With the integration of 5G communication technology and robotic surgical systems, remote robot-assisted thoracic surgery is overcoming geographical barriers, offering an innovative approach to addressing the uneven distribution of medical resources. This study conducted a systematic literature review—using databases such as PubMed and CNKI, with the search period extending up to 2025—incorporating clinical studies, case reports, and review articles to comprehensively evaluate the clinical efficacy and safety of 5G-enabled remote robot-assisted thoracic surgery (5G-RRATS). The analysis also examined current technological limitations and potential future development trajectories. Existing evidence indicates that, given adequate technical support, 5G-RRATS can achieve perioperative outcomes comparable to those of conventional local robotic surgeries across procedures including pulmonary wedge resection, lobectomy, and esophagectomy. Furthermore, it demonstrates potential advantages in minimizing surgical incisions and reducing intraoperative blood loss. Nevertheless, challenges related to network stability, latency control, interdisciplinary collaboration between medical and engineering teams, and legal, regulatory, and ethical considerations continue to hinder widespread clinical adoption. Looking ahead, the emergence of a "one-to-many" remote surgical model, combined with the integration of artificial intelligence and augmented reality technologies, as well as advancements in low-orbit satellite communications, may enable 5G-RRATS to further advance precision and efficiency in thoracic surgery, thereby facilitating equitable access to high-quality care for a broader patient population.

Objective To evaluate the safety and feasibility of remote robot-assisted thoracoscopic surgery utilizing 5G technology. Methods Clinical data from five patients who underwent 5G remote robot-assisted thoracoscopic surgery at the Thoracic Surgery Center of Gansu Provincial People's Hospital from May to October 2024 were retrospectively analyzed. Results Finally, five patients were included. There were 2 males and 3 females at median age of 50 (42-63) years. All five surgeries (including 1 patient of lobectomy, 3 patients of partial lung resection and 1 patient of mediastinal lesion resection) were successfully completed without conversion to thoracotomy, complications, or mortality. The median intraoperative signal delay across the patients was 39 (37-42) ms. The median psychological load score for the surgeons was 9 (3-13). The median operation time was 100 (80-122) minutes with a median intraoperative blood loss of 100 (30-200) mL. Catheter drainage lasted a median of 4 (3-5) days, and the median drainage volumes on the first, second, and third postoperative day were 200 (100-300) mL, 150 (60-220) mL, and 80 (30-180) mL, respectively. The median postoperative hospital stay was 4 (3-7) days, and the median pain scores on the third postoperative day were 3 (1-4), 3 (0-3), and 1 (0-3), respectively. Conclusion 5G remote robot-assisted thoracoscopic surgery is safe and effective, with good surgical experience, smooth operation and small intraoperative delay.

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective:To explore the clinical and pathological features and survival outcomes of patients with early-onset intrahepatic cholangiocarcinoma (EOICC).Methods:This is a multicenter, retrospective cohort study. Data of 1 160 intrahepatic cholangiocarcinoma patients undergoing radical resection in 14 tertiary Grade A hospitals in China from January 2010 to November 2021 were retrospectively collected. The cohort included 632 males and 528 females, aged( M (IQR)) 61 (14) years (range: 22 to 93 years). ICC aged ≤50 years at the time of diagnosis was defined as EOICC and >50 years as