Three-dimensional modeling of the liver using CT scan or MRI data improves surgical planning.Threedimensional simulation of hepatectomy facilitates intraoperative identification of the vascular anatomy and control of the hepatic blood flew,and accurately predicts the volume of liver to be resected and surgical margins.Preoperative virtual hepatectomy might be useful not only to facilitate laparoscopic hepatectomy but also to improve therapeutic efficacy. A virtual navigation system enables users to revert to previously recorded digital imaging data at any time during radiofrequency ablation procedures.The spatial information gained from three-dimensional imaging facilitates an appropriate needle path to the target and projects the intended ablation area in three dimenisions.The safety and efficacy of radiofrequency ablation assisted by this navigation system may substantially improve as it is used in clinical practice. Augmented reality superimposes the preoperative threedimensional liver model onto the real intraoperative view of the patient.Augmented reality provides surgeons with a transparent view of the liver and guides surgeons by providing virtual augmentation of their real surgical tools.These virtally augmented tools are tracked in real-time during the procedure,thereby optimizing therapy.

Objective　To study the expression of 5 multidrug-resistant genes in hepatocellular carcinoma (HCC) and establish the criteria for genetic diagnosis of multidrug resistance (MDR). Methods　The expression of mRNA and proteins of the multidrug-resistant genes were detected with reverse transcriptase polymerase chain reaction (RT-PCR) and flow cytometry (FC) respectively. IC50 of the original HCC cells was determined with MTT method. Results　MDR in HCC was associated with the genes of mdr1, MRP, LRP, Topo II α and GSTTP1. mdr1 mRNA ≥0.5, MRP mRNA ≥0.6, LRP mRNA ≥0.8, GSTP1 ≥0.7 and Topo II α mRNA ≤0.4 could be used as the criteria for genetic diagnosis of MDR in HCC. Conclusion　The complex MDR is the main form of drug resistance of HCC. Using RT-PCR to detect the mRNA expression of 5 multidrug-resistant genes is necessary and feasible for predicting sensitivity of chemotherapy for HCC.

The postoperative neurological complications is associated with intraoperative cerebral emboli, which results from extracorporeal circulation and operation. It can effectively reduce the incidence of neurological complications with ultrasonic radiation. In fluids, a particle will change it's motion trail when it is acted by the radiation force generated by the ultrasound. This article mainly discuss how to shielding emboli with ultrasound. The equipment can transmit phased ultrasonic signals, which is designed on a FPGA development board. The board can generate a square wave, which is converted into a sine wave through a power amplifier. In addition, the control software has been developed on Qt development environment. The result indicates it's feasible to shielding emboli with ultrasonic radiation force. This article builds a strong foundation for the future research.
Humans ; Intracranial Embolism ; diagnostic imaging ; prevention & control ; Intraoperative Complications ; prevention & control ; Postoperative Complications ; prevention & control ; Ultrasonics ; instrumentation ; Ultrasonography

BACKGROUND:Each clinical treatment option for avascular necrosis of the femoral head has its own advantages and disadvantages, but early diagnosis and early treatment are firmly rooted in most of orthopedic doctors, and the purpose of treatment is focused on how to preserve the femoral head and how to maintain the hip function.
OBJECTIVE:To summarize the current opinions and studies concerning the treatment of avascular necrosis of the femoral head, including core decompression and porous tantalum rod implantation, and to elucidate the clinical results and cost-effectiveness of the use of porous tantalum rod.
METHODS:The PubMed database was searched by the first author for the articles on the aspect of pathogenesis, risk factors, disease staging and treatment options of avascular necrosis of the femoral head from January 1985 to August 2013 with the key words of“avascular necrosis”,“osteonecrosis of the femoral head”and “tantalum rod”in titles or abstracts. Literatures exhibiting poor correlation with the research purpose and duplicate literature were excluded, and final y, 42 articles were included in result analysis.
RESULTS AND CONCLUSION:The key point of treating avascular necrosis of the femoral head depends on early diagnosis and early intervention. Core decompression plus porous tantalum rod implantation is a minimal y invasive technique in treating early-stage avascular necrosis of the femoral head, in which the subchondral fracture and the femoral head col apse do not occur. If core decompression and porous tantalum rod implantation is used properly, this option does delay or prevent the progress of avascular necrosis of the femoral head. But, if avascular necrosis of the femoral head is in late stage, which means that subchondral fracture and the femoral head col apse occur, the clinical results of this option are poor. Although porous tantalum rod implantation in the treatment of early-stage avascular necrosis of the femoral head demonstrates good exciting short-term results, the clinical value of its long-term results and cost-effectiveness should be elucidated in multicentre, double-blinded, randomized, control ed trials in the future.

