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Objective:To study the clinical characteristics and differences of severe hyperbilirubinemia caused by hemolytic disease of the newborn (HDN) and glucose-6-phosphate dehydrogenase (G6PD) deficiency.Methods:From January 2014 to December 2021, newborns (gestational age ≥ 35 weeks and postnatal age ≤ 28 d) admitted to the Department of Neonatology of Hunan Children's Hospital with severe hyperbilirubinemia caused by HDN or G6PD deficiency were retrospectively analyzed. According to the etiology of hyperbilirubinemia, they were assigned into HDN group and G6PD deficiency group. The general conditions, clinical manifestations, laboratory results, treatment and prognosis of the two groups were compared using SPSS 26.0 software.Results:A total of 532 cases were in the HDN group and 413 cases in the G6PD deficiency group. The HDN group reached peak hyperbilirubinemia earlier than the G6PD deficiency group [3(2,5) d vs. 6(4,8)d, P<0.05]. The HDN group had lower peak value of total serum bilirubin [379.5(345.6,426.7) μmol/L vs. 486.4 (413.5,577.4) μmol/L] and lower incidence of anemia [37.4% (199/532) vs. 55.0% (227/413)]than the G6PD deficiency group.The incidence of anemia with elevated reticulocyte percent(Ret%) in the HDN group was higher than the G6PD deficiency group[66.3%(132/199) vs. 5.7%(13/227), P<0.05]. Compared with the G6PD deficiency group, the incidences of exchange transfusion and repeated (≥2 times) exchange transfusion, acute bilirubin encephalopathy(ABE) and the mortality rate after withdrawal of treatment in the HDN group were significantly lower ( P<0.05). Conclusions:Neonatal severe hyperbilirubinemia caused by HDN has early onset. G6PD deficiency caused hyperbilirubinemia has higher incidences of anemia, more severe jaundice and ABE, without increased Ret%.
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Objective:To investigate the epidermal growth factor receptor (EGFR) mutation rate, mutation characteristics and distribution characteristics of different mutation types in patients with non-small cell lung cancer (NSCLC) in Fuyang of Yunnan province, to provide the clinical individualized targeted therapy of NSCLC in this region.Methods:A total of 328 NSCLC patients whose native place were Fuyuan and who underwent EGFR test in Fuyuan County People's Hospital in Yunnan Province from January 2018 to August 2020 were selected, and their clinical data such as gender, age, ethnicity, pathological type and the results of EGFR test were collected for statistical analysis.Results:The EGFR mutation rate of NSCLC patients was 40.55% (133/328). The EGFR mutation rate of female patients was higher than that of males ( P < 0.01). The EGFR mutation rate showed a downward trend with age, the EGFR mutation rate of patients ≤ 60 years old was higher than that of patients > 60 years old ( P = 0.014). The EGFR mutation rate in ethnic minority was not statistically different from Han nationality ( P = 0.789). The EGFR mutation rate of patients without smoking history was higher than that of patients with smoking history ( P<0.01). Patients with adenocarcinoma had a higher EGFR mutation rate than squamous cell carcinoma ( P = 0.002). The EGFR mutation rate in patients with stage Ⅰ-Ⅱwere higher than that in patents with stage Ⅲ-Ⅳ ( P = 0.013). The EGFR mutation rate in tissue samples were higher than that in peripheral blood samples ( P = 0.009). In 328 patients the EGFR single-point mutation rate was 24.70% (81/328), and the compound mutation rate was 15.85% (52/328); the common mutation rate was 17.07% (56/328), and the rare mutation rate was 23.48% (77/328). The top 5 mutation types were L858R (10.06%), G719X+S768I (7.32%), 19-Del (7.01%), G719X+L861Q (6.40%), and G719X (4.21%). In 133 patients with EGFR mutation, the proportion of patients with rare mutation [57.89% (77/133)] was higher than the proportion of patients with common mutation [42.11% (56/133)]. Conclusion:The EGFR mutation rates of female, adenocarcinoma, non-smoking and young NSCLC patients in Fuyuan area are high, and the rare mutation rate is high.
