Objective To investigate the anesthesia effects of different concentrations of sevoflurane combined with propofol during primary liver cancer resection surgery,as well as the changes in immune function in patients.Methods Using single-blind method,120 cases of primary hepatocellular carcinoma admitted to the Third Affiliated Hospital of Naval Military Medical University from January 2023 to September 2023 were prospectively selected as the study subjects,and the patients were randomly(using the randomized numerical table method)included in the control group(60 cases)and the observation group(60 cases).During hepatic cancer resection,the control group was given 0.5 alveolar minimum effective concentration(MAC)sevoflurane combined with propofol target-controlled infusion anesthesia,and the observation group was given 1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,and both groups were observed for 3 d postoperatively.The perioperative related indexes,the sedation and quality of awakening in the immediate moment of extubation,15 min after extubation,and 30 min after extubation,the cognitive function before and at 1 and 3 d postoperatively,vital signs before induction of anesthesia,after induction of anesthesia,at the moment of intubation,at the end of surgery,immune function before and 1 d postoperative,and adverse reactions during the observation period were compared between the two groups.Results The time for extubation,recovery of spontaneous respiration,recovery of orientation,and awakening in the observation group were(11.25±1.69)min,(9.76±1.34)min,(69.23±3.35)min,and(10.13±1.43)min,and the control group were(14.57±2.28)min,(13.55±2.76)min,(73.44±4.52)min,(14.26±2.25)min,all of which were shorter in the observation group than in the control group(P＜0.05).The Ramsay sedation score at the immediate moment of extubation was(4.16±0.22)in the observation group,and(3.21±0.10)in the control group;the standardized(Aldrete)score in the awakening room of the observation group at the immediate moment of extubation,and 15 min after extubation were(9.56±0.12)and(9.77±0.20),respectively,and the control group was(9.02±0.13),respectively,(9.05±0.17)points;the scores of the brief mental state examination(MMSE)scale in the observation group were(26.23±1.12)points and(25.17±0.98)points in the control group in the 1 d postoperative period,which were higher than those of the control group(P＜0.05).The heart rate(HR)at the moment of intubation and at the end of operation in the observation group were(73.08±4.10)beats/min,(75.27±6.03)beats/min,and the mean arterial pressure(MAP)was(81.56±4.49)mmHg and(86.07±5.48)mmHg,respectively,and in the control group the HR was(75.47±5.78)beats/min,(77.91±6.79)beats/min,and the MAP was(85.22±5.08)mmHg and(88.25±6.01)mmHg in the observation group,respectively,which were lower than those in the control group(P＜0.05).The whole blood natural killer(NK)cells,CD4+and CD4+/CD8+in the observation group at 1 d postoperatively were(35.62±5.54)％,(50.09±3.32)％,and(1.42±0.25),the control group were(24.12±4.09)％,(43.17±4.20)％,and(1.20±0.19),the observation group was higher than the control group(P＜0.05);whole blood CD8+was(26.55±3.02)％in the observation group and(28.71±4.45)％in the control group,the observation group was lower than the control group(P＜0.05).The total incidence of adverse reactions during the observation period was 16.67％in the observation group and 5.00％in the control group,which was higher than the control group(P＜0.05).Conclusion Compared with 0.5 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia had less effect on hemodynamics and immune function in patients undergoing resection for primary hepatocellular carcinoma,and it could improve the quality of patients'awakening,cognitive function,and promote postoperative recovery,and the anesthesia was more effective,but it had more adverse effects.

Objective:To explore how the teaching of ideological and political courses in colleges and universities can effectively guide online public opinion under the background of melted media,so as to cope with the challenges posed by diversified information transmission channels and complex and changeable online public opinion,thereby promoting the formation of correct values and ideological cognition among students.Methods:A total of 1 353 students who volunteered to participate in this survey in a university that offers courses related to online public opinion guidance were selected as the survey subjects.Multiple linear regression analysis was used to analyze how universities should teach students to deal with online hot topics through relevant ideological and political courses.Results:Results of multiple linear regression analysis indicated that the teaching of ideological and political courses in colleges and universities under the background of melted media significantly enhanced students'awareness of online public opinion,and the courses played a positive role in the guidance.The improvement of media literacy facilitated the formation of students'correct values and ideological cognition,effectively responding to the challenges of diversified information dissemination.Variables including the infringement of personal privacy by online public opinion,the enhancement of civic consciousness,the impact on learning,and the distortion of reality understanding all had an impact on students'perception of the teaching effect of ideological and political courses.Conclusions:The teaching of ideological and political courses in colleges and universities plays a significant role in guiding online public opinion under the background of melted media.By enhancing students'media literacy,discernment,and emotional management ability,it effectively promotes the formation of students'correct values and ideological ideological,and provides strong support for the healthy growth of students in the complex network environment.The important role of ideological and political teaching in cultivating students'comprehensive abilities and guiding them to correctly deal with online public opinion is emphasized.

