Objective: To identify the differentially expressed genes (DEGs) between hepatocellular carcinoma (HCC) tissues and normal liver tissues by bioinformatic methods, and to explore the intrinsic mechanism of these candidate genes involving in the occurrence and development of HCC from transcriptome level as well as the clinical significance of their associations with the prognosis of HCC patients. Methods: Gene expression profiles of GSE45267, GSE64041, GSE84402 and TCGA were downloaded from GEO (Gene Expression Omnibus) and TCGA(The Cancer GenomeAtlas), respectively. R software and Bioconductor packages were used to identify the DEGs between HCC tissues and para-cancer tissues, and then Gene Ontology (GO) Enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, Protein-Protein Interaction (PPI) network analysis and survival analysis were performed. Results: Forty-six up-regulated genes and 154 down-regulated genes were screened out,and GO enrichment analysis showed that these DEGs were mainly related to cell division, proliferation, cycle regulation, oxidation-reduction process and certain metabolic pathways. KEGG pathway analysis revealed that DEGs were mainly involved in tryptophan metabolism, retinol metabolism and other metabolic pathways as well as p53 pathway. Over-expression of a panel of up-regulated genes (CCNA2, CDK1, DLGAP5, KIF20A, KPNA2 and MELK) was shown to be significantly negatively correlated with the prognosis of HCC patients in the TCGA dataset (all P<0.01). Conclusion: A set of up-regulated hub genes that are negatively correlated with prognosis will provide potential guiding value for the clinical research on the diagnosis and treatment of HCC.

AIM:To investigate the relationship among lens parameters and their correlation with ocular anatomic characteristics in myopia patients implanted with posterior-chamber phakic implantable collamer lens(Phakic-ICL).METHODS:Retrospective study. A total of 46 myopia patients(46 eyes)who underwent Phakic-ICL implantation were collected in the Wuxi Huaxia Eye Hospital from June 2022 to June 2023. Preoperative evaluation of ocular anatomical characteristics included corneal central thickness(CCT), anterior chamber depth(ACD), axial length(AL), white-to-white(WTW), horizontal sulcus to sulcus(STSH), horizontal angle to angle(ATAH), and vertical sulcus to sulcus(STSV), vertical angle to angle(ATAV). Furthermore, lens parameters included horizontal crystalline lens rise(CLRH), vertical CLR(CLRV)and vertical lens thickness(LTV). The difference, consistency and correlation of the above parameters were analyzed.RESULTS:Except for differences between WTW and STSV, STSH and ATAV, which were not statistically significant(all P>0.05), the other horizontal and vertical ocular anatomical characteristics were statistically significant(P<0.05). CLRH and CLRV had statistically significant difference(P<0.01), while LTH and LTV were not statistically significant difference(P>0.05). Bland-Altman results revealed that the anatomical characteristics in the horizontal or vertical diameters showed poor consistency. The consistency between CLRH and CLRV was poor. There was consistency between LTH and LTV, with the 95% limits of agreement(LoA)between the differences ranging from -0.21 to 0.28 mm, and the proportion of out-of-line points off the 95% LoA was 4.35%. Pearson correlation analysis revealed that there were correlations between the anatomical characteristics of the horizontal and vertical diameters(P<0.01). Meanwhile, there was no correlation between the anteroposterior diameters(P>0.05). There were correlations between the lens parameters(P<0.05), excepted for the CLRH, LTH and LTV, which had no correlation. AL correlated with the anatomical characteristics of the horizontal and vertical diameters(P<0.05), but it had no correlation with lens parameters(P>0.05). Multiple linear regression analysis revealed that LT=0.419+0.017×age-0.548×ACD+0.371×ATAH+0.884×CLRV, CLRH=-0.443+0.809×CLRV, CLRV=-0.092-0.200×ATAH+0.560×CLRH(corrected R2=0.458, 0.482, 0.589, respectively).CONCLUSION:Horizontal and vertical diameters were not interchangeable. CLRH and CLRV were not interchangeable, while LTH and LTV were interchangeable. Partial lens parameters, WTW, STS, and ATA were correlated with ACD. Finally, age, ACD, ATAH, and CLRV influenced LT.

Objective To establish a gas chromatography-mass spectrometry(GC-MS)method for blood samples of death cases with nitrite poisoning and examine the stability of nitrite in blood,so as to provid a reference for inferring the concentration of nitrite in blood at the time of death and determining whether the death was caused by nitrite poisoning.Methods The 1,8-diaminonaphthalene(1,8-DAN)derivatized GC-MS method was used to detect the blood samples of people who died of nitrite poisoning;Blank blood was taken with nitrite standards,and the content was measured regularly.The stability of nitrite in blood was observed,and its concentration change trend was obtained.Results The concentration in blood of 11 cases of nitrite poisoning deaths ranged from 1.165 μg/mL to 351.551 μg/mL;With the increase of time,the concentration of nitrite in the labeled blood samples gradually decreased.Conclusion The detection method established in this research is easy to operate,has high accuracy and good precision.Nitrite is unstable in blood,it is recommended to detect it as soon as possible to prevent missed detection.

