1.Comparison of Anatomic Locking Titanium Plate and Intramedullary Nail in the Treatment of Distal Tibial Fractures
Mengjun MA ; Yanbo CHEN ; Gang ZENG ; Chen CHEN ; Weidong SONG ; Wenzhou LIU
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(1):108-113
		                        		
		                        			
		                        			ObjectivesTo compare the clinical efficacy and complications of anatomic locking titanium plate (hereinafter referred to as “titanium plate screw”) and intramedullary nail in the treatment of distal tibial fractures.Methods From September 2019 to September 2021, 32 patients diagnosed with AO-A fracture of distal tibia at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were included in this study. Of these, 15 cases were treated with titanium plate screws and 17 cases were treated with intramedullary nails. General surgical indexes, fracture healing time and postoperative operation were compared between the two groups.ResultsAll patients were followed up for 10 to 20 months, with an average of 12 months. The operative time and intraoperative fluoroscopy times of intramedullary nail group were longer than those of titanium plate screw group, but the preoperative waiting time and hospitalization days was less or were fewer than those of titanium plate screw group, the difference was statistically significant (P < 0.05). There was no significant difference in fracture healing time between the two groups (P> 0.05). At 6 weeks after operation, VAS scores in both groups were lower than those before operation, with statistically significant difference (P<0.05). There was no significant difference in VAS scores between the intramedullary nail group and the titanium plate screw group (P> 0.05). AOFAS scores 6 months after surgery, ankle joint motion and complication rate 1 year after surgery in intramedullary screw group were better than those in titanium plate screw group, and the differences were statistically significant (P< 0.05). There was no significant difference in AOFAS scores between the two groups at 1 year after operation (P> 0.05).ConclusionTitanium plate screw and intramedullary nail are both effective methods for the treatment of distal tibial AO-A fracture, and there is no significant difference in long-term clinical efficacy. Intramedullary nail has fewer soft tissue complications, less impact on ankle motion, faster recovery and higher safety, while titanium plate screw has a higher probability of postoperative soft tissue infection. We suggest that in clinical work, preoperative evaluation of patients should be done well. Under the premise of grasping the indications, intramedullary nail has fewer complications and certain advantages. 
		                        		
		                        		
		                        		
		                        	
2.Bone remodeling in the Masquelet-induced membrane model of rat femur by modulation of H-type vessels by total flavonoids of rhizome drynariae
Zhikui ZENG ; Wei XIONG ; Weidong LIANG ; Guowen QIAN ; Chaoyi LIANG ; Bin PAN ; Ling GUO ; Wenqiang WEI ; Xunxiang QIU ; Wenfang DENG ; Lingmei YUAN
Chinese Journal of Tissue Engineering Research 2024;28(32):5130-5135
		                        		
