【Objective】 To introduce a surgical technique modified by our center, the establishment of a robot-assisted radical prostatectomy (RARP) channel with extraperitoneal three-port method, and discuss its methods, skills, safety and efficacy. 【Methods】 Clinical data of 21 patients with early and intermediate prostate cancer treated with this surgery during Aug.2022 and Jun.2023 were retrospectively analyzed.Surgical time, intraoperative bleeding volume, postoperative complications, drainage tube retention time, postoperative hospital stay, and follow-up results were observed. 【Results】 All 21 cases of surgery were successfully completed by the same surgeon, without peritoneal rupture or addition of auxiliary holes.The time to establish the extraperitoneal gap and install robotic arm was 20.2 (16.0-28.0) min, the operation time was 107.0(60.0-161.0) min, the amount of intraoperative bleeding was 52.8 (31.0-121.0) mL.All patents resumed eating and drinking the next day after operation.The drainage tube indwelling time was 3.9 (2.0-6.0) d, and the postoperative hospital stay was 4.9 (3.0-7.0) d.No serious complications occurred.The urinary catheter was removed 10 days after operation.One month after operation, 20 patients (95.2%) achieved satisfactory urinary control.The postoperative pathology was prostate adenocarcinoma in all cases, with negative margins, and the prognostic grouping of ISUP was 2 cases in group 1, 6 cases in group 2, 10 cases in group 3, 2 cases in group 4, and 1 case in group 5. 【Conclusion】 RARP by extraperitoneal three-hole method is safe and feasible, with exact establishment of extraperitoneal space, few collisions between instruments, low surgical costs, fast postoperative intestinal recovery, aesthetic incision, and satisfactory recovery of urinary control.

Objective The purpose of this study was to investigate the protective effect of dexmedetomidine(DEX)on pathological car-diomyocyte hypertrophy.Methods An in vitro cell population was established in neonatal rats.The rats were divided into six groups:control group(C)without serum for 24 h,model group(A)with angiotensin Ⅱ(Ang Ⅱ)for 24 h,dexmedetomidine group(AD)with Ang Ⅱ+DEX(5μmol/L)for 24 h,C'group with serum-free culture for 48 h,A'group with Ang Ⅱfor 24 h,and AD'group with DEX+Ang Ⅱfor 24 h.The morphological changes of cells were observed by immunofluorescence.The protein expressions of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),and myosin heavy chain(β-MHC)were detected by western blot,and the cell activity was detected by CCK-8.Results Compared with group C,the size of cells in group A was larger,and that in group AD was even more significant.Simi-lar observations were found for hypertrophy related proteins.Compared with group C,the expression of ANP,BNP,and βMHC increased in group A,although the increase in AD group was more obvious.CCK-8 detection showed that compared with group C,the activity of group A decreased and that of group AD increased significantly.Compared with the C'group,the expression of hypertrophy-related pro-tein in the A'group was significantly increased,but the expression of ANP and BNP protein in the AD'group was significantly lower than that in the A'group.The differences were statistically significant(P<0.05).Conclusion Dexmedetomidine can alleviate the occur-rence of pathological hypertrophy through compensatory mechanisms similar to physiological myocardial hypertrophy,and may play a role in myocardial protection.

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

OBJECTIVE: The research progress of new multifunctional bone cement in bone tumor therapy in recent years was reviewed, in order to provide help for the future research of anti-tumor bone cement. METHODS: The related literature on the treatment of bone tumors with new multifunctional bone cement at home and abroad in recent years was extensively reviewed and summarized. RESULTS: The new multifunctional bone cements include those with the functions of photothermotherapy, magnetic thermotherapy, chemoradiotherapy, and antibacterial after operation, which are discussed from the aspects of anti-tumor, drug controlled release, and cytotoxicity. Controlled drug release has been achieved in multifunctional bone cements by adjusting heat and pH or incorporating particles such as chitosan oligosaccharides and γ-cyclodextrin. At present, multifunctional bone cement with hyperthermia, radiotherapy, and chemotherapy has effectively inhibited the local recurrence and distant metastasis of bone tumors. Broadening the application of bone cement for photothermal and magnetic thermal therapy to deeper bone tumors, investigating more precise controlled release of drug-loaded bone cement, and introducing nanoparticles with both thermal conversion and intrinsic enzymatic activities into bone cement for synergistic anti-tumor therapy are promising research directions. CONCLUSION The new multifunctional bone cement inhibits bone tumor cells, promotes new bone formation in bone defects, and prevents incision infection after tumor resection. Certain progress has been made in anti-tumor, antibacterial, drug-controlled release, and reduction of cytotoxicity. Expanding the deeper application range of the new multifunctional bone cement, verifying the safety in clinical application, and focusing on the individualized treatment of the new multifunctional bone cement are the problems that need to be solved in the future.
Humans ; Bone Cements/therapeutic use* ; Delayed-Action Preparations ; Bone Neoplasms/therapy* ; Anti-Bacterial Agents/therapeutic use* ; Nanoparticles/therapeutic use*

