Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective To investigate the therapeutic effects and mechanisms of emodin(EMO)on dextran sulfate(DSS)-induced ulcerative colitis(UC)in mice.Methods DSS induced UC mouse model,detection of body weight,colon length and histopathological changes.Enzyme-linked immunosorbent assay(ELISA)was used to measure tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-10(IL-10),and myeloperoxidase(MPO)levels.Western blot analysis examined the expression of Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor κB(NF-κB)signaling pathway-related proteins.Flow cytometry assessed the ratio of helper T cells 17(Th17)to regulatory T cells(Treg).Additionally,16S rDNA sequencing was employed to evaluate gut microbiota composition.Results Compared with the normal group,DSS-treated mice exhibited significant weight loss,shortened colon length,and marked histological damage(P<0.001).EMO intervention,particularly at high doses,demonstrated dose-dependent improvements in body weight and colon injury(P<0.05).ELISA analysis showed EMO reduced TNF-α,IL-1β,and IL-6 levels while increasing IL-10(P<0.05).Western blot results indicated EMO inhibited abnormal activation of the TLR4/MyD88/NF-κB pathway and restored IκB.Conclusion EMO effectively mitigates DSS-induced ulcerative colitis(UC)inflammation and intestinal damage by regulating the TLR4/MyD88/NF-κB pathway,restoring Th17/Treg balance,and maintaining microbial homeostasis,providing theoretical support for its potential as a UC therapeutic agent.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Pentaxin 3 (PTX3), as a multifunctional glycoprotein, plays an important role in regulating inflammatory response, promoting tissue repair, inducing ectopic calcification and maintaining bone homeostasis. The effect of PTX3 on bone mineral density (BMD) may be affected by many factors. In PTX3 knockout mice and osteoporosis (OP) patients, the deletion of PTX3 will lead to decrease of BMD. In Korean community "Dong-gu study", it was found that plasma PTX3 was negatively correlated with BMD of femoral neck in male elderly patients. In terms of bone related cells, PTX3 plays an important role in maintaining the phenotype and function of osteoblasts (OB) in OP state;for osteoclast (OC), PTX3 in inflammatory state could stimulate nuclear factor κ receptor activator of nuclear factor-κB ligand (RANKL) production and its combination with TNF-stimulated gene 6(TSG-6) could improve activity of osteoclasts and promote bone resorption;for mesenchymal stem cells (MSCs), PTX3 could promote osteogenic differentiation of MSCs through PI3K/Akt signaling pathway. In recent years, the role of PTX3 as a new bone metabolism regulator in OP and fracture healing has been gradually concerned by scholars. In OP patients, PTX3 regulates bone mass mainly by promoting bone regeneration. In the process of fracture healing, PTX3 promotes fracture healing by coordinating bone regeneration and bone resorption to maintain bone homeostasis. In view of the above biological characteristics, PTX3 is expected to become a new target for the diagnosis and treatment of OP and other age-related bone diseases and fracture healing.
