Abstract
Background
A new device has been added to the Chinese MicroHand surgical robot family, developed based on the successful application of control algorithms. As a benefit of using these ...specialized control algorithms, the motion mapping relation can be accommodated into the system without the help of a built-in image system, resulting in a novel Chinese domestic surgical robot with two arms called MicroHand SII, which is different from the former MicroHand S and da Vinci systems. In this study, we investigate the performance of a novel MicroHand SII robotic platform in patients with obesity.
Methods
From March 2018 to April 2019, a total of 7 patients whose BMI ranged from 29.9 to 49.8 kg/m
2
were operated on with the robot-assisted technique using the MicroHand SII surgical system. Data regarding demography, surgical procedure and the 3-month outcome postoperation were collected.
Results
There were 2 female and 5 male patients with a median age (range) of 35 (20–51) years. The median operative time was 160 (149–195) minutes. None were converted to open surgery. All anthropometry indices improved significantly (p < 0.05) at 3 months postoperatively. There were no cases of surgical site infection, gastrointestinal/abdominal bleeding, or conversion to an open operation.
Conclusions
The initial experience showed that the Chinese domestic robot surgical system MicroHand SII could be feasibly and safely applied in sleeve gastrectomy in patients with obesity. Because of the unique design of this system such as a two-hand robot, an array of master–slave motion strategies, and a roll joint at the end of the instruments that allows 7 degrees of freedom, this robotic platform has presented its own obvious advantages.
Background and objectives: Chinese type 2 diabetes mellitus (T2DM) patients are characterized by a low body mass index (BMI), and significant insulin resistance (IR). The triglyceride glucose (TyG) ...index has not been studied as a means of assessing IR in Chinese T2DM patients with a BMI < 35 kg/m2. Materials and Methods: An open-label cross-sectional study recruited 102 Chinese T2DM patients with a BMI < 35 kg/m2. The hyper-insulinemic euglycemic clamp, homeostatic model assessment of IR (HOMA-IR), and TyG index were used to determine the level of IR. Based on Pearson’s correlations, glucose disposal rate (GDR), TyG index, and HOMA-IR were analyzed. HOMA-IR and TyG index for IR were evaluated using multiple linear regression and multivariate logistic regression analyses. On the basis of the receiver operating characteristic (ROC) curve, the sensitivity, specificity, and optimal cut-off value of HOMA-IR and the TyG index were determined. Results: The mean values of GDR, HOMA-IR, and TyG index were 4.25 ± 1.81, 8.05 ± 7.98, and 8.12 ± 0.86 mg/kg/min, respectively. Pearson’s correlation coefficient was −0.418 between GDR and TyG index and −0.324 between GDR and HOMA-IR. ROC curve analysis showed that, among both sexes, the TyG index was a better discriminator of IR than HOMA-IR. The area under the ROC curve (AUC) of the TyG index (0.785, 0.691−0.879) was higher than that of HOMA-IR (0.73, 0.588−0.873) in all genders. The optimal cut-off values of the TyG index and HOMA-IR were 7.99 and 3.39, respectively. Conclusions: The TyG index showed more effectiveness in identifying IR in Chinese T2DM patients with a BMI < 35 kg/m2 compared to HOMA-IR.
Background:
Insulin resistance (IR) is closely associated with the pathogenesis of type 2 diabetes mellitus (T2DM). However, remission of insulin sensitivity after bariatric surgery in patients with ...T2DM and a body mass index (BMI) of 27.5–32.5 kg/m
2
has not been fully elucidated.
Methods:
Thirty-six T2DM patients with a BMI of 27.5–32.5 kg/m
2
were prospectively consecutively recruited for laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). Hyperinsulinemic euglycemic clamp, oral glucose tolerance test (OGTT), and other indicators were tested at baseline and 6 months postoperative. Glucose disposal rate (GDR), time to reach euglycemia, homeostatic model assessment of IR, quantitative insulin sensitivity check index (QUICKI), triglyceride glucose (TyG) index, 30-min insulinogenic index (IGI30), and disposition index (DI) were calculated at baseline and 6 months after surgery. The criterion for remission in T2DM patients was the achievement of the triple composite endpoint.
