Objective To report our preliminary clinical experience and outcomes of uro-oncology procedures conducted utilizing the SSI Mantra^(TM)surgical robotic system.Methods Data of consecutive patients who underwent various...Objective To report our preliminary clinical experience and outcomes of uro-oncology procedures conducted utilizing the SSI Mantra^(TM)surgical robotic system.Methods Data of consecutive patients who underwent various robot-assisted uro-oncology procedures using the SSI Mantra^(TM)surgical robotic system at our institution between July 2022 and September 2023 were recorded.The specific surgical configurations employed with the SSI Mantra^(TM)for these procedures were duly noted.We assessed the feasibility of these procedures with this novel surgical robotic system and report the outcomes.Results A total of 156 patients were operated with the SSI Mantra^(TM)surgical robotic system.The spectrum of procedures performed comprised robot-assisted laparoscopic radical prostatectomy with bilateral extended pelvic lymph node dissection(n=77),robot-assisted radical cystectomy with bilateral extended pelvic lymph node dissection with extracorporeal urinary diversion(n=39),robot-assisted radical nephrectomy(n=32),robot-assisted partial nephrectomy(n=6),robot-assisted radical nephroureterectomy with bladder cuff excision(n=1),and bilateral robot-assisted video endoscopic inguinal lymph node dissection(n=1).One robot-assisted laparoscopic radical prostatectomy had to be converted to open in view of system malfunction.However,no system-related intraoperative complications or injuries were encountered.Conclusion The SSI Mantra^(TM)surgical robotic system demonstrates significant promise as an innovative robotic platform.In this single-center experience,we have demonstrated the feasibility of a diverse array of surgical procedures using this platform.Further research,involving a larger cohort of patients,is imperative to refine the operative techniques and comprehensively understand the perioperative outcomes of the SSI Mantra^(TM)surgical robotic system,particularly in comparison to other robotic surgical platforms.展开更多
Objective:To assess the safety and effectiveness of urological tumor surgeries using the hinotori^(TM)Surgical Robot System(hinotori)in a real-world clinical setting.Methods:All surgeries including robot-assisted radi...Objective:To assess the safety and effectiveness of urological tumor surgeries using the hinotori^(TM)Surgical Robot System(hinotori)in a real-world clinical setting.Methods:All surgeries including robot-assisted radical prostatectomy(RARP),robot-assisted partial nephrectomy(RAPN),robot-assisted radical nephrectomy(RARN),robot-assisted nephroureterectomy(RANU),robot-assisted adrenalectomy(RAA),and robot-assisted radical cystectomy with intracorporeal urinary diversion(RARC+ICUD)for urological tumors with the hinotori and da Vinci surgical system(da Vinci)from January 2022 to September 2023 were enrolled.We evaluated the safety and effectiveness of surgeries using the hinotori compared with those using the da Vinci.Results:Robotic surgeries using the hinotori were performed in a total of 91 cases,comprising 42 cases of RARP,18 cases of RAPN,six cases of RARN,10 cases of RANU,13 cases of RAA,and two cases of RARC+ICUD;no major intraoperative complications were observed in any of the cases using the hinotori;no major postoperative complications occurred in any of the cases;no case experienced an unrecoverable equipment error during surgery.Meanwhile,robotic surgeries using the da Vinci were performed in a total of 277 cases,comprising 126 cases of RARP,94 cases of RAPN,12 cases of RARN,10 cases of RANU,20 cases of RAA,and 15 cases of RARC+ICUD;major intraoperative complications occurred in two cases;major postoperative complications occurred in seven cases;seven cases required transfusion;one case underwent conversion to open surgery;during the study period,no case experienced an unrecoverable equipment error.Surgical outcomes for cases with the hinotori were comparable to those with the da Vinci.Conclusion:This study demonstrated that the hinotori is a safe and feasible tool for robotic surgeries in the field of urology.展开更多
