Objective:To investigate the anatomic classification and reconstruction of right intrahepatic bile duct in the donor liver of split liver transplantation (SLT).Methods:The retrospective and descriptive study was constructed. The clinical data of 85 patients who underwent SLT in the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to January 2022 were collected. There were 65 males and 20 females, aged 45(range, 1-82)years. Observation indicators: (1) surgical conditions; (2) anatomy of right intrahepatic bile duct; (3) bile duct reconstruction; (4) postoperative biliary complications; (5) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range) or M( Q1, Q3).Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Surgical conditions. Of the 85 donor livers, 11 donor livers were split between the left and right hemilivers, and 74 donor livers were split between the classic right trilobe and left lateral lobe. The cold ischemia time of 85 donor livers was 291(273, 354)minutes, and the operation time, anhepatic phase time and volume of intraoperative blood transfusion of 85 recipients were (497±97)minutes, 51(40, 80)minutes and 8(7, 12)U. (2) Anatomy of right intrahepatic bile duct. Of the 85 donor livers, there were 47 donor livers with classic bile duct anatomical model (type 1), of the ratio as 55.3%(47/85), and 38 donor livers with anatomical variants, of the ratio as 44.7%(38/85). Of the 38 donor livers with anatomical variants, 7 donor livers were type 2, 16 donor livers were type 3a, 2 donor livers were type 3b, 2 donor livers were type 3c, 1 donor liver was type 4, 3 donor livers were type 5a, 4 donor livers were type 5b, 3 donor livers were type 6. For bile duct splitting patterns of the 85 donor livers, 84 donor livers were split with the main trunk of common hepatic duct preserving in the right hemiliver or right trilobe, and 1 donor liver were treated with complete left and right hemiliver splitting to preserve the main trunk of the common hepatic duct in the left hemiliver and the right hemiliver in the right hepatic duct (type 1 bile duct anatomical model). There were 84 donor livers with only one bile duct opening, and 1 donor liver with two bile duct openings (type 3c bile duct anatomical model). (3) Bile duct reconstruction. Of the 85 recipients, there were 69 recipients with common bile duct end-to-end anastomosis to common bile duct of donor liver (38 donor livers with type 1 bile duct anatomical model, 5 donor livers with type 2 bile duct anatomical model, 14 donor livers with type 3a bile duct anatomical model, 2 donor livers with type 3b bile duct anatomical model, 1 donor liver with type 4 bile duct anatomical model, 3 donor livers with type 5a bile duct anatomical model, 4 donor livers with type 5b bile duct anatomical model, 2 donor livers with type 6 bile duct anatomical model), 11 recipients with jejunum anastomosis to common bile duct of donor liver (7 donor livers with type 1 bile duct anatomical model, 2 donor livers with type 2 bile duct anatomical model, 1 donor liver with type 3c bile duct anatomical model, 1 donor liver with type 6 bile duct anatomical model), 3 recipients with jejunum anastomosis to common hepatic duct of donor liver (1 donor liver with type 1 bile duct anatomical model, 2 donor livers with type 3a bile duct anatomical model), 1 recipient with jejunum anastomosis to right hepatic duct of donor liver (type 1 bile duct anatomical model), 1 recipient with common hepatic duct end-to-end anastomosis to right posterior branch of donor liver combined with jejunum of the recipient Roux-en-y anastomosis to common hepatic duct of donor liver (type 3c bile duct anatomical model). (4) Postoperative biliary complications. Of the 85 recipients, 6 cases had postoperative biliary complications, with an incidence of 7.1% (6/85). Of the 6 recipients with postoperative biliary complications, there were 5 recipients with donor liver with type 1 bile duct anatomical model, including 3 cases undergoing postoperative biliary stricture with biliary leakage and 2 cases undergoing postoperative biliary anastomotic stricture, 1 recipient with donor liver with type 3b bile duct anatomical model and undergoing postoperative biliary anastomotic stricture and bile leakage in the liver section. Cases with biliary complications were 5 in the 47 recipients with donor liver with classic bile duct anatomical model and 1 in the 38 recipients with donor liver with anato-mical variants, showing no significant difference between them ( P>0.05). (5) Follow-up. There were 83 recipients receiving followed up for 52(12,96)months. During the follow-up period, 2 recipients died due to non-biliary complication factors (1 donor liver with type 1 bile duct anatomical model and 1 donor liver with 3a bile duct anatomical model). Conclusion:The anatomical classification of right intrahepatic bile duct of donor liver in SLT is mainly classical bile duct anatomical model, and the bile duct reconstruction scheme is mainly common bile duct of donor liver end-to-end anasto-mosis to common bile duct of recipient.

