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1.
Aging (Albany NY) ; 12(5): 4111-4123, 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32155130

RESUMO

Mounting studies have shown that long noncoding RNAs (lncRNAs) play important roles in the development and occurrence of several human diseases. However, the role of LINC00461 in osteoarthritis (OA) remains obscure. A CCK-8 assay was performed to detect cell viability, and qRT-PCR analysis was used to measure mRNA expression. The targeting by miR-30a-5p of the LINC00461 3'UTR was detected using a luciferase reporter assay. Our data indicated that the inflammatory mediators IL-6 and TNF-α induced LINC00461 expression in chondrocytes and that the expression of LINC00461 was upregulated in OA tissues. Furthermore, we showed that TNF-α and IL-6 suppressed the expression of miR-30a-5p and that miR-30a-5p expression was lower in OA tissues than in normal samples. The expression level of miR-30a-5p in OA tissues was negatively related to LINC00461 expression. In addition, we showed that LINC00461 directly interacted with miR-30a-5p in chondrocytes. Elevated expression of LINC00461 induced chondrocyte proliferation, cell cycle progression, inflammation, and extracellular matrix (ECM) degradation. However, we demonstrated that ectopic expression of miR-30a-5p suppressed cell growth, cell cycle progression, inflammation and ECM degradation. Finally, we found that overexpression of LINC00461 enhanced chondrocyte proliferation, cell cycle progression, inflammation, and ECM degradation by downregulating miR-30a-5p. These data demonstrated that LINC00461 may modulate the development of OA by suppressing miR-30a-5p expression in chondrocytes. We propose that LINC00461 and miR-30a-5p may be potential therapeutic and diagnostic targets for OA.

2.
Int J Comput Assist Radiol Surg ; 15(3): 467-477, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31808070

RESUMO

PURPOSE: Knee arthroscopy suffers from a lack of depth information and easy occlusion of the visual field. To solve these limitations, we propose an arthroscopic navigation system based on self-positioning technology, with the guidance of virtual-vision views. This system can work without any external tracking devices or added markers, thus increasing the working range and improving the robustness of the rotating operation. METHODS: The fly-through view and global positioning view for surgical guidance are rendered through virtual-vision rendering in real time. The fly-through view provides surgeons with navigating the arthroscope in the internal anatomical structures using a virtual camera perspective. The global positioning view shows the posture of the arthroscope relative to the preoperative model in a transparent manner. The posture of the arthroscope is estimated from the fusion of visual and inertial data based on the visual-inertial stereo slam. A flexible calibration method that transforms the posture of the arthroscope in the physical world into the virtual-vision rendering framework is proposed for the arthroscopic navigation system with self-positioning information. RESULTS: Quantitative experiments for evaluating self-positioning accuracy were performed. For translation, the acquired mean error was 0.41 ± 0.28 mm; for rotation, it was 0.11° ± 0.07°. The tracking range of the proposed system was approximately 1.4 times that of the traditional external optical tracking system for the rotating operation. Simulated surgical operations were performed on the phantom. The fly-through and global positing views were paired with original arthroscopic images for intuitive surgical guidance. CONCLUSION: The proposed system provides surgeons with both fly-through and global positioning views without a dependence on the traditional external tracking systems for surgical guidance. The feasibility and robustness of the system are evaluated, and it shows promise for medical applications.

