ABSTRACT
Transbronchil biopsy has the characteristic of less trauma and quick recovery compared to percutaneous aspiration biopsy. In order to automate this procedure, it requires the development of a robotic surgical system that combines electromagnetic navigation and flexible endoscope. The robotic surgical system introduced herein consists of flexible endoscope, remote-control handle, electromagnetic navigation and dexterous manipulators. The robotic system supports lung bronchial model segmentation and reconstruction, automatic bronchial path planning, real-time navigation and visual biopsy. In the control of the endoscopic catheter, an elasticity compensation algorithm was proposed to improve the location accuracy of the catheter and operational efficiency. Clinical trials proved that the robotic system had high positioning accuracy, was intuitive to operate, and could improve the biopsy efficiency, shorten the learning time, reduce the burden of surgical operations, and lower radiation exposure and infection rate.
Subject(s)
Catheters , Robotic Surgical Procedures , Endoscopy , BronchoscopyABSTRACT
As the robotic assisted single port surgery arousing attention, a novel single-arm single-port micro-traumatic laparoscopic robotic surgical system is proposed in this study. From the perspective of the mechanics, joints with high rigidity and high reliability were utilized to realize the remote center of motion (RCM). Besides, the cost of consumables was reduced by adding the support of the rigid endoscope. From the perspective of the algorithm, high-precision motion control method and feedback force protection mechanism were implemented. The effectiveness of the aforementioned characteristics were verified by five clinical experiments of cholecystectomy. The results showed that the system is able to reduce the amount of bleeding, accelerate the patient recovery, reduce the infection risk and shorten the learning period. The robotic surgical system had significant clinical application value.
Subject(s)
Humans , Robotic Surgical Procedures , Reproducibility of Results , Laparoscopy , MotionABSTRACT
With the development of techniques for rapid microbial identification, MALDI-TOF MS has become an important tool for clinical identification of fungi. Problems such as the applicability and standardization of protein extraction methods have hindered the development of MALDI-TOF MS technology in the fungal field. This paper analyzed the complex structure of fungal cell walls, introduced the protein extraction methods recommended by MALDI-TOF MS commercial mass spectrometry systems, discussed the protein extraction methods for the identification of various genera of yeast-like fungi and filamentous fungi by MALDI-TOF MS, such as direct smear method, formic acid acetonitrile extraction method and magnetic bead grinding method, and summarized the current status and drawbacks of protein extraction methods in fungal identification by MALDI-TOF MS with a view to providing theoretical reference for subsequent research.
ABSTRACT
AimThe present study discussed the humoral immune response and antibody dynamics after primary and booster immunity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines among patients with chronic liver disease (CLD) in the real world. Thus, it provided data to develop SARS-CoV-2 vaccination strategy. MethodsPatients with confirmed CLD and completed primary or booster immunity of SARS-CoV-2 vaccines were enrolled. Serological specimens were collected after primary or booster immunity of SARS-CoV-2 vaccines to detect novel coronavirus neutralizing antibody (nCoV NTAb) and novel coronavirus spike receptor-binding domain antibody (nCoV S-RBD). Thus, we could evaluate the humoral immune response and antibody dynamics after primary and booster immunity of SARS-CoV-2 vaccines among patients with CLD. Simultaneously, baseline demographics, liver disease-related situations, comorbidity-related situations, SARS-CoV-2 vaccination information, and laboratory examination-related indicators of patients were collected. ResultsA total of 315 patients received SARS-CoV-2 vaccines, including 223 patients who completed the primary immunity of SARS-CoV-2 vaccines, 114 patients who completed booster immunity of SARS-CoV-2 vaccines, and 22 patients who underwent the antibody detection of SARS-CoV-2 vaccines after both primary and booster immunities. The positive rate of nCoV NTAb was 59.64% in Primary and 87.72% in Booster (P<0.001). The median level of nCoV NTAb was 11.53 AU/mL in Primary and 31.98 AU/mL in Booster (P<0.001). The positive rate of nCoV S-RBD was 69.06% in Primary and 91.23% in Booster (P<0.001). The median level of nCoV S-RBD was 21.60AU/mL in Primary and 112.65 AU/mL in Booster (P<0.001). After booster immunity of SARS-CoV-2 vaccines in 22 patients, the positive rate of nCoV NTAb increased from 59.09% to 86.36%, and that of nCoV S-RBD increased from 68.18% to 90.91%. The median level of nCoV NTAb increased from 11.24 AU /mL to 59.14 AU /mL after booster immunity. The median level of nCoV S-RBD increased from 27.28 AU/mL to 219.10 AU/mL. Compared to the antibody level of primary immunity, the median level of nCoV NTAb and nCoV S-RBD in 22 patients was increased by 5.26 and 8.03 times, respectively. Among 22 patients, 9 were negative for nCoV NTAb after primary immunity, while 6 were transformed positive after booster immunity, and the positive conversion rate of nCoV NTAb was 66.7%. On the other hand, 7 patients were negative for nCoV S-RBD after primary immunity, while 5 were transformed positive after booster immunity, and the positive conversion rate of nCoV S-RBD was 71.4%. ConclusionPatients with CLD show improved humoral immune response after completing primary and booster immunity of SARS-CoV-2 vaccines, while booster immunity further improves the positive rate and antibody level of patients with CLD. Finally, the positive conversion rate among patients with primary immunity failure also can be improved after booster immunity.
