(n =9)and control group(n =5).The landrace pigs of the injury group were shot vertically on the head under the protection of helmet plate with 9 mm handgun bullet at velocity of 360 m/s.While the landrace pigs of the control group were dealt with the same process as the injury group except for use of unarmed handgun bullet of the same ammunition dose.The changes of vital sign in the early period and the retina injury at two hours after injury were observed.Porcine cerebrospinal fluid (CSF)at pre-injury and at three hours post-injury were obtained for investigating the levels of neuron specific enolase(NSE)andαⅡ-spectrin protein.Then,the landrace pigs were sacrificed and dissected to examine the general morphological changes of the brain.The brain cortex was taken,fixed and stained with hematoxylin-eosin for microscopic observation.Results The landrace pigs in the injury group manifested decrease of the blood pressure and increase of the heart rate and respiratory rate in the early stage after injury.General morphological observation found retinal hemorrhage(3/9),skull fracture(3/9)and brain surface damage including local impact lesion(9/9)and contrecoup lesion(9/9),with severe impact lesion than contrecoup lesion.Optical microscopic observation revealed acute injury of the cerebral cortex neuron both on the impact and contrecoup locations.The concentrations of NSE and αⅡ-spectrinwere significantly increased in CSF three hours after injury(P ＜ 0.05).Conclusions The handgun bullet impacts on the pig head protected by the bulletproof helmet may induce blunt craniocerebral injury in the early period,with severe impact lesion than contrecoup lesion.Therefore,traumatic brain injury of the soldiers armed with the helmets should be stressed and managed early.

Objective To investigate the accuracy of predicting acute postoperative pain by assessment of intravenous propofol injection-induced pain.Methods Seventy-one ASA I or Ⅱ patients aged 20-40 yr scheduled for induced abortion operation were enrolled in this study. The patients were unpremedicated. ECG, HR, BP and SpO_2 were continuously monitored before and during anesthesia. Anesthesia was induced with 2 mg/kg propofol. A third of the induction dose was injected via a dorsal hand vein. Pain induced by iv propofol injection was assessed with verbal rating scale (VRS) (0 = no pain, 3 = severe pain) . Postoperative abdominal pain was assessed with visual analog scale (VAS) (0 = no pain, 100 = most severe pain) at 20 min after operation. Results The propofol injection pain occurred in 66% of patients. Postoperative VAS scores at rest and during activity and intravenous propofol injection-induced pain were significantly correlated (r = 0.561, P<0.01; r = 0.608, P<0.01). The sensitivity and specificity of iv propofol injection-induced pain (VRS > 1) in predicting clinically significant acute postoperative pain (VAS > 30) were 96% and 52% respectively. Conclusion Preoperative iv propofol injection induced pain is a reliable factor in predicting acute postoperative pain and is useful in identifying those women who will experience greater pain after operation.

Objective To better understand the clinical characteristics of Familial Idiopathic Basal Ganglia Calcifi?cation (FIBGC), including at the perspective of hereditary pattern, clinical test results, onset age, clinical heterogeneity and the volume of basal ganglia calcification (VBGC). Method 8 Eight FIBGC families were collected and draw family pedigrees were draw. Analysis of was conducted on the patient's clinical test results, head CT and MRI changes, onset ag?es, relationship of clinical manifestations with VBGC. Results No significant difference was found in serum calcium, alu?minum, arsenic, cobalt, magnesium, phosphorus, iron, parathyroid hormone and calcitonin concentration between the fam?ily members of patients and healthy controls (P>0.05). Family members from 8 FIBGC families including the two with consanguineous marriage manifested autosomal dominant heredity. The severity of , symptomatic s was correlated with VBGCpatients showed the same clinical manifestations in the dyskinesia family. The psychiatric symptoms was not asso? ciated with VBGC whereas patients with dyskinesia had a large VBGC. There was a significant difference in onset age be?tween patients with psychiatric symptoms and those with dyskinesia. P.atients with dyskinesia suffer larger VBGC, and is characterized by Patients with dyskinesia had relatively later onset age (43.95 ± 2.47 y) whereas those with. psychiatric symptoms hadsymptomatic patients with early onset age (31.32±10.16y). The comparison of the onset age (43.954±2.473 vs. 31.319±10.156 y, t=4.438, P=0.001) and VBGC (1.748±0.622 vs. 0.392±0.276 cm3, t=2.518, P=0.028) with symptom?atic patients between dyskinesia and psychogenic families was significant. Conclusions Eight FIBGC families manifested autosomal dominant heredity. Patients with dyskinesia suffer have a larger VBGC and are associated with a, and is char?acterized by relatively later onset age. In contrast, patients with psychiatric symptomspsychogeny is not related withhave a the small VBGC and showedand their age of onset is young. earlier onset age.

