In vivo quantification of fluorescent molecular markers in real-time: A review to evaluate the performance of five existing methods

With the advent of molecular-targeted fluorescent markers, there is a renewed interest in fluorescence quantification methods that are based on continuous wave excitation and multi-spectral image acquisition. However, little is known about their in vivo quantification performance. We reviewed the performance of five selected methods by analytically describing these and varying input parameters of irradiance, excitation geometry, collection efficiency, autofluorescence, melanin content, blood volume, blood oxygenation and tissue scattering using optical properties representing those for human skin. We identified one method that corrects for variations in all parameters. This requires image acquisition before and after marker administration, under identical geometry. Hence, it is suited for applications where the site of interest can be relocated (e.g. anaesthetized animals and dermatology). For applications where relocation is not possible, we identified a second method where the uncertainty in the fluorescence signal was ±20%. Hence, use of these methods can substantially aid in vivo fluorescence quantification compared to use of the raw fluorescence signal, as this changed by more than 3 orders of magnitude. Since these methods can be computed in real-time, they are of particular interest for applications where direct feedback is critical, as diagnostic screening or image-guided surgery.     

Planning for minimally invasive unicompartmental knee arthroplasty

Unicompartmental knee arthroplasty (UKA) is considered the treatment of choice in patients with single compartment arthritis of the knee at early stages or with osteonecrosis limited to one compartment. However, results in the literature are still controversial and it is a technically difficult procedure. The main goal of UKA is to restore the articular space of the afflicted compartment, without influencing the limb alignment. Selection of patients and pre-operative planning are crucial. The necessity to improve functional results and to reduce immobilization of the patients has led to the development of minimally invasive surgery. Applied to UKA, this approach reduces blood loss and surgical time, causes fewer symptomatic postoperative complications, and permits earlier recovery compared to the traditional incision. The shorter incision makes careful pre-operative planning essential. We briefly review the indications for UKA, the pre-operative clinical and radiological assessment, and the surgical procedure. Proocedings of the Consensus Conference “TSS in hip and knee replacement” (Rapallo, Italy 22–24 June 2006)     

鼻胃管胃肠减压在择期腹部手术中的应用价值

鼻胃管胃肠减压曾被常规应用于择期和急诊的腹部手术后，目的是预防急性胃扩张的发生、治疗梗阻、降低吻合口压力等。但是，鼻胃管置入也会带来一些副作用，如呼吸道并发症、胃-食道反流、体液和电解质的丢失、声带的损伤，以及越来越被重视的患者的不适感。近年来的研究结果也对择期的腹部手术后常规应用鼻胃管胃肠减压提出不同的看法。现重新评价应用鼻胃管胃肠减压的理论基础及相关临床研究的结果，并对鼻胃管胃肠减压在择期腹部手术中的价值作一综述。     

TSS and traditional surgery in hip and knee replacement

Surgery passes through a continuous evolution, thanks to the introduction of new technologies and techniques. Tissue-sparing surgery is a concept introduced in the last years to address prosthetic surgery to a more conservative fashion. We discuss the TSS decalogue with a critical eye, pointing out how traditional surgery is evolving in accordance with TSS statements. Proceedings of the Consensus Conference “TSS in hip and knee replacement”, Rapallo, Italy, 22–24 June 2006     

可吸收性医用珊瑚人工骨的致突变性研究

目的评价珊瑚人工骨的遗传毒性。方法采用Ames试验;细胞染色体畸变试验和小鼠骨髓细胞微核试验。结果不同浓度的浸提液加与不加S9mix条件下Ames试验;细胞染色体畸变试验以及微核试验与阴性对照组比较无显著差异,结果为阴性。结论在本试验系统条件下,可吸收性珊瑚人工骨无致突变作用。     

平板运动试验阴性患者最大ST/HR斜率对冠心病的诊断价值

目的探讨平板运动试验阴性患者最大ST/HR斜率对冠心病的诊断价值.方法选择122例平板运动试验阴性而临床有明显冠心病指征的患者进行冠状动脉造影,测定其最大ST/HR斜率.结果平板运动试验阴性患者最大ST/HR斜率诊断冠心病的敏感性为68.2%,特异性为80.8%,准确性为76.2%;运动峰值心率＜预计最大心率之85%组最大ST/HR斜率诊断冠心病的敏感性为92.8%,特异性为86.7%,准确性为89.7%,高于运动峰值心率≥预计最大心率之85%组.结论平板运动试验阴性患者最大ST/HR斜率对冠心病的临床诊断有较高的敏感性、特异性和准确性,尤其是对低运动水平的患者,对减少运动试验诊断的漏诊率具有重要意义.     

经尿道电气化手术治疗112例膀胱肿瘤的临床分析

目的 :探讨经尿道电气化手术治疗病变局限于膀胱壁内肿瘤的治疗方法。方法:综合采用套切、勾切、气化、凝切及电凝、封闭闭孔神经等技术 ,经尿道根治性电气化手术切除膀胱肿瘤 112例。结果:2例因膀胱穿孔改行开放手术 ,7例需 2次手术完全切除肿瘤 ,全部病例均达到根治性切除目的 ,术后平均留置尿管 3～ 7d。结论 :经尿道电气化切除手术适宜病变局限于膀胱壁内肿瘤的根治性治疗。     

IL-4与IL-10联合诱导异种骨移植免疫耐受的体外研究

目的　探讨 IL - 4和 IL - 10在诱导异种骨移植免疫耐受中的作用。方法　反应细胞为 BAL B/c小鼠脾淋巴细胞 ,刺激细胞为新西兰白兔血淋巴细胞 ,刺激抗原为兔骨上清液。采用经典的混合淋巴细胞培养法及骨上清液与淋巴细胞混合培养法作为异种骨移植的体外实验模型。在各培养液中分别加入 IL - 4、IL - 10及两者联合应用 ,通过测定其 3H- Td R掺入率 ,观察不同细胞因子对刺激淋巴细胞增殖的影响。结果　无论在细胞刺激组还是骨上清液刺激组 ,IL- 4对淋巴细胞增殖均有显著抑制作用 (P<0 .0 0 1和 P<0 .0 5 ) ,IL- 10未表现出抑制作用 (P>0 .0 5 )。在两组 IL- 4和 IL - 10联合应用均产生比 IL - 4单独应用更为明显的细胞增殖抑制作用 (P<0 .0 0 1和 P<0 .0 5 )。结论　 IL - 4对由细胞或骨上清液刺激产生的淋巴细胞增殖均有很好的抑制作用 ,IL- 10没有表现出抑制作用 ;IL- 4与 IL- 10联合应用有协同抑制作用。     

后腹腔镜下肾肿瘤剜除术的临床疗效观察(附5例报告)

目的：探讨后腹腔镜下肾肿瘤剜除术的操作要点及临床价值。方法：采用后腹腔镜下肾肿瘤剜除术治疗肾肿瘤5例，其中肾癌3例，肾错钩瘤2例，瘤体直径1．5～4．0cm。具体方法是：①暴露瘤体和肾动脉；②采用硅胶管牵拉肾动脉，必要时可暂时阻断肾动脉；③于瘤体1cm正常肾组织处用电钩切除瘤体；④采用生物蛋白胶、止血纱布缝合加压处理创面出血。结果：手术均获成功。手术时间150～210min，术中出血80～350ml。术后1～2天肠道功能恢复并可床上活动，1～4天可下床活动。术后住院5～9天，平均7天。结论：后腹腔镜下肾肿瘤剜除术具有创伤小、康复快、安全、住院时间短等优点；对外生性生长、直径小于4cm瘤体，该法可作为首选手术方法。