BACKGROUND: Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood. METHODS: A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000 km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons. RESULTS: All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866 min. The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions. CONCLUSIONS This telesurgery system demonstrated safety and reliability. A total of 320 ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.
Animals ; Robotic Surgical Procedures/methods* ; Laparoscopy/methods*

Objective To investigate the effects of lycium barbarum polysaccharide(LBP)on the proliferation and metastasis of gallbladder cancer cells(NOZ and SGC-996)by regulating cellular ferroptosis.Methods NOZ and SGC-996 cells were cul-tured in vitro by treatment with different doses of LBP.The cells were divided into control group,20 μmol/L LBP group,40μmol/L LBP group,60 μmol/L LBP group,80 μmol/L LBP group,and LBP+Fe-1 groups.Cell activity was detected by MTT assay.Cell proliferation was detected by EdU assay.Cell invasion ability was detected by Transwell assay.Fe2+level was detec-ted by colorimetric assay,reactive oxygen species(ROS)and malondialdehyde(MDA)levels were determined by BODIPYT 581/591 C11 molecular probe.Western blot was used to detect glutathione peroxidase 4(GPX4),acyl-CoA Synthetase long-chain family member 4(ACSL4),β-catenin,and Wnt3A protein expression.Results Compared with the control group,cell viability,proliferation,and invasion were significantly decreased in the 40 μmol/L LBP,and 60 μmol/L LBP groups(all P＜0.05),and Fe2+level,ROS,and MDA activities were significantly increased(all P＜0.05),and GPX4,β-catenin,and Wnt3A protein ex-pressions were significantly reduced,and ACSL4 protein expression was significantly increased(all P＜0.05).Compared with the LBP group,cell viability,proliferation,and invasion ability were significantly increased in the LBP+Fer-1 group(all P＜0.05).Conclusion LBP inhibits the proliferation and metastasis of gallbladder cancer cells by inducing ferroptosis.

Objective To analyze the morphological alterations of corpus callosum in children with spastic cerebral palsy(SCP)using three-dimensional magnetization prepared rapid acquisition gradient echo(3D-MPRAGE)technology and to investigate the correlation between morphological indexes and gross motor function.Methods Sagittal T1WI 3D-MPRAGE data was collected from 136 children with SCP(SCP group)and 132 age-and gender-matched healthy controls(HC)(HC group),and the gross motor function measure-88(GMFM-88)was applied to assess the gross motor function.Independent sample t-test was used to compare the corpus callosum surface area,volume,maximum anterior-posterior diameter,median sagittal area(total area and area of Ⅰ-Ⅴ zone)between the two groups.Partial correlation analysis was performed to calculate the correlation between morphological indexes of the corpus callosum and GMFM-88 with age as a covariate.Results Children under 3 years old,the corpus callosum surface area of the SCP group(3 914.51 mm2±1 207.97 mm2)was lower than that of the HC group(5 725.51 mm2±1 412.66 mm2).The volume of the corpus callosum(6 108.46 mm3±2 803.97 mm3)in the SCP group was lower than that of the HC group(11 297.96 mm3±4 109.02 mm3).Also,the maximum anterior-posterior diameter of the corpus callosum in the SCP group(53.40 mm±6.31 mm)was lower than that of the HC group(57.74 mm±6.04 mm)(all P<0.05).Children over 3 years old,the corpus callosum surface area of the SCP group(4 970.06 mm2±1 191.31 mm2)was lower than that of the HC group(6 372.55 mm2±1 445.59 mm2).The volume of the corpus callosum(8 330.20 mm3±2 888.20 mm3)in the SCP group was lower than that of the HC group(13 599.82 mm3±3 429.81 mm3)(all P<0.05).Partial correlation analysis showed significant correlation between corpus callosum volume,median sagittal area and gross motor score(P<0.01)with age as a covari-ate.Conclusion The 3D-MPRAGE technology can be useful for the comprehensive assessment of morphological alterations of the corpus callosum in SCP.The corpus callosum volume,and median sagittal area may become neuroimaging references for the assess-ment of motor development in cerebral palsy(CP).

