Objective:To compare the efficacy of gasless robotic surgery via transaxillary approach and combined axillary-retroauricular approach for unilateral N1b PTC, and to explore the safety and effectiveness of gasless robotic surgery via transaxillary approach for unilateral N1b PTC. Methods:Unilateral N1b PTC patients who underwent surgery in the Department of Otolaryngology, Sun Yat Sen Memorial Hospital, Sun Yat sen University between July 2016 and December 2024 were included and analyzed. According to the inclusion and exclusion criteria and the differences of surgical approaches, the patients were divided into the transaxillary approach（TA） group and the combined axillary-retroauricular approach（TARA） group. The demographic data, operation time, intraoperative blood loss, postoperative drainage volume, postoperative complications, shoulder function evaluation, postoperative visual analogue scale（VAS） of neck aesthetics and recurrence of the two groups were statistically analyzed. Results:A total of 88 patients undergoing gasless robotic surgery were included in this study, including 23 cases in the TA group and 65 cases in the TARA group. The proportion of males in the TA group was significantly higher than that in the TARA group（56.5% vs 21.5%, χ²=9.776, P=0.002）. The total operation time in the TA group was significantly lower than that in the TARA Group（180.00[155.00, 220.00]min vs 220.00[177.50, 272.50]min, z=-2.775, P=0.006）, and the postoperative blood loss in the TA group was significantly lower than that in the TARA Group（30.00[20.00, 50.00]ml vs 50.00[30.00, 60.00]ml, Z=-2.127, P=0.033）. The proportion of area Ⅱ-Ⅴ in the TA group and the TARA group was 87.0% and 70.8%, respectively, and there was no significant difference between the two groups（P>0.05）. There was no significant difference in lateral cervical lymph node dissection and central lymph node dissection between the two groups（P>0.05）. During the follow-up period, no recurrence was found in the two groups, and there was no significant difference in the incidence of complications between the two groups（P>0.05）. According to the stratification of dynamic recurrence risk assessment, it can be seen that the proportion of curative effect satisfaction in the TA group was as high as 95.7%, and that in the TARA group was as high as 81.5%, with no significant difference between the two groups. There was no significant difference in VAS score of neck, Constant Shoulder Score and NDⅡ scale between the two groups（P>0.05）. Conclusion:Gasless robotic surgery via transaxillary approach for unilateral N1b PTC is safe and feasible, and the amount postoperative lymph node acquisition is equivalent to that of combined axillary-retroauricular approach, which can provide a new choice for the treatment of unilateral N1b PTC patients.
Humans ; Robotic Surgical Procedures/methods* ; Axilla/surgery* ; Male ; Female ; Operative Time ; Middle Aged ; Adult ; Treatment Outcome ; Postoperative Complications

Objective:To compare the clinical efficacies of gasless transoral vestibular robotic surgery and open surgery for the treatment of thyroglossal duct cysts.Methods:A retrospective analysis was conducted on patients with thyroglossal duct cysts who underwent surgical treatment in the Department of Otolaryngology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2020 to October 2023. According to the differences in surgical methods, patients were divided into a robotic surgery group and an open surgery group. Statistical analysis was conducted on demographic data, surgical time, bleeding volumes, drainage volumes, postoperative complications, scar conditions, postoperative aesthetic scores, and recurrence rates of the two groups of patients. For normally distributed measurement data, inter-group comparison was done via independent-sample t-test. For non-normally distributed data, Mann-Whitney U test was applied. Comparisons of composition ratios or rates were performed using the χ2 test or Fisher′s exact probability method. Results:A total of 44 patients with thyroglossal duct cysts who met the inclusion and exclusion criteria were included, including 22 males and 22 females, aged from 3 to 73 years old. Both the robotic surgery group and the open surgery group had respectively 22 cases. The maximum diameter of tumors of the open surgery group was 3.45(2.50, 4.00) cm, while the robotic surgery group measured 2.50 (2.10, 3.20) cm, with the open group demonstrating significantly larger tumor dimensions compared to the robotic group ( Z=-2.329, P<0.05). Compared to the open surgery group, the robotic surgery group showed significantly more surgical time [105.00 (95.00, 135.00) min vs. 65.00(58.75, 76.25) min, Z=-5.377, P<0.05], postoperative hospitalization time [4.00 (3.75, 5.00) days vs. 3.00(2.00, 4.00) days, Z=-3.202, P<0.05] and bleeding volume [20.00 (10.00, 20.00) ml vs. 5.00 (5.00, 10.00) ml, Z=-4.769, P<0.05], but had less scar length [0 cm vs. 4.00 (2.00, 5.00) cm, Z=-6.097, P<0.05] and better postoperative cosmetic satisfaction [10.00 (10.00, 10.00) vs. 8.00 (6.75, 8.00), Z=-5.221, P<0.05]. With follow-up of 10.0-48.0 months, both the robotic surgery group and the open surgery group showed no recurrence. There was no significant difference in the follow-up time between the two groups ( Z=-0.224, P=0.823). Conclusion:Gasless transoral vestibular robotic surgery is safe and feasible for the treatment of thyroglossal duct cysts, with efficacy comparable to traditional surgery, which can provide a new option for the treatment of thyroglossal duct cysts.

