Objective:To evaluate the effect of 5th generation mobile communication technology(5G) remote robot-assisted cholecystectomy on postoperative recovery and quality of life in patients with gallstones.Methods:Clinical data of patients who underwent 5G remote robotic cholecystectomy(20 cases) vs traditional robotic cholecystectomy(20 cases) at Gansu Provincial People's Hospital from May to September 2023 were retrospectively analyzed. Intraoperative and postoperative related indexes were compared between the two groups, and changes in pain analog scores before, 12 hours, and 24 hours after surgery, and global quality of life (GIQLI) scores before and 3 months after surgery were evaluated.Results:There was no significant difference between the two groups in terms of intraoperative and postoperative conditions (intraoperative blood loss, operative time, time to exhaustion, and length of hospital stay). Patients' pain analog scores at 12 and 24 hours postoperatively were lower than preoperatively, but the differences were not statistically significant( P>0.05). In addition, there was no significant difference in recovery indicators between the two groups compared to the control group ( P>0.05). Conclusion:The postoperative recovery metrics of 5G tele-robotic-assisted cholecystectomy were consistent with the results of conventional robotic surgery.

Objective:To evaluate the effect of 5th generation mobile communication technology(5G) remote robot-assisted cholecystectomy on postoperative recovery and quality of life in patients with gallstones.Methods:Clinical data of patients who underwent 5G remote robotic cholecystectomy(20 cases) vs traditional robotic cholecystectomy(20 cases) at Gansu Provincial People's Hospital from May to September 2023 were retrospectively analyzed. Intraoperative and postoperative related indexes were compared between the two groups, and changes in pain analog scores before, 12 hours, and 24 hours after surgery, and global quality of life (GIQLI) scores before and 3 months after surgery were evaluated.Results:There was no significant difference between the two groups in terms of intraoperative and postoperative conditions (intraoperative blood loss, operative time, time to exhaustion, and length of hospital stay). Patients' pain analog scores at 12 and 24 hours postoperatively were lower than preoperatively, but the differences were not statistically significant( P>0.05). In addition, there was no significant difference in recovery indicators between the two groups compared to the control group ( P>0.05). Conclusion:The postoperative recovery metrics of 5G tele-robotic-assisted cholecystectomy were consistent with the results of conventional robotic surgery.

Objective:To explore the feasibility and clinical value of holographic image technology in intracranial tumor surgery.Methods:A total of 40 patients with intracranial tumors in Beijing Tiantan Hospital, Capital Medical University from November 2020 to March 2021 were randomly divided into the experimental group (20 cases) and the control group (20 cases) based on the random number table. Patients in the experimental group underwent craniotomy assisted by holographic technology, while patients in the control group underwent conventional craniotomy. The Karnofsky performance status scores of patients before the operation and 7 days after the operation were recorded, and the self-rating anxiety scale was applied to evaluate the anxiety of the patients' families.Results:The head CT 12 h after surgery showed no tumor cavity hyperdensity in all patients. The head magnetic resonance imaging (MRI) 72 h after surgery revealed 17 cases of total resection and 3 cases of subtotal resection in the experimental group; in the control group, there were 16 cases of total resection and 4 cases of subtotal resection. In the experimental group, 1 patient's left lower limb muscle strength was grade Ⅱ after the operation and recovered to grade Ⅴ-at discharge. In the control group, the left limb muscle strength of 2 patients was grade Ⅲ after the operation and recovered to grade Ⅴ at discharge. The patients with Karnofsky scores of 60, 70, 80, 90, 100 scores were found in 1 case, 5 cases, 8 cases, 6 cases, 0, respectively of the experimental group and 0, 4 cases, 9 cases, 6 cases, 1 case, respectively of the control group before the operation, and the difference was statistically significant ( P > 0.05); the patients with Karnofsky scores of 50, 60, 70, 80, 90, 100 scores were found in 1 case, 0, 0, 7 cases, 9 cases,3 cases, respectively of the experimental group and 0, 3 cases, 6 cases, 4 cases, 5 cases, 2 cases, respectively of the control group after the operation, and the difference was statistically significant ( P = 0.018). The difference of Karnofsky score before and after the operation in the experimental group was statistically significant ( P = 0.029), while there was no statistically significant difference in the Karnofsky score before and after the operation in the control group ( P = 0.241). There were 8 cases, 9 cases, 2 cases and 1 case of non-anxiety, mild anxiety, moderate anxiety, severe anxiety, respectively in the experimental group and 3 cases, 4 cases, 8 cases and 4 cases of non-anxiety, mild anxiety, moderate anxiety, severe anxiety, respectively in the control group before the operation; there were 9 cases, 9 cases, 2 cases and 0 case of non-anxiety, mild anxiety, moderate anxiety, severe anxiety, respectively in the experimental group and 2 cases, 5 cases, 9 cases and 4 cases of non-anxiety, mild anxiety, moderate anxiety, severe anxiety, respectively in the control group after the operation. The preoperative and postoperative anxiety scores of the experimental group were all lower than those of the control group, and the differences were statistically significant (preoperative P = 0.016,postoperative P = 0.002). Conclusions:Holographic technology can assist in formulating an accurate surgical plan before intracranial tumor surgery, intuitively display the anatomical relationship between the tumor and its surrounding important tissues during operation, reduce the surgical side injuries and decrease the anxiety of the patients' family.

