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 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
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
AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,W...AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,Web of Science,Cochrane Library and several Chinese databases were searched at May 2021 to select relevant studies in comparison of clinical outcomes between ICL implantation and SMILE for myopia.The primary outcomes were efficacy,safety,and predictability.And the secondary outcomes were postoperative higher-order ocular aberrations(HOAs),modulation transfer function cutoff frequency(MTF),objective scatter index(OSI),contrast sensitivity and a quality of vision(Qo V)questionnaire.RESULTS:A total of 1036 eyes from 10 studies,of which 503 eyes underwent ICL implantation and 533 eyes underwent SMILE,were enrolled in this Meta-analysis.Pooled results revealed that ICL group had a better safety index and post-corrected distance visual acuity(CDVA)(P=0.007,<0.00001,respectively),and a lower percentage of eyes with a postoperative CDVA lost 1 line(P=0.007)than the SMILE group.No significant differences were found in comparison of the other primary outcomes.In the longterm follow-up(>6mo),ICL group had a lower total HOA,coma,and spherical aberration than SMILE group(P=0.003,<0.00001,0.04).Yet higher trefoil was found in ICL group at 6mo after surgery(P=0.003).Additionally,ICL group also had a higher MTF value(P=0.02),and a higher contrast sensitivity score for spatial frequencies of 1.5,6,and 12 cpds(P=0.02,0.005,0.02,respectively).And it also had a lower score of bothersome in Qo V questionnaire than SMILE group(P=0.003).CONCLUSION:ICL implantation and SMILE have similar and comparable outcomes in term of the efficacy and predictability for correcting high myopia.However,ICL group is relatively safer and also has better visual quality in comparison of SMILE group.展开更多
AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted...AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted on 58 patients(114 eyes)who were followed up for at least 5y after ICL V4c implantation.The observation was done before and on 1d,1mo,1 and 5y or more after the surgical procedure.The visual acuity,subjective refraction,intraocular pressure,vault,axial length,central hole position,pupil diameter,visual quality,and adverse events were analyzed.The visual quality includes aberration,the modulation transfer function cutoff frequency(MTF cutoff),objective scattering index(OSI),Stroller's ratio(SR),and visual quality questionnaire.RESULTS:The average follow-up period was 69.25±3.80mo(range 60–82mo)and the preoperative spherical equivalent(SE)was-8.66±1.97 D.At 5y after operation,the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was-0.65±0.63 D.The 59.6%of the eyes achieved an uncorrected distance visual acuity of 20/20,76.3%of the eyes had SE within±1.0 D at the last visit.The axial length increased by 0.29±0.71 mm 5y after the surgery(t=-3.843,P<0.001).The mean vault at the last follow-up was 510.59±245.61μm.The central hole was on the temporal side in 80 eyes(84.2%).The visual quality questionnaire showed that 98.2%patients were satisfied with the surgical procedure.Adverse events occurred in 4 eyes(3.5%),including the posttraumatic toric ICL rotation(2 eyes),iris incarceration(1 eye),and posttraumatic ICL displacement(1 eye)at the last follow-up.CONCLUSION:Long-term ICL V4c implantation is safe,effective,and stable for correcting moderate and to high myopia,and the visual quality with patients is excellent and satisfactory,but the progression of axial length still needs attention after surgery.展开更多
AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images we...AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images were collected from the Lixiang Eye Hospital to provide the patient’s preoperative parameters as well as the vault of the ICL after implantation.The vault was set as the prediction target,and the input elements were mainly ciliary sulcus shape parameters,which included 6 angular parameters,2 area parameters,and 2 parameters,distance between ciliary sulci,and anterior chamber height.A random forest regression model was applied to predict the vault,with the number of base estimators(n_estimators)of 2000,the maximum tree depth(max_depth)of 17,the number of tree features(max_features)of Auto,and the random state(random_state)of 40.0.RESULTS:Among the parameters selected in this study,the distance between ciliary sulci had a greater importance proportion,reaching 52%before parameter optimization is performed,and other features had less influence,with an importance proportion of about 5%.The importance of the distance between the ciliary sulci increased to 53% after parameter optimization,and the importance of angle 3 and area 1 increased to 5% and 8%respectively,while the importance of the other parameters remained unchanged,and the distance between the ciliary sulci was considered the most important feature.Other features,although they accounted for a relatively small proportion,also had an impact on the vault prediction.After parameter optimization,the best prediction results were obtained,with a predicted mean value of 763.688μm and an actual mean value of 776.9304μm.The R²was 0.4456 and the root mean square error was 201.5166.CONCLUSION:A study based on UBM images using random forest network can be performed for prediction of the vault after ICL implantation and can provide some reference for ICL size selection.展开更多
