Objectives: The main purpose of this study was to compare the surgical strategy and clinical outcomes of single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy for penile cancer. Materials and methods: 21 patients were diagnosis with squamous cell carcinoma and identified from March 2010 to December 2020 in our department. Ten patients were received single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy (robot-assisted group), and eleven patients underwent laparoscopic inguinal lymphadenectomy (laparoscopic group). Preoperative physical examination and related auxiliary examinations all indicated bilateral inguinal lymph node enlargement, and there was no distant metastasis patient presented during the follow-up period. Results: There was no intraoperative conversion to open surgery. The operation time under robotassisted group was 104 +/- 13 min which was significantly shorter than laparoscopic group (136 +/- 11 min, P < 0.01). The average number of lymph nodes was 22.2 +/- 4.5 of both sides in robotassisted group, which was statistically different compared with laparoscopic group (15.4 +/- 3.1, p < 0.01). Moreover, there was significant difference of hospitalization cost between two groups (CNY 67429 +/- 5586 vs 28582 +/- 3774, P < 0.01). No differences in operation time, blood loss, and length of stay were recorded. Conclusions: The single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy reveals with shorter operating time, and better surgical effect, Moreover, we prefer to no change the trocars layout and mechanical arm system during the operation. (c) 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Objective Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by inflammatory synovitis. We developed a new disease activity evaluation system using important cytokines to help doctors better evaluate disease activity in patients with RA. Methods Flow cytometry was used to detect the levels of seven cytokines. Then, the results were analyzed using an R language decision tree. Results The levels of six cytokines, namely interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ, were significantly different between the active disease and remission stages. Decision tree analysis of the six cytokines with statistical significance identified two judgment rules for the remission stage and three judgment rules for the active disease stage. Conclusion We proposed the use of the decision tree method to analyze cytokine levels in patients with RA and obtain a more intuitive and objective RA disease activity scoring system. This method revealed the relationships of IL-6 and TNF-α levels with inflammatory characteristics in patients with RA, which can help predict disease activity.