Objective To explore the effect of clinical pathway in surgical treatment for patients with mandibular fracture.Methods 80 patients with mandibular fracture were randomly divided into the conventional therapy group(the control group) (n =40） and the clinical pathway therapy group (CP group) (n =40).The hospitalization time,medical expenses,satisfaction for the treatment,health awareness,and incidence of complications were compared between two groups.Results The results of hospitalization time,medical expenses,satisfaction for the treatment,and health awareness of the CP group were (11.86 ± 3.05) d,(9 115.43 ± 1 689.84) yuan,(91.19 ± 1.02) ％,(95.18 ±4.11)points,respectively,which were significantly better than those of the control group [(17.53 ± 2.98)d,(12 066.75 ±2 513.22)yuan,(89.39 ±1.35)％,(82.83 ± 6.56) points] (t =8.41,6.16,6.73,10.01,all P ＜0.05).The complication rate of the two groups was 2.5％,7.5％,respectively,which had no significant differences (χ2 =0.26,P ＞ 0.05).Concltsion The clinical pathway for mandibular fracture surgery is worthy of promotion.

Objective To investigate the pathological changes and mechanism in the urethra by parturition-induced stress urinary incontinence.Methods Sprague Dawley female rats underwent vaginal balloon dilation for 4 hours immediately after delivery.One week later,the rats were anesthetized and both ovaries were excised.Then a rat model of stress urinary incontinence (SUI) was successfully established.One month after ovariectomy,conscious cystometry and Leak-Point Pressure (LPP) were measured by MP150.Histological examination and Western blotting were performed after functional assays.Results (1) 85％ of rats presented astress urinary incontinence in the model group.(2) The urethras in SUI rats had decreased muscles,and striated muscles showed fragmentized and disorganized.(3) Elastic fibers were long,well organized and tightly connected to the muscle bundles in sham group,while elastic fibers showed fragmentation and disorganization in the model group.(4) The protein expression of vascular endothelial growth factor (VEGF) and blood vessels were reduced in SUI rats as compared with the sham rats.Conclusions Muscle and elastic fibers in the urethra are disrupted in SUI rat.VEGF may play an important role in regulation of pathological changes in urethra.

Objective To explore the application of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) value in the diagnosis and differential diagnosis of prostatic cancer. Methods Diffusion-weighted echo-planar imaging (EPI) sequences were performed in 46 patients, including 21 cases of benign prostatic hyperplasia (BPH), 9 cases of chronic prostatitis and 16 cases of prostate cancer. DWI were obtained with a b-factor of 800 s/mm2. According to the pathological results obtained by ultrasound guided biopsy, the peripheral zone of prostate was divided into six parts by orientations and they were divided into noncancerous, hyperplasia, prostatitis and cancerous groups. The ADC value of each region was measured and analyzed with one-way ANOVA and ROC analysis. Results Acceptable images for ADC measurement were obtained in all cases.The mean ADC values of prostatic peripheral zone, prostatic central gland, inflammatory area and cancerous area were (2.20±0. 29)×10-3 mm2/s, (1.66±0.14)×10-3 mm2/s, (1.95±0.34)×10-3 mm2/s and ( 1.24 ± 0.32) × 10-3 mm2/s, respectively. There were statistically significant differences in ADC values between the inter-groups (P＜0. 01 ). With ROC cut point setting to 1.49 ×10-3 mm2/s, the diagnostic sensitivity and specificity for prostate cancer were 86. 8% and 94. 0%, the area under the ROC curve (AUC) was 0. 945±0. 010. Conclusions ADC value might be useful to evaluate prostate cancer. DWI has an important clinical application value in the diagnosis and differentiation of prostate cancer.

Objective To evaluate the effectiveness and safety of varicella attenuated live vaccine ( VarV) produced by A Co. Ltd. Methods We selected 3 provinces in China and enrolled 15 002 children aged 3-<11 in this random, multicenter study. Participants were randomly divided into two groups: the ex-perimental group and the control group. Every varicella case was collected and recorded to calculate the vac-cine efficacy. Vaccine safety was assessed by means of spontaneous report and regular follow-up visits. Re-sults During the observation period, the incidence of varicella was 0. 147% in the experimental group and 1. 155% in the control group (P<0. 001). The vaccine efficacy was 87. 27%. The adverse reaction rate af-ter vaccination was lower than the rates reported in other literatures. Conclusion The VarV produced by A Co. , Ltd. in China was effective and safe in preventing varicella.

Primary liver cancer (PLC) is one of the most common malignant tumors with characteristics of strong invasiveness and poor prognosis. The morbidity and mortality of PLC rank among the top malignant tumors in the world. More than half of the world′s liver cancer occurs in China, which seriously threatens the health and life of Chinese people. Due to the imperceptible initial symptoms, most patients are not diagnosed until their tumors have progressed to be in advanced stage, and lose the chance for curative hepatectomy. At present, non-surgical treatment options, including interventional embolization, ablation, radiotherapy, chemotherapy, and systemic chemotherapy, play an increasingly prominent role in the comprehensive treatment of liver cancer. The authors briefly review the current status and research progress of the non-surgical treatment for liver cancer.

