Objective:To analyze the efficacy and safety of modified associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in the treatment of patients with primary liver cancer.Methods:Clinical data of 83 patients with hepatocellular carcinoma (HCC) undergoing hemihepatectomy in the Department of Hepatobiliary and Pancreatic Tumor Surgery of Gansu Provincial Cancer Hospital between January 2022 and November 2023 were retrospectively analyzed, including 53 males and 30 females, aged (54.0±6.5) years. According to the treatment protocol, patients were divided into the control group ( n=41), in which patients underwent traditional ALPPS, and the observation group ( n=42), in which patients underwent modified ALPPS (occlusion of portal venous branch using vascular clips, combined with radiofrequency ablation for physical separation of the diseased lobe, without liver mobilization). The completion rate of staged surgery, interval between surgeries, future liver remnant (FLR) growth rate at 7 days after first-stage surgery, alanine transaminase (ALT) and aspartate transaminase (AST) levels at 5 days after fisrt-stage surgery, and postoperative complications (ascites, nausea, and vomiting, etc.) were compared between the groups. Results:The completion rate of staged surgery was 95.2% (40/42) in the observation group and 90.2% (37/41) in the control group ( χ2=0.62, P=0.431). The ALT and AST levels at 5 days after first-stage surgery were (550.4±86.0) U/L and (327.1±52.8) U/L in the observation group, respectively, which were significantly lower than those in the control group (861.6±106.3) U/L and (533.8±73.7) U/L, respectively ( t=13.13 and P<0.001, t=12.93 and P<0.001). The FLR growth rate were higher in the observation group than that in the control group [(80.4±10.3)% vs (49.3±5.7)%; t=13.13, P<0.001] and the interval between procedures were also shorter in the observation group (10.9±2.1 vs 22.4±4.8, d; t=9.65, P<0.001). The intraoperative blood loss of the first-stage surgery was lower in the observation group than that in the control group (350.5±45.2 vs 825.5±21.7, ml; t=21.43, P<0.001). The total complication rates after the first-stage surgery were 11.9% (5/42) in the observation group and 19.5% (8/41) in the control group, while after the second-stage surgery, the complication rates were 7.5% (3/40) and 18.9% (7/37), respectively, with no statistically significant differences ( χ2=0.65 and P=0.419, χ2=1.81 and 0.177, respectively). Conclusion:The modified ALPPS offers better postoperative liver function, reduced surgical trauma, accelerated FLR growth, and a shorter interval between procedures, demonstrating a favorable safety in the treatment of primary liver cancer.

Depressive disorder is a common psychiatric condition clinically characterized by impaired cognitive function， which profoundly affects patients' daily living and social functioning. Despite extensive research on the mechanism underlying the interaction between ghrelin and depressive disorder， comprehensive reviews， summary， and systematic organization of these findings remain lacking. To address this gap， this study aims to conduct a systematic evaluation of the effects and mechanisms of ghrelin on cognitive function in patients with depressive disorder， thereby providing references for targeted clinical interventions. On October 20， 2024， literature exploring the role and mechanisms of ghrelin in improving cognitive function in depressive disorder was sourced from the CNKI， PubMed and Web of Science databases， covering the period from the inception of the database till October 20， 2024. Two researchers independently conducted literature screening and data extraction. Ultimately， 9 articles were included in this review. The findings suggest that ghrelin improves cognitive function in patients with depressive disorder through multiple mechanisms， including mitigating inflammatory responses， modulating oxidative stress， and activating the cyclic adenosine monophosphate response element binding protein-brain-derived neurotrophic factor （CREB-BDNF） signaling pathway.

