Objective Magnetic resonance simulator(MR Sim)is a novel type of simulation equipment utilized in radiotherapy.Acceptance testing is an essential quality assurance procedure prior to the clinical use of the MR Sim.The report provides the detailed procedures and result analysis of acceptance testing for an MR Sim.Methods The acceptance testing scheme was developed following the recently published AAPM TG284 report and the NCC/T-RT 002-2023 guidelines.Quality control equipments such as ACR(American College of Radiology)large phantom and geometric distortion measurement phantom were used for evaluating various aspects of the MR Sim,including the effectiveness of shielding,the functionality of imaging system,the image quality,the performance of radio frequency coils,the geometric accuracy of large field imaging,the precision of external laser markings,the couch movement accuracy,and the image transmission accuracy.Results The shielding effectiveness at a frequency of 150 MHz exhibited an average value of 105 dB.All of 8 image quality indices,namely geometric accuracy,slice position accuracy,slice thickness accuracy,image uniformity,artifact ratio,signal-to-noise ratio,high-contrast spatial resolution,and low-contrast resolution,fell within recommended tolerances.The maximum geometric distortion observed across a 25 cm field of view was less than 2 mm.The errors in external laser markings and couch movement accuracy were both less than 1 mm.The couch levelness was less than 1°.Both radio frequency coils and image transmission passed the required tests.Conclusion MR Sim is high-precision and complex.To ensure its precise application in radiotherapy,the acceptance testing for an MR Sim should be meticulously designed and executed following the established guidelines and accounting for its unique performance characteristics.

Objective:To investigate the analytical performance verification protocols and performance specifications of CD34+cell enumeration by flow cytometry for clinical laboratories.Methods:According to international guidelines and National Health Standard of China, we designed the performance verification protocols of CD34 +cell enumeration (including percent count and absolute count) by flow cytometry. Four quality assessment materials, three leukapheresis products and three samples of peripheral blood were selected to verify the precision, linearity, carryover, trueness and accuracy of FACSCanto Ⅱ measurement system, and the assessment criterion was set according to the detection technologies of clinical laboratories. Results:The CVs of intra-run precision of percent count and absolute count were 2.5% to 8.9% and 3.0% to 9.0%; the CVs of inter-run precision were 2.8% to 10.5% and 3.8% to 9.9%, respectively. The slopes of linearity regression equation of low range (3.6/μl to 123.6/μl) and high range (113.2/μl to 1196.3/μl) were 0.993 2 and 0.965 2, and R2 were 0.999 6 and 0.993 9, and the biases were -8.67% to 0.22%. The carryover of percent and absolute count were 0.07% and 0.00%. When percent count≤0.2% or absolute count≤20/μl, the absolute biases of trueness were in the range of ±0.006% or ±0.5/μl, and the absolute biases of accuracy were in the range of ±0.02% or ±0.9/μl; when percent count>0.2% or absolute count>20/μl, the relative biases of trueness were in the range of ±5.65%, and the relative biases of accuracy were in the range of ±8.19%. The verification results met the assessment criterion set in this study. Conclusions:The performance verification protocols and assessment criterion formulated in this study not only conform to the recommendations of domestic and foreign guidelines, but also conform to state of the detection technologies of native clinical laboratories, which can be taken as a reference of performance verification for clinical laboratories.

