The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes.This study presents a smartphone-integrated handheld automated biochemical analyzer(sHABA)designed for point-of-care testing of urinary albumin.The sHABA features a pre-loaded,disposable reagent cassette with re-agents for the albumin assay arranged in the order of their addition within a hose.The smartphone-integrated analyzer can drive the reagents following a preset program,to enable automatic sequential addition.The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L.The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity(95.78％)and specificity(90.16％).This research advances the field by providing an automated detection method for albumin in a portable device,allowing even untrained individuals to monitor CKD in real time at the patient's bedside.In the context of promoting tiered diagnosis and treatment,the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.

The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease (CKD). However, existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes. This study presents a smartphone-integrated handheld automated biochemical analyzer (sHABA) designed for point-of-care testing of urinary albumin. The sHABA features a pre-loaded, disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose. The smartphone-integrated analyzer can drive the reagents following a preset program, to enable automatic sequential addition. The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L. The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity (95.78%) and specificity (90.16%). This research advances the field by providing an automated detection method for albumin in a portable device, allowing even untrained individuals to monitor CKD in real time at the patient's bedside. In the context of promoting tiered diagnosis and treatment, the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.

Primary retroperitoneal sarcomas,due to its special anatomical structure and lack of specific clinical manifestations in early stages,often leads to delayed diagnosis.because of the lack of specific clinical manifestations.By the time patients present with noticeable symptoms or palpable masses during clinical examination,the tumors has typically grown significantly in size and exhibits invasive growth patterns,frequently involving adjacent organs.Surgical treatment often necessitates multivisceral en bloc resection,with combined resection and functional reconstruction of gastrointestinal organs becoming critical components of the procedure.The surgical management of primary retroperitoneal sarcoma is characterized by extensive resection scope,technical complexity,and challenges in achieving complete tumor removal with wide clear negative margins.Additionally,the high propensity for local recurrence further increases the complexity of patient management.Current research on surgical treatment strategies for primary retroperitoneal sarcoma,particularly systematic studies focusing on combined gastrointestinal resection and functional reconstruction,remains insufficient.To enhance clinical understanding and optimize surgical approaches,this article systematically reviews domestic and international literature to summarize current research status and recent advancements in combined gastrointestinal resection and functional reconstruction for primary retroperitoneal sarcoma.

Background and purpose:Limbs soft tissue sarcoma(STS)is a common malignant tumor,and surgical resection is the main treatment method for it.The concept of barrier made us realize the blocking effect of natural barrier on STS,and we aimed to search for tissues that can act as barrier,and to perform complete resection of surgical margins around the tissue barrier.This study aimed to investigate the feasibility,safety and prognosis of barrier resection in the treatment of limbs STS.Methods:From December 2013 to September 2016,data of 72 patients who underwent barrier resection of STS of extremities in department of oncosurgery,Minhang Branch,Fudan University Shanghai Cancer Center were retrospectively analyzed,and the resection margin was sampled.All 72 patients underwent preoperative magnetic resonance imaging(MRI)or computed tomography(CT)design,and the physiological barrier or at least 3 cm distance was found outward from the anatomical location of the tumor.And en bloc excision was performed outside this barrier or at a distance of 3 cm.The influence of postoperative pathological margin,musculoskeletal tumor society(MSTS)score and postoperative complications on the patients were analyzed.The 1-and 3-year locoregional recurrence-free survival(LRFS)rates and sarcoma-specific survival(SSS)rates were evaluated,and the influencing factors were analyzed.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(number:1212117-12&1212117-12-1301).Results:All patients had negative margins.The 1-and 3-year LRFS rates were 98.2%and 93.3%,respectively.The 1-and 3-year SSS rates were 98.4%and 94.2%,respectively.The mean MSTS scores were 28.3 preoperatively and 25.5 postoperatively.Surgical complications were grade 1 to 2 in 20 cases and grade 3 in 1 case,and there were no grade 4 to 5 complications.Conclusion:Based on the combination of clinical,imaging and pathology data,barrier resection,including tumor resection and functional reconstruction,can be applied to the surgical treatment of STS,with good feasibility and safety,reliable margin and satisfactory local control.

Primary retroperitoneal sarcomas,due to its special anatomical structure and lack of specific clinical manifestations in early stages,often leads to delayed diagnosis.because of the lack of specific clinical manifestations.By the time patients present with noticeable symptoms or palpable masses during clinical examination,the tumors has typically grown significantly in size and exhibits invasive growth patterns,frequently involving adjacent organs.Surgical treatment often necessitates multivisceral en bloc resection,with combined resection and functional reconstruction of gastrointestinal organs becoming critical components of the procedure.The surgical management of primary retroperitoneal sarcoma is characterized by extensive resection scope,technical complexity,and challenges in achieving complete tumor removal with wide clear negative margins.Additionally,the high propensity for local recurrence further increases the complexity of patient management.Current research on surgical treatment strategies for primary retroperitoneal sarcoma,particularly systematic studies focusing on combined gastrointestinal resection and functional reconstruction,remains insufficient.To enhance clinical understanding and optimize surgical approaches,this article systematically reviews domestic and international literature to summarize current research status and recent advancements in combined gastrointestinal resection and functional reconstruction for primary retroperitoneal sarcoma.

Objective:To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection.Methods:Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed.Results:Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period.Conclusion:Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

Objective:To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection.Methods:Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed.Results:Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period.Conclusion:Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

Robot-assisted laparoscopy hepatectomy (RALH) is a new technique for surgical operation. Compared with conventional laparoscopic hepatectomy, RALH is more frequently used in complex liver tumor and liver tumor with special locations, but this technique is still under development and is limited by the burden of high costs and surgical devices. Meanwhile, there is a lack of generally accepted and confirmed clinical data, and therefore, the role of RALH is still under debate. This article reviews the surgical indication, learning curve, advantages, and limitations of RALH.

Objective To explore the safety and efficacy of laparoscopic cholecystectomy in different time points after endoscopic retrograde cholangiopancreatography in elderly patients with cholecystolithiasis and choledocholithiasis. Methods 99 elderly patients （≥60 years old）with cholecystolithiasis and choledocholithiasis treated by sequential LC after ERCP in the Department of Hepatobiliary and Pancreatic surgery in our hospital from January 2015 to June 2020 were analyzed. Aocording to different time points after ERCP, LC was divided into experimental group (within 1 day after ERCP) and control group (within 2-7 days after ERCP). The complications were followed up by telephone within 3 months after operation. Results After analysis，the difference between the experimental group and the control group in the total length of hospitalization [(13.0±4.6)d vs ( 15.1±4.4)d] and total hospitalization expenses (38 172.5±12 448.9) vs ( 42 535.4±8 814.6)] was statistically significant (P<0.05). However, there was no significant difference in the conversion rate of LC to laparotomy, the total postoperative complications , the length of hospital stay after LC，the amount of blood loss during LC and the time of LC operation between the two groups(P>0.05). Conclusion For elderly patients with cholecystolithiasis and choledocholithiasis, LC within 1 day after ERCP does not increase the difficulty of operation and postoperative complications，but shortens the hospitalization time, and it is economical and safe at the same time.