Objective:Hepatic fibrosis is a common pathological basis for many chronic liver diseases and can progress to cirrhosis,a leading cause of mortality in liver diseases.Early identification and reversal of hepatic fibrosis are key in the treatment of chronic liver disease.This study aims to compare the expression levels of serum core fucosylated low molecular weight kininogen(LMWK-Fc)and alpha-galactosylated(α-Gal)antibodies in patients with hepatic fibrosis at different stages,and to evaluate their diagnostic efficacy for hepatic fibrosis. Methods:A retrospective analysis was conducted on 275 patients with chronic liver disease who visited the Department of Infectious Diseases at the Second Xiangya Hospital of Central South University between June 2022 and March 2023.Among these,115 patients underwent liver biopsy.Based on the extent of collagen deposition and its impact on liver structure and microcirculation,patients were staged from 0 to 4:S0(no significant collagen deposition in liver tissues;liver structure and microcirculation are normal),S1(mild collagen deposition in liver tissues,with partial disruption of lobule structure,but microcirculation remains largely normal),S2(moderate collagen deposition in liver tissues,with partial disruption of lobule structure and microcirculation),S3(extensive collagen deposition in liver tissues,with substantial disruption of lobule structure and microcirculation),and S4(development of cirrhosis,with heavy collagen deposition,complete disruption of lobule structure,and severe impairment of microcirculation).Patients were grouped as no fibrosis(S0),fibrosis(S1-S2),and significant fibrosis(S3-S4).For the 160 patients without liver biopsy,they were categorized based on liver stiffness measurement(LSM)value:no fibrosis(F0:LSM＜7.3 kPa),fibrosis(F1-F2:LSM 7.3-12.4 kPa),and significant fibrosis(F3-F4:LSM＞12.4 kPa).Demographic data(age,gender)and laboratory indicators(alanine transaminase,aspartate transaminase,gamma-glutamyl transferase,alkaline phosphatase,alpha-fetoprotein,platelet count)were collected to calculate the fibrosis-4 index(FIB-4)and aspartate aminotransferase-to-platelet ratio index(APRI).Serum LMWK-Fc and α-Gal antibodies were measured and compared across the groups,and their correlation with fibrosis severity was analyzed.The receiver operating characteristic(ROC)curve was used to assess the predictive value of serum LMWK-Fc and α-Gal antibody levels for hepatic fibrosis. Results:Among the 160 patients without complete liver biopsy,serum α-Gal antibody and LMWK-Fc levels increased progressively from the no fibrosis group to the significant fibrosis group,with statistically significant differences(P＜0.05).Among the 115 patients with liver biopsy,serum LMWK-Fc levels were significantly higher in the fibrosis group and the significant fibrosis groups compared with the no fibrosis group,and α-Gal antibody levels were significantly higher in the significant fibrosis group compared with the no fibrosis group and the fibrosis group(P＜0.001,P=0.032,respectively).Univariate and multivariate linear regression analyses showed that hepatic fibrosis was correlated with gender and LMWK-Fc levels(both P＜0.05),but not with age,α-Gal antibody levels,FIB-4,or APRI(all P＞0.05). Conclusion:The expression levels of serum LMWK-Fc and α-Gal antibodies vary across different stages of hepatic fibrosis,suggesting a potential association with fibrosis progression.LMWK-Fc levels have a certain predictive value for the diagnosis of hepatic fibrosis.