With the widespread adoption of ultrasound guidance,Seldinger puncture techniques,and intracardiac electrical positioning technology for the placement of peripherally inserted central catheters in recent years,an incr...With the widespread adoption of ultrasound guidance,Seldinger puncture techniques,and intracardiac electrical positioning technology for the placement of peripherally inserted central catheters in recent years,an increasing number of medical staff and patients now accept peripheral placement of totally implantable venous access devices(TIVADs)in the upper arm.This approach has the advantage of completely avoiding the risks of hemothorax,pneumothorax,and neck and chest scarring.Medical specialties presently engaged in this study in China include internal medicine,surgery,anesthesiology,and interventional departments.However,command over implantation techniques,treatment of complications,and proper use and maintenance of TIVAD remain uneven among different medical units.Moreover,currently,there are no established quality control standards for implantation techniques or specifications for handling complications.Thus,this expert consensus is proposed to improve the success rate of TIVAD implantation via the upper-arm approach,reduce complication rates,and ensure patient safety.This consensus elaborates on the technical indications and contraindications,procedures and technical points,treatment of complications,and the use and maintenance of upper-arm TIVAD,thus providing a practical reference for medical staff.展开更多
OBJECTIVE Implantable cardiac defibrillators(ICD)implantation in the very elderly remains controversial.We aimed to describe the experience and outcome of patients over 80 years old implanted with an ICD in Belgium.ME...OBJECTIVE Implantable cardiac defibrillators(ICD)implantation in the very elderly remains controversial.We aimed to describe the experience and outcome of patients over 80 years old implanted with an ICD in Belgium.METHODS Data were extracted from the national QERMID-ICD registry.All implantations performed in octogenarians between February 2010 and March 2019 were analysed.Data on baseline patient characteristics,type of prevention,device configuration and all-cause mortality were available.To determine predictors of mortality,multivariable Cox proportional hazard regression modelling was performed.RESULTS Nationwide,704 primo ICD implantations were performed in octogenarians(median age 82,IQR 81-83 years;83% male and 45% secondary prevention).During a mean follow-up of 3.1±2.3 years,249(35%)patients died,of which 76(11%)within the first year after implantation.In multivariable Cox regression analysis age(HR=1.15,P=0.004),oncological history(HR=2.43,P=0.027)and secondary prevention(HR=2.23,P=0.001)were independently associated with 1-year mortality.A better preserved left ventricular ejection fraction(LVEF)was associated with a better outcome(HR=0.97,P=0.002).Regarding overall mortality multivariable analysis withheld age,history of atrial fibrillation,centre volume and oncological history as significant predictors.Higher LVEF was again protective(HR=0.99,P=0.008).CONCLUSIONS Primary ICD implantation in octogenarians is not often performed in Belgium.Among this population,11%died within the first year after ICD implantation.Advanced age,oncological history,secondary prevention and a lower LVEF were associated with an increased one-year mortality.Age,low LVEF,atrial fibrillation,centre volume and oncological history were indicative of higher overall mortality.展开更多
Dear Editor We present a case of spontaneous dislocation of a toric implantable collamer lens(TICL)resulting in corneal endothelial decompensation 8y after implantation.Since 2006,by helping people take off their glas...Dear Editor We present a case of spontaneous dislocation of a toric implantable collamer lens(TICL)resulting in corneal endothelial decompensation 8y after implantation.Since 2006,by helping people take off their glasses,the Visian TICL(Staar Surgical Co,Monrovia,CA,USA)have gained popularity in China.Though complications of intraocular pressure(IOP)elevation,cataract formation and endothelial damage exist as relevant problems,implantable collamer lens(ICL)implantation has been generally accepted as a viable option to correct moderate to high ametropia[1-2].展开更多
BACKGROUND Cardiovascular implantable electronic devices(CIEDs)are implanted in an increasing number of patients each year,which has led to an increase in the risk of CIED infection.Antibacterial CIED envelopes locall...BACKGROUND Cardiovascular implantable electronic devices(CIEDs)are implanted in an increasing number of patients each year,which has led to an increase in the risk of CIED infection.Antibacterial CIED envelopes locally deliver antibiotics to the implant site over a short-term period and have been shown to reduce the risk of implant site infection.These envelopes are derived from either biologic or nonbiologic materials.There is a paucity of data examining patient risk profiles and outcomes from using these envelope materials in the clinical setting and comparing these results to patients receiving no envelope with their CIED implantation.AIM To evaluate risk profiles and outcomes of patients who underwent CIED procedures with an antibacterial envelope or no envelope.METHODS After obtaining Internal Review Board approval,the records of consecutive patients who underwent a CIED implantation procedure by a single physician between March 2017 and December 2019 were retrospectively collected from our hospital.A total of 248 patients within this period were identified and reviewed through 12 mo of follow up.The CIED procedures used either no envelope(n=57),a biologic envelope(CanGaroo®,Aziyo Biologics)that was pre-hydrated by the physician with vancomycin and