Research progress in detection of lung cancer tumor markers by biosensors / 国际生物医学工程杂志

Lung cancer is one of the malignant tumors with the highest morbidity and mortality rate, and effective screening and early diagnosis methods can significantly reduce the morbidity and mortality rate of lung cancer patients. Traditional lung cancer detection methods mainly include imaging tests, sputum cell tests, bronchoscopy, and needle biopsy, but these methods have disadvantages such as being highly invasive, complicated operation processes, prone to false positives, and low detection index. Tumor markers can reflect the occurrence and development of tumors and can monitor the effect of tumor treatment. Therefore, tumor marker detection is of great significance for early cancer diagnosis. Biosensor technology is a new rapid detection technology with promising applications. In recent years, research related to biosensors has been intensified in clinical testing and biomedicine. In this paper, the traditional detection methods for lung cancer were briefly introduced, and the technologies and detection methods related to optical or electrochemical lung cancer tumor marker biosensors based on immunology, nanomaterials, and aptamers were highlighted in recent years, and the future development trend of lung cancer tumor marker biosensors was prospected.

A Standard Method for Performance Detection of Fluorescence Imaging System / 中国医疗器械杂志

Fluorescence imaging now becomes an intraoperative navigation technique that gaining popularity in surgery and clinical research. However, at present, there is no mature and reliable method or other related guidance documents for the detection of fluorescence imaging performance. The performance analysis and quality supervision of products on the market could not be performed, which affects their clinical use and image quality. In this paper, a standard method of fluorescence imaging performance testing for fluorescence imaging system is proposed. Several kinds of fluorescence imaging performance parameters affecting fluorescence images are defined strictly. We also recommend scientific and feasible methods for their detections and analyses, which are verified by practical examples. This paper aims to provide a feasible reference standard for fluorescence performance evaluation.

Drinking water and toilet sanitation of rural schools in Anhui during 2014-2018 / 中国学校卫生

Objective@#To understand current status of drinking water and toilet sanitation in rural schools of Anhui Province, and to provide basic knowledge for environmental sanitation improvement among rural schools in Anhui.@*Methods@#One primary school and one secondary school from each of the 5 villages from 24 counties in Anhui were selected during 2014-2018. Data was collected through information review, on-site inspections and interviews.@*Results@#School water supply methods were mainly based on local water supply from villages and towns, the rate was 58.16%, 58.95%, 65.07%, 62.78%, 67.69% from 2014 to 2018, respectively. Self-supplied water in some schools was initially untreated. The proportion of schools with sanitary toilets was 66.39%, 74.88%，76.26%，82.30%，94.20% during 2014 to 2018, respectively. The proportion of schools with toilets in the teaching building is lower than 30%. Proportions of schools with squatting toilets for girls was highest in 2017 (62.78%). The number of schools with no water faucets and no soap decreased by year, the lowest of 4.02% and 56.70% in 2018.@*Conclusion@#During the past five years, improvement has been observed in drinking water supply in rural schools in Anhui Province, however, the construction of toilets and surrounding environmental facilities still needs to be strengthened. The number of female toilet squats and the number of toilets in the teaching building and in the dormitory are relatively insufficient. While increasing the scale of toilet construction, it is also necessary to strengthen the quality of toilet management, and should pay attention to the relevant health education to teachers and students.

Effects of pricking and cupping combined with rehabilitation training on elbow flexion spasticity of upper limb after stroke and its IEMG value / 中国针灸

