OBJECTIVES: We propose a sparse-view cone-beam CT reconstruction algorithm based on bidirectional flow field guided projection completion (BBC-Recon) to solve the ill-posed inverse problem in sparse-view cone-beam CT imaging. METHODS: The BBC-Recon method consists of two main modules: the projection completion module and the image restoration module. Based on flow field estimation, the projection completion module, through the designed bidirectional and multi-scale correlators, fully calculates the correlation information and redundant information among projections to precisely guide the generation of bidirectional flow fields and missing frames, thus achieving high-precision completion of missing projections and obtaining pseudo complete projections. The image restoration module reconstructs the obtained pseudo complete projections and then refines the image to remove the residual artifacts and further improve the image quality. RESULTS: The experimental results on the public datasets of Mayo Clinic and Guilin Medical University showed that in the case of a 4-fold sparse angle, compared with the suboptimal method, the BBC-Recon method increased the PSNR index by 1.80% and the SSIM index by 0.29%, and reduced the RMSE index by 4.12%; In the case of an 8-fold sparse angle, the BBC-Recon method increased the PSNR index by 1.43% and the SSIM index by 1.49%, and reduced the RMSE index by 0.77%. CONCLUSIONS The BBC-Recon algorithm fully exploits the correlation information between projections to allow effective removal of streak artifacts while preserving image structure information, and demonstrates significant advantages in maintaining inter-slice consistency.
Algorithms ; Cone-Beam Computed Tomography/methods* ; Image Processing, Computer-Assisted/methods* ; Humans

Objective To observe the efficacy and safety of 3 D video-assisted thoracoscopic segmentectomy in patients with stage Ⅰ lung cancer treated with indocyanine green(ICG)fluorescence reverse-staining.Methods A total of 132 patients with stage Ⅰ lung cancer who were admitted from May 2022 to September 2024 all underwent three-dimensional video-assisted thoracoscopic segmental resection of the lung.They were divided into the observation group(63 cases)and the control group(69 cases)according to the method of intersegmental plane exposure.The control group was treated with the modified expansion and collapse method,while the observation group was treated with the ICG fluorescence backstaining method.The surgical conditions,pulmonary function,postoperative pain degree,quality of life and complications of the two groups were compared.Results The postoperative chest tube retention time,surgical time,postoperative hospitalization time,total postoperative thoracic drainage volume,and inter-segmental plane exposure time in the observation group were as follows(2.13±0.37)d,(145.12±25.26)min,(5.21±0.95)d,(261.41±28.57)ml and(9.15±1.73)s,respectively.The data of the control groups were(3.29±0.48)d,(178.31±30.45)min,(6.34±1.36)d,(352.03±36.74)ml and(1 651.28±179.84)s,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the number of intraoperative blood loss and intraoperative lymph node dissections between the two groups(P＞0.05).There was no statistically significant difference in the levels of maximal expiratory flow(PEF),forced expiratory volume in one second(FEV1),and FEV1/forced vital capacity(FVC)between the two groups before the operation and one month after the operation(P＞0.05).The Visual Analogue Scale(VAS)scores of the observation group at 12 hours,48 hours and 72 hours after the operation were(3.25±0.46)points,(2.13±0.35)points and(1.02±0.24)points respectively.The control groups were(4.11±0.59)points,(2.98±0.42)points,and(1.73±0.30)points,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the scores of negative and positive items between the two groups before the operation and one month after the operation(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion The modified dilatation collapse method and ICG fluorescence reverse staining method have no significant effects on lung function and complications in patients with stage Ⅰ lung cancer,and both can improve the quality of life.Compared with the modified dilatation collapse method,ICG fluorescence reverse staining method can shorten the plane exposure time between segments and the operation time,promote postoperative rehabilitation and alleviate postoperative pain.

