Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

OBJECTIVE To optimize the molding process of Xiebai Granules(XG)using the Box-Behnken design-response surface method combined with the BP neural network method,and to evaluate the consistency of particle quality between different bat-ches by establishing physical fingerprint.METHODS Dry paste powder was used as the main drug,dry granulation was adopted,and the forming rate,dissolution rate,moisture absorption rate and angle of repose of the granules were used as evaluation indexes,the ex-cipients dextrin,maltodextrin and lactose of the particles,were screened by single factor test combined with simplex-lattice design and entropy weight method,and the optimal excipient ratio was selected.The entropy weight method combined with the Box-Behnken de-sign-response surface method and the BP neural network algorithm were used to optimize the process parameters,and the process veri-fication was carried out.The physical fingerprint was used to comprehensively characterize the bulk density(Da),hygroscopicity(H),moisture(HR),tap density(Dc),angle of repose(α),Hausner ratio(IH),relative uniformity index(Iθ),Carr index(IC),and in-terparticle pore number(Ie),and the consistency of particle quality in different batches was evaluated.RESULTS The optimal ratio of excipients was dextrin 15%,maltodextrin 48%,and lactose 37%.The optimal process parameters were conveying speed 95 r·min-1,pressure wheel speed 4 r·min-1 and hydraulic pressure 7 MPa.The similarity of the physical fingerprints of the five bat-ches of XG was greater than 0.98.CONCLUSION The optimized molding process of XG is stable and feasible,and the quality of different batches of XG is stable,which can provide a reference for the development and industrial scale-up production of XG.

OBJECTIVE To optimize the molding process of Xiebai Granules(XG)using the Box-Behnken design-response surface method combined with the BP neural network method,and to evaluate the consistency of particle quality between different bat-ches by establishing physical fingerprint.METHODS Dry paste powder was used as the main drug,dry granulation was adopted,and the forming rate,dissolution rate,moisture absorption rate and angle of repose of the granules were used as evaluation indexes,the ex-cipients dextrin,maltodextrin and lactose of the particles,were screened by single factor test combined with simplex-lattice design and entropy weight method,and the optimal excipient ratio was selected.The entropy weight method combined with the Box-Behnken de-sign-response surface method and the BP neural network algorithm were used to optimize the process parameters,and the process veri-fication was carried out.The physical fingerprint was used to comprehensively characterize the bulk density(Da),hygroscopicity(H),moisture(HR),tap density(Dc),angle of repose(α),Hausner ratio(IH),relative uniformity index(Iθ),Carr index(IC),and in-terparticle pore number(Ie),and the consistency of particle quality in different batches was evaluated.RESULTS The optimal ratio of excipients was dextrin 15%,maltodextrin 48%,and lactose 37%.The optimal process parameters were conveying speed 95 r·min-1,pressure wheel speed 4 r·min-1 and hydraulic pressure 7 MPa.The similarity of the physical fingerprints of the five bat-ches of XG was greater than 0.98.CONCLUSION The optimized molding process of XG is stable and feasible,and the quality of different batches of XG is stable,which can provide a reference for the development and industrial scale-up production of XG.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective:To compare the effects of high-power and conventional power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation, postoperative troponin levels, and atrial fibrillation recurrence.Methods:A retrospective selection was conducted on 105 patients with paroxysmal atrial fibrillation admitted to the Baoding NO.1 Central Hospital from January 2017 to December 2020. According to different treatment methods, they were divided into a high-power ablation group of 52 cases and a conventional power ablation group of 53 cases. The intraoperative rate of single circle acute pulmonary vein isolation, the recovery of electrical conduction after acute pulmonary vein isolation, and the location and number of points that need to be added were compared between the two groups; At the same time, two groups were compared in terms of surgical time, ablation time, surgical radiation exposure time and radiation dose, intraoperative complications postoperative cardiac troponin levels at 12 hours, and recurrence of atrial fibrillation within 1 year after ablation.Results:The intraoperative single loop pulmonary vein isolation rate and postoperative troponin levels in the high-power atrial fibrillation ablation group were higher than those in the conventional atrial fibrillation ablation group (all P<0.05). The surgical time, ablation time, and the number of sites and points that need to be added during surgery were less than those in the conventional atrial fibrillation ablation group (all P<0.05). There was no statistically significant difference in the incidence of intraoperative complications and postoperative atrial fibrillation recurrence between the two groups (all P>0.05). Conclusions:High power atrial fibrillation ablation has a higher single loop acute pulmonary vein isolation rate, fewer patch sites and points, shorter surgical time, and greater ablation damage compared to conventional ablation, and the clinical efficacy of the two groups is similar after surgery.

