Objective To investigate the role of knockdown of peroxiredoxin-6(PRDX6)in injury and adaptive expression of bile acid transporter in human hepatoellular carcinomas(HepG2)cells induced by rifampicin(RFP).Methods Cells in logarithmic growth phase were uniformly inoculated in six-well plates,and HepG2 cells were transiently transfected with specific PRDX6-siRNA and control-siRNA to construct the knockdown group and control group.After 24 h of induction with 100 μmol/L RFP,Western blot and qRT-PCR were performed to detect the protein and gene expression levels of PRDX6,multidrug resistance protein 1(MDR1),multidrug resist-ance-associated proteins 2,3 and 4(MRP2,MRP3 and MRP4),and Na+/taurine taurocholate cotransporter pro-tein(NTCP).Annexin V-FITC/PI double staining assay was used to detect the apoptosis rate of cells in each group;CCK-8 assay was used to detect the changes of cell proliferation in each group;The relative contents of ala-nine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),indirect bilirubin(IBIL)and total bile acid(TBA)in the supernatant of cell culture medium of each group were detected by kits.Results RFP increased the protein and gene expression levels of MRP2,MRP3,MRP4,MDR1,NTCP and PRDX6 in HepG2 cells(P<0.05),while the protein and gene expression levels of MRP2,MRP3,MRP4,MDR1 and NTCP decreased to different degrees after PRDX6 knockdown(P<0.05).In addition,PRDX6 knockdown re-sulted in increased apoptosis rate of HepG2 cells(P<0.05),decreased cell proliferation ability(P<0.05),and increased levels of cell injury markers(ALT,AST,TBIL,DBIL,TBA)in cell culture supernatants(P<0.05).Conclusion RFP increased the protein and gene expression of bile acid transporter and PRDX6 to increase in HepG2 cells.However,following knockdown of PRDX6 and treatment with RFP,the protein and gene expression levels of the bile acid transporter decreased and cell injury was aggravated,suggesting that PRDX6 played a protec-tive role in RFP-induced adaptive response in HepG2 cells.

Objective To investigate the application and effectiveness of the 90°oblique lateral decubitus position in retroperi-toneal laparoscopic urological surgery,providing a clinical approach to effectively reduce the incidence of pressure injuries on the skin.Methods A retrospective study was conducted on 60 urology patients who were admitted to the Department of Urology in our hospital from September to December 2023 for retroperitoneal laparoscopic surgery.The patients were divided into a traditional group and a trial group based on the surgical position,with 30 patients per group.A conventional 90°lateral decubitus position during surgery was applied to the patients in control group,while a 90°oblique lateral decubitus position was offered to the patients in trial group.The two groups were compared in terms of the incidence rate of skin pressure injury,lumbar back pain on the healthy side within 24 hours after surgery and the score of satisfaction from the surgical team.After controlling for demographic variables using logistic regression analysis,the risk of intraoperative pressure injury occurrence in the two groups of patients was found to be related to the group type.The risk of occurrence in the control group was 6.22 times that of the trial group.Results The observation group demonstrated a significantly lower incidence rate of postoperative skin pressure injury,a significantly lower postoperative lumbar back pain on the healthy side within 24 hours,and a significantly higher score in the surgical team satisfaction compared with those of the control group(all P<0.05).Conclusion In retroperitoneal laparoscopic urological surgery,the 90° oblique lateral decubitus position shows a superiority to the conventional lateral decubitus position in reducing the incidence rate of postoperative pressure injury and decreasing the lumbar back pain on the healthy side.

Children with short bowel syndrome (SBS) mainly rely on long-term parenteral nutrition to obtain adequate nutrients until the length and function of the small intestine are improved. In recent years, the clinical application of human glucagon-like peptide 2 analogue Teduglutide has made it more likely for SBS patients to discontinue parenteral nutrition as early as possible and achieve intestinal functional autonomy. This paper reports two cases of SBS children who were treated with Teduglutide combined with parenteral and enteral nutrition for intestinal rehabilitation, and finally got rid of parenteral nutrition. According to the author, there have been no reports of pediatric children using Teduglutide in China.

Children with short bowel syndrome (SBS) mainly rely on long-term parenteral nutrition to obtain adequate nutrients until the length and function of the small intestine are improved. In recent years, the clinical application of human glucagon-like peptide 2 analogue Teduglutide has made it more likely for SBS patients to discontinue parenteral nutrition as early as possible and achieve intestinal functional autonomy. This paper reports two cases of SBS children who were treated with Teduglutide combined with parenteral and enteral nutrition for intestinal rehabilitation, and finally got rid of parenteral nutrition. According to the author, there have been no reports of pediatric children using Teduglutide in China.

