Cardiopulmonary effects of prolonged surgical abdominal retractors application during general anesthesia: a prospective observational comparative study

Abstract Introduction: Increasing abdominal pressures could affect pulmonary compliance and cardiac performance, a fact based on which the aim of the present study to detect the cardiopulmonary burden of multiple retractors application during supine versus lateral abdominal surgeries. We hypothesized that surgical ring multiple retractors application would affect the pulmonary and cardiac functions during both lateral and supine abdominal surgeries. Methods: Prospective observational comparative study on forty surgical patients subdivided into two groups twenty each, comparing pulmonary compliance and cardiac performance before, during and after retractors application, group (S) supine position cystectomy surgery, and group (L) lateral position nephrectomy surgery under general anesthesia, Composite 1ry outcome; dynamic compliance C-dyn and cardiac index CI and Other outcome variables ICON cardio-meter were also recorded. Results: C-dyn and C-stat were significantly decreased late during retractor application in lateral compared to supine surgery with significant decrease compared to basal values all over the surgical time. CI was significantly increased after retractor removal in both of the study groups compared to basal values. PAW P was significantly increased in -lateral compared to supine surgery -with significant increase compared to basal value all over the surgical time in both of the study groups. significant increase in DO2I compared to basal value during both supine and lateral positions. Conclusion: Surgical retraction results in a short-lived significant decreases in lung compliance and cardiac output particularly during the lateral-kidney position than the supine position compliance.

Research status of machine perfusion of heart / 器官移植

High-quality donor heart is the prerequisite and fundamental guarantee for successful heart transplantation. Reasonable donor heart preservation technique plays a key role in improving the quality of donor heart and the prognosis of heart transplantation. Static cold storage (SCS) is currently the standard preservation technique for cardiac allograft. However, it is prone to cause severe cold ischemia injury to the donor heart, and it is impossible to evaluate heart function during SCS. As an important emerging technique of organ preservation, machine perfusion better matches with physiological conditions compared with SCS, which may remove metabolic wastes and provide basic substances for metabolic needs during organ preservation, prolong the preservation time and improve the preservation effect to a certain extent. Besides, it may also effectively evaluate organ function and improve clinical prognosis of heart transplantation. Meantime, it can also repair organ damage, significantly optimize organ quality and improve the utilization rate of donor organs. In this article, research status of machine perfusion of donor heart was reviewed.

Vibration sensation associated with motor function has specific frequency characteristics in community-dwelling older Japanese adults / 体力科学

Vibration sensation is related to motor function. However, it is unclear which vibration frequencies are associated with motor function. Therefore, in this cross-sectional study, we investigated whether a specific frequency of vibration sensation could explain motor functions. Thirty-two community-dwelling Japanese healthy older adults aged 70 years or older participated in the present study. Grip strength, one-leg standing time, and 10-m walking time were evaluated as indicators of motor function. Vibratory (40, 128, and 256 Hz) and tactile sensory tests were examined as sensory functions. Grip strength per body weight was significantly correlated with sex, body mass index, falls efficacy scale, vibration sensation with 40 and 128 Hz, and 10-m walking time (P < 0.05). Furthermore, one-leg standing time showed a correlation between vibration sensation (128 and 256 Hz) and fall history (P < 0.05). However, 10-m walking time was significantly correlated with only the grip strength to body weight ratio. Multiple regression analysis showed that vibration sensation with 128 Hz (β = 0.427) and sex (β = -0.335) (P < 0.05) were significant independent variables associated with grip strength to body weight ratio. Vibration sensation with 256 Hz (β = 0.465) and age (β = -0.343) (P < 0.05) were significant independent variable associated with one-leg standing time. No significant variables were identified for the 10-m walking time. Vibration sensation associated with motor function shows specific frequency characteristics in community-dwelling older Japanese adults.

