Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
ObjectiveTo investigate the influence of gender, age, activity level, and diameter of graft on the anterior cruciate ligament (ACL) reconstruction.MethodsBetween February 2012 and June 2017, 179 cases (111 males and 68 females) with an average age of 30.0 years (range, 11-63 years) were included in study. The patients underwent internal fixator removal at 2 years or more after single bundle ACL reconstruction with hamstring tendon autografts. All patients were sports injuries. The time from injury to operation ranged from 3 days to 26 years (median, 120 days). Lachman test and pivot shift test were positive. Univariate analysis was conducted on gender, age, post-operative activity level (Tegner score at the time of internal fixator removal), diameter of graft, and number of graft strands, and logistic regression was used to conduct multivariate analysis to screen the independent risk factors.ResultsAll patients were followed up 24-90 months (mean, 29.1 months). At last follow-up, Lachman test was positive in 25 cases and pivot shift test was positive in 28 cases. The KT-2000 side-to-side difference was –1-7 mm (mean, 1.89 mm). Eleven patients (6.15%) failed after ACL reconstruction. Univariate and multivariate analyses showed that the age, gender, post-operative activity level, diameter of graft, and number of graft strands were not risk factors for the failure of ACL reconstruction (P>0.05).ConclusionThere was no significant difference in the risk for ACL reconstruction failure among age, gender, and activity level. ACL reconstruction failure rate cannot be reduced by increasing the number of graft strands to increase the diameter of grafts.
Objective To investigate the thirst status of patients in intensive care unit (ICU) who underwent oral tracheal intubation and ventilator assisted ventilation, and explore its influence factors. Methods A total of 172 patients with oral tracheal intubation admitted in ICU from June 2020 to September 2021 were investigated, and a numerical rating scale was employed for rating their thirst feelings. The patients were divided into a thirst group and a non-thirst group based on thirst status. The thirst status and influence factors of thirst distress were analyzed. Results The incidence of thirst in the ICU patients with oral tracheal intubation and ventilator assisted ventilation was 88.4%, and the thirst score in the thirst group was 7.70±1.17. Single factor analysis showed statistically significant difference between the two groups in sex, medical payment, smoking, drinking, duration of mechanical ventilation, humidification effect, sputum viscosity, gastrointestinal decompression, fasting, continuous renal replacement therapy, diuretics, 24-hour urine volume and liquid balance, heart function grading, sedatives, agitation, sweating, acute physiology and chronic health evaluation Ⅱ, endotracheal intubation depth, body mass index, PCO2, PO2, HCO3–, tidal volume, and sodium ion (all P<0.05). Multivariable regression analysis demonstrated that diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, intubation depth, and cardiac function were independent influence factors for the occurrence of thirst in the ICU patients who received tracheal intubation (P<0.01). Conclusions The incidence of thirst was high in ICU patients with airway intubation and ventilator assisted ventilation. Diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, 24-hour urine volume, and cardiac function grading were independent influence factors for the occurrence of thirst in ICU patients with tracheal intubation. It is necessary to implement targeted intervention to prevent and alleviate the thirst degree of patients, reduce the occurrence of related complications, and improve patient comfort.
ObjectiveTo evaluate the effect of the surgeon’s handedness on the distribution of prosthesis during primary total knee arthroplasty (TKA).MethodsA retrospective analysis was performed on 86 patients (100 knees) with primary TKA completed by the same right-handed surgeon between December 2016 and December 2018, including 72 cases of single knee and 14 of bilateral knees. The patients were divided into dominant group (right side) and non-dominant group (left side) according to the operating position of the surgeon and each group had 50 knees. There was no significant difference in gender, age, body mass index, disease duration, clinical diagnosis, preoperative Hospital for Special Surgery (HSS) score, and other general data between the two groups (P>0.05). The operation time and complications were recorded in both groups. The function of knee was evaluated by HSS score. Hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), and mechanical medial proximal tibial angle (mMPTA) were measured by using X-ray film of full-length lower extremity before TKA and at 2 weeks after TKA that were used to evaluate the coronal position of the prosthesis. Posterior distal femoral angle (PDFA) and posterior proximal tibial angle (PPTA) were measured by using lateral X-ray films at 3 months after operation that were used to evaluate the sagittal position of the prosthesis.ResultsThere was no significant difference in operation time between the two groups (t=?1.128, P=0.262). One case of posterior tibial artery thrombosis occurred in the dominant group, and 1 case of poor healing of the incision occurred in each of the dominant group and the non-dominant group. Patients in both groups were followed up 12-34 months with an average of 22.0 months. The HSS scores at last follow-up were 87.2±4.3 in the dominant group and 86.8±5.0 in the non-dominant group. There was no significant difference between the two groups (t=0.471, P=0.639). No complications such as periprosthetic infection, prosthetic loosening, or periprosthetic fracture occurred during follow-up. There was no significant difference in the HKA, mLDFA, and mMPTA between the two groups before and after operation (P>0.05). The differences in the incidence of sagittal femoral prosthesis malposition and PDFA between the two groups were significant (P<0.05); however, there was no significant difference in the PPTA, the rate of femoral prosthesis distributed in the neutral position, the incidence of over-flexed femoral prosthesis, and the incidence of anterior femoral notch (P>0.05).ConclusionThe surgeon’s handedness is one of the factors affecting the placement of the sagittal femoral prosthesis in primary TKA. The incidence of sagittal femoral prosthesis malposition could increase when the surgeon performs on the non-dominant side.
