Objective To investigate the clinical feature,treatment and prognosis of both themother and the fetus with gestational diabetes insipidus.Methods A total of 7 cases of gestational diabetes insipidus collected in the First Affiliated Hospital of Wenzhou Medical College,Wen'zhou Combination ofTraditional Chinese Medicine with Western Medicine Hospital,and Zhejiang Taizhou Hospital from June 1993to June 2006 were analyzed retrospectively.Resuits Seven cases symptoms all characterized by excessive thirst polydipsia and polyuria.The average 24 h urinary output was between 11 L to 13 L and manifested of hypobaricuria.After effective treatment(three cases were treated with 1-deamino-8-D-arginine vasopressin,another three patients were managed with hydrochlorothiazide,and the last one was cured with antisterone),seven patients with gestational diabetes insipidus did not have any severe consequences.Their symptoms of excessive thirst,polyuria,and polydypsia disappeared from 7 days to 3 months after parturition.Urinary volume returned to normal standard of 1000-2000 ml during 24 hours.Specific gravity of urine recovered normally between a range 1.015-1.025 and serum sodium recovered between 135-147 mmol/L Theaverage duration of illness was 52 days.Eight newborn infants survived.Two of them were sent to neonatal intensive care unit for treatment.One was because of premature delivery caused by antepartum eclampsia,and the other case was one of the twins who had hydronephrosis.The baby of the first case left hospital after 3 weeks'treatment.The latter one's symptom disappeared 2 weeks after delivery.No obvious symptom was discovered among all the babies through follow-up telephone calls 42 days after childbirth.Conclusion Gestational diabetes insipidus is a rare endocrinopathy complicating pregnancy.This disorder is characterized by excessive thirst,polydypsia,polyuria,hypobaric urine and electrolyte disturbances usually manifesting in the third trimester of pregnancy or puerperium.This is a transient syndrome.The first treatment of choice in patients with gestational diabetes insipidus is 1-deamino-8-D-arginine vasopressin and the second-choice is hydrochlorothiazide.Early diagnosis and appropriate management of the disease may reduce the hazard forboth the mother and the fetus during perinatal period.

Objegtlve To study the effect of lipexins on the proliferation and secretion of peritoneal macrophages from patients with preeclampsia in vitro.Methods Peritoneal macrophages were obtained from 24 patients with preeclampsia(preeclampsia group)and 24 normal pregnant women(normal pregnant group)who were treated in the First Affiliated Hospital of Wenzhou Medical Coilege from March to July 2007.Enzyme linked immunosorbent assay (ELISA) was used to detect the concentration of tumor necrosis factor-α(TNF-α)in the supernatant of macrophages which were pulsed with lipoxins at different concentrations(0,10,100 nmol/L)in both groups after 48 hours.Methyl thiazolyl tetrazolium (MTT)assay was used to detect the inhibition rate of cell proliferation of macrophages which were pulsed with lipoxins at different concentrations(0,10,100 nmol/L)in both groups after 24 hours.Results (1)The concentration of TNF-α:the levels of TNF-α were(1867.5±47.3),(1836.9±4.5) and (1800.5±2.7)ng/L after treatment with differed concentrations of lipoxins(0,10,100 nmol/L)in preeclampsia group vs normal pregnant group[(791.3±62.2),(789.4±2.3),(781.5±1.9)ng/L].The levels of TNF-α in preeclampsia group were significantly higher than that in normal pregnant group(P＜0.05).Lipoxins significantly inhibited the concentration of TNF-α in a dose-dependent manner in preeclampsia group (P＜0.05),while it had no significant effect in normal pregnant group(P＞0.05).(2)Cell proliferation inhibition:Incubation with lipoxins produced a dose-dependent(0,10,100 nmol/L)inhibitory effect on proliferation in preeclampsia group,[(14.8±6.3)%,(32.9±3.6)%,(36.7±3.8)%],vs normal pregnant group[(16.8±6.9)%,(16.7±5.4)%,(15.9±2.1)%].The rate of cell proliferation in preeclampsia group was significantly hisher than that in normal pregnant group.Lipoxins significandy inhibited this growth(P＜0.05),while it had no significant effect in normal pregnant group(P＞0.05).Conclusion Lipoxins can inhibit the proliferation of macrophage and secretion of TNF-α in preeclampsia in a dose-dependent manner.Lipoxins may be potentially useful in prevention and treatment of preeclampsia.

The experimental teaching of psychology is not only an important course in the undergraduate and graduate education of applied psychology, but also can assist the practical teaching of quite a few other subjects. It clearly divides three basic functions of experimental psychology teaching center: teaching, scientific research and service, which play an important role in facilitating teachers and students to understand corresponding courses. At the same time, it is discussed and proposed to strengthen the internal and external scientific linkage of the experimental center under the network background, and put forward the use of Internet technology, in order to improve the scientific use of the experimental teaching center, and reflect its maximum value, thereby achieving the purpose of university laboratory joint construction and serve the university to cultivate innovative and compound personnels.