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BACKGROUND: Gypenosides have antioxidant properties, with beneficial effects such as reducing blood pressure, anti-aging and anti-tumor, but the specific protective mechanism is not clear. It is also unknown whether gypenosides have effect on the proliferation and differentiation of oxidative stress-damaged osteoblasts. OBJECTIVE: To investigate the mechanism by which gypenosides alleviate oxidative stress injury in rat osteoblasts and the effect on the proliferation and differentiation of oxidatively damaged osteoblasts. METHODS: Monolayer cell culture method was used to separate neonatal rat skull cells for the culture of osteoblasts. In this experiment, there were three groups, with normal culture medium as blank group, normal culture medium+oxidative damage as control group, and normal culture medium containing gypenosides and oxidative damage as experimental group. Osteoblasts in the experimental and control groups were cultured in the culture medium containing 150 μmol/L H2O2. After 3 and 5 days of intervention, cell counting kit-8 method was used to detect the effects of gypenosides on oxidative damage of osteoblasts. Alkaline phosphatase staining was used to detect alkaline phosphatase activity on day 7 after induction. Alizarin red staining was used on day 21 of induction to observe osteoblast mineralization. Western blot was used to detect the expression of NOX4, bone morphogenetic protein 2 and Smad4. The experimental protocol was approved by the Animal Ethics Committee of Guangzhou University of Chinese Medicine. RESULTS AND CONCLUSION: Gypenosides could promote the proliferation of oxidatively damaged osteoblasts. The results of alkaline phosphatase staining and alizarin red staining showed that gypenosides could promote the differentiation of oxidatively damaged osteoblasts. Compared with the control group, gypenosides could downregulate the expression of NOX4 protein and upregulate the expression of bone morphogenetic protein 2 and Smad4 protein in the experimental group, with statistically significant results (P < 0.05). All these findings indicate that gypenosides have a protective effect on H2O2-induced oxidative stress injury in osteoblasts, and promote the proliferation and differentiation of damaged osteoblasts. The mechanism may be related to the inhibition of Nox4 protein expression and the activation of bone morphogenetic protein/Smad pathway.
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BACKGROUND@#Lung cancer is the most common neoplasmas with a poor prognosis and a low 5-year survival rate. Early screening is an important measure for the prevention and treatment of lung cancer. At present, different countries have issued corresponding lung cancer screening guidelines, but China still lacks guidelines based on Chinese population research. Therefore, the National Cancer Center launched a Multi-center Cancer Screening Program in Urban China. This study analyzed the evaluation of lung cancer risk assessment model and screening effect in urban China of Yunnan, so as to explore the evaluation model of high-risk lung cancer population suitable for China's national conditions and develop lung cancer screening guidelines for Chinese.@*METHODS@#A questionnaire survey and lung cancer risk assessment were conducted on 165,337 people in 36 street offices in 4 main urban areas of Kunming, Yunnan Province, using cluster sampling method from January 2015 to December 2019. People with high-risk of lung cancer conducted low-dose computed tomography (LDCT) screening of chest. What's more, all participants were followed up by active or passive follow-up.@*RESULTS@#There were 264 patients were diagnosed lung cancer by pathology, and the overall incidence of lung cancer was 0.16% (264/165,337). The high-risk group (0.31%, 116/37,914) was higher than the non-high-risk group (0.12%, 148/127,423), and the difference was statistically significant (P<0.001). The incidence of lung cancer in the high-risk group was higher than the non-high-risk group among the male, female, and lower 50-year-old or more than 50-year-old subgroups, with statistical differences (P<0.001), but there was no statistical difference in the group without LDCT screening (P=0.73). The sensitivity of the lung cancer high-risk population assessment model was 43.94% (116/264) and the specificity was 77.10% (127,275/165,073). The early diagnosis rate of the screening group was 72.97% (54/74), which was significantly higher than that of the non-screening group [28.48% (43/151)].@*CONCLUSIONS@#The lung cancer high-risk population assessment model of National Key Public Health Program: Cancer Screening Program in Urban China can detect high-risk populations and improve the early diagnosis rate of lung cancer effectively.
