Feasibility of computed tomography-guided irreversible electroporation for porcine kidney ablation

Objective: The objective was to evaluate the feasibility and safety of computed tomography (CT)-guided percutaneous irreversible electroporation (IRE) in porcine kidneys. Materials and Methods: Under CT guidance, two monopole probes were used to precisely puncture through the renal parenchyma into the renal hilum in nine anesthetized adult Bama miniature pigs. After which, IRE ablation was performed. Biochemical and pathological examinations were carried out 2 h, 2, 7, and 14 days after the procedure. Results: All procedures were performed successfully without any serious complications such as bleeding, infection, or death. All pigs survived until the end of the study. Pathological examinations showed that cells in the ablation area were dead within 2 days after the procedure, whereas the vascular endothelium showed only slight damage. After 2 days, endothelialization ensued and regrowth of smooth muscle cells was observed after 14 days. Hemogram tests indicated a transient increase but gradually returned to baseline levels 14 days after the procedure. Conclusion: IRE was essentially safe, however further studies on tumor ablation using several different animal models are needed

Application of a single-chain fragment variable (scFv) antibody for the confirmatory diagnosis of hydatid disease in non-endemic areas

Background: Hydatid disease is a serious parasitic disease threatening public health. Because of its rarity in non-endemic coastal areas, determining the nature and origin of a chronic, enlarged liver cystic mass is challenging in these regions. Under these circumstances, physicians need a confirmatory diagnostic tool beyond immunological and radiological examinations. This study investigated a novel human single-chain fragment variable (scFv) antibody for the confirmative diagnosis of 18 atypical hydatid disease cases in non-endemic coastal areas. Results: A scFv antibody against cystic echinococcosis was produced by genetic engineering and then applied to the immunohistochemical diagnosis of 18 cases of cystic echinococcosis presented in non-endemic coastal areas. The diagnosis of these cases by ultrasound and serum-based examinations was inconclusive. The 750 bp scFv antibody gene was expressed in COS-7 cells, and the antibody localized in the cytoplasm. The scFv antibody can detect the germinal layer and protoscolices of actively growing cysts but not of the degenerating protoscolices and has a diagnostic efficiency higher than that of single serum or ultrasound testing (P b 0.05). The combined use of scFv antibodies with serology and ultrasound diagnostics results in a diagnostic efficiency comparable to that of surgery. The scFv antibody can be used as a confirmatory test for the diagnosis of hydatid disease in non-endemic areas, providing a beneficial supplementary diagnostic method that complements traditional immune testing and ultrasonic radiology and thus helping physicians to effectively differentiate hydatid disease.

Integrating Clinical Practice and Research Skills into Comprehensive Capability for Translational Medicine, Zhejiang Experience on the Hepato-bilio-pancreatic Surgeon Program.

A highly skilled surgical team relies on a standardized training program. This article presents a comprehensive description on the current status, problems, and strategies in Hepato-bilio-pancreatic surgery education reform in Zhejiang University School of Medicine (ZJU), China. A multiple-discipline joint training program was set up by integrating the basic laboratory and clinical research as well as routine clinical practice. Reform includes resident training in the Royal College of Surgeons of Edinburgh, curriculum resetting, surgery textbook rewriting, clinical teaching and training bases construction, teaching methods improvement, English reading, writing and reporting skills training and a research assignment. ZJU establishes rigorous processes for managing teaching quality and ensuring graduates promote evidence-based surgical practice. ZJU has built its leading position in the Hepato-Bilio-Pancreatic surgery in China. In 2011, 6 post-doctoral researchers, 52 Ph.D. students and 83 master students were enrolled in the 7year MD program and 8year Ph.D. MD/Ph.D. program. The admission scores have been listed as the top three of the 264 master degrees programs and 181 doctoral degrees programs in Zhejiang University, which ranks among the top three in all Chinese Universities. Historical experience and the advanced experience of Western countries are adopted as a reference to build up a surgical education system with Chinese characteristics to achieve a continuous, sound, and rapid development of surgical education in ZJU, China. However, there are differences relating to the healthcare systems of China and Western countries. These differences present major challenges for the internationalization of surgical education. This article may facilitate the process of surgical training development in a global context.