With the rapid development of minimally invasive techniques in surgery, arti-ficial intelligence (AI), particularly deep learning, is playing an increasingly important role in mini-mally invasive surgery. By automated analysis of surgical videos, AI can efficiently perform key tasks such as instrument recognition, surgical phase identification, action analysis, anatomical structure recognition, intraoperative diagnosis, adverse event monitoring and smart desmoking. These appli-cations provide essential support for real-time monitoring, surgical navigation and skill assessment during surgery. The authors summarize the current research progress of AI in minimally invasive surgery, including its applications in the fields of hepatobiliary and pancreatic surgery, as well as gastrointestinal surgery. It also explores the potential of AI in enhancing surgical safety, efficiency and skill assessment. By synthesizing the latest research achievements of AI technology in the field of surgery, as well as analyzing its technical challenges and risks, it aims to provide guidance for future innovations and clinical applications, promoting the advancement and implementation of AI in minimally invasive surgery.

Purpose To investigate the changes in quadriceps femoris microcirculatory perfusion level after low-load blood flow restriction training and its relationship with muscle strength.Materials and Methods Twenty-five healthy subjects were prospectively recruited in the First Affiliated Hospital of Kunming Medical University from September to November 2022.A 200 mmHg pressure cuff was applied at the root of the left thigh for blood flow restriction,and the subjects completed regular knee extension training within 4 weeks.Before the first training session and within 24 hours after the last training session,all subjects underwent scanning with the 3.0T MRI intravoxel incoherent motion sequence and the multi-echo steady-state acquisition three-dimentional imaging sequence.After image post-processing,the quadriceps femoris cross-sectional area,perfusion fraction and pseudo-diffusion coefficient were obtained,and the peak torque was measured using an isokinetic dynamometer.The MRI and muscle strength test parameters before and after training were compared,and correlation analyses were performed between the change of peak torque and the change of perfusion fraction,cross-sectional area,and pseudo-diffusion coefficient respectively.Results After low-load blood flow restriction training,the cross-sectional area of the left quadriceps femoris in subjects increased(t=-4.515,P<0.05).Among its components,the cross-sectional area of the left rectus femoris,vastus intermedius and vastus lateralis all increased(t=-3.302,-2.877,-3.207,all P<0.05).The perfusion fraction value of the left quadriceps femoris increased(t=-5.447,P<0.05);the perfusion fraction values of the left rectus femoris,vastus intermedius,vastus lateralis and vastus medialis all increased(t=-5.723,-4.621,-3.767,-4.682,all P<0.05);the muscle strength of the left quadriceps femoris increased(t=-3.983,P<0.05).There was a highly positive correlation between change of perfusion fraction and peak torque of the left quadriceps femoris in subjects(r=0.708,P<0.05).Conclusion After low-load blood flow restriction training,the changes in quadriceps femoris muscle microperfusion quantified by intravoxel incoherent motion are related to muscle strength,which is helpful for formulating rehabilitation training strategies for young patients.

Ileocecal duplication is a rare congenital gastrointestinal abnormality,with lesions predominantly localized near the ileocecal valve and manifesting as cystic structures.Clinically,it presents with diverse symptoms,including abdominal pain,vomiting,abdominal mass,etc.However,symptoms such as intussusception and appendicitis are easily confused with it.Furthermore,the imaging features of ileocecal duplication are nonspecific,which further increases the risk of misdiagnosis.Treatment options include laparoscopic surgery and laparotomy.Notably,laparoscopic surgery is highly feasible,especially for infants and young children,and achieves a prognosis comparable to that of laparotomy.In the case report presented in this study,a 1-year-old male patient was admitted to the hospital due to abdominal pain.Definitive diagnosis could not be established through comprehensive imaging examinations,and the diagnosis of ileocecal duplication cyst was ultimately confirmed surgically.Additionally,the diagnosis,imaging features,treatment,and prognosis of ileocecal duplication are systematically collated and summarized.