Research status and progress on limb preservation technology / 器官移植

Limb replantation and transplantation is the optimal treatment for traumatic limb amputation. Safe and effective limb preservation is the key factor to determine the success of limb replantation and transplantation. Currently, static cold storage is the gold standard of limb preservation. However, the preservation time is short, which may no longer meet clinical requirements. With rapid development of organ preservation in recent years, novel preservation technologies, such as ultra-low temperature preservation, supercooling preservation and mechanical perfusion preservation, have successively emerged. However, at present, these techniques are primarily applied to the preservation of solid organs rather than composite tissue allografts with blood vessels including limbs. In this article, research status and progress on the application of static cold storage and mechanical perfusion preservation in limb preservation were reviewed, aiming to provide reference for clinical application of limb preservation technology and promote the development of limb replantation and transplantation.

Liver graft preservation and functional maintenance accelerate the development of liver transplantation / 器官移植

As an effective treatment for end-stage liver disease, liver transplantation has been widely carried out worldwide and gradually captivated widespread recognition. With the advancement of liver transplantation techniques, the incidence of postoperative complications has been gradually declined, and the short-term and long-term prognosis of recipients have been constantly improved. However, a huge gap has existed between the supply and demand of donor organs, which is a major factors restricting the development of liver transplantation. The amount of liver transplantation operation in China is increasing year by year, the shortage of donor liver is becoming more and more prominent, and marginal donor liver is increasingly used in clinic. In recent years, the selection criteria of donor organs, organ preservation and functional maintenance have been continuously improved. In this article, the application and development trend of different techniques were reviewed from the perspectives of donor liver preservation and functional maintenance, and recent technical development and research results were summarized, aiming to provide reference for further enhancing the survival rate of grafts and recipients and promoting the development of liver transplantation in China.

Application and Progress of Digital Navigation Technology in Micro-apical Surgery / 中国医疗器械杂志

As imaging technology develops rapidly, dynamic and static guided technology is widely used in many medical fields now. In order to improve the success rate, reduce surgical complications and improve future prognosis, domestic and foreign experts have introduced digital navigation technology into apical surgery. With the help of digital navigation technology, apical lesions can be easily located and the scope of osteotomy can be limited, which can make the surgery be completed accurately, especially in complex clinical cases. This study overviews the clinical use and research progress of dynamic and static guided technology in apical surgery, summarizes the advantages and disadvantages of this technique as well as looks forward to its future.

Effect of hypothermic machine perfusion on expression levels of inflammatory cytokines in rat kidney / 器官移植

Objective To evaluate the effect of hypothermic machine perfusion (HMP) on the expression levels of inflammatory cytokines in rat kidney. Methods Thirty male rats were randomly divided into the control (Control group), static cold storage group (SCS group) and HMP group, with 10 rats in each group. The velocity, intrarenal resistance and pH value of perfusion effluent were recorded during HMP. The expression levels of CXC chemokine ligand (CXCL)1, CXCL2, interferon (IFN)-β1, IFN-α4, CC chemokine ligand (CCL)2, CCL20, interleukin (IL)-17α, IL-17C and tumor necrosis factor (TNF)-α messenger RNA (mRNA) in renal tissues were evaluated by reverse transcription polymerase chain reaction (RT-PCR). Pathological changes of the kidney were observed by hematoxylin-eosin (HE) staining. Results During HMP, the velocity and intrarenal resistance remained stable, and the pH value of perfusion effluent was decreased slowly. RT-PCR showed that the relative expression levels of CXCL1, CXCL2, CCL2, CCL20, IL-17α, IL-17C and TNF-α mRNA in the SCS and HMP groups were higher compared with those in the Control group. Compared with the SCS group, the relative expression levels of CXCL1, CXCL2, CCL2, CCL20, IL-17α and TNF-α mRNA were up-regulated in the HMP group (all P<0.05). HE staining revealed that the morphology of renal cells was normal in the Control group, whereas evident epithelial necrosis, cytoplasmic vacuolation, brush border loss and epithelial shedding were observed in the SCS group. Compared with the SCS group, pathological changes in the HMP group were alleviated. Conclusions HMP may activate renal inflammation, and inhibiting the activation of inflammation during HMP is expected to further improve the effect of allograft preservation.

