BACKGROUND: Percutaneous laser disk decompression(PLDD) is a new interventional therapy of lumbar disk herniation recently. Posterior lateral route is often employed. Puncture route was investigated by the application of anatomic methods previously. However, there are relative fewer reports regarding the observation of the route of lumbar nerve root in intervertebral plane and triangle working area from thin section anatomy and CT section anatomy.OBJECTIVE: To clarify the intervertebral route and its adjacent relationship of lumbar nerve root on thin section and CT section to provide a anatomic gist for puncture route in PLDD.DESIGN: An observational study based on corpus and normal individual.SETTING: Department of radiology of a military medical university of Chinese PLA affiliated hospital and the department of anatomy of a military medical university of Chinese PLA.PARTICIPANTS: The collection of the first Chinese visible human was completed in the Department of Anatomy(laboratory of computer medicine) the Faculty of Medicine, Third Military Medical University of Chinese PLA in October 2002. Totally 53 subjects without confirmed vertebral and intervertebral disc diseases and other diseases of the adjacent organs received CT examination and measurement in the Department of Radiology of the Third Military Medical University of Chinese PLA Affiliated Southwest Hospital between january and March 2000.INTERVENTIONS: The intervertebral route of lumbar nerve root in the first Chinese visible human was observed descriptively. The route, morphology, size, adjacent structure, and the distance between puncture line and lumbar nerve in 53 normal individuals were observed and measured by CT.MAIN OUTCOME MEASURES: To describe the intervertebral route of lumbar nerve root in the first CVH and normal individual, to measure the intervertebral length and width of lumbar nerve, and the distance between puncture line and lumbar nerve.RESULTS: The first Chinese visible human lumbar has 48 layers of intervertebral space with a thickness of each layer of 1.0 mm. The route and adjacent structure of lumbar nerve displayed in each section were clear. CT image clearly showed the intervertebral route, size and adjacent structure of lumbar nerve root.CONCLUSION: The first Chinese visible human lumbar nerve root intervertebral route is a continuous and intact thin section specimen. The intervertebral route and morphology of lumbar root nerve have great alterations. The relationship between puncture route and its adjacent lumbar nerve root, anterior articular process, ilium wing and vessels is very close.

Objective To study the structures of the plasmids of Klebsiella pneumoniae KF3 at the genome metagenome level througth with whole plasmid DNA sequencing, to analyze the functional genes carried by plasmid and to identify the correlation of resistance and pathogenicity between the plasmids and the host strains. Methods The alkaline lysis method was used to extract plasmids. We constructed the small insert pUC18 library and the large insert Forsmid library, sequenced and used the Phred / Phrap / Consed package to assemble these sequences and gained a complete sequence. The open reading frame(ORFs) were predicted by the Glimmer software and annotated, analyzed the functions of these genes. Results We successfully constructed the pUC18 library and the Fosmid libraries for the plasmid DNA and obtained three circular double-stranded DNA plasmids: pKF3-70 (69 477 bp), pKF3-90 (91 327 bp) and pKF3-147 ( 147 416 bp). There were drug resistant genes, conjugative transfer genes and mobile DNA elements identified on three plasmids. Conclusion The three plasmids of KF3 could be transferred among different strains. It would lead to the dissemination of the resistant genes.

This study reports the diagnosis and treatment of 2 children with isolated testicular recurrence (ITR) of acute B lymphoblastic leukemia (B-ALL) treated with CD 19 targeted chimeric antigen receptor T (CD 19 CAR-T) cells in May and December 2019 in the Department of Hematology and Oncology, Children′s Hospital of Soochow University, and explores the efficacy of CD 19 CAR-T cells therapy versus conventional radiotherapy and chemotherapy through literature review.Both cases were diagnosed as B-ALL by the morphologic, immunologic, cytogenetic and molecular biology methods.ITR was diagnosed by testicular biopsy at 60 months and 38 months after initial diagnosis in 2 cases, respectively.After infusion of CD 19 CAR-T cells at 7.0×10 6/kg and 1.5×10 7/kg, respectively for 7-10 days, testicular leukemia cell infiltration disappeared and complete remission was obtained.Among them, case 2 developed cytokine release syndrome and immune effector cell-related neurotoxicity syndrome after treatment, which was improved after drug intervention.It is suggested that CD 19 CAR-T cells are effective in the treatment of ITR in children, which may be an alternative to orchiectomy or local radiotherapy for ITR in children with B-ALL.

