implantation

摘要： BACKGROUND Laparoscopic myomectomy is increasingly used for resecting gynecological tumors.Leiomyomas require morcellation for retrieval from the peritoneal cavity.However,morcellated fragments may implant on the peritoneal cavity during retrieval.These fragments may receive a new blood supply from an adjacent structure and develop into parasitic leiomyomas.Parasitic leiomyomas can occur spontaneously or iatrogenically;however,trocar-site implantation is an iatrogenic complication of laparoscopic uterine surgery.We describe a parasitic leiomyoma in the trocar-site after laparoscopic myomectomy with power morcellation.CASE SUMMARY A 50-year-old woman presented with a palpable abdominal mass without significant medical history.The patient had no related symptoms,such as abdominal pain.Computed tomography findings revealed a well-defined contrast-enhancing mass measuring 2.2 cm,and located on the trocar site of the left abdominal wall.She had undergone laparoscopic removal of uterine fibroids with power morcellation six years ago.The differential diagnosis included endometriosis and neurogenic tumors,such as neurofibroma.The radiologic diagnosis was a desmoid tumor,and surgical excision of the mass on the abdominal wall was successfully performed.The patient recovered from the surgery without complications.Histopathological examination revealed that the specimen resected from the trocar site was a uterine leiomyoma.CONCLUSION Clinicians should consider the risks and benefits of laparoscopic vs laparotomic myomectomy for gynecological tumors.Considerable caution must be exercised for morcellation to avoid excessive tissue fragmentation.

摘要： OBJECTIVE To evaluate the association of longitudinal changes in physical activity(PA)with long-term outcomes after im-plantable cardioverter-defibrillator(ICD)or cardiac resynchronization therapy defibrillator(CRT-D)implantation.METHODS Patients with ICD/CRT-D implantation from SUMMIT registry were retrospectively analyzed.Accelerometer-de-rived PA changes over 12 months post implantation were obtained from the archived home monitoring data.The primary end-points were cardiac death and all-cause mortality.The secondary endpoints were the first ventricular arrthymia(VA)and first ap-propriate ICD shock.RESULTS In 705 patients,446(63.3%)patients showed improved PA over 12 months after implantation.During a mean 61.5-month follow-up duration,99 cardiac deaths(14.0%)and 153 all-cause deaths(21.7%)occurred.Compared to reduced/un-changed PA,improved PA over 12 months could result in significantly reduced risks of cardiac death(improved PA≤30 min:hazard ratio(HR)=0.494,95%CI:0.288−0.848;>30 min:HR=0.390,95%CI:0.235−0.648)and all-cause mortality(improved PA≤30 min:HR=0.467,95%CI:0.299−0.728;>30 min:HR=0.451,95%CI:0.304−0.669).No differences in the VAs or ICD shocks were observed across different groups of PA changes.PA changes can predict the risks of cardiac death only in the low baseline PA group,but improved PA was associated with 56.7%,57.4%,and 62.3%reduced risks of all-cause mortality in the low,moderate,and high baseline PA groups,respectively,than reduced/unchanged PA.CONCLUSIONS Improved PA could protect aganist cardiac death and all-cause mortality,probably reflecting better clinical efficacy after ICD/CRT-D implantation.Low-intensity exercise training might be encouraged among patients with different baseline PA levels.

摘要： Bioprinting is an emerging additive manufacturing technology that has enormous potential in bone implantation and repair. The insufficient accuracy of the shape of bioprinted parts is a primary clinical barrier that prevents widespread utilization of bioprinting,especially for bone design with high-resolution requirements. During the last five years, the use of computer vision for process control has been widely practiced in the manufacturing field. Computer vision can improve the performance of bioprinting for bone research with respect to various aspects, including accuracy, resolution, and cell survival rate. Hence, computer vision plays a substantial role in addressing the current defect problem in bioprinting for bone research. In this review, recent advances in the application of computer vision in bioprinting for bone research are summarized and categorized into three groups based on different defect types: bone scaffold process control, deep learning, and cell viability models. The collection of printing parameters,data processing, and feedback of bioprinting information, which ultimately improves printing capabilities, are further discussed. We envision that computer vision may offer opportunities to accelerate bioprinting development and provide a new perception for bone research.

