Cooperative laparoscopic endoscopic and hybrid laparoscopic surgery for upper gastrointestinal tumors: Current status

AIM: To investigate the cooperative laparoscopic and endoscopic techniques used for the resection of upper gastrointestinal tumors.METHODS: A systematic research of the literature was performed in Pub Med for English and French language articles about laparoscopic and endoscopic cooperative,combined,hybrid and rendezvous techniques. Only original studies using these techniques for the resection of early gastric cancer,benign tumors and gastrointestinal stromal tumors of the stomach and the duodenum were included. By excluding case series of less than 10 patients,25 studies were identified. The study design,number of cases,tumor pathology size and location,the operative technique name,the endoscopy team and surgical team role,operative time,type of closure of visceral wall defect,blood loss,complications and length of hospital stay of these studies were evaluated. Additionally all cooperative techniques found were classified and are presented in a systematic approach.RESULTS: The studies identified were case series and retrospective cohort studies. A total of 706 patients were operated on with a cooperative technique. The tumors resected were only gastrointestinal stromal tumors(GIST) in 4 studies,GIST and various benign submucosal tumors in 22 studies,early gastric cancer(p T1 a and p T1b) in 6 studies and early duodenal cancer in 1 study. There was important heterogeneity between the studies. The operative techniques identified were:laparoscopic assisted endoscopic resection,endoscopic assisted wedge resection,endoscopic assisted transgastric and intragastric surgery,laparoscopic endoscopic cooperative surgery(LECS),laparoscopic assisted endoscopic full thickness resection(LAEFR),clean non exposure technique and non-exposed endoscopic wallinversion surgery(NEWS). Each technique is illustrated with the roles of the endoscopic and laparoscopic teams; the indications,characteristics and short term results are described.CONCLUSION: Along with the traditional cooperative techniques,new procedures like LECS,LAEFR and NEWS hold great promise for the future of minimally invasive oncologic procedures.

Learning curve for hand-assisted laparoscopic D2 radical gastrectomy

AIM:To describe the learning curves of hand-assisted laparoscopic D2 radical gastrectomy(HALG) for the treatment of gastric cancer.METHODS:The HALG surgical procedure consists of three stages:surgery under direct vision via the port for hand assistance,hand-assisted laparoscopicsurgery,and gastrointestinal tract reconstruction.According to the order of the date of surgery,patients were divided into 6 groups(A-F) with 20 cases in each group.All surgeries were performed by the same group of surgeons.We performed a comprehensive and indepth retrospective comparative analysis of the clinical data of all patients,with the clinical data including general patient information and intraoperative and postoperative observation indicators.RESULTS:There were no differences in the basic information among the patient groups(P > 0.05).The operative time of the hand-assisted surgery stage in group A was 8-10 min longer than the other groups,with the difference being statistically significant(P = 0.01).There were no differences in total operative time between the groups(P = 0.30).Postoperative intestinal function recovery time in group A was longer than that of other groups(P = 0.02).Lengths of hospital stay and surgical quality indicators(such as intraoperative blood loss,numbers of detected lymph nodes,intraoperative side injury,postoperative complications,reoperation rate,and readmission rate 30 d after surgery) were not significantly different among the groups.CONCLUSION:HALG is a surgical procedure that can be easily mastered,with a learning curve closely related to the operative time of the hand-assisted laparoscopic surgery stage.

Enhanced recovery after surgery with laparoscopic radical gastrectomy for stomach carcinomas

AIM: To study the efficacy of the enhanced recovery after surgery(ERAS) program in laparoscopic radical gastrectomy for stomach carcinomas.METHODS: From June 2010 to December 2012, 61 gastric cancer patients who underwent laparoscopicassisted radical gastrectomy with D2 lymphadenectomy at First Hospital of Jilin University were enrolled in this randomized controlled trial.(Clinical Trials.gov, registration ID: NCT01955096). The subjects were divided into the ERAS program group and the conventional control group. The clinical characteristics, recovery variables, and complications of patients were analyzed.RESULTS: The time to first ambulation, oral food intake, and time to defecation were significantly shorter in the ERAS group(n = 30), compared to the conventional group(n = 31; P = 0.04, 0.003, and 0.01, respectively). The postoperative hospital stay was less in the ERAS group(6.8 ± 1.1 d) compared to the conventional group(7.7 ± 1.1 d)(P = 0.002). There was no significant difference in postoperative complications between the ERAS(1/30) and conventional care groups(2/31)(P = 1.00). There were no readmissions or mortality during the 30-d follow-up period.CONCLUSION: The ERAS program is associated with a shorter hospital stay in gastric cancer patients undergoing laparoscopic radical gastrectomy. The ERAS protocol is useful in the treatment of gastric cancer.

