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Thyroid cancer is among the most common endocrine malignancies, necessitating effective surgical interventions. Traditional open cervicotomy has long been the standard approach for thyroidectomy. However, the advent of robotic surgery has introduced new possibilities for minimally invasive procedures with benefits in terms of cosmetic outcomes, enhanced precision, comparable complication rates, and reduced recovery time. This study mainly reviewed the most widely used and well-known robotic thyroidectomy approaches: the transaxillary approach, the bilateral axillo-breast approach, and the transoral approach. This review examines the current status and future potential of robotic surgery in thyroid cancer treatment, comparing its efficacy, safety, and outcomes with those of conventional open cervicotomy. Challenges such as a longer operative time and higher costs exist. Future directions include technological advancements, tele-surgery, single-port surgery, and the integration of artificial intelligence. Robotic surgery holds promise in optimizing patient outcomes in thyroid cancer treatment.
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Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death. Recent studies have underlined the importance of non-contrast-enhanced chest CT scans not only for emphysema progression quantification, but for correlation with clinical outcomes as well. As about 40 percent of the 300 million CT scans per year are contrast-enhanced, no proper emphysema quantification is available in a one-stop-shop approach for patients with known or newly diagnosed COPD. Since the introduction of spectral imaging (e.g., dual-energy CT scanners), it has been possible to create virtual non-contrast-enhanced images (VNC) from contrast-enhanced images, making it theoretically possible to offer proper COPD imaging despite contrast enhancing. This study is aimed towards investigating whether these VNC images are comparable to true non-contrast-enhanced images (TNC), thereby reducing the radiation exposure of patients and usage of resources in hospitals. In total, 100 COPD patients with two scans, one with (VNC) and one without contrast media (TNC), within 8 weeks or less obtained by a spectral CT using dual-layer technology, were included in this retrospective study. TNC and VNC were compared according to their voxel-density histograms. While the comparison showed significant differences in the low attenuated volumes (LAVs) of TNC and VNC regarding the emphysema threshold of -950 Houndsfield Units (HU), the 15th and 10th percentiles of the LAVs used as a proxy for pre-emphysema were comparable. Upon further investigation, the threshold-based LAVs (-950 HU) of TNC and VNC were comparable in patients with a water equivalent diameter (DW) below 270 mm. The study concludes that VNC imaging may be a viable option for assessing emphysema progression in COPD patients, particularly those with a normal body mass index (BMI). Further, pre-emphysema was generally comparable between TNC and VNC. This approach could potentially reduce radiation exposure and hospital resources by making additional TNC scans obsolete.
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BACKGROUND: The sibling comparison analysis is used to deal with unmeasured confounding. It has previously been shown that in the presence of non-shared unmeasured confounding, the sibling comparison analysis may introduce substantial bias depending on the sharedness of the unmeasured confounder and the sharedness of the exposure. We aimed to improve the awareness of this challenge of the sibling comparison analysis. METHODS: First, we simulated sibling pairs with an exposure, a confounder and an outcome. We simulated sibling pairs with no effect of the exposure on the outcome and with positive confounding. For varying degrees of sharedness of the confounder and the exposure and for varying prevalence of the exposure, we calculated the sibling comparison odds ratio (OR). Second, we provided measures for sharedness of selected treatments based on Danish health data. RESULTS: The confounded sibling comparison OR was visualized for varying degrees of sharedness of the confounder and the exposure and for varying prevalence of the exposure. The confounded sibling comparison OR was seen to increase with increasing sharedness of the exposure and the confounded sibling comparison OR decreased with an increasing prevalence of exposure. Measures for sharedness of treatments based on Danish health data showed that treatments of chronic diseases have the highest sharedness and treatments of non-chronic diseases have the lowest sharedness. CONCLUSIONS: Researchers should be aware of the challenge regarding non-shared unmeasured confounding in the sibling comparison analysis, before applying the analysis in non-randomized studies. Otherwise, the sibling comparison analysis may lead to substantial bias.
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Hermanos , Humanos , Factores de Confusión Epidemiológicos , Sesgo , Oportunidad RelativaRESUMEN
Objective: This study analyzed the popularity of TikTok health knowledge popularization accounts with the objective of creating a template for accounts suited to widely disseminating information, thereby enhancing the public's access to health knowledge on a broader scale. Methods: This study is based on 40 Chinese TikTok short video accounts that were active from February to April 2022 and were engaged in health science popularization. Data were validated by structured calibration using three qualitative anchors. It employs the "content-context" and the elaboration likelihood models as the theoretical framework. A qualitative comparative analysis is used to explore the factors affecting the popularity of this type of account mechanism. Results: Among the nine variables involved in the calculation, one reached 0.909091, demonstrating that the number of followers was both a necessary factor and a condition for the popularity of short health science video accounts. There were 16 paths in the complex solution with a consistency of 1, and their overall coverage reached 0.878788, indicating that approximately 87% of the cases could be explained. From the spread of the content and communication situation, professional medical knowledge, current hot topics, professionals, and serious issues were the most likely combinations for rapid spread. From the perspective of the central and edge paths, "likes" exceeding 100,000 and fans exceeding 1 million were essential combinations. Conclusions: The dissemination of medical knowledge has gained significant traction, especially with regard to trending and popular topics. When it comes to the tone of communication, a serious style proved effective in fostering what can be termed "hot communication." From the standpoint of central and peripheral paths, it is crucial that the number of likes in the past month and the total number of fans surpass 100,000 and one million, respectively.
