Objective To explore the feasibility and reference value of allogeneic lung transplantation and postoperative monitoring in miniature pigs for lung transplantation research. Methods Two miniature pigs (R1 and R2) underwent left lung allogeneic transplantation. Complement-dependent cytotoxicity tests and blood cross-matching were performed before surgery. The main operative times and partial pressure of arterial oxygen (PaO₂) after opening the pulmonary artery were recorded during surgery. Postoperatively, routine blood tests, biochemical blood indicators and inflammatory factors were detected, and pathological examinations of multiple organs were conducted. Results The complement-dependent cytotoxicity test showed that the survival rate of lymphocytes between donors and recipients was 42.5%-47.3%, and no agglutination reaction occurred in the cross-matching. The first warm ischemia times of D1 and D2 were 17 min and 10 min, respectively, and the cold ischemia times were 246 min and 216 min, respectively. Ultimately, R1 and R2 survived for 1.5 h and 104 h, respectively. Postoperatively, in R1, albumin (ALB) and globulin (GLB) decreased, and alanine aminotransferase increased; in R2, ALB, GLB and aspartate aminotransferase all increased. Urea nitrogen and serum creatinine increased in both recipients. Pathological results showed that in R1, the transplanted lung had partial consolidation with inflammatory cell infiltration, and multiple organs were congested and damaged. In R2, the transplanted lung had severe necrosis with fibrosis, and multiple organs had mild to moderate damage. The expression levels of interleukin-1β and interleukin-6 increased in the transplanted lungs. Conclusions The allogeneic lung transplantation model in miniature pigs may systematically evaluate immunological compatibility, intraoperative function and postoperative organ damage. The data obtained may provide technical references for subsequent lung transplantation research.

Objective:To investigate the prevalence of depression in non-bedridden elderly in integrated medical and elderly care institutions and analyze its risk factors.Methods:Using convenience sampling,196 non-bedridden elderly individuals from integrated medical and elderly care institutions in Chizhou from Jan 2023 to Jan 2024 were selected as subjects.The Geriatric Depression Scale-15(GDS-15)was used to assess the depression levels of the elderly.A general information questionnaire,the Pittsburgh Sleep Quality Index(PSQI),and the SF-12 Health Survey were used to collect factors related to depression in non-bedridden elderly.Multivariable logistic regression analysis was performed to identify risk factors for depression in non-bedridden elderly in integrated medical and elderly care institutions.Results:Among the 196 non-bedridden elderly individuals,68 exhibited depression,with a detection rate of 34.69%.Multivariable logistic regression analysis revealed that lower education level(OR=2.644,95%CI:1.259-5.551),lack of physical exercise(OR=2.976,95%CI:1.456-6.081),cognitive training(OR=2.981,95%CI:1.446-6.145),and social activities(OR=3.822,95%CI:1.805-8.093),poorer health status(OR=3.450,95%CI:1.578-7.543),and lower quality of life(OR=3.979,95%CI:1.890-8.375)were independent risk factors for depression(P＜0.05).Conclusions:The detection rate of depression among non-bedridden elderly in integrated medical and elderly care institutions is relatively high.Targeted interventions,such as strengthening mental health management,promoting cultural education,physical exercise,and social participation,and improving quality of life,should be implemented to prevent depression.

Objective:To investigate the prevalence of depression in non-bedridden elderly in integrated medical and elderly care institutions and analyze its risk factors.Methods:Using convenience sampling,196 non-bedridden elderly individuals from integrated medical and elderly care institutions in Chizhou from Jan 2023 to Jan 2024 were selected as subjects.The Geriatric Depression Scale-15(GDS-15)was used to assess the depression levels of the elderly.A general information questionnaire,the Pittsburgh Sleep Quality Index(PSQI),and the SF-12 Health Survey were used to collect factors related to depression in non-bedridden elderly.Multivariable logistic regression analysis was performed to identify risk factors for depression in non-bedridden elderly in integrated medical and elderly care institutions.Results:Among the 196 non-bedridden elderly individuals,68 exhibited depression,with a detection rate of 34.69%.Multivariable logistic regression analysis revealed that lower education level(OR=2.644,95%CI:1.259-5.551),lack of physical exercise(OR=2.976,95%CI:1.456-6.081),cognitive training(OR=2.981,95%CI:1.446-6.145),and social activities(OR=3.822,95%CI:1.805-8.093),poorer health status(OR=3.450,95%CI:1.578-7.543),and lower quality of life(OR=3.979,95%CI:1.890-8.375)were independent risk factors for depression(P＜0.05).Conclusions:The detection rate of depression among non-bedridden elderly in integrated medical and elderly care institutions is relatively high.Targeted interventions,such as strengthening mental health management,promoting cultural education,physical exercise,and social participation,and improving quality of life,should be implemented to prevent depression.

