Disagreement in middle ear volume estimation between tympanometry and three-dimensional volume reconstruction in the context of tympanic membrane perforation

Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni correction.Results: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p < 0.0001). Significance was demonstrated between fourth and first average MEV quartiles(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.

Computed tomography three-dimensional reconstruction in the diagnosis of bleeding small intestinal polyps:A case report

BACKGROUND Computed tomography(CT)small bowel three-dimensional(3D)reconstruction is a powerful tool for the diagnosis of small bowel disease and can clearly show the intestinal lumen and wall as well as the outside structure of the wall.The horizontal axis position can show the best adjacent intestinal tube and the lesion between the intestinal tubes,while the coronal position can show the overall view of the small bowel.The ileal end of the localization of the display of excellent,and easy to quantitative measurement of the affected intestinal segments,the sagittal position for the rectum and the pre-sacral lesions show the best,for the discovery of fistulae is also helpful.Sagittal view can show rectal and presacral lesions and is useful for fistula detection.It is suitable for the assessment of inflammatory bowel disease,such as assessment of disease severity and diagnosis and differential diagnosis of the small bowel and mesenteric space-occupying lesions as well as the judgment of small bowel obstruction points.CASE SUMMARY Bleeding caused by small intestinal polyps is often difficult to diagnose in clinical practice.This study reports a 29-year-old male patient who was admitted to the hospital with black stool and abdominal pain for 3 months.Using the combination of CT-3D reconstruction and capsule endoscopy,the condition was diagnosed correctly,and the polyps were removed using single-balloon enteroscopyendoscopic retrograde cholangiopancreatography without postoperative complications.CONCLUSION The role of CT-3D in gastrointestinal diseases was confirmed.CT-3D can assist in the diagnosis and treatment of gastrointestinal diseases in combination with capsule endoscopy and small intestinal microscopy.

Evaluating the use of three-dimensional reconstruction visualization technology for precise laparoscopic resection in gastroesophageal junction cancer

BACKGROUND Laparoscopic gastrectomy for esophagogastric junction(EGJ)carcinoma enables the removal of the carcinoma at the junction between the stomach and esophagus while preserving the gastric function,thereby providing patients with better treatment outcomes and quality of life.Nonetheless,this surgical technique also presents some challenges and limitations.Therefore,three-dimensional reconstruction visualization technology(3D RVT)has been introduced into the procedure,providing doctors with more comprehensive and intuitive anatomical information that helps with surgical planning,navigation,and outcome evaluation.AIM To discuss the application and advantages of 3D RVT in precise laparoscopic resection of EGJ carcinomas.METHODS Data were obtained from the electronic or paper-based medical records at The First Affiliated Hospital of Hebei North University from January 2020 to June 2022.A total of 120 patients diagnosed with EGJ carcinoma were included in the study.Of these,68 underwent laparoscopic resection after computed tomography(CT)-enhanced scanning and were categorized into the 2D group,whereas 52 underwent laparoscopic resection after CT-enhanced scanning and 3D RVT and were categorized into the 3D group.This study had two outcome measures:the deviation between tumor-related factors(such as maximum tumor diameter and infiltration length)in 3D RVT and clinical reality,and surgical outcome indicators(such as operative time,intraoperative blood loss,number of lymph node dissections,R0 resection rate,postoperative hospital stay,postoperative gas discharge time,drainage tube removal time,and related complications)between the 2D and 3D groups.RESULTS Among patients included in the 3D group,27 had a maximum tumor diameter of less than 3 cm,whereas 25 had a diameter of 3 cm or more.In actual surgical observations,24 had a diameter of less than 3 cm,whereas 28 had a diameter of 3 cm or more.The findings were consistent between the two methods(χ^(2)=0.346,P=0.556),with a kappa consistency coefficient of 0.808.With respect to infiltration length,in the 3D group,23 patients had a length of less than 5 cm,whereas 29 had a length of 5 cm or more.In actual surgical observations,20 cases had a length of less than 5 cm,whereas 32 had a length of 5 cm or more.The findings were consistent between the two methods(χ^(2)=0.357,P=0.550),with a kappa consistency coefficient of 0.486.Pearson correlation analysis showed that the maximum tumor diameter and infiltration length measured using 3D RVT were positively correlated with clinical observations during surgery(r=0.814 and 0.490,both P<0.05).The 3D group had a shorter operative time(157.02±8.38 vs 183.16±23.87),less intraoperative blood loss(83.65±14.22 vs 110.94±22.05),and higher number of lymph node dissections(28.98±2.82 vs 23.56±2.77)and R0 resection rate(80.77%vs 61.64%)than the 2D group.Furthermore,the 3D group had shorter hospital stay[8(8,9)vs 13(14,16)],time to gas passage[3(3,4)vs 4(5,5)],and drainage tube removal time[4(4,5)vs 6(6,7)]than the 2D group.The complication rate was lower in the 3D group(11.54%)than in the 2D group(26.47%)(χ^(2)=4.106,P<0.05).CONCLUSION Using 3D RVT,doctors can gain a more comprehensive and intuitive understanding of the anatomy and related lesions of EGJ carcinomas,thus enabling more accurate surgical planning.

