Diseases that Harm Require Therapies that Harm Less

---Sir William Osler(1849-1919)
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ISMIVS Newsletter December, 2020

Newsletter 2020 December

2020 年 12 月简报
About Us 国际微无创医学会简介
The International Society of Minimally Invasive and Virtual Surgery (ISMIVS, previously known as International Society of Minimally Invasive and Noninvasive Medicine) was founded in July 2013 at the gala of the 1st Yangtze International Summit of Minimally Invasive and Noninvasive Medicine in Chongqing, China. ISMIVS envisions to accelerating the progress in minimally invasive and noninvasive medicine by promoting research, education, communication, and international collaboration.
国际微无创医学会(ISMIVS)是在 2013 年 7 月在中国重庆召开的第一届国际微无创医学长江高峰论坛上宣布成立的,旨在通过学术研究、教育、交流以及国际合作加快微无创医学的发展。
Become a member 注册成为会员 >
The Personality in the Medical Education World 医学教育界的大人物
From the July issue of our ISMIVS Newsletter, we would like to introduce some pioneers in the field of minimally-invasive and noninvasive medicine. They are not only prestigious in their field but also willing to share their experience and ideas with younger doctors, hence making a great contribution to medical education. In this issue, we are going to introduce Dr. Abayomi Ajayi.
从 7 月刊开始,国际微无创医学会将为大家介绍微无创医学领域的一些领军人物。他们不仅在各自的领域享负盛名,而且非常乐意与年轻医生分享他们的经验、理念和想法,从而为医学教育做出了巨大的贡献。本月刊要介绍的医学教育界的大人物是阿巴约米·阿贾伊( Abayomi Ajayi )医生。
Dr. Abayomi Ajayi was born in Lagos, Nigeria. He attended CMS Grammar School, Lagos from 1973 to 1978, and then graduated from the College of Medicine, University of Lagos in 1984. He completed his postgraduate training at the University College Hospital, Ibadan in 1994 with the fellowship of the West African College of Surgeons in Obstetrics and Gynecology.
阿贾伊医生生于尼日利亚拉各斯市。1973 年至 1978 年,阿贾伊就读于拉各斯 CMS 语法学校;1984 年,毕业于拉各斯大学医学院;1994 年,在伊巴丹大学学院医院完成医学研究生教育,并获得西非妇产科医学院奖学金。
Dr. Abayomi Ajayi joined the services of Lagoon Hospital, Lagos as a Consultant in Obstetrics & Gynecology in February 1995 and held this position till October 2002, when he left to start Nordica Fertility Centre, Lagos. During his stay at Lagoon Hospital, he was appointed the coordinator of the out-patient services of the Hospital. He is currently the Managing Director & Chief Executive Officer of Nordica Fertility Centre, Lagos which pioneered the Intracytoplasmic Morphologically Selected Injection (IMSI) in Nigeria; the clinic specializes in in-vitro fertilization and treatment of infertility. He is the country's representative of obgyn.net, which is an international network of obstetricians and gynecologists.
1995 年 2 月,阿贾伊医生加入拉各斯泻湖医院,担任妇产科顾问医师一职,直到 2002 年 10 月离职,随后成立了拉各斯 Nordica 辅助生殖中心( Nordica Fertility Centre )。在泻湖医院工作期间,他还被任命为医院门诊服务协调员。现任拉各斯 Nordica 辅助生殖中心总经理兼首席执行官,该中心在尼日利亚率先开展卵浆内形态选择后单精子注射( IMSI )技术的应用;该中心专长体外受精和不孕症治疗。除此之外,阿贾伊医生也是国际妇产科医师网络联盟( obgyn.net )的尼日利亚国家代表。
In November 2019, Dr Abayomi Ajayi launched a Physicians Mentoring Programme for young medical professionals to tackle the high rate of brain drain in Nigeria's health sector. Ajayi is the country representative for Endometriosis Support Group. He has appeared on numerous television and radio programs and channels talking and educating people about infertility. He is an advocate for helping couples with infertility and speaks on the topic on the programme Nordica Fertility Center on “STV today”. In addition to this, he hosts a bi-weekly 30-minute long live interactive session on Facebook & Instagram where he talks about fertility related issues. This has had a huge influence on both the local communities in his country, as well as the world at large.
2019 年 11 月,阿贾伊医生为年轻的医学专业人士启动了医生指导计划,以解决尼日利亚卫生部门人才流失率高的问题。阿贾伊医生是尼日利亚子宫内膜异位症支持小组的代表,曾在许多电视和广播节目及频道中,与大众宣讲、科普不孕症。他倡导帮助不孕夫妇,并在“今日 STV ”的 Nordica 辅助生殖中心节目中就该主题发表演讲。此外,他还经常在脸书( Facebook ) 和图片墙( Instagram )平台上与大众直播互动,谈论生育相关的话题,直播每两周举行一次,每次时长 30 分钟。这对他所在的尼日利亚本地社区以及整个世界都产生了巨大的影响。