Objective To explore the sensitizing effect of manganese for radiotherapy against tumors and its possible mechanisms.Methods A total of 300 male C57BL/6 mice(6～8 weeks old,weighing 20～23 g)with subcutaneous tumor were randomly divided into 4 groups:control group,radiotherapy group,manganese treatment group,and combined radiotherapy and manganese treatment group.Nasal drip with 10 μg manganese adjuvant was applied to the mice from the latter 2 groups on day 9 of tumor bearing,then single dose of 20 Gy radiation was locally administered on day 10.Tumor growth and mouse survival were monitored regularly.The sensitizing effect of manganese on radiotherapy was determined by monitoring and comparing the tumor growth among different unilateral mouse models.Bilateral tumor-bearing model was used to examine the effect of manganese on abscopal effects induced by radiotherapy.Flow cytometry was used to illustrate the changes in tumor-infiltrating immune cells in unilateral tumor bearing model.Immunohistochemical staining was employed to evaluate the spleen function in unilateral tumor bearing mice.Results Based on repeated validation of 3 different unilateral tumor-bearing models,radiotherapy combined with manganese therapy significantly inhibited tumor growth and prolonged survival of mice(P＜0.05).The results of bilateral tumor-bearing model showed that manganese therapy enhanced abscopal effects of radiotherapy,and significant regression was observed in both side of tumor under radiotherapy or not(P＜0.05).Flow cytometry revealed that manganese further increased radiation-induced CD8+T infiltration(P＜0.05)and decreased radiation-induced infiltration of Treg cells and myeloid-derived suppressor cells(MDSCs)(P＜0.05).Furthermore,manganese increased lymphocyte reserve pool of the spleen and improved its function.Conclusion Manganese adjuvant could act as a sensitizing agent for radiotherapy,by improving the function of spleen and reprogramming the tumor microenvironment synergistically.

Objective To establish an animal model and evaluation system for lymph node metastasis of breast cancer.Methods A total of 60 female BALB/c mice(6～8 weeks old)were subjected,and then 6 models of lymph node metastasis(n=10)were constructed through injection at different parts in the mice with cell suspension of 4T1 breast cancer cells.Transgenic mice(n=5)of mouse mammary tumor virus-polyoma middle T antigen(MMTV-PyMT)were employed and served as model of spontaneous tumor metastasis.Then the advantages and disadvantages of different lymph node metastasis models were comprehensively evaluated from multiple aspects,such as operability,histomorphology and pathological detection,tumor growth rate and mouse survival.Results Among the 7 metastasis models,4 models of lymph node metastasis were successfully established.Among them,the PyMT mouse spontaneous tumorigenesis model showed the best clinical reproduction,with a tumorigenesis rate of up to 100％,but had a disadvantage of poor experimental standardization.The hind paw-popliteal lymph node model had the fastest lymph node metastasis,easy operation and high repeatability,and a tumorigenesis rate of 100％,indicating its suitable for lymph node metastasis related research.The thigh subcutaneous-inguinal lymph node model also successfully simulated lymph node metastasis,with simple operation and high repeatability,a tumorigenesis rate of up to 100％,but its metastasis time was slightly longer than the hind paw-popliteal lymph node model.The inguinal lymph node-contralateral lymph node model was also a successful lymph node metastasis model,but with difficult operation,only 50％tumor-bearing rate,and poor repeatability.Lymph node metastasis model was not successfully established in the other 3 tumor-bearing models(under the tongue-internal jugular scapular tongue muscle lymph node model,bone marrow-inguinal lymph node model and right upper back skin-axillary lymph node model)in a short time,with no tumor cells observed in the pathological sections.Conclusion Through the comprehensive comparison of multiple models,mouse hind paw-popliteal lymph node model is the most suitable for conducting related research.

