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Objective: To compare the efficacy of gasless robotic surgery through transaxillary approach and open surgery for papillary thyroid carcinoma (PTC). Methods: The data of patient undergoing robotic surgery through transaxillary approach and traditional open surgery for PTC at the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from November 2016 to June 2023 were retrospectively analyzed. A 1â¶1 propensity score matching (PSM) was performed to balance age, sex, extent of surgery, tumor size, capsule invasion, and multifocality. Surgical data, postoperative pathological data, complications, postoperative 2-month visual analog scale (VAS) scores for aesthetics, and follow-up data were compared between the two groups. Results: A total of 728 PTC patients were included. There were 339 patients in the robotic group, among which 262 were female (77.3%) and 77 were male (22.7%), with the age of [M (Q1, Q3)] 39 (32, 46) years and a body mass index (BMI) of 22.8 (20.7, 25.0) kg/m². Meanwhile, 389 patients were in the open group, among which 290 were female (74.6%) and 99 were male (25.4%), with the age of 47 (38, 55) years and a BMI of 23.2 (21.3, 25.5) kg/m2. Further analysis after PSM (there were 264 cases in both groups) showed that in the subtotal thyroidectomy and central neck dissection (LT+CCND) subgroup, the robotic group had longer operative time, higher blood loss, and greater drainage volume compared with the open group [100 (80, 130) min vs 60 (50, 80) min; 10 (10, 20) ml vs 10 (10, 20) ml; 103 (69, 145) ml vs 75 (57, 98) ml; all P<0.001], and the central lymph node metastasis rate was higher in the robotic group [45.6% (57/125) vs 31.8% (47/148), P=0.019]. In the total thyroidectomy and central neck dissection (TT+CCND) subgroup, the robotic group also had longer operative time, higher blood loss, and greater drainage volume compared with the open group [150 (110, 180) min vs 85 (75, 100) min; 20 (10, 20) ml vs 10 (10, 20) ml; 155 (107, 206) ml vs 90 (70, 120) ml; all P<0.001]. The incidence of chest skin numbness at 3 months postoperatively was higher in the robotic group compared with the open group (12.9% vs 0, P<0.001), while there were no statistically significant differences in other postoperative complications (all P>0.05). The VAS score at 2 months postoperatively was higher in the robotic group compared with the open group [9 (9, 9) vs 8 (7, 9), P<0.001]. Three cases of contralateral lobe recurrence occurred in the open group, while there were no case of recurrence in the robotic group. The 5-year overall survival rate was 100.0% in both the robotic and open groups, and there was no statistically significant difference in the 5-year disease-free survival rate between the robotic and open groups (100.0% vs 98.6%, P=0.068). Conclusion: Gasless robotic surgery through transaxillary approach for total thyroidectomy or lobectomy in the treatment of PTC is safe, feasible, and effective, with good cosmetic outcomes and comparable efficacy to traditional surgery.
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Axila , Procedimientos Quirúrgicos Robotizados , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Tiroidectomía , Humanos , Procedimientos Quirúrgicos Robotizados/métodos , Masculino , Femenino , Cáncer Papilar Tiroideo/cirugía , Adulto , Estudios Retrospectivos , Neoplasias de la Tiroides/cirugía , Persona de Mediana Edad , Tiroidectomía/métodos , Resultado del Tratamiento , Tempo Operativo , Puntaje de PropensiónRESUMEN
Objective: To evaluate the efficacy of neoadjuvant chemoimmunotherapy (NACI) combined with transoral robotic surgery (TORS) in the treatment of locally advanced oropharyngeal squamous cell carcinoma (OPSCC). Methods: This was a retrospective study of 15 patients with locally advanced OPSCC who underwent TORS after neoadjuvant therapy (NAT) at the Department of Otolaryngology-Head and Neck Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from April 2019 to February 2023. There were 12 males and 3 females, aged 31 to 74 years. Twelve cases were tonsil cancer, and 3 cases were tongue base cancer. There were 11 cases in stage â ¢ and 4 cases in stage â £. Two patients received neoadjuvant chemotherapy and 13 patients received NACI, with 2 to 3 cycles, and all patients underwent TORS after multidisciplinary team consultation. The clinicopathological characteristics, surgical outcomes, and oncological results were summarized. Results: All surgeries were successfully completed with negative surgical margins, and no case was required conversion surgery. All patients were fed via nasogastric tubes postoperatively, with a median gastric tube stay of 7 days (range: 2-60 days). No tracheotomy was applied. There were no major complications such as postoperative bleeding. Pathological complete response (pCR) was found in 10 cases (76.9%) among the 13 patients with NACI. The follow-up time was 21 months (range: 10-47 months), and there was no death or distant metastasis. One patient with rT0N3M0 tonsil cancer had local recurrence 5 months after surgery. The 2-year overall survival and 2-year disease-free survival were respectively 100.0% and 93.3% in the 15 patients. Conclusion: NACI combined with TORS provides a safe, effective and minimally invasive treatment for patients with locally advanced oropharyngeal squamous cell carcinoma.
