Objective:To evaluate the safety and efficacy of the domestic robotic surgical system for general surgery.Methods:A prospective single-center, single-arm exploratory study was conducted at Gansu Provincial People's Hospital from Jun 2022 to Oct 2023, enrolling 54 patients undergoing general surgery using domestically produced Toumai? Endoscopic Surgical Robotic System. The primary study endpoint was surgical success rate, and the secondary study endpoints were intraoperative bleeding, operative time, complications, system performance, hospitalization days.Results:In this study, robotic surgery was successfully completed in 52 patients, and in 2 patients undergoing thyroid operation it was converted to open surgery due to bleeding, with a success rate of 96%, no organ injury or death during surgery, and no system failure. The types of surgery included cholecystectomy, radical gastric cancer resection, radical colorectal cancer resection, inguinal hernia repair, partial hepatectomy, total thyroidectomy and choledocho-jejunal anastomosis.Conclusion:The study provides preliminary evidence of the safety and efficacy of the Toumai? Endoscopic Surgical Robotic System for the treatment of general surgical diseases.

Objective:To provide reference for establishing the testing method for quality control of neutron beam in boron neutron capture therapy (BNCT) equipment in China by testing the radiation characteristic parameters and dosimetry characteristic parameters of epithermal neutron beam in hospital neutron irradiator (IHNI).Methods:By comparing the uncertainties in the result of various test items with the deviation values recommended by the European Joint Research Center (EC-JRC), the feasibility of the relevant of testing method was analyzed and evaluated.Results:The uncertainty in epithermal neutron fluence rate was 2.7%. The uncertainty in ratio of thermal to epithermal neutron fluence rate was 3.1%. The uncertainty in ratio of fast neutron air kerma to epithermal neutron fluence rate was 9.3%. The uncertainty in ratio of gamma air kerma to epithermal neutron fluence rate was 8.7%. The uncertainty in spatial distribution of neutron fluence rate was 2.7%. The uncertainty in thermal neutron fluence rate in phantom was 1.8%. The uncertainty in neutron and gamma-ray dose rate in phantom was 17.1% and 4.0%, respectively.Conclusions:The uncertainty in neutron dose rate measurement result in phantom is higher, and further research is needed to improve the accuracy of the testing method. The uncertainty in the measurement result of other test items is lower, and the accuracy of the test result is expected to meet the allowable deviation value recommended by the European Joint Research Center, and the test method is feasible.

The development of famous classical formula compound preparations has been a research hotspot in recent years， carrying great expectations from the government， academia and industry. During the process of its research and development， it reflects many problems related to traditional Chinese medicine （TCM） industry and deserves deep consideration by the academic community. Based on the current status of development of famous classical formulas， this paper summarizes the key problems and made an in-depth analysis. The results show that three key issues should be paid attention. The first is the weakness of basic research in TCM， which affect the healthy development of TCM. The second is the understanding of development of famous classical formula compound preparations is not in-depth， and the formulation of relevant policies needs to be more reasonable. Thirdly， the expectation for the development of famous classical formula compound preparations is too high， which affects the research and development process of the compound preparations. It is hoped that the TCM industry can take this opportunity to face the problems， propose solutions， and form new breakthroughs to promote the development and progress of TCM.