Results:
Anthropometric and glucolipid metabolism parameters significantly improved following surgery. The GDR increased significantly from baseline to 6 months after LRYGB (from 4.28 ± 1.70 mg/kg/min to 8.47 ± 1.89 mg/kg/min,
p
< 0.0001) and LSG (from 3.18 ± 1.36 mg/kg/min to 7.09 ± 1.69 mg/kg/min,
p
< 0.001). The TyG index decreased after surgery (RYGB group, from 9.93 ± 1.03 to 8.60 ± 0.43,
p
< 0.0001; LSG group, from 10.04 ± 0.79 to 8.72 ± 0.65,
p
= 0.0002). There was a significant reduction in the IGI30 (RYGB group, from 2.04 ± 2.12 to 0.83 ± 0.47,
p
= 0.005; LSG group, from 2.12 ± 1.73 to 0.92 ± 0.66,
p
= 0.001). The mean DI significantly increased from 1.14 ± 1.35 to 7.11 ± 4.93 in the RYGB group (
p
= 0.0001) and from 1.25 ± 1.78 to 5.60 ± 4.58 in the LSG group (
p
= 0.003). Compared with baseline, HOMR-IR, QUICKI, area under the curve-C-peptide release test (AUC-CRT), and AUC-OGTT were significantly changed at 6 months postoperative. Overall, 52.63% of patients in the LRYGB group versus 29.41% of patients in the LSG group achieved the triple composite endpoint.
Conclusion:
Both LRYGB and LSG effectively induced remission of IR in patients with T2DM and a BMI of 27.5–32.5 kg/m
2
.
As a complication of obesity, type 2 diabetes (T2D) is a chronic disease that is difficult to manage. However, bariatric surgery makes it possible to alleviate T2D. While the existing generic index ...glycosylated hemoglobin (HbA1c) is a powerful tool for examining overall blood glucose levels, it still has some limitations as a daily measure of blood glucose levels and as a judge of the effectiveness of bariatric surgery. Using the time-in-range (TIR) measurement and its derivatives is a better way to evaluate short-term blood glucose fluctuations and can be used as a supplement to HbA1c. In this article, we discuss the utility and limitations of HbA1c and other indicators used during surgery. In addition, we mentioned TIR as a novel metric that can act as an accurate predictor of the risk of T2D complications and an index of preoperative risk assessment in bariatric surgery. In contrast to previous indicators, TIR has the advantage that it cannot be affected by caloric restriction to better reflect the patient's glucose level and the level of pancreatic islet function. On this basis, TIR is a promising indicator for both the diagnosis of diabetes and the preoperative and postoperative prediction and evaluation.
The efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes mellitus (T2D) is closely associated with the preoperative body mass index (BMI) of the patient. There is a lack of ...long-term and large sampling evidence on the efficacy of LRYGB in T2D patients with low BMI in China.
This retrospective study aimed to evaluate the efficacy of surgical treatment in a Chinese population with T2D (especially patients with BMI<27.5 kg/m
).
University-affiliated hospital, China METHODS: Seventy-eight patients with T2D were included in the study and evaluated before and after LRYGB surgery. No patients were lost to follow-up at any time points.
Thirty-eight T2D patients with BMI≥27.5 kg/m
in group 1 (high BMI group) had significant improvements in waist circumference, blood glucose levels, homeostasis model assessment-insulin resistance index, and C-peptide levels after LRYGB (P<.05). Forty T2D patients with BMI<27.5 kg/m
in group 2 (low BMI group, including 19 T2D patients with BMI<25 kg/m
) had significant improvements in waist circumference and waist-to-hip ratio after LRYGB (P< .05).
LRYGB surgery may be beneficial in T2D patients with BMI<27.5 kg/m
in China.
The inhibitor of apoptosis protein survivin has a critical regulatory role in carcinogenesis and treatment tolerance in colorectal cancer (CRC). However, the targeted drugs for survivin protein are ...extremely limited. In the present research, we discovered that Tanshinone IIA (Tan IIA) played a dual regulatory role in inhibiting tumorigenesis and reversing 5-Fu tolerance via modulating the expression and phosphorylation of survivin in CRC cells. Mechanistically, Tan IIA suppressed the Akt/WEE1/CDK1 signaling pathway, which led to the downregulation of survivin Thr34 phosphorylation and destruction of the interaction between USP1 and survivin to promote survivin ubiquitination and degradation. Furthermore, Tan IIA significantly facilitated chemoresistant CRC cells to 5-Fu sensitivity. These results revealed that Tan IIA possessed a strong antitumor activity against CRC cells and could act as an up-and-coming agent for treating CRC and overcoming chemotherapy resistance.