<p><b>OBJECTIVE</b>Based on rehabilitation training, to observe the clinical effect difference between pricking combined with cupping and western medication for elbow flexion spasticity of upper limb of stroke patients.</p><p><b>METHODS</b>Sixty patients were randomly assigned by SPSS software random number generator into a comprehension group and a western medication group, 30 cases in each one. Rehabilitation was used in the two groups. Pricking and cupping were applied at the affected abdominal center of biceps brachii muscle on Tuesday and Friday continuously for 4 weeks in the comprehensive group. Baclofen was prescribed orally continuously for 4 weeks, once 10 mg and 3 times a day in the western medication group. The indexes were observed before and after 4-week treatment as well as at immediate treatment, immediately after the first treatment in the comprehension group and 24 h after treatment in the western medication group, including the affected elbow joint activity, modified Ashworth scale (MAS), simple Fugl-Meyer assessment (FMA), integrated electromyogram (IEMG) of the affected biceps brachii and triceps brachii. The clinical effects were evaluated.</p><p><b>RESULTS</b>After treatment, the elbow joint activity in the two groups was improved compared with that before treatment (both＜0.05), with better result in the comprehension group (＜0.05). There was no statistical significance for MAS and FMA scores at immediate treatment between the two groups (both＞0.05). After treatment, the MAS score decreased and the FMA score increased in the two groups (both＜0.05), with better results in the comprehension group (both＜0.05). At immediate treatment and after treatment, biceps brachii IEMG decreased in the two groups (all＜0.05). The biceps brachii IEMG in the comprehension group at the immediate treatment was higher and that after treatment was lower compared with those in the western medication group (both＜0.05). The triceps brachii IEMG at immediate treatment was not statistically different from that before treatment in the comprehension group (＞0.05) and that in the western medication group decreased (＜0.05). After treatment, the triceps brachii IEMG increased in the two groups (both＜0.05), with higher IEMG in the comprehension group (＜0.05). The total effective rate was 83.3% (25/30) in the comprehensive group, which was higher than 60.0% (18/30) in the western medication group (＜0.05). .</p><p><b>CONCLUSION</b>Pricking and cupping combined with rehabilitation training can reduce the IEMG of the biceps brachii muscle in patients with stroke, and improve the spasticity and motor function.</p>

Effects of electroacupuncture at "Changqiang" (GV 1) on expression of nerve growth factor and brain derived neurotrophic factor in rats after acute spinal cord injury / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture (EA) at"Changqiang"(GV 1) on expression of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) in rats after acute spinal cord injury (ASCI), and to explore the mechanism of EA at"Changqiang"(GV 1) on ASCI.</p><p><b>METHODS</b>Twenty-four adult female SD rats were randomly divided into an EA group, a model group and a sham operation group, 8 rats in each one. The rats in the sham operation group were treated with laminectomy to expose the spinal cord without any strike. The rats in the model group and EA group were treated with modified Allen's method to establish ASCI model. After model was established, the rats in the EA group were treated with EA at"Changqiang"(GV 1), once a day for continuous 7 days. The rats in the sham operation group and model group were treated with immobilization, once a day, without any other interventions. The basso beattie bresnahan (BBB) was evaluated 1, 3, 5, 7 days after operation. 7 days after operation, the rats were sacrificed with perfusion and the spinal cord was embedded with paraffin. The morphological changes of spinal cord and neuron were observed by Nissl's staining method; the expressions of NGF and BDNF were detected by immune fluorescence method.</p><p><b>RESULTS</b>3 days, 5 days and 7 days after operation, the BBB scores in the EA group were higher than those in the model group (<0.05, <0.01). The Nissl's staining indicated the gray matter of spinal cord was butterfly-shaped with complete structure and clear boundaries between the gray and white matter; the tabby-shaped Nissl bodies were observed in cytoplasm. There were incomplete gray nucleus, big and saturate local stasis plaque. Compared with the model group, the smallerarea of blood stasis, less severity of neuron edema, better morphology of neuron and no vacuole change were observed in the EA group. The immune fluorescence results indicated the expressions of NGF and BDNF in the model group and EA group were higher than those in the sham operation group (all <0.01); the expressions of NGF and BDNF in the EA group were higher than those in the model group (both <0.01).</p><p><b>CONCLUSION</b>EA at"Changqiang"(GV 1) could improve the expression of NGF and BDNF and increase the score of BBB in rats with ASCI, which is beneficial to the repair of ASCI.</p>

