Diagnostic efficacy of virtual organ computer-assisted analysis in measuring the volume ratio of subchorionic hematoma with serum progesterone

BACKGROUND Subchorionic hematoma(SCH)is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane.SCH can lead to adverse pregnancy outcomes such as miscarriage,preterm birth,and other complications.Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.AIM To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis(VOCAL)in measuring the volume ratio of SCH to gestational sac(GS)combined with serum progesterone on early pregnancy outcomes in patients with SCH.METHODS A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled.All patients were followed up until a gestational age of 20 wk.The parameters of transvaginal two-dimensional ultrasound,including the circumference of SCH(Cs),surface area of SCH(Ss),circumference of GS(Cg),and surface area of GS(Sg),and the parameters of VOCAL with transvaginal three-dimensional ultrasound,including the three-dimensional volume of SCH(3DVs)and GS(3DVg),were recorded.The size of the SCH and its ratio to the GS size(Cs/Cg,Ss/Sg,3DVs/3DVg)were recorded and compared.RESULTS Compared with those in the normal pregnancy group,the adverse pregnancy group had higher Cs/Cg,Ss/Sg,and 3DVs/3DVg ratios(P<0.05).When 3DVs/3DVg was 0.220,the highest predictive performance predicted adverse pregnancy outcomes,resulting in an AUC of 0.767,and the sensitivity,specificity were 70.2%,75%respectively.VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients,with a high sensitivity of 82.1%and a specificity of 72.1%,which showed a significant difference between AUC.CONCLUSION VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH,while combined serum progesterone better predicts adverse pregnancy outcomes.

Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.

Computer-assisted rescue of the inferior mesenteric artery in a child with a giant ganglioneuroblastoma: A case report

BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.

Computer-assisted Surgery for Scaphoid Fracture

The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scaphoid fractures remains experimental.The related studies are scanty and most of them are cadaver researches.Some intrinsic defects from the registration procedure,scan and immobilization of limbs may inevitably result in deviations. Some deviations become more obvious with operations of small bones (such as scaphoid)although they are acceptable for spine and other orthopedic surgeries.We reviewed the current literatures on the applications of CAS for scaphoid operation and summarized technical principles,scan and registration methods,immobilization of limbs and their outcomes.On the basis of the data,we analyzed the limitations of this technique and envisioned its future development.

Establishment and validation of a computer-assisted colonic polyp localization system based on deep learning

BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.

Glutathione Peroxidase Revisited—Simulation of the Catalytic Cycle by Computer-Assisted Molecular Modelling

Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium catalysis. Starting from the established X-ray structure of bovine GPX, all kinetically defined intermediates and enzyme substrate complexes were modelled. The models thus obtained support the hypothesis that the essential steps of the catalysis are three distinct redox changes of the active site selenium which, in the ground state, presents itself at the surface of selenoperoxidases as the center of a characteristic triad built by selenocysteine, glutarnine and tryptophan. In GPX, four arginine residues and a lysine residue provide an electrostatic architecture which, in each reductive step, directs the donor substrate GSH towards the catalytic center in such a way that 1ts sulfhydryl group must react with the selenium moiety. To this end, different equally efficient modes of substrate binding appear possible. The models are consistent with substrate specificity data, kinetic pattern and other functional characteristics of the enzyme. Comparison of molecular models of GPX with those of other members of the GPX superfamily reveals that the cosubstrate binding mechanisrns are unique for the classical type of cytosolic glutathione peroxidases but cannot operate e. g. in plasma GPX and phospholipid hydroperoxide GPX. The structural differences between the selenoperoxidases, shown to be relevant to their specificities, are discussed in terms of functional diversification within the GPX superfamily

Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy:A controlled study

BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Novel techniques are required to assist in planning and navigation.AIM To apply and evaluate the Hisense computer-assisted surgery(CAS)system in PCNL.METHODS A total of 60 patients with complex renal stones were included.Thirty patients in the CAS group had three-dimensional(3 D)virtual models constructed with the CAS system.The model assisted in planning and navigating in the CAS system.Thirty patients in the control group planned and navigated as standard PCNL,without the application of the CAS system.Success rate of one attempt,operation time,initial stone-free rate,decrease in hemoglobin,and complications were collected and analyzed.RESULTS There were no statistically significant differences in the baseline characteristics or planning characteristics.The success rate of one puncturing attempt(90%vs 67%,P=0.028)and the initial stone-free rate(87%vs 63%,P=0.037)were significantly higher in the CAS group.However,there were no statistically significant differences in the operation time(89.20±29.60 min vs 92.33±33.08 min,P=0.859)or in the decrease in hemoglobin(11.07±8.32 g/L vs 9.03±11.72 g/L,P=0.300)between the CAS group and the control group.No statistically significant differences in the incidence of complications(Clavien-Dindo grade≥2)were found.CONCLUSION Compared with standard PCNL,CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate.The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive,precise and convenient PCNL.

