Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow ...Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.展开更多
Bone injuries induced by accidents or bone-related disease have dramatically increased in the past decades.The application of biomaterials has become an inextricable part of treatment for new bone formation and regene...Bone injuries induced by accidents or bone-related disease have dramatically increased in the past decades.The application of biomaterials has become an inextricable part of treatment for new bone formation and regeneration.Different from traditional bone-regeneration materials,injectable biomaterials—ranging from bioceramics to polymers—have been applied as a means of promoting surgery with a minimal intervention approach.In this review,we summarize the most recent developments in minimally invasive implantable biomaterials for bone reconstruction and different ways to achieve osteogenesis,with a focus on injectable biomaterials for various applications in the orthopedic field.More specifically,bioceramics and polymeric materials,together with their applications in bone fracture healing,vertebral body augmentation,bone implant fixation,bone tumor therapy,and bone-defect-related infection treatment are reviewed in detail.Recent progress in injectable biomaterials with multiple functionalities and bioresponsive properties is also reviewed.Finally,we summarize the challenges in this field and future directions for clinical treatment.展开更多
Ultrasound neuromodulation is a powerful tool for brain investigation and holds great promise for treating brain diseases.However,due to the heterogeneous acoustic properties of skulls,existing ultrasound neuromodulat...Ultrasound neuromodulation is a powerful tool for brain investigation and holds great promise for treating brain diseases.However,due to the heterogeneous acoustic properties of skulls,existing ultrasound neuromodulation faces the challenge of severe transcranial acoustic attenuation.To overcome such limitations,we report an implantable bio-chip for visible and controllable mi-crowave-induced transcranial acoustic generation(MI-tAG).The bio-chip is soft,flexible,and biocompatible,with a thickness of 3mm,making it suitable for human intracranial implantation.The constituted fluid channels can cover an area of 50 mm×60 mm,enabling widefield neuronstimulation.The particles filled in the fluid channels have both high microwave absorption.ensuring efficient ultrasound generation,and magnetism,allowing noncontact and flexible ma-nipulation by external magnetic fields.The experimental results demonstrate that the optimal MI-tAG can be realized by the combination of particles arranged in a linear pattern and corre-sponding illumination via a linearly polarized microwave.Stability evaluation indicates that the particles can maintain a consistent acoustic intensity without degradation for at least seven days.The results of in vitro and in vivo experiments show that the MII-tAG can manipulate ultrasound sources and visibly locate them in real time.This study provides a potential innovative approach for future ultrasound neuromodulation,inspiring the development of more useful methods to advance brain research.This study introduces a promising innovative approach for transcranial acoustic generation,potentially inspiring the development of more effective methods for ad-vancing ultrasound neuromodulation.展开更多
AIM:To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens(TICL)implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surg...AIM:To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens(TICL)implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surgically induced astigmatism vector(SIA).METHODS:Retrospective analysis was conducted on eyes with TICL alignment achieved through manual marking(n=75)or VERION image-guided system-assisted marking(n=83).Each group was further classified into horizontal and vertical subgroups based on implant orientation.Additionally,patients were categorized into superior and temporal incision subgroups according to the position of main corneal incision.The misalignment and rotational stability of TICL were analyzed using slit-lamp anterior segment photography.Surgical predictability,efficacy,safety,and corneal SIA were also evaluated.RESULTS:In general,the TICL implantation with manual and digital image-guided systems all achieved robust predictability,efficacy,and safety.The misalignment of TICL was comparable between the manual and VERION groups(0.16°±3.97°vs 0.52°±5.59°,P=0.633),while a significant difference was observed in the absolute misalignment of TICL between the two groups(3.02°±2.55°vs 4.28°±3.61°,P=0.043).There were no significant differences in the distribution of TICL misalignment between the manual and VERION groups or between horizontal and vertical implant orientation groups(P>0.05).Furthermore,different orientations of TICL placement did not show statistically significant differences in rotational stability(P=0.46).Statistically significant differences were found in anterior corneal SIA between the manual and VERION groups(0.46±0.27 vs 0.33±0.21 D,P=0.001),especially for superior incision position(0.60±0.27 vs 0.35±0.23 D,P<0.0001).The anterior SIA exhibited a significant difference between superior and temporal incisions in the manual group(0.60±0.27 vs 0.35±0.20 D,P<0.0001).CONCLUSION:Compared with the conventional manual marking method,this study indicates that the digital image-guided system with VERION is safe and effective in TICL implantation.The digital system offers the advantage of minimizing corneal SIA compared to the manual method.展开更多
AIM:To predict the post-operative vault and the suitable size of the implantable collamer lens(ICL)by comparing the performance of multiple artificial intelligence(AI)algorithms.METHODS:A retrospective analysis of 83 ...AIM:To predict the post-operative vault and the suitable size of the implantable collamer lens(ICL)by comparing the performance of multiple artificial intelligence(AI)algorithms.METHODS:A retrospective analysis of 83 patients with 132 eyes was conducted from 2020 to 2023.All patients underwent implantation of EVO-V4C ICLs.ICLs were selected based on STAAR’s recommended formula.Postoperative vault values were measured using anterior segment optical coherence tomography(ASOCT).First,feature selection was performed on patients’preoperative examination parameters to identify those most closely related to postoperative vault and incorporate them into the machine learning model.Subsequently,four regression models,namely MLP,XGBoost,RFR,and KNN,were employed to predict the vault,and their predictive performances were compared.The ICL size was set as the prediction target,with the vault and other input features serving as new inputs for predicting the ICL size.RESULTS:Among all preoperative parameters,16 parameters were most closely related to postoperative vault and were included in the prediction model.In vault prediction,XGBoost performed the best in the regression model(R^(2)=0.9999),followed by MLP(R^(2)=0.9987)and RFR(R^(2)=0.8982),while the KNN model had the lowest predictive performance(R^(2)=0.3852).XGBoost achieved a prediction accuracy of 99.8%,MLP had a prediction accuracy of 98.9%,while RFR and KNN had accuracies of 87.1%and 57.4%,respectively.CONCLUSION:AI effectively predicts postoperative vault and determines ICL size.XGBoost outperforms other machine-learning algorithms tested.Its accurate predictions help ophthalmologists choose the right ICL size,ensuring proper vaulting.展开更多