		                        			
		                        			BACKGROUND:Several studies have found that the total flavonoids of rhizome drynariae can promote neovascularization in the induced membrane,improve the biological properties of the induced membrane,and accelerate bone remodeling in the induced membrane,but the related molecular mechanisms still need to be further explored. OBJECTIVE:To explore the effect of total flavonoids of rhizome drynariae on bone remodeling in rat femoral Masquelet-induced membrane model by regulating H-type blood vessels. METHODS:Thirty-six male Sprague-Dawley rats were stratified by body mass and then randomly divided into blank group,model group and traditional Chinese medicine group,with 12 rats in each group.A 4-mm femoral bone defect model was established in all the rats.Bone defects in the model group and traditional Chinese medicine group were filled with polymethylmethacrylate bone cement.At 6 weeks after modeling,the tail bone of the rats was implanted in the blank group,as well as in the other two groups after removal of bone cement.The traditional Chinese medicine group was given 157.5 mg/kg per day of total flavonoids of rhizome drynariae at 3 days after bone implantation,while the model and blank groups were given the same amount of saline by gavage until the 8th week after bone implantation.Bone graft samples were taken for relevant testing at 8 weeks after implantation. RESULTS AND CONCLUSION:X-ray films showed that in the blank group,the fracture line in the defect area was clear,and only a small amount of bone callus formed;in the model group,the bone defect area still existed,where discontinuous cortical bone was visible;in the traditional Chinese medicine group,the defect area was filled with newborn bone tissues,the bone marrow cavity and part of the cortical bone formed,and the fracture line disappeared.Micro-CT scans showed that the amount of new bone in the defect area was low in the blank group,the number of bone trabeculae in the defect area was significantly increased in the model group,and a large amount of new bone tissue was filled in the bone defect area in the traditional Chinese medicine group.Hematoxylin-eosin staining results showed that in the blank group,only a small amount of new bone formed in the defect area and the quality of osteogenesis was poor;in the model group,there was more new bone tissue in the defect area,but some fibrous connective tissues were interspersed within the bone tissue;and in the traditional Chinese medicine group,a large amount of new bone formed in the defect area and the quality of osteogenesis was the best.CD31/Emcn immunofluorescence double-labeling staining results showed that the number of H-type blood vessels in the newborn bone tissue in the bone defect area of the blank group was sparse and sparsely distributed;compared with the blank group,there were more H-type blood vessels in the bone tissue in the bone defect area of the model group,and the blood vessels were distributed in relatively regular strips;the number of H-type blood vessels in the bone defect area of the traditional Chinese medicine group was the highest and the blood vessels were densely distributed.To conclude,the total flavonoids of rhizoma drynariae can upregulate the expression of H-type blood vessels to enhance the angiogenic-osteogenic effect,improve the osteogenic efficiency of the rat femoral Masquelet induced membrane model,and promote bone remodeling.
		                        		
		                        		
		                        		
		                        	
3.Monitoring and analysis of food microbial contamination in rural compulsory education schools in Baiyin City from 2013 to 2021
YANG Junpeng, CHEN Anming, ZHANG Guoqin, ZENG Tongxia, QIANG Weidong
Chinese Journal of School Health 2022;43(6):934-936
		                        		
		                        			Objective:
		                        			To analyze the level and trend of microbial contamination in food in rural compulsory education schools in Baiyin City, so as to provide a reference for playing an early warning role in eliminating potential food safety hazards as soon as possible.
		                        		
		                        			Methods:
		                        			According to the "National Food Contaminants and Harmful Factors Risk Monitoring Workbook", etc., 8 pathogenic bacteria such as Salmonella, Listeria monocytogenes, Staphylococcus aureus, total bacterial count, and 2 hygienic indicator bacteria of coliform were tested.
		                        		
		                        			Results:
		                        			A total of 908 food samples were collected from 2013 to 2021, 47 were positive and the overall positive rate was 5.18%. The positive rate of samples collected in different years showed a downward trend year by year. The detected pathogenic bacteria ranked from high to low as follows: Escherichia coli (1.87%), Bacillus cereus (0.99%), Staphylococcus aureus (0.44%), mold (0.33%), Listeria monocytogenes (0.22%). Hygiene indicator bacteria total number of bacteria exceeded the standard rate was higher (2.09%). Among all kinds of food, milk and dairy products, frozen food, cold food, barbecue, rice and flour products had higher positive rates. According to quarterly statistics, the positive rate in the first and second quarters was relatively high.
		                        		
		                        			Conclusion
		                        			There are different degrees of microbial contamination risks in the food of rural compulsory education schools. All relevant departments should pay attention to the current situation of school food hygiene and safety in poverty stricken areas, and strengthen rural compulsory education school food, especially for milk and dairy products, frozen food, cold food, Supervision of key foods such as barbecue, rice and flour products, and efforts to improve their safety standards, do a good job in school food hygiene and safety, and ensure the healthy growth of young people.
		                        		
