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PURPOSE: In soft tissue reconstructive surgery, perforator localization and flap harvesting have always been critical challenges, but augmented reality (AR) has become a dominant technology to help map perforators. METHODS: The lateral circumflex femoral artery (LCFA) and its perforators were reconstructed by CTA in consecutive patients (N = 14). Then, the anterolateral thigh perforators and the points from which the perforators emerged from the deep fascia were marked and projected onto the skin surface. As the virtual images were projected onto patients according to bony markers, the courses of the LCFA and its perforators were depicted on the skin surface for intraoperative guidance. Finally, the locations of the emergence points were verified by intraoperative findings and compared to those determined by handheld Doppler ultrasound. RESULTS: The sources, locations, and numbers of perforators were determined by CTA. The perforators and their emergence points were accurately mapped on the skin surface by a portable projector to harvest the anterolateral thigh perforator flap. During the operation, the accuracy of the CTA & AR method was 90.2% (37/41), and the sensitivity reached 97.4% (37/38), which were much higher than the corresponding values of Doppler ultrasound. Additionally, the differences between the AR-marked points and the intraoperative findings were much smaller than those seen with Doppler ultrasound (P < 0.001). Consequently, all of the flaps were well designed and survived, and only one complication occurred. CONCLUSION: Augmented reality, namely, CTA combined with projection in this study, plays a vital and reliable role in locating the perforator emergence points and guiding the procedure to harvest flaps and has fewer potential risks.
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Realidade Aumentada , Humanos , Coxa da Perna/diagnóstico por imagem , Coxa da Perna/cirurgia , Veias , Retalhos Cirúrgicos , AngiografiaRESUMO
BACKGROUND: How to treat the posterior cruciate ligament (PCL) tibial insertion small and comminuted avulsion fracture is still challenging. Our study evaluated the clinical and radiological outcomes after ORIF of PCL tibial insertion avulsion fractures through the inverted L-shaped postero-medial approach using a homemade pin-hook. METHODS: Between January 2009 and December 2020, twenty-four patients with isolated PCL tibial insertion bony avulsion were enrolled. There were 16 males and 8 females. The age range was 18-48 (32.5 ± 9.3) years. The time from injury to surgery was 1-10 (4.4 ± 2.8) days. There were 11 cases in the left knee and 13 cases in the right knee. The patients received anticoagulant therapy to prevent thrombosis. Preoperative standard X-ray, computerized tomography (CT) and magnetic resonance imaging (MRI) were performed. According to the Meyers-McKeever classification, there were 8 cases of type II and 16 cases of type III. RESULTS: The operation time was 60-120 (89.6 ± 19.8) min. Postoperative follow-up ranged from 3 to 18 months. The average follow-up was 11.4 ± 4.3 months. In all patients, one or two homemade pin-hooks were used to fix different sizes of fracture segments. X-ray or CT scans taken after surgery revealed fracture union. The fractures healed in 9-16 (11.8 ± 1.7) weeks. At the last follow-up, the patients were able to fully straighten. The ROM (132.6° ± 3.9°), the Tegner-Lysholm score (96.2 ± 2.3) and the IKDC scores (95.5 ± 1.6) were all significantly improved compared with the preoperative values (77.5° ± 13.1°, 46.8 ± 8.9, 36.2 ± 7.9). The posterior drawer test was negative. The gastrocnemius muscle strength did not diminish. No internal fixation migration was observed during the follow-up. No neurovascular bundle- or hardware-related complications were reported. CONCLUSIONS: The inverted L-shaped postero-medial approach with homemade pin-hook fixation for the treatment of PCL avulsion fractures produces acceptable clinical and radiological results. Moreover, the homemade pin-hook made of K-wires is affordable and reduces patient costs. It is a practical application and worth recommending, especially for community hospitals.
