The minimally invasive approach is the direction of cardiac surgery.With the development of telemanipulation and computer technology,the minimally robotic surgery has become reality.As the one of the most minimally invasive cardiac surgery,the robotic surgical system provides cardiac surgeons with less invasive manner and dexterity manipulation.Robotic cardiac surgery is an evolutionary process and has resulted in a substantial increased attention to surgeons and patients.This review is to introduce the recent clinical application of robotic technology in cardiac surgery.

ObjectiveTo investigate the prevention and management of the hemorrhage during laparoscopic cholecystectomy( LC), and improve success ratio. MethodsThe medical data of 420 cases with LC from May 2003 to 2009, September were analyzed retrospectively, including total number, hemorrhage site and ways of prevention and management. Results417 cases experienced successful C,with success ratio 99.3%. 49 cases ( 11.7% ) had hemorrhage, and in 46 cases(93. 9% ), it was stopped by laparoscope or hemostasis by compression,3 cases were rescued by operation. All hemorrhage sites included 15 cases(30. 6% ) in triangle de Calot,26 cases(53. 1% ) in gallbladder bed, and 8 cases ( 16.3% ) in incision. ConclusionA reliable opetration and appropriate hemostasis are critical of the successful operation and prevention of complications after LC.

Biological Therapy ; Carcinoma, Neuroendocrine ; Thyroid Neoplasms ; therapy

Thyroid cancer is the most common malignant tumor of the human endocrine system. A papillary thyroid microcarci-noma (PTMC) is usually defined as a papillary thyroid tumor that is less than 10 mm in diameter. The incidence of thyroid cancers has obviously increased in recent years. The surgical treatment of PTMC differs in China and overseas. Aside from conventional surgery, novel surgical methods, such as ultrasound-guided percutaneous ablation, have been used for the surgical treatment of PTMC. This arti-cle mainly discusses the research progress in the surgical treatment of PTMC.

Familial non-medullary thyroid carcinoma (FNMTC) is de fi ned as the presence of two or more affected fi rst-degree relatives with non-medullary thyroid cancers without other known familial syndromes. FNMTC is one of the most inheritable forms of all cancers, with a high risk of a first-degree relative developing the disease. Compared with sporadic non-medullary thyroid carcinoma (NMTC), FNMTC presents at a younger age and is associated with a higher incidence of multifocal disease and metastasis. This in-creased aggressiveness has been hypothesized to translate into higher recurrence rates and decreased survival of patients with FNMTC. The genes involved in the pathogenesis of FNMTC are yet to be elucidated, although some recent studies identified several predisposi-tion loci with a high degree of genetic heterogeneity. Since 2005, next-generation sequencing (NGS) technologies have been developing as rapid, high-throughput, and cost-effective approaches to fulfill medical sciences and research demands. With the use of NGS, the un-derlying causative genes can be directly distinguished via systematic filtering, through which the identified gene variants are verified for novelty and functionality.

Base Sequence ; Carcinoma, Medullary ; genetics ; surgery ; Codon ; genetics ; Exons ; genetics ; Female ; Humans ; Middle Aged ; Mutation ; Proto-Oncogene Proteins c-ret ; genetics ; Thyroid Neoplasms ; genetics ; surgery ; Thyroidectomy

Congresses as Topic ; Otolaryngology

BACKGROUND:There are two ways to treat the enamel before bracket bonding: etching and sandblasting, but the few studies focus on the direct use of sandblasting technology on untreated enamel surface.
OBJECTIVE:To observe the damage of etchingversus sandblasting to the enamel surface, and to compare the bonding strength of metal brackets adhesive to isolated teeth with these two kinds of surface treatments.
METHODS:(1) Nine premolar teeth removed for orthodontic treatment were randomized into three groups: sandblasting, acid etching and polishing treatment groups. Surface roughening effects of these three kinds of treatments were observed under scanning electron microscope. (1) Another 40 premolar teeth removed for orthodontic treatment were randomized into two groups: sandblasting and acid etching groups. At 24 hours after bracket bonding, the shear strength was detected using mechanical testing machine, and the adhesive residue index of tooth surface was statisticaly calculated.
RESULTS AND CONCLUSION: (1) Under the scanning electron microscope, polishing treatment had no damage to the enamel surface; but in the other two groups, the enamel surface was damaged to varying degrees, especialy in the sandblasting group. (2) The bonding strength in the sandblasting group was significantly higher than that in the acid etching group (P < 0.05), but there was no difference in the adhesive residue index of tooth surface between the two groups (P > 0.05). These findings indicate that compared with the acid etching technology, the sandblasting technology can increase the bonding strength between the enamel and metal bracket, but it also results in more damage.

