Outcomes of simple saline-coupled bipolar electrocautery for hepatic resection

AIM:To evaluate the application of bipolar coagulation(BIP)in hepatectomy by comparing the efficacy of BIP alone,cavitron ultrasonic surgical aspirator(CUSA)+BIP and conventional clamp crushing(CLAMP).METHODS:Based on our database of patient records,a total of 380 consecutive patients who underwent hepatectomy at our hospital were retrospectively studied for the efficacy of BIP alone,CUSA+BIP and CLAMP.Of all the patients,75 received saline-coupled BIP(Group A),53 received CUSA+BIP(Group B),and252 received CLAMP(Group C).The pre-,mid-,and postoperative clinical manifestations were compared,and the effects of those maneuvers were evaluated.RESULTS:There was no obvious difference among the preoperative indexes between the different groups.The operative time was longer in Groups A and B than in Group C(P<0.001 for both).The amount of bleeding and the rate of transfusion during the operation were significantly higher in Group C than in Groups A and B(P<0.001 for all).The incidence of postoperative complications in Group C(46.43%)was higher than that in Groups A(30.67%,P=0.015)and B(28.30%,P=0.016).The patients’liver function recovery and postoperative hospital stay were not significantly different.BIP could decrease intraoperative hemorrhage and postoperative complications compared to CLAMP.CONCLUSION:Simple saline-coupled BIP should be considered a safe and reliable technique for liver resection to decrease intraoperative hemorrhage and postoperative complications.

Artificial Intelligence to Diagnose Tibial Plateau Fractures: An Intelligent Assistant for Orthopedic Physicians

Objective:To explore a new artificial intelligence(AI)-aided method to assist the clinical diagnosis of tibial plateau fractures(TPFs)and further measure its validity and feasibility.Methods:A total of 542 X-rays of TPFs were collected as a reference database.An AI algorithm(RetinaNet)was trained to analyze and detect TPF on the X-rays.The ability of the AI algorithm was determined by indexes such as detection accuracy and time taken for analysis.The algorithm performance was also compared with orthopedic physicians.Results:The AI algorithm showed a detection accuracy of 0.91 for the identification of TPF,which was similar to the performance of orthopedic physicians(0.92±0.03).The average time spent for analysis of the AI was 0.56 s,which was 16 times faster than human performance(8.44±3.26 s).Conclusion:The AI algorithm is a valid and efficient method for the clinical diagnosis of TPF.It can be a useful assistant for orthopedic physicians,which largely promotes clinical workflow and further guarantees the health and security of patients.

Sliding-cupping along meridian for lymphedema after breast cancer surgery: A randomized controlled trial

Objective:To observe the clinical efficacy difference between sliding-cupping along meridian combined with short-stretch elastic bandage wrapping and comprehensive detumescence therapy in treating lymphedema after breast cancer surgery.Methods:Sixty patients with lymphedema after breast cancer surgery were randomly divided into the sliding-cupping group and the comprehensive detumescence therapy(CDT)group,with 30 cases in each one.The sliding-cupping group used the sliding-cupping along meridian therapy,and the sliding-cupping was applied along the three yin meridians and three yang meridians on the hand of the affected-side upper limbs,continuing for 25-30 min.After the sliding-cupping was finished,the affected limb was wrapped with the short-stretch elastic bandage.The CDT group was treated with comprehensive detumescence therapy(CDT).Both groups were treated once a day,with14 times as one course of treatment,and there was totally 1 course of treatment.The changes of circumferences before and after treatment of the affected limb were measured by a flexible ruler,and the efficacy was evaluated.The subcutaneous tissue thickness and the full skin layer thickness of the patients with moderate to severe edema in sliding-cupping group were measured by color Doppler ultrasound.Results:After treatment,the circumferences at the cubital crease,5 cm above olecranon,and 10 cm above the olecranon of the affected limbs in the sliding-cupping group were(26.02±2.42)cm,(28.43±3.13)cm,and(30.05±2.80)cm respectively,which were all reduced compared with the pre-treatment circumference(27.95±3.00)cm,(30.80±3.38)cm,and(32.17±2.96 cm).In the sliding-cupping group,the post-treatment subcutaneous tissue thicknesses at 5 cm above the olecranon,10 cm above the olecranon and 5 cm below the olecranon,and full skin layer thickness at 10 cm below the olecranon of the 15 patients with moderate to severe edema were(8.71±2.83)cm,(8.53±2.4)cm,(6.46±1.38)cm,and(1.61±0.17)cm respectively,which were all reduced compared with pre-treatment(11.90±3.56)cm,(11.84±3.27)cm,(9.12±1.84)cm,and(1.87±0.23)cm,and the difference was statistically significant(all P<0.05).The total effective rate of the sliding-cupping group was 86.6%,and the total effective rate of the CDT group was 80%,and the difference was statistically significant(P<0.05).Conclusion:Compared with CDT,the sliding-cupping along meridian combined with short-stretch elastic bandage wrapping for the treatment of lymphedema after breast cancer surgery was more effective.