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Fratura Avulsão , Fraturas Cominutivas , Ligamento Cruzado Posterior , Fraturas da Tíbia , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Ligamento Cruzado Posterior/diagnóstico por imagem , Ligamento Cruzado Posterior/cirurgia , Fratura Avulsão/diagnóstico por imagem , Fratura Avulsão/cirurgia , Artroscopia/métodos , Técnicas de Sutura , Resultado do Tratamento , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Cominutivas/cirurgia , AnticoagulantesRESUMO
PURPOSE: Treating scapular fractures is still a challenging task for surgeons. We aimed to evaluate the feasibility, accuracy, and effectiveness of augmented reality (AR) and three-dimensional (3D) plate library-assisted posterior minimally invasive surgery, named AR-scapular system for scapula fracture. We speculated that using AR-scapular system would improve efficiency and quality for scapular fracture surgery. METHODS: We retrospectively reviewed the records of 21 patients with scapular fractures treated by posterior minimally invasive surgery with reconstruction plates: nine patients were treated with conventional fixation in group I; whereas 12 patients were treated with pre-operative virtual simulation and intra-operative navigation-assisted fixation using AR-scapular system. We compared operative time, blood loss, complication, and Hardegger function between two groups. Statistical analyses evaluated significant differences between the groups for each of these variables. RESULTS: In group II, the pre-operative virtual simulation time was 44.42 ± 15.54 min. The time required for pre-operative contouring of the plates was 16.08 ± 5.09 minutes. The patients in group II had significantly shorter operation time and less blood loss (- 28.75 min and - 81.94 ml, respectively; P < 0.05) than patients in the conventional surgery group. The average numbers of plates used were 1.56 ± 0.53 in group I and 1.25 ± 0.45 in group II. The difference was not statistically significant (P > 0.05). The follow-up function outcome results were similar between groups (P > 0.05). There were no intra-operative or post-operative complications for all patients. CONCLUSION: Augmented reality and 3D plate library-assisted posterior minimally invasive surgery is an effective and reliable method for treating scapular fractures which can provide precise pre-operative planning and intraoperative navigation. This time-saving approach can give a more customized treatment plan, allowing for a safer reduction surgery. What is more, the portable projector is cheap and easy to use.
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Realidade Aumentada , Fraturas Ósseas , Fraturas do Ombro , Cirurgia Assistida por Computador , Traumatismos Torácicos , Acetábulo/cirurgia , Placas Ósseas , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Impressão Tridimensional , Estudos Retrospectivos , Escápula/cirurgia , Cirurgia Assistida por Computador/métodos , Resultado do TratamentoRESUMO
BACKGROUND: The aim of this study was to examine the associations of tea consumption with the serum uric acid (SUA) level, hyperuricemia (HU) and the risk of gout. METHODS: A comprehensive literature search up to June 2016, using PUBMED and EMBASE databases, was conducted to identify the relevant observational studies that examined the associations of tea consumption with the SUA level, HU and the risk of gout. RESULTS: A total of fifteen observational studies were included in this study, and nine studies were extracted for meta-analysis. For the SUA level, seven studies were included. According to the combined weighted mean difference (WMD), there was no significant difference between the highest and the lowest tea intake category in terms of the SUA level (WMD = 7.41 µmol/L, 95%CI: -2.34 to 17.15; P = 0.136). In subgroup analysis including three studies, green tea consumption was positively associated with the SUA level (WMD = 17.20 µmol/L, 95%CI: 7.00 to 27.40; P = 0.01). For the prevalence of HU, five studies were included. The overall multi-variable adjusted odds ratio (OR) for the highest versus the lowest category of tea consumption was 0.98 (95%CI: 0.77 to 1.24; P = 0.839). For the risk of gout, two prospective cohort studies showed that there was no relationship between tea consumption and the risk of gout in males and females, respectively. CONCLUSION: The current evidences suggest that tea consumption does not seem to be associated with the SUA level, HU and the risk of gout. However, due to the limited number of studies, green tea consumption might be positively associated with the SUA level. More well-designed prospective cohort studies are needed to elaborate these issues further.
