AIM:The complications following liver transplantation consist of the liver damage and the function failure of other organs,among which lung is the most prone and the earliest affected lesion.By establishing an autologous orthotopic liver transplantation(OLT) model in rats,this study was to investigate the acute lung injury after liver transplantation and the role of alkaline phosphatase(AP) in protection of the injury.METHODS:①The experiments were performed in the Test Animal Center and Digestion Laboratory,Nanfang Hospital,Southern Medical University from May to October in 2007.All the proposals were in accordance with the ethical standard of animals.② Twenty-four SD rats were randomly divided into three groups:sham-operation control group,autologous OLT group and AP group,each containing 8 animals.Autologous OLT models were induced in OLT group and AP group,while control group,the abdomen was only opened and then closed besides the liver lobes were isolated.Lingual vein injection of AP was given in AP group 5 minutes before the blood supply of the liver restored.③The concentration of myeloperoxidase(MPO),malondialdehyde(MDA) and surfactant protein A(SP-A) in lung tissue were respectively examined in each group,lung dry-to-wet weight ratio was also measured.Furthermore,hepatic and lung pathological sections were observed.RESULTS:All the 24 rats were involved in the result analysis.①Compared to control group,the concentration of MPO and MDA in lung tissue were significantly increased in OLT group and AP group(P

Objective: To create a model for early prediction of essential hypertension (EH) based on the TreeNet algorithm, so as to provide a tool for early monitoring of EH. Methods: The health examination data were collected from individuals receiving health examinations in Hangzhou Haiqin Health Examination Center or Shanghai Yibao Health Management Co., Ltd from 2014 to 2016, and a predictive model for EH was created based on the TreeNet algorithm. The effectiveness of the model for early prediction of EH was evaluated using root mean square error (RMSE), mean absolute deviation (MAD), coefficient of determination (R2) and receiver operating characteristic (ROC) curve. Results: A total of 12 variables were included in the model, and the highest contributing variable was body mass index (BMI), followed by BMI difference, two-year BMI difference, two-year triglyceride (TG) difference, two-year total cholesterol (TC) difference, high-density lipoprotein cholesterol (HDL-C) in 2014, TG in 2014, low-density lipoprotein cholesterol (LDL-C) in 2014, body weight in 2015, fasting blood glucose in 2015, TG in 2015, urea nitrogen difference and platelet in 2015. The highest predictive accuracy was 100.00%, and the lowest was 56.89%. The risk of EH significantly increased among individuals with BMI in 2015 of >25 kg/m2, two-year BMI difference of >0.5 kg/m2, two-year TG difference ranging from 1.3 to 3.3 mmol/L, TC in 2015 of 2.0 to 2.4 mmol/L and HDL-C in 2014 of <0.52 mmol/L. The model presented RMSE of 0.082, MAD of 0.064, R2 of 0.811, area under the ROC curve of 0.788 (95%CI: 0.741-0.815), sensitivity of 69.05% and specificity of 66.21% for prediction of EH Conclusion The TreeNet algorithm-based model is effective for early monitoring of high-risk individuals for EH.

Purpose:To investigate the prognostic value of P-glycoprotein(Pgp), mutant P53 protein and epidermal growth factor receptor (EGFR) expression in primary superficial transitional cell carcinomas(TCCs) of bladder.Methods:Specimens from 46 patients with untreated superficial bladder TCCs were analyzed for the expression of Pgp,mutant P53 and EGFR respectively and their clinical data were obtained by follow-up for over 3 years.Results:Pgp, mutant P53 protein and EGFR were positive in 45.7%,58.7% and 52.2% respectively. A strongly inverse relationship between the expression of Pgp, mutant P53 and EGFR and disease free survival (DFS)could be demonstrated by Kaplan Meier survival analysis. Multivariate analysis(Cox regression)indicated that DFS or recurrence was associated with overexpression of Pgp and mutant P53 protein, no significant correlation between EGFR overexpression and recurrence was found.Conclusions:Overexpression of Pgp, mutant P53 can be used as the important prognostic factor of recurrence of superficial TCCs.

OBJECTIVETo establish a modified rat model of liver cancer with concurrent cirrhosis for the study of carcinogenesis characteristics and drug intervention of liver cancer.

METHODSFifty male Wistar rats weighing 100-120 g were randomly divided into normal control group (20 rats) and model group (30 rats). In the model group, the rats were subjected to intraperitoneal injection of 50 mg/kg DEN N-diethylnitrosamine (DEN) twice a week for 4 consecutive weeks, followed then by weekly injections for another 10 weeks. The control rats received injections of 0.1 ml saline in the same manner. At 2, 4, 8, 12, 14, and 18 weeks, 3 rats from each group were sacrificed for assessing tumor formation and liver cirrhosis.

RESULTSLiver cancer with concurrent cirrhosis was induced successfully after 14 weeks of DEN injections. At the 14th week, 3 out of the 5 rats were found to have cirrhosis and LC, and at the 18th week, all the 3 rats examined had cirrhosis and liver cancer. The total carcinogenesis rate in the rats was 75% at 18 weeks with an overall mortality of 33%.

CONCLUSIONThis approach to establishing rat models of liver cancer with concurrent cirrhosis requires simple operation, shortens the time of carcinogenesis, and ensures a high success rate of carcinogenesis and a low mortality rate. The carcinogenesis characteristics in this model are similar to those in human.

Animals ; Liver Cirrhosis, Experimental ; complications ; pathology ; Liver Neoplasms, Experimental ; etiology ; pathology ; Male ; Rats ; Rats, Wistar

Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.

