Technology and Health Care - Volume 32, issue 2

Authors: Lin, Wenqian | Lin, Jun | Yang, Yongyong | Lin, Lianhe | Lin, Qun

Article Type: Review Article

Abstract: BACKGROUND: Dural mater is punctured by using a spinal needle without drugs administrated into intrathecal space directly in dural puncture epidural (DPE) analgesia. OBJECTIVE: This study aimed to summarize the evidence of benefits and risks of DPE analgesia with 25-G spinal needles for labor pain relief. METHODS: DPE analgesia with EP analgesia for labor pain relief were systematically searched. The Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science databases were systematically searched till 6th November 2022 to find out randomized controlled trials (RCTs) comparing DPE (using 25-G spinal …needles) with conventional epidural (EP) analgesia. The risk of bias was assessed with the Cochrane tool. Risk ratio, mean difference, and 95% confidence intervals were calculated. RESULTS: Seven RCTs with 761 parturients were identified. Pool data showed that DPE technique was associated with shorter time to pain score ⩽ 3/10, higher percentage with pain score ⩽ 3/10 at 10 min and 20 min, lower incidence of epidural top-up bolus and no S2 block, higher incidence of bilateral S2 blockade at 10 min and during labor, lower incidence of epidural top-up bolus and incidence of asymmetric block. No statistical difference in side effect and parturient satisfaction between DPE and EP technique. CONCLUSION: DPE technique with 25-G spinal needles was associated with faster analgesia onset and sacral coverage, greater sacral spread, lesser requirement of epidural top-up and lower incidence of asymmetric block. DPE technique with 25-G spinal needles showed a greater benefit to parturients. Show more

Keywords: Labor pain, epidural, analgesia, meta-analysis

DOI: 10.3233/THC-230059

Citation: Technology and Health Care, vol. 32, no. 2, pp. 495-510, 2024

Authors: Wang, Pu | Fu, Yan-Hua | Qi, Hong-Feng | He, Peng | Wang, Hai-Feng | Li, Chao | Liu, Xue-Cong

Article Type: Review Article

Abstract: BACKGROUND: Radical resection of lung cancer and chemotherapy are the main methods for the treatment of early lung cancer, but surgical treatment is still the key and preferred method. OBJECTIVE: To evaluate the efficacy and safety of robotic-assisted thoracic surgery (RATS) and video assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC). METHODS: The clinical cohort studies on the comparison of the effects of RATS and VATS in the treatment of NSCLC published in Web of Science, PubMed, The National Library of Medicine (NLM), China National Knowledge Infrastructure (CNKI) and Wanfang database …from January 1, 2015 to December 31, 2022 were searched. Two researchers independently screened the literature, extracted the data, such as operation time, intraoperative conversion rate, intraoperative blood loss, number of lymph nodes dissected, and evaluated the quality of the included literature based on the Newcastle-Ottawa Scale (NOS). RevMan 5.3 software was used for Meat analysis. RESULTS: A total of 18 articles and 21,802 subjects were included. The results of the meta-analysis showed that the intraoperative blood loss of RATS was significantly less than that of VAS, and the difference was statistically significant [MD = - 38.43 (95% CI: - 57.71, - 19.15, P < 0.001)]. Compared with VATS, the number of lymph nodes dissected in RATS was significantly higher [MD = 2.61 (95% CI: 0.47, 4.76, P = 0.02)]. The rate of conversion to thoracotomy in RATS was lower, and the difference was statistically significant [OR = 0.59 (95% CI: 0.50, 0.70, P < 0.001)]. There was no significant difference between RATS and VATS in operation time [MD = - 9.34 (95% CI: - 28.72, 10.04, P = 0.34)], postoperative thoracic drainage time [MD = - 0.08 (95% CI: - 0.42, 0.26, P = 0.64)], postoperative hospital stay [MD = - 0.05 (95% CI: - 0.19, 0.08, P = 0.42)], postoperative mortality [OR = 0.88 (95% CI: 0.56, 1.36, P = 0.56)] and postoperative complications [OR = 1.03 (95% CI: 0.93, 1.13, P = 0.57)]. CONCLUSION: Compared with VATS, the number of lymph nodes dissected in RATS was significantly more, and the removal of lesions and lymph nodes was more thorough and accurate. More flexible and precise operation avoids the injury of important blood vessels during operation, effectively reduces the amount of blood loss during operation, shortens the indwelling time of thoracic drainage tube, and is conducive to postoperative rehabilitation of patients. Show more