Application of computer-assisted navigation in treating congenital maxillomandibular syngnathia:A case report

BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion.However, surgical procedures for this disease are rarely reported.CASE SUMMARY Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour,the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.CONCLUSION Application of computer-assisted navigation can significantly improve accuracy,effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.

Novel computer-assisted method for revision arthroplasty of the knee

AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical point and tracker identification to assess kinematic and anatomical landmarks.The system automatically positions the cutting guides with a motorized cutting unit.The cutting unit is placed on the distal femur with a femoral clamp and acts as a rigid body and the base for all femoral cuts.The surgical technique for using the navigation system for revision TKA is based on the technique used in primary TKA.However,there are some important differences.The most notable are:(1) differences in estimation of the position of the primary implant relative to the bone and the mechanical axes;(2) the specific possibilities the revision navigation software offers in terms of optimal joint level positioning; and(3) the suggested "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are taken into account to find the optimal femoral component position.We assessed the surgical technique,and accompanying software procedural steps,of the system,identifying any advantages or disadvantages that they present.RESULTS: The system aims to visualize critical steps of the procedure and is intended as a tool to support the surgeon in surgical decision-making.Combining a computer-assisted cutting device with navigation makes it possible to carry out precise cuts without pinning.Furthermore,the femoral clamp provides a stable fixation mechanism for the motorized cutting unit.A stable clamp is paramount in the presence of periarticular bony defects.The system allows the position of the primary implant relative to the bone and mechanical axes to be estimated,at which point any malalignments can be corrected.It also offers an optimal joint level position for implantation,and suggests a "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are considered.The surgeon can therefore make decisions intraoperatively to maximise alignment and,hence,outcomes.Based on the intraoperative findings of joint stability,the surgeon can modify the preoperative plan and switch from a constrained condylar system to a hinged version,or vice versa.CONCLUSION: The system is flexible and easy to learn and allows improvements in workflow during TKA.

Computer-Assisted Surgery for Mandibular Reconstruction Using a Patient-Specific Titanium Mesh Tray and Particulate Cancellous Bone and Marrow

Craniomaxillofacial surgery is difficult due to the complexity of the regional anatomy. Computer-assisted surgery is a promising tool aiming to improve the safety and precision of such surgery. A computer-assisted surgical navigation approach for reconstruction of mandibular defects using a patient-specific titanium mesh tray and particulate cancellous bone and marrow (PCBM) harvested from bilateral anterior ilia is proposed. This case report involves a large multicystic ameloblastoma affecting the right mandible of a 31-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, computer-assisted surgical simulation with a virtual 3-dimensional (3-D) model was designed using surgical planning software based on the pre-operative computed tomography data. Long-span segmental resection of the mandible was planned, and the defect was analyzed for reconstruction using a patient-specific reconstruction titanium mesh tray mediated with computer-aided design and manufacturing (CAD/CAM) techniques. During the actual surgery, the ultrasonic bone cutting instrument in the surgeon’s hand was connected to the navigation system to touch an anatomical position on the patient. Therefore, osteotomies were performed finely and smoothly according to the navigation images of the cutting bone line by sequentially moving the instrument. Finally, a CAD/CAM-mediated titanium mesh tray condensed by PCBM was adapted to the remaining mandibular fragments. Six months postoperatively, the patient had a good mandibular configuration and facial contour. Integration of different technologies, such as software planning and 3-D surgical simulation, combined with intraoperative navigation and CAD/CAM techniques, provides safe and precise mandibular reconstruction surgery.

COMPUTER-ASSISTED TESTING OF METALINGUISTIC COMPETENCE

The paper is devoted to the description of possible approaches to designing materials for computer-assisted testing of metalinguistic competence of the intending foreign language teachers. By metalinguistic competence we here mean the learners’ comprehension of such fundamental concepts of linguistic theory as: grammatical and lexical meanings and their types, the concepts of grammatical form and grammatical category, homonyms and synonyms,

Clinical application of improved 2D computer-assisted fluoroscopic navigation through simulating a 3D vertebrae image to guide pedicle screw internal fixation

Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction

Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed treatment.Computed tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the haemorrhage.AIM To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic findings.METHODS In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were enrolled.Twenty-three(65.7%)patients underwent endoscopy before CTA.Bleeding volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated software.Bleeding rate was obtained from volume change between the two phases and standardised for unit time.Patients were divided into two groups,according to the angiographic signs and their concordance with CTA.RESULTS Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)cases.Despite no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

Effect of BNT162b2 mRNA COVID-19 vaccine on sperm morphokinetics and DNA integrity: A prospective observational study in Japan