Please see below two papers by Dr.Abayomi Ajayi:
阿贾伊医生的两篇文章分享如下:
Maternal height and prior vaginal delivery as predictive factors in the trial of labour after one Caesarean Section.
《产妇身高和先前阴道分娩:剖腹产后分娩试验的预测因素》
https://www.tandfonline.com/doi/abs/10.1080/01443619768551?journalCode=ijog20
Daycare diagnostic Laparoscopy in Infertility evaluation.
《不孕评估中的诊断性腹腔镜》
https://www.researchgate.net/publication/272782627_Daycare_diagnostic_laparoscopy_in_infertility_evaluation
News 新闻
ISMIVS launching its online training program
国际微无创医学会培训课程上线中
The International Society of Minimally Invasive and Virtual Surgery is pleased to announce the availability of a series of online training courses on the clinical application of noninvasive focused ultrasound therapy. A variety of courses related with ultrasound-guided high intensity focused ultrasound (HIFU) ablation of uterine fibroids will enlighten doctors about the physics and biological effect of HIFU, case screening, clinical protocol, anesthesia plan, nursing care, etc. In the meantime, more courses on focused ultrasound therapy of other diseases will be uploaded in the future, please follow us on www.ismivs.org for what you are interested in.
国际微无创医学会很高兴向大家宣布:我们的线上培训课程开始正式上线。课程将涵盖超声引导的高强度聚焦超声(HIFU)消融子宫肌瘤的物理学基础和生物学效应、病例筛选、临床方案、麻醉方案以及临床护理等。同时更多聚焦超声无创治疗其他疾病的课程将陆续上线,欲了解更多,请关注我们的官方网站 www.ismivs.org
The training courses are accessible only to part of ISMIVS members.
培训课程仅向部分国际微无创医学会会员开放。
Online course: The Correlation between HIFU Dosage and HIFU Ablation Effect
线上课程:动物离体试验下聚焦超声消融剂量与效果的关系
This video records the process and result of the in vitro animal experiment on the correlation between HIFU dosage and HIFU ablation effect. Through this video, trainees are expected to understand the relationship between the treatment effect and the treatment depth, acoustic power and treatment time.
本课视频录制了聚焦超声消融离体动物组织试验的过程和结果,研究 HIFU 剂量与消融效果的关系。本课学习目标是通过试验视频理解消融效果与治疗深度、声功率以及治疗时间的关系。
Online course: MRI Features of Pelvic Diseases
线上课程:盆腔疾病 MRI 特征
This lecture shall introduce the critical role and use of MRI examination in HIFU treatment. Trainees are expected to learn the MR signal features of human tissues and be able to diagnose some typical uterine diseases and predict the treatment effect through preoperative MRI, as well as to evaluate the treatment efficacy through postoperative MRI.
本节课介绍了 MRI 检查在 HIFU 治疗中的重要作用以及应用。本课程学习目标是掌握不同人体组织的核磁信号特征,能够通过术前 MRI 诊断典型的子宫疾病并预测疗效以及通过术后 MRI 评价疗效。
Become a member >
申请成为会员 >
To apply for the training courses,
please contact the ISMIVS Secretariat
jennyzhang@isminim.org
申请线上课程学习,
请联系国际微无创医学会秘书处
jennyzhang@isminim.org
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ESGE HIFU SYMPOSIUM:TREATMENT OF SYMPTOMATIC MYOMATA
WITHOUT MEDICATION OR SURGERY: A RISING PHOENIX ?
欧洲妇科内镜学会(ESGE)2020 年会 HIFU 专场研讨会
非药物,非手术治疗有症状的子宫肌瘤的方式:腾飞的凤凰?
The online ESGE HIFU symposium was held on the 8th of December, 2020, drawing attention of many international OBGYNs. It was co-chaired by Prof. Rudy Leon De Wilde, Past President of European Society for Gynaecological Endoscopy (ESGE) and Prof. David Cranston, President of the International Society of Minimally Invasive and Virtual Surgery (ISMIVS).
2020 年 12 月 8 日, 欧洲妇科内镜学会(ESGE)2020 年会 HIFU 专场研讨会于线上举行,吸引了世界各地众多妇产科专家的关注。本次研讨会由欧洲妇科内镜协会(ESGE)前主席鲁迪·里昂·德·王尔德(Rudy Leon De Wilde)教授和国际微无创医学会( ISMIVS )主席大卫·克兰斯顿(David Cranston)教授共同主持。

