Objective:To observe the effects of adipose-derived stem cells(ADSC)combined with acellular scaffold(AS)on the ultrastructure of dorsal root ganglion and the protein and mRNA expression levels of ciliary neurotrophic factor(CNTF),Janus kinase 2(JAK2),phosphorylated JAK2(p-JAK2),signal transducer and activator of transcription 3(STAT3)and phosphorylated STAT3(p-STAT3)in the rats with sciatic nerve injury(SNI),and to clarify the protective effect of ADSC combined with AS on dorsal root ganglion in the SNI rats and its possible mechanism.Methods:The rat ADSCs were isolated and cultured and their multidirectional differentiation potential was detected.The AS of rats was prepared,and ADSCs were injected into the AS to construct tissue-engineered nerve.A total of 36 rats were randomly divided into control group,model group,AS group,and ADSC+AS group.The rats in control group were routinely fed,and the rats in other groups were used to establish the SNI models by resecting 10 mm of right sciatic nerve.The rats in model group received no further treatment,while the rats in AS group and ADSC+AS group were bridged with AS and the constructed tissue-engineered nerve at the two ends of the injured nerve,respectively.At 6 weeks after surgery,transmission electron microscope was used to observe the ultrastructure of dorsal root ganglion of the rats in various groups;immunofluorescence method was used to detect the protein expression levels of CNTF,p-JAK2,and p-STAT3 in dorsal root ganglion of the rats;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the mRNA expression levels of CNTF,JAK2,and STAT3 in dorsal root ganglion of the rats in various groups.Results:After 7 d of primary ADSC culture,a large number of large and long spindle-shaped cells were observed under the inverted microscope,arranged in clusters or whirlpools;red lipid droplets were observed with oil red O staining under microscope,and calcified nodules were observed with Alizarin red staining under microscope,indicating that the isolated and cultured cells had multidirectional differentiation ability.Compared with normal nerve tissue,the level of DNA in AS of rats was significantly decreased(P<0.05).Compared with control group,the nuclear membrane of dorsal root ganglion cells in model group was uneven and serrated,the number of organelles in the cytoplasm was decreased,mitochondria were swollen with broken or missing cristae and unclear structure;the CNTF protein and mRNA expression levels were significantly decreased(P<0.01),the p-JAK2 and p-STAT3 protein expression levels were significantly increased(P<0.01),and the JAK2 and STAT3 mRNA expression levels were significantly increased(P<0.01).Compared with model group,the serrated change of nuclear membrane of the dorsal root ganglion cells in AS group was significantly alleviated,the number of organelles in the cytoplasm was increased,and mitochondrial swelling was reduced;in ADSC+AS group,the nuclear membrane of dorsal root ganglion cells tended to be intact,the number of organelles was increased,and mitochondrial swelling and vacuolization were significantly reduced;the CNTF protein and mRNA expression levels in the dorsal root ganglion in AS group and ADSC+AS group were significantly increased(P<0.01),the p-JAK2 and p-STAT3 protein expression levels were significantly decreased(P<0.01),and the JAK2 and STAT3 mRNA expression levels were significantly decreased(P<0.01).Compared with AS group,the CNTF protein and mRNA expression levels in ADSC+AS group were significantly increased(P<0.05 or P<0.01),the p-JAK2 and p-STAT3 protein expression levels were significantly decreased(P<0.01),and the JAK2 and STAT3 mRNA expression levels were significantly decreased(P<0.01).Conclusion:The application of ADSC combined with AS can improve the ultrastructure of dorsal root ganglion in the SNI rats,and the mechanism may be related to the increased CNTF expression and decreased activation of the JAK2/STAT3 signaling pathway in the dorsal root ganglion by ADSC combined with AS application.

Objective:To analyze the distribution, drug resistance, and factors influencing pathogenic microorganisms in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) combined with intra-abdominal infection (IAI).Methods:A retrospective analysis was conducted on 282 cases with HBV-ACLF admitted to the Hepatobiliary Internal Medicine Department of Mengchao Hepatobiliary Hospital of Fujian Medical University from May 2019 to December 2022. Patients combined with IAI and positive pathogen culture were enrolled in the infection group (141 cases), and patients combined without IAI admitted during the same period were included in the non-infection group (141 cases). Patient's general clinical data, laboratory examination indicators, pathogen types, and drug sensitivity test results were collected. Logistic regression analysis was used for IAI occurrence risk factors in patients with HBV-ACLF.Results:A total of 204 pathogenic bacteria were detected in the infection group, including 115 strains of Gram-negative bacteria (56.37%), 74 strains of Gram-positive bacteria (36.28%), and 15 strains of fungi (7.35%). The most frequently detected bacterial genera were Escherichia coli (21.57%, 44/204), Klebsiella pneumoniae (12.25%, 25/204), Enterococcus faecium (6.37%, 13/204), Staphylococcus aureus (5.39%, 11/204), and Staphylococcus epidermidis (4.90%, 10/204). The results of drug sensitivity tests showed that the resistance rates of Escherichia coli and Klebsiella pneumoniae to levofloxacin and ciprofloxacin were over 50% (66.67%,26/39;61.54%,24/39)and 30% (34.79%,8/23;39.13%,9/23)respectively. The resistance rate of Pseudomonas aeruginosa to carbapenems ( meropenem and imipenem) was 60.00%. The resistance rates of Acinetobacter baumannii to meropenem and imipenem were 100% (4/4) and 50.00% (2/4) respectively. The resistance rates of Enterococcus faecium and Enterococcus faecalis to penicillin were 100% (13/13) and 33.33% (1/3) respectively. The resistance rates of Staphylococcus aureus to penicillin (77.78%,7/9) and oxacillin (33.33%, 3/9) were relatively high. The results of the multivariate unconditional logistic regression analysis showed that puncture and drainage ( OR=17.90, 95% CI: 7.94-43.42, P<0.001), procalcitonin ( OR=3.23, 95% CI: 1.56-8.98, P=0.012), C-reactive protein ( OR=1.05, 95% CI: 1.02-1.00, P=0.003), and age ( OR=1.06, 95% CI: 1.02-1.10, P=0.001) were independent risk factors for IAI in patients with HBV-ACLF. Conclusions:The pathogenic microorganisms were mainly enterobacteriaceae and enterococci with varying degrees of drug resistance in HBV-ACLF patients combined with IAI. Early-stage intervention is an effective measure to prevent the occurrence of increase of inflammatory indicators in patients with intra-abdominal infection with HBV-ACLF.