Objective:To investigate the feedback on the effectiveness of labor education courses and analyze the factors influencing their development in a medical college.Methods:A satisfaction survey on labor education courses was conducted among first-year undergraduate and college students in a medical college.Comparative analyses focused on students'perceptions of labor education development,personal cognitive attitudes toward labor education,and feedback on course effectiveness.Multiple linear regression analysis was used to analyze the feedback on the effectiveness of labor education courses.Results:A total of 2 688 valid and complete questionnaires were collected.The study found a significant positive correlation between the development of labor education courses and feedback on course effectiveness.And students'cognition and attitudes toward labor education courses also significantly affected course effectiveness.Multiple linear regression analysis further confirmed the importance of these factors in influencing feedback on the effectiveness of labor education courses.Conclusion:The quality of labor education courses and students'cognitive attitudes have a significant impact on the effectiveness of the courses.Colleges and universities need to optimize the labor education environment and improve the quality of education,and strengthen students'labor concept education to promote the comprehensive development of labor education.

Objective:To explore how the teaching of ideological and political courses in colleges and universities can effectively guide online public opinion under the background of melted media,so as to cope with the challenges posed by diversified information transmission channels and complex and changeable online public opinion,thereby promoting the formation of correct values and ideological cognition among students.Methods:A total of 1 353 students who volunteered to participate in this survey in a university that offers courses related to online public opinion guidance were selected as the survey subjects.Multiple linear regression analysis was used to analyze how universities should teach students to deal with online hot topics through relevant ideological and political courses.Results:Results of multiple linear regression analysis indicated that the teaching of ideological and political courses in colleges and universities under the background of melted media significantly enhanced students'awareness of online public opinion,and the courses played a positive role in the guidance.The improvement of media literacy facilitated the formation of students'correct values and ideological cognition,effectively responding to the challenges of diversified information dissemination.Variables including the infringement of personal privacy by online public opinion,the enhancement of civic consciousness,the impact on learning,and the distortion of reality understanding all had an impact on students'perception of the teaching effect of ideological and political courses.Conclusions:The teaching of ideological and political courses in colleges and universities plays a significant role in guiding online public opinion under the background of melted media.By enhancing students'media literacy,discernment,and emotional management ability,it effectively promotes the formation of students'correct values and ideological ideological,and provides strong support for the healthy growth of students in the complex network environment.The important role of ideological and political teaching in cultivating students'comprehensive abilities and guiding them to correctly deal with online public opinion is emphasized.

Objective:To investigate the feedback on the effectiveness of labor education courses and analyze the factors influencing their development in a medical college.Methods:A satisfaction survey on labor education courses was conducted among first-year undergraduate and college students in a medical college.Comparative analyses focused on students'perceptions of labor education development,personal cognitive attitudes toward labor education,and feedback on course effectiveness.Multiple linear regression analysis was used to analyze the feedback on the effectiveness of labor education courses.Results:A total of 2 688 valid and complete questionnaires were collected.The study found a significant positive correlation between the development of labor education courses and feedback on course effectiveness.And students'cognition and attitudes toward labor education courses also significantly affected course effectiveness.Multiple linear regression analysis further confirmed the importance of these factors in influencing feedback on the effectiveness of labor education courses.Conclusion:The quality of labor education courses and students'cognitive attitudes have a significant impact on the effectiveness of the courses.Colleges and universities need to optimize the labor education environment and improve the quality of education,and strengthen students'labor concept education to promote the comprehensive development of labor education.

