Liver failure is a clinical syndrome characterized by serious liver damages.It can results from a variety of causes,and the prognosis is usually poor.How to objectively assess the severity of liver failure and accurately predict the prognosis are the hot spots and challenges in studies on liver failure.The assessment criteria and models widely used clinically include:Child-Turotte-Pugh (CTP) score,acute physiology,age and chronic health evaluation(APACHE) Ⅱ/Ⅲ score,King's College Hospital (KCH) criteria,sequential organ failure assessment (SOFA) score and model for end-stage liver disease (MELD) score.Besides,more factors are identified as potential markers in prognosis assessment.This paper reviews the importance of prognosis assessment in liver failure,and introduces current and new systems or markers in prognosis assessment.

Objective To construct a cDNA subtractive library of genes transactivated by c-terminally truncated middle surface protein of hepatitis B virus(MHBs t) with suppression subtractive hybridization technique for cloning genes associated with transactivation. Methods The mRNA was isolated from HepG2 cells transfected with pcDNA3.1(-)-Mt167 and pcDNA3.1(-) empty vectors, respectively, then cDNA was synthesized. After restriction enzyme Rsa I digestion, small-size cDNAs were obtained. Then tester cDNA was divided into two groups and ligated to the specific adaptor 1 and adaptor 2, respectively. After tester cDNA was hybridized with driver cDNA twice and underwent two times of nested PCR and then was subcloned into T/A plasmid vectors to set up the subtractive library. Amplification of the library was carried out with E. coli strain JM109. The cDNA was sequenced and analyzed in GenBank with Blast search after PCR. Results The subtractive library of genes transactivated by MHBs t was constructed successfully. The amplified library contained 94 positive clones. Colony PCR showed that these clones contained 200-800bp inserts. Sequence analysis was performed in 50 clones,and the full length sequences were obtained with bioinformatics method. 23 coding sequences were obtained in total, which consisted of 19 known and 4 unknown ones.Conclusions The obtained sequences may be target genes transactivated by MHBs t, among which some genes coding proteins may involve in cell cycle regulation, immune response and tumour genesis.

Objective To evaluate the model for end-stage liver disease (MELD) and MELD combined with serum natrium level (MELD-Na) in predicting short-term prognosis of liver failure.Methods Clinical data of 322 patients with liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from April 2003 to April 2012 were retrospectively analyzed.MELD and MELD-Na scores were calculated at diagnosis and one week after the diagnosis,and then △MELD and △MELD-Na were determined.Receiver operating characteristics (ROC) curve and Kaplan-Meier survival curve were used to evaluate the value of the above scores in predicting 3-month prognosis.Results The 3-month mortality rates of acute/sub-acute,acute-on-chronic and chronic liver failure were 77.4％ (24/31),41.7％ (50/120) and 56.1％ (96/171),respectively,and the difference was of statistical significance (x2 =14.273,P ＜0.01).For acute/sub-acute liver failure,the areas under ROC curve (AUCs) were 0.699-0.836 for each scoring system in predicting short-term prognosis,and no significant difference was observed (Z =0.507,0.622,0.712,0.727,0.779 and 0.599,P ＞0.05).For acute-on-chronic liver failure,AUCs were 0.889 and 0.897 for △MELD and △MELD-Na in predicting short-term prognosis,which were higher than those of MELD and MELD-Na scores at the baseline (Z =3.110 and 3.500,P ＜ 0.05),but no significant difference was observed between △MELD and △MELD-Na (Z =0.310,P ＞ 0.05) ; Kaplan-Meier survival curve showed that the 3-month mortality rate for patients with △MELD ＞ 3.5 was 87.8％,and the average survival time was 34.05 d.For chronic liver failure,AUC of △MELD was 0.871 in predicting short-term prognosis,which was higher than that of △MELD-Na (Z =4.229,P ＜0.05) ; Kaplan-Meier survival curve showed that the 3-month mortality rate for patients with △MELD ＞ 4.5 was 89.9％,and the average survival time was 29.08 d.Conclusion For acute/sub-acute liver failure,MELD,MELD-Na,△MELD and △MELD-Na are all satisfactory in predicting short-term prognosis; for acute-on-chronic liver failure,△MELD and △MELD-Na are better than MELD,MELD-Na scores at the baseline; and for chronic liver failure,△MELD is the best indicator.

Objective To investigate the empathy of obstetric nurses and the related factors.Methods Chinese Version of the Jefferson Scale of Empathy was used to investigate the empathy of 80 obstetric nurses in our hospital and the related factors.Results The score on empathy of obstetric nurses was 65~137,averaged 108.87±10.62 and ranked at the medium level.The empathy was mainly influenced by whether the nurses had studied the empathy-related courses and the satisfaction with their occupation and working environment.Conclusion The empathy of obstetric nurses is at the medium level.Their empathy is mainly influenced by whether the nurses have studied the empathy-related courses and the satisfaction of their occupation and working environment.In addition to promote the training,the nursing manager should improve the satisfaction of the occupation and working environment.

