Objective To evaluate the effect of LifePort combined with polymyxin B in preventing donor-derived infections caused by preservation solution contamination. Methods Clinical data of 110 kidney transplant recipients were retrospectively analyzed. According to the decontamination status of preservation solution, the recipients were divided into the decontamination group (n=62) and the non-decontamination group (n=48). The general data of the two groups were compared, and the preventive effect of polymyxin B on possible donor-derived infections (p-DDI) was analyzed, especially infections associated with multidrug-resistant Gram-negative bacteria (MDR GNB). Results There were no statistically significant differences in baseline data (gender, age, preservation solution contamination status, etc.) between the decontamination group and the non-decontamination group (all P > 0.05). The overall contamination rate of preservation solution was 80.0%, and 68 contaminated samples were with single microorganism and 20 with multiple microorganisms. Coagulase-negative staphylococci, Enterococcus and Klebsiella pneumoniae were the most common microorganisms in the positive samples. Fifteen cases of preservation solution were contaminated by MDR GNB, including 10 cases in the non-decontamination group and 5 cases in the decontamination group, with no statistically significant difference between the two groups (P = 0.053). Postoperative infection-related events occurred in 69 recipients, including 39 cases in the non-decontamination group and 30 cases in the decontamination group, with the incidence rate in the non-decontamination group significantly higher than that in the decontamination group (P < 0.001). Only 10 cases of infections were identified as p-DDI, all of which were positive for preservation solution culture, including 8 cases in the non-decontamination group and 2 cases in the decontamination group (P < 0.05). There were 5 cases of p-DDI related to MDR GNB in the non-decontamination group, while no such cases occurred in the decontamination group (P < 0.05). No adverse reactions related to polymyxin B were observed, and no recipient death or renal allograft dysfunction occurred in either group. Conclusions Adding polymyxin B to the preservation fluid during hypothermic machine perfusion with LifePort before renal transplantation may reduce p-DDI and its potential adverse consequences.

Objective This study aims to investigate the current status and determinants of compassion fatigue symptoms among orthopedic nurses,and to analyze the interrelationships among these determinants to provide references for targeted intervention development.Methods From May to June 2024,a convenience sampling method was employed to recruit orthopedic nurses from 20 tertiary hospitals across 14 provinces and cities in China.The survey instruments encompassed the general demographic information sheet,the Compassion Fatigue Scale,the Social Support Rating Scale,the Nurses' Psychological Capital Questionnaire,and the Professional Identity Questionnaire.The data were analyzed using univariate analysis,Spearman correlation analysis,and multiple linear regression analysis.A structured equation model was also developed.Results Totally 1 397 valid questionnaires were collected,and the effective response rate was 96.94％(1 397/1 441).The average score of compassion fatigue symptoms was 47.41±12.16.The multiple linear regression analysis indicated that professional identity,social support,psychological capital,length of service,and frequency of night shifts per week were independent determinants of compassion fatigue symptoms(P＜0.05).The path analysis demonstrated a good fit with the specified indicators.Psychological capital exhibited a direct mediating effect on compassion fatigue symptoms(β=-0.15,P＜0.05).Furthermore,professional identity(β=1.46,P＜0.001;β=-0.38,P＜0.001)and social support(β=0.14,P＜0.001;β=-0.99,P＜0.001)served as mediators in the relationship between psychological capital and compassion fatigue symptoms.Conclusion The compassion fatigue symptoms among orthopedic nurses are relatively severe.It is imperative for nursing managers to address associated factors of compassion fatigue symptoms among orthopedic nurses and implement effective preventive strategies to mitigate its level.