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This study analyzed the distribution of high-risk population, the compliance and detected lesions of colorectal cancer screening from the Cancer Screening Program in urban areas of Kunming,Yunnan Province from 2014 to 2017. A total of 127 960 residents were included,of which 14 791 (11.70%) cases were diagnosed with high risk of colorectal cancer by the National Cancer Center High Risk Population Assessment System. A total of 3 484 cases completed colonoscopy clinical screening and the rate of participation was 23.55%. The screening results showed that 592 positive cases were detected, and the positive rate was 17.17%. The detection rates of polyps,adenomas,advanced adenomas,precancerous lesions and colorectal cancer were 16.27%,13.12%,7.18%,7.63% and 0.26%, with 567, 457, 250, 266 and 9 cases, respectively.
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Objective@#To explore the screening efficiency of colorectal cancer in urban residents of Kunming, China.@*Methods@#Using the method of cluster sampling, from October 2014 to October 2017, residents of the three jurisdictions of Xishan, Guandu and Chenggong Districts of Kunming city were investigated. The inclusion criteria: (1) resident (for more than 3 years) population of Kunming city aged 40-74 years old; (2) voluntarily participating and receiving colonoscopy; (3) signing informed consent. Based on the Harvard Cancer Risk Index, the questionnaire was built on the consensus of more than 20 years of common cancer epidemiology in China. Through the consensus reached by the multidisciplinary expert panel discussion, a comprehensive evaluation system for cancer risk in China was designed. The high-risk group of colorectal cancer was determined by preliminary screening of the questionnaire, and a free colonoscopy was performed for the appointment to the gastrointestinal endoscopy department of the Yunnan Cancer Hospital. All polypoid lesions and ulcers found by colonoscopy must be biopsied to confirm the diagnosis. χ2 test or Fisher exact probability method was used to compare the detection of colorectal cancer in 4 groups of 40-49 years old, 50-59 years old, 60-69 years old, and ≥70-years old. Detection of colonoscopy, compliance, pathological examination, pathological diagnosis, and morbidity of colorectal cancer were analyzed.@*Results@#A total of 127 960 people from 40 to 74 years old of urban residents in Kunming city participated in the preliminary screening of the questionnaire, including 59 748 (46.7%) males and 68 212 females (53.3%) with mean age of (53.6±8.6) years old. The 40-49 years old group had the largest number of participants (48 044, 37.5%), followed by the groups of 50-59 years old (42 473, 33.2%), 60-69 years old (34 111, 26.7%), and ≥70 years old (3332, 2.6%). Till October 2017, a total of 14 971 people were screened as at high risk of colorectal cancer, with the high-risk detection rate of 11.7%, and the high-risk detection rate of women was significantly higher than that of men [13.4% (9 109/68 212) vs. 9.8% (5 862/59 748), χ2=386.947, P<0.001]. The highest high-risk detection rate was in the 50-59 years group in both gender [men: 11.1% (2202/19 831), women: 15.3% (3034/22 642)]. A total of 3449 people among the high-risk population received colonoscopy examination. The compliance rate of colonoscopy was 23.0% (3449/14 971), and the male compliance rate was 19.8% (1162/5862), which was significantly lower than that of females [25.1% (2287/9109), χ2=56.175, P<0.001]. The highest compliance was observed in the 50-59 years group [25.4% (1438/5668)], followed by 40-49 years and 60-69 year group [22.1%(1091/4931) and 22.0%(891/4048), respectively], and the compliance of ≥70 years old group was the lowest [9.0% (29/324)]. Colonoscopy examination revealed 606 cases with lesions, the detection rate of lesions was 17.6%, and the male detection rate was significantly higher than that of females [26.9% (313/1162) vs. 12.8% (293/2287), χ2=106.140, P<0.001]. The detection rate of lesions increased with age [40-49, 50-59, 60-69, ≥70: 10.9% (119/1091), 17.5% (252/1438), 25.0% (223/891) and 41.4% (12/29), respectively, χ2=79.010, P<0.001]. A total of 584 cases underwent endoscopic excision and pathological diagnosis, and 465 cases (13.5%) of precancerous lesions were detected. The prevalence of precancerous lesions in men was higher than that in women [21.3% (247/1162) vs. 9.5% (218/2287), χ2=90.801, P<0.001], the precancerous lesion detection rate increased with age [40-49, 50-59, 60-69, ≥70: 8.0% (87/1091), 14.3% (206/1438), 18.1% (161/891) and 37.9% (11/29); χ2=58.109, P<0.001]. A total of 4 patients with colorectal cancer were detected, including 3 males and 1 female. The detection rate of male colorectal cancer was 258.2/100 000, and the female was 43.7/100 000, whose difference was not statistically significant (χ2=1.488, P=0.223). There was no significant difference in the detection rate of colorectal cancer among 4 age groups [40-49, 50-59, 60-69, ≥70: 91.7/100 000 (1/1091), 69.5/100 000 (1/1438), 224.5/100 000 (2/891) and 0, respectively, P=0.696].@*Conclusions@#Screening for colorectal cancer is an important measure to control the onset and death of colorectal cancer. Through the questionnaire risk assessment plus colonoscopy, two-step screening method can improve the screening efficiency and greatly reduce the screening cost.
