1.Short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures.
Guo-Liang LI ; Jian-Yong ZHAO ; Xiao-Ming LI ; Tie-Qiang WANG ; Kang CHEN ; Qi-Lin LIU
China Journal of Orthopaedics and Traumatology 2023;36(9):809-814
Objective To explore the short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures, and explore the quantification of traditional Chinese medicine manual reduction and personalized improvement of splinting. Methods The clinical data of 50 patients with AO type-A distal radius fractures, who received treatment at the outpatient department of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province, were retrospective analyzed. The patient cohort included 22 females and 28 males, with ages ranging from 25 to 75 years old. Among them, 27 cases presented with distal radius fractures on the left side, and 24 cases on the right side. The patients were categorized into two groups: treatment group (n=25) and control group(n=25). There were 13 males and 12 females in the treatment group, with an average age of (56.2±5.5) years old. Treatment approach for this group involved several steps. Initially, Mimics Research software was used to conduct comprehensive analysis of complete CT data from the affected limb, resulting in the creation of a three-dimensional model. Subsequently, 3D models of the bones and skin contours, stored as STL format files, were imported into the Materialise Magics 23.0 software for model processing and repair. This facilitated the simulation of reduction and recording of displacement data, effectively generating a "digital prescription" to guide and quantify traditional Chinese medicine manipulation procedures. Finally, a personalized 3D printed splint was applied for fixation treatment. There were 15 males and 10 females in the control group, with an average age of (53.32±5.28) years old. These patients were treated with manualreduction combined with traditional splinting. The clinical efficacy of the two groups was assessed in terms of fracture reduction quality, fracture healing time, Gartland-Werley wrist joint score and X-ray parameters (palminclination angle, ulnar deviation angle, radius height) at 6 weeks post-operatively. Results The treatment group exhibited a shorter duration for achieving clinical healing compared to the control group (P<0.05). Six weeks post-operatively, the treatment group demonstrated higher wrist joint function scores, and a higher proportion of excellent and good outcomes than the control group(P<0.05). The treatment group was superior to the control group in terms of imaging parameters 6 weeks post-operatively (P<0.05). Conclusion By quantifying skin contours through digital simulation prescription reduction, a personalized 3D printed splint is developed to effectively stabilize fractures, enhancing localized fixation while ensuring greater adherence, stability, and comfort. This innovative approach offers personalized treatment for AO type-A distal radius fractures and presents a novel, precise treatment strategy for consideration.
Adult
;
Aged
;
Female
;
Humans
;
Male
;
Middle Aged
;
East Asian People
;
Printing, Three-Dimensional
;
Retrospective Studies
;
Splints
;
Wrist Fractures/therapy*
;
Medicine, Chinese Traditional/methods*
;
Therapy, Computer-Assisted/methods*
;
Manipulation, Orthopedic/methods*
;
Tomography, X-Ray Computed
;
Precision Medicine/methods*
2.Functional Connectivity-Based Modelling Simulates Subject-Specific Network Spreading Effects of Focal Brain Stimulation.
Xiaoyu CHEN ; Chencheng ZHANG ; Yuxin LI ; Pei HUANG ; Qian LV ; Wenwen YU ; Shengdi CHEN ; Bomin SUN ; Zheng WANG
Neuroscience Bulletin 2018;34(6):921-938
Neurostimulation remarkably alleviates the symptoms in a variety of brain disorders by modulating the brain-wide network. However, how brain-wide effects on the direct and indirect pathways evoked by focal neurostimulation elicit therapeutic effects in an individual patient is unknown. Understanding this remains crucial for advancing neural circuit-based guidance to optimize candidate patient screening, pre-surgical target selection, and post-surgical parameter tuning. To address this issue, we propose a functional brain connectome-based modeling approach that simulates the spreading effects of stimulating different brain regions and quantifies the rectification of abnormal network topology in silico. We validated these analyses by pinpointing nuclei in the basal ganglia circuits as top-ranked targets for 43 local patients with Parkinson's disease and 90 patients from a public database. Individual connectome-based analysis demonstrated that the globus pallidus was the best choice for 21.1% and the subthalamic nucleus for 19.5% of patients. Down-regulation of functional connectivity (up to 12%) at these prioritized targets optimally maximized the therapeutic effects. Notably, the priority rank of the subthalamic nucleus significantly correlated with motor symptom severity (Unified Parkinson's Disease Rating Scale III) in the local cohort. These findings underscore the potential of neural network modeling for advancing personalized brain stimulation therapy, and warrant future experimental investigation to validate its clinical utility.
Adult
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Aged
;
Brain Mapping
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Connectome
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Deep Brain Stimulation
;
methods
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Female
;
Humans
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Image Processing, Computer-Assisted
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Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Neural Pathways
;
diagnostic imaging
;
physiology
;
Oxygen
;
blood
;
Parkinson Disease
;
diagnostic imaging
;
pathology
;
therapy
;
ROC Curve
;
United Kingdom
3.Percutaneous Radiologically-Guided Gastrostomy (PRG): Safety, Efficacy and Trends in a Single Institution.