3.
Am J Transl Res ; 11(11): 7027-7034, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31814906

RESUMO

Osteoarthritis (OA) is the most common degenerative joint disease. microRNAs (miRNAs) have been showen to act critical roles in several diseases including OA. However, the involvement and underlying mechanism of miR-137 in development of OA remains unkown. In our study, we firstly showed that IL-1ß decreased the expression of miR-137 in the chondrocytes and we demonstrated that the miR-37 expression level was lower in the OA cases than in the control patients. Dual-luciferase reporter analysis was performed to confirm that ADAMTS-5 was a direct target gene of miR-137. Furthermore, we indicated that elevated expression of miR-137 decreased the protein expression of ADAMTS-5 in the chondrocytes. In additional, we showed that IL-1ß induces the ADAMTS-5 expression in the chondrocytes. The ADAMTS-5 expression level was higher in the OA cases than in the control patients. We showed that the expression of ADAMTS-5 was negatively correlated with the miR-137 expression level in OA tissues. Overexpression of miR-137 suppressed cell growth, extracellular matrix (ECM) degradation and inflammation in chondrocytes. These preliminary data elucidated that miR-137 suppressed OA progression via inhibiting cell growth, inflammation and ECM degradation.

4.
Mol Med Rep ; 19(6): 5263-5274, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31059041

RESUMO

Genetic biomarkers for the diagnosis of ankylosing spondylitis (AS) remain unreported except for human leukocyte antigen B27 (HLA­B27). Therefore, the aim of the present study was to screen the differentially expressed genes (DEGs), and those that also possess differential single nucleotide polymorphism (SNP) loci in the whole blood of AS patients compared with healthy controls by integrating two mRNA expression profiles (GSE73754 and GSE25101) and SNP microarray data (GSE39428) collected from the Gene Expression Omnibus (GEO). Using the t­test, 1,056 and 1,073 DEGs were identified in the GSE73754 and GSE25101 datasets, respectively. Among them, 234 DEGs were found to be shared in both datasets, which were subsequently overlapped with 122 differential SNPs of genes in the GSE39428 dataset, resulting in identification of two common genes [eukaryotic translation elongation factor 1 epsilon 1 (EEF1E1) and serpin family A member 1 (SERPINA1)]. Their expression levels were significantly upregulated and the average expression log R ratios of SNP sites in these genes were significantly higher in AS patients than those in controls. Function enrichment analysis revealed that EEF1E1 was involved in AS by influencing the aminoacyl­tRNA biosynthesis, while SERPINA1 may be associated with AS by participating in platelet degranulation. However, only the genotype and allele frequencies of SNPs (rs7763907 and rs7751386) in EEF1E1 between AS and controls were significantly different between AS and the controls, but not SERPINA1. These findings suggest that EEF1E1 may be an underlying genetic biomarker for the diagnosis of AS.


Assuntos
Biomarcadores/metabolismo , Fatores de Alongamento de Peptídeos/genética , Espondilite Anquilosante/diagnóstico , Proteínas Supressoras de Tumor/genética , Alelos , Estudos de Casos e Controles , Bases de Dados Genéticas , Frequência do Gene , Genótipo , Humanos , Polimorfismo de Nucleotídeo Único , Mapas de Interação de Proteínas/genética , RNA de Transferência/metabolismo , Espondilite Anquilosante/genética , Transcriptoma , alfa 1-Antitripsina/genética
5.
Med Biol Eng Comput ; 57(1): 47-57, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29967935

RESUMO

It is challenging to achieve high implant accuracy in dental implant placement, because high risk tissues need to be avoided. In this study, we present an augmented reality (AR) surgical navigation with an accurate cone beam computed tomography (CBCT)-patient registration method to provide clinically desired dental implant accuracy. A registration device is used for registration between preoperative data and patient outside the patient's mouth. After registration, the registration device is worn on the patient's teeth for tracking the patient. Naked-eye 3D images of the planning path and the mandibular nerve are superimposed onto the patient in situ to form an AR scene. Simultaneously, a 3D image of the drill is overlaid accurately on the real one to guide the implant procedure. Finally, implant accuracy is evaluated postoperatively. A model experiment was performed by an experienced dentist. Totally, ten parallel pins were inserted into five 3D-printed mandible models guided by our AR navigation method and through the dentist's experience, respectively. AR-guided dental implant placement showed better results than the dentist's experience (mean target error = 1.25 mm vs. 1.63 mm; mean angle error = 4.03° vs. 6.10°). Experimental results indicate that the proposed method is expected to be applied in the clinic. Graphical abstract ᅟ.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Imagem Tridimensional , Calibragem , Humanos , Mandíbula/inervação , Mandíbula/cirurgia , Cirurgia Assistida por Computador
6.
Int J Oral Maxillofac Implants ; 33(6): 1219-1228, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30427952

