Objective:To investigate the application value of laparoscopic-assisted total liver transplantation.Methods:The retrospective and descriptive study was conducted. The clinical data of 9 pairs of donors and recipients who underwent laparoscopic-assisted total liver transplanta-tion in People′s Hospital of Guangxi Zhuang Autonomous Region from January to April 2024 were collected. Of the donors, there were 8 males and 1 female, aged (39±18)years and with body mass index (BMI) of (20±4)kg/m 2. Of the recipients, there were 7 males and 2 females, aged (41±13)years and with BMI of (24±4)kg/m 2. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers. Results:(1) Surgical conditions. Of the 9 recipients, 7 recipients underwent laparoscopic-assisted total liver transplantation successfully, 1 recipient with severe portal hypertension converted to open surgery with reverse L-shaped incision due to the hemorrhage during the dissection of the first hepatic portal after completing liver mobilization under laparoscopy, and 1 recipient underwent trans-umbilical extension incision through the middle of the epigastric region due to the limited space for operation in the implantation of the donor liver. The total operation time for 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (648±31)minutes, with a time of anhepatic phase of (57±5)minutes, the volume of intraoperative blood loss of (1 322±627)mL, the donor liver mass of (1 195±232)g, and the ratio of donor liver mass to recipient body mass of 1.86%±0.42%. The operation time for laparoscopic liver dissection and porta hepatis dissection in 8 recipients during surgery was (212±35)minutes. (2) Postoperative conditions. All 9 recipients recovered smoothly after surgery, without any vascular or biliary related complications, and the surgical incision recovered well. The duration of postoperative hospital stay of 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (14.2±2.0)days. (3) Follow-up. All 9 recipients were followed up for 3 months after surgery. During the follow-up period, there was no vascular or bile duct related complication.Conclusion:Laparoscopic-assisted total liver transplantation can be applied to recipients who meet surgical conditions and achieve good short-term clinical efficacy.

Objective:To investigate the application value of laparoscopic-assisted total liver transplantation.Methods:The retrospective and descriptive study was conducted. The clinical data of 9 pairs of donors and recipients who underwent laparoscopic-assisted total liver transplanta-tion in People′s Hospital of Guangxi Zhuang Autonomous Region from January to April 2024 were collected. Of the donors, there were 8 males and 1 female, aged (39±18)years and with body mass index (BMI) of (20±4)kg/m 2. Of the recipients, there were 7 males and 2 females, aged (41±13)years and with BMI of (24±4)kg/m 2. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers. Results:(1) Surgical conditions. Of the 9 recipients, 7 recipients underwent laparoscopic-assisted total liver transplantation successfully, 1 recipient with severe portal hypertension converted to open surgery with reverse L-shaped incision due to the hemorrhage during the dissection of the first hepatic portal after completing liver mobilization under laparoscopy, and 1 recipient underwent trans-umbilical extension incision through the middle of the epigastric region due to the limited space for operation in the implantation of the donor liver. The total operation time for 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (648±31)minutes, with a time of anhepatic phase of (57±5)minutes, the volume of intraoperative blood loss of (1 322±627)mL, the donor liver mass of (1 195±232)g, and the ratio of donor liver mass to recipient body mass of 1.86%±0.42%. The operation time for laparoscopic liver dissection and porta hepatis dissection in 8 recipients during surgery was (212±35)minutes. (2) Postoperative conditions. All 9 recipients recovered smoothly after surgery, without any vascular or biliary related complications, and the surgical incision recovered well. The duration of postoperative hospital stay of 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (14.2±2.0)days. (3) Follow-up. All 9 recipients were followed up for 3 months after surgery. During the follow-up period, there was no vascular or bile duct related complication.Conclusion:Laparoscopic-assisted total liver transplantation can be applied to recipients who meet surgical conditions and achieve good short-term clinical efficacy.