Objective To build the dataset of Chinese visible human female. Methods After undergoing macroscopical, CT and MRI examinations to exclude organic lesions, a young female cadaver of medium height was selected as the subject. After morphological measurement and vascular perfusion, the cadaver was embedded with 5% gelatin and cryopreserved in a -30 ℃ icehouse for 1 week. A digital milling machine TK 6350 (milling accuracy of 0.001 mm) was used to shave off slices of the body layer by layer from head to foot in a laboratory at -25 ℃. The successive cross sections were photographed with a high definition digital camera, and the pictures were put into a computer to establish a dataset of human body. By utilizing the image dataset derived from the successive cross sections, 3D reconstruction and stereodisplay of human structure were finished with a SGI Workstation which was equipped with an independently self developed software package for 3D reconstruction. Results The selected specimen, a 22 year old female native of Chongqing, was 1 620 mm in height, 54 kg in weight and died of non organic disease. CT scans were made in every 1.0 mm for head and neck and every 2.0 mm for rest parts, and the thickness for MRI scans was 1.5 mm for head and 3.0 mm for rest parts. For serial cross sections, the thickness was 0.25 mm for head and 0.5 mm for rest parts. Thus, a total of 3640 slices were obtained, and the photo for every slice was saved as a 36 MB file in a resolution of 6 291 456 pixels (3 072?2 048). Finally, the complete data files reached to 131.04 GB. Conclusion ① This is the first formally reported case of Chinese visible human female, suggesting that China becomes the second country owning visible human female dataset of her population. We set up a website for the purpose of exchanging ideas and information on this subject. So, the results are issued simultaneously on the Internet (http://www.chinesevisiblehuman.com).② According to US Visible Human Project(VHP), the data of the 3 junctional parts of their female cadaver were absent because the body was cut into 4 segments. Taking the age of 59 year old into account, the visible human female's body was not exactly perfect. The sections of 0.33 mm in thickness were saved to pictures at a resolution of 2 490 368 pixels (2 048?1 216). While, the first Chinese visible human female reported here is a young female without organic disease or lesion. No sectional datum is lost for being acquired from successive sections of the whole body. The resolution of cross sectional image reaches to 6 291 456 pixels (3 072?2 048).

Objective To achieve computer visualization of the first Chinese visible male and female Methods After acquisition of the dataset of the first Chinese visible male and female (2 518 cross sections were obtained from the visible male, the complete data files take up 90 468 GBs; while 3 640 cross sections from the female, the complete data files take up 131 04 GBs ), we processed 2 D images in an SGI Workstation and on P4 computer respectively Then, image registration was performed through reserved scaling point Reconstruction was achieved by two approaches: volume rendering reconstruction and surface rendering reconstruction Results We visualized the whole body and special parts of Chinese visible male and female on an SGI Workstation and a personal computer respectively Furthermore, by optimizing 3 D reconstruction and data processing technique, interactive 3 D visualization of the dataset was achieved Conclusions ①The dataset of the first Chinese visible male and female proves to be eligible for 3 D visualization research ②The platform setup of interactive 3 D visualization of Chinese visible male and female dataset provides foundation for digital human anatomy and virtual surgery ③The models of human organs and parts built through data segmentation, classification, registration and drawing lay basis for rendering complex structures of the whole human body delicately