Objective The aim of this study is to address learning curve and clinical outcomes of totally robotic atrial septal defect repair on the basis of a single - center experience.Methods 54 cases of atrial septal defect (ASD) were repaired using “da Vinic S surgical system on arrested ( group Ⅰ,54 cases) or beating heart ( group Ⅱ,40 cases) from January 2007 to December 2010.Learning curves were assessed by means of regression analysis with logarithmic curve fit.The effect of operative variables on clinical outcome was analyzed by linear by regression using the Spearman's rho coefficient.Results All cases were accomplished successfully without complications.No residual shunt was detected at intraoperative or postoperative echocardiography.Significant learning curves were noted for corss clamp time in group Ⅰ:y (min) =68.741 -8.283 (n) (x)( r2 =0.489 ; P ＜ 0.01 ) ; the operation time in group Ⅱ:y (min) =355.51 - 56.29 (n) (x) ( r2 =0.581 ; P ＜ 0.01 ).No correlation was detected between operation time,cardiopulmonary bypass time,or cross clamp time and intubation time,intensive care unit stay,or total length of stay.Conclusion The robotic atrial septal defect repair can be performed safely.The learning curves is steep and the longer cardiopulmonary bypass times,operation time or cross clamp time had no negative impact on intraoperative and postoperative outcome.

BACKGROUND: We can investigate mechanism of endogenous neuroprotection in rat cerebral hypoxic tolerance trial. OBJECTIVE: To observe the characteristics of cerebral hypoxic tolerance in rat models with cerebral hypoxic preconditioning. DESIGN: Randomized controlled observation. SETTING: Department of Neurology, China-Japanese Friendship Hospital, Jilin University. MATERIALS: The experiment was performed in the Basic Animal Experimental Center, China-Japan Friendship Hospital, Jilin University from April 2003 to April 2004. Inbred line healthy Wistar rats, of either sex, with the body mass of 200-300 g, were randomly assigned into normal control group (n=6), sham operation group (n=6), ischemic control group (n=20), hypoxic preconditioning (3 hours, 8% O2 and 92% N2) plus ischemic group (n=60) (according to different hypoxic phases, there were 5 time phases: 30 minutes, 1, 3, 5 and 6 hours with 12 rats in each time phase), hypoxic preconditioning group (n=18) [according to different hypoxic phases, there were 3 time phases: 1, 3 and 5 hours with 6 rats in each time phase, 3 rats received TTC staining and 3 rats received hematoxylin and eosin (HE) staining]. METHODS: ①Hypoxic preconditioning: Firstly, natrica calx was put into closed glass container to absorb CO2 and O2, secondly, mixed gas of 8% O2 and 92% N2 was input, and then animals were put into the container, 3 rats each time. Temperature and humidity were kept steadily. ②Permanent ischemic middle cerebral artery rat models were established. ③The models were determined with a series in procedures: neurological score, infarcted volume evaluation, pathological sample preparation, immunohistochemical staining, imaging analysis and so on. ④The data were compared in groups with variance analysis.MAIN OUTCOME MEASURES: Changes in cerebral infarcted volume, neurological score and pathological morphology in rats of experimental group and control group. RESULTS: Neurological score in the hypoxic preconditioning (8% O2, at hours 1, 3 and 5) plus ischemic group was lower than in the ischemic control group(P＜0.01). Neurological score at minute 30 and hour 6 after hypoxia (8% O2) had insignificant difference in the ischemic control group. Mean cerebral infarcted volume ratio in the hypoxic preconditioning (8% O2, at hours 1, 3 and 5) plus ischemic group was lower than in the ischemic control group(P＜0.01). Mean cerebral infarcted volume ratio after hypoxia (8% O2, at minute 30 and hour 6) had insignificant difference with ischemic control group (P＞0.05). CONCLUSION: Hypoxic preconditioning in rats can effectively release nerve injury induced by focal cerebral ischemia, suggesting that it has protective effect on brain. The procedure of establishing cerebral ischemic tolerance models with hypoxic preconditioning, which is simple and stable, with little injury on experimental animals, is a useful tool for studying cerebral ischemic tolerance.