Objective : To investigate the effect of mesencephalic astrocyte-derived neurotrophic factor (MANF) on the adaptive expression of bile acid transporter in human hepatoellular carcinomas (HepG2) induced by rifampicin (RFP) ． Methods: The control group cell line (Y07) and the knockdown group cell line (Y25) were constructed by lentiviral stable transfection technology．The Y07 and Y25 cells were treated with RFP of 200 μmol / L for 48 h， and qRT-PCR and Western blot were used to detect the protein and gene expression levels of MANF，bile salt export pump ( BSEP) ，multidrug resistance-related proteins 2 /3 /4 ( MRP2 ，MRP3 ，MRP4) ，multidrug resistance protein 1 (MDR1) ，organic solute transporter a / β ( OSTα/ β) ，organic anion transporter ( OATP2B1) ．The protein and gene expression levels of proliferating cell nuclear antigen ( PCNA) ，proliferating cell marker Ki67 were used to evaluate the proliferation of cells in each group changes in levels．Changes in the protein and gene expression levels of C / EBP homologous protein( CHOP) and cysteinyl aspartate specific proteinase-3 ( Caspase-3) were used to evaluate the apoptosis of cells in each group．The relative contents of alanine aminotransferase(ALT) ，aspartate aminotransferase(AST) ，alkaline phosphatase ( ALP) ，total bilirubin ( TBIL) ，indirect bilirubin ( IBIL) and total bile acid(TBA) in the supernatant of cell culture medium of each group were detected by kits. Results: RFP could induce the protein and gene expression of MANF，BSEP ，MRP2 ，MRP3 ，MRP4 ，MDR1 ，OSTα , OSTβ , OATP2B1 in HepG2 cells (P ＜0. 05 ) ，while the protein and gene expression levels of BSEP ，MRP2 ，MRP3， MRP4，MDR1，OSTα、OSTβ、OATP2B1 decreased after MANF knockdown(P＜0. 05) ．Moreover，under the action of RFP，the protein expression of PCNA and Ki67 in the knockdown group was still higher．The protein and gene levels of CHOP and Caspase-3 significantly increased after MANF knockdown(P＜0. 05) ．The levels of the hepatic cell injury markers in the cell supernatant increased significantly(P＜0. 05) ． Conclusion RFP can induce the expression of bile acid transporter such as BSEP，MRP2，MRP3，MRP4，MDR1，OSTα , OSTβ and OATP2B1 to increase in HepG2 cells(P＜0. 05) ，but the expression of bile acid transporter of HepG2 after MANF knockdown will significantly decrease under the induction of rifampicin(P＜0. 05) ，and cell indury is aggravated，indicating that MANF plays a protective role in RFP-induced adaptive responses by regulating the bile acid transporter.

Objective:To explore the preventive effect of disposable incision protector on incision infection in patients with hepatolithiasis after open hepatectomy.Methods:A retrospective collection of patients with hepatolithiasis who underwent open hepatectomy with a disposable incision protector from January 2015 to December 2018 in the First Affiliated Hospital of Sun Yat-sen University was used as the intervention group. At the same time, patients with hepatolithiasis who did not use the incision protector to undergo partial hepatectomy from January 2012 and December 2014 were collected as the control group. Propensity matching analysis was used to reduce case selection bias and incidences of postoperative incision infection between the two groups were compared before and after matching.Results:In the primary cohort, there were 245 patients in the intervention group and 201 patients in the control group. Patients in the intervention group were younger than those of the control group ( P<0.05) . The proportion of patients with a history of biliary tract surgery in the intervention group was lower than that of the control group, and the operation time was shorter than that of the control group (all P<0.05) . The incidence of incision infection in the intervention group before matching was 5.7% (14/245) , lower than 15.9% in the control group (32/201) , and the difference was statistically significant (χ 2=4.436, P=0.035) . After propensity matching, 165 pairs of patients were generated, there were 165 patients in each group. There was no statistically significant difference in clinical baseline variables between the two groups ( P>0.05) . In the matching cohort, the incidence of incision infection in the intervention group was 7.9% (13/165) , which was lower than 15.2% (25/165) in the control group, and the difference was statistically significant (χ 2=4.283, P=0.039) . Conclusions:The disposable incision protector can effectively prevent postoperative incision infection in patients undergoing open hepatectomy for hepatolithiasis.