Objective The study analyzed and identified the components in Shangketianshao Gel by LC-Q-TOF/MS.Methods The analysis was performed on Agilent Eclipse Plus C18(250 mm×4.6 mm,5 μm)column was applied with methanol and 0.1%formic acid as mobile phase for gradient elution,flow rate was 1 mL·min-1 and column temperature was 30℃.The analytes were determined by positive and negative ion modes with electro-spray ionization source,combined message of standard reference and the literature.Results 103 constituents were identified,all compounds were classified to their medicinal materials derivation.22 compounds from Paeoniae Radix Rubra,33 compounds from Rhei Radix et Rhizoma,20 compounds from Angelicae Dahuricae,23 compounds from Cortex Phellodendr and 14 compounds from Trichosanthes kirilowii Maxim.9 components were jointly owned.Conclusion The study provided a suitable way for Chemical fundamentals and quality control of Shangketianshao Gel and laid a foundation for in depth studies of its pharmacodynamics and the quality control.

Objectives:To compare the efficacy of transcatheter aortic valve replacement(TAVR)combined with percutaneous coronary intervention(PCI)versus surgical aortic valve replacement(SAVR)combined with coronary artery bypass grafting(CABG)in patients with intermediate or high risk severe aortic stenosis(AS)and coronary artery disease(CAD). Methods:Embase,Medline,the Cochrane Library,PubMed,VIP,Wanfang Database,CNKI were searched for studies comparing the efficacy of TAVR combined with PCI and SAVR combined with CABG in patients with intermediate or high risk severe aortic stenosis complicated with CAD,from the establishment of the database to July 4,2023. Results:Six studies were included,including one randomized controlled study and five observational cohort studies.A total of 2 137 patients were enrolled,including 833 in the TAVR+PCI group and 1 304 in the SAVR+CABG group.The results of the meta-analysis showed that compared with SAVR+CABG,TAVR+PCI did not significantly increase the risk of myocardial infarction(OR=0.65,95%CI:0.28-1.46,P=0.29),stroke(OR=0.81,95%CI:0.45-1.48,P=0.50)within 30 days and the risk of acute kidney injury(OR=0.38,95%CI:0.14-1.02,P=0.05),major bleeding(OR=0.66,95%CI:0.22-2.00,P=0.47)during follow-up,and significantly reduced all-cause mortality within 30 days(OR=0.66,95%CI:0.44-0.99,P=0.04),but significantly increased all-cause mortality(OR=1.47,95%CI:1.12-1.93,P=0.005)and vascular complications(OR=11.48,95%CI:2.69-48.94,P=0.001),pacemaker implantation(OR=3.09,95%CI:1.68-5.68,P<0.001)during long-term(≥2 years)follow-up. Conclusions:In patients with intermediate or high risk severe AS and CAD,compared with SAVR+CABG,TAVR+PCI significantly reduced the risk of all-cause mortality within 30 days,but significantly increased the risk of all-cause mortality,vascular complications,and pacemaker implantation during long-term follow-up.

