Objective:To explore the effect of humanistic care on the quality of life and the negative emotion of patients with liver cancer operation. Methods: A total of 577 patients with liver cancer surgery were selected to participate in this study from January 2014 to December 2015 . From January 2014 to December 2014 , 288 cases of liver cancer patients were given routine nursing care as the control group. From January 2015 to December 2015, 289 patients were given humanistic care nursing as experimental group. The emotion of depression and anxiety were evaluated using Self-rating Depression Scale and Self-rating Anxiety Scale, the quality of life was evaluated with the core scale of life quality measurement system for cancer patients, while sleep quality with the Pittsburgh Sleep Quality Index. Results:Both depression and anxiety score of the subjects in experimental group were lower than those in the control group(P<0. 05). Physical function, cognitive function, social function, emotional function, role function, and overall health status of the subjects in the experimental group were higher than those in the con-trol group (P<0. 05), while pain, tiredness, nausea, vomiting, shortness of breath, insomnia, diarrhea, loss of appetite, constipation, economic difficulties and other score were statistically lower than those in the control group (P<0. 05). The subjects′quality of life of in the experimental group was better than those in the control group(P<0 . 05 ) , but the sleep index score was lower in the experimental group ( P<0 . 05 ) . Conclusion: Humanistic care nursing can effectively reduce the negative emotions of patients with liver cancer surgery, and thus to improve the quality of life.

Objective:The three-step model of ″new nurse, professional group nurse, and clinical nurse specialist″ combines the clinical professional nursing group to promote the development of clinical nurse research capabilities and the construction of nursing research teams.Methods:A three-step model of ″new nurse, professional group nurse, and clinical nurse specialist″ was established by combining the individual development of nurses and team collaboration. Taking the clinical professional nursing group as the entry point, clinical work of the clinical professional nursing group, quality control of clinical professional nursing groups, quality control circle activities, nurse career development, and nursing research team building were integrated to implement the three-step model, thereby driving the development of clinical nurses′ research capacity and nursing research team construction. The methods of the three-step model combined with clinical professional nursing groups to promote the development of clinical nurse research capabilities and the construction of nursing research teams were implemented. The following were the eleven specific management measures: Improving the structure and echelon construction of clinical professional nursing groups, developing research plans and goals from four dimensions (departments, clinical professional nursing groups, individual nurses, and new nurses), carrying out nursing research training to clinical professional nursing groups that emphasizes both theriotical methods and practical operations, organizing nursing research projects by clinical professional nursing groups, promoting the innovation of work towards digitization and informatization, promoting clinical professional nursing groups to conduct interventional studies, launching quality control circle projects by clinical professional nursing groups, participating in and hosting nursing rounds by clinical professional nursing groups, improving the clinical technical problem by The clinical professional nursing groups, encouraging collaboration and communication between clinical professional nursing groups and physicians, facilitating the cross-integration and development of clinical professional nursing groups.Results:The three-step model has promoted the growth of nurses from the route of ″new nurse, professional group nurse, and clinical nurse specialist″, built a nursing research team and talent echelon based on the breakthrough of clinical professional nursing groups, and solved clinical practical problems and produced scientific research results.Conclusions:Implementing the three-step model combined with clinical professional nursing groups to promote the development of clinical nurse research capabilities and the construction of nursing research teams can promote the collaborative development of clinical nursing research and clinical nursing work.