OBJECTIVE To explore the distribution of pathogens isolated from the cardiac surgery children with postoperative catheter-related bloodstream infection(CRBSI)and observe the transforming growth factor β1(TGF-β1)gene polymorphisms and the change of high-sensitivity C-reactive protein(hs-CRP),Smad homologue 2 and Smad 3 levels.METHODS A total of 88 children who received peripherally inserted central catheter(PICC)puncture after cardiac surgery and were complicated with postoperative CRBSI in the First People's Hospital of Zunyi from Aug.2019 to Oct.2023 were assigned as the infection group.Meanwhile,110 children who were trea-ted with PICC and did not have postoperative CRBSI were randomly chosen as the non-infection group.The base-line data,TGF-β1 gene polymorphisms and the levels of hs-CRP,Smad 2 and Smad 3 were compared between the two groups.The distribution of the pathogens isolated from the infection group was observed.The values of hs-CRP,Smad 2 and Smad 3 in diagnosis of the postoperative CRBSI in the cardiac surgery children were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of patients with intravenous cathe-ter indwelling no less than 10 days,length of intensive care unit(ICU)stay no less than 5 days,the frequencies of CC genotypes and C allele at TGF-β1+869C/T locus were higher in the infection group than those in the non-infection group(P＜0.05).Acinetobacter baumannii was the predominant species of pathogen isolated from the infection group,accounting for 24.20％.The levels of serum hs-CRP,Smad 2 and Smad 3 of the infection group were(24.65±7.65)mg/L,(13.54±2.45)pg/ml and(13.65±2.65)pg/ml,respectively,higher than those of the non-infection group(all P＜0.001).The area under the curve(AUC)of the joint detection of hs-CRP,Smad 2 and Smad 3 was highest in diagnosis of the postoperative CRBSI in the cardiac surgery children(P＜0.05).CONCLUSIONS A.baumannii is dominant among the pathogens isolated from the cardiac surgery children with postoperative CRBSI.The postoperative CRBSI may be associated with the intravenous catheter in-dwelling time and length of ICU stay.The C allele at TGF-β1+869C/T locus may be the susceptibility gene for the postoperative CRBSI.The joint detection of hs-CRP,Smad 2 and Smad 3 has the highest value in diagnosis of the postoperative CRBSI.

OBJECTIVE To explore the distribution of pathogens isolated from the cardiac surgery children with postoperative catheter-related bloodstream infection(CRBSI)and observe the transforming growth factor β1(TGF-β1)gene polymorphisms and the change of high-sensitivity C-reactive protein(hs-CRP),Smad homologue 2 and Smad 3 levels.METHODS A total of 88 children who received peripherally inserted central catheter(PICC)puncture after cardiac surgery and were complicated with postoperative CRBSI in the First People's Hospital of Zunyi from Aug.2019 to Oct.2023 were assigned as the infection group.Meanwhile,110 children who were trea-ted with PICC and did not have postoperative CRBSI were randomly chosen as the non-infection group.The base-line data,TGF-β1 gene polymorphisms and the levels of hs-CRP,Smad 2 and Smad 3 were compared between the two groups.The distribution of the pathogens isolated from the infection group was observed.The values of hs-CRP,Smad 2 and Smad 3 in diagnosis of the postoperative CRBSI in the cardiac surgery children were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of patients with intravenous cathe-ter indwelling no less than 10 days,length of intensive care unit(ICU)stay no less than 5 days,the frequencies of CC genotypes and C allele at TGF-β1+869C/T locus were higher in the infection group than those in the non-infection group(P＜0.05).Acinetobacter baumannii was the predominant species of pathogen isolated from the infection group,accounting for 24.20％.The levels of serum hs-CRP,Smad 2 and Smad 3 of the infection group were(24.65±7.65)mg/L,(13.54±2.45)pg/ml and(13.65±2.65)pg/ml,respectively,higher than those of the non-infection group(all P＜0.001).The area under the curve(AUC)of the joint detection of hs-CRP,Smad 2 and Smad 3 was highest in diagnosis of the postoperative CRBSI in the cardiac surgery children(P＜0.05).CONCLUSIONS A.baumannii is dominant among the pathogens isolated from the cardiac surgery children with postoperative CRBSI.The postoperative CRBSI may be associated with the intravenous catheter in-dwelling time and length of ICU stay.The C allele at TGF-β1+869C/T locus may be the susceptibility gene for the postoperative CRBSI.The joint detection of hs-CRP,Smad 2 and Smad 3 has the highest value in diagnosis of the postoperative CRBSI.