Objective:To explore the prospects of ovarian tissue oocyte- in vitro maturation (OTO-IVM) in fertility preservation for patients with malignancy. Methods:OTO-IVM outcomes from 27 malignant tumor patients who underwent fertility preservation in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-Sen University from March 2017 to August 2022 were analyzed, including the number of mature oocytes (M II oocytes), maturation rate, and maturation time. The fertilization rate, the cleavage rate, and the embryonic development potential of IVM-derived M II were also analyzed. Further, the short-term use of gonadotropin (Gn) in OTO-IVM before ovarian tissue acquisition was initially explored. Results:After OTO-IVM, 81.48% (22/27) of patients had at least one M II oocyte, with a mean number of M II oocytes of 3.00 (1.50, 7.00) and a maturation rate of 38.81%. About 4.85% (13/268) of oocytes matured within 24 h; 14.93% (40/268) matured between 24 h and 36 h; 16.79% (45/268) matured between 36 h and 48 h, and only 2.24% (6/268) matured after 48 h. A total of 41 M II oocytes from 4 patients were fertilized by intracytoplasmic sperm injection (ICSI), with a fertilization rate of 85.37% (35/41), cleavage rate of 94.29% (33/35), variable embryo rate of 54.29% (19/35), and high-quality embryo rate of 34.29% (12/35). The IVM rate was significantly higher in patients who used Gn than in those who did not [63.16% (48/76) vs. 29.17% (56/192), P<0.001]. Conclusion:OTO-IVM can be used as a complementary method for fertility preservation in oncology patients and obtain a certain number of oocytes and embryos. Short-term use of Gn before ovarian tissue acquisition can improve oocyte maturation rate, but further studies are needed to verify the value of Gn in OTO-IVM.

Objective:To explore the prospects of ovarian tissue oocyte- in vitro maturation (OTO-IVM) in fertility preservation for patients with malignancy. Methods:OTO-IVM outcomes from 27 malignant tumor patients who underwent fertility preservation in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-Sen University from March 2017 to August 2022 were analyzed, including the number of mature oocytes (M II oocytes), maturation rate, and maturation time. The fertilization rate, the cleavage rate, and the embryonic development potential of IVM-derived M II were also analyzed. Further, the short-term use of gonadotropin (Gn) in OTO-IVM before ovarian tissue acquisition was initially explored. Results:After OTO-IVM, 81.48% (22/27) of patients had at least one M II oocyte, with a mean number of M II oocytes of 3.00 (1.50, 7.00) and a maturation rate of 38.81%. About 4.85% (13/268) of oocytes matured within 24 h; 14.93% (40/268) matured between 24 h and 36 h; 16.79% (45/268) matured between 36 h and 48 h, and only 2.24% (6/268) matured after 48 h. A total of 41 M II oocytes from 4 patients were fertilized by intracytoplasmic sperm injection (ICSI), with a fertilization rate of 85.37% (35/41), cleavage rate of 94.29% (33/35), variable embryo rate of 54.29% (19/35), and high-quality embryo rate of 34.29% (12/35). The IVM rate was significantly higher in patients who used Gn than in those who did not [63.16% (48/76) vs. 29.17% (56/192), P<0.001]. Conclusion:OTO-IVM can be used as a complementary method for fertility preservation in oncology patients and obtain a certain number of oocytes and embryos. Short-term use of Gn before ovarian tissue acquisition can improve oocyte maturation rate, but further studies are needed to verify the value of Gn in OTO-IVM.

Objective: To investigate the effects of embryonic inflammation on the hippocampal synaptosomal-associated protein 25(SNAP-25) level and cognitive function in middle-aged. Methods: During gestational days 15-17, the CD-1 maternal mice received a daily intraperitoneal injection of lipopolysaccharides(LPS, 50 μg/kg) or the equal volume of normal saline, and the corresponding offspring were regarded as LPS group and CON group respectively. At the age of young(3-month-old) and middle-aged(15-month-old), the spatial learning and memory ability was assessed using Morris water maze(MWM), and the expression of hippocampal SNAP-25 protein was detected by immunohistochemical method and Western blot. Results: Compared with the 3-month CON group, the 15-month CON group had longer swimming distance(P<0.01), lower swimming distance percentage(P<0.01) in the target quadrant, and higher hippocampal subregions(CA1, CA3, DG) SNAP-25 levels(P<0.01). The same results were obtained in 15-month LPS group compared with 15-month CON group in learning and memory phase(P<0.05), and higher hippocampal subregions(CA1, DG) SNAP-25 levels(P<0.01). Pearson correlation analysis indicated that the hippocampal CA1 and CA3 subregions SNAP-25 level was positively correlated with the swimming distance, but negatively correlated with the percentage of swimming distance in the target quadrant. Conclusion Embryonic inflammation can accelerate the impairment of spatial learning and memory and the increase of hippocampal CA1 and CA3 subregions SNAP-25 protein in middle-aged CD-1 mice, and there may be a correlation between them.