Objective:To explore the risk factors and time distribution of renal relapse in patients with lupus nephritis (LN).Methods:Clinical, pathological characteristics and long-term outcomes of LN patients who were diagnosed and followed in Jinling Hospital from January 2004 to December 2008 were retrospectively analyzed. The patients were divided into relapse group and non-relapse group. The differences of clinical pathological characteristics between the two groups were compared. The multivariate Cox proportion risk model was used to analyze the risk factors affecting renal relapse in LN. The risk factors and time distribution of renal relapse were analyzed with annual relapse risk-time curve.Results:A total of 814 patients with LN were included in the study, with 419 cases (51.5%) of complete remission and 395 cases (48.5%) of partial remission. The age was (30.24±10.90) years old, and there were 112 males (13.8%). There were 367 patients suffering renal relapse. The time of first renal relapse was (3.21±2.70) years. The results of multivariate Cox regression showed that age ( HR=0.976, 95% CI 0.966-0.986, P<0.001), renal pathological activity index (AI) score ( HR=1.039, 95% CI 1.013-1.065, P=0.003), remission status after induction treatment ( HR=0.671, 95% CI 0.504-0.894, P=0.006), 24 h urinary protein quantitation ( HR=1.297, 95% CI 1.115-1.508, P=0.001), anti-double strand DNA antibody (A-dsDNA, HR=1.450, 95% CI 1.139-1.846, P=0.003) and complement C3 ( HR=0.223, 95% CI 0.128-0.389, P<0.001) were correlated with increasing risk of renal relapse in LN. The annual relapse risk profile was unimodal, with a peak period of the second year after maintenance treatment. Similar patterns of relapse were presented in subgroup analysis. Conclusions:Age, renal pathological AI score, remission status after induction therapy, 24 h urine protein, A-dsDNA and blood complement C3 are the influencing factors for relapse of LN patients. The peak period of renal relapse in patients with LN is in the second year of maintenance therapy.

Objective To establish a mouse model of acute liver failure induced by lipopolysaccharide /D-galac-tosamine ( LPS/D-GalN) .Methods The optimum dose of LPS/D-GalN was determined by i .p.injection of eight differ-ent doses of LPS and D-GalN into 40 female C57BL/6 mice and observation of their survival time .Then, 32 female C57BL/6 mice were i.p.injected with the optimal dose of LPS/D-GalN and sacrificed at 0, 1, 4, 8 hours after the injec-tion, 8 mice in each group.The control mice received saline injection .Hepatic changes were observed by pathology and se-rum ALT, IL-6, MCP-1 and TNF-αwere measured by biochemistry or flow cytometry .Results LPS (2.5 mg/kg) and D-GalN (0.3 g/kg) were determined as the optimal dose for the establishment of mouse model of acute liver injury .Com-pared with the control group , the hepatocellular damages were progressing in a positive correlation with the time course after LPS/D-GalN administration .The level of serum ALT was significantly increased after LPS/D-GalN administration ( P <0.001).The levels of inflammatory cytokines IL-6, MCP-1 and TNF-αwere increased and reached a peak at one hour after LPS/D-GalN administration and then decreased almost to that of the control group 8 hours later(P<0.001).Conclusions The mouse model of acute liver injury is successfully established by LPS /D-GalN administration , and provide an effective animal model for the study of pathogenic mechanisms of acute liver failure and evaluation of therapeutic drugs .

Objective To analyze and compare the pathological changes of lung tissue in mice infected with the novel H7N9 influenza virus and 2009 pandemic H1N1 influenza virus, respectively, and to preliminarily study the mecha-nisms of acute lung injury induced by those virus infection .Methods SPF 6-week old BALB/c mice ( body weight 18-20 g, male∶female=1∶1) (n=3 in each subgroup) were intranasally infected with H7N9 virus and H1N1 virus, respec-tively.The behavior and survival time of mice after virus infection were observed and the survival rates were analyzed .The heart, liver, spleen, lung, kidney, intestines, and brain were collected at indicated time points for histopathological exami-nation using H&E staining .The distribution of virus antigen was detected by immunohistochemistry .The neutrophil infiltra-tion was also observed .The correlation of lung injury with virus replication and host immune responses was analyzed .Re-sults The lung and spleen injury of mice infected with H 7N9 virus was slighter and their survival rate (100%) was high-er than those of mice infected with H1N1 virus.The damages of the lung and spleen in H1N1virus-infected mice were more severe than that in H7N9 virus-infected mice, and all the 10 mice in this group died within 9 days after virus inoculation . The distributions of both the virus antigens were mainly in the bronchial epithelial cells , a few stromal cells and alveolar ep-ithelial cells .The levels of virus replication in the two groups were not significantly different .There were more intense neu-trophil infiltration in the lung and inflammatory response in the H 1N1 virus-infected mice than those in the H7N9 virus-in-fected mice .Conclusions There are some differences of the pathological characteristics and extent of lung injury in the mice infected with H7N9 virus and H1N1 virus, respectively.The virus replication is a precipitating factor but not the deci-sive factor of the lung injury , and there is a close relationship between the host immune responses and acute lung injury .