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Objective:To analyze the application effect of nano-carbon lymphatic tracer technology in laparoscopic colon cancer (CC) radical resection based on propensity matching.Methods:Retrospective case-control study was performed in this study. From January 2016 to April 2021, 714 cases of CC patients who underwent laparoscopic CC radical resection in Kunshan Second People′s Hospital were divided into groups according to whether or not the nano-carbon lymphatic tracing technique was applied. Seventy-eight cases in group A were applied with nano-carbon lymphatic tracing technique, while 636 cases in group B were not applied with nano-carbon lymphatic tracing technique. The initial data were matched 1∶3 by the propensity score matching method, and finally group A (73 cases) and group B (219 cases) were obtained. The detection of lymph nodes in the two groups after propensity score matching was compared.Results:By comparing the baseline data of the two groups after propensity score matching, it was found that there were no significant differences in gender, height, weight, body mass index, tumor T stage, tumor N stage, tumor TNM stage, preoperative chemotherapy, or tumor location ( P>0.05). The total number of lymph nodes in group A was higher than that in group B: (22.24 ± 7.08) pieces vs. (19.03 ± 6.29) pieces, and the difference was statistically significant ( t = 3.66, P<0.05); the number of positive lymph nodes and the degree of lymph node metastasis in group A were not significantly different from those in group B ( P>0.05). Tumor T stage T 3, tumor N stage N 0, tumor TNM stage Ⅱ, and preoperative chemotherapy, the total number of lymph nodes in group A was higher than that in group B: 23 (6, 60) pieces vs. 19 (4, 54) pieces , 20 (3, 62) pieces vs. 18 (3, 75) pieces, 23 (6, 59) pieces vs. 20 (7, 54) pieces, 22 (5, 45) pieces vs. 14 (4, 46) pieces, and the difference was statistically significant ( Z = 2.43, 2.70, 2.64 and 3.32; P<0.05); the number of positive lymph nodes and the degree of lymph node metastasis of tumor N stage N 2 in group A were lower than those in group B: 4 (4, 9) pieces vs. 6 (4, 25) pieces , 16 (10, 42) pieces vs. 32 (19, 100) pieces, and the difference between groups was statistically significant ( Z = -2.53 and -2.87, P<0.05). Followed up to April 2022, among the 292 patients, 5 were lost to follow-up, the 3-year disease-free survival rates of 72 patients in group A and 215 patients in group B were 83.33% (60/72) and 91.16% (196/215) respectively, there was no significant difference between two groups ( P>0.05). Conclusions:The number of lymph nodes detected in laparoscopic CC radical resection increases after the application of nano-carbon lymphatic tracing technology.
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Objective:To observe the application of near-infrared autofluorescence imaging (NIRAF) technology combined with carbon nanoparticle (CNP) negative imaging in identification of parathyroid gland (PG) during thyroid carcinoma surgery.Methods:80 patients with thyroid cancer who underwent total thyroidectomy + central lymph node dissection performed by the same experienced physician team at the 960th Hospital of the PLA from Jan. to Mar. 2022 were prospectively included. Before operation, they were divided into two groups using random number table method before surgery: control group (40 cases) using CNP negative imaging, and experimental group (40 cases) using CNP negative imaging combined with NIRAF technique for intraoperative identification of PG. The gold standard for the identification of parathyroid glands was to compare the amount of intraoperative discovery retention misresection and transplantation of PG and the number of postoperative parathyroid hormone (PTH) and the number of complications in the two groups by immune colloidal gold technique. SPSS 25.0 software was used for statistical analysis.Results:All patients in the two groups were successfully operated and followed up. 137 149 PG were found and confirmed in the control group and the observation group, 108 132 PG were retained in situ and 29 17 PG were transplanted, the differences were statistically significant (all P <0.05) ; The number of A1 PG was 103 and 109, respectively. Among them, 84 102 were retained in situ and 19 7 were transplanted, the difference was statistically significant ( P <0.05) . There was no significant difference in the amount of A2 type PG and B type PG between the two groups ( P >0.05) . No A3 type PG was found in the two groups, and a total of 3 A3 types of PG were confirmed in postoperative pathological reports. There were no significant differences in misresection in the control group and the observation group, 5 and 2 PG were mistakenly cut, respectively (all P >0.05) . The PTH 1 day after surgery was 17.7 (5.6,30.4) pg/mL in the control group and 21.7 (12.8,38.3) pg/mL in the observation group, the difference was statistically significant ( P<0.05) . There were no significant differences in the levels of serum calcium and serum phosphorus 1 day after operation and PTH 1 month after surgery between the two groups (all P > 0.05) . Conclusion:Compared with CNP alone, combined with NIRAF technique can quickly and effectively identify PG, and PG can be better protected in situ and postoperative hypoparathyroidism can be reduced.
