Robot-assisted surgery with its advantages such as three-dimensional high-definition vision, dexterous robotic arms, and tremor filtration, is increasingly being applied to complex radical gastrectomy. However, the role of the surgical assistant remains crucial during the procedure. The assistant is responsible for tasks outside the console, including adjusting robotic arms, changing instruments, exposing the surgical field, and addressing unexpected situations. The technical proficiency of the assistant and their collaboration efficiency with the primary surgeon directly impact the smoothness of surgery and patients' outcomes. With the expansion of robot-assisted surgical indications, the establishment of a standardized training system and the optimization of team collaboration models have become urgent challenges to address. This article draws on the author's practical experience as an assistant in robot-assisted gastric cancer surgeries, conducting an in-depth analysis of the responsibilities and operational skills of surgical assistants in robot-assisted procedures. The aim is to develop a relatively comprehensive set of operational guidelines for surgical assistants in robot-assisted radical gastrectomy, providing valuable references for enhancing the overall efficiency of surgical teams and improving surgical outcomes.

Objective Chronic obstructive pulmonary disease(COPD)is a global respiratory disorder characterized by chron-ic inflammation and airflow limitation.Dysregulation of lipid metabolism plays a pivotal role in its progression.This study aimed to explore the expression of the lipid metabolism-related gene GRIM-12 in COPD,and assess the therapeutic potential of its in-hibitor,Danthron.Methods Gene expression datasets GSE10006 and GSE11784 from the Gene Expression Omnibus(GEO)were analyzed to identify GRIM-12 as a lipid metabolism-related gene upregulated in the small airway epithelium(SAE)of COPD patients.Human airway epithelial cells(16HBE)were stimulated in vitro with cigarette smoke extract(CSE)to evaluate GRIM-12 expression and the regulatory effects of Danthron.IL-6 level was assessed by using enzyme-linked immunosorbent assay(ELISA),while reactive oxygen species(ROS)level was quantified via fluorescence probe assays.The involvement of the Nrf2/HO-1 signaling pathway was also investigated.Results GRIM-12 expression was significantly upregulated in the SAE of COPD patients and in CSE-treated 16HBE cells.Molecular docking analysis showed that Danthron had a high binding affinity with GRIM-12,and inhibited its function through hydrogen bonding and hydrophobic interaction.Danthron treatment significantly suppressed CSE-induced GRIM-12 overexpression in v itro,reduced IL-6 secretion,and attenuated ROS production,alleviated oxidative stress and inflammatory responses.Mechanistic studies further revealed that Danthron enhanced cellular antioxidant defenses by activating Nrf2/HO-1 signaling pathway,thereby mitigating CSE-induced oxidative damage and inflammation.It is proved that Danthron regulated COPD-related pathological changes by targeting and inhibiting GRIM-12 expression.Conclusion Danthron effectively alleviates oxidative stress and inflammation in COPD by GRIM-12 expression inhibition and Nrf2/HO-1 signaling pathway activation,offering a promising therapeutic strategy for COPD management.

Robot-assisted surgery with its advantages such as three-dimensional high-definition vision, dexterous robotic arms, and tremor filtration, is increasingly being applied to complex radical gastrectomy. However, the role of the surgical assistant remains crucial during the procedure. The assistant is responsible for tasks outside the console, including adjusting robotic arms, changing instruments, exposing the surgical field, and addressing unexpected situations. The technical proficiency of the assistant and their collaboration efficiency with the primary surgeon directly impact the smoothness of surgery and patients' outcomes. With the expansion of robot-assisted surgical indications, the establishment of a standardized training system and the optimization of team collaboration models have become urgent challenges to address. This article draws on the author's practical experience as an assistant in robot-assisted gastric cancer surgeries, conducting an in-depth analysis of the responsibilities and operational skills of surgical assistants in robot-assisted procedures. The aim is to develop a relatively comprehensive set of operational guidelines for surgical assistants in robot-assisted radical gastrectomy, providing valuable references for enhancing the overall efficiency of surgical teams and improving surgical outcomes.

