Objective:To explore the safety and short-term efficacy of single-port robotic transanal total mesorectal excision (SPr-taTME).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of six patients who underwent SPr-taTME at Daping Hospital of Army Medical University from October to November 2024 were collected. There were 3 males and 3 females, aged (65±5)years. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represen-ted as Mean± SD, measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Intraoperative situations. All patients successfully underwent SPr-taTME without conversion to laparotomy or blood transfusion. There was no intraoperative complication such as accidental hemorrhage or adjacent organ injury. No intra-operative adverse events or mortality occurred. The operation time of the 6 patients was 286(range, 240?400)minutes. The time of transanal platform setup and robotic docking was (21±10)minutes, transanal dissection time was (97±45)minutes, and transabdominal dissection time was (90±35)minutes. The volume of intraoperative blood loss was (47±14)mL. Among the six patients, 1 case underwent synchronous transanal and transabdominal surgery, while 5 cases underwent non-synchronous procedures. Specimens were extracted transanally in 5 cases and via an auxiliary abdominal incision in 1 case. The single-port robotic platform was utilized for the abdominal surgery in 3 cases, while laparoscopy was used in 3 cases. Splenic flexure mobilization was performed in 3 cases and omitted in the other 3 cases. Three patients underwent hand-sewn sigmoid colon-anal anastomosis, 1 case underwent modified Bacon pull-through anastomosis, 1 case received stapled sigmoidorectal anastomosis, 1 case underwent sigmoid colostomy without anastomosis due to significant bowel edema. Two cases didn′t undergo intestinal stoma, 2 cases underwent virtual ileostomy, 1 case underwent ileostomy, and 1 case underwent sigmoid colostomy. (2) Postoperative situations. All patients started water drinking and out‐of‐bed activities on postoperative day 1 and liquid diet intake on postoperative day 2. The time to postoperative first flatus was 1(range, 1?3)days, and duration of postoperative hospital stay was (8±2)days.The total number of lymph nodes dissected was 13±2, with the number of positive lymph nodes as 0(range, 0?3) and the distance of distal resection margin as (23±8)mm. Pathological examination of 6 patients showed 1 case in stage T1N0, 2 cases in stage ypT0N0, 1 case in ypT1N0, 1 case in ypT3N1, and 1 case in ypT0N1. The degree of mesorectal integrity was complete in 5 patients and nearly complete in 1 patient. The surgical specimens of 6 patients showed negative in distal, proximal and circumferential margin. (3) Follow-up. All 6 patients completed the 30-day postoperative follow-up. None of the patients experienced postoperative complication such as bleeding, intestinal obstruction or anastomotic leakage. There was no readmission within 30 days after surgery. Digital rectal examination or colonoscopy on postoperative 30 day confirmed no anastomosis-related complications, including stenosis, dehiscence or anastomotic leakage. All 6 patients survived.Conclusion:The SPr-taTME is safe and feasible, with satisfactory short-term efficacy.

