This study systematically explores the assessment tools for balance function in elderly patients after total hip arthroplasty and their clinical applications, while also envisioning future trends toward multidimensional integration and intelligent development. By summarizing the commonly used subjective and objective assessment in clinical practice and analyzing the application of these methods in preoperative prehabilitation and postoperative rehabilitation monitoring for elderly total hip arthroplasty patients, this article proposes that future efforts should focus on promoting the integration of subjective and objective assessment, developing intelligent predictive models, and establishing closed-loop rehabilitation systems to enhance the precision and effectiveness of assessment and rehabilitation.
Liddle syndrome and Gordon syndrome are two rare single-gene inherited hypertension diseases. In patients≤40 years, the prevalence of Liddle syndrome is about 1% and Gordon syndrome is uncertain all over the word, for which is often misdiagnosed and mistreated. The therapies of those diseases are targeted at gene mutation sites, as well as combined with modified lifestyle, and can achieve satisfactory diseases control. This paper reports a patient who is diagnosed with Liddle syndrome and Gordon syndrome at the same time. We aimed to consolidate and improve the diagnosis and accurate treatment of those two diseases by sharing, studying and discussing together with clinical doctors.
Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease caused by the mutations in the NF1 gene, with an incidence of approximately 1/3 000. Affecting multiple organs and systems throughout the body, NF1 caused a wide variety of clinical symptoms. A comprehensive multidisciplinary diagnostic and treatment model is needed to meet the diverse needs of NF1 patients and improve their quality of life. In recent years, the emergence of targeted therapies has further benefited NF1 patients, and the number of clinical consultations has increased dramatically. However, due to the rarity of the disease itself and insufficient attention previously, the standardized, systematic, and precise diagnosis and treatment model of NF1 still needs to be further improved. In this paper, we reviewed the current status of comprehensive diagnosis and treatment of NF1 in China, combine with our long-term experiences in diagnosis and treatment of this disease. Meanwhile, we propose future directions and several suggestions for the comprehensive diagnosis and treatment model for Chinese NF1 patients.
Objective To evaluate effects of three-dimensional (3D) visualized reconstruction technology on short-term benefits of different extent of resection in treating hepatic alveolar echinococcosis (HAE) as well as some disadvantages. Methods One hundred and fifty-two patients with HAE from January 2014 to December 2016 in the Department Liver Surgery, West China Hospital of Sichuan University were collected, there were 80 patients with ≥4 segments and 72 patients with ≤3 segments of liver resection among these patients, which were designed to 3D reconstruction group and non-3D reconstruction group according to the preference of patients. The imaging data, intraoperative and postoperative indicators were recorded and compared. Results The 3D visualized reconstructions were performed in the 79 patients with HAE, the average time of 3D visualized reconstruction was 19 min, of which 13 cases took more than 30 min and the longest reached 150 min. The preoperative predicted liver resection volume of the 79 patients underwent the 3D visualized reconstruction was (583.6±374.7) mL, the volume of intraoperative actual liver resection was (573.8±406.3) mL, the comparison of preoperative and intraoperative data indicated that both agreed reasonably well (P=0.640). Forty-one cases and 38 cases in the 80 patients with ≥4 segments and 72 patients with ≤3 segments of liverresection respectively were selected for the 3D visualized reconstruction. For the patients with ≥4 segments of liver resection, the operative time was shorter (P=0.021) and the blood loss was less (P=0.047) in the 3D reconstruction group as compared with the non-3D reconstruction group, the status of intraoperative blood transfusion had no significant difference between the 3D reconstruction group and the non-3D reconstruction group (P=0.766). For the patients with ≤3 segments of liver resection, the operative time, the blood loss, and the status of intraoperative blood transfusion had no significant differences between the 3D reconstruction group and the non-3D reconstruction group (P>0.05). For the patients with ≥4 segments or ≤3 segments of liver resection, the laboratory examination results within postoperative 3 d, complications within postoperative 90 d, and the postoperative hospitalization time had no significant differences between the 3D reconstruction group and the non-3D reconstruction group (P>0.05). Conclusion 3D visualized reconstruction technology contributes to patients with HAE ≥4 segments of liver resection, it could reduce intraoperative blood loss and shorten operation time, but it displays no remarkable benefits for ≤3 segments of liver resection.
Objective To investigate the safety and feasibility of transcatheter arterial chemoembolization (TACE) assisted by transradial approach and cone beam computed tomography (CBCT) three-dimensional vascular reconstruction in the treatment of primary liver cancer. Methods The clinical data of 124 patients with primary liver cancer who underwent precision TACE via radial artery in our hospital from May 2018 to December 2019 were retrospectively collected. Results Among the 124 patients, 118 patients were successfully punctured through the left radial artery and completed the TACE operation. The operation time was (109.57±31.32) min, and the median of postoperative hospitalization was 3 d. One patient changed to the right radial artery to complete TACE due to chronic renal failure and left brachial artery and vein puncture and catheterization before operation. The operation time was 119 minutes, and the patient was discharged after 5 days of hospitalization. After successful puncture of the left radial artery in one patient, the forearm artery was twisted into a loop and the guide wire catheter failed to pass, and the right femoral artery was used to complete TACE. The operation time was 123 minutes, and the patient was discharged after 4 days of improvement. The radial artery puncture was unsuccessful in four patients, and the right femoral artery approach was used to complete the operation; the operation time was (111.66±32.77) min, and the median of postoperative hospitalization was 3 d. One of the patients successfully completed up to 5 consecutive TACE via the radial artery. All patients underwent precision TACE with superselective cannulation assisted by CBCT three-dimensional vascular reconstruction. No vascular injury andocclusion, urinary retention, subcutaneous hemorrhage, and other complications occurred in all patients. Conclusions Trans-radial arterial precision TACE is safe and effective, which can be repeated many times and has few complications and high patient comfort. It can be used as one of the routine approaches of TACE.