late-onset intrahepatic cholangiocarcinoma (LOICC). Of these, there were 247 cases in the EOICC group and 913 cases in the LOICC. The clinical and pathological characteristics of both groups were analyzed and compared using the independent sample t-test, Mann-Whitney U test or Kaplan-Meier method. Univariate and multivariate Cox regression models for patient outcomes were constructed and forest graphed. Results:Compared with the patients in the LOICC group, patients in the EOICC group had lower carcinoembryonic antigen levels (2.5(4.0) μg/L vs. 3.1(5.2)μg/L, U=124 899, P=0.009) and CA19-9 level (63.4(524.7)U/ml vs. 77.9(611.3)U/ml, U=120 320, P=0.013), higher levels of ALT (29(35)U/L vs. 24(26)U/L, U=101 214, P=0.013), a lower score of the Eastern US Cooperative Oncology Group (0 score patients: 54.7% vs. 44.1%, χ2=12.472, P=0.014), higher TNM stage ( χ2=11.807, P=0.038), and proportion of lymph node dissection (62.3% vs. 54.1%, χ2=5.355, P=0.021). Patients in the two groups in sex, first diagnosis symptoms, intrahepatic bile duct stone history, nail protein, albumin, total bilirubin, transaminase, liver function Child-Pugh grade, T stage, stage, N stage, preoperative laparoscopic exploration proportion, tumor diameter, vascular invasion proportion, differentiation, margin, intraoperative bleeding, postoperative complications, postoperative hospital days were no statistical significance (all P>0.05). Patients in the EOICC group had better outcomes than the LOICC group (median survival time: 29.7 months vs. 25.0 months, 3-year overall survival: 45.1% vs. 37.8%, P=0.027). Conclusion:EOICC patients are better than LOICC patients in carcinoembryonic antigen, CA19-9, ALT, physical strength status and TNM stage, and the long-term prognosis is also better than LOICC patients.

Objective To study the effect and duration of point-of-use filters on the improvement of endoscopic fi-nal rinse water quality.Methods The final rinse water end at the gastroscope manual cleaning workstation in the Endoscopy Centre of the First Affiliated Hospital with Nanjing Medical University was selected to install a tap ter-minal filter;five specimens of final rinse water were collected consecutively before the installation,immediately after the installation,and 1-11 weeks after the installation.At each sampling time,the staff responsible for clea-ning and disinfecting were asked whether the flow rate of discharged water could satisfy the working demand;the final rinse water was inoculated on R2A culture medium with membrane filter method,bacterial colony forming unit(CFU)was calculated after 30℃ incubation for 5 days.Results The qualified rates of endoscopic final rinse water before point-of-use filter installation was 0,immediately after and 1-9 weeks after installation were both 100％,10 and 11 weeks after installation were 80.0％and 20.0％,respectively.The mean CFU of endoscopic final rinse wa-ter before point-of-use filter installation was 102 CFU/100 mL,immediately after and 1-9 weeks after installation were both ≤2 CFU/100 mL,10 and 11 weeks after installation were 8 and 18 CFU/100 mL,respectively.The feedback from the cleaning and disinfection staff before installation,immediately after installation,and 1-11 weeks after installation indicated that the flow rate of discharged water gradually slowed down over time,but could still meet the work requirements.Conclusion The point-of-use filter can quickly and effectively improve the quality of endoscopic final rinse water,with use duration of up to 9 weeks after installation;Its biggest advantage is that it can serve as the final barrier to all integrated measures,playing a supplementary role in case of any problems occu-rring in the front-end process,and ensuring the microbial quality of the final rinse water to the greatest extent possible.

