Objective To investigate how to improve the survival rate,and to avoid the serious complications in fat grafting.Methods Under comprehensive design of facial filling area,the fat was harvested by concentration in mesh;under the micro autologous fat transplantation gun with blunt needle injection technique,the fat was filled into the face to achieve the effect of improving the facial contour and the rejuvenation.From June 2014 to July 2015,78 patients with facial contour and facial soft tissue relaxation depression were treatment by the technique.Results The follow-up of 2 months to 1 year showed that 64 patients had the soft,young,significantly enhanced facial contour;7 patients had second times grafts and the remaining were satisfied.7 patients gave up the second times grafts because the other reasons.The surgical complications such as facial nerve injury and infection and embolism were not seen.Conclusions This technique by comprehensive design and purification of autogenous fat granules achieves a better effect on facial rejuvenation with fewer complications.

Objective To explore the effect of various information means in the training of newly recruited nurses and to provide a practical basis for comprehensive and thorough development of the training. Methods Nurses who are enrolled in 2015 were chosen as the test group. Its applications can be in the form of Mobile APP,office software,online software and We Chat public platform. Afterwards,the effect of various information means can be judged by comparing the test results with the nurses who are enrolled in 2013 (the control group). The nurses in the test group were surveyed in the form of questionnaires to evaluate the training effect. Results The scores of theory ex amination and nasal feeding in the test group were higher than those of control group(P<0.01). The 93.8 percent of the nurses in test group believe that training is beneficial to the understanding and consolidation of knowledge as well as to improve the ability of self-learning. Also the training effect is prominent. Conclusion The various information means in the training of newly recruited nurses can improve training efficiency and enhance training effectiveness.

Objective To understand the demands of elderlies in a community in Hangzhou for the elder care with medical support and the current supply, and analyze the influencing factors. Methods A questionnaire survey was conducted among 1 416 elderlies at 12 communities of 3 neighborhoods in Jianggan district of Hangzhou city, using stratification sampling. Results For the elderlies with demands for medical care, such services as medical advice in community, pharmacy in community and annual physical examination were made available and the highest satisfactions, being 70. 4%, 67. 1% and 64. 0% respectively. In contrary, less than 30% of the rest eight medical care demands were met. For the elderlies with demands for nursing care in community, supply of nine elderly care services fell below 30%. For the elderlies with demands for rehabilitation services, supply of six community rehabilitation services fell below 15%. Age, self-care ability and the number of chronic diseases were the main factors affecting old people′s demand for medical-nursing combined care(P ＜0. 05). Conclusions A gap is found between elderlies′demands for elderly care with medical support and the services available. Medical care, nursing care and rehabilitation service deserve further development efforts. Those of advanced age, with declining self-care ability, and those afflicted with many diseases should attract major attention.

Antibody-drug conjugate (ADC) is a new class of therapeutics composed of a monoclonal antibody and small cytotoxin moieties conjugated through a chemical linker. ADC molecules bind to the target antigens expressed on the tumor cell surfaces guided by the monoclonal antibody component. The binding ADC molecules can be internalized and subsequently the toxin moieties can be released within the tumor cells via chemical and/or enzymatic reactions to kill the target cells. The conjugation combines the merits of both components, i.e., the high target specificity of the monoclonal antibody and the highly potent cell killing activity of the cytotoxin moieties. However, such complexities make the pharmacokinetic and metabolic studies of ADCs highly challenging. The major challenges should include characterization of absorption, distribution, metabolism and excretion, investigation of underlying mechanisms, assessment of pharmacokinetic- pharmacodynamic relationship, and analytical method development of ADC drugs. This review will discuss common pharmacokinetic issues and considerations, as well as tools and strategies that can be utilized to characterize the pharmacokinetic and metabolic properties of ADCs.