To start with, Prof. Hugo C. Verhoeven, Chair of ESGE Working Group on Non-surgical ablative therapy of benign uterine disease, shared his understanding of HIFU with the participants. From his perspective, HIFU is a non-invasive technology that provides a possible alternative or complement to surgery, radiation, medication, and cancer therapy. He also introduced the two major advantages of HIFU ablation with the audience, namely, its clinical advantages and social advantages.
欧洲妇科内镜学会( ESGE )“子宫良性疾病非手术消融技术”工作组主席雨果·C·维霍文(Hugo C. Verhoeven)教授分享了他对海扶的见解。在他看来,HIFU 是一种非侵入性技术,可以替代或补充手术、放射、药物和癌症治疗。雨果·C·维霍文教授还介绍了 HIFU 消融的两种主要优势,即其临床优势和社会优势。

Dr. LEE Keen Whye, a founding member of the Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy (APAGE), also offered the audience valuable insights into this new technology. In his speech, he sent a clear message to the world that by using HIFU technology to treat a disease like symptomatic myomata, we need less endovision camera systems and blood transfusions. And at the same time, we can have a better deployment of medical resources such as operation rooms and nurses for other types of surgeries, representing a positive cost saving to the hospitals.
亚太妇产科内视镜暨微创治疗医学会(APAGE)创始董事李建威医生还向观众提供了对该新技术的宝贵见解。在演讲中,他向全世界传达了一个明确的信息,即通过使用 HIFU 技术治疗症状性肌瘤等疾病,我们可以减少内窥镜摄像系统以及输血的使用。同时,我们可以更好地部署医疗资源,例如手术室和护士,从而用于其他类型的手术,这在很大程度上为医院节省了成本。
Due to the time limit, there was no Q&A session this time. However, another session will be scheduled to enable the audience to have an opportunity to ask any questions they may have.
由于时间限制,此次会议没有问答环节。 不过,讲课专家们将安排另一场会议,以便听众提问和专家解答。
For the playback of the webinar, please click the link below:
观看会议回放,请点击以下链接:
https://youtu.be/8ikWu5qi7fU or http://live.99zigong.com/Html/video/997.html
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Emergency and Innovative Medicine Summit Forum
应急与创新医学高峰论坛暨生命健康产业博览会成功举办
The Emergency and Innovative Medicine Summit Forum during 2020 Beijing International Health Industry Expo was successfully held on the afternoon of December 12, 2020 in China International Exhibition Center, Beijing, China. It was co-organized by the China Association for Promoting UN Procurement and Beijing Huatong Guokang Foundation with the support of the United Nations Development Programme (UNDP) and the Global Health Forum of Boao Forum for Asia. Over 100 United Nations officials, World Health Organization officials and Presidents of Chinese hospitals attended this forum.
2020 年 12 月 12 日下午,由中国联合国采购促进会与北京华通国康公益基金会共同主办,联合国开发计划署、博鳌亚洲论坛全球健康论坛大会为支持单位的 “应急与创新医学高峰论坛暨生命健康产业博览会”在北京中国国际展览中心成功举办。100 多位联合国官员、世界卫生组织官员、多家中国医院院长参会。

Prof. David Cranston, University of Oxford, President of the International Society of Minimally Invasive and Virtual Surgery (ISMIVS) and Curator of 13 Norham Gardens and Osler's Library Oxford, was invited to deliver a speech entitled From William Osler's Medical Philosophy to the Guiding Principles of Minimally Invasive and Noninvasive Surgery. Via a video recorded for this Forum a few days ago, Prof. David Cranston gave a brief introduction to Sir William Osler and his legacy to medicine as well as the clinical research and application of Oxford University in the field of high intensity focused ultrasound (HIFU) in the past two decades for uterine fibroids, liver and kidney tumors, sacral chordomas, targeted drug delivery, etc.
牛津大学教授、国际微无创医学会( ISMIVS )主席、牛津诺勒姆花园 13 号奥斯勒图书馆馆长大卫·克兰斯顿(David Cranston)教授受邀参会,通过提前录制视频的方式给现场听众发表了题为“从威廉·奥斯勒的医学哲学到微无创外科的指导原则” 的演讲。大卫·克兰斯顿教授先是简要介绍了威廉·奥斯勒及其留给世人的医学财富,随后又介绍了牛津大学近 20 年来在高强度聚焦超声(HIFU)方面的研究和应用,适应症包括子宫肌瘤、肝肿瘤、肾肿瘤、骶骨脊索瘤、靶向给药等。

