Objective:To explore the factors influencing the success rate of culturing patient-derived gastric and colorectal cancer organoids.Methods:From Feb 2022 to Oct 2023, 398 tumor tissue specimens from patients who underwent gastric cancer and colorectal cancer resection at the Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, were used for organoid culture. The clinicopathological factors affecting the success rate of organoid culture were analyzed.Results:The overall success rate of organoid culture in this group was 75.1% (299/398), with the success rate of gastric cancer organoid culture being 79.8%(154/193) and that of colorectal cancer being 70.7% (145/205). Different clinicopathological T stage ( χ2=4.765, P<0.05),histological type ( χ2=11.248, P<0.05), and tumor regression grade (TRG) grade after neoadjuvant chemotherapy ( χ2=7.797, P<0.05) were related to the success rate of organoid culture . Multivariate analysis showed that the TRG grade was an independent influencing factor( P=0.040). For colorectal cancer, different pathological T stage ( χ2=5.108, P<0.05), histological type ( χ2=11.270, P<0.05), and TRG grade after neoadjuvant chemotherapy ( χ2=6.797, P<0.05) were related to the success rate of organoidculture . Different from gastric cancer, the results of multivariate analysis of colorectal cancer showed that the histological type was an independent influencing factor ( P=0.018). Conclusions:The pathologic T stage, histological type of tumors, and TRG of cancer patients all have a significant impact on the success rate of establishing tumor organoids. Among them, the TRG grade is an independent influencing factor for the culture of gastric cancer organoids, and the histological type is an independent influencing factor for colorectal cancer organoids.

Objective:To compare the effects of robotic and laparoscopic radical gastrectomy on short-term clinical outcomes and long-term prognosis in obese patients with gastric cancer.Methods:Clinical data from 231 obese gastric cancer patients undergoing laparoscopic or robotic radical gastrectomy at the Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University between Jan 2015 and Dec 2022 was analyzed. After propensity score matching, the patients were divided into robotic surgery group ( n=79) and laparoscopic surgery group ( n=79). The short-term clinical outcomes and long-term prognosis were compared. Results:Compared with the laparoscopic group, the robotic group had a significantly greater number of dissected lymph nodes [(32±13) vs. (26±11), t=2.797, P=0.006], shorter operation time [(245±65) min vs. (272±62) min, t=-2.669, P=0.008], less intraoperative blood loss[(84±69) vs. (119±56) ml, t=-3.502, P=0.001], shorter postoperative hospital stay [(8.2±3.5) vs. (9.6±4.2) d, t=-2.363, P=0.019], and higher hospitalization cost [(102,139±18,303) vs. (77,857±18,325) yuan, t=8.333, P<0.001]. The 5-year overall survival and disease-free survival rates were comparable between the robotic and laparoscopic groups (77.2% vs. 74.7%, P=0.684; and 73.4% vs. 68.4%, P=0.491, respectively). Conclusions:Robotic radical gastrectomy is a safe and feasible alternative for obese gastric cancer patients in experienced hands. It offers advantages in short-term clinical outcomes, however, it fails to provide a significant long-term survival benefit.

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 investigate the epidemiological characteristics of hospital-associated infections caused by multidrug-resistant organisms(MDROs)among the burn wound patients so as to provide bases for taking tar-geted control measures.METHODS A systematic search was conducted in the worldwide database for nosocomial outbreaks,PubMed and CNKI databases so as to summarize and analyze the data regarding to outbreaks of MDROs hospital-associated infections among burn wound patients.RESULTS A total of 61 incidents of MDROs hospital-associated infections outbreaks among the burn wound patients were included,involving 2 293 patients from 21 countries and regions,50(81.97％)of which were reported for the infection sites or colonization sites in-volving burn wound,12(19.67％)involving the respiratory tract,10(16.39％)involving the bloodstream infec-tions.Methicillin-resistant Staphylococcus aureus(28 incidents,45.90％)was dominant among the pathogens causing the infections,followed by multidrug-resistant Acinetobacter baumannii(17 incidents,27.87％)and multidrug-resistant Pseudomonas aureus(9 incidents,14.75％).52 incidents(82.25％)of outbreaks were reported the contact as the major transmission mode.The suspected sources of the outbreaks included the patients(37 incidents,28.46％),health care workers(30 incidents,23.08％),ward environments(28 incidents,21.54％),medical equipments(19 incidents,30.56％),drainage systems(6 incidents,4.62％).The major pre-vention and control measures included environmental cleaning and disinfection,screening of colonization in patients and health care workers,isolation of patients with infections and hand hygiene;8 incidents were taken the measure of closing the ward.CONCLUSIONS The outbreaks of MDROs infections in the burn wound patients are mostly associated with the high frequently contact environments,medical equipments and hand hygiene of health care workers.In view of the peculiarities of the burn wound patients,it is feasible to take the targeted measures based on the summarized prevention and control combinations for MDROs so as to prevent the outbreak of hospital-asso-ciated infections.