Objective To establish more detailed dataset of Chinese visible human male. Methods After undergoing macroscopical, CT and MRI examinations to exclude organic lesion, a young aged, middle sized male cadaver was selected as the subject. First, morphological measurement and vascular perfusion were performed. Second, after embedding with 5% gelatin, the cadaver was put in ice house and frozen to -30 ℃ for 1 week. Third, TK 6350 numerical control milling machine (milling accuracy of 0.001 mm) was used to shave off slices of the body layer by layer from head to foot at -25 ℃ in low temperature laboratory. Fourth, the successive cross sections were photographed with high resolution digital camera and scanned into an animation computer. Thus, data acquisition from cadaver model was completed to obtain structural dataset of the human body. Results The selected sample was a 21 year old, 1 820 mm in height, 66 kg in weight male died due to non organic disease. CT with 1.0 mm slice thickness for the head and neck and 2.0 mm for the rest of the body was performed. MRI with 1.5 mm slice thickness for the head and neck and 3.0 mm for the rest of the body was also performed. A total of 18 398 serial cross sections with the thickness of 0.1 mm of each section were obtained. The digital photographs were sampled at a resolution of 10 989 056 (4 064?2 704) pixels. The data file of each section occupies 62.9 MB. The complete data files occupy 1 157.23 GB. The research results are issued simultaneously on the Internet (http://www.chinese visiblehuman.Conclusion ① Review of the related literatures reveals that the thinnest thickness of the reported cross section of the visible human dataset is 0.2 mm(the thickness of the sections of the skull base of the first case of Chinese visible human reported by our research group is 0.1 mm.), and the slices consist of several thousands of serial cross sections with several millions of pixels. The data files occupy several tens of GB or more than 100 GB. However, the thickness of the cross sections of the whole body of the dataset achieved in our research is 0.1 mm. The total slices consist of 18 398 serial cross sections with the photographic resolution of 11 million pixels and the total data file reaches 1 157.23 GB. The three indexes mentioned above are elevated by 1 log unit. ② We have solved the key technical problems in data acquisition of visible human such as super thin serial cross sectioning, enormous quantity of data storing and display of tiny blood vessels.

Objective:To investigate the effect of self-made medical ventilation chair in patients with acute respiratory distress syndrome (ARDS) ventilated in prone position, with the aim of reducing the occurrence of complications in patients with ARDS ventilated in prone position.Methods:This study was a quasi experimental research method. In this study, 78 patients admitted to the respiratory intensive care unit of Changsha Central Hospital affiliated to South China University from October 2019 to September 2021 were selected for the study by convenience sampling method, and were divided into a control group and a experimental group according to the order of admission, with 39 cases in each group. The experimental group was ventilated in the prone position using a self-made medical ventilation chair, and the control group was ventilated in the prone position using the conventional turning method, comparing the facial skin injury, tracheal displacement, tracheal tube obstruction, and RICU hospitalization time in the two groups.Results:At the end of prone position ventilation, the incidence of facial skin intact and redness and swelling was 56.41% (22/39) and 43.59% (17/39) in the experimental group and 25.64% (10/39) and 69.23% (27/39) in the control group, respectively, with statistically significant differences ( χ2=7.63, 5.21, both P<0.05); there was no statistically significant difference in the incidence of facial skin breakdown between the two groups ( P>0.05); the incidence of complications was 5.13% (2/39) in the experimental group and 20.51% (8/39) in the control group, with statistically significant differences ( χ2=4.13, P<0.05); the duration of RICU stay was (13.34 ± 3.85) days in the experimental group and ( 15.80 ± 5.55) days, with a statistically significant difference ( t=2.25, P<0.05). Conclusions:The use of self-made medical ventilation chair can reduce the facial skin damage of patients, reduce the occurrence of related complications, and shorten the hospitalization time of RICU. It is worth popularizing and applying in ICU.

