Objective:To explore the correlation between conventional ultrasound and contrast-enhanced ultrasound features and invasive histological features of T 1a clear cell renal cell carcinoma (ccRCC). Methods:A retrospective case series study was conducted. Sixty-seven T 1a ccRCC patients who were admitted to Shanxi Province Cancer Hospital from May 2018 to August 2023 were selected. According to the World Health Organization (WHO)/International Society of Urology and Pathology (ISUP) renal tumor grading system, the patients were divided into the low-grade group (WHO/ISUP grades 1-2, 53 cases) and the high-grade group (WHO/ISUP grades 3-4, 14 cases). The conventional ultrasound and contrast-enhanced ultrasound characteristics of two groups of patients were compared. Multivariate logistic regression model was used to analyze the independent factors of conventional ultrasound and contrast-enhanced ultrasound related to T 1a ccRCC with WHO/ISUP high grade. Results:There were no statistically significant differences in clinical characteristics between the two groups of patients (all P > 0.05). In conventional ultrasound examination, the proportion of patients with tumor exophytic rate <50% in the high-grade group was higher than that in the low-grade group [64.3% (9/14) vs. 34.0% (18/53)], and the difference was statistically significant ( χ2 = 4.23, P = 0.040); there were no statistically significant differences in the distribution of patients with different tumor maximum diameter, laterality, polarity, depth, echo, boundary, and shape between the two groups (all P > 0.05). In contrast-enhanced ultrasound examination, the proportion of patients lack of pseudocapsule sign in the high-grade group was higher than that in the low-grade group [57.1% (8/14) vs. 24.5% (13/53)], and the difference was statistically significant ( χ2 = 4.06, P = 0.044); there were no statistically significant differences in the distribution of patients with different perfusion mode, enhancement degree, enhancement uniformity, and regression mode between the two groups (all P > 0.05). Multivariate logistic regression analysis showed that the conventional ultrasound tumor exophytic rate < 50% (compared to exophytic rate ≥ 50%, OR = 3.732, 95% CI: 1.019-13.664, P = 0.047) and the absence of pseudocapsule sign (compared to the presence of pseudocapsule sign, OR = 4.357, 95% CI: 1.201-15.804, P = 0.025) on contrast-enhanced ultrasound were independent risk factors for high-grade T 1a ccRCC. Conclusions:T 1a ccRCC with the exophytic rate <50% and absence of pseudocapsule sign may have invasive histological features.

Objective:To explore the correlation between conventional ultrasound and contrast-enhanced ultrasound features and invasive histological features of T 1a clear cell renal cell carcinoma (ccRCC). Methods:A retrospective case series study was conducted. Sixty-seven T 1a ccRCC patients who were admitted to Shanxi Province Cancer Hospital from May 2018 to August 2023 were selected. According to the World Health Organization (WHO)/International Society of Urology and Pathology (ISUP) renal tumor grading system, the patients were divided into the low-grade group (WHO/ISUP grades 1-2, 53 cases) and the high-grade group (WHO/ISUP grades 3-4, 14 cases). The conventional ultrasound and contrast-enhanced ultrasound characteristics of two groups of patients were compared. Multivariate logistic regression model was used to analyze the independent factors of conventional ultrasound and contrast-enhanced ultrasound related to T 1a ccRCC with WHO/ISUP high grade. Results:There were no statistically significant differences in clinical characteristics between the two groups of patients (all P > 0.05). In conventional ultrasound examination, the proportion of patients with tumor exophytic rate <50% in the high-grade group was higher than that in the low-grade group [64.3% (9/14) vs. 34.0% (18/53)], and the difference was statistically significant ( χ2 = 4.23, P = 0.040); there were no statistically significant differences in the distribution of patients with different tumor maximum diameter, laterality, polarity, depth, echo, boundary, and shape between the two groups (all P > 0.05). In contrast-enhanced ultrasound examination, the proportion of patients lack of pseudocapsule sign in the high-grade group was higher than that in the low-grade group [57.1% (8/14) vs. 24.5% (13/53)], and the difference was statistically significant ( χ2 = 4.06, P = 0.044); there were no statistically significant differences in the distribution of patients with different perfusion mode, enhancement degree, enhancement uniformity, and regression mode between the two groups (all P > 0.05). Multivariate logistic regression analysis showed that the conventional ultrasound tumor exophytic rate < 50% (compared to exophytic rate ≥ 50%, OR = 3.732, 95% CI: 1.019-13.664, P = 0.047) and the absence of pseudocapsule sign (compared to the presence of pseudocapsule sign, OR = 4.357, 95% CI: 1.201-15.804, P = 0.025) on contrast-enhanced ultrasound were independent risk factors for high-grade T 1a ccRCC. Conclusions:T 1a ccRCC with the exophytic rate <50% and absence of pseudocapsule sign may have invasive histological features.