Objective:To compare the short- and long-term outcomes of robotic versus laparoscopic gastrectomy in patients with locally advanced gastric cancer after neoadjuvant chemotherapy.Methods:Data from 321 patients with locally advanced gastric cancer undergoing neoadjuvant chemotherapy followed by robotic ( n=109) and laparoscopic ( n=212) radical gastrectomy at our center between May 2017 and Sep 2022 was collected. After 1∶1 propensity score matching, 106 patients from each group were included in the final analysis to compare short-term clinical outcomes and long-term prognostic indicators. Results:The robotic group had a significantly lower overall complication rate (13.2% vs. 28.3%, χ2=6.453, P=0.007) and surgery-related complication rate (8.5% vs. 17.9%, χ2=3.333, P=0.043) than the laparoscopic group. The robotic group also retrieved more total lymph nodes (35.3±4.9 vs. 31.4±6.3, t=4.863, P<0.001) and supra-pancreatic lymph nodes (13.1±3.4 vs. 10.1±2.1, t=5.258, P<0.001). Additionally, the robotic group had a shorter operative time [(218±47) min vs. (267±71) min, t=-6.001, P<0.001], less intraoperative blood loss [(47±12) ml vs. (71±17) ml, t=-5.424, P<0.001], and faster postoperative recovery. The 3-year recurrence-free survival rate was significantly higher in the robotic group compared to the laparoscopic group (75.5% vs. 62.3%, P=0.017). Conclusion:Compared with laparoscopic gastrectomy, robotic gastrectomy allows for a more lymph nodes harvest, significantly reduces intraoperative blood loss and complication rates and significantly improves recurrence-free survival.

Objective Chronic obstructive pulmonary disease(COPD)is a global respiratory disorder characterized by chron-ic inflammation and airflow limitation.Dysregulation of lipid metabolism plays a pivotal role in its progression.This study aimed to explore the expression of the lipid metabolism-related gene GRIM-12 in COPD,and assess the therapeutic potential of its in-hibitor,Danthron.Methods Gene expression datasets GSE10006 and GSE11784 from the Gene Expression Omnibus(GEO)were analyzed to identify GRIM-12 as a lipid metabolism-related gene upregulated in the small airway epithelium(SAE)of COPD patients.Human airway epithelial cells(16HBE)were stimulated in vitro with cigarette smoke extract(CSE)to evaluate GRIM-12 expression and the regulatory effects of Danthron.IL-6 level was assessed by using enzyme-linked immunosorbent assay(ELISA),while reactive oxygen species(ROS)level was quantified via fluorescence probe assays.The involvement of the Nrf2/HO-1 signaling pathway was also investigated.Results GRIM-12 expression was significantly upregulated in the SAE of COPD patients and in CSE-treated 16HBE cells.Molecular docking analysis showed that Danthron had a high binding affinity with GRIM-12,and inhibited its function through hydrogen bonding and hydrophobic interaction.Danthron treatment significantly suppressed CSE-induced GRIM-12 overexpression in v itro,reduced IL-6 secretion,and attenuated ROS production,alleviated oxidative stress and inflammatory responses.Mechanistic studies further revealed that Danthron enhanced cellular antioxidant defenses by activating Nrf2/HO-1 signaling pathway,thereby mitigating CSE-induced oxidative damage and inflammation.It is proved that Danthron regulated COPD-related pathological changes by targeting and inhibiting GRIM-12 expression.Conclusion Danthron effectively alleviates oxidative stress and inflammation in COPD by GRIM-12 expression inhibition and Nrf2/HO-1 signaling pathway activation,offering a promising therapeutic strategy for COPD management.

Objective:To compare the short- and long-term outcomes of robotic versus laparoscopic gastrectomy in patients with locally advanced gastric cancer after neoadjuvant chemotherapy.Methods:Data from 321 patients with locally advanced gastric cancer undergoing neoadjuvant chemotherapy followed by robotic ( n=109) and laparoscopic ( n=212) radical gastrectomy at our center between May 2017 and Sep 2022 was collected. After 1∶1 propensity score matching, 106 patients from each group were included in the final analysis to compare short-term clinical outcomes and long-term prognostic indicators. Results:The robotic group had a significantly lower overall complication rate (13.2% vs. 28.3%, χ2=6.453, P=0.007) and surgery-related complication rate (8.5% vs. 17.9%, χ2=3.333, P=0.043) than the laparoscopic group. The robotic group also retrieved more total lymph nodes (35.3±4.9 vs. 31.4±6.3, t=4.863, P<0.001) and supra-pancreatic lymph nodes (13.1±3.4 vs. 10.1±2.1, t=5.258, P<0.001). Additionally, the robotic group had a shorter operative time [(218±47) min vs. (267±71) min, t=-6.001, P<0.001], less intraoperative blood loss [(47±12) ml vs. (71±17) ml, t=-5.424, P<0.001], and faster postoperative recovery. The 3-year recurrence-free survival rate was significantly higher in the robotic group compared to the laparoscopic group (75.5% vs. 62.3%, P=0.017). Conclusion:Compared with laparoscopic gastrectomy, robotic gastrectomy allows for a more lymph nodes harvest, significantly reduces intraoperative blood loss and complication rates and significantly improves recurrence-free survival.