Keywords: Robotic-assisted thoracic surgery, video assisted thoracic surgery, non-small cell lung cancer

DOI: 10.3233/THC-230201

Citation: Technology and Health Care, vol. 32, no. 2, pp. 511-523, 2024

Authors: Nie, Xiaojuan | Wang, Dandan | Pan, Ye | Hua, Ye | Lü, Peng | Yang, Yanhua

Article Type: Review Article

Abstract: BACKGROUND: The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system is an acquired immune system of bacteria and archaea. Continued research has resulted in the identification of other Cas13 proteins. OBJECTIVE: This review briefly describes the discovery, classification, and application of the CRISPR-Cas13 system, including recent technological advances in addition to factors affecting system performance. METHODS: Cas13-based molecular therapy of human, animal, and plant transcriptomes was discussed, including regulation of gene expression to combat pathogenic RNA viruses. In addition, the latest progress, potential shortcomings, and challenges of the CRISPR-Cas system for treatment of …animal and plant diseases are reviewed. RESULTS: The CRISPR-Cas system VI is characterized by two RNA-guided higher eukaryotes and prokaryotes nucleotide-binding domains. CRISPR RNA can cleave specific RNA through the interaction between the stem-loop rich chain of uracil residues and the Cas13a protein. The CRISPR-Cas13 system has been applied for gene editing in animal and plant cells, in addition to biological detection via accurate targeting of single-stranded RNA. CONCLUSION: The CRISPR-Cas13 system offers a high-throughput and convenient technology for detection of viruses and potentially the development of anti-cancer drugs in the near future. Show more

Keywords: CRISPR, Cas13, genome edit, gene detection

DOI: 10.3233/THC-230258

Citation: Technology and Health Care, vol. 32, no. 2, pp. 525-544, 2024

Authors: Jiang, Ye | Ju, Weina | Gai, Ning | Qi, Baochang

Article Type: Other

Abstract: BACKGROUND: Nonunion is a major concern for orthopedic surgeons, particularly nonunion of the clavicle, which can cause severe pain, loss of full range of motion, poor sleep quality, and loss of strength in the affected individuals. Platelet-rich plasma (PRP), an important biological agent, is widely used in orthopedics. OBJECTIVE: We used a combination of three techniques – the PRP technique, autologous bone grafting technique, and internal plate fixation technique – to ensure adequate internal fixation and enable a bone growth-supportive environment at the fracture site. METHODS: The surgical approach was applied to a …patient with clavicle nonunion. RESULTS: Based on postoperative follow-up findings and intraoperative findings at the time of re-removal of the patient’s implant, the prognosis at the fracture site was considered satisfactory. CONCLUSION: We observed that the patient treated with this method had favorable clinical outcomes, and we recommend that this technique be used in patients with long-bone nonunion. Show more

Keywords: PRP, autologous bone grafting, internal plate fixation

DOI: 10.3233/THC-230336

Citation: Technology and Health Care, vol. 32, no. 2, pp. 545-550, 2024

Authors: Kayama, Mizue | Nagai, Takashi | Futagami, Takao | Terasawa, Koji

Article Type: Research Article

Abstract: BACKGROUND: The actual changes in biological and physiological parameters during walking are little understood in multiple aspects. OBJECTIVE: The objective of this paper was to examine and link the disparate measures of motor, vision, and brain activity for elderly and young adults. METHOD: The participants were 15 elderly adults and 10 young adults. Accelerometry, eye tracking, and prefrontal cortex (PFC) activity in the functional near-infrared spectroscopy (fNIRS) were used to evaluate the participants in a 10-m walking test. RESULT: The results for the elderly adults were 1) low variabilities of …velocity and acceleration along the front-back and up-down axes, 2) a wider gaze range on the right-left axis than the young adults, 3) a high mean PFC activity, and 4) a larger number of high-relation pairs than the young adults for the correlation coefficients of both gait vs. gaze and gait vs. PFC activity. The variabilities of velocity and acceleration, gaze and PFC activity changes for the young adults were selective. CONCLUSION: Measuring 10-m walking in a polymetric approach may capture some indicators related to physical and cognitive difficulties such as frailty and dementia. Show more

Keywords: 10-m walking, gait, gaze, PFC activity, polymetric approach, elderly adults