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Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias Orofaríngeas , Procedimientos Quirúrgicos Robotizados , Neoplasias Tonsilares , Masculino , Femenino , Humanos , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia , Terapia Neoadyuvante , Carcinoma de Células Escamosas/cirugía , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados/métodos , Neoplasias Orofaríngeas/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: To predict microvascular invasion (MVI) in hepatocellular carcinoma (HCC) using a model based on multiphase dynamic-enhanced CT (DCE-CT) radiomics feature and hierarchical fusion of multiple classifiers. METHODS: We retrospectively collected preoperative DCE-CT images from 111 patients with pathologically confirmed HCC in Guangzhou First People's Hospital between January, 2016 and April, 2020. The volume of interest was outlined in the early arterial phase, late arterial phase, portal venous phase and equilibrium phase, and radiomics features of these 4 phases were extracted. Seven classifiers based on different algorithms were trained using the filtered feature subsets to obtain multiple base classifiers under each phase. According to the hierarchical fusion strategy, a multi-criteria decision-making-based weight assignment algorithm was used for fusing each base classifier under the same phase with the model after extracting the phase information to obtain the prediction model. The proposed model was evaluated using a 5-fold cross-validation and assessed for area under the ROC curve (AUC), accuracy, sensitivity, and specificity. The prediction model was also compared with the fusion models using a single phase or multiple phases, models based on a single phase with a single classifier, models with different base classifier diversities, and 8 classifier models based on other ensemble methods. RESULTS: The experimental results showed that the performance of the proposed model for predicting HCCMVI was optimal after incorporating the 4 phases and 7 classifiers, with AUC, accuracy, sensitivity, and specificity of 0.828, 0.766, 0.877, and 0.648, respectively. Comparative experiments showed that this prediction model outperformed the models based on a single phase with a single classifier and other ensemble models. CONCLUSION: The proposed prediction model is effective for predicting MVI in HCC with superior performance to other models.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/patología , Estudios Retrospectivos , Radiómica , Tomografía Computarizada por Rayos X/métodosRESUMEN
OBJECTIVE: To explore the performance of a new multimodal feature fusion classification model based on distance matching and discriminative representation learning for differentiating high-grade glioma (HGG) from solitary brain metastasis (SBM). METHODS: We collected multi-parametric magnetic resonance imaging (MRI) data from 61 patients with HGG and 60 with SBM, and delineated regions of interest (ROI) on T1WI, T2WI, T2-weighted fluid attenuated inversion recovery (T2_FLAIR) and post-contrast enhancement T1WI (CE_T1WI) images. The radiomics features were extracted from each sequence using Pyradiomics and fused using a multimodal feature fusion classification model based on distance matching and discriminative representation learning to obtain a classification model. The discriminative performance of the classification model for differentiating HGG from SBM was evaluated using five-fold cross-validation with metrics of specificity, sensitivity, accuracy, and the area under the ROC curve (AUC) and quantitatively compared with other feature fusion models. Visual experiments were conducted to examine the fused features obtained by the proposed model to validate its feasibility and effectiveness. RESULTS: The five-fold cross-validation results showed that the proposed multimodal feature fusion classification model had a specificity of 0.871, a sensitivity of 0.817, an accuracy of 0.843, and an AUC of 0.930 for distinguishing HGG from SBM. This feature fusion method exhibited excellent discriminative performance in the visual experiments. CONCLUSION: The proposed multimodal feature fusion classification model has an excellent ability for differentiating HGG from SBM with significant advantages over other feature fusion classification models in discrimination and classification tasks between HGG and SBM.
