Objective To summarize the clinical application of esophagogastrostomy with layered anastomosis and to observe the healing quality of anastomotic stoma in animal experiments. Methods One thousand and twenty-four patients suffered from carcinoma of esophagus or carcinoma of gastric cardia had undergone esophagogastrostomy by layered anastomosis with absorbable suture. Twenty-four experimental dogs (adult male healthy hybrid dogs) were divided into two groups: the experimental group and the control group. The former (experimental group) underwent the layered anastomosis, the diameter of esophagogastric stoma and the length and depth of stomal scar were measured under anesthesia in both groups on 5th,8th,14th,and 42th postoperative day, respectively. So were done the histological measurement, such as the count infiltrating inflammatory cells, the proliferation of blood capillary and other cells. And the cytokines related to wound healing (LsAB technique) such as epidermal growth factor(EGF), transforming growth factor-beta 1 (TGF-beta 1) were detected, either. Results One thousand and twenty-four patients had no anastomotic leakage. There were only 6 patients suffered from mild anastomotic stricture, and they got well after one dilatation. The results of the measurement of 24 experimental dogs revealed that, in the experimental group, the mucosa was in good connecting condition, had a soften anastomotic stoma and a thin scar. The counts of inflammatory cells and fibroblast showed more in number at the early time after operation (Plt;0.05), while showed less in number at the advanced time of operation (Plt;0.05). In the control group, however, the mucosa were in a bad connecting condition, the scar was thicker, and the muscle layer was frequently exposed. The counts of inflammatory cells and fibroblast were fewer at the early time after operation, however, they had a clearly tendency of increasing at the anaphase after the operation. On the cytokines related to the healing of wound in the experimental group, there was a high expression and activity at the early period. There were a little expression up to postoperative 42 d. Whereas, in the control group, there had a low expression level,increased clearly on postoperative 8 d, and still a higher expression up to postoperative 42 d. Conclusions The esophagogastrostomy by layered anastomosis has a high healing quality with a thin scar. The proliferation of cells and the expression of growth factors benefits the normal healing of wound by first intention.
Objective To investigate the application of magnetic resonance imaging (MRI) in preoperative assessment of rectal cancer. Methods Combined with the literatures, the MRI features and measurements of rectal tumor staging, extramural vascular invasion, circumferential margin involvement, and the distance between distal margin of the tumor from the anorectal ring and the anal margin were described. Results On T2-weighted images (T2WI), T1 staging-tumors were those in which the normal submucosa was replaced by the iso-intensity of tumor tissue without invasion of muscularis propria; T2 staging-tumors were those with extension into the muscularis propria, but not invaded the high-intensity of mesorectal fat; T3 staging-tumors manifested as the rectal tumor penetrated into the muscularis propria and invaded the high-intensity of mesorectal fat; T4 staging-tumors manifested as the tumor invaded adjacent structures or organs. The metastatic lymph nodes were showed with irregular boundaries and mixed signals on T2WI. The tumor signals could be found in the extramural vascular on T1-weighted images (T1WI), accompanied by irregular distortion and expansion of the blood vessels. On T2WI, metastatic lymph nodes, extramural vascular invasion, and the distance between the residual tumor and the low-signal of mesorectal fascia was within 1 mm, indicated the positive circumferential margin. On T2WI, the distal margin of the tumor was located at the junction of hyperintense submucosa and iso-signal of tumor, the tip of the iso-signal puborectal muscle was the apex of the anorectal ring, and the lowest point of the iso-signal external sphincter was the anal margin. Conclusion MRI can provide reliable imaging information for preoperative staging, height measurement, and prognosis of rectal cancer, and it is helpful for early diagnosis and treatment of rectal cancer.
