Biomechanical research progress on minimally invasive surgical repair of pectus excavatum / 医用生物力学

开展漏斗胸微创矫形手术的生物力学研究以及阐述矫形机制对于提高矫形手术水平、开展个性化手术治疗、发展新的矫形手术方法和扩展微创矫形手术的应用范围具有重要意义。漏斗胸微创矫形手术已经成功用于儿童的漏斗胸矫形，但是成人漏斗胸矫形手术的应用还未普及。面对漏斗胸矫形可能会加重脊柱侧弯的风险，医生被迫放弃手术，致使部分漏斗胸合并脊柱侧弯的患者终生不能得到治疗。总结漏斗胸微创矫形手术的生物力学研究进展，包括胸廓模型的三维重建、矫形模型的应用、矫形过程的数值模拟以及数值模拟结果在临床的应用。结合成人漏斗胸矫形数值模拟的特点提出解决方法，并针对漏斗胸的生物力学研究现状提出需要解决的问题，如计算模型需要考虑主要肌肉、椎间盘、前后纵韧带、椎体横凸棘间韧带和棘上韧带，验证数值计算结果的实验研究方法等。

Thoracic bone remodeling after minimally invasive repair for pectus excavatum in adults and its clinical efficacy / 解放军医学杂志

Objective To study thoracic bone remodeling after minimally invasive corrective surgery for pectus excavatum (PE) in adults and ascertain its clinical efficacy. Methods A total of 82 patients aged 18 to 57 (23.5 6.1) were enrolled in this study. There were 67 male patients and 15 female patients. The symmetric type (? type) composed of 37 cases, whereas the nonsymmetric type (II type) comprised 45 cases. Haller index (HI) was 3.2 to 11.8. Under general anesthesia, incisions located on looth sides of the mid-axillary line were made in all patients. The prepared supporting bar was inserted behind the sternum by videoassisted thoracoscopic monitoring (one bar for 60 patients and two bars for 22 patients). All patients were checked by chest CT scan pre-operation and 1 week post-operation to create a three-dimensional reconstruction thoracic image. In the sagittal plane, the center line of the body of the thoracic vertebrae was regarded as the incision line. The distance was measured between the sternum and the frontal edge of the body of the thoracic vertebrae. The condition of the displacement of the heart was also observed. Results When one bar was used, the middle and the inferior extremity of the mid-sternum was moved forward for 8.69 and 15.69mm, respectively, after correction. There was significant difference compared with that of the pre-operation (P<0.01). However, the upper extremity of the mid-sternum and upper and inferior extremities of the manubrium were moved forward to 2.39, -2.38, and 1.44mm, which did not exhibit obvious difference compared with the values taken before the operation. When two bars were used for the patients, the inferior extremity of the manubrium and each of upper, middle, and inferior extremities of the mid-sternum showed a forward displacement for 10.8, 12.45, 17.61, and 20.62mm, respectively. There was significant difference compared with the pre-operative values (P<0.001). The upper extremity of the manubrium exhibited forward displacement of 2.34mm, which did not exhibit any significant difference with the pre-operative values. The CT image showed the cardiac position returned to normal after operation. The thoracic appearances when two bars were used were better compared with that using one bar. Conclusions The strength of the reshaping bar is useful in thoracic bone remodeling after minimally invasive repair for PE in adult. Thoracic bone remodeling using one bar or two bars showed different change regularities and mechanisms of mechanics.

Serum amyloid A protein: a potential biomarker correlated with clinical stage of lung cancer / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To identify serum diagnosis or progression biomarkers in patients with lung cancer using protein chip profiling analysis.</p><p><b>METHOD</b>Profiling analysis was performed on 450 sera collected from 213 patients with lung cancer, 19 with pneumonia, 16 with pulmonary tuberculosis, 65 with laryngeal carcinoma, 55 with laryngopharyngeal carcinoma patients, and 82 normal individuals. A new strategy was developed to identify the biomarkers on chip by trypsin pre-digestion.</p><p><b>RESULTS</b>Profiling analysis demonstrated that an 11.6 kDa protein was significantly elevated in lung cancer patients, compared with the control groups (P < 0.001). The level and percentage of 11.6 kDa protein progressively increased with the clinical stages I-IV and were also higher in patients with squamous cell carcinoma than in other subtypes. This biomarker could be decreased after operation or chemotherapy. On the other hand, 11.6 kDa protein was also increased in 50% benign diseases of lung and 13% of other cancer controls. After trypsin pre-digestion, a set of new peptide biomarkers was noticed to appear only in the samples containing a 11.6 kDa peak. Further identification showed that 2177 Da was a fragment of serum amyloid A (SAA, MW 11.6 kDa). Two of the new peaks, 1550 Da and 1611 Da, were defined from the same protein by database searching. This result was further confirmed by partial purification of 11.6 kDa protein and MS analysis.</p><p><b>CONCLUSION</b>SAA is a useful biomarker to monitor the progression of lung cancer and can directly identify some biomarkers on chip.</p>

The study on freezing intercostal nerves for the relief of postoperative chest pain / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the best freezing time and the optimum analgesia modality.</p><p><b>METHODS</b>In dogs, intercostal nerves were froze at -70 degrees C at different time including 30, 60, 90, 120, 180 s. Samples were got at the operative day, in 10 days and 60 days respectively, then carried on the pathology exam. In clinical study, 150 patients undergoing thoracotomy were randomly designated into 5 groups, all patients were recorded the heart rate, blood pressure, SO2, VAS, the dosage of dolantin, and observed the complications and side effects.</p><p><b>RESULTS</b>At operative day, the freezing nerves appeared brown print macroscopically, and presented degeneration, necrosis of the nerve fiber microscopically with more than 90 s. After 10 days, nerves with more than 90 s became thinner than normal. After 60 days, all nerves had no obvious differentiation than normal. In clinical study, both 90 s group and 90 s with PCIA group were significantly better than 60 s group or PCIA group; The VAS of 90 s with PCIA group was significantly lower than 90 s group but had more side effects such as vomiting, nausea.</p><p><b>CONCLUSIONS</b>At -70 degrees C, the freezing time should be no less than 90 s. The freezing intercostal nerves can safely and effectively relieve postoperative chest pain. The effect of analgesia of 90 s with PCIA group is the best, but has many side effects.</p>