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Objective To make a comparative study of the two intelligent Pubmed-based retrieval tools,Gopubmed and Pubmedpro.Methods We took lung cancer literatures as an example in this article,probed into the difference between these two tools in several aspects including retrieval tech niques,browse,boolean retrieval,statistical analysis items,statistical analysis accuracy,access and retrieval speed.Results Gopubmed and Pubmedpro shared the similar retrieval techniques,but the latter had more browse,boolean retrieval and statistical analysis functions,and had better analysis accuracy,easier access and faster retrieval speed.Conclusion Pubmedpro had advantages over Gopubmed in general.
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Objective To evaluate whether the comparability of 3 automatic blood cell analyzers meet the clinical requirements by conducting the comparative study on the detection results of these instruments.Methods With the Sysmex 2100 automatic blood cell analyzer as the reference instrument,Sysmex 1000i and Abbott 1800 as the experimental instrument,the original quality control provided by the instrument factory and the patient′s fresh anticoagulant blood samples in the laboratory were adopted to monitor for continuous 40 d by these three instruments and the detection results of WBC,RBC,HGB,HCT and PLT were analyzed.Results The detection results of these 3 instruments were statistically tested by the F test,the differences showed no statistical significance (P >0.05)and the bias was in 1/2 of the maximum permissible error range in America department clinical test revised regulations (CLIA′88).Conclusion The detection results by these 3 instruments are comparable and can meet the clinical requirements.
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Objective To understand the variation of thyroid hormones in each trimesters of pregnancy in women.Methods A total of 1 839 pregnant women in different trimesters were enrolled and thyroid hormones including FT3,FT4,TT3, TT4,TSH,TGAb and TPOAb were measured.The reference range of hormone in each trimester was calculated.Results There were statistically differences in all thyroid hormones among all trimesters of pregnancy women (P<0.05 )except for TT4 between the early and middle trimesters (P>0.05 ).The median of FT3 and FT4 were gradually reduced as the pregnant trimester grew up while the median of TSH had the adverse tendency.The median of TT3 was highest during the middle trimester (1.47 nmol/L).TT4 median was lowest during the late trimester (80.67 nmol/L).The TSH level of pregnant women over 30 years old was significantly lower than that of below 30 age group during all trimesters(P<0.05 ). There were significant differences in FT4,TT3 and TT4 level among early and middle trimesters among different ages groups(P<0.05 ).The positive rates of TGAb and TPOAb during late trimester (4.74% and 1.63%)were significantly lower than those of early trimester (1 4.40% and 5.56%)and middle trimester (1 4.40% and 5.56%)(P<0.05 ). Conclusion Significant differences of thyroid hormones are found not only in different stages of pregnancy,but also in different ages.Therefore,establishing trimester-specific reference data of thyroid hormones during different pregnency may be important for clinical practice.
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Objective To analyze the characteristics of published radiology original articles in China,and compare radiology research inboard and abroad.Methods According to the Contents of Chinese Science Core Periodicals in 2012,there were 15 comprehensive radiological core periodicals in China.All of them were retrospectively surveyed,and original articles published between October 2011 and October 2012were evaluated.The following information was abstracted from each article:radiologic technique used,radiologic subspeciahy,type of research,sample size and study design.At the same time,all the original articles from two top radiology journals,Radiology and European Radiology (ER) at the same period were evaluated.Chi-square test was used to compare the composition percentage inboard and abroad.Results There were 2784 original articles published in the 15 Chinese top radiological periodicals in total The most commonly used radiologic techniques were CT (1093 of 2784,39.3％),MRI (824 of 2784,29.6％) and intervention (402 of 2784,14.4％).Radiology and ER totally published 560 original articles.MRI (265 of 560,47.3％),CT (170 of 560,30.4％) and mixed techniques (63 of 560,11.3％) were most used.In China,as much as 2572 (92.4％) articles were clinical research,115 (4.1％) was basic research,9 (0.3％) was clinical and basic research,and 83 (3.2％) was non-basic non-clinical research.The sample size of less than 10,between 10 to 50,and more than 50 was 374 (13.4％),1448 (52.0％) and 847 (30.4％) respectively.339 (12.2％) Chinese articles belonged to perspective research,and 1211 (43.5％) were retrospective.For Radiology and ER,515 (92.0％) articles were clinical research,39 (7.0％) was basic research,3(0.5％) was clinical and basic research,and 3(0.5％) was non-basic non-clinical.The sample size of less than I0,between 10 to 50,and more than 50 was 30 (5.4％),225 (40.2％) and 252 (45.0％) respectively.230 (41.1％) articles belonged to perspective research,and 202 (36.1％) ones were retrospective.Radiology and ER articles used MRI more than that published in Chinese radiology journals (x2 =666.690,P ＜ 0.01).Clinical research was the most commonly used research type both inboard and abroad (x2 =0.116,P ＞0.05).Articles of sample size more than 50 abroad were more than that of China (x2 =44.895,P ＜0.01).Perspective research was used more abroad (x2 =275.667,P ＜ 0.01),and the main research type in China was retrospective.Conclusion Chinese radiology workers might need to do more perspective and larger sample size clinical researches.
