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.

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.

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.

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.

ObjectiveTo investigate the risk factors for open pancreatic necrosectomy (OPN), an effective treatment method for severe acute pancreatitis (SAP) after the failure of percutaneous catheter drainage (PCD), in patients with SAP. MethodsA retrospective analysis was performed for 156 patients with SAP who underwent surgical intervention based on the step-up approach in The Affiliated Hospital of Zunyi Medical University from January 1, 2010 to June 30, 2018, and according to whether OPN was performed, the patients were divided into PCD group with 126 patients and PCD+OPN group with 30 patients. Related clinical data were collected, including age, sex, etiology, blood calcium on admission, white blood cell count on admission, whether CTSI score was ＞7, APACHE-Ⅱ score, Ranson score, presence or absence of peripancreatic fluid accumulation, presence or absence of infection, presence or absence of multiple organ failure (MOF), and whether PCD was performed at more than 1 week after admission. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a multivariate logistic regression analysis was used to determine the independent predictive factors for OPN. ResultsThe probability of OPN was 19.2% for SAP patients in the later stage. Compared with the PCD+OPN group, the PCD group had a significantly lower proportion of patients with MOF on admission ［27.0% (34/126) vs 70.0% (21/30), χ2=19.642, P＜0.01］ and a significantly higher proportion of patients undergoing PCD at less than 1 week after admission ［61.9% (78/126) vs 20.0% (6/30), χ2=17.121, P＜0.01］. MOF on admission (odds ratio ［OR］=5.343, 95% confidence interval ［CI］: 1.832-15.583, P＜0.05), initial PCD performed at more than 1 week after admission (OR= 5.518, 95% CI: 1.742-17.477, P＜0.05), and infection on admission (OR=5.016, 95% CI: 1.322-19.378, P＜0.05) were independent risk factors for subsequent OPN in SAP patients. ConclusionSAP with MOF on admission, initial PCD performed at more than 1 week after admission, and SAP with infection on admission are independent risk factors for subsequent OPN in SAP patients undergoing PCD in the early stage based on the step-up approach. Timely identification of related risk factors helps to grasp the timing of OPN in clinical practice and improve the clinical prognosis of SAP patients.

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.