The existing doctor-patient communication pattern often falls prey to insufficient informed consent and even medical disputes. In the patient centered perspective, Zhejiang Provincial People′s Hospital explored a new communication mode centering on patients. Based on diagnosis-related groups catalogues and high-frequency surgeries catalogues of the departments, multimedia technology was called into play to produce dubbed PPTs and videos that were easy to understand, standardized and homogeneous, which were embedded into medical records system. Following observation of the PPT or video, patients could directly sign an informed consent on the computer. This practice not only deepens patient′s understanding and achieves homogeneous level of the communication, but also elevates doctor′s work efficiency, contributing to building a harmonious doctor-patient relationship.

The construction of safe hospital is the foundation of high-quality development of the hospital, and innovation provides power for the construction of safe hospital from the perspective of high-quality development. Taking Zhejiang Provincial People′s Hospital as an example, the authors introduced the innovation construction path of safe hospital in detail, and put forward the construction strategy of safe hospital with " two hearts" (patient-centered, employee-centered)and " four wings" (multimedia doctor-patient communication, Wulin aunt medical studio, integrated operation safety inspection, third-party medical liability insurance). Through the combination of basic safety management and innovative practice, the hospital vigorously promoted the culture of " two hearts" , and established an efficient collaborative information management system, so as to form replicable and promotable practical experience and promote the development of safe hospital.

Objective To investigate the effects of different high-fat diet feeding time durations on blood glucose (BG), insulin resistance index(HOMA-IR), and urinary albumin excretion rate(UAER)in rats with high fat diet-induced type 2 diabetic nephropathy(DN). Methods Unilateral renal artery ligation, high-fat diet(throughout the ex-periment period),and low dose streptozotocin(STZ)intraperitoneal injection were used to establish a type 2 DN rat mod-el. After the operation,rats in the DN1 and DN2 groups received an intraperitoneal injection of STZ 30 mg/kg after 4 and 8 weeks of high-fat diet feeding,respectively. UAERs of the DN1 and DN2 groups were compared at 4 weeks after the STZ injection and the end of study(EOS). BG,body weight,HOMA-IR,kidney index,and pathological changes of the kidney were observed. Results UAER was increased in both groups at 4 weeks after the STZ injection,but significantly higher in the group DN2 than in the DN1 group(P<0.01). At the end of study(the 12th week),the renal tissues showed patho-logical changes,including glomerular capillary loop hypertrophy,increased mesangial matrix,and decreased capsule space in both groups. Compared with the DN1 group,the body weight was significantly higher(P<0.01),kidney index was sig-nificantly lower(P<0.01),while BG,serum insulin level,HOMA-IR,and UAER were no significantly changed in the DM2 group(P>0.05,respectively). Conclusions The results show that extending the feeding time of high-fat diet can aggravate the kidney damages in diabetic rats,but it can also delay the start of any planned intervention. Therefore,the ex-perimental protocol should be carefully designed based on the study objective.

Objective To evaluate the effect of hydrogen on the postoperative cognitive function in aged mice.Methods Sixty aged male Kunming mice,aged 12-14 months,weighing 35-45 g,were assigned into 3 groups (n=20 each) using a random number table:sham operation group (group Sham),partial hepatectomy group (group PH) and partial hepatectomy plus hydrogen-enriched saline group (group PH-H).On preoperative day 3,during operation and on postoperative day 3,hydrogen-enriched saline 10 ml/kg was intraperitoneally injected once a day in group PH-H,and the equal volume of normal saline was intraperitoneally injected once a day in S and PH groups.The spatial probe test was performed on postoperative day 7 to evaluate the cognitive function.Ten mice were selected on postoperative days 3 and 7 (after the end of the spatial probe test),and blood samples were collected for determination of serum tumor necrosis factor-alpha (TNF-α),interleukin-lbeta (IL-1β) and high-mobility group box 1 protein (HMGB1) concentrations by enzyme-linked immunosorbent assay.The animals were sacrificed after blood sampling,brains were removed and hippocampi were isolated for detection of the expression of TNF-α,IL-1β and HMGB1 by Western blot.Results Compared with group S,the percentage of time of staying at the target quadrant and the number of crossing the platform within 1 min were significantly decreased,the serum concentrations of TNF-α,IL-1β and HMGB1 were increased,and the expression of hippocampal TNF-α,IL-1β and HMGB1 was up-regulated in group PH (P＜0.05),and no significant change was found in the variables mentioned above in group PH-H (P＞0.05).Compared with group PH,the percentage of time of staying at the target quadrant and the number of crossing the platform within 1 min were significantly increased,the serum concentrations of TNF-α,IL-1β and HMGB1 were decreased,and the expression of hippocampal TNF-α,IL-1β and HMGB1 was down-regulated in group PH-H (P＜0.05).Conclusion Hydrogen can improve the postoperative cognitive function in aged inice.

