With the integration of 5G communication technology and robotic surgical systems, remote robot-assisted thoracic surgery is overcoming geographical barriers, offering an innovative approach to addressing the uneven distribution of medical resources. This study conducted a systematic literature review—using databases such as PubMed and CNKI, with the search period extending up to 2025—incorporating clinical studies, case reports, and review articles to comprehensively evaluate the clinical efficacy and safety of 5G-enabled remote robot-assisted thoracic surgery (5G-RRATS). The analysis also examined current technological limitations and potential future development trajectories. Existing evidence indicates that, given adequate technical support, 5G-RRATS can achieve perioperative outcomes comparable to those of conventional local robotic surgeries across procedures including pulmonary wedge resection, lobectomy, and esophagectomy. Furthermore, it demonstrates potential advantages in minimizing surgical incisions and reducing intraoperative blood loss. Nevertheless, challenges related to network stability, latency control, interdisciplinary collaboration between medical and engineering teams, and legal, regulatory, and ethical considerations continue to hinder widespread clinical adoption. Looking ahead, the emergence of a "one-to-many" remote surgical model, combined with the integration of artificial intelligence and augmented reality technologies, as well as advancements in low-orbit satellite communications, may enable 5G-RRATS to further advance precision and efficiency in thoracic surgery, thereby facilitating equitable access to high-quality care for a broader patient population.

Objective To optimize the extraction process of Xuetong capsules and establish its quality control method. Methods The extraction process was optimized by orthogonal experiment using ethanol reflux method to investigate the effects of different factors on diphenylstilbene, aloin and extraction yield. The content of 5 anthraquinone compounds in Xuetong capsule was determined by HPLC. Results The optimal extraction process was to add 10 times ethanol, with an ethanol concentration of 70%, and extract 3 times, each time for 1 h; 5 components had a good linear relationship with peak area within a certain concentration range, r>0.999 7; The range of sample recovery rate was 93.66%-96.85%, RSD range of 1.48%-1.66%. The content determination results of the 5 components in three batches of Xuetong capsules were （0.632-0.641）, （0.660-0.681）, （1.968-1.991）, （2.547-2.580）, and （1.076-1.101） mg/g. Conclusion The method was accurate, reproducible, and highly feasible, which could be references for producing and improving the quality control standards of Xuetong capsules.

OBJECTIVE To explore the potential mechanism of Yiqi Wenyang Recipe in the intervention of allergic rhinitis(AR)mice.METHODS C57/BL6 mice were randomly divided into blank,model,Yiqi Wenyang Recipe and Yiqi Wenyang Recipe+EX-527[Sirtuin 1(SIRT1)inhibitor]groups.The AR model of mice was established by ovalbumin based challenge sensitization method,each group received corresponding intervention measures.Assessment of behavioral changes in mice;nasal mucosal lesions were observed by HE and toluidine blue staining;the serum levels of interleukin-4(IL-4),interferon-γ(IFN-γ),and immunoglobulin E(IgE)were measured by ELISA;the expression levels of phospho-Janus kinase 2(p-JAK2),phospho-signal transducer and activator of transcription 6(p-STAT6),phospho-dynamin-related protein 1(p-Drp1),SIRT1,peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α)in nasal mucosa were determined by Western blot combined with immunofluorescence;reactive oxygen species(ROS)levels were detected by fluorescent probe method;the morphological changes of mitochondria in the microstructure of na-sal mucosa were observed by transmission electron microscopy.RESULTS Compared with the blank group,the frequency of scratch-ing and sneezing in the model group was significantly increased,and a large number of eosinophils and mast cells were found in the na-sal mucosa(P<0.05);compared with the model group,the nasal allergic symptoms and the level of nasal mucosal inflammatory reaction in the Yiqi Wenyang Recipe group were significantly improved(P<0.05);compared with the Yiqi Wenyang Recipe group,the scratch-ing and sneezing of mice in the Yiqi Wenyang Recipe+EX-527 group increased again,and the counts of eosinophils and mast cells in nasal mucosa increased significantly(P<0.05).Compared with the model group,the levels of serum IL-4 and IgE in the Yiqi Wenyang Recipe group decreased,while the level of serum IFN-γ increased(P<0.05);the serum IL-4 and IgE of mice in the Yiqi Wenyang Recipe+ex-527 group were significantly higher than those in the Yiqi Wenyang Recipe group(P<0.05).Western blot and immunofluo-rescence showed that Yiqi Wenyang Recipe could effectively inhibit the increase of p-JAK2,p-STAT6,p-Drp1(ser616)levels induced by ovalbumin sensitization,as well as the decrease of SIRT1 and PGC-1 α expression(P<0.01);however,the intervention of EX-527 significantly blunted the regulatory effect of Yiqi Wenyang Recipe on the above signaling molecules(P<0.05,P<0.01).The results of transmission electron microscopy and fluorescent probe showed that in the model group,a large number of spherical mitochondria were found in the mitochondria of nasal mucosa,and the level of ROS was significantly increased(P<0.01);;the intervention of Yiqi We-nyang recipe effectively restored the long tubular morphology of mitochondria and reduced ROS level(P<0.01);,while the intervention of EX-527 weakened the above improvement effect(P<0.01).CONCLUSION Yiqi Wenyang Recipe can regulate SIRT1 to activate PGC-1α,and then inhibit Drp1 mediated excessive mitochondrial fission to intervene AR;SIRT1 may be one of the important targets of Yiqi Wenyang Recipe in the intervention of AR.