Sensory dysfunction is a common clinical problem for children with cerebral palsy.Proprioception plays a key role in maintaining postural adjustment and balance coordination, so proprioceptive assessment is of great significance for further rehabilitation of children with cerebral palsy.At present, proprioception assessment is mainly used in adults such as stroke and joint injury, but there is still a lack of research in children, especially in children with cerebral palsy.Therefore, this paper aims to review the evaluation of proprioception of children with cerebral palsy at home and abroad.

Objective To explore the clinical utility of endoclip papilloplasty in endoscopic retrograde cholangiopancreatography(ERCP).Methods A prospective study was conducted and selected 62 patients who underwent ERCP from November 2021 to November 2022.30 out of 32 patients who randomly underwent endoclip papilloplasty were successful.These patients were assigned to successful endoclip papilloplasty group(group A,n=30)or the duodenal papilla unclamping group(group B,n=30).The aim was to compare the difference in short-term and long-term complications between the two groups.Results The success rate of papillary plasty was 93.8%(30/32),with no statistically significant differences observed in the incidence of postoperative pancreatitis,postoperative hemorrhage after ERCP,and postoperative cholangitis between the two groups(P>0.05).The duodenal perforation rate was 0.There were no significant differences between the two groups in terms of total cholangitis incidence and recurrence rate of calculus of common bile duct within 1 year(P>0.05).However,there was a statistical difference in terms of total the incidence of cholangitis+calculus of common bile duct recurrence within 1 year(P<0.05).Conclusion The endoclip papilloplasty exhibits a high success rate and safety and feasibility procedure reducing long-term recurrence rate of cholangitis and calculus of common bile duct in endoscopic papillary large balloon dilation(EPLBD)procedure.

This experiment was conducted to investigate the effects of agaric polysaccharides on an-tioxidant capacity,immune function,and intestinal flora of calves.Twenty-four healthy Holstein calves of(30±3)days of age and with the similar body weight at(55.33±1.86)kg were selected and randomly divided into two groups:the control group(group C)and test group(group T)with 12 replicates in each group and one calves in each replicate.Group C was fed starter and milk repla-cer,and group T was fed starter and milk replacer with 10 g of agaric polysaccharides to each calve for 10 d.Serum antioxidant,immune indexes and intestinal flora were tested.The results showed as follows:compared with group C,the enzyme activities of SOD and GSH-Px in serum of calves in group T were significantly increased(P＜0.05),and were increased by 29.09％and 15.35％,re-spectively;compared with group C,IgA,IL-2 and TNF-α were significantly increased in T group(P＜0.05).Adding agaric polysaccharides significantly increased the relative abundance of Firmi-cutes(P＜0.05)and decreased the relative abundance of Proteobacteria in feces of calf(P＞0.05);the relative abundance of Lactobalillus and Faecalibacterium were increased(P＜0.05);the relative abundance of Butyricoccus-pullicaecorum was increased(P＜0.05).LEfSe analysis results showed that there were 11 marker species in group T,such as Firmicutes and Lactobacillus,and 9 marker species in group C,such as Proteobacteria.The results showed that agaric polysaccharides could improve the antioxidant capacity and immune function of calves,and also could improve the structure of intestinal flora.

