The surgical treatment of hepatocellular carcinoma have advanced greatly in recent years: associating liver partition and portal vein ligation for staged hepatectomy can bring hope and relief to patients with advanced liver cancer and less future liver remnant; the application range of laparoscopic hepatectomy and robotic hepatectomy were amplified; hepatectomy following anatomic or non-anatomic direction should be decided by particular situations; the precise preoperative assessment of liver reserve function ensured the success of extended hepatectomy; the further discussion of United Network for Organ Sharing criteria for liver transplantation made the appearance of University of California at San Francisco, Up-to-seven and Hangzhou criteria; bridge therapy can decrease tumor progression and the dropout rate from the liver transplantation waiting list; downstaging treatment is used in selected patients with more advanced liver cancer who are beyond the accepted transplant criteria to acquire the chance of liver transplantation and increase survival rates.
Carcinoma, Hepatocellular ; surgery ; Hepatectomy ; Humans ; Ligation ; Liver Neoplasms ; surgery ; Liver Transplantation ; Portal Vein ; surgery ; Survival Rate ; Treatment Outcome

Objective:To analyze the relationship between each dimension of emotional intelligence and interpersonal communication ability, and explore how to improve the interpersonal communication ability of residents through targeted emotional intelligence training.Methods:A total of 132 first-year residents of clinical medicine in the residency training base were jointly measured with emotional intelligence and interpersonal communication evaluation scale on the basis of self-assessment and grading. The differences between groups in self-assessment and grading were detected by one-way ANOVA, and the relationship between various dimensions of emotional intelligence and interpersonal communication ability was explored by correlation analysis and multiple linear stepwise regression analysis. SPSS 19.0 was used to conduct statistical analysis.Results:The self rating scale clearly divided the subjects into three levels. In the total score of emotional intelligence and its various dimensions, the differences between the three levels were statistically significant; the scores of the "good" group were higher than those of the "fair" group and the "slightly insufficient" group. There were statistical significance in the total score of emotional intelligence ( P<0.001) and its emotional perception ( P<0.001), self emotional management ( P<0.001), others' emotional management ( P<0.001) and emotional utilization ( P<0.001). In the total score of interpersonal communication ability and its various dimensions, the differences among the three levels were statistically significant. In the conflict management, the difference between the "good" group and the "fair" group was not statistically significant, and the differences in other items were statistically significant. The total score of emotional intelligence and its dimensions were positively correlated with interpersonal communication ability ( P<0.001), but the two dimensions that had the most significant impact on interpersonal communication ability were emotional perception and others' emotional management ( R2=0.531, P<0.001). Conclusion:By focusing on the cultivation of each dimensions of emotional perception and other emotional management for residents, it is expected to play a positive role in achieving the national goal of cultivating interpersonal communication skills.

Objective:To investigate the application effect of the teaching model of massive open online course (MOOC)+small private online course (SPOC) in the undergraduate clinical teaching of Fundamentals of Surgery.Methods:A total of 30 undergraduate medical trainees in the five-year program were randomly divided into experimental group and control group, with 15 trainees in each group. With the chapter of basic surgical procedures as an example, the trainees in the control group received traditional teaching, and those in the experimental group received MOOC+SPOC teaching. Theoretical assessment and surgery simulation were performed at one week after the course to evaluate the teaching effect. SPSS 17.0 was used for the t-test and the chi-square test. Results:The experimental group had a theoretical assessment score of (92.5±6.4) points and a basic skill operation score of (91.7±2.2) points, while the control group had a theoretical assessment score of (85.3±7.3) points and a basic skill operation score of (83.6±6.4) points. The experimental group had an excellent rate of 60% (9/15) in theoretical assessment and 66.7% (10/15) in basic skill operation test, while the control group had an excellent rate of 40% (6/15) in theoretical assessment and 33.3% (5/15) in basic skill operation test. The experimental group had significantly higher scores and grades than the control group ( P<0.05). Conclusion:MOOC+SPOC teaching can significantly enhance the understanding of theoretical knowledge and the mastery of operational skills among trainees and improve teaching effect, and therefore, it has a good application prospect.

Objective:To analyze the risk factors for central lymph node metastasis (CLNM) in patients with papillary thyroid cancer (PTC) aged 55 years and above, and to construct a predictive model with columnar graph.Methods:This retrospective study included 406 PTC patients aged 55 and above, treated at the First Affiliated Hospital of Zhengzhou University from Nov. 2019 to Feb. 2022. Data on demographic characteristics, disease features, and laboratory test results were collected. Univariate and multivariate logistic regression analyses were used to identify risk factors for CLNM and develop a clinical prediction model and nomogram.Results:The study involved 406 patients, divided into a modeling group (285 patients) and a validation group (121 patients). The predictive model identified independent risk factors for CLNM. In the modeling group, the model demonstrated a ROC AUC of 0.769, with 82.6% sensitivity, 63.0% specificity, and 67.7% accuracy. The validation group showed 66.7% sensitivity, 74.5% specificity, and 72.7% accuracy, with an AUC of 0.760. Hosmer-Lemeshow tests indicated good fit in both groups. Decision curve analysis confirmed the model's clinical decision-making value, showing better performance than traditional strategies and good generalizability and reliability.Conclusions:Sex, maximum tumor diameter, bilateral involvement of thyroid lobes, clinically evident cervical lymph nodes, and local invasion are independent predictive factors for CLNM in patients over 55 with papillary thyroid carcinoma (PTC). A clinical risk stratification nomogram model based on these risk factors demonstrates good predictive performance.