Preoperative systemic immune-inflammation index-based nomogram for lung carcinoma following microwave ablation -a real world single center study.

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.

Radiofrequency ablation for stage

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.

Preoperative controlling nutritional status score (CONUT) predicts postoperative complications of patients with bronchiectasis after lung resections.

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.

Histone deacetylase inhibitor attenuates intestinal mucosal injury in fatally scalded rats.

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.

Master manipulator optimisation for robot assisted minimally invasive surgery.

BACKGROUND: In robot-assisted minimally invasive surgery, the surgeon controls a robot by operating a pair of master manipulators. Thus, the performance of a master manipulator directly affects the work of the surgeon physiologically and psychologically. AIMS: In order to improve the operability and quality of operation, a structure optimisation method of master manipulator is proposed. MATERIALS & METHODS: The optimisation index of workspace and dexterity of main manipulator based on ergonomics and kinematics is established, and the reasonable weight coefficient of optimisation index is determined by using combination weighting method. RESULTS: Experiments verified that the proposed optimisation method ensures a large workspace and good kinematic performance for the master manipulator. CONCLUSION: This improves the comfort of the surgeon and can effectively avoid the problem of cutting off master-slave communication to adjust the position of the master manipulator owing to the small workspace.

MicroRNA-520a-3p suppresses epithelial-mesenchymal transition, invasion, and migration of papillary thyroid carcinoma cells via the JAK1-mediated JAK/STAT signaling pathway.

Papillary thyroid cancer (PTC) is a kind of thyroid cancer and frequently presents with epithelial-mesenchymal transition (EMT). MicroRNAs (miRNAs) were previously reported to be associated with PTC. Thus, this study aims to define the role of microRNA-520a-3p (miR-520a-3p) in PTC through the JAK/STAT signaling pathway by targeting JAK1. The PTC and normal thyroid tissues of 137 PTC patients were collected. First of all, the expression pattern of miR-520a-3p, JAK1, JAK2, STAT3, E-cadherin, and vimentin in PTC was identified. The relationship between miR-520a-3p and JAK1 was predicted and analyzed. And a series of miR-520a-3p mimic or inhibitor, or siRNA JAK1 introduced into PTC cells were applied to examine the effect of miR-520a-3p on PTC cell viability, migration, invasion, cell cycle, apoptosis, and EMT. Meanwhile, the regulatory effect of miR-520a-3p and JAK1 on the JAK/STAT signaling pathway was also determined. The expression of JAK1, JAK2, STAT3, and vimentin increased yet miR-520a-3p and E-cadherin decreased in PTC tissue. JAK1 was negatively regulated by miR-520a-3p. Functionally, EMT induction was prevented by miR-520a-3p upregulation through downregulating JAK1. When upregulating miR-520a-3p or silencing JAK1 in PTC cells, PTC cell viability, migration, and invasion were inhibited yet cell apoptosis promoted with cells arrested at G1 phase, indicating that miR-520a-3p prevented PTC progression by downregulating JAK1. Moreover, miR-520a-3p elevation or JAK1 inhibition inactivated the JAK/STAT signaling pathway. Collectively, miR-520a-3p prevents cancer progression through inactivating the JAK/STAT signaling pathway by downregulating JAK1 in PTC.

Expert consensus on image-guided radiofrequency ablation of pulmonary tumors: 2018 edition.

Lung cancer ranks first in incidence and mortality in China. Surgery is the primary method to cure cancer, but only 20-30% of patients are eligible for curative resection. In recent years, in addition to surgery, other local therapies have been developed for patients with numerous localized primary and metastatic pulmonary tumors, including stereotactic body radiation therapy and thermal ablative therapies through percutaneously inserted applicators. Percutaneous thermal ablation of pulmonary tumors is minimally invasive, conformal, repeatable, feasible, cheap, has a shorter recovery time, and offers reduced morbidity and mortality. Radiofrequency ablation (RFA), the most commonly used thermal ablation technique, has a reported 80-90% rate of complete ablation, with the best results obtained in tumors < 3 cm in diameter. Because the clinical efficacy of RFA of pulmonary tumors has not yet been determined, this clinical guideline describes the techniques used in the treatment of localized primary and metastatic pulmonary tumors in nonsurgical candidates, including mechanism of action, devices, indications, techniques, potential complications, clinical outcomes, post-ablation surveillance, and use in combination with other therapies. In the future, the role of RFA in the treatment of localized pulmonary tumors should ultimately be determined by evidence from prospective randomized controlled trials comparing sublobar resection or stereotactic body radiation therapy.

Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments.

BACKGROUND: Magnetic anchored surgical instruments (MASI), relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT) deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI. METHODS: For MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT. RESULTS: Abdominal wall at C point in the middle third lumbar vertebra plane (L3) is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. "BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x) = P1 × x 2 + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056), P2 = 1.098 (0.03197, 2.164), P3 = -18.52 (-31.64, -5.412), R-square: 0.99. CONCLUSIONS: Abdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of "BMI-ICAWT" curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.

Optimal Scan Time of 18F-FDG PET in Identifying Therapeutic Efficacy Secondary to Radiofrequency Ablation of Lung Cancer: Case Report.

Positron emission tomography (PET)/computed tomography (CT)-guided radiofrequency ablation (RFA) has become a major treatment approach for small tumors. Identifying this quantitative dynamic 18F-2-fluoro-2-deoxy-d-glucose (18F-FDG) activity at the primary lesion can minimize misdiagnosis and allow an opportunity to reintervene. Here, we report 3 patients with nonsmall cell lung cancer (NSCLC) who underwent the ablative therapy with split-dose 18F-FDG fused PET/CT scans for early identification of residual tumors and follow-up evaluation of treatment. Our results indicate that reliable post-RFA imaging follow-up is critical in fast and efficient assessment of complete tumor resection in patients experienced the ablation procedure.

A prospective randomized single-blind control study of volume threshold for chest tube removal following lobectomy.

BACKGROUND: The aim of the current study was to assess the feasibility and safety of a new volume threshold for chest tube removal following lobectomy. METHODS: The prospective randomized single-blind control study included 90 consecutive patients who underwent lobectomy or bilobectomy for pathological conditions between March 2012 and September 2012. Eligible patients were randomized into two groups: early removal group (chest tube removal at the drainage volume of 300 ml/24 h or less) and traditional management group (chest tube removal when the drainage volume is less than 100 ml/24 h). Criteria for the early removal group were established and met prior to chest tube removal. The volume and characteristics of drainage, time of drainage tube extraction, and postoperative hospital stay were recorded. All patients received standard care while in the hospital and a follow-up visit was performed 7 days after discharge from hospital. RESULTS: In accordance with the exit criteria, 20 patients were excluded from the study. The remaining 70 patients included in the final analysis were divided into two groups: early removal group (n = 41) and traditional management group (n = 29). There was no difference between the two groups in terms of age, sex, comorbidities, and pathological evaluation of resection specimens. In eligible patients (n = 70), the mean volume of drainage 24 h after surgery was 300 ml, while the mean volume of drainage 48 h after surgery was 250 ml. The average daily drainage 48 h after surgery was significantly different than the average daily drainage 24 h after surgery (Z = -2.059, P = 0.039). The mean duration of chest tube placement was 44 h in the early removal group and 67 h in the traditional management group (P = 0.004). Patients who underwent early removal management had a shorter postoperative hospital stay compared to the traditional management group (5 vs. 6 days, P < 0.01). No statistically significant differences were observed between the rates of pleural effusion development, thoracentesis, and postoperative complications 1 week after hospital discharge. CONCLUSION: Early removal of the chest tube after lobectomy is feasible and safe and may shorten patient hospital stay and reduce morbidity without the added risk of postoperative complications.

[Early removal of the chest tube after lobectomies: a prospective randomized control study].