Glioblastoma(GBM)is a highly infiltrative brain tumor.The treatment of GBM is challenging due to the existence of blood brain barrier,its highly invasive nature,and its heterogeneity.Given the limitations of conventio...Glioblastoma(GBM)is a highly infiltrative brain tumor.The treatment of GBM is challenging due to the existence of blood brain barrier,its highly invasive nature,and its heterogeneity.Given the limitations of conventional therapies,this Perspective explores the development trajectory of implantable devices,highlighting the advantages of current models.With the progression in research,these implantable devices certainly hold promising potential for GBM therapy.展开更多
Implantable temperature sensors are revolutionizing physiological monitoring and playing a crucial role in diagnostics,therapeutics,and life sciences research.This review classifies the materials used in these sensors...Implantable temperature sensors are revolutionizing physiological monitoring and playing a crucial role in diagnostics,therapeutics,and life sciences research.This review classifies the materials used in these sensors into three categories:metal-based,inorganic semiconductor,and organic semiconductor materials.Metal-based materials are widely used in medical and industrial applications due to their linearity,stability,and reliability.Inorganic semiconductors provide rapid response times and high miniaturization potential,making them promising for biomedical and environmental monitoring.Organic semiconductors offer high sensitivity and ease of processing,enabling the development of flexible and stretchable sensors.This review analyzes recent studies for each material type,covering design principles,performance characteristics,and applications,highlighting key advantages and challenges regarding miniaturization,sensitivity,response time,and biocompatibility.Furthermore,critical performance parameters of implantable temperature sensors based on different material types are summarized,providing valuable references for future sensor design and optimization.The future development of implantable temperature sensors is discussed,focusing on improving biocompatibility,long-term stability,and multifunctional integration.These advancements are expected to expand the application potential of implantable sensors in telemedicine and dynamic physiological monitoring.展开更多
BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances s...BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in individuals diagnosed with NICM,with a specific focus on the elderly.METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conducted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focusing on patients aged 75 years and older.RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95%CI:0.61-0.85;P<0.01),with significant heterogeneity(I2=83%).RCT subgroup analysis,was not statistically significant(pooled OR=0.82;95%CI:0.64-1.06;P=0.41;I2=0%).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95%CI:0.81-1.15;I2=39%).CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly reduces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the importance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.展开更多
BACKGROUND This case report examines the challenges associated with removing a totally implantable venous access port(TIVAP)used for long-term chemotherapy in a patient with breast cancer.Prolonged use of TIVAPs can r...BACKGROUND This case report examines the challenges associated with removing a totally implantable venous access port(TIVAP)used for long-term chemotherapy in a patient with breast cancer.Prolonged use of TIVAPs can result in complications such as catheter kinking,thrombosis,and adhesions between the catheter and surrounding tissues,potentially complicating their removal.CASE SUMMARY A breast cancer patient with bone metastasis presented with difficulty aspirating blood from a TIVAP that had been placed in the right internal jugular vein for 3 years.Initial removal attempts at the Department of Venous Access Center were unsuccessful,likely due to adhesions,necessitating a subsequent successful catheter extraction in a hybrid operating room.Imaging revealed no abnor-malities,and the catheter was removed using a mosquito clamp to detach it from surrounding tissues.CONCLUSION This case highlights the challenges of removing TIVAPs inserted via the internal jugular vein,particularly when the catheter traverses the sternocleidomastoid muscle.Repeated neck movements might lead to significant adhesions around the catheter,complicating its removal.Careful consideration should be given during catheter placement to avoid muscle-related adhesions and facilitate smoother extraction in long-term use.展开更多
BACKGROUND Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer.Peripherally inserted central catheters(PICC)and totally implantable venous access ports(TIVAP)are ...BACKGROUND Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer.Peripherally inserted central catheters(PICC)and totally implantable venous access ports(TIVAP)are widely used,but comparative data regarding their impact on catheter-related complications and quality of life(QoL)remain limited.AIM To evaluate the impact of TIVAPs compared with PICC on catheter-related complications and QoL in patients with gastrointestinal cancer undergoing chemotherapy.METHODS This retrospective study included adults with gastrointestinal cancer who underwent central venous access device insertion for chemotherapy at our institution between December 2021 and December 2024.Inclusion criteria encompassed indications for intermittent intravenous chemotherapy,anticipated treatment duration of≥12 weeks,an adequate preoperative hematologic profile,accessible upper body veins,and complete medical records.Patients were excluded if they had an anticipated survival of less than three months,active systemic infection,severe thrombosis or coagulopathy,communication barriers,or an urgent need for dialysis access.Patients were assigned to either the PICC or TIVAP group based on device type.Data collected included demographic variables,cancer characteristics,insertion procedure details,complications,and QoL,assessed via the EuroQol 5-Dimensions-3 levels,visual analogue scale,and the European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30.RESULTS A total of 346 patients were analyzed.Baseline demographic,clinical,and cancer characteristics were similar between groups.The TIVAP group demonstrated a significantly lower incidence of catheter-related complications than the PICC group,with no pneumothorax occurring in either group.QoL assessments at baseline were comparable.At one month,the TIVAP group exhibited significantly higher EuroQoL Five Dimensions health state scores and QLQ-C30 global health status scores.Multivariate analysis identified TIVAP use,catheter tip placement in the distal superior vena cava/right atrium,prophylactic antibiotic administration,and antimicrobial dressing application as independent protective factors associated with reduced complications and improved QoL.CONCLUSION In patients with gastrointestinal cancer undergoing chemotherapy,TIVAPs are associated with a lower incidence of catheter-related complications and improved QoL than PICCs.Optimal device selection,precise catheter tip positioning,and effective perioperative management are critical for minimizing complications and enhancing patient-reported outcomes during treatment.展开更多