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Objective:To explore the feasibility and clinical value of sentinel lymph node (SLN) biopsy through cervix-uterine combined two-step injection with two tracers in patients with early stage endometrial cancer.Methods:From July 2019 to April 2021, a total of 73 patients, aged (54.2±3.3) year, who were preoperatively diagnosed as stage Ⅰ-Ⅱ endometrial cancer (including 56 low-risk patients and 17 medium-high risk patients) in Affiliated Hospital of Qingdao University were selected. According to the different sites of tracer injection, the patients were randomly divided into three groups: cervical injection group (25 cases): 1 ml of nano-carbon was used to inject at 3 and 9 o'clock in the cervix; uterine injection group (21 cases): the magnetic resonance imaging examination was performed to determine the location of the lesion, and 4 ml of methylene blue was injected into the uterine body at 2 sites where the lesion was located; combined injection group (27 cases): cervical injection of nano-carbon (1 ml) combined with uterine injection of methylene blue (4 ml). The SLN in all patients were identified under laparoscopy, removed, and followed by frozen pathological examination. Pathological ultra-staging was performed if the postoperative pathological outcome of SLN was negative. The total detection rate of SLN, bilateral pelvic SLN detection rate, sensitivity, negative predictive value, and location of SLN in each group were calculated and compared.Results:(1) In 73 patients with endometrial cancer, the overall detection rate of SLN was 88% (64/73), the detection rate of bilateral pelvic SLN was 67% (49/73), and the detection rate of para-aortic SLN was 49% (36/73). The overall detection rate of SLN (71%, 15/21) and bilateral pelvic SLN (43%, 9/21) in the intrauterine injection group were significantly lower than those in the cervical injection group [92% (23/25), 76% (19/25), respectively] and the combined injection group [96% (26/27), 78% (21/27), respectively; all P<0.05]; the detection rate of para-aortic SLN in the cervical injection group (28%, 7/25) was significantly lower than those in the intrauterine injection group and combined injection group [52% (11/21) and 67% (18/27), respectively; both P<0.05]. Among 73 cases with endometrial cancer, 9 had lymph node metastasis confirmed by postoperative pathological examination, 8 of them had lymph node metastasis detected by SLN and 1 had no lymph node metastasis detected by SLN, with a total sensitivity of 89% and a negative predictive value of 98%. The sensitivity and negative predictive value of cervical injection group and combined injection group were 100%, while the sensitivity and negative predictive value of intrauterine injection group were 67% and 95%. Among 56 low-risk patients, only one patient with lymph node metastasis was confirmed by postoperative pathology by SLN detection, and the metastasis rate was 2% (1/56), and the sensitivity and negative predictive value were 100%. Lymph node metastasis was confirmed in 8 of 17 patients (8/17) with a sensitivity of 88% and a negative predictive value of 90%. (2) A total of 459 SLN were detected in 73 endometrial cancer patients, with the highest proportion of external iliac (33.3%, 153/459).The obturator foramen was 25.3% (116/459), para-aortic 19.6% (90/459), iliac 12.0% (55/459), and presacral 9.8% (45/459). The proportion of para-aortic SLN in the cervical injection group was 12.4% (21/169), which were significantly lower than that in the intrauterine injection group and the combined injection group [27.4% (26/95) and 22.1% (43/195), respectively; both P<0.05]. (3) Pathological super-staging results: among 64 patients with negative SLN routine paraffin pathology, 4 cases of lymph node micro-metastases and 1 case of isolated tumor cell metastasis were detected, and the SLN micro-metastases rate was 8% (5/64), including 2 cases of low-risk patients and 3 cases of medium-high risk patients. Conclusions:SLN biopsy has high sensitivity and negative predictive value in patients with early endometrial cancer and could be used as an alternative to systematic lymph node dissection in low-risk patients. The SLN mapping through cervical-uterine combined injection could further improve the detection rate effectively and avoid the missed detection of positive para-aortic lymph node, especially for high-risk patients or patients with fundal tumor involvement.
