ObjectiveTo evaluate the value of real-time indocyanine green fluorescence imaging navigation (ICG-FIN) in laparoscopic rectal cancer surgery. MethodsThe patients who adopted ICG-FIN during laparoscopic rectal cancer surgery in the Department of Anorectal Surgery of Xuzhou Central Hospital from April 2022 to June 2023 according to the inclusion and exclusion criteria (ICG-FIN group) were collected, meanwhile matching (1∶1) of patients who did not adopt ICG-FIN during laparoscopic surgery from January 2021 to May 2022 (control group). The general data, surgical conditions, intraoperative and postoperative outcomes between the two groups were compared. ResultsThere were 62 patients in the ICG-FIN group and 62 patients in the control group. There were no statistical differences in the gender, age, body mass index, comorbidities, and so on between the two groups (P>0.05). The tumor localization, lymph node tracing, fluorescence imaging of the intended resection of intestinal tract and anastomotic site were observed in the ICG-FIN group. Seven patients (11.3%) had changed in the intended resection of intestinal anastomotic line during surgery, while there were no changes of the surgical plan in the control group. There were no statistical differences (P>0.05) in terms of surgical method, operative time, intraoperative bleeding, proportion of ileostomy, time of the first postoperative exhaust, postoperative hospital stay, and incidence of short-term complications between the two groups. Compared with the control group, the incidence of anastomotic leakage was lower (P=0.012), and the number of lymph nodes cleaned was more (P=0.016) in the ICG-FIN group. However, there was no statistical difference in the number of positive lymph nodes detected between the two groups (P=0.343). ConclusionsAccording to the results of this study, ICG-FIN is a reliable and effective method during laparoscopic rectal cancer surgery, which can accurately localize tumor, trace and guide lymph node dissection. Real-time evaluation of intestinal blood flow perfusion is of great practical value in reducing anastomotic leakage.
ObjectiveTo summarize the application progress of indocyanine green (ICG) angiography in diagnosis and treatment of lymphedema.MethodsThe literature related to dynamic imaging tracing of lymphedema at home and abroad was reviewed extensively. And the research status and progress of ICG angiography in diagnosis and treatment of lymphedema were retrospectively analyzed.ResultsICG angiography can be used as the gold standard for the diagnosis of lymphedema at present and the classification of lymphedema severity, selection of surgical incisions and methods, and intraoperative operation. It can also be used to observe lymphatic drainage and regeneration within 1.5 cm of subcutaneous and determine the prognosis.ConclusionCompared with traditional methods, ICG angiography has more obvious advantages and value in diagnosis and treatment of lymphedema. However, it also has problems such as slow development speed and difficulty in developing deep lymphatic vessels (nodes).
Objective To insure early detection and hence efficient prevention of allograft rejection in transplanted heart, investigate possible applications of NAD(P)H fluorescence components analysis at the level of living cardiac cells to propose new approaches for diagnosis of rejection. Methods NAD(P)H was studied for noninvasive fluorescent probing of the mitochondrial function. Human cardiomyocyte were isolated from one additional endomyocardial biopsy (EMB) of 14 pediatric patients with heart ransplantation. Rat cardiomyocyte (n=5, 13-14 week old) were also isolated by the same approach for human myocytes. Autofluorescence(AF) was recorded in living cardiomyocytes following excitation with 375 nm UVlight and detection by spectrallyresolved time correlated single photon counting (TCSPC), based on the simultaneous measurement of the fluorescence spectra and lifetimes. Rat cardiac cells were divided into four groups: normoxic condition, normoxia with Rotenone, ischemic condition and ischemia with Rotenone. Comparison of cardiomyocyte AF between human and rat; compared kinetics of rat cardiomyocytes AF in normoxic conditions to ischemiamimicking ones, induced at physiological temperatures by reducing cell pH and oxygen content; comparison of cardiomyocyte AF dynamic changes in transplanted pediatric patients presenting either no rejection (R0) or mild rejection (R1). Results We have achieved appropriate isolation of living cardiomyocytes from human biopsies, as well as from rat cardiac tissues and determined their AF. At least a 3-exponential decay with 0.5-0.7ns, 1.9-2.4 ns and 9.0-15.0 ns lifetime pools is necessary to describe