ABSTRACT
Objective@#To investigate the oral health service demands and utilization among school-age children in Xiangfang district of Harbin, and to explore the related influencing factors.@*Methods@#A total of 7 944 children aged 6-11 were investigated for oral health status through questionnaire survey in Xiangfang District, Harbin. Descriptive analysis, Chi-square test, nonparametric test and Logistic regression were used to analyze the oral health service demands and utilization of school-age children.@*Results@#The rate of caries, unfilled caries, malocclusion and traumatic dental injuries were 89.7%, 60.7%, 59.3% and 12.5%, respectively. In the past 12 months, 53.8% of children had toothache. The rate of seeking medical treatment in stomatology department was 31.6%, with the primary reason being treatment (47.6%), while the rate of preventive dental treatment was 15.6%. Multivariate analysis showed that girls, father s education being high school or technical secondary school, father s education higher or equal to junior college, poor oral health evaluation, high score on oral knowledge and oral attitude, brushing teeth once a day, brushing teeth twice a day or more, having attended oral health courses, having toothache experience, having dental trauma experience, suffering from dental caries were more likely to visit the oral clinics (OR=1.11，1.17，1.50，0.80，1.07，1.21，1.60，2.27，1.28，1.49，1.54，1.67, P<0.05).@*Conclusion@#In Xiangfang District of Harbin, there is a large demand for oral health services for school-age children, however, both of the utilization rate and the preventive medical treatment rate is low. Many factors affect the utilization of oral health services for children. It is suggested that targeted measures should be taken to improve the utilization level of school-age children s health resources.
ABSTRACT
Schizophrenia is a kind of neurodevelopmental brain disease with genetic background.Cognitive impairment has always been concerned as the core symptom of schizophrenia, and genetic factors play an important role in the cognitive impairment process of schizophrenia.This paper intends to explore the relationship between various neurotransmitter systems and neurodevelopmental related genes and cognitive impairment in schizophrenia. With " schizophrenia" " cognitive" and " genetic" " dopamine" " glutamate" " serotonin" " norepinephrine" " acetylcholine" " neurodevelopmental" " genome-wide association studies" as key words, the author searched the English and Chinese literatures published from January 2001 to October 2019 in several databases, such as Pubmed, ScienceDirect, CNKI academic journal database, Wanfang academic journal database, and selected the literature that was in line with the review topic after a large number of readings.Meanwhile, the author applied the literature tracing method to search the references of the literature that had been reviewed. Finally, 29 related literatures were included, and it was found that cognitive impairment in schizophrenia is related to multiple neurotransmitter system genes and neurodevelopmental genes, and these genes have different mechanisms of action in the process of cognitive impairment. The occurrence and development of cognitive impairment in schizophrenia involve multiple gene effects. The genetic study of neurotransmitter system and neurodevelopmental level is helpful to explore the pathological mechanism of cognitive impairment in schizophrenia.Future research should focus on how the pathogenesis/candidate genes of schizophrenia affect the neurotransmitter system and neurodevelopmental circuits, and further elucidate the mechanism of genetic factors in the development of cognitive impairment in schizophrenia.
ABSTRACT
At present, there still exist some limitations in the laparoscopic surgery robot represented by da Vinci surgical robot, such as the lack of force feedback function. Doctor can not feel the force feedback while operating. In this paper, a new minimally invasive laparoscopic surgery robot system is designed. Based on the master side surgeon's console, stereo vision subsystem and the slave side surgical cart, the multi-dimensional instrument force feedback technology and force feedback based safety protection strategy are introduced. The design realizes the force sensing function of full state operation. Besides, a number of different live pig experiments are carried out. The amount of bleeding in these experiments is relatively small compared with the data of the same kind of surgical robots, which effectively validates the force feedback and surgical safety protection strategies of the new robot system.
