Medicine Format Research Articles

Application effect of head-mounted mixed reality device combined with 3D printing model in neurosurgery ventricular and hematoma puncture training

BackgroundThe purpose of this study was to explore the applicability of application effect of head-mounted mixed reality (MR) equipment combined with a three-dimensional (3D) printed model in neurosurgical ventricular and haematoma puncture training.MethodsDigital Imaging and Communications in Medicine (DICOM) format image data of two patients with common neurosurgical diseases (hydrocephalus and basal ganglia haemorrhage) were imported into 3D Slicer software for 3D reconstruction, saved, and printed using 3D printing to produce a 1:1-sized head model with real person characteristics. The required model (brain ventricle, haematoma, puncture path, etc.) was constructed and imported into the head-mounted MR device, HoloLens, and a risk-free, visual, and repeatable system was designed for the training of junior physicians. A total of 16 junior physicians who studied under this specialty from September 2020 to March 2022 were selected as the research participants, and the applicability of the equipment and model during training was evaluated with assessment score sheets and questionnaires after training.ResultsAccording to results of the assessment and questionnaire, the doctors trained by this system are more familiar with the localization of the lateral anterior ventricle horn puncture and the common endoscopic surgery for basal ganglia haemorrhage, as well as more confident in the mastery of these two operations than the traditional training methods.ConclusionsThe use of head-mounted MR equipment combined with 3D printing models can provide an ideal platform for the operation training of young doctors. Through holographic images created from the combination of virtual and real images, operators can be better immersed in the operation process and deepen their understanding of the operation and related anatomical structures. The 3D printed model can be repeatedly reproduced so that doctors can master the technology, learn from mistakes, better achieve the purpose of teaching and training, and improve the effect of training.

A Scientific Proposal for Surgical Decision-Making in Occult Intertrochanteric Fractures Based on Finite Element Analysis.

Background In the treatment of femoral intertrochanteric fractures, there is still a lack of consensus on the optimal approach for isolated greater trochanteric fractures and insufficient intertrochanteric fractures. The limited number of patients and restricted access to accurate assessment of fracture extension using magnetic resonance imaging contribute to the unclear treatment strategy. This study aims to utilize finite element (FE) analysis to analyze stress values at the fracture line and investigate their influence on intertrochanteric fracture extension under different loading conditions. The hypothesis is that fracture extension occurs following certain conditions, supporting the need for surgery based on scientific evidence. Methodology Osseous data from a computed tomography (CT) scan was used to create a proximal femur FE model using FEA software. CT scan data were converted to Digital Imaging and Communications in Medicine format and used to generate the FE model. Trabecular bone and cortex were meshed into tetrahedral elements. The model consisted of 1,592,642 elements and 282,530 nodes. Two models were created, namely, healthy proximal femur (HF) and femoral insufficient intertrochanteric fracture (FIF). Material properties were assigned based on CT values and conversion equations. The distal end of the femur was constrained. Stress analysis using the dynamic explicit approach was performed. Von Mises stresses were calculated for the proximal femur. The number of elements exceeding yield stress was counted to predict fracture risk by focusing on fracture line spots. In this study, the distribution of von Mises stress was compared between the HF and the FIF models. Six loading combinations were considered, namely, two weight-bearing conditions (3 W loading simulating for walking and 1/3 W for touch-down standing) and three hip flexion angles (0°, 15°, and 23°). Results Under 3 W loading, no significant stress elevations were observed in the HF model at any flexion angles. However, the FIF model exhibited increased stress at the site of the posterior fracture line extension. This stress-induced element destruction was observed in both cortical and cancellous bone. For the 1/3 W loading condition, only minimal stress elevation was observed in both HF and FIF models. To assess the influence on fracture extension, the number of yielded elements was evaluated along the fracture line edges (greater trochanter and middle of the intertrochanteric ridge). Under 3 W loading, the HF model had only one yielded element, indicating minimal fracture risk. In contrast, the FIF model exhibited a notable presence of yield elements in various regions (total/greater trochanter/shaft) at different flexion angles: 0° (115/16/28), 15° (265/158/23), and 23° (446/233/34). Under the 1/3 W loading condition, neither the HF nor the FIF models showed any yielding elements, regardless of the direction of external force. Conclusions The results demonstrated elevated stress levels at the fracture line in the FIF model, particularly during walking, indicating a higher risk of fracture extension at the flex position. However, under reduced weight-bearing conditions, the stress at the fracture site remained within the yield stress range, suggesting a relatively low risk of fracture extension. These findings hold significant clinical implications for developing surgical protocols that consider patients' compliance with weight-bearing restrictions.

