Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation

BACKGROUND Prior studies have shown that preserving the left colic artery(LCA)during laparo-scopic radical resection for rectal cancer(RC)can reduce the occurrence of anasto-motic leakage(AL),without compromising oncological outcomes.However,anatomical variations in the branches of the inferior mesenteric artery(IMA)and LCA present significant surgical challenges.In this study,we present our novel three dimensional(3D)printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.AIM To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.METHODS We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital.Patients were divided into the 3D printing and control groups for sta-tistical analysis of perioperative characteristics.RESULTS The 3D printing observation group comprised of 72 patients,while the control group comprised 68 patients.The operation time(174.5±38.2 minutes vs 198.5±49.6 minutes,P=0.002),intraoperative blood loss(43.9±31.3 mL vs 58.2±30.8 mL,P=0.005),duration of hospitalization(13.1±3.1 days vs 15.9±5.6 days,P<0.001),postoperative recovery time(8.6±2.6 days vs 10.5±4.9 days,P=0.007),and the postoperative complication rate(P<0.05)were all significantly lower in the observation group.CONCLUSION Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively,thereby reducing intraoperative bleeding and shortening operating time,demonstrating better clinical application potential.

Posterior Reduction and Monosegmental Fusion with Intraoperative Three-dimensional Navigation System in the Treatment of High-grade Developmental Spondylolisthesis

Background： The treatment of high-grade developmental spondylolisthesis （HGDS） is still challenging and controversial. In this study, we investigated the efficacy of the posterior reduction and monosegmental fusion assisted by intraoperative three-dimensional （3D） navigation system in managing the HGDS. Methods： Thirteen consecutive HGDS patients were treated with posterior decompression, reduction and monosegmental fusion ofL5/S1, assisted by intraoperative 3D navigation system. The clinical and radiographic outcomes were evaluated, with a minimum follow-up of 2 years. The differences between the pre- and post-operative measures were statistically analyzed using a two-tailed, paired t-test. Results： At most recent follow-up, 12 patients were pain-free. Only l patient had moderate pain, There were no permanent neurological complications or pseudarthrosis. The magnetic resonance imaging showed that there was no obvious disc degeneration in the adjacent segment. All radiographic parameters were improved. Mean slippage improved from 63.2% before surgery to 12.2% after surgery and 11.0% at latest follow-up. Lumbar lordosis changed from preoperative 34.9 ± 13.3° to postoperative 50.4 ±9.9°, and 49.3 ± 7.8° at last follow-up. L5 incidence improved from 71.0 ± 11.3° to 54.0 ± 1 1.9° and did not change significantly at the last follow-up 53.±1 15.4°. While pelvic incidence remained unchanged, sacral slip significantly decreased from preoperative 32.7± 12.5° to postoperative 42.6 ± 9.8°and remained constant to the last follow-up 44.4 ± 6.9°. Pelvic tilt significantly decreased from 38.4±12.5° to 30.9± 8.1° and remained unchanged at the last fbllow-up 28.1± 11.2°. Conclusions： Posterior reduction and monosegmental fusion of L5/S1 assisted by intraoperative 3D navigation are an effective technique for managing high-grade dysplastic spondylolisthesis. A complete reduction of local deformity and excellent correction of overall sagittal balance can be achieved.

Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery

With the continuous development of digital medicine,minimally invasive precision and safety have become the primary development trends in hepatobiliary surgery.Due to the specificity and complexity of hepatobiliary surgery,traditional preoperative imaging techniques such as computed tomography and magnetic resonance imaging cannot meet the need for identification of fine anatomical regions.Imaging-based three-dimensional(3D)reconstruction,virtual simulation of surgery and 3D printing optimize the surgical plan through preoperative assessment,improving the controllability and safety of intraoperative operations,and in difficult-to-reach areas of the posterior and superior liver,assistive robots reproduce the surgeon’s natural movements with stable cameras,reducing natural vibrations.Electromagnetic navigation in abdominal surgery solves the problem of conventional surgery still relying on direct visual observation or preoperative image assessment.We summarize and compare these recent trends in digital medical solutions for the future development and refinement of digital medicine in hepatobiliary surgery.

Three-Dimensional Gravity Model Applied to Underwater Navigation

At present, new integrated navigation, which usesthe location function of reference gravity anomaly map to control the errors of the inertial navigation system (INS), has been developed in marine navigation. It is named the gravity-aided INS. Both the INS and real-time computation of gravity anomalies need a 3-D marine normal gravity model. Conventionally, a reduction method applied in geophysical survey is directiy introduced to observed data processing. This reduction does not separate anomaly from normal gravity in the observed data, so errors cannot be avoided. The 3-D marine normal gravity model was derived from the J2 gravity model, and is suitable for the region whose depth is less than 1000 m.