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Objective:To explore the effect of nano-carbon in lymph node dissection for thyroid cancer.Methods:46 patients with thyriod cancer were randomly divided into treatment group and control group.The identification rate of lymph nodes,lymph node positivity and parathyroid function were compared after surgery.Results:Compare to the control group,the identification rate of lymph nodes in treatment group was higher (P＜0.05),but there was no significant difference on lymph node positivity (P＞0.05).what's more,patients with low blood calcium and parathyroid hormone in treatment group were less than that in control group after surgery (P＜0.05).The difference of severity of clinical symptoms was not statistically significant (P＞0.05).Conclusion:Nano-carbon increases the lymph node identification rate and reduces the risk of parathyriod injury in patients with thyroidectomy.
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Objective To explore the application value of nano carbon lymph tracing technique in the radical resection of gallbladder cancer.Methods The prospective study was conducted.The clinical data of 120 patients with gallbladder cancer who were admitted to the Henan Provincial People's Hospital between January 2010 and December 2014 were collected.All the patients were allocated into the experimental group and control group by random number table.For the experimental group,a total of 0.1 mL carbon nanoparticles were injected at 4-6 locations subserously around the cancerous site,radical resection of gallbladder cancer were performed at 15 minutes after injection,and intraoperative stained lymph nodes were used as markers to guide lymphadenectomy.Patients in the control group underwent regular radical resection of gallbladder cancer.Observation indicators:(1) intra-and post-operative situations;(2) number of lymph node sorting;(3) follow-up situations.Follow-up using telephone interview was performed to detect survival of patients up to January 2016.Measurement data with normal distribution were represented as x-±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M(P25,P75),and comparison between groups was analyzed by the Mann-whitney rank-sum test.Comparisons of count data were analyzed using the chi-square test.Comparison of ordinal data were analyzed by the nonparametric test.The survival curve was drawn by the Kaplan-Meier method.Survival analysis was done using the Log-rank test.Results One hundred and twenty patients were screened for eligibility,and were allocated into the experimental group and control group,60 in each group.(1) Intra-and postoperative situations:operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were respectively (164± 51) minutes,(200 ± 98) mL,(13 ± 4) days in the experimental group and (178± 52) minutes,(225±98)mL,(14±5)days in the control group,with no statistically significant difference between groups (t=-l.50,-1.42,-1.03,P＞0.05).(2) Comparison of lymph node sorting:overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 13.0 (12.0,15.0),8.0 (5.0,9.0),7.0 (5.0,8.0),3.0 (2.0,4.0) in the experimental group and 10.0 (8.0,12.0),5.0 (4.0,6.0),5.0 (3.0,5.0),1.0 (1.0,2.0) in the control group,with statistically significant differences between groups (Z =-5.51,-4.37,-6.24,-6.18,P＜0.05).Number of N1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 6.0 (5.0,6.0),4.0 (3.0,5.0) in the experimental group and 6.0 (4.0,7.0),4.0 (2,0,5.0) in the control group,with no statistically significant difference between groups (Z =-0.82,-1.34,P＞0.05).Overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 5.0 (4.8,6.3),0(0,0.8),2.0 (1.0,3.3),0(0,0.5) in patients with stage Ⅱ of the experimental group and 3.0 (2.0,4.3),0 (0,0),0 (0,1.3),0(0,0) in patients with stage Ⅱ of the control group,with statistically significant differences between groups (Z=-2.96,-2.02,-2.38,-2.01,P＜0.05).Number of N 1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 3.0 (3.0,3.3),0 (0,0.3) in patients with stage [[of the experimental group and 3.0 (2.0,3.0),0 (0,0) in patients with stage Ⅱ of the control group,with no statistically significant difference between groups (Z=-1.18,-1.81,P＞0.05).Overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 13.0 (12.0,15.0),7.0 (5.0,8.0),7.0 (5.0,8.0),3.0 (2.0,4.0) in patients with stage Ⅲ of the experimental group and 10.0 (9.0,12.0),5.0 (4.0,6.0),5.0 (4.0,5.0),2.0 (1.0,2.0) in patients with stage Ⅲ of the control group,with statistically significant differences between groups (Z =-4.80,-3.43,-5.25,-4.76,P＜ 0.05).Number of N1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 6.0 (6.0,8.0),4.0 (3.0,5.0) in patients with stage Ⅲ of the experimental group and 6.0 (5.0,7.0),4.0 (3.0,4.5) in patients with stage Ⅲ of the control group,with no statistically significant difference between groups (Z=-1.52,-1.16,P＞0.05).Overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 14.0 (13.0,15.0),9.0 (8.0,10.0),8.0 (7.5,8.0),4.0 (4.0,5.0) in patients with stage Ⅳa of the experimental group and 11.0 (10.0,13.0),6.0 (4.0,8.0),5.0 (5.0,6.0),2.0 (1.0,2.0) in patients with stage Ⅳ a of the control group,with statistically significant differences between groups (Z =-3.47,-3.25,-4.02,-3.92,P＜0.05).Number of N1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 6.0 (5.5,6.0),5.0 (4.0,5.0) in patients with stage Ⅳa of the experimental group and 6.0 (5.0,7.0),4.0 (3.0,6.0) in patients with stage Ⅳa of the control group,with no statistically significant difference between groups (Z=-0.14,-0.45,P＞0.05).(3) Follow-up situations:120 patients were followed up for 12-60 months,with a median time of 28 months.The postoperative overall survival time was (45.7 ± 2.3) months in the experimental group and (36.5 ± 2.4) months in the control group,with a statistically significant difference between groups (x2 =8.32,P＜ 0.05).The postoperative overall survival time was (54.5±3.0) months in patients with stage Ⅱ of the experimental group and (39.6±0.9)months in patients with stage Ⅱ of the control group,with no statistically significant difference between groups (x2 =3.77,P＞0.05).The postoperative overall survival time was (42.2±2.7)months in patients with stage Ⅲ of the experimental group and (35.0±3.0)months in patients with stage]Ⅲ of the control group,with a statistically significant difference between groups (x2=4.12,P＜0.05).The postoperative overall survival time was (37.7±2.5)months in patients with stage Ⅳa of the experimental group and (27.0±3.1)months in patients with stage Ⅳa of the control group,with a statistically significant difference between groups (x2 =4.14,P＜0.05).Conclusion The nano carbon lymph tracing technique in the radical resection of gallbladder cancer can guide precise operation,increase the numbers of overall and positive lymph nodes sorting,and extend postoperative overall survival time.
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Objective@#To evaluate the usage of ultrasound guided wire-localization, nano-carbon staining and the combination of the above two methods in detecting sentinel lymph node (SLN) in breast cancer.@*Methods@#A total of 159 cases of breast cancer from May 2015 to December 2017 in Shanxi Provincial Cancer Hospital were selected, and they were treated with ultrasound guided wire-localization, nano-carbon staining and combination of the two methods separately to detect SLN before the operation. After the operation, SLN and axillary lymph node in each group were marked and made pathological diagnosis.@*Results@#There were 69 cases with pathological diagnosis of SLN metastasis and 90 cases without abnormal representation. With the patient as the unit, the sensitivity of ultrasound guided wire-localization was 100.0% (69/69), the sensitivity of nano-carbon staining was 98.6% (68/69), and the sensitivity of combination of the two methods was 97.1% (67/69). The specificity of ultrasound guided wire-localization was 3.3% (3/90), the specificity of nano-carbon staining was 2.2% (2/90), and the specificity of combination of the two methods was 5.6% (5/90). With the count of SLN as the unit, the combination of the two methods had the highest diagnostic efficiency in detecting SLN, and the difference was statistical significant (χ2 = 34.31, P < 0.001).@*Conclusions@#Ultrasound guided wire-localization and nano-carbon staining are safe and accessible methods for detecting SLN. It provides a precise treatment for early breast cancer, and it can protect medical staff from radiation, which is expected to be the best method for detection of SLN in breast cancer.
