Vav guanine nucleotide exchange factor 3 (Vav3) protein is one of the guanine nucleotide exchange factors of the Rho family GTPases. It is encoded by the proto-oncogene Vav3 and is involved in the regulation of cell proliferation and apoptosis, differentiation, migration, etc. In recent years, Vav3 has been closely related to the development of a variety of malignant tumors. In glioma, breast cancer, non-small cell lung cancer, gastric cancer, pancreatic cancer, colorectal cancer, prostate cancer, ovarian cancer, osteosarcoma and acute leukemia, the expression of Vav3 is elevated to varying degrees, and it participates in regulating multiple signaling pathways, which promotes the progression of tumors and affects the prognosis of patients. Therefore, Vav3 is expected to be a potential therapeutic target for these malignant tumors.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Objective:To investigate the application of artificial intelligence based on the neural network radiation field in repair of soft tissue defects at lower limbs.Methods:A retrospective analysis was performed of the 23 patients who had been admitted to Department of Orthopedic Surgery, Renmin Hospital of Wuhan University from June 2020 to May 2022 for soft tissue defects at lower limbs. There were 14 males and 9 females, aged (38.6±6.7) years. Causes for soft tissue defects: traffic injury in 9 cases, benign or malignant primary soft tissue tumor in 6 cases, mechanical injury in 4 cases, crush injury in 2 cases, and chronic ulcer in 2 cases. Defect locations: the thigh in 3 cases, the lower leg in 7 cases, and the ankle and distal foot in 13 cases. The areas of soft tissue defect ranged from 6.0 cm×3.8 cm to 14.7 cm×12.8 cm. The defects were repaired and reconstructed by transplantation of an anterolateral femoral free flap in 7 cases and a pedicled flap in 16 cases with the assistance of artificial intelligence based on the neural network radiation field, a cutting-edge artificial intelligence algorithm that can quickly construct and process three-dimensional model images through volume rendering under the radiation field. The flap survival rate, aesthetic satisfaction before and after treatment, time for skin flap harvesting and transplantation, functional recovery of lower limbs and incidence of complications were recorded.Results:All the 23 patients were followed up for 32(28, 36) weeks. All the flaps were harvested smoothly and survived. The time for flap harvesting and transplantation was 65.8(50.0, 76.0) min. The aesthetic satisfaction scored (2.3±0.7) points before treatment and (8.4±1.6) points 4 weeks after treatment, showing a statistically significant difference ( P<0.05). The skin flaps healed well with no complications such as hematoma or infection in all but one patient who suffered from superficial necrosis at the distal skin flap due to venous crisis but healed with a scar. On average, the functional recovery of lower limbs scored 23.7(22.0, 25.0) points at 12 weeks after operation according to the Enneking evaluation system, and the functional recovery of lower limbs was 79% (23.7/30.0). Conclusion:Application of artificial intelligence based on the neural network radiation field can achieve ideal results in repair of soft tissue defects at lower limbs, due to its advantages of rapid and accurate surgical procedures, limited damage to the donor site, and a short learning curve.

This article introduced the background, significance, working mode, talent training, qualification certification and clinical practice of oncology genetic nurses, providing the analysis of oncology genetic nurse development opportunities and challenges in our country. Proposals were put forward that China should draw lessons from successful experience of the development of oncology genetic nurses, strengthen the genetic nursing ability of nurses, establish oncology genetic nurse training mode, improve the post-setting and operation mechanism to meet the needs of hereditary oncology nursing management.