Animals ; Male ; Mice ; Bone Resorption/metabolism* ; Cell Differentiation ; Fracture Healing/genetics* ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Osteoporosis/genetics* ; Phosphatidylinositol 3-Kinases/pharmacology*

Objective:To investigate the impact of " staging" hybrid coronary artery revascularization (HCR) on the short-and long-term efficacy of patients with multiple coronary artery lesions.Methods:A retrospective case-control study was conducted. Eighty patients with multiple coronary artery lesions admitted to the Baoding Second Central Hospital from January 2017 to October 2018 were selected and divided into two groups according to different surgical methods. Forty patients were treated with " staging" HCR and were designated as the HCR group, and 40 patients were treated with off-pump coronary artery bypass grafting (OPCAB) and were designated as the OPCAB group. The perioperative related indicators and perioperative serious complications were compared between the two groups. The serum myocardial injury marker levels were detected preoperatively and 48 hours postoperatively, including heart-type fatty acid binding protein (H-FABP) and troponin I (cTnI). All subjects were followed up for at least 3 years to calculate the incidence of major adverse cardiovascular and cerebrovascular events (MACCE).Results:The bypass surgery time, mechanical ventilation time, ICU stay time, and total hospital stay time in the HCR group were all less than those in the OPCAB group (all P<0.05), and the incision length in the HCR group was shorter than that in the OPCAB group ( P<0.05). The intraoperative bleeding volume, postoperative 24-hour drainage volume, red blood cell transfusion volume, and plasma transfusion volume in the HCR group were all less than those in the OPCAB group (all P<0.05). Forty-eight hours after surgery, the serum H-FABP and cTnI levels in both groups were significantly higher than those preoperatively (all P<0.05), but the increase was more significant in the OPCAB group (all P<0.05). The perioperative serious complication rate in the HCR group was 2.50%(1/40), which was significantly lower than that in the OPCAB group [20.00%(8/40)] ( P<0.05). During the 3-year follow-up after surgery, the MACCE incidence in the HCR group was 12.50%(5/40), and that in the OPCAB group was 22.50%(9/40). There was no significant difference in the long-term MACCE incidence between the two groups ( P>0.05). Conclusions:" Staging" HCR treatment for multiple coronary artery lesions can achieve ideal surgical results. Compared with OPCAB, its short-term efficacy is more significant, and long-term efficacy is equivalent.

Objective:To compare the efficacy and safety of ticagrelor and clopidogrel in antiplatelet aggregation after 2-staged hybrid coronary revascularization (HCR).Methods:A prospective randomized controlled trial was conducted. According to the postoperative antiplatelet therapy scheme, the patients with coronary artery multivessel disease who underwent 2-staged HCR operation in our hospital were divided into ticagrelor group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 90 mg orally twice daily for 1 year) and clopidogrel group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 75 mg orally once daily for 1 year). The general condition, platelet aggregation funtion [maximum platelet aggregation rate (MPAR) and P2Y12 reaction unit (PRU) ] at different time points before and after operation, and platelet inhibition rate [aspirin resistance (AA), ticagrelor or clopidogrel resistance (ADP)], major adverse cardiovascular events (MACE), bleeding events, and adverse reactions after operation were analyzed and compared between the 2 groups.Results:A total of 124 patients were enrolled in the study, 62 patients each in the ticagrelor group and clopidogrel group. There were no statistically significant differences in baseline data (gender, age, New York Heart Association cardiac function classification, concomitant diseases, etc.) between the 2 groups (all P>0.05). The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group and clopidogrel group were lower than those before operation [(50±9)%, (36±8)%, (29±6)% vs. (65±11)% and (59±10)%, (47±9)%, (38±7)% vs. (65±12)%, all P<0.001]. The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group[(50±9)% vs. (59±10)%, (36±8)% vs. (47±9)%, (29±6)% vs. (38±7)%, all P<0.001]. The PRUs at 24 h, 7 d, and 1 month after operation in the 2 groups were lower than those before operation (all P<0.001). The PRUs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group(all P<0.001). There was no significant difference in the incidence of AA 24 hours after operation between the 2 groups ( P>0.05); the inhibition rate of ADP in the ticagrelor group was higher than that in the clopidogrel group ( P<0.001). At the 24th month of follow-up, the incidence of MACE in the ticagrelor group was lower than that in the clopidogrel group (11.3% vs. 27.4%, P<0.05). At the 12th month of follow-up, there was no statistically significant difference in incidence of bleeding events between the 2 groups (3.2% vs. 8.1%, P>0.05) . There was no statistically significant difference in the incidence of adverse reactions between the 2 groups (16.1% vs. 11.3%, P>0.05) . Conclusions:Compared with clopidogrel+aspirin regimen, ticagrelor+aspirin regimen is more effective in inhibiting platelet aggregation and reducing postoperative MACE after 2-staged HCR. Both antiplatelet aggregation regimens do not increase the risk of bleeding and have no serious adverse reactions. Both regimens have good safety.