Sex prediction with morphometric measurements of first and fifth metatarsal and phalanx obtained from X-ray images by using machine learning algorithms.

The aim of this study is to predict sex with machine learning (ML) algorithms by making morphometric measurements on radiological images of the first and fifth metatarsal and phalanx bones. In this study, radiologic images of 263 individuals (135 female, 128 male) between the ages of 27 and 60 were analysed retrospectively. The images in digital imaging and communications in medicine (DICOM) format were transferred to personal workstation Radiant DICOM Viewer programme. Length and width measurements of the first and fifth metatarsal and foot phalanx bones were performed on the transferred images. In addition, the ratios of the total length of the first proximal and distal phalanx and length of the first metatarsal and total length of fifth proximal, middle, and distal phalanx and maximum length of fifth metatarsal were calculated. As a result of machine learning algorithms, highest accuracy, specificity, sensitivity, and Matthews correlation coefficient values were found as 0.85, 0.86, 0.85, and 0.71, respectively with decision tree algorithm. It was found that accuracy rates of other algorithms varied between 0.74 and 0.83. As a result of our study, it was found that sex estimation was made with high accuracy rate by using machine learning algorithms on X-ray images of the first and fifth metatarsal and foot phalanx. We think that in cases when pelvis, cranium and long bones are harmed and examination is difficult, bones of the first and fifth metatarsal and foot phalanx can be used for sex estimation.

The first report of Champsosaurus lindoei (Choristodera: Champsosauridae) from the Campanian of the United States: anatomical, phylogenetic, and palaeoecological significance

Abstract Although the neochoristodere Champsosaurus is well documented in Campanian deposits of western North America, species-diagnostic remains from these strata are restricted to the Dinosaur Park Formation of Alberta, Canada. Here, we describe an exceptionally well-preserved specimen of Champsosaurus lindoei from the Two Medicine Formation of Montana, USA—one of the few occurrences of the genus within the formation, and the first confirmed occurrence of C. lindoei outside of Dinosaur Provincial Park and its vicinity. This specimen preserves previously unknown aspects of this species, including the pes, tail, and integument, allowing for the first detailed postcranial description in this taxon. The integumentary impressions preserved on the ventral surface are the largest described thus far for Champsosaurus, supporting previous suggestions that Champsosaurus scales increase in size ventrally. We also conducted the first species-level phylogeny for Champsosaurus, where we recovered a pectinate tree topology with Palaeocene species as the sister taxa to older Maastrichtian and Campanian species, and provide further evidence for at least three lineages of Champsosaurus surviving the Cretaceous-Palaeogene (K-Pg) extinction. Finally, the recovery of the specimen from the semi-arid upland deposits of the Two Medicine Formation suggests that Champsosaurus may have been better able to withstand drier environments than previously thought.

Exploration on the Construction of County Medical Community Information Platform

By combing the development status and key problems of the county medical community model, analyzing the practical scenarios of the county medical community, combining Big data, cloud computing, artificial intelligence related technologies, designing the architecture model of the county medical community information platform, and exploring the construction methods of the county medical community information platform that meet the social development status and meet the people's health needs. It provides reference for the landing and development of future medical informatization, medical Big data platform and county medical community information platform.

A Bibliometric Analysis of Diagnosis Related Groups from 2013 to 2022.

