Wearable physiological parameter monitoring devices play an increasingly important role in daily health monitoring and disease diagnosis/treatment due to their continuous dynamic and low physiological/psychological load characteristics. After decades of development, wearable technologies have gradually matured, and research has expanded to clinical applications. This paper reviews the research progress of wearable physiological parameter monitoring technology and its clinical applications. Firstly, it introduces wearable physiological monitoring technology’s research progress in terms of sensing technology and data processing and analysis. Then, it analyzes the monitoring physiological parameters and principles of current medical-grade wearable devices and proposes three specific directions of clinical application research: 1) real-time monitoring and predictive warning, 2) disease assessment and differential diagnosis, and 3) rehabilitation training and precision medicine. Finally, the challenges and response strategies of wearable physiological monitoring technology in the biomedical field are discussed, highlighting its clinical application value and clinical application mode to provide helpful reference information for the research of wearable technology-related fields.
ObjectiveTo evaluate the feasibility and safety of laparoscopic cholecystectomy (LC) in same-day surgery model. MethodsThe patients who underwent LC at West China Tianfu Hospital of Sichuan University from November 1, 2023 to July 31, 2024, were retrospectively reviewed. The enrolled patients were divided into a same-day surgery LC group and a conventional inpatient LC group. In the same-day surgery group, a same-day discharge protocol was implemented, whereby patients were admitted, operated on, and discharged on the same day, with discharge required no later than 21:00 without an overnight stay. The conventional inpatient group was managed according to the conventional model. A comparison was carried out between the two groups concerning baseline characteristics, perioperative outcomes, surgery-related complications, postoperative urinary retention, total length of stay, hospitalization costs, and 30-day follow-up results. ResultsA total of 347 patients were included, comprising 164 in the same-day surgery LC group and 183 in the conventional inpatient LC group. No statistically significant differences (P > 0.05) were found between the two groups in the following terms: total anesthesia time, operative time, intraoperative blood loss, intraoperative fluid infusion, length of stay in the post-anesthesia care unit (PACU), fluid infusion in the PACU, placement of abdominal drains, visual analog scale pain score at discharge, rates of unplanned revisits due to changes in their disease conditionwithin 30 d after discharge, readmission rates, and the incidence of surgery-related complications. All complications in both groups were graded as Clavien-Dindo Ⅰ. The same-day surgery LC group demonstrated significantly lower preoperative fluid infusion, postoperative fluid infusion, total hospitalization costs, and a shorter total length of stay compared to the conventional inpatient LC group (P<0.05). Furthermore, the incidence of postoperative urinary retention was significantly lower in the same-day surgery LC group (P<0.05). ConclusionsThis study demonstrates that same-day surgery LC is a safe and feasible approach for appropriately selected patients. Its outcomes in key perioperative safety metrics are comparable to those of the conventional inpatient LC model, while it offers the significant advantages of effectively reducing the length of hospital stay, lowering medical costs, and decreasing the incidence of certain postoperative complications.
Pulmonary hypertension (PH), characterized by diverse etiologies and intricate pathological mechanisms, is a complex cardiopulmonary vascular disorder featuring high morbidity and mortality. Percutaneous pulmonary artery denervation (PADN) represents an emerging interventional treatment method, which shows good prospects in the clinical practice of PH. The PADN has attained preliminary achievements in terms of safety and efficacy. Nevertheless, its long-term prognosis, the characteristics of the appropriate patient populations, and the optimization strategies combined with targeted pharmacotherapy remain to be further explored. This article reviews the current clinical applications of PADN as well as the challenges it confronts.
