Objective To summarize the history, status quo, and prospect of robotic surgery system in domestic department of hepatobiliary surgery. Methods Related papers published in many databases, such as CNKI, VIP, WanFang, PubMed, an so on, were collected to make a review. Results With the development by nearly 8 years in our country, robotic surgery system has been preliminary used in all kinds of complicated operation in domestic department of hepatobiliary surgery, and positive results has been achieved. Currently robotic surgery technique is still in the continuous improvement and innovation. With the progression of robotic surgery technique and development of related equipment, this system would be more widely applied in domestic department of hepatobiliary surgery. Conclusions Robotic surgery system is now in the stage of development and promotion, but robotic surgery system has its unique advantages and it also has great development potential in technology. We believe that the robotic surgery system will be widely used in department of hepatobiliary surgery.
With the development of thin section axial computed tomography scan, the detection rate of pulmonary ground-glass nodules (GGN) continues increasing. GGN has a special natural growth history: pure ground-glass nodules (PGGN) smaller than 10 mm can hold steady for a long term, surgery resection is unnecessary, patients need regular follow up. Larger part solid ground-glass nodules (PSN) with a solid component can be malignant early stage lung cancer, which requires early surgery intervention. Establishment of a standard definition of GGN growth, investments in the long term natural growth history of GGN, validation of the clinical, radiology and genetic risk factors would be beneficial for the management of GGN patients.
ObjectiveTo investigate the blood pressure level and prevalence of hypertension in middle-aged people with positive family history of hypertension in Chengdu area, compare the differences between middle-aged people with positive family history of hypertension and middle-aged people with negative family history of hypertension, and explore the influencing factors of hypertension in middle-aged people with positive family history of hypertension.MethodsFrom September 2013 to March 2014, the stratified sampling method was used to survey 3 096 middle-aged people aged 40-59 years in Chengdu. Their height, weight, blood pressure, blood glucose, and blood lipids were measured. Questionnaire surveys were conducted using a uniformly designed questionnaire. The blood pressure levels and hypertension prevalences were compared between people with and without positive family history of hypertension. The influencing factors of hypertension in middle-aged people with positive family history of hypertension were analyzed using multiple logistic regression.ResultsThere were significant differences between the middle-aged people with positive family history of hypertension and the ones with negative family history of hypertension in systolic blood pressure [(137.4±22.4) vs. (118.0±11.3) mm Hg (1 mm Hg=0.133 kPa), P<0.001], diastolic blood pressure [(84.1±12.2) vs. (73.9±7.7) mm Hg, P<0.001], and prevalence of hypertension (28.6% vs. 22.2%, P<0.001). Ageing [odds ratio (OR)=1.107, 95% confidence interval (CI) (1.071, 1.144), P<0.001], monthly personal income ≥3 000 yuan [OR=1.566, 95%CI (1.003, 2.445), P=0.048], and abdominal obesity [OR=1.658, 95%CI (1.091, 2.520), P=0.018] were the risk factors for hypertension in middle-aged males with positive family history. Ageing [OR=2.257, 95%CI (1.202, 4.025), P=0.026] and overweight or obesity [OR=2.365, 95%CI (1.653, 3.385), P<0.001] were the risk factors, and physical exercise [OR=0.529, 95%CI (0.304, 0.918), P=0.024] was the protective factor for hypertension in middle-aged females with positive family history.ConclusionsThe prevalence of hypertension is high in middle-aged population with positive family history of hypertension in Chengdu and is significantly higher than that in the ones with negative family history of hypertension. Strengthening health education on hypertension-related knowledge, and reasonably controlling waist circumference and body weight may have positive significance in preventing or delaying the occurrence of hypertension in people with positive family history of hypertension.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) was recommended as the gold standard procedure for metabolic and bariatric surgery by the National Institutes of Health in the 1990s and then had been adopted till now, which could effectively control excess weight and treat metabolic diseases relevant to obesity in a long term. The current LRYGB procedure had been performed more than half a century of development and update, and is still constantly evolving. Standardized and precise surgical procedures are of great significance in ensuring treatment effect and reducing the incidence of complications. Thus, the author reviewed the development process of LRYGB, further understanding and emphasizing the importance of standardized and precise surgical procedures.