gentamicin(n=89),or a non-biologic envelope(Tyrx^(TM),Medtronic)that was coated with a resorbable polymer containing the drug substances rifampin and minocycline by the manufacturer(n=102).Patient selection for receiving either no envelope or an envelope(and which envelope to use)was determined by the treating physician.Statistical analyses were performed between the 3 groups(CanGaroo,Tyrx,and no envelope),and also between the No Envelope and Any Envelope groups by an independent,experienced biostatistician.RESULTS On average,patients who received any envelope(biologic or non-biologic)were younger(70.7±14.0 vs 74.9±10.6,P=0.017),had a greater number of infection risk factors(81.2%vs 49.1%,P<0.001),received more high-powered devices(37.2%vs 5.8%,P=0.004),and were undergoing more reoperative procedures(47.1%vs 0.0%,P<0.001)than patients who received no envelope.Between the two envelopes,biologic envelopes tended to be used more often in higher risk patients(84.3%vs 78.4%)and reoperative procedures(62.9%vs 33.3%)than non-biologic envelopes.The rate of CIED implant site pocket infection was low(any envelope 0.5%vs no envelope 0.0%)and was statistically equivalent between the two envelope groups.Other reported adverse events(lead dislodgement,lead or pocket revision,device migration or erosion,twiddler’s syndrome,and erythema/fever)were low and statistically equivalent between groups(biologic 2.2%,non-biologic 3.9%,no envelope 1.8%).CONCLUSION CIED infection rates for biologic and non-biologic antibacterial envelopes are similar.Antibacterial envelopes may benefit patients who are higher risk for infection,however additional studies are warranted to confirm this.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
Implantable bioelectronics for analyzing physiological biomarkers has recently been recognized as a promising technique in medical treatment or diagnostics. In this study, we developed a self-powered implantable skinl...Implantable bioelectronics for analyzing physiological biomarkers has recently been recognized as a promising technique in medical treatment or diagnostics. In this study, we developed a self-powered implantable skinlike glucometer for real-time detection of blood glucose level in vivo. Based on the piezo-enzymatic-reaction coupling effect of GOx@ZnO nanowire, the device under an applied deformation can actively output piezoelectric signal containing the glucose-detecting information. No external electricity power source or battery is needed for this device, and the outputting piezoelectric voltage acts as both the biosensing signal and electricity power. A practical application of the skin-like glucometer implanted in mouse body for detecting blood glucose level has been simply demonstrated. These results provide a new technique path for diabetes prophylaxis and treatment.展开更多
To overcome some of the problems inherent in conventional heating aids such as low gain at high fi'equencies due to acoustic feedback, discomfort in occlusion of the extemal ear canal and so on, implantable middle ea...To overcome some of the problems inherent in conventional heating aids such as low gain at high fi'equencies due to acoustic feedback, discomfort in occlusion of the extemal ear canal and so on, implantable middle ear hearing devices (IMEHDs) have been developed over the past two decades. For such kinds of IMEHDs, this paper presents the design of a floating mass piezoelectric actuator using a PMN-30%PT stack as a new type of vibrator. The proposed piezoelectric actuator consists of only three components of a piezoelectric stack, a metal case and a clamp. For the purpose of aiding the design of this actuator, a coupling biomechanics model of human middle ear and the piezoelectric actuator was constructed. This model was built based on a complete set of computerized tomography section images of a healthy volunteer's left ear by reverse engineering technology. The validity of this model was confirmed by comparing the motion of the tympanic membrane and stapes footplate obtained by this model with published experimental measurements on human temporal bones. It is shown that the designed actuator can be implanted on the incus long process by a simple surgical operation, and the stapes footplate displacement by its excitation at 10.5 V root-mean-square(RMS) voltage was equivalent to that from acoustic stimulation at 100 dB sound pressure level(SPL), which is adequate stimulation to the ossicular chain. The corresponding power consumption is 0.04 mW per volt of excitation at 1 kHz, which is low enough for the transducer to be used in an implantable middle ear device.展开更多
Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time.Advantages of ports include a simple nursing process,low risk of infecti...Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time.Advantages of ports include a simple nursing process,low risk of infection and embolism,and high patient comfort.In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications,the Chinese Research Hospital Association Digestive Tumor Committee,the Chinese Association of Upper Gastrointestinal Surgeons,the Chinese Gastric Cancer Association,and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nationwide expert letter reviews and on-site seminars,and formulated an expert consensus of the operation guidelines.展开更多
