Robot-assisted radical nephroureterectomy using the KangDuo Surgical Robot-01 System versus the da Vinci System: a multicenter prospective randomized controlled trial

ABSTRACT Introduction: We aim to compare the safety and effectiveness of the KangDuo (KD)-Surgical Robot-01 (KD-SR-01) system and the da Vinci (DV) system for robot-assisted radical nephroureterectomy (RARNU). Materials and Methods: This multicenter prospective randomized controlled trial was conducted between March 2022 and September 2023. Group 1 included 29 patients undergoing KD-RARNU. Group 2 included 29 patients undergoing DV-RARNU. Patient demographic and clinical characteristics, perioperative data, and follow-up outcomes were collected prospectively and compared between the two groups. Results: There were no significant differences in patient baseline demographic and preoperative characteristics between the two groups. The success rates in both groups were 100% without conversion to open or laparoscopic surgery or positive surgical margins. No significant difference was observed in docking time [242 (120-951) s vs 253 (62-498) s, P = 0.780], console time [137 (55-290) min vs 105 (62-220) min, P = 0.114], operative time [207 (121-460) min vs 185 (96-305) min, P = 0.091], EBL [50 (10-600) mL vs 50 (10-700) mL, P = 0.507], National Aeronautics and Space Administration Task Load Index scores, and postoperative serum creatinine levels between the two groups. None of the patients showed evidence of distant metastasis, local recurrence, or equipment-related adverse events during the four-week follow-up. One (3.4%) patient in Group 2 experienced postoperative enterovaginal and enterovesical fistulas (Clavien-Dindo grade III). Conclusions: The KD-SR-01 system is safe and effective for RARNU compared to the DV Si or Xi system. Further randomized controlled studies with larger sample sizes and longer durations are required.

High risk factors of retinopathy of prematurity / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the incidence and high risk factors of retinopathy of prematurity(ROP).<p>METHODS:Retrospective study. A total of 161 neonates in Gaozhou People's Hospital from January 2018 to January 2021 who met the screening guidelines for retinopathy of prematurity in China(2014)were selected as subjects. Retcam Ⅲ was used for fundus screening. Clinical data of neonates and their mothers were analyzed retrospectively. Univariate analysis and Logistic regression analysis were used to analyze the risk factors for ROP.<p>RESULTS: Among 161 neonates meeting the inclusion criteria, 26(16.1%)were in the ROP group and 135(83.9%)were in the non-ROP group. Gestational age, neonatal red blood cell count, birth weight, maternal age, gestational hypertension, method of conception showed statistical significance between the two groups(<i>P</i><0.05)in Univariate analysis. Multivariate Logistic regression analysis revealed that age(<i>OR</i>=0.549, 95%<i>CI</i>: 0.391-0.770, <i>P</i>=0.001)is a protective factor of ROP, however, hypertension during pregnancy(<i>OR</i>=3.947, 95%<i>CI</i>: 1.049-14.852, <i>P</i>=0.042)and assisted reproductive(<i>OR</i>=4.632, 95%<i>CI</i>: 1.112-19.305, <i>P</i>=0.035)are risk factors of ROP.<p>CONCLUSION: Gestational age is a protective factor for ROP, and assisted reproduction is a risk factor for ROP. High attention should be paid to the neonates with low gestational age, assisted reproductive technology and whose mother has hypertensive disorders of pregnancy. Early screening, early detection, and early treatment of neonatal fundus may reduce blindness caused by ROP.

