Surgery takes up the core position in the treatment for rectal cancer. Compared to traditional laparoscopic surgery, the most significant technological advantage of robotic surgery is its ability to perform precise and dexterous procedures in narrow spaces, making it particularly suitable for rectal surgery. With the development of robotic surgery of rectal cancer, accumulating evidence suggests that the technological advantages of robotic surgery are gradually demonstrated in treatment effect. Several randomized controlled trials and large cohorts suggest that robotic rectal cancer surgery has certain advantages over laparoscopic surgery in terms of short-term outcomes (conversion rate, incidence of complication, etc.), and is comparable in terms of specimen quality. Evidence concerning long-term outcomes remains limited. In this article, we will review evidence in the field of robotic surgery of rectal cancer, summarize recent progress, and envision future development.

Surgery takes up the core position in the treatment for rectal cancer. Compared to traditional laparoscopic surgery, the most significant technological advantage of robotic surgery is its ability to perform precise and dexterous procedures in narrow spaces, making it particularly suitable for rectal surgery. With the development of robotic surgery of rectal cancer, accumulating evidence suggests that the technological advantages of robotic surgery are gradually demonstrated in treatment effect. Several randomized controlled trials and large cohorts suggest that robotic rectal cancer surgery has certain advantages over laparoscopic surgery in terms of short-term outcomes (conversion rate, incidence of complication, etc.), and is comparable in terms of specimen quality. Evidence concerning long-term outcomes remains limited. In this article, we will review evidence in the field of robotic surgery of rectal cancer, summarize recent progress, and envision future development.

Robotic colorectal cancer surgery has rapidly evolved and matured in recent years, with a significant increase in the volume of surgeries and a continuous diversification of surgical types. Increasing high-level evidence indicates that robotic colorectal cancer surgeries, particularly robotic rectal cancer surgeries, significantly accelerate postoperative recovery, reduce the incidence of complica-tions, enhance postoperative quality of life, and decrease rate of positive circumferential resection margins, thereby improving the radical cure rate of the tumor. In recent years, with the rapid develop-ment of medical artificial intelligence (AI) technologies, early explorations such as AI-enhanced surgery and AI autonomous robotic surgeries have also emerged. The authors summarize the develop-ment history, current status, and the application of AI technology in robotic colorectal cancer surgeries.

Purpose/Significance To explore the feasibility of applying blockchain technology to the current healthcare system of hos-pitals,and to achieve the purpose of protecting patients'privacy to the greatest extent possible at a lower cost.Method/Process 505 questionnaires are randomly distributed and collected from people of different age groups in Beijing,Tianjin,Shanghai and Shenzhen who have a certain degree of understanding of blockchain technology,and the results are analyzed.Result/Conclusion Different age groups are highly concerned about personal privacy and privacy protection,and are willing to accept blockchain as an emerging technology.There is a greater demand and acceptance for the application of blockchain technology in the primary health care systems.

【Objective】 To investigate the resource allocation status of blood testing laboratories in 14 blood stations in Gansu Province, explore the impact of differences in basic conditions on the comprehensive testing ability of laboratories, so as to promote the homogenization and standardization of blood screening capacity in blood stations in Gansu and improve blood safety and effectivenes. 【Methods】 An evaluation index system of laboratory resource allocation was constructed and a question-naire was designed. The data of human resources, infrastructure and key equipment of 14 blood stations were collected. The entropy weight -TOPSIS method was used to evaluate and rank the resource allocation of 14 blood stations. 【Results】 In the comprehensive evaluation of blood testing laboratory resource allocation in 14 blood stations in Gansu, the top three were laboratories A, B and I, and the last three were laboratories G, M and J. On the whole, the main issue was unreasonable structure of human resources: most laboratories had unreasonable age structure; except for Laboratory A, there was no personnel with bachelor's degree or above in laboratories; most laboratories had not established a team with intermediate professional titles. In terms of infrastructure, the size of seven laboratories could not meet the needs of modern laboratory testing, and all eight blood stations had no spare nucleic acid laboratories nor a mutual spare laboratory with other blood stations As for the key equipment, 5 laboratories had no automatic blood grouping diagnostic instrument, 5 laboratories only had one set of enzyme immunoassay detection system, 3 laboratories had no spare equipment for the key equipment, which means if the equipment failure could not be repaired in time, the release of results would be affected. 【Conclusion】 There were significant differences in human resources, infrastructure and key equipment of blood testing laboratories in 14 blood stations in Gansu, which had a great impact on laboratory testing capacity and subsequent development. It is suggested that governments at all levels and health administrative departments optimize the input of laboratory resource allocation according to the blood collection volume of blood stations to gradually narrow the differences in resource distribution between different regions, improve the degree of laboratory automation and optimize the personnel structure, so as to build high-quality and efficient blood testing laboratories and ensure the safety of clinical blood use.

