Objective To investigate the risk factors of uroschesis in patients with cervical cancer after extensive hysterectomy.Methods The clinical data of 92 patients with cervical cancer who had undergone extensive hysterectomy plus pelvic lymph node dissection from August 2008 to June 2011 were analyzed retrospectively.The incidence rate and related risk factors of uroschesis after operation were analyzed.Results Thirty-one of 92 cases had postoperative uroschesis.The incidence rate of uroschesis was 33.70％.Univariate analysis showed that age,intraoperative blood loss,time of indwelling urinary catheter and urinary tract infection had significant correlation with postoperative uroschesis (P ＜0.05).While operative time,clinical stage,pathological type,preoperative adjuvant therapy,postoperative wound infection or fat liquefaction had no obvious correlation with postoperative uroschesis (P＞ 0.05).Multivariate Logistic regression analysis showed that age,time of indwelling urinary catheter and urinary tract infection were risk factors of postoperative uroschesis.Conclusions Age,time of indwelling urinary catheter and urinary tract infection are independent factors of postoperative uroschesis.The key method to reduce the incidence rate of postoperative uroschesis is to shorten the continuous catheterization time with comprehensive measure,to prevent and control urinary tract infection in early time.

[ Abstract] Vitamin D is a steroid derivative. It has the effect of regulating calcium -phosphorus metabolism. With the development of medicine, the effects of vitamin D in other respects, such as regulation of blood pressure, blood glucose, nerve protection, and immunity have received more and more attention. A lot of research show s that the level of vitamin D is closely associated w ith the onset and outcome of ischemic stroke. In addition, some researchers explored the relationship betw een vitamin D and stroke from the genetic perspective. How ever, the existing research results are not consistent. The link betw een vitamin D and ischemic stroke is not clear. This article review s the correlation studies of the relationship among vitamin D and vitamin D receptor gene polymorphism, the onset of ischemic stroke, outcomes and risk factors in recent years.

Objective To investigate the relationship between osteoprotegerin ( OPG ) gene polymorphisms and ischemic stroke etiological subtypes, as well as the extent and distribution of cerebral atherosclerosis ( AS) lesions.Methods Patients with ischemic stroke included 285 cases of large-artery atherosclerosis (LAA), 91 cases of small-artery occlusion (SAO) and 42 cases of purely AS, and 165 healthy controls were enrolled in this study.The LAA group was respectively divided into 3 subgroups according to the number and the distribution of stenostic vessels.Genotyping of three single nucleotide polymorphisms (SNPs;rs2073617, rs3134069, and rs3102735) in the promoter region of the OPG gene was performed by polymerase chain reaction-restriction fragment length polymorphism.Results Regarding the three SNPs of OPG gene, the frequence of genotype CC/CT and the prevalence of allele C of rs3102735 were higher in the LAA group contrasting with the control group ( 24.04% vs 14.85%, 44.21% vs 27.88%,χ2 =10.758, 11.804, P =0.001,0.024).However, comparisons of other frequences of genotypes or alleles did not reveal any significant differences among the LAA group, the SAO group, the AS group and the control group, as well as among different subgroups of LAA group.Haplotype analysis revealed that the frequencies of haplotype C-C-T in LAA group and SAO group were significantly lower ( 0.023, 0.017 vs 0.068,χ2 =10.399, 5.841,P=0.001, 0.016), while that of haplotype T-A-C was significantly higher in SAO group(0.043 vs 0.016,χ2 =4.708, P=0.030) compared with controls.Conclusions Our findings indicate that OPG gene polymorphisms might be associated with increased susceptibility to LAA ischemic stroke.But we fail to show association of OPG gene with the extent and distribution of AS.

Objective To investigate the inhibitive effects of Ad-PUMA combined with temozolomide on human glioblastoma cells growth in vivo experiments. Methods The nude mouse model with human glioblastoma cells subcutaneous transplantation was established. The mice were randomly divided into 4 groups to receive subcutaneous injection at the 14th day separately with: Normal saline 100 μl (control, n=8), Ad-PUMA 2×108 pfu/100 μl (PUMA group, n=8), 10 mg/kg TMZ (TMZ group, n=8) and 2×108 pfu/100 μl Ad-PUMA + 10 mg/kg TMZ (combined group, n=8). Mice were killed after 20 days treatment.Tumor volume, inhibition rates and apoptotic index (AI) were measured, meanwhile, apoptotic tumor cells were detected by TUNEL technology respectively. The expression of MGMT mRNA and MGMT protein were revealed by the methods of RT-PCR and Western blot. Results According to the order: control group, AdPUMA group, TMZ group, combined group, tumor volumes were (3.68±0.09), (2.63±0.13), (2.13±0.07),(0.97±0.02) cm3 respectively (P＜0.05); the inhibitive rates were 0, 28.5 %, 42.1%, 73.6 % respectively and AI were (2.0±1.2) %, (11.4±2.6) %, (7.6±3.2) %, (20.6±8.6) % (P＜0.05). The results of Western blot and RT-PCR showed that MGMT mRNA and MGMT protein levels in TMZ group were higher than other groups (all P＜0.01). Conclusion Ad-PUMA combined with TMZ greatly enhances the sensitivity of human glioblastoma cells to TMZ and could effectively inhibit the proliferation and promote the apeptosis of glioblastoma cells, its mechanism was probably related Ad-PUMA promote apoptosis and inhibit MGMT expression.