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To analyze the distribution, drug resistance, and factors influencing pathogenic microorganisms in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) combined with intra-abdominal infection (IAI).Methods:A retrospective analysis was conducted on 282 cases with HBV-ACLF admitted to the Hepatobiliary Internal Medicine Department of Mengchao Hepatobiliary Hospital of Fujian Medical University from May 2019 to December 2022. Patients combined with IAI and positive pathogen culture were enrolled in the infection group (141 cases), and patients combined without IAI admitted during the same period were included in the non-infection group (141 cases). Patient's general clinical data, laboratory examination indicators, pathogen types, and drug sensitivity test results were collected. Logistic regression analysis was used for IAI occurrence risk factors in patients with HBV-ACLF.Results:A total of 204 pathogenic bacteria were detected in the infection group, including 115 strains of Gram-negative bacteria (56.37%), 74 strains of Gram-positive bacteria (36.28%), and 15 strains of fungi (7.35%). The most frequently detected bacterial genera were Escherichia coli (21.57%, 44/204), Klebsiella pneumoniae (12.25%, 25/204), Enterococcus faecium (6.37%, 13/204), Staphylococcus aureus (5.39%, 11/204), and Staphylococcus epidermidis (4.90%, 10/204). The results of drug sensitivity tests showed that the resistance rates of Escherichia coli and Klebsiella pneumoniae to levofloxacin and ciprofloxacin were over 50% (66.67%,26/39;61.54%,24/39)and 30% (34.79%,8/23;39.13%,9/23)respectively. The resistance rate of Pseudomonas aeruginosa to carbapenems ( meropenem and imipenem) was 60.00%. The resistance rates of Acinetobacter baumannii to meropenem and imipenem were 100% (4/4) and 50.00% (2/4) respectively. The resistance rates of Enterococcus faecium and Enterococcus faecalis to penicillin were 100% (13/13) and 33.33% (1/3) respectively. The resistance rates of Staphylococcus aureus to penicillin (77.78%,7/9) and oxacillin (33.33%, 3/9) were relatively high. The results of the multivariate unconditional logistic regression analysis showed that puncture and drainage ( OR=17.90, 95% CI: 7.94-43.42, P<0.001), procalcitonin ( OR=3.23, 95% CI: 1.56-8.98, P=0.012), C-reactive protein ( OR=1.05, 95% CI: 1.02-1.00, P=0.003), and age ( OR=1.06, 95% CI: 1.02-1.10, P=0.001) were independent risk factors for IAI in patients with HBV-ACLF. Conclusions:The pathogenic microorganisms were mainly enterobacteriaceae and enterococci with varying degrees of drug resistance in HBV-ACLF patients combined with IAI. Early-stage intervention is an effective measure to prevent the occurrence of increase of inflammatory indicators in patients with intra-abdominal infection with HBV-ACLF.

Objective:To investigate the value of ultrasound guided preoperative percutaneous portal vein puncture indocyanine green (ICG) in laparoscopic anatomic liver S8 resection.Methods:The clinical data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anabolic S8 hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2023 to December 2023 were retrospectively analyzed, including 13 males and 2 females with the age of (57.77±11.53) years. Clinical data such as China liver cancer staging (CNLC), target portal vein puncture operation time, operation time, intraoperative blood loss, postoperative complications and perioperative death were recorded.Results:Among the 15 patients, 11 were CNLC Ia stage and 4 were CNLC Ib stage. The operation time of target portal vein puncture for the 15 patients was (11.33±4.51) min, and they all successfully completed percutaneous portal vein puncture ICG fluorescence injection under ultrasound guidance. However, the dyeing effect was not up to expectations for 2 patients. All patients completed laparoscopic anatomical resection of the liver S8 segment, including 6 cases of resection of the liver S8 segment, 8 cases of resection of the posterior segment of the liver S8 segment, and 1 case of resection of the anterior segment of the liver S8 segment. The operative time of laparoscopic anabolic S8 hepatectomy was 181.3 (119.0, 237.0) min, the intraoperative blood loss was 203.3 (100.0, 300.0) ml, there was no intraoperative blood transfusion, and the postoperative hospital stay was (12.00±3.88) d. No positive surgical margin was found in postoperative pathology, and the tumor diameter of 15 patients was (3.29±1.10) cm. No complications of Clavien-Dindo grade Ⅲ or above occurred after surgery, and no perioperative death occurred, and only 1 patient developed pulmonary infection after surgery.Conclusion:Preoperative ultrasound-guided percutaneous portal vein puncture ICG can effectively assist laparoscopic anatomic S8 hepatectomy in patients with hepatocellular carcinoma.