Image interpolation is often required during medical image processing and analysis. Although interpolation method based on Gaussian radial basis function (GRBF) has high precision, the long calculation time still limits its application in field of image interpolation. To overcome this problem, a method of two-dimensional and three-dimensional medical image GRBF interpolation based on computing unified device architecture (CUDA) is proposed in this paper. According to single instruction multiple threads (SIMT) executive model of CUDA, various optimizing measures such as coalesced access and shared memory are adopted in this study. To eliminate the edge distortion of image interpolation, natural suture algorithm is utilized in overlapping regions while adopting data space strategy of separating 2D images into blocks or dividing 3D images into sub-volumes. Keeping a high interpolation precision, the 2D and 3D medical image GRBF interpolation achieved great acceleration in each basic computing step. The experiments showed that the operative efficiency of image GRBF interpolation based on CUDA platform was obviously improved compared with CPU calculation. The present method is of a considerable reference value in the application field of image interpolation.
ObjectiveTo review the progress of radiomics in the field of colorectal cancer in recent years and summarize its value in the imaging diagnosis of colorectal cancer.MethodsEighty English and seven Chinese articles were retrieved through PUBMED, OVID, CNKI, Weipu and Wanfang. The structure and content of these literatures were classified and analyzed.ResultsIn five studies predicting the preoperative stages of colorectal cancer based on CT radiomics, the area under curve (AUC) ranged from 0.736 to 0.817; in two studies predicting the preoperative stages of colorectal cancer based on MRI radiomics, the AUC were 0.87 and 0.827 respectively. In two studies about radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy based on CT, the AUC were 0.79 and 0.72 respectively; in four studies about radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy based on MRI, the AUC ranged from 0.84 to 0.979. In one study evaluating the sensitivity of neoadjuvant chemotherapy based on MRI radiomics, the AUC was 0.79. In one study predicting the postoperative survival rate based on MRI radiomics, the AUC value of the final model was 0.827. In one study, the accuracy of the model based on PET/CT radiomics in 4-year disease-free survival (DSS), progression-free survival (DFS) and overall survival (OS) were 0.87, 0.79 and 0.79 respectively.ConclusionAt present, radiomics has a valuable impact on preoperative staging, neoadjuvant therapy evaluation, and survival analysis of colorectal cancer.
With the advancement of thyroid tumor treatment concepts and the progress of standardized treatment processes nationwide, the 5-year survival rate of thyroid tumors in China has risen from 67.5% in 2003 to 84.3% in 2015. As China has been continuously enriching its treatment options for advanced thyroid cancer in recent years, gradually improving the standardized treatment system for early and intermediate thyroid cancer, enhancing multidisciplinary collaboration methods and concepts, and regularizing scientific statistics, the survival rate of thyroid tumors continues to improve. We still need to consider the future development direction and core driving force of China’s thyroid discipline, correctly view the “prosperous” stage of domestic thyroid discipline development, and actively review the future development direction of China’s thyroid discipline.
Lung cancer is one of the leading causes of cancer deaths worldwide. Many options including surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy have been applied in the treatment for lung cancer patients. However, how to develop individualized treatment plans for patients and accurately determine the prognosis of patients is still a very difficult clinical problem. In recent years, radiomics, as an emerging method for medical image analysis, has gradually received the attention from researchers. It is based on the assumption that medical images contain a vast amount of biological information about patients that is difficult to identify with naked eyes but can be accessed by computer. One of the most common uses of radiomics is the diagnosis and treatment of non-small cell lung cancer (NSCLC). In this review, we reviewed the current researches on chest CT-based radiomics in the diagnosis and treatment of NSCLC and provided a brief summary of the current state of research in this field, covering various aspects of qualitative diagnosis, efficacy prediction, and prognostic analysis of lung cancer. We also briefly described the main current technical limitations of this technology with the aim of gaining a broader understanding of its potential role in the diagnosis and treatment of NSCLC and advancing its development as a tool for individualized management of NSCLC patients.
In recent years, deep learning has provided a new method for cancer prognosis analysis. The literatures related to the application of deep learning in the prognosis of cancer are summarized and their advantages and disadvantages are analyzed, which can be provided for in-depth research. Based on this, this paper systematically reviewed the latest research progress of deep learning in the construction of cancer prognosis model, and made an analysis on the strengths and weaknesses of relevant methods. Firstly, the construction idea and performance evaluation index of deep learning cancer prognosis model were clarified. Secondly, the basic network structure was introduced, and the data type, data amount, and specific network structures and their merits and demerits were discussed. Then, the mainstream method of establishing deep learning cancer prognosis model was verified and the experimental results were analyzed. Finally, the challenges and future research directions in this field were summarized and expected. Compared with the previous models, the deep learning cancer prognosis model can better improve the prognosis prediction ability of cancer patients. In the future, we should continue to explore the research of deep learning in cancer recurrence rate, cancer treatment program and drug efficacy evaluation, and fully explore the application value and potential of deep learning in cancer prognosis model, so as to establish an efficient and accurate cancer prognosis model and realize the goal of precision medicine.