Objective:To investigate the effect of tranexamic acid on perioperative hemorrhage of cranioplasty for craniosynostosis.Methods:A retrospective analysis was performed on the clinical data of children who received cranial remodeling from the Children’s Hospital of Fudan University from February 2015 to October 2018. The patients were divided into two groups: tranexamic acid treatment group (TXA group) and no tranexamic acid treatment group (control group). The average intraoperative blood loss, the average amount of blood transfusion, postoperative average amount of blood transfusion, average drainage volume, and changes of postoperative hemoglobin and blood coagulation function were observed. The measurement data were described by M ( Q1, Q3) and analyzed with Mann-Whitney U test. Results:A total of 41 patients were included in this study. There were 26 patients in TXA group, 18 males and 8 females, aged 9.5 (7.0, 38.8) months; in the control group, there were 15 patients, 10 males and 5 females, aged 9.2 (6.6, 18.3) months. The results showed that there was no significant difference in preoperative hemoglobin level between the two groups ( P>0.05). The hemoglobin level of TXA group was higher than that of control group immediately after operation and 24 h and 72 h after operation ( P<0.05). Total intraoperative blood loss and blood loss per kilogram of body weight in TXA group were lower than those in control group [150.0 (57.5, 225.0) ml vs. 200.0(80.0, 300.0) ml, P<0.05; 13.6(6.8, 18.5) ml/kg vs. 15.8(7.0, 27.0) ml/kg, P<0.01]. The amount of intraoperative transfusion volume per kilogram of body weight in TXA group was less than that in control group [15.0(8.8, 17.7) ml/kg vs.17.1 (13.0, 23.3) ml/kg, P<0.05]. There were no significant differences between the two groups in postoperative total transfusion volume, transfusion volume per kilogram of body weight, total drainage volume and drainage volume per kilogram of body weight ( P>0.05). There was no significant difference in prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen between the two groups before and after surgery ( P<0.05). Conclusion:TXA can reduce the amount of blood loss and blood transfusion in craniosynostosis in children.

Objective:To investigate the effect of tranexamic acid on perioperative hemorrhage of cranioplasty for craniosynostosis.Methods:A retrospective analysis was performed on the clinical data of children who received cranial remodeling from the Children’s Hospital of Fudan University from February 2015 to October 2018. The patients were divided into two groups: tranexamic acid treatment group (TXA group) and no tranexamic acid treatment group (control group). The average intraoperative blood loss, the average amount of blood transfusion, postoperative average amount of blood transfusion, average drainage volume, and changes of postoperative hemoglobin and blood coagulation function were observed. The measurement data were described by M ( Q1, Q3) and analyzed with Mann-Whitney U test. Results:A total of 41 patients were included in this study. There were 26 patients in TXA group, 18 males and 8 females, aged 9.5 (7.0, 38.8) months; in the control group, there were 15 patients, 10 males and 5 females, aged 9.2 (6.6, 18.3) months. The results showed that there was no significant difference in preoperative hemoglobin level between the two groups ( P>0.05). The hemoglobin level of TXA group was higher than that of control group immediately after operation and 24 h and 72 h after operation ( P<0.05). Total intraoperative blood loss and blood loss per kilogram of body weight in TXA group were lower than those in control group [150.0 (57.5, 225.0) ml vs. 200.0(80.0, 300.0) ml, P<0.05; 13.6(6.8, 18.5) ml/kg vs. 15.8(7.0, 27.0) ml/kg, P<0.01]. The amount of intraoperative transfusion volume per kilogram of body weight in TXA group was less than that in control group [15.0(8.8, 17.7) ml/kg vs.17.1 (13.0, 23.3) ml/kg, P<0.05]. There were no significant differences between the two groups in postoperative total transfusion volume, transfusion volume per kilogram of body weight, total drainage volume and drainage volume per kilogram of body weight ( P>0.05). There was no significant difference in prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen between the two groups before and after surgery ( P<0.05). Conclusion:TXA can reduce the amount of blood loss and blood transfusion in craniosynostosis in children.

OBJECTIVE: To explore diagnosis and surgical treatment of symptomatic lumbar spinal epidural lipoplasia. METHODS: A retrospective analysis of 19 patients with symptomatic lumbar spinal epidural hyperplasia treated with hemilaminectomy and interbody fusion and internal fixation from February 2012 to November 2018 were performed, including 7 males and 12 females, aged from 48 to 72 years old with an average of (57.6±1.2) years old;the course of disease ranged from 6 to 60 months with an average of (18.6±5.1) months;plane requiring decompression:L RESULTS: All patients were followed up from 12 to 37 months with an average of (16.3±3.8) months. Ninteen patients were successfully completed operation, and all adipose tissues in the compressed segment of the spinal canal were removed. Operation time was from 125 to 260 min with an average of (186± 15) min, and blood bleeding was from 150 to 500 ml with an average of (280±46) ml. Two patients occurred partial incision fat liquefaction and exudate did not heal, the incision was opened to remove effusion, the dressing was changed and anti-inflammatory treatments were performed. No complications such as cauda equina injury, cerebrospinal fluid leakage, and broken nails occurred. Preopertaive VAS of back pain and leg pain were 5.3±0.7 and 6.8±0.8, respectively, while 2.1±0.4 and 2.3±0.5 respectively at 6 months after opertaion, there were statisticalsignificant difference between 6 months after operation and before operation ( CONCLUSION Patients with symptomatic lumbar spinal epidural lipoplasia undergo hemilaminectomy and internal fixation of compression segment could relieve compression of dura mater and cauda equina, and achieve good clinical results.
Back Pain ; Child, Preschool ; Female ; Humans ; Infant ; Lumbar Vertebrae/surgery* ; Male ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