GPU-accelerated three-dimensional reconstruction method of the Compton camera and its application in radionuclide imaging

A novel and fast three-dimensional reconstruction method for a Compton camera and its performance in radionuclide imaging is proposed and analyzed in this study. The conical surface sampling back-projection method with scattering angle correction(CSS-BP-SC) can quickly perform the back-projection process of the Compton cone and can be used to precompute the list-mode maximum likelihood expectation maximization(LM-MLEM). A dedicated parallel architecture was designed for the graphics processing unit acceleration of the back-projection and iteration stage of the CSS-BP-SC-based LM-MLEM. The imaging results of the two-point source Monte Carlo(MC) simulation demonstrate that by analyzing the full width at half maximum along the three coordinate axes, the CSS-BP-SC-based LM-MLEM can obtain imaging results comparable to those of the traditional reconstruction algorithm, that is, the simple back-projection-based LM-MLEM. The imaging results of the mouse phantom MC simulation and experiment demonstrate that the reconstruction results obtained by the proposed method sufficiently coincide with the set radioactivity distribution, and the speed increased by more than 664 times compared to the traditional reconstruction algorithm in the mouse phantom experiment. The proposed method will further advance the imaging applications of Compton cameras.

Three-dimensional computed tomography reconstruction diagnosed digestive tract perforation and acute peritonitis caused by Monopterus albus:A case report

BACKGROUND Few reports have described living foreign bodies in the human body.The current manuscript demonstrates that computed tomography(CT)is an effective tool for accurate preoperative evaluation of living foreign bodies in clinic.The threedimensional(3D)reconstruction technology could clearly display anatomical structures,lesions and adjacent organs,improving diagnostic accuracy and guiding the surgical decision-making process.CASE SUMMARY Herein we describe a 68-year-old man diagnosed with digestive tract perforation and acute peritonitis caused by a foreign body of Monopterus albus.The patient pre-sented to the emergency department with complaints of dull abdominal pain,profuse sweating and a pale complexion during work.A Monopterus albus had entered the patient’s body through the anus two hours ago.During hospitalization,the 3D reconstruction technology revealed a perforation of the middle rectum complicated with acute peritonitis and showed a clear and complete Monopterus albus bone morphology in the abdominal and pelvic cavities,with the Monopterus albus biting the mesentery.Laparoscopic examination detected a large(diameter of about 1.5 cm)perforation in the mid-rectum.It could be seen that a Monopterus albus had completely entered the abdominal cavity and had tightly bitten the mesentery of the small intestine.During the operation,the dead Monopterus albus was taken out.CONCLUSION The current manuscript demonstrates that CT is an effective tool for accurate preoperative evaluation of living foreign bodies in clinic.

Single exposure passive three-dimensional information reconstruction based on an ordinary imaging system

Existing three-dimensional(3D) imaging technologies have issues such as requiring active illumination, multiple exposures, or coding modulation. We propose a passive single 3D imaging method based on an ordinary imaging system.Using the point spread function of the imaging system to realize the non-coding measurement on the target, the full-focus images and depth information of the 3D target can be extracted from a single two-dimensional(2D) image through the compressed sensing algorithm. Simulation and experiments show that this approach can complete passive 3D imaging based on an ordinary imaging system without any coding operations. This method can achieve millimeter-level vertical resolution under single exposure conditions and has the potential for real-time dynamic 3D imaging. It improves the efficiency of 3D information detection, reduces the complexity of the imaging system, and may be of considerable value to the field of computer vision and other related applications.

Image processing based three-dimensional model reconstruction for cross-platform numerical simulation

Numerical simulation is the most powerful computational and analysis tool for a large variety of engineering and physical problems.For a complex problem relating to multi-field,multi-process and multi-scale,different computing tools have to be developed so as to solve particular fields at different scales and for different processes.Therefore,the integration of different types of software is inevitable.However,it is difficult to perform the transfer of the meshes and simulated results among software packages because of the lack of shared data formats or encrypted data formats.An image processing based method for three-dimensional model reconstruction for numerical simulation was proposed,which presents a solution to the integration problem by a series of slice or projection images obtained by the post-processing modules of the numerical simulation software.By means of mapping image pixels to meshes of either finite difference or finite element models,the geometry contour can be extracted to export the stereolithography model.The values of results,represented by color,can be deduced and assigned to the meshes.All the models with data can be directly or indirectly integrated into other software as a continued or new numerical simulation.The three-dimensional reconstruction method has been validated in numerical simulation of castings and case studies were provided in this study.

Multi-Segmental Osteocutaneous Free Fibula Flap for Three-Dimensional Post-Traumatic Thumb and Wrist Reconstruction

Thumb reconstruction following a traumatic injury challenge depends on the extent of the injury. Ideally, reconstruction should restore thumb length and position and retain thumb stability, mobility, and strength, while preserving sensation and aesthetics. Achieving these outcomes can be especially challenging in severe cases of soft tissue and bony loss. The authors present a case of a 20-year-old right-hand dominant female involved in a motor vehicle accident who sustained severe crush injuries and burns to her right hand. Her injuries included soft tissue and bony defects extending from the thumb to the distal radius, namely avulsion of the thumb and significant loss of the distal radial and carpal column, resulting in severe wrist instability. We employed a three-segment vascularized osteocutaneous fibula flap to reconstruct the thumb and wrist to restore bony construct, carpal support, and soft tissue coverage. Thumb motion could not be achieved, but this technique offered a sensate, functional post for opposition and the appearance of an anatomic hand. Because of this surgery, the patient was enabled to graduate from college and pursue full-time employment. The authors hope that this report will add to the fund of knowledge and surgeon armamentarium for similar devastating injuries demanding thumb and wrist reconstruction.

Variational Reconstruction and Simulation Experiments of Sea Surface Wind Field for Ocean Data Buoy

The sea surface wind field is an important physical parameter in oceanography and meteorology.With the continuous refinement of numerical weather prediction,air-sea interface materials,energy exchange,and other studies,three-dimensional(3D)wind field distribution at local locations on the sea surface must be measured accurately.The current in-situ observation of sea surface wind parameters is mainly achieved through the installation of wind sensors on ocean data buoys.However,the results obtained from this single-point measurement method cannot reflect wind field distribution in a vertical direction above the sea surface.Thus,the present paper proposes a theoretical framework for the optimal inversion of the 3D wind field structure variation in the area where the buoy is located.The variation analysis method is first used to reconstruct the wind field distribution at different heights of the buoy,after which theoretical analysis verification and numerical simulation experiments are conducted.The results indicate that the use of variational methods to reconstruct 3D wind fields is significantly effective in eliminating disturbance errors in observations,which also verifies the correctness of the theoretical analysis of this method.The findings of this article can provide a reference for the layout optimization design of wind measuring instruments in buoy observation systems and also provide theoretical guidance for the design of new observation buoys in the future.

