【Abstract】ObjectiveTo investigate the causes of biliary tract complications after liver transplantation, and to put forward effective measures of prevention, diagnosis and treatment. MethodsThe literatures of recent years were reviewed and summarized. Results The causes of biliary tract complications after liver transplantation are very complex, and there are no standard preventive measures. Treatment differs according to causes. ConclusionOne of the most important causes leading to biliary complications is preservative and ischemic injury. Poorly operative techniques and blood supply to biliary tract are also disastrous. Improving T tube placement can reduce the incidence of biliary complications related with T tube. To prevent biliary complications, it is crucial to completely wash the biliary tract， avoid damaging the blood supply to donor biliary tract and manage perfect biliary mucosatomucosa anastomosis without tension. T tube cholangiography combined with noninvasive MRCP enables accurate depiction of the biliary tree and diagnosis of biliary complications. Doppler ultrosonography should be routinely applied postoperatively. Timely application of interventional radiological technique is a valuable nonoperative procedure for treatment of biliary complications. Meanwhile, biliary sludge or cholestasis and mixed infections of biliary tract should be handled actively and properly.
Postoperative stability reconstruction following spinal tumor resection is a critical step to ensure functional recovery and quality of life for patients. This article systematically reviews the current status of anterior and posterior column reconstruction techniques after spinal tumor resection, including strategies such as bone cement augmentation, structural implants, and three-dimensional-printed personalized prostheses. It emphasizes the need for individualized treatment plans based on tumor type, anatomical location, and the patient’s overall condition. The article also highlights the importance of restoring sagittal balance, multidisciplinary collaboration, and complication prevention for long-term outcomes. In the future, innovations in biomaterials, along with the minimally invasive and intelligent evolution of surgical techniques, will further advance the goal of achieving stable, pain-free, and functionally effective spinal reconstruction for each patient, ultimately enhancing their quality of life.
Objective To explore the operative result of intrarectal proctoptosis accompanying hernia of pelvic floor due to common outlet obstructive constipation(OOC).MethodsEleven cases of intrarectal proctoptosis with of pelvic floor surgically treated were analysed. Results In a week following operation, 9 of 11 patients’ symptoms disappeared, the other 2 cases recovered after 3 months, functional exercise. Conclusion Functional rectal suspension combined with repair of pelvic, partial sigmoidectomy, surgical elevation of pelvic floor and hysteropexy are highly effective in alleviating symptoms in patients with intrarectal proctoptosis accompanying pelvic floor herniation.
Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is a rare type of lung cancer with special characteristics of epidemiology, clinical diagnosis, treatment and prognosis. It has close relationship with Epstein-Barr virus (EBV) infection and has prominent regional feature. Most patients are young and non-smoking. There is no specificity of clinical manifestation. Most patients are asymptomatic at the time of diagnosis. As for treatment, the standard treatment for early stage disease is complete resection. Platinum-based doublet chemotherapy has been applied in locally advanced disease as the first line therapy. Due to its rarity, the treatment of advanced PPLELC is still lack of evidence of large sample randomized controlled trial. Whether target therapy or immunotherapy is effective is worth further study. This article reviews the research progress of PPLELC, to give a particular sight for clinicians and provides a better understanding of this rare tumor for researchers.
Aortic dissection is one of the most devastating cardiovascular diseases. One of the most important pathological features of aortic dissection is local inflammatory response, including the infiltration of inflammatory cells, extracellular matrix degradation, and smooth muscle cell phenotype switch. Macrophages which are the core of the inflammatory response play an extremely pivotal role in the progression of inflammation and tissue remodeling. Macrophages can be artificially divided into M1 and M2 types, of which the M1-type promotes inflammation while the M2-type is associated with the regression of inflammation and tissue healing. Mastering the switch of phenotypic transformation of macrophages may be of great help in inhibiting the inflammation of aortic tissue and facilitating tissue healing, as well as the treatment of aortic dissection. In this paper, we focus on the polarization of macrophages and discuss the role of macrophages in aortic dissection, the polarization pathway and the effect of related polarizing agents on the treatment of aortic dissection.
Minimally invasive surgery is the development direction of surgery in the 21st century, and thoracoscopic or laparoscopic skills are essential skills that all surgeons must master. Thoracoscopic or laparoscopic skills training is an important part of surgical resident training. However, there are various methods for thoracoscopic or laparoscopic skill training internationally. The assessment is still in the stage of examiners’ visual observation and subjective evaluation. Here, we reviewed the current research status of thoracoscopic and laparoscopic simulation training and assessment, discussed the development experience and application achievements of Huaxi Intelligent Thoracoscopic Skill Training and Assessment System. We aimed to provide a theoretical basis and practical experience for the development of thoracoscopic or laparoscopic simulation education.