Objective:To investigate the effect of anterior or posterior debridement on infections of the lumbar vertebral fusion with cage and pedical screw system.Methods:A total of 10 cases (3 males and 7 females, age 49.80±13.29 years) with infections in the lumbar fusion device were admitted from January 2013 to December 2019. The cases were diagnosed with deep infections after the preview surgery at 10.80±13.24 months, including 10 cases with 12 cages infections and 8 cases with screw system infections. 7 cases were done with debridement and removal of the cages via the anterior approach. And another 3 cases underwent posterior debridement and removal of lumbar fusion cages. The changes in laboratory examination such as WBC count, ESR, CRP, visual analogue scale (VAS) and Oswestry Disability Index (ODI) score were compared preoperatively, 2 months and 6 months postoperatively.Results:No patients were lost in the follow-up. The average follow-up time periods is 16.30±5.10 months (range 9-24 months). There was no significant difference in WBC count between 2 and 6 months after surgery compared with preoperation ( F=0.855, P=0.436). The ESR, CRP, VAS and ODI scores decreased in 2 months and 6 months after sugery, which has significant differences compared preoperation ( P<0.05). The abnormal signals in the lambar vertebral showed a gradual fading trend in the postoperative MRI. The completely fading time was 5.00±1.33 months (range 3-7 months). One-stage bone grafting was performed in 6 cases with 8 spaces via anterior approach, 5 cases with 7 spaces showed the intervertebral fusion after postoperative with 6.80±2.28 months (range 4-10 months), 1 case wirh 1 space was not fused. One-stage bone grafting was performed in 2 cases via posterior approach: 1 case was fused after postoperative and the other patient was not, which due to bone graft area infection. Postoperative bone graft displacement occurred with 1 case and 1 case with L 5 nerve root pulling injury during the operation. Conclusion:The fusion cage can be removed by debridement via posterior approach, but it is difficult to done the completely debridement, which the main reason is the obstruction of the posterior nerve and bone structure. Posterior approach also have risks of infection recurrence and nerve root injury. Cage removal via anterior approach was relatively easy and debridement was thoroughly, which has the risk of injury of important adjacent vessels.

Objective: To examine the association of abnormal metabolic indexes and its clustering with carotid intima-media thickness (cIMT) in childhood. Methods: A convenient sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results: The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9% (203/657) of boys and 29.7% (173/583) girls respectively.The cIMT of boys and girls were (0.49±0.08) and (0.45±0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values <0.001). Children with 0, 1, 2 and ≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07), (0.48±0.08), (0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (P_trend<0.001). Conclusion Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.

Objective: To examine the relationship between clustering of metabolic abnormalities with non-alcoholic fatty liver disease (NAFLD) in hypertensive children and adolescents, and to provide a scientific reference for the prevention and control of NAFLD among children and adolescents. Methods: Data were based on a school-based cross-sectional study conducted from September 2012 to September 2014 in Jinan. A total of 261 hypertensive children and adolescents aged 6 to 17 years were included in this study. Chi-square test was used to analyze the prevalence of NAFLD by numbers of metabolic abnormalities. Multivariable logistic regression model was used to examine the relationship between clustering of metabolic abnormalities and NAFLD in hypertensive children and adolescents after adjustment for potential confounding variables. Results: Among the included 261 hypertensive participants, the prevalence of NAFLD with the number of metabolic abnormalities ≤1, 2 and ≥3 was 5.3%, 25.5% and 36.0%, respectively. After adjustment for sex, age and systolic/diastolic blood pressure, compared with hypertensive children and adolescents carrying ≤1 metabolic disorder, those with two metabolic disorders had 6.51 (95%CI=2.52-16.81) times higher risk for NAFLD, and those with≥3 metabolic disorders had 8.89 (95%CI=3.03-26.06) times higher risk. Conclusion Clustering of metabolic abnormalities is an independent risk factor for NAFLD in hypertensive youth. Comprehensive prevention and control of metabolic disorders in childhood may be helpful to prevent NAFLD.

Objective To examine the association of abnormal metabolic indexes and its clustering with carotid intima?media thickness (cIMT) in childhood. Methods A convenient sampling method was used to conduct a cross?sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9% (203/657) of boys and 29.7% (173/583) girls respectively.The cIMT of boys and girls were (0.49 ± 0.08) and (0.45 ± 0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values<0.001). Children with 0, 1, 2 and≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07), (0.48±0.08), (0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (Ptrend<0.001). Conclusion Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.

Objective To examine the association of abnormal metabolic indexes and its clustering with carotid intima?media thickness (cIMT) in childhood. Methods A convenient sampling method was used to conduct a cross?sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9% (203/657) of boys and 29.7% (173/583) girls respectively.The cIMT of boys and girls were (0.49 ± 0.08) and (0.45 ± 0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values<0.001). Children with 0, 1, 2 and≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07), (0.48±0.08), (0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (Ptrend<0.001). Conclusion Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.

Objective To discuss the adjustment effects of kidney reinforcing medicine on growth and development and the content of choline acetyl transferase (CHAc) in rats with kidney-deficiency constitution. Methods The method of cats scare rats was used to build composite offspring rat models with deficiency and acquired dystrophy, and then the models were divided into model group, Zuogui Pill group and Yougui Pill group. The rats in blank group came from normal pregnant rats. Baby rats were scared and received gavage at the same time. All administration groups received suspension of Zuigui Pills or Yougui Pills. Blank group and model group received the same amount of normal saline, once a day, for 3 months. Growth and development of rats were observed. Weight and food utilization of rats aged 5–8 weeks in each group were recorded. The content of brain CHAc was detected by ELISA. Results When offspring were 5–8 weeks old, weights of rats in the model group were lower than blank group (P<0.01); while weights of rats in Zuogui Pill group and Yougui Pill group increased significantly (P<0.05) and the food utilization was positively correlated with weight; the CHAc content in the model group decreased significantly compared with blank group (P<0.05, P<0.01); while the CHAc content in Zuogui Pill group and Yougui Pill group increased significantly compared with the model group (P<0.01). Conclusion Kidney reinforcing medicine can improve backward growth and development of rats with kidney-deficiency constitution and adjust CHAc in the brain, so as to promote the learning and memory ability of rats with kidney-deficiency constitution.