Technology and Health Care - Volume Pre-press, issue Pre-press

Authors: Shao, Liang | Gao, Ying | Zhang, Dan | Yang, Mengdan | Jiang, Mimi | Li, Hongfeng | Yan, Yanting

Article Type: Research Article

Abstract: BACKGROUND: non-small cell lung cancer (NSCLC) accounts for more than 80% of all lung cancer populations. Stereotactic radiotherapy (SBRT) is mainly suitable for early NSCLC patients who are not suitable for surgery or refuse surgery. OBJECTIVE: To analyze the effects of stereotactic radiotherapy (SBRT) plus immunotherapy for non-small cell lung cancer (NSCLC) patients on their immune status and survival quality. METHODS: NSCLC patients admitted to our hospital from 2019–2022 were divided into 61 cases in control group (SBRT) and 60 cases in observation group (SBRT plus immunotherapy) by the randomized numerical table method …to compare the efficacy, the level of tumor markers in the serum, the level and activity of the immune cells in the peripheral blood and the Kahlil’s functional status (KPS) scores. RESULTS: The observation group had a higher efficacy rate than that of the control group (P < 0.05). There was no statistical difference between the two groups in serum tumor marker content, immune cell level and activity in peripheral blood and KPS score before treatment (P > 0.05). After treatment, serum tumor markers were lower than those in control group, and immune cell level, NK cell-related activity and KPS score were higher than those in control group (P < 0.05). CONCLUSION: SBRT plus immunotherapy can reduce the level of various tumor markers, improve the immune status and quality of survival for NSCLC patients. Show more

Keywords: Stereotactic radiotherapy, immunotherapy, non-small cell lung cancer, immune status, survival quality

DOI: 10.3233/THC-241177

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Liu, Bo | Wang, Kebing | Ye, Si

Article Type: Research Article

Abstract: BACKGROUND: Accurately identifying the branches of pulmonary segmental vessels and bronchi, as well as adjacent structures, and determining the spatial location of lesions within pulmonary segments, are major challenges for thoracic surgeons. The application of three-dimensional reconstruction technology holds promise in addressing this issue. OBJECTIVE: To evaluate the clinical value of three-dimensional reconstruction in thoracoscopic segmental surgery. METHODS: Seventy-seven patients who underwent thoracoscopic segmental surgery combined with three-dimensional reconstruction at our hospital from January 1, 2020, to August 31, 2023, were retrospectively analyzed. Preoperative chest enhanced CT scans were conducted, and MIMICS software …aided in reconstructing DICOM format original data for patients with pulmonary nodules to facilitate intraoperative nodule localization. Accurate segmental pneumonectomy was performed by comparing preoperative anatomical identification of target segmental arteries, veins, and bronchi, with surgical details and postoperative outcomes recorded, including intraoperative pulmonary resection distribution, operation time, blood loss, chest tube drainage, extubation time, hospital stay, and complications. RESULTS: Following preoperative three-dimensional reconstruction, successful segmental lung surgeries were performed, predominantly with single segmental resection (92.2%), and a minority with combined segmentectomy (7.8%). Median operation time was 130225 minutes, with intraoperative blood loss at 70100 mL and postoperative chest tube drainage at 347 mL (159690 mL). Median extubation time and hospital stay were 4 days and 7 days, respectively. Complications within the 3-month follow-up affected 11.7% of cases, including persistent pulmonary leakage (7.1%), pulmonary infection (4.3%), atelectasis (4.3%), and pleural effusion (1.4%), with no fatalities. CONCLUSION: Preoperative 3D reconstruction can help the operator to perform safe, efficient and accurate thoracoscopic segmental pneumonectomy, which is worth popularizing in clinic. Show more

Keywords: Segmental resection, pulmonary nodules, lung cancer, thoracoscopic three-dimensional reconstruction