Feasibility of single-incision laparoscopic cholecystectomy for acute cholecystitis

AIM: To assess the safety of single-incision laparoscopic cholecystectomy(SILC) for acute cholecystitis.METHODS: All patients who underwent SILC at Sano Hospital(Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay. Patient backgrounds were statistically compared between those with and without conversion to laparotomy.RESULTS: A total of 100 patients underwent SILC for acute cholecystitis during the period. Preoperative endoscopic treatment was performed for suspected choledocholithiasis in 41 patients(41%). The mean time from onset of acute cholecystitis was 7.7 d. According to the Updated Tokyo Guidelines(TG13) for the severity of cholecystitis, 86 and 14 patients had grade Ⅰ and grade Ⅱ acute cholecystitis, respectively. The mean operative time was 87.4 min. The mean estimated blood loss was 80.6 mL. The critical view of safety was obtained in 89 patients(89%). Conversion laparotomy was performed in 12 patients(12%). Postoperative complications of Clavien-Dindo grade Ⅲ or greater were observed in 4 patients(4%). The mean duration of postoperative hospital stay was 5.7 d. Patients converted from SILC to laparotomy tended to have higher days after onset.CONCLUSION: SILC is feasible for acute cholecystitis; in addition, early surgical intervention may reduce the risk of laparotomy conversion.

Laparoskopy and Thoracoscopy in Complex Inspection and Treatment Patients with Locally Extended Esophageal Cancer

The great attention has been paid to the mini-invasive methods of the distribution of the malignant process in the thoracic and abdominal cavities for last time. In the Thoracic department of the Republican Research Oncological Centre of the Republic of Uzbekistan during the period from 2004 to 2008 in the plan of investigation of the patients with esophageal and stomach cancer including roentgenoscopy and (or) roentgenography of the thoracic chest, contrast esophageal and stomach roentgenoscopy, EPGDS and ultrasonography of the mediastinal and abdominal cavity organs additionally computed tomography and diagnostic thoraco-and (or) laparoscopy were included. The cancer of mesothoracic esophageal part with invasion into the upper thoracic part was diagnosed in 2 patients, the cancer of mesothoracic esophageal part-in 12 patients, the cancer of the middle and the lower parts-in 7 patients, the cancer the lower thorax part-in 7 patients, the cardioesophageal cancer-in 9 patients, a total cancer of a stomach with affection of the bottom third of the oesophagus-in 1 patient. Thoracoscopy and laparoscopy allow determination of the respectability of the tumorous process in the esophageal and stomach cancer considerably lowering the number of exploratory thoracotomies and laparotomies.

Genome-wide investigation to assess copy number variants in the Italian local chicken population

Background Copy number variants(CNV)hold significant functional and evolutionary importance.Numerous ongoing CNV studies aim to elucidate the etiology of human diseases and gain insights into the population structure of livestock.High-density chips have enabled the detection of CNV with increased resolution,leading to the identification of even small CNV.This study aimed to identify CNV in local Italian chicken breeds and investigate their distribution across the genome.Results Copy number variants were mainly distributed across the first six chromosomes and primarily associated with loss type CNV.The majority of CNV in the investigated breeds were of types 0 and 1,and the minimum length of CNV was significantly larger than that reported in previous studies.Interestingly,a high proportion of the length of chromosome 16 was covered by copy number variation regions(CNVR),with the major histocompatibility complex being the likely cause.Among the genes identified within CNVR,only those present in at least five animals across breeds(n=95)were discussed to reduce the focus on redundant CNV.Some of these genes have been associated to functional traits in chickens.Notably,several CNVR on different chromosomes harbor genes related to muscle development,tissue-specific biological processes,heat stress resistance,and immune response.Quantitative trait loci(QTL)were also analyzed to investigate potential overlapping with the identified CNVR:54 out of the 95 gene-containing regions overlapped with 428 QTL associated to body weight and size,carcass characteristics,egg production,egg components,fat deposition,and feed intake.Conclusions The genomic phenomena reported in this study that can cause changes in the distribution of CNV within the genome over time and the comparison of these differences in CNVR of the local chicken breeds could help in preserving these genetic resources.

