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1.
Org Lett ; 26(18): 3951-3956, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38678546

RESUMO

Herein, we report a chiral boro-phosphate-catalyzed reductive amination for the desymmetrization of 2,2-disubstituted 1,3-cyclopentadiones with pinacolborane as the reducing agent, delivering chiral ß-amino ketones with an all-carbon quaternary stereocenter in good yields (≤94%), high enantioselectivities (≤97% ee), and excellent diastereoselectivities (>20:1 dr). This reaction has a broad substrate scope and high functional group tolerance. The importance of the chiral products was also demonstrated through the preparation of multifunctional building blocks and heterocycles.

2.
Front Oncol ; 14: 1305262, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38571504

RESUMO

Background: The preoperative inflammatory condition significantly influences the prognosis of malignancies. We aimed to investigate the potential significance of preoperative inflammatory biomarkers in forecasting the long-term results of lung carcinoma after microwave ablation (MWA). Method: This study included patients who received MWA treatment for lung carcinoma from Jan. 2012 to Dec. 2020. We collected demographic, clinical, laboratory, and outcome information. To assess the predictive capacity of inflammatory biomarkers, we utilized the area under the receiver operating characteristic curve (AUC-ROC) and assessed the predictive potential of inflammatory biomarkers in forecasting outcomes through both univariate and multivariate Cox proportional hazard analyses. Results: A total of 354 individuals underwent MWA treatment, of which 265 cases were included in this study, whose average age was 69.1 ± 9.7 years. The AUC values for the Systemic Inflammatory Response Index (SIRI) to overall survival (OS) and disease-free survival (DFS) were 0.796 and 0.716, respectively. The Cox proportional hazards model demonstrated a significant independent association between a high SIRI and a decreased overall survival (hazard ratio [HR]=2.583, P<0.001). Furthermore, a high SIRI independently correlated with a lower DFS (HR=2.391, P<0.001). We developed nomograms utilizing various independent factors to forecast the extended prognosis of patients. These nomograms exhibited AUC of 0.900, 0.849, and 0.862 for predicting 1-year, 3-year, and 5-year OS, respectively. Additionally, the AUC values for predicting 1-year, 3-year, and 5-year DFS were 0.851, 0.873, and 0.883, respectively. Conclusion: SIRI has shown promise as a valuable long-term prognostic indicator for forecasting the outcomes of lung carcinoma patients following MWA.

3.
Eur J Cardiothorac Surg ; 65(3)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38479816

RESUMO

OBJECTIVES: To evaluate the safety and feasibility of removing drainage tubes at larger size of air leak in patients with prolonged air leak after pulmonary surgery. METHODS: Ninety-five patients who underwent pulmonary surgery with prolonged air leak in our centre were enrolled in this randomized controlled, single-centre, non-inferiority study. The drainage tube was clamped with a stable size of air leak observed over the last 6 h, which was quantified by gas flow rate using the digital drainage system. The control group (n = 48) and the study group (n = 46) had their drainage tube clamped at 0-20 ml/min and 60-80 ml/min, respectively. We continuously monitored clinical symptoms, conducted imaging and laboratory examinations, and decided whether to reopen the drainage tube. RESULTS: The reopening rate in the study group was not lower than that in the control group (2.08% vs 6.52%, P > 0.05). The absolute difference in reopening rate was 4.44% (95% confidence interval -0.038 to 0.126), with an upper limit of 12.6% below the non-inferiority margin (15%). There were significant differences in the length of stay [16.5 (13-24.75) vs 13.5 (12-19.25), P = 0.017] and the duration of drainage [12 (9.25-18.50) vs 10 (8-12.25), P = 0.007] between the control and study groups. No notable differences were observed in chest X-ray results 14 days after discharge or in the readmission rate. CONCLUSIONS: For patients with prolonged air leak, removing drainage tubes at larger size of air leak demonstrated similar safety compared to smaller size of air leak, and can shorten both length of stay and drainage duration. CLINICAL TRIAL REGISTRATION NUMBER: Name of registry: Gas flow threshold for safe removal of chest drainage in patients with alveolar-pleural fistula prolonged air leak after pulmonary surgery. Registration number: ChiCTR2200067120. URL: https://www.chictr.org.cn/.


