这项研究得到了日本医学研究与开发机构 （AMED） 在疾病研究综合神经技术脑图 （Brain/MINDS） 项目（资助号 JP23dm0207001）下的部分支持。

本研究经 RIKEN（日本埼玉县）动物实验委员会批准 （W2023-2-041） 进行，并根据动物实验机构指南进行。在本研究中，使用了 6 只雌性狨猴 （2-6 岁）。
1. 开始治疗的标准
<ol><li>当符合以下任何一项标准时开始治疗： i） 体重< 300 克或每月体重减少 >20 克;ii） 低白蛋白血症（血清白蛋白 < 3.8 g/dL）;iii） 贫血（血细胞比容< 35%）;iv） 无 艰难梭菌、肠致病性 大肠杆菌或肠道原生动物的慢性腹泻;v） 肌肉质量明显减少。 注意：由于脱水和随后的血液浓缩伴随着 WMS，受影响动物的血清白蛋白和血细胞比容值可能会人为升高。</li>
</ol>2. 口服
<ol><li>将 0.1 mL 铁制剂（参见 材料表）与一块海绵蛋糕混合。</li>
	<li>将土豆泥喂给处理过的狨猴。 注意： 确保处理过的狨猴已完全吞下醪糟。</li>
</ol>3. 皮下给药
<ol><li>轻轻握住尾巴，将受 WMS 影响的狨猴捕捉到家笼中。</li>
	<li>用另一只手从后面握住动物的上半身。</li>
	<li>将动物带到治疗室。</li>
	<li>让动物紧贴助手的胸部或手臂。</li>
	<li>用酒精棉签清洁动物的背部区域。</li>
	<li>使用 0.1 G 针头将 26 mL 氨甲环酸（5% 溶液，参见 材料表）皮下注射到背部，每周 5 次。</li>
	<li>使用 5.0 G 针头皮下注射 0.1 mL 乳酸林格氏液（见 材料表）和 26 mL 维生素制剂（见 材料表），每周 3 次。 注意：每次注射应在 1 分钟内在每个不同的位置进行。</li>
</ol>4. 氨基酸制剂的静脉给药
<ol><li>轻轻握住尾巴，将受 WMS 影响的狨猴捕捉到家笼中。</li>
	<li>用另一只手从后面握住动物的上半身。</li>
	<li>将动物带到治疗室。</li>
	<li>让助手握住双臂的根部来约束动物的上半身，用另一只手握住双腿的根部来约束下半身。让助手将束缚动物下半身的拇指放在动物膝盖的前侧，以防止其弯曲。</li>
	<li>用酒精棉签清洁动物的小腿。</li>
	<li>使用 2.0 G 蝶形针每周 3 次，通过大隐静脉静脉注射 27 mL 氨基酸制剂（参见 材料表）。 注意：注射必须尽可能缓慢地进行，最长可达 2 分钟。</li>
	<li>注射后，让助手用脱脂棉按压该区域，直到出血停止。</li>
</ol>5. 体重测量
<ol><li>治疗后（静脉内和/或皮下注射），每周用手提箱称量动物体重以监测体重。 注意：大约在同一时间称量狨猴的体重，因为体重会受到食物存在的影响。</li>
</ol>6. 全血细胞计数 （CBC） 分析和血清化学测试
<ol><li>轻轻握住尾巴，将受 WMS 影响的狨猴捕捉到家笼中。</li>
	<li>用另一只手从后面握住动物的上半身。</li>
	<li>将动物带到治疗室。</li>
	<li>让助手握住双臂的根部来约束动物的上半身，用另一只手握住任一条腿的根部来约束下半身。</li>
	<li>请医生握住没有束缚的动物腿。</li>
	<li>用酒精棉签清洁动物的腹股沟区域。</li>
	<li>每月使用 0.4 G 针头从股静脉收集 26 mL 血液。</li>
	<li>使用 0.05 mL 血样进行 CBC 分析，包括血细胞比容。</li>
	<li>让其余的血样在室温下静置 1 小时，并以 1,800 × g 离心 20 分钟。</li>
	<li>使用血清进行化学测试，包括白蛋白。 注：通过尽量减少血清化学测试的参数数量，可以减少血样的体积。根据个体狨猴的情况调整血样的体积。</li>
</ol>