Objective:To explore the effect of enhanced recovery after surgery (ERAS) nursing model based on multidisciplinary collaboration in the perioperative management of patients with colorectal cancer.Methods:Using the convenience sampling method, 98 patients with colorectal cancer who underwent elective surgery at Shanxi Provincial People's Hospital from January to December 2019 were selected as the control group, and 103 patients with colorectal cancer who underwent elective surgery at Shanxi Provincial People's Hospital from January to December 2020 were selected as the observation group. Patients in the control group were treated with general surgery routine nursing model, and patients in the observation group were treated with the ERAS nursing model based on multidisciplinary collaboration . The postoperative recovery and quality of life of the two groups of patients were compared.Results:The first postoperative exhaust time, eating time, out-of-bed time, and length of hospital stay in the observation group were shorter than those in the control group, and the differences were statistically significant ( P<0.05) . After surgery the observation group had higher scores of functional areas and overall health than the control group, and the scores of main symptoms and specific items were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The ERAS nursing model based on multidisciplinary collaboration is conducive to postoperative recovery of colorectal cancer patients, shortens the length of hospital stay, and improves the quality of life of patients. It is worthy of clinical application.

Objective:To explore the construction and effect of biobank in biological research in nursing field.Methods:Through the establishment of a biological research plan for nursing in Affiliated Jinhua Hospital, Zhejiang University School of Medicine, the biobank in biological research for nursing was constructed from aspects of biological samples, instruments and equipment, operating software, biobanking team formation, personnel training and standardized process formulation.Results:In August 2020, the Nursing Department and Central Laboratory of Affiliated Jinhua Hospital, Zhejiang University School of Medicine established a biobank for biological research in the nursing field, formed a biobank team, conducted personnel training and formulated standardized procedures. From December 1, 2020 to June 30, 2021, biological samples were collected from 264 gastric cancer patients and 56 healthy controls, mainly including whole blood, serum and urine.Conclusions:The construction of biobank for biological research in nursing field can collect abundant biological samples, which lays a foundation for subsequent independent biological research in nursing field.

Objective:To improve the rate of successful rescue through analyzing the clinical features and treating processes of septic shock caused by lymphocyst infection after lymph node dissection in diabetic patients.Methods:A total of 462 cases of diabetic patients with bladder, prostate, renal cancers, cervical, endometrial and ovarian were retrospectively analyzed, all of whom underwent standard surgical treatments including pelvic lymph node dissection, hospitalized in department of urology surgery and gynecology of Sun Yat-sen Memorial Hospital from Jan 2015 to Jan 2020. Lymphocytes were confirmed in 148 cases, of which 89 cases were complicated by infection, and 13 cases developed septic shock. Patients with lymphocyst infection were divided into shock and non-shock groups, and age, sex, duration of diabetes, BMI, glycosylated hemoglobin at admission, number of lymph nodes surgically removed, retention time of drainage tube after operation, maximum diameter of lymphocyst and time between infection and previous chemotherapy were compared. The initial symptoms, blood routine in the first time after the onset of the infection, the time from onset to drainage puncture and catheterization and the final outcomes were analyzed in 13 patients with septic shock. The results of pathogen culture and drug sensitivity of infected lymphocyst fluid were also analyzed.Results:Categorical variable test showed that: in diabetic patients with lymphocyst infection, there were significant differences in glycosylated hemoglobin ( P=0.018) , adjuvant chemotherapy ( P=0.014) and lymphocyst size ( P<0.001) between shock group and non-shock group. Among the 13 cases of septic shock, 11 caseshad mild to moderate fever or abdominal pain. The total leukocyte count of all cases in the first hemogram were less than 20×10 9/L. The average time from onset to drainage was 33 hours. Among the 13 patients, 5 developed MODS and 1 died. There were 2 patients whose conditions were complex with frequent fluctuations. In the 12 patients who recovered from septic shock, only 1 underwent a residual lymphocyst pretreatment, 4 had recurrent cyst infection for 1-2 times, 2 had septic shock again, and 1 died. Gram negative bacteria were the most common pathogens, and the main was Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Piperacillin / tazobactam, carbapenems and tigecycline were commonly sensitive, while the drug resistance rates of ceftazidime, ceftriaxone and levofloxacin were more than 50%. Conclusions:Poor glycemic control, adjuvant chemotherapy and big lymphocyst size(d≥5 cm) are the high risk factors of septic shock. Most of shock patients' initial symptoms and total white blood cell count have no warning significance, leading to longer time from infection to drainage, and delayed treatment. Early diagnosis, timely drainage and active anti-infection treatment are the key to a successful treatment. The possibility of connection between lymphocyst and surrounding organ should be considered when the treatment effect is not good. After septic shock of postoperative lymphocyst infection in patients with diabetes, the larger esidual lymphocyst should be intervened actively to avoid serious infection again.