Objective:To explore the feasibility of autologous transplantation of frozen-thawed ovarian tissue to induce pubertal development in adolescent females.Methods:Before hematopoietic stem cell transplantation in patient with severe β-thalassemia, 11 pieces of ovarian tissue were frozen in the Center of Reproductive Medicine, the Sixth Affiliated Hospital of Sun Yat-sen University in 2019. The patient was diagnosed as premature ovarian failure after hematopoietic stem cell transplantation. There were no signs of puberty development and menarche. Orthotopic ovarian tissue transplantation was performed for the patient through laparoscopy, and a total of 5 pieces of ovarian tissue were transplanted on January 20, 2022. Postoperatively, we followed up the sex hormone levels, growth and development of the patients and menarche.Results:The patient developed menarche 5 months after ovarian transplantation. The levels of sex hormones showed that follicle-stimulating hormone and luteinizing hormone were significantly decreased, and estradiol levels were significantly increased, indicating that ovarian tissue transplantation was successful, and follicles had begun to recruit and develop. The patient's ultrasonography revealed a markedly enlarged uterus and a thickened endometrium. Antral follicles were detected in the left implantation site of pelvic cavity.Conclusion:Cryopreservation of ovarian tissue is recommended for fertility preservation in prepubertal children. Autologous frozen-thawed ovarian tissue transplantation can induce natural puberty development and restore the reproductive endocrine function in children with ovarian failure, delayed puberty development or even stagnation.

Objective:To explore the feasibility of autologous transplantation of frozen-thawed ovarian tissue to induce pubertal development in adolescent females.Methods:Before hematopoietic stem cell transplantation in patient with severe β-thalassemia, 11 pieces of ovarian tissue were frozen in the Center of Reproductive Medicine, the Sixth Affiliated Hospital of Sun Yat-sen University in 2019. The patient was diagnosed as premature ovarian failure after hematopoietic stem cell transplantation. There were no signs of puberty development and menarche. Orthotopic ovarian tissue transplantation was performed for the patient through laparoscopy, and a total of 5 pieces of ovarian tissue were transplanted on January 20, 2022. Postoperatively, we followed up the sex hormone levels, growth and development of the patients and menarche.Results:The patient developed menarche 5 months after ovarian transplantation. The levels of sex hormones showed that follicle-stimulating hormone and luteinizing hormone were significantly decreased, and estradiol levels were significantly increased, indicating that ovarian tissue transplantation was successful, and follicles had begun to recruit and develop. The patient's ultrasonography revealed a markedly enlarged uterus and a thickened endometrium. Antral follicles were detected in the left implantation site of pelvic cavity.Conclusion:Cryopreservation of ovarian tissue is recommended for fertility preservation in prepubertal children. Autologous frozen-thawed ovarian tissue transplantation can induce natural puberty development and restore the reproductive endocrine function in children with ovarian failure, delayed puberty development or even stagnation.

The Kirkpatrick Model has been widely used in nursing staff training. This article reviews the origin and content of the Kirkpatrick Model as well as its application in nursing staff training in order to provide a reference for establishing a nursing training mechanism and improving the professional quality of nursing staff.

Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group (40 cases) and control group (40 cases).The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0％ (36/40) and 72.5％ (29/40) for the control group,the difference was statistically significant (P＜0.05).There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.