OBJECTIVE: To evaluate the feasibility and safety of early chest tube removal after lobectomies for lung diseases. METHODS: A prospective randomized control study was performed with data collected from lobectomies between March 2012 and September 2012. Eligible patients (n = 70) were randomized into two groups; early removal group (removal of chest tube when drainage less than 300 ml/24 h, n = 41) and traditional management group (removal of chest tube when drainage less than 100 ml/24 h, n = 29). Criteria for early removal were established and met before chest tube removal. The volume and character of drainage, time of extracting drainage tube and postoperative hospital stay were measured. All patients received standard care during hospital admission and a follow-up visit was performed after 7 days of discharge from hospital. RESULTS: There were no differences between two groups with respect to age, sex, comorbidities, or pathologic evaluation of resection specimens. The median volume of drainage within 24 h after surgery was 300 ml and within 48 h was 250 ml, there was significantly different between two groups (Z = -2.059, P = 0.039). Patients undergoing early removal management had a shorter Chest tube duration (44 hours vs. 67 hours, Z = -2.914, P = 0.004) and a shorter postoperative hospital stay (5.0 days vs. 6.0 days, Z = -3.882, P = 0.000). Analysis of data showed no statistically significant differences between the rate of pleural effusions developed, thoracentesis and complications, one week after discharge from hospital. CONCLUSIONS: Compared to the traditional management group (drainage ≤ 100 ml/24 h), early removal of chest tube after lobectomy (drainage ≤ 300 ml/24 h) is feasible and safe. It could result in a shorter hospital stay, and most importantly, reduces morbidity without the added risk of complications.

Combined laparoscopic and thoracoscopic Ivor Lewis esophagectomy for esophageal cancer: initial experience from China.

BACKGROUND: Minimally invasive Ivor Lewis esophagectomy was usually performed with either hand-sewn or circular stapler anastomosis through a small thoracotomy or using a side-to-side stapler anastomotic technique. This study aimed to present our initial results of Ivor Lewis esophagectomy using a circular-stapled anastomosis with transoral anvil technique. METHODS: Six patients with esophageal cancer underwent minimally invasive Ivor Lewis esophagectomy with an intrathoracic circular-stapled end-to-end anastomosis. The abdominal portion was operated on laparoscopically, and the thoracic portion was done using thoracoscopic techniques. A 25 mm anvil connected to a 90 cm long delivery tube was introduced transorally to the esophageal stump in a tilted position, the anvil head was then connected to circular stapler. The anastomosis was completed under direct thoracoscopic view. RESULTS: A total of six patients in this report successfully underwent total laparoscopic and thoracoscopic Ivor Lewis esophagectomy with a circular-stapled anastomosis using a transoral anvil. They were five male and one female patients, and had a mean age of 55 years (range, 38-69 years). The thoracic and abdominal operations were successfully performed without any intraoperative complications or conversion to laparotomy or thoracotomy. The passage of the anvil head was technically easy and successful in all six cases. The mean overall operative time was (260 ± 42) minutes (range, 220-300 minutes), and the mean estimated blood loss was (520 ± 160) ml (range, 130-800 ml). Patients resumed a liquid oral diet on postoperative day seven. The median length of hospital stay was 17 days (range, 9-25 days). The postoperative pathological diagnosis was esophageal squamous cell carcinoma in five patients and esophageal small cell carcinoma in one patient. Tumors were staged as T(2)N(0)M(0) in three cases, T(2)N(1)M(0) in one case, and T(3)N(0)M(0) in two cases. During the mean follow-up of 2.5 months (range, 2-4 months), there were no intraoperative technical failure of the anastomosis or major postoperative complications such as leak or stricture. CONCLUSIONS: The initial results of this small series suggest that minimally invasive Ivor Lewis esophagectomy for malignant esophageal tumor is technically feasible. However, further multi-center prospective studies and thorough evaluation are needed to evaluate the long-term results.

Elevated circulating levels of osteopontin are associated with metastasis in advanced non-small cell lung cancer.