Objective:To investigate the value of whole-lesion histogram parameters of apparent diffusion coefficient (ADC) in evaluating and predicting the pathological complete response(PCR) to neoadjuvant chemotherapy (NAC) in different subtypes of breast cancer.Methods:This retrospective study included 117 patients with breast cancer who underwent MRI examination before NAC prior to surgery from January 2016 to December 2017 in the First Affiliated Hospital of Nanjing University. All cases were divided into Luminal B, HER2 positive ( n=21) and triple negative ( n=26) groups. The surgical pathology after chemotherapy was evaluated by Miller-Payne (M-P) system and the patients were divided into PCR group and non-PCR (nPCR) group. Firevoxel software was used to generate the whole-lesion ADC histogram. The parameters included mean (ADC mean), skewness, kurtosis, the minimum (ADC min), the maximum (ADC max), 10th percentile(ADC 10%), 50th percentile (ADC 50%) and 90th percentile (ADC 90%). The two independent samples t test or Mann-Whitney U test was used to compare the differences between PCR and nPCR groups in each subtype. The diagnostic performance of statistically different ADC parameters for predicting PCR was evaluated by receiver operating characteristic (ROC) curve. Results:Kurtosis was significantly higher in PCR group than that in nPCR group in HER2 positive subtype ( P=0.039). It achieved an area under the curve (AUC) of 0.813 with sensitivity of 100% and specificity of 68.7% at the optimal cutoff value (1.861) for differentiating PCR from nPCR cases. In triple negative subtype, ADC mean and ADC 50% were smaller in PCR group than those in nPCR group ( P=0.028,0.013). They achieved AUCs of 0.800, 0.842, respectively. When ADC mean of 1.030×10 -3 mm 2/s and ADC 50% of 0.976×10 -3 mm 2/s were used as cutoff value to differentiate PCR from nPCR, the sensitivities were 75.0%, 80.0% and the specificities were 83.3%, 83.3%, respectively. Conclusion:Kurtosis can predict post-NAC PCR in patients with HER2 positive breast cancer, while ADC 50% has a high value in predicting post NAC PCR of triple negative breast cancer patients.

Objective To systematically review the effect of enteral nutrition via a naso-gastric (intestinal) tube (NG) vs a percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) after liver transplantation,and provide support for the selection of proper nutrition.Methods Pub Med,web of science,Cochrane Library (Jan,2018),CNKI,VIP and Wanfang Date were search until Jan,2018.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer,about the research of retrospective study for the effects of enteral nutrition via NG vs PEG/PEJ after liver transplantation was performed and supplemented.Publication bias were evaluated,and Meta-analyses were conducted with RevMan5.3.Results 4 studies were collected,involving 430 patients.The Meta-analysis showed that starting time of enteral nutrition of PEG/PEJ was earlier than NG (MD =-1.77,95％ CI-1.83 to-1.70,P＜0.05).The average hospitalization time of PEG/PEJ was shorter than NG (MD=-2.88,95％CI-5.19 to-0.56,P＜0.05).The diarrhea incidence of PEG/PEJ was higher than NG (OR=1.66,95％CI 1.04 to 2.65,P＜0.05),and gastroesophageal reflux incidence of PEG/PEJ was lower than NG (OR=0.29,95％CI 0.12 to 0.66,P＜0.05).The gastric retention rate of PEG/PEJ was lower than NG (OR =0.26,95％ CI 0.14 to 0.41,P＜0.05).Dislocation incidence of PEG/PEJ was lower than NG (OR =0.06,95％CI 0.01 to 0.46,P＜0.05).The pneumonia incidence of PEG/PEJ tube was lower than NG (OR=0.59,95％CI 0.36 to 0.99,P＜0.05).There were no significant differences between PEG/PEJ and NG on indwelling time,occlusion,abdominal infection,acute renal insufficiency,and acute rejection reaction.Conclusion PEG/PEJ had earlier starting time of enteral nutrition,shorter hospitalization time,lower nutrition tube placement related complications such as gastric esophagus reflux,gastric retention,dislocation rate and lower incidence of pneumonia,but the incidence of diarrhea was higher.NG is the first choice after liver transplantation,and for patients with serious basic diseases,weak digestive function or digestive system disorders PEG/PEJ can be chosen.

Objective To systematically review the predictive factors associated with reversibility of post-transplantation diabetes mellitus in adults using Meta-analysis,and to provide a theoretical basis for clinical prevention and treatment of diabetes after transplantation.Methods Pub Med,Web of Science,Cochrane Library (Issue 5,2017),CNKI,VIP and WanFang Data were searched from inception until May 2017.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer.Publication biases were evaluated,and the Meta-analyses were conducted with RevMan5.3.Results A total of 7 studies were analyzed which involved 979 adults.Metaanalysis showed the following significant predictive factors:male (OR =1.73,95％ CI 1.19 to 2.50,P ＜0.05),advanced age (MD =1.73,95％ CI 0.07 to 10.39,P =0.05),high FPG before transplantation (MD=5.66,95％CI 0.11 to 11.31,P=0.05),hepatitis C virus (HCV) infection (OR=1.52,95％CI 1.08 to 2.14,P ＜ 0.05),high frequency of combination therapy with MMF (OR =0.26,95％ CI 0.11 to 0.61,P ＜ 0.05),and short time before development of PTDM (MD =-19.08,95％ CI-37.08 to -1.07,P ＜ 0.05).There was no correlation with preoperative BMI,family history of diabetes and acute rejection.Conclusion The study showed that male,advanced age,high FPG before transplantation,hepatitis C virus infection,high frequency combination therapy with MMF,short time before development of posttransplantation diabetes mellitus were the predictive factors associated with reversibility of post-transplantation diabetes mellitus.

