Objective:To summarize the initial experience of 5G-ultra-long-distance robotic hepatectomy.Methods:This is a retrospective case series study. The clinical information from 5 cases of 5G ultra-long-distance robot-assisted hepatectomy performed was collected from June 2023 to October 2024, in collaboration between Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Hangzhou and Alaer Hospital, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Alaer, located 4 600 km apart. The patients comprised 1 male and 4 females, aged from 36 to 59 years, with an average age of 48 years. Their body mass index ranged from 20.4 to 30.9 kg/m2, with an average of 24.62 kg/m2. Preoperatively, 5 patients were diagnosed with liver disease requiring hepatectomy. The operations used 5G ultra-remote four-arm endoscopic robot surgery system. The remote control room was located in Sir Run Run Shaw Hospital (Hangzhou, Zhejiang), and the robot operating room was located in Alaer Hospital (Alaer, Xinjiang). The wired network relied on 60 Mb/s high-speed public Internet special line (China Telecom). In order to ensure the security of data transmission, the system implemented a double-layer encryption strategy for the wired network, and carried out strict debugging and verification for both the wired and wireless networks. Perioperative data and information on network performance were collected for 5 patients.Results:The surgical duration of the 5 cases of 5G ultra-long-distance robot-assisted hepatectomy ranged from 49 to 342 minutes, with an average of 184 minutes. Intraoperative blood loss varied from 5 to 800 ml, averaging 183 ml. Network performance was evaluated during the surgery, revealing an average network latency of 108.2 ms, with no significant lag or delay observed during any of the procedures. All patients recovered smoothly, with a postoperative hospital stay ranging from 5 to 10 days, averaging 7.2 days. Postoperative complications included 1 case of hypoproteinemia and 1 case of pleural effusion. Pathological examination confirmed that all cases suffered benign liver diseases (three patients with hepatic hemangioma, one with regenerative nodule in cirrhosis, and one with hepatolithiasis and choledocholithiasis).Conclusion:The preliminary exploration of clinical practice indicated that 5G-ultra-long-distance robot-assisted surgery is feasible for hepatectomy, with no severe complications affecting patients′ recovery.

Objective:To summarize the initial experience of 5G-ultra-long-distance robotic hepatectomy.Methods:This is a retrospective case series study. The clinical information from 5 cases of 5G ultra-long-distance robot-assisted hepatectomy performed was collected from June 2023 to October 2024, in collaboration between Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Hangzhou and Alaer Hospital, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Alaer, located 4 600 km apart. The patients comprised 1 male and 4 females, aged from 36 to 59 years, with an average age of 48 years. Their body mass index ranged from 20.4 to 30.9 kg/m2, with an average of 24.62 kg/m2. Preoperatively, 5 patients were diagnosed with liver disease requiring hepatectomy. The operations used 5G ultra-remote four-arm endoscopic robot surgery system. The remote control room was located in Sir Run Run Shaw Hospital (Hangzhou, Zhejiang), and the robot operating room was located in Alaer Hospital (Alaer, Xinjiang). The wired network relied on 60 Mb/s high-speed public Internet special line (China Telecom). In order to ensure the security of data transmission, the system implemented a double-layer encryption strategy for the wired network, and carried out strict debugging and verification for both the wired and wireless networks. Perioperative data and information on network performance were collected for 5 patients.Results:The surgical duration of the 5 cases of 5G ultra-long-distance robot-assisted hepatectomy ranged from 49 to 342 minutes, with an average of 184 minutes. Intraoperative blood loss varied from 5 to 800 ml, averaging 183 ml. Network performance was evaluated during the surgery, revealing an average network latency of 108.2 ms, with no significant lag or delay observed during any of the procedures. All patients recovered smoothly, with a postoperative hospital stay ranging from 5 to 10 days, averaging 7.2 days. Postoperative complications included 1 case of hypoproteinemia and 1 case of pleural effusion. Pathological examination confirmed that all cases suffered benign liver diseases (three patients with hepatic hemangioma, one with regenerative nodule in cirrhosis, and one with hepatolithiasis and choledocholithiasis).Conclusion:The preliminary exploration of clinical practice indicated that 5G-ultra-long-distance robot-assisted surgery is feasible for hepatectomy, with no severe complications affecting patients′ recovery.