Objective This study aims to investigate the current status and determinants of compassion fatigue symptoms among orthopedic nurses,and to analyze the interrelationships among these determinants to provide references for targeted intervention development.Methods From May to June 2024,a convenience sampling method was employed to recruit orthopedic nurses from 20 tertiary hospitals across 14 provinces and cities in China.The survey instruments encompassed the general demographic information sheet,the Compassion Fatigue Scale,the Social Support Rating Scale,the Nurses' Psychological Capital Questionnaire,and the Professional Identity Questionnaire.The data were analyzed using univariate analysis,Spearman correlation analysis,and multiple linear regression analysis.A structured equation model was also developed.Results Totally 1 397 valid questionnaires were collected,and the effective response rate was 96.94％(1 397/1 441).The average score of compassion fatigue symptoms was 47.41±12.16.The multiple linear regression analysis indicated that professional identity,social support,psychological capital,length of service,and frequency of night shifts per week were independent determinants of compassion fatigue symptoms(P＜0.05).The path analysis demonstrated a good fit with the specified indicators.Psychological capital exhibited a direct mediating effect on compassion fatigue symptoms(β=-0.15,P＜0.05).Furthermore,professional identity(β=1.46,P＜0.001;β=-0.38,P＜0.001)and social support(β=0.14,P＜0.001;β=-0.99,P＜0.001)served as mediators in the relationship between psychological capital and compassion fatigue symptoms.Conclusion The compassion fatigue symptoms among orthopedic nurses are relatively severe.It is imperative for nursing managers to address associated factors of compassion fatigue symptoms among orthopedic nurses and implement effective preventive strategies to mitigate its level.

【Objective】 To understand the current situation of social emotional competence of infants and toddlers, and analyze its relationship with home rearing environment, in order to provide the basis for improving the level of infant social emotional development. 【Method】 A study was conducted on 390 individuals from a child health institution in Hubei and Henan provinces.The "Infant and Toddler Social-Emotional Assessment Scale" and "1 - 3 Years Child Home Rearing Environment Scale" were used to investigate the social emotions ability and home rearing environment of infants and toddlers. 【Results】 A total of 390 valid questionnaires were collected in this survey, of which 199 were boys (51.0%) and 191 girls (49.0%). The average age of infants was (27.13±6.86)months.The age distribution is mainly among infants and young children aged 24 to 36 months, with a total of 305 people (78.2%). The caregiver′s registered residence (Z=-3.570), father′s education level (H=17.106), mother′s education level (H=7.980), per capita monthly income of the family (H=13.986), and the home rearing environment (Z=-8.881) had statistical significance on the social emotional competence of infants(P<0.05 or <0.01).There was a significant positive correlation between family rearing environment and infants′ social emotion (r=0.582, P<0.01).Multiple regression analysis showed that the social adaptation/self-care(β=0.30, 95%CI: 0.18 - 0.52, P<0.01)and language cognition dimensions(β=0.22, 95%CI: 0.07 - 0.59, P<0.05) in the home rearing environment had a statistically significant impact on the social emotional ability of infants and toddlers. 【Conclusion】 The home rearing environment is closely related to the social emotional development of infants and young children.Improve the parenting knowledge and skills of the main caregivers of infants and young children, build a good family rearing environment for infants and young children, which is beneficial to promote the development of children′s social emotions.

【Objective】 To evaluate the value of platelet-to-lymphocyte ratio (PLR) in the prognosis of prostate cancer. 【Methods】 Relevant studies were searched in CNKI, Wanfang, CBM, VIP, PubMed, Web of Science, Cochrane Library and Embase databases from inception to Dec.2021. The literature was screeded, data were extracted, and the quality was evaluated according to the inclusion and exclusion criteria. A meta-analysis by using the hazard risk (HR) and 95% confidence interval (CI) was adopted to assess the prognostic value of PLR. The data were analyzed with STATA 16.0 software. 【Results】 A total of 10 studies were included, involving 1 802 patients. For patients with high level of PLR, the overall survival (OS) (HR=1.70, 95%CI:1.25-2.30, P=0.001) and disease-free survival (DFS)(HR=1.44, 95%CI:1.15-1.81, P=0.002) were significantly shorter. 【Conclusion】 PLR is an independent risk factor affecting the long-term prognosis of prostate cancer patients. Pretreatment detection of PLR is meaningful in determining the prognosis.

