The rotary left ventricular assist device (LVAD) has been an effective option for end-stage heart failure. However, while clinically using the LVAD, patients are often at significant risk for ventricular collapse, called suction, mainly due to higher LVAD speeds required for adequate cardiac output. Some proposed suction detection algorithms required the external implantation of sensors, which were not reliable in long-term use due to baseline drift and short lifespan. Therefore, this study presents a new suction detection system only using the LVAD intrinsic blood pump parameter (pump speed) without using any external sensor. Three feature indices are derived from the pump speed and considered as the inputs to four different classifiers to classify the pumping states as no suction or suction. The in-silico results using a combined human circulatory system and LVAD model show that the proposed method can detect ventricular suction effectively, demonstrating that it has high classification accuracy, stability, and robustness. The proposed suction detection system could be an important part in the LVAD for detecting and avoiding suction, while at the same time making the LVAD meet the cardiac output demand for the patients. It could also provide theoretical basis and technology support for designing and optimizing the control system of the LVAD.
[Abstract]Patients with locally advanced thyroid cancer often face challenges in achieving radical surgery during initial diagnosis. This has become a significant hurdle in the treatment of thyroid cancer. With the continuous development of systemic therapy for thyroid cancer, several studies have demonstrated that neoadjuvant therapy can shrink tumors in some patients, thereby increasing the chances of complete resection and improving prognosis. Targeted therapy plays a crucial role as a core component of neoadjuvant treatment. Simultaneously, the potential efficacy of immunotherapy has gained attention, showing promising prospects. We aim to summarize the research progress and existing issues regarding neoadjuvant therapy for locally advanced thyroid cancer. We look forward to more high-quality clinical studies providing robust evidence for neoadjuvant therapy in locally advanced thyroid cancer, expanding the breadth of treatment options.
Objective To determine the effects of controlled hypotension (CH) on cerebra1 blood flow, cerebra1metabolism, and cognitive functions. Methods Randomized controlled trials (RCTs) were identified from MEDLINE (1966 to 2008), EMbase (1974 to 2008), The Cochrane Library (Issue 2, 2008), CBM (1978 to 2008), and CNKI (1994 to 2008). The quality of included trials was assessed by two reviewers independently. RevMan 4.2.7 software provided by The Cochrane Collaboration was used for statistical analysis. Results Nine RCTs involving a total of 295 patients were included. Most of the studies were of poor methodological quality. Meta-analysis was performed because the outcomes were the comparisons of the means of several repeated measures, and so a descriptive analysis was conducted. There were no significant differences in cerebral blood flow velocity, hypoxia-induced metabolites, and cognitive function between the CH group and the control group (Plt;0.05). But the S100B protein level in cerebrospinal fluid or blood was significantly higher in the CH group than that in the control group (Plt;0.02). Conclusion CH has no adverse effects on cerebra1 blood flow, cerebra1 metabolism, or cognitive functions. But isoflurane-induced hypotension may increase the release of S100B, indicating worse brain injury. The above conclusions were made from the limited evidence, and more rigorous RCTs are needed.
【摘要】 目的 探讨高频彩色多普勒超声对浅表软组织肿物的诊断价值。 方法 回顾性分析2008年1-11月70例经手术、活检病理证实的浅表软组织肿物的声像图特征，包括肿物的部位、形态大小、内部回声、边界及其与周边组织的关系、长径与厚度比值（L/T）及病变周边与内部血流分布情况。 结果 超声对浅表肿块病灶的显示率为100%，良性肿瘤有脂肪瘤、表皮囊肿、滑膜囊肿、神经鞘瘤，血管瘤、异物肉芽肿等，恶性肿物包括皮肤纤维肉瘤，转移性腺癌。 结论 彩色多普勒超声对浅表肿块的检出、定位及物理性质可做出准确的诊断，综合分析肿物的边界、形态、内部回声及血流分布等特点对肿物的良恶性诊断具有重要价值。【Abstract】 Objective To evaluate the value of high-frequency color Doppler ultrasonography in diagnosing the superficial soft tissue masses. Methods The clinical data of 70 patients with superficial soft tissue masses from January to November 2008 were retrospectively analyzed. Superficial soft tissue masses was diagnosed by the surgery and biopsy. The sonographic features, including the location, morphology, size, internal echo, boundary, relationship with peripheral tissues, longitude to transverse ratio (L/T), and the vascularity, were observed. Results The results of sonographic examination showed that 100% superficial masses could be found. Benign masses included lipoma, sebaceous cysts, synovial cysts, nerve sheath tumors, haemangioma, foreign body granulomas, etc. Malignant soft tissue tumors included fibrous sarcoma and metastatic neoplasms. Conclusion Color Doppler ultrasonography can precisely diagnose the presence, localization and the physical characters of superficial soft tissue masses. It is an excellent modality to diagnose the benign or malignant masses by analyzing the boundary, configuration, internal echo and vascularity of the masses.