Preparation of static training animal models and research status analysis / 针灸推拿医学（英文版）

As a form of Tuina(Chinese therapeutic massage)Qigong exercises and an essential part of exercise therapy,static training has proven clinical efficacy.However,further evidence is required to reveal its mechanism of action provided by animal experiments.There are four major ways to establish static training animal models:pole climbing,hind-limb suspension,isometric-contraction weight bearing,and electrical stimulation.These models have been used to study diseases of the motor,circulatory,and endocrine systems,etc.,and the mechanism has got extensive exploration.It reviewed static training animal models and the research progress to provide theoretical evidence for static training's experimental research and mechanism exploration.

Effect of autologous fat transplantation on facial contouring / 中华医学美学美容杂志

Objective:To explore the application experience of autologous fat transplantation in improving the facial contour of young cosmetic patients.Methods:From October 2017 to October 2020, the plastic surgery department of Beijing Tsinghua Changgung Hospital admitted 10 young cosmetic patients with poor facial contours, including 1 male and 9 females, aged 18-35 years, with an average of 28 years. Autologous subcutaneous fat was harvested by liposuction and static purification and then injected into the areas with poor facial contour with an amount of 10%-30% over.Results:The facial contour of 10 young cosmetic patients was well improved, and there were no postoperative complications such as facial asymmetry, local uneven skin, skin infection and necrosis or fat embolism. 8 cases were filled once and 2 cases were filled twice. The patients were followed up for 6-24 months and the postoperative effect was good. The excellent and good rate evaluated by patients, plastic surgeon and the third party doctor was more than 80%.Conclusions:The use of autologous fat to improve the facial contour of young cosmetic patients is easy to operate with less trauma and good effect, which is worthy of promotion.

A Case of Laryngeal Venous Malformation Successfully Treated with Keishibukuryogan and Daiokanzoto / 日本東洋医学雑誌

Laryngeal venous malformation has a risk of airway obstruction due to its enlargement or bleeding. It requires treatment such as sclerotherapy, laser treatment or surgery. However, adult-type laryngeal venous malformation occurs frequently in the upper part of the glottis, and causes almost no symptoms except when it occurs in the vocal cords. So some patients do not wish to undergo surgery. This time, we describe a case of an asymptomatic laryngeal venous malformation patient who did not wish to receive laser treatment, and was significantly improved by Kampo medicine. The patient was a 69-year-old man. He consulted us because of an accidental laryngeal mass on upper gastrointestinal endoscopy during a medical examination, but he had no particular pharyngeal symptoms. A venous malformation was found in the upper part of the right glottis, and we recommended him laser treatment. But he did not wish it because he had no symptoms. We considered the condition of static blood (oketsu), and administered keishibukuryogan for 7 weeks, but there was no change. Since he had constipation, we administered daiokanzoto together with keishibukuryogan, and his bowel movement improved. Thirteen weeks after the beginning of the combined use, the venous malformation also remarkably reduced.

Effect of couch rotation angle on non-coplanar static intensity-modulated radiotherapy plan for gastric cancer / 中国辐射卫生