ObjectiveTo evaluate the changes of the flow parameters before and after the anastomotic port exploration and dredging during coronary artery bypass grafting by using the transit time flow measurement (TTFM).MethodsA total of 167 patients who underwent continuous coronary artery bypass grafting and anastomotic port exploration and dredging surgery in Beijing Anzhen Hospital from 2018 to 2019 were enrolled in this study. There were 136 male and 31 female patients aged 41-82 (58.35±17.26) years. If the probe entered and exited the anastomotic port smoothly, it was recorded as a non-resistance group; if the resistance existed but the probe could pass and exit, it was recorded as a resistance group; if the probe could not pass the anastomotic port for obvious resistance, it was recorded as the stenosis group. In the stenosis group, the grafts were re-anastomosed and the flow parameters were re-measured by TTFM.ResultsA total of 202 anastomotic ports were carried out by exploration and dredging. Among them, 87 anastomosis (43.1%) were in the non-resistance group, and there was no significant change in the blood flow volume (BFV) and pulsatility index (PI) before and after exploration and dredging (6.16±3.41 mL/min vs. 6.18±3.44 mL/min, P=0.90; 7.06±2.84 vs. 6.96±2.49, P=0.50). Sixty-four anastomosis (31.7%) were in the resistance group, the BFV was higher after exploration and dredging than that before exploration and dredging (17.11±7.52 mL/min vs. 4.96±3.32 mL/min, P<0.01), while the PI was significantly smaller (3.78±2.20 vs. 8.58±2.97, P<0.01). Fifty-one anastomosis (25.2%) were in the stenosis group, and there was no significant change in the BFV and PI before and after exploration and dredging (3.44±1.95 mL/min vs. 3.48±2.11 mL/min, P=0.84; 10.74±4.12 vs. 10.54±4.11, P=0.36). After re-anastomosis, the BFV was higher (16.48±7.67 mL/min, P<0.01) and the PI deceased (3.43±1.39, P<0.01) than that before exploration and dredging.ConclusionThe application of anastomotic exploration and dredging can reduce the occurrence of re-anastomosis, and promptly find and solve the stenosis of the distal coronary artery, improve the poor perfusion of distal coronary, and thus improves the prognosis of patients.
Traditional methods of non-contact human respiratory rate measurement usually require complex devices or algorithms. Aiming at this problem, a non-contact respiratory rate measurement method based on only the RGB video information was proposed in this paper. The method consisted of four steps. Firstly, spatial filtering was applied to each frame of the input video. Secondly, a gray compensation algorithm was used to compensate for the gray level change caused by the environmental light. Thirdly, the gray levels of each pixel over time were filtered separately by a low-pass filter. Finally, the region of interest was determined based on the filtering results, and the respiration rate of the human is measured. The physical measurement experiments were designed, and the measurement accuracy was compared with that of the biological radar. The error of the proposed method was between − 5.5% and 3% in different detection directions. The results show that the non-contact respiration rate measurement method can effectively measure the human respiration rate.
Transit time flow measurement (TTFM),which is independent of vessel size and shape, has been considered to be an easy, reproducible and non-invasive method to assess the hemodynamic characteristics. Moreover, current studies have shown that TTFM has clinical application in identifying the function of grafted vessel and prognosis. Researchers have proved some reliable indicators for the function of grafted vessel as follows: mean graft flow (MGF) > 15 ml/min, diastolic flow (DF) >50% and pulsatility index (PI)<3 or 5. This article focuses on the review of clinical application and research progress of TTFM in CABG.
Based on repeated experiments as well as continuous researching and improving, an efficient scheme to measure velocity and displacement of the coxa and knee movements based on video image processing technique is presented in this paper. The scheme performed precise and real-time quantitative measurements of 2D velocity or displacement of the coxa and knee using a video camera mounted on one side of the healing and training beds. The beds were based on simplified pinhole projection model. In addition, we used a special-designed auxiliary calibration target, composed by 24 circle points uniformly located on two concentric circles and two straight rods which can rotate freely along the concentric center within the vertical plane, to do the measurements. Experiments carried out in our laboratory showed that the proposed scheme could basically satisfy the requirements about precision and processing speed of such kind of system, and would be very suitable to be applied to smart evaluation/training and healing system for muscles/balance function disability as an advanced and intuitional helping method.
