[Use of indocyanine green fluorescence navigation in laparoscopic anatomical hepatectomy].

Objective: To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. Methods: Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the χ2 test or Fisher's exact probability method was used for comparison between groups. Results: (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(M (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (P=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (P=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (P=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(P=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, q=235.5,P=0.004;(611±389)IU/L(331±242) IU/L, q=265.2, P=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. Conclusion: Laparoscopic anatomical hepatectomy guided by ICG fluorescence through arterial staining and portal vein staining is safe and feasible for primary hepatocellular carcinoma treatment.

[The changes of blood-labyrinth barrier in idiopathic sudden sensorineural hearing loss and the relationship with clinical features and prognosis].

Objective: To investigate the clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with blood-labyrinth barrier breakdown (BLB-B). Methods: Clinical data of patients with unilateral ISSNHL hospitalized from December 2017 to December 2018 were retrospectively analyzed. According to the results of 3D-FLAIR MRI and enhanced MRI scanning, these patients were divided into two groups, i.e., normal and abnormal inner ear groups. The patients in abnormal inner ear group were further divided into two subgroups: BLB-B and BLB-B with exudation. The differences and correlations among the groups in clinical characteristics, in terms of gender, age, deafness side, basic diseases, dizziness/vertigo, vestibular function, hearing loss degree, as well as classification of hearing curve, and prognosis were analyzed by statistical software SPSS 23.0. Results: Data were collected from 150 cases, in which 68 were male and 82 were female, aged (46.2±14.6) years, including 67 cases with normal inner ears and 83 cases with abnormal inner ears (13 cases with BLB-B; 70 cases with BLB-B and exudation). The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, HIT and VAT) and therapeutic effect were different between normal and abnormal inner ear groups (P<0.05). The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different among normal inner ear, BLB-B and BLB-B with exudation groups (P<0.05). Pairwise comparison between groups revealed that vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different between normal inner ear and BLB-B groups (P<0.05); The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different between normal inner ear and BLB-B with exudation groups (P<0.05). There was no significant different between BLB-B and BLB-B with exudation groups. Conclusion: BLB-B displayed by 3D-FLAIR MRI manifestation in ISSNHL patients indicates more serious cochlear and vestibular dysfunction, and worse therapeutic effect.

[3D-FLAIR MRI findings in idiopathic sudden sensorineural hearing loss and the correlations with clinical features and prognosis].

Objective: To explore the correlations of different appearances of labyrinthine 3D-FLAIR MRI with clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: Clinical data of patients with unilateral ISSNHL hospitalized from May 2017 to January 2019 were retrospectively analyzed. According to the results of 3D-FLAIR MRI, the patients were divided into three groups including hyperintense with absorption, hyperintense without absorption and normal. The differences and correlations among the three groups in clinical characteristics (gender, age, deafness side, duration, treatment days, dizziness/vertigo, basic diseases, vestibular function, deafness classification and typing) and prognosis were analyzed by SPSS 20.0 software. Results: Data were collected from 1 245 cases, including 739 (59.36%) with normal signal, 288 (23.13%) hyperintense without absorption, and 218 (17.51%) hyperintense with absorption. The side ratio, treatment days, dizziness/vertigo incidence, vestibular dysfunction, deafness classification and typing were different among the three groups (P<0.001). The incidence of right side was significantly higher in both the hyperintense with and without absorption groups than that in the normal. The vestibular dysfunction was more common in the hyperintense with absorption group than in the normal and hyperintense without absorption groups. It showed statistical differences in the dizziness/vertigo incidence, deafness classification, treatment days, and deafness typing compared between groups, which was the most significant in the hyperintense with absorption group, followed by the hyperintense without absorption group. There was no statistical difference in the total effective rate among the three groups (P=0.139), whereas a significant difference in the recovery rate (P<0.001). The prognosis was significantly correlated with duration, age, treatment days and dizziness/vertigo in the normal group (all P<0.001), correlated with duration and treatment days in the hyperintense with absorption group (both P<0.001), only correlated with the duration in the hyperintense without absorption group (P<0.001). Conclusion: 3D-FLAIR MRI manifestation is closely related to the clinical features and efficacy of ISSNHL. It is helpful to clarify the pathology of inner ear, which is expected to be a new imaging indicator for disease evaluation.

[Sleep quality analysis in patients with unilateral idiopathic sudden sensorineural hearing loss].