As an important management method of the global healthcare system, diagnosis related groups (DRGs) classify patients into different cost groups and pay more attention to the equitable distribution of medical resources and the quality of medical services. At present, most countries have used DRGs to help medical institutions and doctors to treat patients more accurately, avoid the waste of medical resources, and improve treatment efficiency. The Web of Science database was searched to collect all relevant literature on DRGs from 2013 to 2022. The literature information was imported into CiteSpace, Vosviewer, and Histcite for data analysis and visualization of the results. Analyze the cooperative relationship among the countries, institutions, journals, and authors. The usage trend of keywords; Highlight the content of the cited articles. The number of articles published in this decade was stable, and the number of citations in 2014 was the highest. The United States and Germany, as the first countries to use the DRGs system, are ahead of other countries in terms of the number and quality of articles. We have carried out content research on the articles with high citations, and summarized the application range of DRGs; classification method; advantages and disadvantages of the application. In general, the development trend of DRGs in foreign countries is to continuously optimize the classification method, expand the scope of application, and improve the application effect. These provide support and reference for the improvement of medical services and the perfection of the medical insurance system. The application of DRGs can improve the quality and efficiency of medical services, and reduce the waste of medical expenses. It can also promote the rational allocation of medical resources and the equity of medical services. In the future, DRGs will pay more attention to the personalized diagnosis and treatment and fine management of patients, and the sharing and standardization of medical data, to promote the development of medical informatization.

Practical training of the 5th-year students in clinical departments

The educational process is a significant part of specialists' formation in medicine, including dentistry. Seekers of medical education in universities need the support and guidance of highly specialized teachers for their future realization as professionals. However, it is equally important for the students to be interested in successfully mastering the disciplines in different ways, from classroom work to independent projects. On the difficult student path of becoming a dentist, a teacher who can direct their ward in the right direction in the field of dental practice play a considerable role. Additionally, it is important to provide students with a high-quality theoretical base in university departments, modern clinical equipment for polishing professional practical skills, and constant support in the form of consultations, lectures, and master classes from leading specialists of the higher education institution. General medical disciplines are also a significant component of the educational program of dental students, as these subjects provide basic medical knowledge. Without mastering the materials of these disciplines, it will be difficult for the future dentist to integrate into the general field of medical practice. To fully understand and assimilate the material and topics during the lectures and classes, students need to be interested in learning more than what is prescribed in the curriculum of the educational program of the dental specialty; since this area of medicine is undergoing rapid development today. Therefore, such a type of activity as independent work is introduced in the student's curriculum. This type of work for students majorly contributes to improving discipline on the one hand and increases the ability of clinical thinking of future dentists on the other. The article is written in the form of a short scientific report. Keywords: clinical practice, independent work, practical skills, education seeker, practical classes.

Gender Estimation with Parameters Obtained From the Upper Dental Arcade by Using Machine Learning Algorithms and Artificial Neural Networks

Objective: The aim of this study is to estimate gender with parameters obtained from the upper dental arcade by using machine learning algorithms and artificial neural networks. Methods: The study was conducted on cone-beamed computed tomography images of 176 individuals between the ages of 18 and 55 who did not have any pathologies or surgical interventions in their upper dental arcade. The images obtained were transferred to RadiAnt DICOM Viewer program in Digital Imaging and Communications in Medicine format and all images were brought to orthogonal plane by applying 3D Curved Multiplanar Reconstruction. Length and curvature length measurements were performed on these images brought to orthogonal plane. The data obtained were used in machine learning algorithms (ML) and artificial neural networks input and rates of gender estimation were shown. Results: In the study, an accuracy ratio of 0.86 was found with ML models linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), logistic regression (LR) algorithm and an accuracy ratio of 0.86 was found with random forest (RF) algorithm. It was found with SHAP analyser of RF algorithm that the parameter of width at the level of 3rd molar teeth contributed the most to gender. An accuracy rate of 0.92 was found as a result of training for 500 times with multilayer perceptron classifier (MLCP), which is an artificial neural network (ANN) model. Conclusion: As a result of our study, it was found that the parameters obtained from the upper dental arcade showed a high accuracy in estimation of gender. In this context, we believe that the present study will make important contributions to forensic sciences.

Comparison of two software programs used to determine the relative supersaturation of urine ions.

Relative supersaturation (RSS) values for urine crystals are a measure of the risk of urinary stone formation and have been shown to be lowered in foods shown to aid in the management of urolithiasis. In order to calculate RSS in pets, computer programs have been developed to calculate RSS and aid in the understanding of stone formation in veterinary medicine. However, some older programs have not been updated for use in animals, and the specific coefficients used are not publically available. One of the first RSS programs was developed in BASIC computer language and published in 1985 which was called EQUIL2. The EQUIL2 program was updated to a compiled version compatible with a PC platform. However, the formulas could not be read or altered. This study evaluates a new program with known coefficients to the original EQUIL2 program. The RSS values of the two programs were compared through a t-test, calculating the r2 from correlation analysis, Lin's concordance correlation coefficient, and by a Bland-Altman analysis of outputs from the two programs using urine samples from healthy dogs and cats. Our results show that for both magnesium ammonium phosphate (struvite) and calcium oxalate, the RSS values of the original program could be calculated from the new programs RSS values. Although the actual RSS values were different (as might be expected through the use of the updated coefficients and different thermodynamic stability constants in the calculations) the results were highly correlated, finding elevations and reductions in RSS proportionally in the same urine samples. The current work creates a foundation for using the modernized program to calculate RSS and provides a shared method for understanding the risk of struvite and calcium oxalate stone formation.