Objective To observe the efficacy and safety of 3 D video-assisted thoracoscopic segmentectomy in patients with stage Ⅰ lung cancer treated with indocyanine green(ICG)fluorescence reverse-staining.Methods A total of 132 patients with stage Ⅰ lung cancer who were admitted from May 2022 to September 2024 all underwent three-dimensional video-assisted thoracoscopic segmental resection of the lung.They were divided into the observation group(63 cases)and the control group(69 cases)according to the method of intersegmental plane exposure.The control group was treated with the modified expansion and collapse method,while the observation group was treated with the ICG fluorescence backstaining method.The surgical conditions,pulmonary function,postoperative pain degree,quality of life and complications of the two groups were compared.Results The postoperative chest tube retention time,surgical time,postoperative hospitalization time,total postoperative thoracic drainage volume,and inter-segmental plane exposure time in the observation group were as follows(2.13±0.37)d,(145.12±25.26)min,(5.21±0.95)d,(261.41±28.57)ml and(9.15±1.73)s,respectively.The data of the control groups were(3.29±0.48)d,(178.31±30.45)min,(6.34±1.36)d,(352.03±36.74)ml and(1 651.28±179.84)s,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the number of intraoperative blood loss and intraoperative lymph node dissections between the two groups(P＞0.05).There was no statistically significant difference in the levels of maximal expiratory flow(PEF),forced expiratory volume in one second(FEV1),and FEV1/forced vital capacity(FVC)between the two groups before the operation and one month after the operation(P＞0.05).The Visual Analogue Scale(VAS)scores of the observation group at 12 hours,48 hours and 72 hours after the operation were(3.25±0.46)points,(2.13±0.35)points and(1.02±0.24)points respectively.The control groups were(4.11±0.59)points,(2.98±0.42)points,and(1.73±0.30)points,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the scores of negative and positive items between the two groups before the operation and one month after the operation(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion The modified dilatation collapse method and ICG fluorescence reverse staining method have no significant effects on lung function and complications in patients with stage Ⅰ lung cancer,and both can improve the quality of life.Compared with the modified dilatation collapse method,ICG fluorescence reverse staining method can shorten the plane exposure time between segments and the operation time,promote postoperative rehabilitation and alleviate postoperative pain.

Objective To evaluate the long-term outcomes of total knee arthroplasty (TKA) for end-stage hemophilic arthropathy.Methods Eighteen patients (24 knees) with hemophilic arthropathy underwent TKA from June 2003 to January 2009 were retrospectively reviewed.All patients were hemophilia A with an average age of 33.7± 13.0 years (18-56tyears) old at Surgery.Pharmacokinetic tests of coagulation factors were performed after consultation of hematologist.Based on the guideline of World Federation of hemophilia,the protocol of coagulation factor replacement was adjusted according to our experience and the financial status.Normally,peak level of coagulation factor concentrations were maintained at 100％ on the day of surgery,at about 80％ in the first 3 days after surgery,at 60％ on the postoperative days of 4-6 and at 40％ on postoperative days of 7-10.The dose was then gradually tapered to 20％ or 30％.Zimmer prosthesis was used in three cases (PS prosthesis in two cases,LCCK prosthesis in one case),Centerpulse prosthesis in three cases,and the rest were from Smith & Nephew (including one case of constrained prosthesis and one case of revision prosthesis).Preoperative and last follow-up Hospital for Special Surgery (HSS) score,Knee Society Score (KSS),knee flexion contracture and complications were evaluated.Results Fourteen patients(20 knees) were followed-up,with an average duration of 124±17 months (96-145 months).Knee flexion contracture improved from 16.7°±12.2° (0°-40°) preoperative to 3.3 °±5.0° (0°-10°) at the last follow-up.The average preoperative HSS score was 42.4± 16.0 (t 0-60),whereas postoperative score was 74.8± 10.6 (59-87).The preoperative KSS clinical and functional score were 36.1 ± 10.5 (20-50) and 36.1±5.5 (25-40),which were improved to 85.8±7.1 (70-93) and 80.9±22.4 (40-100) at the last follow-up,respectively.Postoperative infection,aseptic loosening of the implant and hematoma occurred in one patient respectively.All of them recovered after a revision surgery.One patient had secondary skin ulceration due to tension blisters and recovered after anterolateral thigh myocutaneous flap transplantation.Conclusion The long-term outcomes of TKA under coagulation factor substitution for hemophilic arthropathy are promising.However,the effects are inferior to those in non-hemophilic patients,and the risk of infection,aseptic loosening of the implant and hematoma are higher.

