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.
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.
ObjectiveTo systematically evaluate the application effect of CT-guided Hook-wire localization and CT-guided microcoil localization in pulmonary nodules surgery. MethodsThe literatures on the comparison between CT-guided Hook-wire localization and CT-guided microcoil localization for pulmonary nodules were searched in PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang, VIP and CNKI databases from the inception to October 2021. Review Manager (version 5.4) software was used for meta-analysis. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of studies.ResultsA total of 10 retrospective cohort studies were included, with 1 117 patients including 473 patients in the CT-guided Hook-wire localization group and 644 patients in the CT-guided microcoil localization group. The quality of the studies was high with NOS scores>6 points. The result of meta-analysis showed that the difference in the localization operation time (MD=0.14, 95%CI ?3.43 to 3.71, P=0.940) between the two groups was not statistically significant. However, the localization success rate of the Hook-wire group was superior to the microcoil group (OR=0.35, 95%CI 0.17 to 0.72, P=0.005). In addition, in comparison with Hook-wire localization, the microcoil localization could reduce the dislocation rate (OR=4.33, 95%CI 2.07 to 9.08, P<0.001), the incidence of pneumothorax (OR=1.62, 95%CI 1.12 to 2.33, P=0.010) and pulmonary hemorrhage (OR=1.64, 95%CI 1.07 to 2.51, P=0.020). ConclusionAlthough Hook-wire localization is slightly better than microcoil localization in the aspect of the success rate of pulmonary nodule localization, microcoil localization has an obvious advantage compared with Hook-wire localization in terms of controlling the incidence of dislocation, pneumothorax and pulmonary hemorrhage. Therefore, from a comprehensive perspective, this study believes that CT-guided microcoil localization is a preoperative localization method worthy of further promotion.
To solve the problem of precise positioning of carp brain tissue coordinates, it is proposed in this paper for a method for transforming the coordinates of magnetic resonance imaging of carp brain tissue into the coordinates of electrode implantation using a brain stereotaxic apparatus. In this study, the 3.0T magnetic resonance imaging instrument was used to scan the carp brain. We independently established the three-dimensional positioning coordinate system of the brain, the three-dimensional coordinate assistance system of skull surface and the three-dimensional coordinate assistance system in brain tissue. After two coordinate transformations, the magnetic resonance image coordinates of the brain electrodes implantation sites were converted into the three-dimensional stereotactic coordinate system to guide the electrodes implantation. The experimental groups were divided into two groups, A and B. Group A was the group of magnetic resonance imaging apparatus combining with the brain stereotaxic apparatus, and group B was the group of brain atlas combining with the brain stereotaxic apparatus. Each group had 20 tails of carps (n = 20). This two methods were used to implant the electrodes into the cerebellar motor area. The underwater experiments of the carp robots were carried out to test the two methods. The results showed that the accuracy of the implanted electrodes were 90% in group A and 60% in group B. The success rate of group A was significantly higher than that of group B (P < 0.05). Therefore, the new method in this paper can accurately determine the coordinates of carp brain tissue.
【Abstract】ObjectiveTo evaluate the localized biopsy of nonpalpable breast lesions (NPBLs) and its role in the early diagnosis and treatment of breast cancer. MethodsOne hundred and fifty-eight NPBLs from a series of 141 women detected by mammography were resected with wire localization technique. ResultsForty-two lesions (26.6%, 42/158) in 42 patients were diagnosed with malignant result, including 12(28.6%) patients with stage 0 breast cancer, 24(57.1%) with stageⅠ, 2(4.8%) with stage Ⅱ and 4(9.5%) with stage Ⅲ disease according to American Joint Committee on Cancer (AJCC) staging system（the 6th edition）. The contralateral axillary lymph nodes metastasis were found in only one (2.4%) patient with stage Ⅲ disease and the other fortyone patients remained free of recurrent disease at a median follow-up of 31 months.ConclusionThe results showed that the most nonpalpable breast cancers detected by mammography were earlystage breast cancers and had good prognosis. The NPBLs should get a localized biopsy in order to facilitate the early diagnosis and treatment of nonpalpable breast cancers.
Confocal laser endomicroscopy technology can obtain cell-level images in real time and in situ, which can assist doctors in real-time intraoperative diagnosis, but its non-invasiveness makes it difficult to relocate the optical biopsy site. The confocal probe localization algorithm can automatically calculate the coordinates of the probe tip, that is, the coordinates of the optical biopsy site. In this paper, a confocal probe localization algorithm based on region growing and endoscope size prior was proposed. The algorithm detected the probe region by region growing on the probe edge image, then searched for tip points based on a given probe axis, and iteratively optimized it. Finally, based on the single-degree-of-freedom motion characteristics of the probe, the three-dimensional coordinates of the tip of the probe were calculated by using the prior information of the size of the endoscope, which solved the scale uncertainty problem of the monocular camera. The confocal probe localization algorithm was tested on the dataset collected in this paper. The results showed that our algorithm no longer relied on the color information of the probe, avoided the influence of uneven illumination on the gray value of the probe pixels, and had a more robust location accuracy and running speed. Within the length of the probe extending out of the endoscope from 0 to 5 cm, the pixel error could be as low as 11.76 pixels, and the average relative position error could be as low as 1.66 mm, which can achieve the real-time and accurate localization of the confocal probe.
ObjectiveTo introduce a new method to remove the small foreign body in the hand or foot, and to discuss its feasibility and effectiveness.