Here are some Osler Quotes/奥斯勒名言如下:
1. Soap and water and common sense are the best disinfectants. 肥皂、水和医学常识是最好的消毒。
2. Diseases that harm require treatments that harm less. 伤害人体的疾病需要对人体伤害更小的治疗方法。
3. Medicine is learned by the bedside and not in the classroom. 医学知识是在病人床边习得的,而不是在教室里。
4. The good physician treats the disease, but the great physician treats the patient who has the disease. 好的医生治病,伟大的医生治病人。
5. It is much simpler to buy books than to read them and easier to read them than to absorb their contents. 买书比读书简单,而读书比汲取书中的营养容易。
6. He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all. 不结合书籍学医就像是在一片未知的海域上航行,而一味学医而不去了解病人等同于连海都没出。
7. Care more for the individual patient than for the special features of the disease. Put yourself in his place, the kindly word, the cheerful greeting, the sympathetic look — these the patient understands. 多关注每个患者而不仅是疾病特征;设身处地,将心比心,亲切的话语、愉快的问候和关怀的眼神,这些是病人能感受到的。
8. A physician who treats himself has a fool for a patient. 给自己看病的医生是在给病人看笑话。
9. Start at once a bedside library and spend the last half hour of the day in communion with the saints of humanity. 设置一个床头图书馆,用一天的最后半个小时读一会儿书,与圣贤交流。
10. The young doctor should look about early for a pastime, that will take him away from patients, pills, and potions. 年轻医生应该尽早有点爱好,好暂离病人、药片和药水。
11. We are here to add what we can to life, not to get what we can from it. 我们的存在是来给生活做贡献的,而不是从中索取。
12. The first duties of the physician is to educate the masses not to take medicine. 医生的首要职责就是教育大众不要吃药。
13. The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases. 年轻医生刚执业时会给每种疾病开 20 种药,而老医生最后则会给 20 种疾病只开一种药。
14. The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. 医学实践是一门艺术而不是一桩生意,是使命而不是交易;医学实践这项使命需要用心和用情来修炼。
15. The philosophies of one age have become the absurdities of the next, and the foolishness of yesterday has become the wisdom of tomorrow. 一个时代的哲理可以成为昨日的谬论,而昨日的愚蠢可以成为明日的智慧。
Due to the time limit, there was no Q&A session this time. However, another session will be scheduled to enable the audience to have an opportunity to ask any questions they may have.
For the playback of the webinar, please click the link below:
观看会议回放,请点击以下链接:
https://youtu.be/bexiqn3MX-c or http://live.99zigong.com/Html/login/1024.html

Tech Update 微无创技术新进展
Gynecological endoscopic society of malaysia statement and recommendations on
gynecological laparoscopic surgery during COVID-19 pandemic
马来西亚妇科内镜学会关于COVID-19大流行期间妇科腹腔镜手术的声明和建议
In this article, the author presented the guidelines and recommendations on gynecological laparoscopic surgery during this COVID-19 outbreak in Malaysia, for example:
作者在本文提出了COVID-19在马来西亚爆发期间妇科腹腔镜手术的指导方针和建议,比如:
1. COVID-19 screening swab test should be taken to determine patient's status before all surgery, including laparoscopy.
1. 在所有手术(包括腹腔镜手术)之前,应进行 COVID-19 筛查拭子检测,以确定患者状态。
2. For asymptomatic patients who were negative for COVID-19 in their viral swab test, the laparoscopic procedures should be encouraged as with usual practice.
2. 对于 COVID-19 病毒拭子检测呈阴性的无症状患者,应按常规鼓励腹腔镜手术。
3. During intubation and extubation, all healthcare workers (HCWs) should vacate the operating room until the anesthetist has prepared the patient.
3. 在插管和拔管时,所有医护人员应撤离手术室,直到麻醉师准备好病人。
4. In view of the pandemic with limited resources and time, the procedure should involve only a privileged and an experienced anesthetist, surgeon, and their assistants.
4. 鉴于新冠疫情大流行的资源和时间有限,腹腔镜手术应只涉及一位享有特殊待遇之人、一位经验丰富的麻醉师和外科医生及其助手。
5. Beware of the high risk of explosive dispersion of bodily fluid with specimen removal (both abdominally and vaginally).
5. 体液爆炸分散的风险很高,在(经腹和经阴道)取出标本时,务必小心。
Read More >
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Adverse effect analysis of high-intensity focused ultrasound
in the treatment of benign uterine diseases
高强度聚焦超声(HIFU)治疗妇科良性疾病的副反应分析
A 19-center retrospective case series of 27,053 patients on the side effects of HIFU treatment that includes 4 indications (uterine fibroids (n=17,402), adenomyosis (n=8434), caesarean scar pregnancy (n=876), or placenta accreta (n=341)) was published in the International Journal of Hyperthermia in 2018. Adverse effects were evaluated based on Society of Interventional Radiology classification system. Minor side effects (Class A and B) rate was around 48%, out of which the rate of Class A was at 47.5030%. Major side effects (Class C and D) was at 0.3844%. It decreased from 0.9565% in 2011 to 0.2852% in 2017. This study showed that HIFU is safe and effective in treating benign uterine diseases and major adverse effects occur at very low rate.
一项大样本多中心回顾性研究对 19 家中心的 27053 例接受超声消融的子宫肌瘤(17402 例)、子宫腺肌症(8434 例)、瘢痕妊娠(876 例)或胎盘植入(341 例)患者进行副反应分析。不良反应依据美国介入放射学会(SIR)的标准进行评估分级,轻微副反应(A 级和 B 级)率约为 48%,其中 A 级副反应率为 47.5030%;严重副反应(C 级和 D 级)率为 0.3844%,从 2011 年的 0.9565%下降至 2017 年的 0.2852%。该研究证明超声消融妇科良性疾病是安全有效的,并且严重副反应发生率非常低。
Read More >
The status and prospects of the clinical application of focused ultrasound ablation surgery 聚焦超声消融手术的临床应用现状及展望