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Objective To investigate the effect of nano carbon tracer for protecting parathyroid function in the surgery of thyroid cancer.Methods A total of 178 patients with thyroid cancer admitted in our hospital from Jun.2014 to Mar.2016 were collected and divided into the control group and the observation group according to the random number table method,89 cases in each group.The control group received routine surgery,while the observation group received nanocarbon suspension during surgery.The levels of serum parathyroid hormone and serum calcium in the 2 groups were measured at 3 days after surgery,and the patients with low parathyroid hormone,normal parathyroid hormone and low calcium were counted.Results The rate of ormal serum calcium in the observation group was 91.01％(81/89),significantly higher than 67.42％(60/89) in the control group (P＜ 0.05).The rate of normal parathyroid hormone in observation group was 94.38％ (84/89),significantly higher than 64.04％ (57/89) in the control group (P＜0.05).Conclusion The nano carbon tracer is helpful for protection of parathyroid function in the surgery of thyroid cancer.
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Objective To explore the clinical significance of Nano-Carbon particles and 3D laparoscopy in central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer. Methods We conduct a retrospective analysis of sixty-five patients with cN0 thyroid cancer who were received 3D laparoscopic thyroidectomy in the last 3 years. All patients were received total resection of thyroid plus the affected side and (or) contralateral side central compartment lymph node dissection. All patients were allocated to control group (n = 32) and carbon nano-particles trace group (tracer group, n = 33). The lymph node-related indexes (including number of dissected lymph node at Ⅵ area, number of Metastatic lymph node and Frozen lymph node-positive rate at Ⅵ area), serum calcium (24 h after surgery) and PTH (48 h after surgery) were collected and compared between the 2 groups. Results Number of dissected lymph node at Ⅵ area, positive rates of intraoperative frozen-section examination of parathyroid glands and PTH (48 h after surgery) were found statistical higher in nanoparticles group than control (P < 0.05). No statistical difference were found in Number of Metastatic lymph node and serum calcium (24 h after surgery) (P < 0.05). Conclusion The clinical significance of carbon nanoparticles and 3D laparoscopy is effective and feasible for central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer.
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Objective:to explore the effect of nano-carbon tracer on the dissection of central group lymph nodes in thyroid cancers.Methods:60 patients with thyroid cancers enrolled from January 2015 to December 2015 in our hospital were selected as research objects.Tracing group contained 30 cases would carry out nano-carbon tracer for the dissection of lymph nodes,while the other 30 patients without using nano-carbon tracer were defined as control group.The number of dissected lymph nodes,the discovery rate of positive lymph nodes and the postoperative parathyroid function were made a comparison between the two groups.Results:the total number of dissected lymph nodes in the tracing group was more than the control group (269 vs 204).The average number of dissected lymph nodes in the tracing group (8.97 ± 1.65/case) was also significantly more than the control group(6.8 ± 1.52/case)(P＜0.05).In the tracing group,the total discovery rate of positive lymph nodes was 40.15％,while the control group was 37.25％.Therefore,the average number of dissected positive lymph nodes in the tracing group (3.6 ± 1.16/case) was significantly more than the control group (2.53 ± 1.17/case)(P＜0.05).Observation of the postoperative adverse reactions,there were fewer patients suffering hypocalcemia or recurrent laryngeal nerve injury in the tracing group compared to the control group.In detail,although the blood calcium levels on the 2nd day after operation in both two groups decreased compared with preoperative baseline values,significantly statistical difference was only observed in the control group with 2.173 ±0.20mmol/L in postoperation vs 2.28 ± 0.06mmol/L in pre-operation (P＜0.05).What's more,the blood calcium level in the tracing group on the 2nd day after operation (2.27 ± 0.19mmol/L) was significantly higher than the control group (2.173 ± 0.20mmol/L)(P＜0.05).Besides,the postoperative PTH levels in both two groups reduced in some degree compared to the preoperative baseline values,but there were no statistical differences (P＞0.05).Conclusion:using nano-carbon tracer during the operation would be benefit for the dissection of positive central group lymph nodes,the recognition of parathyroid glands and reduction of postoperative adverse reactions.