Objective:To investigate the clinical outcomes of patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection.Methods:Patients who undergoing radical surgical resection for ICC from Jan 2015 to Apr 2021 at the Department of General Surgery, the First Affiliated Hospital of Anhui Medical University were included in this retrospective cohort study.Results:There were 67 patients in the final analysis, The median follow-up duration was 14 months (range: 1-60 months). Firty three patients (79.1%) had tumor recurrence, 52 patients (77.6%) died, Among them, 49 patients (73.1%) died from tumor recurrence. The 1-、2-、and 3-year accumulated disease-free and overall survival rate were 35.6%, 19.6%, 16.8% and 53.7%, 32.4%, 20.8%. respectively. The overall survival rate of the group without microvascular invasion was significantly better than those of the group with microvascular invasion ( χ2=5.916, P=0.015). CA19-9≥1 000 U/ml was the only independent risk factor for the disease-free survival. CA19-9≥1 000 U/ml、blood loss≥600 ml、microvascular invasion and tumor recurrence were the independent risk factors for the overall survival. Conclusion:For ICC patients with single tumor, when the tumor diameter is less than 5 cm and has no microvascular invasion, surgical resection is recommended, and a satisfactory prognosis could be achieved.

Objective To analyze the risk factors of multi-drug resistant organism (MDRO) infection after liver transplantation. Methods The clinical data of 77 recipients undergoing liver transplantation were retrospectively analyzed. According to the incidence of MDRO infection, all recipients were divided into the non-MDRO infection group (n=51) and MDRO infection group (n=26). The infection rate and strain distribution of MDRO in liver transplant recipients were summarized. The risk factors of MDRO infection in liver transplant recipients were identified. Clinical prognosis of all recipients was statistically compared between two groups. Results The infection rate of MDRO after liver transplantation was 34% (26/77), mainly carbapenem-resistant MDRO infection. The main sites of infection included lung, abdominal cavity and incision. Univariate analysis showed that postoperative tracheal intubation ≥48 h, length of intensive care unit (ICU) stay ≥72 h, length of hospital stay ≥30 d, re-operation, continuous renal replacement therapy (CRRT) and tacrolimus (Tac) blood concentration ≥15 ng/mL were the risk factors for MDRO infection after liver transplantation. Cox regression analysis indicated that postoperative tracheal intubation≥48 h, re-operation, CRRT and Tac blood concentration ≥15 ng/mL were the independent risk factors for MDRO infection after liver transplantation. The fatality in the MDRO infection group was significantly higher than that in the non-MDRO infection group [31%(8/26) vs. 10%(5/51), P=0.01]. Conclusions Postoperative tracheal intubation ≥48 h, re-operation, CRRT and Tac blood concentration ≥15 ng/mL may increase the risk of MDRO infection after liver transplantation and affect clinical prognosis of the recipients.

Objective To summarize the experience of complex hepatic artery reconstruction in orthotopic liver transplantation. Methods Clinical data of 7 liver transplantation recipients who underwent complex hepatic artery reconstruction from January 2015 to March 2019 were retrospectively analyzed. Among them, 4 recipients received classical liver transplantation and 3 cases underwent piggyback liver transplantation. Intraoperative general conditions including anhepatic phase, intraoperative blood loss, hepatic artery anastomosis time and operation time of the recipients were recorded. The clinical prognosis and complications were observed. Results In two donors, variant right hepatic artery was used for vascular reconstruction. The celiac trunk or the common hepatic artery of the donors was anastomosed with the common hepatic artery of the recipients. Iliac artery bypass was employed in 2 cases, and then the hepatic artery of the donors was anastomosed with the abdominal aorta of the recipients. The superior mesenteric artery of 1 donor was end-to-end anastomosed with the common hepatic artery of the recipient. The celiac trunk of 1 donor was anastomosed with the splenic artery of the recipient. Only 1 case was required to undergo secondary liver transplantation due to acute hepatic artery thrombosis after hepatic artery anastomosis. All the 6 recipients successfully completed the liver transplantation. No perioperative death was observed. The anhepatic phase endured from 49 to 77 min. The intraoperative blood loss was ranged from 300 to 1 500 mL. The anastomosis time of hepatic artery was 23-56 min. The operation time was ranged from 5.3 to 11.1 h. The length of postoperative hospital stay was 23-56 d. Neither hepatic artery thrombosis nor stenosis occurred. The liver function of all recipients was basically restored to normal within postoperative 2 weeks. No severe surgical complications occurred. The liver graft achieved excellent function. Conclusions Appropriate identification of the hepatic artery variation, proper management of liver artery of the donors and recipients and reconstructing the blood supply of liver graft are the crucial procedures of liver transplantation.