Surgical Instrument Detection Algorithm Based on Improved YOLOv7x.

The counting of surgical instruments is an important task to ensure surgical safety and patient health. However, due to the uncertainty of manual operations, there is a risk of missing or miscounting instruments. Applying computer vision technology to the instrument counting process can not only improve efficiency, but also reduce medical disputes and promote the development of medical informatization. However, during the counting process, surgical instruments may be densely arranged or obstruct each other, and they may be affected by different lighting environments, all of which can affect the accuracy of instrument recognition. In addition, similar instruments may have only minor differences in appearance and shape, which increases the difficulty of identification. To address these issues, this paper improves the YOLOv7x object detection algorithm and applies it to the surgical instrument detection task. First, the RepLK Block module is introduced into the YOLOv7x backbone network, which can increase the effective receptive field and guide the network to learn more shape features. Second, the ODConv structure is introduced into the neck module of the network, which can significantly enhance the feature extraction ability of the basic convolution operation of the CNN and capture more rich contextual information. At the same time, we created the OSI26 data set, which contains 452 images and 26 surgical instruments, for model training and evaluation. The experimental results show that our improved algorithm exhibits higher accuracy and robustness in surgical instrument detection tasks, with F1, AP, AP50, and AP75 reaching 94.7%, 91.5%, 99.1%, and 98.2%, respectively, which are 4.6%, 3.1%, 3.6%, and 3.9% higher than the baseline. Compared to other mainstream object detection algorithms, our method has significant advantages. These results demonstrate that our method can more accurately identify surgical instruments, thereby improving surgical safety and patient health.

Effects of Piper betle Extracts against Biofilm Formation by Methicillin-Resistant Staphylococcus pseudintermedius Isolated from Dogs.

Emergence of methicillin-resistant Staphylococcus pseudintermedius (MRSP) isolated from dogs with cutaneous and wound infections has significantly impacted veterinary medicine. This study aimed to isolate S. pseudintermedius from canine pyoderma and investigate the effects of ethanolic extracts of Piper betle (PB), P. sarmentosum (PS), and P. nigrum (PN) on the bacterial growth and biofilm formation of S. pseudintermedius and MRSP. Of the isolated 152 isolates, 53 were identified as S. pseudintermedius using polymerase chain reaction, and 10 isolates (6.58%) were identified as MRSP based on the presence of mecA. Based on phenotype, 90% of MRSPs were multidrug-resistant. All MRSP had moderate (10%, 1/10) and strong (90%, 9/10) biofilm production ability. PB extracts were the most effective in inhibiting planktonic cells, and the minimum inhibitory concentration at which ≥50% of the isolates were inhibited (MIC50) was 256 µg/mL (256-1024 µg/mL) for S. pseudintermedius isolates and 512 µg/mL (256-1024 µg/mL) for MRSP isolates. The MIC90 for S. pseudintermedius and MRSP was 512 µg/mL. In XTT assay, PB at 4× MIC showed an inhibition rate of 39.66-68.90% and 45.58-59.13% for S. pseudintermedius and MRSP, respectively, in inhibiting biofilm formation. For PB at 8× MIC, the inhibition rates for S. pseudintermedius and MRSP were 50.74-81.66% and 59.57-78.33%, respectively. Further, 18 compounds were identified in PB using gas chromatography-mass spectrometry, and hydroxychavicol (36.02%) was the major constituent. These results indicated that PB could inhibit bacteria growth of and biofilm formation by S. pseudintermedius and MRSP isolated from canine pyoderma in a concentration-dependent manner. Therefore, PB is a potential candidate for the treatment of MRSP infection and biofilm formation in veterinary medicine.