We have discovered and synthesized a series of indole-based derivatives as novel sigma-2 (σ ₂) receptor ligands. Two ligands with high σ ₂ receptor affinity and subtype selectivity were then radiolabeled with F-18 in good radiochemical yields and purities, and evaluated in rodents. In biodistribution studies in male ICR mice, radioligand [¹⁸F]9, or 1-(4-(5,6-dimethoxyisoindolin-2-yl)butyl)-4-(2-[¹⁸F]fluoroethoxy)-1H-indole, was found to display high brain uptake and high brain-to-blood ratio. Pretreatment of animals with the selective σ ₂ receptor ligand CM398 led to significant reductions in both brain uptake (29%-54%) and brain-to-blood ratio (60%-88%) of the radioligand in a dose-dependent manner, indicating high and saturable specific binding of [¹⁸F]9 to σ ₂ receptors in the brain. Further, ex vivo autoradiography in male ICR mice demonstrated regionally heterogeneous specific binding of [¹⁸F]9 in the brain that is consistent with the distribution pattern of σ ₂ receptors. Dynamic positron emission tomography imaging confirmed regionally distinct distribution and high levels of specific binding for [¹⁸F]9 in the rat brain, along with appropriate tissue kinetics. Taken together, results from our current study indicated the novel radioligand [¹⁸F]9 as the first highly specific and promising imaging agent for σ ₂ receptors in the brain.

Objective:To investigate the effect of expanded polytetrafluoroethylene (E-PTFE) combined with autologous costal cartilage in rhinoplasty.Methods:Forty-two patients who underwent rhinoplasty in the form of E-PTFE combined with autologous costal cartilage in the Department of Plastic Surgery, Jiangsu Province Hospital of Chinese Medicine from January 2017 to December 2018 were selected as the research object. The polytetrafluoroethylene combined with autologous costal cartilage was used for rhinoplasty. The dorsal nasal skin was dissected through an inverted " V" type combined with subalar cartilage incision, and then the costal cartilage was cut into appropriate cartilage slices to build the nasal tip stent. According to the degree of elevation of the nasal dorsum, the sculpted E-PTFE was placed under the nasal dorsal fascia. The rectus abdominis fascia covered the apex of the nose, and the incision was closed by suture.Results:The nasal appearance of the forty-two patients was significantly improved, with good nasal shape and no serious complications. After 6-12 months of follow-up, 40 cases were satisfacted with the effect of the rhinoplasty, accounting for 95.2%.Conclusions:The use of polytetrafluoroethylene combined with autologous costal cartilage can effectively raise the dorsum of the nose, extend the length of the nose, project the nasal tip in the rhinoplasty. This procedure is accurate and safe, reach a favorable long-term shape and own high satisfaction, and it thus is worthy of popularization in clinic.

Objective To investigate the anatomical classification of left intrahepatic bile duct (LHD) and the pattern of bile duct reconstruction during pediatric split liver transplantation and their relationship with postoperative biliary complications. Methods Clinical data of 75 pediatric recipients undergoing split liver transplantation were analyzed retrospectively. Before splitting the donor liver, iopromide injection was used for retrograde cholangiography through the common bile duct. According to the patterns of intrahepatic bile ducts in the second, third and fourth segments, the anatomical classification of LHD of the donor liver was determined. The biliary reconstruction regimens for different classification types of LHD were summarized. The incidence and treatment of biliary complications after pediatric split liver transplantation were analyzed. Results Among 75 donor livers, the anatomical classification of LHD included 57 cases (76%) of type Ⅰ, 9 cases (12%) of type Ⅱ, 4 cases (5%) of type Ⅲ and 5 cases (7%) of type Ⅳ LHD, respectively. Among 75 pediatric recipients, 69 cases (53 cases of type Ⅰ, 8 type Ⅱ, 4 type Ⅲ and 4 type Ⅳ) underwent the left hepatic duct-jejunum Roux-en-Y anastomosis, 1 case received common bile duct-jejunum Roux-en-Y anastomosis (type Ⅳ), and 5 cases underwent the left hepatic duct-common bile duct end-to-end anastomosis (4 cases of type Ⅰ and 1 type Ⅱ). Postoperative biliary complications occurred in 6 cases (8%), including 3 cases of biliary anastomotic stenosis, 2 cases of biliary anastomotic leakage and 1 case of bile leakage on the hepatic resection surface. Among 6 recipients, 4 cases were classified as type Ⅰ and 2 cases of type Ⅲ LHD. No significant difference was observed in the incidence of biliary complications between typical type and anatomical variant type of LHD (all P > 0.05). Among 3 recipients with biliary anastomotic stenosis, 2 cases underwent percutaneous transhepatic cholangial and drainage (PTCD) and 1 case repeatedly received biliary-intestinal anastomosis. Two cases of biliary anastomotic leakage underwent PTCD and 1 case of bile leakage on the hepatic resection surface received local drainage. All 6 children survived after treatment. Conclusions Anatomical variation of LHD can be observed in 24% of donor livers, and type Ⅱ accounts for the highest proportion of 12%. Prior to donor liver splitting, routine cholangiography and fine biliary anastomosis may effectively lower the incidence of biliary complications. The incidence of postoperative biliary complications is not significantly associated with the anatomical classification of LHD.