一种治疗消瘦性狨猴综合征的有效改良方法

<ol>
	<li>Baxter, V. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Serum+albumin+and+body+weight+as+biomarkers+for+the+antemortem+identification+of+bone+and+gastrointestinal+disease+in+the+common+marmoset.">Serum albumin and body weight as biomarkers for the antemortem identification of bone and gastrointestinal disease in the common marmoset.</a> PLoS ONE. 8 (12), e82747 (2013).</li><li>Brack, M., Rothe, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chronic+tubulointerstitial+nephritis+and+wasting+disease+in+marmosets+(Callithrix+jacchus).">Chronic tubulointerstitial nephritis and wasting disease in marmosets (Callithrix jacchus).</a> Vet Pathol. 18, 45-54 (1981).</li><li>Chalifoux, L. V., Bronson, R. T., Escajadillo, A., McKenna, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+analysis+of+the+association+of+gastroenteric+lesions+with+chronic+wasting+syndrome+of+marmosets.">An analysis of the association of gastroenteric lesions with chronic wasting syndrome of marmosets.</a> Vet Pathol Suppl. 7, 141-162 (1982).</li><li>Logan, A. C., Khan, K. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+pathologic+changes+in+two+marmosets+with+wasting+syndrome.">Clinical pathologic changes in two marmosets with wasting syndrome.</a> Toxicol Pathol. 24 (6), 707-709 (1996).</li><li>Ludlage, E., Mansfield, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+care+and+diseases+of+the+common+marmoset+(Callithrix+jacchus).">Clinical care and diseases of the common marmoset (Callithrix jacchus).</a> Comp Med. 53 (4), 369-382 (2003).</li><li>Ross, C. N., Davis, K., Dobek, G., Tardif, S. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aging+phenotypes+of+common+marmosets+(Callithrix+jacchus).">Aging phenotypes of common marmosets (Callithrix jacchus).</a> J Aging Res. 2012, 567143 (2012).</li><li>Yoshimoto, T., Niimi, K., Takahashi, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Curative+effects+of+tranexamic+acid+with+supportive+measures+on+wasting+marmoset+syndrome.">Curative effects of tranexamic acid with supportive measures on wasting marmoset syndrome.</a> Comp Med. 66 (6), 1-6 (2016).</li><li>Niimi, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measurement+of+the+&#945;1-proteinase+inhibitor+(&#945;1-antitrypsin)+of+common+marmoset+and+intestinal+protein+loss+in+wasting+syndrome.">Measurement of the &#945;1-proteinase inhibitor (&#945;1-antitrypsin) of common marmoset and intestinal protein loss in wasting syndrome.</a> Biosci Rep. 39 (7), 20190562 (2019).</li><li>Otovic, P., Smith, S., Hutchinson, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+glucocorticoids+in+marmoset+wasting+syndrome.">The use of glucocorticoids in marmoset wasting syndrome.</a> J Med Primatol. 44 (2), 53-59 (2015).</li><li>Turner, P. V., Brabb, T., Pekow, C., Vasbinder, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Administration+of+substances+to+laboratory+animals:+routes+of+administration+and+factors+to+consider.">Administration of substances to laboratory animals: routes of administration and factors to consider.</a> J Am Assoc Lab Anim Sci. 50 (5), 600-613 (2011).</li><li>Lewis, S. M., Hotchkiss, C. E., Ullrey, D. E., Wolfe-Coote, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chapter+13.+Nutrition+and+nutritional+diseases.">Chapter 13. Nutrition and nutritional diseases.</a> The Laboratory Primates. , 181-208 (2005).</li></ol>