Objective:To compare the prognosis of patients with unilateral sporadic medullary thyroid carcinoma treated by different surgical selection, and analyze the independent risk factors affecting the prognosis.Methods:One hundred and twenty-six patients at Tianjin Medical University Cancer Institute and Hospital from Feb 2011 to Oct 2018 were retrospectively divided into group A (total thyroiclectomy) and group B (unilateral lobectomy).Results:There were no significant differences in postoperative recurrence rate ( χ2=0.394, P=0.530), mortality ( χ2=3.175, P=0.146), biochemical cure rate ( χ2=0.613, P=0.434), progression free survival and overall survival ( P=0.278, 0.175) between group A and group B; Tumor diameter ≥4 cm and lateral cervical lymph node metastasis were independent risk factors affecting the overall survival. The incidence of postoperative temporary hypocalcemia ( χ2=5.068, P=0.024) and permanent hypocalcemia ( χ2=6.590, P=0.010) in group A was higher than that in group B. Conclusions:Ipsolateral thyroidectomy can be applied to patients with unilateral sporadic medullary thyroid carcinoma with similar long term prognosis and tower incidence of temporary hypocalcemia and permanent hypocalcemia compared to total thyroidectomy.

Objective:To analyze the correlations between serum thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) and clinicopathological features in children and adolescents with papillary thyroid carcinoma (PTC).Methods:A retrospective analysis was conduced on the clinicopathological data of children and adolescents (age≤21 years old) with PTC admitted to Tianjin Medical University Cancer Hospital from 2011 to 2019, and then, we used χ 2 test or Fisher′s exact probability test to compare the differences in clinicopathological characteristics between groups with different TgAb and TPOAb status and multivariate logistic regression model analysis to evaluate independent predictors of cervical lymph node metastasis. Results:A total of 304 patients, including 89 males and 215 females, aged 5-21 years (median age 19 years), were enrolled in this study. The comparison between groups with different TgAb and TPOAb status showed that there were significant differences in gender, preoperative thyroglobulin (Tg) level, primary tumor location, number of primary tumors and maximum tumor diameter (all P<0.05), which suggested that TgAb +group ( n=81) and TPOAb +group ( n=84) had relatively better primary tumor characteristics. Patitents with TgAb +and TPOAb +were more common in females and their preoperative Tg level was mostly within the normal range, and there were significant differences in primary tumor location, number of primary tumors and maximum tumor diameter between TgAb +and TgAb -(223 cases) groups (all P<0.05). There was significant difference in the maximum tumor diameter between TPOAb +and TPOAb -(220 cases) groups ( P<0.05). Analysis of risk factors for cervical lymph node metastasis showed that independent risk factors for central lymph node metastasis were maximum tumor diameter>2 cm ( OR=2.84, 95% CI: 1.59-5.07, P<0.001) and extra-thyroid extension ( OR=0.32, 95% CI: 0.17-0.60, P<0.001), and independent risk factors for lateral neck lymph node metastasis included age≤14 years old ( OR=0.34, 95% CI: 0.18-0.67, P=0.002), preoperative Tg +( OR=2.16, 95% CI: 1.10-4.24, P=0.026) and maximum tumor diameter>2 cm ( OR=3.99, 95% CI: 2.33-6.82, P<0.001). Conclusion:It is recommended to test routinely serum TgAb and TPOAb before surgery in children and adolescents with PTC. Preoperative Tg +, age≤14 years, maximum tumor diameter>2 cm, and extra-thyroid extension are risk factors for cervical lymph node metastasis.