Iatrogenic biliary stricture: a disastrous mistake in biliary surgery / 中华消化外科杂志

Traumatic biliary stricture,usually iatrogenic during biliary surgeries,is still a disastrous mistake because of its serious consequences.As the rapid development of hepatic surgery and liver transplantation and widespread use of laparoscopic cholecystectomy,patterns of traumatic biliary stricture changes in result as more complicated.In the future,more will be expected from the changes of the view point that the biliary system is actually an organ rather than merely an excretory duct,and,further more,the preservation of integrity of physiological function of the biliary tract should be considered during surgical repair.A simplified classification of bile duct injuries and biliary stricture is presented for discussion.

Prospect and destination of biliary surgery in the era of minimally invasive surgery / 中华消化外科杂志

Bile duct has great attraction to surgeons due to its special anatomical location,unique biological features and origin of complicate diseases.Minimally invasive surgery,represented by laparoscopic cholecystectomy and Davinci robotic surgical system,has brought technic revolutions to traditional biliary surgery.In order to understand the prospect and regression of biliary surgery in the new era,we need to upgrade the knowledge of the biliary system,and systemically investigate the anatomy and development of bile duct.The study of biliary system should follow the path of extrahepatic system to hilar and then to the intrahepatic system,and the intrahepatic biliary disease should be emphasised in this new era.

Surgeons in the era of minimally invasive surgery / 中华消化外科杂志

Since the success of the first case of laparoscopic cholecystectomy in 1987,minimally invasive surgery has become the most active field in all the branches of surgery.The traditional concept of surgery needs to be changed as the rapid development of surgical procedures,medical materials and devices,and the requirement of biopsychosocial model of medicine also poses great challenges to today's surgeons.Traditionally trained surgeons may find it difficult to adapt to the new developments.While,on the other hand,young laparoscopists may be at a loss when facing the difficulties encountered during the laparoscopic operation.The surgeons of tomorrow should have profound base of the knowledge of surgery and skillful in laparoscopy at the same time.

A new era for the development of general surgery / 中华消化外科杂志

General surgery has been the clinical foundation for all of the branches of the surgical specialties.The scientific principles developed in general surgery have spread through the specialties as well.This is the basis for surgical mastery.The rapid development of information sciences brings great opportunities for further developments in general surgery.General surgeons will be challenged to learn how to incorporate these advances into their practice.Integrating other disciplines such as digital imaging will be required for general surgeons in the 21st century.General surgeons should not only understand the essence of traditional general surgery,but also be proficient in the usage of advanced diagnostic and therapeutic tools which will lead to promoting further developments in general surgery.

Surgical management of incidental gallbladder cancer discovered during or after laparoscopic cholecystectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the surgical management of incidental gallbladder cancer (IGBC) discovered during or after laparoscopic cholecystectomy (LC) and to evaluate the associated factors of survival.</p><p><b>METHODS</b>A retrospective analysis of patients with IGBC between January 2002 and December 2013 was performed. A total of 10 080 consecutive patients underwent LC operation for presumed gallbladder benign disease in Chinese People's Liberation Army General hospital. And among them, 83 patients were histologically diagnosed as IGBC. Data covering clinical characteristics, surgery records, local pathological stage, histological features and factors for long term survival were reviewed. The survival analysis was performed using Kaplan-Meier method, and the results were examined using the log-rank test.For multivariate statistical analyses of prognostic factors, a Cox proportional hazards model was carried out.</p><p><b>RESULTS</b>A total of 83 patients with IGBC:68.7% females (57/83), median age of 61 years (range 34-83 years). There were 47 cases accepted the initial simple LC, 18 cases converted to open extended radical cholecystectomy, 16 cases with radical second resection, and 2 cases with re-laparotomy; the 5-year survival rates for each group were 89.4%, 38.9%, 87.5%, and 0, respectively. The 5-year survival rates in T1a, T1b, T2, and T3 stage patients were 95.7% (22/23), 90.0% (18/20), 75.0% (15/20), and 40.0% (8/20), respectively. Univariate analysis for prognostic factors associated with cancer-specific death showed that depth of invasion, lymph-node status, vascular or neural invasion, tumor differentiation, extent of resection, bile spillage during prior LC and type of surgery were statistically significant.In multivariate analysis, depth of invasion, extent of resection and bile spillage were the most important prognostic factors related to both cancer-specific mortality and disease relapse (P < 0.05).</p><p><b>CONCLUSIONS</b>Simple LC is appropriate for T1a patients with clear margin and unbroken gallbladder. An extended radical resection in patients with T1b or more is highly recommended, and provided as a potentially curative R0 resection only if it is necessary.</p>