Assuntos
Tubos Torácicos , Remoção de Dispositivo , Humanos , Drenagem/métodos , Tempo de Internação , Doenças Pleurais , Pneumonectomia/métodos , Pneumotórax/etiologia , Pneumotórax/diagnóstico , Remoção de Dispositivo/efeitos adversos
4.
Comput Biol Med ; 170: 107999, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38244470

RESUMO

The precise prostate gland and prostate cancer (PCa) segmentations enable the fusion of magnetic resonance imaging (MRI) and ultrasound imaging (US) to guide robotic prostate biopsy systems. This precise segmentation, applied to preoperative MRI images, is crucial for accurate image registration and automatic localization of the biopsy target. Nevertheless, describing local prostate lesions in MRI remains a challenging and time-consuming task, even for experienced physicians. Therefore, this research work develops a parallel dual-pyramid network that combines convolutional neural networks (CNN) and tokenized multi-layer perceptron (MLP) for automatic segmentation of the prostate gland and clinically significant PCa (csPCa) in MRI. The proposed network consists of two stages. The first stage focuses on prostate segmentation, while the second stage uses a prior partition from a previous stage to detect the cancerous regions. Both stages share a similar network architecture, combining CNN and tokenized MLP as the feature extraction backbone to creating a pyramid-structured network for feature encoding and decoding. By employing CNN layers of different scales, the network generates scale-aware local semantic features, which are integrated into feature maps and inputted into an MLP layer from a global perspective. This facilitates the complementarity between local and global information, capturing richer semantic features. Additionally, the network incorporates an interactive hybrid attention module to enhance the perception of the target area. Experimental results demonstrate the superiority of the proposed network over other state-of-the-art image segmentation methods for segmenting the prostate gland and csPCa tissue in MRI images.


Assuntos
Próstata , Neoplasias da Próstata , Masculino , Humanos , Próstata/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Redes Neurais de Computação , Neoplasias da Próstata/diagnóstico por imagem
5.
Polymers (Basel) ; 15(21)2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-37959964

RESUMO

Sandwich structures are engineered with continuous layers surrounding the inner lattices, which combines the advantages of the high strength of the continuous layer and the light weight of the lattice layer. They are widely employed in weight-critical energy-absorbing engineering fields such as aerospace, automobile, and robotics. However, the application of sandwich structures made of polymer matrix composites is still limited due to lack of essential performance investigation and adequate reference data. The following innovative works are accomplished in this paper: (i) Continuous long glass fiber (CGF) is employed within the continuous layer of the sandwich structure, with composite short carbon fiber/polyamide (SCF/N) applied within the lattice layer. (ii) Sandwich structures with different cell types and orientations of the lattice infills are designed and prepared by additive manufacturing. (iii) The basic mechanical properties of the sandwich structures, i.e., the bi-directional tension/compression compound performance, failure modes and mechanisms in characteristic directions, are analyzed systematically. (iv) The effects of geometric features on the three-point bending properties of L-shaped sandwich structures are investigated and compared with those of pure SCF/N structures. The results show that the bending resistance per unit weight was up to 54.3% larger than that of pure SCF/N, while the weight could be decreased by 49%, and the bending flexibility before fracture could be increased by 44%. These studies contribute fundamental research data to the application of sandwich structures prepared by fiber reinforced polymer matrix composites.

6.
Sci Rep ; 13(1): 19930, 2023 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-37968566

RESUMO

To research the magnetic field and mechanical characteristics of the permanent magnet governor, the static magnetic field of the sector permanent magnet is analyzed by the molecular current method in the permanent magnet governor. The magnetic flux distribution is acquired at any spatial position. Comparing the analytical value with the simulation value, the results show that they are basically consistent. Based on the analytical formula, the influence of the radial position, radial length, thickness, and pole number on the magnetic induction intensity of the permanent magnet governor is studied. Thus, it provides the theoretical reference for the structural optimized design. At the same time, a test bench was set up to measure the magnetic induction intensity. The calculation and experimental results show that the magnetic induction strength of the permanent magnet is increased by 27.5%, the axial component of the air gap flux density is increased by 14.3%, and the permanent magnet material is reduced by 7.84%.