Objective:To investigate the "V" -shaped anatomical approach in the prevention of bile duct injury during laparoscopic complex cholecystectomy and its clinical application value.Methods:The patients with complex gallbladder from June 2020 to June 2021 in the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology were selected as the research objects, and they were randomly divided into observation group and control group, with 60 cases in each group. All patients underwent laparoscopic cholecystectomy. The observation group underwent laparoscopic cholecystectomy through the triangle "V" shape of the gallbladder, and the control group did not use the "V" shape anatomy. The operation status, complications and postoperative recovery of the two groups of patients were compared.The measurement data of normal distribution were expressed by ( Mean± SD), and t test was used for comparison between groups, and chi-square test was used for comparison between groups of count data. Results:The conversion rate to laparotomy, intraoperative bleeding and operation time of observation group were 3.33%, (97.31±13.27) mL, (65.27±13.82) min, which were significantly lower than those in the control group[8.33%, (111.27±25.18) mL, (81.35±12.12) min], the differences between the two groups were statistically significant( P<0.05). The incidence of biliary injury, total incidence of complications of the observation group were 0, 8.33%, which were significantly lower than those in the control group(6.67%, 28.33%), the differences between the two groups were statistically significant( P<0.05). The postoperative exhaust time, drainage tube retention time, hospitalization cost and hospitalization time of the observation group were (9.89±3.58) h, (32.58±5.17) h, (3 142.92±137.93) yuan, (4.73±1.42) d, and significantly lower than those in the control group [(11.65±2.45) h, (46.18±6.49) h, (3 424.29±156.34) yuan, (5.38±1.25) d], the differences between the two groups were statistically significant ( P<0.05). Conclusions:For laparoscopic complex cholecystectomy, the use of the triangular "V" -shaped gallbladder anatomical approach is more conducive to the operation, can reduce the patient's operation time and intraoperative blood loss, reduce the rate of intraoperative conversion to laparotomy, and reduce biliary tract injury and bile leakage. Such as the incidence of complications, prompting patients to recover as soon as possible, it is worthy of clinical application and promotion.

The Corona Virus Disease 2019 (COVID-19) since December, 2019 has a wide range of infection due to the strong infectious characteristics. Both medical staff and patients are at increased risk of infection. It is an urgent clinical problem for specialist doctors to work with diagnosis and treatment of cancer patients during the epidemic situation. Based on the colorectal cancer diagnosis and treatment guidelines (2019 CSCO guideline), combined with their own experience, the authors propose the overall management strategies for colorectal cancer patients. This strategies cover the key diagnosis and treatment of colorectal cancer, and provide targeted clinical practice. These work will be helpful for colorectal cancer specialists to carry out the diagnosis and treatment of colorectal cancer effectively under the epidemic of COVID-19.

Since its inception, the surgical robot system with technical advantages has quickly become a new trend in surgery, and has been widely used at home and abroad. A large number of retrospective studies and a small number of randomized controlled studies have shown that compared with traditional laparoscopic surgery, robotic surgery presented some improvements, such as lower conversion rate, less urinary and sexual dysfunction, and less intraoperative blood loss, though more convincing evidence is needed. Robotic colorectal cancer surgery started late in China, but developed rapidly. Not only the number of surgeries has increased rapidly, but also many new surgeries have been innovated. Meanwhile, many problems emerged, such as lack of unified technical specifications, and excessive dependence on imported surgical robot equipment. Through high-quality clinical researches and big data analyses, the formulation of standardization, the establishment of training system, and the combination of medicine, research and production, robotic surgery will continue to lead the development trend of surgery in the new era.