Objective To compare the effect and safety of endoscopic duodenal papillal incision combined dilatation(ESBD) and endoscopic sphincterotomy(EST) in the treatment of common bile duct stone.Methods A retrospective analysis of 71 cases of choledocholithiasis,according to surgical methods,were divided into group EST (45 cases) and group ESBD (26 cases).The effect and safety of the above two kinds of treatment was evaluated through observing the rate of one-time stone clearance and postoperative complications.Results The success rate of removing calculous of the two groups was above 95%,and there was no significant difference between the two kinds of treatment(EST and ESBD)(P>0.05).Recent complications:the incidence rate of hemorrhage of the EST group was 0.0%,which of the ESBD group was 3.8%,there was no significant difference between the two groups(P>0.05).The incidence rate of postoperative pancreatitis of the EST group was 8.8%,which the ESBD group was 3.8%,there was no significant difference between the two groups(P>0.05).The diameter of the removed stone of the two groups:the EST group was (0.70±0.35)cm,and the ESBD group was (1.41±0.69)cm,there was significant difference between the two groups(P<0.05).Conclusion There are no significant differences in early complications and the success rate of removing stone between the EST group and the ESBD group.However,ESBD preserved teat sphincter's physiological barrier function to the greatest extent and the diameter of the removed stone was obviously larger than the EST group.Therefore,it is much safer for those who have quite large common bile duct stone or people who are with joint periampullary diverticulum to be treated by ESBD.

Orthostatic hypertension (OHT)in children was first proposed by Chinese scholars in 2012.The diagnostic criterion was revised in 2015.OHT in children was not rare in clinical practice.Children and adolescents are susceptible to OHT when they suddenly change posture or standing for a long time.The mechanisms of OHT were not clear.Dizziness,headache,nausea and vomiting were the main manifestations of OHT.Severe symptom in childhood OHT includes syncope.The prognosis of OHT was good,but the abnormal blood pressure will last to adults.Further study in OHT will help to predict the risk of cardiovascular and cerebrovascular diseases and help to evaluate target or-gan injury.The treatment of OHT has been explored,and non -medical treatment is the main option.Study in medical treatment for OHT has not been conducted.Now,the diagnostic criteria in children,epidemiologic status,clinical fea-tures and treatment of OHT were focused to deepen the understanding of OHT in children and improve the clinical standard of the disease.

OBJECTIVETo observe the impact of electroacupuncture (EA) on the quality of life in the patients of female mixed urinary incontinence (MUI) and evaluate its clinical efficacy.

METHODSEA was adopted in 25 cases of MUI at Zhongliao (BL 33) and Huiyang (BL 35), needle retaining for 30 min each time. The treatment was given once every two days, three treatments a week, totally for 12 weeks of treatment. The incontinence quality of life questionnaire (I-QOL), the incontinence impact questionnaire-7 (IIQ-7), the urogenital distress inventory short form (UDI-SF) and the visual analogue scale (VAS) were adopted in the comparison before and after treatment. The efficacy was evaluated.

RESULTSThe curative rate was 52.0% (13/25) and the total effective rate was 96.0% (24/25) in 25 cases. In comparison before and after treatment, in I-QOL, the score of limiting behaviors was increased up to (30.32 ± 3.39) from (11.52 ± 2.45), the score of psychosocial impacts was up to (36.48 ± 2.90) from (13.52 ± 2.25) and the score of social isolation was up to (21.52 ± 1.61) from (9.84 ± 2.23). The score of IIQ-7 was decreased, down to (2.48 ± 1.36) from (11.96 ± 3.45), the score of UDI-SF was down to (2.92 ± 0.95) from (8.84 ± 2.58) and VAS score was down to (1.40 ± 0.91) from (6.96 ± 1.65). The differences were all significant statistically in comparison (all P < 0.05).

CONCLUSIONEA improves effectively the quality of life in MUI patients and the clinical efficacy is apparent.

Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Middle Aged ; Quality of Life ; Treatment Outcome ; Urinary Incontinence ; physiopathology ; therapy ; Urination