Objective To calculate the residoal liver volume using a virtaal liver surgery planning system,and to investigate the value of standardized estimated liver remnant volume ratio (STELR) in prcdicting hepatic dysfunction after hepatectomy.MethodsThe clinical data of 76 patients with primary liver cancer who were admitted to the First Affiliated Hospital of Fujian Medical University from April 2007 to October 2011 were retrospectivcly analyzed.The virtual resection and residual liver volume measurements were carried out using Liv 1.0 software.The value of STELR in predicting hepatic dysfunction was assessed using receiver operator characteristic (ROC) curves.Effects of different risk factors on postoperative hepatic dysfunction were analyzed using univariate analysis of variance and multivariate Logistic regression models. Results The mean residual liver volumes predicted by the software and resected during operation were (489 ± 206)ml and (459 ± 199 )ml,respectively,with a positive correlation between predicted and actual resection volumes (r =0.916,P ＜ 0.05).Of the 76 patients,48 had mild hepatic dysfunction,19 had moderate hepatic dysfunction and 9 had severe hepatic dysfunction.A critical STELR of 53％ was associated with severe hepatic dysfunction.Severe hepatic dysfunction was detected in 2 out of 59 (3％) patients with STELR ≥ 53％ and 7 out of 17 (41％) patients with STELR ＜ 53％,which represented a significant difference ( x2 =5.085,P ＜ 0.05 ).The result of univariate analysis revealed that STEL,R,operating time,intraoperative blood loss were significant prognostic indicators for severe hepatic dysfunction ( F =7.227,8.630,13.809,P ＜0.05).Multivariate Logistic regession revealed that STELR was a significant independent predictor of severe hepatic dysfunction ( Wald =6.675,P ＜ 0.05 ).Conclusion The likelihood of severe hepatic dysfunction after hepatectomy can be predicted by STELR.

BACKGROUND:Traditional 3D dental segmentation methods usually utilize predefined spatial geometric features,such as curvature and normal vectors,as the reference information for tooth segmentation. OBJECTIVE:To propose an algorithm for complex 3D dental segmentation and deeply explore the correlation between segmentation results and application scenarios. METHODS:A 3D dental segmentation algorithm based on dual stream extraction of structural features and spatial features was established,and the modular design of split flow was used to avoid feature confusion.Among them,the attention mechanism on the structural feature flow was used to capture the fine-grained semantic information required for tooth segmentation,and the Tran Net based on the spatial feature flow was used to ensure the robustness of the model to complex tooth and jaw segmentation.This algorithm verified its effectiveness and reliability based on clinical datasets including healthy dental jaws and complex dental jaws such as missing teeth,malocclusion and dentition crowding.The segmentation performance of the model was measured in terms of overall accuracy,mean intersection over union,and directional cut discrepancy. RESULTS AND CONCLUSION:The overall segmentation accuracy of this algorithm in the clinical data set is 97.08%,and the segmentation effect is superior to that of other competitive methods from the qualitative and quantitative perspectives.It is verified that the structural feature flow designed in this paper can extract more precise local details of tooth shape from coordinate and normal information by constructing an attention aggregation mechanism,and the spatial feature flow designed in this paper can ensure the robustness of the model to complex teeth such as missing teeth,dislocated teeth,and crowded dentition by constructing a transformation network(Tran Net).Therefore,this tooth segmentation algorithm is highly reliable for clinicians'practical reference.