Objective:To explore the mediating role of mindfulness between professional identity and positive emotions among medical students.Methods:From February to April 2022, a total of 878 undergraduates from a medical school in Shandong Province were selected by cluster sampling method. The medical professional identity questionnaire, positive and negative affective scale, and mindful attention awareness scale were utilized for cross-sectional investigation. SPSS 22.0 software was used for descriptive and correlation analysis, and AMOS 25.0 software was used to test the mediating effect.Results:(1) The scores for medical students' professional identity, positive emotions, and mindfulness were 140.00 (125.00, 150.00), 30.00 (28.00, 35.00), and 52.00 (44.00, 63.00), respectively. The dimension scores of occupational cognition, occupational emotion, occupational commitment, occupational behavior, occupational expectation and occupational sense of value in the medical professional identity questionnaire were 23.00 (20.00, 25.00), 19.00 (16.00, 20.00), 19.00 (16.00, 21.00), 16.00 (13.00, 16.00), 32.00 (28.00, 36.00), and 31.00 (29.00, 34.00), respectively. (2) The total and dimension scores of professional identity, positive emotions, and mindfulness were significantly and positively correlated with each other( r=0.125-0.390, all P<0.001). (3) Mindfulness partially mediated the relationship between professional identity and positive emotions (effect size=0.02, 95% CI=0.01-0.04), and the mediating effect accounted for 4.76%(0.02/0.42) of the total effect. Conclusion:Professional identity can directly affect the positive emotions of medical students, and indirectly affect the positive emotions through the mediating role of mindfulness.

Objective To evaluate the effect of inverse ratio ventilation (IRV) strategy on the pulmona-ry function in obese patients with laparoscopic operation under general anesthesia.Methods The databases of Web of Science,Cochrane Library,Embase,PubMed,CNKI,Wangfang and VIP were systematically retrieved. All study literatures of randomized controlled trials of using IRV strategy in obese patients with laparoscopic operation under general anesthesia were collected.The conventional ventilation group adopted the conventional volume controlled protective pulmonary mechanical ventilation (respiratory ratio was 1:2).The IRV group adopted IRV(respiratory ratio was 1:1-2:1).The retrieval time was the database establishment to May 21,2022.Based on the inclusion and exclusion standard,the Endnote was used to screen the literatures,the Co-chrane risk bias evaluation tool was used to evaluate the quality of included literatures and the meta analysis was performed by using the RevMan5.3 software.Results Five articles were finally included by screening,in-volving 312 patients,there were 156 cases in the IRV group and 156 cases in the conventional ventilation group.The inspiratory peak pressure at pneumoperitoneum 30 min (MD=-3.06,95％CI:-3.77 to-2.34,P<0.01) and pneumoperitoneum 60 min (MD=-3.58,95％CI:-4.08 to-3.07,P<0.01) in the IRV group was decreased compared with the conventional ventilation group;the average airway pressure at pneu-moperitoneum 30 min (MD=1.95,95％CI:1.51-2.39,P<0.01),pneumoperitoneum 60 min (MD=1.87,95％CI:1.40-2.35,P<0.01) was increased compared with the conventional ventilation group;the pulmona-ry dynamic lung compliance at pneumoperitoneum 30 min (MD=2.78,95％CI:2.05-3.52,P<0.01) and pneumoperitoneum 60 min (MD=1.87,95％CI:1.40-2.33,P<0.01) was also increased compared with the conventional ventilation group;the oxygenation index (MD=66.83,95％CI:51.11-82.54,P<0.01) and oxygen saturation (PaO2,MD=35.20,95％CI:28.21-42.19,P<0.01) at pneumoperitoneum 60 min in the IRV group was increased compared with the conventional ventilation group.There was no statistically significant difference in PaCO2,PETCO2,mean arterial pressure,heart rate,SaO2,postoperative shoulder pain incidence,and post-operative subcutaneous emphysema incidence between the two groups (P>0.05).Conclusion Application of IRV in the obese patients with laparoscopic surgery under general anesthesia has a certain pulmonary protective effect,which could serve as a selection for mechanic ventilation modes in obese patients in clinic.