Objective:To study the clinical results of personalized surgical treatment for portal hypertension based on portal venous hemodynamics.Methods:A retrospective study was performed on patients with portal hypertension who underwent surgical treatment from January 2016 to December 2020 at the People’s Hospital of Ningxia Hui Autonomous Region and Wuhai People’s Hospital. Of 229 patients included into this study, there were 156 males and 73 females, with age of (4±11) years old. Portal vein CT and ultrasound doppler examination were performed preoperatively and portal vein manometry and ultrasound doppler examination were performed intraoperatively to evaluate portal venous hemodynamics. Based on the evaluation results, different surgical treatments were adopted. Postoperative complications and results of the operations were recorded. Long-term outcomes were evaluated by the rate of recurrence of gastroesophageal varices which was classified as disappearance, mild, moderate and severe according to endoscopic findings.Results:All the 229 patients completed the operations successfully. All together 13 operative treatments were used: (1) simple splenectomy ( n=11); (2) devascularization ( n=176), including 86 patients with splenectomy combined with extensive devascularization, 44 patients with splenectomy combined with selective devascularization and with preservation of paraesophageal veins, 39 patients with splenectomy combined with selective devascularization and reconstruction of spontaneous portosystemic shunt (34 patients with selective devascularization and reconstruction of spontaneous gastrorenal shunt and 5 patients with selective devascularization and reconstruction of spontaneous splenorenal shunt), 4 patients with secondary devascularization for variceal recurrence and 3 patients with devascularization and preservation of spleen; (3) shunt procedures were performed in 42 patients including 21 patients with splenectomy combined with coronary renal shunt, 11 patients with splenectomy combined with coronary-caval shunt, 6 patients with distal splenorenal shunt, 2 patients with proximal splenorenal shunt combined with devascularization, 1 patient with right gastroepiploic vein-inferior vena cava shunt and 1 patient with trans-inferior mesenteric vein coronary renal shunt. There were no operative deaths. The Clavien-Dindo grade 3 and above postoperative complication rate was 6.6% (15/229). Two hundred and eight patients were followed up for 6-60 months, with a median follow-up of 38 months. Severe recurrent varices were found in 21 patients (10.1%, 21/208), with 5 patients (2.4%, 5/208) presented with variceal bleeding. The rate of severe varices after selective shunting and selective devascularization by reconstructing the spontaneous portosystemic shunt (4.2%, 3/72) was significantly lower than that of the other devascularization procedures (13.7%, 17/124)(χ 2=4.53, P=0.033). Conclusion:Better clinical results were achieved by selecting the appropriate surgical procedures based on portal venous hemodynamic characteristics of patients. Selective shunting and selective devascularization by reconstructing the spontaneous portosystemic shunts significantly reduced the recurrence rate of severe varies.

Objective:To evaluate the preventive effect of proximal splenic vein ligation after splenectomy on the splenic vein originated portal vein thrombosis (PVT) in portal hypertension.Methods:The clinical data of 94 patients of portal hypertension who had received splenectomy were retrospectively analysed. The proximal splenic vein was ligated in 36 cases during pericardial devascularization and coronary renal shunt with splenectomy. The other 58 cases who had received pericardial devascularization without proximal splenic vein ligation served as control. All of the patients in both groups were given heparin infusion postoperatively through the catheter which was placed in the right gastroepiploic vein during operation. CT portal veinography was performed at the 7th-14th postoperative day for detection of PVT.Results:None of the PVT occurred in the splenic vein ligation group. In the control group, PVT occurred in 22 cases(38%) and splenic vein thrombosis occurred in all the 58 cases (100%). PVT incidence between the two groups is significantly different (0 vs. 38%, χ 2=17.828, P<0.05). Conclusions:Ligation of the proximal splenic vein during splenectomy can effectively prevent the postoperative splenic vein originated PVT in portal hypertension.

The SARS-CoV-2 has been spread to 26 countries around the world since its outbreak. By February 16, 2020, more than 68 000 people had been diagnosed with COVID-19. Researchers from all over the world have carried out timely studies on this public health emergency and produced a number of scientific publications. This review aims to re-analyze and summarize the current research findings in a timely manner to guide scholars in relevant fields to further SARS-CoV-2 research and assist healthcare professionals in their work and decision-making. The SARS-CoV-2 related terms were selected in both English and Chinese and were searched in several major databases, including Pubmed, Web of Science, CNKI, Wanfang, and VIP databases. The reference list of each search result was screened for relevance, which was further supplemented to the search results. The included studies were categorized by topics with key characteristics extracted, re-analyzed, and summarized. A total of 301 articles were finally included with 136 in Chinese and 165 in English. The number of publications has rapidly increased since mid-January, 2020, and a peak day was 6th February on which 50 articles were published. The top three countries publishing articles were China, the United States and the United Kingdom. The and its specialty journals have published the most articles, with contribution also from journals such as ( ), ( ), and . All articles were categorized into epidemiology, clinical diagnosis and treatment, basic research, pregnant women and children, mental health, epidemic prevention & control, and others. The literatures related to SARS-CoV-2 are emerging rapidly. It is necessary to sort out and summarize the research topic in time, which has a good reference value for staff in different positions. At the same time, it is necessary to strengthen the judgment of the quality of literatures.
Betacoronavirus ; Bibliometrics ; Biomedical Research ; trends ; China ; Coronavirus Infections ; Humans ; Pandemics ; Periodicals as Topic ; Pneumonia, Viral ; United Kingdom ; United States