Subject(s)
Animals , Equipment Design , Laparoscopy , Minimally Invasive Surgical Procedures , Robotic Surgical Procedures , Robotics , SwineABSTRACT
Objective To explore the application value of thromboelastography(TEG) in perioperative evaluation of patients with antiplatelet therapy-associated cerebral hemorrhage. We aimed to investigate whether platelet transfu-sion, compared with standard care, reduced bleeding in patients with antiplatelet therapy-associated cerebral hemor-rhage. Methods A retrospective analysis of clinical data was conducted in 30 patients (12 patients receiving platelet transfusion) with antiplatelet therapy-associated basal ganglia hemorrhage who underwent emergency surgery. TEG was used to evaluate the intraoperative bleeding, postoperative bleeding and transfusion treatment. Results The routine co-agulation test was in the normal range in the two groups. However, TEG showed that the platelet function was exces-sively inhibited in patients with antiplatelet therapy before spontaneous cerebral hemorrhage (Platelet inhibition rate>90%). There were significant differences in the intraoperative blood loss (t=-3.998, P=0.008), total transfusion volume (Z=-3.245, P=0.001), postoperative hematoma volume (t=-2.909, P=0.043) and lead volume (t=-8.790, P=0.041) between two groups (P<0.05). One case from platelet transfusion group, and 4 cases from no-platelet transfusion group re-ceived a second surgical operation. However, the difference was not statistical significant ( P=0.317). Conclusion TEG can effectively assess the preoperative coagulation status in the patients with spontaneous cerebral haemorrhage after antiplatelet therapy. Platelet transfusion can reduce intraoperative and postoperative bleeding, decrease blood transfu-sion in the patients with antiplatelet therapy-associated cerebral hemorrhage.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate normal bony anatomy of the glenoid rim, to measure inner glenoid rim angle and outer glenoid rim angle, and the angles for successful anchor insertion for arthroscopic labral repairs.</p><p><b>METHODS</b>Twelve unpaired isolated human glenoids (6 right, 6 left) without any evidence of trauma were for studying. The glenoid specimens were scanned using 320-slice CT (Aquilion ONE), then reconstruction glenoid to a three dimensional model using materialise's interactive medical image control system (Mimics) and to obtain cross-sectional images in 6 different planes, mark the right glenoid rim with clockwise tag, the left with counterclockwise tag. Inner glenoid rim angle marked as angle α and outer glenoid rim angle marked as angle β were measured from the cross-sectional images of the glenoids at 8 positions: 2-, 3-, 4-, 5-, 6-, 7-, 8- and 9-o'clock positions. Glenoid morphology was noted for each position. Using 12 mm as radius, measured the minimum insertion angle of anchor, marked as angle γ. Normal distribution of the data was confirmed with Kolmogorov-Smirnov test. Paired t-test was performed to detect differences in the angles between two locations. Two independent samples t-test was performed to detect differences in the angles between same location of left and right. Analysis of variance (ANOVA) was performed to detect differences in the angles between right and left, and different locations of the glenoid rim.</p><p><b>RESULTS</b>The smallest α was at the 4-o'clock position (right 50° ± 6°, left 52° ± 9°), significant difference were seen when compared with the 6-o'clock position (t = 10.466, P = 0.000) or the 5-o'clock position (t = 3.754, P = 0.003), no significant difference exist between 4-o'clock position and 3-o'clock posion (t = 0.926, P = 0.374). The smallest β was at the 3-o'clock position (right 50° ± 6°, left 53° ± 10°), significant difference were seen when compared with the 6-o'clock position (t = 9.862, P = 0.000) or the 5-o'clock position (t = 3.634, P = 0.003), no significant difference exist between 4-o'clock position and 3-o'clock posion (t = 0.697, P = 0.501). Asymmetric morphology of the glenoid was noted with an almost straight line extending medially from the rim at the 3-o'clock position, whereas a concave morthology was noted at the 9-o'clock position. Similary at the 4- and 5-o'clock position, the scapular bony surface did not curve toward the base as markedly as it did at the corresponding posterior 8- and 7-o'clock position. Angle γ from the 3-o'clock to the 9-o'clock were 25° ± 4°, 54° ± 6°, 83° ± 4°, 119° ± 2° at right side, 23° ± 4°, 57° ± 4°, 89° ± 7°, 119° ± 4° at left side. No significant difference of any angle at the same position was noted between left and right (α:t = 0.283-1.785, P > 0.05;β:t = 0.369-2.067, P > 0.05;γ:t = 0.145-0.492, P > 0.05).</p><p><b>CONCLUSIONS</b>The available bone mass for the anchor insertion is found to vary depending on the position of the glenoid rim. The smallest inner and outer glenoid rim angle are at the 4- and 3-o'clock position. The minimum insertion angles of anchor differ at different position. Both rim angle and glenoid morthology for each position must be considered when selecting the ideal anchor insertion angle for Bankart repair. Meanwhile, minimum insertion angle of anchor should also be considered before anchor insertion.</p>