经颅磁刺激(transcranial magnetic stimulation, TMS)是一种神经调制方法,临床中凭借医生经验手动确定TMS线圈摆放位姿,导致线圈摆放位置和姿态不准确且重复定位精度差。针对上述问题,提出一种TMS线圈机器人辅助定位系统,使用RGB相机...经颅磁刺激(transcranial magnetic stimulation, TMS)是一种神经调制方法,临床中凭借医生经验手动确定TMS线圈摆放位姿,导致线圈摆放位置和姿态不准确且重复定位精度差。针对上述问题,提出一种TMS线圈机器人辅助定位系统,使用RGB相机替代导航系统中双目红外相机,采用一种基于神经网络的无标志物TMS线圈机器人辅助定位方法。搭建神经网络实现相机空间线圈姿态到操作臂空间关节角度的映射,并通过仿真数据训练验证了该神经网络架构适用于TMS线圈位姿摆放问题。随后,通过实验验证了该方法的可行性,同时表明训练的神经网络针对TMS线圈定位任务具有良好的泛化能力。最后,在笛卡儿空间的位姿验证结果显示TMS线圈三维位置平均误差为2.16 mm,总体姿态误差为0.055 rad,使用RGB相机的TMS线圈机器人辅助定位系统在精度上达到了与其他使用双目红外相机的科研或商用系统相同的水平,满足TMS临床治疗要求,具备临床应用的可行性。展开更多
Objective Hepatocyte nuclear factor 4-alpha(HNF4A)is a critical transcription factor in the liver and pancreas.Dysfunctions of HNF4A lead to maturity onset diabetes of the young 1(MODY1).Notably,MODY1 patients with HN...Objective Hepatocyte nuclear factor 4-alpha(HNF4A)is a critical transcription factor in the liver and pancreas.Dysfunctions of HNF4A lead to maturity onset diabetes of the young 1(MODY1).Notably,MODY1 patients with HNF4A pathogenic mutations exhibit decreased responses to arginine and reduced plasma triglyceride levels,but the mechanisms remain unclear.This study aims to investigate the potential target genes transcriptionally regulated by HNF4A and explore its role in these metabolic pathways.Methods A stable 293T cell line expressing the HNF1A reporter was overexpressed with HNF4A.RNA sequencing(RNA-seq)was performed to analyze transcriptional differences.Transcription factor binding site prediction was then conducted to identify HNF4A binding motifs in the promoter regions of relevant target genes.Results RNA-seq results revealed a significant upregulation of transmembrane 4 L six family member 5(TM4SF5)mRNA in HNF4A-overexpressing cells.Transcription factor binding predictions suggested the presence of five potential HNF4A binding motifs in the TM4SF5 promoter.Finally,we confirmed that the DR1 site in the-57 to-48 region of the TM4SF5 promoter is the key binding motif for HNF4A.Conclusion This study identified TM4SF5 as a target gene of HNF4A and determined the key binding motif involved in its regulation.Given the role of TM4SF5 as an arginine sensor in mTOR signaling activation and triglyceride secretion,which closely aligns with phenotypes observed in MODY1 patients,our findings provide novel insights into the possible mechanisms by which HNF4A regulates triglyceride secretion in the liver and arginine-stimulated insulin secretion in the pancreas.展开更多
文摘Objective To report our preliminary clinical experience and outcomes of uro-oncology procedures conducted utilizing the SSI Mantra^(TM)surgical robotic system.Methods Data of consecutive patients who underwent various robot-assisted uro-oncology procedures using the SSI Mantra^(TM)surgical robotic system at our institution between July 2022 and September 2023 were recorded.The specific surgical configurations employed with the SSI Mantra^(TM)for these procedures were duly noted.We assessed the feasibility of these procedures with this novel surgical robotic system and report the outcomes.Results A total of 156 patients were operated with the SSI Mantra^(TM)surgical robotic system.The spectrum of procedures performed comprised robot-assisted laparoscopic radical prostatectomy with bilateral extended pelvic lymph node dissection(n=77),robot-assisted radical cystectomy with bilateral extended pelvic lymph node dissection with extracorporeal urinary diversion(n=39),robot-assisted radical nephrectomy(n=32),robot-assisted partial nephrectomy(n=6),robot-assisted radical nephroureterectomy with bladder cuff excision(n=1),and bilateral robot-assisted video endoscopic inguinal lymph node dissection(n=1).One robot-assisted laparoscopic radical prostatectomy had to be converted to open in view of system malfunction.However,no system-related intraoperative complications or injuries were encountered.Conclusion The SSI Mantra^(TM)surgical robotic system demonstrates significant promise as an innovative robotic platform.In this single-center experience,we have demonstrated the feasibility of a diverse array of surgical procedures using this platform.Further research,involving a larger cohort of patients,is imperative to refine the operative techniques and comprehensively understand the perioperative outcomes of the SSI Mantra^(TM)surgical robotic system,particularly in comparison to other robotic surgical platforms.