human cardiomyocyte AF within 420560 nm spectral range. Rat cardiomyocyte steadystate AF in ischemiamimicking condition was significantly increased when compared normoxic ones (Plt;0.05); application of Rotenone induced a significant increase in AF intensity in ischemic and normoxic condition, however no significant difference between the two groups (Plt;0.05).Human cardiomyocyte AF was found significantly lower in comparison to experimental rat model in the same condition(Plt;0.05). A correlation between changes in steadystate NAD(P)H fluorescence and rejection grades was found when comparison of R1 to R0. R1 showed significantly increased fluorescence intensity (Plt;0.05), without change in the spectra shape, results can be comparable to the effect of ischemiamimic conditions. Conclusion Our studies clearly demonstrated that spectrallyresolved fluorescence spectral analysis coupled to fluorescence lifetime are high sensitive approaches to examine mitochondrial metabolic oxidative state directly in living human cardiomyocytes with good reproducibility. Human cardiomyocytes are more metabolically active than the rat ones, while this activity (and thus ATP production) seems lowered during rejection process. In perspective, the advantage of this method is the possibility of its combination to multiphoton confocal microscopy, which can result in the adaptation of this approach directly to tissue biopsy, as well as in vivo directly via cardiac catheterization without the necessity of cell isolation. This approach provides promising new tool for clinical diagnosis and treatment of allograft rejection, and will enhance our knowledge about cardiomyocyte oxidative metabolism and/or its dysfunction at a cellular level.
Objective To analyze the variation of intestinal microflora in patients with colorectal cancer by SYBR GreenⅠreal-time fluorescence quantitative PCR and reveal the role and significance of intestinal microflora in the colorectal cancer-associated molecular pathogenesis. Methods A set of 16S rRNA gene group of species-specific primers for Bifidobacterium spp., Lactobacillus group, Escherichia coli, and ddl gene-targeted species-specific primers for Enterococcus faecalis and feces Enterococcus were designed. Patients with colorectal cancer (colorectal cancer group, n=30) and healthy volunteers (normal control group, n=30) were included and whose feces were collected to extract bacterial genome DNA. SYBR GreenⅠ real-time fluorescence quantitative PCR was used to analyze the five mentioned bacterial amounts. Results Level of Bifidobacterium spp. (4.52±0.49) and Lactobacillus group (5.46±0.12) in colorectal cancer group were significantly lower than those （9.25±0.83 and 7.45±0.37） of normal control group (Plt;0.05), whereas levels of Escherichia coli (5.82±0.47), Enterococcus faecalis (10.6±0.30) and feces Enterococcus (5.74±0.16) in colorectal cancer group were significantly higher than those （4.68±0.32, 4.95±0.24, and 5.03±0.43） of normal control group (Plt;0.05). Conclusions The fecal microflora composition of patients with colorectal cancer is significantly decreased in Bifidobacterium spp. and Lactobacillus group, whereas increased in Escherichia coli, Enterococcus faecalis, and feces Enterococcus. These data underline that the occurrence and progress of colorectal cancer may be related to intestinal microflora.
Objective Using chemically extracted acellular methods to treat extracranial section of the canine whole facial nerve, to evaluated its effects on nerve structure and the removal extent of Schwann cells and myel in. Methods Twenty whole facial nerves were exposed from 10 canines [weighing (18 ± 3) kg]. The extracranial trunk of canine facial nerve and its branches (temporal branch, zygomatic branch, buccal branch, marginal mandibular branch, and cervical branch) were dissected under l ight microscope. Twenty facial nerves were divided into the experimental group (n=12) and control group (n=8) randomly. In experimental group, the nerve was extracted with the 3%TritonX-100 and 4% sodium deoxycholate. In control group, the nerve was not extracted. HE staining and immunofluorescence histological stainings for Hoechst33258, P75, Zero, and Laminin were performed. Results After histological staining, it was found that myel in and Schwann cells were removed from the facial nerve while the basal lamina tube remained intact. The whole canine facial nerves (one nerve trunk and multiple nerve branches) had the similar result. Conclusion The canine whole facial nerve has natural structure (one nerve trunk and multiple nerve branches) by extracted with chemically extracted acellular methods, so it is an available graft for repairing the defect of the whole facial nerve.
