Five Year Trends in the Utilization of Robotic Bariatric Surgery Procedures,United States 2015–2019

Purpose

Robotic approaches have been steadily replacing laparoscopic approaches in metabolic and bariatric surgeries (MBS); however, their superiority has not been rigorously evaluated. The main goal of the study was to evaluate the 5-year utilization trends of robotic MBS and to compare to laparoscopic outcomes.

Methods

Retrospective analysis of 2015–2019 MBSAQIP data. Kruskal-Wallis test/Wilcoxon and Fisher’s exact/chi-square were used to compare continuous and categorical variables, respectively. Generalized linear models were used to compare surgery outcomes.

Results

The use of robotic MBS increased from 6.2% in 2015 to 13.5% in 2019 (N= 775,258). Robotic MBS patients had significantly higher age, BMI, and likelihood of 12 diseases compared to laparoscopic patients. After adjustment, robotic MBS patients showed higher 30-day interventions and 30-day readmissions alongside longer surgery time (26–38 min).

Conclusion

Robotic MBS shows higher intervention and readmission even after controlling for cofounding variables.

Graphical Abstract

     

Experimental animal models of pancreatic carcinogenesis and metastasis

Pancreatic cancer is a lethal disease characterized by early metastasis, local invasion, and resistance to conventional therapies. To understand its etiology and eventually make prevention of it possible and effective, appropriate carcinogenesis models will certainly help us understand the effects of environmental and genetic elements on pancreatic carcinogenesis. The development of new treatment strategies to control cancer metastasis is of immediate urgency. Fulfillment of this task relies on our knowledge of the cellular and molecular biology of pancreatic cancer metastasis and the availability of biologically and clinically relevant model systems. Many of the existing pancreatic cancer carcinogenesis and metastasis animal models are described in this review. The advantages and disadvantages of each model and their clinical implications are discussed, and special attention is focused on experimental therapeutic strategies targeting pancreatic cancer metastasis.     

LKB1表达下调对培养海马神经元突触mEPSC的影响

目的研究离体培养的海马神经元LKB1表达下调对于神经元微小兴奋性突触后电流(mEP-SC)的影响。方法选用17d的胚胎大鼠培养海马神经元,分别用电穿孔的方法转染CAG-RE质粒和LKB1RNAi质粒,培养10~12d后进行电生理记录,选用全细胞膜片钳方式及自由记录模式,细胞外液加TTX阻断动作电位,加Bicucullin抑制GABA电流,记录神经元的mEPSC,比较2组神经元的mEPSC频率和幅度的差别。结果转染CAG-RE的神经元mEPSC幅度平均为25.6pA,频率平均为(5.21±0.25)Hz,是基线的99.8%;转染LKB1RNAi的神经元mEPSC幅度平均为35.1pA,频率平均为(5.79±0.27)Hz,是基线的127.1%;比较2组间频率、幅度变化,差别有显著性意义(P<0.05)。结论LKB1基因表达下调增强了培养海马神经元突触传递的效率。     

Structural shielding design for a gamma ray stereotactic body radiotherapy system.

An OUR-QGD gamma ray stereotactic body radiotherapy system (body knife), made in China, is described. According to its structure and the principle of gamma radiation revolved on a focus, the energy distribution of scattered radiation in its treatment room is calculated. The structural shielding of the wall, roof, and door for a certain treatment room is calculated according to the local radiation protection law.     

间期细胞原位PCR检测B细胞系恶性淋巴瘤

目的：应用原位PCR技术检测B细胞系恶性淋巴瘤。方法：采用免疫球蛋白重链（IgH)基因第三互补决定区（CDR－Ⅲ）的引物，dig-11-dUTP标记物，应用直接原位PCR技术检测Ⅲ-Ⅳ级恶性淋巴瘤的间期淋巴细胞，结果：在初诊的15例恶性淋巴瘤患中，12例检测到IgH基因重排；4例临床表现呈现淋巴瘤性白血病患，治疗后骨髓完全缓解，2例间期细胞原位PCR仍显示有IgH基因重排，6个月复发，结论：间期细胞原位PCR技术能敏感、准确地检测Ⅲ级以上的恶性淋巴瘤，并帮助预测复发，为一有效的基因诊断方法。     

百年乐与人参黄芪合剂对心血管系统的药理作用比较

百年乐和人参黄芪合剂对心血管系统的作用研究表明:百年乐能加速小鼠肠系膜微循环障碍的恢复,增加离体兔耳血管的流量,使主动脉平滑肌松弛,对抗心肌缺氧,抑制血栓形成,其作用强于人参黄芪合剂。     

中药口服与灌肠配合氦-氖激光治疗老年人慢性肾功能衰竭临床观察

观察调中益肾活血通腑中药口服与灌肠配合低能量氦 -氖激光血管内照射(ILIB)疗法对老年人慢性肾功能衰竭 (CRF)的疗效。治疗组予中药口服与灌肠配合ILIB疗法 ,并与阳性对照药依那普利作比较。结果 :两组病例在Scr、BUN、尿蛋白方面均有显著降低 ,但治疗组在改善临床症状、提高红细胞SOD及血浆免疫球蛋白方面均优于对照组。结论 :调中益肾活血通腑中药口服与灌肠配合ILIB疗法具有明显改善老年CRF的肾功能、调整胃肠机能、提高机体免疫能力的作用。     

脑卒中急性期白细胞反应及临床意义

脑卒中急性期大多数患者白细胞增多，表现为中性粒细胞计数与白细胞总数增高，脑出血组白细胞增高姓率高于脑梗塞组，而中性粒细胞增高发生率二组间无差别，外周血白细胞增高与临床神经功能缺损程度评分有密切关系，中性粒细胞计数越高，近期神经功能预后则越差。     

Treatment of cross-bite of anterior teeth with rare earth magnetic appliance with double rails

In this paper, the rare earth magnets (Nd-Fe-B) were used for treatment of cross-bite of anterior teeth. Eight patients were selected. In an attempt to achieve the labial movement of upper anterior teeth, removable appliance with repelling magnetic force were used. The treatment results are satisfactory. The following facts were discussed: (1) the direction of the repelling magnetic force can be controlled well with the double rails; (2) the time for treatment was short and there was no manifestation of unfavorable reaction and (3) no adverse bioeffects have been reported in regard to the use of this kind of device.