Objective: To investigate the role and mechanism of action of Yiqi Huoxue Recipe (YQHXR) in regulating autophagy and reversing liver fibrosis in rats with carbon tetrachloride (CCl4)-induced liver fibrosis. Methods: Healthy male Wistar rats were intraperitoneally injected with a mixture of CCl4 (30%) and olive oil (70%) twice a week for 8 weeks to establish a rat model of liver fibrosis. The rats administered normal diet were used as control group. Furthermore, YQHXR or Fuzheng Huayu Recipe (FZHYR) was intragastrically administered to the rats. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured using an automatic biochemical analyzer. Hematoxylin-eosin (HE) staining and Masson staining were performed to observe the degree of fibrosis in rat liver. The protein expression of α-smooth muscle actin (α-SMA) and type I collagen α1 chain (Col1A1) in liver tissue was measured by immunohistochemistry. Furthermore, the mRNA and protein expression of α-SMA, Col1A1, autophagy-related protein 7 (Atg7), microtubule-associated protein 1 light chain 3 (LC3), and ubiquitin-binding protein (SQSTM1/p62) were determined using qRT-PCR and Western blotting, respectively. Comparison between multiple groups was made by one-way analysis of variance, and comparison between any two groups was made using the LSD test. P < 0.05 was considered as statistically significant. Results: The YQHXR group and FZHYR group had significantly lower serum levels of ALT and AST than the model group (ALT: 66.8±10.42 U/L and 73.2±10.33 U/L vs 106.80±18.24 U/L, F = 31.672, P < 0.001; AST: 122.6±16.65 U/L and 125.4±16.92 U/L vs 278.4±66.14 U/L, F = 25.539, P < 0.001). The pathological grades of hepatic fibrosis were S5.64±0.22, S3.70±0.35, and S3.90±0.34 in the model group, YQHXR group, and FZHYR group, respectively (F = 362.188, P < 0.001). Compared with the control group, the YQHXR group and FZHYR group had significantly reduced mRNA and protein expression of α-SMA, Col1A1, Atg7, and LC3B and significantly increased expression of p62 (all P < 0.05), and the differences were greatest in the YQHXR group. Conclusion YQHXR and FZHYR can prevent or reverse liver fibrosis by regulating hepatocyte autophagy and inhibiting hepatic stellate cell activation and collagen deposition.

Objective To observe the clinical efficacy of the Mingmen eight array massage combined with compound lysine hydrochloride and zinc gluconate granules for the treatment of infantile diarrhea. Methods Totally 120 children with diarrhea met the inclusion criteria were divided into the treatment group, Western medicine group, and general massage group by random number table method, 40 cases in each group. All 3 groups were given dietary guidance and did moderate exercise. Western medicine group was administered orally for compound lysine hydrochloride and zinc gluconate granules, two bags per day for the aged 1–10, three bags per day for the aged >10. Treatment group was given the Mingmen eight array massage therapy based on Western medicine. General massage group received conventional massage therapy based on Western medicine, with four weeks as treatment course. 3 groups of patients were observed before and after treatment for salivary amylase, blood zinc value, urine D-xylose absorption and excretion test, TCM symptom score, and clinical efficacy were evaluated. Results There was statistical significance in the salivary amylase, blood zinc value, and urinary D-xylose absorption and excretion rate between before and after t reatment(P<0.05); after treatment, treatment group showed higher salivary amylase, blood zinc value, and urinary D- xylose absorption and excretion rate than the Western medicine group and general massage group (P<0.05); scores of diarrhea, loose stool, lassitude, lusterless complexion, and appetite reduction decreased compared with before treatment (P<0.05); after treatment, all integrals of treatment group were lower than Western medicine group and general massage group (P<0.05). The total effective rates of the treatment group, Western medicine group and general massage group were 92.50％ (37/40), 72.50％ (29/40), and 75％ (30/40) respectively. There was statistical significance among the three groups (P<0.05). Conclusion Mingmen eight array massage combined with compound lysine hydrochloride and zinc gluconic granules can effectively alleviate the clinical symptoms of patients with infantile diarrhea, and improve the level of laboratory parameters.

