Hepatic alveolar echinococcosis is a highly invasive zoonotic parasitic disease with poor prognosis. Surgical intervention serves as the pivotal approach to achieve radical cure and improve the prognosis of hepatic alveolar echinococcosis patients. In recent years, with the popularization of the concept of precision surgery and the development of the multidisciplinary diagnosis and treatment model, the surgical treatment strategies for hepatic alveolar echinococcosis have been continuously enriched, and the selection of surgical procedures has become increasingly diversified. Although key surgical techniques such as radical hepatectomy, autologous liver transplantation and allogeneic liver transplantation have achieved remarkable progress in clinical application, many insurmountable challenges still remain. Therefore, by sorting out the latest evidence-based advances in the field of surgical treatment for hepatic alveolar echinococcosis, this article focuses on discussing the application status and bottlenecks of radical hepatectomy, autologous liver transplantation and allogeneic liver transplantation in hepatic alveolar echinococcosis, aiming to provide a reference for the clinical treatment of hepatic alveolar echinococcosis.

OBJECTIVE To investigate the effects of different sterilization methods on 3D-printed polylactic acid(PLA)guide plates for orthopedic surgery,and to analyze their physical properties,microbial contamination,structural performance and bio compatibility after sterilization.METHODS PLA guide plates for orthopedic surgery were prepared with 3D printing technology and divided into a blank group,a hydrogen peroxide plasma steriliza-tion group,an ethylene oxide sterilization group and a pressure steam sterilization group.Before and after sterili-zation,the changes in volume and weight of the surgical guide plates were measured,microbial detection was con-ducted,structural changes were observed with a laser scanning confocal microscope,and cell co-culture was con-ducted to evaluate biocompatibility,thereby the effects of different sterilization methods were assessed.RESULTS The three sterilization methods had no significant effect on the volume and weight of PLA surgical guide plates.Microbial detection showed that all three sterilization methods were effective in killing bacteria,and bacte-rial cultures were negative.Laser confocal scanning microscopy revealed that sterilization treatment caused certain changes to the microstructure of the surgical guide plates,but high-temperature sterilization had a more pro-nounced effect on the deformation of the guide plate edges.Cell co-culture results indicated that the surgical guide plates treated with the three sterilization methods exhibited acceptable cytotoxicity and had little effect on cell pro-liferation.CONCLUSIONS All three sterilization methods cause microstructural changes to the surgical guide plate.Among them,pressure steam sterilization significantly deforms the structure of the guide plate,directly af-fecting its precise positioning of mutual spatial distances,angular relationships and orientation during surgery.Al-though hydrogen peroxide plasma sterilization does not cause significant deformation,ethylene oxide sterilization has the least impact on material properties and structural stability while ensuring the sterilization effect of PLA surgical guide plates.

OBJECTIVE To investigate the effects of different sterilization methods on 3D-printed polylactic acid(PLA)guide plates for orthopedic surgery,and to analyze their physical properties,microbial contamination,structural performance and bio compatibility after sterilization.METHODS PLA guide plates for orthopedic surgery were prepared with 3D printing technology and divided into a blank group,a hydrogen peroxide plasma steriliza-tion group,an ethylene oxide sterilization group and a pressure steam sterilization group.Before and after sterili-zation,the changes in volume and weight of the surgical guide plates were measured,microbial detection was con-ducted,structural changes were observed with a laser scanning confocal microscope,and cell co-culture was con-ducted to evaluate biocompatibility,thereby the effects of different sterilization methods were assessed.RESULTS The three sterilization methods had no significant effect on the volume and weight of PLA surgical guide plates.Microbial detection showed that all three sterilization methods were effective in killing bacteria,and bacte-rial cultures were negative.Laser confocal scanning microscopy revealed that sterilization treatment caused certain changes to the microstructure of the surgical guide plates,but high-temperature sterilization had a more pro-nounced effect on the deformation of the guide plate edges.Cell co-culture results indicated that the surgical guide plates treated with the three sterilization methods exhibited acceptable cytotoxicity and had little effect on cell pro-liferation.CONCLUSIONS All three sterilization methods cause microstructural changes to the surgical guide plate.Among them,pressure steam sterilization significantly deforms the structure of the guide plate,directly af-fecting its precise positioning of mutual spatial distances,angular relationships and orientation during surgery.Al-though hydrogen peroxide plasma sterilization does not cause significant deformation,ethylene oxide sterilization has the least impact on material properties and structural stability while ensuring the sterilization effect of PLA surgical guide plates.

