Objective:To explore the clinicopathologic features of early-onset pancreatic cancer (EOPC) and its correlation with dyslipidemia and prognostic analysis.Methods:This is a retrospective cohort study. Clinical and pathological data of 455 patients with pancreatic cancer who underwent radical surgery from January 2013 to September 2020 in the Department of Pancreatic Surgery, Qilu Hospital, Shandong University were retrospectively collected. According to the onset age≤50 years, the patients were divided into EOPC group(67 cases) and later-onset pancreatic cancer (LOPC) group(388 cases). There were 48 males and 19 females in the EOPC group, aged (44.4±5.7) years(range: 28.0 to 50.0 years); and 230 males and 158 females in the LOPC group, aged (63.0±7.2)years (range: 51.0 to 86.0 years). EOPC was divided into two groups according to the blood lipid status: dyslipidemia (50 cases) and normal (17 cases). General information, blood lipid data, clinicopathological parameters and follow-up information were collected. χ2 test, Mann-Whitney U test and Logistic regression analysis were used to evaluate the difference or correlation between groups, and Cox regression analysis and Kaplan-Meier survival curve were used to analyze the impact of EOPC and dyslipidemia on the prognosis. Propensity score matching was used to match two groups of patients in a 1∶1 ratio using nearest neighbor matching, with a caliper set at 0.05. Results:Compared with LOPC group, EOPC group with a higher proportion of patients with body mass index ≥24 kg/m 2 (55.8%(24/43) vs. 38.7%(113/292), χ2=4.542 ,P=0.033), dyslipidemia(74.6%(50/67) vs. 57.7%(224/388), χ2=6.808, P=0.009), pancreatic head cancer (73.1% (49/67) vs. 60.0%(231/385), χ2=4.176, P=0.041) and a lower proportion of patients with type 2 diabetes (9.0%(6/67) vs. 24.2%(94/388), χ2=7.771, P=0.005) and hypertension (9.0%(6/67) vs. 33.0%(128/388), χ2=15.885, P<0.01). Compared the proportion of dyslipidemia in the two groups,there was a higher proportion of high density lipoprotein cholesterol(HDL-C) abnormality in the EOPC group (65.7%(44/67) vs. 42.8%(166/388), χ2=12.044, P<0.01), whereas there was no significant difference in other lipid indices. Kaplan-Meier survival curve analysis of dyslipidemia did not have a significant effect on the prognosis of EOPC patients ( P=0.430). The results of further Logistic regression analysis showed that gender( OR=6.445 (95% CI: 1.692 to 24.548), P=0.006) and tumor location ( OR=5.352 (95% CI: 1.374 to 20.846), P=0.016) were independent related factors with serum lipid level in patients with EOPC. Conclusions:Compared with LOPC, EOPC is more likely to be combined with obesity and HDL-C abnormalities, and the proportion of pancreatic head cancer is also higher, but there is no significant difference in prognosis between the two groups. In the EOPC patients, serum lipid level is associated with gender and tumor site, but has no effect on survival.

Objective:To explore the clinicopathologic features of early-onset pancreatic cancer (EOPC) and its correlation with dyslipidemia and prognostic analysis.Methods:This is a retrospective cohort study. Clinical and pathological data of 455 patients with pancreatic cancer who underwent radical surgery from January 2013 to September 2020 in the Department of Pancreatic Surgery, Qilu Hospital, Shandong University were retrospectively collected. According to the onset age≤50 years, the patients were divided into EOPC group(67 cases) and later-onset pancreatic cancer (LOPC) group(388 cases). There were 48 males and 19 females in the EOPC group, aged (44.4±5.7) years(range: 28.0 to 50.0 years); and 230 males and 158 females in the LOPC group, aged (63.0±7.2)years (range: 51.0 to 86.0 years). EOPC was divided into two groups according to the blood lipid status: dyslipidemia (50 cases) and normal (17 cases). General information, blood lipid data, clinicopathological parameters and follow-up information were collected. χ2 test, Mann-Whitney U test and Logistic regression analysis were used to evaluate the difference or correlation between groups, and Cox regression analysis and Kaplan-Meier survival curve were used to analyze the impact of EOPC and dyslipidemia on the prognosis. Propensity score matching was used to match two groups of patients in a 1∶1 ratio using nearest neighbor matching, with a caliper set at 0.05. Results:Compared with LOPC group, EOPC group with a higher proportion of patients with body mass index ≥24 kg/m 2 (55.8%(24/43) vs. 38.7%(113/292), χ2=4.542 ,P=0.033), dyslipidemia(74.6%(50/67) vs. 57.7%(224/388), χ2=6.808, P=0.009), pancreatic head cancer (73.1% (49/67) vs. 60.0%(231/385), χ2=4.176, P=0.041) and a lower proportion of patients with type 2 diabetes (9.0%(6/67) vs. 24.2%(94/388), χ2=7.771, P=0.005) and hypertension (9.0%(6/67) vs. 33.0%(128/388), χ2=15.885, P<0.01). Compared the proportion of dyslipidemia in the two groups,there was a higher proportion of high density lipoprotein cholesterol(HDL-C) abnormality in the EOPC group (65.7%(44/67) vs. 42.8%(166/388), χ2=12.044, P<0.01), whereas there was no significant difference in other lipid indices. Kaplan-Meier survival curve analysis of dyslipidemia did not have a significant effect on the prognosis of EOPC patients ( P=0.430). The results of further Logistic regression analysis showed that gender( OR=6.445 (95% CI: 1.692 to 24.548), P=0.006) and tumor location ( OR=5.352 (95% CI: 1.374 to 20.846), P=0.016) were independent related factors with serum lipid level in patients with EOPC. Conclusions:Compared with LOPC, EOPC is more likely to be combined with obesity and HDL-C abnormalities, and the proportion of pancreatic head cancer is also higher, but there is no significant difference in prognosis between the two groups. In the EOPC patients, serum lipid level is associated with gender and tumor site, but has no effect on survival.

