Objective To study the dynamic CT features of severe acute respiratory syndrome (SARS) in recovery phase, and to analyze the correlative remaining factors on CT images. Methods Total 50 patients with SARS were followed-up with chest spiral CT and HRCT in 3, 6, 9, 14, 24 months after onset. Results (1)The pulmonary lesions were completely absorbed in 24 cases in 3 months, 30 cases in 6 months and 37 cases in 24 months. Abnormal CT findings were showed in 13 patients later, which appeared ground-glass opacity 8,irregular lines 6, thickening of interlobular septa 4, subpleural lines 2 and bronchiectasis 2. (2)Reviewing the lesions on CT between the remained group in the third month and the absorption group, there was a difference in the extent and the progress of the lesions .(3) There was a difference of the appearance rate of remaining lesion in lungs in two groups (≥40 ages and

Myopia is an important public health issue.Great attention has been paid to myopia in children and teenager since its incidence is progressing rapidly worldwide, especially in Asia.Although there are substantial reports on both myopia progression and its risk factors in children and teenager, challenges are encountered when attempting to compare results among individual studies due to different population, definition of myopia, cycloplegic eye drops, refraction methods, and so on.This review aimed to summarize the reports on myopia progression and its risk factors such as age, gender, refractive state, near work, outdoor activities, parental myopia, or parental bearing age in children and teenager (＜18 years) since 1990.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.

OBJECTIVETo construct three-dimensional (3D) models of renal stones and perform percutaneous nephrolithotomy (PCNL) virtual surgery simulation. Methods CT images were obtained from 8 patients with renal stones. Images segmentation and reconstruction were performed using MIMICS 10.0 software to construct the 3D model of the renal stones, which provided the anatomical relationships between the kidney and the adjacent organs. The optimal PCNL virtual surgery simulation for each individual case was performed using FreeForm Modeling System on the basis of the 3D model.

RESULTSEight 3D models of renal stone were constructed. The 3D model of the renal stones represented the interrelationships of the stones, intrarenal vessel, and the collecting system with the adjacent anatomical structures. Individualized PCNL virtual surgery simulations including percutaneous puncture, dilatation and pneumatic lithotripsy were performed successfully in all the 8 3D models.

CONCLUSIONDigital 3D model of renal stone provides the reliable and comprehensive imaging information for surgical design, and PCNL virtual surgery simulation has important clinical significance to improve the stone clearance rate and reduce the surgical complications.

Adult ; Female ; Humans ; Imaging, Three-Dimensional ; Kidney Calculi ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Software ; Tomography, Spiral Computed ; User-Computer Interface

Objective To investigate the value of liver imaging reporting and data system version 2018(LI-RADS v2018)features in predicting microvascular invasion(MVI)of hepatocellular carcinoma(HCC).Methods Ninety-two patients diagnosed as LR-5 and pathologically confirmed HCC were included and divided into MVI positive group and MVI negative group.The major and ancillary features of LI-RADS v2018 were compared between the two groups.Logistic univariate and multivariate regression analyses were used to obtain the independent risk factors for MVI,and the value of differential features in predicting MVI was also assessed using the receiver operating characteristic(ROC)curve.Results In the MVI positive group,the pathological grade of HCC was higher than that in the MVI negative group,with larger tumor diameter and higher incidence of mosaic architecture and corona enhancement.However,there was no difference in any other features.In logistic univariate analysis,tumor diameter,mosaic architecture and corona enhancement were independent risk factors for predicting the MVI,with area under the curve(AUC)values of 0.763 and 0.628 and 0.670 for the diagnosis of MVI,respectively.Conclusion In high-risk LR-5 population,tumor diameter,mosaic architecture and corona enhancement can help to predict the MVI.Accurate identification of LI-RADS v2018 features may facilitate personalized management of HCC patients.

Objective:To investigate the prenatal ultrasonographic features and diagnosis of 16p12.2 copy number variation (CNV).Methods:This retrospective study recruited seven fetuses with 16p12.2 microdeletion/microduplication in the First Affiliated Hospital of Fujian Medical University from January 2017 to December 2021. Data, including the prenatal diagnostic indications, ultrasound findings, karyotypes, genetic testing and mutation tracing results, pregnancy outcomes, and postnatal follow-up data, were summarized with descriptive statistical analysis.Results:Prenatal ultrasound indicated three fetuses with structural abnormalities, including one case each of multiple malformations, interventricular septal defect, and cleft lip and palate. The other four cases were positive for ultrasonic soft markers involving the heart and kidney. The chromosome karyotypes of the seven fetuses were normal. Single nucleotide polymorphism array (SNP array) results showed that four cases had a 381.7-542.4 kb microdeletion containing three genes ( OTOA, METTL9, and IGSF6) in Online Mendelian Inheritance in Man (OMIM) at 16p12.2 (distal region) and three cases had a 484.0-701.7 kb microdeletion/microduplication containing four OMIM genes ( UQCRC2, CDR2, EEF2K, and POLR3E) at 16p12.2 (proximal region). Five (cases 1, 2, 4, 5, and 6) out of the seven fetuses inherited the variants from their phenotypically normal mother/father, and among them, three (cases 2, 4, and 5) were delivered at term and healthy. Two cases (cases 3 and 7) refused to undergo pedigree verification. Case 3, a full-term infant, underwent ventricular septal defect repair three months after birth, and no abnormality was found at 18 months of age. Conclusions:No specific phenotype presents in fetuses with 16p12.2 microdeletion/microduplication in prenatal diagnosis. OTOA gene is the key gene associated with abnormality in the distal region of 16p12.2. Pedigree analysis is conducive to preventing unnecessary termination of pregnancy.

