Comparison of robotic camera holders with human assistants in endoscopic surgery: a systematic review and meta-analysis.

BACKGROUND: Robotic camera holders can overcome the shortcomings of human assistants, such as shaking and accidental rotation in endoscopic surgery. Robotic camera holder is not affected by the operation time and surgical position and reduces the size of the team. However, there is still controversy over the practicality of robotic camera holders. MATERIAL AND METHODS: We searched PubMed, Web of Science, Embase, Cochrane Library PubMed, Embase, Cochrane Library and Web of Science. The last database search was performed on 30 April 2022. Two reviewers independently reviewed the studies. RESULTS: A total of eight studies (n = 698, 354 controls and 344 robotic camera holders) were included in our analysis. The results showed that the robotic camera holder significantly outperformed human assistants on the frequency of lens cleaning (SMD, -0.48; 95% CI, -0.90 to -0.05) and inappropriate movements (MD, -3.57; 95% CI, -4.93 to -2.21). There was no difference in total operation time (MD, 6.99; 95% CI, -2.47 to 16.72), preparation time (MD, 2.43; 95% CI, -0.32 to 5.18) or blood loss (MD, 34.47; 95% CI, -8.05 to 76.98) between the robotic camera holder and human assistant. However, the robotic camera holder was significantly slower in the core operation (MD, 5.06; 95% CI, 1.18 to 8.94), and surgeons had mixed reviews of robotic systems. CONCLUSIONS: The robotic camera holder provided the surgeon with a highly stable environment. Although the robotic camera holder will not increase the total time, it still needs to improve the core operation time. There is much room for improvement in robotic camera holders. Further development of devices with intuitive control systems and a greater range of motion will be required to accommodate more complex surgeries.

Operating room nurse's awareness and implementation status of the prevention of patient's intraoperative acquired pressure injuries: design and validation of a questionnaire.

Aim: To compile the awareness and implementation status of patients with intraoperative acquired pressure injuries prevention by operating room nurses and to test its reliability and validity. Design: This is an equipment development research based on recommendations for developing a reliable and valid questionnaire. Methods: The research was carried out in two phases from February to November 2022. Through a panel discussion, expert consultation, and literature review, the questionnaire for operating room nurses on the current status of awareness and implementation of the prevention of intraoperative acquired pressure injuries was preliminarily formulated. The formal questionnaire was developed through validity analysis, reliability analysis and item analysis, and reliability and validity tests were conducted. Moreover, according to the questionnaire survey results, confirmatory factor analysis was carried out to construct the structural equation model. Results: The initial questionnaire consisted of five dimensions with 48 items, which was finalized to five dimensions with 38 items after reliability and validity testing and analysis. The five dimensions included implementation of intraoperative acquired pressure injuries prevention, intraoperative acquired pressure injuries preventing cognitive conditions, preoperative intraoperative acquired pressure injuries preventing cognitive conditions, basic knowledge of pressure injuries, and implementation of intraoperative acquired pressure injuries prevention in special patients. Cronbach's α of the overall questionnaire was 0.969 while that of each dimension was 0.846-0.959. The KMO value of structural validity was 0.945 (P < 0.001), and the contribution rate of cumulative variance was 70.694%. The fitting of confirmatory factor analysis was found to be generally ideal: χ2/df = 2.382, RMR = 0.027, TLI = 0.894, RMSEA = 0.072, IFI = 0.905, CFI = 0.904. Conclusions: The study and design of the questionnaire for operating room nurses on the current status of awareness and implementation of the prevention of intraoperative acquired pressure injuries are scientific and rational, providing a scientific basis for the standardized reform of hospitals and the optimization of the intraoperative acquired pressure injuries management system of the operating room.

Ropivacaine represses the ovarian cancer cell stemness and facilitates cell ferroptosis through inactivating the PI3K/AKT signaling pathway.