RESUMO

PURPOSE: This research aimed to propose a three-dimensional (3D) augmented reality navigation method with point cloud-based image-patient registration that could merge virtual images in the real environment for dental implants using a 3D image overlay and to evaluate its feasibility. MATERIALS AND METHODS: A total of 12 rapid prototyping mandibular models were fabricated using a 3D printing method and were divided into two groups: 3D augmented reality-guided group and traditional two-dimensional (2D) image-guided group. A point cloud-based preoperative image-to-patient registration method was introduced to replace the traditional point-to-point registration. After the registration, dental implant surgery was performed in the two model groups using an augmented reality-guided navigation method and a traditional two-dimensional image-guided navigation method. The planned and actual postoperative implant positions were compared for measuring positional implantation errors. The surgery time was also recorded and compared between the two groups. RESULTS: In the model experiment, the root-mean-square deviation of registration was 0.54 mm, and the implant surgery results showed < 1.5-mm mean linear deviation and < 5.5-degree angular deviation. The augmented reality-guided implantation showed smaller horizontal, vertical, and angular errors in the apical areas of the central incisor and the canine region. The surgery time using the augmented reality-guided navigation method was significantly shorter than that using the two-dimensional (2D) image-guided navigation method (P < .05). Moreover, the volunteer experiment demonstrated that the preoperative 3D models in situ accurately overlaid onto the surgical site. CONCLUSION: The proposed point cloud-based registration method can achieve excellent registration accuracy. Dental implant placement guided by the proposed 3D augmented reality navigation method showed better accuracy and applicability, as well as higher efficiency, than the traditional 2D image navigation method.


Assuntos
Implantes Dentários , Imagem Tridimensional/métodos , Cirurgia Assistida por Computador/métodos , Humanos , Mandíbula/cirurgia , Boca Edêntula/cirurgia , Imagens de Fantasmas , Impressão Tridimensional , Técnicas Estereotáxicas/instrumentação , Tomografia Computadorizada por Raios X/métodos , Interface Usuário-Computador
7.
Adv Exp Med Biol ; 1093: 193-205, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30306483

RESUMO

Augmented reality (AR) techniques play an important role in the field of minimally invasive surgery for orthopedics. AR can improve the hand-eye coordination by providing surgeons with the merged surgical scene, which enables surgeons to perform surgical operations more easily. To display the navigation information in the AR scene, medical image processing and three-dimensional (3D) visualization of the important anatomical structures are required. As a promising 3D display technique, integral videography (IV) can produce an autostereoscopic image with full parallax and continuous viewing points. Moreover, IV-based 3D AR navigation technique is proposed to present intuitive scene and has been applied in orthopedics, including oral surgery and spine surgery. The accurate patient-image registration, as well as the real-time target tracking for surgical tools and the patient, can be achieved. This paper overviews IV-based AR navigation and the applications in orthopedics, discusses the infrastructure required for successful implementation of IV-based approaches, and outlines the challenges that must be overcome for IV-based AR navigation to advance further development.


Assuntos
Imagem Tridimensional , Procedimentos Cirúrgicos Bucais , Ortopedia , Cirurgia Assistida por Computador , Humanos , Processamento de Imagem Assistida por Computador , Interface Usuário-Computador
8.
Front Genet ; 9: 320, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30233637

