Objective To compare the clinical effect of total laparoscopic and open liver resection for tumors in segments Ⅶ and Ⅷ.Methods The clinical data of patients with tumors in segments Ⅶ and Ⅷ of the liver who met the inclusion criteria and received operation at Affiliated Hospital of Nantong University from January 2011 to January 2015 were retrospectively analyzed.Among these patients, there were 17 cases who received total laparoscopic liver resection (LLR group), and 25 cases who received open liver resection (OLR group).Results LLR group has obvious advantages in aspects of the level of serum alanine transaminase (ALT) on 1st and 3rd day postoperation, the time anal exsufflation, the drainage volume of abdominal cavity in 3 days after operation and the postoperative hospital stay than those in OLR group (respectively t =-3.075,-3.175,-2.499,-2.088,-2.419, all P ＜ 0.05).There were no significant differences in blood transfusion rate, the resection margin to the tumor, the postoperative morbidity and the total medical cost between the two groups (x2 =1.437, t =-1.244, x2 =0.209, t =1.079, all P ＞ 0.05).Though the mean operative time and intraoperative blood loss of LLR group compared with OLR group increased obviously (respectively t =3.360, 2.189, all P ＜ 0.05).During the postoperative follow-up, there were no significant differences in the postoperative recurrence rate and the long-term survival rate in patients with malignant tumors (respectively x2 =0.240, 0.000, all P ＞ 0.05).Conclusion The therapeutic effect of total laparoscopic and open liver resection are equal in segments Ⅷ and Ⅷ hepatectomy, while, LLR has advantages of less trauma.

Objective To study three-dimensional reconstruction system (IQQA-Liver) in evaluation of resection volume and margin of hepatocellular carcinoma.Method Data of 51 hepatocellular carcinoma patients undergoing hepatectomy from March 2014 to October 2015 were analyzed retrospectively.All patients received preoperative ultrasound and CT/MIR evaluation.Three-dimensional reconstruction system (IQQA-Liver) was used to reconstruct tumor shape and location,the relationship between tumor and adjacent vessels or bile ducts.Then liver volume,liver resection volume,residual liver volume and surgical margin were calculated and compared with the actual resection liver values and actual margin.Results Images of three-dimensional reconstruction system (IQQA-Liver) were accurate,clear and directly perceived.In terms of the resection liver volume and resection margin,there was no significant difference between the predicted results and actual results [resection liver volume:(412.93 ± 471.26)cm3 vs.(487.02±529.01)cm3,t=0.75,P=0.46,resection margin:(13.72 ± 4.58) mm vs.(13.92 ±4.21)mm,t =0.23,P =0.82].The predicted resection liver volume was significantly correlated with the actual resection volume (r =0.91,P ＜ 0.01),the predicted resection margin was also correlated with the actual resection margin (r =0.89,P ＜ 0.01).Conclusion Three-dimensional reconstruction system (IQQALivcr) could accurately assess the resection volumc and margin of hepatocellular carcinoma.

