【Objective】To investigate the relationship between the expression of lymphocyte function-associated antigen-1 (LFA-1) on peripheral lymphocytes and acute rejection after orthotopic liver transplantation (OLTx) in rat.【Methods】Adult male rats were divided into 2 groups.In the non-rejection group,40 SD rats were used as both donors and recipients.In the rejection group,20 Wistar rats were used as donors and 20 SD rats as recipients.Blood samples were collected through the tail vein 1 day before transplantation and on days 1、3、5、7 after OLTx.The expression of LFA-1 (CD11a) on peripheral lymphocytes was analyzed by using indirect immunofluorescent marker-flow cytometry.【Results】The expression level of LFA-1 on peripheral lymphocytes in recipient rats after orthotopic liver transplantation was markedly lower than that before operation (P<0.01);The expression level of LFA-1 on peripheral lymphocytes in rats with acute liver rejection was significantly higher than that in the non-rejection group (P<0.01).【Conclusion】Monitoring the expression level of LFA-1 on peripheral lymphocytes may be helpful to the diagnosis of acute graft rejection.

Objective To investigate the relationship between the intercellular adhesion molecule-1(ICAM-1) and lymphocyte function associated with antigen-1( LFA-1) and acute rejection of liver transplantation in rats. Methods SD rats and Wistar rats were randomly divided into normal control group, isograft group, and allograft group. Liver biopsies from the recipients were obtained on the day 2,4, and 7 postoperatively to examine the expression level of ICAM-1 and LFA-1 in liver grafts. Samples were firstly stained with specific monoclonal antibodies using immunohistochemistry stain and then applied to image semiquantitive analysis. Results The expression levels of ICAM-1 and LFA-1 in allograft group were obviously higher than those in both isograft group and normal group. Moreover, the expression levels of ICAM-1 and LFA-1 were correlated positively with the degree of acute liver rejection. Conclusions Detecting the expressions of ICAM-1 and LFA-1 in liver graft tissue may be helpful to the diagnosis of acute rejection after liver transplantation.

Objective: To understand the changing trend and influencing factors of health literacy among residents in Hangzhou from 2016 to 2020, so as to provide basis for health literacy promotion. Methods: The monitoring data of health literacy of residents in Hangzhou from 2016 to 2020 were collected. The five year cumulative growth and average growth rate were used to reflect the changing trend. The multivariate logistic regression model under complex survey design was used to analyze the influencing factors for health literacy. Results: From 2016 to 2020, the health literacy levels of Hangzhou residents were 26.91%, 29.49%, 31.83%, 34.73% and 38.00%, respectively. The five year cumulative growth was 11.09% and the average growth rate was 9.01%. Among three aspects of health literacy, the levels of basic knowledge and concept as well as healthy lifestyle and behaviors increased year by year (P<0.05), with the average growth rates of 15.12% and 2.92%. Among six types of health problems, the levels of chronic disease prevention and treatment, basic medical treatment, scientific view, health information as well as safety and first aid increased year by year ( P<0.05 ), with the average growth rates of 32.76%, 15.82%, 8.41%, 7.12% and 1.53%, respectively. The multivariate logistic regression analysis showed that education level ( junior high school, OR=5.359, 95%CI: 1.151-24.953;high school/vocational high school/technical secondary school, OR=9.214, 95%CI: 2.906-29.213; college or above, OR=29.977, 95%CI: 9.689-92.741 ) and occupation ( students, OR=2.564, 95%CI: 1.113-5.907 ) were the influencing factors for health literacy. Conclusion The health literacy levels of Hangzhou residents from 2016 to 2020 have been increasing year by year. The residents with higher education levels and students may have higher health literacy levels.

Objective: To analyze knowledge, attitudes and practice regarding protection against COVID-19 among primary and middle school students in Hangzhou and to provide a scientific basis for schools to carry out targeted prevention and control measures. Methods: Anonymous network sampling survey was carried out through the questionnaire star, and a total of 14 216 subjects from primary and middle school in Hangzhou were recruited to fill in the questionnaire regarding knowledge, attitudes and practice of COVID-19 from March 3 to March 7, 2020. Results: Primary and middle school students showed high awareness rate of transmission (85.83%) and incubation period (77.44%), but lower awareness on symptoms (44.70%) of COVID-19. The practice of wearing masks, cough etiquette and correct hand washing were 97.27%, 88.01% and 91.82%, respectively. The protective practice among primary and middle school students were generally good, 91.21% of them were at moderate level or above. 83.91% of primary and secondary school students reported worries about infection of COVID-19, and 55.42% of primary and secondary school students were anxious about returning to school. Primary school students and rural students were more anxious about returning to school(χ 2=46.66, 26.70, P<0.05). Conclusion The primary and middle school students in Hangzhou have a relatively good level of knowledge and practice concerning COVID-19. Yet, it is necessary to carry out targeted health education and strengthen mental health education for primary and middle school students.