Objective:To analyze the detection of obesity with reduced muscle mass under different evaluation criteria and its association with metabolic abnormalities.Methods:This cross-sectional study consecutively enrolled 3 740 participants who underwent health examinations at the Health Management Center of the First Affiliated Hospital of Guangxi Medical University from January to December in 2023. Body composition parameters, including body mass index (BMI), body fat percentage (BFP), visceral fat area (VFA), waist circumference (WC), waist-to-hip ratio (WHR), and skeletal muscle mass index (SMI) were obtained via bioelectrical impedance analysis (BIA) using a standardized body composition analyzer. The waist-to-height ratio (WHtR) was calculated from these measurements. The blood lipids, blood pressure, blood glucose, and serum uric acid were also assessed. The consistency in detecting obesity with reduced muscle mass under different evaluation criteria was analyzed using the kappa test, and the association between obesity with reduced muscle mass and metabolic abnormalities was examined via the chi-square test.Results:Among the 3 740 participants included in the analysis, 2 105 were male and 1 635 were female. The detection rates of obesity with reduced muscle mass ranged from 0-3.8% in males and 0-12.7% in females. When using BMI+SMI as the evaluation criterion, only one case (0.1%) was identified with obesity and reduced muscle mass. For other criteria-BFP+SMI, VFA+SMI, WC+SMI, WHR+SMI, and WHtR+SMI-the detection rates in males was 3.8%, 2.0%, 1.0%, 3.5%, and 3.0%, respectively, while in females, it was 12.7%, 6.5%, 0.2%, 10.1%, and 3.9%, respectively. Notably, the BFP+SMI, VFA+SMI, and WHtR+SMI criteria demonstrated moderate to good inter-rater agreement ( kappa>0.4), particularly in males ( kappa>0.6) (all P<0.05). In females, the prevalence of hypertension was significantly higher in the obesity with reduced muscle mass-positive group compared to the negative group when using BFP+SMI, VFA+SMI, WHR+SMI, and WHtR+SMI criteria (20.3% vs 10.9%, 26.4% vs 11.1%, 20.0% vs 11.2%, and 25.4% vs 11.6%)(all P<0.05). When BFP+SMI and VFA+SMI were used as evaluation criteria, the detection rate of glucose metabolism disorders were higher in individuals who are positive for obesity combined with reduced muscle mass than in those who were negative (43.9% vs 36.4%, 48.6% vs 36.6%) (both P<0.05). In males, the WHtR+SMI criterion identified a significantly elevated prevalence of abnormal serum uric acid levels in the obesity with reduced muscle mass-positive group compared to the negative group (42.9% vs 30.2%) ( P<0.05). Conclusion:Compared to alternative adiposity metrics, the evaluation criteria incorporating BFP, VFA and WHtR demonstrate significantly stronger associations between obesity with reduced muscle mass and metabolic abnormalities.

Objective:To analyze the efficacy and safety of modified associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in the treatment of patients with primary liver cancer.Methods:Clinical data of 83 patients with hepatocellular carcinoma (HCC) undergoing hemihepatectomy in the Department of Hepatobiliary and Pancreatic Tumor Surgery of Gansu Provincial Cancer Hospital between January 2022 and November 2023 were retrospectively analyzed, including 53 males and 30 females, aged (54.0±6.5) years. According to the treatment protocol, patients were divided into the control group ( n=41), in which patients underwent traditional ALPPS, and the observation group ( n=42), in which patients underwent modified ALPPS (occlusion of portal venous branch using vascular clips, combined with radiofrequency ablation for physical separation of the diseased lobe, without liver mobilization). The completion rate of staged surgery, interval between surgeries, future liver remnant (FLR) growth rate at 7 days after first-stage surgery, alanine transaminase (ALT) and aspartate transaminase (AST) levels at 5 days after fisrt-stage surgery, and postoperative complications (ascites, nausea, and vomiting, etc.) were compared between the groups. Results:The completion rate of staged surgery was 95.2% (40/42) in the observation group and 90.2% (37/41) in the control group ( χ2=0.62, P=0.431). The ALT and AST levels at 5 days after first-stage surgery were (550.4±86.0) U/L and (327.1±52.8) U/L in the observation group, respectively, which were significantly lower than those in the control group (861.6±106.3) U/L and (533.8±73.7) U/L, respectively ( t=13.13 and P<0.001, t=12.93 and P<0.001). The FLR growth rate were higher in the observation group than that in the control group [(80.4±10.3)% vs (49.3±5.7)%; t=13.13, P<0.001] and the interval between procedures were also shorter in the observation group (10.9±2.1 vs 22.4±4.8, d; t=9.65, P<0.001). The intraoperative blood loss of the first-stage surgery was lower in the observation group than that in the control group (350.5±45.2 vs 825.5±21.7, ml; t=21.43, P<0.001). The total complication rates after the first-stage surgery were 11.9% (5/42) in the observation group and 19.5% (8/41) in the control group, while after the second-stage surgery, the complication rates were 7.5% (3/40) and 18.9% (7/37), respectively, with no statistically significant differences ( χ2=0.65 and P=0.419, χ2=1.81 and 0.177, respectively). Conclusion:The modified ALPPS offers better postoperative liver function, reduced surgical trauma, accelerated FLR growth, and a shorter interval between procedures, demonstrating a favorable safety in the treatment of primary liver cancer.

