Comparison of the short-term efficacy of MIS-TLIF and Endo-LIF for the treatment of two-segment lumbar degenerative disease.

BACKGROUND: This study retrospectively compared short-term clinical outcomes and complications of minimally invasive surgery transforaminal lumbar interbody fusion(MIS-TLIF)and endoscopic lumbar interbody fusion(Endo-LIF))for two-segmental lumbar degenerative disease, aiming to guide spine surgeons in selecting surgical approaches. METHODS: From January 2019 to December 2023, 30 patients were enrolled,15 in the MIS-TLIF group and 15 in the Endo-LIF group. All patients were followed up for more than 3 months after surgery and the following information was recorded: (1)surgery time, difference in hemoglobin between preoperative and postoperative, surgical costs, first time out of bed after operation, postoperative hospitalization time, postoperative complication; (2) ODI score (The Oswestry Disability Index), leg and back VAS score (Visual Analogue Scale), and lumbar vertebra JOA score (Japanese Orthopaedic Association Scores); (3) MacNab score at final follow-up to assess clinical outcome, CT to evaluate lumbar fusion. RESULTS: There were significant differences between the two groups regarding operation time and cost, with the MIS-TLIF group performing significantly better. Intraoperative bleeding was considerably less in the Endo-LIF group compared to the MIS-TLIF group. However, there were no significant differences in the time of the first postoperative ambulation, postoperative hospitalization time, and postoperative complications. There was no significant difference in preoperative VAS, ODI, and JOA between the two surgical groups There were no significant differences in VAS(leg), ODI, and JOA scores between the two groups before and at 1 day,7 days, 1 month, 3 months and final follow-up. However, at 1 day postoperatively, the VAS( back)score in the Endo-LIF group was lower than that in the MIS-TLIF group, and the difference was statistically significant. At the final follow-up, all patients achieved grade III and above according to the Bridwell criteria, and there was no significant difference between the two surgical groups compared to each other. According to the MacNab score at the final follow-up, the excellent rate was 80.00% in the Endo-LIF group and 73.33% in the MIS-TLIF group, with no significant difference between the two groups. CONCLUSION: There was no significant difference in short-term efficacy and safety between Endo-LIF and MIS-TLIF for two-segment degenerative lumbar diseases. MIS-TLIF has a shorter operative time and lower costs, while Endo-LIF causes less tissue damage, blood loss, and early postoperative pain, aiding long-term recovery. Both MIS-TLIF and Endo-LIF are promising for treating two-segment lumbar degenerative disease. The choice of a surgical procedure depends on the patient's financial situation, their ability to tolerate surgery, and the surgeon's expertise.

Enhancing substance identification by Raman spectroscopy using deep neural convolutional networks with an attention mechanism.

Raman spectroscopy is widely used for substance identification, providing molecular information from various components along with noise and instrument interference. Consequently, identifying components based on Raman spectra remains challenging. In this study, we collected Raman spectral data of 474 hazardous chemical substances using a portable Raman spectrometer, resulting in a dataset of 59 468 spectra. Our research employed a deep neural convolutional network based on the ResNet architecture, incorporating an attention mechanism called the SE module. By enhancing the weighting of certain spectral features, the performance of the model was significantly improved. We also investigated the classification predictive performance of the model under small-sample conditions, facilitating the addition of new hazardous chemical categories for future deployment on mobile devices. Additionally, we explored the features extracted by the convolutional neural network from Raman spectra, considering both Raman intensity and Raman shift aspects. We discovered that the neural network did not solely rely on intensity or shift for substance classification, but rather effectively combined both aspects. This research contributes to the advancement of Raman spectroscopy applications for hazardous chemical identification, particularly in scenarios with limited data availability. The findings shed light on the significance of spectral features in the model's decision-making process and have implications for broader applications of deep learning techniques in Raman spectroscopy-based substance identification.

Comparison of Different Blood Transfusion Methods in Patients Undergoing Cesarean Section.

Purpose: To compare the effect of allogeneic transfusion and acute normovolemic hemodilution (ANH) autologous transfusion in patients undergoing cesarean section. Methods: Patients who underwent cesarean section and received blood transfusion therapy from February 2019 to July 2021 in our hospital were observed and divided into the allogeneic group (n = 55) who received allogeneic transfusion therapy and the autologous group (n = 55) who received ANH autologous transfusion therapy according to the mode of transfusion. Observations included vital signs [heart rate (HR), mean arterial pressure (MAP), stroke volume variation (SVV)], blood routine [red blood cells (RBC), platelets (PLT), hematocrit (HCT), hemoglobin (Hb)], T-cell subsets (CD4+, CD8+, CD4+/CD8+), immunoglobulins (IgA, IgM, IgG), inflammatory factors [C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6], and adverse effects were counted in both groups. Results: There was no statistical significance in the intra-group and inter-group comparisons of HR, MAP, and SVV between the two groups before transfusion and transfusion for 10 min (P > 0.05). 5d after operation, the RBC, PLT, HCT, and Hb of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). 5d after operation, the CRP, TNF-α, and IL-6 of the allogeneic group were higher than those before operation, and the autologous group was lower than that of the allogeneic group (P < 0.05). 5d after operation, the CD4+, CD4+/CD8+ of the allogeneic group were lower than before operation, and the CD8+ was higher than before operation. The CD4+ and CD4+/CD8+ of the autologous group were higher than that of the allogeneic group, and CD8+ was lower than that of the allogeneic group (P < 0.05). 5d after operation, the IgA, IgG, and IgM of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). During blood transfusion, there was no significant difference in the adverse reaction rate between the two groups (P > 0.05). Conclusion: Both allogeneic transfusion and ANH autologous transfusion have little effect on the vital signs of patients undergoing cesarean section, but ANH autologous transfusion is more helpful to the stability of blood routine, T-cell subsets, immunoglobulin, and inflammation levels after surgery, which is a safe and effective way of blood transfusion.

Diagnostic blood loss from phlebotomy and hospital acquired anemia in patients with severe burns.

PURPOSE: The study was performed to estimate the diagnostic blood loss (DBL) volume during hospitalization and investigate its relationship with the development of moderate to severe hospital acquired anemia (HAA) and increased number of red blood cell (RBC) transfusion following extensive burns. MATERIALS AND METHODS: This was a retrospective study of adult burned patients with total body surface area (TBSA) burn larger than 40%, who were admitted to burn center of Changhai hospital between January 2005 and December 2017. RESULTS: We included a final number of 157 patients in the present study. Moderate to severe HAA within the fourth week postburn was developed in 46 of 121 patients who stayed over 28-day hospitalization. Patients with moderate to severe HAA had both significantly higher total DBL volume [245 (IQR: 183.75, 325.25) mL vs 168 (119, 163) mL ; P = 0.001] and DBL volume per day [10.22 (IQR: 8.57, 12.38) mL vs 6.63 (5.22, 10.42) mL/day; P = 0.005]. Logistic regression analysis revealed that both DBL volume per day and TBSA burn were independent risk factors for the development of moderate to severe HAA. CONCLUSIONS: Severely burned patients appear to be prone to develop HAA during hospitalization. The DBL volume contribute to the occurrence of moderate to severe HAA, which might be a modifiable target for preventing HAA.