Objective To compare the clinical and radiological outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and minimally invasive tubular TLIF (MT-TLIF) in treatment of lumbar degenerative diseases. Methods A clinical data of 75 patients with lumbar degenerative diseases, who met the selection criteria between August 2019 and August 2020, was retrospectively analyzed, including 35 patients in the UBE- TLIF group and 40 patients in the MT-TLIF group. There was no significant difference in general data such as gender, age, body mass index, disease type and duration, and surgical segment between the two groups (P>0.05), which was comparable. The operation time, intraoperative blood loss, hemoglobin (Hb) before operation and at 1 day after operation, the length of hospital stay, incidence of complications, and visual analogue scale (VAS) score of low back and leg pain, Oswestry Disability Index (ODI), Short-Form 36 Health Survey Scale (SF-36 scale), intervertebral disc height (IDH), sagittal Cobb angle, lumbar lordosis (LL), and the intervertebral fusion were compared between the two groups. Results Compared with MT-TLIF group, UBE-TLIF group had significantly longer operation time but less intraoperative blood loss and shorter length of hospital stay (P<0.05). The Hb levels in both groups decreased at 1 day after operation, but there was no significant difference in the difference before and after operation between the two groups (P>0.05). All patients were followed up, and the follow-up time was (14.7±2.5) months in the UBE-TLIF group and (15.0±3.4) months in the MT-TLIF group, with no significant difference (t=0.406, P=0.686). In both groups, the VAS score of low back pain, VAS score of leg pain, SF-36 scale, and ODI after operation significantly improved when compared with those before operation (P<0.05). There was no significant difference between 1 month after operation and last follow-up (P>0.05). There was no significant difference in the VAS score of low back pain, VAS score of leg pain, and SF-36 scale between the two groups before and after operation (P>0.05). At 1 month after operation, the ODI in the UBE-TLIF group was significantly better than that in the MT-TLIF group (P<0.05). At 1 month after operation, IDH, Cobb angle, and LL in both groups recovered when compared with those before operation (P<0.05), and were maintained until last follow-up (P>0.05). There was no significant difference in the IDH, Cobb angle, and LL between the two groups at each time point (P>0.05). Thirty-three cases (89.2%) in the UBE-TLIF group and 35 cases (87.5%) in the MT-TLIF group achieved fusion, and the difference was not significant (χ2=0.015, P=0.901). In the UBE-TLIF group, 1 case of intraoperative dural tear and 1 case of postoperative epidural hematoma occurred, with an incidence of 5.7%. In the MT-TLIF group, 1 case of intraoperative dural tear, 1 case of postoperative epidural hematoma, and 1 case of superficial infection of the surgical incision occurred, with an incidence of 7.5%. There was no significant difference in the incidence of complications between the two groups (χ2=1.234, P=1.000). Conclusion Compared with MT-TLIF, UBE-TILF can achieve similar interbody fusion in the treatment of lumbar degenerative diseases, and has the advantages of smaller incision, less bleeding, and shorter length of hospital stay.
ObjectiveTo overview the systematic reviews of the efficacy of cancer patient decision aids (PDAs) for treatment decision-making. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CINAHL, JBI, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect the systematic reviews relevant to the objective from inception to September 2023. Literature screening, data extraction, methodological quality assessment of the included literature, and summary and grading of the evidence were carried out independently by two researchers, and duplication of original studies in the included systematic evaluations was investigated using the corrected covered area (CCA). ResultsA total of 17 systematic reviews were included, of which 13 (76.47%) were low- or very low-quality studies. A total of 64 pieces of evidence were included, of which only 26 (40.62%) were of moderate quality, and the original studies included in the included literature had a low degree of overlap (CCA=0.05). The results of meta-analysis showed that PDAs could increase decision-related knowledge, reduce decision conflict and regret in cancer patients' treatment decision (P<0.05). However, there was no significant difference in decision satisfaction, anxiety or depression (P>0.05). ConclusionPDAs can improve cancer patients' knowledge related to treatment decision, reduce decision conflicts and regrets, and have no significant negative effects on decision preparation, satisfaction, anxiety, and depression. However, the existing systematic reviews are of low quality and limited to a few cancer types.
Traditional classifiers, such as support vector machine and Bayesian classifier, require data normalization for removing experimental batch effects, which limit their applications at the individual level. In this paper, we aim to build a classifier to distinguish lung cancer and non-cancer lung tissues (pneumonia and normal lung tissues). We identified gene pairs as signatures to build a classifier based on the within-sample relative expression orderings of gene pairs in a particular type of tissues (cancer or non-cancer). Using multiple independent datasets as the training data, including a total of 197 lung cancer cases and 189 non-cancer cases, we identified three gene pairs. Classifying a sample by the majority voting rule, the average accuracy reached 95.34% in the training data. Using multiple independent validation datasets, including a total of 251 lung cancer samples and 141 non-cancer samples without data normalization, the average accuracy was as high as 96.78%. The rank-based signature is robust against experimental batch effects and can be used to diagnose lung cancer using samples measured by different laboratories at the individual level.