Objective:To explore the short-term and long-term prognostic outcomes of anatomical liver resection(AR)for patients with perihilar cholangio-carcinoma. Methods:This is a retrospective study.All data were obtained from 4 centers,including The First Affiliated Hospital of Army Medical University,Eastern Hepatobiliary Hospital of Naval Medical University,Sichuan Provincial People's Hospital and Affiliated Hospital of Qinghai University,of a multi-center database.A total of 305 consecutive perihilar cholangiocarcinoma patients receiving radical resection between January 2013 and June 2021 were included in this study.According to the method of liver resection,all patients were divided into the AR group(n=205)and the non-anatomical liver resection(NAR)group(n=100).The baseline characteristics,short-term prognosis and long-term prognosis of the 2 groups were compared. Results:The perioperative transfusion rate and the 30-day complication rate were significantly lower in the AR group than those in the NAR group(P＜0.05).There was no statistically significant difference in the survival rates between the AR and the NAR groups(P＞0.05). Conclusion:The 2 hepatic resection modalities had no obvious effect on the long-term prognosis of perihilar cholangiocarcinoma patients after radical resection,but choosing AR tends to achieve a better short-term prognosis and is worth promoting in clinical practice.

Health coaching is a patient-centered intervention process, which had conducted many years in patients with chronic obstructive pulmonary disease (COPD) and made many positive outcomes. This article reviews the concept of health coaching, specific implementation measures, application effects, existing deficiencies and inspiration in patients with COPD, with a view to providing reference for the further development of health coach technology in patients with COPD.

Objective:To explore whether health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.Methods:The highrisk people with stroke admitted to the hospital were randomly divided into a test group (49) and a control group (49) by excel random function method.The control group was given telephone health education once a week, a total of 12 times last 3 months; On this basis, the test group carried out from every week to every months,a total of 8 timeshealth and wellness coaching, measuring the health promotion lifestyle (HPLP-Ⅱ) scale scores of the two groups of subjects at baseline, at the end of the intervention, and 3 months after the end of the intervention.Results:There was no statistical difference in the general demographic data of the two groups of subjects. Repeated measures analysis of variance showed that three months after the intervention, the two groups of subjects had statistically significant differences in nutrition, health responsibilities, physical activity, self-actualization, and health promotion lifestyle scores between the groups, time, and interaction ( F values were 12.131-502.649, P<0.01). There were no statistical differences in interpersonal relationship and stress coping dimensions ( P>0.05). Simple effect analysis found that at the end of the intervention, the two groups of subjects had only statistical differences between the self-actualization dimension and the total score of health promotion lifestyle ( P<0.01). Three months after the end of the intervention, the total scores of nutrition, health responsibilities, sports, self-actualization and health-promoting lifestyles of the two groups of study subjects were significantly different ( P<0.01). Conclusions:Health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.