ObjectiveTo investigate the mid-term effectiveness of debridement with prosthesis retention for periprosthetic joint infection (PJI) after total hip arthroplasty (THA) and total knee arthroplasty (TKA), and analyze the influence factors that affected the effectiveness.MethodsA clinical data of 45 cases with PJI after THA (16 cases) and TKA (29 cases) that were treated with debridement with prosthesis retention between January 2011 and January 2015 were collected and analyzed. There were 19 males and 26 females with a mean age of 58.4 years (range, 23-78 years). PJI occurred after primary joint arthroplasty in 40 cases and after revision in 5 cases. The mean time interval between the performance of infection symptoms and the arthroplasty or revision was 15.5 months (range, 0.5-72.0 months). The time interval between the performance of infection symptoms and debridment was 35 days (range, 3-270 days). There were early postoperative infections in 13 cases, acute hematogenous infections in 24 cases, and late chronic infections in 8 cases. X-ray films showed that the location of prosthesis was good. The results of bacilli culture showed that 28 cases were positive and 17 were negative. Twelve cases had sinuses. Length of stay, Hospital for Special Surgery (HSS) score, and Harris score were recorded to evaluate risk factors by using a multivariate logistic regression.ResultsThe mean length of stay was 22.6 days (range, 5-79 days). All patients were followed up 24-74 months (mean, 52 months). There were 33 cases that retained the prosthesis without further evidence of infection with the success rate was 73.3%. There were significant differences in Harris score and HSS score between pre- and post-operation (P<0.05). The univariate analysis results showed that the failure of debridement with prosthesis retention had a significant correlation with sinus developing and duration of infection symptoms more than 14 days (P<0.05). Multivariate logistic regression analysis results showed that sinus developing was an independent risk factor of failure (P<0.05).ConclusionDebridement with prosthesis retention plays an important role in treating PJI after THA and TKA. These patients with sinus performing and duration of infection symptoms more than 14 days have higher risk to develop infection again.
Dental composite resin is a kind of material which has been widely used in dental restoration. Research has found that the influence of residual monomer on the material mechanical, chemical and biological properties cannot be ignored. This paper elaborates these harms of residual monomers. The effects of resin matrix, inorganic filler and initiating system, illumination, secondarily treatment on the degree of conversion were also analyzed. The paper also discusses the effective measures to increase the conversion, and offers theoretical basis for the clinical application and development of composite resin.
ObjectiveTo investigate the factors of breast cancer patients who met breast-conserving conditions after neoadjuvant chemotherapy when choosing surgical mode.MethodsA questionnaire survey was conducted on 228 breast cancer patients who met breast-conserving conditions after neoadjuvant chemotherapy. Chi square test, nonparametric rank sum test and binary logistic regression were used to analyze the factors affecting the choice of surgical mode.ResultsUnivariate analysis showed that age, clinical stage, family history of cancer, molecular type, neoadjuvant chemotherapy effect, surgeon’s recommendation, chemotherapy side effects, and surgical complications were the factors affecting patient’s chose for breast-conserving surgery (P<0.05). Multivariate analysis showed that the effect of neoadjuvant chemotherapy [OR=0.312, 95%CI (0.255, 0.662), P<0.001] and the surgeon’s recommendation [OR=53.947, 95%CI (4.570, 6.239), P=0.002] were independent factors that affected the choice of surgery.ConclusionsThe decision of the surgical mode is a process in which doctors and patients participate together. Individualized neoadjuvant chemotherapy improves the remission rate and the progress of the surgeon’s comprehensive treatment strategy can play a role in improving the breast-conserving rate and the rate of breast-conserving success. Doctors should give positive guidance in accordance with the specific situation of the patient to make the best choice.
Objective To analyze the risk factors for chronic cough following pulmonary surgery in patients with non-small cell lung cancer (NSCLC). Methods A retrospective analysis was conducted on 427 NSCLC patients who underwent pulmonary surgery in the Department of Thoracic Surgery, The First Affiliated Hospital of the University of Science and Technology of China, between January 2021 and June 2023. Patients were categorized into a chronic cough group (103 patients) and a non-chronic cough group (324 patients) based on the presence of cough at 8 weeks post-surgery. A comparative analysis was performed between the two groups, considering gender, age, smoking history, comorbidities, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration. Factors showing statistical significance in univariate analysis underwent multivariate logistic regression analysis. Results Among the 427 patients undergoing pulmonary surgery, there were 165 males and 262 females, with an average age of (59.93±12.11) years. The incidence of chronic cough was 24.12%. Univariate analysis revealed significant differences in smoking history, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration ≥135.5 minutes, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration (P<0.05). Multivariate logistic regression analysis indicated that the surgical site (right upper lung), operative techniques (lobectomy), lymph node dissection, and anesthesia time ≥135.5 minutes were independent risk factors for chronic cough following pulmonary surgery. ConclusionPatients undergoing right upper lung surgery, lobectomy, lymph node dissection, and experiencing anesthesia duration ≥135.5 minutes are at a higher risk of developing chronic cough post-pulmonary surgery.
