Application of enhanced recovery after surgery in abdominal tumor surgery / 中国肿瘤临床

Enhanced recovery after surgery (ERAS) represents a transformation to the evidence-based medicine paradigm in perioperative treatment. ERAS aims to reduce recovery time, postoperative complications, and healthcare costs. Here, we review the development and principal components of ERAS along with its application in abdominal tumor surgery. The benefits and feasibility of the ERAS protocol have been demonstrated in clinical practice, particularly in relation to colorectal surgery.

Evidence for probable aerosol transmission of SARS-CoV-2 in a poorly ventilated restaurant

BackgroundThe role of aerosols in the transmission of SARS-CoV-2 remains debated. We analysed an outbreak involving three non-associated families in Restaurant X in Guangzhou, China, and assessed the possibility of aerosol transmission of SARS-CoV-2 and characterize the associated environmental conditions. MethodsWe collected epidemiological data, obtained a video record and a patron seating-arrangement from the restaurant, and measured the dispersion of a warm tracer gas as a surrogate for exhaled droplets from the suspected index patient. Computer simulations were performed to simulate the spread of fine exhaled droplets. We compared the in-room location of subsequently infected cases and spread of the simulated virus-laden aerosol tracer. The ventilation rate was measured using the tracer decay method. ResultsThree families (A, B, C), 10 members of which were subsequently found to have been infected with SARS-CoV-2 at this time, or previously, ate lunch at Restaurant X on Chinese New Years Eve (January 24, 2020) at three neighboring tables. Subsequently, three members of family B and two members of family C became infected with SARS-CoV-2, whereas none of the waiters or 68 patrons at the remaining 15 tables became infected. During this occasion, the ventilation rate was 0.75-1.04 L/s per person. No close contact or fomite contact was observed, aside from back-to-back sitting by some patrons. Our results show that the infection distribution is consistent with a spread pattern representative of exhaled virus-laden aerosols. ConclusionsAerosol transmission of SARS-CoV-2 due to poor ventilation may explain the community spread of COVID-19.

Transmission dynamics of 2019 novel coronavirus (2019-nCoV)

RationaleSeveral studies have estimated basic production number of novel coronavirus pneumonia (NCP). However, the time-varying transmission dynamics of NCP during the outbreak remain unclear. ObjectivesWe aimed to estimate the basic and time-varying transmission dynamics of NCP across China, and compared them with SARS. MethodsData on NCP cases by February 7, 2020 were collected from epidemiological investigations or official websites. Data on severe acute respiratory syndrome (SARS) cases in Guangdong Province, Beijing and Hong Kong during 2002-2003 were also obtained. We estimated the doubling time, basic reproduction number (R0) and time-varying reproduction number (Rt) of NCP and SARS. Measurements and main resultsAs of February 7, 2020, 34,598 NCP cases were identified in China, and daily confirmed cases decreased after February 4. The doubling time of NCP nationwide was 2.4 days which was shorter than that of SARS in Guangdong (14.3 days), Hong Kong (5.7 days) and Beijing (12.4 days). The R0 of NCP cases nationwide and in Wuhan were 4.5 and 4.4 respectively, which were higher than R0 of SARS in Guangdong (R0=2.3), Hongkong (R0=2.3), and Beijing (R0=2.6). The Rt for NCP continuously decreased especially after January 16 nationwide and in Wuhan. The R0 for secondary NCP cases in Guangdong was 0.6, and the Rt values were less than 1 during the epidemic. ConclusionsNCP may have a higher transmissibility than SARS, and the efforts of containing the outbreak are effective. However, the efforts are needed to persist in for reducing time-varying reproduction number below one. At a Glance CommentaryO_ST_ABSScientific Knowledge on the SubjectC_ST_ABSSince December 29, 2019, pneumonia infection with 2019-nCoV, now named as Novel Coronavirus Pneumonia (NCP), occurred in Wuhan, Hubei Province, China. The disease has rapidly spread from Wuhan to other areas. As a novel virus, the time-varying transmission dynamics of NCP remain unclear, and it is also important to compare it with SARS. What This Study Adds to the FieldWe compared the transmission dynamics of NCP with SARS, and found that NCP has a higher transmissibility than SARS. Time-varying production number indicates that rigorous control measures taken by governments are effective across China, and persistent efforts are needed to be taken for reducing instantaneous reproduction number below one.

FBP initialized few-view CT reconstruction algorithm using similar prior image constraint.