Relationship Between Gene-Phenotype and Clinical Manifestations of Chromosomal Copy Number Variations Indicated by Non-Invasive Prenatal Testing

Objective:To analyze the clinical value of non-invasive prenatal testing(NIPT)in detecting chromosomal copy number variations(CNVs)and to explore the relationship between gene expression and clinical manifestations of chromosomal copy number variations.Methods:3551 naturally conceived singleton pregnant women who underwent NIPT were included in this study.The NIPT revealed abnormalities other than sex chromosome abnormalities and trisomy 13,18,and 21.Pregnant women with chromosome copy number variations underwent genetic counseling and prenatal ultrasound examination.Interventional prenatal diagnosis and chromosome microarray analysis(CMA)were performed.The clinical phenotypes and pregnancy outcomes of different prenatal diagnoses were analyzed.Additionally,a follow-up was conducted by telephone to track fetal development after birth,at six months,and one year post-birth.Results:A total of 53 cases among 3551 cases showed chromosomal copy number variation.Interventional prenatal diagnosis was performed in 36 cases:27 cases were negative and 8 were consistent with the NIPT test results.This indicates that NIPT’s positive predictive value(PPV)in CNVs is 22.22%.Conclusion:NIPT has certain clinical significance in screening chromosome copy number variations and is expected to become a routine screening for chromosomal microdeletions and microduplications.However,further interventional prenatal diagnosis is still needed to identify fetal CNVs.

CoPy/C催化剂应用碱性介质氧还原催化的电化学性能(英文)

利用碳黑(Vulcan XC-72R)中加入硫酸钴和吡啶(Py)作为催化剂前驱体,经溶剂分散热处理构建了一类新型的高效氧还原CoPy/C复合催化剂.并运用循环伏安法(CV)和旋转圆盘电极(RDE)技术研究了不同Co含量的CoPy/C催化剂在碱性介质中对氧还原的电催化活性.结果表明:Co的存在对氧的催化剂活性位的形成有重要影响,800℃下所制备的10%Co30%Py/C(质量分数)复合催化剂表现出最佳的氧还原催化活性.以其制备的气体扩散电极在3.0 mol·L^(-1)KOH电解质溶液(O_2气氛)中0.014 V(相对于标准氧电极(RHE))即可产生明显的氧还原电流.同40%Py/C相比,10%Co30%Py/C催化氧还原的起峰电位正移了71 mV,同时表现出明显的极限扩散电流.在-0.16 V时电流密度达到最大值,电流密度为1.0 mA·cm^(-2),半波电位在-0.07 V.透射电镜分析表明所制备的碳黑载吡啶钴(10%Co30%Py/C)催化剂平均粒径为20 nm.

加工中心在线测量系统在自由曲面COPY加工中的应用研究

在没有三坐标测量机等不具备逆向设计条件的情况下,通过编制用户宏指令对在线测量系统进行控制,收集和处理模型曲面测量数据,则可以实现类似三坐标测量机自动扫描曲面测量和实现仿形加工的功能。阐述了COPY加工的原理、程序的编制方法、加工误差分析及为保证加工精度应采取的措施。

Isolation of Rice EPSP Synthase cDNA and Its Sequence Analysis and Copy Number Determination

In order to isolate the total cDNA of rice (Oryza sativa L.) epsps gene, RT-PCR was carried out with template of rice first-strand cDNA and primers designed according to rice EPSP synthase genomic sequence obtained in previous study. A 1 585-bp cDNA fragment was amplified and cloned. The 1 585-bp cDNA contains an open reading frame (ORF) comprising of 1 533 nucleotides (nt) which encodes a 511 residue polypepetides, including 67 amino acids chloroplast transit peptide and 444 amino acids EPSP synthase mature peptide. A comparison between the EPSP synthase of different sources indicates that the mature peptide shows more than 51% identity except for the fungi EPSP synthase and the transit peptide shows considerably less sequence conservation. The copy number of rice epsps gene is estimated to be one copy per haploid rice genome using southern blot. RT-PCR indicated that rice epsps gene is expressed in rice leaves, endosperms and roots and has the highest expression level in leaves.

