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To evaluate the feasibility and safety of percutaneous transluminal forceps biopsy (PTFB) with an adjustable curved sheath in patients with obstructive jaundice.Forty-two patients who underwent PTFB with an adjustable curved sheath were analyzed retrospectively. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were calculated for all populations and in different situations. Technical success and safety were evaluated.The technical success rate was 100%. Thirty-five of 42 cases were diagnosed malignant diseases, the sensitivity of PTFB with an adjustable curved sheath was 74.29% (26/35), the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 43.75% (7/16), and the accuracy rate was 78.57% (33/42). There was a better sensitivity for bile duct malignancies when compared with non-bile duct malignancies (PTFB with an adjustable curved sheath is an effective and safe technique, without being limited by approaches and obstruction sites.

The purpose of this prospective randomized study was to compare the nosocomial biliary tract infection rate of biliary stent implantation with a biliary stent loaded with radioactive 125 I seeds (radioactive biliary stent, RBS) and conventional biliary stent (CBS); additionally, to preliminary discuss the causes of postoperative cholangitis. Moreover, the results will provide clinical evidence for the prevention of postoperative biliary tract infection.We prospectively analyzed the nosocomial infection rate of the distal malignant biliary obstruction (MBO) treatment by stent implantation with RBS and CBS. All MBO patients who initially visited our tertiary hospital between July 2015 and December 2019 (n= 196) were evaluated, enrolled, and randomly divided into 2 groups, RBS (n=97) and CBS (n=99) group. χ 2 test was used to evaluate the categorical data, and t test was used to evaluate the numerical data.Our analysis of the study showed the incidence of postoperative infections of a biliary tract of the RBS group (23.7%) was significantly higher than the CBS group (11.1%). The difference was statistically significant (χ 2 =5.425, P =0.020). Our study also showed the most common pathogenic bacteria after surgery was Escherichia coli (26.5%).Treatment for distal MBO with biliary stent loaded with radioactive 125 I seeds had a higher nosocomial infection rate, and the most common pathogenic bacteria was E coli. , Supplemental Digital Content 1, http://links.lww.com/sle/A350.

Background The aim of the study is to analyze the effect of multiple punctures in computed tomography (CT)-guided microcoil localization of pulmonary nodules with other risk factors for common complications. Methods Consecutive patients who underwent CT-guided microcoil localization and subsequent video-assisted thoracoscopic surgery (VATS) between January 2020 and February 2021 were enrolled. Nodules successfully located after only one puncture were defined as the single puncture group, and nodules requiring two or more punctures were defined as the multiple puncture group. Binary logistic regression analysis was performed to assess the relationship between the number of punctures and pneumothorax and intrapulmonary hemorrhage. Results A total of 121 patients were included. There were 98 (68.1%) pulmonary nodules in the single puncture group compared with 46 (31.9%) nodules in the multiple puncture group. The frequencies of pneumothorax and intrapulmonary hemorrhage were higher in the multiple puncture group than in the single puncture group (p = 0.019 and Conclusion Multiple punctures resulted in an increased incidence of pneumothorax and intrapulmonary hemorrhage compared with single puncture during CT-guided microcoil localization of pulmonary nodules and were independently associated with both pneumothorax and intrapulmonary hemorrhage.

Objective To investigate and summarize the effectiveness and safety of CT guided microcoil localization before video-assisted thoracic surgery (VATS) for the removal of ground glass opacity (GGO).Method 147 patients with GGO who were treated in our hospital from January 2019 to February 2021 were retrospectively analyzed. They were divided into two groups according to the final position of the end of the microcoil, intracavity group (n=78) and extracavity group (n=69). Comparison of the two groups of patients with puncture complications, and the influence of the end position of the coil for VATS.Results The proportion of supine and prone position in the intracavity group was significantly higher than that in the extracavity group (82.1% vs. 66.7%, P0.05). The time of VATS and the rate of conversion to thoracotomy in the intracavity group were significantly lower than those in the extracavity group (103.4±21.0min vs. 112.2±17.3min, 0% vs. 5.8%, PConclusion CT-guided placement of the microcoil was a very practical, simple and convenient localization method before VATS with high success rate and few complications, further more, it was a better method to place the end of the coil in the pleural cavity because of the lower complication rate, shorter VATS time and lower rate of thoracotomy conversion.

Today, artificial intelligence and virtual reality are rapidly developing as a new technology, and major universities and training institutions have opened relevant courses one after another. However, the traditional course management system cannot meet the needs of virtual reality technology. Therefore, the virtual reality course management system based on artificial intelligence has become an important technological breakthrough to solve this problem. The purpose of this article is to study the design of a virtual reality course management system based on artificial intelligence. This article first, on the basis of fully understanding the core concepts of virtual reality, transforms the curriculum management needs into actual functions for design, and designs the three key functional modules of the design and research of the virtual reality curriculum management system based on artificial intelligence in detail. At the same time, the software architecture and database of the system are rationally designed, the system is designed and explained, and the key points in the main functional modules are explained in more detail. Finally, combined with the artificially designed virtual reality curriculum management system based on artificial intelligence, the application technology, education application and application experience analysis are carried out through questionnaire survey. The results of the questionnaire show that 47% of students are “very willing” to join the immersive virtual reality classroom teaching, and 40% of students choose “more willing”, indicating that students are more willing to accept the management system model.

Objective To study changes in T lymphocyte subsets, cytokines, and liver enzymes in patients with malignant obstructive jaundice (MOJ) before and after external biliary drainage (percutaneous transhepatic cholangiography drainage, PTCD) and internal biliary drainage (percutaneous transhepatic insertion of biliary stents, PTIBS). Methods MOJ patients undergoing PTCD (n = 44) and PTIBS (n = 38) at our hospital were enrolled in the study from January 2017 until December 2019. Peripheral blood total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), CD3+%, CD4+%, CD4+/CD8+ ratio, interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α were measured before and 1 week after biliary drainage. Results There was no significant difference in any parameter between the two groups before biliary drainage. TBIL, DBIL, AST and ALT following PTCD were significantly lower than before PTCD. By contrast, CD3+%, CD4+%, CD4+/CD8+ ratio, IL-2, IL-6 and TNF-α showed no significant difference before and 1 week after PTCD. TBIL, DBIL, AST, ALT, IL-6 and TNF-α were significantly lower following PTIBS than before PTIBS. CD3+%, CD4+%, CD4+/CD8+ ratio and IL-2 were significantly higher following PTIBS than before PTIBS. Conclusion Both PTCD and PTIBS were effective for treatment of MOJ, but PTIBS was more beneficial for recovery of immune function.

With the development of economy and society, virtual reality technology has been paid more and more attention and gradually applied to all walks of life. Due to its interactive, immersive and real-time nature, virtual reality has a broad prospect in the field of architecture, especially in interior decoration and design. The use of virtual reality interior design allows designers and users to experience effect of what they see is what they get, but also allows users to feel as if they are in the design of the virtual scene, immersive mood. The purpose of this paper is to study the development status and trend of indoor VR technology design under the background of big data. After reviewing the development background of virtual reality technology and its application status in interior design, this paper introduces the technology related to big data, studies the global lighting rendering technology, and then analyzes the interior design system based on big data and VR technology. The experimental results show that the interior design system designed in this paper is accurate. By comparing the detection results of the digital model with the real results, the error of the digital model is not more than 0.5.