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Objective To design a method for rapid detection of fecal occult blood, calcium and cancer embryo antigen based on the immunochromatography of nanoparticles. Methods Used nano carbon lateral flow immune chromatography technology which applicated in trace detection of drug development,choose human hemoglobin,calcium,protein,carcinoembryonic antigen suitable double antibody. 1 resistance of three test taged by colloidal carbon probe cured in carbon mat, and the corresponding test pairs of another plant 2 fixed on nitrocellulose membrane resistance test region(Line T), quality control line(Line C) which composed of sheep anti-mouse IgG antibody,glue water cushion,nitrocellulose membrane,colloidal carbon release pad and sample pad, drying cutting made test card.Choose 100 cases of endoscopic check negatie and 100 cases of colorectal cancer patients with intestinal preparation before stool specimens, dropped the dissolved the centrifugal supernatant in normal saline into the strip and put the special card slot, applied independent research of real-time quantitative detector checked the content of fecal occult blood, the calcium content of protein, carcinoembryonic antigen respectively. Results The application of nano carbon lateral flow immune chromatography test card for fecal occult blood calcium, protein, carcinoembryonic antigen was conveniented.Real-time quantitative detector check readable data range of 0-7000, the sensitivity data of 0.2 ng/mL. The positive rate of endoscopic check negatie and colorectal cancer patients with fecal occult blood were 1.91% and 77.01% respectively,the average content of calprotectin were (26.81±5.96) μg/g and (589.00±42.29) μg/g. Average content of carcinoembryonic antigen were (1.21±0.45) μg/g and (234.32±11.24) μg/g respectively. Conclusion The rapid detection method of nanometer carbon particle immunochromatography was reliable, and fecal occult blood, calcium protamine and cancer embryo antigen jiont test was value for colorectal cancer screening.
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Objective To explore the clinical significance of Nano-Carbon particles and 3D laparoscopy in central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer. Methods We conduct a retrospective analysis of sixty-five patients with cN0 thyroid cancer who were received 3D laparoscopic thyroidectomy in the last 3 years. All patients were received total resection of thyroid plus the affected side and (or) contralateral side central compartment lymph node dissection. All patients were allocated to control group (n = 32) and carbon nano-particles trace group (tracer group, n = 33). The lymph node-related indexes (including number of dissected lymph node at Ⅵ area, number of Metastatic lymph node and Frozen lymph node-positive rate at Ⅵ area), serum calcium (24 h after surgery) and PTH (48 h after surgery) were collected and compared between the 2 groups. Results Number of dissected lymph node at Ⅵ area, positive rates of intraoperative frozen-section examination of parathyroid glands and PTH (48 h after surgery) were found statistical higher in nanoparticles group than control (P < 0.05). No statistical difference were found in Number of Metastatic lymph node and serum calcium (24 h after surgery) (P < 0.05). Conclusion The clinical significance of carbon nanoparticles and 3D laparoscopy is effective and feasible for central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer.
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Objective:to explore the effect of nano-carbon tracer on the dissection of central group lymph nodes in thyroid cancers.Methods:60 patients with thyroid cancers enrolled from January 2015 to December 2015 in our hospital were selected as research objects.Tracing group contained 30 cases would carry out nano-carbon tracer for the dissection of lymph nodes,while the other 30 patients without using nano-carbon tracer were defined as control group.The number of dissected lymph nodes,the discovery rate of positive lymph nodes and the postoperative parathyroid function were made a comparison between the two groups.Results:the total number of dissected lymph nodes in the tracing group was more than the control group (269 vs 204).The average number of dissected lymph nodes in the tracing group (8.97 ± 1.65/case) was also significantly more than the control group(6.8 ± 1.52/case)(P＜0.05).In the tracing group,the total discovery rate of positive lymph nodes was 40.15％,while the control group was 37.25％.Therefore,the average number of dissected positive lymph nodes in the tracing group (3.6 ± 1.16/case) was significantly more than the control group (2.53 ± 1.17/case)(P＜0.05).Observation of the postoperative adverse reactions,there were fewer patients suffering hypocalcemia or recurrent laryngeal nerve injury in the tracing group compared to the control group.In detail,although the blood calcium levels on the 2nd day after operation in both two groups decreased compared with preoperative baseline values,significantly statistical difference was only observed in the control group with 2.173 ±0.20mmol/L in postoperation vs 2.28 ± 0.06mmol/L in pre-operation (P＜0.05).What's more,the blood calcium level in the tracing group on the 2nd day after operation (2.27 ± 0.19mmol/L) was significantly higher than the control group (2.173 ± 0.20mmol/L)(P＜0.05).Besides,the postoperative PTH levels in both two groups reduced in some degree compared to the preoperative baseline values,but there were no statistical differences (P＞0.05).Conclusion:using nano-carbon tracer during the operation would be benefit for the dissection of positive central group lymph nodes,the recognition of parathyroid glands and reduction of postoperative adverse reactions.
