Objective To explore the preliminary experience and clinical outcomes of domestic(Jingfeng)robot-assisted laparoscopic radical cystectomy and detubularized sigmoid neobladder construction, and to evaluate the technical feasibility, safety, and postoperative functional recovery. Methods A retrospective analysis was conducted on 12 patients undergoing surgery in our department during Jun. and Dec.2024. The operation time, intraoperative blood loss, postoperative complications, and hospital stay were recorded to assess the surgical efficacy and safety.Results All 12 procedures were successfully completed. The average operation time was 460(390-540)minutes, including 213(170-250)minutes for radical cystectomy with lymph node dissection and 247(200-300)minutes for neobladder reconstruction and anastomosis. Intraoperative blood transfusion was required in 2 cases, and postoperative hemoglobin levels decreased by 22(7-46)g/L in 10 patients. All surgical margins were negative. No major complications of Clavien-Dindo Ⅲ or above occurred postoperatively. The average hospital stay was 9(7-14)days, and bowel function recovered within 2.58(2-3)days. During the follow-up of 2 to 6 months, 11 patients achieved daytime urinary continence, and 6 had normal continence. All patients had no obvious obstruction or hydronephrosis in the upper urinary tract. Conclusion Domestic robot-assisted laparoscopic radical cystectomy and detubularized sigmoid neobladder reconstruction is technically feasible, with advantages in precision, minimal invasiveness, and favorable postoperative recovery. Initial results demonstrate its potential in lymph node dissection, nerve preservation, and urinary continence restoration, suggesting it can become a valuable option for bladder cancer treatment.

Deactivation of the mitochondrial pyruvate dehydrogenase complex (PDC) is important for the metabolic switching of cancer cell from oxidative phosphorylation to aerobic glycolysis. Studies examining PDC activity regulation have mainly focused on the phosphorylation of pyruvate dehydrogenase (E1), leaving other post-translational modifications largely unexplored. Here, we demonstrate that the acetylation of Lys 488 of pyruvate dehydrogenase complex component X (PDHX) commonly occurs in hepatocellular carcinoma, disrupting PDC assembly and contributing to lactate-driven epigenetic control of gene expression. PDHX, an E3-binding protein in the PDC, is acetylated by the p300 at Lys 488, impeding the interaction between PDHX and dihydrolipoyl transacetylase (E2), thereby disrupting PDC assembly to inhibit its activation. PDC disruption results in the conversion of most glucose to lactate, contributing to the aerobic glycolysis and H3K56 lactylation-mediated gene expression, facilitating tumor progression. These findings highlight a previously unrecognized role of PDHX acetylation in regulating PDC assembly and activity, linking PDHX Lys 488 acetylation and histone lactylation during hepatocellular carcinoma progression and providing a potential biomarker and therapeutic target for further development.
Humans ; Acetylation ; Carcinoma, Hepatocellular/genetics* ; Liver Neoplasms/genetics* ; Pyruvate Dehydrogenase Complex/genetics* ; Gene Expression Regulation, Neoplastic ; Animals ; Mice ; Cell Line, Tumor ; Protein Processing, Post-Translational ; Histones/metabolism* ; Disease Progression

Objective:To investigate the differences in acute intestinal injury and regulatory mechanisms in mice following carbon ion FLASH radiotherapy (FLASH-RT) and conventional dose rate radiotherapy (CONV-RT).Methods:Healthy C57BL/6J mice were randomly divided into three groups: control group, FLASH-RT group (100 Gy/s), and CONV-RT group (0.1 Gy/s), with 9 mice in each group. All mice received carbon ion whole abdominal radiotherapy. DNA double-strand breaks (DSB) and cell proliferation were evaluated by measuring the expression of phosphorylated histone H2AX (γ-H2AX) and nuclear-associated antigen 67 (Ki67) using immunohistochemistry; apoptosis was analyzed using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL); transcriptome sequencing was used to analyze the differences in molecular pathways between FLASH-RT and CONV-RT.Results:Compared with the CONV-RT group, the FLASH-RT group showed significantly reduced intestinal γ-H2AX signal at 3 h after radiotherapy ( t=3.80, P<0.01), significantly increased expression of Ki67 at the base of intestinal crypts at 6 h after radiotherapy ( t=4.30, P<0.001), and a significantly decreased number of TUNEL-positive cells at 12 h after radiotherapy ( t=3.08, P<0.01). Transcriptome sequencing analysis showed that FLASH-RT specifically activated the insulin-like growth factor (IGF) pathway, avoiding the excessive activation of CONV-RT-induced nuclear factor-κB and B cell receptor inflammatory pathways as well as the inhibition of energy metabolism. Conclusions:Compared with CONV-RT, carbon ion FLASH-RT can reduce DSB damage, preserve the proliferative activity of intestinal stem cells, activate the IGF pathway, and regulate inflammatory, immune, and metabolic pathways, thereby significantly alleviating acute intestinal epithelial injury. Specifically, the regulation of repair pathways mediated by reduced DSB and the inhibition of inflammatory pathways are potential protective mechanisms for normal tissues.