Objective: To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m², 10 mg/m² or 12 mg/m² as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) . Methods: A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m²) as induction chemotherapy in newly diagnosed patients of adult AML. Results: Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m² group and IDA 12 mg/m² group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m² group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m² was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m² when compared with the IDA 8 mg/m² was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×10⁹/L in IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×10⁹/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) . Conclusions For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m² is clinically superior to IDA 8 mg/m² and IDA 12 mg/m² in favorable intermediate AML subgroup. However, idarubicin 12 mg/m² is more suitable to adverse AML subgroup.

Under the general requirements of China's national health reform, the basic framework of Shanghai's health reform was constructed at five different aspects the long term vision, goal, strategies, measures, supportive reform activities. The general thought of Shanghai's health reform can be concluded into two aspects: first, establishing a basic healthcare system of covering both urban and rural residents universally; second, enhancing the foundation of enabling sustainable health development.

Objective:To explore the clinic and pathologic characteristics of primary breast lymphoma(PBL) for its diagnosis and treatment.Methods: Five cases of PBL that has been diagnosed during 1998-2005 were analyzed.Results: One patient died 1 month after her final diagnosis.Tow patients have survived 4 and 3 years,respectively,after radical operation plus chemotherapy,although inguinal lymphatic metastasis was found in the later one 2 years after her operation.Another two patients have been accepting chemotherapy for 3 months after their local resection.Conclusion: PBL is diagnosed basically by methods of pathology and immunohistochemistry,and treated mainly by chemotherapy combining with other therapies.

AIM: To observe the effect of continuous epidural analgesia (CEA) of tramadol on postoperative gastrointestinal function and serum motilin level in the patients with cholecystectomy. METHODS: Twenty eight ASAⅠ-Ⅱpatients (8 male, 20 female) aged 24-56 yr, scheduled for elective cholecystectomy under epidural anesthesia, were randomly divided into tramadol group (T, n=14) and control group (C, n=14). The combination of tramadol 800 mg+ bupivacaine 150 mg+ droperidol 5 mg, which diluted with normal saline to 100 ml and pumped 2 ml?h -1, was administered in group T. The combination in group C was bupivacaine 150 mg+ droperidol 5 mg. The VAS values, the first anorectum exhaust timing (FAET), and the time of the first eliminating stool timing (FEST) were recorded, and serum motilin level measured with radioimmunoassay at the different times after surgery. RESULTS: There was a significant difference in the mean VAS values between group T ( 1.2? 1.2) and group C ( 3.3? 1.3) (P