OBJECTIVE: To study the development of surgical robots at home and abroad in recent years. METHODS: Through a large number of literature review and analysis, the qualification approval and technical function characteristics of domestic and foreign surgical robots from January 2019 to July 2022 were analyzed. RESULTS: The related situations of 39 surgical robots were analyzed and reported, and the shortcomings and future development direction of the current surgical robots were summarized. CONCLUSIONS The development of surgical robots in China is now in a rapid development stage. At present, surgical robots generally have the disadvantages of high cost, lack of tactile feedback (force feedback), large size, large space occupation and difficult to move. In the future, it will develop towards intelligent, miniaturized, remote, open and low-cost.
China ; Robotics ; Robotic Surgical Procedures

Objective:To explore the application and effect of the online teaching in the clinical nursing practice of obstetrics and gynecology during the coronavirus disease 2019 (COVID-19) epidemic.Methods:A total of 26 undergraduate nursing interns in the obstetrics and gynecology department of Xiangya Hospital of Central South University during the epidemic period were enrolled in this study. The interns accepted online practical teaching, and the teaching effect was analyzed and evaluated through the results of the exit examination and online teaching satisfaction.Results:The theoretical course scores of nursing students are all above 80 points, among which 22 (84.62%) are above 90 points. The operation scores are all above 90 (94.04±2.96) points. The results of the online teaching satisfaction survey show that, 23 (88.46%) nursing students are satisfied with the effect of their online practice.Conclusion:The online teaching mode during COVID-19 epidemic can help nursing students master the theoretical knowledge of obstetrics and gynecology, improve their clinical reasoning ability, strengthen their practical operation skills, and enhance their autonomous learning ability.

OBJECTIVETo investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province.

METHODS44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March, 2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't.

RESULTS33.8% (69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16% (702/865) of the records were with accurate information. 74.36% (522/702) of the patients received normative services. Blood pressure was well controlled in 86.92% (299/344) of the hyperpietics, and FPG was well controlled in 85.46% (288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69% (677/686), but of which had not was just 40.38% (21/52) (χ² = 320.52, P < 0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ² = 2.92, P = 0.087).

CONCLUSIONThe quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Objective To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province. Methods 44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March,2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't. Results 33.8%(69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16%(702/865) of the records were with accurate information. 74.36%(522/702) of the patients received normative services. Blood pressure was well controlled in 86.92%(299/344) of the hyperpietics, and FPG was well controlled in 85.46%(288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69%(677/686), but of which had not was just 40.38% (21/52) (χ2=320.52,P<0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ2=2.92,P=0.087). Conclusion The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Objective To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province. Methods 44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March,2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't. Results 33.8%(69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16%(702/865) of the records were with accurate information. 74.36%(522/702) of the patients received normative services. Blood pressure was well controlled in 86.92%(299/344) of the hyperpietics, and FPG was well controlled in 85.46%(288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69%(677/686), but of which had not was just 40.38% (21/52) (χ2=320.52,P<0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ2=2.92,P=0.087). Conclusion The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

ObjectiveTo study the feasibility and technique in liver transplantation (LT) in an adult with situs inversus (SI) and reviewed the medical literature on this subject.MethodsA 45-year-old male with complete SI,suffered from progressive hepatic failure secondary to hepatolithiasis,obstructive jaundice,portal hypertension and liver cirrhosis.He underwent liver transplantation in July 2004.His anatomy was studied by preoperative CT scan and three-dimensional liver reconstruction imaging and angiography.LT was performed using the modified piggyback technique.The donor right liver was rotated 45 degree to the left,making the donor left liver pointing to the left paracolic sulcus and the donor right liver was in the recipient hepatic fossa.The donor suprahepatic vena cava was anastomosed end-to-side to the recipient vena cava,and the infrahepatic vena cava was closed by oversewing.ResultThe patient recovered uneventfully.His liver function was stable during a follow-up of 75 months.ConclusionLT in patients with SI is safe and feasible.Exact determination of the anatomy,comprehensive preoperative planning,and good technique in liver transplantation play important roles in LT for patients with SI.

Objective To explore the significance of surgical resection for the pineal region tumor,the extent of tumor resection,the surgical approaches and treatment measures of hydrocephalus.Methods Twentythree patients diagnosed of pineal region cancer were recruited for this study.Thirteen patients received ventriculo-peritoneal shunt(V-P),during which 7 cases received intraoperative end-plate colostomy.Two of the 13 cases received a second V-P procedure.Another 13 cases received operation by corpus callosum- septum-Dome Room-the third ventricle approach to remove the tumor; Eight cases underwent the tumor resection by suboccipital supratentorial approach (Poppen approach )and 2 cases underwent the tumor resection by the infratentorial cerebellar approach( Krause approach).Results Total tumor resection was performed in 11 cases,subtotal or major total resection in 8 cases and partial resection in 4 cases.Nine cases underwent postoperative radiotherapy alone,8 receiving radiotherapy plus chemotherapy,and 6 cases receiving neither radiotherapy nor chemotherapy.Two cases died during treatment.Conclusion Though it is not practicable to completely remove the germ cell tumor in patients with relatively large tumors,cerebrospinal fluid circulation pathways should be reestablished,including ventriculo-peritoneal shunt,colostomy from the end of the third ventricle to the end plate.If tumors are not too large,they would be easy to be removed.The effects on the surrounding brain tissue would not be much significant.If the connection of Ⅲ,V ventricles were normal,the patient may not need shunt or colostomy.Radiotherapy and chemotherapy can be given to this kind of patients after the surgery.To improve the efficacy,other types of tumors,expecially the benign tumors,should be totally removed.

