In 2022, there were 367.7 thousands new cases and 316.5 thousands deaths of primary liver cancer in China. Radiofrequency ablation (RFA) is one of the radical treatments for liver cancer. It has the characteristics of definite curative effect, minimal invasion and low cost. In patients with early liver cancer, the curative effect is similar to surgical resection. The concept and practice of precision surgery provide new ideas for improving the efficacy of RFA. Based on the RFA treatment experience of more than ten thousand cases, the author’s team has carried out research on the precise ablation treatment of primary liver cancer. Now, the author will combine the existing literature and our team’s experience to discuss the application and prospect of the precise surgery concept in RFA treatment.
Objective To explore efficacy and safety of radiofrequency ablation (RFA) in the treatment of large hepatocarcinoma. MethodsFortythree cases of large hepatocarcinoma underwent RFA with the expandable cluster electrode,eight of all cases had undergone transcatheter artery chemoembolization (TAE) for 1-2 sessions within 2 months before RFA; the tumors were 5-10 cm in diameter, mean 7.5 cm. Hepatic function examination, alphafetoprotein, enhanced CT scans,color ultrasonography and needle biopsy were performed,pre and posttreatment. Complete necrosis was evaluated by dynamic enhanced CT scans and biopsy. Therapeutic time and sessions of RFA,length of stay in hospital and complications of RFA were observed; and thirtynine of 43 cases after RFA were followed up for 12-18 months.ResultsFortythree cases of large hepatocarcinoma received RFA for 67 sessions， 1-3 sessions per case，mean 1.6 sessions; therapeutic time 55-150 min,mean 75 min; length of stay in hospital 3-15 day， mean 8.7 day; major complications of RFA included local skin burn of electrode board in 2 cases （4.6%） and moderatetolarge right pleural effusion in 3 cases （7.0%），overall complications rate was 11.6%; complete necrosis was achieved in 41.0% of cases which were evaluated by dynamic enhanced CT scans at least 6 months followed RFA; of thirtyone cases of positive AFP, AFP level became negative in 3,decreased obviously in 5 within 6-12 months after RFA; in 12-18 months followup,oneyear survival rate was 69.2%.Conclusion RFA appears to be safe, effective and minor invasive for the treatment of large hepatocarcinoma.
Brain-computer interface (BCI) system is a system that achieves communication and control among humans and computers and other electronic equipment with the electroencephalogram (EEG) signals. This paper describes the working theory of the wireless smart home system based on the BCI technology. We started to get the steady-state visual evoked potential (SSVEP) using the single chip microcomputer and the visual stimulation which composed by LED lamp to stimulate human eyes. Then, through building the power spectral transformation on the LabVIEW platform, we processed timely those EEG signals under different frequency stimulation so as to transfer them to different instructions. Those instructions could be received by the wireless transceiver equipment to control the household appliances and to achieve the intelligent control towards the specified devices. The experimental results showed that the correct rate for the 10 subjects reached 100%, and the control time of average single device was 4 seconds, thus this design could totally achieve the original purpose of smart home system.
Objective To evaluate the efficacy of Radiofrequency （RF） modified maze procedure combined with open-heart surgery for atrial fibrillation （AF）. Methods From January 2003 to October 2004, 66 patients underwent the RF modified maze Ⅲ procedure for AF combined with open-heart surgery. The preoperative and postoperative indexes of electrocardiogram and echoeardiogram were compared through retrospective analysis and follow-up. Postoperative cardiac function and thromboembolie events were evaluated through telephone and mail. Results The time needed for RF modified maze Ⅲ was 18.61±3.56 min. There were no hospital deaths and the complications was 15.15%（10/66）. Follow-up duration was 14.25±6.47 months with 95.45%（63/66） completion. At the lastest follow-up, the rate of freedom from AF was 80.95% （51/63）and the rate of restoration to sinus rhythm was 74.60%（47/63）. No thromboembolic events was seen. 77.78%（49/63） of patients were in NYHA class Ⅰ. Significant decrease was seen in both left atrial dimension （LAD） and left ventricular dimension （LVD）（P〈0.01） more than 6 months after operation. Conclusion RF modified maze Ⅲ procedure as an adjunctive procedure is safe, time-sparing and effective in eliminating AF.
Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.