Innovative drugs are defined as new chemical entities that play a vital role in the treatment and maintenance of human health. While single-target innovative drugs have achieved notable success, they face limitations in addressing the increasingly complex and precise spectra of diseases. The advent of multi-target innovative drugs offers new opportunities, supported by a growing body of pharmacological evidence. Herbal medicines are recognized as valuable sources of multi-target therapeutics due to their proven efficacy in treating complex diseases. However, the identification and validation of such drugs from herbal sources continue to pose significant challenges. This paper presents a comprehensive review of the literature on traditional Chinese medicine, integrated medicine, chemistry, and biology from 2015 to 2025. It summarizes the strategies employed in integrating traditional Chinese and Western medicine for innovative drug development, along with successful application cases. We believe these efforts will deepen understanding of the current landscape, accelerate the discovery of multi-target innovative drugs from herbal medicine, and contribute to addressing major human health challenges.

Objective To explore the diagnostic value of hemodynamic and morphological characteristics based on four-dimensional flow magnetic resonance imaging(4D Flow MRI)for unstable saccular intracranial aneurysms(IAs).Methods Seventy-four patients with saccular unruptured intracranial aneurysms(UIAs)who underwent 4D Flow MRI examinations were selected.Morphological and hemodynamic data of the IAs were collected and followed up.According to the follow-up results,patients were divided into stable group and unstable group.Logistic regression analysis was used to identify factors associated with the unstable group,and the diag-nostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves and the area under the curve(AUC).Results The aneurysm diameter,height,width,neck width,and aspect ratio(AR)value in the unstable group were greater than those in the stable group.The wall shear stress(WSS)at the aneurysm neck and the parent artery inflow,as well as the end diastolic velocity(EDV)at the parent artery inflow,were lower in the unstable group than those in the stable group(P＜0.05).Multivariate logistic regression analysis showed that the AR and WSS at the aneurysm neck were independent predictors of unstable IAs(P＜0.05).The combined model of WSS at the aneurysm neck and AR showed an AUC of 0.742[95％confidence interval(CI)0.608-0.875],repre-sented the highest diagnostic performance.Conclusion The hemodynamic characteristics quantified by 4D Flow MRI offer supple-mentary information for risk assessment of IAs.Combining hemodynamic and morphological characteristics is of significant value in identi-fying unstable saccular IAs.

