简介：FromApril1995toOctober1999,135patientswithconcussionofbrainwereexaminedwiththreedimensionaltranscranialDoppler(3D-TCD)andthechangeofcerebralbloodflowinvariousphaseswasanalyzedtoevaluatetheeffectof3D-TCDondiagnosisandtherapyofbrainconcussion.

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简介：Introduction:Middleearvolume(MEV)isaclinicallyrelevantparameteracrossmiddleeardiseases.MEVvaluesbetweenthesetechniqueshaveneverbeforebeentestedforagreementinearswithperforatedtympanicmembranes(TMs).Methods:Middleearswereidentifiedfrom36patientsranging18e89yearsofagewithTMperforationswhounderwenttympanometryandtemporalbonecomputedtomography(CT)between2005and2015.MEVscalculatedbybothtympanometryandthree-dimensionalvolumereconstruction(3DVR)wereanalyzedforagreementusingBlandAltmanplots.Thedifferencesbetweentympanometricand3DVRMEVvaluesforeachgivenmiddleearwerecharacterizedacrossMEVquartiles(1?smallest;4?largest)andacrossincreasingstatesofmiddleeardiseaseusingKruskaleWallisandWilcoxontestingwithBonferronicorrection.Results:BlandAltmanplotsdemonstratedsignificantdisagreementbetweenMEVmeasurementtechniques.Differencesbetweentympanometric(T)and3DVRMEVvaluesweresignificantlygreaterwithincreasingaverage(i.e.(Tt3DVR)/2))MEVperlinearregression(p<0.0001).SignificancewasdemonstratedbetweenfourthandfirstaverageMEVquartiles(p?0.0024),fourthandsecondquartiles(p?0.0024),thirdandfirstquartiles(p?0.0048),andthirdandsecondquartiles(p?0.048).AbsoluteMEVdifferencewasnotsignificantlydifferentacrossvaryingstatesofmiddleeardisease(p?0.44).Conclusion:Statisticallyandclinicallysignificantdisagreementwasdemonstratedbetweentympanometricand3DVRMEVvalues.StudiesthatvaryinMEVestimationtechniquesmaybeexpectedtodemonstratesignificantlydifferentresults.ThesepreliminaryresultssuggestthatcliniciansshouldendeavortoseekfurtherconfirmationwheninterpretinghightympanometricMEVvalues.

简介：Diastemaoftenoccuredinmaxillarycompletedentureresinbaseintheclinic,although"Lucitone199"hadbeenusedwithmoretensilestrength.Mechanicalex-perimentshaveprovedthehightransversetensilestress(σ_x~+)concentratinginanteri-orteethregionandtheirpalatalsurfaceofmaxillarycompletedentureresinbasewhileitwasexposedtoverticalloadingincenterocclusion.Settingstrengtheningnetinresinbasehasachievedbetterresults.Forevaluatingpurpose,twentykinds

简介：客观:测量基于空间邻近的图象和相互的信息的类似原则调查一个4D-CT重建方法的可行性。方法:驾驶正弦曲线运动站台在房子里做了的一台马达被用来创造沿着CT睡椅的纵的轴的一个维的期刊运动。正弦曲线运动的振幅被设为一个振幅吗？

简介：Areaswithhighfrequencyactivitywithintheatriumarethoughttobe'drivers'oftherhythminpatientswithatrialfibrillation(AF)andablationoftheseareasseemstobeaneffectivetherapyine-liminatingDFgradientandrestoringsinusrhythm.ClinicalgroupshaveappliedthetraditionalFFT-basedapproachtogeneratethethree-dimensionaldominantfrequency(3DDF)mapsduringelectro-physiology(EP)proceduresbutliteratureisrestrictedonusingalternativespectralestimationtech-niquesthatcanhaveabetterfrequencyresolutionthatFFT-basedspectralestimation.

简介：目的将创造膝系带并且到压力在不同的膝屈曲侧面的并行的系带(LCL)改变与或没有代替的运动的分析的有限元素模型调节的3-dimensional。four-major-ligament从一个成年人包含了膝标本的方法死于颅骨损害为与精确预先标记的可检测的系带插入脚印，地点和取向扫描的CT作好准备。扫描图象的CT与3-dimensional重建技术被变换成膝的一个3-dimensional模型并且由ANSYS的软件转变了成有限元素模型。模型用另外的科学家获得的试验性、数字的结果被验证。在五个不同的膝屈曲角度的LCL的自然压力变化(0

简介：AbstractBackground:Three-dimensional (3D) fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively.Methods:We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors' location, volume, cavernous sinus involvement, vascular encasement, and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated.Results:The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = 0.772, P < 0.001). The scoring system had good predictive capacity with an accuracy of 69.60%.Conclusions:We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging.Trial registration:Retrospectively registered