DOI: 10.3233/THC-240786

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

Authors: Li, Pengxin | Peng, Sheng | Song, Zhenghuan | Tan, Jing | Gu, Lianbing

Article Type: Research Article

Abstract: BACKGROUND: Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2–4 times compared with that in patients without diabetes. OBJECTIVE: This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus METHODS: This clinical study totally includes 40 patients with diabetes mellitus, and these patients are divided into following two groups: diabetes mellitus deep anesthesia group and diabetes mellitus light anesthesia group, and …then these patients receive general anesthesia combined with laparoscopic surgery. Preoperative patient general data and intraoperative patient general data are collected and analyzed. Calcitonin gene-related peptide (CGRP) and substance P (SP) level are determined by Enzyme-linked immunosorbent assay (ELISA) RESULTS: This study included a total of 40 patients. There were no significant differences in demographic and preoperative patient general data between the two groups. Measurements were taken for operative time, anesthesia time, recovery time after drug withdrawal, dwell time in the recovery room, intraoperative fluid volume, intraoperative blood loss, and intraoperative urine output between the two groups. Significant differences were observed in the recovery time after drug withdrawal between the two groups. CGRP and SP level in diabetes mellitus deep anesthesia group are evidently more than those in diabetes mellitus light anesthesia group. CONCLUSIONS: CGRP and SP level are involved in the diabetes mellitus and up-regulated CGRP and SP can prevent the development of diabetes mellitus. Our study extends the existing literature by addressing a gap in knowledge regarding the impact of anesthesia depth on neuropeptide levels in diabetes mellitus patients. By delineating this relationship, we aim to contribute to the advancement of perioperative care practices and ultimately improve outcomes for individuals with diabetes undergoing surgical procedures. Our study’s findings provide valuable insights into the complex interactions between anesthesia, neuropeptides, and diabetes mellitus, offering the potential for personalized perioperative care, enhanced pain management, and improved surgical outcomes. These implications highlight the clinical relevance of our research and its potential to inform future advancements in perioperative care for diabetic patients undergoing surgery. Show more

Keywords: Diabetes mellitus, general anesthesia, CGRP, SP

DOI: 10.3233/THC-240907

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024

Authors: Han, Zhen | Liu, Yangan | Tan, Ming | Hua, Zhaolai | Dai, Chun

Article Type: Research Article

Abstract: BACKGROUND: Surgery remains the most effective treatment for colon cancer. However, there are still controversies regarding the tumor treatment effect, prognosis, and perioperative impact of complete mesocolic excision (CME) surgery in colon carcinoma resection. OBJECTIVE: This study aims to compare laparoscopic complete mesocolic excision (LCME) and traditional open D2 radical surgery in colon carcinoma resection through a retrospective analysis using 1:1 propensity score matching (PSM). METHODS: 98 cases undergoing LCME or open D2 colon carcinoma resection at our hospital from January 2014 to November 2021 were retrospectively collected. After excluding cases and 1:1 matching using …PSM based on baseline clinical data, 86 patients were assigned in research queue. 43 patients were in each group. Two groups were compared for general clinical baseline indicators. Surgical results and postoperative adverse events of patients were also compared. Disease-free survival (DFS) rate and overall survival (OS) rate was analyzed. RESULTS: After 1:1 PSM matching, there was no statistically significant differences in baseline data between the LCME group and D2 group (P > 0.05). LCME was characterized by longer total duration of surgery (P < 0.001), less intraoperative bleeding volume (P < 0.001), more postoperative drainage fluid volume (P < 0.001), greater number of lymph nodes retrieved (P = 0.014). No statistically differences was observed regarding intraoperative blood transfusion, hospital stay, Clavien-Dindo complicating disease classification (all P > 0.05), 1 and 3-year DFS rate (P = 0.84) and OS rate (P ⩾ 0.1). CONCLUSION: LCME had a longer duration of surgery but less intraoperative bleeding volume and more postoperative drainage fluid volume and retrieved lymph nodes compared to D2 radical surgery. LCME surgery is comparable to D2 surgery in terms of postoperative prognosis, but LCME surgery shows a positive trend in the overall survival curve. Show more

Keywords: Laparoscopic complete mesocolic excision, traditional D2 radical surgery, Colonic Neoplasms, propensity score matching

DOI: 10.3233/THC-241149

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024

Authors: Sun, Rui | Hao, Jianfeng | Li, Qian | Xie, Weinan | Hu, Xiaoyan | Chen, Zhenzhen | Liu, Zhi | Yuan, Ling