Objective To reduce the incidence of falls in elderly patients and improve the quality of nursing safety using tracing method. Methods The tracking methodology was used to formulate fall prevention system and implement tracking path. The tracking centered on patients with high risk of fall and included three aspects: mastery degree of nurses on fall prevention system, participation degree of patients and the implementation of first class quality control. The comparison of tracking result analysis of two quarters in 2016 helped to find out the main reason of the occurrence of falls in elderly patients, make targeted improvement measures and evaluate the effect. Results After the continuous improvement of using tracking methodology, the scores of inspection results and the mastery degree of all nurses on fall core competence in the second quarter were significantly improved when compared to the first quarter (t=23.18, 17.25;P< 0.01); the incidence of falls decreased from 13 cases (6.5%) in the first quarter to 4 cases (2.0%) in the second quarter, while patients' satisfaction degree increased from 85.5% in the first quarter to 98.5% in the second quarter with statistically significant differences between two quarters (χ2=6.38, 14.72; P< 0.01). Conclusions The application of tracing method can effectively reduce the incidence of falls in elderly patients. The method is beneficial to the long-term management of nursing quality, simple, feasible, easy to use, and worthy promoting.

The ancient books on traditional Chinese medicine are mainly covered in the comprehensive bibliogra-phies and special bibliographies of traditional Chinese medicine in the past ages.Their classification was thus de-scribed in the Seven-Classification System, Four-Classification System, Twelve-Classification System,Bibliogra-phy of medical collection and General Bibliography of ancient books on traditional Chinese medicine, followed by an analysis of the classification systems of ancient books on traditional Chinese medicine in the past ages and their evo-lution, which helps to search the medical literature from the vast ancient books according to their classification.

OBJECTIVE To investigate the factors influencing the effects of disinfection of HBV on dental hand piece. METHODS After polluted with HBV positive serum,the dental hand piece was disinfected with sterilizer at the condition of 134℃ for 5 minutes according different treatment procedures.The samples were then taken and detected HBsAg by the automatic enzyme immune analyzer using the third generation EIA agent.The efficacy of disinfection of HBV was presented by the reaction of HBsAg detection. RESULTS If the dental hand piece was sterilized directly not cleansed using clean water after pollution and dried in room temperature,there were 96.87% of the samples being HBsAg positive,and the polluted but dried hand piece,even cleansed there were 87.5% of positive result, even if prolonged the time of sterilization and the frequencies of vacuumization,the HBsAg positive rate of the sample was still up to 56.25%.But if the hand piece was irrigated and cleansed immediately after pollution and sterilized,all samples were HBsAg negative. CONCLUSIONS Whether or not cleansed immediately is the most important factor influencing the efficacy of hand piece sterilization after pollution.

In this article, the plasma half life of IL-2 and its bio-distribution were studied using radio-nucleus Technetium-99M labeled IL-2. The results showed the plasma half life of IL-2 was merely 10 minutes mainly due to IL-2 distribute to its target organ such as liver, kidney etc,rather than clear out of the body. Our results indicated that IL-2 is a high organ-specific drug. It's plasma half life is short under high concentration in its target organ. So it might have advantages of high effectiveness and low whole body toxicity in treatment of tumor of liver and kidney.