The incidence and mortality rate of hepatocellular carcinoma rank among the top of all cancer types,seriously threatening the life and health of human beings. In recent years,the rapid development of artificial intelligence and the deepening of the concept of precision medicine have led to a boom in interdisciplinary research. Pathomics,as an emerging omics technology driven by artificial intelligence,can mine massive information from high-resolution whole slide images,and shows broad application prospects in the diagnosis,treatment and prognosis assessment of hepatocellular carcinoma. However, pathomics research in hepatocellular carcinoma is still in its infancy, and its research patterns and clinical applications still face several controversies and challenges, including data security, ethics, and “black box” issues. Future research should focus on conducting prospective studies, integrating multimodal data, improving computational technologies, and establishing professional standards to promote the high-quality development of pathomics technology in both clinical and basic research of hepatocellular carcinoma.

The incidence and mortality rate of hepatocellular carcinoma rank among the top of all cancer types,seriously threatening the life and health of human beings. In recent years,the rapid development of artificial intelligence and the deepening of the concept of precision medicine have led to a boom in interdisciplinary research. Pathomics,as an emerging omics technology driven by artificial intelligence,can mine massive information from high-resolution whole slide images,and shows broad application prospects in the diagnosis,treatment and prognosis assessment of hepatocellular carcinoma. However, pathomics research in hepatocellular carcinoma is still in its infancy, and its research patterns and clinical applications still face several controversies and challenges, including data security, ethics, and “black box” issues. Future research should focus on conducting prospective studies, integrating multimodal data, improving computational technologies, and establishing professional standards to promote the high-quality development of pathomics technology in both clinical and basic research of hepatocellular carcinoma.

Objective To evaluate 3D visualization technology in the preoperative planning of hepatic malignancy surgery.Methods The clinical data of 42 patients with hepatic malignancy undergoing radical resection after 3D reconstruction assessment from Feb 2015 to Feb 2018 in our center was retrospectively studied.The predicted resected liver volume were compared with that of resected specimen.Results Surgery was successful in all the 42 patients,and there were no operative deaths.The average operation time was (303 ± 109) minutes,the average intraoperative blood loss was (510 ±482) ml,and 28 patients had intraoperative hepatic inflew occlusion.Postoperative Clavien Ⅲ complications occurred in 4 cases.In terms of the resection liver volume,there was no significant difference between the predicted results (PELV) and actual results [resection liver volume (AELV):(1 143 ± 584) ml vs.(1 091 ± 570) ml,t =0.414,P ＞ 0.05].There is a strong positive correlation between AELV and PELV (r =0.996,P ＜ 0.01).PELV was highly consistent with AELV data (ICC =0.998).Conclusion Three-dimensional visualization technology can accurately reflect the anatomic relationship between intrahepatic tumors and vessels,and correctly assess liver volume,guide surgical resection,thus,it can instruct radical resection of liver malignancy.

Objective:To investigate the influencing factors for textbook outcome (TO) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted. The clinicopathological data of 216 patients with hepatolithiasis who were admitted to The First Affi-liated Hospital of Anhui Medical University from January 2015 to March 2023 were collected. There were 69 males and 147 females, aged 61(range, 22-85)years. Observation indicators: (1) treatment situations; (2) TO after hepatectomy; (3) Influencing factors for TO after hepatectomy. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were expressed as absolute numbers. Logistic regression models were used for univariate and multifactorial analyses. Results:(1) Treatment situations. All the 216 patients underwent hepatectomy, including 45 cases of laparoscopic hepatectomies and 171 cases of open hepatectomies, 161 cases of anatomical hepatectomies and 55 cases of non-anatomical hepatectomies. All the 216 patients underwent intraoperative choledochoscopy exploration and lithotripsy. There were 170 patients with normal Oddi sphincter function and 46 patients with Oddi sphincter dysfunction. All the 216 patients underwent biliary drainage, including 198 cases of external T-tube drainage and 18 cases of internal bile-intestinal drainage. The operation time was (226±75)minutes and volume of intraoperative blood loss was (106±82)mL. There were 29 patients with perioperative blood transfusion and 14 patients with intraoperative severe adverse events. There were 189 patients achieved immediate stone clearance. Of 183 patients with intraoperative bile cultures, 76 cases were positive for bacteria culture. (2) TO after hepatectomy. Of 216 patients, 93 cases had postoperative complications, all of which were successfully discharged after active treatment. One patient had surgery-related death within 90 days after surgery, and the cause of death was liver failure. Five patients were readmitted within 90 days after surgery, and 18 patients had postoperative stone residual. Of 216 patients, 164 cases achieved TO postoperatively and 52 cases did not achieve TO postoperatively. (3) Influencing factors for TO after hepatectomy. Results of multivariate analysis showed that cholangitis, stone distribution, surgical approaches, anatomical hepatectomy, immediate stone removal and postoperative review of choledochoscopy were independent influencing factors for TO after hepatectomy in patients with hepatolithiasis ( P<0.05). Conclusion:Cholangitis, stone distribution, surgical approaches, anatomical hepatectomy, imme-diate stone removal and postoperative review of choledochoscopy are independent influencing factors for TO after hepatectomy in patients with hepatolithiasis.