Objective:To explore the influencing factors of dietary habits on the progression from prediabetes to type 2 diabetes mellitus(T2DM)in elderly individuals undergoing health check-ups.Methods:In the cross-sectional study, we enrolled individuals aged 60-70 years with fasting plasma glucose (FPG)≥6.0 mmol/L who underwent health examinations at the Health Management Medical Center of Wenjiang District People's Hospital in Chengdu from 2019 to 2022.Demographic characteristics, dietary habit questionnaires, and FPG values were collected.Unconditional binary logistic regression analysis was used to identify factors influencing the natural progression from prediabetes to T2DM.A nomogram prediction model was established based on logistic regression results, and its predictive performance was evaluated by calculating the C-statistics and drawing a calibration curve.Results:A total of 13 681 elderly participants with FPG ≥6.0 mmol/L were included, comprising 4 306(31.5%)prediabetes cases(FPG 6.0-7.0 mmol/L), aged(63.54±16.49)years and 9 375(68.5%)T2DM cases(FPG>7.0 mmol/L), aged(63.09±16.21)years.Unconditional binary logistic regression analysis showed that frequent breakfast( OR=0.777, 95% CI: 0.696-0.868, P<0.001), dietary preference for light diet( OR=0.781, 95% CI: 0.710-0.858, P<0.001), salty taste( OR=0.571, 95% CI: 0.504-0.648, P<0.001), raw food( OR=0.327, 95% CI: 0.224-0.478, P<0.001)and spicy taste( OR=0.124, 95% CI: 0.112-0.137, P<0.001)were the protective factors for the conversion of prediabetes to the T2DM stage in the elderly physical examination population.While fast eating rate( OR=4.327, 95% CI: 3.978-4.772, P<0.001), dietary preference for sweets( OR=5.168, 95% CI: 4.703-5.678, P<0.001), and high-fat diet( OR=1.401, 95% CI: 1.275-1.539, P<0.001)were risk factors for conversion of prediabetes to T2DM stage.C-statistic of the Nomogram prediction model was 0.781; the goodness-of-fit test of the calibration curve was χ2=11.258, P=0.188, and the model predicted well. Conclusions:Regular breakfast, light diet, and dietary preferences for salty, raw, and spicy foods were protective factors for the transition from prediabetes to T2DM stage, whereas rapid eating rate, preference for sweets, and high-fat diets were risk factors for the transition from prediabetes to T2DM stage in the medical examination population.The constructed risk prediction model helped to find out the magnitude of the risk of T2DM in an individual, which increases the evidence for the transition from prediabetes to T2DM stage prevention evidence.

Objective To explore the effects of Shenyuan Yiqi Huoxue Capsules on cardiopulmonary exercise function and quality of life in patients with ischemic cardiomyopathy.Methods Totally 66 patients with ischemic cardiomyopathy were divided into treatment group and control group using random number table method,with 33 cases in each group.Both groups received standardized Western medicine treatment,and the treatment group was additionally given Shenyuan Yiqi Huoxue Capsules,the control group was given Shenyuan Yiqi Huoxue Capsules simulator,three capsules per time,three times a day,orally.The observation period was 30 days.To evaluate the efficacy of TCM syndrome in two groups.The observation indicators included baseline data,TCM syndrome scores,cardiopulmonary exercise test detection indicators,MLHFQ score,SF-36 score,echocardiographic indicators,N-terminal pro-B-type natriuretic peptide(NT-pro BNP)and safety indicators.Results The total effective rate of the treatment group was 93.94%(31/33),while that of the control group was 78.79%(26/33).The treatment group was significantly better than the control group(P<0.05).Compared with before treatment,the TCM syndrome scores of the two groups of patients decreased(P<0.05),and after treatment,the TCM syndrome score of the treatment group was lower than that of the control group(P<0.05).Compared with before treatment,the peak oxygen uptake(peak VO2),anaerobic threshold(AT)and peak oxygen pulse(peak O2 pulse)of both groups of patients increased,while the carbon dioxide ventilation equivalent slope(VE/VCO2 slope)decreased(P<0.05).After treatment,the treatment group had higher peak VO2,AT and peak O2 pulse than the control group,while the VE/VCO2 slope was lower than the control group(P<0.05).Compared with before treatment,both groups of patients showed a decrease in MLHFQ score and an increase in SF-36 score(P<0.05);after treatment,the MLHFQ score in the treatment group was lower than that in the control group,and the SF-36 score was higher than that in the control group(P<0.05).Compared with before treatment,both groups of patients showed a decrease in left ventricular end systolic diameter,left ventricular end diastolic diameter and NT-pro BNP levels,while myocardial motion index and left ventricular ejection fraction increased(P<0.05);after treatment,the treatment group showed a decrease in left ventricular end systolic diameter,left ventricular end diastolic diameter and NT-pro BNP levels,while myocardial motion index and left ventricular ejection fraction increased(P<0.05).During the treatment period,no adverse reactions such as dizziness,nausea,vomiting or diarrhea were found in both groups of patients.Conclusion Shenyuan Yiqi Huoxue Capsules can significantly improve the clinical efficacy of ischemic cardiomyopathy patients,alleviate TCM symptoms,improve their cardiorespiratory function and quality of life.

