Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.

Objective: To examine the impact of physical intelligence teaching on the function of children s sensory integration, so as to provide reference for promoting the development of sensory integration system. Methods: From February to May 2023, the intervention was implemented for 12 weeks among 136 children aged 4-5 (68 in the intervention group and 68 in the control group). The intervention group received situational and game based physical intelligence teaching, the control group received sports game teaching according to the original curriculum objectives of the kindergarten. Intervention was administered 3 times a week for 40 minutes each time. The sensory integration ability of the intervention group and the control group were evaluated before and after the intervention with Chi square test and t test. Results: The vestibular sensation, proprioception and tactile sensation of between boys and girls in the intervention group were significantly improved compared with before intervention (boys：44.14±11.52 vs. 53.34± 9.49 ，44.57±12.76 vs. 50.54±11.86，49.31±12.18 vs. 55.00±10.24,girls：46.00±11.01 vs. 54.58±10.06，48.79±13.17 vs. 53.64±11.97，52.67±11.67 vs. 56.91±10.42, t =-3.24，-2.49，-2.09，-5.24，-12.94，-2.56， P <0.05). There was no significant difference in vestibular sensation between boys and girls in the control group (boys：45.91±11.66 vs. 46.31± 11.20，girls：48.27±13.56 vs. 48.45 ±13.54, t =-0.87，-0.07， P >0.05), but there was a significant improvement in proprioception and tactile sensation in both boys and girls (boys：46.63±11.76 vs. 48.06±11.69，51.63±11.98 vs. 52.40±12.18，girls：50.45±12.16 vs. 51.67± 12.03 ，53.36±12.48 vs. 54.39±12.57， t =-3.36，-2.08，-4.66，-2.86， P <0.05). After the intervention, compared with the control group, the vestibular sensation of both boys and girls significantly improved ( t=2.83, 2.08, P <0.05), with exception of proprioception and tactile sensation ( t =0.88,0.67,0.97,0.88, P >0.05). In the experimental group, the number of normal boys increased from 12 to 24, while the number of dysfunctional boys decreased from 23 to 11, with a statistically significant difference ( χ 2=11.53, P <0.01). There was no statistically significant difference in sensory integration in boys of the control group before and after the experiment ( χ 2= 1.10 , P >0.05). After intervention,the number of normal girls in the experimental group increased from 15 to 27, while the number of dysfunctional girls decreased from 18 to 6, with a statistically significant difference ( χ 2=10.39, P < 0.05 ). There was no statistically significant difference in sensory integration in girls from the control group before and after the experiment ( χ 2=2.08, P > 0.05 ). Conclusion Physical intelligence teaching can effectively improve children s sensory integration ability, especially for vestibular function.

Objective:To investigate the effect of ultrasound-guided transversus abdominis plane (TAP) block combined with iliohypogastric/ilioinguinal TAP block in high-risk elderly patients undergoing inguinal hernia repair.Methods:Sixty male patients undergoing elective inguinal hernia repair, aged ≥70 years, BMI 18-23 kg/m 2, ASAⅢ-Ⅳ grade, were randomly divided into two groups: ultrasound-guided lateral TAP block combined with iliohypogastric/ilioinguinal TAP block group (combined group) and lateral TAP block group (lateral group), with 30 cases in each group. In the combined group, the injection concentration of 0.375% ropivacaine 20 ml was at the iliohypogastric/ilioinguinal TAP puncture site and the lateral TAP puncture site was also 20 ml, and the lateral group only injected 0.375% 20 ml at the lateral TAP puncture site. The Visual Analogue Scale (VAS) of the two groups were compared at surgical skin incision (T 1), opening of external oblique aponeurosis (T 2), free hernia sac (T 3), separation of preperitoneal space and patch placement (T 4), suture of transverse abdominal fascia (T 5), suture of external oblique abdominal aponeurosis (T 6) and skin incision are closed (T 7); The VAS were compared during rest and activity at 2, 4, 6, 8, 12 and 24 hours after surgery. The cumulative consumption of relief analgesics was compared. Results:Compared with the lateral group, the VAS of the combined group during T 3-T 5 was significantly lower ( P<0.05). The VAS score at 4, 6 and 8 hours after operation in the combined group was also significantly lower ( P<0.05). There was no statistical significance in VAS score at rest between the two groups 24 h after operation ( P>0.05). The cumulative consumption of relief analgesics in the combined group was lower ( P<0.05). The difference of adverse events between the two groups was not statistically significant ( P>0.05). Conclusion:In high-risk elderly patients, ultrasound-guided transverse abdominal muscle plane two-point block can be used as a safe alternative method of intraoperative analgesia.

Endoscopy ; Hernia, Ventral/surgery* ; Herniorrhaphy ; Humans ; Laparoscopy ; Postoperative Complications ; Surgical Mesh