7.
Thorac Cancer ; 14(32): 3181-3190, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37740563

RESUMO

Pulmonary carcinoma represents the second common cancer for human race while its mortality rate ranked the first all over the world. Surgery remains the primary option for early-stage non-small cell lung cancer (NSCLC) in some surgical traditions. Nevertheless, only less than half of patients are operable subjected to the limited lung function and multiple primary/metastatic lesions. Recent improvements in minimally invasive surgical techniques have made the procedure accessible to more patients, but this percentage still does not exceed half. In recent years, radiofrequency ablation (RFA), one of the thermal ablation procedures, has gradually advanced in the treatment of lung cancer in addition to being utilized to treat breast and liver cancer. Several guidelines, including the American College of Chest Physicians (ACCP), include RFA as an option for some patients with NSCLC although the level of evidence is mostly limited to retrospective studies. In this review, we emphasize the use of the RFA technique in patients with early-stage NSCLC and provide an overview of the RFA indication population, prognosis status, and complications. Meanwhile, the advantages and disadvantages of RFA proposed in existing studies are compared with surgical treatment and radiotherapy. Due to the high rate of gene mutation and immunocompetence in NSCLC, there are considerable challenges to clinical translation of combining targeted drugs or immunotherapy with RFA that the field has only recently begun to fully appreciate.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Ablação por Cateter , Neoplasias Pulmonares , Ablação por Radiofrequência , Carcinoma de Pequenas Células do Pulmão , Humanos , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Estudos Retrospectivos , Resultado do Tratamento , Ablação por Cateter/métodos , Carcinoma de Pequenas Células do Pulmão/cirurgia
8.
Cyborg Bionic Syst ; 4: 0025, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37303861

RESUMO

The robot used for disaster rescue or field exploration requires the ability of fast moving on flat road and adaptability on complex terrain. The hybrid wheel-legged robot (WLR-3P, prototype of the third-generation hydraulic wheel-legged robot) has the characteristics of fast and efficient mobility on flat surfaces and high environmental adaptability on rough terrains. In this paper, 3 design requirements are proposed to improve the mobility and environmental adaptability of the robot. To meet these 3 requirements, 2 design principles for each requirement are put forward. First, for light weight and low inertia with high stiffness, 3-dimensional printing technology and lightweight material are adopted. Second, the integrated hydraulically driven unit is used for high power density and fast response actuation. Third, the micro-hydraulic power unit achieves power autonomy, adopting the hoseless design to strengthen the reliability of the hydraulic system. What is more, the control system including hierarchical distributed electrical system and control strategy is presented. The mobility and adaptability of WLR-3P are demonstrated with a series of experiments. Finally, the robot can achieve a speed of 13.6 km/h and a jumping height of 0.2 m.

9.
Thorac Cancer ; 14(22): 2093-2104, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37349884

RESUMO

BACKGROUND: Lung adenocarcinoma (LUAD) is the leading cause of death among cancer diseases. The tumorigenic functions of AHNAK2 in LUAD have attracted more attention in recent years, while there are few studies which have reported its high molecular weight. METHODS: The mRNA-seq data of AHNAK2 and corresponding clinical data from UCSC Xena and GEO was analyzed. LUAD cell lines were transfected with sh-NC and sh-AHNAK2, and cell proliferation, migration and invasion were then detected by in vitro experiments. We performed RNA sequencing and mass spectrometry analysis to explore the downstream mechanism and interacting proteins of AHNAK2. Finally, western blot, cell cycle analysis and CO-IP were used to confirm our assumptions regarding previous experiments. RESULTS: Our study revealed that AHNAK2 expression was significantly higher in tumors than in normal lung tissues and higher AHNAK2 expression led to a poor prognosis, especially in patients with advanced tumors. AHNAK2 suppression via shRNA reduced the LUAD cell lines proliferation, migration and invasion and induced significant changes in DNA replication, NF-kappa B signaling pathway and cell cycle. AHNAK2 knockdown also caused G1/S phase cell cycle arrest, which could be attributed to the interaction of AHNAK2 and RUVBL1. In addition, the results from gene set enrichment analysis (GSEA) and RNA sequencing suggested that AHNAK2 probably plays a part in the mitotic cell cycle. CONCLUSION: AHNAK2 promotes proliferation, migration and invasion in LUAD and regulates the cell cycle via the interaction with RUVBL1. More studies of AHNAK2 are still needed to reveal its upstream mechanism.