Objective:To explore the technical points and clinical effects of breast augmentation with silicone prosthesis through inframammary fold(IMF) incision.Methods:From January 2018 to June 2019, 26 cases of patients undergoing breast augmentation in our department were collected, including 10 cases of breast hypoplasia and 16 cases of breast atrophy, ranging in age from 24 to 38 years, with an average year of 30.2. The preselection of the volume, type of prosthesis and the design of new position of IMF were based on the height, weight, breast measurements and individual demand. During the operation, after precisely dissecting the lacunae, water were injected into the circular expander to reassess the volume of prosthesis, then the final prosthesis was implanted and the inframammary fold was reconstructed. After operation, patients were given analgesic pump and combined anti-cicatricial treatment. Postoperative complications, breast morphology, incision scar, and whether the patient was satisfied with the surgical evaluation were followed up.Results:All operations were successful and the operative time ranged from 38 to 45 minutes, the drainage time was 3-4 days, the drainage volume of the unilateral space was 30-50 ml, 96 percent of the patients (25/26) were satisfied with the incision. Postoperative following up lasted from 8 months to 16 months with an average of 12 months. No complications such as hematoma, infection or capsular contracture occurred. The breast shape of 26 patients after operation was natural, erect, plump and bilaterally symmetrical. The incision scar of new IMF was not conspicuous. The patients were very satisfied with the operation effect.Conclusions:Breast augmentation through IMF incision has advantages of short operating path, accurate dissecting and hemostasis under direct vision, short operation time. During the operation, in combination with re-evaluation after the expander inflated with saline to the required prosthesis volume and reconstruction of IMF, satisfactory clinical effects can be achieved with fewer complications.

Objective:To explore the technical points and clinical effects of breast augmentation with silicone prosthesis through inframammary fold(IMF) incision.Methods:From January 2018 to June 2019, 26 cases of patients undergoing breast augmentation in our department were collected, including 10 cases of breast hypoplasia and 16 cases of breast atrophy, ranging in age from 24 to 38 years, with an average year of 30.2. The preselection of the volume, type of prosthesis and the design of new position of IMF were based on the height, weight, breast measurements and individual demand. During the operation, after precisely dissecting the lacunae, water were injected into the circular expander to reassess the volume of prosthesis, then the final prosthesis was implanted and the inframammary fold was reconstructed. After operation, patients were given analgesic pump and combined anti-cicatricial treatment. Postoperative complications, breast morphology, incision scar, and whether the patient was satisfied with the surgical evaluation were followed up.Results:All operations were successful and the operative time ranged from 38 to 45 minutes, the drainage time was 3-4 days, the drainage volume of the unilateral space was 30-50 ml, 96 percent of the patients (25/26) were satisfied with the incision. Postoperative following up lasted from 8 months to 16 months with an average of 12 months. No complications such as hematoma, infection or capsular contracture occurred. The breast shape of 26 patients after operation was natural, erect, plump and bilaterally symmetrical. The incision scar of new IMF was not conspicuous. The patients were very satisfied with the operation effect.Conclusions:Breast augmentation through IMF incision has advantages of short operating path, accurate dissecting and hemostasis under direct vision, short operation time. During the operation, in combination with re-evaluation after the expander inflated with saline to the required prosthesis volume and reconstruction of IMF, satisfactory clinical effects can be achieved with fewer complications.

Objective:To explore the sense of coherence in the main caregivers of cancer patients, analyze its influencing factors, and explore the relationship between sense of coherence and care burden.Methods:From March 2018 to March 2019, convenience sampling method was used to select the main caregivers of 229 cancer patients admitted to two ClassⅢ Grade A hospitals in Harbin as the research object. The questionnaire survey was conducted with the General Information Questionnaire, Sense of Coherence Scale (SOC-13) and the Family Caregiver Burden Scale. Statistical analysis was carried out with t test, single factor analysis of variance, Pearson correlation as well as multiple linear regression. A total of 237 questionnaires were issued and 229 valid questionnaires were returned, with an effective recovery rate of 96.62%. Results:The score of sense of coherence in main caregivers of cancer patients was (55.67±9.23) , which was at a low level. The results of univariate analysis showed that there were statistically significant differences in the score of sense of coherence in main caregivers of cancer patients with different genders of caregivers, occupational status of caregivers, medical cost burden status, patient self-care level, and cumulative care time ( P<0.05) . The results of Pearson correlation analysis showed that the score of sense of coherence in main caregivers of cancer patients was positively correlated with the care burden score of the terminal cancer ( r=0.398, P<0.01) . The results of multiple linear regression analysis showed that the burden of medical expenses, the degree of self-care ability of patients, the cumulative care time, and the care burden of end-of-cancer (physical and mental burden, economic burden, life burden) were the main influencing factors of the sense of coherence in the main caregivers of cancer patients ( P<0.05) , which explained 32.2% variation of the sense of coherence. Conclusions:The main caregivers of cancer patients have a low level of sense of coherence and are affected by many factors. Clinical medical and nursing staff can carry out targeted interventions from patients, caregivers, society and other aspects to enhance the sense of coherence of the main caregivers, thereby improving the quality of life of patients and their main caregivers.

