Autofluorescence imaging for recurrence detection in skin cancer postoperative scars

This clinical study is a first attempt to use autofluorescence for recurrence diagnosis of skin cancer in postoperative scars. The proposed diagnostic parameter is based on a reduction in scar autofluorescence, evaluated in the green spectral channel. The validity of the method has been tested on 110 postoperative scars from 56 patients suspected of non‐melanoma skin cancer, with eight patients (13 scars) available for the repeated examination. The recurrence diagnosis within a scar has been made after two subsequent autofluorescence check‐ups, representing the temporal difference between the scar autofluorescence amplitudes as a vector. The recognition of recurrence has been discussed to represent the significant deviations from the value of vector angle θ. This new autofluorescence‐based method can be easily integrated into the postoperative monitoring of surgical scars and can help diagnose the recurrence of skin cancer from the early stage of scar development.     

Synaptic interactions among neurons that coordinate swimmeret and abdominal movements in the crayfish

1. Many interneurons in the crayfish (Procambarus clarkii) abdominal nervous system influence two behaviors, abdominal positioning and swimmeret movements. Such neurons are referred to as dual output cells. Other neurons which influence either one behavior or the other are single output cells. 2. Extensive synaptic interactions were observed between both dual and single output neurons involved in the control of abdominal positioning and swimmeret movements. Over 60% of all neuron pairs examined displayed interactions. Pairs of agonist neurons displayed excitatory interactions, while pairs of antagonists had inhibitory interactions. This pattern of interaction was observed in about 75% of interactive neuron pairs whether abdominal positioning or swimmeret outputs were considered. 3. Evidence for both serial and parallel connectivity, as well as, reciprocal or looping connections was observed. Looping connections can be found both between the abdominal positioning and swimmeret systems and within each system. 4. Most (28/34) single output neurons were not presynaptic to dual output neurons. No single output neurons were found to excite dual output neurons to spiking, although inhibitory interactions and weak excitations were observed. 5. Abdominal positioning inhibitors displayed properties consistent with a role in mediating some of the coordination between the swimmeret and abdominal positioning systems. 6. None of the dual output neurons examined influenced the swimmeret motoneurons directly.     

The response of plasma gastric-inhibitory polypeptide (GIP) to slow and fast glucose ingestion in Billroth II resected patients and normal controls

Eight Billroth II resected patients and 8 normal controls were given two oral glucose loads, one ingested within 2 min, and the other ingested slowly over 80 min. In the Billroth II resected group, the integrated plasma GIP release was significantly higher after the fast than after the slow glucose ingestion. In this group the integrated plasma GIP release was also significantly higher than in the control group, but only after the fast glucose ingestion. These findings indicate that the rate of glucose delivery into the intestine may be of importance in the plasma GIP response to oral glucose.     

系列硬质胆囊镜的研发

中国医生提出的硬镜微创保胆取石（息肉）新概念,对于治疗胆囊结石和胆囊息肉取得较好的临床效果。目前国内外没有专门针对胆囊病手术所设计的内镜设备。专门为胆囊病手术的发展而研发的系列硬质胆囊镜及其配套附件,已经获得多项国家专利授权,并成功在国家认定的药物临床试验机构中应用手术120多例。     

腔内大量盐水灌洗辅助取出乳房内聚丙烯酰胺水凝胶临床应用

目的：探讨聚丙烯酰胺水凝胶注射隆胸后取出新方法.方法：对48例注射聚丙烯酰胺水凝胶隆胸患者术前行双乳MRI或彩超检查结合触诊准确定位.全麻小切口开放直视下吸出水凝胶,再用大量生理盐水反复灌洗所有腔隙,直至手感探测不到硬结,盐水中无水凝胶为止.结果：48例患者术后无继发感染和出血等并发症.术前诸症状体征消失,无明显乳房变形,乳房形态术后恢复满意.术后双乳MRI复查未见明显异物残留.术后1 ～12月（6.2±0.3月）45例随访复查MRI亦未见异物残留,乳房修复完好.结论：注射隆乳后腔内大量盐水灌洗辅助取出水凝胶具有创伤小、出血少、操作简单、费用低廉的优点,是一种较好的、值得推广的凝胶取出术式.     