作者没有需要披露的利益冲突。

2016 年，我们报道了氨甲环酸联合支持措施是 WMS 的有效治疗方法，这是第一篇证明 WMS 治疗不使用糖皮质激素的报告。在人类中，糖皮质激素被认为是治疗 IBD 最有效的药物。然而，普莱多唑酮是最常用的糖皮质激素之一，由于其不良反应，不适合 WMS 治疗。尽管据报道，布地奈德是一种糖皮质激素，用于治疗 WMS9，但该疗法对急性 WMS 的动物相对无效。氨甲环酸是一种具有抗炎作用的纤溶酶抑制剂，在我们原来的方法中没有发现明显的副作用。然而，尽管最初的治疗方案肯定有效，但它给动物和护理人员带来了沉重的负担。
在本研究中，进行了改良的 WMS 治疗方法，以减少动物的生理负荷和照顾者的工作量。在改良的方法中，氨甲环酸的给药途径发生了变化 （从腹膜内到皮下），这有助于降低腹部器官损伤的风险。在本实验步骤中未稀释氨甲环酸溶液，以降低污染风险和制备时间。在原始方法中，静脉注射 3.0 mL 氨基酸制剂。然而，体积有点大，因为建议以 5.0 mL/kg 作为10 次推注给药。因此，在修改后的方法中体积减小。 
该方案中使用的维生素制剂含有维生素 B 和 C。在原始方法中，0.5 mL 的维生素制剂含有 2.5 mg 盐酸硫胺素，是实验室饲养的断奶后非人灵长类动物所需量的 2.5 倍11。在本方法中，施用 0.1 mL 维生素制剂，其中含有 1.0 mg 盐酸硫胺素。在改良的方法中，铁制剂和氨甲环酸溶液的给药频率降低，这有助于减轻动物和护理人员的负担。 
如代表性结果部分所述，修改后的方法具有显著的处理效果。平均治疗期限为 37.8 ± 25.34 d，短于原始方法 （56 d）。由于狨猴对精神压力敏感，因此长期治疗对动物产生相反的效果，例如食欲下降。因此，我们建议护理人员不仅应根据每个参数的值，还应根据动物的行为来全面决定治疗终止的时间。

消耗性狨猴综合征 （WMS） 是一种严重的疾病，是圈养普通狨猴群落所特有的。主要症状是体重减轻、肌肉量减少、贫血、低白蛋白血症和慢性肠炎 1,2,3,4。一些研究报告说，60.5% 的安乐死圈养狨猴有慢性肠炎的证据 5,31-44% 的死亡与这种疾病有关6。这种疾病的高患病率需要其有效治疗。
2016 年，我们报道了氨甲环酸联合支持措施是 WMS7 的有效治疗方法。此外，这种处理显着减轻了受 WMS 影响的狨猴的肠道蛋白丢失8。虽然最初的治疗方案肯定有效，但它包括一些高容量的静脉注射、高剂量的维生素制剂和日常约束。由于狨猴容易受到手捕捉和束缚，因此这些动作必须不那么频繁。因此，我们的目标是通过一些修改来减轻动物的负担。
在本文中，我们将提供修改后的方法：每周 5 次皮下注射未稀释的氨甲环酸（代替腹膜内注射 5 倍稀释的氨甲环酸溶液，每周 7 次），静脉注射 2.0 mL 氨基酸制剂（代替 3.0 mL），皮下注射维生素 0.1 mL（代替 0.5 mL）， 和每周 5 次口服铁制剂（而不是每周 7 次）。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>1.0 mL Syringe</td>
			<td>Terumo Corporation, Tokyo, Japan</td>
			<td>SS-01T</td>
			<td>For subcutaneously injection of Tranexamic acid</td>
		</tr>
		<tr>
			<td>10 mL Syringe</td>
			<td>Terumo Corporation, Tokyo, Japan</td>
			<td>SS-10SZ</td>
			<td>For Intravenous Administration of Amino acid formulation</td>
		</tr>
		<tr>
			<td>26 G Needle</td>
			<td>Terumo Corporation, Tokyo, Japan</td>
			<td>NN-2613S</td>
			<td>For subcutaneously injection</td>
		</tr>
		<tr>
			<td>27 G Butterfly Needle Type D</td>
			<td>Terumo Corporation, Tokyo, Japan</td>
			<td>SV-27DL</td>
			<td>For Intravenous Administration of Amino acid formulation</td>
		</tr>
		<tr>
			<td>5 mL Syringe</td>
			<td>Terumo Corporation, Tokyo, Japan</td>
			<td>SS-05SZ</td>
			<td>For subcutaneously injection of Ringer&#39;s lactate and Vitamin formulation</td>
		</tr>
		<tr>
			<td>Aminoleban Injection</td>
			<td>Otsuka Pharma Factory Inc., Tokyo, Japan</td>
			<td>1942</td>
			<td>For subcutaneously injection of Ringer&#39;s lactate and Vitamin formulation</td>
		</tr>
		<tr>
			<td>C-PARA</td>
			<td>Takata Pharma Co., Ltd., Saitama, Japan</td>
			<td>120-31960-0</td>
			<td>Vitamin formulation</td>
		</tr>
		<tr>
			<td>FCV Liquid</td>
			<td>Minerva Corporation, Saitama, Japan</td>
			<td></td>
			<td>Iron formulation</td>
		</tr>
		<tr>
			<td>Lactec Injection</td>
			<td>Otsuka Pharma Factory Inc., Tokyo, Japan</td>
			<td>0714</td>
			<td>Ringer&#8217;s lactate&#160;</td>
		</tr>
		<tr>
			<td>Vasolamin Injection</td>
			<td>Meiji Seika Pharma Co., Ltd., Tokyo, Japan</td>
			<td>DBASOS</td>
			<td>Tranexamic acid</td>
		</tr>
	</tbody>
</table>