Phakic intraocular lens implantation has become one of the important means of correcting refractive errors today.Among them,the implantable collamer lens(ICL)is favored for its wide range of correction,excellent optic...Phakic intraocular lens implantation has become one of the important means of correcting refractive errors today.Among them,the implantable collamer lens(ICL)is favored for its wide range of correction,excellent optical quality,and high safety,but the risks of postoperative complications such as glaucoma and anterior subcapsular opacification still exist.Vault is an important indicator for evaluating the safety after ICL implantation,and its ideal state is crucial for preventing complications.Studies have shown that iris morphology has a significant impact on vault.In order to further optimize surgical outcomes and improve surgical safety,this review comprehensively reviews the research progress of iris-related parameters in ICL implantation and discusses the importance of various parameters in preoperative evaluation and postoperative follow-up.展开更多
Background:Ventricular arrhythmia is a common cause of mortality in adult congenital heart disease(ACHD).The beneficial effects of implantable cardioverter-defibrillators(ICD)in patients with ACHD have been demonstrat...Background:Ventricular arrhythmia is a common cause of mortality in adult congenital heart disease(ACHD).The beneficial effects of implantable cardioverter-defibrillators(ICD)in patients with ACHD have been demonstrated;however,evidence on this topic remains insufficient.This study aimed to assess the long-term outcomes after ICD implantation in the ACHD population.Methods:We retrospectively reviewed 35 consecutive patients with ACHD who underwent ICD implantation between December 2012 and August 2022.ICD implantation was classified as primary or secondary prevention.The long-term outcomes,including all-cause mortality,appropriate and inappropriate ICD therapy,and complications related to ICD implantation,were evaluated.Results:Among the 35 patients,18 patients underwent ICD implantation for primary prevention.During a median follow-up period of 1484 days,3 patients in the primary prevention group and 1 patient in the secondary prevention group died.The 2-and 5-year all-cause mortality rates were 6.2%and 13.6%,respectively.Two(11.1%)and 4(23.5%)patients in the primary and secondary prevention groups,respectively,received appropriate therapy.Six patients(17%)were administered inappropriate therapy,and 2 patients(5.7%)experienced device-related complications.Kaplan-Meier analysis revealed no significant differences in the all-cause mortality or the rates of appropriate and inappropriate therapy between the primary and secondary prevention groups(p=0.297,p=0.427,and p=0.490,respectively).Conclusions:The incidence of appropriate ICD therapy in patients with ACHD was considerably high and comparable to that observed in patients with acquired heart disease,both in primary and secondary prevention.ICD implantation for primary prevention as well as for secondary prevention may be important in patients with ACHD.展开更多
The subthalamic nucleus(STN)is considered the best target for deep brain stimulation treatments of Parkinson’s disease(PD).It is difficult to localize the STN due to its small size and deep location.Multichannel micr...The subthalamic nucleus(STN)is considered the best target for deep brain stimulation treatments of Parkinson’s disease(PD).It is difficult to localize the STN due to its small size and deep location.Multichannel microelectrode arrays(MEAs)can rapidly and precisely locate the STN,which is important for precise stimulation.In this paper,16-channel MEAs modified with multiwalled carbon nanotube/poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate)(MWCNT/PEDOT:PSS)nanocomposites were designed and fabricated,and the accurate and rapid identification of the STN in PD rats was performed using detection sites distributed at different brain depths.These results showed that nuclei in 6-hydroxydopamine hydrobromide(6-OHDA)-lesioned brains discharged more intensely than those in unlesioned brains.In addition,the MEA simultaneously acquired neural signals from both the STN and the upper or lower boundary nuclei of the STN.Moreover,higher values of spike firing rate,spike amplitude,local field potential(LFP)power,and beta oscillations were detected in the STN of the 6-OHDA-lesioned brain,and may therefore be biomarkers of STN localization.Compared with the STNs of unlesioned brains,the power spectral density of spikes and LFPs synchronously decreased in the delta band and increased in the beta band of 6-OHDA-lesioned brains.This may be a cause of sleep and motor disorders associated with PD.Overall,this work describes a new cellular-level localization and detection method and provides a tool for future studies of deep brain nuclei.展开更多
AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who receiv...AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.展开更多
This review summarizes recent progress in developing wireless,batteryless,fully implantable biomedical devices for real-time continuous physiological signal monitoring,focusing on advancing human health care.Design co...This review summarizes recent progress in developing wireless,batteryless,fully implantable biomedical devices for real-time continuous physiological signal monitoring,focusing on advancing human health care.Design considerations,such as biological constraints,energy sourcing,and wireless communication,are discussed in achieving the desired performance of the devices and enhanced interface with human tissues.In addition,we review the recent achievements in materials used for developing implantable systems,emphasizing their importance in achieving multi-functionalities,biocompatibility,and hemocompatibility.The wireless,batteryless devices offer minimally invasive device insertion to the body,enabling portable health monitoring and advanced disease diagnosis.Lastly,we summarize the most recent practical applications of advanced implantable devices for human health care,highlighting their potential for immediate commercialization and clinical uses.展开更多