Determination of chlorogenic acid, total flavones, and anti-oxidant activity of Flos Lonicerae Japonicae and Flos Lonicerae / 中草药

Objective To determine the content of chlorogenic acid, total flavones, and anti-oxidant activity in Flos Lonicerae japonicae and Flos Lonicerae obtained from three different origins and compare their differences. Methods The optimized extraction conditions of chlorogenic acid were ultrasonic extraction 30 min in 65 ℃ with ethanol: water (60︰40) and solid-liquid ratio (1︰20). The optimized extraction conditions of total flavonoids were ultrasonic extraction 30 min at 65 ℃ with 60% methanol solution, solid-liquid ratio (1︰10). HPLC and UV spectrophotometry were used to determine the content of chlorogenic acid and total flavonoids in the samples, and then estimation of anti-oxidative activity of Flos Lonicerae japonicae and Flos Lonicerae by DPPH radical scavenging capacity method. Results A method for the analysis of chlorogenic acid and total flavonoids was established, which have a good linear relationship of chlorogenic acid in 0.119-1.190 mg/mL and R2 was 0.999 2 (n = 6); A good linear relationship between 0.008 and 0.050 mg/mL and r2 was 0.999 5 (n = 6) for analysis of the total flavonoids. The average content of chlorogenic acid, total flavonoids, and free radical scavenging rate of Flos Lonicerae from Hunan Province was 3.99%, 13.43%, and 62.41%, respectively. The average content of chlorogenic acid, total flavonoids and free radical scavenging rate of Flos Lonicerae from Chongqing were 3.29%, 10.08%, and 51.48% respectively. The average content of chlorogenic acid, total flavonoids, and free radical scavenging rate of Flos Lonicerae japonicae from Guangxi Province were 2.55%, 7.10%, and 39.51%, respectively. Conclusion This study proposed an analytical method combining the chemical composition analysis and anti-oxidant activity to compare the differences between the different producing areas of Flos Lonicerae japonicae and Flos Lonicerae. Combining the “spectrum-effect”, it provides a new model for the quality control and identification of two plants.

Effect of social cognition and interactive training on rehabilitation of schizophrenic patients in community / 上海交通大学学报（医学版）

Objective·To explore the effectiveness and feasibility of social cognitive and interactive training (SCIT) in rehabilitation of schizophrenic patients, and propose to establish a new mode of community rehabilitation. Methods·A total of 60 patients with schizophrenia managed in the community in Shanghai Hongkou District were divided into control group and intervention group with 30 cases in each group. The control group was treated with conventional community management. The intervention group accepted SCIT courses at the base of conventional community management. Before and after the intervention, all patients completed the related scales for schizophrenia. Scale scores were analyzed with analysis of variance by SPSS 22.0 to explore the rehabilitation effect of training. Results·In intervention group, the time used in the face emotion identification task (FEIT) had no significant difference with the control group, but the correct rate for FEIT increased significantly. In intervention group, ambiguous intentions hostility questionnaire-ambiguous items (AIHQ-A) scores were significantly lower. The total and sub scale scores of positive and negative syndrome scale (PANSS) and scale for assessment of negative symptoms (SANS), Calgary depression scale for schizophrenia (CDSS) scores were significantly decreased in intervention group. Otherwise, Toronto alexithymia scale (TAS) scores also decreased. Personal and social performance scale (PSP) scores in the SCIT group were increased after training. Finally, according to the training participation and the feedback of the patients, the training had a higher degree of acceptance and positive affirmation. Conclusion·SCIT can improve the social cognition and social function of schizophrenic patients in the community, also improve the mental symptoms, especially the negative symptoms and depressive symptoms, and has high feasibility and acceptability, so it can be promoted in community-based rehabilitation.

