Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Objective:To compare the recurrence of common bile duct stones (CBDS) in patients with gallstones and concurrent CBDS treated by two surgical approaches: synchronous laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) (LC+LCBDE) and synchronous LC combined with intraoperative endoscopic sphincterotomy (IO-EST) (LC+IO-EST).Methods:From Apr 2013 to Apr 2020, the clinical data of 903 patients with gallstones with CBDS who were admitted to the Clinical Medical College, Yangzhou University were retrospectively analyzed.Results:Based on the chosen surgical method, we categorized 389 cases into group A (LC+LCBDE) and 514 cases into group B (LC+IO-EST). Our findings revealed that group A had a significantly lower rate of CBDS recurrence and re-recurrent CBDS compared to group B (4.4% vs. 8.4%, P=0.024; 0.8% vs. 3.1%, P=0.010). Moreover, Logistic regression analysis after inverse probability of treatment weighting, revealed that the surgical approach implemented in group A was an independent protective factor of recurrent CBDS and second recurrence of CBDS ( OR=0.482, 95% CI: 0.365-0.637, P<0.001; OR=0.118, 95% CI:0.080-0.173, P<0.001). Conclusion:LC+LCBDE is an optimal treatment option to LC+IO-EST for patients with gallstones combined with CBDS and common bile duct ≥8 mm.

Oral diseases concern almost every individual and are a serious health risk to the popula-tion.The restorative treatment of tooth and jaw defects is an important means to achieve oral function and support the appearance of the contour.Based on the principle of"learning from the nature",Deng Xu-liang's group of Peking University School and Hospital of Stomatology has proposed a new concept of"microstructural biomimetic design and tissue adaptation of tooth/jaw materials"to address the worldwide problems of difficulty in treating dentine hypersensitivity,poor prognosis of restoration of tooth defects,and vertical bone augmentation of alveolar bone after tooth loss.The group has broken through the bottle-neck of multi-stage biomimetic technology from the design of microscopic features to the enhancement of macroscopic effects,and invented key technologies such as crystalline/amorphous multi-level assembly,ion-transportation blocking,and multi-physical properties of the micro-environment reconstruction,etc.The group also pioneered the cationic-hydrogel desensitizer,digital stump and core integrated restora-tions,and developed new crown and bridge restorative materials,gradient functionalisation guided tissue regeneration membrane,and electrically responsive alveolar bone augmentation restorative membranes,etc.These products have established new clinical strategies for tooth/jaw defect repair and achieved inno-vative results.In conclusion,the research results of our group have strongly supported the theoretical im-provement of stomatology,developed the technical system of oral hard tissue restoration,innovated the clinical treatment strategy,and led the progress of the stomatology industry.

Objective:To explore deficiencies in the reform of China's health remuneration system through empirical data,provide data support and references for optimization of China's remuneration policy for health technicians.Methods:The Gini coefficient is calculated based on the data of CHIP to analyze the equity of salary distribution of health technicians in different regions and different genders.Results:Health technicians'income is rising and at a higher level in society.Eastern,urban,and male health technicians receive higher salary;income distribution gap across regions and female is increasing;income distribution in health industry is more even than most industry.Conclusion:It is needed to continue to push forward the reform of the health remuneration system,balance efficiency and equity,formulate income distribution scheme according to local conditions,strengthen attention and protection to the income distribution for female health technicians.

Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.

Objective:To explore deficiencies in the reform of China's health remuneration system through empirical data,provide data support and references for optimization of China's remuneration policy for health technicians.Methods:The Gini coefficient is calculated based on the data of CHIP to analyze the equity of salary distribution of health technicians in different regions and different genders.Results:Health technicians'income is rising and at a higher level in society.Eastern,urban,and male health technicians receive higher salary;income distribution gap across regions and female is increasing;income distribution in health industry is more even than most industry.Conclusion:It is needed to continue to push forward the reform of the health remuneration system,balance efficiency and equity,formulate income distribution scheme according to local conditions,strengthen attention and protection to the income distribution for female health technicians.

Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.

Objective:To explore deficiencies in the reform of China's health remuneration system through empirical data,provide data support and references for optimization of China's remuneration policy for health technicians.Methods:The Gini coefficient is calculated based on the data of CHIP to analyze the equity of salary distribution of health technicians in different regions and different genders.Results:Health technicians'income is rising and at a higher level in society.Eastern,urban,and male health technicians receive higher salary;income distribution gap across regions and female is increasing;income distribution in health industry is more even than most industry.Conclusion:It is needed to continue to push forward the reform of the health remuneration system,balance efficiency and equity,formulate income distribution scheme according to local conditions,strengthen attention and protection to the income distribution for female health technicians.

Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.