Objective:To analyze the characteristics of sleep quality and its correlation with the clinical features and hearing curative effects in patients with unilateral idiopathic sudden sensorineural hearing loss (ISSHL). Method:Pittsburgh sleep quality index (PSQI) was applied to evaluate the sleep quality of unilateral ISSHL patients in our department. Patient group is divided into poor sleep quality subgroup (total PSQI score>7 points) and normal sleep subgroup (total PSQI score≤7 points). The differences of Patient group and two subgroups between hearing curative effect in the 30 days after treatment and sleep quality scores were compared and analyzed. Questionnaire survey was applied to control group, which contained 70 healthy people with normal hearing level and age matched. Result:A total of 75 cases were collected. To compare with control group, there were statistical difference in the scores of subjective sleep quality, habitual sleep efficiency, sleep disturbance and PSQI before treatment and in the score of habitual sleep efficiency after the treatment for 30 d (P<0.05). The sleep quality between poor sleep quality subgroup and normal sleep subgroup, total therapeutic effect after treatment for 30 d was no significant difference (P>0.05). The proportion for poor sleep quality were no statistically significant differences in the different efficacy of two subgroups (P>0.05). Two subgroups before treatment, in addition to sleep duration, there were statistically significant in all the sleep quality dimensions (P<0.05); after treatment for 30 d, in addition to subjective sleep quality, sleep duration, all have statistical difference (P<0.05). The poor sleep quality subgroup in the case group compared before and after treatment for 30 d, there was statistically significant in subjective sleep quality (P<0.05). The sleep disturbance before treatment, the sleep duration and PSQI scores after treatment for 30 d were associated with clinical features in patients with unilateral ISSHL (P<0.05). Conclusion:The sleep quality of patients with Unilateral SSNHL was significantly lower than that of normal hearing patients, the sleep quality had no significant effect on the general efficacy of unilateral SSNHL, but some sleep quality dimensions are associated with the clinical features before and after treatment.

The W alloying effect on thermal stability and hardening of nanostructured Cu-W alloyed thin films.

In order to achieve desired mechanical properties of alloys by manipulating grain boundaries (GBs) via solute decoration, it is of great significance to understand the underlying mechanisms of microstructural evolution and plastic deformation. In this work, nanocrystalline (NC) Cu-W alloyed films with W concentrations spanning from 0 to 40 at% were prepared by using magnetron sputtering. Thermal stability (within the temperature range of 200 °C-600 °C) and hardness of the films were investigated by using the x-ray diffraction, transmission electron microscope (TEM) and nanoindentation, respectively. The NC pure Cu film exhibited substantial grain growth upon all annealing temperatures. The Cu-W alloyed films, however, displayed distinct microstructural evolution that depended not only on the W concentration but also on the annealing temperature. At a low temperature of 200 °C, all the Cu-W alloyed films were highly stable, with unconspicuous change in grain sizes. At high temperatures of 400 °C and 600 °C, the microstructural evolution was greatly controlled by the W concentrations. The Cu-W films with low W concentration manifested abnormal grain growth (AGG), while the ones with high W concentrations showed phase separation. TEM observations unveiled that the AGG in the Cu-W alloyed thin films was rationalized by GB migration. Nanoindentation results showed that, although the hardness of both the as-deposited and annealed Cu-W alloyed thin films monotonically increased with W concentrations, a transition from annealing hardening to annealing softening was interestingly observed at the critical W addition of ∼25 at%. It was further revealed that an enhanced GB segregation associated with detwinning was responsible for the annealing hardening, while a reduced solid solution hardening for the annealing softening.

[Analyses of prognostic factors relevant to acute low-tone sensorineural hearing loss].