Objective To investigate the awareness rate of colorectal cancer(CRC)prevention and control among residents in Fuzhou City.Methods Random sampling method was used to conduct a questionnaire survey among adults aged 18 to 70 years who came to the Health Management Center of Fujian Provincial Hospital Affiliated to Fuzhou University from June 2022 to December 2023.The questionnaire contained 15 questions on CRC incidence trends,CRC risk factors,CRC screening population,CRC screening methods and screening cycles.Results A total of 2256 people were surveyed,and 2233 valid questionnaires were returned,with an effective rate of 98.9％ .The results showed that the awareness rate was 40.3％ .The correct rate of each question in the core knowledge questionnaire of CRC screening was between 11.33％ to 77.34％ .The rate of fecal occult blood test was 20.7％ ,and the rate of colonoscopy was 23.2％ .There were significant differences in awareness rate and screening rate among different age groups,occupations and income levels(P＜0.05).Conclusion There is still room for improvement in the awareness and participation of CRC screening among residents in Fuzhou.It is necessary to carry out health education on CRC prevention and control knowledge to improve CRC screening rate.

Objective: To explore the impact of sleep quality, experience of childhood maltreatment, and their interaction on depressive symptoms among middle school students, so as to provide the reference for early intervention of depressive symptoms among middle school students. Methods: From September to December 2023, a questionnaire survey was conducted among 1 231 students from two secondary schools in Harbin, Heilongjiang Province by a convenient sampling method. The survey included general demographic information, Childhood Trauma Questionnaire Short Form, Pittsburgh Sleep Quality Index and Short Version of Center for Epidemiological Studies Depression Scale. The Chi square test was used to analyze the differences in depressive symptom, sleep quality and childhood maltreatment among students with different demographic characteristics. Correlation analysis was conducted using Logistic regression, and interaction analysis was performed by both additive and multiplicative interaction models. Results: The detection rate of depressive symptoms among middle school students was 22.7%, and the rate for high school students (35.2%) was significantly higher than that for middle school students (17.0%) ( χ 2=50.35, P <0.01). The detection rates of depressive symptoms among middle school students with a history of childhood maltreatment and poor sleep quality were 45.8% and 44.0%, respectively. Multivariate Logistic regression analysis showed that compared to students without a history of childhood maltreatment, students with a history of childhood maltreatment had a higher risk of depressive symptoms ( OR =4.49，95% CI =3.31~ 6.09 , P <0.01);students with poor sleep quality had a higher risk of depressive symptoms than students with good sleep quality ( OR = 5.99，95% CI =4.37~8.22, P <0.01).The interaction results showed that the presence of childhood maltreatment and poor sleep quality had an additive interaction on the occurrence of depression in middle school students. Compared with students without childhood maltreatment and having good sleep quality, students with childhood maltreatment and poor sleep quality had a 22.49 times higher risk of developing depression ( OR =22.49，95% CI =14.22~35.59, P <0.01). Conclusion Depressive symptoms among middle school students are associated with childhood maltreatment and poor sleep quality, and there is an additive interaction between childhood maltreatment and poor sleep quality on the impact of depressive symptoms.

Inguinal hernia is a defect disease in the abdominal wall. Surgeons have tried various ways to repair the defect for more than 100 years. The traditional herniorrhaphy destroys the normal anatomical structure, and the recurrence rate is quite high. After that, surgeons began to repair the defects with prostheses, from the initial use of rough metal materials such as silver, tantalum, stainless steel, to nylon, fiberglass, silicone rubber and other non-metallic materials, and also from artificial synthetic polymer non-absorbable materials such as polypropylene, polyester, ePTFE, to synthetic absorbable materials such as polyglycolic acid and the acellular extracellular matrix derived from biological meshes. However, these prostheses still can not meet the diverse needs of patients. Thus, multifunctional composite prostheses consisting of two or more materials were born, and various types of composite prostheses, stem cell coating meshes, 3D meshes, microstructure meshes were developed. The repair method evolved from traditional hernia repair to tension-free hernia repair and laparoscopic hernia repair. Surgeons are dedicated to finding idealized meshes for the perfect repair of defects, while considering postoperative complications, patient's quality of life, long-term efficacy and other issues. In the face of a wide variety of repair materials, the choice of surgeons is blind, and there is no standard to determine which prostheses are suitable for patients. Therefore, we have combed the development of different types of prostheses, summarized the development process of hernia repair materials for the past 100 years, and put forward the prospects for future development of prostheses, in order to provide reference for the selection of prostheses.
Hernia ; Herniorrhaphy ; Humans ; Materials Science ; Quality of Life ; Surgical Mesh