Objective:To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical methods of preferential hepatic parenchymal preservation (non-anatomical liver resection, NAR).Methods:The clinical data of 1 390 cases with solitary HCC combined with liver cirrhosis at an early stage who underwent liver resection at Mengchao Hepatobiliary Hospital of Fujian Medical University and six other medical centers from September 2013 to May 2019 were retrospectively analyzed. Patients were divided into the AR group (486 cases) and the NAR group (904 cases) and the wide surgical margin (WSM) group (745 cases) and the narrow surgical margin (NSM) group (645 cases) according to whether they received AR and the width of the surgical margin (1 cm). The basic information of the patients, preoperative evaluation index data, and postoperative follow-up (follow-up every 3 months) were collected. The Kaplan-Meier method was used to plot the survival curve.The log-rank test was used to compare the difference in survival between the two groups. The Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. Propensity score matching (PSM) was applied to reduce intergroup bias.Results:The overall survival (OS) rates for all patients at 1, 3, and 5 years were 95.5%, 79.9%, and 63.5%, respectively. The recurrence-free survival (RFS) rates were 81.5%, 59.0%, and 43.7%, respectively. There was a statistically significant difference in RFS rate between the AR group and the NAR group prior to PSM, but no statistically significant difference in OS rate (RFS rate: 47.0% vs. 41.9%, P<0.05; OS rate: 64.4% vs. 62.9%, P>0.05). The postoperative RFS rate and OS rate were significantly superior in the WSM group than those of the NSM group (RFS rate: 47.8% vs. 37.2%, P<0.001; OS rate: 69.0% vs. 57.3%, P<0.001). There was no statistically significant difference in OS rate and RFS rate between the AR group and the NAR group following PSM (RFS: 46.3% vs. 45.1%, P>0.05; OS rate: 64.0% vs. 64.3%, P>0.05).The 5-year OS and RFS rates in the WSM group were 66.8% and 60.2%, respectively. The 5-year OS and RFS rates for the NSM group were 48.7% and 41.4%, respectively, with a statistically significant difference ( P<0.05). Cox multivariate analysis indicated that serum albumin, tumor diameter, microvascular invasion, and surgical margin were independent prognostic factors affecting OS and RFS. The Child-Pugh grade and satellite lesions were independent prognostic factors affecting OS. Conclusion:Anatomical liver resection is not an independent risk factor for prognosis, but the state of the resection margin determines the prognosis of patients with solitary HCC combined with cirrhosis. Therefore, hepatic resection margins should be prioritized in such patients.

Objective:To analyze the latent profiles of voice behavior among head nurses and to explore the influencing factors associated with different voice behavior categories.Methods:A convenience sampling method was used to recruit 527 head nurses from 104 medical institutions across 17 provinces in East, South, Central, North, Northwest, Southwest, and Northeast China between November 2023 and January 2024. Data were collected using a General Information Questionnaire, Voice Behavior Scale, Organizational Justice Scale, General Self-Efficacy Scale, and a Brief Personality Inventory. Latent profile analysis was conducted to identify subgroups of voice behavior, and multinomial Logistic regression was performed to explore influencing factors.Results:The score of head nurses' voice behavior was (45.84±6.88). Three latent profiles were identified: low-capacity fluctuating type, medium-capacity stable type, and high-capacity promoting type. Logistic regression analysis showed that openness personality trait, organizational justice, self-efficacy, and hospital grade were significant predictors of voice behavior profiles (all P<0.05) . Conclusions:The overall level of voice behavior among head nurses is above average, with evident heterogeneity. Nursing administrators should actively encourage voice behavior, provide timely feedback, and foster a fair organizational environment to promote a positive and constructive voice culture.