Liquiritigenin(LG)is a flavone of pharmacological importance,however,its application potential is severely limited due to its poor water solubility.LG could be disassociated slightly in water to form phenolate anion,therefore,better solubilization effect is expected by inclusion with cationic cyclodextrins(CCDs).In this work,four kinds of CCDs modified with amino groups at the primary face were synthesized,and their solid inclusion complexes with LG were successfully prepared by preparing their saturated solutions.The formation of the solid inclusion complexes was confirmed by scanning electron microscopy(SEM)and powder X-ray diffraction(PXRD),and their supramolecular binding behavior in solution was studied using multiple techniques.A 1∶1 inclusion stoichiometry of inclusion complexation was defined using Job plot by ultraviolet-visible(UV-vis)spectroscopy,and their binding stability constants(Ks)were determined as 2862.77,3494.70,6521.85 and 9599.48 L/mol using UV-vis spectroscopic titration,far more superior to that of nativeβ-CD(Ks=236.79 L/mol).This indicated that the amino side chains on CCDs could actively participate in the inclusion complexation through anion-cation interactions,significantly strengthening the host-guest binding between CCDs and LG.The inclusion modes were further elucidated based on proton and two-dimensional rotating-frame overhauser enhancement spectroscopy(2D-ROESY)nuclear magnetic resonance(NMR)experiments and molecular docking.Water solubility of LG was dramatically promoted up to 4.9 mg/mL,which was 70-fold higher than that of native LG.This study could draw inspiration for the binding and solubilization of phenols such as flavones by design of cationic macrocyclic molecules.

A dielectric barrier discharge ionization source with rapid evaporation and self-aspiration sampling(RE-SADBDI)was developed,integrating a rapid evaporation(RE)module and a dielectric barrier discharge ionization(DBDI)module.The sample was introduced into the RE module via a sampling swab and rapidly vaporized within it.The sealed design of the ionization source could enable the sample to be self-aspirated into the ionization region without the need of additional inert gas.All vaporized sample was efficiently directed into the ionization region due to the relatively enclosed environment for sample transfer and ionization,resulting in improved transfer and ionization efficiencies.Experimental results showed that the limit of detection(LOD)under ion isolation mode reached 0.05 ng/mL(caffeine),with a relative standard deviation(RSD)of 6.9%.Furthermore,when coupled with a miniaturized linear ion trap mass spectrometer,the source enabled real-time analysis of various sample types.The developed RE-SADBDI source was suitable for on-site analysis with miniaturized mass spectrometers.

To explore the clinical characteristics of primary intracranial germ cell tumors (iGCT) and analyze the risk factors for the occurrence of neuroendocrine dysfunction.Methods:A case series study was conducted. The data of 130 children diagnosed with iGCT who were admitted to the Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, from February 2021 to December 2023 was collected. The clinical characteristics of iGCT were summarized, including general information, clinical manifestations, imaging findings, laboratory tests and outcomes. Children were divided into groups aged 0-9 and 10-18 years, and divided into group non-neuroendocrine dysfunction, group partial neuroendocrine dysfunction and group combined hypothalamic and pituitary-target gland axis dysfunction. Multivariate Logistic regression was employed for statistical analysis to identify risk factors for neuroendocrine dysfunction in iGCT children.Results:A total of 130 iGCT children were included, with an age of (10±3) years, 87 males and 43 females. Among them, 82 children (63.1%) had germinoma and 48 children (36.9%) had non-germinomatous germ cell tumors (NGGCT). One hundred and ten children (84.6%) had single lesions, including 47 cases in the sellar region, 29 cases in the pineal region and 34 cases in the basal ganglia region. Multi-leisions presented in the 20 children (15.4%), with 10 cases in the sellar+pineal region, 6 cases in the sellar+basal ganglia region, 3 cases in the pineal+ganglia region and 1 case in the sellar+pineal+basal ganglia region. Dissemination was presented to 26 children (20.0%). Initial clinical manifestations presented with symptoms of cranial hypertension like headache and vomiting in 75 cases, vision changes in 28 cases, limb movement disorders in 42 cases, diabetes insipidus in 67 cases, precocious puberty in 23 cases, growth retardation in 22 cases and delayed puberty in 2 cases. Among the 72 children aged 0-9 years, 37 cases (51.4%) had germinoma and 35 cases (48.6%) had NGGCT, while among the 58 children aged 10-18 years, 45 cases (77.6%) had germinoma and 13 cases (22.4%) had NGGCT. Non neuroendocrine dysfunction group included 39 children, partial neuroendocrine dysfunction group 54 children, and combined hypothalamic and pituitary-target gland axis dysfunction group 37 children. Univariate analysis showed statistical difference in gender, disease duration, tumor location, and serum human chorionic gonadotropin level among the 3 groups (all P<0.05). Multivariate Logistic regression analysis revealed that girl ( OR=5.29, 95% CI 1.54-18.16) and long disease duration ( OR=1.07, 95% CI 1.01-1.14) were risk factors for neuroendocrine dysfunction in iGCT patients (both P<0.05). Conclusions:iGCT occurs in children of all ages, with a higher incidence in males. The proportions of germinoma and NGGCT are similar in children aged 0-9 years, while germinoma is more common in patients aged 10-18 years. The clinical symptoms are atypical and diverse. Female gender and longer disease duration demonstrate the presence of neuroendocrine dysfunction in iGCT.