Objective : To investigate equity of resource allocation in ophthalmology departments of medical institutions in Shenzhen City, so as to provide insights into the optimization of resource allocation in ophthalmology departments in Shenzhen City. Methods : The numbers of beds and ophthalmologists in ophthalmology departments of medical institutions in Shenzhen City were collected through the Shenzhen Health Statistical Yearbook 2019. The distribution of resources and equity of resource allocation were evaluated in ophthalmology departments of Shenzhen City using Lorenz curve and Gini coefficient. Results : There were 5.95 beds and 4.62 ophthalmologists in ophthalmology departments per 100 000 permanent residents in Shenzhen City in 2019. There were 13.35 beds and 9.51 ophthalmologists in ophthalmology departments per 100 000 permanent residents within the former special zone (Luohu, Futian, Nanshan and Yantian districts), and 2.17 beds and 2.13 ophthalmologists in ophthalmology departments per 100 000 permanent residents outside the former special zone (Guangming, Baoan, Longhua, Longgang, Pingshan districts and Dapeng New Area). The Gini coefficients of beds and ophthalmologists in ophthalmology departments were 0.348 and 0.243 by permanent residents in Shenzhen City, 0.386 and 0.386 within the former special zone and 0.086 and 0.012 outside the former special zone, respectively. The Lorenz curves of beds and ophthalmologists in ophthalmology departments were closer to the equity line outside the former special zone in relative to within the former special zone. Conclusion The gross number of beds and ophthalmologists remains to be increased in ophthalmology departments of medical institutions in Shenzhen City, and the equity of regional resource allocation is poor, which is mainly characterized by resource scarcity in ophthalmology departments outside the former special zone.

Objective:To investigate the impacts of two anesthesia approaches on infections of immunological parameters during splenectomy in hepatocellular carcinoma patients .Methods: Sixty hepatocellular carcinoma patients were divided into two groups randomly,each groups was thirty (liver function Child-Pugh grade was A-B).Total intravenous anesthesia with pmpofol group (group A,n=30 ) and combined intravenous inhalational anesthesia with sevoflurane group (group B,n=30 ).Before induction of anesthesia , at the end of operation ,and after operation 24 hours.blood samples were collected to determined with the level of CD 3+,CD4+,CD8+, CD4+/CD8+and TNF-α, IL-2, IL-6 of hepatocellular carcinoma patients .Results: The perioperative physiological index MAP , HR, SpO2,RR each point had no obvious difference between two groups (P>0.05).The levels of CD3+,CD4+,CD8+,CD4+/CD8+had no significant difference between two groups before anesthesia (P>0.05).There was no significant changes in CD3+,CD8+with two groups in all moments.Compared with the T0,A,B two groups of CD4+,CD4+/CD8+were lower (P<0.05)in T1 point,but T2 point and T0 point had no significant difference in group B .The levels of CD4+,CD4+/CD8+in group B were higher than in group A ( P<0.05 ) . Compared with T0 moment,group A and group B patients postoperative IL-6 in T1,T2 level increased significantly (P<0.05),and there was no statistically significant difference between group A and group B in all moment .( P>0.05 ) .Compared with the T0 moment,there was no significant change in group A of TNF-αlevel (P>0.05),while group B increased significantly in postoperative day ( P<0.05 ) .The level of IL-2 in each moment interval between the two groups had no significant difference ( P>0.05 ) . Conclusion: Both total intravenous anesthesia with pmpofol and combined intravenous inhalational anesthesia with sevoflurane inhibit the immune function of the patients with hepatocellular carcinoma cell immune reaction .The inhibitory effect of sevoflurane inhalation anesthesia on cell immune function is less affected .

Objective:To evaluate the effect of Arg and Gln enriched PN on nutrition status,immune function and stress status of gastric cancer patients after radical treatment.Methods:Eighty patients with gastric cancer were randomly divided into 4 groups: arg group(arginine enriched PN group),Gln group(glntamine supplemented PN group),Arg+Gln group(arginine and glutamine enriched PN group)and Rou group(Routine PN group).The distinct immune nutrients were added into PN in the different groups for 7 consecutive days.The difference of the patients' nutrition status,immune function and stress status were analyzed after operation.Results: The nutritional station and immunue fuction in Arg group,Gln group and Arg+Gln group were better than in Rou group on the 8th postoperative day.The concentration of CRP in the Arg+Gln group was different from that in other groups(P