Objective:To study the efficacy and safety of CT guided percutaneous transhepatic microwave ablation (PTPMWA) for primary liver cancer (PLC) in liver segment 9.Methods:A retrospective study was conducted on PLC patients between October 2013 and March 2019 at Dongguan People’s Hospital, Southern Medical University. Of 41 patients who entered into the study, there were 36 males and 5 females, with an average age of 59.1 years. These patients were diagnosed to have PLC in segment 9. The surgical related data and follow-up results were collected and analyzed.Results:All patients enrolled in the study completed the treatment procedure. CT scan was performed immediately after ablation which showed that the tumor areas to be completely covered by ablation. The duration of operation ranged from 45 to 260 (mean 91) min. The amount of bleeding during treatment was 1.0 to 5.0 (mean 1.4) ml. The complete response rate was 97.6% (40 patients) and the partial response rate was 2.4% (1 patient). The cumulative survival rates at 1, 2, 3, 4 and 5 years were 95.1%, 85.4%, 75.3%, 45.2% and 45.2%, respectively. Only 4 patients (9.8%) developed recurrence after treatment. The timings of recurrence were 1, 6, 13 and 67 months after treatment, respectively. The recurrent lesions were ablated again and complete response was obtained in all patients. There were no serious problems related to complications from ablation. The rate of postoperative complication was 7.3% (3 patients).Conclusion:PTPMWA is a novel treatment for patients with PLC in liver segment 9, the advantages of this treatment include good safety, high efficacy, low complications and local recurrence. The treatment is worthy of further future studies.

Objective To explore the application method and value of mind mapping in the clinical teaching of general practitioners for the purpose of improving the teaching qualities. Methods A total of 60 GPs were divided into the test group and control group, undergoing the mind mapping teaching and tra-ditional teaching, respectively. The clinical knowledge achievements were compared in the two groups, and the results were analyzed. At the same time, a questionnaire was conducted. Results The difference between two groups in theoretical teaching was statistically significant (P<0.05), and there was no significant difference in physical examination (P>0.05). In addition, the results of the questionnaire survey showed that the test group was better than the control group in medical knowledge, self-learning ability, interpersonal communication ability, team cooperation ability and other dimensions. Conclusion Mind mapping is an effective teaching tool for general practitioners.

Objective: To conduct an epidemiological investigation of two leptospirosis death cases reported in Guizhou Province in 2014. Methods: The information of the patients were investigated and analyzed. The serological detection, samples of the two patients was detected using ELISA and microscopic agglutination test (MAT). Leptospira carrier status of murine host animal in the living environment of the two patients was investigated in October and November of 2014. Leptospires in the kidney were cultured and isolated, the isolates were identified using Leptospira specific PCR and further identified with serogroup specific PCR and the conventional MAT. The relativity between the carrier status of murine and the death cases of human leptospirosis was analyzed. Results: The two death cases of human leptospirosis came from Liping County and the clinical symptoms were consistent with the diagnosis criteria for Leptospirosis. The results of ELISA detection showed that the anti-Leptospira antibody was positive for one of the death cases, MAT identified the serum reacted with sera-group icterohaemorrhagiae Leptospira, while the serum sample of the other case was failed to perform antibody detection due to hemolysis. 1 600 traps were placed in the living environment of the two death cases and 183 murine rodents were trapped. The murine density was 11.44% (183/1 600); 40 leptospirea suspected strains were isolated and all of them were isolated from Apodemus agrarius. The positive rate was 21.86% (40/183); 95 Apodemus agrarius were trapped and the murine density was 5.93% (95/1 600). Species specific PCR identified all the 40 strains as Leptospire. Serogroup specific PCR further identification showed that they were iterohaemorrahgiae serogroup Leptospria. interrogans. Conclusion Anti-iterohaemorrahgiae Leptospira antibody was detected from one of the two patients. 40 strains of iterohaemorrahgiae serogroup Leptospira interrogans were isolated and all of them were isolated from Apodemus agrarius in the living environment and the serogroup of the Leptospira matched with the serological detection results from patients, which indicated that the two death cases were caused by the infection of iterohaemorrahgiae serogroup Leptospira interrogans, and Apodemus agrarius were the potential source of infection.

OBJECTIVETo understand the genetic and epidemiologic characteristic of Brucella (B.) melitensis strains isolated in Guizhou province in 2010-2012.

