Objective:To explore the cleaning quality of different cleaning methods on robotically luminal apparatuses.Methods:This research innovated and invented specially cleaning holder that could support boiling after reducing pressure,and protective device for preprocessing so as to better clean robotically luminal apparatuses.A total of 600 robotic luminal apparatuses,which were used in urology surgery at The First Affiliated Hospital with Nanjing Medical University in November 2023,were selected as the research object,and they were divided into control group,experimental group 1 and experimental group 2 according to the principle of randomization and balance,with 200 apparatuses in each group.The luminal apparatuses of control group were cleaned as the cleaning process of the manufacturer's instructions,and these of experimental group 1 were cleaned through ultrasonic cleaning machine with perfusion in the cleaning process of the manufacturer's instructions,and boiling after reducing pressure was selected to clean those of experimental group 2 through specially cleaning holder that was innovated and invented,which could support boiling after reducing pressure.Both two experiment groups adopted protective device that was invented by our research patent.The visual estimation and magnifying glass(5-10 times)with light source,adenosine triphosphate(ATP)fluorescence detector,and detection device for protein residue were adopted to test and judge cleaning quality,cleaning time,and wear rate of transportation in luminal apparatus after cleaning.Results:The qualified rates of visual estimation and magnifying glass with light source in control group,experiment group 1 and experiment group 2 were respectively 94.5%,99.0%and 99.5%,and the differences of pairwise comparison among three groups were significant(x2=6.44,8.591,P<0.05).The qualified rates of the fluorescence detection and the detection for protein residue in control group were respectively 93.5%and 90%,and those in experiment group 1 were respectively 98.5%and 97%,and the differences among two groups were significant(x2=6.51,11.41,P<0.05).For the cleaning time of single apparatus,the experiment group 1 was shortest,and the experiment group 2 was longest,and there were significant differences in pairwise comparison among three groups(t=2.981,48.178,34.419,P<0.05).The cleaning time of 8 cleaned apparatuses of experiment group 1 still can keep advantage,while there was not significant difference in that between it and control group(P>0.05).The cleaning time of 12 cleaned apparatuses of experimental group 2 was shortest,and that of experiment group 1 was longest,and the differences of that among three groups were significant(t=2.743,5.292,3.177,P<0.05).The average wear rates of transportation of control group,experiment group 1 and experiment group 2 were respectively(9.5±1.8)%,(6.2±1.5)%and(5.8±1.3)%,and the average wear rates of transportation of experiment group 1 and 2 were significantly lower than that of control group,and the differences of that in pairwise comparison among three groups were significant(t=21.7,24.3,P<0.05),while the difference of that between two experiment groups was not significant(P>0.05).Conclusion:The cleaning technique of boiling after reducing pressure can play better cleaning effect for the slender lumen of robotic apparatuses,while the wear rates of experiment group 1 and 2,which use protective device for preprocessing,are better than that of control group.The full load amount of the application of the special cleaning holder of the robotic luminal apparatuses of experiment group 2 can increase by 1 time,which is high efficient and convenient.

Objective:To explore the cleaning quality of different cleaning methods on robotically luminal apparatuses.Methods:This research innovated and invented specially cleaning holder that could support boiling after reducing pressure,and protective device for preprocessing so as to better clean robotically luminal apparatuses.A total of 600 robotic luminal apparatuses,which were used in urology surgery at The First Affiliated Hospital with Nanjing Medical University in November 2023,were selected as the research object,and they were divided into control group,experimental group 1 and experimental group 2 according to the principle of randomization and balance,with 200 apparatuses in each group.The luminal apparatuses of control group were cleaned as the cleaning process of the manufacturer's instructions,and these of experimental group 1 were cleaned through ultrasonic cleaning machine with perfusion in the cleaning process of the manufacturer's instructions,and boiling after reducing pressure was selected to clean those of experimental group 2 through specially cleaning holder that was innovated and invented,which could support boiling after reducing pressure.Both two experiment groups adopted protective device that was invented by our research patent.The visual estimation and magnifying glass(5-10 times)with light source,adenosine triphosphate(ATP)fluorescence detector,and detection device for protein residue were adopted to test and judge cleaning quality,cleaning time,and wear rate of transportation in luminal apparatus after cleaning.Results:The qualified rates of visual estimation and magnifying glass with light source in control group,experiment group 1 and experiment group 2 were respectively 94.5%,99.0%and 99.5%,and the differences of pairwise comparison among three groups were significant(x2=6.44,8.591,P<0.05).The qualified rates of the fluorescence detection and the detection for protein residue in control group were respectively 93.5%and 90%,and those in experiment group 1 were respectively 98.5%and 97%,and the differences among two groups were significant(x2=6.51,11.41,P<0.05).For the cleaning time of single apparatus,the experiment group 1 was shortest,and the experiment group 2 was longest,and there were significant differences in pairwise comparison among three groups(t=2.981,48.178,34.419,P<0.05).The cleaning time of 8 cleaned apparatuses of experiment group 1 still can keep advantage,while there was not significant difference in that between it and control group(P>0.05).The cleaning time of 12 cleaned apparatuses of experimental group 2 was shortest,and that of experiment group 1 was longest,and the differences of that among three groups were significant(t=2.743,5.292,3.177,P<0.05).The average wear rates of transportation of control group,experiment group 1 and experiment group 2 were respectively(9.5±1.8)%,(6.2±1.5)%and(5.8±1.3)%,and the average wear rates of transportation of experiment group 1 and 2 were significantly lower than that of control group,and the differences of that in pairwise comparison among three groups were significant(t=21.7,24.3,P<0.05),while the difference of that between two experiment groups was not significant(P>0.05).Conclusion:The cleaning technique of boiling after reducing pressure can play better cleaning effect for the slender lumen of robotic apparatuses,while the wear rates of experiment group 1 and 2,which use protective device for preprocessing,are better than that of control group.The full load amount of the application of the special cleaning holder of the robotic luminal apparatuses of experiment group 2 can increase by 1 time,which is high efficient and convenient.