PURPOSE: Ovarian cancer is a malignant tumor in women all over the world. Ropivacaine is identified as a potential drug for the treatment of malignant tumors, but the role and mechanism of ropivacaine in ovarian cancer remains unknown. MATERIALS AND METHODS: Ovarian cancer cells were treated with different doses of ropivacaine. The function of ropivacaine in ovarian cancer was assessed using Cell Counting Kit-8 assay, flow cytometry, sphere-formation assay, Western blot, Fe2+ level analysis, and immunofluorescence. Meanwhile, the mechanism of ropivacaine in ovarian cancer was investigated by multiple molecular experiments. The protective function of ropivacaine in ovarian cancer was further confirmed by in vivo assay. RESULTS: The functional research data indicated that the growth and stemness of ovarian cancer cells were restrained after ropivacaine treatment, while the ferroptosis in ovarian cancer cells was facilitated. The mechanism results confirmed that ropivacaine inactivated the PI3K/AKT signaling pathway in ovarian cancer cells. Furthermore, in vivo assay demonstrated that ropivacaine repressed the proliferation of ovarian cancer cells in vivo and had a protective function in ovarian cancer. CONCLUSION: Ropivacaine restrained ovarian cancer cell stemness and accelerated cell ferroptosis by inactivating PI3K/AKT signaling pathway.

Thyroid Stimulating Hormone Triggers Hepatic Mitochondrial Stress through Cyclophilin D Acetylation.

BACKGROUND & AIMS: Oxidative stress-related liver diseases were shown to be associated with elevated serum thyroid stimulating hormone (TSH) levels. Mitochondria are the main source of cellular reactive oxygen species. However, the relationship between TSH and hepatic mitochondrial stress/dysfunction and the underlying mechanisms are largely unknown. Here, we focused on exploring the effects and mechanism of TSH on hepatic mitochondrial stress. METHODS: As the function of TSH is mediated through the TSH receptor (TSHR), Tshr -/- mice and liver-specific Tshr -/- mice and liver-specific Tshr -/- mice and liver-specific. RESULTS: A relatively lower degree of mitochondrial stress was observed in the livers of Tshr -/- mice and liver-specific in vitro. Microarray and RT-PCR analyses showed that Tshr -/- mice and liver-specific. CONCLUSIONS: TSH stimulates hepatic CypD acetylation through the lncRNA-AK044604/SIRT1/SIRT3 signaling pathway, indicating an essential role for TSH in mitochondrial stress in the liver.

Rs739837 Polymorphism in MiR-885-3p Binding Site Within 3'-Untranslated Region of Vitamin D Receptor is Associated with a Decreased Risk of Pressure Ulcers.

BACKGROUND/AIMS: Accumulative evidence has shown that miR-885-3p plays a crucial role in human carcinogenesis. From miRNA database, we also found that rs739837 polymorphism in miR-885-3p binding site within 3'-untranslated region of Vitamin D receptor (VDR), compromising the suppressive effect of miR-885-3p on VDR. Moreover, Vitamin D is involved in controlling the cell immune response and may play a role in pressure ulcers development. However, whether this polymorphism is actually linked with pressure ulcers remains unclear. The aim of the present study was to investigate the potential association between the rs739837 polymorphism and pressure ulcers, and to explore molecular mechanism of VDR in pressure ulcers. METHODS: Luciferase assays were performed to validate the relationship between miR-885 and VDR, which was confirmed by western-blotting analysis. The relationship between rs739837 and the risk of pressure ulcers was explored using logistic regression analysis. RESULTS: We first conducted statistical analysis to explore the association between the rs739837 genotype and risk of pressure ulcers, and found that the polymorphism genotype was significantly associated with the risk of pressure ulcers (OR 0.68, 95% CI 0.43-0.95, P value = 0.02). We then searched the miRNA database online and identified VDR as a direct target. We established the negative regulatory relationship between miR-885-3p and VDR using luciferase assays. Meanwhile, we transfected cells with scramble control, miR-885-3p mimics, VDR siRNA and miR-885-3p inhibitors. The results further confirmed the negative regulatory relationship between miR-885-3p and VDR. CONCLUSION: VDR is a virtual target of miR-885-3p, and rs739837 might be a predictive biomarker for the risk of pressure ulcers.