Objective To report 3 cases of using the EXIT(ex-utero intrapartum treatment)procedure in the peri-surgical caring of congenital diaphragmatic hernia of neonatus.Methods Preparing and consulting of multiple clinical departments before operation,inhibit uterine contraction to avoid placental abruption.Keep puerperae and their babies warm.Result No complications happened to neither maternity nor neonatus.Conclusion Co-operations of multiple clinical departmens were essential to the successful using the EXIT(ex-utero intrapartum treatment)procedure in the congenital diaphragmatic hernia of neonatus.

Objective To investigate the incidence of trisomy 12(+12) and 11 q23 deletion [ del ( 11q23) ] in chronic lymphocyticleukemia (CLL). Methods Fluorescein labeled DNA probe 12 and sequence specific probe ATM for 11q23 were used to perform inter-phase fluorescence in situ hybridization (I-FISH) assays in 30 patients with CLL. The results were compared with that of conventional cyto-genetic (CC) examination. Results With CC examination , only 4 cases (13.3%) were found to have chromosomal abnormalities, whereaswith I-FISH assay ,8 cases (26.7%) were found to have genomic aberrations, including trisomy 12 in 5 cases , deletion of 11q23 in 3 ca-sea. Conclusion I-FISH is a useful method for detection of genomie aberration in CLL, the significance of trisomy 12 and del (11q23) inpredicting the prognosis of B-CLL need to be investigated further.

Objective To investigate the possible association between the XbaI polymorphism of the glycogen synthase gene and non-insulin-dependent diabetes mellitus (NIDDM) in Chinese population.Methods 216 NIDDM patients and 106 healthy controls were studied. DNA fragment containing XbaI restriction site was amplified by the polymerase chain reaction,digested by the XbaI enzyme and compared by gel electrophoresis with a positive control from Finland.Results The XbaI polymorphism was found in 18 of 216 Chinese patients (8.3%) and was also found in 10 of 106 controls (9.4%) (P>0.05).Conclusions The results suggest that the XbaI polymorphism of the glycogen synthase gene could not be used as a genetic marker for NIDDM in Chinese population of Henan Han nationality.

Myeloid differentiation factor 88 (MYD88) is a key linker in the Toll-like receptor (TLR) signaling pathway, which plays an important role in the progression of the tumour. Recent studies have shown that the activating mutation of MYD88 L265P has been identified in about of 90% lymphoplasmacytic lymphoma/Waldenstrom's macroglobulinemia and about of 40% diffuse large B-cell lymphoma and other subtypes of B-cell proliferative neoplasms. Different types of B-cell proliferative neoplasms have their own histology, immunohistochemistry and clinical characteristics, thus, mutation rates of MYD88 L265P are different. This review discusses the latest progress of MYD88 L265P mutation in B-cell proliferative neoplasms.

Objective:To retrieve and summarize evidence for prevention of hypothermia at birth in newborn.Methods:Databases such as Up To Date, BMJ Best Practice, National Institute for Health and Care Excellence(NICE), Joanna Briggs Institute (JBI), Cochrane Library, Registered Nurses′Association of Ontario (RNAO), American Heart Association(AHA), Web of Science, PubMed, Chinese Biology Medical Literature database, Wanfang Med Online were searched to collect relevant evidence for prevention of hypothermia at birth in newborn, including guidelines, systematic reviews, evidence summaries and expert consensus. Two researchers independently evaluated the quality of the literature and extracted the data of the literature which met the criteria.Results:Six articles were selected, including 1 clinical decision support system, 2 guidelines, 1 systematic review and 2 expert consensuses. Nineteen pieces of best evidence were summarized.Conclusions:This study summarized the best evidence for the prevention of hypothermia at birth in newborn, and provided evidence-based support for clinical practice.

Objective Based on performance assessment indicators for tertiary public hospitals,a retrospec-tive analysis was carried out on the surgical medical quality and operational efficiency of a specific tertiary A-level public hospital for the first quarter of 2024.The analysis yielded recommendations for the advancement of hospital sur-gical departments.Methods The comprehensive evaluation of the surgical performance level of a certain tertiary A-level public hospital was conducted using the weighted TOPSIS method,the rank sum ratio(RSR)method,and a fuzzy combination of the two methods.Results For the first quarter of 2024,A12,A13,and A6 were ranked in the top three by the complete review,while A3,A22,and A1 were listed in the bottom three.The majority of depart-ments fell into the middle.The evaluation's findings mainly matched the hospital departments'real state of develop-ment,showing variations in each department's performance.Conclusion The overall performance level of the surgical department in the tertiary public general hospital needs improvement.The results of surgical performance are signifi-cantly impacted by"functional positioning".In order to raise performance levels,technical innovation and efficiency optimisation should be prioritised,along with a greater attention on different components.