Objective To investigate the effect of couch rotation angle on non-coplanar static intensity-modulated radiotherapy (IMRT) plan for gastric cancer and to provide a reference for clinical planning. Methods A retrospective analysis was conducted on patients who recently underwent postoperative IMRT for gastric cancer. Twenty patients who received radiotherapy in the centre of Radiation Oncology of Huanggang Central Hospital from August 2022 to January 2023 were selected. That were selected to receive a seven-field coplanar static IMRT plan based on a couch rotation angle of 0° as the control group. Then, based on the coplanar IMRT plan, only the couch rotation angle of gantry angles 30° and 330° was changed to 10°, 20°, 30°, 40°, 50°, 60°, 70°, 80°, and 90°, respectively, and nine different non-coplanar plans were established. The homogeneity index (HI), conformity index (CI) of the target volume, and monitor unit (MU), as well as Dmean, V20, and V30 of the left and right kidneys, Dmax, Dmean, V10, V20, and V30 of the spinal cord, and Dmax, Dmean, V10, V20, V30, and V40 of the small intestine and liver were compared among the 10 plans. The MU and the dosimetric parameters of the target volumes and When the couch rotation angle was 60°, the minimum HI and maximum CI of the target volume were 0.0714±0.0089 and 0.9271±0.0108, respectively, and the minimum MU was 438±26, with the best homogeneity and conformity in the target volume and the shortest machine treatment time (P＜0.05). When the couch rotation angle was 10°, the Dmax of the small intestine was lowest, being (4620.73±99.27) cGy. When the couch rotation angle was 60°, the Dmean of the left and right kidneys was lowest, being (1246.30±130.35) cGy and (1001.52±103.33) cGy, respectively; the V20 of the left and right kidneys was lowest, being 22.87±6.29 and 19.69±1.84, respectively; the V10 and V30 of the spinal cord were lowest, being 40.08±4.92 and 1.68±0.34, respectively (P＜0.05). Conclusion The couch rotation angle has some influence on the postoperative treatment planning for patients with gastric cancer. In the design of non-coplanar plan for gastric cancer, the couch rotation angle of 60° contributes to establishing a better radiotherapy plan.

Development status and new challenges of heart transplantation / 器官移植

Heart transplantation is the primary therapeutic option for patients with end-stage heart failure. The shortage of donors has been the main limiting factor for the increasing quantity of heart transplantation. With persistent updating and introduction of novel technologies, the donor pool has been increasingly expanded, such as using the heart from older donors, donors infected with hepatitis C virus, donors dying from drug overdose or donation after cardiac death (DCD) donors, etc. Meantime, the proportion of recipients with advanced age, multiple organ dysfunction, mechanical circulatory support and human leukocyte antigen antibody sensitization has been significantly increased in recent years. The shortage of donors, complication of recipients' conditions, individualized management of immunosuppressive therapy and prevention and treatment of long-term cardiac allograft vasculopathy are all challenges in the field of heart transplantation. In this article, novel progresses on donor pool expansion, improving the quality of recipients, strengthening the diagnosis and treatment of rejection, and preventing cardiac allograft vasculopathy were reviewed, aiming to prolong the survival and enhance the quality of life of patients with end-stage heart failure on the waiting list or underwent heart transplantation.

Do static and dynamic pupillary parameters differ according to childhood, adulthood, and old age? A quantitative study in healthy volunteers

Purpose: We aimed to evaluate the normative pupillometry values and mean pupil dilatation speed in healthy individuals in different age groups in our study. Methods: The study group included 180 eyes of 90 healthy volunteers in different age groups. Group 1 consisted of 30 participants between the ages of 6 and 18, group 2 consisted of 30 participants aged 19–40, and group 3 consisted of 30 participants aged 41–75. Scotopic, mesopic, photopic, and dynamic measurements were taken with automatic pupillometry of Sirius Topographer (CSO, Firenze, Italy). The mean pupil dilation speed at the 18th second was calculated according to dynamic measurements. Results: Group 1 had a significantly larger pupil diameter than groups 2 and 3 in all static and dynamic parameters, and the mean pupil dilation speed was the highest among the groups (P < 0.001 for all static and dynamic parameters). In addition, group 2 had a significantly larger pupil diameter than group 3 (P < 0.001 for all static and dynamic parameters) and the mean pupil dilation speed was faster than group 3 (P = 0.027). Conclusion: We have presented the static and dynamic parameters and the mean speed of pupil dilatation at the 18th second with automatic pupillometry in healthy individuals in childhood, adulthood, and old age. More studies with higher participants and younger age children are needed.