Objective: To compare the efficacies of the two techniques of "micro-hemostasis and micro-cutting" with straight bipolar electrocoagulation forceps and traditional clamp-ligation for hemostasia in thyroid surgery. Methods: A total of 228 patients who underwent surgical treatment for thyroid neoplasms in our hospital between January 2015 and December 2018 were retrospectively analyzed, including 50 males and 178 females, aged 23-68 years old. Of those, 150 cases as electric knife group received traditional thyroid surgery between January 2015 and December 2018 and 78 cases as bipolar electrocoagulation group received thyroid surgery by using the technique of bipolar electrocoagulation with meticulous anatomy between January 2018 and December 2018. The total operation time, single operation time, intraoperative hemorrhage, postoperative drainage volume on the first day, postoperative hoarseness and hypocalcemia were compared between the two groups. SPSS 16.0 was used to analyze the data. Results: The total operation time and intraoperative hemorrhage in the bipolar electrocoagulation group were significantly lower than those in the electric knife group ((59.33±18.29)min vs (77.21±25.39)min, (14.83±9.22)ml vs (36.86±11.80)ml, all P<0.01). The single operation time of the bipolar electrocoagulation group was shorter than that of the electric knife group((10.25±6.16) min vs (20.34±7.24)min, (16.25±7.15)min vs (35.68±8.25)min, (12.12±5.25)min vs (20.68±7.26)min, t value was 3.948,16.262,8.238, all P<0.01).There was no significant difference between the two groups in postoperative drainage volume on the first day (P>0.05) and the incidence of postoperative hoarseness (P>0.05), while the incidence of hypocalcemia in the bipolar electrocoagulation group(10.26%) was lower than that in the electric knife group(21.33%,χ²=4.353, P<0.05). Conclusions The fine dissection for thyroid operation can be achieved by using straight bipolar electrocoagulation tweezers. The use of "micro-hemostasis" and "micro-cutting" technique with bipolar electrocoagulation tweezers can greatly reduce intraoperative bleeding, operation time and postoperative complication.

Objective To optimize the matrix prescription and preparation technology of compound pyocutaneous gels. Methods Use the method of L9(34 ) orthogonal test, take the Carbopol-940 quantity, pH, glycerol and ethanol as factors,and take viscosity, pH value, appearance properties, temperature resistance as the comprehensive evaluation index, and compare the effects of stewing, centrifugal and ultrasound methods on removing bubbles in the gel. Ultimately determine the optimum preparation process. Results The best matrix prescription of compound pyocutaneous gels is as follows: carbopol-940 1.4%, 10% sodium hydroxide solution 3.3%,glycerol 2.3%,ethanol 6%;the best way to remove bubbles is centrifugation,with rotation rate at 3 000 r?min-1 for 10 min. Conclusion The selected matrix formulation is simple and feasible, the preparation technology is stable and reliable with good reproducibility, and can be used for the preparation of compound pyocutaneous gel.

Objective To evaluate the accuracy of an expiratory resistance device assisting pulse pressure variation (PPV) in predicting volume responsiveness in the spontaneously breathing patients.Methods Forty spontaneously breathing patients of both sexes,aged 22-61 yr,weighing 51-73 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation,were enrolled.Before induction of anesthesia,mean arterial pressure (MAP),heart rate (HR),central venous pressure (CVP),cardiac index (CI) and pulse pressure variation (PPVB) were recorded after haemodynamics were stable.Then the expiratory resistance device was used,and MAP,HR,CVP,CI,and PPVA were recorded.The device was then removed.Volume expansion was carried out.6％ hydroxyethyl starch 130/0.4 6 ml/kg was infused over 10 min.MAP,HR,CVP,CI and PPVB were recorded within 3 min after volume expansion.The device was used again,and 1 min later MAP,HR,CVP,CI and PPVA were recorded.The device was then removed.The patients were divided into 2 groups according the percentage of increase in CI after volume expansion (△ CI):△ CI≥ 15％ considered to be a positive response group (group P),and ACI＜15％ considered to be a negative response group (group N).A receiver-operating characteristic (ROC) curve for PPV was plotted.According to the ROC curve,the diagnostic threshold,sensitivity,specificity,area under the curve,and 95％ confidence interval of the expiratory resistance device assisting PPV in predicting volume responsiveness were determined.Results The area under the curve (95％ confidence interval) of PPVA was 0.880 (0.70-0.98),the diagnostic threshold was 13.5％,and the sensitivity and specificity in determining volume responsiveness were 87％ and 88％,respectively.Compared with the value before administration of the loading dose,the CVP and CI were significantly increased,and PPVB and PPVA were decreased after volume expansion in group P,and the CVP and CI were significantly increased after volume expansion in group N (P＜0.05).Compared with group P,the PPVA was significantly decreased before volume expansion,and the CI was increased after volume expansion in group N (P＜0.05).Conclusion The expiratory resistance device can assist PPV in predicting volume responsiveness in the spontaneously breathing patients.

Objective To explore the effects of nurses′ risk perceptions of occupational HIV exposure and the self-efficacy on their attitudes and behavior of self-protection in nursing care. Methods An anonymous survey was conducted in eligible nurses with self-designed questionnaire in three conveniently selected comprehensive hospitals in Wuhan. Structural equation modeling was applied in the data analysis. Results Risk perceptions exerted positive effects on the attitudes of self-protection. The standardized path coefficient was 0.45 (P=0.009). The attitudes of self-protection and the risk perceptions exerted no impact on the behavior of self-protection (P > 0.05).The impacts of the self-efficacy on the attitudes and the behavior of self-protection was positive. The standardized path coefficient was 0.15(P=0.02)and 0.53 (P<0.01), respectively. Conclusions Risk perceptions exerted positive effects on the attitudes of self-protection. But the attitudes of self-protection and the risk perceptions exerted no impact on the behavior of self-protection. Self-efficacy can improve the attitudes of self-protection and enhance the behavior of self-protection.