ObjectiveTo introduce the method of prior-localization femoral tunnel by using a special positioning tool under the C-arm radiographic machine before surgery, and to study the effect on the knee function recovery after medial patellofemoral ligament (MPFL) reconstruction.MethodsBetween January 2014 and January 2016, 32 patients with recurrent unilateral knee patellar dislocation were treated by arthroscopic patellofemoral lateral retinaculum release and MPFL reconstruction. The femoral tunnel position during MPFL reconstruction was prior-localizated under C-arm radiographic machine before operation. There were 8 males and 24 females, aged from 15 to 37 years, with an average of 23.8 years. The time from injury to admission ranged from 1 to 24 months, with an average of 9.7 months. Isometric point distance was measured on CT three-dimensional reconstruction image after operation to evaluate whether the position of femoral tunnel was isometric, and knee joint function was evaluated by Lysholm score. Spearman correlation analysis was performed between isometric point distance and Lysholm score.ResultsAll the 32 patients were followed up 12-18 months (mean, 14.2 months). No symptoms of patellar subluxation or dislocation was found during follow-up. Patellar extrapolation test and patellar extrapolation fear test were negative. The isometric point distance was 1.5-5.9 mm (mean, 3.44 mm) at 3 days after operation. All femoral tunnels were located in equidistant tunnels. At last follow-up, the Lysholm score of the patients was 92.8±2.1, which was significantly improved when compared with preoperative score (54.4±2.8) (t=61.911, P=0.000). Isometric point distance was negatively correlated with Lysholm score (r=–0.454, P=0.009).ConclusionC-arm radiographic machine can locate the femoral tunnel position of MPFL easily and accurately before operation. The short-term and medium-term effectiveness are satisfactory, and the ionizing radiation injury caused by multiple fluoroscopy during operation is avoided.
Recently, the frequency of lung disease appears higher and more precise than previously estimated. Small pulmonary nodules (SPNs) are frequently detected on high-resolution computed tomography (CT) scans. For the reason of high rate of false positives by fine needle aspirate biopsy, small lung nodules often can not be confirmed by monitor or palpation with forceps. How to precisely locate and mark the nodule before the surgery is one of the most important things for video-assisted thoracoscopic surgery (VATS). We reviews the methods of location the pulmonary nodules before the surgery and analyzes the advantages and disadvantages of various methods.
Objective To develop an innovative recognition algorithm that aids physicians in the identification of pulmonary nodules. MethodsPatients with pulmonary nodules who underwent thoracoscopic surgery at the Department of Thoracic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School in December 2023, were enrolled in the study. Chest surface exploration data were collected at a rate of 60 frames per second and a resolution of 1 920×1 080. Frame images were saved at regular intervals for subsequent block processing. An algorithm database for lung nodule recognition was developed using the collected data. ResultsA total of 16 patients were enrolled, including 9 males and 7 females, with an average age of (54.9±14.9) years. In the optimized multi-topology convolutional network model, the test results demonstrated an accuracy rate of 94.39% for recognition tasks. Furthermore, the integration of micro-variation amplification technology into the convolutional network model enhanced the accuracy of lung nodule identification to 96.90%. A comprehensive evaluation of the performance of these two models yielded an overall recognition accuracy of 95.59%. Based on these findings, we conclude that the proposed network model is well-suited for the task of lung nodule recognition, with the convolutional network incorporating micro-variation amplification technology exhibiting superior accuracy. Conclusion Compared to traditional methods, our proposed technique significantly enhances the accuracy of lung nodule identification and localization, aiding surgeons in locating lung nodules during thoracoscopic surgery.
The pharmaceutical industry is characterized by the intensive capital and knowledge. Its international competitiveness and sustainable development should be established on a complete national drug innovation system. At the same time, the development of new drug innovation system in China can be really promoted by the accurate location of pharmaceutical enterprises as research and development (R & D) and production, the improved R & D strength, as well as the increased investment in innovation. This paper reviews both the development of Chinese drug innovation system and the orientation of pharmaceutical enterprises innovation during this process. Furthermore, the changes of innovation capability and positioning of pharmaceutical companies have been investigated before and after the launch of the Drug Innovation Major Project. Although, the construction of Chinese pharmaceutical innovation system has greatly promoted the progress of our pharmaceutical companies, a wide gap in the level of drug innovation still exists between Chinese pharmaceutical enterprises and international leading drug companies in the world.
Objective To investigate the accuracy of preoperative three-dimensional reconstruction of tumor in craniotomy for supratentorial convex brain tumors, and to provide an accurate and safe auxiliary method for craniotomy. Methods Patients with supratentorial convexity brain tumors who were admitted to the Department of Neurosurgery, West China Hospital, Yibin Hospital, Sichuan University between April 2018 and November 2020 were prospectively enrolled and randomly divided into reconstruction group and control group. In the reconstruction group, preoperative three-dimensional reconstruction of the tumor was used for craniotomy positioning, while in the control group, traditional two-dimensional tomographic imaging was used. The basic conditions, intraoperative localization and tumor exposure satisfaction rate, maximum diameter of bone window, operation time, cerebral draining vein injury, and postoperative subcutaneous effusion or intracranial infection were compared between the two groups. Results A total of 43 patients were included, 22 in the reconstruction group and 21 in the control group. There was no significant differences in age, gender composition, incidence of midline shift, tumor growth site and tumor size between the two groups (P>0.05). There was no significant difference in the incidence of cerebral drainage vein injury and postoperative subcutaneous effusion or intracranial infection between the two groups (P>0.05). The satisfaction rate of intraoperative positioning and tumor exposure in the reconstruction group (95.5% vs. 66.7%) was higher than that in the control group, the maximum diameter of the bone window [(6.26±1.32) vs. (7.31±1.13) cm] and the operation time [(194.00±22.76) vs. (214.57±26.53) min] were lower than the control group, and the differences were statistically significant (P<0.05). Conclusions Preoperative three-dimensional reconstruction helps to locate the tumor more accurately, improves the satisfaction rate of tumor exposure, reduces the diameter of the craniotomy window, and shortens the operation time. Compared with traditional two-dimensional tomographic positioning, it has more advantages.
ObjectiveTo summarize the current common clinical laparoscopic gastrointestinal tumor surgical localization methods, and to provide reference for clinicians to choose reasonable localization methods. MethodThe domestic and foreign literatures related to laparoscopic gastrointestinal tumor surgical localization methods were searched and reviewed. ResultsThe common localization methods for laparoscopic gastrointestinal tumor surgery were imaging localization, preoperative endoscopic localization, intraoperative endoscopic localization and intraoperative fluorescence localization, among which abdominal enhanced CT and endoscopic-related localization methods were the most commonly used localization methods in clinical practice at present. ConclusionA variety of methods are available for surgeons to choose from, and the precise localization of tumors is better facilitated by combining multiple methods.
【摘要】 目的 探討伽瑪刀治療三叉神經痛MRI定位的最佳掃描序列。 方法 選擇2004年7月-2006年3月行伽瑪刀手術的原發性三叉神經痛患者60例，隨機分為3組，每組各20例。伽瑪刀術前上頭架定位，然后對3組分別采用快速自旋回波序列（Turbo Spin Echo，TSE）、增強三維小角度激發快速梯度回波序列（enhanced three-dimensiunal fast low angle shot，enhanced 3D-FLASH）、三維結構干涉穩態序列（three-dimensional constructive interference in steady state，3D-CISS）進行掃描，觀察三叉神經及周圍血管的顯示情況。 結果 ①TSE掃描20例三叉神經，14例顯示優，血管顯示一般。②增強3D-FLASH掃描三叉神經，18例顯示優，2例顯示良，周圍血管顯示優。③3D-CISS掃描三叉神經，20例均顯示優，周圍血管顯示良。 結論 3D-CISS和增強3D-FLASH序列的融合影像能夠清晰地顯示三叉神經根及周圍血管，有利于伽瑪刀的精確定位，具有較高的臨床應用價值，可以作為伽瑪刀治療原發性三叉神經痛的常規定位方法。【Abstract】 Objective To evaluate the optimal MRI localization sequences of gamma knife radiosurgery for trigeminal neuralgia. Methods From July 2004 to March 2006, sixty patients with primary trigeminal neuralgia were divided into three groups, using MR Turbo Spin Echo ( TSE), enhanced three-dimensiunal fast low angle shot 3D-FLASH and three-dimensional constructive interference in steady state ( 3D-CISS) sequence for stereotactic localization, respectively. The trigeminal nerve and surrounding vessels were observed. Results Only 14 trigeminal nerves were precisely displayed by MR TSE sequence, while 20 by 3D-CISS and 18 by 3D-FLASH. The display of surrounding vessels was excellent, good, and general by 3D-FLASH, 3D-CISS, and MR TSE, respectively. Conclusion 3D-CISS and enhanced 3D-FLASH fusion image can help achieve accurate orientation of gamma knife, which provides clear images of the trigeminal nerve and the surrounding vessels. Therefore it is of high value in clinical application, which can be used as the conventional localization method for gamma knife radiosurgery in the treatment of primary trigeminal neuralgia.
Building a harmonious socialist society reflects the inherent requirement of building a prosperous, democratic, civilized and harmonious modern socialist country. Strengthening medical and health services, and improving the level of people's health is one of the most important measures in constructing a socialist harmonious society of the CPC Central committee. Hospital is an important part of medical and health services. Hospital trade union is the bridge and link between the party and workers. Therefore, hospital trade union should give full play to its function and role, actively participate and promote the construction of harmonious hospital. The current hospital trade unions need positioned and explored under the present situation.
