AIM:To detect the expression levels of miR-744-5p and E3 ubiquitin protein ligase(PELI3)in conjunctival epithelial cells of perimenopausal patients with dry eye, and analyze their correlation with sex hormone level, inflammatory factor level and tear secretion function.METHODS: A total of 60 perimenopausal patients with dry eye admitted to our hospital from February 2020 to February 2022 were selected as the observation group, in addition, 60 perimenopausal subjects with no abnormal eye examination were included as a control group. The tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein staining(FL)scores of perimenopausal patients with dry eye were collected. The conjunctival epithelial cells of the two groups were obtained by impression cytology, the expression level of miR-744-5p was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR), the PELI3 levels of conjunctival epithelial cells and serum levels of follicle stimulating hormone(FSH), estradiol(E2), luteinizing hormone(LH), interleukin-1(IL-1), interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay; correlation analysis was conducted by Pearson and Spearman methods.RESULTS: The expression level of miR-744-5p in conjunctival epithelial cells of patients in the observation group was higher than that in the control group, and the expression level of PELI3 was lower than that in the control group(all P<0.05). Compared with the control group, the expression levels of FSH, IL-1, IL-6 and TNF-α in serum of patients increased in the observation group, and the expression levels of E2 and LH in serum decreased(all P<0.05). Correlation analysis showed that miR-744-5p was negatively correlated with PELI3 in conjunctival epithelial cells of perimenopausal dry eye patients(r=-0.476, P<0.01); miR-744-5p was negatively correlated with LH, E2, BUT and SⅠt(all P<0.05), while it was positively correlated with FSH, IL-1, IL-6, TNF-α and FL scores(all P<0.05); PELI3 was negatively correlated with FSH, IL-1, IL-6, TNF-α and FL scores, while it was positively correlated with E2, BUT and SⅠt(all P<0.05).CONCLUSION: The level of miR-744-5p increased and PELI3 decreased in conjunctival epithelial cells of perimenopausal patients with dry eye. PELI3 and miR-744-5p were closely related to the sex hormones level, inflammatory factor level and the function of tear secretion in perimenopausal patients with dry eye.

AIM:To detect the expression levels of miR-744-5p and E3 ubiquitin protein ligase(PELI3)in conjunctival epithelial cells of perimenopausal patients with dry eye, and analyze their correlation with sex hormone level, inflammatory factor level and tear secretion function.METHODS: A total of 60 perimenopausal patients with dry eye admitted to our hospital from February 2020 to February 2022 were selected as the observation group, in addition, 60 perimenopausal subjects with no abnormal eye examination were included as a control group. The tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein staining(FL)scores of perimenopausal patients with dry eye were collected. The conjunctival epithelial cells of the two groups were obtained by impression cytology, the expression level of miR-744-5p was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR), the PELI3 levels of conjunctival epithelial cells and serum levels of follicle stimulating hormone(FSH), estradiol(E2), luteinizing hormone(LH), interleukin-1(IL-1), interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay; correlation analysis was conducted by Pearson and Spearman methods.RESULTS: The expression level of miR-744-5p in conjunctival epithelial cells of patients in the observation group was higher than that in the control group, and the expression level of PELI3 was lower than that in the control group(all P<0.05). Compared with the control group, the expression levels of FSH, IL-1, IL-6 and TNF-α in serum of patients increased in the observation group, and the expression levels of E2 and LH in serum decreased(all P<0.05). Correlation analysis showed that miR-744-5p was negatively correlated with PELI3 in conjunctival epithelial cells of perimenopausal dry eye patients(r=-0.476, P<0.01); miR-744-5p was negatively correlated with LH, E2, BUT and SⅠt(all P<0.05), while it was positively correlated with FSH, IL-1, IL-6, TNF-α and FL scores(all P<0.05); PELI3 was negatively correlated with FSH, IL-1, IL-6, TNF-α and FL scores, while it was positively correlated with E2, BUT and SⅠt(all P<0.05).CONCLUSION: The level of miR-744-5p increased and PELI3 decreased in conjunctival epithelial cells of perimenopausal patients with dry eye. PELI3 and miR-744-5p were closely related to the sex hormones level, inflammatory factor level and the function of tear secretion in perimenopausal patients with dry eye.