Clinical application of precise liver surgery techniques for donor hepatectomy in living donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of techniques of precise liver surgery for donor hepatectomy in living donor liver transplantation.</p><p><b>METHODS</b>Eighty-nine donors aged from 19 to 57 years were performed by the same surgical team from June 2006 to December 2013 in Chinese People's Liberation Army General Hospital.Individualized surgical program were developed according to preoperative imaging examination and hepatic functional reserve examination. The evaluation included liver function, liver volume, vascular anatomy and bile duct anatomy. According to the results after the operation, preoperative evaluation accuracy, postoperative donor liver function and postoperative complications were analyzed. ANOVA analysis was used to compare the difference of graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight. Pearson correlation test and linear regression analysis were used to verify the correlation between the estimated graft volume each method and actual graft postoperative weight.</p><p><b>RESULTS</b>All the 89 cases operation protocol as following, there were 5 cases with left lateral lobe graft, 10 cases with left lobe liver graft, 74 cases with right lobe graft. There were 59 cases with middle hepatic vein (MHV) harvested, and 30 cases without MHV. The mean graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight were (656.2±134.1) ml, (631.7±143.2) ml and (614.5±137.7) ml respectively. ANOVA analysis results showed that there were no statistically significant difference in the three methods (P>0.05). Compared to the actual postoperative graft weight, the average error rate of the two methods were 7.9% and 5.3% respectively. Pearson correlation test showed the graft volume calculated by two-dimensional and three-dimensional methods had a significantly positive correlation with actual graft weight (r=0.821, 0.890, P<0.01) and linear regression analyze showed the R2 were 0.674 and 0.792, respectively. The accuracy rate of preoperative evaluation about portal vein, hepatic vein, hepatic artery and bile duct were 100%, 100%, 97.8% and 95.5%, respectively. The preoperative plan and postoperative practical scheme coincidence rate was 95.5%. Overall donor complication rate was 7.4%. All donors were alive. Sixteen donors received right lobe hepatectomy with gallbladder preserved had a good liver function and gallbladder function.</p><p><b>CONCLUSION</b>Through the precise preoperative evaluation, surgical planning, fine operation and excellent postoperative management, precise liver surgery technique can ensure the safety of donor in living donor liver transplantation.</p>

Effect of simulated 400 m He-O2 saturation diving on oxidative-antioxidative system in lungs of rats / 军事医学

Objective To investigate the effect of simulated 400 m He-O2 saturation diving on the pulmonary oxidative-antioxidative system in rats.Methods SD rats were exposed to 4.1 MPa He-O2 mixture for 24 h in an animal chamber. Normal air pressure was used in the control group .The histopathology , contents of malondialdehyde ( MDA) , 8-hydroxy-2′-deoxyguanosine(8-OHdG),and glutathione(GSH) and activities of superoxide dismutase (SOD) and glutathione peroxi-dase( GSH-Px) in pulmonary tissues were determined .Results No difference was found during pathological examination or in MDA, 8-OHdG and SOD activity.GSH and GSH-Px activity were decreased significantly (P<0.05) after hyperbaric exposure.Conclusion Exposure to 4.1 MPa He-O2 for 24 h may promote oxidative stress and reduce antioxidative capacity rather than cause obvious oxidative damage in rat lungs .