Detection of Exogenous Gene Copies in Transgenic Soybean by Taqman Quantitative PCR Technique

[Objective] Taqman Quantitative PCR technique was adopted to detect the copies of exogenous nos terminator in transgenic hybrid soybean.[Method] With soybean Lectin as the endogenous reference gene,and gene complex DNA in non-GMO soybeans as the endogenous reference standard,the method of gradient dilution was used for separately calculate Ct value of endogenous reference gene and plasmid DNA and correlation standard curve equation of logarithm of copies,and then to calculate the copies of samples through substituting thus-obtained Ct into the standard curve equation.[Result] The standard curve equation of endogenous reference gene is y=-3.422x＋35.201,R2=0.998;and the standard curve equation of exogenous gene is y=-3.348x＋34.890,R2=0.999.Nos terminator and its lower boundary sequences in transgenic soybean is of single copy.[Conclusion] The study has provided a theoretical basis for determining exogenous gene copies in transgenic soybean.

COPYCAD软件在逆向工程中的应用

随着计算机技术和自动化测量技术的高速发展,逆向工程已经成为一种重要的设计手段,同时也出现了很多专门用于逆向工程的软件.本文通过对COPYCAD的介绍,展示了这些软件工作的一般步骤,总结了他们的一些共性.

基于KVM的虚拟机Post-Copy动态迁移算法稳定性优化

虚拟机动态迁移技术为虚拟化系统的资源调度提供了强有力的支撑,Post-Copy算法作为虚拟机动态迁移的两个核心算法之一,凭借其总体迁移时间稳定与迁移停机时间短的优点,一直是国内外学者研究的热点问题。对虚拟机的故障容错机制、迁移过程中的内存页面传输方式与缺页错误的关联性,以及QEMU-KVM平台源码进行了深入的研究,提出了基于事务同步的故障容错方法以提升Post-Copy迁移算法的稳定性。试验结果表明,提出的虚拟机Post-Copy迁移优化算法,能保证迁移过程中源端虚拟机故障、目标端虚拟机故障以及网络故障的迅速修复,能通过较小的代价解决稳定性问题,所提出的方法有效地提升了Post-Copy迁移算法的稳定性,也为以后的优化研究方向提供了参考。

图像内部Move-Copy篡改盲取证算法研究

针对一般Move-Copy图像篡改取证算法低鲁棒性特点,提出新算法.首先利用颜色不变量检测特征点位置,提高特点的数量和取证结果的召回率;其次用RGB颜色通道扩充Surf描述子向量维数,提高特征向量的健壮性和鲁棒性;然后定义噪声敏感系数判断图像噪声点并对之进行预处理;接着利用序贯相似性检测算法对特征点进行配准以提高配准速度;最后利用肯德尔系数和四条假设对取证结果进行约束,得到最后结果.实验结果表明,本文算法取证准确率较高,鲁棒性强,具有较强的取证说服力.

同源视频Copy-Move篡改检测及恢复

针对同源视频序列的copy-move篡改方式,提出一种通过度量图像内容间的相关性,来实现对视频序列的copy-move篡改检测并恢复的方法.首先将视频帧内容转化为一系列连续的图像帧,对图像分块,提取每帧图像的8个特征矢量,再利用欧氏距离计算帧间相关性,并通过添加偏差矩阵构造动态偏差阈值,检测出copy-move篡改序列且精确至帧,从而实现对视频序列的篡改检测与恢复.实验表明,该算法对同源视频序列的copy-move篡改检测及恢复能够取得理想的效果.