Objective:To analyze the latent profiles of voice behavior among head nurses and to explore the influencing factors associated with different voice behavior categories.Methods:A convenience sampling method was used to recruit 527 head nurses from 104 medical institutions across 17 provinces in East, South, Central, North, Northwest, Southwest, and Northeast China between November 2023 and January 2024. Data were collected using a General Information Questionnaire, Voice Behavior Scale, Organizational Justice Scale, General Self-Efficacy Scale, and a Brief Personality Inventory. Latent profile analysis was conducted to identify subgroups of voice behavior, and multinomial Logistic regression was performed to explore influencing factors.Results:The score of head nurses' voice behavior was (45.84±6.88). Three latent profiles were identified: low-capacity fluctuating type, medium-capacity stable type, and high-capacity promoting type. Logistic regression analysis showed that openness personality trait, organizational justice, self-efficacy, and hospital grade were significant predictors of voice behavior profiles (all P<0.05) . Conclusions:The overall level of voice behavior among head nurses is above average, with evident heterogeneity. Nursing administrators should actively encourage voice behavior, provide timely feedback, and foster a fair organizational environment to promote a positive and constructive voice culture.

Objective:To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical methods of preferential hepatic parenchymal preservation (non-anatomical liver resection, NAR).Methods:The clinical data of 1 390 cases with solitary HCC combined with liver cirrhosis at an early stage who underwent liver resection at Mengchao Hepatobiliary Hospital of Fujian Medical University and six other medical centers from September 2013 to May 2019 were retrospectively analyzed. Patients were divided into the AR group (486 cases) and the NAR group (904 cases) and the wide surgical margin (WSM) group (745 cases) and the narrow surgical margin (NSM) group (645 cases) according to whether they received AR and the width of the surgical margin (1 cm). The basic information of the patients, preoperative evaluation index data, and postoperative follow-up (follow-up every 3 months) were collected. The Kaplan-Meier method was used to plot the survival curve.The log-rank test was used to compare the difference in survival between the two groups. The Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. Propensity score matching (PSM) was applied to reduce intergroup bias.Results:The overall survival (OS) rates for all patients at 1, 3, and 5 years were 95.5%, 79.9%, and 63.5%, respectively. The recurrence-free survival (RFS) rates were 81.5%, 59.0%, and 43.7%, respectively. There was a statistically significant difference in RFS rate between the AR group and the NAR group prior to PSM, but no statistically significant difference in OS rate (RFS rate: 47.0% vs. 41.9%, P<0.05; OS rate: 64.4% vs. 62.9%, P>0.05). The postoperative RFS rate and OS rate were significantly superior in the WSM group than those of the NSM group (RFS rate: 47.8% vs. 37.2%, P<0.001; OS rate: 69.0% vs. 57.3%, P<0.001). There was no statistically significant difference in OS rate and RFS rate between the AR group and the NAR group following PSM (RFS: 46.3% vs. 45.1%, P>0.05; OS rate: 64.0% vs. 64.3%, P>0.05).The 5-year OS and RFS rates in the WSM group were 66.8% and 60.2%, respectively. The 5-year OS and RFS rates for the NSM group were 48.7% and 41.4%, respectively, with a statistically significant difference ( P<0.05). Cox multivariate analysis indicated that serum albumin, tumor diameter, microvascular invasion, and surgical margin were independent prognostic factors affecting OS and RFS. The Child-Pugh grade and satellite lesions were independent prognostic factors affecting OS. Conclusion:Anatomical liver resection is not an independent risk factor for prognosis, but the state of the resection margin determines the prognosis of patients with solitary HCC combined with cirrhosis. Therefore, hepatic resection margins should be prioritized in such patients.