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OBJECTIVE: To study and compare the compositions of traditional decoction and compatible granules of Duhuo Jisheng Tang and reveal their differences in inner quality. METHODS: The compositions of eight medicines, i.e., duhuo, sangjisheng, danggui, chuangxiong, fuling, baishao, qinjiao and gancao in traditional decoction and dispensing granule decoction, were identified by TLC. And the contents of paeoniflorin were determined by HPLC. RESULTS: There were more spots of the eight than dispensing granules. The content of peaoniflorin of the traditional decoction was 29.37mg·g-1. The content of peaoniflorin of the dispensing granule decoction is 2.59 mg·g-1. CONCLUSION: Composition contents in traditional decoction from Duhuo Jisheng Tang is higher than that of dispensing granule decoction.
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Objective To find an appropriate r3diobiological model for analyzing the biological effect of the radiotherapy for breast cancer by comparing different results computed by various types of radiobiological models. Methods DVHs database simulating breast conserving radiotherapy was set up,based on clinical DVHs data of the heart.the lung and PTV of 22 patients with early breast cancer given conventional tangential radiotherapy.Two models assessing NTCP of radiation pneumonitis and cardiac mortality and four models assessing TCP were compared by analyzing the effects of the parameters and DVH database input methods on the results. Results When mean irradiation dose of the whole lung was 30 Gy.the incidence of radiation pneumonitis was 32%and 54%predicted by NTCP-RSM model and NTCP-Lyman model,respectively.When 1%cardiac mortality of radiation was assumed,28 Gy and 40 Gy isodose should cover the heart assessed by the two models.The mean TCP were 21.1%.80.8%.38.4%and 41.0%when assessed by LQ-Poisson-TCP,Zaider-TCP,Poisson-TCP and Logit-TCP models,respectively.Setting various differential DVH(dDVH)bins had very few effect on the NTCP/TCP results in a certain model.Adopting physical dose or LQED2 affected the results with greater resu]ts for physical dose.Variation in α or β value,tumor cell density and D50 had significant effect upon TCP results in LQ-Poisson-TCP(P:0.000). Conclusions NTCP-Lyman model is better for predicting the incidence of radiation pneumonitis while NTCP-RSM model is better for predicting radiation-induced cardiac mortality.LQ-Poisson-TCP is the best TCP model for clinical application.Parameters selected for model can significantly affect the results.It is imporrant to understand the distinct characteristics of different models.
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During periodontal examination and periodontal recall visit, patients might feel pain. Probing with 0.45mm diameter probe, "overprobing" into connective tissue underlying periodontal pocket could be the primary aspect of pain. The purpose of present study, performed during recall visit, was to compare the levels of pain experienced by patients during periodontal probing using probes with the tip diameter of either 0.45mm or 0.63mm. Twenty patients were enrolled: 3 periodontists each exammined 20 patients at the Dankook university dental hospital. in each patient at six sites per tooth, diagonal maxillary/mandibular quadrants were probed with 0.45mm diameter and 0.63mm diameter probe. Lower pain responses following probing with the 0.63mm diameter probe as compared to the 0.45mm probe were observed for patients of therapist 2 and the upper VAS quartile Groups(P<0.05). For therapist 1 and 3 groups, no differences were found. Patient worry about the pain while dental treatment procedures. If therapist use 0.63mm diameter probe while periodontal examination and recall visit, the patient's pain and discomfort could be reduced. Therefore, patient will cooperate more during the treatment, which leads to a better result. Dental therapists should make an effort to minimize the degree of discomfort during treatment. Dental therapist periodically should evaluate this part of their skill by asking patients and promote this skill.
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Humanos , Tejido Conectivo , Bolsa Periodontal , DienteRESUMEN
Objective To screen and analyse the dominated related factors for medical discipline construction and development,and provide evidences for the reinforcement of discipline connotation construction.Methods The candidate medical disciplines of State Key Disciplines Evaluation of 2007 were served as study subjects.Disciplines from the results of State Key Discipline Evaluation were divided into "new discipline" group(n=51),"breeding discipline" group(n=33)and "failed discipline" group(n=81).The differences between results of State Key Discipline Evaluation and corresponding data of past years(2001 to 2006)in academic team,scientific research,graduate education and lab construction were analysed by nonparametric Kruskal-Wallis test.Results There were significant differences in academic leader,state key project,prize level,graduates quality and scientific research base among the results of State Key Discipline Evaluation(P≤0.05),and the dominated factors for the unsuccessful result were lack of high-level academic leader,state key discipline,prize,gruaduates and scientific research base.Conclusion The adoption of appropriate measures for the construction of academic team,the reinforcement of scientific research and the establishment of academic achievement evaluation may help to upgrade the academic level.