Objective To explore the diagnostic value of hemodynamic and morphological characteristics based on four-dimensional flow magnetic resonance imaging(4D Flow MRI)for unstable saccular intracranial aneurysms(IAs).Methods Seventy-four patients with saccular unruptured intracranial aneurysms(UIAs)who underwent 4D Flow MRI examinations were selected.Morphological and hemodynamic data of the IAs were collected and followed up.According to the follow-up results,patients were divided into stable group and unstable group.Logistic regression analysis was used to identify factors associated with the unstable group,and the diag-nostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves and the area under the curve(AUC).Results The aneurysm diameter,height,width,neck width,and aspect ratio(AR)value in the unstable group were greater than those in the stable group.The wall shear stress(WSS)at the aneurysm neck and the parent artery inflow,as well as the end diastolic velocity(EDV)at the parent artery inflow,were lower in the unstable group than those in the stable group(P＜0.05).Multivariate logistic regression analysis showed that the AR and WSS at the aneurysm neck were independent predictors of unstable IAs(P＜0.05).The combined model of WSS at the aneurysm neck and AR showed an AUC of 0.742[95％confidence interval(CI)0.608-0.875],repre-sented the highest diagnostic performance.Conclusion The hemodynamic characteristics quantified by 4D Flow MRI offer supple-mentary information for risk assessment of IAs.Combining hemodynamic and morphological characteristics is of significant value in identi-fying unstable saccular IAs.

Objective:To compare the clinical efficacies of gasless transoral vestibular robotic surgery and open surgery for the treatment of thyroglossal duct cysts.Methods:A retrospective analysis was conducted on patients with thyroglossal duct cysts who underwent surgical treatment in the Department of Otolaryngology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2020 to October 2023. According to the differences in surgical methods, patients were divided into a robotic surgery group and an open surgery group. Statistical analysis was conducted on demographic data, surgical time, bleeding volumes, drainage volumes, postoperative complications, scar conditions, postoperative aesthetic scores, and recurrence rates of the two groups of patients. For normally distributed measurement data, inter-group comparison was done via independent-sample t-test. For non-normally distributed data, Mann-Whitney U test was applied. Comparisons of composition ratios or rates were performed using the χ2 test or Fisher′s exact probability method. Results:A total of 44 patients with thyroglossal duct cysts who met the inclusion and exclusion criteria were included, including 22 males and 22 females, aged from 3 to 73 years old. Both the robotic surgery group and the open surgery group had respectively 22 cases. The maximum diameter of tumors of the open surgery group was 3.45(2.50, 4.00) cm, while the robotic surgery group measured 2.50 (2.10, 3.20) cm, with the open group demonstrating significantly larger tumor dimensions compared to the robotic group ( Z=-2.329, P<0.05). Compared to the open surgery group, the robotic surgery group showed significantly more surgical time [105.00 (95.00, 135.00) min vs. 65.00(58.75, 76.25) min, Z=-5.377, P<0.05], postoperative hospitalization time [4.00 (3.75, 5.00) days vs. 3.00(2.00, 4.00) days, Z=-3.202, P<0.05] and bleeding volume [20.00 (10.00, 20.00) ml vs. 5.00 (5.00, 10.00) ml, Z=-4.769, P<0.05], but had less scar length [0 cm vs. 4.00 (2.00, 5.00) cm, Z=-6.097, P<0.05] and better postoperative cosmetic satisfaction [10.00 (10.00, 10.00) vs. 8.00 (6.75, 8.00), Z=-5.221, P<0.05]. With follow-up of 10.0-48.0 months, both the robotic surgery group and the open surgery group showed no recurrence. There was no significant difference in the follow-up time between the two groups ( Z=-0.224, P=0.823). Conclusion:Gasless transoral vestibular robotic surgery is safe and feasible for the treatment of thyroglossal duct cysts, with efficacy comparable to traditional surgery, which can provide a new option for the treatment of thyroglossal duct cysts.