Objective To investigate the clinical efficacy of minimally invasive mitral valvuloplasty (MVP) in the treatment of infective endocarditis (IE) with mitral regurgitation (MR). Methods A retrospective analysis was conducted on the clinical data of patients who underwent MVP for IE with MR in the Department of Cardiovascular Surgery at Zhongshan Hospital, Fudan University from January 2016 to December 2020. Patients were divided into two groups based on the surgical incision: those with a right mini-thoracotomy were classified as a minimally invasive surgery (MIS) group, and those with a median sternotomy were classified as a median sternotomy (MS) group. All patients had isolated mitral valve involvement. Perioperative data were analyzed, and mid- to long-term outcomes were compared between the two groups. Results A total of 86 patients were included, with 40 in the MIS group (22 males and 18 females, with a mean age of 39±15 years ranging from 8 to 71 years) and 46 in the MS group (27 males and 19 females, with a mean age of 49±16 years ranging from 14 to 71 years). The patients in the MIS group were relatively younger (P=0.004) with better preoperative cardiac function (P=0.004). There was no statistical difference in preoperative fever, gender, or comorbidities between the two groups (P>0.05). The MIS group had shorter postoperative ventilation times, less postoperative 24-hour drainage, less blood transfusion, and shorter total hospital stays compared to the MS group (P=0.001, 0.018, 0.005, 0.005). There was no statistical difference in cardiopulmonary bypass times or ICU stays between the two groups (P>0.05). The perioperative complication rates and mortality rates were not significantly different between the two groups (P>0.05). Follow-up was conducted for 11-92 months, with a mean duration of 49±19 months and an overall follow-up rate of 91.6%. During the follow-up, 3 patients in each group required reoperation for mitral valve issues, with no statistical difference in incidence (7.5% vs. 6.5%, P=0.691). There were no warfarin-related complications, recurrences, or deaths in either group during follow-up. Multivariate regression analysis identified age, preoperative cardiac function, and surgeon experience as influencing factors for the choice of surgical approach. Conclusion Minimally invasive MVP for IE with MR is relatively safe in the perioperative period and shows significant efficacy, with clear mid- to long-term outcomes. It is recommended for younger patients with better preoperative cardiac function and when performed by surgeons with extensive experience in mitral valvuloplasty.
ObjectiveTo observe the changes of body composition in patients with obesity after sleeve gastrectomy (SG) and know the factors affecting the effective weight loss. MethodsThe obese patients who received SG treatment at the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from October 2019 to October 2022 were included according to the inclusion and exclusion criteria. The anthropometric parameters, lipid metabolism indexes, and body composition data were collected before surgery (1 d) and at 1-, 3-, 6-, and 12-month after surgery. The risk factors affecting the effective weight loss were analyzed. ResultsA total of 170 patients were included in the study. ① The anthropometric parameters such as body weight, body mass index, waist circumference, hip circumference, and waist-to-hip ratio at different time points after surgery as compared with the baseline (1 day before surgery) values were decreased (P<0.05) and showed continuous downward trends after surgery (P<0.05), meanwhile the percentage total weight loss and percentage excess weight loss (%EWL) indicators showed continuous upward trends (P<0.05). ② The lipid metabolic indexes such as triglyceride, total cholesterol, and uric acid, except for the total cholesterol indexes at the 6th and 12th month had no statistical differences as compared with the baseline value (P>0.05) and the uric acid was increased at the 1st month after surgery (P<0.05), the other indexes at different time points after surgery showed continuous downward trends as compared with the baseline values (P<0.05). ③ All the body composition parameters except percentage fat-free mass of the left and right lower limbs (P>0.05) at different time points after surgery as compared with the baseline values were decreased (P<0.05), and some body composition indicators, such as fat mass, percentage fat mass, visceral fat area, and obesity degree continued to decrease within 1 year after surgery (P<0.05). ④ There were 93 patients with reaching the standard of effective weight loss (%EWL was 50% or more). The multivariate logistic regression analysis showed that the lower fat mass of right lower limb, the higher probability of effective weight loss [OR (95%CI)=0.452 (0.290, 0.703), P<0.001]. The area under the receiver operating characteristic curve of the fat mass of the right lower limb was 0.782 [95%CI=(0.672, 0.893), P<0.001], its sensitivity and specificity were 0.679 and 0.792, respectively, and the cut-off value was 7.35 kg. ConclusionsThe results of this study suggest that SG can markedly improve the anthropometric and lipid metabolism indicators of patients with obesity, and achieve effective weight loss in a short-time. The body composition from the whole body to limbs and trunk might be changed. The fat mass of the right lower limb is closely related to the short-term effective weight loss after surgery and it has a moderate ability to distinguish achieving effective weight loss.