On April 7, 2020, the status and prospects of the clinical application of focused ultrasound ablation surgery (FUAS) was published on the National Medical Journal of China, introducing the development history of FUAS, the status of clincal application of FUAS and problems and development directions facing FUAS.
2020 年 4 月 7 日,中华医学杂志发布了《聚焦超声消融手术的临床应用现状及展望》,介绍了聚焦超声消融手术的发展历史、临床应用现状以及发展面临的问题及发展方向。

Focused ultrasound ablation surgery (FUAS) or focused ultrasound ablation (FUA), i.e., high-intensity focused ultrasound (HIFU) ablation, is a non-invasive tumor treatment technology that has been developed in recent years. The principle is to make use of the effective penetration of ultrasound waves through human tissues; the ultrasound beams generated by the ultrasound transducer outside the human body is precisely focused on the target lesion in the body under monitoring image guidance, causing coagulative necrosis of the lesion by the conversion of mechanical effect into thermal and cavitation effect, thereby achieving non-invasive ablation of the lesion.
聚焦超声消融手术(FUAS)或聚焦超声消融(FUA),即高强度聚焦超声(HIFU)消融,是近年发展起来的一种非侵入性肿瘤治疗技术。其原理是利用超声波在人体组织的良好穿透性,在监控影像的引导下,将超声换能器(治疗头)在人体外产生的超声波精准聚焦于体内病灶靶点,通过将机械效应转化为热效应、空化效应,使病灶产生凝固性坏死,从而可实现无创消融病灶的目的。

After nearly 20 years of clinical research and clinical implementation, FUAS has become increasingly mature for the treatment of benign and malignant tumors. In recent years, MRgFUS technology has conducted very beneficial explorations in the treatment of metastatic bone tumors and intracranial nervous system diseases, and has achieved satisfactory results. Compared with MRgFUS, USgFUAS has wider indications, shorter treatment time, and higher ablation efficiency. USgFUAS has been widely used not only in the treatment of uterine fibroids, adenomyosis, benign prostatic hyperplasia, but also in the treatment of such malignant tumors as liver cancer, pancreatic cancer, bone tumors, soft tissue tumors, prostate cancer, breast cancer and kidney cancer.
经过近 20 年的临床研究和临床实践,FUAS 在治疗良恶性肿瘤等方面日趋成熟。 近年来,MRgFUS 技术在转移性骨肿瘤及颅内神经系统疾病的治疗方面进行了非常有益的探索,取得了令人满意的效果。与 MRgFUS 比较,USgFUAS 的适应证更广,治疗时间更短 ,消融效率更高。USgFUAS 不仅广泛用于治疗子宫肌瘤、子宫腺肌病、良性前列腺增生,还用于肝癌、胰腺癌、骨肿瘤、软组织肿瘤、前列腺癌、乳腺癌及肾癌等恶性肿瘤的治疗。
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+86 23 67886199

ISMIVS 2020