Effect of Tanshinone IIA in Preventing and Treating Oxaliplatin Induced Peripheral Neuropathy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe preventive and therapeutic effects of Tanshinone IIA (T II A) on oxaliplatin induced peripheral neuropathy (OlPN) and to explore its effects on the expression of calcitonin gene related peptide (CGRP) and never growth factor (NGF).</p><p><b>METHODS</b>Totally 36 phase II - III patients with malignant tumor of digestive tract undergoing chemotherapy program with oxaliplatin, were equally assigned to the T II A group (using THA at 80 mg/day 1 day before oxaliplatin chemotherapy for 3 successive days) and the control group (using chemotherapy program with oxaliplatin alone) by segmented randomization. After 4 cycles of chemotherapy, the incidence degree and incidence of OlPN were evaluated. Sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity ( MNCV) were tested by EMG evoked potential device. Serum levels of CGRP and NGF were also detected in the two groups before and after chemotherapy. The correlation of serum levels of CGRP and NGF to OIPN was assessed using linear correlation analysis.</p><p><b>RESULTS</b>After chemotherapy the OlPN incidence was 27.8% (5/18 cases) in the T II A group, obviously lower than that in the control group (55.6%, 10/18 cases; P < 0.05). Compared with before treatment in the same group, SNCV and MNCV of common peroneal nerve were slowed down, serum NGF levels decreased, and serum CGRP levels obviously increased in the two groups (all P < 0.05). Compared with the control group after treatment, SNCV and MNCV of common peroneal nerve were obviously accelerated, serum NGF levels increased, and serum CGRP levels obviously decreased in the THA group (all P < 0.05). Results of linear correlation analysis indicated serum NGF level was negatively correlated with peripheral neuropathy (PN), serum CGRP expression was positively correlated with neurotoxicity (P < 0.05).</p><p><b>CONCLUSION</b>T II A could reduce the incidence of OlPN, which might be associated with inhibiting the expression of CGRP and up-regulating NGF activities.</p>

Correlation between Expression of Peripheral IL-17 Protein and Aggression of Bipolar Mania / 法医学杂志

OBJECTIVE@#To explore the correlation between the interleukin-17 (IL-17) level of peripheral blood and aggression of bipolar mania.@*METHODS@#Thirty-six patients of bipolar mania were selected as experimental group by DSM-IV-TR and received treatment with quetiapine and lithium. Thirty-six healthy volunteers with similar age and gender were selected as control group. The level of IL-17 at baseline in each group and the level of IL-17 in the experimental group after treatment for 2, 4 and 8 weeks were detected by ELISA.@*RESULTS@#The level of IL-17 in experimental group at baseline, after treatment for 2 and 4 weeks were all significantly higher than that in control group. After 8 weeks treatment, there was no significant difference between the two groups (P > 0.05). After 2, 4 and 8 weeks treatment, the total score and aggression score of Young Mania Rating Score (YMRS) were significantly lower than the baseline level (P < 0.05). In experimental group, the level of IL-17 was positively correlated with the two scores of YMRS at baseline (P < 0.05).@*CONCLUSION@#Bipolar mania may be related to the up-regulation of IL-17. The level of IL-17 is related to the severity of manic symptoms at baseline, especially aggression symptom.

Aldosterone antagonist inhibits fibrosis-induced NOX4 protein expression in hepatic cells and tissues of rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the inhibitory potential of aldosterone antagonist on NOX4 protein expression in hepatic fibrosis by using a rat model of carbon tetrachloride (CCl4)-induced hepatotoxicity.</p><p><b>METHODS</b>Twenty-four male Wistar rats were randomly divided into three equal groups: fibrosis model group (receiving three subcutaneous injections per week of 2.5 ml/kg 40% CCl4); spironolactone (Sp)-treated fibrosis model group (receiving CCl4 regimen plus three injections per day of 20 mg/kg Sp in olive oil); negative-treatment fibrosis model group (receiving CCl4 regimen plus three injections per day of olive oil alone). Unmanipulated rats (receiving no CCl4 and no supplemental treatments) served as normal controls. After 4 weeks, liver histology was carried out to assess cytotoxicity (by hematoxylin-eosin staining), fibrosis (by Masson staining and METAVIR scoring), and NOX4 protein expression (by immunohistochemistry). In addition, in vitro analyses of immortalized rat hepatic stellate cells, HSC-T6, were performed to evaluate dose-response (10-9, 10-7 and 10-5 mol/L) and time-response (6, 12 and 24 h) of aldosterone agonist (Ald) and an aldosterone antagonist, eplerenone (EPLE). Effects on NOX4 protein expression were evaluated by western blotting.</p><p><b>RESULTS</b>The fibrosis model group showed significantly more fibrosis than the normal control group (16.060 +/- 0.300 vs. 2.471 +/- 0.160, P = 0.000]; however, the Sp-treated fibrosis model group showed significantly less CCl4-induced fibrosis (5.761 +/- 0.152 vs. model: 16.060 +/- 0.300, P = 0.000). The fibrosis model group also showed significantly higher NOX4 protein expression in liver tissues than the normal control group (7.231 +/- 0.211 vs. 1.350 +/- 0.252, P = 0.000), and the Sp-treated fibrosis model tissues showed significantly less CCl4-induced up-regulated NOX4 protein expression (4.270 +/- 0.242 vs. model: 7.231 +/- 0.211, P = 0.000]. Ald induced up-regulated NOX4 protein expression in HSC-T6 cells in dose- and concentration-dependent manners, with the peak expression being induced by the 10-5 mol/L concentration and 24 h exposure. The Ald-treated cells expressed significantly more NOX4 protein than the untreated control cells (0.710 +/- 0.011 vs. 0.316 +/- 0.015, P = 0.000]. and the EPLE-treated cells showed significantly less Ald-induced up-regulated NOX4 expression (0.615 +/- 0.014 vs. 0.710 +/- 0.011, P = 0.000].</p><p><b>CONCLUSION</b>Aldosterone antagonists inhibit the fibrosis-induced NOX4 protein expression in rat hepatic cells.</p>