Objective:To master the changes of Kashin-Beck disease and the examination and acceptance in Zhalantun City, and to provide scientific basis for formulating prevention and control strategies of Kashin-Beck disease.Methods:From 2016 to 2017, in each county under the jurisdiction of Zhalantun City, 5 townships affected by the disease were selected, 3 villages were selected from each township, and the prevalence of Kashin-Beck disease of all residential children aged 7 to 12 years who lived in the villages for more than 6 months were investigated. The clinical and X-ray diagnosis were performed according to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010) standard, and the prevalence of Kashin-Beck disease in children aged 7 to 12 years in Zhalantun City in 2016 and 2017 were compared. In accordance with the "Key Endemic Disease Control and Elimination Evaluation Measures" ([2014]79), the condition of Kashin-Beck disease and the implementation of its prevention and control measures was assessed.Results:From 2016 to 2017, 1 697 children aged 7 to 12 years were examined, there were no clinical cases of Kashin-Beck disease and 11 cases of X-ray positive changes. Among them, 844 children were examined in 2016, the positive rate of X-ray was 0.24% (2/844), the positive rate of metaphyseal was 0.24% (2/844), and no positive changes of extremities and triad were detected. A total of 853 children were examined in 2017, the positive rate of X-ray was 1.06% (9/853), the positive rate of metaphyseal was 1.06% (9/853), and no positive changes of extremities and triad were detected. The positive rate of X-ray and metaphyseal of Kashin-Beck disease in children aged 7 - 12 years in 2017 were higher than those in 2016 (χ 2 = 4.409, 4.409, P < 0.05). All surveyed villages had reached the national elimination standard (no clinical cases for children aged 7 - 12 years, X-ray positive rate ≤3% and no cases of hand bone end changes); the organization management scores of Kashin-Beck disease prevention and treatment in Zhalantun City in 2016 and 2017 were 88 points, reaching the qualified standard ( > 85 points). Conclusion:The condition of Kashin-Beck disease in Zhalantun City has reached the standard of elimination, which lays a foundation for further comprehensive elimination of Kaschin-Beck disease in Hulunbuir City.

Objective:To study the prevalence of body dysmorphic disorder (BDD) in patients with plastic and cosmetic by performing meta-analysis.Methods:We searched, collected and screened the published studies on the prevalence of BDD in population with cosmetic surgery at home and abroad, and conducted a meta-analysis to calculate the prevalence of BDD in this population. The literatures were screened strictly according to the inclusion and exclusion criteria, and the quality of the included studies was evaluated with reference to AHRQ scale. Cochrane Q test was used to analyze the heterogeneity among the studies. If there was no heterogeneity, the fixed effect model was used for the pooled analysis of effect size. If there was heterogeneity, the random effect model was used for the pooled analysis of effect size, and the potential sources of heterogeneity were tested by meta regression, and subgroup analysis was performed. Sensitivity analysis was performed to test the stability of the result. Funnel plot was used to determine whether publication bias existed.Results:Thirteen articles were finally included in the meta-analysis, including 4 Chinese articles and 9 English articles, with a total sample size of 3 366 cases. A total of 435 cases of BDD were detected. The AHRQ scores of the 13 articles were greater or equal to 4 points. Heterogeneity test showed that there was a high degree of heterogeneity among the 13 studies, so the random effect model was used for pooled analysis of effect size. The results showed that the prevalence rate of BDD in population with plastic surgery was 13% (95% CI 9% - 18%). Sensitivity analysis shows that the result calculated by the random effect model are stable and reliable. Meta regression analysis showed that the difference of surgical site was one of the reasons for heterogeneity. Thirteen articles were divided into two groups according to patients with rhinoplasty and plastic surgery in other parts, and meta-analysis was conducted respectively. There were 3 articles in rhinoplasty group and 10 articles in other part of the plastic surgery. The result showed that the prevalence of BDD was 29% (95% CI 24% - 35%) in rhinoplasty group and 9% (95% CI 8% -10%) group with plastic surgery in other parts. Funnel plot analysis showed that there was no publication bias in this study. Conclusions:About 9% of the people with cosmetic surgery suffer from BDD, and the prevalence of BDD in the people seeking nasal plastic surgery can be as high as 29%. Plastic surgeons should pay special attention to this kind of people in clinical work, and use appropriate screening tools to identify them, so as to provide more scientific diagnosis and treatment plan for patients. Aesthetic plastic surgeons should pay attention to the evaluation of patients’ psychological state in clinical work.