Abstract OBJECTIVE Linezolid(LZD) is a synthetic oxazolidone antibacterial drug that has activity against most Gram positive bacteria. LZD is widely used in pediatric patients, and its common adverse reactions include gastrointestinal reactions and bone marrow suppression, etc. In recent years, LZD-induced hyperlactatemia has gradually attracted attention. LZD-induced hyperlactatemia can exacerbate the condition of pediatric patients and is associated with high mortality rates in children. However, there is currently a lack of data on the risk factors for LZD-induced hyperlactatemia in pediatric patients. METHODS Therefore, this paper collected and retrospectively analyzed the information of hospitalized pediatric patients who received LZD treatment at the Children's Hospital of Chongqing Medical University from October 2012 to February 2023, including demographic characteristics of pediatric patients and clinical treatment related records, etc. According to the inclusion and exclusion criteria, this paper identified whether the included pediatric patients had developed hyperlactatemia and evaluated the causal relationship between LZD and hyperlactatemia using the Naranjo's Scale. The risk factors were analyzed using univariate and multivariate logistic regression, and the dose-response relationship between risk factors and LZD-induced hyperlactatemia was further analyzed using a restricted cubic spline(RCS) model. RESULTS A total of 331 pediatric patients were included, of which 145 pediatric patients(43.8%) developed LZD-induced hyperlactatemia, including 122 cases of mild hyperlactatemia and 23 cases of severe hyperlactatemia; the causal relationship score of LZD-induced hyperlactatemia was “possibly related” in 87 cases(60.0%) and “highly likely related” in 58 cases(40.0%). The median age of pediatric patients was 3(0.92, 9) years old, with 55.29% males, 25.38% patients with liver disease, 8.76% pediatric patients with kidney disease, and 36.56% pediatric patients with cardiovascular disease; the median number of treatment days for pediatric patients receiving LZD was 13(8, 22) d, with pediatric patients with hyperlactatemia having a longer median number of LZD treatment days than those without hyperlactatemia[16(10, 28) vs 11(7, 18)]; 41.09% of pediatric patients used P-glycoprotein inducers in combination, with more pediatric patients(57.4%) experiencing hyperlactatemia; 53.47% of pediatric patients used P-glycoprotein inhibitors in combination; the median values of lactic acid baseline, creatinine baseline, and baseline estimated glomerular filtration rate(eGFR) were 0.92(0.80, 0.92)mmol·L-1, 26(18.25, 34.90) μmol·L-1, 179.97(137.23, 222.70)mL·min-1·(1.73 m)-2, respectively. Multivariate logistic regression analysis showed that pediatric patients received longer LZD treatment duration(OR=1.026, P=0.004), and the combination of P-glycoprotein inducers(OR=2.023, P=0.004), higher lactic acid baseline levels(OR=2.408, P=0.022), and lower eGFR(OR=0.997, P=0.047) were independent risk factors for LZD-induced hyperlactatemia. The RCS model showed that as the number of days of LZD treatment increases, the risk of LZD-induced hyperlactatemia increased nonlinearly(P-non-linear=0.041); when the lactic acid baseline value was -1, the risk of LZD-induced hyperlactatemia dramatically increased as the lactic acid baseline value increased, when it was >0.92 mmol·L-1, the risk of LZD-induced hyperlactatemia slowly increased as the lactic acid baseline value increased(P-non-linear=0.013). CONCLUSION This study explores for the first time the risk factors of LZD-induced hyperlactatemia in pediatric patients, including the impact of the interaction between LZD and drugs that affect mitochondrial function, P-glycoprotein inducers, and P-glycoprotein inhibitors on hyperlactatemia. RCS models are used to analyze the dose-response relationships between LZD treatment days, lactic acid baseline values, and the occurrence of LZD-induced hyperlactatemia. When LZD is combined with P-glycoprotein inducers(mainly isoniazid, rifampicin, and ethambutol), the risk of LZD-induced hyperlactatemia increases, and its related mechanisms still need further research. In addition, pediatric patients with renal insufficiency may need to adjust the LZD dosage appropriately to avoid the occurrence of hyperlactatemia. In conclusion, when pediatric patients receive LZD treatment, attention should be paid to risk factors such as lactic acid baseline value, duration of LZD use, combined use of P-glycoprotein inducers, and renal dysfunction, in order to prevent the occurrence of LZD-induced hyperlactatemia based on the pediatric patient's treatment needs.

Objective:To study the risk factors of postoperative permanent hypoparathyroidism after total thyroidectomy.Methods:In this retrospective study ,the receiver operating characteristic (ROC) curve of postoperative 24 h parathyroid hormone(PTH) values was used to predict the risk of permanent hypoparathyroidism.The clinical and pathological features that related to postoperative permanent hypoparathyroidism were studied by χ2 test and multivariate Logistic regression analysis. Results:Eight hundred and eighty-nine patients were enrolled, the incidence of postoperative transient and permanent hypoparathyroidism was 33.3% and 4.0%, respectively. When 24 h PTH levels less than or equal to 5.84 pg/ml were used as cut off value, the sensitivity of the prediction of permanent hypoparathyroidism was 100%, the specificity was 72%, and the positive predictive value was 22.5%. The presence of parathyroid gland in the pathologic specimen, parathyroid autotransplantation and PTH≤5.84 pg/ml at 24 h after operation were statistically significant risk factor for permanent hypoparathyroidism in multivariate analysis( χ2=10.900, P=0.001; χ2=4.415, P=0.044; χ2=13.576, P=0.000). Group analysis found that the lower 24 h PTH the higher incidence of permanent hypoparathyroidism. Conclusions:For patients undergoing total thyroidectomy, when parathyroid gland is involved and/or the PTH value is low at 24 h after surgery, the occurrence of permanent hypoparathyroidism is high.