Objective:To explore the safety and short-term efficacy of single-port robotic transanal total mesorectal excision (SPr-taTME).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of six patients who underwent SPr-taTME at Daping Hospital of Army Medical University from October to November 2024 were collected. There were 3 males and 3 females, aged (65±5)years. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represen-ted as Mean± SD, measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Intraoperative situations. All patients successfully underwent SPr-taTME without conversion to laparotomy or blood transfusion. There was no intraoperative complication such as accidental hemorrhage or adjacent organ injury. No intra-operative adverse events or mortality occurred. The operation time of the 6 patients was 286(range, 240?400)minutes. The time of transanal platform setup and robotic docking was (21±10)minutes, transanal dissection time was (97±45)minutes, and transabdominal dissection time was (90±35)minutes. The volume of intraoperative blood loss was (47±14)mL. Among the six patients, 1 case underwent synchronous transanal and transabdominal surgery, while 5 cases underwent non-synchronous procedures. Specimens were extracted transanally in 5 cases and via an auxiliary abdominal incision in 1 case. The single-port robotic platform was utilized for the abdominal surgery in 3 cases, while laparoscopy was used in 3 cases. Splenic flexure mobilization was performed in 3 cases and omitted in the other 3 cases. Three patients underwent hand-sewn sigmoid colon-anal anastomosis, 1 case underwent modified Bacon pull-through anastomosis, 1 case received stapled sigmoidorectal anastomosis, 1 case underwent sigmoid colostomy without anastomosis due to significant bowel edema. Two cases didn′t undergo intestinal stoma, 2 cases underwent virtual ileostomy, 1 case underwent ileostomy, and 1 case underwent sigmoid colostomy. (2) Postoperative situations. All patients started water drinking and out‐of‐bed activities on postoperative day 1 and liquid diet intake on postoperative day 2. The time to postoperative first flatus was 1(range, 1?3)days, and duration of postoperative hospital stay was (8±2)days.The total number of lymph nodes dissected was 13±2, with the number of positive lymph nodes as 0(range, 0?3) and the distance of distal resection margin as (23±8)mm. Pathological examination of 6 patients showed 1 case in stage T1N0, 2 cases in stage ypT0N0, 1 case in ypT1N0, 1 case in ypT3N1, and 1 case in ypT0N1. The degree of mesorectal integrity was complete in 5 patients and nearly complete in 1 patient. The surgical specimens of 6 patients showed negative in distal, proximal and circumferential margin. (3) Follow-up. All 6 patients completed the 30-day postoperative follow-up. None of the patients experienced postoperative complication such as bleeding, intestinal obstruction or anastomotic leakage. There was no readmission within 30 days after surgery. Digital rectal examination or colonoscopy on postoperative 30 day confirmed no anastomosis-related complications, including stenosis, dehiscence or anastomotic leakage. All 6 patients survived.Conclusion:The SPr-taTME is safe and feasible, with satisfactory short-term efficacy.

AIM:To investigate the protective effect of decylubiquinone(DUb)against medium-wave ultravio-let(UVB)-induced photodamage in HaCaT cells and its molecular mechanism.METHODS:The photodamage model was established by irradiating HaCaT cells with UVB.The experiment was divided into 6 groups:control group,UVB model group(30 mJ/cm2),UVB+low-,medium-and high-concentration(2.5,5 and 10 μmol/L)DUb groups,and DUb(10 μmol/L)group.Cell viability was detected using the CCK-8 assay.The morphological changes of the HaCaT cells were observed under a light microscope.The production of reactive oxygen species(ROS)content in the HaCaT cells was analyzed by fluorescence probe of DCFH-DA,and the superoxide dismutase(SOD)activity,intracellular glutathione(GSH)and malondialdehyde(MDA)levels were detected using biochemical reagents.The apoptosis rate was detected through flow cytometry.The protein expression levels of Bax、Bcl-2、caspase-3 and p53 were detected by Western blot.RESULTS:Compared with the control group,the cell viability of UVB model group was significantly decreased(P＜0.01),and obvious morphological changes,ROS and MDA were significantly increased(P＜0.01),GSH and SOD were significantly decreased(P＜0.01),the apoptosis rate was increased(P＜0.01).DUb pretreatment significantly increased the viability of UVB-induced photodamage HaCaT cells(P＜0.01),decreased intracellular ROS and MDA production(P＜0.05,P＜0.01),increased GSH content and SOD activity(P＜0.05,P＜0.01),and reduced apoptosis(P＜0.01).Addi-tionally,the protein expression levels of Bax,caspase-3 and p53 in medium-and high-dose DUb groups were significantly decreased(P＜0.01),while the anti-apoptotic protein Bcl-2 was significantly increased(P＜0.01).CONCLUSION:Dec-ylubiquinone can alleviate UVB-induced photodamage to HaCaT cells,reduce apoptosis and enhance the antioxidant ca-pacity of cells,and protect HaCaT cells against UVB radiation.