Objective To investigate the changes of serum IL-1β,IL-6 ,TNF-α,NGF and BDNF levels and their correlation with clinical symptoms of schizophrenia inpatiens and their value in the auxiliary diagnosis of schizophrenia .Methods The case-control study was used .The levels of serum IL-1β,IL-6 ,TNF-α,NGF and BDNF were measured by using the enzyme linked immunosorbent assay(ELISA) in 85 inpatients with schizophrenia and 85 healthy controls .Their changes in the case group were compared between before treatment and after 3-month treatment .The Pearson correlation analysis was used to analyze the correlation between the lev-els of IL-1β,IL-6 ,TNF-α,NGF and BDNF with the positive and negative syndrome scale (PANSS) score and the auxiliary diagnosis value of serum cytokine and neurotrophic factor levels were evaluated with the receiver operating characteristic (ROC) curve .Re-sults The levels of serum IL-1β(t=4 .560) ,IL-6(t= 4 .957) and TNF-α(t= 4 .799) before treatment in the schizophrenia case group were significantly higher than those in control group ,while the NGF(t= -4 .806) and BDNF(t= -4 .881) levels were sig-nificantly lower than those in the control group ,the differences were statistically significant (P<0 .01) .After 3-month treatment , the levels of serum IL-1β(t=4 .543) ,IL-6(t=4 .327) and TNF-α(t=4 .654) in the schizophrenia case group were significantly de-creased compared with before treatment ,while the NGF(t= -4 .641) and BDNF(t= -4 .876) levels were significantly increased , the differences were statistically significant (P< 0 .01) .IL-1β was positively correlated with the positive symptoms scores (r=0 .325 ,P<0 .01) ,IL-6 was positively correlated with the negative symptoms scores (r=0 .319 ,P<0 .01) ,TNF-α was positively correlated with the positive symptoms scores (r= 0 .281 ,P< 0 .01) ,NGF was negatively correlated with the positive symptoms scores(r= -0 .229 ,P<0 .05) ,BDNF was negatively correlated with the positive symptoms scores (r= -0 .272 ,P< 0 .05) .The cut-off values of serum IL-1β,IL-6 ,TNF-α,NGF and BDNF in the auxiliary diagnosis of schizophrenia were 40 .083 ,20 .037 ,17 .115 ,19 .998 ,584 .157pg/mL respectively ,the corresponding areas under the ROC were 0 .723 ,0 .772 ,0 .686 ,0 .712 and 0 .708 respectively ,the sensitivities were 0 .565 ,0 .871 ,0 .894 ,0 .859 and 0 .729 respectively ,and the specificities were 0 .871 ,0 .565 ,0 . 365 ,0 .494 and 0 .624 respectively .Conclusion The levels of serum IL-1 ,IL-6 ,TNF-α,NGF and BDNF have the correlation with the clinical symptoms of schizophrenic inpatients and have a certain value in the auxiliary diagnosis of schizophrenia .

Objective To investigate the safety of trial of labor after cesarean (TOLAC) and clinical factors associated with successful TOLAC and to compare TOLAC with elective repeat caesarean section (ERCS) in terms of obstetric and neonatal outcomes.Methods A prospective cohort study was conducted among gravidas who had a history of lower segment cesarean section and were hospitalized in the Department of Obstetrics and Gynecology,the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January to December 2014.Exclusion criteria included indications for caesarean section (such as placenta previa,placenta accreta,twin pregnancy,breech presentation and severe preeclampsia),serious maternal complications after cesarean section,lower uterine segment thinner than 3 mm and poor healing of uterine incision.Totally,287 gravidas were enrolled.Among them,142 chose TOLAC and the other 145 requested ERCS.Clinical data of those gravidas were collected and statistically analyzed by t-test,Log-rank test,Chi-square or Fisher's exact test.Results (1) The success rate of TOLAC was 90.8％ (129/142).There was no significant difference in maternal age,gestational age,thickness of lower uterine segment,interval between the two deliveries and neonatal birth weight and asphyxia rate between the successful (n=129) and unsuccessful (n=13) groups (all P＞0.05).Although the two groups had no significant difference in postpartum hemorrhage (PPH) rate,the gravidas who failed in TOLAC lost more blood than those who succeeded [425 (195-675) vs 200 (50-1 400) ml,P＜0.05].Moreover,higher amniotic fluid contamination rate was observed in the unsuccessful group [6/13 vs 17.1％ (22/129),P＜0.05].In the TOLAC group,99.3％ (141/142) were under continuous fetal heart rate monitoring.Incomplete uterine rupture occurred in one women without serious maternal or neonatal outcomes.The reasons for 13 failed TOLAC cases were unbearable pain during labor,abnormal labor,fetal distress and threatened rupture of uterus.(2) Compared with the ERCS group,the TOLAC group showed shorter interval from last cesarean section to the indexed delivery[5 (2-18) vs 6 (2-19) years],younger maternal age [(31±4) vs (33 ±4) years old] and less blood loss [200 (50-1 400) vs 300 (100-1 500) ml] (all P＜0.05).Conclusion Our study shows that,those who preferred TOLAC were younger,or had shorter pregnancy interval from last cesarean section.The success rate of TOLAC is high for women undergoing systematic prenatal assessment and close management during labor with less blood loss and non-serious maternal and neonatal complications compared with ERCS.

