Objective To develop an innovative minimally invasive rotary-cutting surgical system for axillary osmidrosis,and conduct clinical validation.Methods The design concept,technical principles and system composition of the innovative minimally invasive rotary-cutting surgical system for axillary osmidrosis were introduced.A total of 73 patients(146 axillae)with axillary osmidrosis were enrolled as subjects,and underwent surgery using the newly developed surgical system.Clinical validation of the system was performed by evaluating postoperative scarring,odor elimination rate,postoperative complication incidence,and patient satisfaction.Results The study demonstrated favorable clinical outcomes in the following aspects:postoperative scarring,odor elimination rate,postoperative complication incidence,and patient satisfaction.Conclusion The minimally invasive rotary-cutting surgical system for axillary osmidrosis is rationally designed.The rotary-cutting puncture device is safe,effective,minimally invasive,and convenient for axillary osmidrosis surgery,warranting further clinical validation and widespread application.

Objective To develop an innovative minimally invasive rotary-cutting surgical system for axillary osmidrosis,and conduct clinical validation.Methods The design concept,technical principles and system composition of the innovative minimally invasive rotary-cutting surgical system for axillary osmidrosis were introduced.A total of 73 patients(146 axillae)with axillary osmidrosis were enrolled as subjects,and underwent surgery using the newly developed surgical system.Clinical validation of the system was performed by evaluating postoperative scarring,odor elimination rate,postoperative complication incidence,and patient satisfaction.Results The study demonstrated favorable clinical outcomes in the following aspects:postoperative scarring,odor elimination rate,postoperative complication incidence,and patient satisfaction.Conclusion The minimally invasive rotary-cutting surgical system for axillary osmidrosis is rationally designed.The rotary-cutting puncture device is safe,effective,minimally invasive,and convenient for axillary osmidrosis surgery,warranting further clinical validation and widespread application.

Purpose To investigate the relationship between FN1 expression and clinical and pathologic features of laryngeal squamous cell carcinoma(LSCC)and the expression of tumor-associated macrophages(TAMs).Methods LSCC datasets GSE33232 and GSE84957 were analyzed and screened the differentially expressed gene FN1,and draw the receiver operating characteristic(ROC)curve.Bioinformatics analysis of FN1 expression,and prognosis in LSCC was performed.To investigate the effect of down-regulating FN1 expression in TU177 cells on the malignant bio-logical behavior of LSCC,we performed a scratch wound healing assay and a Transwell chamber assay to assess the effect of FN1 on cell proliferation,migration,and invasion in vitro.Immunohistochemical(IHC)staining was per-formed to detect the expression of FN1 and CD 163 in LSCC tissues.Results Analysis of the GSE33232 and GSE84957 datasets and online databases showed that FN1 was significantly overexpressed in LSCC tissues(P＜0.05),and patients with high FN1 expression had a significantly lower recurrence-free survival rate(HR=1.6,P=0.017).After transfection with si-FN1,the expression of FN1 in TU177 cells was significantly reduced(0.34±0.02 vs 1.00±0.03,P＜0.01).Compared with the control group,the down-regulation of FN1 expression inhibited the in vitro migra-tion(56.1±3.1 vs 19.23±1.0)and invasion(480±23 vs 288±20)ability of TU177 cells(both P＜0.01).Im-munohistochemistry findings showed that FN1 was highly expressed in both the tumor parenchyma(nest)and stromal cells of LSCC tissue,with a statistically significant difference[52.1％(24/46)vs 71.7％(33/46),P＜0.001].It was found that high expression of N-FN1 was associated with patients' pathological grade and lymph node metastasis(P＜0.05),while high expression of S-FN1 was associated with patients' age,lymph node metastasis,and TNM stage(P＜0.05).In addition,the co-expression of FN1 and CD163 was correlated with patients' pathological grad-ing,lymph node metastasis,and TNM stage(all P＜0.05).Conclusion FN1 and CD163 exhibit high expression levels in LSCC patients,which are closely associated with malignant progression,including invasion and metastasis.Notably,during LSCC progression,there may be a potential synergistic interaction between FN1 and CD 163-positive macrophages in the tumor microenvironment.