RESUMO

Neuropathic pain (NP) is a type of chronic pain that is different from the common type of pain. The mechanisms of NP are still poorly understood. Exploring the key genes and neurobiological changes in NP could provide important diagnostic and treatment tools for clinicians. GSE24982 is an mRNA-seq dataset that we downloaded from the Gene Expression Omnibus database to identify key genes in NP. Differentially expressed genes (DEGs) were identified using the BRB-ArrayTools software and R. Functional and pathway enrichment analyses of the DEGs were performed using Metascape. A protein-protein interaction network was created and visualized using Cytoscape. A total of 123 upregulated DEGs were obtained. Among these genes, p53 was the node with the highest degree; hence, we validated it experimentally using a chronic constriction injury mouse model. Our results showed that overexpression of the p53 gene, and the subsequent increase in caspase-3 expression, in dorsal root ganglion neurons led to increased apoptotic changes in these neurons. p53 may therefore be partly responsible for the development of chronic constriction injury-induced NP.

9.
Neurosci Lett ; 683: 174-180, 2018 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-30075286

RESUMO

Neuropathic pain is a severe and chronic neurological disease caused by injury or disease of the somatosensory system. Currently, there are no effective treatments for neuropathic pain. Neuroinflammation, characterized by activation of spinal glial cells and increased production of pro-inflammatory cytokines (for example, IL-1ß, TNF-α and IL-6), is a pathophysiological process closely related to neuropathic pain. The anti-inflammatory drug sulfasalazine (SFZ) is approved for inflammatory bowel disease and rheumatoid arthritis. Although the analgesic effect of SFZ has been reported in diabetic mice, its role in neuropathic pain caused by peripheral nerve injury has not been clarified. Here, we show that SFZ significantly alleviated mechanical hypersensitivity and attenuated neuroinflammatory response in neuropathic pain induced by chronic constriction injury (CCI) in rats. Additionally, SFZ inhibited the activation of astrocytes and abolished the CCI-induced increase of NF-κB in the spinal cord. Hence, our results show that SFZ is a potential treatment for neuropathic pain induced by peripheral nerve injury.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Hiperalgesia/tratamento farmacológico , NF-kappa B/antagonistas & inibidores , Neuralgia/tratamento farmacológico , Sulfassalazina/uso terapêutico , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Astrócitos/efeitos dos fármacos , Astrócitos/metabolismo , Doença Crônica , Constrição , Hiperalgesia/metabolismo , Masculino , NF-kappa B/metabolismo , Neuralgia/metabolismo , Ratos , Ratos Sprague-Dawley , Sulfassalazina/farmacologia
10.
J Thorac Dis ; 10(5): 2924-2932, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29997958

RESUMO

Background: For the surgery of esophageal cancer, cervical, mediastinal, and abdominal lymph node dissection (three-field lymph node dissection, 3FLND) is still controversial in most countries. This study aims to provide additional evidence of this procedure comparing with mediastinal-abdominal lymph node dissection (two-field lymph node dissection, 2FLND) from a high volume center in China, and also attempts to identify routes to reduce postoperative complications associated with 3FLND. Methods: From January 2009 to December 2013, 348 consecutive patients received esophagectomy with 3FLND and 1,406 patients received Ivor-Lewis with 2FLND in Fudan University Shanghai Cancer Center. After propensity-score matching, 282 pairs of cases without neoadjuvant treatment were selected. Postoperative outcomes and survival of the two groups were analyzed. Results: Operative morbidity and mortality rates were 34.8% and 0.4% for 3FLND group; and 25.5% and 0.7% for 2FLND group. Compared with the 2FLND group, the 3FLND group reported more cases of anastomotic leakage (14.9% vs. 4.3%, P<0.001). Multivariate analysis showed that an independent factor of anastomotic leakage was the anastomotic location [HR =0.096 (0.037-0.247), P<0.001] rather than the extent of lymph node dissection. The intrathoracic anastomosis subgroup of 3FLND showed a similar leakage rate as the 2FLND group (4.2% vs. 4.3%). At a median follow-up of 42 months, no significant difference was observed in overall survival between the groups (P=0.529). A subgroup of patients with N1 status who underwent 3FLND showed a better survival trend than those who underwent 2FLND (P=0.093). No significant difference was observed in overall survival between the intrathoracic anastomosis subgroup and cervical anastomosis subgroup (P=0.334). Conclusions: Intrathoracic anastomosis may reduce the incidence of anastomotic leakage in esophagectomy with 3FLND, with no compromise on overall survival. Compared with the 2FLND, patients with N1 status might benefit more from the 3FLND technique.

