Objective To explore the technical process and clinical application of laparoscopic combined upper midline incision minimally invasive liver transplantation. Methods A retrospective analysis was conducted on 30 cases of laparoscopic combined upper midline incision minimally invasive liver transplantation. The cases were divided into cirrhosis group (15 cases) and liver failure group (15 cases) based on the primary disease. The surgical and postoperative conditions of the two groups were compared. Results All patients successfully underwent laparoscopic "clockwise" liver resection, with no cases of passive conversion to open surgery or intolerance to pneumoperitoneum. In 6 cases, the right lobe was relatively large, and the right hepatic ligaments could not be completely mobilized. One case required an additional reverse "L" incision during open surgery. All patients successfully completed the liver transplantation, with no major intraoperative bleeding, cardiovascular events, or other occurrences in the 30 patients. The model for end-stage liver disease (MELD) score in the cirrhosis group was lower than that in the liver failure group (P<0.001). There were no statistically significant differences between the two groups in terms of age, surgical time, blood loss, anhepatic phase, or cold ischemia time (all P>0.05). During the perioperative period, there was 1 case of hepatic artery embolism, 1 case of portal vein anastomotic stenosis, no complications of hepatic vein and inferior vena cava, and 3 cases of biliary anastomotic stenosis, all of which occurred in the liver failure group. Conclusions In strictly selected cases, the minimally invasive liver transplantation technique combining laparoscopic hepatectomy with upper midline incision for graft implantation has the advantages of smaller incisions, less bleeding, relatively easier operation, and faster postoperative recovery, which is worthy of clinical promotion and application.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To explore the optimization effect of the nursing pathway driven by the theory of planned behavior(TPB)on postoperative rehabilitation in patients with senile cataract.Methods A total of 100 patients with senile cataract were selected as the research subjects and ran-domly divided into control group and study group using the random number table method,with 50 ca-ses in each group.The control group received routine nursing care,while the study group received TPB-driven nursing pathway intervention in addition to routine care.The postoperative recovery sta-tus,hospitalization expenses,visual quality[Visual Function Index Questionnaire(VF-14)score],self-care ability[Exercise of Self-care Agency Scale(ESC A)score],postoperative complications,and behavioral change intention were compared between the two groups.Results The postoperative visual acuity in the study group was higher,while the intraocular pressure and hospitalization expen-ses were lower than that in the control group.The visual acuity recovery time and hospitalization dura-tion were shorter in the study group than those in the control group,with statistically significant differ-ences(P＜0.05).After the intervention,the VF-14 score and ESC A score in the study group were higher than those in the control group;the overall incidence of postoperative complications in the study group was 4.00％,which was lower than 16.00％in the control group;the scores of each di-mension of behavioral change intention after the intervention in the study group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The TPB-driv-en nursing pathway can effectively optimize the postoperative rehabilitation effect in patients with senile cataract,improve their postoperative visual acuity,visual quality,and self-care ability,thereby enhancing the quality of rehabilitation.

Objective To develop nanobodies with broad-spectrum reactivity,specificity,and high sensitivity that can be used for detecting multiple subtypes of influenza A virus,and to establish a nanobody-based enzyme-linked immunosorbent assay(ELISA)method.Methods Gene sequences of twelve nanobodies against influenza A virus were retrieved from the National Center for Biotechnology Information(NCBI)and nanobody databases.The nanoantibodies were prepared using molecular biological techniques including gene synthesis and recombinant expression.The binding activity,specificity,sensitivity,and affinity of these nanobodies were determined by ELISA screening and Gator affinity analysis.A double-antibody sandwich ELISA assay was established by combining the selected nanobody with a traditional mouse monoclonal antibody.Results Twelve nanobodies were expressed and purified.Two nanobodies capable of binding to multiple subtypes of influenza virus including H1,H3,H5,H7,and H9 were obtained and designated as VHH54 and KV108.Both nanobodies showed no cross-reactivity with other respiratory virus antigens.Furthermore,the KV108 nanobody exhibited the highest binding affinity,with a dissociation constant of 5.94×10-9mol/L for the influenza virus nucleoprotein(NP),and the lowest detection concentration for the NP antigen reached 0.00064 μg/mL.The double-antibody sandwich ELISA,using a combination of KV108 and a mouse monoclonal antibody,could sensitively detect the five common subtypes of influenza A virus(H1N1,H3N2,H5N1,H7N9,and H9N2).The lowest detection limit reached 110-403 PFU/mL,which was higher than that of the commercial colloidal gold kitfor influenza virus detection.Conclusion This study has identified a nanobody KV108,which is capable of binding to multiple subtypes of influenza virus,and established a nanobody-based ELISA method that can detect multiple subtypes of influenza A virus.This study can facilitate the development of nanobody-based influenza detection technologies.

Ulcerative colitis(UC)is a chronic inflammatory bowel disease affecting the colon(particularly the descending colon and sigmoid)and rectum.UC primarily presents with persistent or recurrent diarrhea,abdominal pain,bloody stools,and other symptoms.The primary pathological mechanism of UC involves intestinal barrier injury.When the intestinal barrier function is compromised,characterized by loss of epithelial layer integrity,thinning of the mucus layer,and microbiota dysregulation,pathogenic microorganisms can infiltrate the lamina propria from the intestinal lumen through the damaged barrier,triggering and exacerbating the intestinal inflammatory response.Current treatments for UC are limited by high costs,numerous adverse reactions,and a high likelihood of relapse.Consequently,there is an urgent need for the development of new drugs that can effectively and safely treat UC.Natural products have become significant research targets in treating various diseases due to their broad biological activity,multiple action targets,low toxicity,and easy availability.They play a crucial role in the targeted repair of the intestinal barrier,with potential mechanisms including enhancing intes-tinal epithelial cells and their secreted proteins,regulating gut microbiota and its metabolism,and balancing immune cell subsets.Additionally,it is essential to consider the synergistic effects,bioavailability,and safety of natural products.This paper summarizes the natural products reported in the past five years for their anti-UC properties by repairing the intestinal barrier,providing a theoretical basis for the development and application of natural products in anti-UC drugs.