Objective:To investigate the effects of circular RNA(circRNA)hsa_circ_0081621 on the malignant biological behaviors of human laryngeal squamous cell carcinoma AMC-HN-8 and TU177 cells.Methods:AMC-HN-8 and TU177 cells were routinely cultured.si-NC,si-hsa_circ_0081621,empty vector(vector),and hsa_circ_0081621 overexpression vector(hsa_circ_0081621-OE)were transfected into AMC-HN-8 and TU177 cells,namely si-NC,si-hsa_circ_0081621,vector,and hsa_circ_0081621-OE groups,respectively.The effects of knockdown or overexpression of hsa_circ_0081621 on the proliferation,migration,and invasion of AMC-HN-8 and TU177 cells were detected by CCK-8 assay,colony formation assay,scratch wound healing assay,and Transwell chamber assay.Results:Successful knockdown or overexpression of hsa_circ_0081621 was achieved in AMC-HN-8 and TU177 cells.hsa_circ_0081621 knockdown significantly inhibited while hsa_circ_0081621 overexpression significantly promoted the proliferation,migration,and invasion of AMC-HN-8 and TU177 cells(P<0.01 or P<0.001 or P<0.0001).Conclusion:hsa_circ_0081621 promotes the malignant biological behaviors of human laryngeal squamous cell carcinoma AMC-HN-8 and TU177 cells.

Purpose To investigate the relationship between FN1 expression and clinical and pathologic features of laryngeal squamous cell carcinoma(LSCC)and the expression of tumor-associated macrophages(TAMs).Methods LSCC datasets GSE33232 and GSE84957 were analyzed and screened the differentially expressed gene FN1,and draw the receiver operating characteristic(ROC)curve.Bioinformatics analysis of FN1 expression,and prognosis in LSCC was performed.To investigate the effect of down-regulating FN1 expression in TU177 cells on the malignant bio-logical behavior of LSCC,we performed a scratch wound healing assay and a Transwell chamber assay to assess the effect of FN1 on cell proliferation,migration,and invasion in vitro.Immunohistochemical(IHC)staining was per-formed to detect the expression of FN1 and CD 163 in LSCC tissues.Results Analysis of the GSE33232 and GSE84957 datasets and online databases showed that FN1 was significantly overexpressed in LSCC tissues(P＜0.05),and patients with high FN1 expression had a significantly lower recurrence-free survival rate(HR=1.6,P=0.017).After transfection with si-FN1,the expression of FN1 in TU177 cells was significantly reduced(0.34±0.02 vs 1.00±0.03,P＜0.01).Compared with the control group,the down-regulation of FN1 expression inhibited the in vitro migra-tion(56.1±3.1 vs 19.23±1.0)and invasion(480±23 vs 288±20)ability of TU177 cells(both P＜0.01).Im-munohistochemistry findings showed that FN1 was highly expressed in both the tumor parenchyma(nest)and stromal cells of LSCC tissue,with a statistically significant difference[52.1％(24/46)vs 71.7％(33/46),P＜0.001].It was found that high expression of N-FN1 was associated with patients' pathological grade and lymph node metastasis(P＜0.05),while high expression of S-FN1 was associated with patients' age,lymph node metastasis,and TNM stage(P＜0.05).In addition,the co-expression of FN1 and CD163 was correlated with patients' pathological grad-ing,lymph node metastasis,and TNM stage(all P＜0.05).Conclusion FN1 and CD163 exhibit high expression levels in LSCC patients,which are closely associated with malignant progression,including invasion and metastasis.Notably,during LSCC progression,there may be a potential synergistic interaction between FN1 and CD 163-positive macrophages in the tumor microenvironment.

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.