In vivo monitoring of animal physiological information plays a crucial role in promptly alerting humans to potential diseases in animals and aiding in the exploration of mechanisms underlying human diseases.Currently,...In vivo monitoring of animal physiological information plays a crucial role in promptly alerting humans to potential diseases in animals and aiding in the exploration of mechanisms underlying human diseases.Currently,implantable electrochemical microsensors have emerged as a prominent area of research.These microsensors not only fulfill the technical requirements for monitoring animal physiological information but also offer an ideal platform for integration.They have been extensively studied for their ability to monitor animal physiological information in a minimally invasive manner,characterized by their bloodless,painless features,and exceptional performance.The development of implantable electrochemical microsensors for in vivo monitoring of animal physiological information has witnessed significant scientific and technological advancements through dedicated efforts.This review commenced with a comprehensive discussion of the construction of microsensors,including the materials utilized and the methods employed for fabrication.Following this,we proceeded to explore the various implantation technologies employed for electrochemical microsensors.In addition,a comprehensive overview was provided of the various applications of implantable electrochemical microsensors,specifically in the monitoring of diseases and the investigation of disease mechanisms.Lastly,a concise conclusion was conducted on the recent advancements and significant obstacles pertaining to the practical implementation of implantable electrochemical microsensors.展开更多
AIM:To observe early clinical outcome with lens position adjustment following the implantable collamer lens(ICL)surgery.METHODS:Sixty patients were selected for this retrospective study.One eye from each patient recei...AIM:To observe early clinical outcome with lens position adjustment following the implantable collamer lens(ICL)surgery.METHODS:Sixty patients were selected for this retrospective study.One eye from each patient received Toric ICL for astigmatism correction,and the other received non-astigmatic ICL surgery using horizontal position.Patients with higher postoperative arch height were selected,and their non-astigmatic eye clinical outcome were observed after ICL surgery at 1wk,1,and 3mo.The clinical measurements included uncorrected visual acuity(UCVA),intraocular pressure(IOP),refractive state,corneal endothelium cell count,and arch height.Three months later,the ICL in each patient’s non-astigmatic eye was adjusted to the vertical from the horizontal position.The results were compared before and 1wk,1,and 3mo after adjustment.RESULTS:UCVA and IOP were significantly reduced 1wk after position adjustment compared to 1wk after ICL implantation(P<0.05).The patients demonstrated significantly reduced arch height and corneal endothelium cell count 1wk,1,and 3mo after adjusting position compared to 1wk,1,and 3mo after ICL implantation(P<0.05).However,there was no significant difference in refraction between 1wk,1,and 3mo after ICL implantation and position adjustment(P>0.05).CONCLUSION:Early positioning adjustment postphakic ICL implantation can benefit patients with adjusted arch height or higher IOP.Despite the good clinical effects,the doctors should pay attention to the potential for adverse effects on UCVA and corneal endothelium cells following early position adjustment after posterior chamber phakic ICL implantation.展开更多
AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants ...AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.展开更多
As cardiac implantable electronic devices(CIED)become more prevalent,it is important to acknowledge potential electromagnetic interference(EMI)from other sources,such as internal and external electronic devices and pr...As cardiac implantable electronic devices(CIED)become more prevalent,it is important to acknowledge potential electromagnetic interference(EMI)from other sources,such as internal and external electronic devices and procedures and its effect on these devices.EMI from other sources can potentially inhibit pacing and trigger shocks in permanent pacemakers(PPM)and implantable cardioverter defibrillators(ICD),respectively.This review analyzes potential EMI amongst CIED and left ventricular assist device,deep brain stimulators,spinal cord stimulators,transcutaneous electrical nerve stimulators,and throughout an array of procedures,such as endoscopy,bronchoscopy,and procedures involving electrocautery.Although there is evidence to support EMI from internal and external devices and during procedures,there is a lack of large multicenter studies,and,as a result,current management guidelines are based primarily on expert opinion and anecdotal experience.We aim to provide a general overview of PPM/ICD function,review documented EMI effect on these devices,and acknowledge current management of CIED interference.展开更多
AIM To test of the implantable-cardioverter-defibrillator is done at the time of implantation. We investigate if any testing should be performed.METHODS All consecutive patients between January 2006 and December 2008 ...AIM To test of the implantable-cardioverter-defibrillator is done at the time of implantation. We investigate if any testing should be performed.METHODS All consecutive patients between January 2006 and December 2008 undergoing implantable cardioverterdefibrillator(ICD) implantation/replacement(a total of 634 patients) were included in the retrospective study.RESULTS Sixteen patients(2.5%) were not tested(9 with LA/LVthrombus, 7 due to operator's decision). Analyzed were 618 patients [76% men, 66.4 + 11 years, 24% secondary prevention(SP), 46% with left ventricular ejection fraction(LVEF) < 20%, 56% had coronary artery disease(CAD)] undergoing defibrillation safety testing(SMT) with an energy of 21 + 2.3 J. In 22/618 patients(3.6%) induced ventricular fibrillation(VF) could not be terminated with maximum energy of the ICD. Six of those(27%) had successful SMT after system modification or shock lead repositioning, 14 patients(64%) received a subcutaneous electrode array. Younger age(P = 0.0003), non-CAD(P = 0.007) and VF as index event for SP(P = 0.05) were associated with a higher incidence of ineffective SMT. LVEF < 20% and incomplete revascularisation in patients with CAD had no impact on SMT.CONCLUSION Defibrillation testing is well-tolerated. An ineffective SMT occurred in 4% and two third of those needed implantation of a subcutaneous electrode array to passa SMT > 10 J.展开更多
基金Supported by the National Key Research and Development Program(No.2019YFC1710200)the Shandong Province Pharmaceutical Technology Development Project(No.202107020970).