Objective To analyze the hot spots,rules and distribution on safety research of inhalation preparations at home and abroad in the past 20 years,and to summarize the current status of safety and risk control research on inhalation preparations.Methods This reaserch is based on the literature related to the safety and risk control of inhalation preparations in the core collection database of the Web of Science.With the help of Excel 2021 and CiteSpace6.1.R3,visualized processing and analysis were carried out on the annual number of publications,countries,institutions,authors,co-occurrence of keywords,clustering and prominence.Results A total of 365 articles were included,the annual publication number in the field of the safety and risk control of inhalation preparations was less than 30 per year from 2002 to 2018.But since 2019,the number of articles published this year has exceeded 30.Through the analysis of the cooperation network of countries and institutions,the top four countries in terms of publication volume are the United States,the United Kingdom,Germany,and China,and the top three institutions are AstraZeneca,GlaxoSmithKline and Pfizer.Through the analysis of the author cooperation network,the cooperation network between European and American authors was formed earlier,and a certain research group has appeared in 2002.In contrast,a more concentrated cooperation network has been formed in China in 2020.Conclusions In the past 20 years,the research on inhalation preparations has mainly focused on their safety and efficacy,while there are few studies on their risk control.There is a disconnect between safety assessment and risk assessment,and the future focus maybe focused on the adverse reaction assessment and risk management research of inhalation preparations.

Objective To explore the effect of a phased rehabilitation training programme to relieve shoulder dys-function in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recov-ery of patients.Methods This study has been reviewed and approved by the Ethics Committee,and informed consent has been obtained from patients.A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion,and 70 eligible patients from Hospital of Stomatology,Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group(35 patients in each group).The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery,such as shoulder mobility and coordination training and small range of motion training of the neck,while the test group took part in a rehabilitation training program that included familiarization maneuver training,protective rehabilitation,exercise rehabilitation,and resistance training in the following four stages:preoperative,postop-erative general anesthesia and awake until the removal of stitches,the removal of stitches until 6 weeks after surgery,and 6 weeks after surgery until 1 year after surgery.The frequency of training in both groups was at least 3 days per week,and the length of each training session was 10-15 min.The intensity of exercise was 2-3 points on the Borg Conscious Ex-ercise Intensity Scale(i.e.,mild-to-moderate tachypnea or fatigue).The neck dissection injury index(NDII)was used to evaluate the quality of life related to shoulder joint function at four time points:preoperative,postoperative 3 months,postoperative 6 months,and postoperative 12 months.The higher the score,the better the quality of life.Results 28 cases in the test group and 32 cases in the control group completed a one-year follow-up.At 3 and 6 months postopera-tive,the NDII of the test group was significantly higher than that of the control group[3 months postoperative:test group(93.48±9.36)vs.control group(80.00±11.34)(P＜0.001),6 months postoperative:test group(98.21±4.76)vs.control group(90.70±9.12)(P＜0.001)];12 months after surgery,the NDII of the test group(97.23±4.88)was still higher than that of the control group(96.33±4.49),but the difference was not statistically significant(P=0.458).The difference in NDII scores among subjects at 3,6,and 12 months after surgery was statistically significant in each group(P＜0.001).Conclusion The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients'shoulder joint function within 6 months after surgery.