AIM:To investigate the protective effect of decylubiquinone(DUb)against medium-wave ultravio-let(UVB)-induced photodamage in HaCaT cells and its molecular mechanism.METHODS:The photodamage model was established by irradiating HaCaT cells with UVB.The experiment was divided into 6 groups:control group,UVB model group(30 mJ/cm2),UVB+low-,medium-and high-concentration(2.5,5 and 10 μmol/L)DUb groups,and DUb(10 μmol/L)group.Cell viability was detected using the CCK-8 assay.The morphological changes of the HaCaT cells were observed under a light microscope.The production of reactive oxygen species(ROS)content in the HaCaT cells was analyzed by fluorescence probe of DCFH-DA,and the superoxide dismutase(SOD)activity,intracellular glutathione(GSH)and malondialdehyde(MDA)levels were detected using biochemical reagents.The apoptosis rate was detected through flow cytometry.The protein expression levels of Bax、Bcl-2、caspase-3 and p53 were detected by Western blot.RESULTS:Compared with the control group,the cell viability of UVB model group was significantly decreased(P＜0.01),and obvious morphological changes,ROS and MDA were significantly increased(P＜0.01),GSH and SOD were significantly decreased(P＜0.01),the apoptosis rate was increased(P＜0.01).DUb pretreatment significantly increased the viability of UVB-induced photodamage HaCaT cells(P＜0.01),decreased intracellular ROS and MDA production(P＜0.05,P＜0.01),increased GSH content and SOD activity(P＜0.05,P＜0.01),and reduced apoptosis(P＜0.01).Addi-tionally,the protein expression levels of Bax,caspase-3 and p53 in medium-and high-dose DUb groups were significantly decreased(P＜0.01),while the anti-apoptotic protein Bcl-2 was significantly increased(P＜0.01).CONCLUSION:Dec-ylubiquinone can alleviate UVB-induced photodamage to HaCaT cells,reduce apoptosis and enhance the antioxidant ca-pacity of cells,and protect HaCaT cells against UVB radiation.

Objective: To investigate the methods for qualitative pathological assessment of dynamic changes in liver fibrosis/cirrhosis after antiviral therapy in patients with chronic hepatitis B (CHB), since antiviral therapy can partially reverse liver fibrosis and cirrhosis caused by hepatitis B and semi-quantitative, rather than qualitative, pathological assessment is often used for the research on liver fibrosis regression. Methods: Previously untreated CHB patients with liver fibrosis and cirrhosis were enrolled, and liver biopsy was performed before treatment and at 78 weeks after the antiviral therapy based on entecavir. The follow-up assessment was performed once every half a year. Based on the proportion of different types of fibrous septum, we put forward the new qualitative criteria called P-I-R classification (predominantly progressive, predominantly regressive, and indeterminate) for evaluating dynamic changes in liver fibrosis. This classification or Ishak fibrosis stage was used to evaluate the change in liver fibrosis after treatment and Ishak liver inflammation score was used to evaluate the change in liver inflammation after treatment. Results: A total of 112 CHB patients who underwent liver biopsy before and after treatment were enrolled, and among these patients, 71 with an Ishak stage of ≥3 and qualified results of live biopsy were included in the final analysis. Based on the P-I-R classification, 58% (41/71) were classified as predominantly progressive, 29% (21/71) were classified as indeterminate, and 13% (9/71) were classified as predominantly regressive; there were no significant differences between the three groups in alanine aminotransferase, aspartate aminotransferase, albumin, HBeAg positive rate, HBV DNA, and liver stiffness (P < 0.05). After treatment, the proportion of predominantly progressive, indeterminate, or predominantly regressive patients changed to 11% (8/71), 11% (8/71), and 78% (55/71), respectively. Among the 35 patients who had no change in Ishak stage after treatment, 72% (25/35) were classified as predominantly regressive and had certain reductions in the Laennec score, percentage of collagen area, and liver stiffness. Conclusion This new P-I-R classification can be used to assess the dynamic changes in liver fibrosis after antiviral therapy in CHB patients.