Background:Ulcerative colitis(UC),a chronic non-specific inflammatory bowel disease,is characterized by a prolonged course and a high tendency to relapse.Currently,there is no specific drug for its treatment.An increasing number of studies have revealed that washed microbiota transplantation(WMT)exhibits certain therapeutic effects on UC.Aims:To investigate the clinical efficacy and safety of WMT in treating UC,and to provide a reference basis for the selection of transplantation routes in the future.Methods:The clinical data of 49 UC patients who underwent WMT at the First Affiliated Hospital of Guangdong Pharmaceutical University from May 2017 to December 2020 were retrospectively analyzed.Among them,19 patients were in the middle digestive tract route group and 30 patients were in the lower digestive tract route group.The modified Mayo score,intestinal barrier function(diamine oxidase,D-lactic acid,and bacterial endotoxin),blood parameters,and adverse reactions were compared between the two groups.Results:The modified Mayo score of both groups were significantly lower after treatment compared with those before treatment(P＜0.05).After treatment,in the middle digestive tract route group,the scores for defecation frequency,endoscopic findings,and physician assessment were all significantly decreased(P＜0.05);in the lower digestive tract route group,the scores for defecation frequency,hematochezia,and physician assessment were significantly decreased(P＜0.05).After treatment,the level of bacterial endotoxin in the middle digestive tract route group was significantly reduced(P＜0.05),while there were no significant differences in the levels of diamine oxidase and D-lactic acid(P＞0.05);in the lower digestive tract route group,there were no significant differences in the levels of diamine oxidase,D-lactic acid,and bacterial endotoxin compared with those before treatment(P＞0.05).After treatment,there were no significant changes in hemoglobin,white blood cell count,platelet count,AST,ALT,albumin,creatinine,and blood urea nitrogen in both groups compared with those before treatment,and no severe adverse reactions occurred.Conclusions:WMT demonstrates good clinical efficacy and safety in the treatment of UC.The middle digestive tract transplantation route is more effective in improving intestinal mucosal inflammation and reducing bacterial endotoxin,while the lower digestive tract transplantation route is more effective in reducing patients'hematochezia.This indicates that hematochezia,endoscopic findings,and bacterial endotoxin can be used as references for the selection of transplantation routes.

Background:Ulcerative colitis(UC),a chronic non-specific inflammatory bowel disease,is characterized by a prolonged course and a high tendency to relapse.Currently,there is no specific drug for its treatment.An increasing number of studies have revealed that washed microbiota transplantation(WMT)exhibits certain therapeutic effects on UC.Aims:To investigate the clinical efficacy and safety of WMT in treating UC,and to provide a reference basis for the selection of transplantation routes in the future.Methods:The clinical data of 49 UC patients who underwent WMT at the First Affiliated Hospital of Guangdong Pharmaceutical University from May 2017 to December 2020 were retrospectively analyzed.Among them,19 patients were in the middle digestive tract route group and 30 patients were in the lower digestive tract route group.The modified Mayo score,intestinal barrier function(diamine oxidase,D-lactic acid,and bacterial endotoxin),blood parameters,and adverse reactions were compared between the two groups.Results:The modified Mayo score of both groups were significantly lower after treatment compared with those before treatment(P＜0.05).After treatment,in the middle digestive tract route group,the scores for defecation frequency,endoscopic findings,and physician assessment were all significantly decreased(P＜0.05);in the lower digestive tract route group,the scores for defecation frequency,hematochezia,and physician assessment were significantly decreased(P＜0.05).After treatment,the level of bacterial endotoxin in the middle digestive tract route group was significantly reduced(P＜0.05),while there were no significant differences in the levels of diamine oxidase and D-lactic acid(P＞0.05);in the lower digestive tract route group,there were no significant differences in the levels of diamine oxidase,D-lactic acid,and bacterial endotoxin compared with those before treatment(P＞0.05).After treatment,there were no significant changes in hemoglobin,white blood cell count,platelet count,AST,ALT,albumin,creatinine,and blood urea nitrogen in both groups compared with those before treatment,and no severe adverse reactions occurred.Conclusions:WMT demonstrates good clinical efficacy and safety in the treatment of UC.The middle digestive tract transplantation route is more effective in improving intestinal mucosal inflammation and reducing bacterial endotoxin,while the lower digestive tract transplantation route is more effective in reducing patients'hematochezia.This indicates that hematochezia,endoscopic findings,and bacterial endotoxin can be used as references for the selection of transplantation routes.