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In this paper, we established magnetic fluid hyperthermia (MFH) model for rat tumor using the finite element software COMSOL based on the linear response theory. By analyzing four kinds of magnetic medium within relaxation mechanism, such as Fe O 、FeCo、fccFePt and L1 FePt, we studied the influence of the change of magnetic medium radius on dissipation power and temperature field, respectively. At the same time, the optimization method for the parameters of several magnetic medium is proposed, and the applications of four kinds of magnetic medium are given as well. By increasing the dissipation power of the magnetic medium as much as possible, the dose of magnetic medium used in the treatment can be reduced, meanwhile, the adverse effects on health tissue surrounding the tumor will be minimized. The conclusions of this paper can provide reference for magnetic medium preparation applied to MFH.
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Animales , Ratas , Calor , Hipertermia Inducida , Magnetismo , Neoplasias , TerapéuticaRESUMEN
BACKGROUND@#Lung cancer screening is an effective measure to reduce lung cancer mortality. Currently, lung cancer screening is recommended internationally and nationally. China had launched a large-scale early diagnosis and early treatment of rural and urban lung cancer in 2009 and 2012. Yunnan Province participated in related projects in 2009 and 2014, but the results of large-scale lung cancer screening have not been reported in Yunnan Province. In this study, we participated in the National Key Public Health Program, Cancer Screening Program in Urban China and analyzed the results of lung cancer screening in 10,154 urban residents in Kunming, Yunnan Province from 2014 to 2018, and evaluated the screening effect of early diagnosis and treatment of lung cancer in urban.@*METHODS@#A total of 31,824 people with high risk of lung cancer were evaluated with 40-74 year-old population in Kunming. A high-risk group underwent low-dose spiral computed tomography (CT) scan of the chest, and analyze the high risk rate and detection rate. A total of 150,535 questionnaires were completed in 5 years, and 31,824 people with high risk of lung cancer were evaluated.@*RESULTS@#The high-risk rate was 21.14%. A total of 10,154 low-dose spiral CT screenings were performed, with a participation rate of 31.91%. The detection rate of intrapulmonary nodules was 22.28% (2,262/10,154), of which the detection rate of <5 mm solid/partial solid nodules was 11.30% (1,332/10,154) and the detection rate of <8 mm non-solid nodules was 2.20% (219/10,154). The positive nodule detection rate was 7.00% (711/10,154), the suspected lung cancer detection rate was 0.60% (59/10,154), and the lung cancer detection rate was 0.27% (27/10,154). The detection rate of the positive nodules, <8 mm non-solid nodules and suspected lung cancer in male were significantly higher than that in female, and the positive nodules, <5 mm solid nodules, suspected lung cancer and confirmed lung cancer detection rate increased with age.@*CONCLUSIONS@#Low-dose spiral CT is suitable for screening of high-risk populations of lung cancer, which is helpful for early detection of positive nodules and related diseases in the lungs. It is necessary to pay attention to the screening of lung cancer in people over 60 years old. Understand the lung health status of residents in Kunming. Raise awareness of lung cancer prevention and treatment among residents, and improve the rate of early diagnosis and treatment of lung cancer.