周六手术在医院运行管理中的价值和意义

目的 通过开展周六手术,缩短病人平均术前等待日及平均住院日。在保证医疗质量的前提下,达到提高效率,增加产能的目的。方法 在多部门协作的基础上,开展周六手术,改变原有人力配置方式和手术流程,以配合周六手术的进行。结果 手术流程再造后,与之前同期相比术前等待日缩短25.00%, 月平均手术台次增加12.35%, 病人平均住院日降低9.22%。结论 开展周六手术,能缩短患者平均住院日和术前等待日,为患者节约宝贵的时间和金钱,在一定程度上解决了患者看病难、看病贵的问题,提高了医院的工作效率。     

改良丁字带对妇科阴式手术后阴道微生态的影响

目的 探讨改良丁字带对比传统丁字带对妇科阴式手术后患者阴道微生态的影响。方法 选择妇科阴式手术患者186例作为研究对象,随机分为两组,观察组93例使用改良丁字带固定,对照组93例使用传统丁字带固定。对比分析两组患者术后阴道微生态,敷料污染,引流管阻塞、脱落,皮肤受损,排尿困难等的发生情况。结果 观察组阴道微生态失衡发生率为23.66%,敷料污染发生率为29.03%,引流管阻塞发生率为7.52%,皮肤受损发生率为3.23%,均明显低于对照组,差异具有统计学意义（均P<0.05）。结论 妇科阴式手术后使用改良丁字带固定能够减少手术患者阴道微生态失衡及相关并发症的发生率,提高患者生活质量。     

Specific features of ex‐obese patients significantly influence the functional cell properties of adipose‐derived stromal cells

Adipose‐derived stromal cells (ADSC) are increasingly used in clinical applications due to their regenerative capabilities. However, ADSC therapies show variable results. This study analysed the effects of specific factors of ex‐obese patients on ADSC functions. ADSC were harvested from abdominal tissues (N = 20) after massive weight loss. Patients were grouped according to age, sex, current and maximum body mass index (BMI), BMI difference, weight loss method, smoking and infection at the surgical site. ADSC surface markers, viability, migration, transmigration, sprouting, differentiation potential, cytokine secretion, telomere length and mtDNA copy number were analysed. All ADSC expressed CD73, CD90, CD105, while functional properties differed significantly among patients. A high BMI difference due to massive weight loss was negatively correlated with ADSC proliferation, migration and transmigration, while age, sex or weight loss method had a smaller effect. ADSC from female and younger donors and individuals after weight loss by increase of exercise and diet change had a higher activity. Telomere length, mtDNA copy number, differentiation potential and the secretome did not correlate with patient factors or cell function. Therefore, we suggest that factors such as age, sex, increase of exercise and especially weight loss should be considered for patient selection and planning of regenerative therapies.     

数字化外科技术在颌面部外伤修复重建中的应用与展望

近年来,数字化外科技术在颌面部外伤修复重建临床应用中得到不断发展和完善,极大地提高了手术的精确性和可靠性,节约了手术时间。本文主要从术前手术模拟、快速打印3D头模、术中导航、导板制作、个性化修复体及机器人的临床应用等六个方面来阐述数字化外科技术在颌面部骨折修复重建中的应用,总结了各个技术的原理、优缺点及应用现状,回顾了我们单位应用数字化技术提高颌面部外伤修复手术的精确度和可行性以及恢复了患者良好的面型及功能的临床应用经验。同时,本文对未来数字化外科在颌面部骨折修复重建中的应用提出了新的展望,我们认为,结合术前手术模拟、术中导航及术中机器人技术依据术中具体情况自动调整手术方案进行颌面部骨折修复重建的完全自动化智能机器人的实现将是最终的目标。     

Intraoperative multispectral and hyperspectral label‐free imaging: A systematic review of in vivo clinical studies

Multispectral and hyperspectral imaging (HSI) are emerging optical imaging techniques with the potential to transform the way surgery is performed but it is not clear whether current systems are capable of delivering real‐time tissue characterization and surgical guidance. We conducted a systematic review of surgical in vivo label‐free multispectral and HSI systems that have been assessed intraoperatively in adult patients, published over a 10‐year period to May 2018. We analysed 14 studies including 8 different HSI systems. Current in‐vivo HSI systems generate an intraoperative tissue oxygenation map or enable tumour detection. Intraoperative tissue oxygenation measurements may help to predict those patients at risk of postoperative complications and in‐vivo intraoperative tissue characterization may be performed with high specificity and sensitivity. All systems utilized a line‐scanning or wavelength‐scanning method but the spectral range and number of spectral bands employed varied significantly between studies and according to the system's clinical aim. The time to acquire a hyperspectral cube dataset ranged between 5 and 30 seconds. No safety concerns were reported in any studies. A small number of studies have demonstrated the capabilities of intraoperative in‐vivo label‐free HSI but further work is needed to fully integrate it into the current surgical workflow.