Objective To investigate the protective effect of human umbilical cord mesenchymal stem cell-derived exosome (hucMSC-Exo) on renal ischemia-reperfusion injury (IRI), and to clarify the critical role and regulating mechanism of transient receptor potential canonical (TRPC) 6/poly adenosine-diphosphate-ribose polymerase (PARP) 1 signaling pathway during this process. Methods The hucMSC-Exo was extracted by ultracentrifugation, and identified by transmission electron microscope (TEM), nanoparticle tracing analysis and Western blot. SD rats were randomly divided into the sham operation group (group S), sham operation+TRPC6 inhibitor SKF96365 group (group SS), renal IRI group (group IRI), exosome treatment group (group EXO) and exosome +TRPC6 inhibitor SKF96365 group (group ES), with 6 rats in each group. Serum creatinine and blood urea nitrogen levels were detected. Pathological changes of renal tissues were observed by hematoxylin-eosin (HE) staining and Paller score was calculated. The expression levels of key molecules of necroptosis in rat renal tissues, including receptor-interacting protein kinase (RIPK)1, RIPK3 and mixed-lineage kinase domain-like protein (MLKL), TRPC6 and PARP1, were detected by Western blot. Results Typical saucer-like structure was observed under TEM. Nanoparticle tracing analysis showed that the average diameter of the extracted substance was 125.9 nm. Western blot revealed that the surface markers of CD9, CD63 and CD81 were positively expressed, confirmed that the extracted substance was exosome. Compared with group S, the serum creatinine and blood urea nitrogen levels were up-regulated, the pathological damage of renal tissues was worsened, Paller score was elevated, the relative expression levels of TRPC6 and PARP1 proteins were down-regulated, and the relative expression levels of RIPK1, RIPK3 and MLKL proteins were up-regulated in group IRI (all P < 0.05). Compared with group IRI, the serum creatinine and blood urea nitrogen levels were down-regulated, the pathological damage of renal tissues was mitigated, Paller score was decreased, the relative expression levels of TRPC6 and PARP1 proteins were up-regulated, and the relative expression levels of RIPK1, RIPK3 and MLKL proteins were down-regulated in group EXO (all P < 0.05). Compared with group EXO, the serum creatinine and blood urea nitrogen levels were up-regulated, the pathological damage of renal tissues was aggravated, Paller score was increased, the relative expression levels of TRPC6 and PARP1 proteins were down-regulated, and the relative expression levels of RIPK1, RIPK3 and MLKL proteins were up-regulated in group ES (all P < 0.05). Conclusions hucMSC-Exo may alleviate the necroptosis induced by renal IRI in rat models, which is related to the activation of TRPC6/PARP1 signaling pathway.

Ischemia-reperfusion injury (IRI) refers to the reperfusion injury caused by the recovery of blood supply of ischemic tissues or organs, which commonly occurs in organ transplantation and other surgical procedures. IRI may cause a series of severe clinical issues, such as delayed graft function, acute kidney injury, myocardial infarction, ischemic stroke and circulatory arrest, etc. These events yield high incidence and fatality. At present, no effective solution has been available. Transient receptor potential canonical 6 (TRPC6), a member of Ca²⁺ channel family, is highly expressed in multiple types of cells. It may adjust many physiological functions by regulating intracellular Ca²⁺ concentration, which has become an important target for developing therapeutic drugs for multiple diseases. In this article, research progresses on the introduction and function of TRPC6, the association between TRPC6 and IRI and the therapeutic prospect of TRPC6 targeted drugs in IRI were reviewed, aiming to provide novel insights into the prevention and treatment of IRI during organ transplantation

Objective:To explore the application effect of "Internet +" training assessment mode in single cardiopulmonary resuscitation (CPR) training for nurses, so as to provide direction for homogenization training and assessment of nurses.Methods:Using the convenience sampling method, nurses who participated in the 2019 single-person CPR training assessment in the Second Hospital of Shanxi Medical University and whose job number was an odd number were selected as the control group ( n=763) . Nurses who participated in the "Internet +" CPR training assessment in 2020 and whose job number was an even number were selected as the observation group ( n=763) . Based on theoretical performance, operational performance, chest compression quality and training assessment satisfaction, the "Internet +" training assessment mode was evaluated and analyzed. Results:After training, there was no statistically significant difference in theoretical scores of of nurses between the two groups ( P>0.05) . The operation performance and training assessment satisfaction scores of nurses in the observation group were higher than those in the control group, and the quality of single cardiopulmonary compression was better than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "Internet +" training and assessment model has significant effects in single nurse CPR, which can improve the satisfaction level of nurses' CPR practice and training assessment satisfaction, which is worthy of clinical promotion.