Carbon dots derived from Poria cocos polysaccharide as an effective"on-off"fluorescence sensor for chromium(Ⅵ)detection / 药物分析学报

Chromium is a harmful contaminant showing mutagenicity and carcinogenicity.Therefore,detection of chromium requires the development of low-cost and high-sensitivity sensors.Herein,blue-fluorescent carbon quantum dots were synthesized by one-step hydrothermal method from alkali-soluble Poria cocos polysaccharide,which is green source,cheap and easy to obtain,and has no pharmacological ac-tivity due to low water solubility.These carbon quantum dots exhibit good fluorescence stability,water solubility,anti-interference and low cytotoxicity,and can be specifically combined with the detection of Cr(Ⅵ)to form a non-fluorescent complex that causes fluorescence quenching,so they can be used as a label-free nanosensor.High-sensitivity detection of Cr(Ⅵ)was achieved through internal filtering and static quenching effects.The fluorescence quenching degree of carbon dots fluorescent probe showed a good linear relationship with Cr(Ⅵ)concentration in the range of 1-100 μM.The linear equation was F0/F=0.9942+0.01472[Cr(Ⅵ)](R2=0.9922),and the detection limit can be as low as 0.25 μM(S/N=3),which has been successfully applied to Cr(Ⅵ)detection in actual water samples herein.

Normothermic machine perfusion of kidney and ischemia-free kidney transplantation / 器官移植

To increase the utilization rate of expanded criteria donor (ECD) kidney, the kidney preservation methods have been ever advancing in recent years. The application of normothermic machine perfusion (NMP) promotes the preservation, evaluation and repair of ex vivo donor kidneys and accelerates the innovation of surgical approaches of kidney transplantation. Ischemia-free kidney transplantation (IFKT), which initiated by Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, keeps the blood flow and oxygen supply of the donor kidney with NMP machine during the entire process of acquisition, preservation and transplantation, thereby fundamentally avoiding ischemia-reperfusion injury (IRI) of the donor kidney and reducing the risk of delayed graft function (DGF) and acute rejection after surgery. In this article, recent progresses upon the kidney NMP, surgical procedures and short-term outcomes of IFKT were reviewed, aiming to provide reference for enhancing the utilization rate of ECD donor kidney and resolving the issue of organ shortage.

Static balance and limits of stability in patients with cervical vertigo / 中国康复理论与实践

@#Objective To analyze the characteristics of static balance and limits of stability (LOS) in patients with cervical vertigo (CV). Methods From January, 2020 to August, 2021, 30 CV patients in our hospital (vertigo group) and 30 healthy people (control group) were selected and tested with PRO-KIN system, under the conditions of eyes open and closed. The standard deviation of the vertical and horizontal amplitude, the mean of vertical and horizontal sway velocities, the area of the movement, the length of the movement, and LOS at eight directions, The Romberg ratios of the area and the length were caculated. Results All the indicators of the static balance were higher under eyes closed than under eyes open in both groups (|Z| > 2.138, P < 0.05); whether under the eyes open or closed, the static balance indicators were higher in the vertigo group than in the control group (|Z| > 2.004, P < 0.05), except for the mean of horizontal sway velocities (|Z| < 1.026, P > 0.05). The LOS and total LOS completion percentage in the front (upper right, right above, upper left) were lower in the vertigo group than in the control group (|Z| > 2.240, P < 0.05). Conclusion The static balance abilities decrease for CV patients, and the balance control depends on visual compensation. The range of LOS reduces, means a higher risk of falling.

