OBJECTIVE: Complications after laparoscopic liver resection (LLR) are important factors affecting the prognosis of patients, especially for complex hepatobiliary diseases. The present study aimed to evaluate the value of a three-dimensional (3D) printed dry-laboratory model in the precise planning of LLR for complex hepatobiliary diseases.
METHODS: Patients with complex hepatobiliary diseases who underwent LLR were preoperatively enrolled, and divided into two groups according to whether using a 3D-printed dry-laboratory model (3D vs. control group). Clinical variables were assessed and complications were graded by the Clavien-Dindo classification. The Comprehensive Complication Index (CCI) scores were calculated and compared for each patient. Multivariable analysis was performed to determine the risk factors of postoperative complications.
RESULTS: Sixty-two patients with complex hepatobiliary diseases underwent the precise planning of LLR. Among them, thirty-one patients acquired the guidance of a 3D-printed dry-laboratory model, and others were only guided by traditional enhanced CT or MRI. The results showed no significant differences between the two groups in baseline characters. However, compared to the control group, the 3D group had a lower incidence of intraoperative blood loss, as well as postoperative 30-day and major complications, especially bile leakage (all P < 0.05). The median score on the CCI was 20.9 (range 8.7-51.8) in the control group and 8.7 (range 8.7-43.4) in the 3D group (mean difference, -12.2, P = 0.004). Multivariable analysis showed the 3D model was an independent protective factor in decreasing postoperative complications. Subgroup analysis also showed that a 3D model could decrease postoperative complications, especially for bile leakage in patients with intrahepatic cholelithiasis.
CONCLUSIONS: The 3D-printed models can help reduce postoperative complications. The 3D-printed models should be recommended for patients with complex hepatobiliary diseases undergoing precise planning LLR.

Extended reality (XR) technology refers to any situation where real-world objects are enhanced with computer technology, including virtual reality, augmented reality, and mixed reality. Augmented reality and mixed reality technologies have been widely applied in orthopedic clinical practice, including in teaching, preoperative planning, intraoperative navigation, and surgical outcome evaluation. The primary goal of this narrative review is to summarize the effectiveness and superiority of XR-technology-assisted intraoperative navigation in the fields of trauma, joint, spine, and bone tumor surgery, as well as to discuss the current shortcomings in intraoperative navigation applications. We reviewed titles of more than 200 studies obtained from PubMed with the following search terms: extended reality, mixed reality, augmented reality, virtual reality, intraoperative navigation, and orthopedic surgery; of those 200 studies, 69 related papers were selected for abstract review. Finally, the full text of 55 studies was analyzed and reviewed. They were classified into four groups-trauma, joint, spine, and bone tumor surgery-according to their content. Most of studies that we reviewed showed that XR-technology-assisted intraoperative navigation can effectively improve the accuracy of implant placement, such as that of screws and prostheses, reduce postoperative complications caused by inaccurate implantation, facilitate the achievement of tumor-free surgical margins, shorten the surgical duration, reduce radiation exposure for patients and surgeons, minimize further damage caused by the need for visual exposure during surgery, and provide richer and more efficient intraoperative communication, thereby facilitating academic exchange, medical assistance, and the implementation of remote healthcare.

Monoamine oxidase A (MAO-A) is a dimeric flavoprotein that is found in the mitochondrial membrane. Currently, there is a lack of near-infrared fluorescent probes (NIR-FPs) with good specificity and high sensitivity for detecting MAO-A, making it difficult to accurately recognize and image cells in vitro and in vivo. In this study, the NIR-FP DDM-NH2 was designed and synthesized in order to detect MAO-A specifically in live biological systems. The probe comprised two functional components: dicyanoisophosphone as an NIR dye precursor and alanine as a recognition moiety. After identifying MAO-A, the probe exhibited an NIR emission peak at 770 nm with a significant Stokes shift (180 nm), 11-fold response factor, low detection limit of 99.7 nM, and considerably higher affinity toward MAO-A than that toward MAO-B, indicating high sensitivity. In addition, DDM-NH2 was effective when applied to the image-based assessment of MAO-A activity in HeLa cells, zebrafish, and tumor-bearing mice, demonstrating great potential for visualization-based research and MAO-A application in vivo.

OBJECTIVE: To evaluate the feasibility and application value of mixed reality technology (MR) in Primary retroperitoneal tumour (PRT) surgery.
METHODS: From 276 patients who underwent PRT resection at the First Affiliated Hospital of Xi\'an Jiaotong University, we screened 46 patients who underwent MR-assisted retroperitoneal tumour resection and 46 patients who underwent tumour resection without MR assistance. The intraoperative and postoperative recovery of the patients in both groups were compared, and the reliability and validity of the application of MR were further examined using the Likert scale.
RESULTS: There was a significant difference in the mean intraoperative bleeding volume between the two groups, but it was reduced in the MR group. The results of the Likert scale showed higher scores in the MR group than non-MR group.
CONCLUSIONS: MR can be used to assist PRT resection and has great potential to improve the rate of complete retroperitoneal tumour resection.

