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Throughout the 1 34-year development of hepatectomy,whether open,laparoscopic,or robotic,it has inherited an anatomical,empirical surgical approach based on morphology,which has not fundamentally changed the two-dimensional diagnosis and treatment of the disease.Over the last 20 years,the diagnosis and treatment of primary liver cancer have undergone profound changes with the advent and evolution of digital intelligent diagnosis and treatment technologies.Three-dimensional visualization techniques have allowed the pre-operative visualization of tumors and complex liver anatomy,changing the traditional two-dimensional diagnosis and treatment paradigm.The development of indocyanine green fluorescence imaging has enabled intraoperative visualization of tumor boundaries at the molecular and cellular levels.The application of augmented reality navigation technology has allowed the visualization of anatomical structures during surgery.Hepatectomy has transformed from traditional empirical surgery into modern intelligent navigation-based minimally invasive surgery,ushering in a new era of digital intelligent liver surgery.This review has summarized the most recent research progress of digital intelligent minimally invasive treatment of primary liver cancer.
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Objective To understand the current prevalence of clonorchiasis in Jiangxi Province. Methods A survey was performed according to the scheme of the 3rd Principal Human Parasites of Jiangxi Province. Based on the ecological regions,a stratified cluster sampling method was applied by the economic and geographic situation. In rural areas,the investigation of C. si?nensis was carried out together with the soil?transmitted helminths investigation,and in the urban areas,the random cluster sam?pling method was applied for the C. sinensis investigation. There were 92 survey sites from 32 counties. The eggs of C. sinensis in stool were examined by Kato?Katz technique,and health knowledge was also investigated by questionnaires in some people at the same time. Results A total of 23 606 sample residents were investigated,and 138 were found infected with C. sinensis, with the infection rate of 0.58%. Light infection was found in most of them. Totally 124 C. sinensis infected persons focused in Xinfeng County,and only a few of infected people scattered in the other counties. In Xinfeng County,851 residents were investi?gated. Among them,the infected people were found in all the age groups except the 0?year age group. The highest infection rate appeared in the 70? years group(24.00%). The male infection rate was 20.29%,which was higher than that of the female (6.25%),showing a statistically significant difference(P<0.01). The infection rate was highest in the population who received high school or technical secondary school education(31.48%). For the occupation distribution,the infection rate was highest in public officers(39.39%). The questionnaire survey showed that the infection rate in the populations in Xinfeng County who had the history of eating raw fish or raw shrimp was 33.15%. Conclusions The distribution of C. sinensis infection presents a region?al aggregation in Xinfeng County,but in other areas,the distribution is sporadic. It is necessary to continue to carry out the para?sitic disease screening,and in Xinfeng County,it is necessary to strengthen the comprehensive prevention and control interven?tion.
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Objective To discuss the clinical effect and safety of the unilateral C2 pedicle screw-plate(C2PSP)combined with contralateral C2 laminar screw-rod(C2LSR)for atlanto-axial joint and occipital cervical fixation.Methods 11 patients were treated by internal fixation with pedicle screw plate system combined with contralateral C2 laminar screw rod system.The cause of atlantoaxial instability was fresh type Ⅱ odontoid fracture in 5 patients,old odontoid fracture in 3 patients,occipitalization mal-formation in 2 patients,atlantoaxial instability in 2 patients.6 patients had small pedicle of the vertebral arch,2 patients had a high-riding vertebral artery(VA),2 patients had an asymmetrical VA,1 patient re-ceived a revision operation.9 patients performed C1-2 fixation,2 patients performed occipito-cervical fixa-tion.1 patient of irreducible atlantoaxial dislocation also performed anterior atlantoaxial joint release before posterior Fixation.All patients performed bone grafting to achieve a further occipito-cervical fusion or at-lantoaxial fusion.Before and after the operation,the neurologic function was scored according JOA scale. The X-ray and CT-scan also performed at regular intervals to evaluate cervical alignment and the fusion. Results All cases were complete reposition without vertebral artery,spinal cord or never root injuried.All patients were followed up for 6-32 months ( mean 16 months ),clinical symptom were improved visibly. The mean postoperative JOA scores was 14.9(13-16).The postoperative JOA score improvement rate was 76%-92%,and its mean value was 83%.All patients achieved bone fusion approved by CT scan after six months of operation.The reduction maintained well and the internal fixation was well positioned.Conclu-sion It will be an effective and safe way to achieve atlantoaxial fusion by posterior unilateral C2 pedicle screwing combined with contralateral C2 laminar screwing,but this study had not including clinical com-parative study.