Research progress on application of machine perfusion in quality maintenance of donor kidney from organ donation after citizen's death / 器官移植

Organ donation after citizen's death has become the main source of organ donation in China. However, the complexity of donor quality and the increasing proportion of expanded criteria donor (ECD) exert significant impact upon the availability of donor kidney and the long-term prognosis of recipients after kidney transplantation. Strengthening the quality maintenance and evaluation of donor kidney is of great significance for improving the quality of donor kidney, increasing the procurement and utilization of donor kidney and prolonging the long-term survival of recipients and kidney allografts. As one of the major approaches of organ preservation, machine perfusion preservation may not only prolong the preservation time and improve the quality of donor kidney, but also play a critical role in the repair and function evaluation of donor kidney. Based on literature review, several hot issues, corresponding treatment strategies and research progress on machine perfusion in the quality maintenance of donor kidney from organ donation after citizen's death were reviewed in this article, aiming to provide reference for selecting the optimal preservation method of donor kidney and enhancing the quality and utilization rate of ECD donor kidney.

Chinese expert consensus on organ protection of transplantation (2022 edition) / 器官移植

Organ transplantation is the most effective treatment for end-stage organ failure, and voluntary donation after citizen's death is the only source of transplant organ in China. Clinically, transplant organ protection technique plays a critical role in improving the quality of transplant organs and the prognosis of recipients. On the basis of domestic and worldwide basic research and clinical practice of transplant organ protection and according to the Oxford evidence classification and GRADE system, the experts organized by Branch of Organ Transplant Physicians of Chinese Medical Doctor Association, Branch of Transplantation Group of Surgery of Chinese Medical Association and China Liver Transplant Registry Scientific Committee had compiled and published the Chinese Expert Consensus on Organ Protection of Transplantation (2016 edition) for liver, kidney, pancreas, small intestine, heart, lung transplant organs. With the support of China Liver Transplant Registry, National Trauma Medical Center, National Quality Control Center for Human Donated Organ Procurement, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation and National Center for Healthcare Quality Management in Liver Transplant combined with recent domeatic and worldwide clinical practice and research progress for organ transplantation and organ protection, the Chinese Expert Consensus on Organ Protection of Transplantation (2022 edition) has been published recently. This consensus focuses on updating the technical progress and evidence-based medicine of organ procurement, preservation, transport, and quality evaluation in clinical practice. Additionally, the content of composite tissue transplantation mainly including limb transplantation has also been covered. The aim is to promote the the scientific and standardized clinical organ transplantation.

Integrating dynamic elements to static biochemistry-the practice of unitized "micro-teaching" / 生物工程学报

As the content of static biochemistry is boring and traditional cramming education fails to draw the attention of students, we divided the course into small units and then made full use of "micro-teaching" resources such as multimedia slides, pictures, objects, experimental demonstrations and animations of the biochemical principles. The method created a "micro-teaching" environment, which combined boring static knowledge with vivid dynamic elements, thus producing a strong sensory impact on students, highlighting the knowledge in their mind, prompting students' participation, and greatly improving the teaching effects. This article introduces the goals and development process of this teaching method, and takes "Protein Denaturation and Renaturation" as an example to demonstrate the design and implementation process of the "micro-teaching", which seems to be of great significance to the improvement of the teaching quality of biochemistry course and serves as a reference for reform in other courses.

Evaluation Method of Static Balance Ability Based on Human Pelvic Center Measurement / 中国医疗器械杂志

This study evaluates the static balance ability of human body based on lower limb rehabilitation robot.According to the balance parameters obtained from the movement trajectory of the center of human pelvis, SPSS statistical software was used to verify that there was significant difference between the two groups (P<0.01). Principal component analysis is used to allocate the weight of each parameter and establish the comprehensive evaluation value. The comprehensive evaluation value of the control group was 0.383±0.038, and the experimental group was 0.875±0.136. When the subject's comprehensive evaluation value is between 0.739 and 1.011, it indicates the presence of balance dysfunction, and when it is between 0.345~0.421, it indicates that the balance of the lower limbs of the subject is normal. Experimental results show that this evaluation method can objectively and quantitatively reflect the static equilibrium state of human body.