Technology and Health Care最新文献

Background: Blood transfusion is a critical medical intervention, and accurate cross-matching is essential to prevent adverse reactions. However, difficult cross-matching (DCM), often caused by irregular antibodies, poses significant challenges, particularly in patients with prior transfusions, pregnancies, or certain medical conditions.

Objective: To analyze the incidence and causes of DCM from 2017 to 2021 and propose strategies to improve transfusion safety and compatibility.

Methods: A total of 363 patients who underwent difficult cross-matching due to incompatible blood matching between January 2017 and December 2021 were selected as the study population. Pre-transfusion testing was conducted for all patients to observe patterns in difficult cross-matching, assess the causes of blood mismatch, and analyze irregular antibody detection results. Based on these findings, specific treatment measures were proposed to address the causes of incompatibility.

Results: Most DCM cases occurred in females (81.27%), especially under 45 years of age, with obstetrics and gynecology being the most affected departments. Positive irregular antibodies were identified in 86.50% of cases, mainly from the Rh blood group system (42.99%), followed by autoantibodies (19.43%) and other blood group antibodies. Effective strategies included selecting antigen-negative blood, warming transfusions for cold autoantibodies, and using saline for pseudoagglutination.

Conclusion: Irregular antibodies are the main cause of DCM. Accurate identification and tailored transfusion strategies are essential to ensure safety. Greater awareness and improved screening can reduce risks and enhance clinical outcomes.

BackgroundInflammatory Bowel Disease (IBD) significantly affects patients' long-term health and survival quality. Accurate and technology-driven assessment tools are essential for monitoring disease impact and optimizing individualized treatment strategies.ObjectiveTo develop a standardized and technology-enhanced evaluation system for IBD based on patient-reported outcomes (IBDPRO), enabling a comprehensive and dynamic assessment of patients' survival quality.MethodsA multidimensional evaluation system was constructed using the three-dimensional quality structure model. The framework incorporated expert consensus through the Delphi method, semi-structured interviews, and analytic hierarchy process (AHP) for weight assignment. A digital platform based on the REDCap system was used for data collection and patient follow-up. Statistical correlations were analyzed between survival quality scores and disease activity indices (PMS and HBI), as well as subjective self-assessments.ResultsHigh expert authority coefficients (0.926, 0.931) and significant agreement levels (Kendall's W = 0.226, 0.239, P < 0.01) were achieved. survival quality was strongly negatively correlated with disease activity (Spearman's r = -0.76, P < 0.001) and positively correlated with patients' self-perceived condition changes (r = 0.79, P < 0.001). The system demonstrated reliability, validity, and responsiveness across multiple dimensions.ConclusionsThe IBDPRO system provides a scientifically rigorous and technologically integrated method for evaluating the survival quality in IBD patients. This approach facilitates data-driven clinical decision-making and supports a transition toward personalized, patient-centered healthcare.

BackgroundThe increasing demand for dental implants necessitates the exploration of advanced materials and manufacturing techniques. Three-dimensional (3D) printing has emerged as a viable method for producing custom dental implants, allowing for intricate designs and improved patient-specific fits. This study focuses on the design and structural deformation assessment of 3D-printed dental implants using Finite Element Analysis (FEA). By simulating the mechanical behavior of these implants under realistic loading conditions, we aim to evaluate their performance and predict potential failure points, ultimately enhancing their reliability and longevity in clinical applications.ObjectiveThe primary objective of this study is to conduct a comprehensive design and structural deformation assessment of three-dimensional (3D) printed dental implants using Finite Element Analysis (FEA). Specifically, the study aims to: Evaluate stress distribution and deformation patterns in three 3D-printed dental implant designs under simulated physiological loading.Compare the stiffness, strength, and elastic behavior of PEEK and CFR-PEEK under occlusal forces.Identify failure points in implants and bone-implant interfaces by analyzing high stress concentrations.Predict the biomechanical behavior of a novel dental implant by determining its elastic modulus through finite element analysis (FEA).MethodsThree models 3D were designed to understand stress distribution with different structures using PEEK as biomaterial, with 4 test conditions modeled and compared. An occlusal load was applied (230 N at 90˚ and 30˚) on the implants. Isotropic, linear elastic, and homogeneous were considerate as properties of the components.ResultsUnder axial loads, all models stayed within physiological stress limits, while under 30° oblique loading, Model 3 showed the lowest stress, strain, and pressure.ConclusionsFEA results indicate that 3D-printed dental implants, particularly the optimized Model 3, maintain safe stress levels under axial and oblique loads, supporting their potential for immediate loading. However, due to numerical limitations, experimental validation remains necessary to advance implant designs that optimize bone regeneration and material efficiency.

