ObjectiveTo understand the psychological pressure when the surgeon-in-chief remotely completes animal surgery using home-made Tumai surgical robot in combination with 5G network (Abbreviated as“remote robotic surgery” ), and investigate and analyze the sources of psychological pressure, and then provide evidence guidance for the training of surgeon in performing remote robotic surgery. MethodsA modified perceptual stress scale was used to conduct a questionnaire survey. The 44 surgeons-in-chief with robot operation qualification from 10 medical units in the Gansu Province recruited by Gansu Provincial People’s Hospital were as observation subject, who participated in the psychological stress validation test of remote robotic surgery, from September 4, 2022 to October 10, 2022. The difference of psychological stress before and after the test was compared. The stressor of surgeon-in-chief was analyzed by Likert scale. The animals in this study were swines. ResultsA total of 132 valid questionnaires were obtained from 44 surgeons-in-chief. The surgical physician’s perceived stress score after the test was statistically higher than before the test [(47.50±9.06) points vs. (38.34±5.55) points, mean difference and its 95% confidence interval=9.61 (7.00, 12.27), t=7.42, P<0.001]. The analysis results of multiple linear regression showed that the number of robotic surgery performed by the surgeon-in-chief in the past had a negative impact on the psychological pressure of the surgeon-in-chief after the test (β=–0.292, P=0.042); At the same time, the subjective perception data of the surgeon-in-chief, such as unstability of signal transmission and unskilled equipment manipulation by the surgeon had positive impacts on the psychological pressure of the surgeon-in-chief after the test (β=1.987, P=0.026; β=3.184, P=0.010), and the tacit understanding between the surgeon-in-chief and the first assistant had a negative impact on the psychological pressure of the surgeon-in-chief after the test (β=–2.185, P=0.047). ConclusionsAccording to the data from this study, remote robotic surgery will increase the psychological pressure of the surgeon-in-chief. Previous experience in robotic surgery can reduce psychological stress after surgery. The main sources of psychological pressure are unstability of signal transmission, unskilled equipment manipulation by the surgeon, and the tacit understanding between the surgeon-in-chief and the first assistant.
ObjectiveTo summarise the application research progress of clinical prediction models in postoperative complications of gastric cancer, in order to reduce the risk of complications after gastric cancer surgery. MethodThe literature on the study of postoperative complications of gastric cancer at home and abroad was read and reviewed. ResultsAt present, the main way of treating gastric cancer was still radical resection, and the occurrence of complications after surgical treatment seriously affected the recovery and survival quality of patients. With the deepening of research, the prediction models of postoperative complications in gastric cancer were constantly constructed, and these models provided strong evidence for the early judgement of postoperative complications in gastric cancer, and provided a scientific basis for the improvement of patients’ life quality. ConclusionClinical predictive models are expected to become risk screening tools for predicting the risk of postoperative complications of gastric cancer with clinical utility.
ObjectiveTo study effects of oxymatrine on proliferation and apoptosis of gastric cancer cell line BGC-823 and explore role of endoplasmic reticulum stress in apoptosis of gastric cancer cells induced by oxymatrine and elucidate its mechanism.MethodsThe gastric cancer BGC-823 cells at the logarithmic phase were divided into a control group, oxymatrine alone group (oxymatrine at 10, 30, 60 and 90 μmol/L concentrations), and combination group (oxymatrine at various concentrations combined with 2 μmol/L endoplasmic reticulum stress inhibitor salubrinal). The MTT assay was used to observe the inhibitory effect of the oxymatrine on the growth of BGC-823 cells. The flow cytometry was used to analyze the apoptosis and cell cycle. The Western blot and RT-PCR methods were used to detect the expressions of GRP78/Bip and the caspase-12 protein and gene, respectively.Results① Compared with the control group, the oxymatrine could significantly inhibit the growth of gastric cancer BGC-823 cells in a concentration-time dependent manner (P<0.05) and its IC50 (48 h) value was (59.5±0.5) μmol/L. The inhibitory effect of the combination group of 30, 60, and 90 μmol/L oxymatrine was significantly weakened as compared with the the corresponding oxymatrine alone group (P<0.05). ② The oxymatrine could significantly induce the apoptosis and arrest the G2/M phase in the gastric cancer BGC-823 cells in a concentration-dependent manner (P<0.05). The combination group of 60 μmol/L oxymatrine could significantly decreased the apoptosis rate and the number of cells in the G2/M phase in the gastric cancer BGC-823 cells after treating 48 h (P<0.05). ③ The protein and gene levels of GRP78/Bip and caspase-12 showed significant increases with the increase of oxymatrine concentrations in the oxymatrine alone group (except the protein and gene levels of caspase-12 at 10 μmol/L oxymatrine) as compared with the control group (P<0.05), which in the combination group of 60 μmol/L and 90 μmol/L oxymatrines were significantly decreased as compared with the corresponding oxymatrine alone group (P<0.05).ConclusionOxymatrine can inhibit growth of human gastric cancer cell line BGC-823, which maybe related to caspase-12-dependent induction of apoptosis and up-regulation of GRP78/Bip expression, which needs further experimental verification.