OBJECTIVE: To investigate the preparation of bone acellular extra-cell matrix(AECM) and to analyze its component. METHODS: With low-osmosis theory and method of cell extraction by detergent, bone acellular extra-cell matrix was prepared. We observed morphologic changes with HE, Mallory-Heidenhain rapid one-step dyeing and Alcian blue dyeing and examined fibronectin(FN) and laminin(LN) with immunohistochemistry. RESULTS: Light microscope showed that the collagen fibers arranged regularly in AECM with blankness of bone lacunas by HE, Mallory-Heidenhain rapid one-step dyeing and that the region around bone lacunas was stained different degrees of blue-green by Alcian blue dyeing. The result of immunohistochemistry showed there are positive markers of FN and LN in ECM. CONCLUSION: This method for preparation of bone acellular extra-cell matrix is effective, and it can keep natural structure of collagen fibers and maintain components of ECM, such as proteoglycan, FN and LN.
Abstract： Objective To evaluate the safety, feasibility, and clinical outcome of complete video-assisted thoracoscopic surgery （VATS） lobectomy for patients with early-stage non-small cell lung cancer （NSCLC）. Methods We retrospectively analyzed the clinical data of 160 consecutive patients（the VATS group, 83 males and 77 females with average age at 60.8 years）with early-stage NSCLC who underwent complete VATS lobectomy between January 2005 andDecember 2008 in Zhongshan Hospital of Fudan University，and compared them with 357 patients（the thoracotomy group, 222 males and 135 females with average age at 59.5 years）who underwent open thoracotomy in the same period. Results The conversion rate of the VATS group was 5.0%（8/160）. The operation time of the VATS group was significantly shorter than that of the thoracotomy group（113.0 min vs.125.0 min, P=0.039）. Length of postoperative hospital stay was not statistically different between the two groups（10.3±4.3 d vs.9.1±4.6 d，P=0.425）. The postoperative morbidity of the VATS lobectomy group and the thoracotomy group was 9.4%（15/160）and 10.1% （36/357） respectively，and the postoperative mortality of the two groups was 0.6%（1/160）and 2.0%（7/357）respectively. There was no statistical difference in the mean group of lymph node dissection （2.4±1.5 groups vs.2.4±1.7 groups，P=0.743） and the mean number of lymph node dissection （9.8±6.3 vs.10.1±6.4，P=0.626） between the two groups. The overall 5-year survival rate of the VATS group was significantly higher than that of the thoracotomy group （81.5% vs.67.8%, P=0.001）. Subgroup analysis showed that the 5-year survival rate of pⅠa stage, pⅠb stage, and pⅢa stage was 86.0%, 84.5%, and 58.8% respectively in the VATS group, and 92.9%, 76.4%, and 25.3% respectively in the thoracotomy group. Conclusion Complete VATS lobectomy is technically safe and feasible for patients with early-stage NSCLC. The lymph node dissection extension of complete VATS lobectomy is similar to that of open thoracotomy, and long-term outcome of complete VATS lobectomy is superior to that of open thoracotomy. Randomized controlled trials of large sample size are further needed to demonstrate superiority.
Objective According to health technology assessment (HTA) methodology, to assess the efficacy and safety of different doses of metoprolol in the treatment of atrial fibrillation (AF). Methods Based on the principles of HTA, we searched some important medical databases including MEDLINE, EMBASE, The Cochrane Library and CMCC, as well as several national special heart disease databases and side effect centers. We selected eligible studies based on the inclusion and exclusion criteria and critically assessed their quality. Results Intravenous metoprolol 10 mg - 15 mg could control rapid ventricular rate in patients with chronic AF. On either rest or exercise, oral metoprolol 150 mg/d had a better control of rapid ventricular rate than 50 mg/d in patients with chronic AF. For preventing postoperative AF (POAF), the intravenous metoprolol 20 mg group and the 30 mg group could decrease the incidence of POAF compared to the 10 mg group. Oral metoprolol 150 mg/d was more effective than 100 mg/d in preventing POAF. In addition, intravenous metoprolol therapy was well-tolerated and more effective than oral metoprolol therapy in preventing atrial fibrillation after cardiac surgery. Results from several national side effect centers demonstrated that the incidence of adverse reactions associated with metoprolol was low. Conclusion Present evidence showed that high dose of metoprolol was superior to low dose in treating AF, however, the evidence available is insufficient. It is suggested that adequate evidence through further studies are needed. The safety profile of different doses of metoprolol is similar.
