Objective:To analyze the clinical efficacy of vascular resection and reconstruction during radical resection in patients with hilar cholangiocarcinoma.Methods:A retrospective analysis was conducted on the clinical data of 151 patients with hilar cholangiocarcinoma who underwent radical resection in the Department of Hepatobiliary and Pancreatic Surgery at the First Affiliated Hospital of Anhui Medical University from April 2018 to April 2025. Among them, there were 91 males and 60 females, with an age of (65.4±10.5) years. According to whether radical resection of hilar cholangiocarcinoma was combined with vascular resection, the patients were divided into the vascular resection group ( n=19) and the control group ( n=132). Postoperative complications such as bleeding, biliary fistula, and thrombosis were recorded, along with intraoperative blood loss, R 0 resection rate, perioperative mortality, and recurrence rate at six months postoperatively. Results:The preoperative bilirubin reduction and intraoperative blood loss in the vascular resection group were 6 (31.6) and 200 (200, 200) ml, respectively, while those in the control group were 45 (34.1) and 200 (100, 200) ml, respectively. There were no statistically significant differences between the two groups (all P>0.05). The combined liver resection, Billroth operation type Ⅰ-Ⅱ, and operation time in the vascular resection group were 18 (94.7), 1 (5.3), and 420 (377.5, 512.5) min, respectively, while those in the control group were 79 (59.8), 38 (28.8), and 322.5 (260, 410) min, respectively. There were statistically significant differences between the two groups (all P<0.05). The R 0 resection, perioperative mortality rate, postoperative bleeding, postoperative biliary fistula, postoperative thrombosis, postoperative pathology (adenocarcinoma), and recurrence rate at 6 months after surgery in the vascular resection group were 16 (84.2), 2 (10.5), 2 (10.5), 3 (15.8), 1 (5.3), 18 (94.7), and 1 (5.9), respectively, while those in the control group were 103 (78.0), 5 (3.8), 5 (3.8), 25 (18.9), 2 (1.5), 121 (91.7), and 6 (4.7), respectively. There were no statistically significant differences between the two groups (all P>0.05). The postoperative hospital stay, alanine aminotransferase on the 1st and 3rd day after surgery, and postoperative liver failure in the vascular resection group were 18 (13.5, 21.5) days, 619 (305.4, 1 634.0) U/L, and 1 (5.3), respectively, while those in the control group were 14 (11, 18), 254.5 (139.3, 468.3) U/L, and 3 (2.3), respectively. There were statistically significant differences between the two groups (all P<0.05). Conclusion:Vascular resection and reconstruction during radical resection of hilar cholangiocarcinoma in patients has certain safety and efficacy.

Objective:To analyze the clinical efficacy of vascular resection and reconstruction during radical resection in patients with hilar cholangiocarcinoma.Methods:A retrospective analysis was conducted on the clinical data of 151 patients with hilar cholangiocarcinoma who underwent radical resection in the Department of Hepatobiliary and Pancreatic Surgery at the First Affiliated Hospital of Anhui Medical University from April 2018 to April 2025. Among them, there were 91 males and 60 females, with an age of (65.4±10.5) years. According to whether radical resection of hilar cholangiocarcinoma was combined with vascular resection, the patients were divided into the vascular resection group ( n=19) and the control group ( n=132). Postoperative complications such as bleeding, biliary fistula, and thrombosis were recorded, along with intraoperative blood loss, R 0 resection rate, perioperative mortality, and recurrence rate at six months postoperatively. Results:The preoperative bilirubin reduction and intraoperative blood loss in the vascular resection group were 6 (31.6) and 200 (200, 200) ml, respectively, while those in the control group were 45 (34.1) and 200 (100, 200) ml, respectively. There were no statistically significant differences between the two groups (all P>0.05). The combined liver resection, Billroth operation type Ⅰ-Ⅱ, and operation time in the vascular resection group were 18 (94.7), 1 (5.3), and 420 (377.5, 512.5) min, respectively, while those in the control group were 79 (59.8), 38 (28.8), and 322.5 (260, 410) min, respectively. There were statistically significant differences between the two groups (all P<0.05). The R 0 resection, perioperative mortality rate, postoperative bleeding, postoperative biliary fistula, postoperative thrombosis, postoperative pathology (adenocarcinoma), and recurrence rate at 6 months after surgery in the vascular resection group were 16 (84.2), 2 (10.5), 2 (10.5), 3 (15.8), 1 (5.3), 18 (94.7), and 1 (5.9), respectively, while those in the control group were 103 (78.0), 5 (3.8), 5 (3.8), 25 (18.9), 2 (1.5), 121 (91.7), and 6 (4.7), respectively. There were no statistically significant differences between the two groups (all P>0.05). The postoperative hospital stay, alanine aminotransferase on the 1st and 3rd day after surgery, and postoperative liver failure in the vascular resection group were 18 (13.5, 21.5) days, 619 (305.4, 1 634.0) U/L, and 1 (5.3), respectively, while those in the control group were 14 (11, 18), 254.5 (139.3, 468.3) U/L, and 3 (2.3), respectively. There were statistically significant differences between the two groups (all P<0.05). Conclusion:Vascular resection and reconstruction during radical resection of hilar cholangiocarcinoma in patients has certain safety and efficacy.