基于FMT的快速Copy-Move篡改检测

为了对图像篡改中常用的复制-移动伪造进行检测,基于傅里叶-梅林变换的平移、旋转和缩放的不变性提出一种快速图像区域分割和匹配的高效篡改检测算法。不同于以往模板匹配方式中按照单像素点移动得到重叠块划分方法,该算法采用相邻图像块的图像区域分割方式来减少整个图像块的数量。通过相似性匹配检测,得到初步的复制图像区域,然后利用边缘处理的方法处理改善篡改区域,从而达到改进篡改检测算法的效率和准确性。最后通过实验验证了该算法的有效性。

Copy:提高分块算法性能的有效方法

本文介绍的ｃｏｐｙ 方法就是针对大规模线性代数问题而提出的一种ｃａｃｈｅ优化方法， 基本思想是把不连续的数组元素拷贝到一连续的数组， 以减少ｃａｃｈｅ自冲突，且使分块算法的访存连续，从而提高ｃａｃｈｅ利用率。文中以大规模矩阵乘法为例进行了验算，

同幅数字图像中Copy-Move型篡改的盲检测

为了快速有效地检测复制-粘贴(Copy-Move)图像篡改,提出了一种基于重叠块统计值的Copy-Move型篡改图像盲认证方式。该算法先将图像进行一次离散小波变换(Discrete wavelet transform,DWT)并取其低频部分分解为重叠块,接着统计各重叠块的7个统计值并计算重叠块间的相似性找出相似块,最后返回原篡改图像找出篡改部分。仿真结果表明,该方法能快速有效地检测出篡改部分经过JPEG有损压缩、高斯白噪声污染和这两者结合的篡改图像。

Determining the Copy Number of Exogenous Gene in Transgenic Plant by SYBR Green Real-time Quantitative PCR

[Objective] To explore the feasibility of using SYBR Green real-time quantitative PCR technique to estimate the copy numbers of exogenous gene in a transgenic plant.[Methods] Using SYBR Green real-time quantitative PCR technique,we have determined the copy numbers of the exogenous CYCD3;1 in transgenic Arabidopsis by comparing an endogenous single copy reference gene with CYCD3;1 copy numbers in transgenic plant,meanwhile comparing CYCD3;1 copy numbers between wild plant and transgenic plant.[Results]The exogenous CYCD3;1 copy numbers calculated by this method is identical with results of traditional Southern blot analysis which is highly accurate.[Conclusion]This method is simple,effective and safe for estimating transgene copy numbers.

CoPy/C催化氧还原的碱效应及活性位研究

以碳黑(Vulcan XC-72R)为载体,硫酸钴(CoSO4.7H2O)和吡啶(Py)作为催化剂前躯体,经溶剂分散及800℃热处理可制备出高效催化氧还原反应(ORR)的碳载钴吡啶复合催化剂(15%Co25%Py/C,质量分数).采用红外光谱(IR)和X射线光电子能谱(XPS)等对催化剂的结构进行表征.运用旋转圆盘电极(RDE)技术研究了不同浓度的KOH溶液(0.05～12.0 mol/L)对CoPy/C催化氧还原活性的影响.结果表明,不同浓度的KOH溶液对CoPy/C催化剂催化氧还原反应(ORR)的性能影响很大,在0.05和0.1 mol/L KOH溶液中催化剂活性最高.以其制备的气体扩散电极在0.05 mol/L KOH溶液(O2气氛)中的半波电位为-0.138 V[vs.标准氢电极(SHE)],起峰电位为0.10 V,同时表现出明显的极限扩散电流.在-0.381 V时电流密度达到最大值(4.39 mA/cm2).随着KOH溶液浓度的增加(pH值下降),起始电压沿负方向移动,同时动力学、混合动力学和扩散区的电流密度均下降.RDE研究结果表明,在0.05和0.1 mol/L KOH溶液中,O2在CoPy/C电极上的还原主要经4e-过程还原成H2O.XPS研究结果表明,吡啶作为小分子富氮源对提高催化剂的活性具有重要作用,所制备催化剂经800℃高温热处理形成了石墨N、吡啶N以及部分氧化态的氮结构,其中石墨N和吡啶N作为催化剂的活性中心,提供氧还原活性位,从而使该类催化剂对氧还原表现出很好的电催化性能和选择性.