Real-time in situ three-dimensional integral videography and surgical navigation using augmented reality: a pilot study

To evaluate the feasibility and accuracy of a three-dimensional augmented reality system incorporating integral videography for imaging oral and maxillofacial regions, based on preoperative computed tomography data. Three-dimensional surface models of the jawbones, based on the computed tomography data, were used to create the integral videography images of a subject＇s maxillofacial area. The three-dimensional augmented reality system （integral videography display, computed tomography, a position tracker and a computer） was used to generate a three-dimensional overlay that was projected on the surgical site via a half-silvered mirror. Thereafter, a feasibility study was performed on a volunteer. The accuracy of this system was verified on a solid model while simulating bone resection. Positional registration was attained by identifying and tracking the patient/surgical instrument＇s position. Thus, integral videography images of jawbones, teeth and the surgical tool were superimposed in the correct position. Stereoscopic images viewed from various angles were accurately displayed. Change in the viewing angle did not negatively affect the surgeon＇s ability to simultaneously observe the three-dimensional images and the patient, without special glasses. The difference in three-dimensional position of each measuring point on the solid model and augmented reality navigation was almost negligible （〈1 mm）; this indicates that the system was highly accurate. This augmented reality system was highly accurate and effective for surgical navigation and for overlaying a three-dimensional computed tomography image on a patient＇s surgical area, enabling the surgeon to understand the positional relationship between the preoperative image and the actual surgical site, with the naked eye.

Clinical use of augmented reality,mixed reality,three-dimensionalnavigation and artificial intelligence in liver surgery

A precise knowledge of intra-parenchymal vascular and biliary architecture and the location of lesions in relation to the complex anatomy is indispensable to perform liver surgery.Therefore,virtual three-dimensional(3D)-reconstruction models from computed tomography/magnetic resonance imaging scans of the liver might be helpful for visualization.Augmented reality,mixed reality and 3Dnavigation could transfer such 3D-image data directly into the operation theater to support the surgeon.This review examines the literature about the clinical and intraoperative use of these image guidance techniques in liver surgery and provides the reader with the opportunity to learn about these techniques.Augmented reality and mixed reality have been shown to be feasible for the use in open and minimally invasive liver surgery.3D-navigation facilitated targeting of intraparenchymal lesions.The existing data is limited to small cohorts and description about technical details e.g.,accordance between the virtual 3D-model and the real liver anatomy.Randomized controlled trials regarding clinical data or oncological outcome are not available.Up to now there is no intraoperative application of artificial intelligence in liver surgery.The usability of all these sophisticated image guidance tools has still not reached the grade of immersion which would be necessary for a widespread use in the daily surgical routine.Although there are many challenges,augmented reality,mixed reality,3Dnavigation and artificial intelligence are emerging fields in hepato-biliary surgery.

A theory for three-dimensional response of micropolar plates

Through combined applications of the transfer-matrix method and asymptotic expansion technique,we formulate a theory to predict the three-dimensional response of micropolar plates.No ad hoc assumptions regarding through-thickness assumptions of the field variables are made,and the governing equations are two-dimensional,with the displacements and microrotations of the mid-plane as the unknowns.Once the deformation of the mid-plane is solved,a three-dimensional micropolar elastic field within the plate is generated,which is exact up to the second order except in the boundary region close to the plate edge.As an illustrative example,the bending of a clamped infinitely long plate caused by a uniformly distributed transverse force is analyzed and discussed in detail.

Oxygen tension modulates cell function in an in vitro three-dimensional glioblastoma tumor model

Hypoxia is a typical feature of the tumor microenvironment,one of the most critical factors affecting cell behavior and tumor progression.However,the lack of tumor models able to precisely emulate natural brain tumor tissue has impeded the study of the effects of hypoxia on the progression and growth of tumor cells.This study reports a three-dimensional(3D)brain tumor model obtained by encapsulating U87MG(U87)cells in a hydrogel containing type I collagen.It also documents the effect of various oxygen concentrations(1%,7%,and 21%)in the culture environment on U87 cell morphology,proliferation,viability,cell cycle,apoptosis rate,and migration.Finally,it compares two-dimensional(2D)and 3D cultures.For comparison purposes,cells cultured in flat culture dishes were used as the control(2D model).Cells cultured in the 3D model proliferated more slowly but had a higher apoptosis rate and proportion of cells in the resting phase(G0 phase)/gap I phase(G1 phase)than those cultured in the 2D model.Besides,the two models yielded significantly different cell morphologies.Finally,hypoxia(e.g.,1%O2)affected cell morphology,slowed cell growth,reduced cell viability,and increased the apoptosis rate in the 3D model.These results indicate that the constructed 3D model is effective for investigating the effects of biological and chemical factors on cell morphology and function,and can be more representative of the tumor microenvironment than 2D culture systems.The developed 3D glioblastoma tumor model is equally applicable to other studies in pharmacology and pathology.