The nasal swab samples of swine influenza(SI)suspected pigs were collected and tested for H3 subtype swine influenza virus(SIV)positive by RT-qPCR.The positive samples were inoc-ulated into SPF chicken embryos for virus isolation.The full genome sequencing and sequence anal-ysis of the isolated H3N2 subtype SIV were conducted,and its pathogenicity was studied.The re-sults showed that a strain of SIV was successfully isolated and identified as H3N2 subtype by RT-PCR,named A/Swine/Yunnan/KM/06/2023(H3N2).The BLSAT results showed that the eight segments of SIV H3N2 KM had the highest homology with eight different strains of swine influ-enza or human influenza viruses,reaching 95.41％-97.49％.The HA and NA segments were de-rived from H3N2 subtype SIV,the NP segment was derived from H1N1 subtype human influenza virus,the M segment was derived from H1N2 subtype SIV,and all other segments were derived from H1N1 subtype SIV.The key receptor sites(190D,223V,226I,228S)of HA protein remained unchanged.The pathogenicity experiment results showed that infected piglets exhibited symptoms such as fever,sneezing,runny nose,the virus could be detoxified to the outside through the nasal cavity,and the lungs had different degrees of lesion.Immunohistochemistry(IHC)showed that the virus could replicate in the lungs.In conclusion,a strain of H3N2 subtype SIV was successfully iso-lated,and the genetic evolution,molecular characteristics and pathogenicity of the virus were stud-ied.It revealed that H3N2 subtype SIV is constantly evolving and had pathogenicity to piglets,pro-viding a reference for monitoring and preventing SIV epidemics in China,and provided a candidate strain for SI vaccine development.

Purpose To evaluate the carotid artery elasticity and the influencing factors in the offspring of early-onset type 2 diabetes mellitus by RF-data based quantitative analysis on vessel stiffness.Materials and Methods We continuously encrolled 63 offspring of type 2 diabetes mellitus,depending on the parental diagnostic age of diabetes they were divided into two groups:32 cases of early-onset offspring group,31 cases of late-onset offspring group.32 healthy volunteers who were matched for age,gender and body mass index,were selected as controls.Real-time intima-media thickness and RF-data based quantitative analysis on vessel stiffness were employed to evaluate common carotid intima-media thickness,displacement,diameter,hardness coefficient and pulse wave velocity.The differences among the groups were compared.Results The intima-media thickness,pulse wave velocity and hardness coefficient in early-onset offspring group were higher than late-onset offspring group(t=0.054-1.228,P＜0.05),and displacement was lower than late-onset offspring group(t=0.048,0.109,both P＜0.05).Conclusion Carotid artery stiffness in the offspring of diabetes mellitus patients is significantly higher than the control group.And the carotid elasticity of early-onset offspring group decreased more obviously than late-onset group.

Objective:To explore any effect of standing balance dynamic lifting training on balance, motor functioning and the life quality of hemiplegic stroke survivors.Methods:Eighty stroke survivors were randomly divided into a control group and an experimental group, each of 40. Both groups received routine rehabilitation training, while the experimental group additionally underwent standing balance dynamic lifting training. Before the intervention, and 2 and 4 weeks later, everyone′s balance and motor functioning were evaluated using the Brunel balance assessment (BBA) and the timed " up and go" test (TUGT). Life quality was quantified using the stroke special quality of life scale (SS-QOL).Results:Significant improvement in the average walking function score, BBA total score and TUGT time was observed in both groups, with significantly greater improvement after 4 weeks than after two. The improvements in the experimental group were significantly greater than in the control group. After 4 weeks the average total SS-QOL score and the scores on all of its dimensions had increased significantly in the experimental group. The scores for energy, language, motor function, emotions, self-care ability, upper limb function and the average SS-QOL total score were all then significantly better in the experimental group.Conclusions:Standing balance dynamic lifting training can effectively improve the balance, motor function and life quality of stroke survivors with hemiplegia.

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage),basically Yi Zhi Chan pushing at Baliao points in the treatment of functional constipation in infants and children aged 1-3 years old. Methods:Seventy kids were randomly divided into an observation group and a control group,with 35 cases in each group.The control group was treated with conventional Tuina manipulation,while the observation group was treated with Tuina manipulation based on Yi Zhi Chan pushing at Baliao points.Both groups were treated once every other day,with 10 times as 1 course of treatment.The score on the self-developed constipation rating scale and clinical efficacy were compared after 1 course of treatment. Results:The total effective rate was 90.6%in the observation group and 76.7%in the control group,and the difference between the two groups was statistically significant(P<0.05).The degree of defecation difficulty in the children in the observation group was milder than that in the control group(P<0.01). Conclusion:Tuina manipulation based on Yi Zhi Chan pushing at Baliao points can significantly improve the degree of defecation difficulty in children,and the total effective rate is better than that of conventional Tuina manipulation.