Objective:To compare the short-term clinical efficacy and safety of Da Vinci robot and laparoscopic pancreatectomy.Methods:The data of patients with pancreatic occupying lesions who underwent distal pancreatectomy in Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi′an Jiaotong University from September 2021 to January 2024 were retrospectively analyzed. A total of 60 patients were enrolled, including 20 males and 40 females, aged (52.0±14.8) years. According to different operation methods, 60 patients were divided into robotic group ( n=30, Da Vinci robot-assisted pancreatectomy) and laparoscopic group ( n=30, laparoscopic pancreatectomy). The conversion of laparotomy, operation time, intraoperative blood loss, splenic preservation, postoperative hospital stay, postoperative fasting time, reoperation rate within 30 days after surgery, readmission rate within 90 days after surgery, and postoperative complications such as abdominal hemorrhage, abdominal infection and pancreatic fistula were compared between the two groups. Results:There was no conversion to laparotomy in the laparoscopic group, and 1 case (3.3%) in the robotic group. There were no significant differences in conversion to laparotomy rate, operation time, intraoperative blood loss, postoperative hospital stay, reoperation rate within 30 days after surgery, and readmission rate within 90 days after surgery between the two groups (all P>0.05). The spleen preservation rate of the robotic group was 53.3% (16/30), and the postoperative fasting time was 1.0(1.0, 2.0) d, which was better than that of the laparoscopic group 23.3%(7/30), 2.0(2.0, 3.0) d, with statistical significance ( χ2=5.71, Z=4.04, P=0.017, P<0.001). Postoperative abdominal infection occurred in 6 cases (20.0%), grade B or C pancreatic fistula in 7 cases (23.3%), no abdominal hemorrhage in the laparoscopic group, postoperative abdominal hemorrhage in 3 cases (10.0%), abdominal infection in 4 cases (13.3%), and grade B or C pancreatic fistula in 8 cases (26.7%) in the robotic group. There was no significant difference in the incidence of postoperative abdominal hemorrhage, abdominal infection and grade B or C pancreatic fistula between the two groups (all P>0.05). Conclusion:Da Vinci robotic pancreatectomy is safe and feasible, and the success rate of spleen preservation is better than laparoscopic pancreatectomy.

Objective: To describe bullying victimization of middle school students in Dalian and associated factors, so as to provide scientific basis for campus bullying prevention. Methods: The stratified cluster sampling method was used to select 2 540 middle school students from urban and rural areas in Dalian, who were investigated with campus bullying victimization and related factors. Results: The reported rate of campus bullying victimization among middle school students in Dalian was 25.11%. The rates of physical violence (5.99%, 3.66%) and verbal violence(24.93%, 15.87%) of male students were higher than that of female students( χ 2=6.56, 27.94, P <0.05). The rates of verbal violence (22.84%, 16.25%) and emotional neglect(16.84%, 13.18%) of junior high school students were higher than those of high school students( χ 2=14.21, 5.44, P < 0.05 ). The rates of physical violence(6.07%, 3.55%), verbal violence(24.58%, 16.05%) and emotional neglect(18.88%, 12.06 %) of rural students were higher than those of urban students( χ 2=7.72, 24.81, 19.64, P <0.05). Male students, junior high school students and rural students suffered more severe campus bullying than female students, high school students and urban students( Z =3.46, 3.75, 5.89, P <0.01). The structural equation model showed that academic performance (path coefficient -0.003) and father s education (path coefficient -0.004 ) have a direct negative effect on campus bullying behavior, while mother s education (indirect action coefficient -0.000 8), height(indirect action coefficient -0.000 3), father s education (indirect action coefficient -0.000 3) and weight (indirect action coefficient 0.000 2) indirect effects on campus bullying through academic performance. Conclusion The prevalence of campus bullying victimization among middle school students in Dalian is relatively high, which worths further attention to. Rural students, junior high school students and boys are more likely to suffer campus bullying. Improving academic performance might be beneficial for campus bullying prevention.

Objective:To investigate the value of whole-lesion histogram parameters of apparent diffusion coefficient (ADC) in evaluating and predicting the pathological complete response(PCR) to neoadjuvant chemotherapy (NAC) in different subtypes of breast cancer.Methods:This retrospective study included 117 patients with breast cancer who underwent MRI examination before NAC prior to surgery from January 2016 to December 2017 in the First Affiliated Hospital of Nanjing University. All cases were divided into Luminal B, HER2 positive ( n=21) and triple negative ( n=26) groups. The surgical pathology after chemotherapy was evaluated by Miller-Payne (M-P) system and the patients were divided into PCR group and non-PCR (nPCR) group. Firevoxel software was used to generate the whole-lesion ADC histogram. The parameters included mean (ADC mean), skewness, kurtosis, the minimum (ADC min), the maximum (ADC max), 10th percentile(ADC 10%), 50th percentile (ADC 50%) and 90th percentile (ADC 90%). The two independent samples t test or Mann-Whitney U test was used to compare the differences between PCR and nPCR groups in each subtype. The diagnostic performance of statistically different ADC parameters for predicting PCR was evaluated by receiver operating characteristic (ROC) curve. Results:Kurtosis was significantly higher in PCR group than that in nPCR group in HER2 positive subtype ( P=0.039). It achieved an area under the curve (AUC) of 0.813 with sensitivity of 100% and specificity of 68.7% at the optimal cutoff value (1.861) for differentiating PCR from nPCR cases. In triple negative subtype, ADC mean and ADC 50% were smaller in PCR group than those in nPCR group ( P=0.028,0.013). They achieved AUCs of 0.800, 0.842, respectively. When ADC mean of 1.030×10 -3 mm 2/s and ADC 50% of 0.976×10 -3 mm 2/s were used as cutoff value to differentiate PCR from nPCR, the sensitivities were 75.0%, 80.0% and the specificities were 83.3%, 83.3%, respectively. Conclusion:Kurtosis can predict post-NAC PCR in patients with HER2 positive breast cancer, while ADC 50% has a high value in predicting post NAC PCR of triple negative breast cancer patients.

