Objective To observe preserving effect on myocytes in porcine aortic valve replacement with minimal extracorporeal circulation (MECC). Methods 7 pigs were collected as experimental animals and undertook aortic valve replacement with MECC. Morphological and immunofluorescence intensity changes of right atrial and left ventricular tissues were observed. Results HE staining showed that there were not significant changes and edema or injury of myocytes of right atriums and left ventricles between preoperation and postoperation. Immunofluorescence staining showed complement C3b/c in right atrial myocardial tissues after the operation were a little ber, and innate antibody IgG were a little ber in left ventricular myocardial tissues but similarly weak in right atrial myocardial tissues pre- and post-operation. There was not significant changes in HSPG staining in pre-and post-operative right atrial myocardial tissues, but HSPG were obviously weaker in left ventricular myocardial tissues after the operation. Conclusion MECC is effective on support of porcine aorta valve replacement.
This consensus aims to introduce the applications of 4K high-definition technology and fluorescence technology in thoracic surgery, summarize and categorize the technical support for pulmonary segment surgery, and innovatively propose technical support for precise sleeve resection of pulmonary segments. It provides a reference for clinical use, points out the direction for the research and innovation of domestically produced high-end endoscopes, promotes the widespread application of excellent domestically produced medical endoscopes, and facilitates the development of domestically produced medical equipment.
ObjectiveTo observe the detection of circulating tumor cells (CTCs) in peripheral blood of patients with gastric cancer, and to investigate the relationship between the CTCs and clinicalpathological features of gastric cancer. MethodsSixty cases of gastric cancer from September 2011 to September 2013 of our hospital were as the research object, and compared with 40 cases of benign gastric disease over the same period. These patients' venous blood were collected, the CTCs counts were determined by using the CellTracks AutoPrep fluorescence scaning system, and the relationship between CTCs and clinicopathological features of gastric cancer was analyzed. ResultsThe detection rate of CTCs in gastric cancer patients was 70.0% (42/60), in control group was 7.5% (3/40). The positive rate of CTCs in peripheral blood of patients with gastric cancer was significantly higher than that of benign gastric disease (P<0.05). The positive rate of CTCs in peripheral blood were no correlated with gender, age, N staging, distant metastasis, tumor size, and vascular invasion (P>0.05), but were correlated with the TNM staging of tumor and degree of differentiation (P<0.05). The cumulative survival rates of 12 months and 18 months after operation in CTCs negtive patients with gastric cancer were higher than that CTCs positive patients (P<0.05). ConclusionsThe detection of CTCs is easy to manage and repeatable. The positive rate of CTCs in gastric patients is higher, which can reflect the progression of tumor and serve as the prognostic index in gastric cance patients.
ObjectiveTo evaluate the value of real-time indocyanine green fluorescence imaging navigation (ICG-FIN) in laparoscopic rectal cancer surgery. MethodsThe patients who adopted ICG-FIN during laparoscopic rectal cancer surgery in the Department of Anorectal Surgery of Xuzhou Central Hospital from April 2022 to June 2023 according to the inclusion and exclusion criteria (ICG-FIN group) were collected, meanwhile matching (1∶1) of patients who did not adopt ICG-FIN during laparoscopic surgery from January 2021 to May 2022 (control group). The general data, surgical conditions, intraoperative and postoperative outcomes between the two groups were compared. ResultsThere were 62 patients in the ICG-FIN group and 62 patients in the control group. There were no statistical differences in the gender, age, body mass index, comorbidities, and so on between the two groups (P>0.05). The tumor localization, lymph node tracing, fluorescence imaging of the intended resection of intestinal tract and anastomotic site were observed in the ICG-FIN group. Seven patients (11.3%) had changed in the intended resection of intestinal anastomotic line during surgery, while there were no changes of the surgical plan in the control group. There were no statistical differences (P>0.05) in terms of surgical method, operative time, intraoperative bleeding, proportion of ileostomy, time of the first postoperative exhaust, postoperative hospital stay, and incidence of short-term complications between the two groups. Compared with the control group, the incidence of anastomotic leakage was lower (P=0.012), and the number of lymph nodes cleaned was more (P=0.016) in the ICG-FIN group. However, there was no statistical difference in the number of positive lymph nodes detected between the two groups (P=0.343). ConclusionsAccording to the results of this study, ICG-FIN is a reliable and effective method during laparoscopic rectal cancer surgery, which can accurately localize tumor, trace and guide lymph node dissection. Real-time evaluation of intestinal blood flow perfusion is of great practical value in reducing anastomotic leakage.