摘要： The advancement of surgical technology has greatly improved the capability of clinical treatments in recent decades.Advanced surgical technologies,such as minimally invasive,implantation interventional,and robotassisted surgeries,have been emerging,and bring enormous benefits to patients.While these technologies have been widely employed in clinical applications,the fundamentals of the clinical surgeries can also be interpreted in an engineering term as the processing and manipulation of biological tissues and has been merging with biomechanics,materials science and manufacturing science,although surgical technology may stand and often treated as an individual discipline.

摘要： In the aging populations of China,there is an increasing prevalence of various types of bradycardias that require pacing therapy.In 1958,the first transvenous pacemaker(TVPM)was implanted at Karolinska Hospital in Sweden,which unveiled the era of cardiac pacing therapy.[1]A TVPM includes transvenous electrodes and a pulse gener-ator that is implanted subcutaneously.Despite its obvious benefits,the complication rate associated with TVPM could be as high as 10%.

摘要： Extracellular vesicles(EVs)are nanosized membrane-enclosed compartments that serve as messengers in cell-to-cell communication,both in normal physiology and in pathological conditions.EVs can transfer functional proteins and genetic information to alter the phenotype and function of recipient cells,which undergo different changes that positively affect their structural and functional integrity.Biological fluids are enriched with several subpopulations of EVs,including exosomes,microvesicles(MVs),and apoptotic bodies carrying several cargoes,such as lipids,proteins,and nucleic acids.EVs associated with the reproductive system are actively involved in the regulation of different physiological events,including gamete maturation,fertilization,and embryo and fetal development.EVs can influence follicle development,oocyte maturation,embryo production,and endometrial-conceptus communication.EVs loaded with cargoes are used to diagnose various diseases,including pregnancy disorders;however,these are dependent on the type of cell of origin and pathological characteristics.EV-derived microRNAs(miRNAs)and proteins in the placenta regulate inflammatory responses and trophoblast invasion through intercellular delivery in the placental microenvironment.This review presents evidence regarding the types of extracellular vesicles,and general aspects of isolation,purification,and characterization of EVs,particularly from various types of embryos.Further,we discuss EVs as mediators and messengers in reproductive biology,the effects of EVs on placentation and pregnancy disorders,the role of EVs in animal reproduction,in the male reproductive system,and mother and embryo cross-communication.In addition,we emphasize the role of microRNAs in embryo implantation and the role of EVs in reproductive and therapeutic medicine.Finally,we discuss the future perspectives of EVs in reproductive biology.

摘要： BACKGROUND Transcatheter Aortic Valve Implantation(TAVI)has been shown to provide comparable survival benefit and improvement in quality of life to surgical aortic valve replacement(SAVR)for treating patients with severe aortic stenosis(AS)at intermediate surgical risk.This study aimed to evaluate the cost-utility of TAVI compared with SAVR for severe aortic stenosis with intermediate surgical risk in Thailand.METHODS A two-part constructed model was used to analyze lifetime costs and quality-adjusted life-years(QALYs)from societal and healthcare perspectives.The study cohort comprised severe AS patients at intermediate surgical risk with an average age of 80 years.The landmark trials were used to populate the model in terms of mortality and adverse event rates.All cost-related data and quality of life were based on Thai population.Costs and QALYs were discounted at 3%annually and presented as 2021 values.Incremental cost-effectiveness ratios(ICERs)were calculated.Deterministic and probabilistic sensitivity analyses were conducted.RESULTS In comparison to SAVR,TAVI resulted in higher total cost(THB 1,717,132[USD 52,415.51]vs.THB 893,524[USD 27,274.84])and higher QALYs(4.88 vs.3.98)in a societal perspective.The estimated ICER was THB 906,937/QALY(USD 27,684.27/QALY).From a healthcare system perspective,TAVI also had higher total cost than SAVR(THB 1,573,751[USD 48,038.79]vs.THB 726,342[USD 22,171.63])with similar QALYs gained to the societal perspective.The estimated ICER was THB 933,145/QALY(USD 933,145/QALY).TAVI was not cost-effective at the Thai willingness to pay(WTP)threshold of THB 160,000/QALY(USD 4,884/QALY).The results were sensitive to utility of either SAVR or TAVI treatment and cost of TAVI valve.CONCLUSION In patients with severe AS at intermediate surgical risk,TAVI is not a cost-effective strategy compared with SAVR at the WTP of THB 160,000/QALY(USD 4,884/QALY)from the perspectives of society and healthcare system.