modification of the treatment methods for wasting marmoset syndrome with tranexamic acid and supportive measures

消耗性狨猴综合征 （WMS） 是圈养普通狨猴 （Callithrix jacchus） 群体的一种严重疾病，与高死亡率相关。WMS 的具体原因尚不清楚，有效的治疗方法很少。之前，我们报道了一种氨甲环酸疗法联合支持措施是 WMS 的有效治疗方法。在本研究中，我们描述了修改后的方法：每周 5 次皮下注射 0.1 mL 5% 氨甲环酸，每周 3 次静脉注射 2.0 mL 氨基酸制剂，每周 3 次，5.0 mL 乳酸林格氏液与 0.1 mL 维生素制剂，每周 3 次皮下注射，以及每周 5 次口服 0.1 mL 铁制剂。我们还描述了如何通过大隐静脉静脉内施用溶液，并带有束缚动物的尖端，以及口服和皮下给药的详细方法。修改后的方法具有与原始 WMS 处理方法相当的效率。

修改后的治疗方法导致受 WMS 影响的狨猴的血细胞比容（图 1A）、血清白蛋白（图 1B）和体重（图 1C）增加。血细胞比容 （P < 0.05，Wilcoxon 匹配对符号秩检验）、血清白蛋白 （P < 0.05，Wilcoxon 匹配对符号秩检验）和体重 （P < 0.05，Wilcoxon 匹配对符号秩检验）在治疗前后观察到显著差异。
还观察到对外观的治疗效果。 图 2 显示了受 WMS 影响的狨猴的外观。治疗前观察到袢蛤、弓背、粗糙的皮毛（图 2A）和脱发（图 2B），而治疗后未见异常外观（图 2C、D）。
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/66768/66768fig01.jpg"> 图 1：接受改良治疗的狨猴的血细胞比容、血清白蛋白和体重的变化（治疗前与治疗后）。 （A） 血细胞比容值，（B） 血清白蛋白值，以及 （C） 体重。虚线表示条件值。缩写： Htc = 血细胞比容;Alb = 血清白蛋白;BW = 体重。 <a href="https://www.jove.com/files/ftp_upload/66768/66768fig01large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/66768/66768fig02.jpg"> 图 2：受 WMS 影响的狨猴的代表性外观。 （A） 预处理动物的外观：观察到指臼状、弓形背部和粗糙的皮毛。（B） 预处理动物的尾巴：观察到脱发。（C） 治疗后动物的外观。（D） 治疗后动物的尾巴。缩写：WMS = 消耗性狨猴综合症。 <a href="https://www.jove.com/files/ftp_upload/66768/66768fig02large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>