Objective Using chemically extracted acellular methods to treat extracranial section of the canine whole facial nerve, to evaluated its effects on nerve structure and the removal extent of Schwann cells and myel in. Methods Twenty whole facial nerves were exposed from 10 canines [weighing (18 ± 3) kg]. The extracranial trunk of canine facial nerve and its branches (temporal branch, zygomatic branch, buccal branch, marginal mandibular branch, and cervical branch) were dissected under l ight microscope. Twenty facial nerves were divided into the experimental group (n=12) and control group (n=8) randomly. In experimental group, the nerve was extracted with the 3%TritonX-100 and 4% sodium deoxycholate. In control group, the nerve was not extracted. HE staining and immunofluorescence histological stainings for Hoechst33258, P75, Zero, and Laminin were performed. Results After histological staining, it was found that myel in and Schwann cells were removed from the facial nerve while the basal lamina tube remained intact. The whole canine facial nerves (one nerve trunk and multiple nerve branches) had the similar result. Conclusion The canine whole facial nerve has natural structure (one nerve trunk and multiple nerve branches) by extracted with chemically extracted acellular methods, so it is an available graft for repairing the defect of the whole facial nerve.
ObjectiveTo understand the methods of judging the blood supply of parathyroid during thyroidectomy at home and abroad in recent years. MethodThe literature on parathyroid blood supply was collected, the research progress was reviewed, and the advantages and disadvantages of related methods were analyzed. ResultsIn recent years, near-infrared fluorescence, laser speckle contrast imaging and other technologies had been applied. They showed better advantages as compared with naked eye observation. The research on parathyroid blood supply at home and abroad was still in its infancy, and more clinical samples and related equipment optimization were still needed. ConclusionFluorescence imaging technology has a certain auxiliary role in the judgment of intraoperative parathyroid blood supply and can reduce the incidence of hypoparathyroidism to a certain extent.
Objective To insure early detection and hence efficient prevention of allograft rejection in transplanted heart, investigate possible applications of NAD(P)H fluorescence components analysis at the level of living cardiac cells to propose new approaches for diagnosis of rejection. Methods NAD(P)H was studied for noninvasive fluorescent probing of the mitochondrial function. Human cardiomyocyte were isolated from one additional endomyocardial biopsy (EMB) of 14 pediatric patients with heart ransplantation. Rat cardiomyocyte (n=5, 13-14 week old) were also isolated by the same approach for human myocytes. Autofluorescence(AF) was recorded in living cardiomyocytes following excitation with 375 nm UVlight and detection by spectrallyresolved time correlated single photon counting (TCSPC), based on the simultaneous measurement of the fluorescence spectra and lifetimes. Rat cardiac cells were divided into four groups: normoxic condition, normoxia with Rotenone, ischemic condition and ischemia with Rotenone. Comparison of cardiomyocyte AF between human and rat; compared kinetics of rat cardiomyocytes AF in normoxic conditions to ischemiamimicking ones, induced at physiological temperatures by reducing cell pH and oxygen content; comparison of cardiomyocyte AF dynamic changes in transplanted pediatric patients presenting either no rejection (R0) or mild rejection (R1). Results We have achieved appropriate isolation of living cardiomyocytes from human biopsies, as well as from rat cardiac tissues and determined their AF. At least a 3-exponential decay with 0.5-0.7ns, 1.9-2.4 ns and 9.0-15.0 ns lifetime pools is necessary to describe human cardiomyocyte AF within 420560 nm spectral range. Rat cardiomyocyte steadystate AF in ischemiamimicking condition was significantly increased when compared normoxic ones (Plt;0.05); application of Rotenone induced a significant increase in AF intensity in ischemic and normoxic condition, however no significant difference between the two groups (Plt;0.05).Human cardiomyocyte AF was found significantly lower in comparison to experimental rat model in the same condition(Plt;0.05). A correlation between changes in steadystate NAD(P)H fluorescence and rejection grades was found when comparison of R1 to R0. R1 showed significantly increased fluorescence intensity (Plt;0.05), without change in the spectra shape, results can be comparable to the effect of ischemiamimic conditions. Conclusion Our studies clearly demonstrated that spectrallyresolved fluorescence spectral analysis coupled to fluorescence lifetime are high sensitive approaches to examine mitochondrial metabolic oxidative state directly in living human cardiomyocytes with good reproducibility. Human cardiomyocytes are more metabolically active than the rat ones, while this activity (and thus ATP production) seems lowered during rejection process. In perspective, the advantage of this method is the possibility of its combination to multiphoton confocal microscopy, which can result in the adaptation of this approach directly to tissue biopsy, as well as in vivo directly via cardiac catheterization without the necessity of cell isolation. This approach provides promising new tool for clinical diagnosis and treatment of allograft rejection, and will enhance our knowledge about cardiomyocyte oxidative metabolism and/or its dysfunction at a cellular level.
