简介：AbbottLaboratoriesisbettingheartpatientswillbenefitfromanewtypeofarterialstentthatdissolvesawaywhenitisnolongerneeded.Stentsarescaffold-likedevicesusedtopropopenclogged

简介：Anewtechnologythatsimulatestumorshasbeenshowntoperformaswellasresearchanimalsintestingchemotherapydrugs,representingapotentialtoolforscreeningdrugsbeforetreatingapatient.Along-termgoalistoincorporatebiopsiedcancercellsfrompatientsandtesttheeffectivenessofdifferentdrugsonthepatient-derivedcells.

简介：Criticalcardiogenicshockremainsaproblemwithstaggeringmortality,withthebesthopeofsurvivaldependingontimelyandaggressiveintervention.Thisoftenrequirestheuseofextracorporealmechanicalsupportinadditiontovasoactivemedicationstomanagepatientsthroughtheirinitialinsult.Thedecisiontousesuchsupportmustbemadeearlyintheclinicalpresentation,andisbestdoneinamultidisciplinaryfashion.Inthisarticle,wereviewtheliteratureandprovideanalgorithmforthetreatmentofcardiogenicshock.

简介：根据我们的经验，经历割礼的病人主要关于疼痛和阴茎外观被担心。我们进行了未来的使随机化的试用估计一台新可处理的割礼缝术设备(DCSD)的好处。942个病人的一个总数同等地被划分成三个组(常规割礼，商戒指和可处理的缝术设备组)。在DCSD组的病人是有化合物5%lidocaine乳脂的anesthetized，其它与2%lidocaine阴茎块。操作时间，intra起作用的血损失，切口愈合时间，intra起作用、手术后的疼痛，阴茎外观和全面满足度被测量。操作时间和intra起作用的血损失与传统的组相比在商戒指和缝术设备组是显著地更低的(P<；0.001)。Intra起作用的疼痛与另外的二个组相比是在缝术设备组的更少(P<；0.001)；而手术后的疼痛在与另外的二个组相比的传统的组是更高的(P<；0.001)。设备(80.57%)和商戒指(73.57%)组织的在缝术的病人是与常规割礼组相比对阴茎外观满意的更多(20.06%，P<；0.05)。在缝术设备组的病人也比传统的组快显著地愈合了(P<；0.01)。全面满足率在缝术设备组(78.66%)更好与相比常规(47.13%)并且商戒指(50.00%)组(P<；0.05)。DCSD和lidocaine乳脂的联合导致了更短的操作和切口愈合时间，减少了intra起作用、手术后的疼痛并且改进了对化妆外观的耐心的满足。

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简介：Inthispaper,theautocontrolofthesimulationdeviceofsystematiccirculatorysystemwillbepresented.Thepressureandcardiacoutputofsimulationsystemwillbeadjustedtopredeterminatevalueinphysiologicalarea.Thispaperisbasedonfullyunderstandingofphysicalsimulatorytheoriesanddevicedesignofhumancardiovas-cularsystemandthebasicspecificpropertiesofsimulationsystem.Non-linearityexsitsinthissystem,anditisamulti-inputandmulti-outputsystem.Inthemean-time,simulativesystemhasspecialpropertyoftime-lagandtime-variant.Theideaof

简介：Palliativecareisthereliefofsymptomswithoutdealingwiththeunderlyingcause,e.g.useofanalgesia,torelievepain.Theuseofsuchanagentalleviatesthesymptomswithoutcuringtheunderlyingdisease.Thisisthetypeofcareforpatientswithseriousillnesses.Itfocusesonimprovingqualityoflife,notjustinyourbody,butalsoinyourmindandspirit.Thereisathinlinebetweenpalliativecareandhospicecare.

