Robotic gastrectomy (RG) has always been a hot topic in the field of minimally invasive surgery for gastric cancer. More and more studies have confirmed that short- and long-term outcomes of RG are similar to those of laparoscopic gastrectomy. Robotic surgical systems have more advantages in specific regional lymph node dissection. More delicate operation can reduce intraoperative blood loss and the incidence of postoperative complications. Robotic surgical systems are also more ergonomically designed. However, there are also some problems such as high surgical cost, lack of tactile feedback and prolonged total operation time. In the future, robotic surgical system may be further developed in the direction of miniaturization, intelligence and modularity. At the same time, the robotic surgical system deeply integrated with artificial intelligence technology may realize the automation of some operation steps to some extent.
Humans ; Robotic Surgical Procedures/adverse effects* ; Stomach Neoplasms/pathology* ; Artificial Intelligence ; Treatment Outcome ; Lymph Node Excision/adverse effects* ; Gastrectomy/adverse effects* ; Laparoscopy/adverse effects* ; Postoperative Complications/etiology* ; Retrospective Studies

Arbovirus is a group of virus transmitted by blood-sucking arthropod bites, which infects both arthropods and vertebrates. More than 600 arboviruses have been characterized worldwide until now, including 65 highly pathogenic viruses, which pose a high threat to public health. The risk of arbovirus transmission is increasing due to climate change, international trade and urbanization. The review summarizes the discovery and distribution of emerging and reemerging arboviruses and novel arboviruses with potential pathogenic risks, and proposes responses to the arbovirus transmission risk, so as to provide insights into the research and management of arboviruses and arthropod-borne infectious diseases in China.
Animals ; Humans ; Arboviruses/physiology* ; Commerce ; Internationality ; Arbovirus Infections/prevention & control* ; Vertebrates

Intestinal adaptation is a spontaneous compensation of the remanent bowel after extensive enterectomy, which improves the absorption capacity of the remanent bowel to energy, fluid and other nutrients. Intestinal adaptation mainly occurs within 2 years after enterectomy, including morphological changes, hyperfunction and hyperphagia. Intestinal adaptation is the key factor for patients with short bowel syndrome to weaning off parenteral nutrition dependence and mainly influenced by length of remanent bowel, type of surgery and colon continuity. In addition, multiple factors including enteral feeding, glucagon-like peptide 2 (GLP-2), growth hormone, gut microbiota and its metabolites regulate intestinal adaptation via multi-biological pathways, such as proliferation and differentiation of stem cell, apoptosis, angiogenesis, nutrients transport related protein expression, gut endocrine etc. Phase III clinical trials have verified the safety and efficacy of teduglutide (long-acting GLP-2) and somatropin (recombinant human growth hormone) in improving intestinal adaptation, and both have been approved for clinical use. We aim to review the current knowledge about characteristics, mechanism, evaluation methods, key factors, clinical strategies of intestinal adaptation.
Humans ; Adaptation, Physiological ; Glucagon-Like Peptide 2/therapeutic use* ; Intestines/surgery* ; Parenteral Nutrition ; Short Bowel Syndrome/surgery*

There is no national referral criteria for burns in China till now, which brings inconvenience and confusion. Based on the oversea experiences and the actual situation in China, many famous experts on burns discussed and developed this Chinese burn referral criteria (2018 version). We hope these referral criteria will be helpful in clinical practice in burn field and can be improved continuously during application.
Burn Units ; standards ; Burns ; therapy ; China ; Humans ; Practice Guidelines as Topic ; standards ; Referral and Consultation ; standards

Objective: To understand the awareness of hepatic disease related knowledge among hepatic physicians in poverty-stricken counties in China, assess the effectiveness of training and provide a reference for the training in the future. Methods: The training was conducted in 90 clinical hepatic physicians selected from county hospitals in poverty-stricken counties (or cities) in Shanxi and Shaanxi provinces. An examination was conducted before the training, immediately after the training and at 5(th) month after the training, respectively. One-way analysis of variance and χ(2) test were conducted to evaluate the score and the correct rate. Results: The knowledge score was (42.96±14.02) before the training, (62.86±13.28) immediately after the training and (59.03±17.92) at 5(t)h month after the training, and the differences were significant. After the training, the awareness of all aspects of related knowledge was improved, the difference was significant compared to knowledge score before training, and at 5(th) month after the training, the difference was still significant. Conclusion: After the training, the awareness of liver disease related knowledge of clinical hepatic physicians in poverty-stricken counties (cities) in Shanxi and Shaanxi provinces was improved, and the improvement could be maintained for nearly half a year.
Awareness ; China/epidemiology* ; Clinical Competence ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Liver Diseases/therapy* ; Physicians ; Poverty Areas ; Program Evaluation ; Staff Development/methods* ; Surveys and Questionnaires