Objective:To investigate the patterns of lateral and central neck lymph node metastasis in N1b papillary thyroid carcinoma (PTC) patients.Methods:From Jun 2018 to Sep 2020, 96 consecutive treatment-naive unilateral N1b PTC patients were included. After total thyroidectomy, bilateral central neck and unilateral lateral neck dissection (including the level Ⅱa, Ⅱb, Ⅲ, Ⅳ and Ⅴb) metastasis in different levels and pathological status of lymph nodes were analyzed.Results:The lymph node metastasis rates were 85% in ipsilateral paratracheal region, 82% in level Ⅲ, 77% in level Ⅳ, 55% in pre-tracheal region, 47% in contralateral paratracheal region, 40% in level Ⅱa, 34% in pre-laryngeal region, 6% in level Ⅱb, 6% in intermuscular region, 4% in level Ⅴb. Tumor size >1cm and pre-tracheal lymph nodes netastasis were associated with contralateral paratracheal metastasis ( OR=3.282 and 3.064, P<0.05); Metastasis to Ⅵa was associated with metastasis to Ⅵb ( OR=3.364, P<0.05). Conclusion:Level Ⅱa-Ⅳ of lateral neck and all subgroups of central neck lymph nodes tend to be involved in PTC with lateral neck metastasis. Lateral neck including level Ⅱa-Ⅳ and the whole central neck including right Ⅵb lymph nodes dissection is recommended for N1b PTC patients.

Aiming at the problem of timeliness of CBCT reconstruction, a CBCT fast short scan reconstruction method is proposed. At the same time, the image reconstruction process in which a new attenuation compensation algorithm is applied to improve image quality. When performing FDK three-dimensional reconstruction of a single-frame acquisition image, the Parker-weighted image is calculated in real time, and a new attenuation compensation algorithm is applied in the back projection process to complete the short scan Parker-weighted reconstruction. This method simulates the CBCT synchronous acquisition and reconstruction process by establishing collection and reconstruction threads. Under the premise of satisfying the reconstruction quality, the reconstruction can be completed within 1 to 2 seconds after the patient collection is completed, which achieves the purpose of real-time.
Algorithms ; Cone-Beam Computed Tomography ; Humans ; Image Processing, Computer-Assisted ; Spiral Cone-Beam Computed Tomography

OBJECTIVE: To establish a mouse model bearing orthotopic temozolomide (TMZ)-resistant glioma that mimics the development of drug resistance in gliomas METHODS: Seventy-eight adult C57BL/6 mice were randomly divided into 6 groups ( RESULTS: The mouse models bearing TMZresistant glioma was successfully established. The cells from the high-dose induced group showed a significantly higher colony-forming rate than those from the high-dose control group ( CONCLUSIONS Progressive increase of TMZ doses in mice bearing orthotopic gliomas can effectively induce TMZ resistance of the gliomas.
Animals ; Antineoplastic Agents, Alkylating/pharmacology* ; Brain Neoplasms/drug therapy* ; Cell Line, Tumor ; Disease Models, Animal ; Drug Resistance, Neoplasm ; Glioma/drug therapy* ; Mice ; Mice, Inbred C57BL ; Temozolomide/therapeutic use*

Objective:To evaluate the safety of two inactivated COVID-19 vaccines in a large-scale emergency use.Methods:Based on the "Vaccination Information Collection System", the incidence data of adverse reactions in the population vaccinated with the inactivated COVID-19 vaccines developed by Beijing Institute of Biological Products Co., Ltd and Wuhan Institute of Biological Products Co., Ltd, respectively, in emergency use were collected, and the relevant information were analyzed with descriptive epidemiological and statistical methods.Results:By December 1, 2020, the vaccination information of 519 543 individuals had been collected. The overall incidence rate of adverse reactions was 1.06%, the incidence rate of systemic adverse reactions was 0.69% and the incidence rate of local adverse reactions was 0.37%. The main systemic adverse reactions included fatigue, headache, fever, cough and loss of appetite with the incidence rates of 0.21%, 0.14%, 0.06%, 0.05% and 0.05%, respectively; the main local adverse reactions were injection site pain and injection site swelling with the incidence rates of 0.24% and 0.05%, respectively.Conclusion:The two inactivated COVID-19 vaccines by Beijing Institute of Biological Products Co., Ltd and Wuhan Institute of Biological Products Co., Ltd showed that in the large-scale emergency use, the incidence rate of general reactions was low and no serious adverse reactions were observed after the vaccinations, demonstrating that the vaccines have good safety.

Objective:To observe the expression of α-enolase in laryngeal carcinoma patients and its relationship with the infection with HPV16/18.Methods:The expression of α-enolase protein in 98 cases was detected by immunohistochemical method and the relationship between α-enolase and clinical stage was analyzed. The expression of HPV16/18 was detected by PCR, sequencing and immunohistochemistry, the relationship between HPV16/18 expression and α-enolase expression was analyzed.Results:Immunohistochemical result showed that the total positive rate of α-enolase expression was 89.8%, and the total positive rate of HPV gene and protein detection was 40.8%. The localization of α-enolase protein tended to shift from cytoplasm and nucleus expression to more cytoplasmic expression only.Conclusions:With the progression of clinical course and HPV16/18 infection, the expression of α-enolase protein showed a tendency of localization to the cytoplasm. Detection of α-enolase protein can provide laboratory data reference for early diagnosis and treatment of laryngeal carcinoma.