Objective:To evaluate the clinical efficacy and safety of ultrasound negative pressure suction with percutaneous nephroscope in the treatment of perirenal abscess.Methods:The clinical data of 11 patients with perirenal abscess admitted to Zhejiang Provincial People's Hospital from January 2013 to February 2021 were retrospectively analyzed. There were 4 males and 7 females. The average age was 59(51-76) years. The abscess was located on the left side in 4 cases and on the right side in 7 cases. The average diameter of abscess was 11.2(8.1-19.2) cm. All patients had fever, low back pain and abdominal mass, accompanied by bladder irritation in 6 cases, gross hematuria in 5 cases, abdominal distension, nausea and anorexia in 3 cases. There were 7 cases with type 2 diabetes, 2 cases with rheumatoid arthritis and 6 cases with ipsilateral kidney and ureter stone. Among the 11 patients, 6 had a history of urinary tract infection, 1 had a history of upper respiratory tract infection, 1 had secondary infection of perirenal hematoma after traumatic renal rupture, and 3 had secondary infection of perirenal hematoma after percutaneous nephroscopy. All patients were treated with ultrasound negative pressure suction with percutaneous nephroscope under local anesthesia by single operator. The operation time, intraoperative blood loss, drainage volume, drainage tube indwelling time, postoperative body temperature returned to normal time, postoperative hospital stay, therapeutic effect and complications were analyzed.Results:All operation procedures of 11 patients were successfully completed, including 8 cases of single channel, 2 cases of double channels and 1 case of three channels. The average operation time was 44(20-74)min, the average amount of blood loss was 15(10-20)ml, the average amount of pus was 325(200-500)ml, the average indwelling time of drainage tube was 8(6-12)d, the average time of body temperature returned to normal was 0.9(0.5-2.0)d, and the average hospitalization time was 9.6(7.0-14.0)d. Before discharge, CT reexamination showed that the perirenal abscess disappeared. There were no serious complications during and after operation. The average follow-up time was 4.4(3-8) months. There was no recurrence in all patients.Conclusions:Ultrasound negative pressure suction with percutaneous nephroscope is one of the safe and effective surgical methods for the treatment of perirenal abscess. It has the advantages of small trauma, quick recovery, complete drainage, exact effect and fewer complications.

Objective To explore the effects of transtheoretical model-based intervention plan on the quality of life in patients with laryngeal cancer.Methods Totally 67 patients with laryngeal cancer who received surgery between January and June 2016 in Harbin Medical University Cancer Hospital were selected as the control group,and 71 patients who received surgery between July and December 2016 as the experimental group by purposive sampling.Patients in the control group received conventional interventions,while patients in the experimental group received transtheoretical model-based interventions.The phonic function and quality of life were compared between the two groups.Results The patients in the experimental group showed improved fundamental frequency and fundamental frequency perturbation compared to the patients in the control group post intervention (P ＜ 0.05).And the patients in the experimental group scored higher in physical,psychological,social function,feature modules and total score of quality of life than the patients in the control group (P ＜ 0.05).Conclusions The transtheoretical model-based intervention plan helps to improve the patients' phonic function and quality of life,thus worthy of application.

Objective To construct a nomogram model to predict the risk of pressure injuries(PI)in mechanically ventilated patients in the intensive care unit(ICU).Methods Clinical data of mechanically ventilated patients in the ICU of Zhongshan Hospital,Fudan University from January 1,2020 to March 15,2023 were retrospectively collected as the training set,and data from ICU of the same hospital from October 1,2023 to December 11,2023 were collected as the external validation set.Risk variables for PI were selected using LASSO regression and Cox proportional hazards model,and a nomogram model was constructed.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the model.Calibration curve and decision curve analysis(DCA)were used to assess the model's calibration and clinical applicability.The external validation was performed using the validation set data.Results A total of 580 mechanically ventilated patients were included in the training set,with 84 cases(14.5％)of PI.LASSO regression and Cox proportional hazards model selected 10 variables to construct the nomogram model.The ROC curve showed an AUC of 0.830 for predicting PI in mechanically ventilated patients.Calibration curve and DCA indicated good calibration and predictive performance of the model.The external validation set included 100 patients,with 12 cases of PI,and the AUC was 0.870.Calibration curve and DCA showed good model performance.Conclusions The nomogram model based on LASSO-Cox regression has good predictive performance and can be used to screen high-risk population for PI in mechanically ventilated patients.

Objective:To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach.Methods:A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data.Results:All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%).Conclusion:The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients