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.

Microstructure and water-swelling mechanism of red-bed mudstone in the Xining region,Northeastern Tibetan Plateau

This paper examines the effect of the microstructure and electrical conductivity(EC)on the swelling ratio and pressure in red-bed mudstone sampled from arid areas in the Xining region in the northeastern Tibetan Plateau.A series of laboratory tests,including swelling experiments,X-ray diffraction(XRD),and scanning electron microscope(SEM),was carried out for mechanical and microstructural analysis.The coupled influence of the EC and microstructural parameters on the expansion ratio and pressure was investigated,and the weight coefficients were discussed by the entropy weight method.The results revealed an increasing exponential trend in EC,and the maximum swelling speed occurred at an EC of approximately 10 μS/cm.In addition,a method for predicting the expansion potential is proposed based on the microstructure,and its reliability is verified by comparing with swelling experimental results.In addition,according to the image analysis results,the ranges of the change in the clay minerals content(CMC),the fractal dimension(FD),the average diameter(AD)of pores,and the plane porosity(PP)are 23.75%-53%,1.08-1.17,7.53-22.45 mm,and 0.62%-1.25%,respectively.Moreover,mudstone swelling is negatively correlated with the plane porosity,fractal dimension and average diameter and is linearly correlated with the clay mineral content.Furthermore,the weight values prove that the microstructural characteristics,including FD,AD,and PP,are the main factors influencing the expansion properties of red-bed mudstones in the Xining region.Based on the combination of macro and micro-analyses,a quantitative analysis of the swelling process of mudstones can provide a better reference for understanding the mechanism of expansion behavior.

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 non-uniform swelling on coal multiphysics during gas injection: The triangle approach

In current dual porosity/permeability models,there exists a fundamental assumption that the adsorption-induced swelling is distributed uniformly within the representative elementary volume (REV),irrespective of its internal structures and transient processes.However,both internal structures and transient processes can lead to the non-uniform swelling.In this study,we hypothesize that the non-uniform swelling is responsible for why coal permeability in experimental measurements is not only controlled by the effective stress but also is affected by the adsorption-induced swelling.We propose a concept of the swelling triangle composed of swelling paths to characterize the evolution of the non-uniform swelling and serve as a core link in coupled multiphysics.A swelling path is determined by a dimensionless volumetric ratio and a dimensionless swelling ratio.Different swelling paths have the same start and end point,and each swelling path represents a unique swelling case.The swelling path as the diagonal of the triangle represents the case of the uniform swelling while that as the two perpendicular boundaries represents the case of the localized swelling.The paths of all intermediate cases populate inside the triangle.The corresponding relations between the swelling path and the response of coal multiphysics are established by a non-uniform swelling coefficient.We define this method as the triangle approach and corresponding models as swelling path-based ones.The proposed concept and models are verified against a long-term experimental measurement of permeability and strains under constant effective stress.Our results demonstrate that during gas injection,coal multiphysics responses have a close dependence on the swelling path,and that in both future experiments and field predictions,this dependence must be considered.

Effect of slake durability on time dependent swelling behavior of red-bed siltstone in Sichuan Basin

The swelling behavior of red-bed rocks is a significant factor in the abnormal uplift of subgrades for high-speed railways constructed on the red stratum in the Sichuan Basin,China.The prime objective of this paper is to investigate the impact of mineralogical composition,moisture content,and overburden load on the time-dependent unconfined and oedometric swelling behavior of red-bed siltstone in the context of differences in the slake durability.Twenty samples were prepared for the swelling test,with eleven used for the unconfined swelling and slake index tests and nine for the oedometric swelling test.The temporal dependency of swelling is characterized by the viscosity coefficient of water absorption in a proposed swelling model.Results indicate that the swelling deformation of red-bed rocks is due to a combination of hydration swelling within the rock matrix and crack expansion caused by air breakage.In the unconfined swelling test,the final axial swelling strain of red-bed rocks decreases linearly with increasing slake index,while the viscosity coefficient increases exponentially with the slake index.In the oedometric swelling test,red-bed rocks with lower slake durability show greater sensitivity to lateral constraint and overburden load compared to those with higher slake durability.

Swelling pressure evolution characterization of strong expansive soil considering the influence of reserved expansion deformation

Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.

An analytical transient coal permeability model:Sorption non-equilibrium index-based swelling switch

Long-term permeability experiments have indicated that sorption-induced swelling can switch from internal to bulk depending on the evolutive sorption status.However,this sorption swelling switch mechanism has not been considered in current analytical permeability models.This study introduces a normalized sorption non-equilibrium index(SNEI)to characterize the sorption status,quantify the dynamical variations of matrix swelling accumulation and internal swelling partition,and formulate the sorption swelling switch model.The incorporation of this index into the extended total effective stress concept leads to an analytical transient coal permeability model.Model results show that the sorption swelling switch itself results in the permeability switch under stress-constrained conditions,while the confined bulk swelling suppresses the permeability recovery to the continuous reduction under displacement-constrained conditions.Model verifications show that current experimental observations correspond to the early stages of the transient process,and they could be extended to the whole process with these models.This study demonstrates the importance of the sorption swelling switch in determining permeability evolution using simple boundary conditions.It provides new insights into experimentally revealing the sorption swelling switch in the future,and underscores the requirement of a rigorous model for complex coupled processes in large-scale coal seams.

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.

Application of multi-algorithm ensemble methods in high-dimensional and small-sample data of geotechnical engineering:A case study of swelling pressure of expansive soils

Geotechnical engineering data are usually small-sample and high-dimensional,which brings a lot of challenges in predictive modeling.This paper uses a typical high-dimensional and small-sample swell pressure(P_(s))dataset to explore the possibility of using multi-algorithm hybrid ensemble and dimensionality reduction methods to mitigate the uncertainty of soil parameter prediction.Based on six machine learning(ML)algorithms,the base learner pool is constructed,and four ensemble methods,Stacking(SG),Blending(BG),Voting regression(VR),and Feature weight linear stacking(FWL),are used for the multi-algorithm ensemble.Furthermore,the importance of permutation is used for feature dimensionality reduction to mitigate the impact of weakly correlated variables on predictive modeling.The results show that the proposed methods are superior to traditional prediction models and base ML models,where FWL is more suitable for modeling with small-sample datasets,and dimensionality reduction can simplify the data structure and reduce the adverse impact of the small-sample effect,which points the way to feature selection for predictive modeling.Based on the ensemble methods,the feature importance of the five primary factors affecting P_(s) is the maximum dry density(31.145%),clay fraction(15.876%),swell percent(15.289%),plasticity index(14%),and optimum moisture content(13.69%),the influence of input parameters on P_(s) is also investigated,in line with the findings of the existing literature.

Swelling behaviors of heterogeneous red-bed mudstone subjected to different vertical stresses

In this study,the axial swelling strain of red-bed mudstone under different vertical stresses are measured by swell-under-load method,and the microstructure of mudstone after hygroscopic swelling is studied by mercury intrusion porosimetry(MIP).The weakening coefficient and Weibull distribution function are introduced into the coupling model of mudstone moisture diffusion-swelling deformation-fracture based on finite-discrete element method(FDEM).The weakening effect of moisture on mudstone's mechanical parameters,as well as the heterogeneity of swelling deformation and stress distribution,is considered.The microcrack behavior and energy evolution of mudstone during hygroscopic swelling deformation under different vertical stresses are studied.The results show that the axial swelling strain of mudstone decreases with increase of the vertical stress.At low vertical stresses,moisture absorption in mudstone leads to formation of cracks caused by hydration-induced expansion.Under high vertical stresses,a muddy sealing zone forms on the mudstone surface,preventing further water infiltration.The simulation results of mudstone swelling deformation also demonstrate that it involves both swelling of the mudstone matrix and swelling caused by crack expansion.Notably,crack expansion plays a dominant role in mudstone swelling.With increasing vertical stress,the cracks in mudstone change from tensile cracks to shear cracks,resulting in a significant reduction in the total number of cracks.While the evolution of mudstone kinetic energy shows similarities under different vertical stresses,the evolution of strain energy varies significantly due to the presence of different types of cracks in the mudstone.The findings provide a theoretical basis for understanding the hygroscopic swelling deformation mechanism of red-bed mudstone at various depths.

Effect of drying cracks on swelling and self-healing of bentonite-sand blocks used as engineered barriers for radioactive waste disposal

Experiments were conducted to evaluate the healing of drying cracks in air-dried bentonite-sand blocks after hydration and swelling in groundwater,providing justifications to simplify the protection of blocks prior to installation in a high-level radioactive waste repository.Synthetic groundwater was prepared to represent the geochemistry of Beishan groundwater,and was used to hydrate the blocks during the swelling pressure and swelling strain measurements,as Beishan is the most promising site for China's repository.Healing of the surface cracks was recorded by photography,and healing of the internal cracks was visualized by CT images and hydraulic conductivity of air-dried blocks.The results indicate that the maximum swelling pressure and swelling strain are primarily affected by the geochemistry of Beishan groundwater,but not affected by the drying cracks.The maximum swelling pressure and swelling strain of air-dried blocks are comparable to or even higher than the pressure and strain of fresh blocks.The maximum swelling pressure measured in strong(i.e.high ion strength)Beishan groundwater was 44%of the pressure measured in deionized(DI)water,and the maximum swelling strain was reduced to 23%of the strain measured in DI water.Nevertheless,the remained swelling of the blocks hydrated in strong Beishan groundwater was sufficient to heal the surface and internal drying cracks,as demonstrated by the pictures of surface cracks and CT images.The hydraulic conductivity of the air-dried block permeated with strong groundwater was comparable(3.7×higher)to the hydraulic conductivity of the fresh block,indicating the self-healing of drying cracks after hydration and swelling in groundwater.A simplified method of protecting the block with plastic wraps before installation is recommended,since the remained swelling of the block hydrated in Beishan groundwater is sufficient to heal the drying cracks.

Anisotropic swelling pressures of compacted GMZ bentonite infiltrated with salt solutions

In the high-level radioactive waste(HLW)deep geological repository,bentonite is compacted uniaxially,and then arranged vertically in engineered barriers.The assembly scheme induces the initial anisotropy,and with hydration,it develops more evidently under chemical conditions.To investigate the anisotropic swelling of compacted Gaomiaozi(GMZ)bentonite and the further response to saline effects,a series of constant-volume swelling pressure tests were performed.Results showed that dry density enhanced the bentonite swelling and raised the final anisotropy,whereas saline inhibited the bentonite swelling but still promoted the final anisotropy.The final anisotropy coefficient(ratio of radial to axial pressure)obeyed the Boltzmann sigmoid attenuation function,decreasing with concentration and dry density,converging to a minimum value of 0.76.The staged evolution of anisotropy coefficient was discovered,that saline inhibited the rise of the anisotropy coefficient(Dd)in the isotropic process greater than the valley(d1)in the anisotropic process,leading to the final anisotropy increasing.The isotropic stage amplified the impact of soil structure rearrangement on the macro-swelling pressure values.Thus,a new method for predicting swelling pressures of compacted bentonite was proposed,by expanding the equations of Gouy-Chapman theory with a dissipative wedge term.An evolutionary function was constructed,revealing the correlation between the occurrence time and the pressure value due to the structure rearrangement and the former crystalline swelling.Accordingly,a design reference for dry density was given,based on the chemical conditions around the pre-site in Beishan,China.The anisotropy promoted by saline would cause a greater drop of radial pressure,making the previous threshold on axial swelling fail.

Preparation and Swelling Kinetic Analysis of Poly (HPMC-co-AA-co-AM) Super Absorbent Resin

Super absorbent resin(SAR)is prepared by aqueous high temperature polymerization using hydroxypropyl methylcellulose(HPMC)as monomer backbone material,acrylic acid(AA)and acrylamide(AM)as the graft copolymer monomer,potassium persulfate(KPS)as the initiator to generate free radicals,and N,N`-methylenebisacrylamide(MBA)as cross-linking agent for cross-linking reaction.Simutaneously,the influence of individual factors on the water absorption is investigated,and these factors are mainly AA,AM,KPS,MBA,HPMC,and reaction temperature.The optimized conditions are obtained by the experiment repeating for several times.The water absorption multiplicity and salt absorption multiplicity under the conditions are 782.4 and 132.5 g/g,respectivity.Furthermore,the effects of different temperatures and salt concentrations on its water absorption,as well as the swelling kinetics of SAR are studied.It is indicated the water-absorbing swelling process is mainly caused by the difference in water osmotic pressure and Na+concentration inside and outside the cross-linked molecular structure of the resin,which is not only consistent with the quasi-secondary kinetic model,but also with the Fick diffusion model.

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.

Three-dimensional numerical analysis of plant-soil hydraulic interactions on pore water pressure of vegetated slope under different rainfall patterns

Understanding the pore water pressure distribution in unsaturated soil is crucial in predicting shallow landslides triggered by rainfall,mainly when dealing with different temporal patterns of rainfall intensity.However,the hydrological response of vegetated slopes,especially three-dimensional(3D)slopes covered with shrubs,under different rainfall patterns remains unclear and requires further investigation.To address this issue,this study adopts a novel 3D numerical model for simulating hydraulic interactions between the root system of the shrub and the surrounding soil.Three series of numerical parametric studies are conducted to investigate the influences of slope inclination,rainfall pattern and rainfall duration.Four rainfall patterns(advanced,bimodal,delayed,and uniform)and two rainfall durations(4-h intense and 168-h mild rainfall)are considered to study the hydrological response of the slope.The computed results show that 17%higher transpiration-induced suction is found for a steeper slope,which remains even after a short,intense rainfall with a 100-year return period.The extreme rainfalls with advanced(PA),bimodal(PB)and uniform(PU)rainfall patterns need to be considered for the short rainfall duration(4 h),while the delayed(PD)and uniform(PU)rainfall patterns are highly recommended for long rainfall durations(168 h).The presence of plants can improve slope stability markedly under extreme rainfall with a short duration(4 h).For the long duration(168 h),the benefit of the plant in preserving pore-water pressure(PWP)and slope stability may not be sufficient.

The use of carbon-based particle electrodes in three-dimensional electrode reactors for wastewater treatment

The use of three-dimensional(3D)electrodes in water treatment is competitive because of their high catalytic efficiency,low energy consumption and promising development.The use of particle electrodes is a key research focus in this technology.They are usually in the form of particles that fill the space between the cathode and anode,and the selection of materials used is important.Carbon-based materials are widely used because of their large specific surface area,good adsorption performance,high chemical stability and low cost.The principles of 3D electrode technology are introduced and recent research on its use for degrading organic pollutants using carbon-based particle electrodes is summarized.The classification of particle electrodes is introduced and the challenges for the future development of carbon-based particle electrodes in wastewater treatment are discussed.

Three-dimensional visualization technology for guiding one-step percutaneous transhepatic cholangioscopic lithotripsy for the treatment of complex hepatolithiasis

BACKGROUND Biliary stone disease is a highly prevalent condition and a leading cause of hospitalization worldwide.Hepatolithiasis with associated strictures has high residual and recurrence rates after traditional multisession percutaneous transhepatic cholangioscopic lithotripsy(PTCSL).AIM To study one-step PTCSL using the percutaneous transhepatic one-step biliary fistulation(PTOBF)technique guided by three-dimensional(3D)visualization.METHODS This was a retrospective,single-center study analyzing,140 patients who,between October 2016 and October 2023,underwent one-step PTCSL for hepatolithiasis.The patients were divided into two groups:The 3D-PTOBF group and the PTOBF group.Stone clearance on choledochoscopy,complications,and long-term clearance and recurrence rates were assessed.RESULTS Age,total bilirubin,direct bilirubin,Child-Pugh class,and stone location were similar between the 2 groups,but there was a significant difference in bile duct strictures,with biliary strictures more common in the 3D-PTOBF group(P=0.001).The median follow-up time was 55.0(55.0,512.0)days.The immediate stone clearance ratio(88.6%vs 27.1%,P=0.000)and stricture resolution ratio(97.1%vs 78.6%,P=0.001)in the 3D-PTOBF group were significantly greater than those in the PTOBF group.Postoperative complication(8.6%vs 41.4%,P=0.000)and stone recurrence rates(7.1%vs 38.6%,P=0.000)were significantly lower in the 3D-PTOBF group.CONCLUSION Three-dimensional visualization helps make one-step PTCSL a safe,effective,and promising treatment for patients with complicated primary hepatolithiasis.The perioperative and long-term outcomes are satisfactory for patients with complicated primary hepatolithiasis.This minimally invasive method has the potential to be used as a substitute for hepatobiliary surgery.