简介：Theclinicalexploitationofelectricallystimulatedskeletalmusclecirculationas-sistant(SMCA)isanewtechnologyinlater80’s.Itismainlyusedforadvancedstageheartfailureandprogressiveheartdiseases.Thiskindofheartdiseaseshasahigherincidenceanditsdeathrateoccupiesfirstplaceinallkindsofheartdiseases.Thetreatmentsuchashearttransplantingisrestrictedbycertaincircumstances,soitcannotbeusedingeneral.ThewayofSMCAcanavoidmanydisadvantagessuchasex-

简介：AbstractBackground:Applying ultrasonic imaging system during surgery requires the poring of saline, performing the measurement, and acquiring data from its display—which requires time and is highly "performer dependent," i.e., the measure is of a subjective nature. A new ultrasonic device was recently developed that overcomes most of these drawbacks and was successfully applied during tumor-in-brain neurosurgeries. The purpose of this study was to compare the two types of US devices and demonstrate their properties.Methods:The study was performed in the following stages: (i) an ex vivo experiment, where slices of the muscle and brain of a young porcine were laid one on top the other. Thicknesses and border depths were measured and compared, using the two types of US instruments. (ii) During human clinical neurosurgeries, tumor depth was compared by measuring it with both devices. (iii) Following the success of stages (i) and (ii), using solely the new US device, the tumor thickness was monitored while its resection. Correlation, Pearson’s coefficient, average, mean, and standard deviation were applied for statistical tests.Results:A high correlation was obtained for the distances of tissue borders and for their respective thicknesses. Applying these ultrasonic devices during neurosurgeries, tumor depths were monitored with high similarity (87%), which was also obtained by Pearson’s correlation coefficient (0.44). The new US device, thanks to its small footprint, its remote measurement, and the capability of monitoring intraoperatively and in real-time, provides the approach to tumor’s border before its complete resection.Conclusions:The new US device provides better accuracy than an ultrasonic imaging system; its data is objective; it enables to control the residual tumor thickness during its resection, and it is especially useful in restricted areas. These features were found of great help during a tumor-in-brain surgery and especially in the final stages of tumor’s resection.

简介：AbstractPurpose:Treatment of irreducible femoral intertrochanteric fractures often requires open reduction. However, the technique unavoidably causes patients to suffer greater trauma. As such, minimally invasive techniques should be employed to reduce the surgical-related trauma on these patients and maintain a stable reduction of the fractures. Herein, a minimally invasive wire introducer was designed and used for the treatment of femoral intertrochanteric fractures. The effectiveness of using a wire-guided device to treat irreducible femoral intertrochanteric fractures was evaluated.Methods:Between 2013 and 2018, patients with femoral intertrochanteric fractures who were initially treated by intramedullary nail fixation but had difficult reduction using the traction beds were retrospectively reviewed. Decision for an additional surgery was based on the displacement of the fracture. The patients were then divided into two groups: those in the control group received an open reduction surgery while those in the observation group received a closed reduction surgery using a minimally invasive wire introducer to guide the wire that could assist in fracture reduction. The operation time, blood loss, visual analogue scale scores, angulation, reduction, neck-shaft angle, re-displacement, limb length discrepancy, and union time were then recorded and analyzed to determine the efficiency of the wire introducer technique. Categorical variables were analyzed by using Chi-square test, while continuous variables by independent t-test and the Mann-Whitney test accordingly.Results:There were 92 patients included in this study: 61 in the control group and 31 in the observation group. There were no significant differences in baseline demographic factors between the two groups. All surgeries were successful with no deaths within the perioperative period. The average follow-up time for the patients was 23.8 months. However, the observation group had a significantly shorter operation time, lower visual analogue scale score, less intraoperative bleeding, and shorter fracture healing time. There were no significant differences in the angulation, reduction, neck-shaft angle, and limb length discrepancy between the two groups.Conclusion:The minimally invasive wire guide achieved a similar effect to that of open reduction in the treatment of intertrochanteric fractures with difficult reduction. Moreover, the minimally invasive wire introducer is a good technology that accurately guides the wire during reduction. Indeed, it is an effective technique and achieves good clinical outcomes in restoration of irreducible femoral intertrochanteric fractures.