简介：AbstractBackground:Surgical treatment of both-column acetabular fractures is challenging because of the complex acetabular fracture patterns and the curved surface of the acetabulum. Seldom study has compared the application of three-dimensional (3D) printing technology and traditional methods of contouring plates intra-operatively for the surgical treatment of both-column acetabular fractures. We presented the use of both 3D printing technology and a virtual simulation in pre-operative planning for both-column acetabular fractures. We hypothesized that 3D printing technology will assist orthopedic surgeons in shortening the surgical time and improving the clinical outcomes.Methods:Forty patients with both-column acetabular fractures were recruited in the randomized prospective case-control study from September 2013 to September 2017 for this prospective study (No. ChiCTR1900028230). We allocated the patients to two groups using block randomization (3D printing group, n = 20; conventional method group, n = 20). For the 3D printing group, 1:1 scaled pelvic models were created using 3D printing, and the plates were pre-contoured according to the pelvic models. The plates for the conventional method group were contoured during the operation without 3D printed pelvic models. The operation time, instrumentation time, time of intra-operative fluoroscopy, blood loss, number of times the approach was performed, blood transfusion, post-operative fracture reduction quality, hip joint function, and complications were recorded and compared between the two groups.Results:The operation and instrumentation times in the 3D printing group were significantly shorter (130.8 ± 29.2 min, t = －7.5, P < 0.001 and 32.1 ± 9.5 min, t = －6.5, P < 0.001, respectively) than those in the conventional method group. The amount of blood loss and blood transfusion in the 3D printing group were significantly lower (500 [400, 800] mL, Mann-Whitney U= 74.5, P < 0.001 and 0 [0,400] mL, Mann-Whitney U = 59.5, P < 0.001, respectively) than those in the conventional method group. The number of the approach performed in the 3D printing group was significantly smaller than that in the conventional method group (pararectus + Kocher-Langenbeck [K-L] approach rate: 35% vs. 85%; x2 = 10.4, P < 0.05). The time of intra-operative fluoroscopy in the 3D printing group was significantly shorter than that in the conventional method group (4.2 ± 1.8 vs. 7.7 ± 2.6 s; t = －5.0, P < 0.001). The post-operative fracture reduction quality in the 3D printing group was significantly better than that in the conventional method group (good reduction rate: 80% vs. 30%; x2 = 10.1, P < 0.05). The hip joint function (based on the Harris score 1 year after the operation) in the 3D printing group was significantly better than that in the conventional method group (excellent/good rate: 75% vs. 30%; x2 = 8.1, P < 0.05). The complication was similar in both groups (5.0% vs. 25%; x2 = 3.1, P = 0.182).Conclusions:The use of a pre-operative virtual simulation and 3D printing technology is a more effective method for treating bothcolumn acetabular fractures. This method can shorten the operation and instrumentation times, reduce blood loss, blood transfusion and the time of intra-operative fluoroscopy, and improve the post-operative fracture reduction quality.Clinical trail registration:No.ChiCTR1900028230; http://www.chictr.org.cn

简介：AbstractBackground:Traditional tissue engineering methods to fabricate urinary tract patch have some drawbacks such as compromised cell viability and uneven cell distribution within scaffold. In this study, we combined three-dimensional (3D) bioprinting and tissue engineering method to form a tissue-engineered urinary tract patch, which could be employed for the application on Beagles urinary tract defect mode to verify its effectiveness on urinary tract reconstruction.Methods:Human adipose-derived stem cells (hADSCs) were dropped into smooth muscle differentiation medium to generate induced microtissues (ID-MTs), flow cytometry was utilized to detect the positive percentage for CD44, CD105, CD45, and CD34 of hADSCs. Expression of vascular endothelial growth factor A (VEGFA) and tumor necrosis factor-stimulated gene-6 (TSG-6) in hADSCs and MTs were identified by Western blotting. Then the ID-MTs were employed for 3D bioprinting. The bioprinted structure was encapsulated by transplantation into the subcutaneous tissue of nude mice for 1 week. After retrieval of the encapsulated structure, hematoxylin and eosin and Masson’s trichrome staining were performed to demonstrate the morphology and reveal collagen and smooth muscle fibers, integral optical density (IOD) and area of interest were calculated for further semiquantitative analysis. Immunofluorescent double staining of CD31 and α-smooth muscle actin (α-SMA) were used to reveal vascularization of the encapsulated structure. Immunohistochemistry was performed to evaluate the expression of interleukin-2 (IL-2), α-SMA, and smoothelin of the MTs in the implanted structure. Afterward, the encapsulated structure was seeded with human urothelial cells. Immunofluorescent staining of cytokeratins AE1/AE3 was applied to inspect the morphology of seeded encapsulated structure.Results:The semi-quantitative assay showed that the relative protein expression of VEGFA was 0.355 ± 0.038 in the hADSCs vs. 0.649 ± 0.150 in the MTs (t = 3.291, P = 0.030), while TSG-6 expression was 0.492 ± 0.092 in the hADSCs vs. 1.256 ± 0.401 in the MTs (t = 3.216, P = 0.032). The semi-quantitative analysis showed that the mean IOD of IL-2 in the MT group was 7.67 ± 1.26, while 12.6 ± 4.79 in the hADSCs group, but semi-quantitative analysis showed that there was no statistical significance in the difference between the two groups (t = 1.724, P = 0.16). The semi-quantitative analysis showed that IOD was 71.7 ± 14.2 in non-induced MTs (NI-MTs) vs. 35.7 ± 11.4 in ID-MTs for collagen fibers (t = 3.428, P = 0.027) and 12.8 ± 1.9 in NI-MTs vs. 30.6 ± 8.9 in ID-MTs for smooth muscle fibers (t= 3.369, P = 0.028); furthermore, the mean IOD was 0.0613 ± 0.0172 in ID-MTs vs. 0.0017 ± 0.0009 in NI-MTs for α-SMA (t = 5.994, P = 0.027), while 0.0355 ± 0.0128 in ID-MTs vs. 0.0035 ± 0.0022 in NI-MTs for smoothelin (t= 4.268, P = 0.013), which indicate that 3D bioprinted structure containing ID-MTs could mimic the smooth muscle layer of native urinary tract. After encapsulation of the urinary tract patch for additional cell adhesion, urothelial cells were seeded onto the encapsulated structures, and a monolayer urothelial cell was observed.Conclusion:Through 3D bioprinting and tissue engineering methods, we provided a promising way to fabricate tissue-engineered urinary tract patch for further investigation.