OBJECTIVE To explore the potential mechanism of Yiqi Wenyang Recipe in the intervention of allergic rhinitis(AR)mice.METHODS C57/BL6 mice were randomly divided into blank,model,Yiqi Wenyang Recipe and Yiqi Wenyang Recipe+EX-527[Sirtuin 1(SIRT1)inhibitor]groups.The AR model of mice was established by ovalbumin based challenge sensitization method,each group received corresponding intervention measures.Assessment of behavioral changes in mice;nasal mucosal lesions were observed by HE and toluidine blue staining;the serum levels of interleukin-4(IL-4),interferon-γ(IFN-γ),and immunoglobulin E(IgE)were measured by ELISA;the expression levels of phospho-Janus kinase 2(p-JAK2),phospho-signal transducer and activator of transcription 6(p-STAT6),phospho-dynamin-related protein 1(p-Drp1),SIRT1,peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α)in nasal mucosa were determined by Western blot combined with immunofluorescence;reactive oxygen species(ROS)levels were detected by fluorescent probe method;the morphological changes of mitochondria in the microstructure of na-sal mucosa were observed by transmission electron microscopy.RESULTS Compared with the blank group,the frequency of scratch-ing and sneezing in the model group was significantly increased,and a large number of eosinophils and mast cells were found in the na-sal mucosa(P<0.05);compared with the model group,the nasal allergic symptoms and the level of nasal mucosal inflammatory reaction in the Yiqi Wenyang Recipe group were significantly improved(P<0.05);compared with the Yiqi Wenyang Recipe group,the scratch-ing and sneezing of mice in the Yiqi Wenyang Recipe+EX-527 group increased again,and the counts of eosinophils and mast cells in nasal mucosa increased significantly(P<0.05).Compared with the model group,the levels of serum IL-4 and IgE in the Yiqi Wenyang Recipe group decreased,while the level of serum IFN-γ increased(P<0.05);the serum IL-4 and IgE of mice in the Yiqi Wenyang Recipe+ex-527 group were significantly higher than those in the Yiqi Wenyang Recipe group(P<0.05).Western blot and immunofluo-rescence showed that Yiqi Wenyang Recipe could effectively inhibit the increase of p-JAK2,p-STAT6,p-Drp1(ser616)levels induced by ovalbumin sensitization,as well as the decrease of SIRT1 and PGC-1 α expression(P<0.01);however,the intervention of EX-527 significantly blunted the regulatory effect of Yiqi Wenyang Recipe on the above signaling molecules(P<0.05,P<0.01).The results of transmission electron microscopy and fluorescent probe showed that in the model group,a large number of spherical mitochondria were found in the mitochondria of nasal mucosa,and the level of ROS was significantly increased(P<0.01);;the intervention of Yiqi We-nyang recipe effectively restored the long tubular morphology of mitochondria and reduced ROS level(P<0.01);,while the intervention of EX-527 weakened the above improvement effect(P<0.01).CONCLUSION Yiqi Wenyang Recipe can regulate SIRT1 to activate PGC-1α,and then inhibit Drp1 mediated excessive mitochondrial fission to intervene AR;SIRT1 may be one of the important targets of Yiqi Wenyang Recipe in the intervention of AR.