作者聚焦：为消耗性狨猴综合征 （WMS） 开发更安全、更有效的治疗方案

在这里，我们描述了氨甲环酸治疗消耗性狨猴综合征 （WMS，也称为炎症性肠病 （IBD） 样疾病）的改良治疗方法。我们还介绍了如何口服、皮下和静脉注射治疗药物。

氨甲环酸治疗消耗性狨猴综合征的改良及支持措施

Wasting marmoset syndrome (WMS), a serious disease in captive common marmoset (Callithrix jacchus) colonies, is associated with a high mortality rate. The ...

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Medicine

Modification of the Treatment Methods for Wasting Marmoset Syndrome with Tranexamic Acid and Supportive Measures

783 次观看.  RIKEN Center for Brain Science. 我们最初的消瘦狨猴综合症治疗方案绝对有效，但它给狨猴及其护理人员带来了沉重的负担。在这项研究中，我们修改了方案以减少动物的生理负荷和护理人员的工作量。我们使用氨甲环酸的方案有几个优点。与类固醇疗法相比，它不会引起明显的副作用或导致耐受性。此外，皮下给药比腹膜内注射更安全，因为没有损伤腹部器官的风险。我们...

视频: 作者聚焦：为消耗性狨猴综合征 （WMS） 开发更安全、更有效的治疗方案

The Measurement and Treatment of Suppression in Amblyopia

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%1-3, the majority of cases being monocular2. Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation.
Although amblyopia is initially caused by abnormal visual input in infancy, once established, the visual deficit often remains when normal visual input has been restored using surgery and/or refractive correction. This is because amblyopia is the result of abnormal visual cortex development rather than a problem with the amblyopic eye itself4,5 . Amblyopia is characterized by both monocular and binocular deficits6,7 which include impaired visual acuity and poor or absent stereopsis respectively. The visual dysfunction in amblyopia is often associated with a strong suppression of the inputs from the amblyopic eye under binocular viewing conditions8. Recent work has indicated that suppression may play a central role in both the monocular and binocular deficits associated with amblyopia9,10 .
Current clinical tests for suppression tend to verify the presence or absence of suppression rather than giving a quantitative measurement of the degree of suppression. Here we describe a technique for measuring amblyopic suppression with a compact, portable device11,12 . The device consists of a laptop computer connected to a pair of virtual reality goggles. The novelty of the technique lies in the way we present visual stimuli to measure suppression. Stimuli are shown to the amblyopic eye at high contrast while the contrast of the stimuli shown to the non-amblyopic eye are varied. Patients perform a simple signal/noise task that allows for a precise measurement of the strength of excitatory binocular interactions. The contrast offset at which neither eye has a performance advantage is a measure of the "balance point" and is a direct measure of suppression. This technique has been validated psychophysically both in control13,14 and patient6,9,11 populations.
In addition to measuring suppression this technique also forms the basis of a novel form of treatment to decrease suppression over time and improve binocular and often monocular function in adult patients with amblyopia12,15,16 . This new treatment approach can be deployed either on the goggle system described above or on a specially modified iPod touch device15.

Amblyopia is a developmental disorder of the visual cortex that is often accompanied by strong suppression of one eye. We present a new technique for measuring and treating interocular suppression in patients with amblyopia that can be deployed using virtual reality goggles or a portable iPod Touch device.

测量和制止在弱视治疗

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

科研

医学

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area.