Ego-depletion is a phenomenon in which an individual's cognitive, emotional and behavioral control ability or willingness declines after long-term self-control. Patients with chronic diseases need to change their lifestyles for a long time, understand and master the knowledge of the disease, and they are prone to self-depletion after diagnosis. This paper summarized the research progress of ego-depletion in patients with chronic diseases through the concept of ego-depletion, subjective measurement tools, and the current research status of ego-depletion in patients with chronic diseases, and provided inspiration for future research directions, with a view to providing ideas for further research on ego-depletion in patients with chronic diseases.

Objective:To explore the application effect of online teaching supervision in nursing teaching quality of undergraduate nursing students.Methods:Using the convenient sampling method, the 2017 (September 2019 to January 2020) and 2018 (March to July 2020) undergraduate nursing students from the School of Nursing of Harbin Medical University were selected as the research objects. The 2018 undergraduate nursing students were included in the online live teaching group ( n=80) , and the 2017 undergraduate nursing students were included in the offline teaching group ( n=76) . A total of 10 supervisors were selected to evaluate the teaching quality of teachers' online and offline classes through the Multiple Comprehensive Evaluation Tables. The results of the final examination of nursing students in the two groups were used to evaluate the effect of the online live teaching form. The teaching satisfaction with the online live teaching method of nursing students in the two groups was compared. Results:The online teaching scored (95.05±2.14) on the Multiple Comprehensive Evaluation Tables, which was higher than that of the offline teaching (90.05±0.96) , and the difference was statistically significant ( t=6.745, P<0.01) . There were no statistically significant differences in the final exam scores of nursing students in the two groups and their satisfaction with online live teaching methods ( P>0.05) . Conclusions:The practice form of online classroom teaching supervision can effectively ensure the teaching quality and teaching effect of teachers and ensure the teaching satisfaction of nursing students with online live teaching.

Objective A meta-analysis was conducted to evaluate the correlation between hepatitis C virus (HCV) infection and the incidence of intrahepatic cholangiocarcinoma (ICC).Methods EMBASE,MEDLINE,Web of Science,CNKI,Weipu and Wanfang databases were retrieved to identify eligible studies which were published between January 2000 and May 2015.Pooled odds ratios (OR) with 95％ confidence interval (95％ CI) were calculated using RevMAN 5.3.Results 14 case-control studies and 2 cohort studies were included in this study.As there was great heterogeneity among these 16 studies (Chi2 =53.18,df =15,I2 =72％,P ＜0.05),the random-effect model was employed.The combined risk estimates of all the studies showed a significant increase in ICC incidence with HCV infection (OR =3.96,95％ CI 2.63-5.95,P ＜ 0.05).The Begg funnel plot showed no evidence of publication bias.Conclusion HCV infection is related to an increased risk of ICC incidence.

Objective To investigate the timing of super-selective renal artery embolization (SRAE) for the treatment of renal hemorrhage after percutaneous nephrolithotomy (PCNL) .Methods From June 2005 to February 2013 ,a total of 2 165 patients with upper urinary tract calculi underwent PCNL (2 384 PCNL procedures) and 16 of them suffered severe bleeding (0 .74% ) .In the 16 cases ,SRAE was used .The medical records of all the 16 cases were retrospectively analyzed .Results In 16 patients ,15 patients were successful with the first SRAE ,but 2 of them underwent an additional pure renal artery angiography (1 patient before SRAE and 1 patient after SRAE);1 healed after the second SRAE .The mean blood loss and transfusion volume were 32 .9 g/L and 250 mL before the first angiography/SRAE ,and an additional 3 .2 g/L and 0 mL before the second try .Although 1 patient died ,the oth-ers were recovered without complications .Conclusion SRAE should be adopted early for the treatment of severe renal hemorrhage after PCNL .However ,a second try should be considered for the repeated bleeding patients after the negative results of first renal artery angiography or SRAE .

Objective To construct a human phage single chain-antibody library, and to sieve out the antibody ScFv against lung cancer from the library. Methods Total RNA was abstracted from lymph node tissue of the lung cancer, and was used to amplify V_H and V_L gene by RT-PCR. V_H and V_L were joined by a DNA linker by SOE-PCR to form the single chain variable fragment ( ScFv) gene. ScFv gene was coloned into the phage vector pCANT-AB5E. Panning against lung cancer cell line A549 was performed and positive clones were chosen for soluble expression. Results A recombination phage single chain-antibody library was constructed. After 4 rounds panning, the number of eluted phages increased by 115 times. Positive reactions to A549 were detected in 7 of 10 random clones. The human ScFvs against lung cancer were produced and confirmed by SDS-PAGE and ELISA analysis. Conclusion ScFvs against lung cancer were acquired by the construction of phage single chain-antibody library. The soluble ScFvs has specificall avidity to human lung cancer cells.