全息影像技术在机器人辅助腹腔镜下肾部分切除术治疗肾门部肿瘤中的应用

目的评价全息影像技术引导机器人辅助腹腔镜下肾部分切除术(RAPN)治疗肾门部肿瘤的可行性与有效性。方法回顾性分析该院2019年6月-2019年10月收治的11例肾门部肿瘤患者的临床资料。其中,男3例,女8例;左侧4例,右侧7例;患者年龄32~75岁,平均62.6岁,体质指数19.45~28.12 kg/m^2,平均23.75 kg/m^2,肿瘤直径1.1~6.7 cm,平均2.76 cm,R.E.N.A.L.评分8~12分,平均10.7分,患肾肾小球滤过率(GFR)22~51 mL/min,平均35 mL/min。患者术前行全腹部增强CT,利用CT数据进行全息影像重建。术中应用该技术结合达芬奇机器人辅助系统,精准分离、剜除肿瘤,并记录手术持续时间、出血量、肾脏热缺血时间、有无并发症及切缘阳性率等。结果根据全息影像引导,11例患者均顺利剜除肿瘤,完成手术,无中转开放。手术时间60~130 min,平均90 min。术中出血量50~180 mL,平均100 mL,热缺血时间18~25 min,平均21 min,无术后发热、继发出血或漏尿等并发症。术后病理诊断肾透明细胞癌9例(FuhrmanⅠ和Ⅱ级),乳头状细胞癌1例,血管平滑肌脂肪瘤1例,无切缘阳性病例。术后随访3~7个月,平均4.3个月,患肾GFR 18~43 mL/min,平均31 mL/min。术后3个月复查肾脏CT平扫及增强,全部患者未出现复发。结论全息影像技术引导RAPN治疗肾门部肿瘤,围手术期并发症少,安全有效。

Does Postoperative Rehabilitation for Radical Cystectomy Call for Enhanced Recovery after Surgery?A Systematic Review and Metaanalysis

The aim of this review was to systematically compare the outcomes of enhanced recovery after surgery(ERAS)with standard care(SC)after radical cystectomy.We performed a systematic search of PubMed,Ovid?Web of Science,and the Cochrane Library to identify studies published until September 2017 which involved a comparison of ERAS and SC.A meta-analysis was performed to assess the outcomes of ERAS versus SC.Sixteen studies including 8 prospective and 8 retrospective trials met the eligibility criteria.A total of 2100 participants were assigned to ERAS(1258 cases)or SC(842 cases).The time to first flatus passage[WMD=-0.95 days,95%Cl(-1.50,-0.41),P=0.0006],time until return to a regular diet[WMD=-2.15 days,95%Cl(-2.86,—1.45),P<0.00001]and the length of hospital stay[WMD=-3.75 days,95%Cl(-5.13,-2.36),P<0.00001]were significantly shorter,and the incidence of postoperative complications[OR=0.60,95%Cl(0.44,0.83),P=0.002],especially postoperative paralytic ileus[OR=0.43,95%Cl(0.30,0.62),P<0.00001]and cardiovascular complications[OR=0.28,95%Cl(0.09,0.90),P=0.03]was significantly lower in the ERAS group than those in the SC group.This meta-analysis demonstrated that ERAS was associated with a shorter time to first flatus passage,return of bowel fimction,and the length of hospital stay than SC in patients undergoing radical cystectomy,as well as a lower rate of postoperative complications,especially paralytic ileus and cardiovascular complications.

A shape-reconfigurable,light and magnetic dual-responsive shape-memory micropillar array chip for droplet manipulation

Droplet manipulation on an open surface has great potential in chemical analysis and biomedicine engineering.However,most of the reported platforms designed for the manipulation of water droplets cannot thoroughly solve the problem of droplet evaporation.Herein,we report a shape-reconfigurable micropillar array chip for the manipulation of water droplets,oil droplets and water-in-oil droplets.Water-in-oil droplets provide an enclosed space for water droplets,preventing the evaporation in an open environment.Perfluoropolyether coated on the surface of the chip effectively reduces the droplet movement resistance.The micropillar array chip has light and magnetic dual-response due to the Fe3O4 nanoparticles and the reduced iron powder mixed in the shape-memory polymer.The micropillars irradiated by a near-infrared laser bend under the magnetic force,while the unirradiated micropillars still keep their original shape.In the absence of a magnetic field,when the micropillars in a temporary shape are irradiated by the near-infrared laser to the transition temperature,the micropillars return to their initial shape.In this process,the surface morphology gradient caused by the deformation of the micropillars and the surface tension gradient caused by the temperature change jointly produce the driving force of droplet movement.

Antibacterial mechanism of Cu-bearing 430 ferritic stainless steel

Copper(Cu)-bearing stainless steel has testified its effectiveness to reduce the risk of bacterial infections.However,its antibacterial mechanism is still controversial.Therefore,three 430 ferritic stainless steels with different Cu contents are selected to conduct deeper research by the way of bacterial inactivation from two aspects of material and biology.Hereinto,electrochemical and antibacterial results show that the increase in Cu content simultaneously improves the corrosion resistance and antibacterial property of 430 stainless steel.In addition,it is found that Escherichia coli(E.coli)on the surface 430 Cu-bearing stainless steel by the dry method of inoculation possesses a rapid inactivation ability.X-ray photoelectron spectroscopy(XPS)aids with ion chelation experiments prove that Cu(Ⅰ)plays a more crucial role in the contact-killing efficiency than Cu(Ⅱ),resulting from more production of reactive oxygen species(ROS).

