Objective To investigate the application of molecular absorbent recycling system (MARS) in auto liver transplantation (ALT).Methods The clinical data of 46 patients who underwent ALT in Zhongnan Hospital of Wuhan University from September 2014 to August 2015 were retrospectively studied.The patients were randomly divided into the MARS group (n =30) and the hemodialysis group (n =16).In the MARS group,20 patients were male and 10 were female with an average age of (15 ±67) years,and the median age was 46.In the hemodialysis group,8 were male and 8 were female with an average age of (22 ± 54) years.A heparinized left iliac vein was linked to a centrifugal pump of a MARS and an output tube was linked to a left jugular vein.Before the anhepatic phase,physical pretreatment was carried out by ligating the porta hepatis and inferior vena cava (IVC) to adapt the patient to the anhepatic phase.Subsequently,a bypass was established followed by ligation of the IVC.The duration of operation,length of stay in ICU after operation,one-year survival rate and hepatorenal function were studied.Results The duration of operation in the MRAS group and in the hemodialysis group was not significantly different (P ＞0.05).The length of stay in ICU after operation in the MARS group was (12.0 ±3.0) d,which was significantly shorter than that of the hemodialysis group (20.0 ± 2.0) d (P ＜ 0.05).The one-year survival rate in the MARS group was (100％),which was significantly higher than that of the hemodialysis group (93.8％,P ＜0.05).Conclusion The application of MARS in ALT shortened the length of stay in hospital and improved one-year survival rate,resulting in better outcomes than the conventional method.

Objective:To evaluate the effect of the tight-knit medical association model of precise assistance on nursing quality in assisted hospitals.Methods:The tight-knit medical association model of precise assistance was applied to the assisted hospital, the first stage assistance was provided from January 2015 to December 2016 and the second stage assistance was provided from January 2017 to December 2018. Before the assistance (December 2014) , after the assistance (December 2016) and the second year after the assistance (December 2018) , a total of 210 nurses and 210 patients were respectively selected to investigate the satisfaction with the convenient sampling method. The incidences of falls, in-hospital stress injuries and unplanned extubation in the assisted hospital before and after the assistance were compared.Results:In the second year after assistance, the satisfaction rate of nurses in the assisted hospital was 90.476% (190/210) , which was higher than 69.524% (146/210) before assistance and 78.571% (165/210) after assistance, and the differences were statistically significant ( P<0.01) . In the second year after the assistance, the satisfaction rate of patients in the assisted hospital was 93.810% (197/210) , which was higher than 72.381% (152/210) before the assistance and 82.857% (174/210) after the assistance, and the differences were statistically significant ( P<0.01) . After the assistance, the incidences of falls, in-hospital stress injuries and unplanned extubation of patients in the assisted hospital were lower than those before the assistance, and the differences were statistically significant ( P< 0.05) . Conclusions:The tight-knit medical alliance model of precise assistance can improve the satisfaction of nurses' and patients' satisfaction with nursing work in the assisted hospitals and reduce the incidences of falls, in-hospital stress injuries and unplanned extubation, which can improve nursing quality in assisted hospitals.

Delirium evaluation is important for early recognition and management of delirium. The extensive application of information technology in the medical field, provides a favorable condition for delirium patients' evaluation. In this paper, clinical application and status of information technology in delirium evaluation are reviewed, in order to provide theoretical basis and reference for the informatization of delirium assessment in China.

Objective To prepare diosmin suppository and establish a method for its quality control.Methods Diosmin was used as active ingredient.Polyethylene glycol 6000, polyethylene glycol 400 and glycerol were chosen as substrates.Fusion method was applied to prepare the diosmin suppository.The appearance, content uniformity, weight variation and melting time of suppository were evaluated.Results The diosmin suppository has brown color with good hardness at room temperature.The content uniformity, weight variation, melting time and dissolution rate meet the requirements of quality control.Conclusion The diosmin suppository prepared by this method was satisfied the quality requirements of suppository and serves as a new formulation of diosmin.

