ObjectiveTo evaluate the value of individualized preoperative simulation in transjugular intrahepatic portosystemic shunt (TIPS).MethodsThin slice scan data of 39 patients with supine upper abdomen were obtained, three dimensional structures of bone, liver, portal vein, inferior vena cava and hepatic vein in CT scan area were reconstructed in Mimics software. According to the size of interventional instruments, a virtual RUPS-100 puncture kit and an VIATORR stent were established in 3D MAX software. Computer simulations were performed to evaluate the route from the hepatic vein puncture portal vein and stent release position. The coincidence of simulation parameters with actual surgical results was compared.Results① The time of preoperative simulation was controllable. The total simulation time was 70–110 minutes (after summing up the previous experience). Preoperative simulation in daily work would not affect the progress of treatment. ② There were 4 cases of puncturing bifurcation of portal vein, 22 cases of puncturing left branch and 13 cases of puncturing right branch during operation (24 cases of puncturing left branch and 15 cases of puncturing right branch by preoperative simulation plan). The overall coincidence rate was 89.7% (35/39). ③ Preoperative simulations were performed using 8 mm×6 cm/2 cm size VIATORR stents, and the stents used in the actual operation were the same as the simulation results. ④ Preoperative simulation and post-operative retrospective simulation could shortened the teaching and training time and enhanced the understanding of surgical intention and key steps.ConclusionPreoperative simulation based on patient's individualized three-dimensional model and virtual interventional device could guided the actual operation of TIPS more accurately, and had practical value for improving the success rate of operation and training young doctors.
ObjectiveTo evaluate the efficacy and safety of phacoemulsification cataract extraction combined with 180° trabeculotomy assisted by gonioscopy (GT) and combined glaucoma filtration surgery (GFS) in the treatment of primary open angle glaucoma (POAG) with cataract. MethodsThe patients with POAG and cataract in the ophthalmology center of the People’s Hospital of Leshan from June 2021 to March 2022 were included. The patients were divided into GT group and GFS group according to surgical methods. Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR, number of anti-glaucoma drugs used, success rate, and complications were compared between the two groups after 1-year followed-up. ResultsA total of 27 patients (43 eyes) in the GT group and 26 patients (34 eyes) in the GFS group were included. There was no significant difference in baseline between the two groups (P>0.05). BCVA logMAR in the GT group was lower than that in the GFS group at 1 year after surgery, the difference was statistically significant (P<0.01). The postoperative IOP in GT group was lower than that in GFS group, the difference was statistically significant (P<0.05). The difference in total effective rate, the number of anti-glaucoma drugs and the incidence of complications between the two groups were not statistically significant (P>0.05). ConclusionPhacoemulsification cataract extraction combined with GT is safe and effective in the treatment of POAG with cataract and has a good effect on reducing IOP.
To investigate the value of plasma placental growth factor (PlGF) in percutaneous coronary angioplasty and stent implantation. Methods From May 2006 to March 2007, 61 patients (53 males and 8 females, mean age61 years) and 28 normal controls were included. All patients present with acute chest pain and underwent coronary angiography, the lesion severity of coronary arteries was assessed by Gensini coronary scoring system. Of them, 26 patients having serious coronary lesion underwent (percutaneous transluminal coronary angioplasty, PTCA) and stent implantation. Cardiovascular events were recorded after 30 days. Plasma PlGF was determined by ELISA. Results According to the angiography, the patients could be divided into CAD group (n=45) and Non- CAD group (n=16). Plasma PlGF level in CAD group was significantly higher than that in Non-CAD group and control group [(10.70 ± 0.49) ng/L vs (4.53 ± 0.64) ng/L vs (3.64 ± 0.36) ng/L, P lt; 0.001)], and there was no significant difference between the non-CAD group and control group (P gt; 0.05). A significant positive correlation was found between Gensini coronary score and plasma PlGF level (r=0.918, P lt; 0.01). Moreover, patients with cardiovascular events had a higher PlGF level than those without cardiovascular events after PTCA and stent implantation [(13.98 ± 3.39) ng/L vs (7.25 ± 2.96) ng/L, P lt; 0.01)]. Conclusion PlGF level has diagnostic value in patients with acute chest pain. The measurement of plasma PlGF might be helpful for early diagnosis of coronary artery disease. Patients with higher plasma PlGF level may have more severe coronary lesion. PlGF may be one of predictors for cardiovascular events after PCI.