Volume of Aneurysmal Subarachnoid Hematoma Measured Quantitatively by 3D Slicer to Predict Symptomatic Cerebral Vasospasm.

Aneurysmal subarachnoid hemorrhage is strongly associated with symptomatic cerebral vasospasm. This study aims to investigate whether a quantitative measure of aneurysmal subarachnoid hematoma by 3D Slicer is more valuable for vasospasm risk prediction compared with modified Fisher scale and the new scale by Eagles. We performed a retrospective research of Digital Imaging and Communications in Medicine format (DICOM) in aneurysmal patients treated at our institution from 2019 to 2020. Association between vasospasm and hematoma volume by 3D Slicer was explored by univariate and multivariate analyses. Value of risk prediction was compared through area under the receiver operator characteristic curve (AUC) among the modified Fisher scale, the new scale by Eagles, and hematoma volume by 3D Slicer. Hematoma volume by 3D Slicer had a significant relationship with vasospasm both by one-way analysis of variance (ANOVA; F = 19.37, P < 0.001) and a binary logistic regression analysis (odds ratio [OR] = 1.05, P = 0.016). Hematoma volume by 3D Slicer had a significantly higher AUC (0.708; 95% confidence interval [CI]: 0.618-0.798, P < 0.001) than the modified Fisher scale and the new scale by Eagles. The optimal diagnostic threshold for hematoma volume by 3D Slicer was 15.98 ml, and the sensitivity and specificity were 73.5% and 58.6%, respectively. Volume of aneurysmal subarachnoid hematoma measured quantitatively by 3D Slicer can improve the predictive value for symptomatic cerebral vasospasm.

Hemodynamic predictors for the onset of ischemic stroke due to carotid artery stenosis using a computational fluid dynamics analysis

Background: Carotid artery stenosis is one of the major diseases responsible for atherosclerotic ischemic stroke. It is difficult to predict the onset of cerebral infarction by means of their known risk factors, including age, sex, diabetes mellitus, hypertension, dyslipidemia, and smoking habit. The carotid artery shape itself is a risk factor for stenosis, in which hemodynamics may be involved. We conduct an observational clinical study using a computational fluid dynamics (CFD) technique to investigate hemodynamic risk factors for carotid stenosis progression by enrolling and prospectively examining patients with carotid artery stenosis who underwent three-dimensional imaging of the carotid artery and carotid echocardiography. A total of 546 patients were registered in this study, which is designated the NHO Carotid CFD Study. To investigate hemodynamic predictors for the onset of ischemic stroke, we performed a multivariate analysis of 90 cases with carotid stenosis with an area stenosis rate of 50% to 85% among those enrolled in this clinical study, after adjustment for known risks. Methods: Patient-specific geometries of the carotid arteries were segmented and reconstructed from the volume data set of three-dimensional computed tomography angiography images in Digital Imaging and Communications in Medicine (DICOM) format, using Mimics and 3-matic (Materialise, Leuven, Belgium). Pulsatile blood flow was simulated using a CFD software package, ANSYS CFX (ANSYS, PA, USA), based on the Navier-Stokes equations for incompressible fluid. Individual vessel diameters and peak-systolic and end-diastolic velocities were measured with the Doppler ultrasound technique on common carotid arteries and internal carotid arteries of each patient to compute the corresponding flow rates. The stenotic carotid artery defined three regions: the “stenotic site” where the stenosis is present, the “proximal site” from the lower end of the stenosis to 10 mm proximal, and the “distal site” from the upper end of the stenosis to 10 mm distal. Results: Metrics related to proximal wall shear stress (WSS) disturbances, such as proximal transverse WSS (transWSS) (odds ratio (OR) 2.42, 95% confidence interval (95%CI) 1.32 to 5.00), proximal normalized transWSS (NtransWSS) (OR 1.71, 95%CI 1.02 to 3.03), and the stenotic/proximal ratio of transWSS (1/OR 1.59, 95%CI 0.39 to 0.88), had significant correlations with a history of cerebral infarction on the ipsilateral side of the stenotic artery. Conclusions: Our present analysis suggested that carotid arteries with the same degree of stenosis may be more likely to have a cerebral infarction in cases with higher transWSS in the proximal site than the stenotic one. In patients with these hemodynamic risks, underlying diseases should be controlled more strictly with imaging examinations at shorter intervals. This study was supported by a Grant-in-Aid for Japanese National Hospital Organization Multi-Center Clinical Research, and AMED under Grant Number JP15gm0810006h0301. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Medical entity recognition and knowledge map relationship analysis of Chinese EMRs based on improved BiLSTM-CRF