Three-dimensional cell-based strategies for liver regeneration

Liver regeneration and the development of effective therapies for liver failure remain formidable challenges in modern medicine.In recent years,the utilization of 3D cell-based strategies has emerged as a promising approach for addressing these urgent clinical requirements.This review provides a thorough analysis of the application of 3D cell-based approaches to liver regeneration and their potential impact on patients with end-stage liver failure.Here,we discuss various 3D culture models that incorporate hepatocytes and stem cells to restore liver function and ameliorate the consequences of liver failure.Furthermore,we explored the challenges in transitioning these innovative strategies from preclinical studies to clinical applications.The collective insights presented herein highlight the significance of 3D cell-based strategies as a transformative paradigm for liver regeneration and improved patient care.

The combined application of stem cells and three-dimensional bioprinting scaffolds for the repair of spinal cord injury

Spinal cord injury is considered one of the most difficult injuries to repair and has one of the worst prognoses for injuries to the nervous system.Following surgery,the poor regenerative capacity of nerve cells and the generation of new scars can make it very difficult for the impaired nervous system to restore its neural functionality.Traditional treatments can only alleviate secondary injuries but cannot fundamentally repair the spinal cord.Consequently,there is a critical need to develop new treatments to promote functional repair after spinal cord injury.Over recent years,there have been seve ral developments in the use of stem cell therapy for the treatment of spinal cord injury.Alongside significant developments in the field of tissue engineering,three-dimensional bioprinting technology has become a hot research topic due to its ability to accurately print complex structures.This led to the loading of three-dimensional bioprinting scaffolds which provided precise cell localization.These three-dimensional bioprinting scaffolds co uld repair damaged neural circuits and had the potential to repair the damaged spinal cord.In this review,we discuss the mechanisms underlying simple stem cell therapy,the application of different types of stem cells for the treatment of spinal cord injury,and the different manufa cturing methods for three-dimensional bioprinting scaffolds.In particular,we focus on the development of three-dimensional bioprinting scaffolds for the treatment of spinal cord injury.

Effect of navigation endoscopy combined with threedimensional printing technology in the treatment of orbital blowout fractures

●AIM:To explore the combined application of surgical navigation nasal endoscopy(NNE)and three-dimensional printing technology(3DPT)for the adjunctive treatment of orbital blowout fractures(OBF).●METHODS:Retrospective analysis was conducted on the data of patients with OBF who underwent surgical treatment at the Affiliated Eye Hospital of Nanchang University between July 2012 and November 2022.The control group consisted of patients who received traditional surgical treatment(n=43),while the new surgical group(n=52)consisted of patients who received NNE with 3DPT.The difference in therapeutic effects between the two groups was evaluated by comparing the duration of the operation,best corrected visual acuity(BCVA),enophthalmos difference,recovery rate of eye movement disorder,recovery rate of diplopia,and incidence of postoperative complications.●RESULTS:The study included 95 cases(95 eyes),with 63 men and 32 women.The patients’age ranged from 5 to 67y(35.21±15.75y).The new surgical group and the control group exhibited no statistically significant differences in the duration of the operation,BCVA and enophthalmos difference.The recovery rates of diplopia in the new surgical group were significantly higher than those in the control group at 1mo[OR=0.03,95%CI(0.01–0.15),P<0.0000]and 3mo[OR=0.11,95%CI(0.03–0.36),P<0.0000]postoperation.Additionally,the recovery rates of eye movement disorders at 1 and 3mo after surgery were OR=0.08,95%CI(0.03–0.24),P<0.0000;and OR=0.01,95%CI(0.00–0.18),P<0.0000.The incidence of postoperative complications was lower in the new surgical group compared to the control group[OR=4.86,95%CI(0.95–24.78),P<0.05].●CONCLUSION:The combination of NNE and 3DPT can shorten the recovery time of diplopia and eye movement disorder in patients with OBF.