文摘Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.
基金supported by the National Natural Science Foundation of China(81925027,82002275,and 32271421)the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘Bone injuries induced by accidents or bone-related disease have dramatically increased in the past decades.The application of biomaterials has become an inextricable part of treatment for new bone formation and regeneration.Different from traditional bone-regeneration materials,injectable biomaterials—ranging from bioceramics to polymers—have been applied as a means of promoting surgery with a minimal intervention approach.In this review,we summarize the most recent developments in minimally invasive implantable biomaterials for bone reconstruction and different ways to achieve osteogenesis,with a focus on injectable biomaterials for various applications in the orthopedic field.More specifically,bioceramics and polymeric materials,together with their applications in bone fracture healing,vertebral body augmentation,bone implant fixation,bone tumor therapy,and bone-defect-related infection treatment are reviewed in detail.Recent progress in injectable biomaterials with multiple functionalities and bioresponsive properties is also reviewed.Finally,we summarize the challenges in this field and future directions for clinical treatment.
基金supported by the National Key R&D Program of China under grant 2023YFF0715303in part by the National Natural Science Foundation of China under Grant Nos.62305148,62105140,62022037,and 61775028+2 种基金in part by the Department of Science and Technology of Guangdong Province under Grant Nos.2019ZT08Y191 and 2022B1212010003in part by the Shenzhen Science and Technology Program under Grant Nos.JCYJ20220530114010023,RCJC20231211090039066,20231116104616001,KQTD20190929172743294,JCYJ20230807093105010,RCBS20231211090802011in part by the Startup Grant from Southern University of Science and Technology under Grant No.PDJH2021C008.
文摘Ultrasound neuromodulation is a powerful tool for brain investigation and holds great promise for treating brain diseases.However,due to the heterogeneous acoustic properties of skulls,existing ultrasound neuromodulation faces the challenge of severe transcranial acoustic attenuation.To overcome such limitations,we report an implantable bio-chip for visible and controllable mi-crowave-induced transcranial acoustic generation(MI-tAG).The bio-chip is soft,flexible,and biocompatible,with a thickness of 3mm,making it suitable for human intracranial implantation.The constituted fluid channels can cover an area of 50 mm×60 mm,enabling widefield neuronstimulation.The particles filled in the fluid channels have both high microwave absorption.ensuring efficient ultrasound generation,and magnetism,allowing noncontact and flexible ma-nipulation by external magnetic fields.The experimental results demonstrate that the optimal MI-tAG can be realized by the combination of particles arranged in a linear pattern and corre-sponding illumination via a linearly polarized microwave.Stability evaluation indicates that the particles can maintain a consistent acoustic intensity without degradation for at least seven days.The results of in vitro and in vivo experiments show that the MII-tAG can manipulate ultrasound sources and visibly locate them in real time.This study provides a potential innovative approach for future ultrasound neuromodulation,inspiring the development of more useful methods to advance brain research.This study introduces a promising innovative approach for transcranial acoustic generation,potentially inspiring the development of more effective methods for ad-vancing ultrasound neuromodulation.
文摘AIM:To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens(TICL)implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surgically induced astigmatism vector(SIA).METHODS:Retrospective analysis was conducted on eyes with TICL alignment achieved through manual marking(n=75)or VERION image-guided system-assisted marking(n=83).Each group was further classified into horizontal and vertical subgroups based on implant orientation.Additionally,patients were categorized into superior and temporal incision subgroups according to the position of main corneal incision.The misalignment and rotational stability of TICL were analyzed using slit-lamp anterior segment photography.Surgical predictability,efficacy,safety,and corneal SIA were also evaluated.RESULTS:In general,the TICL implantation with manual and digital image-guided systems all achieved robust predictability,efficacy,and safety.The misalignment of TICL was comparable between the manual and VERION groups(0.16°±3.97°vs 0.52°±5.59°,P=0.633),while a significant difference was observed in the absolute misalignment of TICL between the two groups(3.02°±2.55°vs 4.28°±3.61°,P=0.043).There were no significant differences in the distribution of TICL misalignment between the manual and VERION groups or between horizontal and vertical implant orientation groups(P>0.05).Furthermore,different orientations of TICL placement did not show statistically significant differences in rotational stability(P=0.46).Statistically significant differences were found in anterior corneal SIA between the manual and VERION groups(0.46±0.27 vs 0.33±0.21 D,P=0.001),especially for superior incision position(0.60±0.27 vs 0.35±0.23 D,P<0.0001).The anterior SIA exhibited a significant difference between superior and temporal incisions in the manual group(0.60±0.27 vs 0.35±0.20 D,P<0.0001).CONCLUSION:Compared with the conventional manual marking method,this study indicates that the digital image-guided system with VERION is safe and effective in TICL implantation.The digital system offers the advantage of minimizing corneal SIA compared to the manual method.