OBJECTIVE To understand the current management status of the special campaign for enhancing the pathogen detection rate before antimicrobial therapy in hospitalized patients in China,analyze identified issues dur-ing implementation,and propose improvement suggestions.METHOD A questionnaire survey was conducted to collect data from medical institutions participating in the special campaign within the region from May to Jul.2024,covering aspects such as quality control management,coordination mechanisms,data sources,indicator connotations and existing issues.RESULTS Variations were observed among medical institutions in the manage-ment of pathogen detection rates,primarily reflected in inconsistent usage of detection rate indicators,varying im-plementation levels of quality control measures and differences in multi-departmental participation.Additionally,discrepancies in data sources,statistical methods and interpretations of indicator connotations limited the compara-bility of data.CONCLUSIONS To address these issues,improvement measures such as strengthening informatiza-tion construction,standardizing indicator statistical methods and enhancing multi-departmental coordination mech-anisms should be implemented.These efforts will provide a scientific basis for the implementation of special cam-paign and robust support for the rational use of antimicrobial agents.

Inflammatory breast cancer(IBC)is a rare but highly aggressive subtype of breast cancer characterized by rapid clinical progression and poor prognosis.Although it accounts for only 2%-4%of all breast cancer cases,it is responsible for 8%-10%of breast cancer-related mortality.The etiology of IBC is multifactorial,involving genetic,hormonal,environmental,and socioeconomic factors.Pathologically,IBC is marked by the presence of dermal lymphatic tumor emboli,and molecular subtypes are predominantly HER2-positive and triple-negative,indicating high tumor invasiveness.Diagnosis relies on characteristic clinical manifestations and histopathological confirmation,while imaging techniques such as MRI and PET/CT play important roles in evaluating disease extent and metastasis.Given that IBC is often diagnosed at a locally advanced or metastatic stage,there is currently no specific treatment protocol.Instead,management generally follows the treatment paradigm of non-IBC,emphasizing systemic therapy within a multidisciplinary framework.HER2-positive IBC benefits from chemotherapy combined with dual-targeted anti-HER2 therapy;triple-negative IBC may respond to immune checkpoint inhibitors;and CDK4/6 inhibitors show potential efficacy in hormone receptor-positive subtypes.Despite advancements,the prognosis remains poor,with a high risk of early recurrence and distant metastasis.Prognostic factors include lymph node involvement,molecular subtype,and response to neoadjuvant therapy.As research into the tumor microenvironment and molecular mechanisms deepens,targeted and individualized therapies hold promise for improving outcomes.This review summarizes the epidemiology,pathology,diagnostic criteria,treatment strategies,and prognostic factors of IBC,aiming to inform clinical practice and future research.

Objective To analyze the research status,hotspots and development trends in the field of central post-stroke pain(CPSP).Methods Relevant literatures up to April 8,2025 were retrieved from the Web of Science Core Collection database.CiteSpace 6.4.R1 advanced version was used for bibliometric and visualization analysis of publication trends,country/institution/author collaboration networks,keywords and burst terms.Results A total of 119 publications were included.Researches on CPSP have shown an overall upward trend since 2002,which could be divided into a slow development period(from 2002 to 2015)and a rapid growth period(from 2016 onwards).The number of published papers reached its peak in 2024.China and the United States led in pub-lication volume.Harvard University was the most productive institution,and Asian institutions contributed a sig-nificant number of publications.The most prolific author was Gao Ju.The top five keywords by co-occurrence frequency were central post-stroke pain,neuropathic pain,pathophysiology,transcranial magnetic stimulation and motor cortex stimulation.Keyword clustering analysis generated ten clusters,which were integrated into four core research areas:pain types,clinical characteristics and diagnostic techniques,pathophysiological mecha-nisms,and treatment strategies.The bursting words included spinal cord and molecular expression in recent years;pathophysiology was the most bursting word.Conclusion In recent years,researches on CPSP are significantly increasing,focusing on pathophysiological mecha-nisms and intervention strategies.Future studies should strengthen the integration of basic and clinical research,promote multidisciplinary collaboration,and enhance research quality.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objective To systematically evaluate the research progress of risk prediction models for periprosthetic joint infection(PJI)after total joint arthroplasty(TJA),analyze the limitations of current researches,and propose optimized suggestions.Methods Chinese and English databases such as PubMed,Embase,Web of Science,Co-chrane Library,SinoMed,Wanfang Database,VIP Database,and CNKI were retrieved systematically.The re-trieved period was from the establishment of each database to August 31,2024.Two researchers independently screened literatures and extracted data according to the CHARMS checklist,and the risk of bias in the included studies was evaluated by the PROBAST tool.Results A total of 14 studies were included in this study,involving 17 prediction models.The most common predictors included history of diabetes mellitus,obesity(body mass index[BMI]≥30 kg/m2),advanced age(≥65 years old),history of traumatic fracture,and prolonged operation time(≥2 hours).All of the included studies had high risks of bias,mainly study subject selection bias(such as single-center sample)and statistical analysis bias(such as unadjusted confounding factors).Conclusion Most of the cur-rently published risk prediction models for PJA after TJA have good predictive performance,however,there are sig-nificant limitations in the research design,especially in the insufficient control of bias risk.Future research needs to focus on improving methodological design,including adoption of prospective multi-center studies,definition of standardized predictive variables,and sufficient adjustment of confounding factors.

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.