Objective To investigate the correlation between aCAS and the location and volume of cerebral WMH in the elderly people.Methods A total of 188 elderly WMH patients admitted to our hospital from September 2022 to September 2023 were enrolled and divided into no or mild(stenosis≤49％,137 cases),moderate(50％-69％,25 cases),and severe aCAS groups(≥70％,26 cases)according to the degree of carotid stenosis.All of the patients underwent cranial MRI scanning to assess total,periventricular,deep,and juxtacortical WMH volumes.Univariate and multivariate generalized linear model analyses were used.Results The moderate and severe aCAS groups had significantly older age,larger proportions of coronary heart disease and smoking,and higher total,peri ventricular,and juxtacortical WMH volumes than the no or mild aCAS group,and the deep WMH in the severe aCAS group was higher than that in the no or mild aCAS group(P＜0.05).Multivariate generalized linear model analysis showed that both moderate and severe aCAS were independent risk factors for total WMH volume(OR=325.629,95％CI:24.255-4371.608;OR=51.088,95％CI:4.135-631.128),periventricular WMH volume(OR=27.655,95％CI:5.168-147.976;OR=8.988,95％CI:1.754-46.051),deep WMH volume(OR=3.641,95％CI:1.511-8.774;OR=2.589,95％CI:1.105-6.064)and juxtacortical WMH volume(OR=3.005,95％CI:1.831-4.933;OR=2.199,95％CI:1.36-3.566)(P＜0.05,P＜0.01).Conclusion aCAS is an independent risk factor for WMH in the elderly population,and stenosis＞50％has a greater correlation with WMH volume.

Objective To investigate the effects of different surgical position on the comfort of surgeons and patients during hepatectomy.Methods One hundred patients with liver carcinoma in Southern Hospital of Southern Medical University from October 2014 to October 2015 were selected by purposive sampling method. Patients were simply randomly divided into the observation group and the control group by computer generated random numbers,with 50 patients in each group. Patients in two groups were operated by the same team of surgeons using the same basic surgical approach. The control group adopted the traditional supine position, while the observation group used the modified position placement method. Patient's comfort,the convenience and comfort of surgeons as well as postoperative position related complications were evaluated.Results In the observation group,after the application of modified supine position placement,patients' comfort was significantly higher compared to the control group (Z=-3.458,-9.210;P<0.01). The convenience of surgeons significantly increased,and the operation comfort was significantly higher compared to the control group (χ2=7.440,6.061;P<0.01). The satisfaction of patients and surgeons significantly increased. In the observation group,patients' satisfaction was 94.0% and the surgeons' satisfaction was 96.0%,and they were significantly higher compared to the control group (patients:74.0%,surgeons:80.0%;P<0.01).Conclusions During hepatectomy,the application of modified operation position has a good effect on reducing intraoperative physical fatigue and improving the postoperative comfort of patients.