Objective:To summarize the clinical-imaging features and prognoses of acute encephalopathy combined with biphasic seizures and late reduced diffusion (AESD).Methods:A retrospective analysis was performed. The clinical and imaging data and follow-up results of 8 children with AESD, admitted to Departments of Neurology and Rehabilitation Medicine, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2020 to April 2022 were collected.Results:The antecedent infections in 8 children were predominantly gastrointestinal and respiratory tract infections and convulsive seizures occured within 24 h of fever. The clinical presentation was biphasic: 3 had sustained convulsive state in the first phase of the disease, and all showed cluster seizures with worsening impairment of consciousness in the second phase of the disease, including 4 with involuntary movements during recovery from the disease. Seven children required admission to Intensive Care Unit, 4 required tracheal intubation for assisted ventilation, and 1 was combined with septic shock. Brain MRI findings of 8 children were "bright tree" in the second phase of the disease, including bilateral symmetrical and bilateral asymmetrical involvements, with diffuse and focal involvements. All 8 children were treated with glucocorticoids and/or gammaglobulin, and 2 were given mild hypothermia brain protection. Follow-up was performed for more than 3 months, and brain MRI indicated cerebral atrophy, subdural effusion and cerebral malacia. All the 8 children survived with different degrees of sequelae. Two children had Extended Glasgow Outcome Scale scores of 4, 4 had scores of 5, and 2 had scores of 7.Conclusion:AESD is a special clinical-maging syndrome, characterized by biphasic seizure and "bright tree" on head MRI; the survival is high, but neurological sequelae of different degrees are easily left behind.

Gastroesophageal reflux related cough is located in the lung and stomach.The basic pathogenesis is the inversion of stomach qi and the lung loss propagating and descending.In view of the above,based on the theory of"relevance of lung and stomach",this article analyzed the modern mechanism of"relevance of lung and stomach"in gastroesophageal reflux related cough,which included"microinhalation"theory,"esophagus-bronchial reflex"theory,and"airway neurogenic inflammation"theory.This article also put forward the TCM disease name of"gastric cough",and the treatment methods of"simultaneous treatment of lung and stomach"and"treatment of cough from stomach",which would provide new ideas for the theoretical and mechanism research of TCM treatment of gastroesophageal reflux related cough.

OBJECTIVESTo summarize the results of liver transplantation for various end-stage liver diseases at the Sun Yat-Sen University of Medical Sciences (SUMS), define the role of liver transplantation in the treatment of hepatocellular carcinoma and fulminant hepatitis B, and assess the efficiency of lamivudine on preventing HBV recurrence.

METHODSSeventy liver transplants performed at the SUMS between April 1993 and December 2000 were retrospectively analyzed. The main indications for liver transplant were hepatocellular carcinoma (26 cases), liver cirrhosis (21 cases), fulminant hepatitis B (12 cases), sclerosing cholangitis (4 cases) and other terminal liver diseases (7 cases). Lamivudine was used in twelve patients suffering from fulminant hepatitis B. Logistic multivariate regression analysis was applied to determine the risk factors predicting liver transplantation outcomes.

RESULTSFifty-four patients survived for more than one month, and 16 patients died within 30 days after orthotopic liver transplantation (OLT). The overall hospital survival rate was 77.1%. The hospital survival rates in the Child's A and B patients were 87.5% and 83.3%, respectively. Those rates were superior to those of the Child's C patients (P < 0.05). The outcome of patients with small hepatocellular carcinoma (HCC) was superior to that of patients with large HCC. Preoperative APACE III scores, the severity of ascites and serum creatine level had independent influence on outcome. Of the patients with fulminant HBV infection, 9 recipients survived for a follow-up period of 2 - 24 months. Treatment with lamivudine monotherapy was both well tolerated and efficacious in patients with fulminant hepatitis B.

