Objective To investigate the safety and feasibility of the domestic SA-1000 single-port single-arm robot-assisted laparoscopic system in total hysterectomy.Methods Data from 16 patients who underwent total hysterectomy using the SA-1000 system at the Department of Obstetrics and Gynecology,The Second Affiliated Hospital of Naval Medical University,between Mar.2023 and Jan.2024 were retrospectively collected.Surgical parameters were analyzed.Postoperative pain was assessed using the visual analogue scale(VAS)at 24 h after surgery and before discharge.Incision cosmesis was evaluated 3-5 weeks postoperatively using the body image questionnaire(BIQ,score range 3-24).Results All 16 procedures were successfully completed using the SA-1000 system without conversion to open surgery,achieving a 100.0%procedural success rate.The mean whole surgery time was(234.40±56.24)min.The median robotic arm setup time was 8.0(4.0,13.5)min,and the median console operating time was 128.0(100.0,151.0)min.The median intraoperative blood loss was 100.0(100.0,200.0)mL.No perioperative complications,such as hemorrhage,infection,injury to adjacent organs(ureters,bladder,bowel),poor wound healing,or incisional hernia,were observed.The mean wound pain score at 24 h postoperatively was 3.81±1.64,decreasing to a median of 3.0(2.0,4.0)before discharge.The BIQ score assessed at 3-5 weeks postoperatively was 21.88±1.15.Conclusion The application of the domestic SA-1000 single-port single-arm robot-assisted laparoscopic system for total hysterectomy is safe and feasible,demonstrating favorable surgical outcomes.It holds promise for broader implementation and promotion in domestic medical centers.

With the popularization of 5G communication technology and the continuous upgrade of robot-assisted surgery system,telesurgery has developed rapidly.However,there are few of reports about this technique in single-port laparoscopic gynecological surgery.On April 19,2024,the surgeons at the Second Affiliated Hospital of Naval Medical University in Shanghai successfully implemented robot-assisted single-port laparoscopic bilateral adnexectomy for a patient who was admitted to the Naval Hospital of the Eastern Theater Command in Zhoushan,Zhejiang Province through 5G communication technology.The operation time was 90 min,intraoperative bleeding was 20 ml,and no intraoperative complications occurred.There were no adverse events caused by robots such as robot system failure and instrument failure,or adverse events caused by remote communication such as network interruption and network attack.Intraoperative user datagram protocol(UDP)real-time monitoring data showed an average delay of 108 ms(range,105-111 ms)and a packet loss rate of 0.04%.The surgeons had a slight sense of delay when the operation amplitude was too large.There was no obvious stalling which affected the process of the operation.The patient was able to move around on the first day after surgery,and the catheter was removed.No postoperative complications occurred.The patient was discharged from the hospital on the second day after surgery.Postoperative pathological results revealed left fallopian tube ovarian serous cystadenofibroma,fallopian tubal tissue;right fallopian tube ovarian,sent for examination as ovarian and fallopian tube tissue.There were no complaints of discomfort during reexamination one month after surgery,and the umbilical incision healed well.This case is an attempt of telesurgery in the field of gynecology,and provides experiences for the further development of this technique.

OBJECTIVE: To investigate the clinical and prognostic characteristics of primary acute myeloid leukemia (AML) with 11q23/KMT2A rearrangements. METHODS: Clinical data of 90 patients with primary AML and 11q23/KMT2A rearrangements were analyzed retrospectively. RESULTS: By karyotyping analysis, 80 of the 90 patients had translocations involving 11q23/KMT2A, with t(9;11)(p22;q23), t(6;11)(q27;q23), t(10;11)(p12;q23) and t(11;19)(q23;p13) being the most common ones, while 10 cases were found to have non-translocation abnormalities. The overall complete remission (CR) rate was 75.6%, and patients with t(6;11) had lower CR rate compared with non-t(6;11) patients (47.1% vs. 82.2%, P = 0.005). After a median follow-up of 24.5 months, the patients receiving allo-hematopoietic stem cell transplantation (allo-HSCT) had significantly higher 3-year overall survival (OS) (80.3% vs. 16.6%, P < 0.001) and 3-year event-free survival (EFS) (73.5% vs. 16.3%, P < 0.001) compared with non-transplant patients. Patients with t(6;11) had the lowest 3-year OS (11.8% vs. 56.0%, P < 0.001) and 3-year EFS (5.9% vs. 53.8%, P < 0.001) compared with other type of abnormalities. No significant difference was noted in the survival between patients with t(9;11) and non-t(9;11) regardless whether they had received HSCT. CONCLUSION The clinical characteristics of primary AML with 11q23/KMT2A rearrangements are heterogeneous. Patients did not receive HSCT had poorer survival, particularly with the presence of t(6;11). Allo-HSCT could significantly improve the survival of such patients.
Humans ; Retrospective Studies ; Leukemia, Myeloid, Acute/therapy* ; Translocation, Genetic ; Gene Rearrangement ; Prognosis