11.
Surg Innov ; 25(5): 492-498, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29909727

RESUMO

BACKGROUND: We applied augmented reality (AR) techniques to flexible choledochoscopy examinations. METHODS: Enhanced computed tomography data of a patient with intrahepatic and extrahepatic biliary duct dilatation were collected to generate a hollow, 3-dimensional (3D) model of the biliary tree by 3D printing. The 3D printed model was placed in an opaque box. An electromagnetic (EM) sensor was internally installed in the choledochoscope instrument channel for tracking its movements through the passages of the 3D printed model, and an AR navigation platform was built using image overlay display. The porta hepatis was used as the reference marker with rigid image registration. The trajectories of the choledochoscope and the EM sensor were observed and recorded using the operator interface of the choledochoscope. RESULTS: Training choledochoscopy was performed on the 3D printed model. The choledochoscope was guided into the left and right hepatic ducts, the right anterior hepatic duct, the bile ducts of segment 8, the hepatic duct in subsegment 8, the right posterior hepatic duct, and the left and the right bile ducts of the caudate lobe. Although stability in tracking was less than ideal, the virtual choledochoscope images and EM sensor tracking were effective for navigation. CONCLUSIONS: AR techniques can be used to assist navigation in choledochoscopy examinations in bile duct models. Further research is needed to determine its benefits in clinical settings.


Assuntos
Ducto Colédoco , Endoscopia do Sistema Digestório/métodos , Modelagem Computacional Específica para o Paciente , Impressão Tridimensional , Realidade Virtual , Adulto , Colelitíase , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/cirurgia , Humanos , Masculino , Estudo de Prova de Conceito
12.
Development ; 145(11)2018 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-29848638

RESUMO

The postmeiotic development of male germ cells, also known as spermiogenesis, features the coordinated expression of a large number of spermatid-specific genes. However, only a limited number of key transcription factors have been identified and the underlying regulatory mechanisms remain largely unknown. Here, we report that SOX30, the most-divergent member of the Sry-related high-motility group box (SOX) family of transcription factors, is essential for mouse spermiogenesis. The SOX30 protein was predominantly expressed in spermatids, while its transcription was regulated by retinoic acid and by MYBL1 before and during meiosis. Sox30 knockout mice arrested spermiogenesis at step 3 round spermatids, which underwent apoptosis and abnormal chromocenter formation. We also determined that SOX30 regulated the expression of hundreds of spermatid-specific protein-coding and long non-coding RNA genes. SOX30 bound to the proximal promoter of its own gene and activated its transcription. These results reveal SOX30 as a novel key regulator of spermiogenesis that regulates its own transcription to enforce and activate this meiotic regulatory pathway.


Assuntos
Regulação da Expressão Gênica/genética , Fatores de Transcrição SOX/genética , Espermátides/metabolismo , Espermatogênese/fisiologia , Animais , Apoptose/fisiologia , Masculino , Meiose/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Camundongos Knockout , Regiões Promotoras Genéticas/genética , Proteínas Proto-Oncogênicas c-myb/genética , Transativadores/genética , Tretinoína/metabolismo
13.
Stem Cells Dev ; 27(10): 692-703, 2018 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-29631477