AIM:To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).METH...AIM:To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).METHODS:Authors conducted a chart review of 20 patients with a cardiac pacemaker (CP) or implantable cardioverter defibrillator (ICD) who underwent continuous electrocardiographic monitoring during their SBCE from 2003-2008.authors searched for unexplained electrocardiogram (ECG) findings,changes in CP andICD set parameters,any abnormality in transmitted capsule data,and adverse clinical events.RESULTS:There were no adverse events or hemodynamically significant arrhythmias reported.CP and ICD set parameters were preserved.The majority of ECG abnormalities were also found in pre-or post-SBCE ECG tracings and the CP behavior during arrhythmias appeared appropriate.Two patients seemed to have episodes of undersensing by the CP.However,similar findings were documented in ECGs taken outside the time frame of the SBCE.One patient was observed to have a low signal encountered from the capsule resulting in lack of localization,but no images were lost.CONCLUSION:Capsule-induced EMI remains a possibility but is unlikely to be clinically important.CPinduced interference of SBCE is also possible,but is infrequent and does not result in loss of images transmitted by the capsule.展开更多
AIM:To evaluate the clinical outcomes of V4 c implantable collamer lens(Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering.METHODS:This included 49 eye...AIM:To evaluate the clinical outcomes of V4 c implantable collamer lens(Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering.METHODS:This included 49 eyes that received conventional ICL and 94 eyes that received Hole ICL.The eyes that received Hole ICL were divided into three groups according to the degree of decentering:group 1,central hole within 1 hole diameter(HD) from the pupil center;group 2,central hole within 1 HD to 2 HD;and group 3,central hole within 2 HD to 3 HD.Visual acuity(VA),intraocular pressure(IOP),and spherical equivalent(SE) values were assessed at 1wk,1 and 3mo after surgery.The ocular modulation transfer function,Strehl ratio,objective scattering index,and higher order aberrations(HOAs) were measured for 4-mm pupils at 3mo after surgery.RESULTS:There were no significant differences in VA,IOP,and SE among the conventional and Hole ICL groups.With regard to HOAs,values for coma and spherical aberrations showed no differences.The total HOA and trefoil values were significantly higher in group 2 than in group 1(P=0.02,0.03,respectively).There were no significant differences among groups with regard to other optical quality parameter at 3mo after surgery.CONCLUSION:Our results suggest that Hole ICL implantation provides satisfactory visual quality that is equivalent to that provided by conventional ICL,regardless of the presence of central hole and degree of decentering.展开更多
Totally implantable access ports(TIAPs)are used for patients with poor peripheral vascular support requiring central venous access.In recent years,TIAPs have been gradually accepted and promoted by patients,doctors,an...Totally implantable access ports(TIAPs)are used for patients with poor peripheral vascular support requiring central venous access.In recent years,TIAPs have been gradually accepted and promoted by patients,doctors,and nurses owing to their advantages of convenient carrying,a long maintenance period,low complications,and a high quality of life for patients.Currently,medical personnel that handle TIAP implantation and management in China are from different areas of healthcare,including surgery,internal medicine,radiology,nurse anesthesia,vascular access,etc.,and many only handle TIAP as a part of their duties.Therefore,the operating procedures and steps for the diagnosis and treatment of complications of TIAP vary from person to person,resulting in different incidence and treatment methods for complications in the implantation and use of TIAP in different medical units.Based on this,we have updated the Shanghai expert consensus on TIAPs from 2015 and explored the diagnosis and treatment procedures of related complications while continuing to emphasize standardized implantation and maintenance.展开更多
AIM:To assess the safety,efficacy,predictability and stability of implantable collamer lens(ICL) for residual refractive error after corneal refractive surgery.METHODS: This study evaluated 19 eyes of 12 patients ...AIM:To assess the safety,efficacy,predictability and stability of implantable collamer lens(ICL) for residual refractive error after corneal refractive surgery.METHODS: This study evaluated 19 eyes of 12 patients who underwent ICL implantation after corneal refractive surgeries.They were followed up for 1y to 5y of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,flat and steep K value,axial length,intraocular pressure,corneal endothelial cell density,adverse events after ICL surgery.RESULTS: The mean follow-up period was 39.05 ±19.22 mo(range,1-5y).Spherical equivalent refractive error changed from-7.45±3.02 D preoperatively to-0.85±1.10 D 1wk to 1mo after ICL implantation,with the safety and efficacy indices being 1.12 and 1.15,respectively.A total of 52.63% of eyes were within ±0.5 D of the predicted spherical equivalents,73.68% were within ±1.0 D.A trend of mild regression towards myopia with axial elongation after 5y was observed.One eye with mild anterior capsule opacity and retinal detachment 1y after surgery were observed.CONCLUSION: ICL implantation is safe and effective for the correction of residual refractive error after corneal refractive surgeries,especially in moderate to high residual myopia.展开更多
The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis di...The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis difficult with traditional methods and in patients at high risk for surgical site infections(SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.展开更多
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 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.