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Objective To explore the immune mechanism of negative results of immune tests of schistosomiasis japonica pa?tients. Methods Totally 142 schistosomiasis patients(positive stool examinations)of Poyang Lake region were tested by ELI?SA method,and the ROC curve was applied to determine the high and low response of the patients. The levels of cellular immu?nity and cytokines of high and low responders were compared. Results Totally eight schistosomiasis patients were found as low responders. Besides SWAP?IgA(t= -1.588,P > 0.1),the levels of isotype antibodies were significantly lower in the low re?sponders compared with those in the high responders(t = -14.517 to -2.866,all P 0.05)compared with those in the high responders. The differences of IFN?γ and IL?10 between the high and low responders were both not significant(t= -2.426 to 0.216,all P >0.05). Conclusions There is a significant difference between the high and low responders only in the levels of isotype antibod?ies. One of the reasons of low response in the immune tests is the much lower antibody level after the antigen?antibody compound is completely formulated.
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Objective To understand the capability of parasitic disease diagnosis among professionals from the clinic labora?tory of Class A tertiary hospitals in Jiangxi Province. Methods The teams that took part in the competition were formed from 20 Class A tertiary hospitals,with 2 contestants per team. The competition contents included written examination and skill opera?tion. The written examination involved the life cycle of parasites,immunological basis,detecting techniques,etiological diagno?sis etc.,and the skill operation involved making and dying thin and thick blood smears,making Kato?Katz’s fecal thick smears, as well as microscopic examinations of smears. Results A total of 40 participants took part in the competition. Their total aver?age score was 97.3±22.4 with the pass rate of 15.0%,in which the mean score of theoretical knowledge was 56.6±12.8 with the pass rate of 52.5%,and the mean score of skill operation was 40.8±12.4 with the pass rate of 5.0%. In the written examination, the scoring rate of the life cycle of soil?transmitted helminths was the highest(90.0%),and the rate of the basic knowledge of food?borne parasites was the lowest(31.5%). Both the pass rates of blood smear making and examination were higher than those of Kato?Katz’s thick smears,and the differences were statistically significant( both P<0.05). The detection rates of Plasmodi?um vivax,Plasmodium falciparum,Plasmodium ovale and negative slides of the contestants were 38.8%,45.0%,35.0%and 25.0% respectively. As to the microscopic examination of helminth eggs,the detection rate of Trichuris trichiura egg was the highest(87.5%),and the rate of the Sparganum mansoni egg was the lowest(2.5%). The scores of Kato?Katz’s thick smear making and examination of the contestants from the provincial level hospitals were higher than those from the city level hospitals (both P<0.05),and the score of those from teaching hospitals in Kato?Katz’s thick smear making was higher than that of those from non?teaching hospitals(P < 0.05). Conclusions The technique level of professionals from the clinic laboratory of the Class A tertiary hospitals cannot meet the needs of the diagnosis of parasitic diseases in Jiangxi Province ,which should arouse the attention of the health authorities and hospitals.