This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

Oleic Acid-Injection in Pigs As a Model for Acute Respiratory Distress Syndrome

The acute respiratory distress syndrome is a relevant intensive care disease with an incidence ranging between 2.2% and 19% of intensive care unit patients. Despite treatment advances over the last decades, ARDS patients still suffer mortality rates between 35 and 40%. There is still a need for further research to improve the outcome of patients suffering from ARDS. One problem is that no single animal model can mimic the complex pathomechanism of the acute respiratory distress syndrome, but several models exist to study different parts of it. Oleic acid injection (OAI)-induced lung injury is a well-established model for studying ventilation strategies, lung mechanics and ventilation/perfusion distribution in animals. OAI leads to severely impaired gas exchange, deterioration of lung mechanics and disruption of the alveolo-capillary barrier. The disadvantage of this model is the controversial mechanistic relevance of this model and the necessity for central venous access, which is challenging especially in smaller animal models. In summary, OAI-induced lung injury leads to reproducible results in small and large animals and hence represents a well-suited model for studying ARDS. Nevertheless, further research is necessary to find a model that mimics all parts of ARDS and lacks the problems associated with the different models existing today.

In this article, we present a protocol to induce acute lung injury in pigs by central-venous injection of oleic acid. This is an established animal model for studying the acute respiratory distress syndrome (ARDS).

油酸注射液在猪急性呼吸窘迫综合征模型中的研究

The acute respiratory distress syndrome is a relevant intensive care disease with an incidence ranging between 2.2% and 19% of intensive care unit ...

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a common disorder that causes a significant loss of productivity. The transaxillary first rib resection (TFRR) protocol has been used for the decompression of trapped neurovascular structures in the TOS. Among the other surgical procedures, the advantage of the TFRR is that it has the smallest rate of recurrence and better cosmetic outcomes. The disadvantage of TFRR is that it provides a narrow, and deep working corridor that makes obtaining vascular control challenging.

Here, we present a protocol of the transaxillary resection of the first rib for treatment of thoracic outlet syndrome caused by compression of the brachial plexus, subclavian vein and artery.

经腋窝第一肋骨切除术治疗胸廓出口综合征

Thoracic outlet syndrome (TOS) is a common disorder that causes a significant loss of productivity. The transaxillary first rib resection (TFRR) protocol ...

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Various animal models exist to study the complex pathomechanisms of the acute respiratory distress syndrome (ARDS). These models include pulmo-arterial infusion of oleic acid, infusion of endotoxins or bacteria, cecal ligation and puncture, various pneumonia models, lung ischemia/reperfusion models and, of course, surfactant depletion models, among others. Surfactant depletion produces a rapid, reproducible deterioration of pulmonary gas exchange and hemodynamics and can be induced in anesthetized pigs using repeated lung lavages with 0.9% saline (35 mL/kg body weight, 37 &#176;C). The surfactant depletion model supports investigations with standard respiratory and hemodynamic monitoring with clinically applied devices. But the model suffers from a relatively high recruitability and ventilation with high airway pressures can immediately reduce the severity of the injury by reopening atelectatic lung areas. Thus, this model is not suitable for investigations of ventilator regimes that use high airway pressures. A combination of surfactant depletion and injurious ventilation with high tidal volume/low positive end-expiratory pressure (high Tv/low PEEP) to cause ventilator induced lung injury (VILI) will reduce the recruitability of the resulting lung injury. The advantages of a timely induction and the possibility to perform experimental research in a setting comparable to an intensive care unit are preserved.

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS

A combination of surfactant washout using 0.9% saline (35 mL/kg body weight, 37 &#176;C) and high tidal volume ventilation with low PEEP to cause moderate ventilator induced lung injury (VILI) results in experimental acute respiratory distress syndrome (ARDS). This method provides a model of lung injury with low/limited recruitability to study the effect of various ventilation strategies for extended periods.

表面活性剂耗竭与有害通风相结合导致急性呼吸窘迫综合症 （ARDS） 的可重复模型

Various animal models exist to study the complex pathomechanisms of the acute respiratory distress syndrome (ARDS). These models include pulmo-arterial ...