Objective:To investigate the expression of SET-NUP214 fusion gene in hematological malignancies and to analyze its related clinical biological characteristics.Methods:The clinical data of 24 patients with SET-NUP214 fusion gene-positive hematological malignancies were retrospectively analyzed, and the Kaplan-Meier method was used for survival analysis.Results:Among the 24 patients with SET-NUP214 fusion gene, 15 cases of acute lymphoblastic leukemia (ALL) (13 cases of T-ALL and 2 cases of B-ALL) , 7 cases of acute myeloid leukemia (AML) , and 2 cases of T/myeloid mixed acute leukemia have been identified. The immunophenotype of 13 cases of T-ALL was mainly characterized by CD3 +CD2 -, 73.3% of ALL was characterized by myeloid marker expression, and 85.7% of AML was characterized by CD7 expression. Complete remission (CR) was achieved in 22 patients (91.7%) after induction chemotherapy. All 24 patients received allogeneic hematopoietic stem cell transplantation (HSCT) . With a median follow-up of 24 months, the 3-year relapse free survival (RFS) of AML and ALL was 85.7% and 33.3%, respectively ( P=0.128) . Comparing 13 cases of SET-NUP214-positive and 62 cases of SET-NUP214-negative T-ALL, the CR rates of induction chemotherapy were 92.3% and 93.5% ( P=0.445) , and the 4-week CR rates of induction chemotherapy were 69.2% and 72.6%, respectively ( P=0.187) ; the differences were not statistically significant. After HSCT, the 3-year RFS of SET-NUP214 +T-ALL and SET-NUP214 -T-ALL was 38.5% and 66.4%, respectively ( P=0.028) , and the difference was statistically significant. Conclusion:The SET-NUP214 fusion gene is mainly detected in T cell-derived hematological malignancies, and the prognosis of SET-NUP214 positive T-ALL is relatively poor.

Objective To explore the value of OSCE system combined with intelligent network in-formation platform in clinical skills assessment of obstetrics and gynecology. Methods 112 clinical medi-cal students who participated in the practice of gynecology and obstetrics in Second Military Medical Uni-versity in 2017 were randomly divided into the experimental group (network information OSCE) and the control group (traditional OSCE). The teaching results were evaluated by the questionnaire survey of teachers and students and the examination results as well. The statistical analysis was made with the Chi-square test and the t test respectively. Results According to the questionnaire survey of two skills assessment methods, the satisfaction index of the experimental group was higher than that of the control group in both teachers and students, and the difference was statistically significant (P<0.05). The total time of examination in the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The final total score and the results of case analysis and clinical operation examination of experi-mental group were all higher than those of the control group, but there was no statistical difference (P>0.05). Conclusion OSCE combined with the network information system has an unparalleled advantage in the assessment of the obstetrics and gynecology department. The system will promote clinical education of ob-stetrics and gynecology and the evaluation of the clinical ability of the medical students to a new height, which deserves popularization.

OBJECTIVETo report on a case of therapy-related acute monocytic leukemia(t-AML) with t(11;17) (q23;q21)/MLL-AF17q after successful treatment for acute promyelocytic leukemia(APL) with t(15;17) (q22;q21)/PML-RARα.

METHODSA MICM method (bone marrow morphology(M), immunophenotype(I), cytogenetics(C), and molecular biology(M)) was used for the diagnosis and classification of the disease at the time of onset and transformation.

RESULTSThe patient was initially identified with typical morphology and immunophenotype of APL. She has carried t(15;17)(q22;q21) and PML-RARα fusion gene but was without t(11;17)(q23;q21) or MLL gene abnormalities. After 13 months of successful treatment, she has transformed to AML with typical morphology and immunophenotype. t(11;17)(q23;q21) and MLL-AF17q fusion gene were detected in her bone marrow sample, while no PLZF-RARα fusion gene was detected by real-time quantitative reverse-transcription PCR(RQ-PCR) and fluorescence in situ hybridization(FISH).

CONCLUSIONt-AML is a serious complication after successful treatment of APL. t(11;17)(q23;q21) is not specific for the diagnosis of variant APL and can also be detected in t-AML. RQ-PCR and FISH are essential for the diagnosis of such patients.

Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Monocytic, Acute ; genetics ; Leukemia, Promyelocytic, Acute ; genetics ; Middle Aged ; Neoplasms, Second Primary ; genetics

Objective To explore the application of space sand as filling material in the prevention of pressure sore in the lateral position surgery in Neurosurgery Department.Methods A total of 130 cases of lateral decubitus position surgery in Second Hospital of Hebei Medical University from October 2016 to March 2017 were selected and randomly divided into control group (n=65) and observation group (n=65) by random number table method.The control group used traditional gel position pad for lateral decubitus position,while the observation group used self-made space sand position pad for lateral position.The incidence of pressure sores of patients with lateral decubitus surgery of two groups were compared.Results The incidence of pressure sores in the control group was 12.31％,while it was 3.07％ in the observation group.The difference was statistically significant (x2=3.900,P ＜ 0.05).Conclusions The use of space sand position pad can effectively prevent the occurrence of pressure sore in the lateral decubitus position in Neurosurgery Department.

Objective To find an effective and convenient restraint band for the upper limb of the non-compression side for the patients in the lateral decubitus operation in the Neurosurgery Department. Methods From August 2017 to March 2018, patients in the lateral decubitus operation in the Neurosurgery Department,who from the Second Hospital of Hebei Medical University, were selected as the research objects. The self-made posture restraint belt was made of professional exercise shoulder, forearm sheath, binding band and magic stick. By using random number table produced by SPSS 22.0 edition, 160 patients who underwent lateral decubitus operation in the Neurosurgery Department were randomly divided into the control group and the observation group, with 80 cases in each group. In the control group, the conventional shoulder straps and wrist restraint bands were used, while the self-made lateral decubitus upper limb restraint band was used in the observation group. The differences of the time of lateral decubitus placement, the incidence of pressure sore in the non-compression side of the upper limb and the efficiency of restraint were observed and compared between the two groups. Results The time of lateral decubitus placement (365.97±42.08) s and the incidence of pressure sore in the non-compression side upper limb (10.0%) were higher than those of the observation group[ (302.69± 38.25)s, 1.3%]. The differences were statistically significant (P＜0.05). The efficiency (100.0%) of the non-compression side upper limb restraint in the observation group was higher than that in the control group (91.3%). The difference was statistically significant (P＜0.05). Conclusions The self-made upper limb restraint band for neurosurgery lateral position can effectively expose the surgical field, improve the comfort degree of patients, and improve the efficiency of posture placement and restraint.

Objective:To study the diagnostic value of combined detection of IAA,ICA and GADA in the classification of diabetes mellitus.Methods:30 cases of patients with type 1 diabetes who were treated in our hospital from June 2015 to June 2016 were selected as A group,60 cases of patients with type 2 diabetes were selected as B group,50 cases of healthy people were selected as C group.The IAA,ICA and GADA of the three groups were detected by ELISA,and the positive rate of the three groups were compared.Results:The fasting glucose of A group was (10.12± 3.68) mmol/L,B group was (11.23± 3.26) mmol/L,A group and B group were significantly higher than that of C group (P＜0.05),but there was no significant difference between A group and B group (P＞0.05);the positive rates of GADA,ICA and IAA in A group and B group were significantly higher than those in C group (P＜0.05),and the positive rates of GADA,ICA and IAA in A group were significantly higher than those in B group (P＜0.05);the sensitivity and specificity of combined detection of IAA,ICA and GADA in type 2 and type 1 diabetes mellitus were significantly higher than that in the single test (P＜0.05).Conclusions:The combined detection of IAA,ICA and GADA has a high diagnostic value in the classification of diabetes mellitus,which is worth clinical application.

Objective To study the N terminal pro brain natriuretic peptide (NT-proBNP)in serum of hypertension patients. Methods 152 patients with hypertension were included in this study.According to the different degree and development of hypertension,152 patients were divided into three different grade group of hypertension:first grade of hypertension group (30 patients),second grade of hypertension group (36 patients)and third grade of hypertension group (86 patients).And the 86 patients were divided into hypertension group (40 patients)and hypertension with diabetes group (46 patients)re-spectively,comparaed with the level of NT-proBNP in serum of different hypertension grade groups.Results The levels of the NT-proBNP in serum were 68±44,122±31 and 834±309 pg/ml of first grade of hypertension group,second grade of hypertension group and third grade of hypertension group,respectively.The level of the NT-proBNP was gradually increased with grade of hypertension (t=2.455,3.561,P<0.01).The level of the NT-proBNP (1 178±864 pg/ml)of hypertension with diabetes group was significantly higher than hypertension group (599±411 pg/ml)(t=3.785,P<0.01).Conclusion The level of NT-proBNP can obj ectively reflect the grade of the disease in patients with hypertension.it is a certain signifi-cance guiding for monitoring the clinical treatment of the disease.