Post-disaster spatial reconstruction from the perspective of a rural settlement niche in the upper reaches of the Minjiang River

Post-disaster recovery and reconstruction provide an effective way to reduce the disaster vulnerability of, and promote leapfrog development in, an affected area. To date, studies that have used administrative boundaries to investigate the reconstruction of settlement space have not been able to clearly define the real boundaries of land use changes or quantify the degree of response to the ‘Build-Back-Better’ initiative, and have lacked any consideration of the fourth reconstruction stage–development period(10 years). This study constructed a mountain settlement niche and analyzed the characteristics, spatial reconstruction, and drivers of rural settlements during 2009–2019 in the upper reaches of the Minjiang River, southwest China. The results showed the following:(1) Natural factors were the basis for the formation and development of mountain settlement niches. The scale of the settlement niche and its land use structure depended on the physical geography features and the ethnic farming and grazing traditions. The settlement niche provided a realistic boundary for the spatial reconstruction.(2) The layout of residential land around cropland was the common feature of the mountain settlement niche. Of all the land use types, the roads and rural residential lands showed the most change over the 10 years;13,860 residential patches increased in size and 4,742 patches were abandoned.(3) The area of orchards, planted to reconstruct the economy in the mountains, increased by nearly 2.5 times.(4) Collapses, landslides, and debris flow disasters and the ecological red line influenced the spatial reconstruction. While the main focus of post-disaster recovery is spatial reconstruction, initiatives should include economic and spiritual recovery, and should also achieve sustainable development of the region.

Three-dimensional(3D)parametric measurements of individual gravels in the Gobi region using point cloud technique

Gobi spans a large area of China,surpassing the combined expanse of mobile dunes and semi-fixed dunes.Its presence significantly influences the movement of sand and dust.However,the complex origins and diverse materials constituting the Gobi result in notable differences in saltation processes across various Gobi surfaces.It is challenging to describe these processes according to a uniform morphology.Therefore,it becomes imperative to articulate surface characteristics through parameters such as the three-dimensional(3D)size and shape of gravel.Collecting morphology information for Gobi gravels is essential for studying its genesis and sand saltation.To enhance the efficiency and information yield of gravel parameter measurements,this study conducted field experiments in the Gobi region across Dunhuang City,Guazhou County,and Yumen City(administrated by Jiuquan City),Gansu Province,China in March 2023.A research framework and methodology for measuring 3D parameters of gravel using point cloud were developed,alongside improved calculation formulas for 3D parameters including gravel grain size,volume,flatness,roundness,sphericity,and equivalent grain size.Leveraging multi-view geometry technology for 3D reconstruction allowed for establishing an optimal data acquisition scheme characterized by high point cloud reconstruction efficiency and clear quality.Additionally,the proposed methodology incorporated point cloud clustering,segmentation,and filtering techniques to isolate individual gravel point clouds.Advanced point cloud algorithms,including the Oriented Bounding Box(OBB),point cloud slicing method,and point cloud triangulation,were then deployed to calculate the 3D parameters of individual gravels.These systematic processes allow precise and detailed characterization of individual gravels.For gravel grain size and volume,the correlation coefficients between point cloud and manual measurements all exceeded 0.9000,confirming the feasibility of the proposed methodology for measuring 3D parameters of individual gravels.The proposed workflow yields accurate calculations of relevant parameters for Gobi gravels,providing essential data support for subsequent studies on Gobi environments.