Objective To discuss the clinical features of immunocompetent patients with Penicilliosis marneffei.Methods To analyze and summarize the clinical data of 4 immunocompetent patients with Penicilliosis marneffei.Results Clinical manifestation of patients centered on intermittent slight or mild fever,lymphadenectasis,skin eruptions,osteolytic destruction,anaemia,and leukocytosis.The cultural Penicillium marneffei in specimen such as blood,pus showed a higher positive rate.Amphotericin B and itraconazole was available in treatment.Conclusion Immunocompetent people can be infected by Penicillium marneffei,and they appear nonspecific in clinical manifestation after infection.A timely and effective antifungal therapy can improve the prognosis of patients.

Objective To explore the effect of age on clinical postoperative outcomes of elderly patients with colorectal cancer undergoing surgical treatment. Methods The clinical data of 1249 patients from January 1999 to December 2007 were analyzed retrospectively, and patients were divided into two groups according to age; the study group (≥75 years, n=312) and the control group (<75 years, n=937). Results (1) The average age was significantly higher in study group than in control group (t=33.09,P<0.05), and the rates of malnutrition risk, co-morbidity, tumor in right colon and local Iymphonodus metastasis were significantly higher in study group than in control group (x2=47.33, 130.75, 21.24 and 45.33, P<0.05). ( 2 ) The rates of preoperative surgical complications, bowel obstruction and emergency operation were significantly higher in study group than in control group (x2 =26.81, 34.14 and 10.72, P<0.05) . The rate of resection was significantly lower in study group than in control group (x2 =9.732, P<0.05). (3) The overall incidences of postoperative complications, general complications and mortality of perioperative period were significantly higher in study group than in control group (x2= 19.38, 20.75 and 10.11,P<0.05). (4) The two-year survival and five-year survival were significantly lower in study group than in control group (x2=11.91 and 27.17, P<0.05), but there were no significant differences in the cancer-specific two-year survival and five-year survival between the both groups. Conclusions Preoperative complications and co-morbidities, local tumor metastasis and postoperative nonsurgical complications adversely affect the postoperative outcomes for elderly patients with colorectal cancer.

OBJECTIVE To study the pharmacokinetics of heat shock protein 65-mucin 1 (HSP65-MUC1) recombinant fusion protein vaccine in Macaca mulatta monkeys and tumor-bearing mice. METHODS HSP65-MUC1 was labeled by radioactive isotope 125I. M. mulatta monkeys were randomly divided into sc and iv administration groups. Simultaneously, sc administration group was designed as a multiple dose group in which M. mulatta monkeys were sc given [ 125I] HSP65-MUC1 40 μg·g-1, once every 2 weeks for a total of 3 times. Size exclusion chromatography ( SEC) was used to determine concentrations of HSP65-MUC1 in serum samples. The tumor-bearing mice were randomly divided into 0.5, 1.5, 4, 8 and 24 h groups. Mice were sc given [125I] HSP65-MUC1 550 μg·kg-1, tissues were collected and tissue distribution of [125I] HSP65-MUC1 in tumor-bearing mice was studied using trichloroacetic acid (TCA) precipitation method. RESULTS The absolute bioavailability of [125I]HSP65-MUC1 was 38.33% after M. mulatta monkeys were sc given [125I]HSP65-MUC1. In multiple dose group, concentrations of [125I]HSP65-MUC1 after the third dose administration was compared to that of the first dose administration. The accumulation factor (AUC3/AUC1) was 1.17 ±0.25. Distribution of [ 125I]HSP65-MUC1 was significantly different compared with general polypeptide and protein drugs after sc in tumor-bearing mice. The concentration in lymph nodes was the highest. The concentration in other immune tissues, such as thymus and spleen, were not relatively high, but their declined tendency was slow after reaching the peak concentration (cmax ). However, the concentrations in the serum and some other tissues with a large blood volume, such as the heart, liver, and lung, were relatively low and declined quickly after reaching cmax. Its level in the tumor was not very high. [125 I] HSP65-MUC1 was excreted mainly by the kidneys. CONCLUSION The bioavailability of [125I]HSP65-MUC1 is 38.33% after sc administration in M. mulatta. After multiple-dose administration, the vaccine does not accumulate in the body, whose concentration is the highest in lymph nodes after [1251] HSP65-MUC1 was sc given in tumor-bearing mice, but is not very high in tumor. Besides, the vaccine declined tendency is slow after reaching cmax in immune tissues such as thymus and spleen compared with other tissues with a large blood volume.