Objective:To analyze the detection of obesity with reduced muscle mass under different evaluation criteria and its association with metabolic abnormalities.Methods:This cross-sectional study consecutively enrolled 3 740 participants who underwent health examinations at the Health Management Center of the First Affiliated Hospital of Guangxi Medical University from January to December in 2023. Body composition parameters, including body mass index (BMI), body fat percentage (BFP), visceral fat area (VFA), waist circumference (WC), waist-to-hip ratio (WHR), and skeletal muscle mass index (SMI) were obtained via bioelectrical impedance analysis (BIA) using a standardized body composition analyzer. The waist-to-height ratio (WHtR) was calculated from these measurements. The blood lipids, blood pressure, blood glucose, and serum uric acid were also assessed. The consistency in detecting obesity with reduced muscle mass under different evaluation criteria was analyzed using the kappa test, and the association between obesity with reduced muscle mass and metabolic abnormalities was examined via the chi-square test.Results:Among the 3 740 participants included in the analysis, 2 105 were male and 1 635 were female. The detection rates of obesity with reduced muscle mass ranged from 0-3.8% in males and 0-12.7% in females. When using BMI+SMI as the evaluation criterion, only one case (0.1%) was identified with obesity and reduced muscle mass. For other criteria-BFP+SMI, VFA+SMI, WC+SMI, WHR+SMI, and WHtR+SMI-the detection rates in males was 3.8%, 2.0%, 1.0%, 3.5%, and 3.0%, respectively, while in females, it was 12.7%, 6.5%, 0.2%, 10.1%, and 3.9%, respectively. Notably, the BFP+SMI, VFA+SMI, and WHtR+SMI criteria demonstrated moderate to good inter-rater agreement ( kappa>0.4), particularly in males ( kappa>0.6) (all P<0.05). In females, the prevalence of hypertension was significantly higher in the obesity with reduced muscle mass-positive group compared to the negative group when using BFP+SMI, VFA+SMI, WHR+SMI, and WHtR+SMI criteria (20.3% vs 10.9%, 26.4% vs 11.1%, 20.0% vs 11.2%, and 25.4% vs 11.6%)(all P<0.05). When BFP+SMI and VFA+SMI were used as evaluation criteria, the detection rate of glucose metabolism disorders were higher in individuals who are positive for obesity combined with reduced muscle mass than in those who were negative (43.9% vs 36.4%, 48.6% vs 36.6%) (both P<0.05). In males, the WHtR+SMI criterion identified a significantly elevated prevalence of abnormal serum uric acid levels in the obesity with reduced muscle mass-positive group compared to the negative group (42.9% vs 30.2%) ( P<0.05). Conclusion:Compared to alternative adiposity metrics, the evaluation criteria incorporating BFP, VFA and WHtR demonstrate significantly stronger associations between obesity with reduced muscle mass and metabolic abnormalities.

Objective Establish a standardized evaluation system for medical faults,and provide theoretical basis for medical institutions and related industries to evaluate the illegality of medical behaviors.Methods Based on a litera-ture review,the medical fault assessment system was initially constructed,and then a research group was estab-lished to use Delphi method to invite 31 experts to evaluate the importance and feasibility of each article of the medi-cal fault assessment system and put forward suggestions for modification.Results The effective recovery rates of the two rounds of expert consultation were 83.9％and 96.8％,the expert authority coefficient was 0.902 and 0.887,and the Kendall's W test of all levels differences were statistically significant(P＜0.001).The medical fault assess-ment system finally constructed includes 5 first-level items including practicing medicine according to law,informed notification,diagnosis and treatment technology,medical record documents and hospital management,as well as 10 second-level items,20 third-level items and 47 fourth-level items.The mean values of importance and feasibili-ty scores of all articles were greater than 4,standard deviations were less than 1,and coefficients of variation were less than 0.2.Conclusion The medical fault standardized evaluation system is scientific,reliable,innovative and appli-cable.