As a trends of minimally invasive surgery, robot surgery is widely used in clinical practice, especially in hepatobiliary and pancreatic surgery, because of its better surgical field of view, more flexible robot arm, and more stable for fine operation. This article summarizes the research status and combines the author's own experience to review the current research progress and clinical effect of robotic surgery in pancreatic surgery, liver surgery, biliary surgery and prospect the further development trend of robotic surgery in the future.

OBJECTIVE To explore the material basis of the anti-inflammatory effect of the petroleum ether extract from Melastoma dodecandrum by establishing its fingerprint and combining it with cellular pharmacodynamics experiments. METHODS HPLC method was adopted； the fingerprints of 20 batches of petroleum ether extract from M. dodecandrum were drawn using The Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）； similarity evaluation and common peak identification were carried out. The lipopolysaccharide-induced inflammation model of mice mononuclear macrophages （RAW264.7） was established； the inhibitory rates of nitric oxide （NO） and tumor necrosis factor α （TNF-α） were used as indexes to investigate the anti-inflammatory activity of the petroleum ether extract from M. dodecandrum； grey correlation degree method and partial least square regression analysis were adopted to study the spectrum-effect relationship. Molecular docking was used to validate the binding activity of the anti-inflammatory active ingredients with TNF-α and iNOS protein receptor. RESULTS There were 19 common peaks in the fingerprint of the petroleum ether extract from M. dodecandrum， the similarity of 20 batches of samples ranged from 0.603-0.990， and five components were identified， such as vitexin （peak 5）， isovitexin （peak 6）， ellagic acid （peak 7）， quercetin （peak 9） and luteolin （peak 10）. The grey correlation degree between 19 common peaks of the petroleum ether extract from M. dodecandrum and the inhibition rates of NO and TNF-α were all greater than 0.7； peaks 19， 13， 9 （quercetin）， 12， 5 （vitexin）， 6 （isovitexin）， 8， 7 （ellagic acid）， 18， 1 were positively correlated with NO inhibition rate， and peaks 8， 10 （luteolin）， 13， 15， 3， 19， 17， 7 （ellagic acid）， 18， 1 were positively correlated with inhibition rate of TNF-α. The binding energies of vitexin， isovitexin and quercetin with iNOS protein receptor were less than －5.0 kcal/mol. CONCLUSIONS Vitexin， isovitexin and quercetin may be the basis of the anti-inflammatory effect of the petroleum ether extract from M.dodecandrum.

OBJECTIVE To compare the contents of schizandrin A, schizandrin B, schizandrin C, schisandrol A, schisandrol B, schisantherin A, anwuligan, and schisanhenol in Schisandrae Sphenantherae Fructus on market from 12 habitats. METHODS The samples were pre-treated by 96-well fitration plates. The assay was performed on ACE EXCEL 1.7 C18-AMIDE(100 mm×2.1 mm, 1.7 μm) column with 0.1% formic acid-water(A) and methanol(B), gradient elution, flow speed was 0.4 mL·min–1. Ion source was electric spray ion source, positive ion monitoring mode, multireaction monitoring mode for quantitative analysis. Linear, instrument precision, stability, repeatability, average recovery were investigated. RESULTS The content of schisantherin A in 10 of 12 producing areas reached the standard of ≥0.2% of Schisandrae Sphenantherae Fructus in 2020 Edition of Chinese Pharmacopoeia. CONCLUSION UHPLC-MS/MS is suitable for simultaneous determination of multiple components in Schisandrae Sphenantherae Fructus. The Schisandrae Sphenantherae Fructus in the market basically meet the national legal standards.

Objective: To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula (HTQS formula), for the health management and treatment of non-alcoholic fatty liver disease (NAFLD). Methods: A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula. In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology. The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot. Finally, 16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids (SCFAs) and bile acids to determine the impact of the HTQS formula on gut microbiota. Results: The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol (TC), triglycerides, blood glucose, and insulin resistance (IR) without causing liver or kidney injury. We detected 28 components using UPLC‒MS/MS and identified 439 shared targets between NAFLD and the HTQS formula. Primarily, we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis. We validated that the HTQS formula inhibited liver steatosis and inflammation by increasing the phosphorylation levels of PI3K, AKT, P27, GSK3β in the PI3K/Akt signaling pathway. 16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group, which was positively correlated with IR and taurodeoxycholic acid. In addition, Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids, which could be essential to the therapeutic effect of the HTQS formula against NAFLD. Conclusions The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury. Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.