Objective To systematically review the effect of inspiratory muscle training (IMT) on postoperative clinical outcomes among esophageal cancer patients. Methods The PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases were searched from inception to January 16th, 2022 for randomized controlled trials (RCTs) and cohort studies on the clinical application of IMT among postoperative esophageal cancer patients. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results Eight studies were included, including 7 RCTs and 1 cohort study, involving 728 participants. The results of the meta-analysis demonstrated that IMT significantly enhanced postoperative respiratory muscle function [maximum inspiratory pressure (MIP): MD=5.75, 95%CI 0.81 to 10.70, P=0.02; maximum expiratory pressure (MEP): MD=8.19, 95%CI 4.14 to 12.24, P<0.001] and pulmonary function (FEV1%: MD=6.94, 95%CI 5.43 to 8.45, P<0.001; FVC%: MD=4.65, 95%CI 2.70 to 6.60, P<0.001; MVV: MD=8.66, 95%CI 7.17 50 10.14, P<0.001; FEV1/FVC%: MD=8.04, 95%CI 4.68 to 11.40, P<0.001). Additionally, the results indicated that IMT could substantially improve postoperative functional performance [six-minute walk test (6MWT): MD=66.99, 95%CI 10.13 to 123.85, P=0.02; Borg index: MD=−1.03, 95%CI −1.26 to −0.81, P<0.001]. However, no significant reduction in the incidence of postoperative complications was observed. Conclusion IMT can improve the postoperative clinical outcomes of esophageal cancer patients and facilitate patient recovery after surgery, which has high clinical value. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo summarize the application and research progress of robotic-arm in total knee arthroplasty (TKA).MethodsRelevant literature at home and abroad was extensively reviewed to analyze the advantages and disadvantages of robotic-arm assisted TKA (RATKA).ResultsAccurate reconstruction of lower extremity alignment and rotation alignment, accurate osteotomy and implant prosthesis in TKA are very important to improve the effectiveness and prolong the life of the prosthesis. Traditional TKA deviations occur in key links such as osteotomy due to operator’s operation. RATKA solves the above problems to a certain extent and can assist accurate osteotomy and implant prosthesis, and protect the soft tissues around the knee joint. Patients’ satisfaction after RATKA is high, and the operator’s learning curve is shorter, which improves the efficiency of the operation. But it also has disadvantages such as prolonged operation time, increased complications and medical costs.ConclusionPreliminary clinical application studies have shown that RATKA has satisfactory effectiveness, but its definite advantages compared with traditional TKA need to be confirmed by a large number of randomized controlled trials and long-term follow-up.
With the rapid development of all science and technology, new technologies are being used more and more widely in the medical field, bringing convenient diagnosis and treatment methods to medical staff and patients. The application of new technologies in the field of thyroid surgery is also rich, such as intraoperative neuromonitoring, parathyroid positive/negative imaging technique, laparoscopic and robot-assisted surgery technology, molecular and genomic diagnosis technology, artificial intelligence-assisted diagnosis technology, etc. The application of new technologies in the field of thyroid surgery is already a trend. While applying high-tech technologies, we need to have a deep understanding of the limitations of the technology itself. Some limitations must be strictly avoided, especially the early application of new technologies. We must view it dialectically and compare and combine it with traditional technical means to make clinical decisions and provide patients with the best, precise and individualized diagnosis and treatment. At the same time, as clinicians, we must have a deep understanding of the underlying logic of the advancement and development of new technologies themselves, and while deepening our professional fields, we must continuously improve our ability to apply them across disciplines in a comprehensive manner to adapt to and promote technological innovation and improvement and ultimately achieve the core goal of optimal personalized diagnosis and treatment.
The postoperative symptom burden in patients with lung cancer is severe and adversely impairs their quality of life. Symptom management is the cornerstone of medical care. Patient-reported outcome (PRO)-based symptom management is being increasingly recognized as the best "patient-centered care" model in clinical practice. However, the precise implementation of this model in patients undergoing lung cancer surgery is hindered by the lack of a lung cancer surgery-specific scale, implementation standards, clinical application parameters and high-quality researches. The use of a precise and simple PRO scale and an electronic PRO platform may greatly improve the feasibility of implementing this model. Currently, the application of PRO-based symptom management in lung cancer surgery is still being explored and needs to be improved in clinical research and practice.
This consensus aims to elucidate the applications of 3D fluorescence technology in thoracic surgery, summarizing its clinical value and prospects in areas such as sub-lobar resection, mediastinal structure protection, and lymph node dissection, providing a reference for the clinical practice of 3D fluorescence technology in thoracic surgery. Furthermore, this consensus is committed to advancing the research and innovation of domestically produced 3D fluorescence medical endoscopes. It seeks to clarify clinical practice needs and technical development directions, promote the widespread application of high-quality domestic medical endoscopes, and support the independent innovation and development of China's medical equipment industry.