Objective To investigate the correlation between microembolic signal (MES) and immune inflammation in patients with acute ischemic stroke. Methods The consecutive patients with acute ischemic stroke were enroled. According to the results of MES, they were divided into either a positive group or a negative group. The Immune inflammatory indexes, demographics, and baseline clinical data in both groups were compared. Multivariate logistic regression analysis was used to analyze the independent influencing factors of MES in acute ischemic stroke. Results A total of 237 patients were enroled, including 52 in the MES positive group and 185 in the MES negative group. There were significant differences in the levels of triglyceride (2. 130 ± 0. 933 mmol/L vs. 1. 811 ± 0. 962 mmol/L; t = 2. 126, P = 0. 035), plasma fibrinogen (2. 946 ± 0. 255 g/L vs. 2. 833 ± 0. 322 g/L; t = 2. 332, P = 0. 021 ), Lp-PLA2 level ( 288. 265 ± 27. 855 μg/L vs. 261. 652 ± 29. 961 μg/L; t = 2. 897, P = 0. 004 ), as wel as the proportions of CD4 + CD25high Treg (8. 695% ± 1. 461% vs. 9. 445% ± 1. 397% ; t = 3. 386, P = 0. 001), artery stenosis ≥70% (21. 15% vs. 5. 41% ; χ2 = 10. 592, P = 0. 001 ) and smal arterial occlusive stroke (9. 62% vs. 23. 24% ; χ2 = 4.667, P = 0. 031) between the MES positive group and the MES negative group. Multivariate logistic regression analysis showed that the increased plasma fibrinogen level (odds ratio [OR] 3. 257, 95%confidence interval [CI] 1. 124 - 9. 438; P = 0. 030), artery stenosis ≥ 70% (OR 3. 585, 95% CI 1. 394 -9. 219; P = 0. 008), and the decreased ratio of Treg (OR 3. 801, 95% CI 1. 190 - 12. 148; P = 0. 024) were the independent risk factors for positive MES, and smal arterial occlusive stroke was its independent protective factor (OR 0. 244, 95% CI 0. 072 - 0. 829; P = 0. 024). Conclusions MES may be associated with immune inflammation. The relationship between stroke and immune inflammation should be taken seriously.

To understand epidemiological characteristics of Marek's disease virus (MDV) prevalent in china currently,3 Marek's disease (MD) strains were isolated and identified from white feather meat chickens vaccined with MDV CVI988 or 814 through necropsy,histopathological observation,virus isolation and IFA detection,named SDAU1501,SDAU1502 and SDAU1503,respectively.vIL8,pp38,MEQ gene of the three strains of MDV were amplified using PCR,and compared with reference strains.The homology between SDAU1501 and SDAU1502 and virulent strains was above 97％,suggesting some features of virulent strains;while meq gene of SDAU1503 lost P amino acid at the 194 th site as that in CVI988,But the distinctive 177 nucleotide insertion mutations was not existed,predicting that it may be a attenuated vaccine strain.New variations of MDV continued and different types of variants emerged,therefore,prevalence and genetic monitoring of MD should be proceeded;meanwhile,more attentions should be given to MDV vaccine development.

Objective To evaluate the result of laparoscopic pancreaticoduodenectomy (LPD).Methods We retrospectively analyzed the perioperative clinical data of 111 consecutive LPD procedures performed from Jan 2015 to Aug 2018 at Department of General Surgery,the Affiliated Hospital of Xuzhou Medical University.Results Of the 111 patients undergoing laparoscopic procedure,24 patients (21.6％) had abdominal surgery history.The mean operative time was (360.9 ± 108.9)minutes.The mean blood loss was (270.9 ± 184.9)m1.The mean operative time of pancreatojejunostomy and choledochojejunostomy was (46.2 ± 11.6) minutes and (19.0±7.2) minutes,respectively.The mean postoperative hospital stay was (14.9 ± 4.7) days.The rate of pancreatic fistula grade B was 6.3％ and pancreatic fistula grade A was 20.7％.The rate of bile leakage was 1.8％.Second surgical operation was necessary for 5 cases (4.5％),delayed postoperative hemorrhage occurred in 2 cases (1.8％).The mean number of lymph nodes harvested was(14.2 ± 7.9) and the positive rate number was (0.9 ± 1.8).Conclusions LPD improves the operation quality,reduces intraoperative hemorrhage and accelerates the postoperative recovery.