Objective:To investigate the curative effect and mechanism of hyperbaric oxygen therapy on nonalcoholic fatty liver disease in mice.Methods:Twenty-one 8-week-old male C57BL/6J mice were divided into three groups: control group (normal diet), model group (high-fat and high-cholesterol diet), and hyperbaric oxygen group (high-fat and high-cholesterol diet + hyperbaric oxygen therapy), with seven mice in each group. The changes in body weight, serum liver enzymes, and blood lipids were compared after treatment between the three groups. Hematoxylin-eosin staining, Oil Red O staining, Sirius red staining, and F4/80 immunohistochemical staining were used to observe the pathological changes in liver tissues. RT-qPCR and Western blot methods were used to detect the expression levels of oxidative stress and inflammatory factors. One-way analysis of variance was used for comparison among the groups.Results:Mice in the hyperbaric oxygen group had significantly improved liver histopathology. The serological levels of alanine aminotransferase, aspartate aminotransferase, and cholesterol were (77.50±13.59) U/L, (156.06±23.68) U/L, and (4.80±0.53) mmol/L, which were significantly lower than those in the model group [(109.43±16.88) U/L, (216.62±18.79) U/L, and (5.86±0.53) mmol/L, P<0.05], and accompanied by lower levels of lipid deposition, macrophage infiltration, and fibrosis. In addition, compared with the model group, the expression of antioxidant stress protein nuclear transcription factor erythroid 2-related factor 2 [(0.30±0.06) and (2.16±1.21), P<0.05] and heme oxygenase-1 [(0.48±0.19) and (1.01±0.18), P<0.05] in liver tissue showed an upward trend following hyperbaric oxygen treatment, which was also validated at the transcriptional level ( P<0.05). Simultaneously, compared with the model group, the mRNA expressions of tumor necrosis factor-α [(2.60±0.71) and (0.66±0.15), P<0.05], interleukin-1β [(2.41±1.01) and (0.78±0.23), P<0.05], and interleukin-6 [(3.61±2.17) and (0.94±0.25), P<0.05] in the liver tissue of mice in the hyperbaric oxygen group were decreased. The tumor necrosis factor-α protein level [(7.50±4.73) and (1.05±0.58), P<0.05] and interleukin-1β [(1.65±0.35) and (1.02±0.02), P<0.05] was reduced following hyperbaric oxygen treatment compared with those in the model group. Conclusion:Hyperbaric oxygen therapy can slow down the progression of nonalcoholic fatty liver disease by regulating the levels of oxidative stress and inflammation in the mice.