OBJECTIVE To study the cardiotoxicity of ophiopogonin D′(OPD′) for rat H9c2 cardio? myocytes. METHODS H9c2 cells were exposed to OPD′ 0.1, 1, 5, 10, 20, 25 and 50 μmol·L-1 for 24 h. Cell viability was examined by MTS assay, and the morphological changes in H9c2 cells were quanti? fied. The cell nucleus injury was examined by high content immune fluorescence screening and the morphological changes were observed under a fluorescence microscope. After treatment with OPD′ 0.1, 1, 5 and 10 μmol·L- 1 for 24 h, the effect on reactive oxygen species (ROS), mitochondrial mem? brane potential(MMP) and apoptosis was detected by flow cytometry. RESULTS The viability was sig? nificantly reduced following exposure to OPD′ 0.1, 1, 5, 10, 20, 25 and 50 μmol·L- 1 (P<0.05,P<0.01). The IC50 value was 9.9 μmol ·L- 1 and cell shrinkage and apoptosis occurred. The levels of ROS and apoptosis rate of H9c2 cells were significantly increased after exposure to OPD′ 0.1, 1, 5 and 10 μmol·L-1 for 24 h (P<0.05,P<0.01) and MMP markedly declined (P<0.05,P<0.01). CONCLUSION OPD′ has significent cytotoxicity on H9c2 cells. It may be related to inducing apopotsis pathways.

Objective:To analyze the incidence of complications of central venous catheterization and risk factors in the Pediatric Intensive Care Unit of Xi'an Children 's Hospital.Methods:The clinical data of 310 children who underwent central venous catheterization in the Pediatric Intensive Care Unit of Xi 'an Children's Hospital from June 2020 to February 2021 were retrospectively analyzed. The incidence of complications of central venous catheterization and risk factors were analyzed.Results:A total of 334 central venous catheters were used in 310 chidren. Among the 310 children who underwent central venous catheterization, 102 children (30.54%) had complications related to central venous catheterization. The complications related to central venous catheterization included catheter infection (13.17%), catheter malposition (8.38%), exudation at the puncture site (4.79%), catheter occlusion (2.99%), accidental removal (0.60%), and central venous thrombosis (0.60%). Central venous catheters were removed in 82 children (24.55%) because of complications. There was a significant difference in the incidence of central venous thrombosis among three surgical approaches: femoral vein, internal jugular vein, and subclavian vein ( χ2 = 7.06, P = 0.029). Longer time for catheterization resulted in a higher incidence of complications, including catheter-related infection ( χ2 = 7.17, P = 0.028), puncture point exudation and obstruction ( χ2 = 8.59, P = 0.014), central venous thrombosis ( χ2 = 6.78, P = 0.034). Regression analysis showed that suture shedding and bleeding at the insertion sites were the main risk factors for catheter-related complications (suture shedding OR = 4.85, P = 0.001; bleeding at the insertion sites OR = 1.83, P = 0.008). Conclusion:The most common complications of central venous catheterization in the Pediatric Intensive Care Unit of Xi'an Children's Hospital include catheter-related infection, catheter malposition, and puncture site exudation. Risk factors for complications during catheter retention include suture shedding and bleeding at the insertion sites.

Objective:To compare the effects of treatment with Hybrid-Hyrax-Facemask(FM)versus miniscrews in the anterior pal-ate combined with Hybrid-Hyrax-Facemask(MSI/FM)for patients with early Class Ⅲ malocclusion and maxillary deficiency.Methods:18 patients aged with early Class Ⅲ malocclusion and maxillary deficiency were randomly divided into 2 groups(n=9)and treated with FM and MSI/FM respectively.Alternating rapid maxillary expansion and constriction(Alt-RAMEC)protocol combined with a maxillary protraction force of 3.92 N was applied on each side of all patients from elastics connected to the facemask in a down-ward and forward direction of 30° to the occlusal plane.Iortho cephalometric software was used to analyze the data of lateral cephalo-grams of the patients before(T0)and after(T1)treatment.Results:Improvement was verified in the facial profile and occlusion of all patients.In MSI/FM group the average treatment time was shorter.There were significant differences(P＜0.05)between T0 and T1 in the following measurements in FM group:SNA,ANB,Co-A,Co-Gn,Wits,S-Go,Na-Me,MP,U1-SN,UADH,LADH,Overjet,UL-EP increased,U1-L1 decreased.There were significant differences(P＜0.05)between T0 and T1 in the following measurements in the MSI/FM group:SNA,ANB,Co-A,Wits,Na-Me,MP,Y-axis,U1-SN,Overjet,UL-EP increased,SNB,Co-Gn-Co-A,S-Go/N-Me,U1-L1,L1-MP decreased.Conclusion:Both FM and MSI/FM combined with Alt-RAMEC protocol and a maxillary protraction force are effective in the treatment for Class Ⅲ patients with maxillary deficiency.MSI/FM may produce more significant bone effect and re-duce dental compensation,promote more forward growth of midface and more improvement in the growth direction of mandible and re-duce compensatory lip inclination of anterior teeth in shorter treatment time.