CONCLUSIONSThe results indicate that orthotopic liver transplantation could provide long-term cure and palliation for patients with HCC, and that patient selection is extremely important in predicting outcome. The results support the continued application of liver transplantation as a therapeutic modality for various end-stage liver diseases and that lamivudine is an effective and safe monotherapy in OLT for patients with HBV infection.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; mortality ; surgery ; Child ; Child, Preschool ; China ; Cholangitis, Sclerosing ; mortality ; surgery ; Female ; Follow-Up Studies ; Hepatitis B ; mortality ; surgery ; Humans ; Infant ; Liver ; pathology ; surgery ; Liver Cirrhosis ; mortality ; surgery ; Liver Neoplasms ; mortality ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Schools, Medical ; Survival Rate ; Treatment Outcome

Objective To explore the strategies of using psychological crisis intervention in public emergencies.Methods In the early stage,psychological crisis intervention concepts and behavioral responses were formed through literature research and qualitative research methods.Use three rounds of Delphi for expert advice.Three indexes including positive coefficient,authority and coordination were used to test the reliability of expert consultation.Results Overall,it passed 239 out of 269 entries.The first round passed item 210,modified item 18,no consensus item 41;In the second round,8 new entries were added,and 22 entries were deleted through 24 entries.In the third round,there were 5 entries and 16 entries were deleted.The authority coefficient was 0.859,indicating that the experts were very familiar with the items.The coordination coefficient of three rounds of consultations were 0.464,0.696,and 0.407 (P＜0.001)respectively,showing that the coordination degree of experts was excellent,the credibility of feedback was high,and results were highly reliable.Conclusions The strategies of field psychological crisis intervention for public emergencies developed in this study received the consensus by domestic psychological crisis intervention experts,it is will provide a basis for systematic,comprehensive and effective guidance for this work.

Objective:To explore the value of different levels of sonographers and International Ovarian Tumor Analysis (IOTA) simple rules in judging benign and malignant ovarian tumors.Methods:The ultrasound images of 182 patients treated in Beijing Tiantan Hospital, Capital Medical University from January 2017 to November 2020 with ovarian tumors were retrospectively analyzed. The ovarian tumors were diagnosed by two senior sonographers and two junior sonographers without knowing the pathological diagnosis. Another junior sonographer trained in IOTA terminology and simple rules applied IOTA simple rules to diagnose 182 ovarian tumors. The sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis of ovarian tumors by senior sonographers, junior sonographers and IOTA simple rules were calculated using the postoperative pathological diagnosis as the gold standard. The Kappa value was calculated for the consistency between different levels of sonographers and the IOTA simple rules and pathological diagnosis.Results:Of the 182 cases, 61 cases were pathologically benign and 121 cases were pathologically malignant. The diagnostic sensitivity, specificity and accuracy of senior sonographers were 93.4%, 99.2%, 97.2%, respectively, Kappa value was 0.938. The diagnostic sensitivity, specificity, and accuracy of junior sonographers were 80.3%, 90.0%, 86.8%, respectively, Kappa value was 0.704. The diagnostic sensitivity, specificity and accuracy of IOTA simple rules(When an uncertain tumor was classified as malignant) were 95.0%, 73.5%, 80.7%, respectively, Kappa value was 0.614. The diagnostic sensitivity, specificity and accuracy of IOTA simple rules(when an uncertain tumor was excluded) were 94.2%, 90.9%, 92.0%, respectively, Kappa value was 0.834.Conclusions:IOTA simple rules is a very useful diagnostic tool for junior sonographers to judge benign and malignant ovarian tumors. When IOTA simple principle is judged as an uncertain case, it is recommended to refer to experienced senior sonographers for further diagnosis.

Objective:To explore the development trend of the combination of medical treatment and endowment and nursing by analyzing the keywords related to the combination of medical treatment and endowment and nursing in China from 2005 to 2017.Methods:Relevant articles about the combination of medical treatment and endowment which were published up to April 22, 2018 were retrieved from Wanfang, CNKI and VIP databases, and descriptive statistical methods were used to analyze the publication sources, number of keywords, word frequency, value of popularity, word meaning, etc.Results:Totally 5 704 articles were identified, and 1 655 were left after screening. The research on nursing started late among all researches on the combination of Chinese medical treatment and endowment, and there were few literatures, which had not received widespread attention from nursing journals. The proportion of Chinese nursing-related research in the combination of medical treatment and endowment was low. The keyword most concerned about was "senior caregivers". There was a lacking of technical and professional nursing research as well as specific discussions related to home care for the elderly.Conclusions:We should promote multi-angle and multi-level systematic nursing research, strengthen professional research in the combination of medical treatment and endowment and home care for the elderly, and provide technical support and practical basis for improving China's knowledge system of "the combination of medical treatment and endowment", and achieving a win-win situation for healthcare providers, caregivers, nurses and patients.