Objective:To observe the clinical features and treatment outcomes of patients with intraocular foreign bodies with endophthalmitis, and analyze the prognostic factors affecting the anatomic and visual outcomes of patients.Methods:A retrospective clinical study. A total of 1 704 patients (1 704 eyes) with intraocular foreign body at Eye Hospital, Wenzhou Medical University from January 2015 to June 2024 were included in this study. Endophthalmitis was diagnosed in 263 eyes (15.4%, 263/1 704). Patients who lost follow-up in our hospital after surgery were excluded, 155 patients with 155 eyes were finally included in the study. Uncorrected visual acuity (UCVA) examination was performed before operation. Best corrected visual acuity (BCVA) examination was performed both after the first stage debridement and during follow-up. The visual acuity test is performed using a standard logarithmic visual acuity chart, which is statistically converted to logarithm of the minimum angle of resolution (logMAR) visual acuity. Demographic characteristics (gender, age), trauma characteristics (time of injury, occupation characteristics, nature of foreign body), anatomical injury (wound zoning, nature of infection, etc.), clinical treatment (interval between operation and injury, rate of second operation, etc.) and outcome (vision outcome, complications, anatomic outcome, etc.) were recorded. Prophylactic intravitreous injection of 10 mg/ml of cefazolin sodium 0.1 ml (including 1 mg of cefazolin sodium) was given on the basis of perioperative systemic administration of cefazolin sodium from 2022. Anatomical outcomes included anatomical reduction, silicone oil-dependent, and ophthalmectomy. The visual outcomes of the patients were categorized into three groups based on the best-corrected visual acuity at the final follow-up: visual acuity worse than 0.05, visual acuity between 0.05 and 0.3, and visual acuity better than 0.3. Generalized linear mixed model (GLMM) was used to analyze the correlation between the timing of treatment, nature of foreign body, nature of infection, number of operations, location of injury and the anatomic and visual outcomes of patients.Results:Of 155 patients, 149 were males and 6 were females, mean age was (45.7±12.9) years, patients with monocular injury. Magnetic, non-magnetic, unidentified metal and vegetable, mineral, animal and unidentified foreign bodies were 102 (65.8%, 102/155), 2 (1.3%, 2/155), 28 (18.1%, 28/155), 1 (0.6%, 1/155), 12 (7.7%, 12/155), 7 (4.5%, 7/155), 3 (1.9%, 3/155) cases, respectively. The time between injury and removal of foreign body was (98.1±359.5) h. The foreign bodies were removed in 136 eyes (87.2%, 136/155) in the primary surgery, 67 cases combined with debridement and suture, 68 cases combined with pars plana vitrectomy (PPV), and 1 case suffered ophthalmectomy. The slide and culture results revealed that the eyes positive for bacteria and those positive for a mixed infection of bacteria and fungi were 80 (51.2%, 80/155) and 2 (1.3%, 2/155) eyes, respectively; 73 eyes (46.8%, 73/155) were negative. Among the 80 eyes positive for bacteria, staphylococcus epidermidis and bacillus cereus were found in 26 (32.5%, 26/80) and 23 (28.8%, 23/80) eyes, respectively. Drug sensitivity testing indicated that vancomycin, gentamicin and amikacin had low drug resistance (1.79%, 6.67%, 0.0%, respectively). The mean preoperative logMAR UCVA was 1.67±0.79. In the outcome of visual function, 78, 26 and 51 patients with visual acuity <0.05, 0.05-0.3, >0.3, respectively. At the last follow-up, there were 56 cases (36.1%, 56/155) of silicone oil dependence, 93 cases (60%, 93/155) of anatomic reduction, and 6 cases (3.9%, 6/155) suffered ophthalmectomy, the mean intraocular pressure was (13.6±6.1) mm Hg (1 mm Hg= 0.133 kPa). Preoperative visual acuity was strongly correlated with visual outcomes ( F=6.896, P=0.001). Preoperative visual acuity ( F=5.310, P=0.023) and surgical method ( F=20.448, P<0.001) were closely related to the anatomical outcome, while age, treatment time, foreign body nature, wound zoning, infection nature, and foreign body removal time had no statistical correlation with the anatomic and functional outcome ( P>0.05). During 2015 to 2024, the incidence of intraocular foreign body-related endophthalmitis was 12.5%-22.7%, which showed a fluctuating upward trend. The incidence of endophthalmitis increased during 2022 to 2024 compared with the period from 2019 to 2021, but no statistically difference was found ( χ2=3.856, P=0.05). Conclusions:The incidence of intraocular foreign body related endophthalmitis was 15.4%. Staphylococcus epidermidis and Bacillus cereus are the first and second pathogenic bacteria. The incidence of endophthalmitis is not significantly reduced with intravitreal injection of cefazolin sodium. Preoperative UCVA and surgical method were closely related to the anatomic outcome of patients.