简介：ObjectivesToevaluatethefeasibilityandsafetyofdistalprotectiondevice(PercuSurge)duringpercutaneouscoronaryintervention(PCI)inpatientswithacutecoronarysyndrome.MethodsFromOctober2004toAugust2007,40patientswithhighriskacutecoronarysyndromewhoreceivedprimarycoronaryinterventionwereincludedinthisstudy.PatientsweredividedintotwogroupsaccordingtowhetherPercuSurgewasattemptedduringPCI.Thebasicclinicalcharacteristics,angiographicresults,andfollow-updatabeforedischargewerecompared.Coronaryarteriesbloodflowthrombolysisinmyocardialinfarction(TIMI)grade,TIMImyocardialperfusion(TMP)gradeandtherateofno-reflowwereperformedinallcasesafterPCI.ResultsTherewasnosignificantdifferencebetweenthetwogroupsinbasicclinicalcharacteristicsandangiographybeforePCI(P>0.05).AllpatientsunderwentPCIsuccessfullyinbothgroups.InthePercuSurgegroup,PCIwithPercuSurgeguardwireprotectionwasperformedsuccessfullyin18patients.TherewassignificantdifferencebetweenthetwogroupsinTIMI3flowsgainedintargetvesselsafterPCI.BetterpercentageofTMPgrade3oftargetvesselswasachievedinPercuSurgegroup.Lessno-reflowwerefoundinPercuSurgegroup.TherewerelowerpeaktroponinIandserumMBisoenzymeofcreatinekinaselevels,higherleftventricularejectionfractionandsmallerleftventricularend-diastolicdimensioninthePercuSurgegroupafterPCIatthedatebeforedischarge(P<0.05).TherewasnomajoradversecardiaceventsinPercuSurgegroup,onlyonepatientdiedinthecontrolgroup.ConclusionsThisstudydemonstratesthatusingthePercuSurgeGuardwiresystemduringPCIinhighriskacutecoronarysyndromepatientstopreventno-reflowisfeasibilityandsafety.

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简介：ObjectiveToevaluatereliabilityandsafetyofAngio-sealhemostasisdeviceappliedtothefemoralarterialpuncturesiteafterpercutaneouscoronaryintervention(PCI).MethodsIn40patientsafterPCIinourinstituteduringtheperiodbetweenMay2002andDecember2003,Angio-sealdevicewereusedtosealthefemoralarterialpuncturesite.ResultsAlltheAngiosealdevicesweresuccessfullydeployedin40patients(successfulrate;100%);themeantimetohemostasiswas45±12sec;themeantimetoambulateafterangiosealclosurewas1.9?.5hours.Nomajorgroinandsystemiccomplicationwasobserved.Therewasminorgroinoozingin2casesandsmallhemotomain1patient.ConclusionsAngio-sealclosuredeviceofthefemoralarterypuncturesiteafterapercutaneouscoronaryprocedureissafe.Itcanshortenthetimetohemostasis,leadstoearlymobilization,andreducegroincomplication.Thedisadvantageisrelativelyexpensive.

简介：因为输精管切除术的不可避免的复杂并发症，这研究被承担与一个微型外科的方法与没有解剖刀输精管切除术(NSV)相比植入进管腔的一台nonobstructiveintravas设备(IVD)估计男消毒的功效和安全。IVD被分成二种类型：而，IVD-B让一条尾巴使用了修理到管deferens(固定翅膀)IVD--A不做。multicenter未来的使随机化的控制临床的审判在中国被进行。学习由寻求输精管切除术的1459个男志愿者组成随机被分到IVD--一(n=487)，IVD-B(n=485)或NSV(n=487)组并且经历了操作。包括的后续在3rd-6th和12th手术后的月。对这些题目的评价包含了常规物理考试(包括的将军和andrological考试)和精液分析。subjects’；搭挡们也经历了监视因为由月刊的怀孕关于月经会见，如果必要，尿测试。处于怀孕率没有重要差别(0.65%为IVD--一，0为IVD-B并且0.21%为NSV)在三个组之中(P>；0.05)。在12th手术后的月分别地在三个组是零，0.9%和1.7%。在结论，IVD男消毒展出长期的不利事件的低风险并且被发现作为一个男消毒方法有效，类似于NSV技术。IVD男消毒被期望是一个新奇避孕方法。

