Objective To summarize the experience of partial splenctomy in patients with traumatic spleen rupture.Methods Patients were assigned to spleen conservation group in which 59 patients underwent partial splenectomy,control group Ⅰ in which 60 patients underwent splenectomy and control group Ⅱ in which 60 patients underwent gastroinestinal operation. Immunologic function and filtration of red blood cell were detected in the three groups during the preoperation and the first month,the first year postoperation respectively.Results There was no significant difference between the spleen conservation group and the gastroenteric operation group.But IgM,NK-cell activity,T lymphocyte subpopulation and T lymphocyte transformation rate in the spleen conservation group were significantly higher then those in the splenectomy group (P

Objective:To evaluate the relationship betweenparacardial adipose tissue (PAT) volume, body mass index (BMI) and severe coronary artery stenosis in young people by quantitative measurement of 256-slice spiral CT.
Methods: A total of 150 patients younger than 45 years and received coronary angiography (CAG) in our hospital were divided into 2 groups:Lesion group, the patients with severe main coronary branch stenosis and Control group, patients with normal coronary artery. n=75 in each group. The height, body weight and BMI were recorded in all patients;imaging data was uploaded to the workstation to calculate the volumes ofepicardiumadipose tissue (EAT) volume,pericardial outsideadipose tissue volume and PAT volume, the correlation among 3 parameters were analyzed respectively.
Results:Compared with Control group, Lesion group had increased BMI (28.169±2.203) kg/m2 vs (24.960±3.041) kg/m2 and PAT volume (178.676±3.041) ml vs (99.0616±3.041) ml, all P<0.05. Compared with Control group,no matter male or female, Lesion group had larger PAT volume, P<0.01.EAT volume was related to pericardial outside adipose tissue volume (r=0.837, P<0.001) and PAT volume (r=0.971, P<0.001);pericardial outside adipose tissue volume was related to PAT volume (r=0.944, P<0.001).
Conclusion:PAT volume and BMI were obviously correlated to severe coronary artery stenosis in young people.

The gradient bioceramics coating was prepared on the surface of Ti-6Al-4V alloy by using wide-band laser cladding. And the effect of technological parameters of wide-band laser cladding on microstructure and sinterability of gradient bioceramics composite coating was studied. The experimental results indicated that in the circumstances of size of laser doze D and scanning velocity V being fixed, with the increasement of power P, the density of microstructure in bioceramics coating gradually degraded; with the increasement of power P, the pore rate of bioceramics gradually became high. While P = 2.3 KW, the bioceramics coating with dense structure and lower pore rate (5.11%) was obtained; while P = 2.9 KW, the bioceramics coating with disappointing density was formed and its pore rate was up to 21.32%. The microhardness of bioceramics coating demonstrated that while P = 2.3 KW, the largest value of microhardness of bioceramics coating was 1100 HV. Under the condition of our research work, the optimum technological parameters for preparing gradient bioceramics coating by wide-band laser cladding are: P = 2.3 KW, V = 145 mm/min, D = 16 mm x 2 mm.
Ceramics ; chemistry ; Coated Materials, Biocompatible ; chemistry ; Lasers ; Materials Testing ; Surface Properties ; Titanium ; chemistry ; X-Ray Diffraction

Objective:To evaluate the application value of small IT knife pre-cut in assistance to duodenal papillary cannulation compared with conventional guidewire cannulation.Methods:A retrospective analysis was performed on the data of 90 patients with choledocholithiasis including 52 patients with small IT knife pre-cut assisted intubation (small IT knife group) and 38 patients with conventional guidewire intubation (conventional group) in endoscopic retrograde cholangiopancreatography (ERCP) from May 2016 to July 2019 in the digestive endoscopy center of Nanjing Drum Tower Hospital. The basic data, curative effect and complications of the two groups were collected and compared.Results:There was statistically significant difference in gender composition between the small IT knife group and the conventional group ( χ2=5.679, P=0.017), but no significant difference in other baseline data between the two groups (all P>0.05). The median intubation time of the small IT knife group was significantly shorter than that of the conventional group (141.5 s VS 270.0 s, Z=1 268.0, P=0.022). There were no significant differences in the success rate of intubation [98.1% (51/52) VS 94.7% (36/38), χ2=0.760, P=0.571], the incidence of intraoperative bleeding [15.4% (8/52) VS 7.9% (3/38), χ2=1.148, P=0.345], postoperative pancreatitis [5.8% (3/52) VS 7.9% (3/38), χ2=0.159, P=0.694], and postoperative cholangitis [1.9% (1/52) VS 5.3% (2/38), χ2=0.760, P=0.571] between the two groups. No perforation occurred in the two groups. After stratifying according to the operator′s proficiency, the median intubation time was significantly different between the small IT knife expert group and the conventional expert group (116.0 s VS 258.0 s, Z=276.0, P=0.038), while there was no significant difference in the intubation time among other groups (all P>0.05). Conclusion:The small IT knife is safe and effective to pre-cut and assist intubation in ERCP, and it may shorten the intubation time.

Gene editing technology CRISPR/Cas9 and its derivative editing technologies including base editor and prime editor can precisely edit the target genome sequences, having been widely used in tumor therapy and achieved remarkable clinical results in tumor immunotherapy, human papilloma virus infection treatment and oncolytic virotherapy, providing a new means for tumor therapy.