ObjectivesTo analyze epidemiological characteristics of leprosy in Sichuan province from 2000 to 2017.MethodsCase data of all new leprosy patients in Sichuan province from 2000 to 2017 were collected. A retrospective analysis of its epidemiological characteristics was performed by using SPSS 19.0 software.ResultsA total of 3 208 cases of leprosy were detected during 2000 to 2017, of whom 2 197 (71.28%) were male, 885 (28.72%) were female. The younger cases whose ages were less than 14 were 82 (2.66%), and the cases with grade 2 disabilities were 614 (19.92%). The mean age of male was older than female (41.64±14.26 vs. 38.89±15.12 years, P<0.05). The grade 2 disability rate of male was significantly higher than that of female (20.94% vs. 17.40%, P<0.05). Self-report was the most common method of discovery. But the ratio of male who were detected through contact examination was significantly lower than that detected through dermatological clinic, self-report, clues check and report (the ratio of male to female was 1.57, 2.38, 2.88, 2.48, 2.37, respectively, P<0.05).ConclusionsThe case detection of leprosy declines annually in Sichuan province from 2000 to 2017, especially in high-endemic area and male patients. Female patients are younger than male patients when they are detected. The grade 2 disability situation of male patients is significantly more serious than that of female patients. Self-report is the most common way of discovery, while women are more passive.
Objective To investigate the effect of CO2 pneumoperitoneum on the tumor cell port site implantation in laparoscopic surgery. Methods Male SpraqueDawley rats were intraperitoneally injected with gastric cancer cells (cell line SGC-7901). Continuous CO2 pneumo of 15 mm Hg or 30 mm Hg were established for 5 mins, 60 mins, 120 mins and 180 mins with the injection of different concentrations of tumor cells (104/ml, 106/ml respectively). Several samples of peritoneal washing served as positive control. All collecting dishes were incubated at 37℃ with 5% CO2 concentration for one week and then examined for the presence of tumor cell under microscope. Results After one week of incubation, some of the dishes with continuous flow of CO2 gas (5 L/min) at pneumo 30 mm Hg for 60 mins or longer demonstrated tumor growth, and all peritoneal washing samples showed tumor growth, while other dishes showed negative. Conclusion The research suggests that gastric cancer cells can cause port site implantation and the concentration of tumor cells, pneumoperitoneum pressure and duration may affect the occurrence of port site implantation. It may help to find a suitable way to prevent the port site implantation in operations.
As an important basis for lesion determination and diagnosis, medical image segmentation has become one of the most important and hot research fields in the biomedical field, among which medical image segmentation algorithms based on full convolutional neural network and U-Net neural network have attracted more and more attention by researchers. At present, there are few reports on the application of medical image segmentation algorithms in the diagnosis of rectal cancer, and the accuracy of the segmentation results of rectal cancer is not high. In this paper, a convolutional network model of encoding and decoding combined with image clipping and pre-processing is proposed. On the basis of U-Net, this model replaced the traditional convolution block with the residual block, which effectively avoided the problem of gradient disappearance. In addition, the image enlargement method is also used to improve the generalization ability of the model. The test results on the data set provided by the "Teddy Cup" Data Mining Challenge showed that the residual block-based improved U-Net model proposed in this paper, combined with image clipping and preprocessing, could greatly improve the segmentation accuracy of rectal cancer, and the Dice coefficient obtained reached 0.97 on the verification set.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Early diagnosis and effective management are important to reduce atrial fibrillation‐related adverse events. Photoplethysmography (PPG) is often used to assist wearables for continuous electrocardiograph monitoring, which shows its unique value. The development of PPG has provided an innovative solution to AF management. Serial studies of mobile health technology for improving screening and optimized integrated care in atrial fibrillation have explored the application of PPG in screening, diagnosing, early warning, and integrated management in patients with AF. This review summarizes the latest progress of PPG analysis based on artificial intelligence technology and mobile health in AF field in recent years, as well as the limitations of current research and the focus of future research.