Objective To evaluate the midterm outcomes of autologous femoral head grafting in total hip arthroplasty for developmental dysplasia of the hip.Methods From October 2001 to December 2011,36 patients (36 hips) with developmental dysplasia of the hip were treated by total hip arthroplasty with autologous femoral head grafting,of which 34 cases were followed up for at least 30 months.There were 6 males and 28 females.16 patients were involved in the left hip and 18 in right hip.The average age at the operation was 51 years (range,28-68 years).According to Crowe classification for developmental dysplasia of the hip,12 were type Ⅱ,16 type Ⅲ,and 6 type Ⅳ.Cementless prostheses were used for all,but one patient,who received a hybrid prosthesis.Clinical outcomes were evaluated according to Harris score and complications.Components migration,periprosthetic bone changes,the polyethylene wear rate were measured radiologically.Components position and bone healing were assessed in the anteriorposterior and lateral X-ray of the hips.Results Thirty-four patients (34 hips) were followed up for an average duration of 64.1 months (range,31-153 months).The average Harris score was 35.4 (range,23-56) preoperatively,and was 89 (range,82-95) at the latest follow-up.Twenty-eight were classified as excellent,and 6 were good,and the excellent and good rate was 100％.10 cases presented with bone absorption 2-8 months postoperatively.Four patients suffered from dislocation after surgery.All the cases were treated successfully with close reduction,except one with redislocation.Close reduction was performed for this case,and no dislocation occurred again.One patient had periprosthetic fracture due to a fall and open reduction and plate fixation was performed.The fracture was healed at 1 year follow-up,with good position of the implants.Another patient had hypertensive intracerebral hemorrhage 1 year after the surgery,who was treated by conservative treatment and had hemiplegia and apraxia of the surgical hip.Conclusion Autologous femoral head grafting for the treatment of developmental dysplasia of the hip has a satisfactory clinical and radiographic outcomes at an average of five-year follow-up.Bone graft absorption is a natural process of structural bone grafting.Joint dislocation is the most common complication of THA in developmental dysplasia of the hip.

The true meanings of the terms of traditional Chinese medicine (TCM) need to be analyzed on a logical basis. It is not suitable to use a new term to interpret an old term of TCM, or arbitrarily specify the special term of TCM corresponding to some substances of modern medicine. In philosophy of language, language has a logical structure, which reflects the structure of the world, that is to say, language is the picture of the world in a logical sense. Using this idea, the authors collected the ancient literature on "kidney essence", and extracted each necessary condition for "kidney essence". All necessary conditions formed a sufficient condition to define the term "kidney essence". It is expected that this example can show the effectiveness of philosophy of language in analysis of the terms of TCM.

Objective To evaluate the efficacy and toxicity of the combination of gemcitabine and cisplatin in the treatment of patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 30 cases of non-small cell lung cancer (stages Ⅲ and Ⅳ) were treated with gemcitabine (1 200 mg/m 2, iv infusion, at 1 and 8 d) and cisplatin (100 mg/m 2, iv infusion, at 1 d or cisplatin at 30 mg/m 2, iv infusion, at 1 and 8 d). The administration course was 28 d. Results An objective response was obtained in 46.67% of patients (2 complete and 12 partial responses), whereas 11 patients had no change and 5 patients were progressive. The response rate was 52.38% in patients with no prior chemotherapy and the response rate of 33.33% was achieved in patients who had been given prior treatment. There was significant difference between the two groups (P

Objective To evaluate the value of multiplanar reconstruction (MPR) of spiral CT in diagnosing and staging of cervical cancer .Methods SCT scan with a 3～5 mm collimation thickness and MPR in 1.5～2.5 mm reconstruction interval were performed in 20 patients with cervical cancer , confirmed by biopsy pathology. Results The sagittal imaging could show entirely the growing character of a carcinomal mass;the coronal and transverse imagings showed clearly parametrial invasion and pelvic lymph node metastases. Conclusion MPR images in the pelvic could show entirely the character of growing and invasion of a carcinomal mass. It is an important value in dignosing and staging of cervical cancer.