RESUMO

Cultured mouse spermatogonial stem cells (SSCs), also known as germline stem cells (GSCs), revert back to pluripotent state either spontaneously or upon being modified genetically. However, the reprogramming efficiencies are low, and the underlying mechanism remains poorly understood. In the present study, we conducted transcriptomic analysis and found that many transcription factors and epigenetic modifiers were differentially expressed between GSCs and embryonic stem cells. We failed in reprogramming GSCs to pluripotent state using the Yamanaka 4 Factors, but succeeded when Nanog and Tet1 were included. More importantly, reprogramming was also achieved with Nanog alone in a p53-deficient GSC line with an efficiency of 0.02‰. These GSC-derived-induced pluripotent stem cells possessed in vitro and in vivo differentiation abilities despite the low rate of chimera formation, which might be caused by abnormal methylation in certain paternally imprinted genes. Together, these results show that GSCs can be reprogrammed to pluripotent state via multiple avenues and contribute to our understanding of the mechanisms of GSC reprogramming.


Assuntos
Reprogramação Celular/fisiologia , Proteína Homeobox Nanog/metabolismo , Células-Tronco Pluripotentes/metabolismo , Espermatogônias/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Animais , Diferenciação Celular/fisiologia , Linhagem Celular , Metilação de DNA/fisiologia , Proteínas de Ligação a DNA/metabolismo , Células-Tronco Embrionárias/metabolismo , Células-Tronco Embrionárias/fisiologia , Perfilação da Expressão Gênica/métodos , Masculino , Camundongos , Espermatogônias/fisiologia , Fatores de Transcrição/metabolismo
14.
Chem Commun (Camb) ; 54(39): 4923-4926, 2018 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-29561033

RESUMO

The development of flexible and transparent devices requires completely transparent and flexible circuits (TFCs). To overcome the disadvantages of the previously reported TFCs that are partially transparent, lacking pattern control, or labor consuming, we achieve true TFCs via a facile process with precise pattern control, exhibiting concurrent high transparency, conductivity, flexibility, stretchability, and robustness. A highly transparent and flexible conductive film is first made through spin coating silver nanowires (AgNWs) onto polydimethylsiloxane (PDMS), and demonstrates simultaneous high transparency (90.86%) and low sheet resistance (3.22 Ω sq-1). Taking advantage of microfluidic technology, circuits with ultraprecise and complex patterns from the microscale to milliscale are obtained through spin coating of AgNWs into microfluidic channels on PDMS. Without elaborate processing, this method may be suitable for mass production, which would contribute enormously to potential applications in wearable medical equipment and transparent electronic devices.

15.
Hepatobiliary Pancreat Dis Int ; 17(2): 101-112, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29567047

RESUMO

BACKGROUND: Augmented reality (AR) technology is used to reconstruct three-dimensional (3D) images of hepatic and biliary structures from computed tomography and magnetic resonance imaging data, and to superimpose the virtual images onto a view of the surgical field. In liver surgery, these superimposed virtual images help the surgeon to visualize intrahepatic structures and therefore, to operate precisely and to improve clinical outcomes. DATA SOURCES: The keywords "augmented reality", "liver", "laparoscopic" and "hepatectomy" were used for searching publications in the PubMed database. The primary source of literatures was from peer-reviewed journals up to December 2016. Additional articles were identified by manual search of references found in the key articles. RESULTS: In general, AR technology mainly includes 3D reconstruction, display, registration as well as tracking techniques and has recently been adopted gradually for liver surgeries including laparoscopy and laparotomy with video-based AR assisted laparoscopic resection as the main technical application. By applying AR technology, blood vessels and tumor structures in the liver can be displayed during surgery, which permits precise navigation during complex surgical procedures. Liver transformation and registration errors during surgery were the main factors that limit the application of AR technology. CONCLUSIONS: With recent advances, AR technologies have the potential to improve hepatobiliary surgical procedures. However, additional clinical studies will be required to evaluate AR as a tool for reducing postoperative morbidity and mortality and for the improvement of long-term clinical outcomes. Future research is needed in the fusion of multiple imaging modalities, improving biomechanical liver modeling, and enhancing image data processing and tracking technologies to increase the accuracy of current AR methods.