Objective: To investigate the prognostic factors relevant to acute low-tone sensorineural hearing loss (ALHL). Methods: 196 adult ALHL patients, including 82 males and 114 females with mean age of (43.1±14.3)years old were included. All patients received the same therapy and were evaluated the curative effect. To evaluate the impact factors on the prognosis of hearing, inclusive of age, gender, time delay before the first visit, degree of deafness, vestibular function, electrocochleogram, and the serum levels of thyroxines by SPSS 18.0 software. Results: Of those 196 patients with ALHL, 124(63.3%) were recovery, 5(2.6%) were excellent better, 42(21.4%) were better, and 25 (12.8%) were poor, with a total effective rate of 87.2%. Among 15 (12.1%) who recurred the hearing loss, 2 developed into Meniere's disease during the follow-up. The mean age of patients with poor hearing effect was significantly older than that of other patients (P<0.05). No relativity was found between gender and hearing curative effect. There existed a statistical difference in total effective rate among subjects with different histories (P<0.05). In addition, the recovery rate was significantly different between groups, i. e., the course of disease was less than 14 days, between 14 days and 6 months, and between 6 months and 2 years (P<0.05). There was no statistical significance in total effective rate among different degrees of deafness (P>0.05). However, in term of the recovery rate, the difference was statistical significance (P<0.05). The recovery rate in patients with mild hearing loss was higher than that in middle or heavy hearing loss (both P<0.05). Among patients with mild deafness, the recovery rate in patients whose history was less than 3 months was significantly higher than that more than 3 months (P<0.05). For moderate deafness patients, the recovery rate in patients whose history was less than 7 days was significantly higher than that more than 1 month (P<0.05). There were statistical differences in hearing effect of 130 (66.3%) patients with abnormal vestibular function in comparison to that with normal vestibular function (χ2=15.1, P<0.05). There were 17(8.7%) patients with abnormal electrocochleogram combined with abnormal vestibular function, and the hearing effects were all poor. There were 45 (23.0%) patients with abnormal thyroxine levels in serum, which was significant higher than that in health adults of 5.9%(χ2=7.26, P<0.01). There was no significant difference in hearing prognosis between patients with abnormal and normal thyroxine levels (χ2=2.51, P>0.05). Conclusions: With respect to ALHL, the hearing effect is associated significantly with the history. The severity of hearing loss is negative prognostic factor for hearing recovery. Age, vestibular function, and electrocochleogram might predict hearing recovery. Gender and thyroxine levels couldn't predict the hearing prognosis, although there is a high incidence rate in patients with ALHL.

[Ultrahigh-frequency hearing thresholds in middleaged and elderly healthy adults].

Objective:To investigate the ultrahigh-frequency(UHF) hearing thresholds in middle-aged and elderly healthy subjects .Method: Healthy subjects(age range: 50-69 ) were divided into two groups,i.e.50-59 year-old group and >59-69 year-old group.Each subject was tested with both conventional-frequency(0.25,0.50,1.00,2.00,4.00,6.00 and 8.00 kHz) and ultrahigh-frequency(9.0,10.0,11.5,12.5,14.0,16.0,18.0,and 20.0 kHz) audiometry.UHF was performed twice to evaluate the reliability.The best hearings among 20-29 aged healthy adults were considered as normal controls.Results:Seventy five middle-aged and elderly subjects were included,with 39 subjects(78 ears) being 50-59 years old and 36(72 ears) being >59-69 year-old.Eighteen subjects(36 ears) aging from 20 to 29 were considers as controls.For the conventional-frequency,the hearing thresholds in middle-aged and elderly people were significantly higher than those in young people(all P<0.05),especially at ≥4 kHz.Although the conventional-frequency thresholds in >59-69 year-old group were higher than those in 50-59 year-old,the difference was significant just at 4 kHz(P<0.05).The UHF thresholds in middle-aged and elderly people were significantly higher than those in young people(all P<0.05).The thresholds at 9,10,11.5 and 12.5 kHz in >59-69 year-old people were significantly increased than those in 50-59 year-old counterparts(all P<0.05).Hearing threshold at ≥12.5 kHz couldn't be detected in some subjects in middle-aged and elderly group.The response rate at UHF in >59-69 year-old people were just higher than that in 50-59 year-old counterparts (P>0.05),and none responded at 18 and 20 kHz.The standard deviations(SDs) for <14 kHz in 50-59 year-old and for <11.5 kHz in >59-69 year-old subjects,were both higher than that in 20-29 year old counterparts.Above 6 kHz,the SDs in 50-59 year-old subjects were significantly higher than those in >59-69 year-old subjects(all P<0.05).Conclusion:For middle-aged and elderly people,the hearing loss may occur from 4 kHz.Hearing thresholds at UHF were increased with age,and it might be used as an early indicator for age-induced hearing loss.However,the UHF sensitivity decreased as the frequency increased beyond 14 kHz.

Synthesis and evaluation of hydroxycamptothecin-encapsulated chitosan nanospheres for the treatment of liver cancer.

Hydroxycamptothecin-encapsulated chitosan (HC) nanospheres were prepared by Shirasu porous glass (SPG) membrane emulsification technique. The properties and morphology of HC nanospheres were characterized. The diameter of the nanospheres could be controlled within a narrow distribution according to the pore-size of SPG membrane. Hydroxycamptothecin (HCPT) encapsulation efficiency could reach to 81.3%. The long-term drug release of HCPT could be presented by an accumulated drug release of 85.4% in 15 days with an initial burst effect. In vitro study, HC showed its anti-tumor ability to human hepatoma (HepG2) cells. In vivo study, HC could reduce tumor weight and growth rate. The results indicated that HC nanospheres prepared by SPG had potential application as a sustained drug delivery system for the treatment of liver cancer.