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Objective To evaluate the long?term effect of the comprehensive control strategy for schistosomiasis with empha?sis on infectious source control in marshland?type endemic areas of Poyang Lake. Methods Three heavy endemic villages with schistosomiasis in the lake areas were selected as pilots for the comprehensive control strategy which included replacing bovine with tractors and forbidding grazing on marshlands. The data of schistosome infections of residents and Oncomelania hupensis snails were collected and analyzed statistically from 2009 to 2014. Results There were no patients with schistosomiasis through feces examinations in the 3 pilot villages. The average density of live snails in Niuzhou marshland showed a decline trend and the density was stable in Liulingwei marshland. There were no infected snails in the 2 marshlands and no schistosome adult worms were found in the sentinel rats Conclusion The implantation of the comprehensive control strategy for schistosomiasis with em?phasis on infectious source control can control the prevalence of schistosomiasis during a long period.
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Objective To understand the characteristics of schistosome cercarial infested water contact of residents in Poyang Lake endemic areas after the operation of Three Gorges Project,so as to provide the evidence for formulating a well-directed con-trol strategy. Methods The residents in two villages in schistosomiasis endemic areas were selected and surveyed for their activi-ties of infested water contacts by questionnaire. Results The proportion and frequency of infested water contacts of residents in Poyang Lake region were high and the average rate of infested water contacts was 69.77%,and 98.96%of infested water contacts occurred in spring,summer and autumn. The main ways of infested water contacts were fishing/swimming/playing for adult men, washing clothes/fishing for adult women,and swimming/playing for school children,respectively. The rates of infested water con-tacts were 73.33%,71.63%and 61.87%in adult men,women and school children,respectively. The frequencies of infested water contacts>1 time/week,1 time/week-1 time/month,and<1 time/month were 62.61%,23.74%and 13.66%respectively. Conclu-sions The infested water contacts mainly occurs in spring,summer and autumn,and the main way of infested water contacts was fishing. Farming and mowing grass,which had been the primary way,now become the secondary way for the adult residents.
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Objective To explore the impact and change regularity of Oncomelania hupensis snails and vegetation in the marshlands of Poyang Lake caused by the impoundment of the Three Gorges Project. Methods By using the methods of stratified systematic sampling and pinpoint navigation,the succession of vegetation was observed and the distribution of O. hupensis snails was investigated in a period of 8 years on 4 typical marshlands in Poyang Lake. The regularity of changes in vegetation and O. hu-pensis snails was analyzed on the marshlands at high,medium and low elevations,respectively. Results After the impoundment of Three Gorges Project,the average flooding days of these 4 marshlands in 2004 and in 2008 were reduced of 74.8 and 65.8 days compared with those in 2002,the year just before the impoundment of the project,respectively. The change of spatial distribution pattern and the succession of dominant species of vegetation on the marshlands of Poyang Lake have taken place since 2005,and several vegetations showed a trend of moving toward the center of the lake. The hygrophilous vegetation has degenerated and gradu-ally been replaced by mesophily meadow in the marshland area above 14 m elevation. Carex,Phalaris arundinacea and Polygo-num appeared in large area and expanded slowly towards the center of the lake on the marshland below 14 m elevation. O. hupensis snails were mostly found under the Carex association. The tendency of decreasing in density of snails and of migration of snail habi-tats towards low terrain was observed. Conclusions The impoundment of Three Gorges Project has had a significant impact on hy-drological regimes,and a new succession of vegetation has taken place in the marshlands of Poyang Lake. O. hupensis snails and the mesophily vegetation show a trend of migrating slowly to the areas of low elevation in the marshlands.
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Objective To explore the relationship between the vegetation and space distribution of Oncomelania snails in Poyang Lake region,so as to get better understanding of the habitats of Oncomelania snails by using remote sensing technology.Methods The marshlands close to schistosomiasis endemic villages in Poyang Lake region were selected,and the traditional methods were used to investigate the situation of vegetation and Oncomelania snails.The longitude and latitude of investigation spots were recorded by GPS,and the field survey data were vectored by using ArcGIS software.The geometric calibration and unsupervised classification were made on TM satellite images of low-flow period of spring by using PCI 9.0.And then,the relationship between space distribution of snail habitats and vegetation was analyzed through superposing the filed data and satellite images.Results The vegetation in marshlands of Poyang Lake region can be differentiated as three types,in which the single dominant vegetation area was mainly breeding place of Oncomelania snails,and wet vegetation type and hybrid weed type were snail seldom breeding areas.Conclusions The distribution roles of vegetation in marshland are closely related to the habitats of snails,presenting a flaky and bandy distribution.The habitats of Oncomelania snails can be quickly understood by remote sensing technology.