Assuntos
Adenocarcinoma de Pulmão , Neoplasias Pulmonares , Humanos , Adenocarcinoma de Pulmão/patologia , ATPases Associadas a Diversas Atividades Celulares/genética , ATPases Associadas a Diversas Atividades Celulares/metabolismo , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Ciclo Celular/genética , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , DNA Helicases/genética , Regulação para Baixo , Neoplasias Pulmonares/patologia
10.
Aging (Albany NY) ; 15(6): 2293-2307, 2023 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-36971680

RESUMO

BACKGROUND: Increasing evidence has demonstrated the clinical importance of hypoxia and its related factors in lung adenocarcinoma (LUAD). METHODS: RNA-seq datasets from The Cancer Genome Atlas (TCGA) were analyzed using the differentially expressed genes in hypoxia pathway by the Least Absolute Shrinkage and Selection Operator (LASSO) model. Applying gene ontology (GO) and gene set enrichment analysis (GSEA), a risk signature associated with the survival of LUAD patients was constructed between LUAD and normal tissue. RESULTS: In total, 166 hypoxia-related genes were identified. Based on the LASSO Cox regression, 12 genes were selected for the development of the risk signature. Then, we designed an OS-associated nomogram that included the risk score and clinical factors. The concordance index of the nomogram was 0.724. ROC curve showed better predictive ability using the nomogram (AUC = 0.811 for 5-year OS). Finally, the expressions of the 12 genes were validated in two external datasets and EXO1 was recognized as a potential biomarker in the progression of LUAD patients. CONCLUSIONS: Overall, our data suggested that hypoxia is associated with the prognosis, and EXO1 acted as a promising biomarker in LUAD.


Assuntos
Adenocarcinoma de Pulmão , Neoplasias Pulmonares , Humanos , Prognóstico , Adenocarcinoma de Pulmão/genética , Hipóxia/genética , Relevância Clínica , Neoplasias Pulmonares/genética , Exodesoxirribonucleases , Enzimas Reparadoras do DNA
11.
Thorac Cancer ; 14(12): 1071-1076, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36915945

RESUMO

BACKGROUND: To investigate the effect of continuous oral aspirin in perioperative period on bleeding in pneumonectomy. METHODS: A total of 170 patients who underwent pneumonectomy in our hospital from March 2021 to March 2022 were selected as the study objects. All patients took oral aspirin before surgery and did not take other antiplatelet agent or anticoagulants at the same time. The continuation group included 85 cases and continued to take aspirin 100 mg/day during the perioperative period, and the interruption group included 85 cases who stopped aspirin for 7 days before surgery and 3 days after surgery, without bridging therapy. The intraoperative blood loss, operation time, conversion to thoracotomy rate, postoperative bleeding rate, blood transfusion rate, thrombotic events, postoperative drainage volume, length of hospital stay, and total hospital cost of the two groups were compared. RESULTS: There were no statistically significant differences in intraoperative blood loss, operative time, rate of conversion to open, postoperative drainage, hospital stay, and cost between the two groups (p > 0.05), and there were no reoperations due to bleeding between the two groups. CONCLUSIONS: Aspirin should be continued throughout the perioperative period in all high-risk patients requiring pneumonectomy after balancing ischemic-bleeding risks.


