Objective:This study aimed to compare the clinical efficacy of da Vinci robot-assisted subtotal colectomy with laparoscopic surgery in the treatment of slow transit constipation.Methods:A retrospective cohort study was performed. The clinical and follow-up data of 95 patients with slow transit constipation who underwent robotic or laparoscopic subtotal colectomy at the First Affiliated Hospital of Harbin Medical University from July, 2022 to August, 2024 and had a follow-up period of 6 months were retrospectively analyzed. Patients were divided into a robotic surgery group (43 cases) and a laparoscopic surgery group (52 cases) according to surgical approaches. All patients underwent preoperative colonic transit study, barium enema radiography, defecography, and colonoscopy to confirm the diagnosis of slow transit constipation. There were no statistically significant differences in baseline data between the two groups (all P>0.05). Primary observation indicators included Wexner constipation score, gastrointestinal quality of life score, and the time of first ambulation after surgery. Secondary observation indicators included operation time, intraoperative blood loss, first defecation time, length of hospital stay, postoperative defecation frequency, postoperative complications, surgical satisfaction, and postoperative pain. The Wexner constipation score was evaluated at 6 months after surgery as well, and a total score of 15 or above was defined as constipation; the higher the score, the more severe the constipation. The gastrointestinal quality of life index was also evaluated at 6 months after surgery; the lower the score, the poorer the quality of life. Pain assessment was conducted on the 2nd day after surgery using the visual analogue scale (VAS) for self-assessment, and here a higher score indicated greater pain intensity. Observe the patients' intraoperative and pastoperative conditions. Results:Both groups completed the surgery unevenifullg without conversion to laparotomy, and no severe intraoperative complications occurred. Compared to the laparoscopic surgery group, the robotic surgery group had significantly shorter first ambulation time ([18.5±1.3] hours vs. [24.5±0.6] hours, t=-30.437, P<0.001), first defecation time ([21.2±2.2] hours vs. [24.9±0.9] hours, t=-10.818, P<0.001), and hospital stay ([7.8±1.5] days vs. [9.4±3.3] days, t=-3.069, P=0.003), all P<0.05. There were no statistically significant differences between the two groups in terms of operation time, intraoperative blood loss, postoperative pain score, defecation frequency, or incidence of postoperative complications (all P>0.05). Follow-up at 6 months post-operation also showed no statistically significant differences between the two groups in terms of Wexner score, gastrointestinal quality of life score, daily defecation frequency, or surgical satisfaction (all P>0.05). When comparing the follow-up scores between postoperative and preoperative periods in each group, both Wexner scores (laparoscopic group: [2.2±1.2] vs. [17.7±0.9], t=83.580, P<0.001; robotic group: [2.6±1.2] vs. [17.5±0.8], t=69.274, P<0.001) and gastrointestinal quality of life scores (laparoscopic group: [108.6±4.4] vs. [76.0±4.6], t=-41.442, P<0.001; robotic group: [109.3±6.1] vs. [77.8±6.4], t=-29.939, P<0.001) were significantly improved. No additional complications or recurrence were observed in both groups at 6 months post-operation. Conclusion:Compared to laparoscopic subtotal colectomy, da Vinci robot-assisted subtotal colectomy for slow transit constipation is associated with faster postoperative recovery and shorter hospital stays, and the operative times and therapeutic efficacy are similar between the two approaches.

