Objective To investigate the impact of osteotomy mode on the callus morphology in the ex-tension area of tibial bone transfer and its efficacy.Methods The information of the patients with bone defect treated in 910 Hospital of Joint Logistics and Security Force of Chinese People's Liberation Army from May 2016 to June 2022 was collected.By comparing the general data of the patients with different osteotomy meth-ods(minimally invasive osteotomy group,subperiosteal osteotomy group and extraperiosteal osteotomy group),callus morphology in the extension area(sunken type,uniform type and protruding type),healing in-dex,Ilizarov Method Research and Application Society(ASAMI)bone healing and functional evaluation and other information,the curative effect differences of different osteotomy methods on tibial bone transfer were investigated.Results The incidence rate of sunken type of callus in the extension area was 15.8%in the mini-mally invasive osteotomy group,18.9%in the subperiosteal osteotomy group,and 14.3%in the extraperioste-al osteotomy group,with statistically significant differences among the three groups(P<0.05);in which,the incidence of sunken type of callus in the minimally invasive osteotomy group was lower than that in the subpe-riosteal osteotomy group(χ2=10.178,P=0.005),but there was no statistically significant difference when compared to the extraperiosteal osteotomy group(χ2=0.102,P=0.814),the difference betrrween the extra-periosteal osteotomy group and subperiosteal osteotomy group also had no statistical difference(χ2=0.084,P=0.772).The incidence rate of uniform type of callus in the minimally invasive osteotomy group was lower than that in the subperiosteal osteotomy group(χ2=6.579,P=0.013),but there was no statistically signifi-cant difference when compared to the extraperiosteal osteotomy group(χ2=0.443,P=0.506).The difference in the subperiosteal osteotomy group and extraperiosteal osteotomy group also had no statistically significant(χ2=2.602,P=0.107).The incidence rate of protruding type of callus in the minimally invasive osteotomy group was higher than that in the subperiosteal osteotomy group(χ2=9.795,P=0.002),and the incidence rate of protruding type of callus in the extraperiosteal osteotomy group was higher than that in the subperios-teal osteotomy group(χ2=5.170,P=0.023),however,there was no statistically significant difference be-tween the minimally invasive osteotomy group and the extraperiosteal osteotomy group(χ2=0.308,P=0.579).There were no statistically significant differences in healing index,ASAMI scores,contact point non-union,pin tract infection and refracture incidence rate rates among the three groups(P>0.05).Conclusion Sub-periosteal osteotomy in the single plane tibial bone moving does not show the expected results in favor of the extension area mineralization,on the contrary,extraperiosteal osteotomy has the similar clinical efficacy to minimally invasive osteotomy.

When applying deep learning to the automatic segmentation of organs at risk in medical images, we combine two network models of Dense Net and V-Net to develop a Dense V-network for automatic segmentation of three-dimensional computed tomography (CT) images, in order to solve the problems of degradation and gradient disappearance of three-dimensional convolutional neural networks optimization as training samples are insufficient. This algorithm is applied to the delineation of pelvic endangered organs and we take three representative evaluation parameters to quantitatively evaluate the segmentation effect. The clinical result showed that the Dice similarity coefficient values of the bladder, small intestine, rectum, femoral head and spinal cord were all above 0.87 (average was 0.9); Jaccard distance of these were within 2.3 (average was 0.18). Except for the small intestine, the Hausdorff distance of other organs were less than 0.9 cm (average was 0.62 cm). The Dense V-Network has been proven to achieve the accurate segmentation of pelvic endangered organs.
Algorithms ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Neural Networks, Computer ; Organs at Risk ; Pelvis ; Tomography, X-Ray Computed

Objective:To resolve the issue of poor automatic segmentation of the bowel in women with pelvic tumors, a Dense V-Network model was established, trained and evaluated to accurately and automatically delineate the bowel of female patients with pelvic tumors.Methods:Dense Net and V-Net network models were combined to develop a Dense V-Network algorithm for automatic segmentation of 3D CT images. CT data were collected from 160 patients with cervical cancer, 130 of which were randomly selected as the training set to adjust the model parameters, and the remaining 30 were used as test set to evaluate the effect of automatic segmentation.Results:Eight parameters including Dice similarity coefficient (DSC) were utilized to quantitatively evaluate the segmentation effect. The DSC value, JD, ΔV, SI, IncI, HD (cm), MDA (mm), and DC (mm) of the small intestine were 0.86±0.03, 0.25±0.04, 0.10±0.07, 0.88±0.05, 0.85±0.05, 2.98±0.61, 2.40±0.45 and 4.13±1.74, which were better than those of any other single algorithm.Conclusion:Dense V-Network algorithm proposed in this paper can deliver accurate segmentation of the bowel organs. It can be applied in clinical practice after slight revision by physicians.

[ ABSTRACT] AIM:To investigate the effect of the overexpression of voltage-gated chloride channel family protein 3 ( ClC-3) gene on bones of mice .METHODS: The tail gene detection assay was used to confirm the overexpression of ClC-3.The male FVB mice of three months old were divided into two groups , the wild type ( WT) group and the ClC-3 overexpressed (ClC-3 transgene) group.The body weight, length and weight of the right tibias were measured .The upper and middle parts of the tibias were dissected , decalcified, paraffin-imbed, sectioned and stained with HE staining .The bone morphology metrology was used to analyze the changes of bone structures .The percent trabecular area (%Tb.Ar), trabecular number ( Tb.N) , trabecular width ( Tb.Wi) and trabecular separation ( Tb.Sp) of cancellous bone in the upper part of the tibia were measured.The total tissue area (T.Ar), cortical area (Ct.Ar), percent cortical area (%Ct.Ar), marrow area ( Ma.Ar) and percent marrow area (%Ma.Ar) of the cortical bone in the middle part of the tibia were detec-ted .RESULTS:The wild type mice and the ClC-3-overexpressed mice were verified by the tail gene detection assay . Compared with WT group , the body weight and the length and weight of the tibia were decreased in ClC -3 transgene mice (P<0.05).In the cancellous bones of ClC-3 transgene mice, the%Tb.Ar and Tb.Wi were decreased (P<0.05), the Tb.Sp was increased (P<0.05) and the Tb.N was not significantly changed .In the cortical bones of ClC-3 transgene mice, the T.Ar, Ct.Ar and%Ct.Ar were decreased (P<0.05), the%Ma.Ar was increased (P<0.05), and the Ma. Ar was not significantly changed .CONCLUSION:ClC-3 overexpression may lead to the reduction of the bone mass and the destructure of the cancellous and cortical bones .The results suggest that ClC-3 may be involved in the regulation of bone resorption and/or formation.

Objective To study the factors influencing the curative effect of one-stage bihteral total hip arthroplasty in a sequential procedure.Methods Thirty-six patients were indicated for one-stage bilateral total hip arthroplasty from February 1998 to March 2008.All cases were made with Smith-Peterson incision.Results The operative time was(3.2±1.2)h.The volume of blood transfusion during operation was (620 4±120)ml.All the 36 patients were followed up for(22.0±6.0)months.Except for 1 case of deep venous thrombosis of lower limbs,1 case of limb length discrepancy,there were no severe complications,such as postoperative infection,pulmonary embelism,dislocation,loosening or subsiding of components.Postoperative Harris scoreg of the joint function[(88.0±3.6)points]was significantly improved compared with their preoperative Harris scores[(28.0±4.2)points](P<0.05).Conclusions One-stage bilateral total hip arthroplasty is an effective method.However.the satisfactory effects can only be achieved by strict case selection,sufficient preoperative preparation,attention to operation procedures,prevention of complications and active recovery after operations.