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Gota/prevenção & controle , Hiperuricemia/prevenção & controle , Chá , Ácido Úrico/sangue , Humanos , Estudos Observacionais como AssuntoRESUMO
Despite the importance of WRKY genes in plant physiological processes, little is known about their roles in Panax ginseng C.A. Meyer. Forty-eight unigenes on this species were previously reported as WRKY transcripts using the next-generation sequencing (NGS) technology. Subsequently, one gene that encodes PgWRKY1 protein belonging to subgroup II-d was cloned and functionally characterized. In this study, eight WRKY genes from the NGS-based transcriptome sequencing dataset designated as PgWRKY2-9 have been cloned and characterized. The genes encoding WRKY proteins were assigned to WRKY Group II (one subgroup II-c, four subgroup II-d, and three subgroup II-e) based on phylogenetic analysis. The cDNAs of the cloned PgWRKYs encode putative proteins ranging from 194 to 358 amino acid residues, each of which includes one WRKYGQK sequence motif and one C2H2-type zinc-finger motif. Quantitative real-time PCR (qRT-PCR) analysis demonstrated that the eight analyzed PgWRKY genes were expressed at different levels in various organs including leaves, roots, adventitious roots, stems, and seeds. Importantly, the transcription responses of these PgWRKYs to methyl jasmonate (MeJA) showed that PgWRKY2, PgWRKY3, PgWRKY4, PgWRKY5, PgWRKY6, and PgWRKY7 were downregulated by MeJA treatment, while PgWRKY8 and PgWRKY9 were upregulated to varying degrees. Moreover, the PgWRKY genes increased or decreased by salicylic acid (SA), abscisic acid (ABA), and NaCl treatments. The results suggest that the PgWRKYs may be multiple stress-inducible genes responding to both salt and hormones.
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Regulação da Expressão Gênica de Plantas , Panax/genética , Panax/fisiologia , Reguladores de Crescimento de Plantas/metabolismo , Proteínas de Plantas/genética , Cloreto de Sódio/metabolismo , Fatores de Transcrição/genética , Ácido Abscísico/metabolismo , Acetatos/metabolismo , Clonagem Molecular , Ciclopentanos/metabolismo , Perfilação da Expressão Gênica , Genes de Plantas , Oxilipinas/metabolismo , Filogenia , Ácido Salicílico/metabolismo , Sais/metabolismo , Estresse FisiológicoRESUMO
Introduction: Post-stroke central pain is disabling yet ineffectively treated with routine medical intervention. In this study, the authors presented an alternative neuromodulation therapy and conducted a brief narrative literature review to examine current evidence of spinal cord stimulation treatment for central post-stroke pain. Case presentation: Here, the authors reported a case of severe post-stroke syndrome, who achieved satisfactory improvement of pain symptom, as well as muscle rigidity with a novel neuromodulation therapy of short-term implantation of cervical spinal cord stimulation. Clinical discussion: It remains a great challenge in the management of post-stroke pain, which in turn significantly reduces the quality of life and worsens the burden on the public health system. Spinal cord stimulation therapy is an emerging neuromodulation approach to restore pathological pain status and functional impairment to provide a prospective insight into neuromodulation and rehabilitation options in the management of post-stroke syndrome. Conclusion: A potential role of spinal cord stimulation in the treatment of post-stroke pain is proposed in combined with traditional medication or other neuromodulation strategies, to achieve better control of pain in the future.
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AIM: Spinal cord stimulation (SCS) is an effective method to treat neuropathic pain. It is necessary to identify the responders of SCS analgesia before implantation. The aim of this study is to investigate the relationship between the cortical dynamics and SCS analgesia responders in pain management. METHODS: Resting-state EEG recording was performed in patients who underwent short-term implantation of spinal cord stimulation for pain therapy. We then did spectral analysis to capture the pattern of cortical oscillation between neuromodulation therapy analgesia responders and nonresponders. RESULTS: About 58.3% (14 out of 24) of participants were considered as analgesia responders, with average visual analogue scores reduction of 4.8 ± 1.0 after surgery, and 2.1 ± 0.7 for the nonresponder subgroup, respectively. The alpha oscillation was significantly enhanced in responder cohort compared with nonresponders. We also observed an increasing spectral power of gamma band in responders. Furthermore, the attenuation of pain severity was significantly correlated with the global alpha oscillation activity (r = 0.60, P = 0.002). Likely, positive and significant correlation was found between the pain relief and gamma activity (r = 0.58, P = 0.003). CONCLUSIONS: Distinct pattern of neural oscillation is associated with the analgesic effect of spinal cord stimulation in pain management, enhancement of cortical alpha and gamma oscillation may be a predictor of analgesia responders.