Objective Establish a standardized evaluation system for medical faults,and provide theoretical basis for medical institutions and related industries to evaluate the illegality of medical behaviors.Methods Based on a litera-ture review,the medical fault assessment system was initially constructed,and then a research group was estab-lished to use Delphi method to invite 31 experts to evaluate the importance and feasibility of each article of the medi-cal fault assessment system and put forward suggestions for modification.Results The effective recovery rates of the two rounds of expert consultation were 83.9％and 96.8％,the expert authority coefficient was 0.902 and 0.887,and the Kendall's W test of all levels differences were statistically significant(P＜0.001).The medical fault assess-ment system finally constructed includes 5 first-level items including practicing medicine according to law,informed notification,diagnosis and treatment technology,medical record documents and hospital management,as well as 10 second-level items,20 third-level items and 47 fourth-level items.The mean values of importance and feasibili-ty scores of all articles were greater than 4,standard deviations were less than 1,and coefficients of variation were less than 0.2.Conclusion The medical fault standardized evaluation system is scientific,reliable,innovative and appli-cable.

Objective Establish a standardized evaluation system for medical faults,and provide theoretical basis for medical institutions and related industries to evaluate the illegality of medical behaviors.Methods Based on a litera-ture review,the medical fault assessment system was initially constructed,and then a research group was estab-lished to use Delphi method to invite 31 experts to evaluate the importance and feasibility of each article of the medi-cal fault assessment system and put forward suggestions for modification.Results The effective recovery rates of the two rounds of expert consultation were 83.9％and 96.8％,the expert authority coefficient was 0.902 and 0.887,and the Kendall's W test of all levels differences were statistically significant(P＜0.001).The medical fault assess-ment system finally constructed includes 5 first-level items including practicing medicine according to law,informed notification,diagnosis and treatment technology,medical record documents and hospital management,as well as 10 second-level items,20 third-level items and 47 fourth-level items.The mean values of importance and feasibili-ty scores of all articles were greater than 4,standard deviations were less than 1,and coefficients of variation were less than 0.2.Conclusion The medical fault standardized evaluation system is scientific,reliable,innovative and appli-cable.

Objective Establish a standardized evaluation system for medical faults,and provide theoretical basis for medical institutions and related industries to evaluate the illegality of medical behaviors.Methods Based on a litera-ture review,the medical fault assessment system was initially constructed,and then a research group was estab-lished to use Delphi method to invite 31 experts to evaluate the importance and feasibility of each article of the medi-cal fault assessment system and put forward suggestions for modification.Results The effective recovery rates of the two rounds of expert consultation were 83.9％and 96.8％,the expert authority coefficient was 0.902 and 0.887,and the Kendall's W test of all levels differences were statistically significant(P＜0.001).The medical fault assess-ment system finally constructed includes 5 first-level items including practicing medicine according to law,informed notification,diagnosis and treatment technology,medical record documents and hospital management,as well as 10 second-level items,20 third-level items and 47 fourth-level items.The mean values of importance and feasibili-ty scores of all articles were greater than 4,standard deviations were less than 1,and coefficients of variation were less than 0.2.Conclusion The medical fault standardized evaluation system is scientific,reliable,innovative and appli-cable.

Objective Establish a standardized evaluation system for medical faults,and provide theoretical basis for medical institutions and related industries to evaluate the illegality of medical behaviors.Methods Based on a litera-ture review,the medical fault assessment system was initially constructed,and then a research group was estab-lished to use Delphi method to invite 31 experts to evaluate the importance and feasibility of each article of the medi-cal fault assessment system and put forward suggestions for modification.Results The effective recovery rates of the two rounds of expert consultation were 83.9％and 96.8％,the expert authority coefficient was 0.902 and 0.887,and the Kendall's W test of all levels differences were statistically significant(P＜0.001).The medical fault assess-ment system finally constructed includes 5 first-level items including practicing medicine according to law,informed notification,diagnosis and treatment technology,medical record documents and hospital management,as well as 10 second-level items,20 third-level items and 47 fourth-level items.The mean values of importance and feasibili-ty scores of all articles were greater than 4,standard deviations were less than 1,and coefficients of variation were less than 0.2.Conclusion The medical fault standardized evaluation system is scientific,reliable,innovative and appli-cable.