Objective: To analyze the consistency of gastroscopic biopsy in the diagnosis of high grade intraepithelial neoplasia(HGIN) and postoperative pathological diagnosis, and explore the risk factors associated with missed diagnosis of HGIN. Methods: From January 2012 to December 2018, the clinical data of 63 patients who were diagnosed with HGIN by gastroscopic biopsy prior to operation and underwent complete resection in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. There were 55 males and 8 females, with a median age of 60 (35 to 76) years old. The gender, age, endoscopic lesion shape, longest diameter, CT image and inflammatory markers were analyzed, to investigate the correlation between them and pathological upgrading after operation. Receiver operating characteristic (ROC) curve was drawn to analyze the cut off value of measurement data, and the comparison of count data was performed by chi-square test or Fisher exact probability method. Univariate analysis was used to screen potential risk factors, and multivariate logistic regression analysis was futher utilized to analyze the independent risk factors of postoperative pathological upgrading. Results: A total of 63 patients were enrolled, including 47 cases underwent surgical resection and 16 cases underwent endoscopic submucosal dissection(ESD). Among them, 19 patients(30.2%) were pathologically diagnosed with HGIN, while 44 patients(69.8%) were pathologically diagnosed with invasive cancer after resection. Preoperative contrast-enhanced CT showed that 11 patients(17.5%) with perigastric fat spiculation around the lesion, all of which were confirmed as invasive carcinoma after operation. Univariate analysis showed that the longest diameter of the lesion ≥2 cm (P=0.002), ulcer lesions under gastroscopy (P=0.013), platelet to lymphocyte ratio (PLR) ≥103 (P=0.030), lymph node enlargement (P=0.046) and spiculation of the perigastric fat (P=0.025) were significant differences between the groups. Logistic regression analysis showed that the longest diameter of the lesion ≥2 cm (P=0.033) and ulcer lesions under gastroscopy (P=0.007) were independent risk factors for predicting postoperative pathological upgrading. Conclusions Gastroscopy biopsy in the diagnosis of high-grade intraepithelial neoplasia of the stomach has poor consistency with pathological diagnosis after operation. Clinicians should take active surgical intervention, especially for cases with the longest diameter of the lesions ≥2 cm, ulcer or perigastric fat spiculation on CT.

Objective: To compare the diagnostic value of MRI and CT in neuroblastoma of central nervous system. Methods: The clinical and imaging data of 40 patients with highly suspected neuroblastoma of the central nervous system admitted to the Traditional Chinese Medicine Hospital of Putuo District from January 2013 to January 2018 were retrospectively analyzed.According to the imaging examination methods, they were divided into MRI group(22 cases) and CT group(18 cases). Results: A total of 19 cases of neuroblastoma of central nervous system were confirmed by pathology and 16 cases by CT after operation in the group of MRI.The accuracy, sensitivity and specificity of MRI and CT in the diagnosis of neuroblastoma of central nervous system were 86.36%(19/22), 88.89%(16/18), 89.47%(17/19), 87.50%(14/16), 66.67%(2/3) and 50.00%(1/2), respectively.The accuracy, sensitivity and specificity between the two groups had no statistically significant differences(all P>0.05). The solid part of the tumors showed equal or slightly longer T1WI and T2WI signals, while the FLAIR sequence was mainly equal signal.The cystic part showed long T1WI and T2WI signals, while the low FLAIR sequence signals.The tumors had clear margins and slight edema around the tumors.CT showed that the solid part of the tumors was homogeneous or slightly high density, with calcification and cystic part showing homogeneous low density. Conclusion Both MRI and CT are of high accuracy in the diagnosis of neuroblastoma of the central nervous system, and there are some similarities between them.