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Analgesia , Neuralgia , Estimulação da Medula Espinal , Humanos , Estimulação da Medula Espinal/métodos , Manejo da Dor/métodos , Neuralgia/terapiaRESUMO
PURPOSE: Digit-tip amputation caused by crush injury is a common emergency scenario, and the management is full of challenges. The objective of this study was to demonstrate the application of the supermicrosurgery technique in replantation procedures for complex digit-tip amputations resulting from crush injuries, while also assessing functional and aesthetic outcomes. METHODS: We conducted a retrospective analysis of the data from 12 patients who underwent replantation of 15 digits in our department between July 2022 and June 2023. The outcomes of replantation, functional recovery (including return to work, cold tolerance, bone union, DASH score, VAS score, and two-point discrimination test), aesthetic results (including digit appearance, nail deformity, and pulp atrophy), and patient satisfaction were assessed. RESULTS: The amputation of 7 digits occurred within Tamai zone I level, 8 digits within Tamai zone II level, while 4 digits occurred within Ishikawa zone I level, 3 digits within Ishikawa zone II level, 7 digits within Ishikawa zone III level, and 1 digit within Ishikawa zone IV level. The replanted digits all survived (100%) without any indications of arterial insufficiency or venous congestion. The follow-up procedures were conducted on all 12 patients, with an average duration of 9.6 months (range, 6 to 18 months). The fracture successfully underwent healing at 9.2 weeks (range, 8 to 13 weeks). The mean VAS score was 1.75 points (range 0 to 4 points), the mean two-point discrimination test result was 5.72 mm (range 4.0 to 7.0 mm), and the mean DASH score was 9.78 points (range 3.33 to 22.5 points). All patients demonstrated cold tolerance and successfully resumed their pre-injury occupational activities. The nail deformity was observed in one digit following replantation within Tamai zone I, and in three digits following replantation within Tamai zone II; moreover, eight digits exhibited varying degrees of pulp atrophy. All patients expressed satisfaction with both functional and aesthetic outcomes. CONCLUSION: The successful replantation of digit-tip amputation caused by crush injury can be achieved through the application of supermicrosurgery technique, resulting in improved functional and aesthetic outcomes. Digit-tip replantation is a favorable and meaningful procedure with high patient satisfaction.
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Oxygen evolution reaction is a key process in hydrogen production from water splitting. The development of non-noble metal electrode materials with high efficiency and low cost has become the key factor for large-scale hydrogen production. Binary NiCo-layered double hydroxide (LDH) has been used as a non-noble metal electrocatalyst for OER, but its overpotential is still large. The microstructure of the catalyst is tuned by doping Mo ions into the NiCo-LDH/NF nanowires to form ternary NiCoMo-LDH/NF nanosheet catalysts for the purpose of enhancing the active sites and reducing the initial overpotential. Only 1.5 V (vs. reversible hydrogen electrode (RHE), ≈270 mV overpotential) is required to achieve a catalytic current density of 10 mA cm-2 and a small Tafel slope of 81.46 mV dec-1 in 1 M KOH solution, which manifests the best performance of NiCo-based catalysts reported up to now. Electrochemical analysis and micro-morphology show that the high catalytic activity of NiCoMo-LDH/NF is attributable to the change of the microstructure. The interconnected nanosheet arrays have the obvious advantages of electrolyte diffusion and ion migration. Thus, the active sites of catalysts are significantly increased, which facilitates the adsorption and desorption of intermediates. We conclude that NiCoMo-LDH/NF is a promising electrode material for its low cost and excellent electrocatalytic properties.
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Autologous chondrocyte implantation (ACI) is a procedure used to treat articular cartilage injuries and prevent the onset of post-traumatic osteoarthritis. In vitro expansion of chondrocytes, a necessary step in ACI, results in the generation of senescent cells that adversely affect the quality and quantity of newly formed cartilage. Recently, a senolytic peptide, fork head box O transcription factor 4-D-Retro-Inverso (FOXO4-DRI), was reported to selectively kill the senescent fibroblasts. In this study, we hypothesized that FOXO4-DRI treatment could remove the senescent cells in the expanded chondrocytes, thus enhancing their potential in generating high-quality cartilage. To simulate the in vitro expansion for ACI, chondrocytes isolated from healthy donors were expanded to population doubling level (PDL) 9, representing chondrocytes ready for implantation. Cells at PDL3 were also used to serve as the minimally expanded control. Results showed that the treatment of FOXO4-DRI removed more than half of the cells in PDL9 but did not significantly affect the cell number of PDL3 chondrocytes. Compared to the untreated control, the senescence level in FOXO4-DRI treated PDL9 chondrocytes was significantly reduced. Based on the result from standard pellet culture, FOXO4-DRI pre-treatment did not enhance the chondrogenic potential of PDL9 chondrocytes. However, the cartilage tissue generated from FOXO4-DRI pretreated PDL9 cells displayed lower expression of senescence-relevant secretory factors than that from the untreated control group. Taken together, FOXO4-DRI is able to remove the senescent cells in PDL9 chondrocytes, but its utility in promoting cartilage formation from the in vitro expanded chondrocytes needs further investigation.