Objective:To evaluate the clinical outcomes of endoscopic-assisted polyether ether ketone (PEEK) patient-specific implant (PSI) revision for over-resected mandibles caused by the mandibular angle osteotomy.Methods:A retrospective analysis was conducted on 24 patients [8 males, 16 females, aged 19-57 (32.5±9.5) years] with 39 over-resected mandibles that underwent PEEK-PSI mandibular angle revision surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2019 to December 2023. Preoperative cone-beam computed tomography (CBCT) data were used to design and fabricate customized PEEK PSIs based on individual anatomical requirements. An intraoral incision approach with endoscopic assistance was employed to meticulously dissect soft tissue attachment around the angle region, followed by the implantation of a customized PEEK PSI. Postoperative CBCT scans were performed for 3D reconstruction, with root mean square error (RMSE) and maximum deviation (MaxD) as accuracy metrics. Patients′ satisfaction was assessed preoperatively and ≥6 months postoperatively using the face questionnaire (FACE-Q) scores, which included overall facial appearance, lower face and jawline, appearance distress, psychological health and social function.Results:All 24 patients achieved satisfactory recovery with primary healing of intraoral incisions. No complications such as infection, nerve injury, or implant rejection occurred during follow-up period. Patients′ facial appearance and jaw line contouring were significantly improved. Fine anatomical fitting between PEEK-PSI and defect areas was observed: RMSE ranged from 0.117 to 0.315 mm, and MaxD was (5.485±1.300) mm. FACE-Q scores demonstrated significant improvements after surgery in overall facial appearance [(49.8±5.4) vs (65.0±5.3) scores], lower face and jawline [(42.5±5.3) vs (56.1±4.6) scores], appearance distress [(60.0±6.9) vs (70.6±6.5) scores], psychological health [(62.0±5.0) vs (70.8±5.3) scores], and social function [(60.3±4.3) vs (69.3±5.8) scores] (all P<0.001). Conclusion:Endoscopic-assisted PEEK-PSI revision for over-resected mandibles following mandibular angle osteotomy exhibits high surgical precision and safety, effectively restoring mandibular contour and significantly enhancing patients′ satisfaction.

Objective:To investigate the clinical outcomes of precapsular pocket repositioning for correcting implant malposition following augmentation mammoplasty.Methods:A retrospective analysis was conducted on 29 female patients aged 25-37 (28.8±3.4) years who underwent precapsular pocket repositioning at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from December 2015 to August 2024. The surgical technique involved preserving the original capsule, creating a new implant pocket anterior to the capsule, and closing the original capsular space. Postoperative complications were recorded, and breast satisfaction was evaluated preoperatively and at 6 months postoperatively using the BREAST-questionnaire (BREAST-Q).Results:All 29 patients successfully underwent precapsular pocket repositioning with primary wound healing. During the follow-up period, all patients were satisfied with the correction of implant malposition. The mean BREAST-Q score improved significantly from (43.56±3.17) scores preoperatively to (72.56±13.49) scores at 6 months postoperatively ( P<0.001). No hematoma, implant rupture, recurrent malposition, capsular contracture, or surgical site infection occurred in any patient. Conclusion:Precapsular pocket repositioning provides favorable clinical outcomes for patients with implant malposition after augmentation mammoplasty, and there are no severe complications .

Objective To investigate the anesthesia effects of different concentrations of sevoflurane combined with propofol during primary liver cancer resection surgery,as well as the changes in immune function in patients.Methods Using single-blind method,120 cases of primary hepatocellular carcinoma admitted to the Third Affiliated Hospital of Naval Military Medical University from January 2023 to September 2023 were prospectively selected as the study subjects,and the patients were randomly(using the randomized numerical table method)included in the control group(60 cases)and the observation group(60 cases).During hepatic cancer resection,the control group was given 0.5 alveolar minimum effective concentration(MAC)sevoflurane combined with propofol target-controlled infusion anesthesia,and the observation group was given 1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,and both groups were observed for 3 d postoperatively.The perioperative related indexes,the sedation and quality of awakening in the immediate moment of extubation,15 min after extubation,and 30 min after extubation,the cognitive function before and at 1 and 3 d postoperatively,vital signs before induction of anesthesia,after induction of anesthesia,at the moment of intubation,at the end of surgery,immune function before and 1 d postoperative,and adverse reactions during the observation period were compared between the two groups.Results The time for extubation,recovery of spontaneous respiration,recovery of orientation,and awakening in the observation group were(11.25±1.69)min,(9.76±1.34)min,(69.23±3.35)min,and(10.13±1.43)min,and the control group were(14.57±2.28)min,(13.55±2.76)min,(73.44±4.52)min,(14.26±2.25)min,all of which were shorter in the observation group than in the control group(P＜0.05).The Ramsay sedation score at the immediate moment of extubation was(4.16±0.22)in the observation group,and(3.21±0.10)in the control group;the standardized(Aldrete)score in the awakening room of the observation group at the immediate moment of extubation,and 15 min after extubation were(9.56±0.12)and(9.77±0.20),respectively,and the control group was(9.02±0.13),respectively,(9.05±0.17)points;the scores of the brief mental state examination(MMSE)scale in the observation group were(26.23±1.12)points and(25.17±0.98)points in the control group in the 1 d postoperative period,which were higher than those of the control group(P＜0.05).The heart rate(HR)at the moment of intubation and at the end of operation in the observation group were(73.08±4.10)beats/min,(75.27±6.03)beats/min,and the mean arterial pressure(MAP)was(81.56±4.49)mmHg and(86.07±5.48)mmHg,respectively,and in the control group the HR was(75.47±5.78)beats/min,(77.91±6.79)beats/min,and the MAP was(85.22±5.08)mmHg and(88.25±6.01)mmHg in the observation group,respectively,which were lower than those in the control group(P＜0.05).The whole blood natural killer(NK)cells,CD4+and CD4+/CD8+in the observation group at 1 d postoperatively were(35.62±5.54)％,(50.09±3.32)％,and(1.42±0.25),the control group were(24.12±4.09)％,(43.17±4.20)％,and(1.20±0.19),the observation group was higher than the control group(P＜0.05);whole blood CD8+was(26.55±3.02)％in the observation group and(28.71±4.45)％in the control group,the observation group was lower than the control group(P＜0.05).The total incidence of adverse reactions during the observation period was 16.67％in the observation group and 5.00％in the control group,which was higher than the control group(P＜0.05).Conclusion Compared with 0.5 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia had less effect on hemodynamics and immune function in patients undergoing resection for primary hepatocellular carcinoma,and it could improve the quality of patients'awakening,cognitive function,and promote postoperative recovery,and the anesthesia was more effective,but it had more adverse effects.

