Objective:To design a set of simulation system for surgical operation based on virtual reality(VR)technique and intelligent scoring functions,so as to assess its clinical application effect.Methods:The Digital Imaging and Communications in Medicine(DICOM)images of typical patients were collected.Materialise Interactive Medical Image Control System(MIMICS)software was adopted to reconstruct the three-dimensional(3D)model of diseased organs.Surgical instrument models were constructed by using 3D Max software.Unity 3D software was adopted to construct simulation system for surgical operation with VR+intelligent scoring.A total of 40 surgical resident physicians,who were employed with 3 years since 2019 in The Second Affiliated Hospital of Kunming Medical University,were selected.They were divided into observation group and control group,with 20 cases in each group.The observation group used simulation system for surgical operation to conduct intelligent scoring for cholecystectomy under laparoscope,and the control group used conventional scoring for surgical operation.The scores of surgical operation and test between the two groups were compared.Results:The mean value of surgical operation time of the observation group was(1.72±0.41)h,and the average incidence of complication was(0.03±0.02)%,both of them of the observation group were significantly lower than those of the control group[(2.25±0.42)h and(0.05±0.03)%].The differences of them between two groups were statistically significant(t=9.00,4.08,P<0.05).The test scores of surgical operation of the observation group was also significantly higher than that of the control group(t=5.26,P<0.001).Conclusion:The developed simulation system for surgical operation with VR+intelligent scoring can significantly enhance users'surgical operation skills and improve learning outcomes,which has favorable prospects in future applications.

Objective:To design a set of simulation system for surgical operation based on virtual reality(VR)technique and intelligent scoring functions,so as to assess its clinical application effect.Methods:The Digital Imaging and Communications in Medicine(DICOM)images of typical patients were collected.Materialise Interactive Medical Image Control System(MIMICS)software was adopted to reconstruct the three-dimensional(3D)model of diseased organs.Surgical instrument models were constructed by using 3D Max software.Unity 3D software was adopted to construct simulation system for surgical operation with VR+intelligent scoring.A total of 40 surgical resident physicians,who were employed with 3 years since 2019 in The Second Affiliated Hospital of Kunming Medical University,were selected.They were divided into observation group and control group,with 20 cases in each group.The observation group used simulation system for surgical operation to conduct intelligent scoring for cholecystectomy under laparoscope,and the control group used conventional scoring for surgical operation.The scores of surgical operation and test between the two groups were compared.Results:The mean value of surgical operation time of the observation group was(1.72±0.41)h,and the average incidence of complication was(0.03±0.02)%,both of them of the observation group were significantly lower than those of the control group[(2.25±0.42)h and(0.05±0.03)%].The differences of them between two groups were statistically significant(t=9.00,4.08,P<0.05).The test scores of surgical operation of the observation group was also significantly higher than that of the control group(t=5.26,P<0.001).Conclusion:The developed simulation system for surgical operation with VR+intelligent scoring can significantly enhance users'surgical operation skills and improve learning outcomes,which has favorable prospects in future applications.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

BACKGROUND:WIF-1 is a tumor suppressor gene. Promoter hypermethylation causes WIF-1 down-regulationin most tumors. DNA methylation inhibitor can lead to gene demethylation and restore its expression. OBJECTIVE:To observe the differences of tumor pathology and, WIF-1 mRNAand proteinchanges using WIF-1 or 5-aza-2'-deoxycytidine demethylation in animalmodels of osteosarcoma.
METHODS:Murine osteosarcoma models were established and divided into three groups. In the control group, no treatment was given. In the 5-aza-2'-deoxycytidine group, an appropriate amount of 5-aza-2'-deoxycytidine was injected ineach mouse daily. In the WIF-1 group, an appropriate amount of Wnt/β-catenin signal transduction pathway inhibitor WIF-1 was injected in each mouse daily. Seven days after medication, the weight of nude mouse was weighed every 7 days. Short tumor diameter (a) and the long diameter (b) were measured. Therelative tumor volume was calculated. The relative growth rate of tumor was calculated at 7, 14, 21, 28 and 56 days. Four nude mice from ach group were sacrificed by puling the neck at 7, 14, 21, 28 and 56 days after medication. Tumor tissues were stripped and the weight of them was weighed. Pathological analysis of the tumor was conducted. The expression of WIF-1protein and WIF-1 mRNA was detected in osteosarcoma at 56 days after medication in the three groups.
RESULTS AND CONCLUSION:(1) Compared withthe medication and control groups, the weight of nude mice was increased at 7, 14, 21, 28 and 56 days in the treatment group. No significant difference was found between the medication and control groups. (2) The tumor size was significantly smaler in themedication group than in the control group. WIF-1 mRNA and WIF-1 protein expression was increased in the medication group compared with the control group to different degrees. (3) Results suggested that WIF-1 gene promoter methylation is one of the mechanisms of the development of osteosarcoma. Use of WIF-1 or 5-aza-2'-deoxycytidine demethylation can inhibit tumor growth in animal models of osteosarcoma.