		                        		
		                        		
		                        	
4.Spirulina platensis aqueous extracts ameliorate colonic mucosal damage and modulate gut microbiota disorder in mice with ulcerative colitis by inhibiting inflammation and oxidative stress.
Jian WANG ; Liqian SU ; Lun ZHANG ; Jiali ZENG ; Qingru CHEN ; Rui DENG ; Ziyan WANG ; Weidong KUANG ; Xiaobao JIN ; Shuiqing GUI ; Yinghua XU ; Xuemei LU
Journal of Zhejiang University. Science. B 2022;23(6):481-501
		                        		
		                        			
		                        			Ulcerative colitis (UC) is a chronic and recurrent inflammatory bowel disease (IBD) that has become a major gastroenterologic problem during recent decades. Numerous complicating factors are involved in UC development such as oxidative stress, inflammation, and microbiota disorder. These factors exacerbate damage to the intestinal mucosal barrier. Spirulina platensis is a commercial alga with various biological activity that is widely used as a functional ingredient in food and beverage products. However, there have been few studies on the treatment of UC using S. platensis aqueous extracts (SP), and the underlying mechanism of action of SP against UC has not yet been elucidated. Herein, we aimed to investigate the modulatory effect of SP on microbiota disorders in UC mice and clarify the underlying mechanisms by which SP alleviates damage to the intestinal mucosal barrier. Dextran sulfate sodium (DSS) was used to establish a normal human colonic epithelial cell (NCM460) injury model and UC animal model. The mitochondrial membrane potential assay 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and staining with Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) and Hoechst 33258 were carried out to determine the effects of SP on the NCM460 cell injury model. Moreover, hematoxylin and eosin (H&E) staining, transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qPCR), western blot, and 16S ribosomal DNA (rDNA) sequencing were used to explore the effects and underlying mechanisms of action of SP on UC in C57BL/6 mice. In vitro studies showed that SP alleviated DSS-induced NCM460 cell injury. SP also significantly reduced the excessive generation of intracellular reactive oxygen species (ROS) and prevented mitochondrial membrane potential reduction after DSS challenge. In vivo studies indicated that SP administration could alleviate the severity of DSS-induced colonic mucosal damage compared with the control group. Inhibition of inflammation and oxidative stress was associated with increases in the activity of antioxidant enzymes and the expression of tight junction proteins (TJs) post-SP treatment. SP improved gut microbiota disorder mainly by increasing antioxidant enzyme activity and the expression of TJs in the colon. Our findings demonstrate that the protective effect of SP against UC is based on its inhibition of pro-inflammatory cytokine overproduction, inhibition of DSS-induced ROS production, and enhanced expression of antioxidant enzymes and TJs in the colonic mucosal barrier.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Antioxidants/pharmacology*
		                        			;
		                        		
		                        			Colitis/prevention & control*
		                        			;
		                        		
		                        			Colitis, Ulcerative/metabolism*
		                        			;
		                        		
		                        			Colon/metabolism*
		                        			;
		                        		
		                        			Dextran Sulfate/toxicity*
		                        			;
		                        		
		                        			Disease Models, Animal
		                        			;
		                        		
		                        			Gastrointestinal Microbiome
		                        			;
		                        		
		                        			Inflammation/metabolism*
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Mice, Inbred C57BL
		                        			;
		                        		
		                        			Oxidative Stress
		                        			;
		                        		
		                        			Reactive Oxygen Species/metabolism*
		                        			;
		                        		
		                        			Spirulina
		                        			
		                        		
		                        	
5.The measurements of the similarity of dynamic brain functional network.
Yongquan HE ; Li ZHANG ; Shan FANG ; Yaqin ZENG ; Wei YANG ; Weidong CHEN ; Yuling SHAO ; Ruidong CHENG ; Xiangming YE ; Dongrong XU
Journal of Biomedical Engineering 2022;39(2):237-247
		                        		