Background Blindness and low vision represent significant public health issues in China.Late diagnosis is the major reason for the irreversible vision impairment.A feasible,cost-effective screening and referral program is very important for the eye health care,prevention and treatment of blindness in China.Objective This study was to evaluate the feasibility and effectiveness of a health examination center-based opportunistic eye disease screening program.Methods This was a cross-sectional study.Subjects undergoing a routine physical examination at the health examination center of the Fourth People's Hospital of Shenyang were invited to attend this program.Presenting visual acuity,intraocular pressure,and nonmydriatic fundus photography were obtained.Optic diso photographs were evaluated independently by two ophthalmologists.Blindness and moderate to severe vision impairment were defined based on the criteria of World Health Organization Visual Impairment Classification in 2009.Glaucoma,diabetic retinopathy (DR) and other suspected eye diseases were diagnosed according to the fundus photography and intraocular pressure.This study was approved by Ethic Committe of the Fourth People's Hospital of Shenyang,the informed consent of each subject was obtained.Results Totally,15 303 subjects were enrolled and 15 197 of them finished the exanimations,giving a response rate of 99.3％.The overall percentage of blindness and moderate to severe visual impairment was 0.08％ (12/15 197) and 2.34％ (355/15 197).Two hundred and twenty-eight (1.50％) subjects were defined as glaucoma suspects and 80 individuals (0.53％) were diagnosed as epimacular membrane.Other suspected eye diseases included DR (0.41％),branchial retinal vessel occlusion (0.24％),macular degeneration (0.09 ％),and macular hole (0.06％).More than 95 ％ of the eye disease suspects have never been previously diagnosed or treated.A total of 358 subjects (2.36％) were defined as ocular hypertension suspects.Conclusions This health examination center-based opportunistic eye disease screening shows a good efficiency and feasibility.It may become an optional program in the national eye health care project,as well as the work of prevention and treatment of blindness.

Objective:To investigate the diagnostic method and genetic basis of capillary malformation-arteriovenous malformation 2(CM-AVM2).Methods:A retrospective analysis of clinical data of CM-AVM2. The patients who came to the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from January 2019 to January 2020. Literature related to CM-AVM was searched through PubMed database, CNKI, and SinoMed, and the clinical manifestations and diagnostic methods of CM-AVM2 were analyzed based on the collected case data and literature.Results:2 patients with systemic sporadic atypical erythema also with the mutation of EPHB4, and none of them were associated with high-flow vascular malformation. A total of 3 literatures on CM-AVM2 were retrieved and screened. Combined with the literature and 2 cases, it is concluded that CM-AVM2 is often manifested as atypical erythema similar to CM-AVM, which can be combined with high-flow vascular malformation, and the genetic test of EPHB4 gene mutation can be clearly diagnosed of CM-AVM2. Conclusions:Clinical manifestations, family history and genetic test are effective diagnostic method for CM-AVM. Moreover, the abnormal sprouting angiogenesis cause by EPHB4 mutation may be the mechanism of CM-AVM2.

Objective:To investigate the efficacy and safety of a simple three-step excision for combined reduction plastic surgery of labia minora clitoral hood complex.Methods:We selected the clinical data of patients with labia minora and clitoral prepuce hypertrophy treated in the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from May 2017 to November 2021. All the patients underwent composite labia minora and clitoral hood reduction using a simple three-step excision. In the first step, a longitudinal shuttle incision was designed to remove the redundant lateral prepuce of the clitoris; In the second step, the hypertrophic part of labia minora was removed by wedge resection; The third step was to trim the triangular flap formed by the excess skin at the junction of the labia minora and the clitoral hood, and then complete the incision suture. Patients were asked to return for examinations on days 1, 7, and 10 postoperatively. After that, the patients were followed up in the outpatient department or online, and the satisfaction questionnaires were conducted. The contents included appearance improvement, preoperative symptom improvement, postoperative discomfort symptoms, sexual life quality, partner’s evaluation of surgical effect, and patient’s evaluation of surgical impact.Results:A total of 295 patients were enrolled, with an average age of 29 years, ranged from 9 to 52 years old. Patients were divided into 4 categories according to the surgeries they received, including 21 patients (7.1%) with unilateral labia + unilateral prepuce hypertrophy, 12 patients (4.1%) with unilateral labia + bilateral prepuce hypertrophy, 50 patients (16.9%) with bilateral labia + unilateral prepuce and 212 patients (71.9%) with bilateral labia + bilateral prepuce hypertrophy. The incidence of complications was 3.4%(10/295), hematoma occurred in 8 cases, scar hyperplasia with obvious pain in 1 case, and blood supply disorder in 1 case. After the complementary treatments, all patients recovered well from surgeries. 219 questionnaires were obtained three months after surgeries, and 76 cases were lost to follow-up. The overall satisfaction rate of patients was 94.5%(207/219).Conclusions:The preoperative design of three-step resection is simple, which can safely and effectively carry out composite labia minora and clitoral hood reduction, with less complications, concealed incision, slight scar, and high satisfaction.