Objective To compare the analgesic effect, duration and incidence of adverse reactions of liposome bupivacaine (LB) and bupivacaine hydrochloride after intercostal nerve block in single-port thoracoscopic lung surgery. Methods In Department of Thoracic Surgery of the First Affiliated Hospital of Xinxiang Medical University between September 2023 and March 2024, 228 patients who needed to undergo thoracoscopic lung surgery were selected and divided into two groups by random number table method: a group B with bupivacaine hydrochloride (n=118), and a group LB with LB (n=110). Intraoperative intercostal nerve block was performed under endoscopy, and the time of first use of analgesic drugs after surgery, cumulative use of opioids 72 h after surgery, incidence of postoperative nausea and vomiting, length of stay and other indicators were evaluated and recorded. Results Visual analogue scale (VAS) scores at 4 h, 8 h, 12 h, 24 h, 48 h and 72 h in the LB group were significantly lower than those in the group B (P<0.05). The total number of activities within 48 h after surgery in the group B was significantly lower than that in the LB group (P<0.05), and the postoperative hospitalization stay in the LB group was shorter than that in the group B, but the difference was not statistically significant. There was no statistical difference between the two groups in postoperative adverse reactions. Conclusion Intercostal nerve block with LB during single-port thoracoscopic lung surgery can significantly reduce postoperative pain, improve quality of life, and promote recovery of the patients. It is worthy of clinical application.

Heme oxygenase (HO)-1 and its enzymolysis products can mitigate hepatic ischemia-reperfusion injury (HIRI) by alleviating the damage of reactive oxygen free radicals, mitigating cell apoptosis, inhibiting inflammatory reaction and maintaining microcirculation stability. Autophagy is a process in which the cells utilize lysosomes to degrade their damaged organelles and macromolecular substances. It is considered as an adaptive response to alleviate cell damage under stress, which can effectively reduce cell death. In recent years, more and more studies have demonstrated that autophagy is also significantly correlated with HIRI. This article reviewed recent research progresses at home and abroad on HO-1 and HIRI, autophagy and HIRI, the interaction and mechanism between HO-1 and autophagy in HIRI.

Objective: To analyze the heritability of diabetes among the Chinese twin adults. Methods: A total of 10 253 same-sex twin pairs aged 25 years and older, were selected from the Chinese National Twin Registry (CNTR) program. Heritability of diabetes was calculated by using the structural equation model. Results: After adjusted for age and gender, the overall heritability rates of diabetes were 0.41 (0.15-0.75), 0.83 (0.72-0.91) and 0.34 (0.04-0.73) in the <45 and ≥45 years twin pairs, respectively. After adjusted for age, rates of heritability appeared as 0.37 (0.05-0.78) and 0.88 (0.79-0.94) in men and women, respectively. Conclusions Diabetes is affected by both genetic and environmental factors. The genetic effect of diabetes seemed stronger on female than that on male twins but was dying down along with ageing.

Objective To investigate whether there existed a healthy obese subtype.Methods A total of 116 healthy subjects were recruited.They were divided into 3 groups according to BMI and metabolic disorders:40 cases of normal weight and metabolic normality (NMN),36 cases of obesity and metabolic normality (OMN) and 40 cases of obesity and metabolic abnormality (OMA).Anthropometic parameters as height,weight,waist circumference,hip circumference and blood pressure was recorded.Blood glucose,lipids,insulin,high-sensitivity C-reactive protein (hs-CRP) was detected.Body fat distribution was detected by dual-energy X-ray absorptiometry (DXA).Serum von Willebrand factor (vWF),a marker of endothelial dysfunction,were detected by ELISA.Results Both serum vWF levels in OMN group [(733.6±86.2)U/L] and OMA group[(809.2 ±46.3)U/L] are higher than that in NMN group [(466.9 ±65.3)U/L,P ＜0.05] with serum vWF level in OMA group is higher than in OMN group (P ＜ 0.05).Among android fat mass percentage (AFM％),BMI,waist height ratio,waist circumference,hs-CRP,weight,hip circumference and trunk fat mass,AFM％,BMI and hs-CRP are main influencing factors of vWF.Conclusions Endothelial dysfunction existed in obese adults regardless of their metabolic status.There is no healthy obese subtype.AFM％,BMI and hs-CRP are the main influencing factors of endothelial dysfunction.