DOI: 10.3233/THC-220447

Citation: Technology and Health Care, vol. 32, no. 2, pp. 551-563, 2024

Authors: Huang, Ting | Duan, Miao

Article Type: Research Article

Abstract: BACKGROUND: Hyperbilirubinemia is a common disorder in neonates, with premature infants at higher risk of developing the disorder. OBJECTIVE: Glucose-6-phosphate dehydrogenase (G6PD) gene detection was used to determine the incidence of G6PD deficiency and analyze the etiologies of G6PD deficiency in neonates with hyperbilirubinemia in the Zunyi region with the aim of providing scientific evidence for the clinical diagnosis and treatment. METHODS: For the gene detection, 64 neonates with hyperbilirubinemia were selected as the observation group and 30 normal neonates were selected as the control group, and the risk factors for hyperbilirubinemia were …investigated by using multivariate logistic regression analysis. RESULTS: Among the neonates in the observation group, 59 cases had the G1388A mutation (92.19%) and 5 cases had the G1376T mutation (7.81%). No mutation was detected in the control group. In the observation group, the proportion of neonates who were born prematurely, with artificial feeding, with the age of starting feeding of more than 24 h, the time of first bowel movement of more than 24 h, premature rupture of membranes, infection, scalp hematoma, and perinatal asphyxia was higher than that in the control group, and the difference was statistically significant (p < 0.05). Multivariate logistic regression analysis showed that prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding of more than 24 h, and the time of first bowel movement over 24 h were risk factors for the development of neonatal hyperbilirubinemia (p < 0.05). CONCLUSION: The G1338A and G1376T mutations were important features of the genetics of neonatal hyperbilirubinemia, and genetic detection together with the prevention of prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding, and the time of first bowel movement would help reduce the incidence of this disease. Show more

Keywords: Neonate, hyperbilirubinemia, gene detection, G6PD, risk factor

DOI: 10.3233/THC-220472

Citation: Technology and Health Care, vol. 32, no. 2, pp. 565-572, 2024

Authors: Han, Xueyan | Dong, Litong | Zhang, Wenxiao | Liang, Chun | Wang, Zuobin

Article Type: Research Article

Abstract: BACKGROUND: Cells adherence provides specific information about physiology and pathology, the adhesion measurement between living cells and nanostructures can be measured by atomic force microscopy, but this detection technique is difficult to operate and costly. The adhesion height and effective contact area between cells and substrates are also the key factors affecting measurement value of the overall impedance. These factors change with structural parameters of the substrates, so the adhesion measurement between living cells and substrate can be indirectly reflected by the impedance value. OBJECTIVE: To establish a mapping relationship between the impedance measurement and the …adhesion measurement of living cells. The possibility of dynamic measurement of adhesion is realized by this method, and the experimental process is simplified. METHODS: Laser interference technology was used to prepare nanoarray structures with different periods on the surface of silicon wafers for cells culture. Under the same experimental conditions, the impedance of living cells on the substrates of different cycle sizes were measured. The adhesion between cells and different substrates were analyzed by measuring impedance after the interaction between cells and substrate. RESULTS: The adhesion of living cells on the substrates of different sizes be analyzed, and the mapping relationship between the impedance and the adhesion measurement was established. The results showed that, the larger the impedance value between cells and substrate, the larger the effective contact area and the smaller the gap between them. CONCLUSION: The difference of adhesion height and effective adhesion area between living cells and substrates were obtained. This paper, a new method to measure the adhesion properties of living cells is presented, which provides theoretical basis for the related research. Show more

Keywords: Living cells, nanostructure, impedance, adhesion, effective adhesion areas

DOI: 10.3233/THC-220584

Citation: Technology and Health Care, vol. 32, no. 2, pp. 573-583, 2024

Authors: Egenolf, Philipp | Wahlers, Christopher | Grevenstein, David | Gathof, Birgit S. | Eysel, Peer | Oppermann, Johannes

Article Type: Research Article

Abstract: BACKGROUND: C-reactive protein (CRP)- and leukocyte levels are common parameters to evaluate the inflammatory response after orthopaedic surgery and rule out infectious complications. Nevertheless, both parameters are vulnerable to disturbing biases and therefore leave room for interpretation. OBJECTIVE: Since blood groups are repeatedly discussed to influence inflammatory response, our aim was to observe their impact on CRP and leukocyte levels after total hip and knee arthroplasty (THA/TKA). METHODS: Short term postoperative CRP and leukocyte levels of 987 patients, who received either primary TKH (n = 479) or THA …(n = 508), were retrospectively correlated with their blood group. ABO, Rhesus and a combination of both blood groups were differentiated. RESULTS: CRP levels after TKA were significantly higher in blood type AB than in type A and O on day 2–4 and also than in type A on day 6–8. Leukocyte levels after THA were significantly higher in blood group type O than in type A on day 6–8 while still remaining in an apathological range. We observed no significant differences between Rhesus types and Rhesus types and CRP or leukocyte levels. CONCLUSION: We observed significantly increased CRP levels after TKA in patients with blood group AB. Since the elevated CRP levels do not account for early periprosthetic infection, surgeons should include this variation in their postoperative evaluation. Show more