摘要： Background: The traditional culture of eating wood-ash extracts in some countries has led to many health problems.The study assessed the anti-fertility effects of the aqueous wood-ash extract of Parkia biglobosa on female Swissalbino mice. Methods: Healthy female albino mice were procured and randomly grouped into four groups (5/group)where control, 5, 50 and 100 mg/kg doses of the extract were orally administered for 20 days and microscopy ofvaginal smear carried out daily to determine anti-ovulatory activity. Oestrus cycle, including metestrus, diestrus andoestrus phases and histopathology of the uterus were examined daily and at the termination of the experiment.Results: At the end of the study, the highest number of circles (4.80 ± 0.20) was recorded in the control group,administered distilled water, while the lowest number of circles (3.00 ± 0.32) was in the 100 mg/kg dose group.Oestrus (5.80 ± 0.37) also is highest in the control group and lowest (1.20 ± 0.37) in the 100 mg/kg dose group. Thegroup administered 100 mg/kg dose of the aqueous wood-ash extract of Parkia biglobosa had the highest diestrusindex of 45, while the lowest of 17 was obtained in the control group. Histopathology of the uterus tissues shows afew degenerate epithelial cells in 50 mg/kg group and moderate dilatation of lumen and glandular epithelial cells in100 mg/kg group. Conclusion: The study revealed dose-dependent anti-fertility effects of the aqueous wood-ashextract of Parkia biglobosa on female albino mice, which implies its potential reproductive toxicity in humans.

摘要： Objective:To evaluate surgical outcomes after implantation of the Zephyr ZSI 475 inflatable penile prosthesis(IPP)and patients’quality of life.Methods:From December 2014 to September 2018,15 patients underwent prosthesis implantation with ZSI 475.A retrospective review of clinical data was performed.Patients’quality of life after implantation was investigated with Quality of Life and Sexuality with Penile Prosthesis(QoLSPP)questionnaire.Results:The median age of patients was 57 years and the average follow-up time was 22 months.Twelve patients received a standard implantation due to severe erectile dysfunction(ED);three patients also presented penile curvature and additional corporoplasty with grafting was necessary.Three procedures had to be interrupted due to defects of the insertion tools.In one case a manufacturing defect resulted in a pump leak.In one case,a severe postoperative complication occurred,which requested explanation of the device.During the follow-up,four patients experienced mechanical failure of the prosthesis.Results of QoLSPP questionnaire at 12 months were skewed toward the positive end of the scale in all domains.Conclusion:In our initial experience,ZSI 475 suffered a high rate of mechanical failures;on the other hand,the company showed great commitment in order to improve the quality and reliability of the device.The lower cost of ZSI 475 may add to the chances of the product to become a cost-effective alternative to treat those patient who need a IPP.

摘要： Biomedical engineering is a relatively new and exciting branch of life sciences that combines materials,devices,design,and problem-solving engineering with medical and biological sciences in order to improve healthcare treatments,including diagnosis,implantation,monitoring,and therapy.The interdisciplinary field of biomedical engineering is changing the ways in which people interact with the world.From prosthetic limbs to medicine-delivery technology,the pioneering work by biomedical scientists and engineers has been shaking the very foundations of traditional medicines and healthcare treatments.Moreover,the miniaturization of medical equipment has been a major breakthrough,facilitating the development of more advanced wearable devices.