简介：AbstractPurpose:The main aim is to provide clinical reference for the application of mini suture anchor in the reduction and fixation of displaced temporomandibular joint (TMJ) disc with intracapsular condylar fracture.Methods:From October 2018 to October 2019, 21 patients (31 sides) with intracapsular condylar fractures and articular disc displacement from West China Hospital of Stomatology, Sichuan University were included. The selection criteria were: (1) mandibular condylar fractures accompanied by displacement of the TMJ disc, confirmed by clinical examination, CT scan and other auxiliary examinations; (2) indication for surgical treatment; (3) no surgical contraindications; (4) no previous history of surgery in the operative area; (5) no facial nerve injury before the surgery; (6) informed consent to participate in the research program and (7) complete data. Patients without surgical treatment were excluded. The employed patients were followed up at 1, 3, 6 and 12 months after operation. Outcomes were assessed by success rate of operation, TMJ function and radiological examination results at 3 months after operation. Data were expressed as number and percent and analyzed using SPSS 19.0.Results:All the surgical procedures were completed successfully and all the articular discs were firmly attached to the condyles. The articular disc sufficiently covered the condylar head after the fixation. The fixation remained stable when the mandible was moved in each direction by the surgeons. No complications occurred. The functions of the TMJ were well-recovered postoperatively in most cases. CT scan revealed that the screws were completely embedded in the bone without loosening or displacement.Conclusion:Mini suture anchor can provide satisfactory stabilization for the reduced articular disc and also promote the recovery of TMJ functions.

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简介：Despitewidespreadawarenessanduseofscientificallyprovenlife-prolongingmedicalanddevice-basedtherapiesoverthelasttwodecades,heartfailureremainsaleadingcauseofmorbidity,mortality,andhealthcareexpenditureintheUnitedStates.Mechanicalcirculatorysupportwithacontinuous-flowleftventricularassistdevice(CF-LVAD),eitherasabridgetohearttransplantationorasdestinationtherapy,isanincreasinglyusedtreatmentmodalityforpatientswithadvancedheartfailuresyndromesthatworsendespitetheirreceivingstandardtherapies.CF-LVADsupportcreatesuniquehemodynamicalterationsthatmustbeunderstoodtoprovideappropriatecareforthesepatientsbeforeandafterimplantation.EchocardiographyisessentialintheevaluationofpatientswhoarebeingconsideredfororaremechanicallysupportedbyCF-LVADs.Hereweprovideafocusedclinicalreviewontheuseofechocardiographyintwomainaspectsoftheevaluationofthesepatients:(a)optimalpatientselectionforCF-LVADsupportand(b)followupassessmentofoptimalpumpfunction.

简介：AbstractBackground:It remains unclear whether the outcomes of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI) during off-hours are as favorable as those treated during on-hours, especially those with a first medical contact-to-device (FMC-to-device) time within 90 min. We aimed to determine whether off-hours admission impacted late outcomes in patients undergoing PPCI and with an FMC-to-device time ≤90 min.Methods:This multicenter retrospective study included 670 STEMI patients who underwent successful PPCI and had an FMC-to-device time ≤90 min from 19 chest pain centers in Beijing from January 2018 to December 2018. Patients were divided into on-hours group and off-hours group based on their arrival time. Baseline characteristics, clinical data, and key time intervals during treatment were collected from the Quality Control & Improvement Center of Cardiovascular Intervention of Beijing by the "Heart and Brain Green Channel" app.Results:Overall, the median age of the patients was 58.8 years and 19.9% (133/670) were female. Of these, 296 (44.2%) patients underwent PPCI during on-hours and 374 (55.8%) patients underwent PPCI during off-hours. Compared with the on-hours group, the off-hours group had a longer FMC-to-device time and fewer patients with FMC-to-device time ≤60 min (P < 0.05). During the mean follow-up period of 24 months, a total of 64 (9.6%) participants experienced a major adverse cardiovascular event (MACE), with 28 (9.1%) in the on-hours group and 36 (9.6%) in the off-hours group (P > 0.05). According to the Cox regression analyses, off-hours admission was not a predictor of 2-year MACEs (P = 0.788). Similarly, the Kaplan-Meier curves showed that the risks of a MACE, all-cause death, reinfarction, and target vessel revascularization were not significantly different between the two groups (P > 0.05).Conclusions:This real-world, multicenter retrospective study demonstrated that for STEMI patients who underwent PPCI within 90 min, off-hours admission was safe, with no difference in the risk of 2-year MACEs compared with those with on-hours admission.

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