Few-view CT reconstruction attracts wide attention in the purpose of radiation dose reduction. For analytical algorithm filtered back projection (FBP), the reconstructed image would have extremely severe artifacts. Prior information could be used in few-view CT reconstruction to improve image quality, and similar prior images of the same person could provide much more reliable information. However, in most cases, the previous CT scans might be obtained a long time ago and not much the same as the current one. Applying the entire prior image could result in irreversible structure distortions in iterative reconstruction. In our work, we proposed an FBP initialized similar prior image constrained technique (FISPICT) to utilize general distribution information from FBP in few projection views and guide the search of distribution regions from prior images. Matched regions from similar prior image are adopted to approximate the real image in order to suppress structure differences and streak artifacts. The simulation experiments show better performance and detail preservation. The algorithm also has a high robustness while prior image differs.

Establishing and identification of an immortal cell line of familial papillary thyroid carcinoma with MLH1 R217C/BRAF V600E mutations / 天津医药

Objective To establishing an immortal cell line of familial papillary thyroid carcinoma (FPTC), and explore a new approach for studying familial non-medullary thyroid carcinoma (FNMTC). Methods The specimen from a patient with FPTC was selected, separated, and the primary cells were cultured using DMEM/F12 medium (with TSH, T3, EGF and hydrocortisone). To inducing cell immortalization, the exogenous genes SV40T/TERT were transfected into cells by two ways. RT-PCR was used to detect the expressions of thyroid peroxidase (TPO), thyroid globulin (TG), thyroid stimulating hormone receptor (TSHR) and sodium/iodide co-transporter (NIS). Immunofluorescence method was used to detect the expressions of TPO and GPC3. In order to detect the genomic mutations, the peripheral blood DNA of the patient was extracted. The cell genome was detected. Results The FPTC cells adhered to the plate and showed an irregular polygon shape. The cells can stably grow for six months, FPTC-S (with SV40T transfected) passaged to p26, FPTC cells passaged to p23 and FPTC-ST (with SV40T/TERT transfected) passaged to p19. Both FPTC-S and FPTC-ST can stably express TPO, TG and TSHR in mRNA level. MLH1 R217C mutation existed in the peripheral blood of the patient, and BRAF V600E mutation existed in the primary cultured cells. Either the primary or the immortal cells showed MLH1 R217C mutation. Conclusion This study preliminarily established an immortal cell line of familial papillary thyroid carcinoma with MLH 1 R217C and BRAF V600E mutations. This cell line provides a research model for studying these mutations in FPTC.

Dual-dictionary learning based MR image reconstruction with self-adaptive dictionaries.

Dual-dictionary learning method utilizes two dictionaries at two different resolution levels, a high resolution dictionary trained with full-data training set, and a low resolution dictionary co-trained with corresponding undersampled dataset. This method effectively incorporates a priori knowledge of typical structures, specific features and local details, leading to its success in magnetic resonance (MR) image reconstruction from highly undersampled k-space data. In this paper, we improve this dual-dictionary learning method by using self-adaptive dictionaries. The two level dictionaries are updated correspondingly in the inner iteration after updating the reconstruction result to maintain their matching accuracy. Experimental results show that the proposed method can improve the reconstruction quality efficiently and enhance the robustness significantly.

Accelerating the reconstruction of magnetic resonance imaging by three-dimensional dual-dictionary learning using CUDA.

An effective way to improve the data acquisition speed of magnetic resonance imaging (MRI) is using under-sampled k-space data, and dictionary learning method can be used to maintain the reconstruction quality. Three-dimensional dictionary trains the atoms in dictionary in the form of blocks, which can utilize the spatial correlation among slices. Dual-dictionary learning method includes a low-resolution dictionary and a high-resolution dictionary, for sparse coding and image updating respectively. However, the amount of data is huge for three-dimensional reconstruction, especially when the number of slices is large. Thus, the procedure is time-consuming. In this paper, we first utilize the NVIDIA Corporation's compute unified device architecture (CUDA) programming model to design the parallel algorithms on graphics processing unit (GPU) to accelerate the reconstruction procedure. The main optimizations operate in the dictionary learning algorithm and the image updating part, such as the orthogonal matching pursuit (OMP) algorithm and the k-singular value decomposition (K-SVD) algorithm. Then we develop another version of CUDA code with algorithmic optimization. Experimental results show that more than 324 times of speedup is achieved compared with the CPU-only codes when the number of MRI slices is 24.