Objective: To suggest strategies for emergency diagnosis and treatment of trauma orthopedics in the epidemic period of Corona Virus Disease 2019(COVID-19). Methods: In the epidemic of COVID-19 from January 21 to February 15, 2020, 128 patients with orthopaedic trauma sought emergency treatment at Department of Orthopedic Surgery, The People’s Hospital of Wuhan University. They were 71 males and 57 females with an average age of 48.7 years (from 5 to 88 years).Of them, 107 cases were treated at the outpatient department and 21 hospitalized. Emergency operations were carried out for 4 cases and selective operationsfor 17 cases. COVID-19 infections were recorded in the patients and medical staff as well. Measures taken and experiences learned were summarized since the epidemicoutbreak of COVID-19. Results: Of the 107 cases treated at the outpatient department, 3 had a definite diagnosis of COVID-19 and 3 a suspected diagnosis of COVID-19. Of the 4 cases undergoing emergency surgery, one was suspected of having COVID-19. Of the 17 cases undergoing selective surgery, one was diagnosed definitely as COVID-19and 2 were suspected of COVID-19. Two nurses were diagnosed definitely as having mildCOVID-19.One doctor and one nurse were suspected of COVID-19. Since the COVID-19 infections in medical staff occurred all before the preventive and control measures for COVID-19 had been implemented,is was not ruled out that their infections might have come from communities. Conclusions It is particularly important for medical institutions of all levels to maintain safe and effective routine services while doing well in COVID-19 prevention. In the epidemic of COVID-19, front-line medical staff in emergency traumatic orthopedics is faced with great challenges in the process of diagnosing and treating patients. High-quality and safe medical services can be provided as long as nosocomial COVID-19infection is effectively controlled by rigid screening of patientsnewly admitted, classified management of inpatients, optimal management of inpatient wards, standard preventive measures in perioperative period, a perfect system for medical protection, and medical education for patients and their carers.

Objective:To analyze the correlation between hyperuricemia and obesity in young college students.Methods:A total of 19 673 students receiving enrolment physical examinations in Nanjing University from 2018 to 2019 were included in the study. The subjects were divided into underweight, normal, overweight, and obesity groups according to their body mass index. Fasting blood were taken to detect alanine aminotransferase (ALT), serum uric acid, urea nitrogen, and creatinine. The differences between serum uric acid and metabolic parameters among different groups as well as the correlation between body mass index and hyperuricemia were analyzed by using multivariate linear regression and logistic regression analysis.Results:The prevalence of hyperuricemia was 32.35% for the college students, while for the males it reached up to 57.30% that was significantly higher than female ones (6.51%, P<0.01). With the increasing of body mass index, the prevalence of hyperuricemia increased significantly( Ptrend<0.01), as well as serum uric acid in both male and female students ( Ptrend<0.01). Serum uric acid was positively correlated with body mass index in both genders( P<0.01). The odds ratio ( OR) and 95% confidence interval( CI) for overweight, obesity, and underweight body mass index groups were 2.30(95% CI 1.99-2.66), 4.35(95% CI 3.22-5.89), and 0.70(95% CI 0.60-0.82), respectively, compared to the normal body mass index group by adjusting possible factors such as gender, age, ALT, urea nitrogen, creatinine, as well asestimated glomerular filtration rate. Conclusion:The prevalence of hyperuricemia in young students is high. Obesity seems to be an independent risk factor of hyperuricemia.