Objective To establish a modified rat model of liver cancer with concurrent cirrhosis for the study of carcinogenesis characteristics and drug intervention of liver cancer. Methods Fifty male Wistar rats weighing 100-120 g were randomly divided into normal control group (20 rats) and model group (30 rats). In the model group, the rats were subjected to intraperitoneal injection of 50 mg/kg DEN N-diethylnitrosamine (DEN) twice a week for 4 consecutive weeks, followed then by weekly injections for another 10 weeks. The control rats received injections of 0.1 ml saline in the same manner. At 2, 4, 8, 12, 14, and 18 weeks, 3 rats from each group were sacrificed for assessing tumor formation and liver cirrhosis. Results Liver cancer with concurrent cirrhosis was induced successfully after 14 weeks of DEN injections. At the 14th week, 3 out of the 5 rats were found to have cirrhosis and LC, and at the 18th week, all the 3 rats examined had cirrhosis and liver cancer. The total carcinogenesis rate in the rats was 75%at 18 weeks with an overall mortality of 33%. Conclusion This approach to establishing rat models of liver cancer with concurrent cirrhosis requires simple operation, shortens the time of carcinogenesis, and ensures a high success rate of carcinogenesis and a low mortality rate. The carcinogenesis characteristics in this model are similar to those in human.

Objective To establish a modified rat model of liver cancer with concurrent cirrhosis for the study of carcinogenesis characteristics and drug intervention of liver cancer. Methods Fifty male Wistar rats weighing 100-120 g were randomly divided into normal control group (20 rats) and model group (30 rats). In the model group, the rats were subjected to intraperitoneal injection of 50 mg/kg DEN N-diethylnitrosamine (DEN) twice a week for 4 consecutive weeks, followed then by weekly injections for another 10 weeks. The control rats received injections of 0.1 ml saline in the same manner. At 2, 4, 8, 12, 14, and 18 weeks, 3 rats from each group were sacrificed for assessing tumor formation and liver cirrhosis. Results Liver cancer with concurrent cirrhosis was induced successfully after 14 weeks of DEN injections. At the 14th week, 3 out of the 5 rats were found to have cirrhosis and LC, and at the 18th week, all the 3 rats examined had cirrhosis and liver cancer. The total carcinogenesis rate in the rats was 75%at 18 weeks with an overall mortality of 33%. Conclusion This approach to establishing rat models of liver cancer with concurrent cirrhosis requires simple operation, shortens the time of carcinogenesis, and ensures a high success rate of carcinogenesis and a low mortality rate. The carcinogenesis characteristics in this model are similar to those in human.

Objective:To construct the post competency evaluation index system for Da Vinci robot specialist nurses based on onion model, so as to provide references for the training and evaluation of Da Vinci robot specialist nurses in China.Methods:From August to September 2022, using the "onion model" as the theoretical framework, a preliminary draft of the index system was developed using domestic and foreign literature review, semi-structured interviews and group discussions. The Delphi method was applied to 22 nursing experts in the relevant fields to conduct two rounds of expert correspondence, screen and modify the items, and calculate the weight using the analytic hierarchy process. Finally, the post competency index system for Da Vinci robot specialist nurses based on the onion model was formed.Results:Two rounds of expert correspondence were conducted. The positive coefficient of experts was 90.91% (20/22) in the first round and 100.00% (20/20) in the second round, the coefficient of expert authority was 0.840 and 0.873, and the Kendall's coordination coefficient was 0.181 and 0.324 ( P<0.01), respectively. The final post competency evaluation index system for Da Vinci robot specialist nurses consisted of 4 first-level indicators, 14 second-level indicators and 58 third-level indicators. Conclusions:This study constructs a comprehensive post competency evaluation index system for Da Vinci robot specialist nurses based on onion model, with high expert enthusiasm and authority. It can provide references for the training and evaluation of Da Vinci robot specialist nurses in China.

Objective To evaluate the value of fast track surgery (FTS) in laparoscopic hepatectomy.Methods The clinical data of 142 patients undergoing laparoscopic liver resection from January 2014 to January 2016 were analyzed retrospectively.74 patients received fast track surgery treatment (FTS group) and 68 patients received traditional treatment methods (control group).Results Compared with control group,FTS group had a shorter operative time and less blood lose (t =2.279,t =2.432,P ＜0.05),quicker postoperative intestinal function recovery (t =3.548,P ＜ 0.05),a shorter postoperative hospitalization time (t =2.821,P ＜ 0.05),a lower hospitalization cost (t =2.507,P ＜ 0.05),a lower postoperative VAS scores (t =3.394,t =3.176,t =7.079,P ＜ 0.05) in 3 post-op successive days.There were 3 patients with major post-op complications in FTS group (4.05％,3/74) compared with 4 cases in control group (5.88％,4/68) (x2 =0.253,P ＞ 0.05).Conclusion The application of fast track surgery in laparoscopic liver resection is safe and effective,and helpful in reducing patients' inhospital cost.

The oral specialist diagnosis and treatment has the characteristics of diagnosis and treatment behavior immediacy, phased diagnosis and treatment process, diagnosis and treatment population diversity, diagnosis and treatment effect subjectivity, and patient dominance of outpatient medical record storage. In the process of fulfilling the notification obligation, there may be risks such as the protection of the autonomous rights and interests of minor patients, the limited communication time, the insufficient clarity of the first diagnosis plan, the new requirements for the performance form, and the expansion of the application of the presumption of fault. The oral specialist diagnosis should pay attention to the true expression of the informed object; the diversification of the informative channels to obtain the clear attitude of the patient; the optimization of the informative process to make up for the information imbalance; the strict implementation of the core medical safety system to promote the actual fulfillment of the notification obligation.