【摘要】 目的 觀察慢性粒細胞性白血病（chronic myelogenous leukemia， CML）急變（blast crisis，BC）患者罕見染色體異常的臨床及實驗室特點。 方法 2010年2月1例患者因咳嗽和高熱來我院就診，采用常規方法檢查患者骨髓細胞，應用R顯帶技術和熒光原位雜交技術分析骨髓細胞核型。 結果 患者具有CML-BC的典型臨床及實驗室特點，同時核型出現不典型t（1；9；22）合并亞二倍體罕見核型異常，臨床表現病情進展快，對伊馬替尼療效差，生存期短。 結論 慢性粒細胞性白血病患者在急變期出現伴不典型Ph染色體的亞二倍體復雜核型為高危核型，此類患者可能存在對伊馬替尼的耐藥，如能取得血液學緩解應盡早接受異基因骨髓造血干細胞移植，爭取獲得長期療效。【Abstract】 Objective To report a case of chronic myelogenous leukemia (CML) blastic transformation into acute myelogenous leukemia with rare atypical hypodiploid t(1;9;22) complex chromosome abnormalities, and to analyze its clinical and laboratory characteristics. Methods A 47-year-old man was referred to our hospital due to cough and high fever in February 2010. We collected and analyzed the patient’s clinical materials, and performed chromosomal karyotype analysis with R-banding and fluorescence in situ hybridization (FISH). Results The patient demonstrated typical clinical and laboratory characteristics of blastic crisis of chronic myelogenous leukemia (CML-BC) and displayed rare atypical hypodiploid t(1;9;22) complex chromosome abnormalities. Meanwhile, the disease was rapidly progressive, with poor response to imatinib and had short overall survival. Conclusions CML-BC patients with hypodiploidy complex chromosome abnormalities are in high risk. They may show drug-resistance to imatinib. Thus, for this type of patients, once the hematological remission is achieved, allogeneic stem cell transplant should be performed as soon as possible to get better opportunity for long-term survival.
Abdominal aortic aneurysm (AAA) is a common lethal aortic disease in clinical practice. At present, the imaging diagnostic methods used for AAA mainly include Doppler ultrasound, computed tomography and magnetic resonance imaging (MRI), but these methods can only observe the morphological changes of the aorta. These techniques used for the risk assessment of aneurysms, such as aneurysm rupture have some certain limitations. With the continuous development of molecular imaging technology and the further understanding of the pathogenesis of AAA, positron emission tomography (PET), molecular MRI and single photon emission computed tomography (SPECT) techniques can be used to observe the pathological changes of the AAA and assess the risk of rupture from cell and molecular level. In this paper, the latest application of PET, molecular MRI, SPECT in the risk assessment was discussed.
Objective To evaluate the application of the Huaxi Intelligent Endoscopic Skill Training and Assessment System in minimally invasive surgery (MIS) skills training and provide insights for optimizing MIS training models, we analyzed trainee performance during training and assessment. Methods A retrospective analysis was conducted on the use of this system across 28 medical institutions from January 2022 to January 2025. Results By January 2025, the standardized deployment of 139 simulation units had been completed. A total of 403 trainees from various surgical specialties, including thoracic surgery and general surgery, participated in five customized endoscopic skill training modules: endoscopic recognition, grasping training, positioning and placement, cutting training, and suturing training. Throughout the training period, a total of 78 participants took part in 27 formal assessments. Correlation analysis based on Spearman showed that pre-assessment training pass rates were significantly correlated with final assessment scores, indicating enhancing the quality of each training module and overall training efficacy is a key to improving the effectiveness of MIS training. Conclusion The Huaxi Intelligent Endoscopic Skill Training and Assessment System effectively supports MIS training and evaluation.
ObjectiveTo review the research status of anti-infective graft materials and analyze their application prospects, in order to provide inspiration for the development of anti-infective vascular endograft. MethodThe research on endovascular anti-infective grafts at home and abroad was reviewed. ResultsThe anti-infective capability of endovascular graft could be achieved through main approaches like modification of the bulk material, surface modification, or a combination of both. In terms of bulk material modification, this paper delved into the creation of antibacterial composite materials by incorporating other materials into primary materials like metals (such as Mg, Zn), biologically derived materials (such as chitosan, silk fibroin, bacterial cellulose), and synthetic polymers (such as graphene and its derivatives, polyurethane, polylactic acid). Examples included Mg-Nd-Zn-Zr alloy, bacterial cellulose/chitosan nanocrystal composites, and chitosan/silk fibroin composites. For surface modifications, inorganic coatings (such as silver, copper, and nitrides) and organic coatings (such as antibiotics, antimicrobial peptides, and anti-infection polymers) had shown promising antibacterial effects in experiments. ConclusionsThe future research focus is how to synthesize the composite graft material with the mechanical properties of ordinary graft and the cell, blood compatibility and antibacterial properties through nano technology. At the same time, how to synthesize coatings with stable long-term anti-infection and anti-bacterial biofilm performance is also considered to be an important direction of future research.