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Supported by National Natural Science Foundation of China(No.82070937,No.81870640)National Science Foundation for Young Scientists of China(No.82101097)。
文摘AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,Web of Science,Cochrane Library and several Chinese databases were searched at May 2021 to select relevant studies in comparison of clinical outcomes between ICL implantation and SMILE for myopia.The primary outcomes were efficacy,safety,and predictability.And the secondary outcomes were postoperative higher-order ocular aberrations(HOAs),modulation transfer function cutoff frequency(MTF),objective scatter index(OSI),contrast sensitivity and a quality of vision(Qo V)questionnaire.RESULTS:A total of 1036 eyes from 10 studies,of which 503 eyes underwent ICL implantation and 533 eyes underwent SMILE,were enrolled in this Meta-analysis.Pooled results revealed that ICL group had a better safety index and post-corrected distance visual acuity(CDVA)(P=0.007,<0.00001,respectively),and a lower percentage of eyes with a postoperative CDVA lost 1 line(P=0.007)than the SMILE group.No significant differences were found in comparison of the other primary outcomes.In the longterm follow-up(>6mo),ICL group had a lower total HOA,coma,and spherical aberration than SMILE group(P=0.003,<0.00001,0.04).Yet higher trefoil was found in ICL group at 6mo after surgery(P=0.003).Additionally,ICL group also had a higher MTF value(P=0.02),and a higher contrast sensitivity score for spatial frequencies of 1.5,6,and 12 cpds(P=0.02,0.005,0.02,respectively).And it also had a lower score of bothersome in Qo V questionnaire than SMILE group(P=0.003).CONCLUSION:ICL implantation and SMILE have similar and comparable outcomes in term of the efficacy and predictability for correcting high myopia.However,ICL group is relatively safer and also has better visual quality in comparison of SMILE group.
基金Supported by the Science and Technology Innovation Program of Hunan Province,China(No.2020SK50103)Hunan Clinical Medical Technology Innovation Guiding Project in 2020。
文摘AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted on 58 patients(114 eyes)who were followed up for at least 5y after ICL V4c implantation.The observation was done before and on 1d,1mo,1 and 5y or more after the surgical procedure.The visual acuity,subjective refraction,intraocular pressure,vault,axial length,central hole position,pupil diameter,visual quality,and adverse events were analyzed.The visual quality includes aberration,the modulation transfer function cutoff frequency(MTF cutoff),objective scattering index(OSI),Stroller's ratio(SR),and visual quality questionnaire.RESULTS:The average follow-up period was 69.25±3.80mo(range 60–82mo)and the preoperative spherical equivalent(SE)was-8.66±1.97 D.At 5y after operation,the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was-0.65±0.63 D.The 59.6%of the eyes achieved an uncorrected distance visual acuity of 20/20,76.3%of the eyes had SE within±1.0 D at the last visit.The axial length increased by 0.29±0.71 mm 5y after the surgery(t=-3.843,P<0.001).The mean vault at the last follow-up was 510.59±245.61μm.The central hole was on the temporal side in 80 eyes(84.2%).The visual quality questionnaire showed that 98.2%patients were satisfied with the surgical procedure.Adverse events occurred in 4 eyes(3.5%),including the posttraumatic toric ICL rotation(2 eyes),iris incarceration(1 eye),and posttraumatic ICL displacement(1 eye)at the last follow-up.CONCLUSION:Long-term ICL V4c implantation is safe,effective,and stable for correcting moderate and to high myopia,and the visual quality with patients is excellent and satisfactory,but the progression of axial length still needs attention after surgery.