Inhibitory effect of angiotensin (1-7) on hepatic sinusoid angiogenesis in bile duct ligation-induced hepatic fibrosis of rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the inhibitory effect of angiotensin (1-7) on hepatic sinusoid angiogenesis using a rat model of hepatic fibrosis.</p><p><b>METHODS</b>Eighteen male Wistar rats were randomly divided into three equal groups for sham operation (untreated/uninduced control group), bile duct ligation (BDL) (untreated model group), or BDL with angiotensin (1-7) treatment (treated model group). Histological analysis was used to assess the liver fibrosis score, by hematoxylin-eosin staining, and the level of fibrosis, by Masson's trichrome staining. Immunohistochemistry, western blotting, and immunofluorescence were used to assess the expression of the angiogenesis markers vWF, VEGFA, and CD31.</p><p><b>RESULTS</b>Compared with the untreated/uninduced control group, the untreated BDL model group showed remarkably higher fibrosis score, area of the type I collagen expression, and expression levels of vWF, VEGFA, and CD31. However, the angiotensin (1-7)-treatment protected against the BLD-related changes, as evidenced by decreased robustness and down-regulation of the corresponding indicators. Moreover, the expression level of VEGFA was highly correlated to the expression level of vWF (r = 0.956, P = 0.000).</p><p><b>CONCLUSION</b>BDL-induced hepatic fibrosis is accompanied by significant increases in angiogenesis-related factors, but angiotensin (1-7) treatment may inhibit hepatic sinusoid angiogenesis during the liver fibrosis process.</p>

Angiotensin (1-7) inhibits angiotensin II-stimulated expression of connective tissue growth factor mRNA in hepatic stellate cells / 中华肝脏病杂志