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(1) Background: Chronic kidney disease (CKD) increases the susceptibility to the presence of herpes zoster (HZ). Little is known about the risk factors of HZ in CKD patients; (2) Methods: This is a case-control study. CKD patients diagnosed with HZ between January 2015 and June 2021 in a tertiary hospital were identified. One age- and gender- matched control was paired for each case, matched to the date of initial HZ diagnosis. Conditional multiple logistic regression was used to evaluate the risk factors associated with the presence of HZ; (3) Results: Forty-seven HZ patients and controls were identified. In general, about 73.40% (69 out of 94) patients were classified at IV to V stages of CKD. Immunosuppressive agents (p = 0.0012) and dialysis therapy (p = 0.021) were reported more frequently in the HZ cohort. Compared with the control group, the total white cell count and lymphocyte count were significantly lower in the HZ group (p value of 0.032 and 0.003, respectively). The conditional logistics regression model revealed that previous immunosuppressants administration (odds ratio: 10.861, 95% CI: 2.092~56.392, p = 0.005) and dialysis therapy (odds ratio: 3.293, 95% CI: 1.047~10.355, p = 0.041) were independent risk factors of HZ in the CKD population; (4) Conclusions: Dialysis and immunosuppressants therapy were associated with greater risk of HZ disease in CKD patients. Further guideline may highlight the necessity of zoster vaccine for patients with CKD, who undertake associated treatment.
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BACKGROUND: Lumbosacral radicular pain (LSRP) can be caused by disc herniation, spinal stenosis, and failed back surgery syndrome. The clinical effect of pulsed-radiofrequency (PRF) combined with transforaminal epidural steroid injection (TESI) for radiating pain in different population remains unclear. METHODS: We retrospectively reviewed the medical recordings of patients with LSRP caused by different etiologies, who underwent PRF and TESI treatment. The primary clinical outcome was assessed by a 10-point Visual Analog Scale (VAS) pre- and post-treatment. RESULTS: A total of 34 LSRP patients were identified and classified into 3 subgroups (disc herniation, spinal stenosis, and failed back surgery syndrome). The overall immediate pain reduction was 4.4 ± 1.1 after procedure. After a median follow-up of 9.5 months, the VAS decreased from 6.5 ± 1.0 to 2.4 ± 1.9 at the last follow-up. CONCLUSION: PRF combined with TESI is an effective approach to treat persistent LSRP in distinct population.
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BACKGROUND: Minimally invasive techniques, such as percutaneous low-power laser discectomy (PLLD) and low-temperature plasma radiofrequency ablation (coblation) can be applied to treat degenerative cervical radiculopathy. However, less evidence supports the superiority of distinct minimally-invasive therapy. Our study aimed to evaluate the clinical and radiological characteristics of the PLLD and coblation for cervical radiculopathy. METHODS: This was a prospective, multicenter, cohort study (ChiCTR-ONC-17010356). The modified Macnab criteria was performed to assess the clinical improvement pre- and post-surgery. To evaluate the radiological effect, the Pfirrmann grading system and disk herniation index were applied with MRI. RESULTS: In this study, 28 patients were enrolled in the coblation group and 30 patients in the PLLD group. The mean good-excellent rate at 3-month follow-up was 82.1% for PLLD group, and 66.7% for coblation group, respectively (p = 0.179). The PLLD group achieved higher good-excellent rate 6 and 12 months after discharge (92.9 vs. 70.0%, p = 0.026). Radiological data revealed that PLLD but not coblation treatment achieved significant reduction of disk herniation index (p < 0.0001). Coblation treatment did not change the Pfirrmann grades of cervical radiculopathy patients (n = 18), and 7 out of 17 (41.2%) patients achieved improvement after PLLD therapy. None obvious adverse event was observed in this study. CONCLUSION: Both PLLD and coblation are effective and safe option for patients with cervical radiculopathy. Better long-term clinical outcomes may be potentially associated with the improvement of disk degeneration after PLLD treatment.
