OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicent...OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.展开更多
Magnetic Resonance Imaging(MRI)is now a widely used modality for providing multimodal,high-quality soft tissue contrast images with good spatiotemporal resolution but without subjecting patients to ionizing radiation....Magnetic Resonance Imaging(MRI)is now a widely used modality for providing multimodal,high-quality soft tissue contrast images with good spatiotemporal resolution but without subjecting patients to ionizing radiation.In addition to its diagnostic potential,its future theranostic value lies in its ability to provide MRI-guided robot intervention with combined structural and functional mapping,as well as integrated instrument localization,target recognition,and in situ,in vivo monitoring of the therapeutic efficacy.Areas of current applications include neurosurgery,breast biopsy,cardiovascular intervention,prostate biopsy and radiotherapy.Emerging applications in targeted drug delivery and MRI-guided chemoembolization are also being pursued.Whilst promising progress has been made in recent years,there are still significant basic science research and engineering challenges.This paper provides a comprehensive review of the current state-of-the-art in MRI-guided robot intervention and allied technologies in actuation,sensing,new materials,interventional instruments,and interactive/real-time MRI.Potential future research directions and new clinical developments are also discussed.展开更多
Importance:Digital technology is now widely available for the interventions of autism,but its validity and feasibility remain to be proved.Objective:This study aimed to investigate the effectiveness of digital health ...Importance:Digital technology is now widely available for the interventions of autism,but its validity and feasibility remain to be proved.Objective:This study aimed to investigate the effectiveness of digital health interventions(DHIs)in improving core symptoms or intelligence quotient in patients with autism spectrum disorder(ASD).Methods:Three databases including PubMed,Cochrane,and Scopus,were searched on November 15,2022.Randomized clinical trials that enrolled patients with ASD who received DHIs and a control group without DHI treatment were included.Cochrane risk of bias tool(RoB 2)was applied to assess the risk of bias.Results:A total of 33 studies,involving 1285 participants(658[51.2%]in DHI groups and 627[48.8%]in control groups),were analyzed to investigate the differences between DHI groups and control groups.Significantly greater improvements in the overall performance of ASD were observed in the DHI groups compared to the control groups(including active,waitlist,treatment-as-usual,and no treatment)with an effect size of 1.89(Cohen’s d 95%confidence interval[CI]:1.26-2.52).Studies with treatment-as-usual,waitlist,and no treatment control demonstrated large effect sizes of Cohen’s d 3.41(95%CI:0.84-5.97),Cohen’s d 4.27(95%CI:1.95-6.59),and Cohen’s d 4.52(95%CI:2.98-6.06)respectively.In contrast,studies with active control revealed insignificant effect sizes(Cohen’s d 0.73,95%CI:0.12-1.33).Interpretation:This meta-analysis found significantly greater improvements in core symptoms or intelligence quotient in ASD patients receiving DHIs compared to those in control conditions.ASD patients may benefit from the DHIs and reduce the economic burden.展开更多
基金supported by the National Key Research and Development Program of China(No.2022YFC3602500)Beijing High-level Public Health Technical Talents Construction Project(Discipline Leader-03-24)Beijing Hospitals Authority’s Ascent Plan(DFL20240601).
文摘OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.
基金supported in part by the National Key R&D Program of China(2022YFB4702700)the Science and Technology Commission of Shanghai Municipality(21DZ1100300)the Science and Technology Commission of Shanghai Municipality(20DZ2220400).
文摘Magnetic Resonance Imaging(MRI)is now a widely used modality for providing multimodal,high-quality soft tissue contrast images with good spatiotemporal resolution but without subjecting patients to ionizing radiation.In addition to its diagnostic potential,its future theranostic value lies in its ability to provide MRI-guided robot intervention with combined structural and functional mapping,as well as integrated instrument localization,target recognition,and in situ,in vivo monitoring of the therapeutic efficacy.Areas of current applications include neurosurgery,breast biopsy,cardiovascular intervention,prostate biopsy and radiotherapy.Emerging applications in targeted drug delivery and MRI-guided chemoembolization are also being pursued.Whilst promising progress has been made in recent years,there are still significant basic science research and engineering challenges.This paper provides a comprehensive review of the current state-of-the-art in MRI-guided robot intervention and allied technologies in actuation,sensing,new materials,interventional instruments,and interactive/real-time MRI.Potential future research directions and new clinical developments are also discussed.
基金National Natural Science Foundation of China,Grant/Award Numbers:82360279,81860280
文摘Importance:Digital technology is now widely available for the interventions of autism,but its validity and feasibility remain to be proved.Objective:This study aimed to investigate the effectiveness of digital health interventions(DHIs)in improving core symptoms or intelligence quotient in patients with autism spectrum disorder(ASD).Methods:Three databases including PubMed,Cochrane,and Scopus,were searched on November 15,2022.Randomized clinical trials that enrolled patients with ASD who received DHIs and a control group without DHI treatment were included.Cochrane risk of bias tool(RoB 2)was applied to assess the risk of bias.Results:A total of 33 studies,involving 1285 participants(658[51.2%]in DHI groups and 627[48.8%]in control groups),were analyzed to investigate the differences between DHI groups and control groups.Significantly greater improvements in the overall performance of ASD were observed in the DHI groups compared to the control groups(including active,waitlist,treatment-as-usual,and no treatment)with an effect size of 1.89(Cohen’s d 95%confidence interval[CI]:1.26-2.52).Studies with treatment-as-usual,waitlist,and no treatment control demonstrated large effect sizes of Cohen’s d 3.41(95%CI:0.84-5.97),Cohen’s d 4.27(95%CI:1.95-6.59),and Cohen’s d 4.52(95%CI:2.98-6.06)respectively.In contrast,studies with active control revealed insignificant effect sizes(Cohen’s d 0.73,95%CI:0.12-1.33).Interpretation:This meta-analysis found significantly greater improvements in core symptoms or intelligence quotient in ASD patients receiving DHIs compared to those in control conditions.ASD patients may benefit from the DHIs and reduce the economic burden.