With the development of medical informatization, a large number of patients’ electronic medical records (EMRs) have been accumulated in the hospital information system, which is characterized by multi-structured data form, diversified professional vocabulary categories and fuzzy vocabulary demarcation. Natural language processing (NLP) provides a silver lining for parsing electronic medical records, and the mainstream methods include dictionary-based methods, rule-based and statistical methods, and machine learning methods. Due to the semantic richness and structural diversity of Chinese text, Chinese EMRs analysis methods are still scarce compared with English EMRs. In order to overcome the problems of unstructured, multiple meanings of words and unclear word boundaries in text of Chinese electronic medical records, this paper proposes a medical entity recognition method based on RoFormerV2-BiLSTM-CRF fusion model, using BIO annotation method to annotate the recognized medical entities, and using knowledge graph to analyze the medical entity relationships identified in single patient medical record, multiple patient medical records respectively. The relationships between the medical entities identified in a single patient record and multiple patient records are analyzed using knowledge graphs. The experimental analysis was conducted on the expert-annotated dataset CCKS2019, and the results showed that the proposed method was effective for recognizing “Diseases and Diagnoses”, “Laboratory Tests”, “Imaging Examinations”, “Anatomical Sites”, “Drugs” and “Surgery” in the dataset. The average accuracy, recall and F1-Score of the proposed method for the identification of the six medical entities, are 84.8%, 83.5% and 83.9%, respectively, which were 5.3%, 8.6% and 6.8% higher than the traditional Word2Vec-BiLSTM-CRF model, and the existing Word2Vec-BiLSTM-CRF and BERT-BiLSTM-CRF models were iteratively trained with the same evaluation. The experimental results show that the proposed model performs better in medical entity recognition.

3D Printing of Heart Model as Medical Education Tools

Abstract. 3D printing is a rapidly developing technology in the medical world that has been used for pre-operative planning, prosthetic manufacturing, and training for medical education. This 3D printing is needed for medical education to make it easier for students to study anatomical structures. The advantages of 3D printing provide more detail and tactile representation of anatomical aspects of organs to address the problems of online learning and cadaveric limitations. This research aimed to develop the manufacture of 3D printed models of the human heart organ to improve understanding in learning for medical students. Making a 3D printed model of a heart organ is divisible into six parts: the aorta, right ventricle, left atrium, left ventricle, right atrium, and pulmonary artery. The 3D printing model creation procedure consisted of several steps: image acquisition, image post-processing, and 3D printing. This research used Computed Tomography Scanning (CT-Scan) images of the normal heart in Digital Imaging in Medicine (DICOM) format from Saiful Anwar Hospital, Malang. The segmentation uses the grow from seed technique with 3D Slicer software and is saved in STL format. The accuracy of the 3D printing was carried out by measuring dimensions and volume. Measurements are required to ensure the accuracy of 3D printing so that the resulting organs match the initial image data and can be used as learning media in anatomical structures by medical students.

Analytic calculations and synthetic shapes for validation of quantitative contour comparison software.

A high level of variability in reported values was observed in a recent survey of contour similarity measures (CSMs) calculation tools. Such variations in the output measurements prevent meaningful comparison between studies. The purpose of this study was to develop a dataset with analytically calculated gold standard values to facilitate standardization and ensure accuracy of CSM implementations. The dataset was generated in the Digital Imaging and Communications in Medicine (DICOM) format. Both the dataset and the software used for its generation are made publicly available to encourage robust testing of CSM implementations for accuracy, improving consistency between different implementations.