Alzheimer's disease (AD) is one of the major diseases that harmful to healthy elderly, and mild cognitive impairment (MCI) is the early clinical stage of AD. There is a lag in the clinical diagnosis of both diseases. An objective and reliable auxiliary diagnostic method is urgently needed to provide early diagnosis and differential indicators for AD and MCI, to predict the probability of individuals suffering from AD and MCI transforming into AD, and to reduce the overall incidence of AD and reduce the huge medical and economic burden for the country and society. Event-related potential is widely used in AD and MCI, and the resolution at the millisecond level can truly reflect the time course of cognitive processing and the degree of impairment of cognitive function in patients. In this study, we investigated the differences in the amplitude and latency of ERP components in healthy elderly, MCI and AD patients, and the correlation between ERP components and cognitive impairment. Early N170 and P200 showed high sensitivity and specificity in differentiating MCI from healthy elderly or MCI from AD. The late perception-related ERPs also showed high sensitivity and specificity in differentiating healthy elderly from MCI/AD. The differences in ERPs between MCI and AD may be related to the etiology, the degree of disease progression and the site of brain damage. The specific brain mechanism still need to be further explored and will be the focus of future research. With the progress of the research, the relationship between the specific ERP manifestations and the mechanism of brain injury as well as the impairment of cognitive function will be more clear. It is believed that the application of ERP in clinical will bring more benefits to AD and its early clinical MCI.

Objective:To investigate the relationship between lexical semantic processing abnormalities and cognitive function and clinical symptoms in schizophrenia based on the activation diffusion model and semantic distance.Methods:All subjects matched with demographic data were randomly divided into experiment group( n=27) and control group( n=30). The semantic distance of words of different semantic categories and lexical categories were assigned at a level of 1-7.The semantic distance between the two groups was analyzed by repeated measures of variance, and the correlation analysis was conducted on the scores of the MATRICS Consensus Cognitive Battery (MCCB) and positive and negative syndrome scale (PANSS) in the experimental group. Results:The main effects of the groups in semantic distance were statistically significant( F(1, 55)=7.460, P=0.008, ηp2=0.981). The semantic distance in the experimental group (3.672±0.105)was lower than that in the control group (4.068±0.100). The main effect of the semantic category was statistically significant( F(1, 55)= 833.37, P<0.01, ηp2=0.938), and the semantic distance in the relative condition (1.965±0.074) was lower than that in the unrelative condition(5.775±0.117). Under the relative condition, concrete semantic deviation was negatively correlated with the total score of MCCB( r=-0.405, P=0.036)and speech learning ( r=-0.569, P=0.002). Abstract semantic deviation was negatively correlated with speech learning( r=-0.429, P=0.026). Under the unrelative condition, concrete semantic deviation was negatively correlated with MCCB total score ( r=-0.597, P=0.001), speech learning( r=-0.399, P=0.039)and other dimensions.Abstract semantic deviation was negatively correlated with MCCB total score( r=-0.593, P=0.001) and speech learning( r=-0.285, P=0.050). Under the relative condition, the abstract semantic deviation was positively correlated with the general symptom scale score( r=0.448, P=0.019). Under the unrelative condition, abstract vocabulary semantic deviation was positively correlated with PANSS total score( r=0.120, P=0.010), negative scale score( r=0.047, P=0.030) and general symptom scale score ( r=0.306, P=0.010). Conclusion:The semantic distance of lexical processing is abnormal in schizophrenia. The semantic deviation is related to the cognitive function index and symptom index.

s] Objective To detect the feasibility and efficiency of bone age(BA) artificial intelligence(AI) estimation based on deep learning features from traditional regions of interest(ROI) in hand digital radiographs(DR). Methods BA dataset of left hand DR with 11 858 subjects aged from 0 to 18 years in Children′s Hospital of Shanghai were split to training(80.0%) and validation (20.0%) set in this study. An improved regression convolutional neural networks and extreme gradient boosting decision tree method were utilized for the BA analysis based on traditional ROIs in the images. Another set of BA data with 1 229 subjects also in the hospital was adopted for test. Mean average precision(mAP) and mean absolute error(MAE) were used to assess model accuracy of detection and BA prediction, respectively. Results The mAP of ROIs detection of the model was 0.91,and MAE of all male and female subjects was 0.461 and 0.431 years respectively in validation and test sets. The difference less than 1 year in test accounted for 90.07% between BA assessment of the model and of the peadiatric radiologists, with an accuracy rate of 96.67%.The difference over 1 year was 9.03% (with underestimation of 6.43% and overestimation of 2.60%), in which corresponding age data was of being less in training set or sesamoid nearby adductor pollicis or fusion of epiphysis appeared in test set. Conclusion An AI model based on deep learning of traditional ROIs′features in hand DR images is initially achieved to automatically predict BA rapidly and effectively, yet it still needs further optimization.