文摘AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images were collected from the Lixiang Eye Hospital to provide the patient’s preoperative parameters as well as the vault of the ICL after implantation.The vault was set as the prediction target,and the input elements were mainly ciliary sulcus shape parameters,which included 6 angular parameters,2 area parameters,and 2 parameters,distance between ciliary sulci,and anterior chamber height.A random forest regression model was applied to predict the vault,with the number of base estimators(n_estimators)of 2000,the maximum tree depth(max_depth)of 17,the number of tree features(max_features)of Auto,and the random state(random_state)of 40.0.RESULTS:Among the parameters selected in this study,the distance between ciliary sulci had a greater importance proportion,reaching 52%before parameter optimization is performed,and other features had less influence,with an importance proportion of about 5%.The importance of the distance between the ciliary sulci increased to 53% after parameter optimization,and the importance of angle 3 and area 1 increased to 5% and 8%respectively,while the importance of the other parameters remained unchanged,and the distance between the ciliary sulci was considered the most important feature.Other features,although they accounted for a relatively small proportion,also had an impact on the vault prediction.After parameter optimization,the best prediction results were obtained,with a predicted mean value of 763.688μm and an actual mean value of 776.9304μm.The R²was 0.4456 and the root mean square error was 201.5166.CONCLUSION:A study based on UBM images using random forest network can be performed for prediction of the vault after ICL implantation and can provide some reference for ICL size selection.
文摘With the widespread adoption of ultrasound guidance,Seldinger puncture techniques,and intracardiac electrical positioning technology for the placement of peripherally inserted central catheters in recent years,an increasing number of medical staff and patients now accept peripheral placement of totally implantable venous access devices(TIVADs)in the upper arm.This approach has the advantage of completely avoiding the risks of hemothorax,pneumothorax,and neck and chest scarring.Medical specialties presently engaged in this study in China include internal medicine,surgery,anesthesiology,and interventional departments.However,command over implantation techniques,treatment of complications,and proper use and maintenance of TIVAD remain uneven among different medical units.Moreover,currently,there are no established quality control standards for implantation techniques or specifications for handling complications.Thus,this expert consensus is proposed to improve the success rate of TIVAD implantation via the upper-arm approach,reduce complication rates,and ensure patient safety.This consensus elaborates on the technical indications and contraindications,procedures and technical points,treatment of complications,and the use and maintenance of upper-arm TIVAD,thus providing a practical reference for medical staff.
文摘OBJECTIVE Implantable cardiac defibrillators(ICD)implantation in the very elderly remains controversial.We aimed to describe the experience and outcome of patients over 80 years old implanted with an ICD in Belgium.METHODS Data were extracted from the national QERMID-ICD registry.All implantations performed in octogenarians between February 2010 and March 2019 were analysed.Data on baseline patient characteristics,type of prevention,device configuration and all-cause mortality were available.To determine predictors of mortality,multivariable Cox proportional hazard regression modelling was performed.RESULTS Nationwide,704 primo ICD implantations were performed in octogenarians(median age 82,IQR 81-83 years;83% male and 45% secondary prevention).During a mean follow-up of 3.1±2.3 years,249(35%)patients died,of which 76(11%)within the first year after implantation.In multivariable Cox regression analysis age(HR=1.15,P=0.004),oncological history(HR=2.43,P=0.027)and secondary prevention(HR=2.23,P=0.001)were independently associated with 1-year mortality.A better preserved left ventricular ejection fraction(LVEF)was associated with a better outcome(HR=0.97,P=0.002).Regarding overall mortality multivariable analysis withheld age,history of atrial fibrillation,centre volume and oncological history as significant predictors.Higher LVEF was again protective(HR=0.99,P=0.008).CONCLUSIONS Primary ICD implantation in octogenarians is not often performed in Belgium.Among this population,11%died within the first year after ICD implantation.Advanced age,oncological history,secondary prevention and a lower LVEF were associated with an increased one-year mortality.Age,low LVEF,atrial fibrillation,centre volume and oncological history were indicative of higher overall mortality.
基金Supported by 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYJC21025)。
文摘Dear Editor We present a case of spontaneous dislocation of a toric implantable collamer lens(TICL)resulting in corneal endothelial decompensation 8y after implantation.Since 2006,by helping people take off their glasses,the Visian TICL(Staar Surgical Co,Monrovia,CA,USA)have gained popularity in China.Though complications of intraocular pressure(IOP)elevation,cataract formation and endothelial damage exist as relevant problems,implantable collamer lens(ICL)implantation has been generally accepted as a viable option to correct moderate to high ametropia[1-2].