Objective To study effects of operating room nursing pathway in nursing safety management of laparoscopic cholecystectomy.Methods A total of 120 laparoscopic cholecystectomy patients with liver and gallbladder surgery in hospital were randomly divided into operating pathway group and control group (n=60).Operating room pathway group implemented clinical nursing pathway and the control group was given conventional care, preoperative and postoperative hospitalization days, total hospitalization days, hospitalization costs, average hospitalization expenses, time to first motivation after operation, postoperative self-care ability recovery, and satisfaction were observed.Results The preoperative hospitalization days, postoperative hospitalization days and total hospitalization days, average hospitalization expenses, hospitalization expenses, time to first motivation after operation in operating path group were obviously shorter than the control group (P<0.05);Postoperative self-care ability of operating path group was obviously better than control group (P<0.05);Satisfaction was obviously higher than that of control group(P<0.05).Conclusion Nursing pathway intervention can effectively improve symptoms, quality of life, and satisfaction, so it is worthy of popularization and application.

Objective To study effects of operating room nursing pathway in nursing safety management of laparoscopic cholecystectomy.Methods A total of 120 laparoscopic cholecystectomy patients with liver and gallbladder surgery in hospital were randomly divided into operating pathway group and control group (n=60).Operating room pathway group implemented clinical nursing pathway and the control group was given conventional care, preoperative and postoperative hospitalization days, total hospitalization days, hospitalization costs, average hospitalization expenses, time to first motivation after operation, postoperative self-care ability recovery, and satisfaction were observed.Results The preoperative hospitalization days, postoperative hospitalization days and total hospitalization days, average hospitalization expenses, hospitalization expenses, time to first motivation after operation in operating path group were obviously shorter than the control group (P<0.05);Postoperative self-care ability of operating path group was obviously better than control group (P<0.05);Satisfaction was obviously higher than that of control group(P<0.05).Conclusion Nursing pathway intervention can effectively improve symptoms, quality of life, and satisfaction, so it is worthy of popularization and application.

Skeletal muscle is essential for the glucose disposal in organism, which is one of the major sites of insulin resistance.The over-activity of classical renin-angiotensin system ( RAS) induces the oxidative stress, leads to the impairment of insulin signaling and glucose transport, resulting in insulin resistance of skeleton muscle.The activation of non-classical RAS by inhibiting classical RAS activity, can ameliorate insulin resistance in skeletal muscle tissue.

Ribosomal RNAs are important because they catalyze the synthesis of peptides and proteins. Comparative studies of the secondary structure of 18S rRNA have revealed the basic locations of its many length-conserved and length-variable regions. In recent years, many more sequences of 18S rDNA with unusual lengths have been documented in GenBank. These data make it possible to recognize the diversity of the secondary and tertiary structures of 18S rRNAs and to identify the length-conserved parts of 18S rDNAs. The longest 18S rDNA sequences of almost every known eukaryotic phylum were included in this study. We illustrated the bioinformatics-based structure to show that, the regions that are more length-variable, regions that are less length-variable, the splicing sites for introns, and the sites of A-minor interactions are mostly distributed in different parts of the 18S rRNA. Additionally, this study revealed that some length-variable regions or insertion positions could be quite close to the functional part of the 18S rRNA of Foraminifera organisms. The tertiary structure as well as the secondary structure of 18S rRNA can be more diverse than what was previously supposed. Besides revealing how this interesting gene evolves, it can help to remove ambiguity from the alignment of eukaryotic 18S rDNAs and to improve the performance of 18S rDNA in phylogenetic reconstruction. Six nucleotides shared by Archaea and Eukaryota but rarely by Bacteria are also reported here for the first time, which might further support the supposed origin of eukaryote from archaeans.
Animals ; Base Sequence ; Drosophila melanogaster ; genetics ; Eukaryota ; classification ; Molecular Sequence Data ; Nucleic Acid Conformation ; Phylogeny ; RNA, Ribosomal, 16S ; chemistry ; genetics ; RNA, Ribosomal, 18S ; chemistry ; classification ; genetics ; Sequence Alignment ; Sequence Analysis, RNA ; Thermus thermophilus ; genetics