Assuntos
Aspirina , Perda Sanguínea Cirúrgica , Humanos , Pneumonectomia , Estudos Retrospectivos , Inibidores da Agregação Plaquetária
12.
Front Nutr ; 10: 1000046, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36742422

RESUMO

Background: The Controlled Nutritional Status (CONUT) score is a valid scoring system for assessing nutritional status and has been shown to correlate with clinical outcomes in many surgical procedures; however, no studies have reported a correlation between postoperative complications of bronchiectasis and the preoperative CONUT score. This study aimed to evaluate the value of the CONUT score in predicting postoperative complications in patients with bronchiectasis. Methods: We retrospectively analyzed patients with localized bronchiectasis who underwent lung resection at our hospital between April 2012 and November 2021. The optimal nutritional scoring system was determined by receiver operating characteristic (ROC) curves and incorporated into multivariate logistic regression. Finally, independent risk factors for postoperative complications were determined by univariate and multivariate logistic regression analyses. Results: A total of 240 patients with bronchiectasis were included, including 101 males and 139 females, with an average age of 49.83 ± 13.23 years. Postoperative complications occurred in 59 patients (24.6%). The incidence of complications, postoperative hospital stay and drainage tube indwelling time were significantly higher in the high CONUT group than in the low CONUT group. After adjusting for sex, BMI, smoking history, lung function, extent of resection, intraoperative blood loss, surgical approach and operation time, multivariate analysis showed that the CONUT score remained an independent risk factor for postoperative complications after bronchiectasis. Conclusions: The preoperative CONUT score is an independent predictor of postoperative complications in patients with localized bronchiectasis.

13.
Med Image Anal ; 86: 102775, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36848721

RESUMO

Image-guided surgery has been proven to enhance the accuracy and safety of minimally invasive surgery (MIS). Nonrigid deformation tracking of soft tissue is one of the main challenges in image-guided MIS owing to the existence of tissue deformation, homogeneous texture, smoke and instrument occlusion, etc. In this paper, we proposed a piecewise affine deformation model-based nonrigid deformation tracking method. A Markov random field based mask generation method is developed to eliminate tracking anomalies. The deformation information vanishes when the regular constraint is invalid, which further deteriorates the tracking accuracy. Atime-series deformation solidification mechanism is introduced to reduce the degradation of the deformation field of the model. For the quantitative evaluation of the proposed method, we synthesized nine laparoscopic videos mimicking instrument occlusion and tissue deformation. Quantitative tracking robustness was evaluated on the synthetic videos. Three real videos of MIS containing challenges of large-scale deformation, large-range smoke, instrument occlusion, and permanent changes in soft tissue texture were also used to evaluate the performance of the proposed method. Experimental results indicate the proposed method outperforms state-of-the-art methods in terms of accuracy and robustness, which shows good performance in image-guided MIS.


Assuntos
Laparoscopia , Cirurgia Assistida por Computador , Humanos , Algoritmos , Laparoscopia/métodos , Cirurgia Assistida por Computador/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Fumaça
14.
Int J Med Robot ; 18(6): e2440, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35848917

RESUMO

PURPOSE: Vision-based tissue tracking is a significant component for building efficient autonomous surgical robot system. While the methodology involves various challenges caused by occlusion, deformation and appearance changes. METHODS: We propose a novel correlation filter tissue tracking framework for minimally invasive surgery. Our model contains the innovative design of synthetic features, a bi-branch is exploited to enhance the response map. An incrementally learnt detector with the novel updating and trigger schemes is embedded to model the re-detection module for capturing the lost target. RESULTS: Promising validation has been conducted on the publicly available tracking benchmark datasets, a surgical tissue tracking dataset based on publicly available Cholec80 dataset has also been developed to focus on the application in intra-operative scenes. CONCLUSIONS: Our proposed framework meets the outstanding performance and surpasses the existing methods. The work demonstrates the feasibility to perform tissue tracking by taking advantage of the correlation filter.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Cirurgia Assistida por Computador , Humanos , Algoritmos , Cirurgia Assistida por Computador/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
15.
Sci Rep ; 12(1): 12371, 2022 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-35859050

RESUMO

In this paper, a bilateral haptic virtual surgery simulation system under a hybrid controller was studied. An analogue controller realized by a field programmable analogue array (FPAA) was paralleled in the operator robot side, which reduced the impact of controller discretisation on the system. A system stability conditions under hybrid control with multiple-operators were deduced. The stability analysis indicates that the addition of analogue derivative term widens the range of haptic controls gains that satisfy the multiple-users' stability conditions. Finally, the human's performance of a stiffness discrimination task was studied in an independently developed minimally invasive surgical (MIS) platform. The experiment results show that, human operators under the hybrid controller achieve the highest task success rates.