ObjectiveThis study aims to compare the efficacy and safety of Proximal Femoral Nail Anti-Rotation (PFNA) versus Dynamic Hip Screw (DHS) in the treatment of intertrochanteric fractures (IF) in elderly patients. We specifically evaluate perioperative indicators, postoperative hip function, and the rate of internal fixation failure.Methods300 elderly IF patients treated in our hospital from July 2018 to May 2022 were divided into the PFNA group (n = 150), control group (n = 150), PFNA group treated with PFNA, and control group treated with mobility hip screw (DHS). Perioperative bleeding, operation time, postoperative time and hospital time were observed in the two groups: fracture reduction, hip function at 1 and 6 months after surgery, and failure of internal fixation. Observe the postoperative internal fixation failure in the PFNA group.ResultsThe intraoperative blood loss, operation time, first postoperative time and hospital time in the PFNA group were less than in the control group (P < 0.05). One month after surgery, the Harris score of the PFNA group was less than that of the control group (P < 0.05); the Harris score was not different at 6 months (P > 0.05). The excellent rate of fracture reduction in the PFNA group was greater than that in the control group (P < 0.05). The failure rate of internal fixation in the PFNA group was less than that in the control group (P < 0.05). By univariate analysis, Sing Index classification, Evans classification, 25 min and underlying disease were risk factors for postoperative internal fixation failure in PFNA patients (P < 0.05). After multivariate Logistic regression analysis, Sing Index grade, Evans classification, and tip distance 25min were independent risk factors for postoperative internal fixation failure in PFNA patients (P < 0.05).ConclusionThe treatment of elderly IF patients with PFNA has the advantages of small trauma, good fracture reduction, firm internal fixation, low failure rate of internal fixation, and quick postoperative recovery. Sing index classification, Evans classification, and 25min tip distance mainly caused internal fixation failure in patients with PFNA.

ObjectiveTo analyse the characteristic features of infants with pneumonia who test positive for serum milk-specific immunoglobulin E (sIgE) and to provide a reference for the diagnosis, management and prevention of the condition.MethodsWe retrospectively analysed data from 284 infants admitted to our hospital with pneumonia between January 2017 and December 2020 who underwent serum allergen testing. Based on the results, patients were categorised into three groups: pure milk sIgE-positive; mixed milk sIgE-positive; and allergen sIgE-negative. We then compared the general conditions, clinical characteristics, laboratory tests, imaging results and pathogenic data across these groups.ResultsAmong the patient population, 16.20% (46/284) tested positive for pure milk sIgE, 32.75% (93/284) tested positive for mixed milk sIgE and 51.06% (145/284) were negative for any allergen sIgE. Statistically significant differences were observed among the three groups in terms of general conditions, breastfeeding status, pre-existing respiratory infections and history of respiratory infections (>3 times) (p < 0.05 for each). The median length of hospital stay was longer in the pure milk sIgE-positive group and the mixed milk sIgE-positive group (8 [range 7-10] days) compared with the allergen sIgE-negative group (8 [range 6-9] days) (p < 0.05). The eosinophil counts of the mixed milk sIgE-positive group were significantly higher than in the other two groups (p < 0.05). Haemophilus influenzae of the pure milk sIgE-positive group was significantly higher than in the other two groups (p < 0.05).ConclusionThe presence of mixed milk sIgE allergens does not exacerbate clinical symptoms. However, infants who test positive solely for milk sIgE and have pneumonia require longer hospitalisation. This suggests that extra attention is necessary for infants with milk allergies when they develop pneumonia.

BackgroundAlzheimer's disease (AD) is a complex neurodegenerative disorder that complicates our understanding of its origins. Identifying AD-specific biomarkers can reveal its mechanisms and foster the development of innovative diagnostics and therapies, aiming to unlock new ways to combat this pervasive condition.MethodsWe analyzed gene expression data using Weighted Gene Co-expression Network Analysis (WGCNA) and machine learning (random forest, lasso regression, and SVM-REF) to differentiate AD patients from controls and explore gene functions.ResultsWe identified 641 differentially expressed genes (DEGs) and 22 co-expressed genes, with functional enrichment analysis revealing their involvement in immune responses. Notably, EGR1 emerged as a potential diagnostic and therapeutic target.ConclusionIn our study, we applied WGCNA, DEGs and diverse machine learning approaches to uncover potential biomarkers linked to Alzheimer's Disease (AD) and ferroptosis. A particular hub gene emerged as a promising candidate for novel diagnostic and therapeutic markers specifically within the context of ferroptosis in AD. This discovery sheds new light on the pathogenesis of AD, potentially facilitating the development of groundbreaking diagnostic and therapeutic techniques.

Among the many cancers that people face today, skin cancer is among the deadliest and most dangerous. As a result, improving patients' chances of survival requires skin cancer to be identified and classified early. Therefore, it is critical to assist radiologists in detecting skin cancer through the development of Computer Aided Diagnosis (CAD) techniques. The diagnostic procedure currently makes heavy use of Deep Learning (DL) techniques for disease identification. In addition, skin lesion extraction and improved classification performance are achieved through Region Growing (RG) based segmentation. At the outset of this study, noise is reduced using an Adaptive Wiener Filter (AWF), and hair is removed using a Maximum Gradient Intensity (MGI). Then, the best RG, which is the result of integrating RG with the Modified Honey Badger Optimiser (MHBO), does the segmentation. Finally, several forms of skin cancer are classified using the DL model MobileSkinNetV2. The experiments were conducted on the ISIC dataset and the results show that the accuracy and precision were improved to 99.01% and 98.6%, respectively. In comparison to existing models, the experimental results show that the proposed model performs competitively, which is great news for dermatologists treating cancer.

