In recent years, the application of the long read single-molecule sequencing technology in clinical genetics testing has been increasingly widespread. Due to its sequencing process not requiring amplification and its characteristic of single-molecule sequencing and long reads, it has unique advantages compared to traditional molecular genetics testing such as Sanger sequencing, next-generation sequencing and chromosomal microarray. In this article, its application in the detection of chromosomal structural abnormalities, monogenic diseases, and preimplantation genetic testing for monogenic diseases were discussed. Along with a comparative analysis of the advantages and disadvantages of the long read single-molecule sequencing technology in these areas compared to traditional molecular genetics testing techniques. This article preliminarily explores the application prospects and value of the long read single-molecule sequencing technology in clinical genetics testing.
Objective To investigate the impact of the surgeon’s dominant hand-side on the operational efficiency and safety of primary lumbar discectomy under unilateral biportal endoscopy (UBE). Methods A prospective cohort study was conducted in 60 patients with single-level lumbar disc herniation who underwent UBE lumbar discectomy between August 2024 and August 2025 by the same right-handed surgeon, including 30 patients with non-dominant (right approach) (non-matched group) and 30 patients with dominant (left approach) (matched group). No significant difference was observed between the two groups in baseline data including gender, age, body mass index, herniated segment distribution, disease duration, and preoperative visual analogue scale (VAS) score and Oswestry disability index (ODI) (P>0.05). The total operation time, core endoscopic operation time, intraoperative blood loss, and related complications were recorded and compared between the two groups. A self-developed surgeon’s operational fluency assessment score was used for auxiliary subjective evaluation. VAS score and ODI were used to assess pain and functional improvement preoperatively and at 1 and 3 months postoperatively. The modified MacNab criteria was used to evaluate overall surgical outcomes at 3 months postoperatively. Results There was no significant difference in the total operation time and intraoperative blood loss between the two groups (P>0.05). The core endoscopic operation time of the matched group was significantly shorter than that of the non-matched group, and the operational fluency assessment score of the matched group was significantly higher than that of the non-matched group (P<0.05). All patients were followed up 3-6 months, with an average of 4.2 months. Complications occurred in 2 cases (6.7%) in the matched group, including 1 case of dural tear and 1 case of postoperative transient nerve root palsy, and 1 case (3.3%) in the non-matched group, which was postoperative epidural hematoma. There was no significant difference in the incidence of complications between the two groups (P>0.05). The VAS scores and ODI of the two groups decreased at 1 and 3 months after operation, and improved further at 3 months after operation compared with 1 month after operation, and the differences were significant (P<0.05), but there was no significant difference between the two groups after operation (P>0.05). Modified MacNab standard was used to evaluate the curative effect at 3 months after operation, and there was no significant difference in the evaluation grade and excellent and good rate between the two groups (P>0.05). Conclusion Consistency between the surgeon’s dominant hand side and the surgical approach side significantly improves core endoscopic operational efficiency and surgical fluency in UBE lumbar discectomy, without compromising clinical efficacy or safety. It is suggested that this matching factor should be prioritized in surgical scheduling and beginner training to optimize the operative experience and shorten the learning curve.