Objective To observe the clinical application of multidisciplinary team (MDT) treatment in the management of geriatric hip fractures and evaluate its effectiveness. Methods The clinical data of 76 elderly patients with hip fracture managed by MDT approach between August 2016 and February 2018 (MDT group) were retrospectively analyzed and compared with 102 patients managed by traditional orthopedics approach between January 2014 and December 2015 (conventional group). There was no significant difference in gender, age, fracture type, surgical procedure, and other general data between the two groups (P>0.05). However, the number of comorbidities in the MDT group was significantly higher than that in the conventional group (t=6.295, P=0.000), and the proportion of the number of comorbidities between the two groups was also significantly different (χ2=28.442, P=0.000). The consultation rate and transfer rate, time to surgery, rate of surgery within 2 or 3 days, operation time, postoperative hospitalization stay, length of hospitalization stay, hospitalization expense, rate of loss to follow-up, and mortality during hospitalization, 30-day mortality, 90-day mortality, and 1-year mortality after operation were compared between the two groups. Results The rates of total consultations of the conventional group and the MDT group were 56.86% (58/102) and 56.58% (43/76), respectively, and the rates of total transferred patients were 15.69% (16/102) and 15.79% (12/76), respectively, with no significant differences (P>0.05). Among them, the proportion of patients who transferred into intensive care unit (ICU) in conventional group was significantly higher than that in MDT group and the rates of patients who received geriatric consultation or transferred into geriatric department in MDT group were both significantly higher than those in conventional group (P<0.05). There was no significant difference in rates of other department consultation or transfer between the two groups (P>0.05). The time to surgery, operation time, postoperative hospitalization stay, and length of hospitalization stay in MDT group were significantly less than those in conventional group, but the proportion of patients who received surgery within 3 days in MDT group was significantly higher than that in conventional group (P<0.05). There was no significant difference in the proportion of patients who received surgery within 2 days (χ2=2.027, P=0.155). The hospitalization expenses of total patients, femoral neck fracture, and intertrochanteric fracture subgroups in MDT group were all significantly higher than those in conventional group (P<0.05). However, there was no significant difference in hospitalization expense of subtrochanteric fracture subgroup between the two groups (Z=−1.715, P=0.086). The rate of loss to follow-up in conventional group and MDT group was 6.86% (7/102) and 3.95% (3/76), respectively, with no significant difference (χ2=0.698, P=0.403). The mortalities at hospitalization, 1 month, 3 months, and 1 year after operation in conventional group were 0, 1.05% (1/95), 3.16% (3/95), and 7.37% (7/95), respectively, and in MDT group were 0, 0, 2.74% (2/73), 6.85% (5/73), respectively, showing no significant differences in mortalities between the two groups (P>0.05). Conclusion MDT model in the management of geriatric hip fractures has been shown to reduce time to surgery, postoperative hospitalization stay, length of hospitalization stay, operation time, and the proportion of patients who received ICU consultation or transferred into ICU. Furthermore, MDT can improve the capacity for developing operations for patients with complex medical conditions and make medical resources used more rationally.
ObjectiveTo report an improved classification system of Kümmell’s disease and its clinical application.MethodsBased on CT and MRI, an improved classification system of Kümmell’s disease was proposed in terms of the integrity of sagittal endplate, the integrity of posterior wall of vertebral body, and the degree of vertebral compression. Between January 2011 and March 2018, the improved classification system was used to evaluate and guide the treatment of 78 patients with Kümmell’s disease. There were 13 males and 65 females. The mean age was 69.1 years (range, 54-85 years). The mean disease duration was 4.0 months (range, 1-8 months). The mean T value of bone mineral density was −3.66 (range, −3.86- −3.34).The fractures located at thoracic vertebrae in 47 cases and lumbar vertebrae in 31 cases. According to the modified classification system of Kümmell’s disease, there were 11 cases of type A1, 13 cases of type A2, 2 cases of type A3, 10 cases of type B1, 18 cases of type B2, 4 cases of type B3, 4 cases of type C1, 5 cases of type C2, and 11 cases of type C3. According to the classification results, the patients of types A and B were treated with percutaneous kyphoplasty (PKP), while the patients of type C were treated with PKP or intra- vertebral fixation according to the degree of vertebral reduction. Visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to evaluate clinical efficacy. The heights of the anterior, middle, and posterior edges of the vertebrae and the Cobb angle were measured to evaluate the reduction of the injured vertebrae and the improvement of kyphosis deformity. The complications were recorded.ResultsThe statistical analysis showed that the improved classification system has good consistency. All patients were followed up 12-36 months (mean, 24.3 months). The heights of anterior, middle, and posterior edges of the vertebrae, Cobb angle, VAS score, and ODI of all types of patients at last follow-up showed significant differences when compared with those before operation (P<0.05). After operation, 4 patients of type A2 had different degree of vertebral height loss; 2 patients of type B2, 3 patients of type C1, and 2 patients of type C2 developed asymptomatic bone cement leakage during PKP; 2 patients of type B3 and 3 patients of type C2 underwent percutaneous internal fixation and vertebral augmentation due to bone cement loosening.ConclusionThe modified classification system of Kümmell’s disease can be used to guide treatment of Kümmell’s disease, but the number of clinical application cases is limited, and further application and observation are needed.