To explore the angiotensin peptide [Ang (1-7)]-mediated inhibition of Ang II in human hepatic stellate cells (HSCs) and determine the involvement of the ACE2-Ang (1-7)-Mas axis. The human HSC line, LX2, was used in all experiments, and divided into control (unstimulated) and Ang II-stimulated (10-6 mol/L) groups. The Ang II-stimulated cells were further divided among several pre-treatment (prior to Ang II) groups: ROCK-inhibited (Y27632 blocking agent, 10-6 mol/L); irbesartan-inhibited (AT-1 receptor antagonist, 10-6 mol/L); and Mas receptor-inhibited (A779 Mas receptor antagonist, 10-6 mol/L). To explore the potential inhibitory effects of various Ang family members, the Ang II-stimulated and pre-treated LX2 cells were exposed to Ang (1-7) (10-6 mol/L) for 24 h. Western blot, reverse transcription-polymerase chain reaction (RT-PCR), and QuantiGene assay were used to assess changes in protein and mRNA expression levels of RhoA, ROCK, and connective tissue growth factor (CTGF). Compared with the control group, Ang II-stimulated cells showed significantly increased levels of RhoA protein (0.337+/-0.074 vs. 0.870+/-0.093), ROCK2 mRNA (0.747+/-0.061 vs. 0.368+/-0.023), and CTGF mRNA (0.262+/-0.007 vs. 0.578+/-0.028) (all, P less than 0.01). Pre-treatment with irbesartan or Y27632 eliminated these responses. Ang (1-7) inhibited the Ang II-stimulated up-regulation of RhoA, ROCK, and CTGF. Ang (1-7) can inhibit the Ang II-stimulated up-regulation of RhoA, ROCK and CTGF in hepatic stellate cells, indicating that the ACE2-Ang (1-7)-Mas axis, an important branch of the renin-Ang-aldosterone system is involved in the occurrence and development of liver fibrosis.

Endoscope-assisted supraorbital keyhole approach in early microsurgical clipping of anterior communicating artery aneurysm / 中华神经医学杂志

Objective To evaluate the effectiveness of the endoscope-assisted supraorbital keyhole approach in the early surgical treatment of patients with ruptured anterior communicating artery aneurysms (AcoA). Methods Thirty-five patients with ruptured AcoA, admitted to our hospital from January 2002 to January 2010, adopted clipping via endoscope-assisted supraorbital keyhole approach within 72 h of onset. The neurostatus of these patients were ranged from grade 1 to 3 (Hunt-Hiss Scale scores). The surgical details were described, and the clinical results were assessed according to the scores of Glasgow Outcome Scale.Results Operations were successfully finished in all patients; the endoscope-assisted supraorbital keyhole approach offered sufficient exposure of neurovascular structures for clipping AcoA. Intraoperative accidental aneurysm rupture occurred in 2 patients, but these events were managed successfully by blocking-up the parent artery and performing quick aneurysm neck dissection; no serious complications caused by the surgical approach occurred; postoperative DSA or CTA indicated that the aneurysm was totally clipped and the parent artery appeared no stenosis, and distal artery was unobstructed. Three months after the operation, 30 patients (85.7%) achieved very good outcomes (GOS:4-5 scores). All the patients achieved good cosmetic results. Conclusion In selected AcoA patients with grade 1-3, the endoscope-assisted supraorbital keyhole approach is safe and effective for gaining access to and treating the aneurysms on early hemorrhage stage.

Study on the effect of bone-cement interface with bone cement oscillator / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect on increasing bone cement-bone interface micro-gomphosis intensity with bone cement oscillator.</p><p><b>METHODS</b>One hundred femoral bones of adult pig were randomly divided into 6 groups: oscillating group (A1) and control group (A2) of anti-tensile force, oscillating group (B1) and control group (B2) of anti-pressure (n = 20 in each group), oscillating group (C1) and control group (C2) of imaging (n = 10 in each group). Mechanics and CT test was performed, micro-gomphosis intensity of bone cement-bone interface between oscillating group and control group was compared.</p><p><b>RESULTS</b>Mechanics and CT test showed bone cement-bone interface micro-gomphosis intensity in oscillating group was significantly stronger than control group (P < 0.01).</p><p><b>CONCLUSION</b>Bone cement oscillator can significantly increase micro-gomphosis intensity of bone-cement interface, and reduce long-term aseptic loosening of artificial prostheses.</p>