基金Supported by the National Natural Science Foundation of China(No.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To predict the post-operative vault and the suitable size of the implantable collamer lens(ICL)by comparing the performance of multiple artificial intelligence(AI)algorithms.METHODS:A retrospective analysis of 83 patients with 132 eyes was conducted from 2020 to 2023.All patients underwent implantation of EVO-V4C ICLs.ICLs were selected based on STAAR’s recommended formula.Postoperative vault values were measured using anterior segment optical coherence tomography(ASOCT).First,feature selection was performed on patients’preoperative examination parameters to identify those most closely related to postoperative vault and incorporate them into the machine learning model.Subsequently,four regression models,namely MLP,XGBoost,RFR,and KNN,were employed to predict the vault,and their predictive performances were compared.The ICL size was set as the prediction target,with the vault and other input features serving as new inputs for predicting the ICL size.RESULTS:Among all preoperative parameters,16 parameters were most closely related to postoperative vault and were included in the prediction model.In vault prediction,XGBoost performed the best in the regression model(R^(2)=0.9999),followed by MLP(R^(2)=0.9987)and RFR(R^(2)=0.8982),while the KNN model had the lowest predictive performance(R^(2)=0.3852).XGBoost achieved a prediction accuracy of 99.8%,MLP had a prediction accuracy of 98.9%,while RFR and KNN had accuracies of 87.1%and 57.4%,respectively.CONCLUSION:AI effectively predicts postoperative vault and determines ICL size.XGBoost outperforms other machine-learning algorithms tested.Its accurate predictions help ophthalmologists choose the right ICL size,ensuring proper vaulting.
基金financially supported by the National Natural Science Foundation of China(U23A20591 and 52273158).
文摘Glioblastoma(GBM)is a highly infiltrative brain tumor.The treatment of GBM is challenging due to the existence of blood brain barrier,its highly invasive nature,and its heterogeneity.Given the limitations of conventional therapies,this Perspective explores the development trajectory of implantable devices,highlighting the advantages of current models.With the progression in research,these implantable devices certainly hold promising potential for GBM therapy.
基金supported by the National Natural Science Foundation of China(NSFC)(62422501)Beijing Nova Program(20230484254,20240484742)Hebei Natural Science Foundation(F2024105039).
文摘Implantable temperature sensors are revolutionizing physiological monitoring and playing a crucial role in diagnostics,therapeutics,and life sciences research.This review classifies the materials used in these sensors into three categories:metal-based,inorganic semiconductor,and organic semiconductor materials.Metal-based materials are widely used in medical and industrial applications due to their linearity,stability,and reliability.Inorganic semiconductors provide rapid response times and high miniaturization potential,making them promising for biomedical and environmental monitoring.Organic semiconductors offer high sensitivity and ease of processing,enabling the development of flexible and stretchable sensors.This review analyzes recent studies for each material type,covering design principles,performance characteristics,and applications,highlighting key advantages and challenges regarding miniaturization,sensitivity,response time,and biocompatibility.Furthermore,critical performance parameters of implantable temperature sensors based on different material types are summarized,providing valuable references for future sensor design and optimization.The future development of implantable temperature sensors is discussed,focusing on improving biocompatibility,long-term stability,and multifunctional integration.These advancements are expected to expand the application potential of implantable sensors in telemedicine and dynamic physiological monitoring.
文摘BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in individuals diagnosed with NICM,with a specific focus on the elderly.METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conducted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focusing on patients aged 75 years and older.RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95%CI:0.61-0.85;P<0.01),with significant heterogeneity(I2=83%).RCT subgroup analysis,was not statistically significant(pooled OR=0.82;95%CI:0.64-1.06;P=0.41;I2=0%).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95%CI:0.81-1.15;I2=39%).CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly reduces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the importance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.
基金Supported by the Science and Technology Research Project of Jiangxi Provincial Education Department,No.GJJ2208202Science and Technology Program Project of Health Commission of Jiangxi Province,No.202510069+1 种基金Jiangxi Cancer Hospital Doctoral Start-up Fund,No.BSQDJ202309Jiangxi Province Gan Po Talent Support Program,No.20232BCJ23035.
文摘BACKGROUND This case report examines the challenges associated with removing a totally implantable venous access port(TIVAP)used for long-term chemotherapy in a patient with breast cancer.Prolonged use of TIVAPs can result in complications such as catheter kinking,thrombosis,and adhesions between the catheter and surrounding tissues,potentially complicating their removal.CASE SUMMARY A breast cancer patient with bone metastasis presented with difficulty aspirating blood from a TIVAP that had been placed in the right internal jugular vein for 3 years.Initial removal attempts at the Department of Venous Access Center were unsuccessful,likely due to adhesions,necessitating a subsequent successful catheter extraction in a hybrid operating room.Imaging revealed no abnor-malities,and the catheter was removed using a mosquito clamp to detach it from surrounding tissues.CONCLUSION This case highlights the challenges of removing TIVAPs inserted via the internal jugular vein,particularly when the catheter traverses the sternocleidomastoid muscle.Repeated neck movements might lead to significant adhesions around the catheter,complicating its removal.Careful consideration should be given during catheter placement to avoid muscle-related adhesions and facilitate smoother extraction in long-term use.
文摘BACKGROUND Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer.Peripherally inserted central catheters(PICC)and totally implantable venous access ports(TIVAP)are widely used,but comparative data regarding their impact on catheter-related complications and quality of life(QoL)remain limited.AIM To evaluate the impact of TIVAPs compared with PICC on catheter-related complications and QoL in patients with gastrointestinal cancer undergoing chemotherapy.METHODS This retrospective study included adults with gastrointestinal cancer who underwent central venous access device insertion for chemotherapy at our institution between December 2021 and December 2024.Inclusion criteria encompassed indications for intermittent intravenous chemotherapy,anticipated treatment duration of≥12 weeks,an adequate preoperative hematologic profile,accessible upper body veins,and complete medical records.Patients were excluded if they had an anticipated survival of less than three months,active systemic infection,severe thrombosis or coagulopathy,communication barriers,or an urgent need for dialysis access.Patients were assigned to either the PICC or TIVAP group based on device type.Data collected included demographic variables,cancer characteristics,insertion procedure details,complications,and QoL,assessed via the EuroQol 5-Dimensions-3 levels,visual analogue scale,and the European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30.RESULTS A total of 346 patients were analyzed.Baseline demographic,clinical,and cancer characteristics were similar between groups.The TIVAP group demonstrated a significantly lower incidence of catheter-related complications than the PICC group,with no pneumothorax occurring in either group.QoL assessments at baseline were comparable.At one month,the TIVAP group exhibited significantly higher EuroQoL Five Dimensions health state scores and QLQ-C30 global health status scores.Multivariate analysis identified TIVAP use,catheter tip placement in the distal superior vena cava/right atrium,prophylactic antibiotic administration,and antimicrobial dressing application as independent protective factors associated with reduced complications and improved QoL.CONCLUSION In patients with gastrointestinal cancer undergoing chemotherapy,TIVAPs are associated with a lower incidence of catheter-related complications and improved QoL than PICCs.Optimal device selection,precise catheter tip positioning,and effective perioperative management are critical for minimizing complications and enhancing patient-reported outcomes during treatment.