Keywords: Arthroplasty, leukocytes, C-reactive protein, ABO blood-group system

DOI: 10.3233/THC-220635

Citation: Technology and Health Care, vol. 32, no. 2, pp. 585-593, 2024

Authors: Li, Wenzhe | Xu, Li | Wang, Yajing | Li, Wenjun | Maimaiti, Meiligu | Kou, Bin | Liu, Chenchen | Zhang, Meng | Xia, Hongjuan | Yuan, Fang

Article Type: Research Article

Abstract: BACKGROUND: Without timely and effective interventions or treatments, radiation-induced liver damage (RILD) can lead to serious consequences for the patients and their families. OBJECTIVE: To investigate the protective effect of intermittent hypobaric hypoxia preconditioning (IHHP) in RILD. METHODS: Male adult SD rats were randomly divided into 8 groups including one control group, one only irradiation group and other experimental groups. Blood routine tests and liver function tests were all assessed with abdominal venous blood. Moreover, hematoxylin eosin (HE) staining and immunohistochemistry assay were used to detect the histopathological changes and expressions of transforming …growth factor-β 1 (TGF-β 1), tumor necrosis factor α (TNF-α ) and hypoxia-inducible factor 1α (HIF-1α ) in radiated liver sections. RESULTS: Blood routing tests showed that RBC, WBC and Hb were all significantly increased while the differences of these results between different groups with same simulated altitude were approximate. However, liver function in the IHHP plus irradiation at 4000 m group was significantly decreased (P < 0.05) compared to only irradiation groups, and the manifestation of HE and lower positive expression of TNF-α showed improved histopathological changes in the liver section. Furthermore, no significant difference of HIF-1α expression between any two groups treated with IHHP was observed. CONCLUSION: IHHP at the altitude of 4000 m group could alleviate the radioactive liver damage by downregulating TNF-α and less strong positive expression of TGF-β 1. Furthermore, patients exposed to radiation might benefit from this treatment to prevent or reduce the RILD. Show more

Keywords: Liver injury, irradiation, radiation induced liver damage (RILD), hypoxia inducible factor-1α (HIF-1α), intermittent hypobaric hypoxia preconditioning (IHHP), oxidative stress

DOI: 10.3233/THC-220718

Citation: Technology and Health Care, vol. 32, no. 2, pp. 595-604, 2024

Authors: Bing, Wanchun | Zhang, Xiaoxiao | Wang, Dawei | Gu, Xiaoyan

Article Type: Research Article

Abstract: BACKGROUND: Recurrent acute pancreatitis is a common acute abdominal disease in surgery. OBJECTIVE: To evaluate the radiographic features of pancreatic computed tomography (CT) imaging in the diagnosis of acute and chronic pancreatitis. METHODS: 48 pancreatitis patients who met the criteria were selected in this retrospective study from 2010 to 2019. Each diagnosis was evaluated as functional abdominal pain, recurrent acute pancreatitis, or chronic pancreatitis. All clinical data were collected from the patient’s medical records. 54 radiological features were extracted from each region of interest in outline the pancreas and divided into five categories: …first order statistics, the gray level co-occurrence matrix (GLCM), the gray level run-length matrix (GLRLM), the neighborhood gray level difference matrix (NGTDM), and morphological features by the MATLAB program. RESULTS: Of the 48 patients, 16 had functional abdominal pain (33.3%), 18 had recurrent acute pancreatitis (37.5%), and 14 had chronic pancreatitis (29.2%). In the univariate analysis, nine radiological features, eight GLCM features and one NGTDM feature were significantly different between groups. Nine radiological characteristics had important reference values with AUC values ranging from 0.73–0.91. CONCLUSION: Nine radiographic features of CT imaging demonstrate good evaluation efficiency in the diagnosis of pancreatitis and can distinguish patients with functional abdominal pain, recurrent acute pancreatitis, and chronic pancreatitis. Show more

Keywords: Computed tomography, radiomics, recurrent acute pancreatitis, chronic pancreatitis

DOI: 10.3233/THC-220732

Citation: Technology and Health Care, vol. 32, no. 2, pp. 605-613, 2024