Article Type: Research Article

Abstract: BACKGROUND: NiaoDuQing Particle is the first Chinese herbal medicine approved by the China Food and Drug Administration for the treatment of chronic kidney disease. It has been used in clinical practice in China for over twenty years. However, there is limited literature reporting on the long-term therapeutic effects of NiaoDuQing Particles on chronic kidney disease patients. OBJECTIVE: This research aimed to comprehensively assess the therapeutic effect of NiaoDuQing Particles (NDQP) on chronic kidney disease patients based on clinical data analysis. METHODS: This study was carried out on a total of 148 participants diagnosed …with different types of chronic kidney disease. Demographics information, chronic kidney disease classification and chronic kidney disease diganostic indicators were collected and analyzed before and after NiaoDuQing Particles treatment for 3, 6, 9, 12 and 18 months respectively. RESULTS: In all 148 patients, mean eGFR value was increased after NiaoDuQing Particles treatment for up to 18 months, and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). Mean uric acid value was decreased after NiaoDuQing Particles treatment for up to 18 months, and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). Mean urea nitrogen value was decreased after NiaoDuQing Particles treatment for up to 18 months and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). While mean creatinine value was decreased after NiaoDuQing Particles treatment for up to 18 months and was statistically significant at month 6 (P < 0.05). CONCLUSIONS: NiaoDuQing Particles could maintain the stable state of chronic kidney disease patients for up to 18 months especially in improving diagnostic indicators like eGFR, uric acid and urea nitrogen. Show more

Keywords: Chronic kidney disease, NiaoDuQing particles, eGFR, uric acid, urea nitrogen

DOI: 10.3233/THC-241029

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

Authors: Hua, Defeng | Chen, Yan

Article Type: Research Article

Abstract: BACKGROUND: The present study investigated the association between cerebrovascular diseases and sepsis, including its occurrence, progression, and impact on mortality. However, there is currently a lack of predictive models for 28-day mortality in patients with cerebrovascular disease associated with sepsis. OBJECTIVE: The objective of this study is to examine the mortality rate within 28 days after discharge in this population, while concurrently developing a corresponding predictive model. METHODS: The data for this retrospective cohort study were obtained from the MIMIC-IV database. Patients with sepsis and cerebrovascular disease in the ICU were included. Laboratory …indicators, vital signs, and demographic data were collected within 24 hours of ICU admission. Mortality rates within 28 days after discharge were calculated based on patient death times. Logistic regression analysis was used to identify potential variables for a predictive model. A nomogram visualized the prediction model. The performance of the model was evaluated using ROC curves, Calibration plots, and DCA. RESULTS: The study enrolled a total of 2660 patients diagnosed with cerebrovascular disease complicated by sepsis, consisting of 1434 males (53.91%) with a median age of 70.97 (59.60, 80.73). Among this cohort of patients, a total of 751 fatalities occurred within 28 days following discharge. The multivariate regression analysis revealed that age, creatinine, arterial oxygen partial pressure (Pa O2), arterial carbon dioxide partial pressure (Pa CO2), respiratory rate, white blood cell (WBC) count, Body Mass Index (BMI), and race demonstrated potential predictive variables. The aforementioned model yielded an area under the ROC curve of 0.744, accompanied by a sensitivity of 66.2% and specificity of 71.2%. Furthermore, both calibration plots and DCA demonstrated robust performance in practical applications. CONCLUSION: The proposed prediction model allows clinicians to promptly assess the mortality risk in patients with cerebrovascular disease complicated by sepsis within 28 days after discharge, facilitating early intervention strategies. Consequently, clinicians can implement additional advantageous medical interventions for individuals with cerebrovascular disease and sepsis. Show more

Keywords: Predictive model, 28-day mortality, sepsis, cerebrovascular disease

DOI: 10.3233/THC-241150

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Wu, Weichuan | Li, Chengyan | Men, Donghai | Li, Xiaopeng | Huang, Baqi