ObjectiveTo investigate the application value of indocyanine green (ICG) fluorescence imaging technology for determining the blood supply of parathyroid in thyroid surgery.MethodsThe patients who underwent total thyroidectomy and bilateral central lymph node dissection for papillary thyroid carcinoma (PTC) from June 1, 2017 to January 1, 2018 were prospectively enrolled and then divided into a study group and control group randomly. The study group used the ICG fluorescence imaging technology to evaluate the blood supply of the parathyroid glands, while the control group assessed the blood supply by naked eyes, then determined that whether the parathyroid glands were retained in situ or autotransplanted. The incidence of hypoparathyroidism, length of hospital stay, and parathyroid hormone (PTH) were compared between the two groups.Results① A total of 60 patients with PTC were included in the study, and 30 patients in each group. There were no significant differences in the baseline informations of the two groups such as the gender, age, comorbidities, and preoperative PTH, Ca2+ levels, etc. (P>0.05). ② The ICG score of type A parathyroid glands (except type A3) was lower than that of type B parathyroid glands (0.99±0.38 versus 1.45±0.58, t=–2.395, P<0.05). ③ The length of postoperative hospital stay was shorter in the study group than in the control group (t=–2.159, P=0.035). ④ The ICG fluorescence imaging could significantly reduce the incidence of temporary hypoparathyroidism (χ2=5.079, P=0.024). The incidence of permanent hypoparathyroidism was not statistically different between the two groups (χ2=1.000, P=0.317), and only 1 case appeared in the control group. ⑤ There were no statistically significant differences in the PTH and serum Ca2+ levels at day 1, month 1, month 3, and month 6 after the surgery between the two groups (P>0.05). ConclusionICG fluorescence imaging technology could be used to determine blood supply of parathyroid in situ in real time during operation. Further studies are needed to confirm this conclusion.
ObjectiveTo summarize the application status and progress of indocyanine green fluorescence imaging in laparoscopic anatomic liver resection , and to analyze its advantages, limitations, and prospects.MethodThe literatures about indocyanine green fluorescence imaging in laparoscopic anatomic liver resection were reviewed.ResultsIndocyanine green fluorescence imaging had been preliminarily used in the operation of liver tumors and had shown its unique value in the anatomical liver resection, providing a new way to reduce the recurrence of liver cancer, improve the therapeutic effect, and prolong the survival time of patients.ConclusionsThe clinical application of indocyanine green fluorescence imaging in anatomic liver resection is still at the stage of development and popularization. Although it has unique advantages and development potential, it needs to be further improved in the aspects of tissue penetration, specificity, and staining success rate.
ObjectiveTo summarize the application progress of indocyanine green (ICG) angiography in diagnosis and treatment of lymphedema.MethodsThe literature related to dynamic imaging tracing of lymphedema at home and abroad was reviewed extensively. And the research status and progress of ICG angiography in diagnosis and treatment of lymphedema were retrospectively analyzed.ResultsICG angiography can be used as the gold standard for the diagnosis of lymphedema at present and the classification of lymphedema severity, selection of surgical incisions and methods, and intraoperative operation. It can also be used to observe lymphatic drainage and regeneration within 1.5 cm of subcutaneous and determine the prognosis.ConclusionCompared with traditional methods, ICG angiography has more obvious advantages and value in diagnosis and treatment of lymphedema. However, it also has problems such as slow development speed and difficulty in developing deep lymphatic vessels (nodes).