Objective:To explore the clinical characteristics and experiences in diagnosis and treatment of severe hand injuries caused by chaff cutters.Methods:A retrospective analysis was conducted on 60 patients (193 digits) who had mangled hand injuries caused by chaff cutters and admitted to the Department of Upper Limb Repair and Reconstruction, Beijing Jishuitan Hospital Guizhou Hospital between January 2015 and June 2022. The patients were 39 males and 21 females, with 10 to 72 (mean 42.6) years old of age. The injuries involved 41 right hands and 19 left hands. The extent of hand injuries of soft tissue and bones varied from digit-tips to wrist. Among them, 5 digits were completely destroyed in 8 cases, 3 digits including thumb were destroyed in 12 cases, 4 digits including thumb were destroyed in 10 cases, 3 or more fingers without thumb were destroyed in 8 cases, simple hand destroyed in 8 cases, digits and palm destroyed in 8 cases, and total hand destroyed in 6 cases. The sizes of wound ranged from 1.8 cm×2.0 cm to 6.8 cm×15.6 cm. Based on the wound contamination and conditions of tissue damage, surgical treatment included debridement, stump trimming, in-situ replantation, transpositional replantation, venous bridging flap transfer and emergency or phased free second toe and free flap transfers. The flap sizes were 3.0 cm×5.0 cm-7.0 cm×16.0 cm. Both the reconstructed and flap donor sites were primarily closed in one stage. Postoperative follow-ups were conducted through regular visits of outpatient clinic or via WeChat interviews. The survival and functional recovery of flap and finger were observed.Results:Of the 60 patients, emergency orthotopic replantation of 112 digits were performed with survival of 96 digits; 16 digits transposition replantation were carried out with 12 survived; 5 digits received venous bridging flap transfer with 4 survived; all 5 Flow-through anteriolateral thigh perforator flaps (ALTPFs) were survived; all of 12 phase II digit reconstructions with free second toe transfer survived; and all 18 phase II free flap transfers survived [10 ALTPFs and 8 superficial circumflex iliac artery perforator flaps(SCIAPFs)]. Postoperative complications such as wound exudation and fever happened in 8 patients, and all were rectified after debridement and symptomatic anti-infection treatment. The follow-up ranged 6 to 18 months, with 12 months in average. Hand functions were assessed using the Michigan Hand Outcomes Questionnaire (MHQ), and the scores achieved at 20.3 to 72.8 points, with 42.6 points ± 16.6 points in average.Conclusion:Severe hand injuries caused by chaff cutters are severe and complicated. A thorough assessment of wound contamination and residual digits and tissues are required. Successful surgical outcomes can be achieved through emergency and elective surgery with multiple microsurgical techniques and multi-phased surgical reconstructions, although overall functional recovery of the injured hand is often not quite realistic.

Objective To establish the method of simultaneous determination of four main components of Danggui Liuhuang Decoction,including phellodendrine,palmatine,calycosin,and ferulic acid and provide reference for the quality control of Danggui Liuhuang Decoction.Methods Based on the HPLC-MS/MS analysis method,the positive ion data acquisition mode were adopted for the mass spectrometry detection and the four main components were quantified with multiple reaction monitoring mode(MRM)by ESI source.The chromatographic column was Agilent Extend-C18(5 μm,4.6 mm×250 mm),and gradient elution was performed with methanol and 0.5%formic acid in water.Results The linear range of phellodendrine was from 2-200 nmol/ml,and the linear range of palmatine,calycosin and ferulic acid was from 20-2 000 nmol/ml.The contents of the four components in the seven batches of Danggui Liuhuang Decoction were relatively stable,among which ferulic acid was mainly found in Phellodendrine and Coptidis;Phellodendrine was only detected in cortex phellodendri;the content of calycosin in Scutellaria baicalensis and Astragalus was higher;palmatine was detected in both Phellodendron and Astragalus.Conclusion The method had high sensitivity,good specificity and sample stability,which could meet the requirements of quantitative analysis of Traditional Chinese Medicine compounds,and could provide reference for further pharmacokinetics study on the content changes of traditional Chinese medicine compounds in biological samples.

As the backbone force of China's social and economic construction, the health status of workers is closely related to the nation's productivity and social development. Currently, cancers have become one of the major diseases threatening the health of workers. However, there are still many shortcomings in the cancer screening services for the workers. To standardize cancer screening services for workers, ensure the quality of screening services, and improve the overall screening effectiveness, 19 institutions, including Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, have jointly formulated the Group Standard "Specification for service of cancer screening for workers (T/CHAA 023-2023)". This standard follows the principles of "legality, scientific rigor, advancement, and feasibility" and combines the frontier scientific advances in cancer screening. It clarifies the relevant requirements for service principles, service design, service delivery, service management, service evaluation, and improving worker cancer screening. Implementing this group standard will help connect the common screening needs of workers, employers, and cancer screening service providers, standardize the screening process, improve screening quality, and ultimately increase the early diagnosis rate and survival rate of cancer patients. Consequently, this group standard will help safeguard workers' health rights and interests, ensure the labor force resources, promote the comprehensive coordinated and sustainable development of society, and contribute to realizing the "Healthy China 2030" strategic policy.