Liver transplantation for irresectable hilar cholangiocarcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the outcome of patients with irresectable hilar cholangiocarcinoma undergoing orthotopic liver transplantation (OLT) and to identify the prognostic factors that could influence survival.</p><p><b>METHODS</b>The data of 18 patients who underwent OLT for irresectable hilar cholangiocarcinoma between June 2003 and October 2010 were analyzed retrospectively. There were 12 male and 6 female cases with median of 52 years(range from 34 to 65 years).Fifteen patients underwent modified piggyback liver transplantation, 2 patients underwent classical orthotopic liver transplantation and 1 patient underwent living donor liver transplantation. Data were evaluated regarding tumor size, pathologic stage, overall survival, recurrence rates and prognostic factors.</p><p><b>RESULTS</b>OLT with lymphadenectomy was received by 18 patients with hilar cholangiocarcinoma. Median time until tumor recurrence was 20.5 months(range from 6.0 to 33.0 months). Seventeen patients died during follow-up.Of these, 14 patients died from recurrent or metastatic diseases, 2 patients died from multiple organ dysfunction syndrome during peri-operative period, and one patient died from other cause. The median survival time was 29.5 months(range from 3.0 to 84.0 months). The overall survival rate and recurrence-free survival rate at 1, 3, and 5 year were 16/18, 8/18, 1/18 and 13/18, 2/18, 1/18, respectively.Lymph node metastases had a statistically significant negative impact on overall survival. The 1, 3, and 5 year survival rates were 6/7, 1/7,0 and 10/11, 7/11, 1/11 (P < 0.05) in lymph node-positive and lymph node-negative patients.</p><p><b>CONCLUSIONS</b>Acceptable survival rates can be achieved by OLT for irresectable hilar cholangiocarcinoma without lymph node metastases.Strict patient selection plus multimodal chemoradiation therapy prior to OLT are recommend for patients with lymph node metastases.</p>

Perioperative factors related to prognosis of regular hepatectomy in comparison with irregular hepatectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The aim of this research was to analyze the perioperative factors of regular hepatectomy and irregular hepatectomy. The superiority of the clinical application of the two methods was compared in the perioperative period.</p><p><b>METHODS</b>From 1986 to 2011, 1798 patients underwent consecutive liver resections with regular hepatectomy and irregular hepatectomy at the Air Force General Hospital of People's Liberation Army and the General Hospital of Chinese People's Liberation Army. Their medical documentation was investigated retrospectively.</p><p><b>RESULTS</b>In patients on whom regular hepatectomy and irregular hepatectomy were performed, there was no significant difference in perioperative blood loss, complications, in-hospital mortality, hospital stay, and so on. But in regular hepatectomy, operating time was an independent risk factor (P < 0.001, OR = 1.004).</p><p><b>CONCLUSIONS</b>There was no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.</p>

Tissue-specific expression of the NOD-like receptor protein 3 in BALB/c mice

Activation of the innate immune system requires recognition of pathogen-associated molecular patterns, such as NOD-like receptors. The NOD-like receptor protein 3 (NLRP3) inflammasome is involved in induction of the pro-inflammatory cytokine, IL-1beta, and subsequent inflammatory responses. NLRP3 inflammasome plays important roles in the inflammatory and innate immune responses associated with autoimmune/inflammatory syndrome. However, analysis of the tissue distribution and expression profiles in BALB/c mice is still incomplete. In this study, we investigated the tissue distribution and expression pattern of NLRP3 in BALB/c mice to further elucidate its function in innate immunity in this commonly used laboratory animal model. NLRP3 mRNA expression levels and tissue distribution of the protein were investigated by real-time quantitative PCR and immunohistochemical analyses, respectively. NLRP3 mRNA expression was higher in the kidney and inguinal lymph nodes than in other tissues. Cytoplasmic expression of NLRP3 was detected in the epithelial reticular cells of the spleen and thymus, lymphocytes in the inguinal lymph nodes, cardiac muscle cells, cerebral cortex neurons, alveolar macrophages, renal tubule cells and liver sinusoidal endothelial cells. The results of this study will assist investigators in interpreting site-specific functions and roles of NLRP3 in inflammatory responses.