Assuntos
Robótica , Simulação por Computador , Tecnologia Háptica , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Robótica/métodos , Interface Usuário-Computador
16.
IEEE J Biomed Health Inform ; 26(9): 4462-4473, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35653452

RESUMO

Gesture recognition for myoelectric prosthesis control utilizing sparse multichannel surface Electromyography (sEMG) is a challenging task, and from a Muscle-Computer Interface (MCI) standpoint, the performance is still far from optimal. However, the design of a well-performed sEMG recognition system depends on the flexibility of the input-output function and the dataset's quality. To improve the performance of MCI, we proposed a novel gesture recognition framework that (i) Enrich the spectral information of the sparse sEMG signals by constructing a fused map image (denoted as sEMG-Map) that integrates a multiresolution decomposition (by means of orthogonal wavelets) through the raw signals then rely upon the Convolutional Neural Network (CNN) capacity to exploit the composite hierarchies in the constructed sEMG-Map input. (ii) Deals with the label noise by proposing a data-centric method (denoted as ALR-CNN) that synchronously refines the falsely labeled samples and optimizes the CNN model based on two basic assumptions. First, the deep model accuracy improves as the training progress. Second, a set of successive learnable max-activated outputs of a well-performed deep model is a reliable estimator for motion detection in the muscle activation pattern. Our proposed framework is evaluated on three large-scale public databases. The average classification accuracy is 95.50%, 95.85%, and 85.58% for NinaPro DB2, NinaPro DB7, and NinaPro DB3, respectively. The experimental results verify the effectuality of the proposed method and show high accuracy.


Assuntos
Aprendizado Profundo , Gestos , Algoritmos , Eletromiografia/métodos , Mãos , Humanos , Redes Neurais de Computação
17.
Int J Med Robot ; 18(6): e2433, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35679513

RESUMO

BACKGROUND: Accurate and real-time biomechanical modelling of the liver is a major challenge in computer-assisted surgery. Finite element method is often used to predict the deformation of organs for its high modelling accuracy. However, its high computation cost hinders its application in real time, such as virtual surgery simulations. METHOD: A liver model with biomechanical properties similar to real one is created using finite element method and a data set of the liver deformation with different forces (whose magnitude ranges from 0.1 to 0.5 N in omni-direction) acting on different surface points is generated. The mechanical behaviour of liver is simulated in real time by a tree-based LightGBM regression model trained with the generated data set. RESULTS: In comparison with the Random Forest and XGBoost, the LightGBM model achieves the best accuracy with 0.0774 mm, 0.0786 mm, 0.0801 mm in the mean absolute error (MAE) and 0.0591 mm, 0.0609 and 0.0622 mm in the root mean square error (RMSE) along x, y and z axis, respectively. In addition, it only takes 33 ms for the LightGBM model to estimate the deformation of the liver, which is much faster than finite element model (29.91 s). CONCLUSION: These results lay a foundation for the future development of real-time virtual surgery systems of simulating liver deformation during minimally invasive surgeries using our method.


Assuntos
Cirurgia Assistida por Computador , Humanos , Análise de Elementos Finitos , Fígado , Fenômenos Biomecânicos , Simulação por Computador
18.
J Digit Imaging ; 35(4): 923-937, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35266089