Objective To evaluate the short-term outcome and influence of atrial fibrillation ablation and mitral valve replacement for patients with mitral valve stenosis and atrial fibrillation. Methods Retrospective analysis was conducted for 44 patients with rheumatic mitral valve stenosis and atrial fibrillation who experienced mitral valve replacement with or without surgical atrial fibrillation ablation procedure in our hospital from January 2016 to June 2017. Eighteen patients experienced mitral valve replacement and surgical atrial fibrillation ablation procedure (a group 1), and the other 26 patients experienced mitral valve replacement without surgical atrial fibrillation ablation procedure (a group 2). In th group 1, there were 4 males and 14 females, aged 43-67 (55.67±7.56) years, and in the group 2 there were 6 males and 20 females, aged 40-72 (54.81±8.81) years. The patients’ data, preoperative echocardiography, surgery procedures, perioperative events, echocardiography and electrocardiogram at postoperative three months were collected to evaluate the short-term outcome and influence of surgical atrial fibrillation ablation procedure for those patients. Results There was no statistical difference in the operation duration (P=0.867) and ICU stay (P=0.550) between the two groups. But the group 1 had longer extracorporeal circulation duration (P=0.006) and aorta arrest duration (P=0.001) than the group 2. No patient died perioperatively and one patient from the group 1 experienced reoperation because of too much chest tube drainage. At three months after operation, echocardiography and electrocardiogram examination showed that 16 patients in the group 1 and 2 patients in the group 2 had sinus rhythm. There was no statistical difference between postoperative and preoperative examination about variation in left ventricle ejection fraction, pulmonary arterial systolic pressure, left atrial diameter and left ventricular end diastolic diameter between the two groups (all P>0.05). Conclusion Atrial fibrillation ablation does not increase the risk of mitral valve replacement for patients who have mitral valve stenosis and atrial fibrillation. The rate of converting to sinus rhythm is high, but additional atrial fibrillation ablation procedure does not have positive or negative influence on short-term recovery of cardiac structure and function after operation.
ObjectiveTo summarize clinical advantages and outcomes of minimally invasive mitral valve replacement (MVR) combined with atrial fibrillation (AF) radiofrequency ablation via right minithoracotomy. MethodsEight patients with mitral valve disease and AF who received surgical therapy in the First Hospital of China Medical University between October 2009 and October 2012 were included in the study. There were 4 males and 4 females with their age of 34-67 (52.4±17.5) years. All the patients underwent minimally invasive MVR combined with AF radiofrequency ablation via right minithoracotomy. Clinical outcomes were summarized. ResultsThere was no in-hospital death or conversion to conventional sternotomy in this group. Two patients received biological valve replacement and 6 patients received mechanical prosthesis. Operation time was 207.9±18.1 minutes, cardiopulmonary bypass time was 81.7±23.9 minutes, and chest drainage amount was 126.7±34.5 ml. AF recurred in 1 patient on the 3rd postoperative day. All the patients were in sinus rhythm at discharge. These patients were followed up for 18.3±7.4 months. During follow-up, 1 patient had AF recurrence. Seven patients were in NYHA class Ⅰ, and 1 patients was in NYHA class Ⅱ. ConclusionMinimally invasive MVR combined with AF radiofrequency ablation via right minithoracotomy can achieve satisfactory clinical results and esthetic appearance, and is a good choice for patients with mitral valve disease and AF.
Objective To report the preliminary results of intraoperative saline-irrigated radiofrequency modified maze procedure for chronic atrial fibrillation (AF) in mitral valve diseases. Methods From May 2003 to April 2004 forty-one patients underwent intraoperative saline-irrigated modified maze procedure. The patients included 13 male and 28 female. Their age ranged from 27-65 years (46±10 years). The duration of AF varied from 5 months to 15 years (4.5±3.6 years).The left atrial diameter varied from 37-93 mm (54±11mm). There were mitral stenosis 20, mitral regurgitation 1 and mitral stenosis with regurgitation 20 cases. Cardiopulmonary bypass (CPB) was established as usual. Ablation lines were made with Cardioblate (Medtronic, 25-30 W, 180-240ml/h). Having finished right-sided maze procedure, the aorta was cross-clamped and cold crystalloid or blood cardioplegia were used for myocardial protection. Left atrial incision was performed through the interatrial groove. The ablation lines were created to encircle the orifices of the left and right pulmonary veins respectively. The ablation lines were also performed from the left encircling line to the posterior mitral valvular annulus and to the orifice of left atrial appendage respectively. A ablation line was used to connect left and right pulmonary veins circumferential line. Concomitant procedures were performed (there were double valve replacement 10 cases, mitral valve replacement 31 cases, tricuspid annuloplasty 6 cases, removing the left atrial thrombi 6 cases). Results CPB time varied from 71-160 min (105±24 min) and cross-clamping time varied from 32-106 min (62±20 min). The ablation time varied from 4-22 min (11±4 min). One patient died during hospitalization and the death was caused by acute mechanic valve obstruction. During follow-up at discharge and 3 months 35% patients (14/40) were free of AF and the others were not. But at 6 months 67% patients (10/15) were free of AF. Conclusion The intraoperative saline-irrigated radiofrequency modified maze procedure is comparatively simpler and its efficacy is satisfactory.