Not long ago, the list of winners of the 2021 Sichuan Provincial Science and Technology Awards was released.
Among the award-winning projects are many that involve new research and technology in the healthcare field.
For example -
"Construction and application of key technology system for surgical prevention and treatment of recurrence of liver cancer
"Research on the specificity and biological basis of acupuncture point effects
"Research and application of obstetric critical care based on maternal mortality reduction" project
......
Both won the 2021
First Prize of Sichuan Provincial Science and Technology Progress Award
What are the breakthroughs in these new studies and technologies?
And what changes will it bring to our lives?
Let's take a look today
The "gold content" of these award-winning projects!
Reduce the recurrence rate of liver cancer after surgery
This team gives "textbook" surgery
Liver cancer is one of the highest incidence and mortality rates of tumors worldwide.
One of the achievements in the first prize of Sichuan Provincial Science and Technology Progress Award was "Construction and application of key technology system for surgical prevention and treatment of recurrence of liver cancer", which can significantly improve the survival prognosis of patients.
Zeng Yong, a professor of liver surgery at West China Hospital of Sichuan University, has led a team for 17 years to conduct research around the core scientific issues in the field of liver cancer treatment and research, and has achieved a series of innovative results in the research and clinical application of postoperative recurrence mechanisms and key techniques for surgical prevention and treatment of liver cancer, which have effectively improved the long-term survival of liver cancer surgery patients.
Seven years before and after
Study of thousands of liver cancer patients
"In clinical practice, there are three types of treatment for early-stage liver cancer: liver resection surgery, radiofrequency ablation and liver transplantation. The recurrence rate of the first two is as high as about 70%. Liver transplantation treatment does not give many patients enough time to wait for a liver source due to donor tension." Xie Kunlin, a member of Prof. Zeng Yong's team, said that if the high recurrence rate after liver cancer surgery can be cracked, as well as increasing access to liver donor livers for liver transplantation, it will bring hope to more families.
But what type of surgery can reduce recurrence in people with early stage liver cancer? There was once no clinical consensus on the effectiveness of both hepatic resection surgery and radiofrequency ablation.
Against this background, Zeng Yong's team spent about seven years studying thousands of liver cancer patients using a prospective randomized controlled study protocol.
It was found that the 5-year recurrence-free rate for surgical resection patients was 51%; while the 5-year recurrence-free rate for radiofrequency ablation patients was 29%. This high-quality research was published in the Annals of Surgery, the number one ranked journal in the field of surgery.
This achievement has also been adopted by the National Health Care Commission's Primary Liver Cancer Treatment Specification (2019 edition), the U.S. Clinical Practice Guidelines in Oncology, and other liver cancer guidelines as the standard protocol for the treatment of early-stage liver cancer worldwide, resulting in a significant improvement in patient prognosis.
Not only that, Zeng Yong's team discovered for the first time in the world six key regulatory molecules of the recurrence process of liver cancer, which provided candidate drug targets for liver cancer treatment, and was the first in the world to establish an artificially intelligent early warning model of recurrence for liver cancer patients based on imaging and pathology clinical, which provided a basis for early intervention and precise treatment.
Provide model
Improved surgical success rate
The difficulty factor of liver resection surgery is high, especially for tumors growing in the middle of the liver, known as "central liver cancer", which is the most troublesome. Since the tumor is surrounded by blood vessels and bile ducts, the patient will bleed heavily if he is not careful. Therefore, many primary hospitals are unable to perform this type of surgery. Xie Kunlin said, "If we could provide surgeons with a guideline for liver resection, it would certainly improve the success rate of the operation."
After studying hundreds of patients operated for "central liver cancer", Zeng Yong's team has classified "central liver cancer" into four types. How should the different types of cancer be operated? What are the high risk factors for recurrence after surgery? Zeng Yong's team gave the answer.
In this way, a "textbook" was given to liver surgeons. The result was named "Central liver cancer Zeng's staging", which laid the foundation for subsequent clinical practice and promotion.