With the development of neoadjuvant therapy and a multidisciplinary team, the treatment of pancreatic cancer has gradually expanded from "resection" to "cure"."Curative resection" as the core part of the integrated treatment model for patients, its quality directly determines the short-term outcome and affects the long-term prognosis. Previously, the "single complication assessment" model was used to measure the quality of pancreatic cancer surgery. However, the incidence of any specific complication cannot cover the entire surgical procedure, making it difficult to quantify and standardize the interpretation of the outcomes. Recently, the concept of textbook outcome, a comprehensive indicator, has gained popularity in surgical research. Textbook outcome includes multiple complication parameters and reflects optimal surgical outcomes in an "all or none" approach. Implementing a quality improvement program that focuses on textbook outcome will increase the overall standard of complex surgery, ultimately advancing the surgical care of pancreatic cancer in the future. In this article, the latest advances in relevant research are analyzed to provide a brief overview of the textbook outcome of pancreatic cancer.

With the development of neoadjuvant therapy and a multidisciplinary team, the treatment of pancreatic cancer has gradually expanded from "resection" to "cure"."Curative resection" as the core part of the integrated treatment model for patients, its quality directly determines the short-term outcome and affects the long-term prognosis. Previously, the "single complication assessment" model was used to measure the quality of pancreatic cancer surgery. However, the incidence of any specific complication cannot cover the entire surgical procedure, making it difficult to quantify and standardize the interpretation of the outcomes. Recently, the concept of textbook outcome, a comprehensive indicator, has gained popularity in surgical research. Textbook outcome includes multiple complication parameters and reflects optimal surgical outcomes in an "all or none" approach. Implementing a quality improvement program that focuses on textbook outcome will increase the overall standard of complex surgery, ultimately advancing the surgical care of pancreatic cancer in the future. In this article, the latest advances in relevant research are analyzed to provide a brief overview of the textbook outcome of pancreatic cancer.

Objective: To explore the correlation between gut microbiota and renal cell carcinoma (RCC) with Mendelian randomization analysis. Methods: Data involved with genome-wide association of the gut microbiome were retrieved from MiBioGen Consortium as the exposure group data，and RCC data were obtained from the FinnGen GWAS database.Next，a rigorous Mendelian randomization analysis was conducted utilizing multiple methods，including inverse variance weighted (IVW)，MR-Egger，maximum likelihood，and weighted median.Additionally，sensitivity analysis was performed to address heterogeneity and horizontal pleiotropy concerns. Results: A total of 2564 single nucleotide polymorphisms (SNPs) from the complete gut microbiota were analyzed.IVW analysis showed that bacillus (OR=0.780，95% CI:0.614-0.991，P=0.042) and anaerobic bacillus (OR=0.723，95% CI:0.533-0.981，P=0.037) reduced the risk of RCC.Actinomycetes (OR=1.302，95% CI：1.015-1.672，P=0.038)，family Ⅺ (OR=1.197，95% CI: 1.023-1.400，P=0.024)，coprococcus 2 genera (OR=1.440，95% CI：1.046-1.982，P=0.026)，clostridium lactate (OR=1.732，95% CI:1.254-2.392，P=0.001) and Odoribacter (OR=1.685，95% CI:1.150-2.469，P=0.007) were associated with an increased risk of RCC.Sensitivity analysis did not identify any abnormal SNPs，indicating the robustness and reliability of our findings. Conclusion: There may be a cause-and-effect relationship between different types of gut microbiota and genetically predited renal cell carcinoma，and different microbiota may be respectively associated with an increase or decrease in RCC.