Objective To explore the changes of fatigue status before and after radiotherapy in tumor patients and its influencing factors.Methods A total of 150 tumor patients with radiotherapy in the radiother-apy department of this hospital from February to September 2023 were selected as the study subjects.The general data questionnaire and the Multidimensional Fatigue Scale (MFI-20) were adopted to conduct the sur-vey.The fatigue scores and the changes in autonomic nervous function were compared between before and af-ter radiotherapy.The multifactor logistic regression was applied to analyze the influencing factors of changes in fatigue status.Results Compared with before radiotherapy,the average fatigue scores after radiotherapy were higher[(63.99±14.54)points vs. (52.75±17.18)points],low frequency (LF),and high frequency (HF),total power (TP),time domain indicators sinus heart beat RR interval standard deviation (SDNN) and the root-mean-square value of the difference between adjacent NN interval (rMSSD) were lower,LF/HF was higher,and the differences were statistically significant (P<0.05).The univariate analysis results showed that the fatigue situation had statistical difference among the patients with different clinical stages,chronic dis-ease history,pain scores,hemoglobin,lymphocyte,WBC and heart rate variability (HRV,P<0.05).The mul-tivariate logistic regression analysis results showed that the decrease of hemoglobin,WBC and HRV were the independent risk factors of fatigue aggravation (P<0.05).Conclusion It is necessary to guide the clinic to conduct the intervention on the influencing factors aggravating fatigue to improve the outcome of the patients with tumor.

Background and purpose:The incidence of autonomic dysfunction(AD)in patients with advanced cancer is approximately 65%-80%.The neurasthenic symptoms such as dizziness,palpitations and fatigue caused by AD are difficult to alleviate even with sufficient rest,seriously affecting the patients'quality of life.Meanwhile,the cardiovascular autonomic nervous system plays a significant regulatory role in heart rate,myocardial function and myocardial blood flow.AD increases the morbidity and mortality risk of cardiovascular diseases in patients.AD is not only a functional state but might also be an early sign of overall myocardial lesion.Research indicates that after adjusting for age,gender and cardiovascular risk factors,previous radiation exposure is associated with AD manifestations such as increased resting heart rate and abnormal heart rate recovery after exercise.However,there are currently few relevant studies on the effect of radiotherapy on cardiac autonomic function,and the specific injury effects and dose threshold of injury occurrence remain unclear.This study aimed to explore the impact of thoracic radiotherapy on the cardiac autonomic function of patients with malignant tumors by comparing the differences in heart rate variability(HRV)analysis parameters before and after radiotherapy,and to explore the dosimetric risk factors for the occurrence of AD by comparing the dosimetry between the case group and the control group,providing a theoretical basis for optimizing the dose distribution of radiotherapy regimens in order to improve patient prognosis and reduce the occurrence of complications.Methods:We prospectively collected data of patients with malignant tumors who underwent thoracic radiotherapy in the Radiotherapy Department of the Affiliated Hospital of North China University of Science and Technology from February 2023 to December 2023.Inclusion criteria:① Patients who were pathologically confirmed to have malignant tumors(lung cancer breast cancer or esophageal cancer);② patients with radiation therapy indications as recommended by the guidelines;③ patients with an ECOG score of 0-1;④ patients with no significant abnormalities in electrocardiogram and echocardiography results.Exclusion criteria:① previously received chest radiotherapy;② patients with obvious palpitation,chest tightness and chest pain before treatment;③ diabetes,heart disease and other serious underlying diseases;④ anti-arrhythmic drugs are currently being used;⑤ patients who cannot tolerate radiotherapy and who were lost or lost during follow-up.HRV analysis was used to evaluate changes in autonomic nerve function after radiotherapy.Patients with AD were included in the case group,and the remaining patients were included in the control group.Univariate and multivariate logistic regression analysis methods were used to explore the dosimetric risk factors and cardiac dose limitations for the occurrence of AD after thoracic radiotherapy.This study was approved by the ethics committee of Affiliated Hospital of North China University of Science and Technology(ethics number:20230228020).Results:A total of 89 patients with thoracic tumors meeting the study criteria were enrolled in the study.Among them,41(46%)patients experienced cardiac AD after radiotherapy.The cardiac Dmax(6 273.500 cGy vs 4 675.900 cGy,P＜0.001),cardiac Dmean(1513.700 cGy vs 452.050 cGy,P＜0.001),cardiac V5(49.000%vs 21.250%,P＜0.001),V20(30.500%vs 7.300%,P＜0.001),V30(18.700%vs 3.600%,P＜0.001)and V40(10.900%vs 1.500%,P＜0.001)were significantly higher in the case group than in the control group.The results of multivariate logistic regression analysis showed that cardiac V30 was an independent risk factor for the occurrence of cardiac AD[OR(95%CI)=1.583(1.093-2.291),P=0.015].Cardiac V30 could predict the occurrence of radiation-induced cardiac injury with an area under the curve of 0.788,and 17.1%was the optimal cut-offvalue of cardiac V30 for predicting the occurrence of cardiac AD.Conclusion:After thoracic radiotherapy,the cardiac irradiation dose-volume was significantly higher in patients with cardiac AD than in the control group.When cardiac V30 was higher than 17.1%,the risk of cardiac AD in patients significantly increased.