Objective To discuss the clinical application of CT-guided localization of small pulmonary nodules (SPNs) by using double-hook-wire before the performance of video-assisted thoracoscopic (VATS) resection.Methods Before the performance of VATS resection,CT-guided localization by using doublehook-wire was carried out in 54 patients with SPNs (67 small pulmonary nodules in total) and CT-guided localization by using single-hook-wire was employed in 63 patients with SPNs(81 small pulmonary nodules in total).The location success rate and complication rate of the double-hook-wire technique and the singlehook-wire technique were calculated.Results The location success rate of CT-guided localization for SPNs by using double-hook-wire performed before VATS resection in 54 patients was 100％.The incidences of pneumothorax and hemorrhage were 29.6％ (16/54) and 48.1％ (26/54) respectively.In 63 patients receiving single-hook-wire technique,the location success rate for SPNs was 98.4％ (62/63).The incidences of pneumothorax and hemorrhage were 28.5％ (18/63) and 25.4％ (16/63) respectively.Conclusion CT-guided localization for SPNs by using double-hook-wire before VATS resection can reduce the risk of failure in positioning the hook-wire,and this technique is an important supplement for other localization techniques.

Objective:To design a specialized ultrasound therapeutic device for rabbit urethral scars and to verify its applicability and effectiveness.Methods:New Zealand male rabbits were used as the experimental objects, and the ultrasound therapeutic instrument was customized according to the structure and size of the rabbit penises. The ultrasound therapeutic instrument included the ultrasound pulse emission and control system, the final-stage amplifier, and the ultrasound probe. Firstly, the ultrasound probe was designed according to the size and structure of rabbit penises, and the parameters of the ultrasound probe were determined by COMSOL finite element simulation and actual testing of the sound field distribution. Secondly, the driving circuit of the ultrasound probe was designed according to the parameters of the elements. Then the ultrasound pulse emission and control system based on the field-programmable gate array (FPGA) and the serial screen were designed. Subsequently, the ultrasound therapeutic instrument was subjected to a performance test and a safety test. The ultrasound therapeutic instrument was constructed to include the ultrasound amplifier and the ultrasound probe. Finally, a rabbit urethra reconstruction model was constructed, and eight white rabbits were randomly divided into a model group and an experimental group. The rabbits in the experimental group received the ultrasound therapeutic instrument for treatment of the urethra immediately, with an ultrasound frequency of 2 MHz, a pulse interval of 10 ms, and an output sound intensity of 0.73 W/cm 2. The treatment was performed twice a week (on Tuesday and Thursday), with 10 min of irradiation each time, lasting for four weeks. The rabbits in the model group did not receive any treatment. The area percentage of transforming growth factor-β1 (TGF-β1), matrix metalloproteinase-2 (MMP-2), and tumor necrosis factor-α (TNF-α) staining-positive areas in rabbit urethral tissues were quantitatively analyzed, and the urethral circumference was calculated using Image J software. Results:Due to the addition of sound-absorbing materials, the sound pressure distribution in the treatment chamber was more uniform, and the average value of the standing wave ratio was 1.11, indicating that the structural design met the design requirements. In the overall performance test, the natural focal position of the three ultrasonic transducers was 10 mm, and the consistency of the sound field distribution meet the experimental requirements. The relationship between the peak sound pressure of each transducer and the power supply voltage was close to linear. The output sound intensity ranged from 0.35 to 0.74 W/cm 2, which met the experimental requirements. With the ultrasound output, the temperature of the test point increased slowly, and this experiment could increase the temperature of the tissue by up to 3.3 ℃, which would not lead to thermal damage to the tissue. Animal experiment results showed that the immunopositive area fraction of TGF-β1 in the urethral tissues of rabbits in the experimental group [(4.21 ± 1.32)%] was smaller than that of the model group [(8.53 ± 3.43)%] ( t = ?4.24, P < 0.001). The immunopositive area fraction of TNF-α in the urethral tissues of rabbits in the experimental group [(5.14 ± 2.72)%] was smaller than that of the model group [(7.23 ± 1.57)%] ( t = ?3.37, P < 0.05). The MMP-2 level in the urethral tissue of rabbits in the experimental group [(10.65 ± 2.24)%] was higher than that of the model group[(6.98 ± 2.74)%] ( t = 2.19, P < 0.05). The urethral circumference [(12 209 ± 2 743) μm] was higher than that of the model group [(10 127 ± 2 237) μm] ( t = 15.46, P < 0.05). Conclusions:An ultrasound therapeutic instrument dedicated to rabbit urethral scars has been successfully designed and can be used for the study of ultrasound treatment of rabbit urethral scars.

Particle radiotherapy is a new type of radiotherapy with superior targeting and precision for more accurate radiotherapy.Considering the complexity of the particle beams and the different lesion sites and physique of patients,a high-precision beam monitoring system which enables the monitoring of the spatial and energy distributions of the beams,such as position,dose and other important parameters,is needed to ensure the efficacy of particle radiotherapy.The beam monitoring system plays a crucial role in the safety and accuracy of particle therapy.By monitoring vital parameters such as the position and dose of the beams,the treatment plan can be adjusted in real-time,thus ensuring accurate lesion irradiation while minimizing the effects on the surrounding healthy tissues.Consequently,the development and validation of such a beam monitoring system are essential in particle radiotherapy.Herein the advances in beam monitoring for quality assurance for particle therapy are summarized.It gives a brief description of particle radiotherapy,emphasizing the significance of beam monitoring systems for particle radiotherapy,focuses on the development of particle beam monitoring and introduces different types of detectors,along with their applications and research advancements,and explores the future development trend of beam monitoring system and potential challenges it may face.