OBJECTIVE: To explore the technical aspects of the accuracy of cervical pedicle screw placement with O-arm guidance.
METHODS: The clinical data of 21 patients who underwent cervical pedicle screw fixation by O-arm real-time guidance from December 2015 to January 2020 were analyzed retrospectively. There were 15 males and 6 females, aged from 29 to 76 years old with an average of (45.3±11.5) years. The postoperative CT scan was utilized to evaluate the placement of the pedicle screw and classified according to the Gertzbein and Robbins classification.
RESULTS: A total of 132 pedicle screws were implanted in 21 patients, 116 at C3-C6 and 16 at C1 and C2. According to Gertzbein & Robbins classification, the overall breach rates were found to be 11.36% (15/132) with 73.33% (11 screws) Grade B, 26.67% (4 screws) Grade C, and no Grade D or E screw breaches. There were no pedicle screw placement related complications at final follow-up.
CONCLUSIONS: The application of O-arm real-time guidance technology can make cervical pedicle screw placement reliable. High accuracy and better intra-operative control can increase surgeon\'s confidence in using cervical pedicle instrumentation. Considering the high-risk nature of anatomical area around cervical pedicle and the possibility of catastrophic complications, the spine surgeon should have sufficient surgical skills, experience, ensures stringent verification of the system, and never relies solely on the navigation system.

UNASSIGNED: To understand the pathological correlations of multi-b-value diffusion-weighted imaging (MDWI) stretched-exponential model (SEM) parameters of α and diffusion distribution index (DDC) in patients with glioma. SEM parameters, as promising biomarkers, played an important role in histologically grading gliomas.
UNASSIGNED: Biopsy specimens were grouped as high-grade glioma (HGG) or low-grade glioma (LGG). MDWI-SEM parametric mapping of DDC1500, α1500 fitted by 15 b-values (0-1,500 sec/mm2)and DDC5000 and α5000 fitted by 22 b-values (0-5,000 sec/mm2) were matched with pathological samples (stained by MIB-1 and CD34) by coregistered localized biopsies, and all SEM parameters were correlated with these pathological indices pMIB-1(percentage of MIB-1 expression positive rate) and CD34-MVD (CD34 expression positive microvascular density for each specimen). The two-tailed Spearman\'s correlation was calculated for pathological indexes and SEM parameters, as well as WHO grades and SEM parameters.
UNASSIGNED: MDWI-derived α1500 negatively correlated with CD34-MVD in both LGG (6 specimens) and HGG (26 specimens) (r=-0.437, P =0.012). MDWI-derived DDC1500 and DDC5000 negatively correlated with MIB-1 expression in all glioma patients (P<0.05). WHO grades negatively correlated with α1500(r=-0.485; P=0.005) and α5000(r=-0.395; P=0.025).
UNASSIGNED: SEM-derived DDC and α are significant in histologically grading gliomas, DDC may indicate the proliferative ability, and CD34 stained microvascular perfusion may be an important determinant of water diffusion inhomogeneity α in glioma.

Near-infrared (NIR) fluorescence imaging-guided surgery is increasingly concerned in gastrointestinal surgery because it can potentially improve clinical outcomes. This new technique can provide intraoperative image guidance for surgical margin evaluation and help surgeons examine residual lesions and small tumors during surgery. NIR fluorophores methylene blue (MB) is a promising fluorescent probe because of its safety and intraoperative imaging in the clinic. However, whether MB possesses the potential to perform intraoperative navigation of the stomach and gastric tumors needs to be further explored. Therefore, the current study mainly validated MB\'s usefulness in animal models\' intraoperative imaging of stomach and gastric tumors. NIR fluorophores MB can exhibit specific uptake by the gastric epithelial cells and cancer cells. It is primarily found that MB can directly target the stomach in mice. Interestingly, MB was applied for the NIR imaging of gastric cancer cell xenografts, suggesting that MB cannot specifically target subcutaneous and orthotopic gastric tumors in xenograft models. Thus, it can be concluded that MB has no inherent specificity for gastric tumors but specificity for gastric tissues. Apparently, MB-positive and negative NIR imaging are meaningful in targeting gastric tissues and tumors. MB is expected to represent a helpful NIR agent to secure precise resection margins during the gastrectomy and resection of gastric tumors.