Wearable physiological parameter monitoring devices play an increasingly important role in daily health monitoring and disease diagnosis/treatment due to their continuous dynamic and low physiological/psychological load characteristics. After decades of development, wearable technologies have gradually matured, and research has expanded to clinical applications. This paper reviews the research progress of wearable physiological parameter monitoring technology and its clinical applications. Firstly, it introduces wearable physiological monitoring technology's research progress in terms of sensing technology and data processing and analysis. Then, it analyzes the monitoring physiological parameters and principles of current medical-grade wearable devices and proposes three specific directions of clinical application research: 1) real-time monitoring and predictive warning, 2) disease assessment and differential diagnosis, and 3) rehabilitation training and precision medicine. Finally, the challenges and response strategies of wearable physiological monitoring technology in the biomedical field are discussed, highlighting its clinical application value and clinical application mode to provide helpful reference information for the research of wearable technology-related fields.
Monitoring, Physiologic ; Wearable Electronic Devices

Objective:To summarize the surgery effect of tongue volume reduction for macroglossia patients with Beckwith-Wiedemann syndrome (BWS).Methods:The clinical data of children diagnosed as BWS based on clinic symptoms and gene tests, who received operation in Department of Plastic Surgery, Children’s Hospital of Fudan University from July 2012 to December 2019 were analyzed retrospectively. All the patients underwent dorsal tongue bell-shaped resection and ventral V-shaped resection. By pulling tongue tip, the tongue body was cut and dissected along the marking line followed by suturing the muscle layer of the central part of the tongue tissue. Intermittent mattress suture of the dorsal and ventral mucous wounds of the tongue. After operation, all patients kept the trachea intubation and were transferred to PICU for further treatment and received early nasal feeding. The short-term postoperative complications, and long-term follow-up of the tongue body shape and clinical symptoms were recorded.The clinical effect was evaluated by onesurgeon and the parents.The effect was graded into four levels: dissatisifaction, average, satisifaction and great satisifaction.Results:A total of 61 children were included in this study, including 30 males and 31 females, with an average age of 8.5 months. The length of the tongue exposed outside at the resting state was 1.34-2.62 cm, with a median of 1.87 cm. Symmetric hypertrophy was found in 52 cases (85.2%), lateral hypertrophy in 9 cases (14.8%). There were 3 cases with respiratory obstruction (4.9%), 35 cases with salivation (57.4%), 4 cases suffering difficulty of feeding and dysphagia (6.6%). All children underwent the operation successfully, and the average operation time was 35.8 min. Among the short-term complications, there were 3 ventral wounds dehiscence, none of which needed sutured again. By prolonging nasal feeding time, the wounds were all healed in the secondary stage. Respiratory obstruction occurred in 1 patient after operation, and the symptoms were relieved after tongue retraction. The mean follow-up time was 3.3 years (2 months to 7 years), and 1 patient was inadequately corrected and good condition was got after second aryoperation. The remaining children obtained satisfactory resting tongue position and appearance, and the postoperative clinical symptoms were improved. In the long-term follow-up, the comprehensive evaluation results of the resting tongue position and clinical symptoms of the children by surgeon and parents were satisfied in 10 cases (16.4%), very satisfied in 50 cases (82.0%), and average in 1 case (insufficient correction after the first operation).Conclusions:Central resection and volume reduction of tongue body is a simple, effective and safe surgical technique in children with giant tongue diagnosed as BWS.

