Objective To evaluate the safety, effectiveness and feasibility of robotic-assisted kidney transplantation (RAKT). Methods Clinical data of 16 patients who underwent kidney transplantation were collected. Among them, 8 recipients received RAKT (RAKT group) and 8 cases underwent open kidney transplantation (OKT) with the contralateral kidney from the same donor (OKT group). Perioperative status and the recovery of renal allograft function were compared between two groups. Results All patients successfully completed the surgery. In the RAKT group, no patient was converted to open surgery. The operation time in the RAKT group was longer than that in the OKT group (P=0.015). No significant differences were observed in the serum creatinine levels before surgery and upon discharge between two groups (both P>0.05). In the OKT group, one recipient developed delayed graft function (DGF), and the remaining recipients did not experience perioperative complications. No significant difference was noted in the short-term recovery of renal allograft function between two groups (P>0.05). Conclusions Postoperative recovery of the recipients in the RAKT group is equivalent to that of their counterparts in the OKT group. RAKT is a safe and effective procedure for the team expertise in kidney transplantation.

Objective:To explore the application value of Oxford nanopore technologies (ONT) in the diagnosis and treatment of periprosthetic joint infection (PJI).Methods:A prospective analysis was conducted on 32 patients with PJI admitted to the joint department of Xi'an Honghui Hospital from October 2021 to March 2023, who met the 2018 PJI diagnostic criteria of the American Skeletal Infection Society (MSIS), including 15 males and 17 females with an average age of 63.93±8.93 years. 32 revision patients who did not meet the 2018 MSIS PJI criteria during the same period were collected as controls (non PJI group), including 13 males and 19 females with an average age of 65.53±8.54 years. All patients underwent joint fluid puncture before or during surgery, and the specimens were tested by ONT, metagenomic next generation sequencing (mNGS), and general microbial culture. The receiver operating characteristic (ROC) curves were drawn for both groups, and the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the three detection techniques were calculated and compared to evaluate the detection efficiency of different detection methods in PJI.Results:Among the 32 patients with PJI, 30 were positive for ONT, with a total of 30 pathogenic bacteria detected, and the detection time was 22.37±8.36 h. 31 were positive for mNGS, with a total of 33 bacterial species detected, and the detection time was 46.25±9.36 h. 17 were positive for microbial culture, with a total of 8 bacterial species detected, and the detection time was 96.23±15.62 h. Among the 32 patients with non PJI group, 1 was positive for ONT and 5 were positive for mNGS, with a total of 1 and 3 bacterial species detected, respectively. The results of microbial culture were all negative. The detection time and area under the curve (AUC) of ONT and mNGS were 22.37±8.36 h and 0.953[95% CI (0.901, 1.006)], 46.25±9.36 h and 0.906[95% CI (0.835, 0.977)], respectively, which were better than those of microbial culture 96.23±15.62 h and 0.766[95% CI (0.678, 0.853)], and the difference was statistically significant ( P<0.05). The sensitivity of ONT, mNGS, and microbial culture were 0.938, 0.969, and 0.531, respectively, and the specificity was 0.969, 0.844, and 1.000, respectively. The Jordan index was 0.906, 0.813, and 0.531, respectively. Conclusion:ONT testing has higher diagnostic efficacy than mNGS and microbial culture in the diagnosis of PJI, and also has advantages in detection time. It also suggests that some PJI are not caused by a single microbial infection.

Objective:To investigate the prognosis and the factors that influence it in patients with non-gastric gastrointestinal stromal tumors (GISTs) who are at low risk of recurrence.Methods:This was a retrospective cohort study. Clinicopathologic and prognostic data from patients with non-gastric GISTs and at low risk of recurrence (i.e., very low-risk or low-risk according to the 2008 version of the Modified NIH Risk Classification), who attended 18 medical centers in China between January 2000 and June 2023, were collected. We excluded patients with a history of prior malignancy, concurrent primary malignancy, multiple GISTs, and those who had received preoperative imatinib. The study cohort comprised 1,571 patients with GISTs, 370 (23.6%) of whom were at very low-risk and 1,201 (76.4%) at low-risk of recurrence. The cohort included 799 (50.9%) men and 772 (49.1%) women of median age 57 (16–93) years. Patients were followed up to July 2024. The prognosis and its influencing factors were analyzed. Receiver operating characteristic curves for tumor diameter and Ki67 were established, and the sensitivity, specificity, area under the curve (AUC) and optimal cut-off value with 95% confidence intervals were calculated. Propensity score matching was implemented using the 1:1 nearest neighbor matching method with a matching tolerance of 0.02.Results:With a median follow-up of 63 (12–267) months, the 5- and 10-year overall survival (OS) rates of the 1,571 patients were 99.5% and 98.0%, respectively, and the 5- and 10-year disease-free survival (DFS) rates were 96.3% and 94.4%, respectively. During postoperative follow-up, 3.8% (60/1,571) patients had disease recurrence or metastasis, comprising 0.8% (3/370) in the very low-risk group and 4.7% (57/1,201) in the low-risk group. In the low-risk group, recurrence or metastasis occurred in 5.5% (25/457) of patients with duodenal GISTs, 3.9% (25/645) of those with small intestinal GISTs, 9.2% (6/65) of those with rectal GISTs, and 10.0% (1/10) of those with colonic GISTs. Among the 60 patients with metastases, 56.7% (34/60) of the metastases were located in the abdominal cavity, 53.3% (32/60) in the liver, and 3.3% (2/60) in bone. During the follow-up period, 13 patients (0.8%) died of disease. Receiver operating characteristic curves were plotted for tumor diameter and Ki67 and assessed using the Jordon index. This showed that the difference in DFS between the two groups was statistically significant when the cutoff value for tumor diameter was 3.5 cm (AUC 0.731, 95% CI: 0.670–0.793, sensitivity 77.7%, specificity 64.1%). Furthermore, the difference in DFS between the two groups was statistically significant when the cutoff value for Ki67 was 5% (AUC 0.693, 95% CI: 0.624–0.762, sensitivity 60.7%, specificity 65.3%). Multifactorial analysis revealed that tumor diameter ≥3.5 cm, Ki67 ≥5%, and R1 resection were independent risk factors for DFS in patients with non-gastric GISTs at low risk of recurrence (all P<0.05). Furthermore, age >57 years, Ki67 ≥5%, and R1 resection were also independent risk factors for OS in patients with non-gastric GISTs at low risk of recurrence (all P<0.05). We also grouped the patients according to whether they had received postoperative adjuvant treatment with imatinib for 1 or 3 years. This yielded 137 patients in the less than 1-year group, 139 in the 1-year plus group; and 44 in both the less than 3 years and 3-years plus group. After propensity score matching for age, tumor diameter, Ki67, and resection status, the differences in survival between the two groups were not statistically significant (all P>0.05). The 10-year DFS and OS were 87.5% and 95.5%, respectively, in the group treated with imatinib for less than 1 year and 88.5% and 97.8%, respectively, in the group treated for more than 1 year. The 10-year DFS and OS were 89.6% and 92.6%, respectively, in the group treated with imatinib for less than 3 years and 88.0% and 100.0%, respectively, in the group treated with imatinib for more than 3 years. Conclusion:The overall prognosis of primary, non-gastric, low recurrence risk GISTs is relatively favorable; however, recurrences and metastases do occur. Age, tumor diameter, Ki67, and R1 resection may affect the prognosis. For some patients with low risk GISTs, administration of adjuvant therapy with imatinib for an appropriate duration may help prevent recurrence and improve survival.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.