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Objective To study the characteristics of colorectal cancer patients in Yunnan Tumor Hospital, and to provide the basis for the prevention and treatment of colorectal cancer. Methods Retrospective analysis was used to review colorectal cancer patients who were diagnosed first and received the main treatment in Yunnan Cancer Hospital from March 2005 to December 2014.According to the sampling principle ,there were 100 cases each year , with a total of 1000 cases. The clinical and pathological data were analyzed, including age, gender, pathogenesis, pathological type, and TNM stage. Results The average age of the 1000 patients enrolled in the survey was (63.4±12.8) years old, the male and female age group (60-69) accounted for the highest proportion.both men and women aged between 60 and 69 had a high occurance rate, and male patients were more than the female with a fraction of 1.42:1. Rectum is the most common primary site, accounting for 57%, followed by ascending colon, sigmoid colon, straight B junction, transverse colon, descending colon, and cecum. Adenocarcinoma was the main pathological type, accounting for 89.4%.Stage Ⅲ was the most common in TNM staging, accounting for 35.9%, followed by stage Ⅱ, Ⅰ, and stage Ⅳ. Most rectal cancers were found at stage Ⅲ, and colon cancer at stage Ⅱ . Conclusion The proportion of colorectal cancer in the age group (60-69 years) was the highest; the proportion of middle-aged and male was significant.The high incidence of colorectal cancer was 60～69 years old, especially males.The main part of colorectal cancer was located in the rectum.Adenocarcinoma was the most common pathological type. Most patients were later stage when diagnosed.
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Virtual reality technology and force feedback technology are novel human-machine interaction technologies. The virtual surgery simulation training system combined with these two technologies provides a new method for orthopedic surgery training, which can improve the training efficiency,thereby reducing the training costs and shortening the growth cycle of young orthopedic surgeons. In recent years, the virtual drilling bone surgery simulation technology have been researched broadly and obtained a preliminary application. In this paper, the existing research statusof virtual bone drilling operation depended on visuo-haptic techniques were studied, classified and summarized, the main content focused on three key techniques: bone modeling, drilling bone force prediction model and tactile simulation, and then analyzed the advantages and disadvantages of existing methods. Finally,some perspectives for related technology development trend of the virtual simulation bone drilling surgery in future was pointed out.
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Golgi phosphoprotein 3 (GOLPH3 )is closely related to the development and prognosis of cancer,such as non-small cell lung cancer,breast cancer,gastric cancer,esophageal cancer,colorectal cancer,etc.The mainly tumor pathogenisis related GOLPH3 includes modulating the response to DNA damage, vesicle trafficking,mTOR signaling pathway,mitochondrial functions,cytokinesis and Golgi vesicular malignant secretion,and then promoting cell proliferation,invasion and metastasis.GOLPH3 is expected to be a new tar-get for cancer therapy,which may become an important biomarker for the diagnosis,treatment and prognosis of cancer.
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Bone sawing is widely used in orthognathic surgery to correct maxillary deformities. Successful execution of bone sawing requires a high level of dexterity and experience. A virtual reality (VR) surgical simulator can provide a safe, cost-effective, and repeatable training method. In this study, we developed a VR training simulator with haptic functions to simulate bone-sawing force, which was generated by the experimental force model. Ten human skulls were obtained in this study for the determination of surgical bone-sawing force. Using a 5-DOF machining center and a micro-reciprocating saw, bone specimens with different bone density were sawed at different feed rates (20, 40, and 60 mm/min) and spindle speeds (9800, 11,200 and 12,600 cycles per minute). The sawing forces were recorded with a piezoelectric dynamometer and a signal acquisition system. Linear correlation analysis of all experimental data indicates that there were significant positive linear correlations between bone-sawing force and bone density and tool feed rate and a moderate negative linear correlation with tool spindle rate. By performing multiple regression analysis, the prediction models for the bone-sawing procedure were determined. By employing Omega.6 as a haptic device, a medical simulator for the Lefort I osteotomy was developed based on an experimental force model. Comparison of the force-time curve acquired through experiments and the curve computed from the simulator indicate that the obtained forces based on the experimental force model and the acquired data had the same trend for the bone-sawing procedure of orthognathic surgery.
