Objective:To compare the patient-reported outcomes and short-term clinical outcomes between robotic-assisted and laparoscopic-assisted radical gastrectomy for locally advanced gastric cancer.Methods:This single-center prospective randomized controlled trial was conducted in the Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University from October 2020 to August 2022. Patients with locally advanced gastric cancer who were to undergo radical gastrectomy were selected and randomly divided into two groups according to 1∶1, and received robotic surgery and laparoscopic surgery, respectively. Patient-reported outcomes and short-term clinical outcomes (including postoperative complications, surgical quality and postoperative short-term recovery) were compared between the two groups by independent sample t test, Mann-Whitney U test, repeated ANOVA, generalized estimating equation, χ2 test and Fisher′s exact test. Results:A total of 237 patients were enrolled for modified intention-to-treat analysis (120 patients in the robotic group, 117 patients in the laparoscopic group). There were 180 males and 59 females, aged (63.0±10.2) years (range: 30 to 85 years). The incidence of postoperative complications was similar between the robotic group and laparoscopic group (16.7% (20/120) vs. 15.4% (18/117), χ2=0.072, P=0.788). The robotic group had higher patient-reported outcomes scores in general health status, emotional, and social domains compared to the laparoscopic group, differences in time effect, intervention effect, and interaction effect were statistically significant (general health status: χ2 value were 275.68, 3.91, 6.38, P value were <0.01, 0.048, 0.041; emotional: χ2 value were 77.79, 6.04, 6.15, P value were <0.01, 0.014, 0.046; social: χ2 value were 148.00, 7.57, 5.98, P value were <0.01, 0.006, 0.048). However, the financial burden of the robotic group was higher, the differences in time effect, intervention effect and interaction effect were statistically significant ( χ2 value were 156.24, 4.08, 36.56, P value were <0.01, 0.043,<0.01). Conclusion:Compared to the laparoscopic group, the robotic group could more effectively relieve postoperative negative emotions and improve recovery of social function in patients.

Objective:To compare the patient-reported outcomes and short-term clinical outcomes between robotic-assisted and laparoscopic-assisted radical gastrectomy for locally advanced gastric cancer.Methods:This single-center prospective randomized controlled trial was conducted in the Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University from October 2020 to August 2022. Patients with locally advanced gastric cancer who were to undergo radical gastrectomy were selected and randomly divided into two groups according to 1∶1, and received robotic surgery and laparoscopic surgery, respectively. Patient-reported outcomes and short-term clinical outcomes (including postoperative complications, surgical quality and postoperative short-term recovery) were compared between the two groups by independent sample t test, Mann-Whitney U test, repeated ANOVA, generalized estimating equation, χ2 test and Fisher′s exact test. Results:A total of 237 patients were enrolled for modified intention-to-treat analysis (120 patients in the robotic group, 117 patients in the laparoscopic group). There were 180 males and 59 females, aged (63.0±10.2) years (range: 30 to 85 years). The incidence of postoperative complications was similar between the robotic group and laparoscopic group (16.7% (20/120) vs. 15.4% (18/117), χ2=0.072, P=0.788). The robotic group had higher patient-reported outcomes scores in general health status, emotional, and social domains compared to the laparoscopic group, differences in time effect, intervention effect, and interaction effect were statistically significant (general health status: χ2 value were 275.68, 3.91, 6.38, P value were <0.01, 0.048, 0.041; emotional: χ2 value were 77.79, 6.04, 6.15, P value were <0.01, 0.014, 0.046; social: χ2 value were 148.00, 7.57, 5.98, P value were <0.01, 0.006, 0.048). However, the financial burden of the robotic group was higher, the differences in time effect, intervention effect and interaction effect were statistically significant ( χ2 value were 156.24, 4.08, 36.56, P value were <0.01, 0.043,<0.01). Conclusion:Compared to the laparoscopic group, the robotic group could more effectively relieve postoperative negative emotions and improve recovery of social function in patients.

Objective To analyze the training effect of cerebral angiography based on E-Lab surgical teaching system in neurointerventional doctors.Methods A total of 45 doctors who studied at the Neurovascular Center of The First Affiliated Hospital of Naval Medical University from September 2022 to March 2023 were selected.Fourteen doctors who met the inclusion criteria were divided into experimental group and control group,with 7 in each group.The experimental group received training through theoretical teaching and recorded cases based on E-Lab system.The control group received training through traditional theoretical teaching and clinical teaching modes.The learning outcomes of theoretical knowledge and operational skills were compared between the two groups.Results There were no significant differences in the age,professional title,the number of angiography,disease category,aortic arch anatomical type,or the number of radial artery approaches between the two groups(all P＞0.05).There were significant differences in the skill assessment scores and total scores in the final assessment between the two groups(both P＜0.05).There was no significant difference in the theoretical assessment scores between the two groups(P＞0.05).In the skill assessment,there were significant differences in wire control,catheter control,vascular superselection.operation time and proficiency level between the two groups(all P＜0.05).Conclusion E-Lab system has great efficacy and advantages in cultivating operational skills of cerebral angiography in trainees,which provides new ideas for talent cultivation for neural intervention.