【摘要】 目的 探讨彩色多普勒超声对临床甲状腺良恶性结节的诊断价值。 方法 对2007-2010年105例经手术病理证实的甲状腺结节患者资料进行回顾性分析，总结其声像图特征。 结果 105例患者中，良性结节71例，甲状腺癌34例，超声诊断符合率81.9%，误诊18例（17.1%）。 结论 彩色多普勒超声是诊断甲状腺结节的首选影像学检查方法，但对良恶性结节的鉴别及微小癌的诊断有局限性。【Abstract】 Objective To evaluate the value of color Doppler flow imaging in diagnosis of benign and malignant thyroid nodules. Methods We retrospectively analyzed the clinical data of 105 patients with thyroid nodules confirmed by pathology between 2007 and 2010 and summarized the ultrasonography results. Results Among the 105 cases, 71 were benign nodules and 34 were malignant tumors. The overall diagnostic accordance rate was 81.9% with 18 cases (17.1%) of misdiagnosis. Conclusion Ultrasonography is the first imaging modality for thyroid nodule examination, but it is limited in the diagnosis of microcarcinoma and in distinguishing malignant from benign nodules in the same thyroid.
目的 总结胰腺瘘管空肠Roux-en-Y吻合术治疗胰管离断综合征的治疗效果。方法 回顾性分析2002年3月至2010年7月期间我院行胰腺瘘管空肠Roux-en-Y吻合术治疗的5例胰管离断综合征患者的临床资料，分析其治疗效果及手术并发症。结果 5例患者均为急性出血坏死性胰腺炎手术治疗后，经MRCP确诊为胰管离断综合征，手术方式为瘘管空肠Roux-en-Y吻合术，中位手术时间为178min（120～360min），中位术中失血量为300ml（150～600ml），术后中位进食时间为5d（3～8d）。随访中位时间为390d（120～712d），5例患者恢复顺利。2例患者切口感染，经切口换药治愈；1例患者出现短暂的胰肠吻合口漏，经保守治疗治愈。结论 从本组有限的病例资料看，胰腺瘘管空肠Roux-en-Y吻合术是胰管离断综合征较安全的治疗方式。
【Abstract】ObjectiveTo investigate the effect of genetic modulation of the hepatic graft with IL-10 during liver preservation in rat liver transplantation. MethodsEleven cases of orthotopic liver transplantation were performed in Lewis to BN rats according to the cuff’s technique. All rats were divided into 3 groups,which were control group(n=3), Lipo group(n=4) and Lipo-rIL-10 group(n=4). Lipofectamine 2000-pCR3.1 complex and Lipofectamine 2000-pCR3.1 rIL10 complex were respectively injected into portal vein and kept for 45 minutes to transfect grafts during cold preservation in vitro. All rats were killed on postoperative day 6. Serum samples were collected for decting IL-10 by means ELISA. Transgene expression of rIL-10 was assessed by means of RT-PCR and immunohistochemistry. ResultsIn Lipo-rIL-10 group, levels of IL-10 from suprahepatic vena cava were significant higher than those from infrahepatic vena cava (P=0.024), transgene expression of rIL-10 in Lipo-rIL-10 were higher than those of control group and Lipo group assessed by means of RT-PCR and immunohistochemistry. ConclusionDuring cold preservation in vitro through portal vein injection to donor liver, liposome mediated gene transfection can successfully achieve local gene expression.