The development of minimally invasive robotic surgery has always been the focus of the discipline. Pancreaticoduodenectomy has been regarded as the "Mount Everest" of surgical operations because of its high risk and mounting difficulty. Standardized surgical steps and easy-to-follow operation techniques are helpful to promote the application of robotic pancreaticoduodenectomy (RPD). Therefore, in this paper, we summarize the RPD to form an 18-step surgery procedure and analyze the key points of circumferential vessel resection and reconstructive anastomosis techniques, based on the experience of RPD at the First Medical Center of Chinese People's Liberation Army General Hospital, with the hope of promoting the in-depth application of robotics in pancreatic surgery and furthering the establishment of RPD application standards.

With the continuous advancement of robot-assisted surgical system and the continuous accumulation of clinical experience of surgeons, robot-assisted surgical systems are becoming more and more widely used in the field of pancreatic surgery. Several studies have suggested that robot-assisted pancreatic surgery has significant advantages over traditional pancreatic surgery. The “ International consensus guidelines on robotic pancreatic surgery in 2023” provides more standardized guidance on the applicability and safety of robotic-assisted pancreatic surgery, and discusses in detail the indications, safety, learning curve, and related issues of robot-assisted pancreaticoduodenectomy, distal pancreatectomy,and mid pancreatectomy. In addition, the application value of robot-assisted surgical systems in special patients was discussed, as well as the new technology of robot-assisted pancreaticointestinal anastomosis and the new concept of pancreatic duct repair surgery. This article interprets the guidelines based on the recommendations of the guidelines and the practical experience of the authors′ team in the field of robotic-assisted pancreatic surgery

With the continuous advancement of robot-assisted surgical system and the continuous accumulation of clinical experience of surgeons, robot-assisted surgical systems are becoming more and more widely used in the field of pancreatic surgery. Several studies have suggested that robot-assisted pancreatic surgery has significant advantages over traditional pancreatic surgery. The “ International consensus guidelines on robotic pancreatic surgery in 2023” provides more standardized guidance on the applicability and safety of robotic-assisted pancreatic surgery, and discusses in detail the indications, safety, learning curve, and related issues of robot-assisted pancreaticoduodenectomy, distal pancreatectomy,and mid pancreatectomy. In addition, the application value of robot-assisted surgical systems in special patients was discussed, as well as the new technology of robot-assisted pancreaticointestinal anastomosis and the new concept of pancreatic duct repair surgery. This article interprets the guidelines based on the recommendations of the guidelines and the practical experience of the authors′ team in the field of robotic-assisted pancreatic surgery

In the 21st century,surgery has entered the 4.0 era,also known as the era of surgical intelligence.As technology continues to improve and advance,robotic surgery has become an important direction of development in the field of minimally invasive surgery.With significant technical advantages such as high-definition 3D stereoscopic vision and the elimination of physiological tremors,robotic surgery is increasingly being applied in the field of hepatobiliary and pancreatic surgery,gradually becoming the primary surgical approach in this domain.Compared to traditional open surgery and laparoscopic surgical techniques,robotic hepatobiliary and pancreatic surgery demonstrates notable advantages in terms of precision and safety.It not only reduces intraoperative blood loss but also shortens postoperative hospitalization,thereby accelerating patient recovery.The authors'center is one of the largest robotic hepatobiliary and pancreatic surgery centers in the world.Since 2011,it has pioneered robotic hepatobiliary and pancreatic surgery and successfully performed nearly 10 000 cases,gaining a wealth of surgical experience.During this period,the authors'team established a complete robotic hepatobiliary and pancreatic surgery system.This article summarizes the latest research developments in the field of robotic hepatobiliary and pancreatic surgery at home and abroad,combining the rich clinical experience of the authors'center,to provide an in-depth review of the progress and and emerging surgical techniques in robotic pancreatic surgery,liver surgery,and biliary surgery,and also offer an outlook on future trends in robotic hepatobiliary and pancreatic surgery.