The methylation of N6-methyladenosine(m6A)is an important gene expression regulation mechanism in eukaryotes.It is mainly regulated by three types of regulators:writers,erasers and readers.With the development of high-throughput sequencing technology and bioinformatics,various methods have been developed to detect and analyze m6A methylation sites.A growing body of research has shown that m6A methylation plays an important role in the occurrence and development of urological tumors,including tumor proliferation,invasion and metastasis.However,the molecular mechanism and role of m6A in different types of urological tumors have not been fully elucidated.This article reviews the main regulatory mechanism of m6A methylation modification as well as the research progress,the prognostic value and the therapeutic resistance of m6A methylation modification in urological tumors.

Objective:To analyze the incidence and mortality trends of female breast cancer in China from 1990 to 2019 and the impact of age-period-cohort (APC) on it.Methods:The incidence and mortality of breast cancer of Chinese women aged 20-95 years from 1990 to 2019 were collected from the Global Burden of Disease (GBD) in 2019. Joinpoint software was used to estimate the average annual percentage change rate (AAPC) of age standardized incidence and mortality, and analyze the changing trend of disease burden of breast cancer in Chinese women from 1990 to 2019. The R language based APC model developed by the National Cancer Institute of the United States was used to analyze the impact of age, period and cohort on their changes.Results:From 1990 to 2019, the age standardized incidence of female breast cancer in China showed an upward trend, from 17.07/100 000 in 1990 to 35.61/100 000 in 2019, with an average annual increase of 2.59% (95% CI: 2.45%-2.73%, P<0.001) , which was higher than the global level (AAPC=0.47%, 95% CI: 0.31%-0.63%, P<0.001) . The standardized mortality showed a slight downward trend, from 9.16/100 000 in 1990 to 9.01/100 000 in 2019, with a decrease of 0.05% (95% CI: -0.20%-0.09%, P=0.479) , but there was not a statistically significant difference. APC model results showed that the incidence and mortality of female breast cancer increased with age. With the passage of time, the incidence from 1990 to 2019 showed an upward trend, and the incidence risk rose to 1.49 in the 2015-2019 period (95% CI: 1.42-1.57, P<0.001) . The mortality showed a downward trend, and the death risk was the highest in the 1990-1994 period ( RR=0.79, 95% CI: 0.74-0.83, P<0.001) . Cohort effect results showed that the later the women were born, the higher the risk of morbidity. The women born in the cohort from 1995 to 1999 had the highest risk ( RR=3.12, 95% CI: 1.82-5.33, P<0.001) . The risk of death showed a unimodal distribution, showing a trend of first increasing and then decreasing, the later the women were born, the lower the risk of death. The birth cohort from 1950 to 1954 had the highest risk of death ( RR=1.04, 95% CI: 0.98-1.09, P<0.001) , and then showed a downward trend, falling to 0.48 (95% CI: 0.19-1.24, P<0.001) in the birth cohort from 1995 to 1999. Conclusion:From 1990 to 2019, the incidence of breast cancer in Chinese women shows an upward trend, which is significantly higher than the global increase, and the mortality tends to stabilize. APC model analysis finds that the incidence and mortality increase with age, and the period and cohort effects show that the incidence risk of breast cancer in Chinese women gradually increases with the passage of the period and cohort. The period effect of mortality shows a downward trend, and the cohort effect of mortality shows a unimodal distribution, showing a trend of first increasing and then decreasing.