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Maxilar/fisiología , Maxilar/cirugía , Modelos Biológicos , Procedimientos Quirúrgicos Ortognáticos/métodos , Cirugía Asistida por Computador/métodos , Interfaz Usuario-Computador , Anciano , Anciano de 80 o más Años , Cadáver , Simulación por Computador , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estrés MecánicoRESUMEN
Objective To investigate the cognition of the common cold and current situation of the treatment among physicians from various levels of hospitals in Chinese mainland,so as to provide evidence for future continuing medical education and rational medication.Methods A questionnaire designed for this survey was used to learn about the general information,cognitive degree of the common cold and prescription habits of physician who prescribed for cold within last three months,from various levels hospitals.Results A total of 1001 physicians were interviewed.Among them,749 physicians chose right options that the cold was the common cold and the influenza with 79.84％ in resident physicians and 56.76％ in chief physicians.A total of 745 physicians chose options that the course of common cold will be lasting 4 to 7 days; 895 physicians chose options that old people are the most susceptible for complication; 669 physicians thought the common cold was the most common infection in winter; 841 physicians used clinical methods to diagnose the common cold; 736 physicians thought although the cold was a kind of self-limited disease and symptomatic treatment could alleviate symptoms and improve life quality,patients should see doctor in time if it turns to severer; and 745 physicians held the opinion that treatment of the common cold should focus on relieving symptoms first. In addition, 61.60％ physicians had made prescription based on clinical symptoms; 505(54.24％ ) of them thought compound drugs were priority in treating the common cold.However,there were still 43 physicians prescribed antibiotics for common cold.Conclusions There is misunderstanding and discrepancy in cognition towards common cold and treatment among physicians from various levels of hospticals in mainland China.Physicians should standardize diagnosis and treatment for the common cold according to the domestic and foreign guidelines.
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Objective To investigate outpatients' cognition towards common cold and their habituated medication so as to provide evidence for future public healthcare education.Methods Patients who attended hospital for diagnosis and treatment of common cold at least within past three months were asked to fill a questionnaire independently so as to learn their cognition towards common cold and medication habit.Results Among the patients underwent survey,52.2 ％ had incorrect knowledge about common cold; 2.99％ didn't know about the hazards of common cold; 34.80％ couldn't distinguish common cold from influenza; 30.07％ considered common cold couldn't get relief without treatment; 68.24％ didn't know about the proper effects of influenza vaccination; 6.4％ often took oral medicine even intravenous injection when they caught a common cold; 59.77％ often took medication from drugstore without prescription by doctor,and a few asked doctors to prescribe medicine on their request; 9.42％ didn't know about the side effects of drug for cold treatment; and 9.72％ didn't know about the active ingredients of drug for cold treatment.There were significant differences in the common cold cognition among population of different ages and education background.The older or the higher education status patients had a better cognition ( P ＜0.0 ).Conclusion There exist a certain degree of wrong cognition towards common cold among patients of different literacy degree and different age. Public health education on common cold need to be further strengthened.
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In order to maintain good communication between the optical tracking system and image-based surgical navigation software through the serial port, we developed a serial communication software by calling the WinAPI function with Visual C++ 6.0. We then completed the data reading, integration and analysis. We further calculated the relative position between the surgical instruments and the patient coordinate system, realized the registration between the CT model data and the spatial location of patient by using ICP algorithm, and finally achieved real-time tracking surgical instruments on the surgery. The practical effects of clinical surgery have proved that this system has good robustness, real-time property and reliability, which can meet the requirements of clinical surgery.
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Humanos , Algoritmos , Procesamiento Automatizado de Datos , Simulación por Computador , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Programas Informáticos , Cirugía Asistida por Computador , Métodos , Tomografía Computarizada por Rayos X , Interfaz Usuario-ComputadorRESUMEN
Objective:To investigate the impact of polysomy 17 of breast cancer on testing results of human epidermal growth factor receptor 2 (HER2) and its clinicopathologic significance. Methods:Seventy-one patients with primary invasive breast carcinoma were studied. The HER2 gene and chromosome 17 copy numbers were determined by dual-color fluorescence in situ hybridization (FISH). The testing results were expressed by absolute HER2 gene copy number or the ratio of HER2 to chromosome 17. Based on the FISH testing results and HER2 protein expression determined by immunohistochemistry the results were compared between different groups divided by related clinicopathologic parameters.Results:All patients who had doubtable FISH results, either by absolute HER2 copy number (14 of 71 patients; 19.7%) or by the ratio HER2/chromosome 17 (2 of 71 patients, 2.8%), displayed polysomy 17. Polysomy 17-positive patients had no significant difference with HER2-negative patients in tumor grade, lymph node metastasis, and estrogen receptor (ER) expression (all P>0.05); but compared with HER2-positive patients, they showed lower tumor grade (50.0% vs 81.5%, P=0.025), higher rate of negative lymph node (55.6% vs 25.9%, P=0.045), and higher rate of ER positive expression (83.3% vs 41.7%, P=0.005) and progesterone receptor(PR)positive expression (87.5% vs 44.4%, P=0.003).Conclusion:Compared with HER2 gene amplification group, polysomy 17-positive group tends to have negative HER2 gene expression. Polysomy 17 influences the testing results of HER2 and may be the main factor that caused doubtable results in FISH examination.