Gerard Zx LOW ; Chow Wei TOO ; Yen Yeong POH ; Richard Hg LO ; Bien Soo TAN ; Apoorva GOGNA ; Farah Gillan IRANI ; Kiang Hiong TAY
Annals of the Academy of Medicine, Singapore 2018;47(11):494-498
Enteral Nutrition
;
instrumentation
;
methods
;
Female
;
Fluoroscopy
;
methods
;
Gastrostomy
;
adverse effects
;
instrumentation
;
methods
;
Humans
;
Male
;
Middle Aged
;
Outcome and Process Assessment (Health Care)
;
Postoperative Complications
;
classification
;
diagnosis
;
therapy
;
Reproducibility of Results
;
Retrospective Studies
;
Singapore
;
Surgery, Computer-Assisted
;
methods
;
Treatment Outcome
4.Towards precision medicine: from quantitative imaging to radiomics.
U Rajendra ACHARYA ; Yuki HAGIWARA ; Vidya K SUDARSHAN ; Wai Yee CHAN ; Kwan Hoong NG
Journal of Zhejiang University. Science. B 2018;19(1):6-24
Radiology (imaging) and imaging-guided interventions, which provide multi-parametric morphologic and functional information, are playing an increasingly significant role in precision medicine. Radiologists are trained to understand the imaging phenotypes, transcribe those observations (phenotypes) to correlate with underlying diseases and to characterize the images. However, in order to understand and characterize the molecular phenotype (to obtain genomic information) of solid heterogeneous tumours, the advanced sequencing of those tissues using biopsy is required. Thus, radiologists image the tissues from various views and angles in order to have the complete image phenotypes, thereby acquiring a huge amount of data. Deriving meaningful details from all these radiological data becomes challenging and raises the big data issues. Therefore, interest in the application of radiomics has been growing in recent years as it has the potential to provide significant interpretive and predictive information for decision support. Radiomics is a combination of conventional computer-aided diagnosis, deep learning methods, and human skills, and thus can be used for quantitative characterization of tumour phenotypes. This paper discusses the overview of radiomics workflow, the results of various radiomics-based studies conducted using various radiological images such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET), the challenges we are facing, and the potential contribution of radiomics towards precision medicine.
Biomarkers, Tumor
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Diagnosis, Computer-Assisted
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Genome
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Genomics
;
Humans
;
Magnetic Resonance Imaging
;
Neoplasms/therapy*
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Phenotype
;
Positron-Emission Tomography
;
Precision Medicine/methods*
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Radiology/methods*
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Radiology, Interventional/methods*
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Tomography, X-Ray Computed
;
Workflow
6.Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance.
Eun Ju HA ; Jung Hwan BAEK ; Jeong Hyun LEE
Korean Journal of Radiology 2015;16(4):749-766
Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions.
Biopsy, Large-Core Needle/methods
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Catheter Ablation/methods
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Humans
;
Laser Therapy/methods
;
Neck/*anatomy & histology/blood supply/*ultrasonography
;
Surgery, Computer-Assisted/*methods
;
Thyroid Gland/*anatomy & histology/blood supply/*ultrasonography
7.Treatment Response Evaluation of Breast Cancer after Neoadjuvant Chemotherapy and Usefulness of the Imaging Parameters of MRI and PET/CT.
Yeong Yi AN ; Sung Hun KIM ; Bong Joo KANG ; Ah Won LEE
Journal of Korean Medical Science 2015;30(6):808-815
This study was aimed to evaluate the ability of imaging parameters measured on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI) and positron emission tomography/computed tomography (PET/CT) to serve as response markers in breast cancer after neoadjuvant chemotherapy (NAC). In 20 patients with breast cancer, DCE-MRI and DWI using a 3 T scanner and PET/CT were performed before and after NAC. DCE-MRI was analyzed using an automatic computer-aided detection program (MR-CAD). The response imaging parameters were compared with the pathologic response. The areas under the curve (AUCs) for DCE-MRI using MR-CAD analysis, DWI and PET/CT were 0.77, 0.59 and 0.76, respectively. The combination of all parameters measured by MR-CAD showed the highest diagnostic performance and accuracy (AUC = 0.77, accuracy = 90%). The combined use of the parameters of PET/CT with DCE-MRI or DWI showed a trend toward improved specificity and negative predictive value (100%, 100%, accuracy = 87.5%). The use of DCE-MRI using MR-CAD parameters indicated better diagnostic performance in predicting the final pathological response compared with DWI and PET/CT, although no statistically significant difference was observed. The combined use of PET/CT with DCE-MRI or DWI may improve the specificity for predicting a pathological response.