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Objective To design a method for rapid detection of fecal occult blood, calcium and cancer embryo antigen based on the immunochromatography of nanoparticles. Methods Used nano carbon lateral flow immune chromatography technology which applicated in trace detection of drug development,choose human hemoglobin,calcium,protein,carcinoembryonic antigen suitable double antibody. 1 resistance of three test taged by colloidal carbon probe cured in carbon mat, and the corresponding test pairs of another plant 2 fixed on nitrocellulose membrane resistance test region(Line T), quality control line(Line C) which composed of sheep anti-mouse IgG antibody,glue water cushion,nitrocellulose membrane,colloidal carbon release pad and sample pad, drying cutting made test card.Choose 100 cases of endoscopic check negatie and 100 cases of colorectal cancer patients with intestinal preparation before stool specimens, dropped the dissolved the centrifugal supernatant in normal saline into the strip and put the special card slot, applied independent research of real-time quantitative detector checked the content of fecal occult blood, the calcium content of protein, carcinoembryonic antigen respectively. Results The application of nano carbon lateral flow immune chromatography test card for fecal occult blood calcium, protein, carcinoembryonic antigen was conveniented.Real-time quantitative detector check readable data range of 0-7000, the sensitivity data of 0.2 ng/mL. The positive rate of endoscopic check negatie and colorectal cancer patients with fecal occult blood were 1.91% and 77.01% respectively,the average content of calprotectin were (26.81±5.96) μg/g and (589.00±42.29) μg/g. Average content of carcinoembryonic antigen were (1.21±0.45) μg/g and (234.32±11.24) μg/g respectively. Conclusion The rapid detection method of nanometer carbon particle immunochromatography was reliable, and fecal occult blood, calcium protamine and cancer embryo antigen jiont test was value for colorectal cancer screening.
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Objective To evaluate carbon lymph tracer (CH40) in pancreatic cancer surgery.Method 61cases of pancreas head carcinoma undergoing whipple procedure from June 2011 to December 2013 were divided into intraoperative nano carbon group (group A,36 cases),in which resection range was adjusted according to lymph node staining including 13 standard resection cases (group A1),and 23 modified extended radical resection cases (group A2).Standard group (group B,n =17),and extended radical operation group (group C,n =8),respectively.Results The average lymph nodes harvested in group A1 were 25.08 ± 2.72,with positive lymph nodes of 7.92 ± 2.22,significantly more than group B (19.47±1.55,2.68 ±5.24),P＜0.05.In group A2,the average lymph node was 29.91 ±2.68,positive lymph node was 11.04 ± 2.38,significantly more than group C (25.13 ± 2.85,8.49 ± 3.32),P ＜0.05.The mean survival time and overall survival time of group A1 were 43.80 ±4.09 months,51.44 ±1.64 months,significantly more than group B (27.11 ±3.36,41.74 ±3.28 months),P ＜0.05.In group A2,the average tumor free survival time,and overall survival time was 31.58 ±2.99 months,45.02 ±2.54 months,not statistically different with group C (29.13±4.76 month,43.67 ±3.33 months),P ＞0.05.Conclusions Intraoperative lymphatic tracer technology significantly increases lymph node harvest,improving the survival time and tumor free prognosis.
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Objective To explore the clinical efficacy of navigation of sentinel lymph node (SLN) combined with endoscopic submucosal dissection (ESD) for non curative treatment of early gastric cancer.Methods Clinical data of 9 cases with early gastric cancer treated with ESD from August 2015 to December 2015 were enrolled.The SLNs were explored by laparoscopy after nano carbon or indocyanine green(ICG) was injected under endoscopy.Then all stained nodes were resected by laparoscopy.Results The mean number of SLN were 2.75±1.50 in ICG group,which was significantly smaller than the number in nano carbon group(8.40±4.93) according to the laparoscopic pathology,so the accuracy of ICG was higher than that of nano carbon.But ICG performed better in development.The postoperative complications such as postoperative intestinal obstruction,enteritis and gastric paralysis were found in 5 patients of nano carbon group.But no serious complications after operation were found in patients of ICG group.Conclusion Application of ICG can help avoid the excessive removal of tissue,and reduce the incidence of complications.ICG,as a new type of tracer for early gastric cancer,shows good application prospects.