BackgroundThe optimal intervention procedures for scar-related ventricular tachycardia (VT) is still unclear.ObjectiveThis study aimed to compare the acute and long-term outcomes of a stepwise ablation approach targeting critical sites identified through activation mapping during VT or pace mapping followed by substrate ablation with substrate modification alone in patients with scar-related VT.MethodsData of 41 patients with scar-related VTs treated with stepwise ablation (Group 1, n = 29) or substrate modification alone during sinus rhythm (Group 2, n = 12) were retrospectively reviewed. The procedure acute success and long-term success during follow-up were compared.ResultsThere was no statistical difference between the two groups on basic characteristics. Group 1 demonstrated shorter ablation time (P = 0.02), longer VT-free survival rates at a median follow-up of 24.0 months (P = 0.02) and a lower VT recurrence rate (hazard ratio: 0.17, 95% confidence interval: [0.03, 0.93], P = 0.04) compared to Group 2. The acute success and ratio of ablation area to scar area were comparable between the two groups (P ≥ 0.05).ConclusionThe stepwise ablation strategy shows promise for improving acute and long-term outcomes and reducing the recurrence risk in patients with scar-related VT.

BackgroundLung cancer is one of the malignant tumors with the highest morbidity and mortality worldwide. Patients with an advanced stage need to face negative effects from chemotherapy, dread of dying, weakened role function and physical and mental suffering.ObjectivesTo examine the effect of transitional care on the psychological state of patients with advanced lung cancer chemotherapy.MethodsSeventy-two patients with advanced lung cancer who underwent chemotherapy in our hospital were arbitrarily split into the experimental group (30 cases) and the control group (31 cases). The control group received routine discharge care, whereas the experimental group received transitional care. The scores were compared before the first chemotherapy, the day after the end of the first-cycle chemotherapy, and the third week after the end of the 4-week chemotherapy according to SCL-90, PSS, PFE-R, SES, QLQ-C30, the rate of unplanned re-diagnosis and nursing satisfactory.ResultsThere was no significant difference in all aspects of scores between the two groups before and after chemotherapy (P > 0.05). Whereas there were significant differences in emotional function, fatigue, insomnia, depression and interpersonal sensitivity between the two groups after 4 cycles of chemotherapy (P < 0.05). The scores of PSS and PFE-R decreased significantly in the two groups, and the SES and QLQ-C30 in the experimental group were significantly higher than those in the control group (all P < 0.05).FindingsApplying transitional care intervention can lessen patients' negative emotions since being discharged with advanced lung cancer following chemotherapy and diminish the rate of unplanned re-diagnosis.

BackgroundHemineglect (HN) is a post-stroke condition, frequently defined as an impairment in finding spatial targets within an egocentric frame of reference, where the stimulus is coded relative to the self. However, the egocentric reference frame can change with the presence of another person. Immersive virtual reality (IVR) offers several advantages over paper-and-pencil tests typically used to assess HN, such as a realistic and controlled environment, standardised stimulus presentation, and sensitive response acquisition. We developed a new serious game in IVR to assess HN. Here we investigated (1) the feasibility and user experience of this serious game, and (2) the effect of the presence of an avatar on HN.MethodsWe first tested a group of 61 control individuals (CI), followed by a group of post-stroke 11 individuals without HN (SI:HN-), 6 with HN (SI:HN+), and 17 resampled age matched group of control individuals (CI). All participants performed the "Peach test", which required them to find and respond to a target presented among distractors, either alone or in the presence of an avatar. We measured response time (RT) and omissions. The SI:HN- and SI:HN + groups also completed a paper-and-pencil test for HN and a user experience questionnaire.ResultsThe first analysis of results with CI showed no differences in responding to the target when in ipsi- compared to contra-lateral spaces, nor in peri- compared to extra-personal spaces. There were also no differences in responding to the target in the no-avatar condition relative to the two avatars conditions. In the second analysis, SI:HN + were slower than SI:HN- and CI. Although an interaction between group and Laterality was predicted, the results showed that there was no Laterality effect for any of the groups. An interaction between group and proximity, showed that both SI groups were slower in the extra- compared to peri-personal spaces. The user experience was globally positively rated by the SI.ConclusionWe developed a serious game in IVR for the assessment of HN. Although most our findings were inconclusive, the Peach test showed excellent user experience results.Trial registration http://www.clinicaltrials.gov ; Unique identifier: NCT04694833, Date of registration: 11/24/2020.