		                        			
		                        			Brain functional network changes over time along with the process of brain development, disease, and aging. However, most of the available measurements for evaluation of the difference (or similarity) between the individual brain functional networks are for charactering static networks, which do not work with the dynamic characteristics of the brain networks that typically involve a long-span and large-scale evolution over the time. The current study proposes an index for measuring the similarity of dynamic brain networks, named as dynamic network similarity (DNS). It measures the similarity by combining the "evolutional" and "structural" properties of the dynamic network. Four sets of simulated dynamic networks with different evolutional and structural properties (varying amplitude of changes, trend of changes, distribution of connectivity strength, range of connectivity strength) were generated to validate the performance of DNS. In addition, real world imaging datasets, acquired from 13 stroke patients who were treated by transcranial direct current stimulation (tDCS), were used to further validate the proposed method and compared with the traditional similarity measurements that were developed for static network similarity. The results showed that DNS was significantly correlated with the varying amplitude of changes, trend of changes, distribution of connectivity strength and range of connectivity strength of the dynamic networks. DNS was able to appropriately measure the significant similarity of the dynamics of network changes over the time for the patients before and after the tDCS treatments. However, the traditional methods failed, which showed significantly differences between the data before and after the tDCS treatments. The experiment results demonstrate that DNS may robustly measure the similarity of evolutional and structural properties of dynamic networks. The new method appears to be superior to the traditional methods in that the new one is capable of assessing the temporal similarity of dynamic functional imaging data.
		                        		
		                        		
		                        		
		                        			Aging/physiology*
		                        			;
		                        		
		                        			Brain/physiology*
		                        			;
		                        		
		                        			Brain Mapping
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Imaging/methods*
		                        			;
		                        		
		                        			Nerve Net/physiology*
		                        			;
		                        		
		                        			Transcranial Direct Current Stimulation/methods*
		                        			
		                        		
		                        	
6.Differentiation of cystic biliary atresia and choledochal cysts using prenatal ultrasonography
Lizhu CHEN ; Fujiao HE ; Kaihui ZENG ; Bing WANG ; Jingyu LI ; Dan ZHAO ; Zeyu YANG ; Weidong REN
Ultrasonography 2022;41(1):140-149
		                        		
		                        			 Purpose:
		                        			This study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC). 
		                        		
		                        			Methods:
		                        			Fetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth. 
		                        		
		                        			Results:
		                        			Between January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971. 
		                        		
		                        			Conclusion
		                        			The GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC. 
		                        		
		                        		
		                        		
		                        	
7.Spirulina platensis aqueous extracts ameliorate colonic mucosal damage and modulate gut microbiota disorder in mice with ulcerative colitis by inhibiting inflammation and oxidative stress
WANG JIAN ; SU LIQIAN ; ZHANG LUN ; ZENG JIALI ; CHEN QINGRU ; DENG RUI ; WANG ZIYAN ; KUANG WEIDONG ; JIN XIAOBAO ; GUI SHUIQING ; XU YINGHUA ; LU XUEMEI
Journal of Zhejiang University. Science. B 2022;23(6):481-501
		                        		