Objective:To explore the relationship of telomere length, mitochondrial DNA copy number of peripheral blood with hypertension and the interaction between telomere length and mtDNA-CN on hypertension in coal miners.Methods:A case control study was conducted in a coal mine of Shanxi province from July to December of 2013, in which 325 healthy workers were selected as the control group and 378 workers with hypertension as the case group. The information about general demographic characteristics and life behavior habits of the subjects were collected through questionnaire. Levels of telomere length and mtDNA-CN in peripheral blood were detected by real-time PCR. Unconditional logistic regression was used to examine the association between hypertension and telomere length, mtDNA-CN. The interaction test between telomere length and mtDNA-CN on hypertension was performed by adding the interaction term in the corresponding model.Results:The mean telomere length of the workers in the case group was (1.50±0.55) kb, and that of the control group was (2.01±0.62) kb, the difference between two groups was significant ( t=11.68, P<0.001). The correlation analysis showed that telomere length was positively correlated with mtDNA-CN ( r=0.157, P=0.002) in the case group. Multivariate analysis showed that telomere length ( OR=4.408, 95% CI: 3.012-6.452), age ( OR=0.417, 95% CI: 0.284-0.613), BMI ( OR=1.357, 95% CI: 1.162-1.584), monthly household income level ( OR=0.656, 95% CI: 0.553-0.778) and work duration ( OR=1.249, 95% CI: 1.100-1.417) were influencing factors of hypertension. The multiply interaction between telomere length and mtDNA-CN was significant on hypertension ( OR=1.267, 95% CI: 1.094-1.468). Conclusions:The results suggest shorter telomere length is a risk factor of hypertension. There is a multiply interaction between telomere length and mtDNA-CN on hypertension. However, the association between mtDNA-CN and hypertension was not found.

Objective To investigate the clinical efficacy of pancreaticoduodenectomy using artery first approach and prior portal vein (PV)-superior mesenteric vein (SMV) shunting for complicated pancreatic head tumors.Methods The retrospective cohort study was conducted.The clinicopathological data of 91 patients with pancreatic head cancer who were admitted to the Changhai Hospital of Navy Medical University from February 2011 to December 2016 were collected.Among 91 patients undergoing pancreaticoduodenectomy combined with vascular resection and reconstruction,27 using artery first approach and PV-SMV shunting and reconstruction were allocated into the PD-PVR group,23 using conventional approach were allocated into the PD-CVR group,and 41 receiving pancreaticoduodenectomy with vascular resection were allocated into the PD-SVR group.Observation indicators:(1) comparison of intra-and post-operative situations among groups;(2) comparison of postoperative pathological results among groups;(3) comparison of postoperative survival among groups.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to December 2017.Comparisons among groups of count data were done by the chi-square test or Fisher exact probability.Measurement data with normal distribution were represented as x±s,comparisons among groups were analyzed using the ANOVA,and pairwise comparison was done using the LSD method.Measurement data with skewed distribution were described as M(Q),comparison among groups was analyzed using the Kurskal-Wallis rank sum test,and pairwise comparison was done using the paired comparison with adjusted P value.Ordinal data were compared using the nonparametric test.The survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method,and Log-rank test was used for survival analysis.Results (1) Comparison of intra-and post-operative situations among groups:operation time,time of hepatic inflow occlusion,volume of intraoperative blood loss,cases with intraoperative blood transfusion,length of PV or SMV removal,cases with vascular grafts,grading 1,2,3,4 and 5 of Clavien-Dindo classification of postoperative complications and duration of hospital stay were respectively (274±36)minutes,(22±7)minutes,1 661 mL (110 mL,3 800 mL),20,(5.6±1.4)cm,6,11,1,1,1,1,(20±7)days in the PD-PVR group and (281±41)minutes,(27±5)minutes,1 888 mL (176 mL,4 162 mL),18,(5.4±1.5) cm,3,1,8,2,0,0,(21±7)days in the PD-CVR group and (201± 36)minutes,(16±6)minutes,1052 mL (74 mL,3 926 mL),17,(3.2±2.0) cm,5,15,2,3,1,1,(13± 6)days in the PD-SVR group,with statistically significant differences among groups (F=37.060,34.530,x2=13.771,14.015,F=32.260,x2 =39.309,F =19.880,P＜0.05).Patients with postoperative complications were improved by symptomatic and supporting treatment.(2) Comparison of postoperative pathological results among groups:mnaximum tumour dimension was respectively (3.6± 1.3) cm,(4.0± 1.3) cm and (2.6± 1.3) cm in the PD-PVR,PD-CVR and PD-SVR groups,with a statistically significant difference among groups (F =7.845,P＜0.05).Cases with high-differentiated,moderate-differentiated and low-differentiated tumors of tumor differentiation,staging Ⅱ A and Ⅱ B of tumor staging,nerve invasion,positive lymph node,positive resection margins in neck of pancreas,bile duct and SMV were respectively 0,13,14,17,10,17,21,0,0,0 in the PD-PVR group and 1,12,10,10,13,15,19,1,0,0 in the PD-CVR group and 1,29,11,17,24,30,29,2,1,1 in the PD-SVR group,with no statistically significant difference among groups (x2 =4.122,3.306,0.902,1.214,P＞0.05).(3) Comparisons of postoperative survival among groups:of 91 patients,52 were followed up for 3.0-69.3 months,with a median time of 18.0 months and follow-up rate of 57.1％ (52/91),including 16 in the PD-PVR group and 14 in the PD-CVR group and 22 in the PD-SVR group.The median survival time,1-,2-and 3-year overall survival rates in 52 patients were respectively 16.6 months,63.5％,35.7％ and 26.8％.The survival time in the PD-PVR,PD-CVR and PD-SVR groups were respectively 12.3 months (3.9-69.3 months),15.0 months (3.0-63.3 months) and 20.0 months (6.0-65.2 months),with a statistically significant difference in survival among groups (x2=6.201,P＜0.05),and between PD-PVR and PD-SVR groups (x2 =4.412,P＜0.05).There was no statistically significant difference in survival between PD-PVR and PD-CVR groups (x2 =0.001,P＞0.05).Conclusion Pancreaticoduodenectomy using artery first approach and PV-SMV shunting and reconstruction for complicated pancreatic head tumors can reduce the time of hepatic inflow occlusion,it also contributes to the risk control of surgery for complicated pancreatic tumors,increases surgical safety and improves patients' prognosis.