The results show that the 3-year recurrence-free survival rate for patients with "central hepatocellular carcinoma" increased from 35% to 45% after surgery, which is significantly better than the international level at the same time.
Trauma Reduction
Solving short-term donor problems
Liver transplantation is an effective treatment for liver cancer, but how can we improve the source of liver sources?
Xie Kunlin introduced, the main source of liver is donor, living liver transplantation between relatives can be an important channel, but in the past, the traditional surgery will leave an "L-shaped" scar of more than 40 cm on the body of the donor. "If we can reduce the trauma to the donor and allay concerns, we will certainly be able to expand the source of liver to some extent."
To this end, Zeng Yong led his team to achieve "minimally invasive liver donor acquisition for adult living donor liver transplantation", which means "punching" a few holes in the donor's body, or the more popular "minimally invasive surgery". This means that a few holes are made in the donor's body, which is now known as "minimally invasive surgery," and the liver is obtained. Minimally invasive surgery requires more skill than the more invasive methods of liver harvesting, and requires the surgeon to operate a robotic arm to complete the operation. But the advantage of this is that the surgical trauma is basically negligible compared to the original one, and more importantly, through long-term observation, the donor not only has no serious complications, but also shortens the original 11-day hospital stay to 7 days.
In addition, Prof. Zeng Yong's team has completed the first robotic minimally invasive left outer lobe liver donor acquisition in China and the first laparoscopic right hemi-liver donor acquisition in China.
Due to the contributions made by West China Hospital in the field of liver surgery, the Liver Surgery and Liver Transplantation Center of West China Hospital has been listed as one of the top five centers in the world for minimally invasive donor liver acquisition by authoritative experts in the field of liver transplantation, with the remaining four centers in the United States and Japan.
Challenging gaps in international research methodology
He proved to the world that acupuncture "makes sense"
On the fifth floor of the first teaching building of Chengdu University of Traditional Chinese Medicine, a provincial key laboratory is hidden, and the subject of research is acupuncture.
Over the past decade or so, in this laboratory, Liang Prosperity, chief professor of acupuncture at Chengdu University of Traditional Chinese Medicine, has led a team of more than 200 people to prove the scientific validity and effectiveness of Chinese acupuncture to the world based on the characteristics of Chinese acupuncture, using clinical trials and animal experiments and other medical research methods to promote the ancient Chinese acupuncture to embrace modernity and go international. Recently, the project of "Research on the specificity and biological basis of acupuncture point effect by meridian" won the first prize of Sichuan Science and Technology Progress Award in 2021.
Shouting "Esperanto" in "Chinese"
Multidisciplinary cross-sectional research
Filling the Gaps in Acupuncture Research Methods in Chinese Medicine
The first step in bringing Chinese medicine to the world was acupuncture. To date, acupuncture is used in 183 countries and regions around the world.
There are over 1000 TCM acupuncture clinics in London and the cost of an acupuncture session in New York can be as high as $500 ......
Going out, but the road is not smooth. More and more people are recognizing the healing power of acupuncture, but doubts and objections persist.
In 2006, China launched the first 973 project in the field of acupuncture - basic research on the specificity of meridian point effects based on clinical practice, with Liang Prosperity in charge. In 2006, China launched the first 973 project in the field of acupuncture - basic research on the specificity of the effect of meridians based on clinical practice.
The biggest difficulty of the study is the complete gap in the methodology. Previously, a team of German researchers, using Western medical research methods, concluded that there was no significant difference between acupuncture points and non-acupuncture points.
Liang Prosperity is skeptical about this. He became a barefoot doctor at the age of 18, and over the past 40 years, he has learned from practice and books, and has grown into a mainstay of the Chinese acupuncture community through his own efforts. In his opinion, Chinese acupuncture theory is complex and has cultural connotations, and it is not feasible to use the Western research system alone. He has proved to the world that acupuncture "makes sense".
