Splenic vascular flow control in the use of laparoscopic spleen-preserving distal pancreatectomy (Kimura) / 中华普通外科杂志

Objective:To investigate the techniques used in blood flow control of Kimura laparoscopic spleen-preserving pancreatectomy (LSPDP).Methods:Forty·five patients with benign or low-grade malignant pancreatic diseases undergoing LSPDP at Huzhou Central Hospital from May 2014 to Oct 2021 were analyzed retrospectively. Patients were divided into splenic vascular flow control group ( n=22) and routine management group ( n=23). Results:There was no significant difference in gender, age, BMI, accompanying symptoms, hypertension, diabetes, lesion size and pathological diagnosis between the two groups (all P>0.05). A higher overall spleen preservation rate (90.9% vs. 52.2%, χ2=8.213, P=0.004), lower incidence of morbidity with Clavien grade ≥ Ⅱ (22.7% vs. 73.9%, χ2=9.911, P=0.002) and shorter postoperative hospital stay [(9.6±4.5) d vs. (14.3±6.6) d, t=2.447, P=0.008] were achieved in the vascular flow control group compared with those in the routine group. Conclusion:Splenic vascular flow control techniques improve the success rate of spleen preservation in laparoscopic distal pancreatectomy, reduce the postoperative complications and shorten the postoperative hospital stay.

Development of multifunctional medical flowmeter / 医疗卫生装备

Objective To fulfill the precise control of the liquid flow by a multifunctional medical flowmeter. Methods The flowmeter had a separated structure, and was composed of a liquid pipeline unit and a flow control unit. The flow control unit apprehended a velocity of liquid level changes in the sterile pipeline by ultrasonic sensing technique, and regulated fluid speed by a SCM-controlled electromagnetic valve. Results The requirements for sterile environment were fulfilled by the sterile liquid pipeline, and the flow control unit realized precision control of flow rate and achieved the expected effect. Conclusion The flowmeter has simple structure, low cost, convenient operation and use, can greatly reduce the workload of the nursing staff and the possible health risks, and thus is worthy promoting practically.

Noninvasive measurement of human blood glucose under flow control of time gate / 国际生物医学工程杂志

Objective In order to further improve the noninvasive measurement precision of human blood glucose and achieve clinical requirements,experiments were conducted to measure human blood glucose by a novel measurement method our group proposed.Methods The blood flow of the tested parts was stopped by pressure,and dynamic distribution of transmission spectra was measured by time-correlated single-photon counting (TCSPC) technology under the dual wavelength light incident.Oral glucose tolerance test (OGTT) was conducted on three human subjects,and the early arriving photons were selected by Laplace transform.Meanwhile,the human blood glucose concentration was measured using the Roche glucose meter.Results The best curve fitting was got when the Laplace parameter was 1Gs-1 (determining parameter R2=0.0922).Conclusions The experimental results showed that better measurement accuracy can be obtained by selecting appropriate Laplace parameter,and noninvasive measurement of human blood glucose under flow control of time gate was feasible.

N-Butyl Cyanoacrylate Embolization with Blood Flow Control of an Arterioportal Shunt That Developed after Radiofrequency Ablation of Hepatocellular Carcinoma

We present a case of a patient with rapid deterioration of esophageal varices caused by portal hypertension accompanied by a large arterioportal shunt that developed after radiofrequency ablation of hepatocellular carcinoma. We used n-butyl cyanoacrylate (NBCA) as an embolic material to achieve pinpoint embolization of the shunt, because the microcatheter tip was 2 cm away from the shunt site. Under hepatic arterial flow control using a balloon catheter, the arterioportal shunt was successfully embolized with NBCA, which caused an improvement in the esophageal varices.

Interferential electrical stimulation improves peripheral vasodilatation in healthy individuals

BACKGROUND: Interferential electrical stimulation (IES), which may be linked to greater penetration of deep tissue, may restore blood flow by sympathetic nervous modulation; however, studies have found no association between the frequency and duration of the application and blood flow. We hypothesized that 30 min of IES applied to the ganglion stellate region might improve blood flow redistribution. OBJECTIVES: The purpose of this study was to determine the effect of IES on metaboreflex activation in healthy individuals. METHOD: Interferential electrical stimulation or a placebo stimulus (same protocol without electrical output) was applied to the stellate ganglion region in eleven healthy subjects (age 25±1.3 years) prior to exercise. Mean blood pressure (MBP), heart rate (HR), calf blood flow (CBF) and calf vascular resistance (CVR) were measured throughout exercise protocols (submaximal static handgrip exercise) and with recovery periods with or without postexercise circulatory occlusion (PECO+ and PECO -, respectively). Muscle metaboreflex control of calf vascular resistance was estimated by subtracting the area under the curve when circulation was occluded from the area under the curve from the AUC without circulatory occlusion. RESULTS: At peak exercise, increases in mean blood pressure were attenuated by IES (p<0.05), and the effect persisted under both the PECO+ and PECO- treatments. IES promoted higher CBF and lower CVR during exercise and recovery. Likewise, IES induced a reduction in the estimated muscle metaboreflex control (placebo, 21±5 units vs. IES, 6±3, p<0.01). CONCLUSION: Acute application of IES prior to exercise attenuates the increase in blood pressure and vasoconstriction during exercise and metaboreflex activation in healthy subjects. .