文摘BACKGROUND Cardiovascular implantable electronic devices(CIEDs)are implanted in an increasing number of patients each year,which has led to an increase in the risk of CIED infection.Antibacterial CIED envelopes locally deliver antibiotics to the implant site over a short-term period and have been shown to reduce the risk of implant site infection.These envelopes are derived from either biologic or nonbiologic materials.There is a paucity of data examining patient risk profiles and outcomes from using these envelope materials in the clinical setting and comparing these results to patients receiving no envelope with their CIED implantation.AIM To evaluate risk profiles and outcomes of patients who underwent CIED procedures with an antibacterial envelope or no envelope.METHODS After obtaining Internal Review Board approval,the records of consecutive patients who underwent a CIED implantation procedure by a single physician between March 2017 and December 2019 were retrospectively collected from our hospital.A total of 248 patients within this period were identified and reviewed through 12 mo of follow up.The CIED procedures used either no envelope(n=57),a biologic envelope(CanGaroo®,Aziyo Biologics)that was pre-hydrated by the physician with vancomycin and gentamicin(n=89),or a non-biologic envelope(Tyrx^(TM),Medtronic)that was coated with a resorbable polymer containing the drug substances rifampin and minocycline by the manufacturer(n=102).Patient selection for receiving either no envelope or an envelope(and which envelope to use)was determined by the treating physician.Statistical analyses were performed between the 3 groups(CanGaroo,Tyrx,and no envelope),and also between the No Envelope and Any Envelope groups by an independent,experienced biostatistician.RESULTS On average,patients who received any envelope(biologic or non-biologic)were younger(70.7±14.0 vs 74.9±10.6,P=0.017),had a greater number of infection risk factors(81.2%vs 49.1%,P<0.001),received more high-powered devices(37.2%vs 5.8%,P=0.004),and were undergoing more reoperative procedures(47.1%vs 0.0%,P<0.001)than patients who received no envelope.Between the two envelopes,biologic envelopes tended to be used more often in higher risk patients(84.3%vs 78.4%)and reoperative procedures(62.9%vs 33.3%)than non-biologic envelopes.The rate of CIED implant site pocket infection was low(any envelope 0.5%vs no envelope 0.0%)and was statistically equivalent between the two envelope groups.Other reported adverse events(lead dislodgement,lead or pocket revision,device migration or erosion,twiddler’s syndrome,and erythema/fever)were low and statistically equivalent between groups(biologic 2.2%,non-biologic 3.9%,no envelope 1.8%).CONCLUSION CIED infection rates for biologic and non-biologic antibacterial envelopes are similar.Antibacterial envelopes may benefit patients who are higher risk for infection,however additional studies are warranted to confirm this.
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.
基金supported by the National Natural Science Foundation of China (11674048)the Fundamental Research Funds for the Central Universities (N160502002)Liaoning BaiQianWan Talents Program (2014921017)
文摘Implantable bioelectronics for analyzing physiological biomarkers has recently been recognized as a promising technique in medical treatment or diagnostics. In this study, we developed a self-powered implantable skinlike glucometer for real-time detection of blood glucose level in vivo. Based on the piezo-enzymatic-reaction coupling effect of GOx@ZnO nanowire, the device under an applied deformation can actively output piezoelectric signal containing the glucose-detecting information. No external electricity power source or battery is needed for this device, and the outputting piezoelectric voltage acts as both the biosensing signal and electricity power. A practical application of the skin-like glucometer implanted in mouse body for detecting blood glucose level has been simply demonstrated. These results provide a new technique path for diabetes prophylaxis and treatment.
基金supported by National Natural Science Foundation of China (Grant No. 10772121)
文摘To overcome some of the problems inherent in conventional heating aids such as low gain at high fi'equencies due to acoustic feedback, discomfort in occlusion of the extemal ear canal and so on, implantable middle ear hearing devices (IMEHDs) have been developed over the past two decades. For such kinds of IMEHDs, this paper presents the design of a floating mass piezoelectric actuator using a PMN-30%PT stack as a new type of vibrator. The proposed piezoelectric actuator consists of only three components of a piezoelectric stack, a metal case and a clamp. For the purpose of aiding the design of this actuator, a coupling biomechanics model of human middle ear and the piezoelectric actuator was constructed. This model was built based on a complete set of computerized tomography section images of a healthy volunteer's left ear by reverse engineering technology. The validity of this model was confirmed by comparing the motion of the tympanic membrane and stapes footplate obtained by this model with published experimental measurements on human temporal bones. It is shown that the designed actuator can be implanted on the incus long process by a simple surgical operation, and the stapes footplate displacement by its excitation at 10.5 V root-mean-square(RMS) voltage was equivalent to that from acoustic stimulation at 100 dB sound pressure level(SPL), which is adequate stimulation to the ossicular chain. The corresponding power consumption is 0.04 mW per volt of excitation at 1 kHz, which is low enough for the transducer to be used in an implantable middle ear device.
基金Supported by Program of B.Braun Medical,No.CN-0486-AECVSE2019169Program of Military Medicine for Youth,No.QNF19055.
文摘Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time.Advantages of ports include a simple nursing process,low risk of infection and embolism,and high patient comfort.In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications,the Chinese Research Hospital Association Digestive Tumor Committee,the Chinese Association of Upper Gastrointestinal Surgeons,the Chinese Gastric Cancer Association,and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nationwide expert letter reviews and on-site seminars,and formulated an expert consensus of the operation guidelines.