Quantitative geochemical reconstruction of Eocene paleoenvironment in Fushun Basin,northeast China

The quantitative estimation of key parameters of paleotemperature and paleoprecipitation is crucial for paleoclimate reconstruction.Geochemical data from mod-ern sediments are highly consistent with climate data,and their relationship can provide an important reference for the quantitative reconstruction of the paleoclimate.In this study,detailed inorganic geochemical analysis was carried out using high-precision sampling of the Paleogene(LFD-1 well)Guchengzi,Jijuntun and Xiloutian Formations in the Fushun Basin located in the mid-latitudes of the Northern Hemisphere.The Eocene Guchengzi Formation(54.51–47.8 Ma)and Jijuntun Formation(47.8–41.2 Ma)in the Fushun Basin were found to have been deposited under a humid climate.The lower(41.2–40.1 Ma)and upper(40.1–37.8 Ma)parts of the Xiloutian Formation were character-ized by semiarid and semihumid–semiarid climates,respec-tively,which is very similar to the paleoclimatic information reflected by organic carbon isotopes.The Eocene Thermal Maximum 2(ETM2,~53.7 Ma),Early Eocene Climatic Optimum(EECO,~53.1–46.5 Ma),Eocene Thermal Maxi-mum 3(ETM 3,~52.8 Ma),and Middle Eocene Climatic Optimum(MECO,~40.7–40.1 Ma)events significantly enhanced chemical weathering during these periods.The rapid increase in pCO_(2)concentration leads to an increase in temperature,precipitation,and surface runoff,exhibiting strong chemical weathering.The mean annual temperature(MATa)and mean annual precipitation(MAPa,MAPb,and MAPc)were estimated using parameters,such as the corrosion index without potassium(CIA-K),CaO/Al_(2)O_(3),and(Na_(2)O+K_(2)O)/Al_(2)O_(3).Comparing MAPa,MAPb,and MAPc with the MAP estimated using pollen data,MAPa and MAPb were found to be more sensitive to the climate during high precipitation periods(precipitation>1000 mm,Guchengzi Formation),and the recovered average precipi-tation was similar to MAP.In contrast,MAPc was more sensitive to the climate during low precipitation periods(precipitation<1000 mm,Jijuntun,and Xiloutian Forma-tions),with higher accuracy.To fully consider the influence of soluble inorganic salts Ca^(2+)and Na^(+),multivariate linear equations of CIA-K and CaO/Al_(2)O_(3)with CIA,and CIA-K and CaO/Al_(2)O_(3)with MAP were constructed,namely MAPd and MAPe.The results show that MAPe has the highest per-formance and can be effectively used to estimate the change of paleoprecipitation in Northeast Asia.

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.

Comparative analysis of two digestive tract reconstruction methods in total laparoscopic radical total gastrectomy

BACKGROUND The incidence of gastric cancer has significantly increased in recent years.Surgical resection is the main treatment,but the method of digestive tract reconstruction after gastric cancer surgery remains controversial.In the current study,we sought to explore a reasonable method of digestive tract reconstruction and improve the quality of life and nutritional status of patients after surgery.To this end,we statistically analyzed the clinical results of patients with gastric cancer who underwent jejunal interposition double-tract reconstruction(DTR)and esophageal jejunum Roux-en-Y reconstruction(RY).AIM To explore the application effect of DTR in total laparoscopic radical total gastrectomy(TLTG)and evaluate its safety and efficacy.METHODS We collected the relevant data of 77 patients who underwent TLTG at the Fourth Hospital of Hebei Medical University from October 2021 to January 2023.Among them,35 cases were treated with DTR,and the remaining 42 cases were treated with traditional RY.After 1:1 propensity score matching,the cases were grouped into 31 cases per group,with evenly distributed data.The clinical characteristics and short-and long-term clinical outcomes of the two groups were statistically analyzed.RESULTS The two groups showed no significant differences in basic data,intraoperative blood loss,number of lymph node dissections,first defecation time after operation,postoperative hospital stay,postoperative complications,and laboratory examination results on the 1st,3rd,and 5th days after operation.The operation time of the DTR group was longer than that of the RY group[(307.58±65.14)min vs(272.45±62.09)min,P=0.016],but the first intake of liquid food in the DTR group was shorter than that in the RY group[(4.45±1.18)d vs(6.0±5.18)d,P=0.028].The incidence of reflux heartburn(Visick grade)and postoperative gallbladder disease in the DTR group was lower than that in the RY group(P=0.033 and P=0.038).Although there was no significant difference in body weight,hemoglobin,prealbumin,and albumin between the two groups at 1,3 and 6 months after surgery,the diet of patients in the DTR group was better than that in the RY group(P=0.031).CONCLUSION The clinical effect of DTR in TLTG is better than that of RY,indicating that it is a more valuable digestive tract reconstruction method in laparoscopic gastric cancer surgery.