Stern-Geary Constant for X80 Pipeline Steel in the Presence of Different Corrosive Microorganisms

The Stern-Geary constant(B value)is indispensable to measure the corrosion rate in the microbiologically influenced corrosion(MIC)systems.Linear polarization resistance(LPR)and weight loss methods were used to study the variation of B values for X80 pipeline steel in the presence of Pseudomonas aeruginosa,Acetobacter aceti and Desulfovibrio vulgaris.The results showed that B values in the presence of three different bacteria were 35.60±0.55 mV,33.00±1.00 mV and 58.60±0.55 mV,respectively,suggesting that the change of corrosion system significantly affected the B values of X80 pipeline steel.This work further indicated that the determination of B values is necessary to accurately measure the MIC rate by LPR method.

Hot Deformation Behavior and Processing Map of a Cu-Bearing 2205 Duplex Stainless Steel

The hot deformation behavior and processing map of Cu-bearing 2205 duplex stainless steel(2205-Cu DSS)were investigated at temperatures of 950-1150℃ and strain rates of 0.01-10 s^-1.The effects of Cu addition and different deformation parameters on deformation behavior were,respectively,characterized by analyzing flow curves,constitutive equations and microstructures.The results indicated that the shapes of flow curves strongly depended on the volume fraction of two phases.When deformed at low strain rate,DRV in ferrite was prompted with increase in the temperature and was further developed to continuous DRX.At high strain rate,flow localization preferentially occurred in ferrite at low deformation temperature due to the strain partitioning and relatively less fraction of ferrite.The activation energy for 2205-Cu DSS was 452 kJ/mol and was found to connect with the variation of strain,strain rate and deformation temperature.The optimum hot deformation parameters for 2205-Cu DSS were obtained in the temperature range of 1100-1150℃ and strain rate range of 0.1-1 s^-1 with a peak power dissipation efficiency of 41%.Flow localization was the main way to lead to flow instability.Meanwhile,the Cu-rich precipitates were generated within a few ferrite grains when deformed at temperature lower than 1000℃.The interaction between dislocations and Cu-rich precipitates at high strain rate,as well as the limited DRV in ferrite and DRX in austenite,contributed to the complex microstructure and flow behavior.

Stability of passive film and antibacterial durability of Cu-bearing L605 alloy in simulated physiological solutions

In this work,the stability of passive film for long-time immersed Cu-bearing L605(L605-Cu) alloy in the phosphate buffer solution(PBS) was studied by potentiodynamic polarization and electrochemical impedance spectroscopy.The results showed that the impedance of passive film for L605-Cu alloy experienced an initial increase and subsequent stabilization with the increase in the immersion time.In addition,the plate count method was employed to assess the antibacterial durability of L605-Cu alloy against Escherichia coli after long-time immersion.The results indicated that the antibacterial rate of L605-Cu alloy presented a declining tendency with the immersion time prolonging.X-ray photoelectron spectroscopy(XPS) was used to analyze the change of the chemical composition in the passive film on L605-Cu alloy immersed in the PBS for different time.The results showed that Cu content and its compounds in the passive film gradually increased with the immersion time prolonging,hinting declined activity of Cu ions penetrating into the passive film,which resulted in a decrease in the antibacterial performance.

High-throughput sequencing for confirmation of suspected 2019-nCoV infection identified by fluorescence quantitative polymerase chain reaction

To the Editor:Identifying the pathogen from clinical samples is crucial for the diagnosis of a newly emergent infectious disease,such as 2019 novel coronavirus(2019-nCoV).which has posed great threats to global public health.[1]In some cases,despite the positive epidemiological,clinical,and radiographic evidence,coronavirus disease 2019(COVID-19)diagnosis can still be restricted by inconclusive polymerase chain reaction(PCR)results.[2]For samples of suspicious patients,where the fluorescence quantitative PCR(FQ-PCR)results in a few respiratory tract specimens were inconclusive,high-throughput sequencing(HTS)can be an effective confirmation method.Here,we report our experience of applying HTS to confirm a suspected 2019-nCoV infection.

A single-cell encapsulation method based on a microfluidic multi-step droplet splitting system

Single cell analysis is of great significance to understand the physiological activity of organisms.Microfluidic droplet is an ideal analytical platform for single-cell analysis. We developed a microfluidic droplet splitting system integrated with a flow-focusing structure and multi-step splitting structures to form 8-line droplets and encapsulate single cells in the droplets. Droplet generation frequency reached1021 Hz with the aqueous phase flow rate of 1 m L/min and the oil phase flow rate of 15 mL /min. Relative standard deviation of the droplet size was less than 5% in a single channel, while less than 6% in all the8 channels. The system was used for encapsulating human whole blood cells. A single-cell encapsulation efficiency of 31% was obtained with the blood cell concentration of 2.5 ？ 104cells/mL, and the multicellular droplet percentage was only 1.3%. The multi-step droplet splitting system for single cell encapsulation featured simple structure and high throughput.