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Neoplasias Encefálicas , Glioma , Humanos , Neoplasias Encefálicas/patología , Glioma/patología , Imagen por Resonancia Magnética/métodos , Área Bajo la Curva , Radiómica , Estudios RetrospectivosRESUMEN
Long-term tumour recurrence rates and complications of endoscope-assisted partial superficial parotidectomy (PSP) are rarely reported compared to traditional open approaches. This retrospective study included 306 patients with superficial parotid benign neoplasms who were divided into an endoscopy group (endoscope-assisted PSP, n = 102) and a control group (conventional PSP, n = 204). There were no significant differences in clinical and pathological characteristics between the two groups, except age (P = 0.001). Three patients had confirmed recurrence during a mean follow-up duration of 125.1 months. Ten (9.8%) patients in the endoscopy group and 22 (10.8%) in the control group developed transient facial nerve palsy (P = 0.792), and recovered 6 months after the operation. Nine (8.8%) and 19 (9.3%) patients, respectively, suffered from Frey syndrome (P = 0.889). A sensory deficit of the auricle occurred in 24 (23.5%) and 57 (27.9%) patients respectively (P = 0.410). Patients in the endoscopy group were more satisfied with the postoperative scar than those in the control group (P < 0.001). This study demonstrated that the endoscope-assisted PSP can be curative, with better cosmetic outcomes than the conventional approach, and does not increase the incidence of postoperative complications or the local recurrence rate.
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Compuestos Heterocíclicos , Compuestos Organometálicos , Glándula Parótida , Neoplasias de la Parótida , Humanos , Glándula Parótida/cirugía , Estudios de Casos y Controles , Estudios Retrospectivos , Neoplasias de la Parótida/cirugía , Endoscopios , Complicaciones PosoperatoriasRESUMEN
Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P25, P75), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.
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Procedimientos Quirúrgicos Robotizados , Neoplasias de la Tiroides , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Tiroidectomía/efectos adversos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Estudios Retrospectivos , Pérdida de Sangre Quirúrgica , Hipoestesia/complicaciones , Hipoestesia/cirugía , Disección del Cuello/efectos adversos , Neoplasias de la Tiroides/cirugía , Dolor Postoperatorio/complicaciones , Dolor Postoperatorio/cirugía , Complicaciones Posoperatorias/etiologíaRESUMEN
Objective: To explore the association between sleep duration and the risk of frailty among the elderly over 80 years old in China. Methods: Using the data from five surveys of the China Elderly Health Influencing Factors Follow-up Survey (CLHLS) (2005, 2008-2009, 2011-2012, 2014, and 2017-2018), 7 024 elderly people aged 80 years and above were selected as the study subjects. Questionnaires and physical examinations were used to collect information on sleep time, general demographic characteristics, functional status, physical signs, and illness. The frailty state was evaluated based on a frailty index that included 39 variables. The Cox proportional risk regression model was used to analyze the correlation between sleep time and the risk of frailty occurrence. A restricted cubic spline function was used to analyze the dose-response relationship between sleep time and the risk of frailty occurrence. The likelihood ratio test was used to analyze the interaction between age, gender, sleep quality, cognitive impairment, and sleep duration. Results: The age M (Q1, Q3) of 7 024 subjects was 87 (82, 92) years old, with a total of 3 435 (48.9%) patients experiencing frailty. The results of restricted cubic spline function analysis showed that there was an approximate U-shaped relationship between sleep time and the risk of frailty. When sleep time was 6.5-8.5 hours, the elderly had the lowest risk of frailty; Multivariate Cox proportional risk regression model analysis showed that compared to 6.5-8.5 hours of sleep, long sleep duration (>8.5 hours) increased the risk of frailty by 13% (HR: 1.13; 95%CI: 1.04-1.22). Conclusion: There is a nonlinear association between sleep time and the risk of frailty in the elderly.