Association between depression and G72 gene polymorphism / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association between G72 gene polymorphisms and depression,and to probe the difference of G72 gene polymorphisms between depression with and without mixed family history.</p><p><b>METHODS</b>The polymorphisms of G72 gene (rs947267 and rs2181953) were detected by PCR technique in 100 depressive patients without mixed family history, 50 depressive patients with mixed family history and 86 normal controls.</p><p><b>RESULTS</b>(1) The frequencies of rs947267 genotypes and alleles in female depressive patients without mixed family history were significant different to the controls (P=0.017 and P=0.008), the OR scores were 0.300 (A/A, P=0.010), 0.456(A, P=0.008) and 2.195(C, P=0.008) respectively; but in male patients there were no significant differences to the controls (P>0.05). (2) The frequencies of rs2181953 genotypes and alleles in the depressive patients without mixed family history were not significantly different to the controls regardless of sex (P>0.05). (3) The frequencies of rs947267 and rs2181953 genotypes and alleles in the depressive patients with mixed family history were not significantly different to the controls regardless of sex (P>0.05).</p><p><b>CONCLUSION</b>The G72 gene polymorphism may be associated with female depressive patients without mixed family history,C allele of rs947267 may be the risk factor.</p>

Supraorbital keyhole approach for microsurgical treatment of aneurysms in the anterior circulation / 中华外科杂志

<p><b>OBJECTIVE</b>To study the method with endoscope-assisted microsurgical technique through the supraorbital keyhole approach to treat aneurysms in the anterior circulation.</p><p><b>METHODS</b>According to preoperative diagnostic imagings, to work out of the individual operation planning. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was about 2 cm, endoscope-assisted microsurgical technique was used to clip aneurysm. The technique was used in the most recent 12 consecutive patients.</p><p><b>RESULTS</b>Five different kinds of aneurysms in the anterior circulation were clipped through this method and 12 patients were cured. One patient, intraoperative accidental aneurysm rupture occurred. There were no approach-related complications.</p><p><b>CONCLUSIONS</b>This endoscope-assisted microsurgical technique via supraorbital keyhole approach is a safe, minimal invasive and effective way for the treatment of aneurysms in the anterior circulation, and there is more sufficient operating space.</p>

Experimental study on effect of epimedium flavonoids in protecting telomere length of senescence cells HU / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of senescence delay of human diploid fibroblast (2BS) and protecting telomere length by epimedium flavonoids (EF).</p><p><b>METHODS</b>The drug sera of EF were used to treat the 2BS. The population doublings of 2BS cells were observed, the mRNA expression of p16 gene were determined by fluorescence real-time quantitative RT-PCR, the telomerase activation of 2BS cells were determined by TRAP-Hyb, the total retinoblastoma (Rb) and phosphorated Rb protein content were detected by ELISA, the telomere length of 2BS cells were determined by telomere restriction fragment (TRF) Southern blot assay.</p><p><b>RESULTS</b>EF could significantly extend the population doublings of 2BS cells, the expression of p16 mRNA was decreased and the content of phosphorated Rb protein were increased by EF. The telomere lengthening of 2BS cells were improved by EF, but the telomerase was not activated.</p><p><b>CONCLUSION</b>In senescence human fibroblasts 2BS cells, p16 gene mRNA expression increased, content of phosphorated Rb protein decreased and the telomere length of 2BS shortened, EF might delay the aging of cells through inhibiting the p16 gene expression, promoting the production of phosphorated Rb protein and to protect the length of telomere, but not activating the telomerase.</p>

Endoscope-assisted supraorbital keyhole approach for excision of suprasellar region tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To study endoscope-assisted microsurgical technique with supraorbital keyhole approach for the treatment of suprasellar region tumor so as to maximize tumor removal and minimize operative-trauma.</p><p><b>METHODS</b>According to high resolution CT and MR images before operation, individual operation schemes were worked out. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was approximately 2 cm. Endoscope-assisted microsurgical technique was used to resect lesions in 16 consecutive patients.</p><p><b>RESULTS</b>Total Tumors were removed in all of the 16 patients via the supraorbital keyhole approach. No postoperative complications occurred.</p><p><b>CONCLUSIONS</b>Supraorbital keyhole approach may diminish tissue injury considerably and has proven to provide sufficient operating space in the suprasellar region for tumor removal.</p>