		                        			
		                        			Ulcerative colitis (UC) is a chronic and recurrent inflammatory bowel disease (IBD) that has become a major gastroenterologic problem during recent decades. Numerous complicating factors are involved in UC development such as oxidative stress, inflammation, and microbiota disorder. These factors exacerbate damage to the intestinal mucosal barrier. Spirulina platensis is a commercial alga with various biological activity that is widely used as a functional ingredient in food and beverage products. However, there have been few studies on the treatment of UC using S. platensis aqueous extracts (SP), and the underlying mechanism of action of SP against UC has not yet been elucidated. Herein, we aimed to investigate the modulatory effect of SP on microbiota disorders in UC mice and clarify the underlying mechanisms by which SP alleviates damage to the intestinal mucosal barrier. Dextran sulfate sodium (DSS) was used to establish a normal human colonic epithelial cell (NCM460) injury model and UC animal model. The mitochondrial membrane potential assay 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and staining with Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) and Hoechst 33258 were carried out to determine the effects of SP on the NCM460 cell injury model. Moreover, hematoxylin and eosin (H&E) staining, transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qPCR), western blot, and 16S ribosomal DNA (rDNA) sequencing were used to explore the effects and underlying mechanisms of action of SP on UC in C57BL/6 mice. In vitro studies showed that SP alleviated DSS-induced NCM460 cell injury. SP also significantly reduced the excessive generation of intracellular reactive oxygen species (ROS) and prevented mitochondrial membrane potential reduction after DSS challenge. In vivo studies indicated that SP administration could alleviate the severity of DSS-induced colonic mucosal damage compared with the control group. Inhibition of inflammation and oxidative stress was associated with increases in the activity of antioxidant enzymes and the expression of tight junction proteins (TJs) post-SP treatment. SP improved gut microbiota disorder mainly by increasing antioxidant enzyme activity and the expression of TJs in the colon. Our findings demonstrate that the protective effect of SP against UC is based on its inhibition of pro-inflammatory cytokine overproduction, inhibition of DSS-induced ROS production, and enhanced expression of antioxidant enzymes and TJs in the colonic mucosal barrier.
		                        		
		                        		
		                        		
		                        	
8.Efficacy of three-dimensional visualization technology in the precision diagnosis and treatment for primary liver cancer: a retrospective multicenter study of 1 665 cases in China
Chihua FANG ; Peng ZHANG ; Weiping ZHOU ; Jian ZHOU ; Chaoliu DAI ; Jingfeng LIU ; Weidong JIA ; Xiao LIANG ; Silue ZENG ; Sai WEN
Chinese Journal of Surgery 2020;58(5):E011-E011
		                        		
		                        			