Objective:To compare the short-term clinical efficacy and safety of Da Vinci robot and laparoscopic pancreatectomy.Methods:The data of patients with pancreatic occupying lesions who underwent distal pancreatectomy in Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi′an Jiaotong University from September 2021 to January 2024 were retrospectively analyzed. A total of 60 patients were enrolled, including 20 males and 40 females, aged (52.0±14.8) years. According to different operation methods, 60 patients were divided into robotic group ( n=30, Da Vinci robot-assisted pancreatectomy) and laparoscopic group ( n=30, laparoscopic pancreatectomy). The conversion of laparotomy, operation time, intraoperative blood loss, splenic preservation, postoperative hospital stay, postoperative fasting time, reoperation rate within 30 days after surgery, readmission rate within 90 days after surgery, and postoperative complications such as abdominal hemorrhage, abdominal infection and pancreatic fistula were compared between the two groups. Results:There was no conversion to laparotomy in the laparoscopic group, and 1 case (3.3%) in the robotic group. There were no significant differences in conversion to laparotomy rate, operation time, intraoperative blood loss, postoperative hospital stay, reoperation rate within 30 days after surgery, and readmission rate within 90 days after surgery between the two groups (all P>0.05). The spleen preservation rate of the robotic group was 53.3% (16/30), and the postoperative fasting time was 1.0(1.0, 2.0) d, which was better than that of the laparoscopic group 23.3%(7/30), 2.0(2.0, 3.0) d, with statistical significance ( χ2=5.71, Z=4.04, P=0.017, P<0.001). Postoperative abdominal infection occurred in 6 cases (20.0%), grade B or C pancreatic fistula in 7 cases (23.3%), no abdominal hemorrhage in the laparoscopic group, postoperative abdominal hemorrhage in 3 cases (10.0%), abdominal infection in 4 cases (13.3%), and grade B or C pancreatic fistula in 8 cases (26.7%) in the robotic group. There was no significant difference in the incidence of postoperative abdominal hemorrhage, abdominal infection and grade B or C pancreatic fistula between the two groups (all P>0.05). Conclusion:Da Vinci robotic pancreatectomy is safe and feasible, and the success rate of spleen preservation is better than laparoscopic pancreatectomy.

To explore the prevention and treatment of perioperative complications of adult liver transplantation patients from the perspective of ethics, and carry out ethical thinking in order to provide theoretical support. Through a cross-sectional study, 189 patients selected by strict admission criteria who received liver transplantation in the department of hepatobiliary surgery of the First Affiliated Hospital of Xi’an Jiaotong University from January 2018 to May 2019, to explore the incidence and ethical problems of perioperative complications in adult liver transplantation. The results showed that 87 patients had complications among 189 patients, the incidence was 46.03%. Among them, 28 patients with pleural effusion, the incidence was 14.81%; 15 patients with biliary complications, the incidence was 7.94%; 14 patients with diabetes mellitus, the incidence was 7.41%. The incidence of complications after liver transplantation is high, mainly including pleural effusion, biliary complications and diabetes mellitus. Thus, the prevention and intervention from the perspective of nursing ethics is worth exploring.

To explore the prevention and treatment of perioperative complications of adult liver transplantation patients from the perspective of ethics, and carry out ethical thinking in order to provide theoretical support. Through a cross-sectional study, 189 patients selected by strict admission criteria who received liver transplantation in the department of hepatobiliary surgery of the First Affiliated Hospital of Xi’an Jiaotong University from January 2018 to May 2019, to explore the incidence and ethical problems of perioperative complications in adult liver transplantation. The results showed that 87 patients had complications among 189 patients, the incidence was 46.03%. Among them, 28 patients with pleural effusion, the incidence was 14.81%; 15 patients with biliary complications, the incidence was 7.94%; 14 patients with diabetes mellitus, the incidence was 7.41%. The incidence of complications after liver transplantation is high, mainly including pleural effusion, biliary complications and diabetes mellitus. Thus, the prevention and intervention from the perspective of nursing ethics is worth exploring.