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Objective To study carbon nanoparticles lymphatic tracer to guide surgery for gallbladder cancer.Methods 120 patients with gallbladder cancer were randomized into two groups:the experimental group (n =60) and the control group (n =60).For the experimental group,0.1 ml carbon nanoparticles was injected at 4 ～ 6 locations subserosally around the cancerous site intraoperatively.Stained lymph nodes were used as markers to guide lymphadenectomy.The resected specimens were carefully dissected,and then the lymph nodes were studied according to their positions by histopathological examinations.Results Various degrees of stained lymph nodes were seen in the specimens.In the experimental group,the number of lymph nodes (12.0 ± 3.8),and metastatic lymph nodes (6.3 ± 3.3) per patient were obviously higher than those in the control group (9.2 ± 3.6、4.4 ± 2.8),respectively,(P ＜ 0.05).There were significant differences (P ＜ 0.05) in postoperative disease-free survival and overall survival.Conclusions Intraoperative injection of carbon nanoparticles enhanced lymph node clearance and increased the number of lymph nodes and metastatic lymph nodes dissected,which helped to guide pathological staging.There were significant improvements in disease-free survival and overall survival of these patients with gallbladder cancer after surgery.
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Objective To discuss the protection of parathyroid and application of nano-carbon suspen-sion in thyroid surgery .Methods 80 cases were randomly divided into 2 groups:the experimental group which were injected nano-carbon into thyroid during thyroidectomy , and the control group without any injection .Results There were 5 cases with hypocalcemia and 5 cases with PTH decrease in the experimental group , and there were 15 cases and 14 cases respectively in the control group .Pathological results showed that misresection of par-athyroids occurred in 6 cases of the control group(11 parathyroid glands)were while it didn't happen in the experi-mental group .Conclusion Nano-carbon can help to identify and protect the parathyroid , decreasing the proba-bility of parathyroid gland damage during thyroid surgery .
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Objective To investigate activated nano carbon in prophylactic central lymph node dissection of T1 papillary thyroid non-microcarcinoma.Methods Patients with T1 papillary thyroid non-microcarcinoma in Thyroid Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University undergoing surgery from Jan.2012 to Jun.2013 were divided into 2 groups:odd numbers were the experimental group,and even numbers were the control group.Activated nano carbon was injected in the affected side of the thyroid in the experimental group.The lymph node metastasis,parathyroid function,and the rate of recurrent laryngeal nerve (RLN) injury were compared between the 2 groups.Results The total number of resected lymph nodes in the experimental group and the control group were 327 and 238 respectively.The positive lymph nodes in the experimental group and the control group were 120 (36.7％)and 56 (23.5 ％)respectively.The difference had statistical significance (P =0.000 85).The number of patients with lymphatic metastasis in the experimental group and the control group was 42 (56％) and 30 (40％) respectively.The difference had statistical significance (P =0.049 9).The average number of positive lymph node for patients in the experimental group and the control group was (2.86 ± 0.13) and(1.87 ± 0.09) respectively.The difference had statistical significance(P =0.009).The rate of transient hypoparathyroidism in the experimental group and the control group was 34.7％ and 60％ respectively.The difference had statistical significance (P =0.002).The incidence of hoarseness caused by RLN injury was 2.7％ and 4％ respectively in the experimental group and the control group.The difference had no statistical significance(P =1.000).Conclusions Activated nano carbon plays an important role in prophylactic central lymph node dissection of T1 papillary thyroid non-microcarcinoma phase.It not only contributes to lymph node dissection,but also protects parathyroid.However,it can't reduce the incidence of RLN injury.
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Objective To discuss the role of naso-carbon in the protection of parathyroid during surgery. Methods 72 patients were randomly divided into the two groups,Injecting 0.1-0.2mL nano-carbon in the thyroid during a thyroid surgery.When the thyroid and surrounding lymph tissue were stained,then the thyroid surgery should be continued,the non-stained tissue should be protected.Results There were 6 cases with hypocalcemia in the con-trol group and 2 cases in the observation group(χ2 =13.87,P<0.05).5 cases with PTH decrease in the control group and 1 case in the observation group(χ2 =14.53,P<0.05).7 parathyroid glands were examined in the control group,while none in the observation group(χ2 =127.54,P<0.05).Conclusion Using naso-carbon during the thy-roid surgery,parathyroid gland cannot be stained black.The parathyroid gland can be easily identified and preserved.