文摘Objective:To assess the safety and effectiveness of urological tumor surgeries using the hinotori^(TM)Surgical Robot System(hinotori)in a real-world clinical setting.Methods:All surgeries including robot-assisted radical prostatectomy(RARP),robot-assisted partial nephrectomy(RAPN),robot-assisted radical nephrectomy(RARN),robot-assisted nephroureterectomy(RANU),robot-assisted adrenalectomy(RAA),and robot-assisted radical cystectomy with intracorporeal urinary diversion(RARC+ICUD)for urological tumors with the hinotori and da Vinci surgical system(da Vinci)from January 2022 to September 2023 were enrolled.We evaluated the safety and effectiveness of surgeries using the hinotori compared with those using the da Vinci.Results:Robotic surgeries using the hinotori were performed in a total of 91 cases,comprising 42 cases of RARP,18 cases of RAPN,six cases of RARN,10 cases of RANU,13 cases of RAA,and two cases of RARC+ICUD;no major intraoperative complications were observed in any of the cases using the hinotori;no major postoperative complications occurred in any of the cases;no case experienced an unrecoverable equipment error during surgery.Meanwhile,robotic surgeries using the da Vinci were performed in a total of 277 cases,comprising 126 cases of RARP,94 cases of RAPN,12 cases of RARN,10 cases of RANU,20 cases of RAA,and 15 cases of RARC+ICUD;major intraoperative complications occurred in two cases;major postoperative complications occurred in seven cases;seven cases required transfusion;one case underwent conversion to open surgery;during the study period,no case experienced an unrecoverable equipment error.Surgical outcomes for cases with the hinotori were comparable to those with the da Vinci.Conclusion:This study demonstrated that the hinotori is a safe and feasible tool for robotic surgeries in the field of urology.
文摘Objective Hepatocyte nuclear factor 4-alpha(HNF4A)is a critical transcription factor in the liver and pancreas.Dysfunctions of HNF4A lead to maturity onset diabetes of the young 1(MODY1).Notably,MODY1 patients with HNF4A pathogenic mutations exhibit decreased responses to arginine and reduced plasma triglyceride levels,but the mechanisms remain unclear.This study aims to investigate the potential target genes transcriptionally regulated by HNF4A and explore its role in these metabolic pathways.Methods A stable 293T cell line expressing the HNF1A reporter was overexpressed with HNF4A.RNA sequencing(RNA-seq)was performed to analyze transcriptional differences.Transcription factor binding site prediction was then conducted to identify HNF4A binding motifs in the promoter regions of relevant target genes.Results RNA-seq results revealed a significant upregulation of transmembrane 4 L six family member 5(TM4SF5)mRNA in HNF4A-overexpressing cells.Transcription factor binding predictions suggested the presence of five potential HNF4A binding motifs in the TM4SF5 promoter.Finally,we confirmed that the DR1 site in the-57 to-48 region of the TM4SF5 promoter is the key binding motif for HNF4A.Conclusion This study identified TM4SF5 as a target gene of HNF4A and determined the key binding motif involved in its regulation.Given the role of TM4SF5 as an arginine sensor in mTOR signaling activation and triglyceride secretion,which closely aligns with phenotypes observed in MODY1 patients,our findings provide novel insights into the possible mechanisms by which HNF4A regulates triglyceride secretion in the liver and arginine-stimulated insulin secretion in the pancreas.