MethodsBetween May 2007 and March 2012, 78 patients with small foreign bodies embedded in the soft tissue of the hand or foot were treated with the method. There were 51 males and 27 females, aged from 7 to 69 years with an average of 32.5 years. The hand, wrist, and foot were involved in 48, 6, and 24 cases respectively. Foreign body type included fiberglass (57 cases), thorn (11 cases), iron (5 cases), bamboo thorn (2 cases), fishbone (2 cases), and metal needles (1 case). The time between injury and operation was 30 minutes to 16 days (mean, 2.6 days). The position and range of the foreign body were defined using the multipoint centralization method before removal surgery. The skin was cut according multipoint connection for finding small foreign body under a microscope.
ResultsAll foreign bodies were successfully removed. The mean operation time was 6 minutes (range, 3-22 minutes). Healing of incision by first intention was obtained in all cases; no blood circulation disorders or infection occurred. All the patients were followed up 3 months-3 years (mean, 9 months). The distal limb had no feeling or movement disorders.
ConclusionRemoval of small foreign body in soft-tissue using multipoint centralization method is safe and effective.
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 compare the effectiveness of poly ether ether ketone (PEEK) localization marker combined with mixed reality technology versus color doppler ultrasound guidance for the vessel localization of anterolateral thigh perforator flap. Methods A retrospective analysis was conducted on 40 patients with tissue defects after oral cancer resection who underwent repair using the anterolateral thigh perforator flap between January 2022 and June 2023. According to the different intraoperative positioning methods of the anterolateral thigh perforator flap, they were randomly divided into PEEK group [using PEEK localization marker combined with mixed reality technology based on CT angiography (CTA) data] and color ultrasound group (using color ultrasound guidance), with 20 cases in each group. There was no significant difference in gender, age, etiology, and disease duration between the two groups (P>0.05). The number of perforator vessels identified in the two groups of regions of interest was recorded, and compared them with the intraoperative actually detected number to calculate the success identifying rate of perforator vessels; the distance between the perforating point and the actual puncture point was measured, the operation time of the two groups of flaps was recorded. ResultsIn the PEEK group, 32 perforator vessels were identified, 34 were detected by intraoperative exploration, and the success identifying rate was 94.1% (32/34); in the color ultrasound group, 29 perforator vessels were identified, 33 were detected by intraoperative exploration, and the success identifying rate was 87.8% (29/33); there was a significant difference in the success identifying rate between the two groups (P<0.05). The distance between the perforating point and the actual puncture point and the operation time in PEEK group were significantly shorter than those in color ultrasound group (P<0.05). Patients in both groups were followed up 6-30 months, with a median of 17 months; there was no significant difference in follow-up time between the two groups (P>0.05). In the PEEK group, there was 1 case of flap necrosis at the distal edge and delayed healing after trimming and dressing change. In the color ultrasound group, there was 1 case of flap necrosis at 7 days after operation and pectoralis major myocutaneous flap was selected for repair after removal of the necrotic flap. In the rest, the flap survived and the incision healed by first intention. Donor site infection occurred in 1 case in PEEK group and healed after anti-inflammatory treatment. The maxillofacial appearance of the two groups was good, the flap was not obviously bloated, and the patients were satisfied with the repair effect. Conclusion Compared with the traditional color ultrasound guidance, the PEEK localization marker combined with mixed reality technology based on CTA data in vessel localization of anterolateral thigh perforator flap has higher success identifying rate and positioning accuracy, and the flap production time is shorter, which has high clinical application value.
Objective To explore the anatomical parameters of the cervical uncinate process “inflection point” through cervical CT angiography (CTA) and MRI measurements, offering a reliable and safe anatomical landmark for anterior cervical decompression surgery. Methods A retrospective analysis was conducted on the cervical CTA and MRI imaging data of normal adults who met the selection criteria between January 2020 and January 2024. The CTA dataset included 326 cases, with 200 males and 126 females, aged 22-55 years (mean, 46.7 years). The MRI dataset included 300 cases, with 200 males and 100 females, aged 18-55 years (mean, 43.7 years). Based on the CTA data, three-dimensional models of C3-C7 were constructed, and the following measurements were obtained from the superior view: uncinate process “inflection point” to vertebral artery distance (UIVD), uncinate process tip to vertebral artery distance (UTVD), uncinate process “inflection point” to “inflection point” distance (UID), uncinate process long-axis to sagittal angle (ULSA), and uncinate process “inflection point” to transverse foramen-sagittal angle (UITSA). From the anterior view, the anterior uncinate process to sagittal angle (AUSA) was measured. From the posterior view, the posterior uncinate process to sagittal angle (PUSA) was measured. Based on the MRI data, uncinate process “inflection point” to dural sac distance (UIDD) and dural sac width (DSW) were measured. The trends in measurement parameters of C3-C7 were observed, and the differences in measurement parameters between genders and between the left and right sides of the same segment were compared, as well as the difference in UID and DSW within the same segment was compared. Results The measurement parameters from C3 to C7 in the CTA data showed a general increasing trend, with no significant difference between the left and right sides within the same segment (P>0.05). The UIVD, UTVD, and UID were greater in males than in females, with significant differences observed in the UIVD and UTVD at C3 and C6 and UID at C3, C6, and C7 (P<0.05). The MRI measured DSW showed a general increasing trend from C3 to C7, and the DSW at C6 was greater in females than in males, with a significant difference (P<0.05). The UIDD showed a gradual decreasing trend, with the smallest value at C6. There was no significant difference between males and females or between the left and right sides within the same segment (P>0.05). The UID was greater than the DSW at C3-C7, and the differences were significant (P<0.05). ConclusionThe uncinate process “inflection point” is a constant anatomical structure located at the anteromedial aspect of the uncinate process tip and laterally to the dural sac. It maintains a certain safe distance from the vertebral artery. As a decompression landmark in anterior cervical spine surgery, it not only ensures surgical safety but also guarantees complete decompression.