基金Key Research and Development Projects of Zhejiang Science and Technology Plan(No.2021C03103)Research and Development Plan of Zhejiang Science and Technology Department(No.2023C03089)Scientific Research Project of Zhejiang Provincial Department of Education(No.Y202456401)。
文摘Phakic intraocular lens implantation has become one of the important means of correcting refractive errors today.Among them,the implantable collamer lens(ICL)is favored for its wide range of correction,excellent optical quality,and high safety,but the risks of postoperative complications such as glaucoma and anterior subcapsular opacification still exist.Vault is an important indicator for evaluating the safety after ICL implantation,and its ideal state is crucial for preventing complications.Studies have shown that iris morphology has a significant impact on vault.In order to further optimize surgical outcomes and improve surgical safety,this review comprehensively reviews the research progress of iris-related parameters in ICL implantation and discusses the importance of various parameters in preoperative evaluation and postoperative follow-up.
文摘Background:Ventricular arrhythmia is a common cause of mortality in adult congenital heart disease(ACHD).The beneficial effects of implantable cardioverter-defibrillators(ICD)in patients with ACHD have been demonstrated;however,evidence on this topic remains insufficient.This study aimed to assess the long-term outcomes after ICD implantation in the ACHD population.Methods:We retrospectively reviewed 35 consecutive patients with ACHD who underwent ICD implantation between December 2012 and August 2022.ICD implantation was classified as primary or secondary prevention.The long-term outcomes,including all-cause mortality,appropriate and inappropriate ICD therapy,and complications related to ICD implantation,were evaluated.Results:Among the 35 patients,18 patients underwent ICD implantation for primary prevention.During a median follow-up period of 1484 days,3 patients in the primary prevention group and 1 patient in the secondary prevention group died.The 2-and 5-year all-cause mortality rates were 6.2%and 13.6%,respectively.Two(11.1%)and 4(23.5%)patients in the primary and secondary prevention groups,respectively,received appropriate therapy.Six patients(17%)were administered inappropriate therapy,and 2 patients(5.7%)experienced device-related complications.Kaplan-Meier analysis revealed no significant differences in the all-cause mortality or the rates of appropriate and inappropriate therapy between the primary and secondary prevention groups(p=0.297,p=0.427,and p=0.490,respectively).Conclusions:The incidence of appropriate ICD therapy in patients with ACHD was considerably high and comparable to that observed in patients with acquired heart disease,both in primary and secondary prevention.ICD implantation for primary prevention as well as for secondary prevention may be important in patients with ACHD.
基金funded by the National Natural Science Foundation of China(Nos.L2224042,T2293731,62121003,61960206012,61973292,62171434,61975206,and 61971400)the Frontier Interdisciplinary Project of the Chinese Academy of Sciences(No.XK2022XXC003)+2 种基金the National Key Research and Development Program of China(Nos.2022YFC2402501 and 2022YFB3205602)the Major Program of Scientific and Technical Innovation 2030(No.2021ZD02016030)the Scientific Instrument Developing Project of he Chinese Academy of Sciences(No.GJJSTD20210004).
文摘The subthalamic nucleus(STN)is considered the best target for deep brain stimulation treatments of Parkinson’s disease(PD).It is difficult to localize the STN due to its small size and deep location.Multichannel microelectrode arrays(MEAs)can rapidly and precisely locate the STN,which is important for precise stimulation.In this paper,16-channel MEAs modified with multiwalled carbon nanotube/poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate)(MWCNT/PEDOT:PSS)nanocomposites were designed and fabricated,and the accurate and rapid identification of the STN in PD rats was performed using detection sites distributed at different brain depths.These results showed that nuclei in 6-hydroxydopamine hydrobromide(6-OHDA)-lesioned brains discharged more intensely than those in unlesioned brains.In addition,the MEA simultaneously acquired neural signals from both the STN and the upper or lower boundary nuclei of the STN.Moreover,higher values of spike firing rate,spike amplitude,local field potential(LFP)power,and beta oscillations were detected in the STN of the 6-OHDA-lesioned brain,and may therefore be biomarkers of STN localization.Compared with the STNs of unlesioned brains,the power spectral density of spikes and LFPs synchronously decreased in the delta band and increased in the beta band of 6-OHDA-lesioned brains.This may be a cause of sleep and motor disorders associated with PD.Overall,this work describes a new cellular-level localization and detection method and provides a tool for future studies of deep brain nuclei.
基金Supported by the Fundamental Research Funds of the State Key Laboratory of Ophthalmology(No.303060202400201203).
文摘AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.
基金the NSF CCSS-2152638 and the IEN Center Grant from the Institute for Electronics and Nanotechnology at Georgia Tech.