The intersection of disciplines and the integration of the West and China inevitably brings about collisions and a series of technical and methodological difficulties. On the one hand, Liang and his team strictly follow the internationally recognized clinical research methods such as blind selection and randomized controlled studies for trial design; on the other hand, they combine traditional Chinese medicine theories, apply strategies according to diseases, and establish a standard system in terms of manipulation, operation time and acupuncture point combination.
After more than ten years, the team has compared the therapeutic effects of acupuncture points and non-acupuncture points, different points of the same meridian and different points of different meridians. More than 200 scholars from more than 10 universities and research institutes across China have conducted clinical trials on more than 5,000 patients nationwide, and the conditions involved include migraine, angina pectoris, functional dyspepsia, etc. The results of the trials proved that the efficiency of acupuncture was as high as 70% to 90%, proving to the world the effectiveness of acupuncture points.
From the "point" of acupuncture points to the "line" of meridians
Over a decade of relay research
Prove to the world that the acupuncture system "makes sense"
Two years ago, Liang Prosperity proved to the world that "acupuncture points exist", and he stood on the highest podium in Sichuan science and technology, winning the 2019 Sichuan Science and Technology Outstanding Contribution Award.
Liang Prosperity and his team, however, did not stop there and continued to challenge the deep water. They have expanded their research from the "points" of acupuncture points to the "lines" of meridians, trying to prove the effectiveness of meridians to the world and further enrich the theoretical foundation of acupuncture in Chinese medicine.
It is often said in acupuncture circles that "it is better to lose the acupuncture points than the meridians", meaning that the acupuncture points can be taken with some deviation from the acupuncture points, but not from the meridians. Although the existence of acupuncture points has been widely recognized, there are still many skeptical voices in the international community about the existence of meridians.
Liang Prosperity and team further refined the research methodology. For example, in a clinical trial of angina pectoris, the team divided the trial participants into four groups: the meridian-taking group, the non-meridian non-acupuncture group, the other meridian-taking group, and the waiting-for-treatment group. After 4 weeks of acupuncture treatment, it was found that the meridian-taking group had the best treatment effect.
If you have pierced the needles, you will have such a feeling, the moment the needles pierce, the soreness, swelling and numbness compound attack. At this time, the invisible internal body, a series of chain reaction is also taking place. It was found that the local initiation of acupuncture point effect is related to the opening of mast cell mechanosensitive channels, the release of a series of bioactive substances such as adenosine and histamine, the activation of afferent nerve electrical activity, and the discovery of the effect of meridian-specific multi-level, multi-target, overall integrated response of target organ regulation mode.
In other words, there is a string of tight dominoes system between the cells at the acupuncture points to the brain, when the silver needles are lifted and twisted, the organ is triggered, the signal is transmitted to the brain center, and then through the downstream mechanism to regulate the effector organs, and finally the body benefits.
In order to figure out how the brain reacts, Liang Prosperity came up with an imaging approach to study the brain, and the MRI images showed that acupuncture following the meridians had a relatively specific adjustment effect on abnormal activity in brain areas of the patient's autonomic regulatory network, such as the insula. This is the first time in the history of acupuncture research.
She led this project
Driving China's maternal mortality rate down by nearly 70 percent
Maternal mortality has remained high globally for a long time. The top three causes of these maternal deaths are mainly obstetric hemorrhage, gestational hypertension, and amniotic fluid embolism.
In order to reduce maternal mortality in China, Liu Xinghui, Director of the Department of Obstetrics and Gynecology at the Second Hospital of West China, Sichuan University, has led a team to conduct more than 20 years of research on the early warning, prevention and treatment of these two critical obstetric conditions. Recently, Liu Xinghui led the project "research and application of obstetric critical illnesses based on reducing maternal mortality", which got the first prize of Sichuan Science and Technology Progress Award.