Objective:This study aimed to compare the clinical efficacy of da Vinci robot-assisted subtotal colectomy with laparoscopic surgery in the treatment of slow transit constipation.Methods:A retrospective cohort study was performed. The clinical and follow-up data of 95 patients with slow transit constipation who underwent robotic or laparoscopic subtotal colectomy at the First Affiliated Hospital of Harbin Medical University from July, 2022 to August, 2024 and had a follow-up period of 6 months were retrospectively analyzed. Patients were divided into a robotic surgery group (43 cases) and a laparoscopic surgery group (52 cases) according to surgical approaches. All patients underwent preoperative colonic transit study, barium enema radiography, defecography, and colonoscopy to confirm the diagnosis of slow transit constipation. There were no statistically significant differences in baseline data between the two groups (all P>0.05). Primary observation indicators included Wexner constipation score, gastrointestinal quality of life score, and the time of first ambulation after surgery. Secondary observation indicators included operation time, intraoperative blood loss, first defecation time, length of hospital stay, postoperative defecation frequency, postoperative complications, surgical satisfaction, and postoperative pain. The Wexner constipation score was evaluated at 6 months after surgery as well, and a total score of 15 or above was defined as constipation; the higher the score, the more severe the constipation. The gastrointestinal quality of life index was also evaluated at 6 months after surgery; the lower the score, the poorer the quality of life. Pain assessment was conducted on the 2nd day after surgery using the visual analogue scale (VAS) for self-assessment, and here a higher score indicated greater pain intensity. Observe the patients' intraoperative and pastoperative conditions. Results:Both groups completed the surgery unevenifullg without conversion to laparotomy, and no severe intraoperative complications occurred. Compared to the laparoscopic surgery group, the robotic surgery group had significantly shorter first ambulation time ([18.5±1.3] hours vs. [24.5±0.6] hours, t=-30.437, P<0.001), first defecation time ([21.2±2.2] hours vs. [24.9±0.9] hours, t=-10.818, P<0.001), and hospital stay ([7.8±1.5] days vs. [9.4±3.3] days, t=-3.069, P=0.003), all P<0.05. There were no statistically significant differences between the two groups in terms of operation time, intraoperative blood loss, postoperative pain score, defecation frequency, or incidence of postoperative complications (all P>0.05). Follow-up at 6 months post-operation also showed no statistically significant differences between the two groups in terms of Wexner score, gastrointestinal quality of life score, daily defecation frequency, or surgical satisfaction (all P>0.05). When comparing the follow-up scores between postoperative and preoperative periods in each group, both Wexner scores (laparoscopic group: [2.2±1.2] vs. [17.7±0.9], t=83.580, P<0.001; robotic group: [2.6±1.2] vs. [17.5±0.8], t=69.274, P<0.001) and gastrointestinal quality of life scores (laparoscopic group: [108.6±4.4] vs. [76.0±4.6], t=-41.442, P<0.001; robotic group: [109.3±6.1] vs. [77.8±6.4], t=-29.939, P<0.001) were significantly improved. No additional complications or recurrence were observed in both groups at 6 months post-operation. Conclusion:Compared to laparoscopic subtotal colectomy, da Vinci robot-assisted subtotal colectomy for slow transit constipation is associated with faster postoperative recovery and shorter hospital stays, and the operative times and therapeutic efficacy are similar between the two approaches.

With the increasing maturity of laparoscopic surgery, laparoscopic radical resec-tion of colorectal cancer has been widely used in colorectal surgery. Accurate localization of colorectal tumors and surgical margins in the absence of tactile sensation during surgery, ensuring sufficient blood flow perfusion at the anastomotic site and effectively reducing the incidence of anastomotic leakage have become barriers to the development of laparoscopic radical resection of colorectal cancer. The application of indocyanine green fluorescence imaging (ICG-FI) technology is expected to provide feasible solutions to the above-mentioned problems. Through this technology, accurate localization of colorectal tumors, evaluation of blood supply to the anastomotic site, lymphatic system imaging, detection of colorectal liver metastases, and protection of pelvic autonomous nerves and ureters can be achieved during laparoscopic surgery, thereby further improving the surgical quality of laparoscopic radical resection of colorectal cancer. However, the clinical application of ICG-FI technology in colorectal surgery is relatively short, which is still in the stage of exploration and experience accumulation, and there are few guideline or consensus available for reference. Therefore, the authors aim to provide a reference for the clinical application of this technology by reviewing and summarizing relevant literature based on different application types of ICG in colo-rectal cancer surgery.

Slow transit constipation (STC) is generally considered as a complex idiopathic disease affected by multiple factors synergistically. Primarily caused by the condition of gut dysmotility, the transit of intestinal contents turned so slow that the moisture absorption increases, defecation frequency decreases, bowel movement is weakened or even disappeared with or without abdominal distension, dry and hard stool. Its etiology and pathogenesis remains unclear.Recently some researches reported the pathogenesis may be associated with the changes of the enteric nervous system (ENS), such as the change or degeneration of intestinal nerve cells, gut glial cell damage and neurotransmitter changes. Besides, intestinal myopathy, ICC reduction, immune factors, endocrine factors, laxative, mental psychological factors, diet and exercise habits may also be associated with the occurrence and aggravation of STC. The current understanding of STC mechanism can not meet the needs of clinical diagnosis and treatment. Conservative treatment is the main treatment of STC nowadays. For those receiving normative medical treatment but with little effect, surgery is necessary. "Jingling procedure" and "antiperistaltic anastomosis" can both get good efficacy. Treatment aiming at causes of disease will be uncovered as the development of the researches on the pathogenesis and treatment of slow transit constipation.