Objective:To evaluate the clinical outcomes of endoscopic-assisted polyether ether ketone (PEEK) patient-specific implant (PSI) revision for over-resected mandibles caused by the mandibular angle osteotomy.Methods:A retrospective analysis was conducted on 24 patients [8 males, 16 females, aged 19-57 (32.5±9.5) years] with 39 over-resected mandibles that underwent PEEK-PSI mandibular angle revision surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2019 to December 2023. Preoperative cone-beam computed tomography (CBCT) data were used to design and fabricate customized PEEK PSIs based on individual anatomical requirements. An intraoral incision approach with endoscopic assistance was employed to meticulously dissect soft tissue attachment around the angle region, followed by the implantation of a customized PEEK PSI. Postoperative CBCT scans were performed for 3D reconstruction, with root mean square error (RMSE) and maximum deviation (MaxD) as accuracy metrics. Patients′ satisfaction was assessed preoperatively and ≥6 months postoperatively using the face questionnaire (FACE-Q) scores, which included overall facial appearance, lower face and jawline, appearance distress, psychological health and social function.Results:All 24 patients achieved satisfactory recovery with primary healing of intraoral incisions. No complications such as infection, nerve injury, or implant rejection occurred during follow-up period. Patients′ facial appearance and jaw line contouring were significantly improved. Fine anatomical fitting between PEEK-PSI and defect areas was observed: RMSE ranged from 0.117 to 0.315 mm, and MaxD was (5.485±1.300) mm. FACE-Q scores demonstrated significant improvements after surgery in overall facial appearance [(49.8±5.4) vs (65.0±5.3) scores], lower face and jawline [(42.5±5.3) vs (56.1±4.6) scores], appearance distress [(60.0±6.9) vs (70.6±6.5) scores], psychological health [(62.0±5.0) vs (70.8±5.3) scores], and social function [(60.3±4.3) vs (69.3±5.8) scores] (all P<0.001). Conclusion:Endoscopic-assisted PEEK-PSI revision for over-resected mandibles following mandibular angle osteotomy exhibits high surgical precision and safety, effectively restoring mandibular contour and significantly enhancing patients′ satisfaction.

Objective:To investigate the clinical outcomes of precapsular pocket repositioning for correcting implant malposition following augmentation mammoplasty.Methods:A retrospective analysis was conducted on 29 female patients aged 25-37 (28.8±3.4) years who underwent precapsular pocket repositioning at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from December 2015 to August 2024. The surgical technique involved preserving the original capsule, creating a new implant pocket anterior to the capsule, and closing the original capsular space. Postoperative complications were recorded, and breast satisfaction was evaluated preoperatively and at 6 months postoperatively using the BREAST-questionnaire (BREAST-Q).Results:All 29 patients successfully underwent precapsular pocket repositioning with primary wound healing. During the follow-up period, all patients were satisfied with the correction of implant malposition. The mean BREAST-Q score improved significantly from (43.56±3.17) scores preoperatively to (72.56±13.49) scores at 6 months postoperatively ( P<0.001). No hematoma, implant rupture, recurrent malposition, capsular contracture, or surgical site infection occurred in any patient. Conclusion:Precapsular pocket repositioning provides favorable clinical outcomes for patients with implant malposition after augmentation mammoplasty, and there are no severe complications .