Objective To investigate the changes of event-related potentials (ERPs) in patients with intelligence impairments after craniocerebral trauma.Methods 60 patients with intelligence impairments after craniocerebral trauma were enrolled as case group,and 60 healthy subjects were enrolled as control group.EEG instrument was used to record P300 and P50 of the two groups and the differences in P300 and P50 components were compared.Results There are significant differences between case group and control group in latency of P300 ((440.430 ± 77.367) ms vs (342.928 ± 36.175) ms,P＜ 0.01),and case group showed decreased amplitude ((12.692±8.152) μV vs (18.138±6.590) μV,P＜0.01).The S2-P50 amplitude of case group was significantly higher than that of control group ((3.75± 1.59) μV vs (2.42±1.43) μV,P＜0.01).In addition,the S2-P50 amplitude/S1-P50 amplitude ratio of case group was higher than that of the control group,and the difference was statistically significant (0.78±0.54 vs 0.46±0.18,P＜0.01).The latency and amplitude of P300 were significantly correlated with the total score of WAIS-RC (r=-0.31,P＜0.01;r=0.17,P＜0.01);The amplitude of S2-P50 and the ratio of S2-P50 amplitude to S1-P50 amplitude were significantly negatively correlated with the total score of WAIS-RC (r=-0.33,P＜0.01;r=-0.45,P＜0.01).Conclusion P300 and P50 components of ERP can provide references for judicial expertise to evaluate intelligence impairments after craniocerebral trauma.

Objective To explore relevant factors of drinking relapse after alcohol withdrawal for patients with alcohol dependence. Methods 130 patients with pure alcohol dependence who were admitted from January 2012 to February 2013 were selected. They received withdrawal treatment and were followed-up after discharge. They were assigned to relapse group and non-relapse group. The relations between drinking relapse and clinical characteristics, socio-demographic data, family environment and cognitive functions during withdrawal period in the two groups were analyzed. Results Excepted for 21 patients who were out of touch, there were 67 patients in the relapse group and 42 patients in the non-relapse group. Amount of drinking, frequency of drinking, personality changes, emotional symptoms, being single/divorced, finan-cial situation, education years, and family history of alcoholism before the treatment between the two groups were signifi-cantly different (P<0.05). Intimacy, emotional expression, independence, entertainment, organization, controlling and con-tradictoriness in the family environment between the two groups were significantly different (P<0.05). During withdrawal pe-riod, total response number, number of completed classification and correct response rate of attention (DST and CPT-IP), memory (S/VM, SS and DS) and execution (WCST) between the two groups were significantly different (P<0.05). Amount of drinking, emotional symptoms, family intimacy, family organization, family independence, attention and execu-tion were independent influencing factors of drinking relapse for patients with alcohol dependence after withdrawal (P<0.05). Conclusion Patients with alcohol dependence have a large capacity for alcohol previously, and patients with emo-tional symptoms, in lack of intimacy, organization and independence in family environment, or in lack of attention and ex-ecution during withdrawal period are highly likely to relapse. Management of family environment and psychological thera-py should be attached great importance so as to improve patients' cognitive function during withdrawal period.

Objective? To evaluate the influence of resistance training on exercise endurance, pulmonary function and quality of life in the patients with chronic obstructive pulmonary disease(COPD). Methods? Pubmed, Cochrane Library, Embase, Web of Science, Science Direct, CNKI, VIP, WanFang Database and Chinese biomedical literature database (CBM) were searched for Randomized Controlled Trails (RCT) studying the effects of resistance training in COPD patients from database establishment date to August 2018. Meta-analysis was conducted using Revman 5.3. Results? The Meta-analysis result showed that the differences in six-minute walk distance (6MWD), numbers of turns on 6-minute pegboard and ring test (6PBRT), forced exhalation volume in one second (FEV1), the first second forced vital capacity percentage of expected value (FEV1%pre), forced vital capacity(FVC), the ratio of the first second forced vital capacity in forced vital capacity (FEV1/FVC%) between resistance training group and control group were statistically significant (P＜ 0.05). But there were no significant differences in the scores from health survey (SF-36), Chronic Respiratory Disease Questionnaire (CRDQ) or the COPD Assessment Test (CAT) between the two groups (P＞0.05). There may be publication bias. Conclusions? Resistance training is effective to improve exercise endurance, pulmonary function, while the effects on quality of life is not significant in patients with COPD.

