Objective:To evaluate the technical feasibility and perioperative safety of pyeloplasty assis-ted by the CarinaTM modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction(UPJO).Methods:From November to December 2024,five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the CarinaTM modular laparoscopic surgical system at Peking University First Hospital.Data on patient demographics,intraoperative parameters(including docking time,console time,and estimated blood loss),perioperative outcomes,follow-up results,and surgeons' subjective evaluations of system performance were prospectively collected.Descriptive statistics were used;continuous variables were presented as median(range),and categorical variables as frequen-cy and percentage.Results:The cohort included four females and one male.All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery.The me-dian age was 32 years(24-37 years),and the median body mass index was 21.6 kg/m2(15.8-27.3 kg/m2).The median docking time was 8 min(3-12 min),and the median console time was 91 min(71-125 min).Intraoperative blood loss was uniformly 20 mL.The median postoperative drainage du-ration was 3 d(0-4 d),and the median length of hospital stay was 4 d(4-9 d).No Clavien-Dindo grade Ⅲ or higher complications occurred.All the patients had their double-J stents removed at 2 months postoperatively,and pain in the ipsilateral flank,reported preoperatively by all the five patients,was al-leviated.The subjective surgical success rate was 100％.Surgeons reported stable system performance throughout all the procedures,with no instances of mechanical arm interference or visual drift affecting surgical fluency.Conclusion:Preliminary findings indicate that pyeloplasty using the domestically deve-loped CarinaTM modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.

Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7％)had strictures in the upper ureter,9(12.7％)in the middle ureter,15(21.1％)in the lower ureter,and 11(15.5％)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1％)and appendiceal flap ureteroplasty(8/36,22.2％).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1％)and ureteroureterostomy(1/9,11.1％)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3％)and ileal ureter replacement(4/9,44.4％)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7％),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2％)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.

Objective:To investigate the relationship of serum interleukin(IL)-17, IL-21 and IL-22 levels with the severity and prognosis of acute ischemic stroke(AIS).Methods:One hundred patients with AIS and treated in Handan Central Hospital from April 2021 to April 2023 (case group) and 60 patients with high-risk stroke who participated in physical examination during the same period (control group) were retrospectively selected as the study objects. The severity of AIS patients was assessed by the National Institutes of Health Stroke Scale (NIHSS), and 18-month follow-up was completed. They were divided into good prognosis group and poor prognosis group according to recurrence or death. The levels of serum IL-17, IL-21 and IL-22 in all groups were compared, and the correlation between serum IL-17, IL-21 and IL-22 levels and the severity and prognosis of AIS was analyzed by Spearman test. The risk factors of poor prognosis in AIS patients were screened by Logistic regression.Results:The levels of serum IL-17, IL-21 and IL-22 in the case group were higher than those in the control group: (28.77 ± 4.20) ng/L vs. (22.39 ± 3.34) ng/L, (26.53 ± 4.19) ng/L vs. (21.07 ± 3.26) ng/L, (7.21 ± 1.12) ng/L vs. (6.18 ± 0.84) ng/L, there were statistical differences ( P<0.05). There were statistical differences in levels of serum IL-17, IL-21 and IL-22 in AIS patients with different severity ( P<0.05). The levels of serum IL-17, IL-21 and IL-22 in the good prognosis group were lower than those in the poor prognosis group: (27.76 ± 4.06) ng/L vs. (31.37 ± 3.39) ng/L, (25.36 ± 3.34) ng/L vs. (29.52 ± 4.71) ng/L, (6.78 ± 0.77) ng/L vs.(8.35 ± 1.12) ng/L, there were statistical differences ( P<0.05). Spearman test results showed that the levels serum IL-17, IL-21 and IL-22 in AIS patients had positively correlated with the severity of the disease ( r = 0.453, 0.526, 0.470, P<0.05), and had positively correlated with poor prognosis ( r = 0.408, 0.397, 0.574). P<0.05). Logistic regression analysis showed that high levels of IL-17 ( OR = 1.562), IL-21 ( OR = 1.434) and IL-2 ( OR = 15.192) were independent risk factors for poor prognosis in AIS patients ( P<0.05). Conclusions:The levels of serum IL-17, IL-21 and IL-22 are closely related to the severity and prognosis of AIS, and are independent risk factors for poor prognosis of patients, which can be used to evaluate the prognosis.

In December 2024, the European Association for the Study of the Liver (EASL) released the 2024 edition of EASL clinical practice guidelines: management of hepatocellular carci-noma (HCC). Compared to the 2018 edition, the 2024 edition includes significant updates in several areas, such as personalized surveillance strategies based on individual risk assessment, standardiza-tion of liver imaging protocols and diagnostic criteria, the use of minimally invasive surgical approaches in complex cases, an updated approach to liver transplantation integration, transitions between surgery, locoregional, and systemic therapies, as well as the positioning of radiotherapy and the use of combination immunotherapy at various stages of the disease. The authors systematically interpret the main updates related to treatment strategies in the new guidelines, aiming to provide clinicians with clear decision-making references for treatment.

