In thoracoscopic pulmonary nodule resection surgery, precise preoperative planning is crucial. Artificial intelligence (AI)-assisted three-dimensional (3D) reconstruction technologies have shown great potential in this area. AI-assisted 3D reconstruction technologies can provide accurate, personalized models of the pulmonary vasculature and bronchial anatomy, assisting surgeons in detailed surgical planning and thus enhancing the precision and safety of surgeries. This article reviews the application progress of AI-assisted 3D reconstruction technologies in pulmonary nodule surgery, including their applications in preoperative diagnosis, surgical planning, and intraoperative navigation, as well as the advancements in AI- assisted 3D reconstruction technologies. It analyzes the technical features of all kinds of 3D reconstruction methods, their clinical applications, and the challenges they face.
Objective To assess the quality of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) relevant to COPD besides chronic bronchitis and chronic pulmonary cor disease in strengthening immune published in Chinese medical journals to provide scientific basis of systematic review (SR) of regulating the immune function of COPD in Chinese herbs. Methods 54 articles with clinical controlled trials were obtained by electronic searching and handsearching, and the method for randomized allocation, blindness, multi-centres, sample sizes, diagnosis criteria, exclusion criteria, source of cases, immune markers (cellular immunity, humoral immunity, erythrocyte immunity, nonspecific immunity), the clinical outcome assessment, statistical management, course of treatment and the side effects or adverse drag reaction, follow-up were investigated and then methodologically evaluated. According to the investigation, literatures with the method for randomized allocation, correct controls, appropriate sample sizes (≥60), the nation-wide diagnosis criteria, the objective clinical outcome assessment distinct statistical method were stipulated as the high-quality ones relatively. Results Among the 54 trials, 70.4% had explicit diagnosis criteria, 18.5% with exclusion criteria, 20.4% with comparability of baseline, 37.0% with distinct statistical method. In the therapy, 63.0% were with Chinese herbs. Conclusion The selected 7 articles belong to the high quality and possibly are to be explored in Meta-analysis.
Medical ethics must be considered for protecting the fights and interests of patients in clinical trials. Now the fights of the subjects are more and more emphasised, but there are some problems. It is evidence-based medicine (EBM) and emphasis of evidence that need the high-quality clinical trials, yet it violates the principle of ethics in some degree. It will be helpful for the administrators to supervise the clinical trials on drugs well from the point of ethical views.
Assessment on adverse drug reactions (ADR) that directly affects the quality of life and mortality and an important part of the post-marketed reassessment are developing gradually in China. Many problems have been identified in clinical validity and safety for the authorized Chinese herbs. An effective and standardized system is needed in the post-marketed drug reassessment. Evidence-based drug evaluation, which mainly includes clinical epidemiology, systematic review and health technology, will be used to assess the clinical validity, safety and cost of post-marketed drug and play an important role in the process of modernization and internationalization of Chinese herbs.
【摘要】 目的 探讨急性脑梗死对心脏自主神经活性的影响。 方法 Wistar大鼠32只随机分为正常组、假手术组和脑梗死组，脑梗死组用线栓法行右侧大脑中动脉阻塞。脑梗死组和假手术组于术前及术后24 h作心率变异性（HRV）检测，同时检测正常组HRV，将3组的HRV指标进行比较。实验终点取各组心肌组织检测儿茶酚胺和神经肽Y（NPY），进行组间比较。 结果 术后24 h脑梗死组和正常组、假手术组相比，窦性心搏间期标准差、均方根，总功率谱、高频功率谱（HF）、低频功率谱（LF）降低，差异有统计学意义。3组比较LF/HF和分数维无明显差异。脑梗死组心肌组织去甲肾上腺素（NA）和NPY高于正常组和假手术组。 结论 脑梗死引起心脏自主神经总活性降低、自主神经功能受损，自主神经末梢去甲肾上腺素和NPY的异常分泌可能是重要的原因。【Abstract】 Objective To investigate the effect of acute cerebral infarction on cardiac autonomic nervous activity. Methods A total of 32 Wistar rats were divided into normal group, sham operation group and infarction group by random. Experimental cerebral infarction in Wistar rats was induced by intraluminal occlusion of middle cerebral artery. About 24 hours after the occlusion or 24 hours after sham operation, the heart rate variability (HRV) sequences were measured, and the HRV values in the three groups were compared. The levels of catecholamine and neuropeptide (NPY) in myocardium were measured. Results At the 24th hour after the occlusion, the standard deviation and root mean square standard deviation of R-R interval, the total power, high frequency (HF) and low frequency (LF) in infarction group were lower than those in normal and sham operation group. LF/HF and fractal dimension did not differ much among the three groups. The levels of noradrenaline and NPY in myocardium in infarction group were higher than those in the other groups. Conclusion It is suggested that acute cerebral infarction may cause the decrease of autonomic nervous activity and damage of the autonomic nervous function; the abnormal secretion of noradrenalin in autonomic nerve ending and NPY may be the important reasons.