Free-walking:Pedestrian inertial navigation based on dual foot-mounted IMU

The inertial navigation system(INS),which is frequently used in emergency rescue operations and other situations,has the benefits of not relying on infrastructure,high positioning frequency,and strong real-time performance.However,the intricate and unpredictable pedestrian motion patterns lead the INS localization error to significantly diverge with time.This paper aims to enhance the accuracy of zero-velocity interval(ZVI)detection and reduce the heading and altitude drift of foot-mounted INS via deep learning and equation constraint of dual feet.Aiming at the observational noise problem of low-cost inertial sensors,we utilize a denoising autoencoder to automatically eliminate the inherent noise.Aiming at the problem that inaccurate detection of the ZVI detection results in obvious displacement error,we propose a sample-level ZVI detection algorithm based on the U-Net neural network,which effectively solves the problem of mislabeling caused by sliding windows.Aiming at the problem that Zero-Velocity Update(ZUPT)cannot suppress heading and altitude error,we propose a bipedal INS method based on the equation constraint and ellipsoid constraint,which uses foot-to-foot distance as a new observation to correct heading and altitude error.We conduct extensive and well-designed experiments to evaluate the performance of the proposed method.The experimental results indicate that the position error of our proposed method did not exceed 0.83% of the total traveled distance.

BDSec:Security Authentication Protocol for BeiDou-Ⅱ Civil Navigation Message

Due to the lack of authentication mechanism in BeiDou navigation satellite system(BDS),BD-Ⅱ civil navigation message(BDⅡ-CNAV) are vulnerable to spoofing attack and replay attack.To solve this problem,we present a security authentication protocol,called as BDSec,which is designed by using China’s cryptography Shangyong Mima(SM) series algorithms,such as SM2/4/9 and Zu Chongzhi(ZUC)algorithm.In BDSec protocol,both of BDⅡ-CNAV and signature information are encrypted using the SM4 algorithm(Symmetric encryption mechanism).The encrypted result is used as the subject authentication information.BDSec protocol applies SM9 algorithm(Identity-based cryptography mechanism) to protect the integrity of the BDⅡ-CNAV,adopts the SM2 algorithm(Public key cryptosystem) to guarantee the confidentiality of the important session information,and uses the ZUC algorithm(Encryption and integrity algorithm) to verify the integrity of the message authentication serial number and initial information and the information in authentication initialization sub-protocol respectively.The results of the SVO logic reasoning and performance analysis show that BDSec protocol meets security requirements for the dual user identity authentication in BDS and can realize the security authentication of BDⅡ-CNAV.

Method of improving pedestrian navigation performance based on chest card

With the development of positioning technology,loca-tion services are constantly in demand by people.As a primary location service pedestrian navigation has two main approaches based on radio and inertial navigation.The pedestrian naviga-tion based on radio is subject to environmental occlusion lead-ing to the degradation of positioning accuracy.The pedestrian navigation based on micro-electro-mechanical system inertial measurement unit(MIMU)is less susceptible to environmental interference,but its errors dissipate over time.In this paper,a chest card pedestrian navigation improvement method based on complementary correction is proposed in order to suppress the error divergence of inertial navigation methods.To suppress atti-tude errors,optimal feedback coefficients are established by pedestrian motion characteristics.To extend navigation time and improve positioning accuracy,the step length in subsequent movements is compensated by the first step length.The experi-mental results show that the positioning accuracy of the pro-posed method is improved by more than 47%and 44%com-pared with the pure inertia-based method combined with step compensation and the traditional complementary filtering com-bined method with step compensation.The proposed method can effectively suppress the error dispersion and improve the positioning accuracy.

Development of a toroidal soft x-ray imaging system and application for investigating three-dimensional plasma on J-TEXT

A toroidal soft x-ray imaging(T-SXRI)system has been developed to investigate threedimensional(3D)plasma physics on J-TEXT.This T-SXRI system consists of three sets of SXR arrays.Two sets are newly developed and located on the vacuum chamber wall at toroidal positionsφof 126.4°and 272.6°,respectively,while one set was established previously atφ=65.50.Each set of SXR arrays consists of three arrays viewing the plasma poloidally,and hence can be used separately to obtain SXR images via the tomographic method.The sawtooth precursor oscillations are measured by T-SXRI,and the corresponding images of perturbative SXR signals are successfully reconstructed at these three toroidal positions,hence providing measurement of the 3D structure of precursor oscillations.The observed 3D structure is consistent with the helical structure of the m/n=1/1 mode.The experimental observation confirms that the T-SXRI system is able to observe 3D structures in the J-TEXT plasma.