		                        			Objective:To evaluate the efficacy of three-dimensional (3D) visualization technology in the precision diagnosis and treatment for primary liver cancer.Methods:A total of 1 665 patients with primary liver cancer who admitted to seven medical centers in China between January 2009 to January 2019, diagnosed and treated by 3D visualization protocol were analyzed, and their clinical data were retrospectively reviewed. There were 1 255 males (75.4%) and 410 females (24.6%) , with age of (52.9±11.9) years (range: 18 to 86 years) .The acquisition of high-quality CT images with submillimeter spatial resolution were conducted using a quality control system. By means of homogenization methods, 3D reconstruction and 3D visualization analysis were performed. Postoperative observation: pathology reports, microvascular invasion, perioperative complications and follow-up. SPSS 25.0 statistical software was used for statistical description and analysis of clinical data.Results:In the sample of 1 265 patients, 3D reconstructed models clearly displayed in follows. (1) tumor size: ≤2 cm in 155 cases (9.31%) , >2 cm to 5 cm in 551 cases (33.09%) , >5 cm to 10 cm in 636 cases (38.20%) , >10 cm in 323 cases (19.40%) . (2) Classification of hepatic blood vessels. Hepatic artery: type Ⅰ (normal type) in 1 494 cases (89.73%) ,variant hepatic artery in 171 cases (10.27%) , including type Ⅱ in 35 cases, type Ⅲ in 38 cases, and other types in 98 cases. Hepatic vein: type Ⅰ (normal) in 1 195 cases (71.77%) ,variant hepatic veins in 470 cases (28.23%) , including type Ⅱ in 376 cases and type Ⅲ in 94 cases. Portal vein: normal type in 1 315 cases (78.98%) ,variant portal veins in 350 cases (21.02%) , including type Ⅰ in 189 cases, type Ⅱin 103 cases, type Ⅲ in 50 cases, type Ⅳ in 8 cases. Hepatic artery variation coexisting with portal vein variation in 24 cases (1.44%) . Hepatic vein variation coexisting with portal vein variation in 113 cases (6.79%) . Three types of vascular variation in 4 cases (0.24%) , including coexistence of type Ⅱ hepatic artery variation or type Ⅰ portal vein variation with type Ⅲ hepatic vein variation in 2 cases,coexistence of type Ⅲ hepatic artery variation or type Ⅲ portal vein variation with type Ⅱ hepatic vein variation in 2 cases. (3) Preoperative liver volume calculation: 1 499.3 (514.4) ml (range: 641.7 to 6 637.0 ml) of total liver volume, including 479.1 (460.1) ml (range:10.5 to 2 086.8 ml) for liver resection and 959.9 (460.4) ml (range:306.1 to 5 638.0 ml) for residual function. (4) Operative methods: anatomical hepatectomy in 1 458 cases (87.57%) ; non-anatomic hepatectomy in 207 cases (12.43%) . (5) the median operation time was 285 (165) minutes (range: 40 to720 minutes) . (6) The median intraoperative blood loss was 200 (250) ml (range:10 to 4 200 ml) and 346 cases (20.78%) had intraoperative transfusion. (7) Pathology reports: hepatocellular carcinoma in 1 371 cases (82.34%) , cholangiocarcinoma in 260 cases (15.62%) and mixed hepatocellular carcinoma in 34 cases (2.04%) . Microvascular invasion: M0 in 199 cases, M1 in 64 cases, and M2 in 27 cases. (8) Postoperative complications in 207 cases (12.43%) , including Clavien-Dindo grade Ⅰ or Ⅱ in 57 cases, grade Ⅲ or Ⅳ in 147 cases and grade Ⅴ in 3 cases.There were 13 cases (0.78%) of liver failure and 3 cases (0.18%) of perioperative death. (9) The follow-up time was 3.0 to 96.0 months, with a median time of 21.0(17.8) years. The overall 3-year survival and disease-free survival rates were 80.0% and 56.5%, respectively. The overall 5-year survival and disease-free survival rates were 59.7% and 30.0%, respectively.Conclusion:3D visualization technology plays an important role in realizing accurate diagnosis of anatomical location and morphology of primary liver cancer, improving the success rate of surgery and reducing the incidence of complications.
		                        		