Fibrosis is a pathological process characterized by an increase in connective tissue and a decrease in parenchymal cells within organ tissues.During its progression,fibrosis can lead to structural damage and functional decline of the affected organ.In recent years,it has found that non-selective cation channel transient receptor potential vanilloid subfamily 1(TRPV1)channel is closely related to fibrosis.When this channel is activated,it can increase the intracellular cation concentration and cause corresponding physiological and pathological changes,playing a particularly crucial role in regulating tissue fibrosis.Animal models have become important tools in studies into the mechanism by which the TRPV1 channel induces organ fibrosis.This article reviews the role of TRPV1 channels in the fibrosis of organs such as the heart,kidney,and pancreas in mice.The relevant signaling pathways in which TRPV1 channels participate to regulate fibrosis are summarized to provide new ideas for studying the pathogenesis of fibrosis and the development of targeted drugs.

High glucose-induced vascular endothelial cell injury serves as a primary pathological factor contributing to delayed healing of diabetic wounds. Effective wound vascularization remains a core challenge in tissue engineering research. Hydrogel-based injectable technology and three-dimensional (3D) bioprinting technology, through synergistic innovation of biomaterials and advanced manufacturing processes, enable precise construction of bionic tissue structures, laying the foundation for functional organ replacement. This review focuses on discussing the synergistic strategies of injectable hydrogels and 3D bioprinted hydrogels in tissue engineering vascularization, as well as the clinical translation of intraoperative bioprinting and its synergistic vascularization strategies, which is currently in urgent need of development. These advancements are expected to provide novel strategies for the repair of diabetic wounds.

At present, acute brain injuries such as stroke and traumatic brain injury have become a serious burden on public health due to relatively limited treatment methods. As an emerging three-dimensional cell culture model, cerebral organoid can well redisplay the cellular diversity, tissue structure and functional characteristics of the human brain, providing an ideal platform for disease modeling, drug development and regenerative medicine research of acute brain injury. However, the construction and application of cerebral organoid are still in the exploratory stage at present, facing major technical bottlenecks such as insufficient vascularization, lack of immune microenvironment and tissue heterogeneity. This review summarizes the cultivation technique of cerebral organoid, highlights its application in acute brain injury, and analyzes its current technical bottleneck, so as to provide more reference basis for the development and application of this technology.

Objective To summarize the technical procedures and preliminary experience of gasless laparoscopic radical cystectomy,and to evaluate its technical feasibility,safety and clinical effects.Methods A retrospective analysis was conducted on 5 patients undergoing gasless laparoscopic radical cystectomy in our hospital during May 2024 and Mar.2025.The clinical and pathological data,operation time,blood loss,intraoperative arterial PCO2 and hemoglobin level,postoperative recovery and complications were collected and analyzed.Results By using the abdominal wall lifting technique to establish the operating space of the lower abdomen without pneumoperitoneum,all operations were successfully completed,with no conversion to pneumoperitoneum surgery or open surgery.The operation time was 154-200 minutes,and the intestinal function recovered 2.4(2-3)days after the operation.No severe complication was observed perioperatively.During up to 6-month follow-up,no ileus,thrombosis,tumor recurrence or metastasis were observed.Condusion Our preliminary experience shows that gasless laparoscopic radical cystectomy is safe and feasible for selected patients and may reduce the incidence of pneumoperitoneum-related complications.