Objective:To assess whether the coronavirus disease 2019(COVID-19)mRNA vaccine affects sperm morphokinetics using a computer-assisted semen analyzer and other semen parameters using a sperm chromatin structure assay.Methods:Healthy male volunteers in two Japanese clinics between May 2021 and December 2021 were prospectively analyzed.Participants donated sperm twice,two days apart,in the following phases:before vaccination,2 weeks after the first vaccine dose,and 2,4,and 12 weeks after the second dose.Basic sperm parameters,sperm motility characteristics,and the percentage of DNA-damaged sperm were compared among the different phases.Results:Ninety-six semen samples from ten volunteers,who were vaccinated with the BNT162b2 mRNA vaccine,were evaluated.There were no significant differences between any phases in basic semen findings and parameters of the sperm chromatin structure assays.Regarding sperm motion characteristics,the average linear velocity,beat-cross frequency,and sperm motility index significantly decreased after the second vaccine dose(P=0.018,P=0.003,and P=0.027,respectively),with no significant differences between any two phases by post-hoc pairwise comparisons.Conclusions:After COVID-19 mRNA vaccination,while sperm motion characteristics might fluctuate,no apparent deterioration of basic sperm parameters or sperm DNA integrity was observed.Given the adverse effects of COVID-19 on sperm,our findings suggest that there might be no reason to refrain from vaccination for healthy individuals.

An Integrated Software Application for the Ancient Coptic Language

Coptic language was an important period of the Egyptian language,coinciding with a period of social and cultural changes.Coptic is also associated with the Greek language,as its alphabet is used for the transcription of Coptic.Despite the fact that the Coptic element is strong in Greece,the theoretical background is rather weak.For this reason,it is considered necessary to create a software tool that aims to help in the translation of Coptic into Greek and at the same time to overcome various obstacles that the researcher may encounter while processing the various corpora or artifacts,such as processing issuer,diacritics etc.This tool consists of a database,a search engine and an interface.

数字化人体技术在人工耳蜗植入应用解剖教学中的应用

颞骨内的重要组织器官具有复杂而精细的三维立体空间关系,诸如人工耳蜗植入手术等耳科手术对手术的应用解剖要求极高。传统的颞骨解剖教学仅仅停留在平面示意图或模型教学的水平上,其三维立体空间解剖信息和精度远远不能满足需要。受到颞骨标本来源的限制,又使得大量的尸颅解剖和颞骨训练不能广泛开展。而建立在数字化人体技术和多媒体技术基础上的数字化颞骨解剖技术不仅包含全部三维空间解剖信息而且可以通过多种媒体界面与学员互动,具有信息真实、直观生动、形式丰富、易于理解的特点,成为一种高效且经济的教学手段。

基于Authorware的地理信息系统CAI课件的实现

CAI作为一种计算机辅助教学方式,已经广泛地应用到教学中。多媒体CAI课件最显著的特点是集成性和交互性,而Authorware是目前公认的交互能力最强的多媒体著作工具之一。本文的地理信息系统CAI课件是采用Authorware软件开发完成的。分析了多媒体CAI课件的优点和地理信息系统课程的特点,在充分结合二者优势的基础上采用原型法进行地理信息系统CAI课件的设计,介绍了依据张超主编的《地理信息系统实习教程》设计CAI课件中实现的内容情况及地理信息系统多媒体CAI课件各种素材使用的实现方式。

鼻内镜下数码照相机豚鼠中耳成像技术

耳鼻咽喉解剖结构复杂且部位隐蔽，较难直接视及，随着鼻内镜及数字图像采集装置广泛应用，极大促进了本专业的发展。在临床科研工作中常会遇到一些认为有必要保存下来的病例影像资料，由于各种原因导致缺乏数字图像采集装置，使许多病例资料无法保留，且数字图像采集装置受采集芯片的限制，采集的图像像素相对较低。本研究旨在探索鼻内镜下利用普通数码相机拍摄清晰图像的方法，应用数码相机镜头直接接触内镜目镜，将所观察的图像拍摄下来，取得了良好的效果。

放疗导致上颌窦恶性纤维组织细胞瘤1例

1临床资料 患者,女,65岁。1991年于外院行右鼻侧切开术,术后病理报告为霍奇金淋巴瘤,术后放疗1.5个月（剂量未知）。于2001年因左眼眶肿痛,于外院行左眶上部切开肿瘤切除术，术后病理为霍奇金淋巴瘤，术后放疗1个月。于2005年9月复查发现“右上颌窦占位”于外院行右鼻侧切开术，术后病理为恶性纤维组织细胞瘤，术后放疗15次（剂量未知）。此后接受中药治疗。2006年2月起患者出现右面颊部肿痛伴鼻内臭味。查体：鼻外形塌陷，鼻尖、鼻背向右侧偏斜。右侧鼻颊沟、右鼻翼至唇间沟见切口瘢痕。右下眼睑有一个弧形瘢痕，右眶下部塌陷。左眶上缘有切口瘢痕。

The Application of the Computer Assisted Instruction(CAI) in English Teaching in High Schools

On the basis of the brief introduction to CAI and some its distinctive features,this paper minutely arrives at the principles of the application of CAI in high schools and analyses the implication brought about by its application.This research is to provide a further help for English teachers in high shools,so that the students can effectively improve the level of English language learning.