RESUMO

Vision-based detection and tracking of surgical instrument are attractive because it relies purely on surgical instrument already in the operating scenario. The vision knowledge of the surgical instruments is a crucial piece of topic for surgical task understanding, autonomous robot control and human-robot collaborative surgeries to enhance surgical outcomes. In this work, a novel method has been demonstrated by developing a multitask lightweight deep neural network framework to explore surgical instrument articulated joint detection. The model has an end-to-end architecture with two branches, which share the same high-level visual features provided by a lightweight backbone while holding respective layers targeting for specific tasks. We have designed a novel subnetwork with joint detection branch and an instrument classification branch to sufficiently take advantage of the relatedness of surgical instrument presence detection and surgical instrument articulated joint detection tasks. The lightweight joint detection branch has been employed to efficiently locate the articulated joint position with simultaneously holding low computational cost. Moreover, the surgical instrument classification branch is introduced to boost the performance of joint detection. The two branches are merged to output the articulated joint location with respective instrument type. Extensive validation has been conducted to evaluate the proposed method. The results demonstrate promising performance of our proposed method. The work represents the feasibility to perform real-time surgical instrument articulated joint detection by taking advantage of the components of surgical robot system, contributing to the reference for further surgical intelligence.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Redes Neurais de Computação , Procedimentos Cirúrgicos Robóticos/métodos , Instrumentos Cirúrgicos
19.
Ann Transl Med ; 10(2): 54, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35282042

RESUMO

Background: Severe burns, trauma and shock can cause intestinal epithelial barrier dysfunction, which can lead to intestinal endotoxemia and even sepsis and multi-organ dysfunction. Many studies have shown that histone deacetylase inhibitors (HDACIs) can improve cell tolerance to hypoxia and inflammation, thus protecting the functions of important organs in the body, and at the same time, inhibiting the degradation of tight junction (TJ) proteins, protecting the intercellular barrier, and reducing tissue edema and organ damage. However, the mechanism is unclear. Methods: Eighty male Sprague-Dawley rats (weighing 280-300 g) with a 50% total body surface area full-thickness dermal burn were randomly assigned to 4 groups (20 rats/group): sham control (SC group), scald + normal saline (SN group), scald + 2-methyl-2pentenoic acid (2M2P group), and scald + valproic acid (VPA group). After scalding, we measured the following parameters at various time intervals postburn injury: intestinal mucosal injury score, diamine oxidase (DAO) activity, intestinal protein expression of acetyl histone H3 at K9 (Ac-H3K9), hypoxia inducible factor 1α (HIF-1α), erythropoietin (EPO), zonula occludens-1 (ZO-1), endothelial nitric oxide synthase (eNOS) content, nitric oxide (NO) content, and intestinal mucosal blood flow (IMBF). Results: Intestinal mucosa showed significant morphologic injury at 4 and 8 hours after scalding that was attenuated by VPA. DAO activity in the VPA group was significantly decreased compared with the other scald groups. At 4 and 8 hours after scalding, VPA enhanced Ac-H3K9 and ZO-1 expression and decreased HIF-1α and EPO expression in the intestine compared with the other scald groups. At 4 and 8 hours after scalding, eNOS and NO protein content and IMBF in the VPA group were markedly increased compared with the other scald groups. Conclusions: HDACIs attenuated intestinal mucosal injury in fatally scalded rats. This may have involved VPA enhancing Ac-H3K9 and ZO-1 expression, inhibiting HIF-1α and EPO expression and inducing eNOS and NO increments.

20.
Int J Med Robot ; 18(3): e2373, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35133715

RESUMO

BACKGROUND: Fiducial marker-based image-to-patient registration is the most common way in image-guided neurosurgery, which is labour-intensive, time consuming, invasive and error prone. METHODS: We proposed a method of facial landmark-guided surface matching for image-to-patient registration using an RGB-D camera. Five facial landmarks are localised from preoperative magnetic resonance (MR) images using deep learning and RGB image using Adaboost with multi-scale block local binary patterns, respectively. The registration of two facial surface point clouds derived from MR images and RGB-D data is initialised by aligning these five landmarks and further refined by weighted iterative closest point algorithm. RESULTS: Phantom experiment results show the target registration error is less than 3 mm when the distance from the camera to the phantom is less than 1000 mm. The registration takes less than 10 s. CONCLUSIONS: The proposed method is comparable to the state-of-the-arts in terms of the accuracy yet more time-saving and non-invasive.


Assuntos
Cirurgia Assistida por Computador , Algoritmos , Marcadores Fiduciais , Humanos , Imageamento por Ressonância Magnética , Procedimentos Neurocirúrgicos/métodos , Imagens de Fantasmas , Cirurgia Assistida por Computador/métodos
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