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To determine the diagnostic efficiency of parallel detection of the circulating antigens and antibodies in schistosomiasis, sandwich ELISA and indirect ELISA by using the labeled McAb JPG3 were used to detect the presence of the circulating antigens and the circulating IgG antibodies in serum samples from different kinds of population. and then the sensitivity and specificity of this method of testing as well as the efficiency of the application of this method in heavy endemic area. were determined in comparison with serial test. It was found that the sensitivity and specificity of the parallel test were 97.9% and 92.2% , however, those of the serial test were 76.0% and 99.2% respectively. The positive rates of parallel test and serial test to detect the stool examination-positive for schistosoma eggs in population of the endemic area were 94.6% (35/37) and 67.6% (25/37), while those to detect the stool examination-negative for schitosoma eggs were 69.8% (97/139) and 39.6% (55/139) respectively. It is apparent the parallel test for the detection circulating antigens and antibodies in schistosomiasis shows its high diagnostic efficiency, especially in the heavy endemic area of schitosomiasis.
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Objective To explore the relationship between vegetation and the distribution of Oncomelania snails inside and outside the embankments of Poyang Lake region. Methods The plantation and Oncomelania snails were surveyed at 4 villages and their related marshlands in Yugan, Nanchang and Jinxian counties by the stratified systematic sampling method. The investigation was targeted to the vegetation species,height,coverage and frequency of plantation and synchronously to the distribution of snails and infection of snails in marshland of high, middle and low altitudes,adjacent beaches as well in cultivated and waste land inside embankment. The relationship between vegetation dominant association and the distribution of snails in those area was analyzed. Results The vegetation inside and outside the embankment were remarkably diverse. Inside the embankment, the species of vegetation varied greatly and distributed randomly,and no snail was found. While outside the embankment,the distribution of vegetation characterized an unregulated annulus or patch. Plant's association types were distinct on marshlands. The snails mainly distributed in areas at 15-17 m altitude,closely related to the species of vegetation. The coverage of dominant plants,Carex cinerascen and Miscanthus sacchariflorus showed a quadratic curve correlation with the density of snails. Conclusions In the Poyang Lake region,plants and snails are impacted by common environmental factors,which then lead to their close association in distribution. It might be attributed to integrated impacts of changes in ecological factors that Oncomelania snails disappear gradually in areas inside embankment after construction of embankment.
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Objective To understand the effect of the three-cell latrine and B-type tilted ellipsoid methane tank for eliminating eggs of schistosome in different seasons and temperatures in order to evaluate their values for popularization and application in schistosomiasis endemic areas.Methods The eggs of schistosome collected from infected rabbits were put into the three-cell latrines and methane tanks in different seasons.The miracidia were observed and counted after collecting the eggs for hatching experiments on the 5th,10th,15th,20th,25th,30th,40th,50th,and 60th day,respectively.Results In the three-cell latrine,the time of eliminating eggs completely in the fecal residue in winter,spring(autumn),and summer was 50,30,15 days,respectively,and the time of completely eliminating 100 eggs of schistosome was 40,20,10 days,respectively.Correspondingly,in the methane tank,the time of eliminating eggs completely in the fecal residue in winter,spring(autumn),and summer was 30,15,10 days,respectively,and the time of completely eliminating 100 eggs of schistosome was 20,15,5 days,respectively.Conclusions The three-cell latrine and B-type tilted ellipsoid methane tank could effectively eliminate schistosome eggs in human and animal excreta and achieve the national hygienic standard on night soil in the endemic areas of Jiangxi Province.