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Objective:To explore the value of 5G-based robotic remote ultrasound diagnosis system in musculoskeletal joint injuries.Methods:From March to December 2020, 58 volunteers at a training base who felt musculoskeletal pain or paresthesia were selected and performed both robotic remote ultrasound (remote ultrasound group) and conventional ultrasound (portable ultrasound group). The two types of examinations were compared, the consistency of the two diagnosis results was analyzed by the Kappa test, and the the difference of the diagnosis results was compared by McNemar test.Results:Among the 58 volunteers, 40 cases were positive by both methods and 11 volunteers had 2-3 positive results. There were 59 positive results in the remote ultrasound group and 64 positive results in the portable ultrasound group. The positive rate of the examination sites from high to low was knee joint>foot and ankle joint >hand and wrist joint >shoulder joint>elbow joint, calf and hip. The diagnosis results of the two groups were in good consistency (Kappa=0.782, P<0.001), and there was no statistically significant difference in the diagnosis results between the two groups (χ 2=3.2, P=0.063). Five more diseases with positive results were detected in the portable ultrasound group: 1 meniscus injury, 1 medial collateral ligament injury, 1 soft tissue injury around the metatarsal, 1 biceps tendinitis with effusion and 1 cubital ulnar nerve subluxation. Conclusions:The 5G-based robotic remote ultrasound system has good consistency with conventional ultrasound in the diagnosis of musculoskeletal injures. It can be applied to the ultrasound diagnosis of musculoskeletal joint injuries in remote areas.
RESUMO
BACKGROUND: Ahmed glaucoma valve (AGV) is usually implanted at the superotemporal area of eyes. Comeal endothelial calls cannot regenerate,.so the repair of the endothelial cells mainly depend on the extension and progradation of the healthy cells in other area. Therefore, changes of density and shape are observed in the corneal endothelial cells after AGV implantation. OBJECTIVE: To observe the changes of density and morphology of corneal endothelial cells after AGV implantation. METHODS: Ahmed glaucoma valves were implanted in 34 eyes of 34 patients with refractory glaucoma. Density and morphology of corneal endothelial calls were evaluated in the superotemporal, superonasal, infratemporal, infranasal, and central corneal areas to calculate mean value of total comea before and at 3 and 6 months after surgery. Percentage of hexagonal cells was statistically summarized.RESULTS AND CONCLUSION: Mean density of corneal endothelial calls was statistically decreased following AGV implantation (P < 0.05), In particular, the decrease was obvious in the superetemporal area. Density of corneal endothelial cells was not changed in central area before and after AGV implantation. Morphological changes demonstrated that hexagonal cells were increased, but polygon cells were increased (P< 0.05). Density of corneal endothelial cells was gradually decreased, and morphology was also changed at 6 months after AGV implantation, suggesting that more care should be taken during intra-operation in order to minimize damage td the endothelium and prolong monitoring time of corneal endothelial cells following AGV implantation.