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Fragilidad , Anciano , Humanos , Anciano de 80 o más Años , Fragilidad/epidemiología , Duración del Sueño , Estudios Prospectivos , Sueño/fisiología , China/epidemiologíaRESUMEN
Purpose: To evaluate the biomechanical profile of subcortical backup fixation (subcortical button [SB]) in anterior cruciate ligament (ACL) reconstruction as compared with a bicortical post and washer (BP) and suture anchor (SA) when used with interference screw (IS) primary fixation and to evaluate the utility of backup fixation for tibial fixation with extramedullary cortical button primary fixation. Methods: Fifty composite tibias with polyester webbing-simulated graft were used to test constructs across 10 methods. Specimens were separated into the following groups (n = 5): 9-mm IS only, BP (with and without graft and IS), SB (with and without graft and IS), SA (with and without graft and IS), extramedullary suture button (with and without graft and IS), and extramedullary suture button with BP as backup fixation. Specimens were tested under cyclic loading and then loaded to failure. Maximal load at failure, displacement, and stiffness were compared. Results: Without a graft, the SB and BP had similar maximal loads (802.46 ± 185.18 N vs 785.67 ± 100.96 N, P = .560), and both were stronger than the SA (368.13 ± 77.26 N, P < .001). With graft and an IS, there was no significant difference in maximal load between the BP (1,461.27 ± 173.75 N), SB (1,362.46 ± 80.47 N), and SA (1,334.52 ± 195.80 N). All backup fixation groups were stronger than the control group with IS fixation only (932.91 ± 99.86 N, P < .001). There was no significant difference in outcome measures between the extramedullary suture button groups with and without the BP (failure loads of 721.39 ± 103.32 N and 718.15 ± 108.61 N, respectively). Conclusions: Subcortical backup fixation in ACL reconstruction has similar biomechanical properties to current methods and is a viable backup fixation alternative. Backup fixation methods work synergistically with IS primary fixation to strengthen the construct. There is no advantage to adding backup fixation to extramedullary button (all-inside) primary fixation when all suture strands are secured to the extramedullary button. Clinical Relevance: This study provides evidence that subcortical backup fixation is a viable alternative for surgeons during ACL reconstruction.
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OBJECTIVE: To assess the safety and efficacy of Neuroform Atlas stent used in treatment of unruptured wide-neck intracranial aneurysms. METHODS: Clinical data of 62 patients with unruptured wide-neck intracranial aneurysms undergoing Neuroform Atlas stent-assisted coiling from August 2020 to September 2021 were retrospectively analyzed. There were 64 aneurysms in those 62 patients. Among them, 25 aneurysms were located at the bifurcation of M1 segment on middle cerebral artery, 16 at the anterior communicating artery, 10 at the C7 segment of internal carotid artery, 5 at the C6 segment of internal carotid artery, 4 at the apex of basilar artery, 3 at the A3 segment of anterior cerebral artery, and 1 at the M2 segment of middle cerebral artery. All the patients underwent Neuroform Atlas stent-assisted coiling, including 49 patients with single stent assisted coiling and 15 patients with dual stents assisted coiling (14"Y"style and 1"X"style). After the procedure, the immediate DSA was performed to evaluate the status of aneurysm occlusion and the parent artery patency. The clinical follow-up was performed 3 months after the operation and evaluated based on the modified Rankin Scale(mRS).DSA image was reviewed at 6 months after operation and Raymond grading scale was used to assess the status of aneurysm occlusion and the parent artery patency. RESULTS: A total of 62 patients with 64 aneurysms were all achieved technical success(100%).The immediate post-procedural Raymond scale was assessed, including Raymond â in 57 aneurysms(89.1%, 57/64), Raymond â ¡ in 6 aneurysms(9.3%, 6/64) and Raymond â ¢ in 1 aneurysm(1.6%, 1/64). The peri-procedural complications rate was 4.8%(3/62), 2 patients developed intraoperative thrombosis and 1 patient suffered from local subarachnoid hemorrhage. Among them, 55 patients obtained 3 months clinical follow-up after operation and all the patients had good outcomes (mRS≤2), 50 patients with 52 aneurysms were followed up with DSA 6 months after operation, including Raymond â in 45 aneurysms(86.5%, 45/52), Raymond â ¡ in 4 aneurysms(7.7%, 4/52) and Raymond â ¢ in 3 aneurysms(5.8%, 3/52). CONCLUSION: Neuroform Atlas stent for the treatment of unruptured wide-neck intracranial aneurysms has high safety and good efficacy, and has its advantages over other traditional stents.