OBJECTIVE: To investigate the short-term effectiveness of transtibial pull-out technique combined with side-to-side suture technique in treatment of complete radial tear of lateral meniscus body. METHODS: Between May 2020 and August 2023, 15 patients with complete radial tear of lateral meniscus body were repaired by arthroscopic transtibial pull-out technique combined with side-to-side suture technique. There were 11 males and 4 females, with an average age of 25.2 years (range, 15-43 years). Twelve cases were acute injuries and 3 were chronic injuries. All patients had tenderness in the lateral compartment of the knee. No abnormal alignment was observed on the X-ray films of the knee. MRI showed the complete radial tear of lateral meniscus body without associated injuries such as anterior cruciate ligament or cartilage. Preoperative Lysholm score was 44.5±6.4, International Knee Documentation Committee (IKDC) subjective score was 40.2±8.4, Tegner score was 1.3±1.1, and visual analogue scale (VAS) score for pain was 5.1±1.1. The operation time, incision healing, and complications such as vascular/nerve injury were recorded. During follow-up, the range of motion of the knee and tenderness in the lateral compartment of the knee were observed. The knee function and pain were evaluated using Lysholm score, Tegner score, IKDC subjective score, and VAS score. X-ray films and MRI of the knee were reexamined to assess knee degeneration. RESULTS: The operation time was 60-145 minutes (mean, 89.6 minutes). All incisions healed by first intention, and no complication such as vascular/nerve injury occurred. All patients were followed up 17-56 months (mean, 38.4 months). All patients had no knee extension limitation and 3 cases had tenderness in the lateral compartment of the knee. At last follow-up, the Lysholm score, IKDC subjective score, Tegner score, and VAS score for pain were 85.3±7.8, 82.1±15.7, 4.7±1.2, and 1.5±1.0, respectively, which were superior to those before operation ( P<0.05). Imaging reexamination showed that the meniscus was reset at 1 day after operation, and there was no sign of knee degeneration at last follow-up. CONCLUSION Transtibial pull-out technique combined with side-to-side suture technique can effectively treat the complete radial tear of lateral meniscus body and obtain good short-term effectiveness.
Humans ; Male ; Female ; Adult ; Tibial Meniscus Injuries/surgery* ; Adolescent ; Young Adult ; Arthroscopy/methods* ; Treatment Outcome ; Suture Techniques ; Tibia/surgery* ; Menisci, Tibial/surgery* ; Magnetic Resonance Imaging

OBJECTIVE: To investigate the surgical method and short-term effectiveness of arthroscopy edge-to-edge #-shaped suture in the treatment of the complete radial tear of the lateral meniscus body. METHODS: The clinical data of 13 patients with complete radial tear of lateral meniscus body between May 2020 and August 2023 were retrospectively analyzed. There were 10 males and 3 females, aged 15-38 years (mean, 24.2 years). There were 11 cases of acute injury and 2 cases of chronic injury, with time from injury to admission ranging from 2 days to 5 months. All patients had tenderness in the lateral joint space, and 2 patients with chronic injury had positive McMurray's sign. All patients were treated with arthroscopic edge-to-edge #-shaped suture technique. The knee joint activity and tenderness in the lateral joint space were detected, and the healing of the incision and the occurrence of complications were observed. X-ray films and MRI of the knee joint were performed to evaluate joint degeneration and meniscus healing. Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Tegner score, and visual analogue scale (VAS) score were used to evaluate the functional recovery before and after operation. RESULTS: The operation time ranged from 46 to 100 minutes (mean, 80.08 minutes). All the incisions healed by first intention, and no complication such as intraoperative vascular and nerve injury or postoperative infection occurred. All 13 patients were followed up 20-59 months (mean, 29.3 months). All patients had no limitation of knee extension and flexion. One patient with chronic injury continued to have tenderness in the lateral space of the knee joint, while the remaining patients had no tenderness, swelling, and locking in the lateral space. Immediate postoperative MRI of knee joint showed continuous recovery of the lateral meniscus. At last follow-up, no degenerative changes were observed in X-ray films of knee joint. Except for 1 patient with chronic injury, the MRI of the other patients showed the healing performance after lateral meniscus suture. Lysholm score, IKDC subjective score, Tegner score, and VAS score all significantly improved when compared with those before operation (P<0.05). CONCLUSION The edge-to-edge #-shaped suture technique can effectively repair the complete radial tear of the lateral meniscus body, and the short-term effectiveness is satisfactory.
Humans ; Male ; Female ; Adult ; Tibial Meniscus Injuries/surgery* ; Arthroscopy/methods* ; Retrospective Studies ; Adolescent ; Young Adult ; Suture Techniques ; Treatment Outcome ; Menisci, Tibial/surgery* ; Sutures ; Knee Joint/surgery* ; Magnetic Resonance Imaging

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.

Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.