Monocyte chemoattractant protein-1(MCP-1) is a cytokine which belongs to the CC chemokine family. Retinal pigment epithelium (RPE) cells, photoreceptors and microglial cells in the retina can secrete MCP-1. Physiological level of MCP-1 is important for preserving morphology of RPE and glial cells, as well as retinal function and gross morphology. MCP-1 is likely released from Müller glia and the RPE cells when retina under stress, and attracts microglia/macrophages to the sites of retinal damage, activates the microglia to ingest cell debris. MCP-1 has been found upregulated in the intraocular fluid of retina in patients and animal models with retinal detachment, posterior uveitis and age-related macular degeneration. The expression of MCP-1 may be response to retinal inflammation. Therefore, it is tempting to speculate that pharmacological targeting of MCP-1 may be a safe and viable strategy in treatment of retinal disease.
Objective To evaluate the effect of 27G pars plana vitrectomy (PPV) and 25G PPV on idiopathic epiretinal membrane (IMEM). Methods Thirty-eight eyes of 38 patients with IMEM were enrolled into this retrospective and comparative study. Eighteen eyes were treated with 27G PPV (group A), 20 eyes underwent 25G PPV (group B) voluntarily. The best corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp microscope, indirect ophthalmoscopy, fundus color photograph, ocular coherence tomography (OCT) and counting of corneal endothelial cells (CEC) were examined before the surgery. BCVA results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. There was no statistically significant difference between two groups in terms of BCVA, IOP, foveal macular thickness (FMT), the counting of CEC and CEC hexagon rate before the surgery (t=1.627, 0.860, 0.293, 1.238, 0.697;P＞0.05). All operations were performed by the same doctor. Operation time for vitrectomy and peeling membrane was recorded. BCVA, IOP, OCT, FMT, counting of CEC and the improvement of metamorphopsia were observed on 1, 7 days and 1, 3 months after PPV. Results The mean operation time for vitrectomy in group A and B were (6.7±2.8), (10.5±3.3) min, respectively. The mean operation time for vitrectomy in group A was significantly longer than that in group B (t=3.084,P＜0.05). The mean operation time for peeling membrane in group A and B were (10.2±5.2), (11.0±5.9) min, respectively. There was no statistically significant difference between two groups in terms of the time for peeling membrane (t=1.970,P=0.187). On 1, 7 days and 1, 3 months after PPV, the difference of BCVA (t=1.463, 0.683, 0.961, 1.226;P=0.833, 0.509, 0.699, 0.744) and IOP (t=1.314, 1.262, 0.699, 1.116;P=0.763, 0.721, 0.534, 0.712) between two groups were not statistically significant. On 1 day after PPV, there were 2 eyes and 5 eyes with ＜9 mmHg (1 mmHg=0.133 kPa) IOP in group A and B. On 7 days and 1, 3 months after PPV, the difference of FMT between two groups were not statistically significant (t=1.257, 1.368, 1.437;P=0.735, 0.745, 0.869). On 3 months after PPV, the difference of CEC between two groups were statistically significant (t=2.276,P＜0.05); the difference of hexagon rate between two groups were not statistically significant (t=1.473,P=0.889). Conclusion The efficacy of 27G PPV for IMEM appears similar to 25G PPV. But 27G PPV has a shorter operating time for vitrectomy, a more stable IOP and a minimal damage to CEC.