Objective: To study the spatial-temporal dynamical features of hand-foot-mouth disease (HFMD) in Shaanxi Province, so as to provide evidence for the development of relative prevention and control programs on HFMD. Methods: Surveillance data of HFMD was collected from the China Information System for Diseases Control and Prevention from 2009 to 2013. Related data on population and gross domestic product (GDP) was obtained from Shaanxi Statistical Yearbook. Statistical tools as R3.4.1, ArcGIS 10.2 and SaTScan 9.2 software were used to describe the spatial-temporal distribution of the disease. Power-law method on spatial-temporal-multicomponent model was used to analyze the spatial-temporal evolution of the HFMD epidemics in Shaanxi Province. Results: A total of 229 904 cases of HFMD were reported in Shaanxi Province from 2009 to 2013, with an average annual incidence as 122.50 per 100 000. Obvious seasonal characteristics were noticed, with 71.71% of the total cases identified between April and July. Counties with high incidence were mainly distributed in the mid-and east parts of Guanzhong area. Through temporal and spatial scan statistics, we identified that ClassⅠ clustering area was fixed to the central and southeast regions of Shaanxi province which were around Xi'an City between 2009 and 2013, with the relative risk (RR) as 2.24, ranging from 2.18 to 3.08. Results from Power-law analysis showed that the continuous follow-up impact from the previous HFMD epidemics appeared strong in Tongguan, Pucheng districts of Weinan City and Weiyang district of Xi'an, with autoregressive components as 1.14, 0.97 and 0.89, respectively. The risk of HFMD seemed high in Huayin city, Changan and Yanta districts and with the endemic components as 5.08, 4.12 and 4.08, respectively. Impact of the epidemics on nearby districts was largely seen in Lianhu district of Xi'an, Wugong district of Xianyang and Gaoling district of Xi'an with epidemic components as 2.12, 2.08 and 1.77, respectively. The etiological constituents of HFMD were mainly Enterovirus 71 between 2009 and 2012, while HFMD was mainly caused by other entero-viruses, in 2013. Conclusion: Significant spatial-temporal heterogeneity of HFMD was seen in Shaanxi province, which called for specific strategies to be developed in the highly endemic areas.
China/epidemiology* ; Cities ; Cluster Analysis ; Hand, Foot and Mouth Disease/epidemiology* ; Humans ; Incidence ; Public Health Surveillance ; Spatio-Temporal Analysis

Objective: To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Wei River Basin from 2005 to 2015, and analyze the environmental factors that cause the differences of spatial distribution. Methods: HFRS reported cases in Wei River Basin from 2005 to 2015 were collected form "National Disease Reporting Information System" , and the epidemiological features of HFRS were analyzed. Boosted regression trees (BRT) model was applied to evaluate the environment factors on the geographical distribution of HFRS in Wei River basin at 5 km×5 km gird scale. Results: The number of HFRS cases was 18 629, and the average annual incidence from 2005-2015 in Wei River basin was 7.24/100 000. The highest morbidity was 15.18/100 000 in 2012. The middle and lower reaches of Wei River basin had high incidence of HFRS, such as Xi'an, Weinan city. Patients' age was mainly between 16 to 60, and the largest morbidity occured in people over 60 years old. Boosted regression trees modle identified building land, farmland coverage percentage and altitude had higher contribution to the distribution of HFRS. Conclusions: The epidemiological characteristics of HFRS changed significantly. Patients older than 60 years old were having the highest incidence rates. Environmental factors such as buildup land, farmland and altitude played important roles in the geographical distribution of HFRS in the Wei River basin.
Adolescent ; Adult ; Age Distribution ; China/epidemiology* ; Endemic Diseases ; Hemorrhagic Fever with Renal Syndrome/epidemiology* ; Humans ; Incidence ; Middle Aged ; Rain ; Risk Factors ; Rivers

