Feasibility and Safety of Percutaneous Puncture Guided by a 5G-Based Telerobotic Ultrasound System: An Experimental Study.

PURPOSE: To evaluate the feasibility and safety of percutaneous puncture guided by a 5th generation mobile communication technology (5G)-based telerobotic ultrasound system in phantom and animal experiments. MATERIALS AND METHODS: In the phantom experiment, 10 simulated lesions were punctured, once at each of two angles for each lesion, under the guidance of a telerobotic ultrasound system and ultrasound-guided freehand puncture. Student's t test was used to compare the two methods in terms of puncture accuracy, total operation duration, and puncture duration. In the animal experiment, under the guidance of the telerobotic ultrasound system, an 18G puncture needle was used to puncture 3 target steel beads in the liver, right kidney, and right gluteal muscle, respectively. The animal experiment had no freehand ultrasound-guided control group. After puncture, a CT scan was performed to verify the position of the puncture needle in relation to the target, and the complications and puncture duration, etc., were recorded. RESULTS: In the phantom experiment, the mean accuracies of puncture under telerobotic ultrasound guidance and conventional ultrasound guidance were 1.8 ± 0.3 mm and 1.6 ± 0.3 mm (P = 0.09), respectively; therefore, there was no significant difference in the accuracy of the two guide methods. In the animal experiment, the first-attempt puncture success (the needle tip close to the target) rate was 93%. Polypnea occurred during one puncture. No other intraoperative or postoperative complications were observed. CONCLUSION: Puncture guided by a 5G-based telerobotic ultrasound system has shown good feasibility and safety in phantom and animal experiments.

Prevalence and influencing factors of abnormal carotid artery intima-media thickness in Henan Province in China.

Background: Carotid intima-media thickness (CIMT) has been shown to be a valuable predictor of cardiovascular diseases (CVDs). The aim of this study was to investigate the influencing factors of CIMT among adults in Central China. Methods: A total of 2,578 participants who underwent physical examination in Henan Provincial People's Hospital between January 2018 and July 2018 were enrolled. The respondents were divided into two subgroups according to their CIMT value (CIMT ≥1.0 mm group and CIMT <1.0 mm group). Variables considered were age, gender, total cholesterol, triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) triglycerides, fasting blood glucose, and uric acid levels, as well as hypertension, diabetes, body mass index (BMI), waist-to-hip ratio, body fat percentage, and visceral fat area (VFA). Logistic regression analysis was performed to explore the potential factors influencing CIMT. Results: The proportion of CIMT ≥1.0 mm among the physical examination population was 27.42% (707/2 578). The analysis of the two groups revealed significant differences in age, sex, hypertension, diabetes, total cholesterol, and HDL cholesterol. In the logistic regression analysis, age (OR=1.071, 95%CI=1.062-1.080), male sex (OR=2.012, 95%CI=1.251-2.238), hypertension (OR=1.337, 95%CI=1.031-1.735), diabetes (OR=1.535, 95%CI=1.045-2.255), HDL cholesterol (OR=0.540, 95%CI=0.366-0.796), and LDL cholesterol (OR=1.336, 95%CI=1.154-1.544) were significantly associated with abnormal CIMT. Conclusion: Early screening should be carried out among men, the older adults, and those with hypertension, diabetes, and dyslipidemia.

Value of Molybdenum Target X-Ray and High-Frequency Color Doppler Flow Imaging in Early Diagnosis of Breast Carcinoma: A Comparative Analysis.

Background: Breast carcinoma (BC) threatens the physical and mental health of women worldwide, and early diagnosis is important for improving patient outcomes and ensuring successful treatment. Purpose: This research mainly aims to compare and analyze the value of molybdenum target X-ray and high-frequency color Doppler flow imaging (CDFI) in the early diagnosis of BC. Methods: First, 102 patients with suspected early-stage BC (ESBC) admitted to Henan Provincial People's Hospital were examined by molybdenum target X-ray and CDFI. Based on the pathological findings, the diagnostic efficiency data of the two diagnostic modalities such as positive detection rate (PDR), positive predictive value (PPV), negative predictive value (NPV), sensitivity (SEN), specificity (SPE), and accuracy (ACC), as well as imaging information like masses, microcalcifications (MCs), axillary lymph node (LN) metastases, and blood flow signal or vascular sign abnormalities were analyzed. Results: CDFI contributed to higher PDR, PRV, NPV, SEN, and ACC than molybdenum target X-ray in ESBC diagnosis, but similar SPE. The combined diagnosis of molybdenum target X-ray plus CDFI contributed to even higher PDR, PRV, NPV, SEN, and ACC than molybdenum target X-ray alone and higher ACC than CDFI. Imaging inspection revealed that the number of cases of masses, axillary LN metastases, and abnormalities in blood flow signals or vascular signs detected by CDFI was significantly higher than that by molybdenum target X-ray, while the number of MCs was significantly lower. Conclusion: Molybdenum target X-ray plus CDFI is more effective in the diagnosis of ESBC and plays a complementary role in imaging examination, which can synergistically improve the diagnostic ACC of ESBC and is worthy of clinical promotion.

Caspase-3 in glioma indicates an unfavorable prognosis by involving surrounding angiogenesis and tumor cell repopulation.