Mechanisms of heat acclimation with endurance training in humans: a role of active cutaneous vasodilator / 体力科学

Hypovolemia and hyperosmolality due to thermal dehydration suppress thermoregulatory responses of sweating and cutaneous vasodilation in humans, resulting in increasing a risk of heat illness. Recently, we found in young and older subjects that an ingestion of carbohydrate-protein supplement immediately after a bout of exercise during training accelerated an increase in plasma volume and an improvement of thermoregulatory responses. These results suggest that change in plasma volume alters cutaneous vasodilation and sweat rate through baroreflexes; however, no electrical signals in the efferent path of the reflex loop have not been identified. We have recently successfully recorded skin sympathetic nerve signal components synchronized and non-synchronized with cardiac cycles, separately, in passively heated young subjects, and found that although both components increased with cutaneous vasodilation and sweat rate in hyperthermia, an increase in synchronized component was suppressed by hypovolemia with suppressed cutaneous vasidilation, while an increase in non-synchronized component was not suppressed as sweat rate. On the other hand, we found that hyperosmolality suppressed the increases of both components with suppressed cutaneous vasodilation and sweat rate. These results suggest that a synchronized component controls cutaneous vasodilation while a non-synchronized component controls sweat rate, and also that beat-by-beat changes in atrial pressure due to a fluctuation of venous return to the heart varies cutaneous vasodilation through baroreflexes but not sweat rate.

Prótese para controle de fluxo esofagiano como nova técnica para o tratamento da obesidade / Prosthesis for flow control in the esophagus as a new technique for the treatment of obesity

O presente artigo apresenta uma invenção desenvolvida para auxílio à redução e ao controle da obesidade, embasado no controle do fluxo de alimentos no esôfago. Neste novo método proposto, um dispositivo colocado no esôfago diminui seu raio efetivo, reduzindo, por consequência, a velocidade e o fluxo com que o alimento pode ser consumido. A base do método é um dispositivo denominado módulo de látex, com formato aproximadamente cilíndrico, que é aplicado no esôfago. Este módulo contém um lúmen central, com diâmetro consideravelmente menor que o diâmetro do esôfago, que limita a passagem de alimento pelo órgão. Na concepção do método e do módulo, buscou-se realizar o controle de fluxo alimentar através do esôfago, sem causar agressões ao tecido, e sem comprometer a digestão e absorção dos alimentos. Desenvolvido a partir do látex natural, extraído da seringueira Hevea brasiliensis, tal módulo foi avaliado quanto a características construtivas e mecânicas, aplicabilidade, facilidade de remoção, eficácia na redução de fluxo, peso e danos ao esôfago. O módulo foi posicionado no esôfago por meio de vídeo-endoscopia em um cão piloto e manteve-se no local por sete dias, nos quais foi acompanhado por meio de radiografias sucessivas até a sua retirada, momento em que foi avaliada a integridade da mucosa esofágica. Os resultados apresentados demonstram que o método proposto é uma nova possibilidade de controle e redução da obesidade em pessoas e animais.

This work introduces a device to aid in the treatment of obesity by controlling the flow of substances in the esophagus. In the method proposed, a device placed in the esophagus reduces its effective radius, thus reducing the flow and speed in which the food can be consumed. The basis of the method is a nearly cylindrical latex module, which is applied in the esophagus. The module’s central lumen diameter is considerably smaller than the diameter of the esophagus. This limits the rate of food passage through the esophagus. The device was designed in such a way that it could control the food flow through the esophagus without causing aggression to its internal tissue and without compromising the digestion and absorption of food. The device was built using natural latex from the rubber tree Hevea brasiliensis, and was evaluated according to its construction, mechanical properties, applicability, effectiveness in reducing food flow, weight, and damage to the esophagus. The module was placed in the esophagus by means of video-endoscopy and remained in place for seven days, where in it was accompanied by successive radiographies until its with drawal by video-endoscopy, when we were able to examine the integrity of the esophagus wall. The results presented in this paper show that the proposed method is a new possibility for the treatment of obesity in humans and animals.