OBJECTIVE: To explore the application of extended reality (XR) technology in clinical surgeries for improving the success rate of surgeries.
METHODS: To assist the surgeons to better understand the location, size and geometric shape of the lesions and reduce potential radiation exposure in minimally invasive surgical navigation based on two-dimensional images, we constructed three-dimensional models based on CT data and used XR technology to achieve intraoperative navigation. An improved quaternion method was used to improve the accuracy of electromagnetic positioning, with which the system error of positioning accuracy was reduced to below 2 mm. A 5G network was used to optimize the server GPU programming algorithm, and real-time video stream coding strategy and network design were adopted to reduce data transmission jam and delay in the remote surgery network, which achieved an average delay of less than 60 ms. A Gaussian distribution deformation model was used to simulate collision detection and stress deformation of the tissues to achieve a tactile perception effect.
CONCLUSIONS: The intraoperative navigation system based on XR technology allowed more accurate determination of the location of the lesions, effectively reduced the surgical risk, and avoided the risk of intraoperative radiation exposure. The low latency and high fidelity of 5G network achieved real-time interaction during the surgery to provide a technical basis for multi-terminal remote cooperative surgery. The combination of force feedback technology and XR technology enables the surgeons to conduct deep immersion preoperative planning and virtual surgery to improve the success rate of surgery and shorten the learning curve.

UNASSIGNED: To review and evaluate the basic principles and advantages of orthopedic robot-assisted technology, research progress, clinical applications, and limitations in the field of traumatic orthopedics, especially in fracture reduction robots.
UNASSIGNED: An extensive review of research literature on the principles of robot-assisted technology and fracture reduction robots was conducted to analyze the technical advantages and clinical efficacy and shortcomings, and to discuss the future development trends in this field.
UNASSIGNED: Orthopedic surgical robots can assist orthopedists in intuitive preoperative planning, precise intraoperative control, and minimally invasive operations. It greatly expands the ability of doctors to evaluate and treat orthopedic trauma. Trauma orthopedic surgery robot has achieved a breakthrough from basic research to clinical application, and the preliminary results show that the technology can significantly improve surgical precision and reduce surgical trauma. However, there are still problems such as insufficient evaluation of effectiveness, limited means of technology realization, and narrow clinical indications that need to be solved.
UNASSIGNED: Robot-assisted technology has a broad application prospect in traumatic orthopedics, but the current development is still in the initial stage. It is necessary to strengthen the cooperative medical-industrial research, the construction of doctors\' communication platform, standardized training and data sharing in order to continuously promote the development of robot-assisted technology in traumatic orthopedics and better play its clinical application value.
UNASSIGNED: 对骨科机器人辅助技术的基本原理及优势、在创伤骨科领域尤其是骨折复位手术机器人的研究进展、临床应用及局限性进行综述和评价。.
UNASSIGNED: 广泛查阅国内外关于骨科机器人辅助技术原理、骨折复位手术机器人相关研究文献，分析技术优势及临床疗效和不足，探讨该领域未来发展趋势。.
UNASSIGNED: 骨科机器人可辅助医生进行直观的术前规划、术中精准控制及微创操作，极大地拓展了医生对骨科创伤的评估和治疗能力；创伤骨科手术机器人已经实现从基础研究到临床应用的突破，初步结果显示该技术可显著提高手术精度、降低手术创伤，但仍存在有效性评价不足、技术实现手段单一、临床适应证窄等问题。.
UNASSIGNED: 骨科机器人辅助技术在创伤骨科有广阔应用前景，但目前尚处于起步阶段，需要加强医工合作研究、医生交流平台建设、规范化培训及数据共享，才能不断推进骨科机器人辅助技术在创伤骨科的发展，更好地发挥其临床应用价值。.

Glioma is one of the most common intracranial malignant tumors worldwide. Since the glioma is invasive and lacks a clear boundary with normal brain tissue, the neurosurgeon can only determine the extent of surgical resection based on empirical experience. Thus, accurately demarcating its boundaries has become a major challenge for surgeons. Owing to the high glycolysis metabolism of glioma cells, the acidification of the extracellular fluid has become an indicator of glioma evolution. Herein, a ratiometric pH-responsive surface-enhanced Raman scattering (SERS) strategy was developed for the rapid identification of glioma boundaries. A sensing chip composed of silver nanoparticles self-assembled film was fabricated, followed by the self-assembly of a pH-responsive SERS reporter, 4-mercaptopyridine (4-MPY). The characteristic SERS peak ratios of 4-MPY change regularly under different pH conditions. The boundary of glioma invasion was determined by measuring the pH of waterdrops infiltrated by interstitial fluids. The technology enables accurate, non-invasive, and rapid determination of local pH, thereby maximizing the removal of tumor tissue while minimizing damage to normal tissue. This technique is more rapid and simple than intraoperative pathological detection and can be possibly used for intraoperative navigation.