Learning curve of robotic distal and total gastrectomy.

BACKGROUND: This study aims to assess the learning curve of robotic distal gastrectomy (RDG) and robotic total gastrectomy (RTG) for gastric cancer. METHODS: Data on consecutive patients who underwent robotic gastrectomy for gastric cancer by five surgeons between March 2010 and August 2019 at two high-volume institutions were collected. The learning curve was determined based on the analyses of operation time and postoperative complications within 30 days. Cumulative sum analysis (CUSUM) and risk-adjusted-CUSUM (RA-CUSUM) were applied to identify the turning points (TPs). RESULTS: A total of 899 consecutive patients were included. The mean number of patients needed to overcome the learning curve for operation time of RDG and RTG were 22 and 20, respectively. The number of patients needed to overcome the learning curve for postoperative complications after RDG and RTG were 23 and 18, respectively. The surgical outcomes in the post-TP group were better than in the pre-TP group and improved as surgeons' experience increased. Also, increased case numbers in RDG promoted the RTG learning process. CONCLUSION: The present study demonstrated a substantial influence of surgical cumulative volume on improved surgical outcomes in robotic gastrectomy. Increased experience in RDG may help surgeons to achieve proficiency faster in RTG.

Expression of miR-181a in Acute Myeloid Leukaemia and Its Effect on Cell Proliferation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression of miR-181a in AML cell lines and explore its effect on cell proliferation.</p><p><b>METHODS</b>The expression of miR-181a in AML cell lines (NB4,HL-60,K562 and MV-4-11) was detected by quantiative polymerase chain reation(qPCR). Moreover, the cell proliferation and cell cycle were evaluated in several cell lines (HL60, NB4 and K562) by using CCK-8 and flow cytometry after the imitative transfection with miR-181a.</p><p><b>RESULTS</b>The miR-181a expression was significantly increased in most AML cell lines, including NB4,HL-60 and MV-4-11, but decreased in a few AML cell lines(K562), as compared with that in control(P<0.05). Overexpressed miR-181a in the cell lines significantly enhanced the cell proliferation, as well as the cell ratio of S-to and G2-phase by miR-181a imitative transfection in vitro.</p><p><b>CONCLUSION</b>Overexpression of miR-181a can promote AML cell proliferation. MiR-181a may play an oncogene role in AML, studying the MiR-181a may provide a new method for treatment of AML.</p>