Objective : The purpose of this study was to investigate the effects of plasma exosome⁃derived miR⁃29b⁃3p in myocardial ischemia⁃reperfusion injury ( MIRI) rats on hypoxia/reoxygenation ( H/R) cardiomyocyte after sevoflurane (SEV) postconditioning through targeting IGF1 . Methods : The GEO database was used to screen differentially expressed miRNAs in MIRI , and cardiomyocytes were treated with H/R to construct a MIRI cell model. The expression of miR⁃29b⁃3p and IGF1 in the MIRI cell model post⁃treated with SEV was intervened , and then the survival rate of cardiomyocytes was detected by MTT , apoptosis was detected by flow cytometry , and inflammatory factors (IL⁃1β and TNF⁃α ) in cardiomyocytes in each group were detected by ELISA. Results : Compared with Normal group , the expression of miR⁃29b⁃3p in plasma exosomes of MIRI rats was enhanced (P < 0. 05) , and the target⁃binding relationship between miR⁃29b⁃3p and IGF1 was confirmed ( P < 0. 05) . After SEV post⁃treatment , the expression of miR⁃29b⁃3p in H/R⁃stimulated cardiomyocytes decreased , while the expression of IGF1 increased (both P < 0. 05) . Overexpression of miR⁃29b⁃3p in plasma exosomes could significantly inhibit the survival rate of H/R cells after SEV treatment , aggravate apoptosis and inflammatory response , while knockdown of miR⁃29b⁃3p showed a opposite effects (all P < 0. 05) . The rescue experimental data showed that overexpression of IGF1 could partially reverse the effects of overexpression of miR⁃29b⁃3p on H/R cell injury after SEV treatment ( all P <0. 05) . Conclusion Plasma exosome⁃derived miR⁃29b⁃3p promotes H/R cardiomyocyte injury after SEV treatment by targeting IGF1 .

OBJECTIVE：To preliminarily s tudy the potential mechanism of astragaloside Ⅳ on allergic rhinitis （AR）model mice. METHODS ：C57/BL6 mice were randomly divided into blank group ，model group and astragaloside Ⅳ group，with 10 mice in each group. Except for blank group ，AR model was prepared by sensitization and challenge with ovalbumin on day 0，7，14 and 21-27. Astragaloside Ⅳ group was given astragaloside Ⅳ 40 mg/kg intraperitoneally at the dose of 0.02 mL/g on the 15th to 27th day of modeling （given the drug 1 h before challenge sensitization on the 21st to 27th day ）. Blank group and model group were given constant volume of normal saline intraperitoneally ，once a day. Twenty-four hours after sensitization from the last challenge ， the infiltration of inflammatory cells in the nasal mucosa of each group was observed ，and the contents of interleukin 4（IL-4）， IL-5 and interferon gamma （IFN-γ）in the nasal lavage fluid were measured. The levels of reactive oxygen species （ROS），and the count of phosphorylated Janus kinase 2（p-JAK2）and phosphorylation signal transduction and activation of transcription protein 6 （p-STAT6）positive cells in the nasal mucosa and spleen as well as the phosphorylation levels of JAK 2 and STAT 6 proteins in spleen tissue （i.e. p-JAK 2/JAK2 ratio，p-STAT6/STAT6 ratio）were also determined. RESULTS ：Compared with blank group ，the number of inflammatory cells in the nasal mucosa （eosinophils and mast cells ）in the model group ，the contents of IL- 4 and IL- 5 in the nasal lavage fluid ，and the levels of ROS in the nasal mucosa and spleen tissues in the model group ，the count of p-JAK 2 and p-STAT 6 positive cells increased significantly ，the p-JAK2/JAK2 ratio，p-STAT6/STAT6 ratio in the spleen tissue were significantly increased （P＜0.05），and the content of INF-γ in the nasal lavage fluid was significantly decreased（P＜0.05）. Compared with model group ，the count of inflammatory cells infiltrated in the nasal mucosa ，the contents of IL- 4 and IL- 5 in the nasal cavity lavage fluid ，the level of ROS and the number of p-JAK 2 and p-STAT 6 positive cellsin the nasal mucosa and spleen tissue as well as the p-JAK2/JAK2 ratio and p-STAT 6/STAT6 ratio in spleen tissue were decreased significantly （P＜0.05），and the content of INF-γ in nasal lavage fluid was significantly increased（P＜0.05）. CO NCLUSIONS：Astragaloside Ⅳ can effectively improve the inflammatory response in AR model mice ，the mechanism of which may be related to down-regulation of JAK2/STAT6 signaling pathway and ROS level.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.