Objective To explore the clinical effect of applying an improved"outside-in"technique in hip arthroscopic surgery.Methods Totally 136 patients undergoing hip arthroscopic surgery between June 2021 and July 2023 were selected and studied retrospectively.According to their different surgi-cal approach,they were divided into a modified approach group(n=75,including 30 males and 45 fe-males,with an average age of 36±14)and a classic approach group(n=61,including 33 males and 28 females,with an average age of 31±11).Before as well as 4 weeks,3 months and 6 months after the surgery,both groups were evaluated using the visual analog scale(VAS)and Harris hip score,and observed their surgical complications.Moreover,the surgical outcomes and time of sur-gical approach establishment were compared between the two groups.Results There was no significant difference between the two groups in general information,preoperative VAS and Harris scores.More-over,no significant difference was found between the two groups in the Harris score after surgery.Compared with the classic approach group,the improved group had significantly less surgical time(49.0±16.9 min vs.66.0±13.3 min,P<0.05),without using the C-arm fluoroscopy during surgery.Moreover,in the modified approach group,the time for establishing the mid-anteriorapproach was sig-nificantly shortened(10.4±5.9 min vs.25.9±15.1 min,P<0.05),along with the traction time during surgery(66.0±13.3 min vs.49.0±16.9 min,P<0.05).Conclusion The modified"outside-in"hip ar-throscopy technique is a safe and effective surgical method,easier to operate,with shorter surgical time.

Objective:To explore the clinical efficacy of the splenic vessel-oriented anatomical plane priority strategy in Da Vinci robotic Kimura distal pancreatectomy.Methods:A retrospective analysis was conducted on 26 patients who underwent robotic-assisted distal pancreatectomy at Zhejiang Provincial People’s Hospital from January 2019 to September 2024. The cohort included 7 male and 19 female patients, aged (49.3±16.7) years. Surgical outcomes, including operative time, intraoperative blood loss, postoperative complications, and hospital stay, were analyzed, and surgical techniques were summarized.Results:All 26 patients successfully completed the surgery. Pathological diagnoses included 5 cases of intraductal papillary mucinous neoplasm, 5 serous cystadenomas, 1 pancreatic neuroendocrine tumor, 6 solid pseudopapillary neoplasms, 4 mucinous cystic neoplasms, and 5 neuroendocrine tumors. The maximum tumor diameter was (2.3±1.1) cm, and the operative time was (183.2±77.4) min. The spleen preservation rate was 100% (26/26). Intraoperative blood loss was 50.0 (17.5, 125) ml, and postoperative hospital stay was (10.1±3.7) d. No Clavien-Dindo grade III or higher complications occurred. The post-operative pancreatic fistula (POPF) rate was 53.8% (14/26), including 38.5% (10/26) biochemical leak and 15.3% (4/26) grade B POPF, with no grade C POPF.Conclusion:The splenic vessel-oriented anatomical plane priority strategy in robotic-assisted spleen-preserving distal pancreatectomy (Kimura technique) is safe and feasible, significantly improving the spleen preservation rate.

Objective To summarize the technical procedures and preliminary experience of gasless laparoscopic radical cystectomy,and to evaluate its technical feasibility,safety and clinical effects.Methods A retrospective analysis was conducted on 5 patients undergoing gasless laparoscopic radical cystectomy in our hospital during May 2024 and Mar.2025.The clinical and pathological data,operation time,blood loss,intraoperative arterial PCO2 and hemoglobin level,postoperative recovery and complications were collected and analyzed.Results By using the abdominal wall lifting technique to establish the operating space of the lower abdomen without pneumoperitoneum,all operations were successfully completed,with no conversion to pneumoperitoneum surgery or open surgery.The operation time was 154-200 minutes,and the intestinal function recovered 2.4(2-3)days after the operation.No severe complication was observed perioperatively.During up to 6-month follow-up,no ileus,thrombosis,tumor recurrence or metastasis were observed.Condusion Our preliminary experience shows that gasless laparoscopic radical cystectomy is safe and feasible for selected patients and may reduce the incidence of pneumoperitoneum-related complications.