Over the past decade, traditional Chinese medicine (TCM) has widely embraced systems biology and its various data integration approaches to promote its modernization. Thus, integrative pharmacology-based traditional Chinese medicine (TCMIP) was proposed as a paradigm shift in TCM. This review focuses on the presentation of this novel concept and the main research contents, methodologies and applications of TCMIP. First, TCMIP is an interdisciplinary science that can establish qualitative and quantitative pharmacokinetics-pharmacodynamics (PK-PD) correlations through the integration of knowledge from multiple disciplines and techniques and from different PK-PD processes

Objective:To investigate the status of innovative behavioral ability of undergraduate nursing students, analyze the relationship between nursing students′ sense of benefit, self-transcendence and innovative behavioral ability, and explore the mediating effect of occupational benefit in self-transcendence and innovative behavioral ability.Methods:A convenient sampling method was used to select 223 undergraduate nursing students in the First Affiliated Hospital of Guangxi University of Chinese Medicine as the research object from October 2017 to April 2019. The cross-sectional survey was conducted using the occupational benefit, self-transcendment scale and nurses′ innovative behavior scale. Apply SPSS21.0 to analyze the correlation between self-transcendence, occupational benefit and innovative behavior of undergraduate nursing students, apply AMOS 22.0 for mediating effect test, and use the bias-corrected percentile Bootstrap method to estimate the median effect of occupational benefit 95% confidence interval.Results:The path coefficient of undergraduate nursing students′ self-transcendence to innovative behavioral ability was significant ( r value was 0.31, P<0.01). Self-transcendence had a significant positive effect on positive occupational sense ( r value was 0.36, P<0.05). The 95% confidence interval for the Bootstrap test of the indirect effect of positive occupationality was 0.02-0.07; the positive sense of occupation had a partial mediating effect between self-transcendence and innovative behavioral ability, with an effect value of 0.14 and a total effect value of 0.42. That was, the mediation effect value accounted for 33.3% of the total effect value. The path coefficient of the team's ability to feel innovative behavior was significant ( r value was 0.39, P<0.05), and self-transcendence had a positive impact on team belonging ( r value was 0.28, P<0.01). The 95% confidence interval for the Bootstrap test for the indirect effects of team belonging was distributed in 0.10-0.42. The sense of belonging of the team had a partial mediating effect between self-transcendence and innovative behavioral ability. The mediating effect value was 0.07, and the total effect value was 0.42, that was, the mediating effect value accounts for 16.7% of the total effect value. Conclusions:Self-transcendence of undergraduate nursing students can directly predict the ability of innovative behavior, and can also indirectly predict the ability of innovative behavior through the mediating role of positive career perception and team belonging in the sense of professional benefit. Improving the professional benefit and self-transcendence of nursing students in clinical teaching may be an effective way to improve the ability of innovative behavior.

Objective:To observe the effect of personalized nutritional support on postoperative rehabilitation and nutritional status in patients undergoing radical mastectomy and reconstruction of oral malignant tumor.Methods:Eighty-eight patients with oral malignant tumor admitted from January 2018 to December 2018 in Hospital of Stomatology, Sun Yat-sen University were divided into two groups according to the time of admission. 40 patients were selected as the study group and 48 patients were selected as the routine group. The routine group was given traditional health education and dietary guidance. In addition to dietary guidance, the study group was given personalized nutritional support according to the patients' body mass index and nutritional status before and after operation, including oral nutritional supplement before operation, personalized nutritional prescription after operation, and increased protein intake according to the nutritional indicators of the patients. The nutritional status, enteral nutrition complications and postoperative rehabilitation were compared between the two groups two weeks after operation.Results:Two weeks after operation, the hemoglobin, total protein, prealbumin were (107.93±16.19) g/L, (68.40±4.87) g/L, (189.02±55.19) mg/L in the study group, and (101.23±14.62) g/L, (63.11±6.42) g/L, (165.75±40.60) mg/L in the routine group, there were significant differences ( t values were -2.037, -4.271, -2.276, all P<0.05). The incidence of malnutrition, wound infection and gastrointestinal complications were 42.50%(17/40), 0, 5.00%(2/40) in the study group and 64.58%(31/48), 16.67%(8/48), 20.83%(10/48) in the control group, there were significant differences( χ2 values were 4.292, 7.333, 4.644, P<0.05). Conclusions:Perioperative personalized nutritional support can effectively improve the nutritional status, reduce enteral nutrition-related complications, improve immunity and reduce the risk of incision infection in patients undergoing radical mastectomy and simultaneous reconstruction of oral malignant tumors, which is helpful to improve the quality of life of patients and is worthy of clinical reference.