Objective To investigate the effects and complications of the vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment. Methods Seventy-seven eyes of 69 cases undergoing vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment were analyzed retrospectively. Results (1) The postoperative visual acuity was enhanced significantly. (2) Complications during the operation in 11 eyes (14.3%): iatrogenic retinal break in 7 eyes, bleeding in 3 eyes and lens damage in 1 eye. (3) Postoperative complications in 20 eyes (26.0%): rebleeding in 14 eyes, elevated IOP in 6 eyes, retinal detachment in 5 eyes, hyphema in 2 eyes, and exudative membrane in anterior chamber in 1 eye. (4) The main long-term complication was cataract formation (9 eyes) and macular disorder (6 eyes). Conclusion Vitrectomy is an effective method to treat Eales′ disease with vitreous hemorrhage or traction retinal detachment. (Chin J Ocul Fundus Dis, 2002, 18: 215-217)
Objective To investigate the current status of esophageal cancer surgery-related researches using bibliometric methodologies and identify the trend and hotspots. Methods The Chinese and English literature was collected from Web of Science and CNKI from inception of each database to April 1, 2022. VOSviewer 1.6.18 and CiteSpace 6.1 were applied to cluster the authors, institutions, and keywords. For social network and time series analysis, Excel, GraphPad, and R 4.0.3 were used to visualize the literature on esophageal cancer surgery. Results Finally, 19 566 English literature and 19 872 Chinese literature was included. The results demonstrated that the annual publishing of both Chinese and English literature increased over time, with English literature increasing rapidly and Chinese literature maintaining an average number of above 1 000 per year from 2011 to 2019. Researches were predominantly centered in Europe, the United States, Japan, South Korea, and China. China's researches in the field of surgical treatment in esophageal cancer lacked international collaboration, which began later than East Asian countries such as Japan and South Korea and had less influence. From the keyword perspective, previous researches on surgical treatment of esophageal cancer mostly focused on surgical techniques, complications, and comprehensive perioperative therapy. Both Chinese and English literature showed that the prevalence of keywords such as minimally invasive surgery, comprehensive treatment, and clinical trials increased dramatically during the recent years, indicating that these fields may represent the future directions and research trends. Conclusion Compared to East Asia countries, such as Japan and South Korea, Chinese esophageal cancer surgery-related researches are relatively lacking. The research direction and field are similar to those in developed countries such as the United States and Europe. Future attention may be focused on minimally invasive treatment, comprehensive treatment, and clinical trials associated with surgical treatment of esophageal cancer.
目的:探討B超監測下輸尿管鏡治療輸尿管結石的臨床療效及可行性。方法:2007年12月~2008年12月采用B超監測下輸尿管鏡治療輸尿管結石患者34例,結石位于上段4例,中段11例,下段19例。結果:一次性碎石治愈者33例,一次性碎石成功率97%,手術時間(40±15)min,術后2~7天排盡結石,術后住院平均時間3.5(2～5)天。結論:B超監測下輸尿管鏡治療輸尿管結石對于手術操作者易于隨時動態觀察結石情況,對于大于0.4 cm的碎石塊無遺漏,增加術中一次碎石成功率,可行性高。