[The application of indocyanine green fluorescent navigation in laparotomy of cholecystectomy].

Objective: To explore the application of indocyanine green fluorescence navigation in open cholecystectomy. Methods: Forty-eight patients with extrahepatic cholangiography who underwent open cholecystectomy in our hospital from March 2016 to February 2018 were enrolled. They were divided into the control group (24 cases) and the experimental group (24 cases) by using the random number table method. The control group was treated with conventional X-ray cholangiopancreatography, and the experimental group was treated with indocyanine green near-infrared fluorescence imaging for extrahepatic cholangiography. The cholangiography success rate, cholangiography time, cholangiography economic costs, imaging accuracy and security were compared between two groups. The operation time, intraoperative blood loss, blood transfusion amount, length of hospital stays, and hospital expenses were also compared between two groups. Results: The success rate of cholangiography (98.62% vs 97.22%) and the incidence of adverse reactions (25.00 vs 29.17) were not significantly different between the two groups (P>0.05). The cholangiography time (25.69±3.47 min vs 31.42±4.66 min), operation time (90.18±10.27 min vs 81.44±9.35 min), intraoperative blood loss (82.35±8.24 ml vs 78.14±7.82 ml), blood transfusion volume (35.19±4.77 ml vs 29.58±4.03 ml), hospitalization time (7.59±1.52 d vs 6.24±1.25 d), and hospitalization cost (12.7±3.1 thousands vs 10.4±2.5 thousands) of the experimental group were significant lower than those of the control group. The accuracy rate (92.22% vs 87.50%), sensitivity (85.71% vs 50.00%) and specificity (88.24% vs 68.75%) of cholangiography in the experimental group were significantly higher than those in the control group, with statistically significant differences (P<0.05). Conclusion: Indocyanine green fluorescent navigation is more timely and accurate than traditional X-ray cholangiography during temporary angiography in open cholecystectomy, which can effectively shorten the operation time, intraoperative blood loss, blood transfusion, hospitalization time and hospitalization expenses. It does not increase the incidence of adverse reactions, has high safety, and is worthy of clinical promotion.

Green's function extraction by crosscorrelation and multidimensional deconvolution for outdoor sound propagation.

In this work, the Green's function is estimated from outdoor measurements of controlled-sources. Crosscorrelation and multidimensional deconvolution have successfully been employed for Green's function retrieval. Crosscorrelation assumes a lossless medium and equipartitioned wavefield; when these assumptions are not satisfied it may result in a Green's function smeared with the source point-spread function. Multidimensional deconvolution removes the point-spread function from the retrieved Green's function. Both methods are employed to estimate the Green's function between two array stations for a single and multiple controlled-sources. The results demonstrate that the source-to-center radius has a negligible effect on the retrieved Green's function, if the source-to-center radius is larger than the distance between the two array stations.

Acoustic remote sensing for source localization and atmospheric tomography: Applications of the cross-correlation Green's function retrieval method.

In this work, the application of the cross-correlation Green's function retrieval method for source localization and atmospheric acoustic tomography is presented. Open field experimental measurements of an acoustic source, with an impulsive waveform, are conducted for the evaluation of an array system. Of particular interest are the source localization and sound speed estimation capabilities of the array system. The cross-correlation delay-and-sum beamformer is used to estimate source directivity and sound speed. This beamformer inherently employs the cross-correlation Green's function retrieval method between a pair of receivers. The beamforming results adequately identify the various source directions as well as the scatterers along the propagation path. Reasonable sound speed estimates are obtained at the peak frequency of the retrieved Green's functions. In the case of atmospheric acoustic tomography, the estimated sound speed from the array system can serve as an average background sound speed in a tomographic inversion algorithm. Utilizing a tomographic inversion algorithm with radial basis functions and the estimated sound speed, the reconstruction of temperature and wind velocity profiles are demonstrated.

Fatal outcome of nevirapine-associated toxic epidermal necrolysis.

The irregular use of antiretroviral therapy (ART) can result in ART-resistance but can also lead to a sensitization between agents with a cross-sensitivity. We report a case of nevirapine-associated toxic epidermal necrolysis resulting in death in an HIV-infected man.

A novel prognostic biomarker for cholangiocarcinoma: circRNA Cdr1as.

OBJECTIVE: Cholangiocarcinoma (CCA) is the second most common primary malignant hepatobiliary cancer worldwide. The circular RNA (circRNA) Cdr1as has been found to play critical roles in various cancers. However, the relationship between circRNA Cdr1as and CCA is still ambiguous. The aim of this study was to explore the expression level of Cdr1as in CCA and to further investigate the clinicopathological and prognostic value of Cdr1as. PATIENTS AND METHODS: We investigated the circRNA Cdr1as expression in 54 paired tumor and adjacent normal tissues of CCA patients by using quantitative Real-time PCR, and evaluated the relevance between Cdr1as expression level and the clinicopathological features. We further assessed the association of Cdr1as expression with overall survival and its prognostic efficacy. RESULTS: The expression of circRNA Cdr1as in tumor tissues was higher than that in adjacent normal tissues. The overexpression of Cdr1as was closely associated with the advanced TNM stage, lymph node invasion, and postoperative recurrence. The overall survival of CCA patients with high Cdr1as expression was worse than that of the CCA patients with low Cdr1as expression. According to multivariate analysis, the Cdr1as expression could be considered as an independent prognostic biomarker for cholangiocarcinoma with acceptable sensitivity and specificity. CONCLUSIONS: Our finding suggested that circRNA Cdr1as may serve as a potential vicious molecular biomarker to predict the aggressive tumor progression and worse prognosis for CCA patients.

Building peace through participatory health training: a case from Cambodia.

This qualitative study examines the significance and effectiveness of participatory health training as a tool for peace building. It does so by analysing a case of training for 'health promoters' run by a Cambodian government health agency. The authors observed participants during the training and interviewed those involved in the courses. A developing capacity for coexistence and reconciliation between individuals who had been on opposite sides during the years of Khmer Rouge terror and continuous internal war was observed among both participants and trainers. Factors embodied in the training that facilitated favourable changes in self and in relations with others were identified as: (1) 'space for dialogue' was created by concrete common public health interests and urgent needs; (2) training took place 'live-in' style in a rural setting; (3) course contents and methods were consistent with peace education; (4) trainers had a conscious function as role models; and (5) there was continuity of effort and consequent accumulation of experience. To build peace, as well as conducting training directly on a technical topic, these essential factors need to be incorporated in the training programmes.

Sequence of the toxic shock syndrome toxin gene (tstH) borne by strains of Staphylococcus aureus isolated from patients with Kawasaki syndrome.

To explore whether a novel staphylococcal clone or structural variant of toxic shock syndrome toxin 1 is associated with Kawasaki syndrome, six toxigenic strains of Staphylococcus aureus from Kawasaki syndrome patients were studied. The strains were divisible into two groups based on phenotypic and genotypic characteristics and are therefore unequivocally not clonal. Portions of the tstH genes of each strain were sequenced. Three were sequenced in their entirety, while the remainder were sequenced from codon 66 to codon 137 of the mature protein only. Two of the former group differed slightly in the sequences of their signal peptides relative to the sequence published for the tstH signal peptide. Those differences did not affect toxin processing or secretion. The sequenced portions of the regions encoding mature toxic shock syndrome toxin 1 were identical in all six strains and corresponded exactly to the published sequence of tstH. No evidence was found for the existence of a structural variant of tstH uniquely associated with Kawasaki syndrome.