Objective:To evaluate the technical feasibility and perioperative safety of pyeloplasty assis-ted by the CarinaTM modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction(UPJO).Methods:From November to December 2024,five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the CarinaTM modular laparoscopic surgical system at Peking University First Hospital.Data on patient demographics,intraoperative parameters(including docking time,console time,and estimated blood loss),perioperative outcomes,follow-up results,and surgeons' subjective evaluations of system performance were prospectively collected.Descriptive statistics were used;continuous variables were presented as median(range),and categorical variables as frequen-cy and percentage.Results:The cohort included four females and one male.All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery.The me-dian age was 32 years(24-37 years),and the median body mass index was 21.6 kg/m2(15.8-27.3 kg/m2).The median docking time was 8 min(3-12 min),and the median console time was 91 min(71-125 min).Intraoperative blood loss was uniformly 20 mL.The median postoperative drainage du-ration was 3 d(0-4 d),and the median length of hospital stay was 4 d(4-9 d).No Clavien-Dindo grade Ⅲ or higher complications occurred.All the patients had their double-J stents removed at 2 months postoperatively,and pain in the ipsilateral flank,reported preoperatively by all the five patients,was al-leviated.The subjective surgical success rate was 100％.Surgeons reported stable system performance throughout all the procedures,with no instances of mechanical arm interference or visual drift affecting surgical fluency.Conclusion:Preliminary findings indicate that pyeloplasty using the domestically deve-loped CarinaTM modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.

Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7％)had strictures in the upper ureter,9(12.7％)in the middle ureter,15(21.1％)in the lower ureter,and 11(15.5％)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1％)and appendiceal flap ureteroplasty(8/36,22.2％).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1％)and ureteroureterostomy(1/9,11.1％)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3％)and ileal ureter replacement(4/9,44.4％)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7％),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2％)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.

Objective:To investigate the relationship of serum interleukin(IL)-17, IL-21 and IL-22 levels with the severity and prognosis of acute ischemic stroke(AIS).Methods:One hundred patients with AIS and treated in Handan Central Hospital from April 2021 to April 2023 (case group) and 60 patients with high-risk stroke who participated in physical examination during the same period (control group) were retrospectively selected as the study objects. The severity of AIS patients was assessed by the National Institutes of Health Stroke Scale (NIHSS), and 18-month follow-up was completed. They were divided into good prognosis group and poor prognosis group according to recurrence or death. The levels of serum IL-17, IL-21 and IL-22 in all groups were compared, and the correlation between serum IL-17, IL-21 and IL-22 levels and the severity and prognosis of AIS was analyzed by Spearman test. The risk factors of poor prognosis in AIS patients were screened by Logistic regression.Results:The levels of serum IL-17, IL-21 and IL-22 in the case group were higher than those in the control group: (28.77 ± 4.20) ng/L vs. (22.39 ± 3.34) ng/L, (26.53 ± 4.19) ng/L vs. (21.07 ± 3.26) ng/L, (7.21 ± 1.12) ng/L vs. (6.18 ± 0.84) ng/L, there were statistical differences ( P<0.05). There were statistical differences in levels of serum IL-17, IL-21 and IL-22 in AIS patients with different severity ( P<0.05). The levels of serum IL-17, IL-21 and IL-22 in the good prognosis group were lower than those in the poor prognosis group: (27.76 ± 4.06) ng/L vs. (31.37 ± 3.39) ng/L, (25.36 ± 3.34) ng/L vs. (29.52 ± 4.71) ng/L, (6.78 ± 0.77) ng/L vs.(8.35 ± 1.12) ng/L, there were statistical differences ( P<0.05). Spearman test results showed that the levels serum IL-17, IL-21 and IL-22 in AIS patients had positively correlated with the severity of the disease ( r = 0.453, 0.526, 0.470, P<0.05), and had positively correlated with poor prognosis ( r = 0.408, 0.397, 0.574). P<0.05). Logistic regression analysis showed that high levels of IL-17 ( OR = 1.562), IL-21 ( OR = 1.434) and IL-2 ( OR = 15.192) were independent risk factors for poor prognosis in AIS patients ( P<0.05). Conclusions:The levels of serum IL-17, IL-21 and IL-22 are closely related to the severity and prognosis of AIS, and are independent risk factors for poor prognosis of patients, which can be used to evaluate the prognosis.

In December 2024, the European Association for the Study of the Liver (EASL) released the 2024 edition of EASL clinical practice guidelines: management of hepatocellular carci-noma (HCC). Compared to the 2018 edition, the 2024 edition includes significant updates in several areas, such as personalized surveillance strategies based on individual risk assessment, standardiza-tion of liver imaging protocols and diagnostic criteria, the use of minimally invasive surgical approaches in complex cases, an updated approach to liver transplantation integration, transitions between surgery, locoregional, and systemic therapies, as well as the positioning of radiotherapy and the use of combination immunotherapy at various stages of the disease. The authors systematically interpret the main updates related to treatment strategies in the new guidelines, aiming to provide clinicians with clear decision-making references for treatment.

OBJECTIVE: To study cellular immune function of palatine tonsil B lymph cell. METHOD: The phenotype of palatine tonsil cells (PTC) and that of peripheral blood mononuclear cell (PBMC) were compared using fluorescence staining and flow cytometry (FCM) analysis, then immunomagnetic beads were used to separate CD3- cell in PTC and PBMC. The proliferation function of CD3- lymph cell of PTC and PBMC was tested after stimulated by CD20mAb. RESULT: FCM analysis founding that 71.2% PTC express CD20 with higher mean fluorescence intensity, MFI, compared to the 15.5% in PBMC. There's no significant difference between the proliferation of PTC and PBMC B lymph cell. CONCLUSION CD20 expression is different in PTC and PBMC, but corresponding function is still unknown.
Adult ; Antigens, CD20 ; metabolism ; B-Lymphocytes ; cytology ; immunology ; metabolism ; Flow Cytometry ; Humans ; Palatine Tonsil ; cytology ; immunology