Objective:To summarize the surgery effect of tongue volume reduction for macroglossia patients with Beckwith-Wiedemann syndrome (BWS).Methods:The clinical data of children diagnosed as BWS based on clinic symptoms and gene tests, who received operation in Department of Plastic Surgery, Children’s Hospital of Fudan University from July 2012 to December 2019 were analyzed retrospectively. All the patients underwent dorsal tongue bell-shaped resection and ventral V-shaped resection. By pulling tongue tip, the tongue body was cut and dissected along the marking line followed by suturing the muscle layer of the central part of the tongue tissue. Intermittent mattress suture of the dorsal and ventral mucous wounds of the tongue. After operation, all patients kept the trachea intubation and were transferred to PICU for further treatment and received early nasal feeding. The short-term postoperative complications, and long-term follow-up of the tongue body shape and clinical symptoms were recorded.The clinical effect was evaluated by onesurgeon and the parents.The effect was graded into four levels: dissatisifaction, average, satisifaction and great satisifaction.Results:A total of 61 children were included in this study, including 30 males and 31 females, with an average age of 8.5 months. The length of the tongue exposed outside at the resting state was 1.34-2.62 cm, with a median of 1.87 cm. Symmetric hypertrophy was found in 52 cases (85.2%), lateral hypertrophy in 9 cases (14.8%). There were 3 cases with respiratory obstruction (4.9%), 35 cases with salivation (57.4%), 4 cases suffering difficulty of feeding and dysphagia (6.6%). All children underwent the operation successfully, and the average operation time was 35.8 min. Among the short-term complications, there were 3 ventral wounds dehiscence, none of which needed sutured again. By prolonging nasal feeding time, the wounds were all healed in the secondary stage. Respiratory obstruction occurred in 1 patient after operation, and the symptoms were relieved after tongue retraction. The mean follow-up time was 3.3 years (2 months to 7 years), and 1 patient was inadequately corrected and good condition was got after second aryoperation. The remaining children obtained satisfactory resting tongue position and appearance, and the postoperative clinical symptoms were improved. In the long-term follow-up, the comprehensive evaluation results of the resting tongue position and clinical symptoms of the children by surgeon and parents were satisfied in 10 cases (16.4%), very satisfied in 50 cases (82.0%), and average in 1 case (insufficient correction after the first operation).Conclusions:Central resection and volume reduction of tongue body is a simple, effective and safe surgical technique in children with giant tongue diagnosed as BWS.

Objective: This study is to investigate the effectiveness of philtrum repairment for-microform cleft lip, using muscle tension line group reconstruction. Methods: This is a retrospective study of 19 consecutively primary microform cleft lip repairment patients, from January 2015 to December 2017. All the patients were provided muscle tension line reconstruction (group 1) or traditional muscle repairment by horizontal mattress sutures (group 2). The philtral ridge and dimple were evaluated by scores. The statistical analyses were performed using unpaired t-test by Prism 6.0 software. Results: The philtral ridge score was higher in group 1 than group 2 (4.15±0.56 vs. 2.73±0.32, P<0.01). The philtral dimple score of group 1 increased either, when compared with group 2 (2.36±0.50 vs.1.45±0.28, P=0.0004). Conclusions Functional reconstruction of philtrum, using muscle tension line group repair, has satisfactory results in philtral ridge and philtral dimple.

Objective: In clinical, cephalic index is the most common method to evaluate scaphocephaly. However, cephalic index alone is not sufficient to describe the nuances of skull shape. The authors hypothesize that the location of euryon could be a valuable and practical index as the supplement of cephalic index to better describe the skull. Methods: This is a retrospective study. CT scans of 17 scaphocephaly patients and 17 normal controls were included. Eight of 17 scaphocephaly patients have 6 months postoperative CT scan. The preoperative location of euryon of scaphocephaly patients was compared to that of the controls and postoperative. The horizontal location of euryon was defined as the ratio of the distance, from the most prominent point of forehead to euryon, to anteroposterior cranial length. The vertical location of euryon was defined as the ratio of the vertical distance, from the nasion to euryon, to cranial height. Results: Both the horizontal and vertical locations of euryon of preoperative scaphocephaly patients were significantly decreased compared to normals (46.50%±4.02% vs. 50.39%±2.21%, t=3.49, P=0.0014; 35.78%±8.62% vs. 52.6%±8.08%, t=5.86, P<0.001). Both the postoperative horizontal vertical locations of euryon were significantly increased, when compared to preoperative (47.25%±4.23% vs. 44.02%±3.72%, t=2.42, P=0.045; 42.39%±9.06% vs. 35.18%±5.36%, t=2.554, P=0.0379). Conclusions The location of euryon could be a practical and valuable index to describe the nuances of skull shape.