Objective:To study the effect of Long non-coding RNA(LncRNA)small nucleolar RNA host gene 12(SNHG12)regulating miR-138-5p/hypoxia inducible factor-1(HIF-1α)axis on improving the damage of hypoxia/reoxygenation(H/R)human vas-cular endothelial cells.Methods:Human umbilical vein endothelial cells(HUVECs)were cultured in vitro and randomly divided into control group,H/R model group,H/R+LncRNA SNHG12 overexpression group,H/R+miR-138-5p mimics group,H/R+co-transfec-tion group and H/R+co-transfection negative control group,each transfection group was transfected separately,and except for control group,the remaining groups were given hypoxia for 5 hours and then reoxygenated for 1 hour to induce the cell models,and then the cell viability of each group was detected by CCK-8 experiment;the cell apoptosis in each group was detected by flow cytometry experi-ment,and the apoptosis rate of each group was compared;the levels of reactive oxygen species(ROS),lactate dehydrogenase(LDH)and inflammatory factors IL-6,IL-17 and IL-18 in each group were measured by the kit;the expressions of miR-138-5p and HIF-1α mRNA in cells of each group were measured by real-time quantitative PCR(qRT-PCR)experiment;the expressions of apoptotic pro-teins caspase-9,Bcl-2-associated X protein(Bax)and HIF-1α in each group were evaluated by Western blot.Results:Compared with control group,the apoptosis rate,cellular ROS,LDH,IL-6,IL-17 and IL-18 levels,cellular HIF-1α mRNA and protein levels,cellular caspase-9,Bax and HIF-1α protein levels were increased in H/R model group(P<0.05),the cell viability and miR-138-5p level were decreased(P<0.05).Compared with H/R model group and H/R+co-transfection group,the cell viability,cell HIF-1αmRNA and protein levels were increased in H/R+LncRNA SNHG12 overexpression group(P<0.05),the apoptosis rate,cellular ROS,LDH,IL-6,IL-17 and IL-18 levels,cellular caspase-9 and Bax protein levels,and miR-138-5p level were decreased(P<0.05);the cell viability,cellular HIF-1α mRNA and protein levels were decreased in H/R+miR-138-5p mimics group(P<0.05),the apoptosis rate,cellular ROS,LDH,IL-6,IL-17 and IL-18 levels,cellular caspase-9 and Bax protein levels were increased(P<0.05).Com-pared with H/R model group,there was no significant difference in cell index levels between the H/R+co-transfection negative control group and the H/R+co-transfection group(P>0.05).Conclusion:LncRNA SNHG12 can upregulate HIF-1α expression by downregulat-ing miR-138-5p expression,inhibit H/R-induced inflammation and oxidative stress in HUVECs,and reduce cell damage and apoptosis.

Metabolic reprogramming, a newly recognized trait of tumor biology, is an intensively studied prospect for oncology medicines. For numerous tumors and cancer cell subpopulations, oxidative phosphorylation (OXPHOS) is essential for their biosynthetic and bioenergetic functions. Cancer cells with mutations in isocitrate dehydrogenase 1 (IDH1) exhibit differentiation arrest, epigenetic and transcriptional reprogramming, and sensitivity to mitochondrial OXPHOS inhibitors. In this study, we report that berberine, which is widely used in China to treat intestinal infections, acted solely at the mitochondrial electron transport chain (ETC) complex I, and that its association with IDH1 mutant inhibitor (IDH1^mi) AG-120 decreased mitochondrial activity and enhanced antileukemic effect in vitro andin vivo. Our study gives a scientific rationale for the therapy of IDH1 mutant acute myeloid leukemia (AML) patients using combinatory mitochondrial targeted medicines, particularly those who are resistant to or relapsing from IDH1^mi.
Humans ; Oxidative Phosphorylation ; Berberine ; Electron Transport ; Mitochondria ; Leukemia, Myeloid, Acute ; Isocitrate Dehydrogenase