		                        		
		                        		
		                        	
9.Efficacy of three-dimensional visualization technology in the precision diagnosis and treatment for primary liver cancer: a retrospective multicenter study of 1 665 cases in China
Chihua FANG ; Peng ZHANG ; Weiping ZHOU ; Jian ZHOU ; Chaoliu DAI ; Jingfeng LIU ; Weidong JIA ; Xiao LIANG ; Silüe ZENG ; Sai WEN
Chinese Journal of Surgery 2020;58(5):375-382
		                        		
		                        			
		                        			Objective:To evaluate the efficacy of three-dimensional(3D) visualization technology in the precision diagnosis and treatment for primary liver cancer.Methods:A total of 1 665 patients with primary liver cancer who admitted to seven medical centers in China between January 2009 to January 2019, diagnosed and treated by 3D visualization protocol were analyzed, and their clinical data were retrospectively reviewed. There were 1 255 males(75.4%) and 410 females(24.6%), with age of (52.9±11.9) years (range: 18 to 86 years). The acquisition of high-quality CT images with submillimeter spatial resolution were conducted using a quality control system. By means of homogenization methods, 3D reconstruction and 3D visualization analysis were performed. Postoperative observation: pathology reports, microvascular invasion, perioperative complications and follow-up. SPSS 25.0 statistical software was used for statistical description and analysis of clinical data. Kaplan-Meier curve was used to calculate overall survival and disease-free survival rate.Results:(1)In the sample of 1 265 patients, 3D reconstructed models clearly displayed as follows. tumor size: ≤2 cm in 155 cases (9.31%), >2 cm to 5 cm in 551 cases (33.09%), >5 cm to 10 cm in 636 cases (38.20%), >10 cm in 323 cases (19.40%). (2) Classification of hepatic blood vessels. Hepatic artery: type Ⅰ(normal type) in 1 494 cases(89.73%),variant hepatic artery in 171 cases (10.27%), including type Ⅱ in 35 cases, type Ⅲ in 38 cases, and other types in 98 cases. Hepatic vein: type Ⅰ (normal) in 1 195 cases (71.77%),variant hepatic veins in 470 cases(28.23%), including type Ⅱ in 376 cases and type Ⅲ in 94 cases. Portal vein:normal type in 1 315 cases (78.98%), variant portal veins in 350 cases (21.02%), including type Ⅰ in 189 cases, type Ⅱin 103 cases, type Ⅲ in 50 cases, type Ⅳ in 8 cases. Hepatic artery variation coexisting with portal vein variation in 24 cases (1.44%). Hepatic vein variation coexisting with portal vein variation in 113 cases (6.79%). Three types of vascular variation in 4 cases (0.24%), including coexistence of type Ⅱ hepatic artery variation or type Ⅰ portal vein variation with type Ⅲ hepatic vein variation in 2 cases,coexistence of type Ⅲ hepatic artery variation or type Ⅲ portal vein variation with type Ⅱ hepatic vein variation in 2 cases. (3) Preoperative liver volume calculation:1 499.3 (514.4)ml (range:641.7 to 6 637.0 ml) of total liver volume, including 479.1 (460.1) ml (range:10.5 to 2 086.8 ml) for liver resection and 959.9 (460.4)ml (range:306.1 to 5 638.0 ml) for residual function. (4)Operative methods: anatomical hepatectomy in 1 458 cases (87.57%); non-anatomic hepatectomy in 207 cases (12.43%). (5)the median operation time was 285(165)minutes (range: 40 to720 minutes). (6)The median intraoperative blood loss was 200(250)ml (range:10 to 4 200 ml) and 346 cases (20.78%) had intraoperative transfusion. (7)Pathology reports: hepatocellular carcinoma in 1 371 cases (82.34%), cholangiocarcinoma in 260 cases (15.62%) and mixed hepatocellular carcinoma in 34 cases (2.04%). Microvascular invasion: M0 in 199 cases, M1 in 64 cases, and M2 in 27 cases. (8)Postoperative complications in 207 cases (12.43%), including Clavien-Dindo grade Ⅰ or Ⅱ in 57 cases, grade Ⅲ or Ⅳ in 147 cases and grade Ⅴ in 3 cases.There were 13 cases (0.78%) of liver failure and 3 cases (0.18%) of perioperative death. (9) The follow-up time was 3.0 to 96.0 months, with a median time of 21.0(17.8) years. The overall 3-year survival and disease-free survival rates were 80.0% and 56.5%, respectively. The overall 5-year survival and disease-free survival rates were 59.7% and 30.0%, respectively.Conclusion:3D visualization technology plays an important role in realizing accurate diagnosis of anatomical location and morphology of primary liver cancer, improving the success rate of surgery and reducing the incidence of complications.
		                        		
		                        		
		                        		
		                        	
10.Efficacy of three-dimensional visualization technology in the precision diagnosis and treatment for primary liver cancer: a retrospective multicenter study of 1 665 cases in China
Chihua FANG ; Peng ZHANG ; Weiping ZHOU ; Jian ZHOU ; Chaoliu DAI ; Jingfeng LIU ; Weidong JIA ; Xiao LIANG ; Silue ZENG ; Sai WEN
Chinese Journal of Surgery 2020;58(5):E011-E011
		                        		