OBJECTIVE: To investigate the relationship between postoperative metastasis and circulating levels of osteopontin in non-small cell lung cancer (NSCLC). METHODS: The expression of osteopontin mRNA were detected with RT-PCR technique. The circulating levels of osteopontin were measured through ELASA in 46 NSCLC cases that had not been received any anti-cancer treatment at the time of sampling. The tissues from fifteen patients with benign pulmonary diseases were studied as control group. RESULTS: The overall median mRNA expression level of osteopontin was approximately 70-fold higher in tumor tissues than in matched normal lung tissues (P<0.001). Over-expression of osteopontin mRNA was significantly associated with clinical stage (P=0.009). Advanced disease states had higher circulating level of osteopontin (stage I+II versus stage III+VI). In multivariate analysis, stage was the only independent factor influencing circulating levels of osteopontin. All patients were followed up for 12 months, 2 of the 46 patients with both osteopontin mRNA expression and elevated plasma osteopontin levels had local recurrence and 10 had distant metastasis. There was a significant difference in the osteopontin levels between metastasis group and non-metastasis group. CONCLUSION: Preoperative plasma levels of osteopontin are significantly associated with post-operative metastasis in advanced NSCLC.

[Completely minimally invasive Ivor Lewis esophagectomy: the preliminary experience of circular-stapled anastomosis with the trans-oral anvil].

OBJECTIVE: to present the preliminary results of minimally invasive Ivor Lewis esophagectomy using a circular-stapled anastomosis with trans-oral anvil technique. METHODS: six patients with esophageal cancer received minimally invasive Ivor Lewis oesophagectomy from April 2010 to June 2010. There were 5 males and 1 female with mean age of 55 years (ranging 38 to 69 years). The lesion located in cardiac in 1 case, in lower third of the esophagus in 4 cases and in middle third in 1 case. The abdominal portion was operated laparoscopically. The thoracic portion was done using thoracoscopic techniques. The esophago-gastric anastomosis was created using a 25 mm anvil passed trans-orally and connected to a 90 cm long polyvinyl chloride delivery tube through an opening in the esophageal stump. The anastomosis was completed by joining the anvil to a circular stapler (end-to-end anastomosis stapler) inserted into the gastric conduit. RESULTS: six patients with esophageal squamous cell cancer (n = 5) and small-cell cancer (n = 1) underwent an Ivor Lewis esophagectomy. All the operation was successfully performed without intra-operative technical failures of the anastomosis. There was no severe postoperative complications. The mean operation time was 380 min. The mean blood loss was 300 ml. pTNM staging: T2N0M0 in 3 cases, T2N1M0 in 1 case and T3N0M0 in 2 cases. CONCLUSIONS: the circular-stapled anastomosis with the trans-oral anvil is an efficient and safe technique for esophago-gastric anastomosis.

17Beta-estradiol restores excitability of a sexually dimorphic subset of myelinated vagal afferents in ovariectomized rats.

We recently identified a myelinated vagal afferent subpopulation (Ah type) far more prevalent in female than male rats and showed that this difference extends to functionally specific visceral sensory afferents, baroreceptors of the aortic arch. Excitability of myelinated Ah-type afferents is markedly reduced after ovariectomy (OVX). Here we tested the hypothesis that 17beta-estradiol can selectively restore excitability of these sex-specific vagal afferents. Acutely isolated vagal afferent neurons (VGN) from intact and OVX adult female rats were used with patch-clamp technique and current-clamp protocols to assess the effect of acute application of 17beta-estradiol on neuronal excitability. At over physiologically relevant 17beta-estradiol concentrations for rat (1-10 nM) excitability of myelinated Ah-type vagal afferents is restored to discharge frequencies comparable to those in intact females, albeit with some interesting differences related to burst and sustained patterns of neuronal discharge. Restoration of excitability occurs within 3 min of hormone application and is stereo specific, because 1,000 nM 17alpha-estradiol fails to alter excitability. Furthermore, activation of G protein-coupled estrogen receptor GPR30 with highly selective agonist G-1 similarly restores excitability of Ah-type afferents. The effectiveness of 17beta-estradiol and G-1 is completely eliminated by application of high-affinity estrogen receptor ligand ICI-182,780. 17beta-Estradiol conjugated with BSA is approximately 70% as effective as 17beta-estradiol alone in restoring Ah-type VGN excitability. These data support our conclusions that the cellular mechanisms leading to rapid restoration of neuronal excitability of myelinated Ah-type VGN after OVX occur, at least in part, via membrane-bound estrogen receptors. We contend that recovery of high-frequency discharge at physiologically relevant 17beta-estradiol concentrations implies that this unique subtype of low-threshold myelinated vagal afferent may account for some of the sex-related differences in visceral organ system function. Sex differences in cardiovascular and gastrointestinal function and the potential role of GPR30 in modulation of sex-specific myelinated Ah-type vagal afferents are discussed.