Assuntos
Doenças Biliares/cirurgia , Procedimentos Cirúrgicos do Sistema Biliar/métodos , Hepatectomia/métodos , Laparoscopia/métodos , Hepatopatias/cirurgia , Modelagem Computacional Específica para o Paciente , Procedimentos Cirúrgicos Robóticos/métodos , Doenças Biliares/diagnóstico por imagem , Humanos , Imagem Tridimensional , Hepatopatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Interpretação de Imagem Radiográfica Assistida por Computador , Tomografia Computadorizada por Raios X
16.
Int J Med Robot ; 14(4): e1909, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29575601

RESUMO

BACKGROUND: Intramedullary nail (IMN) fixation improves functional outcomes for the diaphyseal fractures of long bones. However, locking the distal holes of the IMN is challenging. Although several navigation methods have been proposed, an intuitive, radiation-free and accurate navigation method that does not suffer from problems of hand-eye coordination has not yet been described. METHODS: This paper proposes an augmented reality (AR) surgical navigation method with hybrid optical and electromagnetic (EM) tracking for distal IMN interlocking. Model experiments are designed to evaluate the AR-guided distal interlocking method. RESULTS: AR-guided drilling procedures were performed on 5 tibia models and a leg phantom. The accuracy (hit or miss) was evaluated using fluoroscopy. The experimental results demonstrated that all 18 drills successfully hit the distal holes at a rate of 100%. CONCLUSIONS: Our results indicate that the AR-guided distal interlocking method is feasible and has many potential applications in clinic after further evaluation.


Assuntos
Fixação Intramedular de Fraturas/métodos , Cirurgia Assistida por Computador/métodos , Pinos Ortopédicos , Fenômenos Eletromagnéticos , Desenho de Equipamento , Estudos de Viabilidade , Fluoroscopia , Fixação Intramedular de Fraturas/instrumentação , Humanos , Imagem Tridimensional , Modelos Anatômicos , Imagens de Fantasmas , Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Robótica/métodos , Cirurgia Assistida por Computador/instrumentação , Fraturas da Tíbia/cirurgia , Interface Usuário-Computador , Dispositivos Eletrônicos Vestíveis
17.
Ann Surg ; 267(5): 826-832, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28448385

RESUMO

OBJECTIVE: To investigate whether survival is improved by using the right thoracic approach (extended lymphadenectomy) compared with the left thoracic approach (limited lymphadenectomy) for esophageal cancer. BACKGROUND: The optimal surgical technique for esophageal cancer remains unclear. METHODS: Between May 2010 and July 2012, 300 patients with middle and lower thoracic esophageal carcinoma were randomized to receive esophagectomy through either the right or left thoracic approach. Of these, 286 patients with squamous cell carcinoma determined by postoperative pathology were included in this analysis. Disease-free survival (DFS) and overall survival (OS) were compared between the right (n = 146) and left thoracic groups (n = 140). RESULTS: The median follow-up was 55.9 months [95% confidence interval (CI): 53.1-58.6]. The 3-year DFS rates were 62% and 52% in the right and left thoracic arms, respectively [hazard ratio (HR) 0.709; 95% CI, 0.506-0.995; P = 0.047, log-rank test]. The 3-year OS rates were 74% and 60%, respectively (HR, 0.663; 95% CI, 0.457-0.961; P = 0.029). Subgroup analyses revealed longer DFS in the right thoracic arm (vs left thoracic arm) in patients with lymph node involvement (HR, 0.632; 95% CI, 0.412-0.969, P = 0.034), but not in patients without lymph node involvement (HR, 0.757; 95% CI, 0.434-1.320, P = 0.325), and in patients with R1-2 resection margins (HR, 0.495; 95% CI, 0.290-0.848, P = 0.009), but not R0 margins (HR, 0.944; 95% CI, 0.603-1.477, P = 0.801). CONCLUSIONS: Compared with the left thoracic approach, the right thoracic approach associated with increased DFS and OS in esophageal squamous cell carcinoma patients, particularly in those with lymph node involvement and/or R1-2 resection margins.