Enclosed passive infraversion lavage-drainage system / 中华肝胆外科杂志

This study gave a detailed explanation of the mechanism and method for the application of the enclosed passive infraversion lavage drainage system.In this drainage system,the rinse solution was infused into the peritoneal cavity passively rather than actively.This guarantees that the output of the solution was more than the input of the solution.It is also a safe and effective system in washing severe bile leakage and pancreatic fistula in the early stage after pancreatoduodenectomy.

Hilar cholangiocarcinoma / 中华消化外科杂志

Hilar cholangiocarcinoma (HCCA) occurs at the confluence of the right and left hepatic bile ducts.Because of the unique anatomical position and the biological behaviour of HCCA,hepatic vessels,nerves,lymph nodes and adjacent tissues are easily invaded by HCCA.The operation for HCCA is difficult,and the prognosis of patients is poor.Extended hepatectomy guided by imaging techniques shed light on the management of HCCA,while controversies on extended hepatectomy exist at home and abroad,and a standard treatment is needed to be formulated.Therefore,the surgical management for HCCA should be standardized for improving the radical resection rate,reducing the incidence of complications and mortality.

Improvement and effect of retroperitoneoscopic necrosectomy for infected necrotizing pancreatitis / 中华肝胆外科杂志

Objectives To evaluate the results and efficacy of gas-insufflated retroperitoneoscopic necrosectomy (GIRN) for proven infected necrotizing pancreatitis (INP).Methods 24 patients presenting proven infected pancreatic necrosis during course of acute pancreatitis were prospectively offered minimally invasive necrosectomy.A descriptive explanation of the GIRN was given together with the results of a retrospective analysis of all patients.Results All 24 patients who underwent retroperitoneoscopic necrosectomies survived.Postoperative hospitai stay ranged from 7 to 105 d (median,29 d).In 14 patients,GIRN yielded excellent results and avoided complementary treatment after a single session.7 patients underwent only one repeated session and the other 3 patients underwent 3 times.3 patients finally underwent laparotomy and necrosectomy due to remaining infected necroses in the peritoneal cavity.Conclusion GIRN has been found safe and is associated with a high success rate in our limited number of patients,and it should be regarded as a first-choice surgical option for INP.

Comparative studies of perioperative period correlation factor of hepatectomy treatment for liver malignant tumor / 中华肝胆外科杂志

Objective To compare superiorities of liver malignant tumors underwent regular and irregular hepatectomies through approaching perioperative factors.Methods 1019 consecutive hepatectomies of liver malignant tumor from 1986 to 2009 at Air Force General Hospital and General Hospital of Chinese PLA were investigated retrospectively according to their medical documentation.Results Multivariate analysis showed that liver malignant tumors on which regular hepatectomy and irregular hepatectomy were performed,there was no significant difference in the blood loss,complications,mortality related to operation,hospital stay,and so on.But the operating time of regular hepatectomy was obvious more than that of irregular hepatectomy (P＜ 0.001,OR=1.004).Conclusions Although for liver malignant tumor,regular hepatectomy seems to be superior to irregular hepatectomy based on oncological theory,in clinical practice,there were no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.

A new era for the development of general surgery / 中华消化外科杂志

General surgery has been the clinical foundation for all of the branches of the surgical specialties.The scientific principles developed in general surgery have spread through the specialties as well.This is the basis for surgical mastery.The rapid development of information sciences brings great opportunities for further developments in general surgery.General surgeons will be challenged to learn how to incorporate these advances into their practice.Integrating other disciplines such as digital imaging will be required for general surgeons in the 21st century.General surgeons should not only understand the essence of traditional general surgery,but also be proficient in the usage of advanced diagnostic and therapeutic tools which will lead to promoting further developments in general surgery.