ObjectiveTo explore the application of cardiac enhanced MRI in acute myocardial infarction with normal result of coronary angiography. MethodsOn October 18, 2013, a male patient underwent coronary angiography under the local anesthesia. Mild coronary stenosis both in left and right side were found in the surgery, but the results of dynamic cardiogram and myocardial markers were abnormal, which accorded with the clinical procedure of myocardial infarction. The patient underwent cardiac enhanced MRI at the 6th day and was finally diagnosed as acute myocardial infarction. We reviewed the database to find out the significance of cardiac enhanced MRI in diagnosis of acute myocardial infarction. ResultsAlthough coronary angiography was the gold standard for the diagnosis of coronary diseases, it had limitations in the diagnosis of coronary eccentric stenosis, branch vascular stenosis and coronary spasm. Cardiac enhanced MRI had the advantages of accurate measurement of the attenuation of myocardium and exhibition of functional changes of ischemic myocardium. ConclusionCardiac enhanced MRI is important for the diagnosis of myocardial infarction with normal result of coronary angiography.
Spinal robotics has rounded out twenty years in clinical, is mainly used for pedicle screw placement at present, can significantly increase the accuracy of screw placement and reduce radiation exposure to the patient and the surgeon. In the future, haptic feedback, automatic collision avoidance, and other technologies will further expand its application to complete precise operations such as decompression and correction, providing safety guarantee for the implementation of complex spinal surgery.
ObjectiveTo investigate whether there is a causal relationship between reproductive history (number of children, age at first birth) and the risk of hormone-related cancers (breast, endometrial, and ovarian) in women. MethodsUnivariate and multivariate Mendelian randomization (MR) methods were used to investigate the causal effects of the number of children (childlessness in infertile women and number of children ever born in fertile women) and age at first birth on three hormone-related cancers. The inverse variance weighting method was used for the primary analysis, and sensitivity analyses and reliability tests were used to ensure the reliability of the results. ResultsUnivariate MR showed that infertile women had a higher risk of breast cancer compared with fertile women (OR=1.07, 95%CI 1.05 to 1.09, P<0.001). Multivariate MR showed that among fertile women, after accounting for the effect of age at first birth, higher number of children ever born may be associated with lower risk of breast cancer (OR=0.61, 95%CI 0.43 to 0.85, P<0.01). Neither univariate nor multivariate MR found a causal relationship between age at first birth and hormone-related cancers, and no causal relationship was found between the number of children ever born and endometrial and ovarian cancers; sensitivity analyses and reliability tests demonstrated that the results were unlikely to be affected by heterogeneity and horizontal pleiotropy. ConclusionThe more children a normal woman has, the lower her risk of breast cancer. Infertile women face a higher risk of breast cancer.
ObjectiveTo summarize the development of surgical treatment of rectal cancer.MethodReviewed the domestic and foreign literatures on surgical methods for rectal cancer.ResultsThe first real surgery for rectal cancer was performed by LisFrance in 1826. Because the early understanding of rectal cancer and its development was not clear, the operation effect was poor, and the postoperative recurrence rate was high. It was not until 1908, when Dr. Miles proposed the classic abdominoperineal resection (APR), that the recurrence of rectal cancer improved significantly. In the 20th century, there also appeared Hartmann, Dixon, Bacon, Parks, and other sphincter-preserving operations, among which Dixon surgery was the most influential. Dixon surgery had changed the focus of rectal cancer treatment from radical APR to more sphincter-preserving surgery. With the emergence of stapler, the introduction of concepts such as total mesorectal excision (TME) and circumferric resection margins (CRM), and the promotion of laparoscopic technology, resection and anastomosis of rectal cancer had a lower location, less surgical trauma, better postoperative quality of life, and higher survival rate. Modern rectal cancer surgery was gradually developing to precision and minimally invasive. Following TME, transanal total mesorectal excision (taTME) and natural orifice specimen extraction surgery (NOSES) had given a new meaning to the operation of rectal cancer.ConclusionsWith the in-depth understanding of the occurrence, development, recurrence, and metastasis of rectal cancer, surgical methods of rectal cancer are constantly developing and improving. The introduction of new concepts and surgical procedures is accompanied by controversy and doubt, which promotes the improvement of the treatment level of rectal cancer.
Blood purification is not only an effective treatment for patients with acute and chronic renal failure, but also plays an important role in the rescue of various critically ill patients. The current blood purification devices is relatively bulky and not suitable for use in daily life and disaster rescue sites. Portable blood purification devices can be divided into portable artificial kidney, wearable artificial kidney, implantable artificial kidneys and mobile continuous renal replacement therapy machine, which have not yet been widely applied in clinical practice. In recent years, with the advancement of materials science and computer science, efficient regeneration of dialysate and intelligent operation of equipment have become possible, and portable blood purification devices is also expected to experience rapid development. This article briefly reviews the development history and future research directions of portable blood purification devices.