Laparoscopic Oocyte Retrieval and Cryopreservation during Vaginoplasty for Treatment of Mayer-Rokitansky-Kuster-Hauser Syndrome

In Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS) patients who are scheduled for laparoscopic vaginoplasty and have a desire for biological motherhood, we propose that a concomitant laparoscopic oocyte retrieval for cryopreservation is performed. Oocyte retrieval is pursued at the beginning of the laparoscopy. Right and left 5 mm trocars are positioned, through which a 17 G ovum aspiration needle is used for puncture of the right and left ovaries, respectively. To facilitate exposure of the follicles, the ovaries are mobilized and held with laparoscopic forceps.
When aspirating multiple follicles near each other, the needle tip is retained in the ovary to reduce the number of times that the ovarian cortex is transfixed and due to the inherent risk of bleeding. Subsequent steps are unchanged compared to the Davydov laparoscopic modified technique for vaginoplasty. Prior to surgery, controlled ovarian stimulation is performed with a gonadotropin hormone-releasing hormone (Gn-RH) antagonist protocol, and the concomitant procedure of oocyte retrieval and vaginoplasty is scheduled 36 h after the final follicular maturation trigger. Follicular fluid is collected in the same 10 mL sterile tubes used during transvaginal oocyte retrieval and transferred in a warming block (37 &#176;C) to the assisted reproduction laboratory, where mature (metaphase II) oocytes are vitrified.
In this case, a series of 23 women with MRKH, oocytes were successfully retrieved and cryopreserved in all patients; vaginoplasty was subsequently conducted without modifications, and the inpatient and outpatient postoperative care (day of urinary catheter removal, day of hospital discharge, dilator use, and comfort at follow-up) remained unaffected. One postoperative complication occurred in one patient (fever developing on day 5 post surgery and intraperitoneal fluid detection on transabdominal ultrasound) and resolved after conservative treatment. Rather than performing surgical vaginoplasty and delaying oocyte retrieval in MRKH patients, this approach combines both procedures in a single laparoscopy, thereby minimizing surgical invasiveness and anesthesiologic risks.

A dedicated team can offer Mayer-Rokitansky-Kuster-Hauser patients the option to perform controlled ovarian stimulation and oocyte cryopreservation at the time of laparoscopic vaginoplasty.

阴道成形术中的腹腔镜卵母细胞提取和冷冻保存治疗Mayer-Rokitansky-Kuster-Hauser综合征

In Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS) patients who are scheduled for laparoscopic vaginoplasty and have a desire for biological motherhood, ...

Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative asoedema, hematoma, sustaining pain, and seminal tract obstruction in patients who have undertaken nonmicroscopic epididymal cyst resection or epididymal resection. Nonmicroscopic epididymal cyst surgery is suggested for patients with childbirth plans as a precaution. The treatment of male epididymal cysts via microtechnology is obviously a beneficial option; we took the lead in carrying out microscopic epididymal exploration and cyst resection surgery in China. From September 2017 to April 2021, 41 young and middle-aged male patients diagnosed with epididymal cysts underwent microtechnology treatment in a program titled &#34;microscopic epididymal exploration and cystectomy&#34;. The postoperative follow-up lasted for 3-50 months. The results confirmed that, as microscopic manipulation largely improved visualization of the subtle tissue structures of the epididymis, the cyst could be clearly dissected apart and completely removed intact under the microscope. Bleeding during the operation was significantly reduced (2-3 mL) and wound drainage was not required. According to follow-up data, microscopic treatment significantly reduced the incidence of postoperative scrotal hematoma, edema, and long-term postoperative pain, thereby promising a higher surgical success rate as well as recurrence prevention. Besides, preliminary experience and reflection suggest that microscopic epididymal exploration and cystectomy provide efficient preservation of the epididymal patency through refined treatment, while a better prognosis can be achieved. We recommend that surgery be carried out before the epididymal cyst develops to 0.8 cm in diameter, for fear that a larger epididymal cyst (&#62;0.9 cm in diameter) could cause the complete destruction of all tubules of the ipsilateral epididymis - a more severe case with damage to the testicular output network.