Article Type: Research Article

Abstract: BACKGROUND: Multiple studies have shown that early decompressive surgery in patients with intracerebral hemorrhage can effectively limit hematoma expansion, reduce perihematomal edema, and improve prognosis. However, these studies are limited by small sample sizes and short follow-up times. OBJECTIVE: To analyze the effect of early decompressive surgery on the long-term prognosis of patients with cerebral hemorrhage and identify the influencing factors for poor prognosis. METHODS: A retrospective analysis of 78 patients with cerebral hemorrhage admitted between January 2020 and December 2022 was conducted. Patients were divided into early and delayed surgery groups for comparison of …outcomes such as mortality rate, modified Rankin Scale score, and Short Form-36 scores. Additionally, factors influencing long-term prognosis were analyzed through logistic regression based on significant differences observed between groups. RESULTS: The early decompressive surgery group showed superior outcomes with lower mortality rates, modified Rankin Scale (mRS) scores, hematoma expansion rates, and perihematomal edema volumes compared to the delayed surgery group (P < 0.05). Additionally, age, preoperative Glasgow Coma Scale (GCS) score, preoperative hematoma volume, and a history of hypertension or diabetes were identified as independent prognostic factors for patients with cerebral hemorrhage, with odds ratios (ORs) greater than 1. CONCLUSIONS: Early decompressive surgery can improve the long-term prognosis and quality of life of patients with cerebral hemorrhage, reduce mortality rates, and decrease hematoma expansion and perihematomal edema. Older patients, those with higher preoperative hematoma volume and GCS score, and those with coexisting hypertension and diabetes should be given special attention to decrease the occurrence of adverse prognosis. Show more

Keywords: Early decompressive surgery, cerebral hemorrhage, long-term prognosis, influencing factors

DOI: 10.3233/THC-240766

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Zhang, Xibing | Yang, Fuli | Han, Lei | Su, Qiuming | Gao, Yang | Wu, Ruichao | Wang, Duo | Li, Wang | Zheng, Kepu | Liu, Fang | Ran, Jianghua

Article Type: Research Article

Abstract: BACKGROUND: Liver fibrosis is a progressive liver disease with increasing incidence, yet its underlying pathogenic mechanisms remain incompletely understood. OBJECTIVE : This study aims to explore potential therapeutic targets for liver fibrosis using weighted gene co-expression network analysis (WGCNA) and experimental validation. METHODS: We retrieved the microarray data (GSE174099) from the GEO database and performed differential expression analysis and WGCNA to identify co-expression modules associated with liver fibrosis. A module with the highest correlation to liver fibrosis was selected for further analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway …enrichment analyses were conducted to investigate the biological functions and signaling pathways of the identified genes. Protein-protein interaction (PPI) networks were constructed using the STRING database. The correlation between core genes and immune cells was analyzed with the CIBERSORT algorithm. Additionally, pathological and molecular biology experiments were performed to validate the expression levels of core genes in liver tissue, including HE and Masson staining, immunohistochemistry, RT-qPCR, and Western blotting. RESULTS: We identified a total of 86 intersecting genes from the differential expression analysis and WGCNA. GO enrichment analysis revealed that these genes were involved in processes such as cellular response to cAMP, collagen-containing extracellular matrix, and G protein-coupled receptor binding. KEGG pathway analysis highlighted the involvement of these genes in pathways like Cell Adhesion Molecules and the PI3K-Akt signaling pathway. Using Cytoscape software, we identified four core genes: Cftr, Cldn4, Map2, and Spp1. Pathological examinations showed that the experimental group exhibited significant fibrous tissue proliferation compared to the control group. Immunohistochemistry, RT-qPCR, and Western blotting analyses confirmed that these core genes were significantly upregulated in the experimental group (P < 0.05). CONCLUSION: This study identified four key genes (Cftr, Cldn4, Map2, Spp1) that are significantly associated with liver fibrosis. These genes are upregulated in liver fibrosis and could potentially as biomarkers for diagnosis and targets for therapeutic interventions. Show more

Keywords: Liver fibrosis, WGCNA, protein-protein interaction, signal transduction, gene expression