Most of the existing near-infrared noninvasive blood glucose detection models focus on the relationship between near-infrared absorbance and blood glucose concentration, but do not consider the impact of human physiological state on blood glucose concentration. In order to improve the performance of prediction model, particle swarm optimization (PSO) algorithm was used to train the structure paramters of back propagation (BP) neural network. Moreover, systolic blood pressure, pulse rate, body temperature and 1 550 nm absorbance were introduced as input variables of blood glucose concentration prediction model, and BP neural network was used as prediction model. In order to solve the problem that traditional BP neural network is easy to fall into local optimization, a hybrid model based on PSO-BP was introduced in this paper. The results showed that the prediction effect of PSO-BP model was better than that of traditional BP neural network. The prediction root mean square error and correlation coefficient of ten-fold cross-validation were 0.95 mmol/L and 0.74, respectively. The Clarke error grid analysis results showed that the proportion of model prediction results falling into region A was 84.39%, and the proportion falling into region B was 15.61%, which met the clinical requirements. The model can quickly measure the blood glucose concentration of the subject, and has relatively high accuracy.
Objective To review the process of radiographic measurements of sagittal balance and offer reference for the clinical practice. Methods The related literature of spino-pelvic sagittal parameters and their clinical application was reviewed and analyzed from the aspects such as the clinical application, the advantages and disadvantages, and how to use them effectively. Results All parameters have their advantages and disadvantages, and they are influenced by age and race. Sagittal vertical axis can only reflect the global balance, and T1 pelvic angle which accounts for both spinal inclination and pelvic tilt can’t be controlled in the surgery. The correction goal for western people may be not suitable for Chinese. Conclusion The parameters should be used wisely when evaluating the sagittal balance, the global balance and local balance should be considered together and the different groups of people need different correction goals.
Accurate measurements of voltage and current from electrosurgery are the basis of development of electrosurgery with feedback function. We, therefore, developed a parameter measurement system based on PC, with high voltage and current from electrosurgery being sensed with transformers, amplified, filtered, transformed into single-ended signals, and then into RMS signals. The root mean square (RMS) signals were transformed into digital signals through DAQ card and the data was processed in PC with Labview. The process included sampling, displaying and storage. The experiment results indicated that the measurement system could measure the output parameters from electrosurgery steadily and correctly so that the development of the system has been successful. It can be the basis of development of embedded parameters measurement system and can provide accurate feedback information for intellectual electrosurgery.
ObjectiveTo explore the anthropometric changes of the auricle after auricular cartilage unfolding in moderate concha-type microtia patients, so as to provide the basis to help evaluate surgical timing and prognostic.MethodsA total of 33 children with moderate concha-type microtia, who were treated with auricular cartilage unfolding between October 2016 and September 2018 and met the inclusive criteria, were included in the study. There were 24 boys and 9 girls with an average age of 1.4 years (range, 1-3 years). Sixteen cases were left ears and 17 cases were right ears. The follow-up time was 12-23 months (mean, 17.5 months). The affected auricular detailed structures were observed and quantitatively analyzed before operation and at immediate after operation. The width, length, and perimeter of auricle before operation and at immediate after operation and at last follow-up were noted with three dimensional-scanning technology. The normal auricle was noted as control.ResultsThere were (7.5±1.0) and (11.3±0.8) structures of the affected auricle at pre- and post-operation, respectively, showing significant difference between pre- and post-operation (t=23.279, P=0.000). The length, width, and perimeter of the affected auricle constantly increased after operation, and there were significant differences between pre-operation and immediately after operation and between immediately after operation and last follow-up (P<0.05). The differences of length, width, and perimeter of the affected auricle between immediately after operation and last follow-up were (3.13±1.44), (2.44±0.92), and (8.50±3.76) mm, respectively. And the differences of length, width, and perimeter of the normal auricle between pre-operation and last follow-up were (3.16±1.54), (2.35±0.86), and (9.79±4.60) mm, respectively. There was no significant difference in the differences of length, width, and perimeter between the affected auricle and the normal auricle (P>0.05).ConclusionThe auricular cartilage unfolding in treatment of the moderate concha-type microtia can receive more ear structures and increase auricle sizes, which make it possible for free composite tissue transplantation. In addition, the affected and the contralateral normal auricles have a very similar growth rate and it offers the theoretical foundation for the early treatment for moderate concha-type microtia.