Intraoperative application of three-dimensional printed guides in total hip arthroplasty: A systematic review

BACKGROUND Acetabular component positioning in total hip arthroplasty(THA)is of key importance to ensure satisfactory post-operative outcomes and to minimize the risk of complications.The majority of acetabular components are aligned freehand,without the use of navigation methods.Patient specific instruments(PSI)and three-dimensional(3D)printing of THA placement guides are increasingly used in primary THA to ensure optimal positioning.AIM To summarize the literature on 3D printing in THA and how they improve acetabular component alignment.METHODS PubMed was used to identify and access scientific studies reporting on different 3D printing methods used in THA.Eight studies with 236 hips in 228 patients were included.The studies could be divided into two main categories;3D printed models and 3D printed guides.RESULTS 3D printing in THA helped improve preoperative cup size planning and post-operative Harris hip scores between intervention and control groups(P=0.019,P=0.009).Otherwise,outcome measures were heterogeneous and thus difficult to compare.The overarching consensus between the studies is that the use of 3D guidance tools can assist in improving THA cup positioning and reduce the need for revision THA and the associated costs.CONCLUSION The implementation of 3D printing and PSI for primary THA can significantly improve the positioning accuracy of the acetabular cup component and reduce the number of complications caused by malpositioning.

Anti-Spoofing:Integrated Information Authentication of BeiDou-ⅡCivil Navigation Message

The BeiDou-Ⅱcivil navigation message(BDⅡ-CNAV)is transmitted in an open environment and no information integrity protection measures are provided.Hence,the BDⅡ-CNAV faces the threat of spoofing attacks,which can lead to wrong location reports and time indication.In order to deal with this threat,we proposed a scheme of anti-spoofing for BDⅡ-CNAV based on integrated information authentication.This scheme generates two type authentication information,one is authentication code information(ACI),which is applied to confirm the authenticity and reliability of satellite time information,and the other is signature information,which is used to authenticate the integrity of satellite location information and other information.Both authentication information is designed to embed into the reserved bits in BDⅡ-CNAV without changing the frame structure.In order to avoid authentication failure caused by public key error or key error,the key or public key prompt information(KPKPI)are designed to remind the receiver to update both keys in time.Experimental results indicate that the scheme can successfully detect spoofing attacks,and the authentication delay is less than 1%of the transmission delay,which meets the requirements of BDⅡ-CNAV information authentication.

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.

A dual adaptive unscented Kalman filter algorithm for SINS-based integrated navigation system

In this study, the problem of measuring noise pollution distribution by the intertial-based integrated navigation system is effectively suppressed. Based on nonlinear inertial navigation error modeling, a nested dual Kalman filter framework structure is developed. It consists of unscented Kalman filter (UKF)master filter and Kalman filter slave filter. This method uses nonlinear UKF for integrated navigation state estimation. At the same time, the exact noise measurement covariance is estimated by the Kalman filter dependency filter. The algorithm based on dual adaptive UKF (Dual-AUKF) has high accuracy and robustness, especially in the case of measurement information interference. Finally, vehicle-mounted and ship-mounted integrated navigation tests are conducted. Compared with traditional UKF and the Sage-Husa adaptive UKF (SH-AUKF), this method has comparable filtering accuracy and better filtering stability. The effectiveness of the proposed algorithm is verified.

MA-Res U-Net:Design of Soybean Navigation System with Improved U-Net Model

Traditional machine vision algorithms have difficulty handling the interference of light and shadow changes,broken rows,and weeds in the complex growth circumstances of soybean fields,which leads to erroneous navigation route segmentation.There are additional shortcomings in the feature extractFion capabilities of the conventional U-Net network.Our suggestion is to utilize an improved U-Net-based method to tackle these difficulties.First,we use ResNet’s powerful feature extraction capabilities to replace the original U-Net encoder.To enhance the concentration on characteristics unique to soybeans,we integrate a multi-scale high-performance attention mechanism.Furthermore,to do multi-scale feature extraction and capture a wider variety of contextual information,we employ atrous spatial pyramid pooling.The segmented image generated by our upgraded U-Net model is then analyzed using the CenterNet method to extract key spots.The RANSAC algorithm then uses these important spots to delineate the soybean seedling belt line.Finally,the navigation line is determined using the angle tangency theory.The experimental findings illustrate the superiority of our method.Our improved model significantly outperforms the original U-Net regarding mean Pixel Accuracy(mPA)and mean Intersection over Union(mIOU)indices,showing a more accurate segmentation of soybean routes.Furthermore,our soybean route navigation system’s outstanding accuracy is demonstrated by the deviation angle,which is only 3°between the actual deviation and the navigation line.This technology makes a substantial contribution to the sustainable growth of agriculture and shows potential for real-world applications.