Objective: To detect the feasibility and efficiency of bone age(BA) artificial intelligence(AI) estimation based on deep learning features from traditional regions of interest(ROI) in hand digital radiographs(DR). Methods: BA dataset of left hand DR with 11 858 subjects aged from 0 to 18 years in Children′s Hospital of Shanghai were split to training(80.0%) and validation (20.0%) set in this study. An improved regression convolutional neural networks and extreme gradient boosting decision tree method were utilized for the BA analysis based on traditional ROIs in the images. Another set of BA data with 1 229 subjects also in the hospital was adopted for test. Mean average precision(mAP) and mean absolute error(MAE) were used to assess model accuracy of detection and BA prediction, respectively. Results: The mAP of ROIs detection of the model was 0.91,and MAE of all male and female subjects was 0.461 and 0.431 years respectively in validation and test sets. The difference less than 1 year in test accounted for 90.07% between BA assessment of the model and of the peadiatric radiologists, with an accuracy rate of 96.67%.The difference over 1 year was 9.03% (with underestimation of 6.43% and overestimation of 2.60%), in which corresponding age data was of being less in training set or sesamoid nearby adductor pollicis or fusion of epiphysis appeared in test set. Conclusion An AI model based on deep learning of traditional ROIs′ features in hand DR images is initially achieved to automatically predict BA rapidly and effectively, yet it still needs further optimization.

Objective To discuss CT,MRI features of fibrous hamartoma of infancy (FHI) compared with pathology.Methyls Cinical data,CT and MRI findings,as well as pathological results of 15 patients with FHI were retrospectively analyzed.Results Totally,there were 17 lesions of FHI in 15 cases,including 13 cases with single lesion and 2 cases with double lesions.The lesions manifesting as subcutaneous-,skin-and mixed-type on CT or MR images accounted for 58.82％ (10/17),17.65％ (3/17) and 23.53％ (4/17),respectively.The subcutaneous-and mixed-type lesions showed " cloud sign" (including "thin-cloud sign" and "thick-cloud sign").The thin-cloud sign lesions composed mainly of mature adipose tissue,while the triphasic composition ratio of adipose,fibrous and primitive mesenchymal cells were relatively consistent in the lesions with thick-cloud sign.The skin-type lesions showed "mountain-inverted sign",which composed mainly of immature mesenchymal component.Conclusion CT and MRI features of FHI are complex,yet have certain characteristics,which can preferably reflect the histopathological features of FHI.

This investigation was made in regard to the changes of plasma Leptin, Tumor Necrosis Factor-alpha (TNF-alpha) and Neuropeptide Y (NPY) levels and their association with insulin resistance and beta-cell secretion function in normal glucose tolerant first-degree relatives of familial type 2 diabetic pedigrees in Chengdu area. Levels of Leptin, TNF-alpha, NPY and lipids (TG, TC, HDL-C) were determined in 86 type 2 diabetic mellitus (DM) patients, 73 normal glucose tolerant (NGT) first-degree relatives in familial type 2 diabetic pedigrees and 65 normal controls (NC) from non-diabetic families. All of the subjects underwent 75 g oral glucose tolerance test (OGTT). Plasma glucose, immunoreactive insulin (IRI) and true insulin (TI) levels were also determined. Fasting glucose and TI levels were used to calculate homeostasis model assessment-insulin resistance (HOMA-IR) and HOMA-beta cell indexes. After being adjusted for age and body mass index (BMI), the levels of Leptin in DM and NGT first-degree relatives were all significantly higher than that in normal controls (P < 0.05). Type 2 diabetic patients showed significantly elevated TNF-alpha levels than did the normal controls (P < 0.05). Furthermore, diabetic subjects showed significantly higher HOMA-IR and lower HOMA-B levels, compared with those in NGT and NC groups (P < 0.05). No statistically significant difference was found in regard to NPY among three groups. NGT first-degree relatives showed significantly higher levels of TG, fasting IRI, OGTT-2h IRI and HOMA-IR than did the normal controls (P < 0.05). Leptin was positively correlated with age, BMI, waist, A1c, fasting and OGTT-2h glucose, OGTT-2h TI and TNF-alpha in all subjects, and was negatively correlated with HOMA-B in females. Leptin levels were significantly elevated in NGT first-degree relatives, which implied that genetic defects of Leptin may play a role in the development of familial type 2 diabetic pedigrees.
Adult ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; genetics ; Female ; Glucose Tolerance Test ; Humans ; Insulin ; secretion ; Insulin Resistance ; Leptin ; blood ; Male ; Middle Aged ; Neuropeptide Y ; blood ; Pedigree ; Tumor Necrosis Factor-alpha ; blood