METHODSB. genus specific BCSP31-PCR and species-specific AMOS-PCR were used to identify the bacteria strain, while the identified strains were analyzed under MLVA-16 and cluster analysis of B. melitensis strains. The strains were isolated from Guizhou and other provinces.

RESULTSSix B. melitensis strains were identified as B. melitensis using the BCSP31-PCR and AMOS-PCR. Data from the MLVA-16 analysis revealed the differences of repeated numbers at parts of the VNTR locus in the six strains isolated in Guizhou province. The six strains from Guizhou province and 105 B. melitensis strains from other province could be divided into 72 MLVA types(MT). Strain ZY and ZA from Guizhou province were typed as MT63, and LL3, LL4 and LL11 were typed as MT67, while strain SQ was typed as MT72. Data from the clustering analysis showed that ZY,ZA, LL3, LL4 and LL9 were most closely clustered with B. melitensis isolates from Yunnan, Fujian and Guangdong provinces, but strain SQ was genetically remote from other strains.

CONCLUSIONPCR methods, combined with MLVA-16, identified the six B. melitensis strains isolated in Guizhou province in 2010-2012 as B. melitensis biovar 3, with the genetic diversity of the strains showed. Six strains were closely related to the B. melitensis strains from Yunnan, Fujian and Guangdong provinces. The results of this study provided scientific basis for the control and prevention of Brucellosis in Guizhou province.

Brucella melitensis ; genetics ; isolation & purification ; Brucellosis ; epidemiology ; China ; epidemiology ; Cluster Analysis ; Genetic Variation ; Humans ; Minisatellite Repeats ; Polymerase Chain Reaction

Objective To understand the genetic and epidemiologic characteristic of Brucella (B.) melitensis strains isolated in Guizhou province in 2010-2012. Methods B. genus specific BCSP31-PCR and species-specific AMOS-PCR were used to identify the bacteria strain,while the identified strains were analyzed under MLVA-16 and cluster analysis of B. melitensis strains. The strains were isolated from Guizhou and other provinces. Results Six B. melitensis strains were identified as B. melitensis using the BCSP31-PCR and AMOS-PCR. Data from the MLVA-16 analysis revealed the differences of repeated numbers at parts of the VNTR locus in the six strains isolated in Guizhou province. The six strains from Guizhou province and 105 B. melitensis strains from other province could be divided into 72 MLVA types(MT). Strain ZY and ZA from Guizhou province were typed as MT63,and LL3,LL4 and LL11 were typed as MT67,while strain SQ was typed as MT72. Data from the clustering analysis showed that ZY,ZA,LL3,LL4 and LL9 were most closely clustered with B. melitensis isolates from Yunnan,Fujian and Guangdong provinces,but strain SQ was genetically remote from other strains. Conclusion PCR methods,combined with MLVA-16, identified the six B. melitensis strains isolated in Guizhou province in 2010-2012 as B. melitensis biovar 3,with the genetic diversity of the strains showed. Six strains were closely related to the B. melitensis strains from Yunnan,Fujian and Guangdong provinces. The results of this study provided scientific basis for the control and prevention of Brucellosis in Guizhou province.

Objective To study outcomes of the family doctor contact system and outpatient coordination system in Qingdao.Methods Random selection of 400 community residents and 576 outpatients for a questionnaire survey,using t tests and time series analysis.The purpose is to analyze the number of insured workers,community referrals,costs of hospitalization and the proportion of out-of-pocket payment,and impacts on community healthcare services.Results Number of insured works increased year by year,up to 1,739,931 in 2010.The proportion of community referred hospitalization was raised to 56.97％ in 2010 and increased 54.26％ compared to 2007.Hospitalization costs and the proportion of out-of-pocket payment were reduced.Conclusion The family doctor contact system and outpatient coordination system in Qingdao proved a success,as the practices were highly popular among the employees,and benefited community health centers as well,making it worthwhile to promote.