Objective:To investigate the risk factors associated with anastomotic leakage after robotic surgery in mid-low rectal cancer.Methods:A retrospective case-control study method was conducted. Inclusion criteria: (1) 18 to 80 years old; (2) pathologically confirmed rectal cancer; (3) distance <10 cm from tumor to anal margin; (4) robotic anterior rectal resection. Patients with previous history of colorectal cancer surgery, distant metastases or other malignant tumors, undergoing emergency surgery, with severe abdominal adhesions or those receiving combined organ resection were excluded. Based on the above criteria, 636 patients undergoing robotic radical sphincter-preserving surgery for mid-low rectal cancer in Zhongshan Hospital from January 2015 to December 2018 were included in this study, including 398 males (62.6%) and 238 females (37.4%) with a mean age of (61.9±11.3) years. Sixty-eight cases (10.7%) received neoadjuvant chemoradiotherapy. Amony the 636 included patients, 123(19.3%) underwent natural orifice specimen extraction surgery (NOSES) and 15 (2.3%) underwent preventive stoma. According to the cirteria developed by the International Rectal Cancer Research Group in 2010, the anastomotic leakage was classified as grade A (no requirement of intervention), B (requirement of intervention), and C (requirement of operation). Logistic regression was used to analyze the relationship between anastomotic leakage and clinicopathological factors. Factors in univariate analysis with P<0.05 were included in the multivariate analysis. Results:Anastomotic leakage occurred in 38 cases (6.0%). The grading of anastomotic leakage was grade A in 13 cases (2.0%), grade B in 19 cases (3.0%), and grade C in 6 cases (0.9%). The 3-year disease-free survival rate of patients with anastomotic leakage and without anastomotic leakage was 83.5% and 83.6% respectively ( P=0.862); the 3-year overall survival rate of the two group was 85.1% and 87.5% respectively ( P=0.296). The results of univariate logistic regression analysis showed that male ( P=0.011), longer operation time ( P=0.042), distance ≤5 cm from tumor to anal margin ( P=0.012), more intraoperative blood loss ( P=0.048) were associated with anastomotic leakage (all P<0.05). NOSES was not associated with anastomotic leakage ( P=0.704). Multivariate analysis confirmed that male (OR=3.03, 95%CI: 1.37 to 7.14, P=0.010), operation time ≥180 minutes (OR=2.04, 95%CI: 1.03 to 3.99, P=0.040), distance ≤5 cm from tumor to anal margin (OR=2.56, 95%CI:1.28 to 5.26, P=0.008) were independent risk factors for anastomotic leakage. Conclusion:Male, short distance from tumor to anal margin, and long operation time are independent risk factors for anastomotic leakage in patients undergoing robotic mid-low rectal cancer radical surgeries. These patients need to be cautiously treated during surgery.

Since its inception, the surgical robot system with technical advantages has quickly become a new trend in surgery, and has been widely used at home and abroad. A large number of retrospective studies and a small number of randomized controlled studies have shown that compared with traditional laparoscopic surgery, robotic surgery presented some improvements, such as lower conversion rate, less urinary and sexual dysfunction, and less intraoperative blood loss, though more convincing evidence is needed. Robotic colorectal cancer surgery started late in China, but developed rapidly. Not only the number of surgeries has increased rapidly, but also many new surgeries have been innovated. Meanwhile, many problems emerged, such as lack of unified technical specifications, and excessive dependence on imported surgical robot equipment. Through high-quality clinical researches and big data analyses, the formulation of standardization, the establishment of training system, and the combination of medicine, research and production, robotic surgery will continue to lead the development trend of surgery in the new era.