Objective To systematically review the effect of enteral nutrition via a naso-gastric (intestinal) tube (NG) vs a percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) after liver transplantation,and provide support for the selection of proper nutrition.Methods Pub Med,web of science,Cochrane Library (Jan,2018),CNKI,VIP and Wanfang Date were search until Jan,2018.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer,about the research of retrospective study for the effects of enteral nutrition via NG vs PEG/PEJ after liver transplantation was performed and supplemented.Publication bias were evaluated,and Meta-analyses were conducted with RevMan5.3.Results 4 studies were collected,involving 430 patients.The Meta-analysis showed that starting time of enteral nutrition of PEG/PEJ was earlier than NG (MD =-1.77,95％ CI-1.83 to-1.70,P＜0.05).The average hospitalization time of PEG/PEJ was shorter than NG (MD=-2.88,95％CI-5.19 to-0.56,P＜0.05).The diarrhea incidence of PEG/PEJ was higher than NG (OR=1.66,95％CI 1.04 to 2.65,P＜0.05),and gastroesophageal reflux incidence of PEG/PEJ was lower than NG (OR=0.29,95％CI 0.12 to 0.66,P＜0.05).The gastric retention rate of PEG/PEJ was lower than NG (OR =0.26,95％ CI 0.14 to 0.41,P＜0.05).Dislocation incidence of PEG/PEJ was lower than NG (OR =0.06,95％CI 0.01 to 0.46,P＜0.05).The pneumonia incidence of PEG/PEJ tube was lower than NG (OR=0.59,95％CI 0.36 to 0.99,P＜0.05).There were no significant differences between PEG/PEJ and NG on indwelling time,occlusion,abdominal infection,acute renal insufficiency,and acute rejection reaction.Conclusion PEG/PEJ had earlier starting time of enteral nutrition,shorter hospitalization time,lower nutrition tube placement related complications such as gastric esophagus reflux,gastric retention,dislocation rate and lower incidence of pneumonia,but the incidence of diarrhea was higher.NG is the first choice after liver transplantation,and for patients with serious basic diseases,weak digestive function or digestive system disorders PEG/PEJ can be chosen.

To confirm the etiology of a dead case for a 6 year-old female Ailurus fulgens,one strain of the predominant bacteria from pathologic tissues(heart,liver,spleen,lung and other samples) of the dead Ailurus fulgens were examined and isolated.The isolate was named R1 and no other bacteria were isolated.The bacterial etiological examination(morphological characteristics,biochemical characteristics and 16S rDNA gene detection)of R1 showed that it was identifed as K.peneumoniae.Artificial infection to mice about R1 was also conducted in this study.R1 had strong pathogenicity to mice and the LD50 is 6.5 × 104 CFU/mL.Moreover,the clinical and pathological features of the dead mice were consistent with that of the Ailurus fulgens.To find effective therapeutic drugs of curing other Ailurus fulgens,antibiotic sensitivity test of R1 was conducted,and the results revealed that R1 was highly sensitive to cefotaxime et al,moderately sensitive to amikacin and resistant to penicillin.These data showed that K.peneumoniae was bacterial pathogen leading to death of the Ailurus fulgens and it had strong resistance to penicillins,macrolides and virginiamycin and it had broad drug resistance spectrum.However,R1 is sensitive to cephalosporins and aminoglycoside antibiotics.

Objective To investigate the application value of a pressure-measuring and stone-extracting ureteral access sheath (UAS) used together with negative pressure suction system during flexible ureteroscopy in the treatment of renal caculus.Methods A retrospective analysis was performed on the 98 cases of renal caculus who received flexible ureteroscopic holmium laser lithotripsy (FURS) in the Department of Urology of the Kunming General Hospital of Chengdu Military Command from November 2014 to September 2015,and the enrolled cases were divided into two groups:group A and group B.The new UAS was used in group A combined with vacuum suction during lithotripsy,and simple manometry type UAS was used in group B.The infusion pump flow rate of 0.2 L/min was set in the operation,the perfusion pressure limit was set to 100 mmHg,the suction pressure of group A was 10 kPa.Perfusion flow rate and pressure was adjusted in a timely manner based on the clear vision and the internal pressure force on the kidney.Then we recorded and compared the internal pressure and variation trend of renal and perfusion time of two groups.Results Two groups of patients were successfully completed surgery.The renal pressures in group A were adjusted duly and were lower than the that in group B in the whole process of operation.The average renal pressure in group A was 10.88 ± 5.91 1mmHg.The average renal pressure in group B was 20.10 ± 7.68 mmHg,the pressure control was difficult and unsteady.Conclusion The new type of UAS in the flexible ureteroscopic holmium laser lithotripsy (FURS) can make the renal pressure in surgery controllable and is safe for the FURS.