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Embolización Terapéutica , Aneurisma Intracraneal , Humanos , Aneurisma Intracraneal/cirugía , Aneurisma Intracraneal/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Embolización Terapéutica/métodos , Stents/efectos adversos , Angiografía CerebralAsunto(s)
ADN Tumoral Circulante , Hemangioendotelioma , Linfangioma , Sarcoma de Kaposi , Niño , Humanos , FamiliaRESUMEN
Objective: To evaluate the feasibility, safety, and short-term efficacy of robotic lateral neck dissection via combined axillary-retroauricular approach for N1b papillary thyroid carcinoma (PTC). Methods: Thirty patients with cT1-2N1bM0 PTC who received robotic lateral neck dissection via combined axillary-retroauricular approach were included in the Department of Otorhinolaryngology of Sun Yat-sen Memorial Hospital from December 2016 to December 2020. There were 10 males and 20 females, with a median age of 34.5 years and a median body mass index of 25.55 kg/m2. The clinical, surgical, complications, pathology and follow-up data were analysed with SPSS 25.0 software package. Results: The median operative time of 30 patients was 255.50 min, the median operative blood loss was 69.00 ml, and the median postoperative hospital stay was 6.00 days. The incidence of postoperative temporary recurrent laryngeal nerve paralysis was 3.33% (1/30), temporary hypoparathyroidism was 16.67%(5/30), temporary accessory nerve injury was 3.33% (1/30), hematoma was 3.33% (1/30) and chylous leakage was 3.33% (1/30). The median visual analogue scale (VAS) score was 8.00, and the follow-up time was 13-38 months, with a median of 25.5 months. One case showed cervical lymph node recurrence 14 months after surgery. The most recent dynamic recurrence risk stratification showed 21 patients (70.00%) had excellent responses. Conclusions: Robotic lateral neck dissection via combined axillary-retroauricular approach for unilateral cN1b PTC is safe, feasible and aesthetic. The short-term efficacy and dynamic recurrence risk stratification results of short-term follow-up are satisfactory. It can provide a surgical option for cN1b PTC patients.
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Carcinoma Papilar , Procedimientos Quirúrgicos Robotizados , Neoplasias de la Tiroides , Adulto , Carcinoma Papilar/cirugía , Femenino , Humanos , Masculino , Disección del Cuello/métodos , Estudios Retrospectivos , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodosRESUMEN
OBJECTIVE: To investigate the auditory response patterns of mouse primary auditory cortex (A1) neurons. METHODS: In vivo cell-attached recordings and neural network modeling were performed to detect the changes in response patterns of A1 neurons of awake C57BL/6J mice to sound stimulation with varying lengths. A1 neuron signals were recorded for 216 neurons in 20 awake mice using a target sound stimulation sequence, and the classification and response characteristics of A1 neuron response patterns were examined using post-stimulus spike time histograms. To simulate the diversity of the A1 neuron response patterns, an A1 neuron model was established based on the Wilson-Cowan model and integral-firing model. The neuron connection weight parameters in the model were calculated by examining the micro loop structure of the pyramidal neurons, parvalbumin neurons, and somatostatin neurons in the A1 region, and the A1 neural network information coding model was constructed. RESULTS: The Onset response neurons only had fast spike response within 10 to 40 ms after the beginning of noise stimulation (122 neurons). The Sustained response neurons had spike response continuously during the noise stimulation (26 neurons). The On-off response neurons had fast spike response after the beginning and the end of noise stimulation (40 neurons). The Offset response neurons only had fast spike response within 10 to 40 ms after the end of noise stimulation (22 neurons). In the neural network model, the Onset peak neural activities of A1 pyramidal neurons, parvalbumin neurons, and somatostatin neurons were 0.7483, 0.5236 and 0.9427, respectively, and their response half peak widths were 18.5 ms, 12 ms and 31 ms during the 100 ms noise stimulation, respectively. By changing the feedforward excitation and synaptic inhibition time constants in the model, the neurons generated numerous different types of spike train. CONCLUSION: The auditory response of mouse A1 neurons to sound stimuli shows mainly the Onset, Sustained, On-off, and Offset response patterns.