Objective To study the influence of traction on the blood circulation of femur head and its evaluation by DSA. Methods Using micro-catheter, transfemoral selective femoral circumflex arteriography in 22 healthy dogs was performed in unilateral hip before (Group A,n =22) and immediately (Group B,n=22) ,30( Group D,n =22) ,60(Group E,n=20) ,90( Group F,n = 10),120 (Group G,n=10) minutes during 2 kg skin hip traction, and immediately after traction removal (Group H,I,J,L and 0), and 30 minutes after traction removal with 60,90 and 120 minutes continuous traction(Group K,M and P),and 60 minutes after traction removal with 90 and 120 minutes continuous traction(Group N and Q). DSA was also performed immediately during 4 kg weight traction before continuous traction in 12 hips( Group C).Blood circulation of the femoral head was evaluated mainly by observing its perfusion and time of circulation. Femur head perfusion was assessed as good scoring 3,poor scoring 2 and extremely poor scoring 1. Femur head circulation time was assessed as normal scoring 3 .prolonged scoring 2 and remarkably prolonged scoring 1. Analysis of variance was employed for analysis of the angiographic findings between different groups.Results Good femoral head perfusion in Group A to Q was 22,0,0,0,0,0,0,22,22,1,18,0,0,8,0,0 and 1 hips respectively, poor one was 0,22,8,22,15,4,1,0,0,15,2,4,6,2,1,3 and 8 hips, respectively,extremely poor one was 0,0,4,0,5,6,9,0,0,4,0,6,4,0,9,7 and 1 hips, respectively; and normal femoral head blood circulation time was 22,0,0,0,0,0,0,22,22,1,18,0,0,8,0,0 and 1 hips, respectively, prolonged one was 0,22,9,22,15,4,2,0,0, 15,2,5,7,2,2,4 and 8 hips, respectively, remarkably prolonged one was 0,0,3,0,5,6,8,0,0,4,0,5,3,0,8,6 and 1 hips, respectively. F value of femoral head perfusion among group A and B,group B and C,group B,D,E,F and G,Group H,I,J,L and O,group K,M and P,Group N and Q was 437. 48,30. 25,29. 04,132. 69,143. 73,25.20, respectively, and their P value was all <0. 01. F value of femoral head circulation time among group A and B,group B and C,group B,D,E,F and G,Group H,I,J,L and O,group K,M and P,Group N and Q was 386. 26,31. 83,22.43,141. 94,119.69,21.68, respectively, and their P value was all < 0.01. Conclusions Traction could lead to ischemic response and circulation disorder of canine femoral head. The longer the traction time or the bigger the traction weight was, the poorer the femoral head perfusion and the longer the femoral head circulation time were, and the slower they recovered. DSA could directly reflect these changes in the femoral head with these angioarchitectural and hemodynamic indexes.

Objective To observe the effect of electroacupuncture(EA) on Calbindin D28K(CB) expression and apoptosis in hippocampus in hyperlipemia rats with concomitant cerebral ischemia(CI).Methods Forty male SD rats were rando-mized into control,hyperlipemia+CI(model),acupuncture Ⅰ,and acupuncture Ⅱ groups,with 10 cases in each.Hyperlipemia model was established by feeding the animals with high fat forage for 6 weeks and CI model established by occlusion of the unila-teral middle cerebral artery.For rats of acupuncture Ⅰ group,EA(1-3 mA,15 Hz) was applied to bilateral "Sanyinjiao"(SP 6) and "Fenglong"(ST 40) for 20 min every time,once daily for 10 days before CI.For rats of both acupuncture Ⅰ and Ⅱ groups,after CI,EA was applied to SP 6,ST 40,"Baihui"(GV 20) and "Shuigou"(GV 26) were punctured with filiform needles and stimulated by twirled the needle with hand continuously for 1 min,once daily for 7 days.The apoptotic cells of hippocampal CA 3 area were displayed by TUNEL(terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling) method.CB antibody staining with immunohistochemistry was used to show CB-positive cells which were observed by optic microscope.Results In comparison with control group,the percentage of apoptotic cells of the hippocampal CA 3 area in model group increased considerably(P