Assuntos
Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia/métodos , Excisão de Linfonodo/métodos , Estadiamento de Neoplasias , Procedimentos Cirúrgicos Torácicos/métodos , Idoso , China/epidemiologia , Intervalo Livre de Doença , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/mortalidade , Carcinoma de Células Escamosas do Esôfago/diagnóstico , Carcinoma de Células Escamosas do Esôfago/mortalidade , Feminino , Seguimentos , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida/tendências , Fatores de Tempo
18.
Oncotarget ; 8(53): 91281-91290, 2017 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-29207643

RESUMO

Osteoarthritis (OA) is a common degenerative disease characterized by degeneration of articular cartilage. Increasing studies showed that long noncoding RNAs (lncRNAs) play important roles in the cartilage damage. However, little is known about the role of UCA1 in the osteoarthritis. The expression level of UCA1 was upregulated in the OA cartilage. Overexpression of UCA1 suppressed the miR-204-5p expression in the chondrocytes. The expression of miR-204-5p was downregulated in the OA cartilage. Moreover, the expression of miR-204-5p was negatively correlated with the UCA1 expression in the OA cartilage. Elevated expression of UCA1 promoted the chondrocytes cell proliferation and overexpression of miR-204-5p suppressed chondrocytes cell proliferation. In addition, overexpression of UCA1 decreased the expression of the type II collagen and type IV collagen expression in the chondrocytes. Elevated expression of miR-204-5p promoted the type II collagen and type IV collagen expression in the chondrocytes. We idetified MMP-13 was a direct target gene of miR-204-5p in the chondrocytes. Overexpression of UCA1 enhanced the MMP-13 expression in the chondrocytes. Elevated expression of UCA1 regulated the chondrocytes cell proliferation and collagen expression through inhibiting the miR-204-5p expression.These results suggested that UCA1 played as an important regulator of survival and matrix synthesis of chondrocytes partly through suppressing the miR-204-5p expression.

19.
J Thorac Dis ; 9(10): 3832-3839, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29268392

RESUMO

Background: Locoregional recurrences are often observed after esophagectomy with lymphadenectomy. The treatment strategy for these patients has not been established completely. The purpose of this study was to evaluate the prognosis of salvage lymphadenectomy through the cervical incision for cervical and cervicothoracic recurrences. Methods: We retrospectively reviewed patients underwent initial esophagectomy and then salvage lymphadenectomy in Fudan University Shanghai Cancer Center during July 2006 and September 2016. Survival curve was calculated by Kaplan-Meier method. Prognostic factors for post-salvage lymphadenectomy overall survival (PSL-OS) were identified by univariate and multivariate analyses. Results: The median disease-free survival (DFS) was 8 months. The median PSL-OS was 40 months (95% CI: 8.850-71.150). The 1-, 2-, 3- and 5-year PSL-OS rate were 87%, 58%, 52% and 41%, respectively. Univariate and multivariate analyses confirmed the initial TNM stage was the only independent prognostic factor for PSL-OS (P=0.000 by log-rank test, P=0.009 by Cox hazards model, HR 3.999, 95% CI: 1.413-11.316) among these patients. Conclusions: PSL survival could be considerable for patients with early initial tumor stage. Prospective studies are warranted to clarify the value of salvage lymphadenectomy.

20.
Medicine (Baltimore) ; 96(37): e8083, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28906410

RESUMO

RATIONALE: Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature. PATIENT CONCERNS: A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks. DIAGNOSES: Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma. INTERVENTION: Three-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference. OUTCOMES: No serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results. LESSONS: AR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system.


Assuntos
Neoplasias dos Ductos Biliares/cirurgia , Hepatectomia , Imagem Tridimensional , Tumor de Klatskin/cirurgia , Modelos Anatômicos , Cirurgia Assistida por Computador , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Simulação por Computador , Humanos , Tumor de Klatskin/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Interface Usuário-Computador
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