Objective To summarize the surgery nursing cooperation points of liver procurement of brain death contributions (DBD) donor in the uninterrupted blood flow way . Methods Complete the following preoperativepreparation such as personnel,brain death donation donor,environment ,surgical content,multiple organ repair system and other related equipments;intraoperative preparation includes surgical instruments and related equipments ,assisting intubation of arteria lienalis ,portal vein and the choledochus and the organ procurement . Result About 3 cases of donor liver procurement were successfully implemented in the interrupt blood flow way, operation time was 3~4 h,bleeding was 200~400 mL,an average of 300 mL. Conclusions Uninterrupted flow liver transplantation can protect liver function to the greatest extent , thus greatly avoids the common complication of organ transplantation.The tacit understanding surgery cooperation improves the rate of surgery successfully.

Objective:To predict the risk of cryptogenic stroke (CS) patients with right-to-left shunt (RLS) by machine learning, and provide potential solutions for accurate and efficient prediction of CS.Methods:A retrospective analysis of clinical data on 289 subjects with positive RLS detected by contrast-enhanced transcranial Doppler tests (c-TCD) treated in the Department of Neurology at Laoshan Campus, the Affiliated Hospital of Qingdao University, from January 2018 to September 2023, including demographic information, medical history, laboratory test indicators, diagnosis, and treatment.The dataset was randomly divided into a training set and a testing set by the machine learning function train_test_split(), with a ratio of 8∶2.Risk prediction models for CS in RLS subjects were constructed by algorithms such as Logistic regression, decision trees, random forests, extreme gradient boosting, artificial neural networks, gradient boosting, extra trees, and adaptive Boosting.The model performance was evaluated by receiver operating characteristic curves (ROC), area under curve (AUC), confusion matrix, precision, recall, accuracy, F1 score, calibration curves, and decision curve analysis.The optimal model was subjected to interpretability analysis by feature importance and SHAP values.The t-test, Mann-Whitney U test and χ2 test were used for data analysis by SPSS 25.0 software.Delong test was used to compare the differences in AUC between the two models. Results:In 289 RLS subjects, there were 166 cases of CS (57.5%) and 123 cases of non-CS (42.5%).The statistical analysis results showed that blood biochemical indicators such as D-dimer, mean platelet volume, and fibrinogen in CS patients were higher than those in non-CS patients (all P<0.01).There were no statistically significant differences in variables between the training and testing sets(all P>0.05).Random forest model achieved the highest AUC (0.885), precision (0.806), recall (0.879), accuracy (0.810), and F1 score (0.841) for CS risk prediction in the testing set.The calibration curve showed that the random forest model was closest to the reference line, and the decision curve analysis indicated that it had a greater net benefit.The interpretability analysis revealed that high-risk factors included mean platelet volume, D-dimer, international normalized ratio, body mass index, and age. Conclusion:The random forest-based prediction tool exhibits excellent performance, demonstrating high accuracy in predicting CS risk in RLS population.

Objective:To investigate the safety and efficacy of using bio-artificial dura mater to wrap around skeletonized hepatic artery during pancreatoduodenectomy in the prevention of gastroduodenal artery(GDA)stump related delayed bleeding.Methods:Clinical data were collected from 45 patients undergoing the bio-artificial dura mater wrapping skeletonized hepatic artery during pancreatoduodenectomy from Oct 2022 to Apr 2023 at Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University.Results:Among the 45 patients, the bio-artificial dura mater was used to completely wrap the GDA stump and part of the common hepatic artery and the proper hepatic artery. The mean operative time was (308.1±93.1) min, the mean wrapping artery time was (18.7±7.5) min. Clinically relevant postoperative grade B pancreatic fistula (CR-POPF) occurred in 6 cases (13.3%), and intra-abdominal infection in 2 cases (4.4%).The rate of bile leakage was 2.2%.There were no second surgical operation, nor perioperative death. Postoperative delayed bleeding occurred in one case (2.2%) on the right hepatic artery branch near the hepatic portal. No pseudoaneurysm formation, nor bleeding occurring in any of the arteries wrapped by bio-artificial dura mater (including the GDA stump) after PD. There were no postoperative hepatic artery wrapping complications, such as hepatic artery stenosis, mesh-associated fluid accumulation and infection.Conclusion:Bio-artificial dura mater wrapping skeletonized hepatic artery technique in the process of pancreaticoduodenectomy can reduce the risk of delayed bleeding due to erosion of GDA stumps in case of post-PD pancreatic fistula.