Objective:To establish a three-dimensional model of lower extremity arteriosclerosis obliterans (LEASO) using Mimics with data from computed tomography angiography (CTA) and digital subtraction angiography (DSA) and to evaluate the safety, effectiveness and accuracy of the diagnosis and treatment of the disease based on the established model.Methods:From January 2020 to March 2023, the data of 70 patients with LEASO who underwent enhanced thin-slice CT and DSA examination of lower extremity arteries in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Henan University were collected, and three-dimensional modeling of lower extremity arteries and plaques was performed by Mimics. The stenosis grading in artery segments, diagnostic agreement rate of diseased arteries, lesion length, stent diameter, and peripheral artery calification scoring system (PACSS) grade were compared between Mimics and DSA. The calcified plaque volume and the calcified proportion of mixed plaques were compared between Mimics and CTA.Results:The diagnostic coincidence rate of Mimics was 94.29% (792/840) with 3.81% (32/840) of overestimation and 1.90% (16/840) of underestimation. For the arterial segments with a stenosis of at least 50%, the sensitivity (97.19%,311/320), specificity (98.08%,510/520), false positive rate (1.92%,10/520), false negative rate (2.81%,9/320), and accuracy (97.74%,821/840) were obtained. The Kappa coefficient was 0.952, suggesting almost perfect agreement. There was no significant difference in the measurement of lesion length and stent diameter between Mimics and DSA (both P>0.05). There was no significant difference in the measurement of calcified plaque volume and the calcified proportion of mixed plaques between Mimics and CTA (both P>0.05). The coincidence rate of Mimics in PACSS grading was 95.07% (135/142) with 1.41% (2/142) of overestimation and 3.52% (5/142) of underestimation. Conclusion:The three-dimensional reconstruction model based on Mimics can visually display the location of lower extremity arterial lesions, and accurately measure the degree of stenosis, lesion length, vessel diameter, plaque volume, etc., which are significant in accurate preoperative diagnosis and treatment of LEASO.

目的:探讨大隐静脉高位结扎联合聚多卡醇泡沫硬化剂在大隐静脉曲张患者中的效果.方法:选取2019年5月～2020年5月收治的94例大隐静脉曲张患者,按随机数字表法分为对照组和观察组,各47例.对照组子以大隐静脉高位结扎加剥脱术,观察组给予大隐静脉高位结扎联合聚多卡醇泡沫硬化剂.随访至术后3个月,对比两组围术期指标、静脉临床表现严重程度(VCSS)、疼痛程度、并发症.结果:观察组手术时间、下床活动时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P＜0.05);术前,两组视觉模拟量表(VAS)评分、VCSS评分比较,差异无统计学意义(P＞0.05);观察组术后24h VAS评分和术后3个月VCSS评分均低于对照组,差异有统计学意义(P＜0.05);观察组并发症发生率低于对照组,差异有统计学意义(P＜0.05).结论:大隐静脉高位结扎联合聚多卡醇泡沫硬化剂在大隐静脉曲张患者治疗中效果确切,具有创伤小、疼痛程度轻等优势,可改善患者静脉曲张症状,促进术后恢复,减少并发症发生,安全可行.

气腔播散的定义与争议 肺癌是世界范围最常见的恶性肿瘤之一,也是恶性肿瘤死亡的最主要原因之一.在中国,根据2019年发布的,2015 年的中国的恶性肿瘤发病率的统计,中国于2015 年共计新增新发恶性肿瘤患者392. 9万例,肺癌以78. 7 万的数量位居全国恶性肿瘤发病首位,同时肺癌以导致63. 1 万例患者死亡位居全国恶性肿瘤死亡首位[1].因此,对于肺癌的研究进展对人民生活质量的提高有着十分重要的意义.传统上,我们一般认为肺癌的浸润方式有:1.肿瘤细胞非贴壁式生长,2. 有间质浸润,3. 脉管或胸膜浸润.[2]但随着研究的深入,Kadota 等[3]于2015 年首次总结了自己往前对肺腺癌病例特征研究的结果,并提出并命名了"气腔播散"(spread through air space,STAS)将其定义为:肺癌细胞经空气扩散到周围肺实质的肺泡腔隙.