简介：AbstractBackground:The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.Methods:Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.Results:The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).Conclusions:The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registration:Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.

简介：AbstractPurpose:This meta-analysis compared the clinical outcome of three-dimensional (3D) printing combined with open reduction and internal fixation (ORIF) to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library, PubMed, Embase, VIP database, CNKI, and Wanfang data-base with keywords "acetabular fracture" , "3D printing" , "three-dimensional printing" , "open reduction and internal fixation" , "Acetabulum" , "Acetabula" from January 2000 to March 2020. Two reviewers independently selected articles, extracted data, assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’ s tools and/or Newcastle-Ottawa scale. When the two analysts had different opinions, they would ask the third analyst for opinion. Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF (3D printing group) versus traditional ORIF (conventional group) in the treatment of acetabular fractures were selected. The data of operation time, intraoperative blood loss, intraoperative fluoroscopy times, incidence of complications, excellent and good rate of Matta score for reduction, and excellent and good rate of hip function score were extracted. Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected, including 5 randomized controlled trials and 4 retrospective studies. A total of 467 patients were analyzed, 250 in the conventional group, and 217 in the 3D printing group. The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant (standardized mean difference (SMD) =-1.19, 95% CI:-1.55 to-0.82, p < 0.05). The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group (SMD=-1.08, 95% CI:-1.65 to-0.51, p < 0.05). The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant (SMD=-1.64, 95% CI:-2.35 to-0.93, p < 0.05). The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group (OR = 0.43, 95% CI: 0.24-0.79, p < 0.05). There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups (OR = 0.60, 95% CI: 0.34-1.06, p > 0.05). There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups (OR = 0.84, 95% CI: 0.46-1.56, p > 0.05), but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF, 3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively, but also effectively reduces operation time, intraoperative blood loss, intraoperative fluoroscopy times, and postoperative complications. However, there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.

简介：Objective:Tostudythefeasibilityofmulti-slicespiralcomputedtomography(MSCT)3-dimensionalreconstruc-tiontechniqueinassistingcervicalpediclescrewfixation(PSF)anddouble-doorlaminoplastytotreatmulti-segmen-taldegenerativespinalstenosiswithtraumaticinstability(MDSTI)oflowercervicalspine.Methods:FromSeptember2006toAugust2007,PSFcombinedwithdouble-doorlaminoplastywasperformedin9patientswithMDSTIoflowercervicalspine.MSCT3-dimensionalreconstructiontechniques,includingvolumerendering(VR)andmulti-planarreconstruction(MPR),wereusedtoassistpreoperativediagnosisandmeasurementtoguidetheprocedure.MPRwasperformedafteroperation.Incoronalview,thedegreeofscrewperforationwasmea-suredpreciselyandthedifferentpositionsofpediclescrewsweredividedintothreegradesaccordingtoRichter'smethod.Inaxialview,thecanalsagittaldiameterandtrans-verseareaofeverylaminoplastylevelweremeasured.Results:NinepatientswithMDSTIoflowercervicalspineunderwentPSF(total44screws).AccordingtotheclassificationofRichter,72.7%(32/44)wasinGrade1and27.3%(12/44)wasinGrade2.NoscrewperforationoccurredinGrade3andnoscrewrevisionwasdoneformisplacement.Noiatrogenicdamagewasobserved.Double-doorlaminoplastywasperformedintotal42volumes.Thepost-operativesagittaldiameterandtransverseareaofcervicalspinalcanalweresignificantlyincreased(P<0.05).Theconfi-denceintervalsofmeanincreasedratiowere23.43%-40.65%insagittaldiameterand23.18%-42.07%intransversearea.Sixmonthsafterlaminoplasty,basedonMSCTaxialview,completeunionbetween"opendoor"andallograftbonewasobtainedin76.19%ofvolumes(32/42),andallograftbonewasabsorbedpartlyin23.81%(10/42).Asolidunioninbilateralgutterswasachievedinallcases.Theywerefollowedupfrom6monthsto1year(mean7.8months).Post-operativeneuralfunctionrecoveryintwocasesimproved2ASIAgrade,5casesi

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