Objective To analyze and compare the incidence of postoperative complications of acute gangrene appendicitis after laparotomy and laparoscopic surgery.Methods This study retrospectively analyzed of 162 cases of acute gangrenous appendicitis treated in Xilin Guole Meng Hospital from January 2015 to January 2018.There were 96 male patients and 66 female patients;age (43.40 ± 16.21) years.According to different surgical methods,162 patients were divided into two groups:laparoscopic group (n =80) and open group (n =82).Laparoscopic appendectomy was performed in the laparoscopic group,and open appendectomy was performed in the open group.To compare the postoperative complications intraoperative and postoperative data between the two groups.It consists of tump fistula or bead inflammation,postoperative pneumonia,abdominal hemorrhage,deep venous thrombosis,incisional hernia,subcutaneous emphysema,incision infection,intestinal obstruction,celiac sepsis,complained of pain intensity classification method for pain score and antibiotic use time,postoperative extubation time,postoperative exhaust time,postoperative bed for the first time for the first time time,length of hospital stay.The measurement data were expressed by (Mean ± SD) and the t test was used with the groups.The counting data were expressed by the percentage or rate and the x2 test was used among the groups.When the number of single group cases was less than 10 cases,the Fisher exact probability method was used for the calibration test.Results The top three complications were incision infection,intestinal obstruction and empyema.The incidence of postoperative complications in open group and laparoscopy group was 65.9％ (54/82) and 8.8％ (7/80) respectively,and there was significant difference between the two groups (F =56.247,P=0.000).The VRS of the lapamscopic group and the open group were 53 points and 12 points for grade Ⅰ,18 points and 36 points for grade Ⅱ,and 9 points and 34 points for grade Ⅲ,The results showed that the difference between the two groups was statistically significant (x2 =2.45,P =0.01).The time of antibiotic use,postoperative tube extraction,postoperative first exhaust,postoperative first time out of bed and hospitalization in the laparoscopic group were respectively (61.2 ±24.2) d,(4.2 ± 1.2) h,(24.6 ±6.9) h,(4.6 ±2.2) h,(5.5 ±3.6) d and the open group were (72±72.6) d,(7.4 ±2.7) h,(52.2 ±4.8) h,(8.4 ±2.6) h,(13.5 ±8.2) d respectively,the differences were statistically significant (P ＜ 0.05).Conclusion The postoperative complications in laparoscopic group were lower than those in open group,so the laparoscopic group was the first choice for the treatment of acute appendicitis,while the open group was another choice for some patients.

Objective:To evaluate the efficacy of holographic image technology in robot-assisted laparoscopic radical prostatectomy (RARP).Methods:The clinical data of 34 patients with prostate cancer who underwent RARP in our hospital during October 2020 and December 2020 was analyzed retrospectively. The average age of the patients was 67.8 (52-78) years. The mean BMI was 25.8 (18.0-32.3) kg/m 2. The median level of PSA before surgery was 13.4 (2-149) ng/ml. Median prostate volume was 31.7 (9.5-159.1) ml. EAU risk groups for biochemical recurrence of localised and locally advanced prostate cancer were list as below: 5 cases of low-risk, 7 cases of medium-risk, 22 cases of high-risk. There were 9, 16, 9 cases with the ASA score of 1, 2, 3 point, respectively. Preoperative Gleason score of 34 patients were list as below: 9 cases in score ≤6 group, 15 cases in score=7 group, 10 cases in score ≥8 group. For clinical stage before the surgery, 13 cases ≤T 2a stage, 1 case in T 2b stage, 20 cases ≥T 2c stage. The engineers established holographic images of 34 patients based on multiparametric magnetic resonance imaging (mpMRI) and the reports before the operation. Surgeons can obtain the size and location of tumors, surrounding neurovascular bundles visually by revolving, assembling, disassembling and concealing images, which was helpful for pre-surgery planning. By manipulating the holographic images extracorporeally, surgeons can discriminate Internal sphincter of urinary bladder and vesicoprostatic muscle, neurovascular bundles, membranous part, seminal vesicle easily, which improves the operation accuracy. Results:All 34 cases underwent operation successfully without transferring to open surgery. The median operative time was 157.5 (95-276) min with an estimated blood loss of 50 (20-300) ml. The median drainage removal time was 2 d and median hospitalization time was 3.5 d, respectively. The catheters were removed within an average time of 20.5 d. For postoperative Gleason score, there were 2 cases in score ≤6 group, 16 cases in score =7 group, 8 cases in score ≥8 group and 8 cases can’t make a score. For clinical stage after the surgery, 10 cases were ≤T 2a stage, 1 case was T 2b stage, 23 cases were ≥cT 2c stage. 22 cases underwent pelvic lymph node dissection, including a patient with right iliac fossa lymph node metastasis. There were 2 cases with positive surgical margin and 3 cases with Clavien-DindoⅠcomplications. The rate of 1-month and 3-month urinary continence were 47.1% and79.4%, respectively, 8 cases recovered erectile function after 3 month. Conclusions:Holographic image technology can promote cancer dissection completely, achieve urinary continence early and reduce perioperative complications tremendously. The technology is the "intraoperative security" for the accurate surgical treatment of prostate cancer.

RNA viruses are critically dependent upon virally encoded proteases to cleave the viral polyproteins into functional proteins. Many of these proteases exhibit a similar fold and contain an essential catalytic cysteine, offering the opportunity to inhibit these enzymes with electrophilic small molecules. Here we describe the successful application of quantitative irreversible tethering (qIT) to identify acrylamide fragments that target the active site cysteine of the 3C protease (3C^pro) of Enterovirus 71, the causative agent of hand, foot and mouth disease in humans, altering the substrate binding region. Further, we re-purpose these hits towards the main protease (M^pro) of SARS-CoV-2 which shares the 3C-like fold and a similar active site. The hit fragments covalently link to the catalytic cysteine of M^pro to inhibit its activity. We demonstrate that targeting the active site cysteine of M^pro can have profound allosteric effects, distorting secondary structures to disrupt the active dimeric unit.