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OBJECTIVES: Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19. METHODS: We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models. RESULTS: A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, -31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL-6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = -8 mm/h, 95% CI = [-14, -2], P = 0.005), SAA (WMD = -43.35 µg/ml, 95% CI = [-80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [-625.89, -171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment. CONCLUSIONS: The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19.
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Betacoronavirus , Infecções por Coronavirus , Inflamação/diagnóstico , Pandemias , Pneumonia Viral , Biomarcadores/análise , COVID-19 , China , Humanos , Prognóstico , SARS-CoV-2RESUMO
Background: Knee osteoarthritis (KOA) is a common degenerative disease associated with joint dysfunction and pain. Ultrasound-guided radiofrequency (RF) may be a promising therapy in the treatment of chronic pain for KOA patients. Objective: To evaluate the efficacy and safety of ultrasound-guided RF treatment for chronic pain in patients with KOA. Design: A systematic review was conducted, and a meta-analysis was carried out when possible. Setting. We examined the studies evaluating the clinical efficiency of ultrasound-guided RF on chronic pain in KOA population. Method: A systematic review for the efficacy and safety of ultrasound-guided RF treatment for pain management of KOA patients was carried out in PubMed, EMBASE, Cochrane Library, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) from the date of inception to February 2020, and a meta-analysis was conducted. The primary outcomes of pain intensity (visual analogue scale or numerical rating scale) and knee function [the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)] were evaluated from baseline to various follow-up times by random-effects model. Heterogeneity was assessed by I 2 statistic and the potential sources of heterogeneity by subgroup and metaregression analyses, respectively. Results: Eight publications with 256 patients were included in the meta-analysis. RF could relieve pain with -4.196 of pooled mean difference and improve knee function by decreasing 23.155 points in WOMAC. Three patients had ecchymosis, two with hypoesthesia and one with numbness after the procedure, and improved within 6 months. Furthermore, study design and treatment target were the sources of heterogeneity by subgroup and metaregression analyses, accounting for 37% and 74% of variances, respectively. Target of genicular nerve achieved better pain relief than intra-articular or sciatic nerve. Sensitivity analysis showed that removal of any single study was unlikely to overturn the findings. Limitations. There were some limitations in the study. Firstly, the small number of relevant studies limited the confidence level of the meta-analysis. Also, the significant heterogeneity may not be explained due to the limited data. Secondly, the direct comparison of two different guidance methods (ultrasound vs. fluoroscopy) for RF therapy is lacking. In addition, the outcomes were blindly assessed in the meta-analysis from all studies according to evaluation of bias, which could affect the reality of the data. Finally, most of the studies only provided short follow-up times, so we could not analyze the long-term effectiveness of ultrasound-guided RF in the treatment of patients with KOA. Conclusions: Ultrasonography is an effective, safe, nonradiative, and easily applicable guidance method for RF in pain relief and functional improvement in KOA patients.
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Dor Crônica/diagnóstico por imagem , Dor Crônica/terapia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/terapia , Manejo da Dor/métodos , Ultrassonografia de Intervenção/métodos , Humanos , Articulação do Joelho/diagnóstico por imagem , Medição da Dor/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Resultado do TratamentoRESUMO
Gene detection plays an important role in public health and consumer finances cause its prominent functions in precision medicine, pathogens detection and species identification. What's more, the announcement of Precision Medicine Initiative would strengthen its status further in many aspects. Therefore, rapid and simplified gene detection techniques are in urgent demand to meet the practical use. During the last decades, gene detection techniques have advanced considerably by integrating various strategies such as microassay, nanotechnologies and electrochemical methods. Herein, we summerized the recent innovations of gene detection methods based on the signal read-out modalities, and highlight those techniques with the potentials to realize Point-of-care (POC) tests. Additionally, gene detection principle, amplification strategies and their applications are also discussed.