Objective To study the morphological character of blood-spleen barrier in patients with hypersplenism,and to discuss the relevance and pathogenesis of hypersplenism.Methods The spleens of 33 patients with cirrhosis with portal hypertension were collected as the experimental group,and 20 patients with traumatic spleen as the matched group.Five pieces of tissues in each spleen were sampled.The samples were made into pathological sections,stained with H.E.and examined microscopically for the total number of germinal centers (GC).The data of patients before operation were collected which included:blood routine (count of RBC,WBC,PLT and HB) and splenic weight.The correlation of blood routine values and sum of GC was studied using relative linear analysis.Results In the experimental group:The blood routine values were remarkably lower,splenic weight (average 764.2 g) and the quantity of the germinal center (average 8817/case) were higher.There was a reverse relationship between the total quantity of germinal centers and the PLT.There was a close relationship between the quantity of germinal center and the extent of the hypersplenism,i.e.the lower the preoperative platelet number,the greater the total number of germinal center; the heavier the splenic weight,the greater the number of germinal center.Conclusions The total number of germinal center increased dramatically in patients with cirrhosis with portal hypertension.The change is accompanied by changes in morphology of the germinal centers and dysfunction in blood-spleen barrier.It is likely that hypersplenism develops on the basis of dysfunction of blood-spleen barrier.

Objective　To observe the effect of various concentration of arsenic trioxide (AT) on hepatoma cell line HLE in variable duration. Methods　The cell activity, morphologic changes and apoptosis were studied after being treated with different concentration of AT. Results　The effect of AT on hepatoma cell lines was depending on the time and concentration obviously. Hepatoma cells cultured with different concentration of AT presented apoptosis features, such as intact cell membrane, chromatin condesation, nucleic fragmentation and apoptotic body formation; flow cytometry analysis showed that an arrestment at G2/M phase, an apoptosis peak presented before sub-G1 cell peak, and a mark DNA ladder of apoptosis appeared. Conclusions　AT can obviously inhibit the growth of hepatoma cell through inducing hepatoma cell apoptosis.

Objective To study the clinical significance of glutathione s-transferases expression ingastric carcinoma tissues. Methods The expression of 98 gastric carcinoma was studied by means ofimmunohistochemical technique. Results The glutathione S-transferases were between 25. 0% and 88. 9%in 98 cases of gastric carcinoma. The GST-? was significantly higher in the cases of poorly differentiatedthan those of well differentiated. But it was not correlated with patient age, sex, tumor size, tumor'slocation,and lymph node metastases. Conclusion The determination of GST-? may be useful for diagnosis,prognosis and treatment of gastric carcinoma.

Objective To study the liver cancer specific DNA damage response/repair/recombination gene expression profile and the difference between liver cancer tissues and their adjacent normal tissues. Methods The cDNA probes labeled with ? 32 P dATP were synthesized from total RNA of cancer tissue and adjacent liver tissues. The cDNA probes were differentially hybridized to two identical Atlas human cancer cDNA expression array membranes containing 588 known genes. A gene specific semiquantitative reverse transcription polymerase chain reaction (RT PCR) method and Northern blot were used to check the expression pattern of two known genes. Results Autoradiographic result analyzed by specific Atlas Image TM (version1.01a) showed among the 588 genes analyzed, 33 genes were related to damage response/repair/recombination and the expression of 4 genes including DNA dependent protein kinase, and DNA topoisomerase Ⅰ were found to be up regulated in liver cancer. The results of RT PCR and Northern blot confirmed the expression pattern of two genes which were detected by Atlas human cancer cDNA expression array. Conclusion The result obtained from Atlas microarray provides a liver cancer specific expression profile comprehensively and systematically. The findings about genes related to DNA damage response/repair/recombination may lead to understanding of the pathogenesis of liver cancer and the mechanism of drug resistant.

Object To study the chemical constituents of cytotoxicity portion in the bark of Reevesia longipetiolata Merr et Chun Methods The constituents were isolated and purified by various chromatographic methods, such as gel column chromatography under normal pressure and increased pressure, Sephadex LH 20 column chromatography and HPLC, and the structures were identified by physicochemical properties and spectral analysis Results Five compounds were obtained in the ethyl acetate fractions and identified as ? sitosterol (Ⅰ), daucosterol (Ⅱ), betulinic acid (Ⅲ), lupeol (Ⅳ) and (+) catechin (Ⅴ) Conclusion All above compounds are obtained from the plants of Reevesia Lindl for the first time, and their cytotoxicity is discussed