文摘This review summarizes recent progress in developing wireless,batteryless,fully implantable biomedical devices for real-time continuous physiological signal monitoring,focusing on advancing human health care.Design considerations,such as biological constraints,energy sourcing,and wireless communication,are discussed in achieving the desired performance of the devices and enhanced interface with human tissues.In addition,we review the recent achievements in materials used for developing implantable systems,emphasizing their importance in achieving multi-functionalities,biocompatibility,and hemocompatibility.The wireless,batteryless devices offer minimally invasive device insertion to the body,enabling portable health monitoring and advanced disease diagnosis.Lastly,we summarize the most recent practical applications of advanced implantable devices for human health care,highlighting their potential for immediate commercialization and clinical uses.
基金the Fundamental Research Funds for the Central Universities,National Natural Science Foundation of China(No.82302345).
文摘In vivo monitoring of animal physiological information plays a crucial role in promptly alerting humans to potential diseases in animals and aiding in the exploration of mechanisms underlying human diseases.Currently,implantable electrochemical microsensors have emerged as a prominent area of research.These microsensors not only fulfill the technical requirements for monitoring animal physiological information but also offer an ideal platform for integration.They have been extensively studied for their ability to monitor animal physiological information in a minimally invasive manner,characterized by their bloodless,painless features,and exceptional performance.The development of implantable electrochemical microsensors for in vivo monitoring of animal physiological information has witnessed significant scientific and technological advancements through dedicated efforts.This review commenced with a comprehensive discussion of the construction of microsensors,including the materials utilized and the methods employed for fabrication.Following this,we proceeded to explore the various implantation technologies employed for electrochemical microsensors.In addition,a comprehensive overview was provided of the various applications of implantable electrochemical microsensors,specifically in the monitoring of diseases and the investigation of disease mechanisms.Lastly,a concise conclusion was conducted on the recent advancements and significant obstacles pertaining to the practical implementation of implantable electrochemical microsensors.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A).
文摘AIM:To observe early clinical outcome with lens position adjustment following the implantable collamer lens(ICL)surgery.METHODS:Sixty patients were selected for this retrospective study.One eye from each patient received Toric ICL for astigmatism correction,and the other received non-astigmatic ICL surgery using horizontal position.Patients with higher postoperative arch height were selected,and their non-astigmatic eye clinical outcome were observed after ICL surgery at 1wk,1,and 3mo.The clinical measurements included uncorrected visual acuity(UCVA),intraocular pressure(IOP),refractive state,corneal endothelium cell count,and arch height.Three months later,the ICL in each patient’s non-astigmatic eye was adjusted to the vertical from the horizontal position.The results were compared before and 1wk,1,and 3mo after adjustment.RESULTS:UCVA and IOP were significantly reduced 1wk after position adjustment compared to 1wk after ICL implantation(P<0.05).The patients demonstrated significantly reduced arch height and corneal endothelium cell count 1wk,1,and 3mo after adjusting position compared to 1wk,1,and 3mo after ICL implantation(P<0.05).However,there was no significant difference in refraction between 1wk,1,and 3mo after ICL implantation and position adjustment(P>0.05).CONCLUSION:Early positioning adjustment postphakic ICL implantation can benefit patients with adjusted arch height or higher IOP.Despite the good clinical effects,the doctors should pay attention to the potential for adverse effects on UCVA and corneal endothelium cells following early position adjustment after posterior chamber phakic ICL implantation.
基金Supported by National Natural Science Foundation of China(No.81900910)Natural Science Foundation of Zhejiang Province(No.LQ19H120003)Basic Scientific Research Project of Wenzhou(No.Y2023809).
文摘AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.
文摘As cardiac implantable electronic devices(CIED)become more prevalent,it is important to acknowledge potential electromagnetic interference(EMI)from other sources,such as internal and external electronic devices and procedures and its effect on these devices.EMI from other sources can potentially inhibit pacing and trigger shocks in permanent pacemakers(PPM)and implantable cardioverter defibrillators(ICD),respectively.This review analyzes potential EMI amongst CIED and left ventricular assist device,deep brain stimulators,spinal cord stimulators,transcutaneous electrical nerve stimulators,and throughout an array of procedures,such as endoscopy,bronchoscopy,and procedures involving electrocautery.Although there is evidence to support EMI from internal and external devices and during procedures,there is a lack of large multicenter studies,and,as a result,current management guidelines are based primarily on expert opinion and anecdotal experience.We aim to provide a general overview of PPM/ICD function,review documented EMI effect on these devices,and acknowledge current management of CIED interference.
文摘AIM To test of the implantable-cardioverter-defibrillator is done at the time of implantation. We investigate if any testing should be performed.METHODS All consecutive patients between January 2006 and December 2008 undergoing implantable cardioverterdefibrillator(ICD) implantation/replacement(a total of 634 patients) were included in the retrospective study.RESULTS Sixteen patients(2.5%) were not tested(9 with LA/LVthrombus, 7 due to operator's decision). Analyzed were 618 patients [76% men, 66.4 + 11 years, 24% secondary prevention(SP), 46% with left ventricular ejection fraction(LVEF) < 20%, 56% had coronary artery disease(CAD)] undergoing defibrillation safety testing(SMT) with an energy of 21 + 2.3 J. In 22/618 patients(3.6%) induced ventricular fibrillation(VF) could not be terminated with maximum energy of the ICD. Six of those(27%) had successful SMT after system modification or shock lead repositioning, 14 patients(64%) received a subcutaneous electrode array. Younger age(P = 0.0003), non-CAD(P = 0.007) and VF as index event for SP(P = 0.05) were associated with a higher incidence of ineffective SMT. LVEF < 20% and incomplete revascularisation in patients with CAD had no impact on SMT.CONCLUSION Defibrillation testing is well-tolerated. An ineffective SMT occurred in 4% and two third of those needed implantation of a subcutaneous electrode array to passa SMT > 10 J.