Objective: To explore the spatio-temporal epidemic trends and related driving effects of meteorological factors on brucellosis in Datong city, Shanxi province, from 2005 to 2015. Methods: We collected the surveillance data on brucellosis and related meteorological data in Datong city from 2005 to 2015, to describe the epidemic characteristics of the disease. Quasi-Poisson distribution lag non-liner model (DLNM) was built to explore the driving effect of monthly meteorological data on the disease. Results: From 2005 to 2015, Datong city reported a total of 17 311 cases of brucellosis including one death, with the annual average incidence as 47.43 per 100 000 persons. A rising trend was seen during the study period. The monthly incidence of Brucellosis presented an obvious curve with a major peak from March to June, accounted for 48.40% of the total cases. The high incidence areas in the city gradually expanded from the northeast and southeast to the western areas. Results from the DLNM studies suggested that seasonality of brucellosis in Datong was significantly affected by metrological factors such as evaporation, rainfall and temperature. The peak of delayed effect appeared the highest when the monthly cumulative evaporation capacity was 140-260 mm and the monthly cumulative rainfall was 20-60 mm with lag less than 1 month or the monthly temperature was -13 ℃ with lag of 4-5 months. Conclusions: The incidence of human brucellosis in Datong city increased significantly from 2005 to 2015. Meteorological factors such as evaporation, rainfall, temperature all showed significant driving effects on the disease.
Brucellosis/epidemiology* ; China/epidemiology* ; Cities ; Climate ; Humans ; Incidence ; Meteorological Concepts ; Space-Time Clustering ; Spatio-Temporal Analysis ; Temperature

Objective: To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast, north, central, east, south, northwest and southwest). The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded. The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared. Results: During the study period, 6 480 patients were admitted for asthma exacerbation, accounting for 3.14% of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals. The ratio of asthmatic patients to total inpatients in the northeast area (5.61%) was highest, and the ratio in east area was lowest (1.97%). Statistical analysis showed that the difference among different areas was significant (P<0.000 1). In most areas, both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October). In the northeast area, east area and south area, the peaks in spring were more obvious, while in the north area and southwest area, the peaks in autumn were more obvious. In the northwest area the peaks occurred in winter (December-January) and summer (June-August), respectively. The differences in hospitalization due to asthma among different months were significant in the northeast, north, and southwest areas (P<0.005). Conclusion: The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China. In most areas, more asthmatic patients were admitted to hospitals in spring and autumn.
Asthma ; China/epidemiology* ; Hospitalization/statistics & numerical data* ; Humans ; Retrospective Studies ; Seasons

Significant evidence supports the role of the vestibular system in the regulation of blood pressure during postural movements. In the present study, the role of the vestibulo-spino-adrenal (VSA) axis in the modulation of blood pressure via the vestibulosympathetic reflex was clarified by immunohistochemical and enzyme immunoassay methods in conscious rats with sinoaortic denervation. Expression of c-Fos protein in the intermediolateral cell column of the middle thoracic spinal regions and blood epinephrine levels were investigated, following microinjection of glutamate receptor agonists or antagonists into the medial vestibular nucleus (MVN) and/or sodium nitroprusside (SNP)-induced hypotension. Both microinjection of glutamate receptor agonists (NMDA and AMPA) into the MVN or rostral ventrolateral medullary nucleus (RVLM) and SNP-induced hypotension led to increased number of c-Fos positive neurons in the intermediolateral cell column of the middle thoracic spinal regions and increased blood epinephrine levels. Pretreatment with microinjection of glutamate receptor antagonists (MK-801 and CNQX) into the MVN or RVLM prevented the increased number of c-Fos positive neurons resulting from SNP-induced hypotension, and reversed the increased blood epinephrine levels. These results indicate that the VSA axis may be a key component of the pathway used by the vestibulosympathetic reflex to maintain blood pressure during postural movements.
Animals ; Axis, Cervical Vertebra* ; Blood Pressure* ; Denervation ; Epinephrine ; Excitatory Amino Acid Antagonists ; Glutamic Acid ; Hypotension ; Immunoenzyme Techniques ; Microinjections ; Neurons ; Nitroprusside ; Rats* ; Receptors, Glutamate ; Reflex* ; Vestibular Nuclei ; Natural Resources