Objective To investigate the effects of mitochondrial DNA (mtDNA) copy number in peripheral blood and related factors on the risk of hypertension in coal miners.Methods A case-control study was conducted in 378 coal miners with hypertension and 325 healthy coal miners recruited from Datong Coal Mine Group.A standard questionnaire was used to collect their general information,such as demographic characteristics,habits and occupational history.Fluorescence quantitative PCR was performed to detect the copy number of mtDNA.Logistic regression model was applied for identifying the related risk factors of hypertension and analyzing the interaction between mtDNA copy number and risk factors.Results The prevalence of hypertension of high mtDNA copy number was lower than mtDNA copy numberin 0-5.67 group,but the difference was not statistically significant (P=0.414).Alcohol drinking (OR=1.80,95％CI:1.26-2.56),family history of hypertension (OR=1.74,95％ CI:1.20-2.50),work shifts (OR=0.69,95％ CI:0.48-0.99),education level (P=0.012) and family monthly income level (P=0.001) were related to the prevalence of hypertension.There were potential interactions between mtDNA copy number and alcohol drinking,family monthly income level,family history of hypertension,respectively.Alcohol drinking was a risk factor for hypertension [1.77(1.25-2.50)].Potential interactions between mtDNA copy number and alcohol drinking reduced the risk of hypertension (OR=1.20,95％CI:1.07-1.35).Family history of hypertension was a risk factor for hypertension [1.81(1.26-2.59)].Potential interactions between mtDNA copy number and family history of hypertension reduced the risk of hypertension (OR=1.24,95％ CI:1.09-1.41).Family monthly income level was a protect factor for hypertension [0.55(0.46-0.66)].Potential interactions between mtDNA copy number and family monthly income level increased the protection role of hypertension (OR=0.90,95％CI:0.86-0.94).Conclusion mtDNA copy number variation was not significantly associated with the prevalence of hypertension in coal miners,but mtDNA copy number shewed multiplication interaction on the prevalence of hypertension with alcohol drinking,family monthly income level as well as family history of hypertension and made their influences weaken.