AIM:To investigate whether Mycoplasma pneumoniae ( Mp)-induced interleukin-1β( IL-1β) pro-duction in RAW264.7 cells is through the activation of NLRP3 inflammasome via reactive oxygen species (ROS).ME-THODS:RAW264.7 cells were randomly divided into 3 groups.In normal group , RAW264.7 cells were treated without Mp.In model group, RAW264.7 cells were treated with 1∶10 multiplicity of infection ( MOI) of Mp.In NAC group, RAW264.7 cells were pretreated with N-acetylcysteine ( NAC) at a concentration of 5 mmol/L for 30 min before infection with Mp.The RAW264.7cells were infected with Mp (1∶10 MOI) for 4, 8, 16 and 24 h in model group and NAC group , respectively.The intracellular ROS level was analyzed by flow cytometry .The mRNA expressions of NLRP3, ASC and caspase-1 were detected by real-time PCR.The protein levels of NLRP3, ASC and caspase-1 p20 were determined by Western blot.The levels of pro-inflammatory cytokine IL-1βin the supernatant were measured by ELISA .RESULTS:Compared with normal group , the production of ROS were significantly increased at 4, 8, 16 and 24 h after infection, the mRNA expression of NLRP3, ASC and caspase-1 were increased at 8, 16 and 24 h after infection, the protein levels of NL-RP3, ASC and caspase-1 p20 were increased at 16 and 24 h after infection, and the releases of IL-1βwere increased at 24 h after infection in model group (P<0.01).Compared with the model group, the level of ROS in NAC group decreased, so as the expression of NLRP3, ASC and caspase-1 at mRNA and protein levels and the releases of IL-1βin the superna-tant at the corresponding time points .CONCLUSION:Mp may stimulate the ROS production to activate NLRP 3 inflam-masome in RAW264.7 cells.

Objective To compare the effect and toxicity of domestic idarubicin (IDA) and imported daunorubicin (DNR) in the treatment of acute leukemia (AL).Methods According to the random number table method,68 patients were randomly divided in IDA group with 35 patients and DNR group with 33 patients.In IDA group,the patients with acute myelocytic leukemia were treated following IA scheme (domestic idataubicin plus cytosine arabinoside) and the patients with acute lymphoblastic leukemia were treated following VICLP scheme (vincristine,domestic idataubicin,cyclophosphamide,lasparaginase and prednisone).In DNR group,the patients with acute myelocytic leukemia were treated following DA scheme (imported daunorubicin plus cytosine arabinoside) and the patients with acute lymphoblastic leukemia were treated following VDCLP scheme (vincristine,imported daunorubicin,cyclophosphamide,lasparaginase and prednisone).Results In IDA group,21 patients achieved a complete remission(CR),5 patients achieved a partial remission(PR),with a 74.2 ％ (26/35) remission rate (RR).In DNR group,the remission rate was 62.3 ％ (20/33).No differences of the remission rate was found between the two groups (t =0.89,P =0.50).17 patients were found remission over one year in IDA group,and 6 patients were in DNR group.The difference was statistically significant between the two groups (x2 =5.56,P =0.02).Conclusion IDA is more effective than DNR in AL treatment.The higher RR and longer remission time are found in IDA group than DNR group.IDA is effective and safe in the treatment of AL.

Objective To observe the role of the P-glycoprotein (P-GP)in the pathogenesis of colitis in FVB and multiple drug resistance (mdr) gene, mdr1a, knockout (mdr1a~(-/-)) mice. Methods The clinical, pathological and immunohistochemical characteristics were observed in FVB control mice and mdr1a~(-/-) mice with or without inflammation of intestinal tract. The functions of T cell and B cell in these mice were analyzed. Results Approximately 26 of the 124 mdr1a~(-/-) mice were found to have symptoms of colitis such as diarrhea and weight loss in this study, and pathologic changes in these mice were similar to that in the human active ulcerative colitis. CD4~+ T cell and B cell infiltrated into the (proper) lamina were observed by immunohistochemical staining in mdr1a~(-/-) mice with colitis. There were (significant) increases in serum antibody titers of all types in mdr1a~(-/-) mice with active colitis. The levels of IgG1, IgG2a, IgG2b, IgG3, IgA and IgM were 7568, 1876, 823, 234, 897 and 189 ?g/ml, (res-)(pectively), significantly higher than those in FVB mice, which were 623, 102, 54, 42, 32 and 58 ?g/ml, (respectively) ( P