Development of D_α band symmetrical visible optical diagnostic for boundary reconstruction on EAST tokamak

To investigate the potential of utilizing visible spectral imaging for controlling the plasma boundary shape during stable operation of plasma in future tokamak, a D_α band symmetric visible light diagnostic system was designed and implemented on the Experimental Advanced Superconducting Tokamak(EAST). This system leverages two symmetric optics for joint plasma imaging. The optical system exhibits a spatial resolution less than 2 mm at the poloidal cross-section, distortion within the field of view below 10%, and relative illumination of 91%.The high-quality images obtained enable clear observation of both the plasma boundary position and the characteristics of components within the vacuum vessel. Following system calibration and coordinate transformation, the image coordinate boundary features are mapped to the tokamak coordinate system. Utilizing this system, the plasma boundary was reconstructed, and the resulting representation showed alignment with the EFIT(Equilibrium Fitting) results. This underscores the system's superior performance in boundary reconstruction applications and provides a diagnostic foundation for boundary shape control based on visible spectral imaging.

Application of multi-planar reconstruction technique in endovascular repair of aortic dissection

BACKGROUND Endovascular repair of aortic dissection is an effective method commonly used in the treatment of Stanford type B aortic dissection.Stent placement during the operation was one-time and could not be repeatedly adjusted during the operation.Therefore,it is of great significance for cardiovascular physicians to fully understand the branch status,position,angle,and other information regarding aortic arch dissection before surgery.AIM To provide more references for clinical cardiovascular physicians to develop treatment plans.METHODS Data from 153 patients who underwent endovascular repair of aortic dissection at our hospital between January 2021 and December 2022 were retrospectively collected.All patients underwent multi-slice spiral computed tomography angiography.Based on distinct post-image processing techniques,the patients were categorized into three groups:Multiplanar reconstruction(MPR)(n=55),volume reconstruction(VR)(n=46),and maximum intensity projection(MIP)(n=52).The detection rate of aortic rupture,accuracy of the DeBakey classification,rotation,and tilt angles of the C-arm during the procedure,dispersion after stent release,and the incidence of late complications were recorded and compared.RESULTS The detection rates of interlayer rupture in the MPR and VR groups were significantly higher than that in the MIP group(P<0.05).The detection rates of De-Bakey subtypesⅠ,Ⅱ,andⅢin the MPR group were higher than those in the MIP group,and the detection rate of typeⅢin the MPR group was significantly higher than that in the VR group(P<0.05).There was no statistically significant difference in the detection rates of typesⅠandⅡcompared to the VR group(P>0.05).The scatter rate of markers and the incidence of complications in the MPR group were significantly lower than those in the VR and MIP groups(P<0.05).CONCLUSION The application of MPR in the endovascular repair of aortic dissection has improved the detection rate of dissection rupture,the accuracy of anatomical classification,and safety.

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.