Stereotactic localization and visualization of the subthalamic nucleus.

BACKGROUND: The subthalamic nucleus (STN) is widely recognized as one of the most important and commonly targeted nuclei in stereotactic and functional neurosurgery. The success of STN surgery depends on accuracy in target determination. Construction of a digitalized atlas of STN based on stereotactic MRI will play an instrumental role in the accuracy of anatomical localization. The aim of this study was to investigate the three-dimensional (3D) target location of STN in stereotactic space and construct a digitalized atlas of STN to accomplish the visualization of the STN on stereotactic MRI, thus providing clinical guidance on the precise anatomical localization of STN. METHODS: One hundred and twenty healthy people volunteered to be scanned by 1.5 Tesla MRI scanning with 1-mm-thick slice in the standard stereotactic space between 2005 and 2006. One adult male was selected for 3D reconstruction of STN. The process of 3D reconstruction included identification, manual segmentation, extraction, conservation and reconstruction. RESULTS: There was a significant correlation between the coordinates and age (P < 0.05). The volume of left STN was significantly larger than the right STN, and there was a significant negative correlation between volume and age (P < 0.05). The surface of the STN nucleus after 3D reconstruction appeared smooth, natural and realistic. The morphological feature of STN on the individual brain could be visualized directly in 3D. The 3D reconstructed STN could be rotated, zoomed and displayed at any direction in the stereotactic space. The anteroposterior diameter of the STN nucleus was longer than the vertical and transverse diameters in 3D space. The 3D reconstruction of STN manifested typical structure of the "dual lens". CONCLUSIONS: The visualization of individual brain atlas based on stereotactic MRI is feasible. However, software for automated segmentation, extraction and registration of MR images need to be further developed.

[Comparison of changes in early pulmonary function and hemodynamic between unilateral and bilateral lung volume reduction for chronic obstructive pulmonary disease].

OBJECTIVE: To compare changes in early pulmonary function and hemodynamics between unilateral and bilateral lung volume reduction (LVRS) for severe chronic obstructive pulmonary disease (COPD). METHODS: Eighty-six patients with severe COPD underwent LVRS, 61 underwent unilateral LVRS and 25 underwent lateral LVRS. The results of lung function (FEV(1), RV, TLC), arterial blood gas analysis (PaO(2), PaCO(2)) and color Doppler echocardiography (CO, CI, EF, PAP) were evaluated preoperatively and 3, 6 months postoperatively. RESULTS: Six patients died. FEV(1), RV and TLC were improved significantly after (P < 0.05). PaO(2) increased (P < 0.05) and PaCO(2) decreased postoperatively (P < 0.05). According to the Doppler echocardiography there were no statistic difference in cardia functions (CO, CI, EF, PAP) between unilateral and bilateral LVRS preoperatively and 3, 6 months postoperatively. CONCLUSIONS: Unilateral and bilateral LVRS is safe and effective in the treatment of patients with severe COPD, the pulmonary function significantly improved postoperatively, but the results of bilateral LVRS is better than unilateral. Both unilateral and bilateral LVRS showed no significant deterioration in hemodynamics, there were no significant difference between preoperatively and postoperatively.

[Study on an actuation system for matrix control of the active catheter in a minimally-invasive intervention surgery].

As it is impossible for an active catheter with a very small space to accommodate overmany lead wires in minimally-invasive surgery, a matrix network system is presented, in this paper, to control SMA actuators using minimum lead wires. Pulse current is adjusted by pulse width modulation (PWM) signals from the single-chip processor. In addition, multiple SMA actuators' cooperation helps the active catheter to succeed in guiding motion.