BACKGROUND:Peripheral nerves play an important role in bone metabolism.In clinical practice,the specific impact of nerve injury on bone transport technology needs further study. OBJECTIVE:To investigate the effect of tibial nerve injury on the treatment of tibial slip by single-plane osteotomy. METHODS:Thirty-two patients with tibial bone defects admitted to Tangshan Second Hospital from May 2011 to June 2022 were selected.According to the presence or absence of tibial nerve injury,patients were divided into the tibial nerve injury group(n=16)and the non-tibial nerve injury group(n=16).Both groups were treated with single-plane osteotomy and bone slip.After treatment,the patients were followed up to collect the mineralization zone healing index,external fixation index,docking point healing and needle infection.After the removal of external fixation,the bone healing and functional evaluation were evaluated by a classification of the Association for the Study and Application of the Method of Ilizarov(ASAMI). RESULTS AND CONCLUSION:(1)All 32 patients were followed up for(25.28±4.79)months.There were no significant differences in bone healing time,external fixation time,healing index and external fixation index between the two groups(P＞0.05).Needle infection occurred in two cases of the tibial nerve injury group and one case of the non-tibial nerve injury group,all of which were PALEY I,and there was no significant difference between the two groups(P＞0.05).The non-union rate of the occlusal end of the tibial nerve injury group was 31%,and that of the non-tibial nerve injury group was 13%;there was no statistical difference between the two groups(P＞0.05).The excellent and good rate of ASAMI bone healing score in the two groups was 100%;the excellent and good rate of limb score was 81%in the tibial nerve injury group and 94%in the non-tibial nerve injury group;there was no statistical difference between the two groups(P＞0.05).(2)Our research shows that tibial nerve injury has no significant effect on the mineralization speed,external fixation time,union of the occlusal end,infection of the needle tract,and the quality of bone formation in the mineralized area of the single-plane osteotomy.

ObjectiveStudy on the mechanism of Guishao Yunpi decoction in preventing and treating breast hyperplasia based on phosphatase and tensin homolog （PTEN）/ phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） pathway. MethodSeventy SPF-grade SD rats were randomly assigned into blank group （n=15） and modeling group （n=55）. The mammary gland hyperplasia model of liver stagnation and spleen deficiency was established by the comprehensive modeling method （hunger and satiety abnormality + tail stimulation + estradiol benzoate + progesterone）， and then 5 rats were randomly selected for model verification. The modeled rats were then randomly assigned into five groups： model group， positive control （4 mg·kg^-1·d^-1 tamoxifen） group， and high-， medium-， and low-dose （17.2， 8.6， 4.3 g·kg^-1·d^-1， respectively） Guishao Yunpi decoction groups， with 10 rats in each group. The rats in the blank group and model group were given 10 mL·kg^-1·d^-1 distilled water， and those in other groups were orally administrated with corresponding drugs. After 30 days of treatment， the general living conditions of rats were observed， and the thickness of breast tissue was measured by an ultrasonic diagnostic instrument. The open field test was carried out for behavioral evaluation. The levels of B-cell lymphoma-2 （Bcl-2） and Bcl-2-associated X （Bax） in the breast tissue were determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein levels of PTEN， PI3K， and Akt in the breast tissue were determined by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultCompared with those in the blank group， the rats in the model group were irritable， curled up in clusters， and showed positive behavior in the open field test. The modeling led to nipple swelling and increased the breast thickness （P<0.05）. Moreover， the modeling elevated the level of Bcl-2 and lowered that of Bax in the breast tissue （P<0.05）， down-regulated the mRNA and protein levels of PTEN， and up-regulated the mRNA and protein levels of PI3K and Akt （P<0.05）. Compared with the model group， drug administration relieved the general survival state， the degree of nipple swelling， and the positive behavior in the open field test and reduced the breast thickness （P<0.05）. In addition， drug administration reduced the level of Bcl-2 and increased that of Bax in the breast tissue （P<0.05）， up-regulated the mRNA and protein levels of PTEN， and down-regulated the mRNA and protein levels of PI3K and Akt （P<0.05）. ConclusionGuishao Yunpi decoction can improve the general living conditions and alleviate the mammary gland hyperplasia of rats with the syndrome of liver depression and spleen deficiency， which may be realized by the regulation of the PTEN/PI3K/Akt pathway.

Artemisinin and its derivative is a kind of efficient,quick and low toxicity of anti-malarial drug.In recent years,we find that artemisinin drugs can not only against malaria,but also have pharmacological effects of immunosuppression,antiviral and anticancer.A number of studies have confirmed that artemisinin and its derivatives have the radiosensitization effects in nasopharyngeal carcinoma,cervical cancer,lung cancer and glioma,and their mechanisms are related to decreasing Weel protein expression,increasing Cyclin B1 protein expression,blocking G2-M phase and cell apoptosis.