High formability Mg-Zn-Gd wire facilitates ACL reconstruction via its swift degradation to accelerate intra-tunnel endochondral ossification

After reconstructing the anterior cruciate ligament(ACL),unsatisfactory bone tendon interface healing may often induce tunnel enlargement at the early healing stage.With good biological features and high formability,Magnesium-Zinc-Gadolinium(ZG21)wires are developed to bunch the tendon graft for matching the bone tunnel during transplantation.Microstructure,tensile strength,degradation,and cytotoxicity of ZG21 wire are evaluated.The rabbit model is used for assessing the biological effects of ZG21 wire by Micro-CT,histology,and mechanical test.The SEM/EDS,immunochemistry,and in vitro assessments are performed to investigate the underlying mechanism.Material tests demonstrate the high formability of ZG21 wire as surgical suture.Micro-CT shows ZG21 wire degradation accelerates tunnel bone formation,and histologically with earlier and more fibrocartilage regeneration at the healing interface.The mechanical test shows higher ultimate load in the ZG21 group.The SEM/EDS presents ZG21 wire degradation triggered calcium phosphate(Ca-P)deposition.IHC results demonstrate upregulation of Wnt3a,BMP2,and VEGF at the early phase and TGFβ3 and Type II collagen at the late phase of healing.In vitro tests also confirmed the Ca-P in the metal extract could elevate the expression of Wnt3a,βcatenin,ocn and opn to stimulate osteogenesis.Ex vivo tests of clinical samples indicated suturing with ZG21 wire did not weaken the ultimate loading of human tendon tissue.In conclusion,the ZG21 wire is feasible for tendon graft bunching.Its degradation products accelerated intra-tunnel endochondral ossification at the early healing stage and therefore enhanced bone-tendon interface healing in ACL reconstruction.

FPGA-based position reconstruction method for neutron beam flux spatial distribution measurement in BNCT

A new measurement method for the spatial distribution of neutron beam flux in boron neutron capture therapy(BNCT)is being developed based on the two-dimensional Micromegas detector.To address the issue of long processing times in traditional offline position reconstruction methods,this paper proposes a field programmable gate array based online position reconstruction method utilizing the micro-time projection chamber principle.This method encapsulates key technical aspects:a self-adaptive serial link technique built upon the dynamical adjustment of the delay chain length,fast sorting,a coordinate-matching technique based on the mapping between signal timestamps and random access memory(RAM)addresses,and a precise start point-merging technique utilizing a circular combined RAM.The performance test of the selfadaptive serial link shows that the bit error rate of the link is better than 10-12 at a confidence level of 99%,ensuring reliable data transmission.The experiment utilizing the readout electronics and Micromegas detector shows a spatial resolution of approximately 1.4 mm,surpassing the current method’s resolution level of 5 mm.The beam experiment confirms that the readout electronics system can obtain the flux spatial distribution of neutron beams online,thus validating the feasibility of the position reconstruction method.The online position reconstruction method avoids traditional methods,such as bubble sorting and traversal searching,simplifies the design of the logic firmware,and reduces the time complexity from O(n2)to O(n).This study contributes to the advancement in measuring neutron beam flux for BNCT.

Stabilizing iridium sites via interface and reconstruction regulations for water oxidation in alkaline and acidic media

Exploring effective iridium(Ir)-based electrocatalysts with stable iridium centers is highly desirable for oxygen evolution reaction(OER).Herein,we regulated the incorporation manner of Ir in Co_(3)O_(4)support to stabilize the Ir sites for effective OER.When anchored on the surface of Co_(3)O_(4)in the form of Ir(OH)_6 species,the created Ir-OH-Co interface leads to a limited stability and poor acidic OER due to Ir leaching.When doped into Co_(3)O_(4)lattice,the analyses of X-ray absorption spectroscopy,in-situ Raman,and OER measurements show that the partially replacement of Co in Co_(3)O_(4)by Ir atoms inclines to cause strong electronic effect and activate lattice oxygen in the presence of Ir-O-Co interface,and simultaneously master the reconstruction effect to mitigate Ir dissolution,realizing the improved OER activity and stability in alkaline and acidic environments.As a result,Ir_(lat)@Co_(3)O_(4)with Ir loading of 3.67 wt%requires 294±4 mV/285±3 mV and 326±2 mV to deliver 10 mA cm^(-2)in alkaline(0.1 M KOH/1.0 M KOH)and acidic(0.5 M H_(2)SO_(4))solution,respectively,with good stability.