Objective:To compare the clinical effects of endoscopic thyroidectomy using the modified gasless transaxillary approach (TA group) and transsubclavian approach (TS group) in the treatment of cN0 papillary thyroid carcinoma (PTC) .Methods:A total of 190 PTC patients (mean age 39.88±9.35 years,38 males, 152 females), who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from Oct. 2020 to Oct. 2022 were retrospectively analyzed, including 65 cases in TA group, 43 cases in TS group and 82 cases through traditional neck approach (TN group). The endoscopic group (TA+TS) consists of the TA group and the TS group. Comparative analyses were performed on operation time, full exposure rate of central compartment, postoperative hospitalization time, postoperative drainage, hospitalization costs, the number of dissected lymph nodes and postoperative complications. The t-test or Wilcoxon rank sum test, the χ2 test or the exact probability method were used for statistical analysis. Results:All endoscopic operations were successfully completed without conversion to traditional neck approach. ① Compared with the TN group, the endoscopic group (TA+TS) had longer operation time[TN group =74.5 (65-87) min, (TA+TS) group =102 (89-121) min, P<0.001], lower full exposure rate of central compartment (TN group=100%, (TA+TS) group=89.8%, P=0.008), more postoperative drainage[TN group=60 (45-76) ml, (TA+TS) group =100 (80-130) ml, P<0.001], higher hospitalization costs[TN group=￥23638 (22158-25901), (TA+TS) group =￥26967 (25572-28284), P<0.001], and higher parathyroid autotransplantation rate (TN group=4.9%, (TA+TS) group =50.9%, P<0.001). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative parathyroid hormone (PTH) ( P>0.05). ② Compared with the TS group, the TA group had longer operation time[TA group=110 (97-127) min, TS group=89 (80-111) min, P<0.001], lower full exposure rate of central compartment (TA group=83.1%, TS group=100%, P=0.012), longer postoperative hospitalization time[TA group=3 (3-4) d, TS group=3 (3-3) d, P=0.002], more postoperative drainage[TA group=110 (82-140) ml,TS group=95 (65~120) ml, P=0.046] and higher hospitalization costs (TA group=￥27510±2578,TS group=￥26609±1878, P=0.038). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative PTH, and parathyroid autotransplantation between the two groups ( P>0.05) . Conclusions:Endoscopic thyroidectomy through axillary/subclavian approach is safe and feasible for the treatment of cN0 PTC. There was no significant difference in the number of dissected central lymph nodes compared with conventional surgery, and the incision was well concealed. In comparison, transsubclavian endoscopic surgery has better clinical application value, with shorter operation time, higher full exposure rate of central compartment and faster postoperative recovery.

OBJECTIVETo study the severe acute respiratory syndrome (SARS)-associated coronavirus genotype and its characteristics.

METHODSA SARS-associated coronavirus isolate named ZJ01 was obtained from throat swab samples taken from a patient in Hangzhou, Zhejing province. The complete genome sequence of ZJ01 consisted of 29,715 bp (GenBank accession: AY297028, version: gi: 30910859). Seventeen SARS-associated coronavirus genome sequences in GenBank were compared to analyze the common sequence variations and the probability of co-occurrence of multiple polymorphisms or mutations. Phylogenetic analysis of those sequences was done.

RESULTSBy bioinformatics processing and analysis, the 5 loci nucleotides at ZJ01 genome were found being T, T, G, T and T, respectively. Compared with other SARS-associated coronavirus genomes in the GenBank database, an A/G mutation was detected besides the other 4 mutation loci (C:G:C:C/T:T:T:T) involved in this genetic signature. Therefore a new definition was put forward according to the 5 mutation loci. SARS-associated coronavirus strains would be grouped into two genotypes (C:G:A:C:C/T:T:G:T:T), and abbreviated as SARS coronavirus C genotype and T genotype. On the basis of this new definition, the ZJ01 isolate belongs to SARS-associated coronavirus T genotype, first discovered and reported in mainland China. Phylogenetic analysis of the spike protein gene fragments of these SARS-associated coronavirus strains showed that the GZ01 isolate was phylogenetically distinct from other isolates, and compared with groups F1 and F2 of the T genotype, the isolates of BJ01 and CUHK-W1 were more closely related to the GZ01 isolate. It was interesting to find that two (A/G and C/T) of the five mutation loci occurred in the spike protein gene, which caused changes of Asp to Gly and Thr to Ile in the protein, respectively.

CONCLUSIONAttention should be paid to whether these genotype and mutation patterns are related to the virus's biological activities,epidemic characteristics and host clinical symptoms.