Here, we present a protocol to treat patients diagnosed with an epididymal cyst using microscopic cyst resection. Based on microscopic manipulation, a largely improved visualization of the subtle tissue structures of the epididymis was obtained, so the cyst could be clearly dissected apart and completely removed intact.

显微镜囊肿切除术治疗诊断为附睾囊肿的患者

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative ...

干燥综合征的唾液腺超声检查技术

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular manifestations including arthralgia, cytopenia, and lymphoma. The presence of autoantibodies against SSA/Ro, labial salivary gland biopsy, ocular staining, Schirmer's test, or salivary flow assessment are included in the current classification criteria of SS. However, the availability and invasiveness of these procedures limit their widespread use in clinical settings. Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality for the evaluation of the salivary gland parenchyma and is increasingly utilized to aid diagnosis and monitoring in SS. 
This article presents the protocol of SGUS for image acquisition at the parotid and submandibular glands. The objective is to present a standardized, reproducible, and practical approach to diagnostic SGUS for SS in daily clinical settings. Major salivary glands are scanned in a stepwise approach, beginning at the angle of the mandible for the superficial lobe of the parotid gland, followed by the deep lobe below the ramus of the mandible. Submandibular areas are then scanned for the submandibular glands. The steps in obtaining salivary gland images at each anatomical site are explained in the accompanying video. The echogenicity and echotexture at the thyroid gland are taken as a reference. The homogeneity, the presence and distribution of hypoechoic areas within the glands, and the border of the salivary glands are examined. The sizes and features of intra-/peri-glandular lymph nodes are recorded. The most distinctive sonographic feature in SS is glandular heterogeneity with the presence of hypoechoic/hyperechoic areas within the glands. 
In summary, while SGUS cannot diagnose SS on its own, it can supplement the current classification criteria of SS and guide the clinical decision for salivary gland biopsy to support the diagnosis of SS in patients with sicca syndrome or suspicious systemic features, combined with autoantibody testing.

作者聚焦：结缔组织病研究中标准化唾液腺超声方案的重点

Salivary gland ultrasonography is a promising tool for the diagnosis and evaluation of disease activity and complications in Sjogren's syndrome (SS). The scanning technique for salivary gland ultrasound examination relevant to SS is described in the article.

干燥综合征唾液腺的超声评估：诊断和监测见解

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular ...

氨甲环酸治疗消耗性狨猴综合征的改良及支持措施

副本

摘要

探索更多视频

此视频中的章节

测量和制止在弱视治疗

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

油酸注射液在猪急性呼吸窘迫综合征模型中的研究

经腋窝第一肋骨切除术治疗胸廓出口综合征

表面活性剂耗竭与有害通风相结合导致急性呼吸窘迫综合症（ARDS）的可重复模型

阴道成形术中的腹腔镜卵母细胞提取和冷冻保存治疗Mayer-Rokitansky-Kuster-Hauser综合征

显微镜囊肿切除术治疗诊断为附睾囊肿的患者

干燥综合征唾液腺的超声评估：诊断和监测见解

干燥综合征唾液腺的超声评估：诊断和监测见解

干燥综合征唾液腺的超声评估：诊断和监测见解

氨甲环酸治疗消耗性狨猴综合征的改良及支持措施

副本

摘要

探索更多视频

此视频中的章节

测量和制止在弱视治疗

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

油酸注射液在猪急性呼吸窘迫综合征模型中的研究

经腋窝第一肋骨切除术治疗胸廓出口综合征

表面活性剂耗竭与有害通风相结合导致急性呼吸窘迫综合症 （ARDS） 的可重复模型

阴道成形术中的腹腔镜卵母细胞提取和冷冻保存治疗Mayer-Rokitansky-Kuster-Hauser综合征

显微镜囊肿切除术治疗诊断为附睾囊肿的患者

干燥综合征唾液腺的超声评估：诊断和监测见解

干燥综合征唾液腺的超声评估：诊断和监测见解

干燥综合征唾液腺的超声评估：诊断和监测见解

表面活性剂耗竭与有害通风相结合导致急性呼吸窘迫综合症（ARDS）的可重复模型