DOI: 10.3233/THC-241142

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024

Authors: Chen, Yumei | Chen, Yanbin

Article Type: Research Article

Abstract: BACKGROUND: Although literature suggests that exercise can improve symptoms in Parkinson’s Disease (PD) patients, research on the effects of aerobic exercise and resistance training (AE&RT) in early-stage PD remains limited. Understanding the synergistic effects of these exercise modalities can provide valuable insights for optimizing exercise interventions for PD patients, particularly in the early stages of the disease, where interventions may have the greatest impact on long-term functional outcomes. OBJECTIVE: This study aimed to investigate the effects of a combined AE&RT program on motor function, postural stability, and cognitive processing speed in early stage PD patients. …METHODS: A total of 236 participants with early-stage PD were assigned to either the Aerobic Exercise Group (AE group) (n = 112) or the AE&RT Group (n = 124) inthis controlled randomized trial. The study employed a one-year supervised exercise program, with the AE Group participating in aerobic activities and the AE&RT Group engaging in combined AE&RT. Outcome measures included symptom improvement, motor function, postural stability, cognitive processing speed, peak oxygen consumption, quality of life evaluation, and the incidence of adverse events. RESULTS: The AE&RT Group demonstrated greater improvements in tremor, muscle rigidity, gait instability, sleep problems, and hyposmia compared to the AE Group. Additionally, the combined exercise group exhibited better cognitive processing speed, as well as enhanced motor function and postural stability. Peak oxygen consumption was significantly higher in the AE&RT Group. However, the quality of life evaluation indicated a statistically higher quality of life in the AE Group. There was no significant difference in the incidence of adverse events between the two groups. CONCLUSION: The findings suggest that the integration of AE&RT in early-stage PD patients leads to more comprehensive improvements in motor symptoms, cognitive function, postural stability, and cardiovascular fitness compared to aerobic exercise alone. These results have important implications for developing tailored exercise interventions to enhance the physical and cognitive well-being of individuals with early-stage PD. Show more

Keywords: Aerobic exercise, resistance exercise, postural stability, cognitive processing speed, parkinson’s disease

DOI: 10.3233/THC-240821

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Liu, Mingsheng | Huang, Zhixiong | Wang, Xiaoyun | You, Pingdi | Cai, Xiaying

Article Type: Research Article

Abstract: BACKGROUND: Non-specific lower back pain (NLBP) is treated with a variety of therapies, including health education, exercise therapy, soft tissue release, psychological interventions, and shockwave therapy. However, some studies have shown that core stability training or fascial release therapy alone is not effective in the treatment of low back pain. BJECTIVE: The aim of this study was to investigate the effects of core stability training on patients’ inflammatory cytokine levels and lumbar muscle temperature when combined with fascial release for the treatment of non-specific low back pain. METHODS: In this study, a total …of 60 patients with non-specific low back pain who were treated in Mindong Hospital of Ningde City between December 2021 and January 2023 were selected and randomly and equally divided into a control group (30 cases) and an experimental group (30 cases). The control group received core stability training, while the experimental group added fascial release surgery to this. We compared and assessed the pain visual analog score (VAS), Oswestry dysfunction index (ODI), lumbar spine mobility (including anterior flexion, posterior extension, left flexion, and right flexion), as well as levels of inflammatory factors IL-6, TNF-a, and muscle tissue temperature in the two groups. RESULTS: This study has been successfully implemented and covered 60 patients throughout the trials. Upon comparison, the two groups did not show statistically significant differences in baseline data such as age, gender and duration of disease (p > 0.05). After four weeks of treatment, the test group showed statistically significant (p < 0.05) differences in VAS scores, ODI scores, and IL-6 and TNF-a levels that were significantly lower than those of the control group. It is worth mentioning that the muscle tissue temperature of the patients in the test group, as well as their performance in lumbar anterior flexion, posterior extension, left flexion, and right flexion mobility, were significantly better than those of the control group, and these differences also showed statistical significance (p < 0.05). CONCLUSION: The combination of core stability training and fascial release demonstrates significant clinical results in the treatment of nonspecific lower back pain. Through medical thermography and serum inflammatory factor testing, we were able to assess the treatment effect more objectively, providing a strong basis for future clinical practice. Show more

Keywords: Core stability training, fascial release, nonspecific low back pain, inflammatory factors, thermal imaging technology

DOI: 10.3233/THC-240902

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024