Objective:To observe whether hair follicle cells from mice of different species can integrate to generate new pigmented hair follicles, and to explore the role of different melanocyte populations in pigmented hair follicle reconstruction in mice.Methods:The epidermal cell population, hair follicle epithelial cell population and dermal cell population were isolated from the skin of fetal or neonatal C57BL/6J and BALB/C mice, and epidermal melanocytes were obtained by culture and purification of the epidermal cell population. The experiments were divided into 3 parts: (1) hair follicle reconstruction experiment in neonatal C57BL/6J mice, which included 2 groups: epidermal cells + hair follicle epithelial cells group and dermal cells group; (2) chimeric hair follicle reconstruction experiment, which included 4 groups: dermal cells of neonatal C57BL/6J mice group, dermal cells of neonatal BALB/C mice group, dermal cells of neonatal BALB/C mice + dermal cells of neonatal C57BL/6J mice group, and dermal cells of fetal BALB/C mice + dermal cells of fetal C57BL/6J mice group; (3) pigmented hair follicle reconstruction experiment, which included 3 groups: dermal cells of neonatal BALB/C mice + epidermal cells of neonatal C57BL/6J mice group, dermal cells of neonatal BALB/C mice + hair follicle epithelial cells of neonatal C57BL/6J mice group, and dermal cells of neonatal BALB/C mice + cultured C57BL/6J epidermal melanocytes group. Different cells were implanted into dorsal skin fold chambers of the nude mice, and there were 4 mice in each group. At weeks 4 and 8 after inoculation, hair follicle reconstruction was assessed by gross observation, histological examination and immunofluorescence assay.Results:Among the 8 BALB/C nude mice in the 2 groups in the hair follicle reconstruction experiment, 7 survived and 1 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, no hair growth was observed in the epidermal cells + hair follicle epithelial cells group (3 mice) , while normal hair grew out in the dermal cells group (4 mice) mixed with epithelial components. Among the 16 BALB/C nude mice in the 4 groups in the chimeric hair follicle reconstruction experiment, 14 survived and 2 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, brown-grey hair grew well in the dermal cells of neonatal BALB/C mice + dermal cells of neonatal C57BL/6J mice group (4 mice) , and dermal cells of fetal BALB/C mice + dermal cells of fetal C57BL/6J mice group (3 mice) . Among the 12 BALB/C nude mice in the 3 groups in the pigmented hair follicle reconstruction experiment, 10 survived and 2 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, only white hair grew out in the dermal cells of neonatal BALB/C mice + cultured C57BL/6J epidermal melanocytes group (3 mice) , and no hair follicle melanocytes were observed by immunofluorescence assay, while brown-grey hair grew well in the dermal cells of neonatal BALB/C mice + epidermal cells of neonatal C57BL/6J mice group (4 mice) , and dermal cells of neonatal BALB/C mice + hair follicle epithelial cells of neonatal C57BL/6J mice group (3 mice) .Conclusions:The interaction between mesenchymal cells and hair follicle epithelial cells is a necessary condition for hair follicle reconstruction. The hair follicle cells from different species of mice can integrate to generate new pigmented hair follicles. Both hair follicle melanocytes and epidermal melanocytes can participate in the formation of pigmented hair follicles, but differentiated melanocytes have no such ability.