Introduction
Optical three‐dimensional scanning devices can produce geometrically accurate, high‐resolution models of patients suitable for clinical use. This article describes the use of a ...metrology‐grade structured light scanner for the design and production of radiotherapy medical devices and synthetic water‐equivalent computer tomography images.
Methods
Following commissioning of the device by scanning objects of known properties, 173 scans were performed on 26 volunteers, with observations of subjects and operators collected.
Results
The fit of devices produced using these scans was assessed, and a workflow for the design of complex devices using a treatment planning system was identified.
Conclusions
Recommendations are provided on the use of the device within a radiation oncology department.
Optical three‐dimensional scanning devices can produce geometrically accurate, high‐resolution models of patients. In this study, the potential application of these models in the design of radiotherapy treatments and devices has been explored by acquiring 173 scans of 26 volunteers. This paper provides a summary of observations made by both subjects and operators, and describes a clinical workflow that could be employed in other departments.
In recent years, magnesium (Mg) ion batteries (MIBs) have gained increasing interest as an alternative to lithium ion batteries because they have excellent volumetric capacity and are less prone to ...dendrite generation. However, the development of MIBs has been limited due to the large polarization of Mg2+ cations and their strong interactions with cathode host materials. On this basis, the exploration of high-performance cathodes has become the top priority for the development of MIBs. This review will focus on the development status of transition metal oxides and transition metal sulfides as cathodes for MIBs from the perspectives of mechanism, performance, and modification strategies and summarize the path for future development.
Display omitted
•This review gives a comprehensive summary of the basic perspectives of transition metal oxide and transition metal sulfide in magnesium-ion batteries.•The advantages and disadvantages of cathode materials with different reaction mechanisms are summarized.•Cathode material modification strategies are discussed.
We prepared a pH-sensitive indicator film incorporating beetroot extract (BTE, 0, 1, 2, and 3%, w/w) encapsulated in pectin from watermelon peel (WMP) to monitor quality changes of chilled beef ...during storage. The results showed that a low BTE content (up to 2%) led to a reduction of oxygen permeability (OP) and water vapor permeability (WVP) and an improvement of mechanical properties. The light transmittance of WMP/BTE films decreased and the thermal stability improved with increasing BTE content. Therefore, a film containing 2% BTE (WMP/BTE2) exhibited the best performance. The release of BTE from the WMP film was controlled by diffusion. In addition to good color stability at natural conditions, the WMP/BTE2 film displayed a colorimetric response at a wide range (3–10) of pH values. The color of the WMP/BTE2 film changed from pink (day 0) to brown (day 8) which was associated with the spoilage of the chilled beef. The above results indicate that WMP/BTE2 has great potential in monitoring the quality of chilled beef.
Display omitted
•A new pH indicator film incorporating pectin from watermelon peels and beetroot extract.•Beetroot extract is a novel pH-sensitive dye showing sensitive color response to pH.•Addition of beetroot extract increases the properties of pectin films.•Films showed sensitive color response to acid and alkaline pH.•These films are suitable to monitor beef spoilage during chilled storage.
Electronic skin can detect minute electrical potential changes in the human skin and represent the body's state, which is critical for medical diagnostics and human–computer interface development. On ...the other hand, sweat has a significant effect on the signal stability, comfort, and safety of electronic skin in a real‐world application. In this study, by modifying the cation and anion of a poly(ionic liquid) (PIL) and employing a spinning process, a PIL‐based multilayer nanofiber membrane (PIL membrane) electronic skin with a dual gradient is created. The PIL electronic skin is moisture‐wicking and breathable due to the hydrophilicity and pore size‐gradients. The intrinsically antimicrobial activities of PILs allow the safe collection of bioelectrical signals from the human body, such as electrocardiography (ECG) and electromyography (EMG). In addition, a robotic hand may be operated in real‐time, and a preliminary human–computer interface can be accomplished by simple processing of the collected EMG signal. This study establishes a novel practical approach for monitoring and using bioelectrical signals in real‐world circumstances via the multifunctional electronic skin.
A dual‐gradient poly(ionic liquid) electronic skin with moisture‐wicking, breathable, and antibacterial properties is prepared. Sweat can be delivered to the outside, away from the skin, keeping the electrode‐skin interface dry, ensuring stable and safe collection of bioelectric signals, further enabling real‐time control of a robotic hand. This work provides an unprecedented practical strategy for monitoring and utilization of bioelectrical signals under real conditions.
PDF