Purpose To investigate the changes in quadriceps femoris microcirculatory perfusion level after low-load blood flow restriction training and its relationship with muscle strength.Materials and Methods Twenty-five healthy subjects were prospectively recruited in the First Affiliated Hospital of Kunming Medical University from September to November 2022.A 200 mmHg pressure cuff was applied at the root of the left thigh for blood flow restriction,and the subjects completed regular knee extension training within 4 weeks.Before the first training session and within 24 hours after the last training session,all subjects underwent scanning with the 3.0T MRI intravoxel incoherent motion sequence and the multi-echo steady-state acquisition three-dimentional imaging sequence.After image post-processing,the quadriceps femoris cross-sectional area,perfusion fraction and pseudo-diffusion coefficient were obtained,and the peak torque was measured using an isokinetic dynamometer.The MRI and muscle strength test parameters before and after training were compared,and correlation analyses were performed between the change of peak torque and the change of perfusion fraction,cross-sectional area,and pseudo-diffusion coefficient respectively.Results After low-load blood flow restriction training,the cross-sectional area of the left quadriceps femoris in subjects increased(t=-4.515,P<0.05).Among its components,the cross-sectional area of the left rectus femoris,vastus intermedius and vastus lateralis all increased(t=-3.302,-2.877,-3.207,all P<0.05).The perfusion fraction value of the left quadriceps femoris increased(t=-5.447,P<0.05);the perfusion fraction values of the left rectus femoris,vastus intermedius,vastus lateralis and vastus medialis all increased(t=-5.723,-4.621,-3.767,-4.682,all P<0.05);the muscle strength of the left quadriceps femoris increased(t=-3.983,P<0.05).There was a highly positive correlation between change of perfusion fraction and peak torque of the left quadriceps femoris in subjects(r=0.708,P<0.05).Conclusion After low-load blood flow restriction training,the changes in quadriceps femoris muscle microperfusion quantified by intravoxel incoherent motion are related to muscle strength,which is helpful for formulating rehabilitation training strategies for young patients.

The evaluation of blood compatibility of biomaterials is crucial for ensuring the clinical safety of implantable medical devices. To address the limitations of traditional testing methods in real-time monitoring and electrical property analysis, this study developed a portable electrical impedance tomography (EIT) system. The system uses a 16-electrode design, operates within a frequency range of 1 to 500 kHz, achieves a signal to noise ratio (SNR) of 69.54 dB at 50 kHz, and has a data collection speed of 20 frames per second. Experimental results show that the EIT system developed in this study is highly consistent with a microplate reader ( R ²=0.97) in detecting the hemolytic behavior of industrial-grade titanium (TA3) and titanium alloy-titanium 6 aluminum 4 vanadium (TC4) in anticoagulated bovine blood. Additionally, with the support of a multimodal image fusion Gauss-Newton one-step iterative algorithm, the system can accurately locate and monitor in real-time the dynamic changes in blood permeation and coagulation caused by TC4 in vivo. In conclusion, the EIT system developed in this study provides a new and effective method for evaluating the blood compatibility of biomaterials.
Electric Impedance ; Animals ; Tomography/instrumentation* ; Biocompatible Materials ; Materials Testing/instrumentation* ; Cattle ; Titanium ; Alloys ; Prostheses and Implants