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Objective To apply the three-dimensional pre-operative simulation and intra-operative real-time navigation in the reconstruction of old maxillofacial fractures so as to increase the surgical precision. Methods Six patients with old maxillofacial fractures were enrolled, and the diagnosis of unilateral old maxillofacial fractures was confirmed by clinical and imaging examinations. Virtual three-dimensional skull models were reconstructed from pre-operative CT images. The fractured bone was moved or rotated, and was reposed in a desired site according to the mirrored part from the healthy side. After patient-to-image registration, the surgical instruments and patients were tracked in real-time by optical tracking system during operation, and in this way the maxillofacial fractures were reposed satisfactorily guided by the virtual image. Results Three-dimensional simulation before operation and real-time navigation of patients and instruments during operation were realized. The error of registration was less than 1 mm. The post-operative CT examinations of these six patients revealed that the fracture reposition was same to the pre-operative planning, and the difference between them was less than 1.5 mm. The operations were minimally-invasive, with no complications. Conclusion Computer-aided surgical simulation and navigation system can effectively increase the surgical precision of reconstruction of old maxillofacial fractures.
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The application of zygoma implants proposes a successful treatment for functional reconstruction of maxillary defects. However, the placement of zygoma implants is not without risk due to anatomically complex operation sites. Aiming at minimizing the risks and improving the precision of the surgery, an image guided oral implantology system (IGOIS) is presented in this study to transfer the preoperative plan accurately to the operating theatre. The principle of IGOIS is introduced in detail, including the framework, 3D-reconstruction, preoperative planning, registration, and the motion tracking algorithm. The phantom experiment shows that fiducial registration error (FRE) and TRE (target registration error) of IGOIS are, respectively, 1.12mm and 1.35mm. With respect to the overall accuracy, the average distance deviations at the coronal and apical point of the implant are, respectively, 1.36+/-0.59mm and 1.57+/-0.59mm, while average angle deviation between the axes of the planned and the actual implant is 4.1 degrees +/-0.9 degrees . A clinical report for a patient with a severely atrophic maxilla demonstrates that the major advantage of this computer-aided navigation technology lies in its accuracy, reliability, and flexibility.
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Prótesis e Implantes , Cirugía Asistida por Computador/métodos , Cigoma/cirugía , Algoritmos , Atrofia , Biometría , Humanos , Imagenología Tridimensional , Masculino , Maxilar/diagnóstico por imagen , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Modelos Anatómicos , Movimiento (Física) , Fantasmas de Imagen , Cirugía Asistida por Computador/instrumentación , Cirugía Asistida por Computador/estadística & datos numéricos , Tomografía Computarizada por Rayos X , Cigoma/diagnóstico por imagenRESUMEN
In this paper is introduced an image guided oral implant system (IGOIS), including the 3D surface-model generation through Marching Cubes algorithm and large-scale triangular mesh simplification, the realization of pre-operative planning module with computer graphics and image processing technology, the non-invasive point-to-point registration with the fabrication of tooth-supported polymer resin templates and ICP algorithm, and the development of the real-time navigation system software by programming in VTK and VC+ +6.0. The experimental test for a patient's rapid prototype model shows that with the support of IGOIS, the precision achieved in the planning phase can be transferred to the patient so that the accuracy of the oral implant surgery under difficult conditions is improved.