Objective: To investigate the microhardness distribution of cancellous bone in the proximal tibia and its clinical significance. Methods: Three fresh tibias were obtained and examined by X-ray and CT to exclude skeletal pathologies, such as osteoporosis, osteoarthritis. According to the Heim's square, the proximal tibias were cut off. Each of the proximal tibias was divided into three parts, the medial condyle, the intercondylar area and the lateral condyle. Each part was divided into three sections, proximal, middle and distal sections. Each of the proximal tibias was divided into 9 regions. Bone specimens with a thickness of 3 mm were taken from each region using a high precision low-speed saw and fixed on flat sheets. The microhardness of the bone tissue was measured using a Vickers microhardness tester after polish. Ten effective micro-indentation tests were conducted in each region. After measurement the diagonal length of the indentations, the microhardness values were calculated via software provided by the hardness tester. Analysis of variance and Tukey method were used to compare the microhardness values of different parts, sections and regions of cancellous bone. The microhardness distribution of the proximal tibia was analyzed. Results: A total of 270 effective indentations were made in the specimens, and the microhardness values were obtained. The average microhardness of the three proximal tibias was 40.98±3.44, 34.92±4.64 and 39.49±3.86 HV, respectively. There was a significant difference among the groups (F=55.87, P=0.000). The microhardness distribution of bone tissue in the three proximal tibias was similar. In the comparison of different parts, the microhardness of medial condyle was greater than that of the lateral condyle, which was larger than that of the intercondylar area. The difference between the parts was statistically significant (F=18.42, 8.236, 10.877; P=0.000, 0.001, 0.000). In the comparison of different sections, the microhardness of the distal section was greater than that of the proximal section, which was larger than that of the middle section. The difference between the sections was statistically significant (F=8.720, 17.140, 6.142; P=0.000, 0.000, 0.003). The microhardness distribution was similar among different regions. The region with the highest microhardness is the medial condyle of the distal section with microhardness of 44.87±3.25 HV (range 39.2-49.7 HV). The lowest microhardness was in the intercondylar area of the middle section with hardness of 29.41±4.53 HV (range 24.8-36.2 HV). Conclusion The microhardness value of cancellous bone near the articular surface at the proximal tibia was smaller, which could disperse the load and protect the fragile of articular cartilage. Furthermore, the microhardness of the transition zone is larger. The microhardness value of the cancellous bone in medial tibia condyle is the greatest, which is related to load-bearing.

Objective: To investigate the distribution characteristics and significance of bone hardness in different segments and layers of clavicle. Methods: The right clavicles of three fresh Chinese corpses were taken and then divided into proximal, middle and distal segments according to Allman's classification. The clavicles were cut with diamond saw in the vertical of long axis equidistant exactly into 15 layers (proximal: 3 layers; midshaft: 7 layers; distal: 5 layers), and each layer was divided into four directions: superior, inferior, anterior, and posterior. The bone hardness were measured by Vickers microindentation, HV(kgf/mm²). The distribution of bone hardness was recorded and analyzed. Results: A total of 180 parts of cortical bone were measured, generating 900 measurements. Meanwhile, a total of 45 parts of cancellous bone were measured, generating 225 measurements. We found that: (1)The average hardness of cortical bone was (35.9±8.1)HV, and the midshaft segment [(41.3±6.8)HV] was harder than the proximal segment [(33.8±6.1)HV] and the distal segment [(29.7±5.4)HV](P<0.05); (2)The average hardness of cancellous bone was (30.7±6.2)HV, and there were significant differences among the midshaft segment [(34.5±5.5)HV], the proximal segment [(29.2±2.9)HV] and the distal segment [(26.3±5.1)HV](P<0.05); (3)for cortical bone, the hardest segment was the fifth layer of the midshaft segment [(44.8±8.6)HV] while the most soft segment was the fourth layer of the distal segment [(28.0±3.5)HV](P<0.05); (4)for cancellous bone, the hardest segment was the fifth layer of the midshaft segmnet [(36.8±5.1)HV] while the most soft was the fifth layer of the distal segment [(23.0±4.4)HV](P<0.05); (5)There were no statistically significant differences among four directions of segments(P>0.05). Conclusion The microindentation hardness varies greatly among different segments and layers of the clavicles. The cortical bone and cancellous bone have consistent hardness changes, which shows that the middle segment is obviously harder than the proximal and distal segments with a gradually gradient decreasing trend from the middle to both ends. The data can be used to guide the design of 3D printing implants that conform to the stress conduction characteristics of the clavicle under physiological conditions, and provide good data support for the modeling and finite element analysis of the clavicle under simulated physiological conditions.