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Corteza Auditiva , Estimulación Acústica , Animales , Corteza Auditiva/fisiología , Ratones , Ratones Endogámicos C57BL , Parvalbúminas , SomatostatinaRESUMEN
OBJECTIVE: To compare the effects of artificial liver treatment with double plasma molecular adsorption system(DPMAS) mode and traditional plasma exchange (PE) mode on platelets in patients, and to evaluate the clinical efficacy of recombinent human thrombopoietin (rhTPO) in the treatment of thrombocytopenia. METHODS: A total of fifteen patients undergoing artificial liver with DPMAS model admitted to the Fifth Affiliated Hospital of Guangzhou Medical University from January 2018 to November 2020 were selected and included in the DPMAS group, and another 15 patients receiving PE were selected and included in the PE group. The improvement of clinical symptoms, such as fatigue, jaundice, oliguria, edema, etc. before and after artificial liver treatment was compared between the two groups, and the trend of blood routine (especially platelet), coagulation function and other indexes before and after treatment were compared between the two groups. The use of rhTPO and the number of platelets were recorded during treatment. RESULTS: The improvement rate of clinical symptoms in DPMAS group was 86.67%, which was higher than that in PE group, but the difference was not statistically significant (P>0.05). There was no statistical significance in the outcome of the two groups within 90 days (P>0.05). There was no significant difference in white blood cell (WBC) and hemoglobin (HB) between the two groups after treatment (P>0.05). However, the level of platelet(PLT) in DPMAS group was significantly lower than that before treatment (P < 0.05), and was significantly lower than that in PE group (P < 0.05). After treatment, the international normalized ratio (INR) level in PE group was significantly improved (P < 0.05), but there was no significant difference in the INR level in DPMAS group (P>0.05). The patients in the DPMAS group received an average of (8.2±3.1) doses of rhTPO and (1.5±0.3) IU of platelet transfusions during hospitalization. In DMPAS group, platelets increased significantly after infusion of terbium. CONCLUSION: Compared with PE mode, the artificial liver with DPMAS mode can reduce platelet levels in patients, but the application of rhTPO can stimulate platelet regeneration and increase platelet levels in the patients, thereby reducing the risk of bleeding due to platelet hypoplasia.
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Hígado Artificial , Trombocitopenia , Plaquetas , Humanos , Intercambio Plasmático , Proteínas Recombinantes , Trombocitopenia/terapia , TrombopoyetinaRESUMEN
OBJECTIVE: To explore whether the characteristic responses to sound stimulations of the auditory neurons in the striatum is regulated in different behavioral states. METHODS: The auditory neurons in the striatum of awake C57BL/6J mice were selected for this study. We recorded the auditory response of the striatum to noises over a long period of time by building a synchronous in vivo electrophysiological and locomotion recording system and using glass microelectrode attachment recording. By analyzing the running speed of the mice, the behavioral states of the mice were divided into the quiet state and the active state, and the spontaneous activity and evoked responses of the auditory neurons in the striatum were analyzed in these two states. RESULTS: Compared with those recorded in the quiet state, the spontaneous activity of the auditory neurons in the striatum of the mice increased significantly (37.06±12.02 vs 18.51±10.91, P < 0.001) while the auditory response of the neurons decreased significantly (noise intensity=60 dB, 3.45±2.99 vs 3.04±2.76, P < 0.001) in the active state. CONCLUSION: Locomotion has a significant inhibitory effect on the auditory response of the striatum, which may importantly contribute to the decline of sound information recognition ability in the active state.
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Corteza Auditiva , Locomoción , Estimulación Acústica , Animales , Corteza Auditiva/fisiología , Potenciales Evocados Auditivos , Locomoción/fisiología , Ratones , Ratones Endogámicos C57BL , NeuronasRESUMEN
Objective: To investigate the safety, efficacy, locally control and survival results of transoral Da Vinci robotic surgery for salvage treatment of locally recurrent nasopharyngeal carcinoma. Methods: This retrospective study included 33 patients with locally recurrent nasopharyngeal carcinoma (stage rT1-2, partial rT3) underwent transoral Da Vinci robotic surgery between October 2017 and January 2020. There were 20 males and 11 females, with an average age of (47.9±10.5) years. The lesions were localized in nasopharyngeal cavity in 14 cases, with extending to parapharyngeal space in 6 cases and the floor of sphenoid sinus in 13 cases. Transnasal endoscopy was used to assist surgery if necessary. SPSS 25.0 statistical software was used for statistical analysis. Results: Transoral robotic nasopharyngectomy was successfully performed in all cases without conversion to open surgery, of which 13 cases were combined with transnasal endoscopic surgery. The average operation time was (126.2±30.0) min, ranging from 90 to 180 min. The postoperative pathological margin was R0 (31 cases) and R1 (2 cases), with no tumor residue. Complications of surgery mainly included symptoms of headache, nasal dryness and velopharyngeal insufficiency without nasopharyngeal hemorrhage. Follow-up time was from 3 to 54 months. One case had tumor recurrence 11 months after operation, 1 case had ipsilateral cervical lymph node metastasis 27 months after operation, 2 cases had distant metastasis and 1 case died of nasopharyngeal hemorrhage 3 months after operation. The 1-year, 2-year and 3-year overall survival rates were 97.0%, 96.0% and 92.9%, respectively and the local recurrence free rates were 97.0%, 95.7% and 91.7%, respectively. Conclusion: Transoral robotic nasopharyngectomy is safe and feasible for local recurrent nasopharyngeal carcinoma in selected patients, with higher local control rate and quality of life.