Objective:To invastigate the targets and signaling pathways of Gubiao Fanggan Modified Formula in regulating the defense against influenza A virus in immunosuppressed mice by network pharmacology,and the key targets were verified by immuno-suppressive mice model.Methods:TCMSP database was used to search the active ingredients of Gubiao Fanggan Modified Formula,and GeneCard,OMIM,PharmGkb databases were used to obtain the potential targets of the active ingredients to prevent influenza,and take their intersection targets were taken;STRING11.5 database was used to make protein-protein interaction network analyzed and finded the core targets;Cytoscape3.8.1 was used to build a traditional Chinese medicine-ingredient-disease target network,and GO enrichment analysis and KEGG enrichment analysis were performed.Intraperitoneal injection of cyclophosphamide was used to construct a mouse model of immune function suppression,normal group,model control group,Gubiao Fanggan Modified Formula group and oseltamivir group were set up,followed by prophylactic administration,and influenza virus intervention was performed on the fourth day.After 7 days of intragastric administration,the key targets were verified by mouse spleen index,HE staining,RT-qPCR and immunohistochemistry.Results:There were 82 active ingredients in five traditional Chinese medicines in Gubiao Fanggan Modi-fied Formula,and 72 common targets of drugs and diseases such as IL-6,TNF-α,IL-2,etc,mainly involving IL-17,TNF and AGE-RAGE signaling pathway.Gubiao Fanggan Modified Formula could increase spleen index and significantly reduce mRNA and protein expressions of IL-6 and TNF-α in spleen tissue of mice(P<0.05 or P<0.01).Conclusion:Gubiao Fanggan Modified Formula may regulate body's immune function through targets such as IL-6 and TNF-α,thereby preventing influenza virus infection.

Objective:This study investigates the influence of the apolipoprotein E ε4(APOE ε4)genotype on the relationship between glucose-lipid metabolism disorders and diabetes-related cognitive impairment(DCI).Methods:A case-control study was conducted involving 891 patients with type 2 diabetes mellitus(T2DM)with a mean age of(62.1±13.8)years, all of whom underwent elective surgery at the First Hospital of Shanxi Medical University between January 2017 and December 2022.Among these participants, 229 were diagnosed with DCI(case group), while 662 were cognitively normal(control group).Routine clinical information was collected, and peripheral venous blood samples were analyzed for glycated hemoglobin(HbA1c)and blood lipid levels.The single nucleotide polymorphisms rs429358 and rs7412 were analyzed to determine the presence of the APOE ε4 genotype.Stepwise Logistic regression was employed to identify independent risk factors for DCI, and subgroup analyses were performed to evaluate the effect of the APOE ε4 genotype on the relationship between HbA1c and blood lipid levels in relation to DCI risk. Results:Among all patients, female gender( OR=1.915, 95% CI: 1.393-2.631, P<0.001), longer duration of T2DM( OR=1.169, 95% CI: 1.087-1.257, P<0.001), elevated triglycerides( OR=1.161, 95% CI: 1.041-1.294, P=0.007), and being an APOE ε4 carrier( OR=1.638, 95% CI: 1.115-2.405, P=0.012)were identified as independent risk factors for developing DCI.High levels of low-density lipoprotein(LDL)were found to be independently associated with an increased risk of DCI specifically in APOE ε4 carriers( OR=1.408, 95% CI: 1.060-1.870, P=0.018), but not in non-APOE ε4 carriers( P>0.05).In contrast, elevated HbA1c was independently associated with a higher risk of DCI in non-APOE ε4 carriers( OR=1.220, 95% CI: 1.040-1.430, P=0.014), but not in APOE ε4 carriers( P>0.05).Additionally, elevated triglycerides were independently linked to an increased risk of DCI across the entire sample and within each APOE ε4 genotype subgroup. Conclusions:The APOE genotype plays a significant role in modulating the relationship between dyslipidemia and the risk of developing DCI.This highlights the critical importance of lipid metabolism disorders and APOE risk genes in both the development and progression of DCI.These findings offer valuable insights for future clinical and mechanistic studies focused on DCI.