Objective To explore the accuracy and efficiency of indocyanine green fluorescence (ICGF) imaging in evaluating blood perfusion of parathyroid gland (PG) during total thyroidectomy. Methods Seventy patients who underwent total thyroidectomy and bilateral central lymph node dissection for papillary thyroid carcinoma (PTC) from March 2021 to December 2021 were enrolled and randomly divided into experimental group (ICGF imaging, n=35) and control group (normal treatment, n=35). Blood perfusion of PGs was evaluated by ICGF imaging and naked eye in each group respectively. The perfusion of PGs, incidence of hypoparathyroidism, and number of autotransplanted PGs were analyzed between the two groups. Results There was no difference between two groups in the incidence of transient hypoparathyroidism (P=0.339), and no one occurred permanent hypoparathyroidism. More PGs were autotransplanted in the experimental group compared to the control group (P＜0.001). At least one PG with good perfusion in the experimental group predicted an extremely high rate of normal parathyroid hormone levels of the patients postoperatively than the control group (P=0.003). Conclusion ICGF imaging can evaluate the blood perfusion of PGs accurately and guide their autotransplantation.
Objective To investigate the value of indocyanine green fluorescence imaging in common bile duct reexploration. Methods The clinical data of 32 patients who underwent open common bile duct reexploration in the Affiliated Hospital of Southwest Medical University from January 2018 to December 2020 were collected retrospectively. All patients divided into the control group (conventional exploration group, 20 patients) and the fluorescence imaging group (using indocyanine green fluorescence imaging, 12 patients) according to the operational manner. The intraoperative and postoperative results of two groups were analyzed. Results The operative time [(165.2±6.9) min vs. (130.8±5.5) min], the time to find extrahepatic bile duct [(43.9±3.8) min vs. (23.1±4.1) min] and the amount of bleeding [(207.7±7.7) mL vs. (127.5±15.3) mL] in the control group were longer or more than those in the fluorescence imaging group (P<0.05). The incidence of postoperative infection in the control group [7 cases (35.0%) vs. 0 cases (0.0%)] and the length of hospital stay [(10.8±2.8) d vs. (7.1±1.3) d] were higher or longer than those in the fluorescence imaging group (P<0.05). There were no significant difference between the two groups in the incidence of postoperative bile fistula [6 cases (30.0%) vs. 2 cases (16.7%)] and the incidence of residual stones [3 cases (15.0%) vs. 3 cases (25.0%), P＞0.05]. Conclusion Indocyanine green fluorescence imaging appears to be a feasible, expeditious, useful, and effective imaging method while performing reexploration.
This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI.2011 1 0292374.1.
Objective To investigate the method of constructing a tissue engineered epidermis with human epidermal cells and polycarbonate membrane, and to establ ish a tissue engineered epidermis with barrier function which is intended to be the replacing model in vitro of skin irritation test. Methods The tissue engineered epidermis was constructed by using polycarbonate membrane as scaffold and stratified differentiated epidermis derived from human keratinocytes. The tissue engineered epidermis was cultured on an inert polycarbonate filter at the air-liquid interface. After 13 days of culture, the composition and structure of tissue engineered epidermis were observed by HE staining, immunofluorescence staining of keratin 10 (K10) amp; K13, K14, laminin,involucrin, and filaggrin, and transmission electronic microscope. The half maximal inhibitory concentration of a substance (IC50) of SDS was determined in the penetration test of tissue engineered epidermis cultured in the absence (control group) or the presence (experimental group) of l i pid supplement for 18 hours. Results The constructed epidermis was similar to normalepidermis, which was consisted of a proliferating basal layer, differentiated spinous layer, granular layer, and stratum corneum. The IC50 values of tissue engineered epidermis cultured in the control group and experimental group were 0.072% (2.36 mmol/L) and 0.183% (6.00 mmol/L), respectively. Conclusion The tissue engineered epidermis constructed on polycarbonate membrane has normal composition and structure and barrier function corresponding to the normal epidermis.
In view of the fact that medical inspection equipment sold in the domestic market is mainly imported from abroad and very expensive, we developed a full-automatic fluorescence analyzer in our center, presented in this paper. The present paper introduces the hardware architecture design of FPGA/DSP motion controlling card+PC+STM32 embedded micro processing unit, software system based on C# multi thread, design and implementation of double-unit communication in detail. By simplifying the hardware structure, selecting hardware legitimately and adopting control system software to object-oriented technology, we have improved the precision and velocity of the control system significantly. Finally, the performance test showed that the control system could meet the needs of automated fluorescence analyzer on the functionality, performance and cost.