		                        			
		                        			Objective:To evaluate the efficacy of three-dimensional (3D) visualization technology in the precision diagnosis and treatment for primary liver cancer.Methods:A total of 1 665 patients with primary liver cancer who admitted to seven medical centers in China between January 2009 to January 2019, diagnosed and treated by 3D visualization protocol were analyzed, and their clinical data were retrospectively reviewed. There were 1 255 males (75.4%) and 410 females (24.6%) , with age of (52.9±11.9) years (range: 18 to 86 years) .The acquisition of high-quality CT images with submillimeter spatial resolution were conducted using a quality control system. By means of homogenization methods, 3D reconstruction and 3D visualization analysis were performed. Postoperative observation: pathology reports, microvascular invasion, perioperative complications and follow-up. SPSS 25.0 statistical software was used for statistical description and analysis of clinical data.Results:In the sample of 1 265 patients, 3D reconstructed models clearly displayed in follows. (1) tumor size: ≤2 cm in 155 cases (9.31%) , >2 cm to 5 cm in 551 cases (33.09%) , >5 cm to 10 cm in 636 cases (38.20%) , >10 cm in 323 cases (19.40%) . (2) Classification of hepatic blood vessels. Hepatic artery: type Ⅰ (normal type) in 1 494 cases (89.73%) ,variant hepatic artery in 171 cases (10.27%) , including type Ⅱ in 35 cases, type Ⅲ in 38 cases, and other types in 98 cases. Hepatic vein: type Ⅰ (normal) in 1 195 cases (71.77%) ,variant hepatic veins in 470 cases (28.23%) , including type Ⅱ in 376 cases and type Ⅲ in 94 cases. Portal vein: normal type in 1 315 cases (78.98%) ,variant portal veins in 350 cases (21.02%) , including type Ⅰ in 189 cases, type Ⅱin 103 cases, type Ⅲ in 50 cases, type Ⅳ in 8 cases. Hepatic artery variation coexisting with portal vein variation in 24 cases (1.44%) . Hepatic vein variation coexisting with portal vein variation in 113 cases (6.79%) . Three types of vascular variation in 4 cases (0.24%) , including coexistence of type Ⅱ hepatic artery variation or type Ⅰ portal vein variation with type Ⅲ hepatic vein variation in 2 cases,coexistence of type Ⅲ hepatic artery variation or type Ⅲ portal vein variation with type Ⅱ hepatic vein variation in 2 cases. (3) Preoperative liver volume calculation: 1 499.3 (514.4) ml (range: 641.7 to 6 637.0 ml) of total liver volume, including 479.1 (460.1) ml (range:10.5 to 2 086.8 ml) for liver resection and 959.9 (460.4) ml (range:306.1 to 5 638.0 ml) for residual function. (4) Operative methods: anatomical hepatectomy in 1 458 cases (87.57%) ; non-anatomic hepatectomy in 207 cases (12.43%) . (5) the median operation time was 285 (165) minutes (range: 40 to720 minutes) . (6) The median intraoperative blood loss was 200 (250) ml (range:10 to 4 200 ml) and 346 cases (20.78%) had intraoperative transfusion. (7) Pathology reports: hepatocellular carcinoma in 1 371 cases (82.34%) , cholangiocarcinoma in 260 cases (15.62%) and mixed hepatocellular carcinoma in 34 cases (2.04%) . Microvascular invasion: M0 in 199 cases, M1 in 64 cases, and M2 in 27 cases. (8) Postoperative complications in 207 cases (12.43%) , including Clavien-Dindo grade Ⅰ or Ⅱ in 57 cases, grade Ⅲ or Ⅳ in 147 cases and grade Ⅴ in 3 cases.There were 13 cases (0.78%) of liver failure and 3 cases (0.18%) of perioperative death. (9) The follow-up time was 3.0 to 96.0 months, with a median time of 21.0(17.8) years. The overall 3-year survival and disease-free survival rates were 80.0% and 56.5%, respectively. The overall 5-year survival and disease-free survival rates were 59.7% and 30.0%, respectively.Conclusion:3D visualization technology plays an important role in realizing accurate diagnosis of anatomical location and morphology of primary liver cancer, improving the success rate of surgery and reducing the incidence of complications.
		                        		
		                        		
		                        		
		                        	
            

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