Objective:To compare the efficacy and safety of ticagrelor and clopidogrel in antiplatelet aggregation after 2-staged hybrid coronary revascularization (HCR).Methods:A prospective randomized controlled trial was conducted. According to the postoperative antiplatelet therapy scheme, the patients with coronary artery multivessel disease who underwent 2-staged HCR operation in our hospital were divided into ticagrelor group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 90 mg orally twice daily for 1 year) and clopidogrel group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 75 mg orally once daily for 1 year). The general condition, platelet aggregation funtion [maximum platelet aggregation rate (MPAR) and P2Y12 reaction unit (PRU) ] at different time points before and after operation, and platelet inhibition rate [aspirin resistance (AA), ticagrelor or clopidogrel resistance (ADP)], major adverse cardiovascular events (MACE), bleeding events, and adverse reactions after operation were analyzed and compared between the 2 groups.Results:A total of 124 patients were enrolled in the study, 62 patients each in the ticagrelor group and clopidogrel group. There were no statistically significant differences in baseline data (gender, age, New York Heart Association cardiac function classification, concomitant diseases, etc.) between the 2 groups (all P>0.05). The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group and clopidogrel group were lower than those before operation [(50±9)%, (36±8)%, (29±6)% vs. (65±11)% and (59±10)%, (47±9)%, (38±7)% vs. (65±12)%, all P<0.001]. The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group[(50±9)% vs. (59±10)%, (36±8)% vs. (47±9)%, (29±6)% vs. (38±7)%, all P<0.001]. The PRUs at 24 h, 7 d, and 1 month after operation in the 2 groups were lower than those before operation (all P<0.001). The PRUs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group(all P<0.001). There was no significant difference in the incidence of AA 24 hours after operation between the 2 groups ( P>0.05); the inhibition rate of ADP in the ticagrelor group was higher than that in the clopidogrel group ( P<0.001). At the 24th month of follow-up, the incidence of MACE in the ticagrelor group was lower than that in the clopidogrel group (11.3% vs. 27.4%, P<0.05). At the 12th month of follow-up, there was no statistically significant difference in incidence of bleeding events between the 2 groups (3.2% vs. 8.1%, P>0.05) . There was no statistically significant difference in the incidence of adverse reactions between the 2 groups (16.1% vs. 11.3%, P>0.05) . Conclusions:Compared with clopidogrel+aspirin regimen, ticagrelor+aspirin regimen is more effective in inhibiting platelet aggregation and reducing postoperative MACE after 2-staged HCR. Both antiplatelet aggregation regimens do not increase the risk of bleeding and have no serious adverse reactions. Both regimens have good safety.

Objective To investigate the effects of 3％ and 7.5％ hypertonic saline (HS) on hemorrhagic shock patients in Emergency Department.Methods From December 2008 to February 2012,patients older than 15 years with severe trauma and systolic blood pressure (SBP) ≤70 mmHg or 70 to 90 mmHg with heart rate≥ 108 per minute were divided into three groups randomly (random number).Group A:patients treated with 3％ hypertonic saline (HS) 300 mL + lactated Ringer' s solutions (LRS).Group B:patients treated with 7.5％ HS 300 mL + LRS.Group C:patients treated with LRS.The mean arterial pressure (MAP),blood pressure (BP),heart rate (HR) were recorded before infusion and at 10,30,45,60 minutes successively after infusion.Incidence of complications and mortality rates were compared between groups.Results Atotal of 148 patients were enrolled in this study.Compared with LRS grouop,MAP was restored more promptly and maintained persistently in 3％ HS group and 7.5％ HS group,and the total volume of fluid infused was decreased to almost 50％ of LRS in the first 1 hour.No significant differences in MAP levels were observed between group A and B except 30 minutes after infusion.Single bolus of 7.5％ HS infusion resulted in increased of HR to mean 127 beats per minute at 10 minutesafter fluid resuscitation.Higher incidence of arrhythmia and transient hypotension occurred in 7.5％ HS group.There were no statistical differences of changes of electrolytic indices,mortality rates,incidences of ARDS and MODS among three groups.Conclusions Resuscitation with 3％ HS provide similar benefits and lower risk of complications compared with 7.5％ HS and LRS.This study demonstrates the practicability and safety of 3％ HS for fluid resuscitation of patients with hypovolemic shock.