THE HISTORICAL PATH OF FORENSIC MEDICINE: FROM LAW TO MEDICINE, FROM MEDICINE TO HIGH TECHNOLOGY

In the structure of the discipline (module) “Forensic Medicine and forensic psychiatry” for students majoring in 40.05.02 – law enforcement, very little time is devoted to the history of forensic medicine, which at all stages of its development is closely connected with the history of law and the development of the world judicial and legal system. Forensic medicine originated, developed and took shape in the process of administrative and judicial practice involving competent persons in the investigation and consideration of criminal and civil cases to clarify issues requiring special medical knowledge. The purpose of the work is to show the origins and historical stages of the development of forensic medicine in accordance with the formation of the state legal system in the world and in our country. The paper presents the origins of forensic science, the main stages of its formation and shows the prospects for further development. Traditions and modern development of world forensic medicine are closely connected with the development of law and the world state-legal system. Knowledge of the stages of the formation of forensic medicine allows you to better understand the history of legal science, legal proceedings and public administration.

The role of 3-dimensional printed models in the management of the distal radius fractures.

This study aimed to compare inter- and intra-observer agreement between radiographs with 2-dimensional and 3-dimensional computed tomography scans with and without 3-dimensional printed models in the evaluation of the distal radius fracture of Association for Osteo synth esis/ Ortho paedi c Trauma Association type C classification. Fifteen consecutive cases with X-Rays, 2-dimensional and 3-dimensional computed tomography reconstructions views, and 3-dimensional printed models were selected. Three-dimensional printed models of the distal radius fractures were created using 2-dimensional computed tomography scan files in Digital Imaging and Communication in Medicine format, processed with the 3-dimensional Slicer software, and segmented, creating a 3-dimensional printed model in Standard Triangle Language format. Threedimensional models were printed using fused deposition modeling (FDM) type 3D printer Zortrax M200Plus using polylactic acid material on a scale of 1 : 1. Twenty observers were invited into the study. Intra- and inter-observer reliability was analyzed using Fleiss' kappa statistics. Overall kappa values for both groups in interobserver agreement range from 0.113 to 0.283 and in intra-observer agreement from 0.25 to 0.545. Generally, inter-observer agreement increased with additional 3-dimensional printed models from slight to fair, and intra-observer agreement increased from fair to moderate. Surgeons' opinions about 3-dimensional printed models with Likert scale-type questions show positive overall results ranging from 8.3± 2.1 to 8.6 ± 1.4. This study has shown that the inter- and intra-observer agreement with the addition of a 3-dimensional printed model for the evaluation of the distal radius fractures of Association For Osteo synth esis/ Ortho pedic Trauma Association C type for classification, fractures morphology, and preoperative planning tends to increase; however, improvements for an inter-observer agreement remain fair. Level III Diagnostic Study.

Brief introduction of Qilu modern acupuncture methods

Qilu acupuncture and moxibustion has promoted the formation and development of traditional Chinese medicine, which has a special historical position. By systematically collecting, sorting out and summarizing the characteristic acupuncture methods and academic ideas of several Qilu acupuncturists since the founding of the People's Republic of China, the understanding of the advantages and characteristics of Qilu modern acupuncture methods is deepened, aiming to exploring the inheritance and development pattern of Qilu acupuncture methods in the new era.

Design and development of a disease-specific clinical database system to increase the availability of hospital data in China

PurposeIn order to meet restrictions and difficulties in the development of hospital medical informatization and clinical databases in China, in this study, a disease-specific clinical database system (DSCDS) was designed and built. It provides support for the full utilization of real world medical big data in clinical research and medical services for specific diseases.MethodsThe development of DSCDS involved (1) requirements analysis on precision medicine, medical big data, and clinical research; (2) design schematics and basic architecture; (3) standard datasets of specific diseases consisting of common data elements (CDEs); (4) collection and aggregation of specific disease data scattered in various medical business systems of the hospital; (5) governance and quality improvement of specific disease data; (6) data storage and computing; and (7) design of data application modules.ResultsA DSCDS for liver cirrhosis was created in the gastrointestinal department of a 3A grade hospital in China and had more than nine data application modules. Based on this DSCDS, a series of clinical studies are being carried out, such as retrospective or prospective cohorts, prognostic studies using multimodal data, and follow-up studies.ConclusionThe development of the DSCDS for liver cirrhosis in this paper provides experience and reference for the design and development of DSCDSs for other specific diseases in China; it can even expand to the development of DSCDSs in other countries if they have the demand for DSCDS and the same or better medical informatization foundation. DSCDS has more accurate, standard, comprehensive, multimodal and usable data of specific diseases than the general clinical database system and clinical data repository (CDR) and provides a credible data foundation for medical research, clinical decision-making and improving the medical service quality of specific diseases.