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Neoplasias Nasofaríngeas , Procedimientos Quirúrgicos Robotizados , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo/cirugía , Neoplasias Nasofaríngeas/patología , Recurrencia Local de Neoplasia/cirugía , Calidad de Vida , Estudios RetrospectivosRESUMEN
Standard quantum theory was formulated with complex-valued Schrödinger equations, wave functions, operators, and Hilbert spaces. Previous work attempted to simulate quantum systems using only real numbers by exploiting an enlarged Hilbert space. A fundamental question arises: are the complex numbers really necessary in the standard formalism of quantum theory? To answer this question, a quantum game has been developed to distinguish standard quantum theory from its real-number analog, by revealing a contradiction between a high-fidelity multiqubit quantum experiment and players using only real-number quantum theory. Here, using superconducting qubits, we faithfully realize the quantum game based on deterministic entanglement swapping with a state-of-the-art fidelity of 0.952. Our experimental results violate the real-number bound of 7.66 by 43 standard deviations. Our results disprove the real-number formulation and establish the indispensable role of complex numbers in the standard quantum theory.
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OBJECTIVE: To study the electrophysiological properties of parvalbumin (PV) neurons in the auditory cortex (AC) and its descending auditory projection area in the tail of the striatum (TS). METHODS: The stimulation response of PV neuron step current was recorded in PV-Cre-Ai14 mice using in vitro patch clamp technique, and the release characteristics and waveform characteristics of PV neuron action potentials (APs) were analyzed using Clampfit and MATLAB software. The release characteristics of the APs included AP onset, rheobase, average firing rate, F/I slope and spike frequency adaptation (SFA); the waveform characteristics included peak and post potential characteristics. RESULTS: The PV neurons of the TS and the AC had significantly different electrophysiological characteristics. In terms of peak potential characteristics, the PV neurons in the TS presented with smaller half peak width (P < 0.001) and larger amplitude (P < 0.01) with larger maximum ascending slope (P < 0.01) and maximum descending slope (P < 0.05). For post potential characteristics, the PV neurons in the TS showed a greater post hyperpolarization (P < 0.01) with a shorter time for recovery of the resting potential (P < 0.01). The firing characteristics of the PV neurons of the TS featured a higher AP rheobase (P < 0.01), a larger F/I slope (P < 0.01), a greater firing onset delay (P < 0.001), and a larger SFA (P < 0.01). CONCLUSION: The PV neurons in the TS and the AC of mice show significantly different electrophysiological characteristics in processing auditory information.
Asunto(s)
Corteza Auditiva , Ratones , Animales , Corteza Auditiva/metabolismo , Parvalbúminas/metabolismo , Neuronas/metabolismo , Potenciales de Acción/fisiología , Técnicas de Placa-ClampRESUMEN
OBJECTIVE: To explore the characteristics of the evolution of auditory response signal-to-noise ratio at all levels of the ascending auditory pathway, its modulation by different brain states in different brain regions, and its potential value as an effective indicator for encoding sound characteristics. METHODS: Eighty C57BL/6J awake mice were used for recording the best frequency auditory response of the neurons in the inferior colliculus (n=20), medial geniculate body (n=20), and primary auditory cortex using a glass microelectrode. The probability density of spontaneous and evoked firing of the neurons was calculated to establish a distribution model of spontaneous and evoked firing, and the evolution of the auditory response signal-to-noise ratio was statistically analyzed. The changes in spontaneous and evoked firing of the neurons and the auditory response signal-to-noise ratio in different brain regions were analyzed at rest and during running. RESULTS: In different brain regions in the ascending auditory pathway, the spontaneous firing of the neurons all showed a Poisson distribution, and the evoked firing showed a lognormal distribution. The auditory response signal-to-noise ratio was significantly greater in the inferior colliculus than in the medial geniculate body and auditory cortex (P < 0.001). The auditory response signal-to-noise ratio in the 3 brain regions remained stable irrespective of the states of motion (P>0.05). CONCLUSION: Auditory response signal-to-noise ratio may serve as an effective indicator of encoding sound characteristics.