Detection of hepatocellular carcinoma circulating tumor cells performed with conventional strategies, is significantly limited due to inherently heterogeneous and dynamic expression of EpCAM, as well as degradation of cytokeratins during epithelial-to-mesenchymal transition, which inevitably lead to non-negligible false negative detection of such "uncapturable and invisible" CTCs. A novel SE-iFISH strategy, improved for detection of HCC CTCs in this study, was applied to comprehensively detect, in situ phenotypically and karyotypically characterize hepatocellular and cholangiocarcinoma CTCs (CD45/CD31) in patients subjected to surgical resection. Clinical significance of diverse subtypes of CTC was systematically investigated. Existence of small cell size CTCs (≤5 μm of WBCs) with cytogenetic abnormality of aneuploid chromosome 8, which constituted majority of the detected CTCs in HCC patients, was demonstrated for the first time. The stemness marker EpCAM aneuploid circulating tumor stem cells (CTSCs), and EpCAM small CTCs with trisomy 8, promote tumor growth. Postsurgical quantity of small triploid CTCs (≥5 cells/6 ml blood), multiploid (≥pentasomy 8) CTSCs or CTM (either one ≥ 1) significantly correlated to HCC patients' poor prognosis, indicating that detection of those specific subtypes of CTCs and CTSCs in post-operative patients help predict neoplasm recurrence.

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As preperitoneal herniorrhaphy, both MK and laparoscopic (TEP/TAPP) procedures are safe and effective, with low incidence rates of life-threatening complications and recurrence. The laparoscopic approach is superior in terms of lower incidence rates of infection and chronic pain, shorter operative time, and faster recovery; however, careful surgical procedure selection and implementation of technical details are required.

Rationale:Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature.Patient concerns:A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks.Diagnoses:Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma.Intervention:Three-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference.Outcomes:No serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results.Lessons:AR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system.

ObjectiveThe purpose of this study was to compare the mechanical properties, host responses and incorporation of porcine small intestine submucosa (PSIS) and porcine acellular dermal matrix (PADM) in a rat model of abdominal wall defect repair.Materials and MethodsPrior to implantation, PSIS and PADM were prepared and evaluated in terms of structure and mechanical properties. Full-thickness abdominal wall defects were created in 50 Sprague-Dawley rats, and were repaired using either PSIS or PADM. Rats were sacrificed 1, 2, 4, 8 and 12 weeks post-repair and examined for herniation, infection, adhesions, contraction, and changes in the thickness and strength of the tissues incorporated at the defect sites. Histopathology and immunohistochemistry were performed to analyze inflammatory responses, collagen deposition and vascularization.ResultsPADM showed more dense collagen deposition and stronger mechanical properties than PSIS prior to implantation (P<0.01). However, the mechanical properties observed after integration with the surrounding native tissues was similar for PADM and PSIS. Both PADM and PSIS showed significant contraction by week 12. However, PADM tissue induced less adhesion and increased in thickness more slowly, and showed less infiltration by foreign giant cells, polymorphonuclear cells, and mononuclear cells. Improved remodeling of host tissue was observed after PSIS implantation, which was apparent from the orientation of bands of fibrous connective tissue, intermixed with newly formed blood vessels by Week 12.ConclusionPSIS showed weaker mechanical properties prior to implantation. However, after implantation PSIS induced more pronounced host responses and showed better incorporation into host tissues than PADM.

Background:Endoscopic placement of multiple plastic stents (MPS) has been the first-line treatment for benign biliary stricture (BBS). Covered self-expanding metal stents (cSEMS) have been used in treatment of BBS; however, the efficacy has not been verified. Therefore, we conducted this meta-analysis according to PRISMA guidelines.Methods:PubMed, Embase, and the Cochrane Library were electronically and manually searched for studies published between January 1, 1990 and April 12, 2017. Of 153 studies screened, 90 were excluded because of duplications. After scanning the title or abstract, only 24 studies were eligible for review and 6 were finally included. The investigators selected publications according to inclusion and exclusion criteria, processed the data, and assessed the quality of the selected studies. The primary endpoint outcome was stricture resolution, and the secondary endpoint outcomes included stricture recurrence rate, the number of endoscopic retrograde cholangiopancreatography (ERCP) sessions, and stent migration.Results:A total of 6 randomized controlled trials with 330 participants were included in the current meta-analysis. There was no significant difference in stricture resolution between the cSEMS and MPS groups (odds ratio [OR] = 1.05, 95% confidence interval [CI] = 0.53–2.07, I2 = 29%, P = .23, Z = 0.13, P = .90). Similarly, the stricture recurrence rates (OR = 1.39, 95% CI = 0.69–2.81, I2 = 38%, P = .17, Z = 0.91, P = .36) were comparable between cSEMS and MPS groups. Stent migration rates (OR = 1.71, 95% CI = 0.84–3.50, I2 = 4%, P = .241, Z = 1.47, P = .14) were similar between cSEMS and MPS groups. There were fewer ERCP sessions in the cSEMS group than in the MPS group.Conclusions:This meta-analysis showed that cSEMS were comparable to MPS in achieving resolution of BBSs with fewer ERCP procedures.

In this paper we present a novel non-rigid optical flow algorithm for dense image correspondence and non-rigid registration. The algorithm uses a unique Laplacian Mesh Energy term to encourage local smoothness whilst simultaneously preserving non-rigid deformation. Laplacian deformation approaches have become popular in graphics research as they enable mesh deformations to preserve local surface shape. In this work we propose a novel Laplacian Mesh Energy formula to ensure such sensible local deformations between image pairs. We express this wholly within the optical flow optimization, and show its application in a novel coarse-to-fine pyramidal approach. Our algorithm achieves the state-of-the-art performance in all trials on the Garg et al. dataset, and top tier performance on the Middlebury evaluation.

Combination of HGF and IGF-1 activated BMSCs complementarily, and controlled release of the two factors promoted protective potential of transplanted BMSCs to repair infarcted myocardium. This suggests a new strategy for cell therapies to overcome acute ischemic myocardial injury.