文摘AIM:To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).METHODS:Authors conducted a chart review of 20 patients with a cardiac pacemaker (CP) or implantable cardioverter defibrillator (ICD) who underwent continuous electrocardiographic monitoring during their SBCE from 2003-2008.authors searched for unexplained electrocardiogram (ECG) findings,changes in CP andICD set parameters,any abnormality in transmitted capsule data,and adverse clinical events.RESULTS:There were no adverse events or hemodynamically significant arrhythmias reported.CP and ICD set parameters were preserved.The majority of ECG abnormalities were also found in pre-or post-SBCE ECG tracings and the CP behavior during arrhythmias appeared appropriate.Two patients seemed to have episodes of undersensing by the CP.However,similar findings were documented in ECGs taken outside the time frame of the SBCE.One patient was observed to have a low signal encountered from the capsule resulting in lack of localization,but no images were lost.CONCLUSION:Capsule-induced EMI remains a possibility but is unlikely to be clinically important.CPinduced interference of SBCE is also possible,but is infrequent and does not result in loss of images transmitted by the capsule.
文摘AIM:To evaluate the clinical outcomes of V4 c implantable collamer lens(Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering.METHODS:This included 49 eyes that received conventional ICL and 94 eyes that received Hole ICL.The eyes that received Hole ICL were divided into three groups according to the degree of decentering:group 1,central hole within 1 hole diameter(HD) from the pupil center;group 2,central hole within 1 HD to 2 HD;and group 3,central hole within 2 HD to 3 HD.Visual acuity(VA),intraocular pressure(IOP),and spherical equivalent(SE) values were assessed at 1wk,1 and 3mo after surgery.The ocular modulation transfer function,Strehl ratio,objective scattering index,and higher order aberrations(HOAs) were measured for 4-mm pupils at 3mo after surgery.RESULTS:There were no significant differences in VA,IOP,and SE among the conventional and Hole ICL groups.With regard to HOAs,values for coma and spherical aberrations showed no differences.The total HOA and trefoil values were significantly higher in group 2 than in group 1(P=0.02,0.03,respectively).There were no significant differences among groups with regard to other optical quality parameter at 3mo after surgery.CONCLUSION:Our results suggest that Hole ICL implantation provides satisfactory visual quality that is equivalent to that provided by conventional ICL,regardless of the presence of central hole and degree of decentering.
文摘Totally implantable access ports(TIAPs)are used for patients with poor peripheral vascular support requiring central venous access.In recent years,TIAPs have been gradually accepted and promoted by patients,doctors,and nurses owing to their advantages of convenient carrying,a long maintenance period,low complications,and a high quality of life for patients.Currently,medical personnel that handle TIAP implantation and management in China are from different areas of healthcare,including surgery,internal medicine,radiology,nurse anesthesia,vascular access,etc.,and many only handle TIAP as a part of their duties.Therefore,the operating procedures and steps for the diagnosis and treatment of complications of TIAP vary from person to person,resulting in different incidence and treatment methods for complications in the implantation and use of TIAP in different medical units.Based on this,we have updated the Shanghai expert consensus on TIAPs from 2015 and explored the diagnosis and treatment procedures of related complications while continuing to emphasize standardized implantation and maintenance.
基金Supported by the Committee of Science and Technology of Shanghai,China(No.09411962100)the Health and Family Planning Committee of Pudong New District of Shanghai,China(No.PW2014D-1)
文摘AIM:To assess the safety,efficacy,predictability and stability of implantable collamer lens(ICL) for residual refractive error after corneal refractive surgery.METHODS: This study evaluated 19 eyes of 12 patients who underwent ICL implantation after corneal refractive surgeries.They were followed up for 1y to 5y of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,flat and steep K value,axial length,intraocular pressure,corneal endothelial cell density,adverse events after ICL surgery.RESULTS: The mean follow-up period was 39.05 ±19.22 mo(range,1-5y).Spherical equivalent refractive error changed from-7.45±3.02 D preoperatively to-0.85±1.10 D 1wk to 1mo after ICL implantation,with the safety and efficacy indices being 1.12 and 1.15,respectively.A total of 52.63% of eyes were within ±0.5 D of the predicted spherical equivalents,73.68% were within ±1.0 D.A trend of mild regression towards myopia with axial elongation after 5y was observed.One eye with mild anterior capsule opacity and retinal detachment 1y after surgery were observed.CONCLUSION: ICL implantation is safe and effective for the correction of residual refractive error after corneal refractive surgeries,especially in moderate to high residual myopia.
文摘The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis difficult with traditional methods and in patients at high risk for surgical site infections(SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.