Objective:To explore the coverage of influenza and pneumonia vaccination and factors influencing the vaccination in children.Methods:A cross-sectional questionnaire survey was conducted in children's parents in Beijing and Gansu by using two-stage cluster-sampling to investigate the influenza and pneumonia vaccination rates and influencing factors in children.Results:A total of 2 377 parents were included in the study, and the results indicated that the influenza vaccination coverage was 35.93% and the pneumonia vaccination coverage was 16.58% in children in survey areas, the vaccination rate of both vaccines was 11.65%. The top three reasons for vaccination for both vaccines were being aware of severity of the diseases (influenza vaccine: 36.02%; pneumonia vaccine: 49.61%), being required by school or organization (influenza vaccine: 28.76%; pneumonia vaccine: 25.45%) and being aware of the susceptibility of the diseases (influenza vaccine: 26.41%; pneumonia vaccine: 13.88%). The top three reasons for having no vaccinations were personal unwillingness, concern about vaccine and vaccine accessibility. Families with multi children, living in rural areas and lower family income were the negative factors for both types of vaccinations.Conclusions:The influenza and pneumonia vaccination coverage in children need further improvement, and rural families and families with multi children are the key concern groups for expanding vaccination coverage. Health education about influenza and pneumonia vaccinations, coordinating vaccine supply and decreasing vaccine prices play an important role in improving influenza and pneumonia vaccination coverage.

Objective:To explore the clinical efficacy of posterior short-segment internal fixation for the treatment of brucella spondylitis (BS).Methods:The medical records of 34 patients with BS admitted from January 2014 to June 2019 were retrospectively analyzed. There were 22 males and 12 females; the age was 52.3±10.6 years (range 35-72 years). On the basis of standardized use of antibacterial drugs, the lumbar spine posterior short-segment internal fixation was used. Twenty-nine cases underwent simple internal fixation, and posterolateral bone graft fusion, while 5 cases underwent primary debridement, autologous bone grafting and interbody fusion. Monitor erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and test tube agglutination test (SAT) were used to assess inflammation control. Imaging examinations of patients before operation, 1 month after operation, 3 months after operation, 6 months after operation, 1 year after operation to the last follow-up were analyzed to evaluate the condition of intervertebral fusion. The clinical efficacy evaluation was based on the pain visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, modified MacNab grading, and American Spinal Injury Association (ASIA) grading, as well as surgery-related complications.Results:The operation time of 34 patients was 104.64±16.72 min (range 65-145 min), the average hospital stay was 16.49±7.41 days (range 7-38 d), and the average postoperative follow-up time was 20.2 months (range 12-34 months). At the last follow-up, the ESR and CRP fell to the normal range, and the SAT was negative. At 3 months postoperatively, 11 cases (32.35%) reached Bridwell fusion criteria of grade II, 23 cases (67.65%) of grade III; 3 cases (8.82%) of grade I fusion at 6 months after surgery, 31 cases reached grade II fusion (91.18%); all reached grade I fusion at the last follow-up. After the operation, the symptoms of the waist or lower extremities were significantly relieved. The VAS score was 6.3±1.4 before the operation, 4.1±1.2 at 1 month after the operation, 2.7±1.4 at 3 months after the operation, 1.6±1.0 at 6 months after the operation, and 1.2±0.8 at the last follow-up. The JOA score before surgery was 13.8±2.4, 1 month after surgery 17.6±2.6, 3 months after surgery 21.7±3.1, 6 months after operation 4.9±2.7, and at the last follow-up 25.7±1.8. Compared with the preoperative time nodes of the above indicators, the differences were statistically significant. At the last follow-up, of the 12 patients (2 cases of grade C, 10 cases of grade D) with preoperative neurological dysfunction, 2 cases recovered from grade C to grade D, and 10 cases recovered from grade D to E; the excellent and good rate of modified MacNab grading reached 97.06% (33/34). No extradural hematoma, nerve damage, cerebrospinal fluid leakage and other surgical complications occurred. Only 1 case had wound infection complication, and the prognosis was good after active treatment. There were no recurrences during the follow-up period.Conclusion:On the basis of standardized antimicrobial treatment, posterior lumbar short-segment internal fixation is a safe and effective method for the treatment of BS, and good clinical effects can be obtained.