Objective To evaluate the effect of different techniques of hepatic artery reconstruction on postoperative hepatic artery complications and clinical prognosis in liver transplantation. Methods Clinical data of 140 liver transplant recipients were retrospectively analyzed. All recipients were divided into the conventional hepatic artery reconstruction group (n=123) and special hepatic artery reconstruction group (n=17) according to hepatic artery reconstruction methods. Intraoperative and postoperative clinical indexes, the incidence of postoperative hepatic artery complications and survival rate were compared between two groups. Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at postoperative 1 d, total bilirubin (TB) at postoperative 7 d and prothrombin time international normalized ratio (PT-INR) at postoperative 30 d in special hepatic artery reconstruction group were higher than those in conventional hepatic artery reconstruction group, and the differences were statistically significant (all P < 0.05). There were no significant differences in the operation time, anhepatic phase, intraoperative blood loss, intraoperative transfusion volume of red blood cells, cold or warm ischemia time, the length of intensive care unit (ICU) stay, the length of hospital stay and postoperative blood flow of liver allograft between two groups (all P > 0.05). In the conventional hepatic artery reconstruction group, 5 recipients developed hepatic artery complications, whereas no hepatic artery complications occurred in the special hepatic artery reconstruction group, with no significant difference between two groups (P > 0.05). In the special hepatic artery reconstruction group, the 1-, 3- and 5-year cumulative survival rates were equally 82.4%, compared with 85.0%, 78.9% and 75.6% in the conventional hepatic artery reconstruction group, respectively. There was no significant difference between two groups (all P > 0.05). Conclusions When hepatic artery variations and (or) lesions are detected in donors and recipients, use of special hepatic artery reconstruction may effectively restore the hepatic arterial blood flow of liver allograft after liver transplantation, and will not affect the incidence of hepatic artery complications and survival rate of the recipients following liver transplantation.

The gastrointestinal microbiome is the most important and complex microecosystem in the human microecosystem,which participates in a variety of physiological processes of the human body and is related to a variety of disease processes.In recent years,the relationship between gastrointestinal microbiome and gastrointestinal tumors has attracted the attention of scholars,and a series of studies have been carried out on the exploration of gastrointestinal microbiota as a new non-invasive biomarker.This article reviewed the relationship between gastrointestinal microbiome and the diagnosis,occurrence and treatment of gastrointestinal tumors through esophageal cancer,gastric cancer,colorectal cancer,gastrointestinal microbiome and tumor treatment,so as to provide new ideas for finding potential molecular targets for prevention,treatment and intervention of tumors.

Liver retransplantation is the final option for graft failure after liver transplantation. The interval between the first and second liver transplantation will directly affect surgical indications, technical difficulties and treatment outcomes of adult liver retransplantation. Previous studies have shown that the overall survival of liver allografts and recipients after liver retransplantation is significantly lower than that after the first liver transplantation. However, with comprehensive progress in organ preservation methods, anesthesia management concepts, intensive care strategies, surgical techniques and new immunosuppressive drugs, clinical efficacy of adult liver retransplantation has been significantly improved. In this article, the changes of indications, timing of operation, long-term efficacy and its influencing factors, technical difficulties, selection of immunosuppressive regimens and the implementation of living donor liver retransplantation were reviewed, and the achievements, challenges and potential solutions of adult liver retransplantation were summarized, aiming to provide reference for enhancing clinical efficacy of adult liver retransplantation.

With a global rise in morbidity rates， obesity has become a pressing public health issue. With increased adipocyte number and volume as the main characteristics， obesity is also manifested by metabolic disorders to varying degrees. At the same time， obesity is a risk factor for diabetes， hypertension， stroke， cancer， and cardiovascular diseases， imposing burdens on society and families. Influenced by lifestyle， environment， behavior， and genetics， obesity is caused by the interaction of many factors， and its pathological process is complex， involving inflammation， autophagy， and intestinal dysbiosis. The mitogen-activated protein kinase （MAPK） cascade reaction， a pivotal signaling pathway， plays a crucial role in cellular processes such as proliferation， differentiation， apoptosis， and stress responses. Both Chinese and international studies indicate that the MAPK signaling pathway can effectively regulate obesity through various pathways， including the modulation of adipocyte differentiation and apoptosis， appetite control， and inflammation improvement. Moreover， traditional Chinese medicine （TCM） has demonstrated significant efficacy in preventing and treating obesity， leveraging advantages such as multiple targets， diverse components， and minimal adverse effects. Research indicates that the MAPK signaling pathway is a primary focus of TCM regulation in this context， although a systematic review in this field is currently lacking. Therefore， this paper， by reviewing the latest Chinese and international research， provided a concise overview of the basic structure of the MAPK pathway， with a specific emphasis on recent progress in TCM interventions targeting the MAPK pathway for obesity treatment. The results indicate that regulating adipose tissue formation， differentiation， and thermogenesis， reducing inflammation and oxidative stress levels， and improving insulin sensitivity and metabolic disorders seem to be the main ways for TCM to regulate the MAPK pathway to prevent and treat obesity. However， it is necessary to find more research methods and explore potential mechanisms underlying TCM formulations based on the MAPK pathway for obesity prevention and treatment.