AIM: Effective biomarkers for estimating glioma prognosis are deficient. Canonically, caspase-3 acts as an "apoptosis executioner". However, its prognostic role in glioma and mechanistic effects on prognosis remain unclear. METHODS: With glioma tissue microarrays, the prognostic roles of cleaved caspase-3 and its association with angiogenesis were explored. Next, by analyzing the mRNA microarray data from the CGGA, the prognostic role of CASP3 expression and correlations between CASP3 and markers of glioma angiogenesis and proliferation were investigated. To biologically interpret the prognostic role of caspase-3 in glioma, the influence of caspase-3 on surrounding angiogenesis and glioma cell repopulation was investigated with an in vitro cell co-culture model, which comprises irradiated U87 cells and un-irradiated firefly luciferase (Fluc)-labeled HUVEC (HUVEC-Fluc) or U87 (U87-Fluc) cells. The over-expressed dominant-negative caspase-3 was used to suppress normal caspase-3 activity. RESULTS: High levels of cleaved caspase-3 expression were associated with poor survival outcomes in glioma patients. Higher microvessel density was observed in patients with high levels of cleaved caspase-3 expression. By mining the microarray data in CGGA, it was revealed that higher CASP3 expression was found in glioma patients with lower Karnofsky Performance score, higher WHO grade, malignant histological subtype, wild-type IDH. Higher CASP3 expression indicated a worse survival rate in glioma patients. Patients with high CASP3 expression and negative IDH mutation showed the worst survival rate. Positive correlations were found between CASP3 and markers of tumor angiogenesis and proliferation. Subsequent data based on an in vitro cell co-culture model revealed that caspase-3 in irradiated glioma cells mediated pro-angiogenic and repopulation-promoting effects via regulating COX-2 signaling. With glioma tissue microarrays, high levels of COX-2 expression showed inferior survival outcomes in glioma patients. Glioma patients with high levels of cleaved caspase-3 and COX-2 expression showed the worst survival outcomes. CONCLUSION: This study innovatively identified an unfavorable prognostic role of caspase-3 in glioma. The pro-angiogenic and repopulation-prompting effects of caspase-3/COX-2 signaling may explain its unfavorable prognostic role and offer novel insights into therapy sensitization and curative effect prediction of glioma.

A 5G-powered robot-assisted teleultrasound diagnostic system in an intensive care unit.

BACKGROUND: Teleultrasound provides an effective solution to problems that arise from limited medical resources, a lack of local expertise, and scenarios where the risk of infection is high. This study aims to explore the feasibility of the application of a 5G-powered robot-assisted teleultrasound diagnostic system in an intensive care unit. METHODS: In this study, the robot-assisted teleultrasound diagnostic system MGIUS-R3 was used. Using 5G network technology, the doctor manipulates the robotic arm to perform teleultrasound examination. The doctor can adjust parameters via the teleultrasound control panel, and real-time transmission of audio, video and ultrasound images can facilitate simultaneous communication between both parties. All patients underwent robot-assisted teleultrasound examination and bedside ultrasound examination of the liver, gallbladder, pancreas, spleen, kidney, as well as assessment for pleural effusion and abdominal effusion. We evaluated the feasibility of the application of the robot-assisted teleultrasound diagnosis system in the intensive care unit in terms of consultation duration, image quality, and safety. We also compared diagnostic consistency and differences. RESULTS: Apart from one patient who was excluded due to severe intestinal gas interference and poor image quality, a total of 32 patients were included in this study. Every patient completed all relevant examinations. Among them, 20 patients were male; 12 were female. The average age of the patients was 61 ± 20 years. The average duration of teleultrasound diagnosis was 17 ± 7 min. Of the 32 patients, 26 had positive results, 6 had negative results, and 5 had inconsistent diagnoses. The overall diagnostic results were basically the same, and there were no differences in diagnostic levels between the two. The overall average image quality score was 4.73 points, which represented a high-quality image. After robot-assisted teleultrasound examination, no significant changes were observed in the vital signs of patients as compared to before examination, and no examination-related complications were found. CONCLUSION: The 5G-powered robot-assisted teleultrasound diagnostic system was associated with the benefits of clear images, simple operation, relatively high levels of consistency in terms of diagnostic results, higher levels of safety, and has considerable application value in the intensive care unit.

High expression of GPNMB indicates an unfavorable prognosis in glioma: Combination of data from the GEO and CGGA databases and validation in tissue microarray.

Glycoprotein non-metastatic melanoma protein B (GPNMB), a transmembrane glycoprotein, has been reported to be involved in tumor progression, but its prognostic value for glioma and the mechanistic effects on glioma progression have not been clearly explored. The present study aimed to investigate the prognostic role of GPNMB in glioma and the potential mechanisms of how GPNMB mediates glioma progression. Differentially expressed genes between the four highest and four lowest GPNMB expression samples in the GSE53733 dataset were first determined. Gene ontology, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis and Gene set enrichment analysis results demonstrated that the significantly enriched pathways in samples with high GPNMB expression compared with those with low GPNMB expression were associated with hypoxia, angiogenesis, migration and invasion. Pearson correlation analysis was conducted to investigate the correlations between GPNMB expression and the markers of hypoxia, angiogenesis, migration and invasion in GSE53733, which were further validated using another mRNA microarray dataset from the Chinese Glioma Genome Atlas (CGGA). In addition, using the CGGA dataset, high GPNMB expression was demonstrated to be significantly associated with advanced WHO grade and short survival time in patients with glioma. Of note, based on the immunohistochemical staining of the tissue microarrays, Kaplan-Meier analysis with the Renyi test and a Cox proportional hazards model were used to validate the unfavorable prognostic role of high GPNMB expression in glioma. In conclusion, high GPNMB expression may be associated with high tumor grade and unfavorable prognosis in glioma. GPNMB expression was demonstrated to correlate with the markers of hypoxia, angiogenesis, migration and invasion, which may be potential mechanisms through which GPNMB mediates glioma progression.