Objective To explore the effect of postoperative progressive resistance training (PRT) on the upper limb function in breast cancer patients. Methods 66 breast cancer patients were randomly divided into intervention group (n=33) and control group (n=33). The intervention group accepted a 12-week PRT and the control group accepted the routine training since 4-6 weeks postoperative as they admitted to hospital for their first chemotherapy. All the patients received a same content of health education. Results The grip strength, range of motion of abduction and flexion of shoulder were more in the intervention group than in the control group after intervention (P<0.01). Conclusion PRT can effectively improve the function of upper limbs in breast cancer patients.

Objective To investigate the status of professional identity of nursing undergraduates in different grades and to search for their different professional identity level, so as to establish a pertinent method on nursing education for promoting nursing undergraduates′professional identity. Methods By stratified sampling, a total of 286 nursing undergraduates from four grades in Dalian Medical University were surveyed by general information questionnaire and the Professional Identification Scale for Nurses. Results The average total scores of the professional identity of nursing undergraduates were (107.29±15.01) points. There was significant difference in the total score and the five dimensions of professional identity,F=5.625, 5.258, 7.459, 4.182, 6.891, 7.299, P<0.01. Professional identity score was on the rise along with the grade growth, but the score of grade two was significant lower than the other three grades, and the score showed an increase in grade three; grade, whether profession was consistent with their own interests or not, the reasons of choosing the profession were the important factors affecting professional identity of nursing undergraduates. Conclusions The professional identity score of nursing undergraduates is in medium level and remains to be improved. It is suggested that nursing educators should take corresponding measures according to different grades, own interest and physical and mental characteristics of the students, so as to improve their professional identity and lay the foundation for stability and sustainable development of the nursing team in the future.

Objective To provide guidance for clinical prevention and treatment of bleeding during percutaneous nephrolithotomy( PC-NL) . Methods The clinical data of 1 012 patients with intraoperative and postoperative bleeding during percutaneous nephrolithotomy in our urology department were collected,hemorrhoea occurred on 36 cases,the occurrence rate was 3. 56%. The incidence,correlation with cal-culi,diabetes mellitus,examination item,technical operation were analyzed and compared. Results The incidence was 5. 52% for patients with complicated calculi. The incidence of delayed massive haemorrhage has been increased postoperatively in the diabetes mellitus patients. This incidence was 1. 81% for patients with preoperative examination. Along with the extension of time in carrying out technology,PCNL asso-ciated bleeding incidence decreased year by year. Conclusion The occurrence of haemorrhage associated with PCNL could be decreased by correctly handling complicated calculi,preoperative examination,keeping blood glucose homeostasis and improving the manipulation ability of operator.

We constructed transgenic chicken bioreactor vector, driven by chicken ovalbumin promoter, lentiviral vector and cytomegalovirus (CMV) promoter control vector encoding green fluorescent protein (GFP) and luciferase (Luc) as reporter genes. The three vectors were used to transfect or infect chicken primary oviduct epithelial cells, embryo fibroblasts cells, mouse 3T3-L1 preadipocytes cells and bovine mammary epithelial cells. High efficient and specific expression vector for transgenic chicken bioreactor was determined by detecting fluorescence and luciferase activity. Reporter gene analysis showed that chicken ovalbumin promoter expression vector was not cell type-specific in these four different cells. Additionally, luciferase reporter analysis illustrated that the chicken ovalbumin promoter activity was over 100 times lower than that of the CMV promoter in four different cells. Both of these two reporter genes were expressed in those four different cells infected by lentiviral expression vectors. Similarly, the GFP reached the similar expression level in cells infected by lentivirus and cells transfected with CMV promoter plasmid vectors when the multiplicity of infection was 20. In conclusion, the transgenic chicken bioreactor vector under the control of chicken ovalbumin promoter was not highly efficient and cell type-specific. However, the efficient expression and extensiveness oflentiviral vector could be used for studying chicken oviduct bioreactor.
3T3-L1 Cells ; Animals ; Animals, Genetically Modified ; Cattle ; Chickens ; genetics ; Cytomegalovirus ; genetics ; metabolism ; Epithelial Cells ; cytology ; Female ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; Lentivirus ; genetics ; metabolism ; Luciferases ; genetics ; Mice ; Ovalbumin ; genetics ; Oviducts ; cytology ; metabolism ; Promoter Regions, Genetic ; genetics ; Transfection