Objective:To study the prevalence of body dysmorphic disorder (BDD) in patients with plastic and cosmetic by performing meta-analysis.Methods:We searched, collected and screened the published studies on the prevalence of BDD in population with cosmetic surgery at home and abroad, and conducted a meta-analysis to calculate the prevalence of BDD in this population. The literatures were screened strictly according to the inclusion and exclusion criteria, and the quality of the included studies was evaluated with reference to AHRQ scale. Cochrane Q test was used to analyze the heterogeneity among the studies. If there was no heterogeneity, the fixed effect model was used for the pooled analysis of effect size. If there was heterogeneity, the random effect model was used for the pooled analysis of effect size, and the potential sources of heterogeneity were tested by meta regression, and subgroup analysis was performed. Sensitivity analysis was performed to test the stability of the result. Funnel plot was used to determine whether publication bias existed.Results:Thirteen articles were finally included in the meta-analysis, including 4 Chinese articles and 9 English articles, with a total sample size of 3 366 cases. A total of 435 cases of BDD were detected. The AHRQ scores of the 13 articles were greater or equal to 4 points. Heterogeneity test showed that there was a high degree of heterogeneity among the 13 studies, so the random effect model was used for pooled analysis of effect size. The results showed that the prevalence rate of BDD in population with plastic surgery was 13% (95% CI 9% - 18%). Sensitivity analysis shows that the result calculated by the random effect model are stable and reliable. Meta regression analysis showed that the difference of surgical site was one of the reasons for heterogeneity. Thirteen articles were divided into two groups according to patients with rhinoplasty and plastic surgery in other parts, and meta-analysis was conducted respectively. There were 3 articles in rhinoplasty group and 10 articles in other part of the plastic surgery. The result showed that the prevalence of BDD was 29% (95% CI 24% - 35%) in rhinoplasty group and 9% (95% CI 8% -10%) group with plastic surgery in other parts. Funnel plot analysis showed that there was no publication bias in this study. Conclusions:About 9% of the people with cosmetic surgery suffer from BDD, and the prevalence of BDD in the people seeking nasal plastic surgery can be as high as 29%. Plastic surgeons should pay special attention to this kind of people in clinical work, and use appropriate screening tools to identify them, so as to provide more scientific diagnosis and treatment plan for patients. Aesthetic plastic surgeons should pay attention to the evaluation of patients’ psychological state in clinical work.

Objective:To prepare nanosilver-hybridized polylactic acid-glycolic acid copolymer (PLGA) microspheres loaded with simvastatin (SIM), and to evaluate its sustained release effect in vitro. Methods:The emulsification-solvent evaporation method was used to prepare SIM-loaded PLGA microspheres. Silk fibroin (SF) was used to modify the surface of SIM-loaded PLGA microspheres by hydrophobic interaction. Then, the microspheres were continually modified by electrostatic adsorption to chitosan (CTS) and nano-silver (AgNPs) to prepare SF-AgNPs-CTS-SF-SIM-PLGA microspheres. Scanning electron microscope, Fourier transform infrared spectrometer, energy spectrometer, Zeta potential meter were used to analyze the SIM-loaded microspheres. The external release properties of the SIM-loaded microspheres were also investigated.Results:The average diameter of the prepared PLGA microspheres was about 9.67 μm. The results of Fourier transform infrared spectroscopy and energy spectroscopy showed that the AgNPs-CTS-SF-SIM-PLGA microspheres have been successfully constructed. The Zeta potential results indicated that the SIM-loaded microspheres were all in a stable state. The in vitro release results showed that the SF-AgNPs-CTS-SF-SIM-PLGA microspheres had a good in vitro release effect, could delay the drug release rate and prolong the drug release time. Conclusions:The SF-AgNPs-CTS-SF-SIM-PLGA microspheres have antibacterial and osteogenic effects, and exhibit a good in vitro release effect. They can be used for local sustained-release administration in the oral cavity, which make makes them potentially useful in the treatment of periodontitis.