Three major innovations
Several world firsts for the right medicine
To address the key issues and challenges in the prevention and treatment of obstetric critical illnesses, Liu Xinghui led his team to start the research project of "Research and Application of Obstetric Critical Illnesses Based on Reducing Maternal Mortality" since 2000, proposing the construction of early warning models, optimization of preventive measures and innovative treatment methods from three aspects of early warning, prevention and treatment of obstetric critical illnesses, so as to reduce obstetric critical illnesses, protect women's fertility and reduce maternal mortality.
● In terms of building early warning models, Liu Xinghui's team was the first in China to establish a big data platform and research method covering the whole life cycle of maternity, and based on this, the first preoperative early warning model for hypertensive disease in pregnancy and postpartum hemorrhage with Chinese maternal characteristics was created; the first preoperative early warning model for cesarean delivery was established.
"Our early warning model has the largest sample size in the world, which is not easy globally." Liu Xinghui said that precisely because the sample size is large enough, the first early warning model for hypertensive disorders in pregnancy has improved by 51.9% compared to the current optimal foreign prediction model.
● In terms of prevention, Liu Xinghui's team has conducted several studies on the prevention of postpartum hemorrhage and hypertensive disorders of pregnancy, and moreover, has developed our own standard guidelines for prevention. She explains, "We have updated the existing clinical guidelines with evidence-based medicine level I evidence, abandoned the traditional preventive measures recommended by the World Health Organization, domestic and international guidelines and textbooks for decades, and optimized the prevention protocol for postpartum hemorrhage."
In terms of treatment, the project team created the world's first "double-incision" hemostasis procedure, which significantly reduced the rate of hysterectomy; carried out a national multi-center study on autologous blood transfusion in obstetrics, which helped save a large amount of blood supply; and created the first three-level emergency procedure for postpartum hemorrhage, which standardized the clinical management of postpartum hemorrhage in China.
"Although the maternal mortality rate in China has decreased significantly, there are still about 10,000 mothers who have their uterus removed each year due to obstetric critical illnesses." Liu Xinghui pointed out that in Sichuan, in particular, the hysterectomy rate is 1.9/1000, much higher than the national rate of 0.38/1000. the project team's pioneering "double-incision hysterectomy" procedure reduced the hysterectomy rate to 3.3% for placental implantation disease, while the hysterectomy rate for other procedures at home and abroad was still as high as 40%-50% during the same period. 50%. The incidence of postpartum hemorrhage was reduced by about 50%.
Promotional Applications
China's maternal mortality rate drops nearly 70 percent
After years of research, the effectiveness of the project is also being proven. Before the project started, the maternal mortality rate in China was still as high as 53.0/100,000, including 66.5/100,000 in Sichuan Province, but after the project ended, it has dropped to 17.8/100,000 and 17.7/100,000 respectively, a decrease of 66.4% and 73.4%; the maternal mortality rate due to obstetric hemorrhage and hypertensive disorders during pregnancy nationwide has dropped by 85.6% and 73.7% respectively.
Because of the remarkable results, the program is being applied nationwide, benefiting millions of pregnant women. For 15 years, the program has continued to provide grassroots training in the treatment of obstetric critical illnesses, including 13,612 on-site training sessions and 1,081,000 online training sessions in the past three years, improving the overall level of diagnosis and treatment of obstetric critical illnesses in China, promoting a significant reduction in maternal mortality, and helping China achieve the UN Millennium Development Goal of reducing maternal mortality ahead of schedule. "This has helped China to achieve the United Nations Millennium Development Goal of reducing maternal mortality ahead of schedule.
Martin, a famous expert in obstetrics and gynecology and academician of the Chinese Academy of Engineering, also spoke highly of the project team's research in the field of obstetric critical care: "The project team led by Professor Liu Xinghui has conducted in-depth innovative research on obstetric critical care for nearly 20 years, applied the results to the clinic and promoted them in national demonstrations, making a significant contribution to reducing maternal mortality in China! "
Comprehensive: Chuan Guan News, Sichuan Daily
Some images according to: Second West China Hospital of Sichuan University, network, etc.