Objective To analyze the diagnostic value of serum procalcitonin ( PCT ) for early postoperative bacterial infection after pediatric living donor liver transplantation.Methods A retrospective study was conducted in pediatric patients after living donor liver transplantation recipients admitted to department of critical care medicine of Beijing Friendship Hospital affiliated to Capital Medical University during June 2013 to October 2015.According to the clinical data , all pediatric patients were divided into infection group(n=60) and non-infection group (n=100).Primary disease, PCT post operation day 1 to day 5 for non-infection group and day 1 to day 9 for infection group , temperature , white blood cell , cold ischemia time, warm ischemia time, operation time, volume of blood loss during operation were recorded.All parameters above were compared between groups.Receiver operating characteristic ( ROC) curve was plotted, and the diagnostic value of PCT was evaluated.Results PCT of both groups were elevated after liver transplantation , there was a markedly resolution in non-infection group within 48 to 72 hours.PCT of pediatric patients with bacterial infection was significantly higher than that of non-infected patients , and the difference was of greatly significant (4.62 ±1.39) ng/ml vs (0.85 ±0.19) ng/ml,t=26.56,P=0.00.ROC curve showed that the peak level of PCT might be valuable in the diagnosis of bacterial infection ( AUC=0.985).There was no significant difference of cold ischemia time [(109.92 ±19.22) min vs (108.04 ± 13.20) min, t=1.05, P=0.29], warm ischemia time[(1.49 ±0.17) min vs (1.52 ±0.12) min, t=1.08, P=0.28], operation time[(8.01 ±0.77)vs (8.00 ±1.05) h, t=0.06, P=0.94], WBC[(8.95 ±1.69) ×109/L vs (8.98 ±2.00) ×109/L,t=-0.08, P=0.93]and body temperature[(37.5 ±0.7) vs (37.5 ±0.8) ℃,t=-0.05, P=0.96] on the first day after surgery between infection and non-infection groups.Amount of bleeding in infection group was higher than that of non infection group [ ( 650.87 ± 90.36) ml vs (240.29 ±67.67) ml, t=32.33, P=0.00], there was longer length of ICU stay in the infection group[(11.01 ±1.81)d vs (6.03 ±1.65)d, t=17.78, P=0.00].Conclusion Peak PCT level was a valuable indicator for early postoperative bacterial infection after pediatric living donor liver transplantation.

To develop a safe and efficient recombinant subunit vaccine to foot-and-mouth disease virus(FMDV)type Asia 1 in sheep,a tandem repeated multiple-epitope gene consisting of residues 137-160 and 197-211 of the VP1 gene of FMDV was designed and artificially synthesized.The biologically functional molecule,the ovine IgG heavy constant region(oIgG)as a protein carrier was introduced for design of the multiple-epitope recombinant vaccine and recombinant expression plasmids pET-30a-RE and pET-30a-RE-oIgG were successfully constructed.The recombinant proteins,RE and RE-oIgG,were expressed as a formation of inclusion bodies in E.coli.The immune potential of this vaccine regime in guinea pigs and sheep was evaluated.The results showed that IgG could significantly enhance the immune potential of antigenic epitopes.The recombinant protein RE-oIgG could not only elicit the high levels of neutralizing antibodies and lymphocytes proliferation responses in the vaccinated guinea pigs,but confer complete protection in guinea pigs against virus challenge.Although the recombinant protein RE could not confer protection in the vaccinated animals,it could delay the appearance of the clinical signs and reduce the severity of disease.Inspiringly,the titers of anti-FMDV neutralizing antibodies elicited in sheep vaccinated with RE-oIgG was significantly higher than that for the RE vaccination.Therefore,we speculated that this vaccine formulation may be a promising strategy for designing a novel vaccine against FMDV in the future.

Objective To investigate the correlated factors of pulmonary metastasis of hepatocellular carcinoma (HCC),so as to provide theoretical evidences for the prevention and treatment.Methods The clinical data of 862 patients with HCC who were admitted to the First Affiliated Hospital of Fujian Medical University from January 2008 to March 2012 were retrospectively analyzed.There were 107 patients with pulmonary metastasis.Factors including serum alpha fetoprotein (AFP) level,serum gamma-glutamyl transpeptidase (GGT) level,hepatitis B virus (HBV) infection,presence and treatment of intrahepatic tumor were analyzed to screen out relevant factors of pulmonary infection of HCC.Univariate and multivariate COX regression model analysis were performed for data analysis.Results The results of univariate analysis showed that high level of AFP (≥400 μg/L),ultra-high level of GGT (≥ 150 U/L),presence of HBV infection,the number of intrahepatic tumors ≥2,no radical resection (or radiofrequency ablation) for intrahepatic tumors,combining with tumor thrombi in the vessels,lymph node metastasis were risk factors of pulmonary metastasis of HCC (RR =1.986,3.653,0.365,3.675,0.252,0.379,0.352,P ＜ 0.05).The results of multivariate analysis showed that high level of AFP (≥400 μg/L),HBV infection,the number of intrahepatic tumors ≥2,no radical resection (or radiofrequency ablation) for intrahepatic tumors,combining with tumor thrombi in the vessels were risk factors of pulmonary metastasis of HCC (RR =2.391,3.462,3.425,3.396,2.418,0.638,P ＜ 0.05).Conclusions AFP ≥400 μg/L,HBV infection,the number of intrahepatic tumors ≥ 2,no radical resection (or radiofrequency ablation),tumor thrombi in the vessels and lymph node metastasis are risk factors of pulmonary metastasis of HCC.Anti-hepatitis virus treatment and early treatment are helpful for the prevention and treatment.