Adult
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Aged
;
Antineoplastic Agents/*therapeutic use
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Breast Neoplasms/*diagnosis/*drug therapy
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Chemotherapy, Adjuvant/methods
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Female
;
Humans
;
Image Interpretation, Computer-Assisted/methods
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Magnetic Resonance Imaging/*methods
;
Mammography/methods
;
Middle Aged
;
Multimodal Imaging/methods
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Neoadjuvant Therapy/methods
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Positron-Emission Tomography/*methods
;
Reproducibility of Results
;
Retrospective Studies
;
Sensitivity and Specificity
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Tomography, X-Ray Computed/*methods
;
Treatment Outcome
8.Treatment of metastatic thoracolumbar tumors by percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds.
Hai HUANG ; Shaonian XU ; Zhenguang DU ; Fusheng LI ; Liang WANG
Chinese Journal of Oncology 2014;36(3):228-231
OBJECTIVETo explore the value of percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds in the treatment of metastatic thoracolumbar tumors.
METHODSBased on the CT images before ¹²⁵I seed implantation, a computer-based treatment planning system (TPS) was used to determine the optimal seed distribution. Under CT guidance and local anaesthesia, ¹²⁵I seeds were implanted into 22 osseous metastatic lesions in 18 patients. Based on the CT images after the implantation, quality check was carried out with TPS. DSA (digital subtraction angiography)-guided vertebroplasty was performed under local anaesthesia, and bone cement was injected into the vertebrae through pedicle of vertebral arch.
RESULTSAll the 18 patients received percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds. Every vertebra was injected with 2-6 ml bone cement, average 3.5 ml, and was injected with ¹²⁵I seeds 16-34 pills, average 26 pills. At 2-months follow-up, their numerical rating scale (NRS) pain scores were 7.12 ± 1.48 before and 2.26 ± 1.07 after treatment, with a significant difference (P < 0.05).
CONCLUSIONSPercutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds is a minimally invasive procedure with small wound and minor complications, and no need of external radiation therapy. It is effective in the alleviation of pain in metastatic thoracolumbar tumor patients, restrains the tumor growth, and improves the quality of life. It is a promising minimally invasive method in the treatment of metastatic thoracolumbar tumors.
Aged ; Angiography, Digital Subtraction ; Bone Cements ; therapeutic use ; Brachytherapy ; Breast Neoplasms ; pathology ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Lumbar Vertebrae ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain Measurement ; Prostatic Neoplasms ; pathology ; Quality of Life ; Radiotherapy Planning, Computer-Assisted ; Spinal Neoplasms ; secondary ; therapy ; Thoracic Vertebrae ; Vertebroplasty ; methods
9.Application of three-dimensional technology in assessment of burn area and treatment strategy of burns.
Wen-bo SHENG ; Guosheng DONG ; Yan WAN ; Li YAO ; Hongtai TANG ; Zhaofan XIA
Chinese Journal of Burns 2014;30(4):353-355
Accurate area assessment of a burn injury and its treatment according to its depth of injury are the foundation of burn treatment due to its complexity, and various techniques and methods have been employed to solve these problems for many years. As the demand of modern medicine calls for individualized and precise therapeutic measures, it is clear that the traditional diagnostic and treatment measures are insufficient. The flourishing development of three-dimensional (3D) technology seems to provide new research approaches and technical opporturities for burn surgery. A series of techniques such as 3D model, 3D scanning, and 3D printing may be promising in advancing burn surgery through basic research to achieve rational clinical applications in the future. In this paper, the applications and achievements of 3D technology in burn surgery in recent years are summarized.
Body Surface Area
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Burns
;
diagnosis
;
pathology
;
therapy
;
Humans
;
Image Processing, Computer-Assisted
;
methods
;
Therapy, Computer-Assisted
10.Effectiveness and safety of computer-controlled periodontal ligament injection system in endodontic access to the mandibular posterior teeth.
Quan JING ; Kuo WAN ; Xiao-jun WANG ; Lin MA
Chinese Medical Sciences Journal 2014;29(1):23-27
OBJECTIVETo evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis.
METHODSA total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth: the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4% articaine and 1:100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure.
RESULTSThe overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively; χ² = 34.3, P<0.01). Both the PM and SM groups showed higher success rates than that of the FM group (v=1, χ² = 16.73, P<0.01; v=1, χ² = 24.5, P<0.01). No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups.
CONCLUSIONThe computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.
Adolescent ; Adult ; Anesthesia, Dental ; adverse effects ; methods ; Anesthesia, Local ; adverse effects ; methods ; Anesthetics, Local ; administration & dosage ; Carticaine ; administration & dosage ; Drug Delivery Systems ; Humans ; Injections ; Mandible ; Mandibular Nerve ; Middle Aged ; Molar ; Nerve Block ; adverse effects ; methods ; Pain Measurement ; Periodontal Ligament ; Pulpitis ; therapy ; Therapy, Computer-Assisted ; Treatment Outcome ; Young Adult

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