Objective: To explore age of menarche and associated factors of Han nationality, Zhuang nationality and Yao nationality girl in Guangxi, and to provide reference for the development of adolescent health education in schools. Methods: The 7-, 10- and 13-year-old girls of Han, Zhuang, Yao nationality were chosed from three counties of Guangxi, and height, weight and other physical indicators were measured for three consecutive years, and age of menarche was inquired. 448 cases of with compete data in the three consecutive years of monitoring. The influencing factors were investigated through questionnaire. Results: Age of menarche of the whole sample was 11.83(95%CI=11.69-11.96)years old, and that of the Han, Zhuang,Yao nationality was 11.87(95%CI=11.64-12.09), 11.44(95%CI=11.25-11.64)and 12.42(95%CI=12.14-12.70)years old respectively, the difference was statistically significant(P<0.05). Height, sitting height, weight of menarche group in 12 and 13 years old were significantly higher those of the group without menarche(P<0.05). Logistic regression analysis primary sitting height,the chest circumference,intake of seafood,duration of sleep in the night and school exercise time were the primary factors for age at menarche(P<0.01). Conclusion There are ethnic differences in age of menarche among girls in Guangxi, and it is related to sleep,physical activity and dietary structure. Puberty recated health education for girls might start at the fourth grade of primary school, focusing on the education of health life patten, balanced dietary habits, regularly routine, with the goal of growth and development promotion.

Objective To explore the value of cytokines and procalcitonin (PCT) in predicting the potential pathogen and the severity of infection in children with hematological malignancies.Methods This was a prospective cohort study.A total of 1 543 children (3 912 episodes) with hematological malignancies admitted to the Department of Hematology/Oncology in Children's Hospital of Zhejiang University School of Medicine from November 2010 to June 2018 were prospectively enrolled in this study.According to the pathogen,the patients were divided into sepsis group with positive blood culture (380 patients/608 episodes),sepsis group with negative blood culture (539/1 484),non-septic infection group (549/1 709),viral infection group (18/21) and fungal infection group (57/90).The patients were also divided into two groups in either shock group (171/187) or non-shock group (1372/3725).Meanwhile,89 children (112 episodes) with matched hematological malignancies without fever were enrolled as the control group.The levels of PCT and cytokines were measured for detecting the potential relationship between these markers and infection severity.Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between groups.The Receiver Operator Characteristic curve analysis was used to explore the predictive value.Results (1) There were significantly higher levels of interleukin (IL) 6 (H=210.002,P＜0.01),IL-10 (H=223.045,P＜0.01),and PCT (H=76.799,P＜0.01) in the infection group,with area under curre (AUC) of 0.67 (95％CI 0.64-0.69),0.69 (95％CI 0.66-0.71) and 0.59 (95％CI 0.56-0.61),respectively.(2) Among the patients in the shock group,IL-6 (Z=11.460,P＜0.01),IL-10 (Z=14.242,P＜0.01) and PCT (Z=10.813,P＜0.01) were significantly higher than those in the non-shock group,with the AUC of 0.75 (95％CI 0.70-0.79),0.81 (95％CI 0.77-0.84) and 0.73 (95％CI 0.69-0.77),respectively.(3) In patients with septic shock,the incidence of Gram negative bacteria (GNB) infection (60 episodes) was significantly higher than Gram positive bacteria (GPB) infection (22 episodes) (x2=29.665,P＜0.01).The AUC of IL-6,IL-10 and PCT for predicting GNB infection were 0.75 (95％CI 0.72-0.78),0.82 (95％CI 0.79-0.85) and 0.67 (95％CI 0.63-0.70),respectively.(4) The predictive power of IL-6,IL-10 and PCT combination (AUC=0.994) was superior to IL-10 alone (AUC=0.810) in predicting septic shock (Z=10.211,P＜0.01).Conclusions IL-6and IL-10 are better predictors of GNB infection than PCT in hematology-oncology children.Furthermore,the combination of these two cytokines and PCT is more valuable in predicting the severity of infection.