Objective To explore the influencing factors of liver cancer occurrence in liver cirrhosis,and to construct a risk prediction model.Methods A total of 307 patients with liver cirrhosis admitted and treated in the Affiliated Hospital of Southwest Medical University from August 2019 to December 2022 were selected as the study subjects,among them 175 patients with simple liver cirrhosis were included in the control group and 132 patients with liver cirrhosis complicating liver cancer were included in the observation group.The lev-els of various indicators were detected by the automatic immunofluorescence analyzer and dry biochemical ana-lyzer.The influencing factors of liver cancer occurrence in liver cirrhosis were analyzed by univariate and mult-ivariate logistic regression.The diagnostic efficiency of single detection and combined detection of various in-fluencing factors for liver cancer occurrence in liver cirrhosis was calculated by receiver operating characteristic (ROC) curve.Results The univariate analysis results showed that the age,smoking history,drinking history,family history of liver cancer,AFP,PIVKA-Ⅱ,ApoA1 and ApoB levels had statistical differences between the two groups (P<0.05).The multivariate logistic regression results showed that PIVKA-Ⅱ (OR=1.240,95％CI:1.064-1.445),ApoA1 (OR=26.154,95％CI:1.224-558.648) and ApoB (OR=23.289,95％CI:2.940-184.520) were the independent risk factors for liver cancer occurrence in liver cirrhosis (P<0.05). The ROC curve results showed that the area under the curve of PIVKA-Ⅱ,ApoA1 and ApoB combined detec-tion for predicting the liver cancer occurrence in liver cirrhosis was 0.853 (95％CI:0.756-0.874),and the sensitivity and specificity were 82.33％ and 65.47％,respectively.Conclusion PIVKA-Ⅱ,ApoA1 and ApoB levels are the independent risk factors for liver cancer occurrence in liver cirrhosis,and their combined detec-tion has a good predictive value for liver cancer occurrence in liver cirrhosis.

Objective:To understand the current status of human resources in Operating Room nursing in China, so as to provide reference for nursing management, human resource allocation, nursing education and training in Operating Rooms.Methods:Using the stratified sampling method, a self-made Operating Room nursing human resource survey questionnaire of Chinese Nursing Society was used as a research tool in July 2021 to investigate the general situation, surgical workload, human resource allocation, Operating Room management, Operating Room information construction, nursing education and training of 2 201 hospitals in 31 provinces, autonomous regions and municipalities of China.Results:Among the 2 201 hospitals, there were 1 021 tertiary hospitals (46.39%), 1 177 secondary hospitals (50.75%), and 63 primary and below hospitals (2.86%). There were 2 056 hospitals with less than 30 Operating Rooms, accounting for 93.41%. There were 1 991 hospitals with an annual number of surgical cases less than 20 000, accounting for 90.46%, the educational background of Operating Room nurses was mainly undergraduate (66.93%, 43 359/64 780), with a total of 67.99% (44 045/64 780) having a bachelor's degree or above. Nurses were the main professional titles (42.66%, 27 632/64 780). Number of Operating Rooms: the number of Operating Room nurses (median) was 1: 2.43 and 78.96% (1 738/2 201) of hospital operating theatres were managed by Nursing Departments or hospitals. A total of 1 479 hospitals (67.20%) established anesthesia recovery rooms in their Operating Rooms, which was higher than 59.34% (1 210 hospitals) surveyed in 2016, and the difference was statistically significant (χ 2=226.701, P<0.01). 74.69% (1 644/2 201) and 87.87% (1 934/2 201) of hospitals carried out post management and capacity classification management in Operating Rooms, respectively. Day surgery and robotic surgery were performed in 47.80% (1 052/201) and 7.68% (169/2 201) hospitals, respectively. 36.98% (814/2 201) of the hospitals passed the information evaluation system certification and 64.61% (1 422/2 201) of the hospitals used the Operating Room information management system. In the Operating Room information system of the hospital, 2.54% (56/2 201) had intelligent functions. And 77.24% (1 700/2 201) of hospitals participated in the qualification training of Operating Room specialist nurses. Conclusions:By July 2021, the number of Operating Rooms in most hospitals in China is less than 30, and the annual number of operating cases is less than 20 000. The educational background and professional title of Operating Room nurses are mainly undergraduate and nurse. More than 60% of hospitals have set up anesthesia recovery rooms and have information management systems for Operating Rooms. At the same time, Operating Rooms in Chinese hospitals have widely implemented diversified nursing management models such as post management and ability grading management.

ObjectiveTo investigate the key compounds affecting the irritation and to clarify the effect of heating and the addition of ginger juice as the auxiliary material during the processing on the irritation of Magnoliae Officinalis Cortex（MOC） by comparing the irritation and composition of volatile oil in MOC and its different processed products. MethodVolatile oil in raw products， water-processed products， ginger-dried products， ginger-fried products（the amounts of ginger were 10%， 50%， respectively） of MOC were extracted by steam distillation and subjected to rabbit eye irritation experiment， and the volatile components of each sample were detected by gas chromatography-mass spectrometry（GC-MS）. Principal component analysis（PCA）and orthogonal partial least squares-discriminant analysis（OPLS-DA） were used to analyze the data of each sample by SIMCA 14.1. The relative contents of different processed products were compared two by two with those of and raw products or ginger-fried products， and the markers that might be related to the irritation were sorted out according to the principles of variable importance in the projection（VIP） value >1 and P<0.05， and the factors influencing the differences in irritation were analyzed. ResultCompared with the blank group， the administration groups all had irritation to the eyes of rabbits， and the degree of irritation was in the order of raw products>water-processed products>ginger-dried products>ginger-fried products（10%）>ginger-fried products（50%）. The results of PCA and OPLS-DA showed that there were differences in the volatile oil from raw products and different processed products. According to VIP value>1 and P<0.05， and combined with the results of eye irritation experiment， ten volatile compounds related to irritation changes were screened out. Among them， cis-cinnamaldehyde was only detected in raw products， the relative contents of β-caryophyllene， （+）-delta-cadinene， α-humulene， γ-muurolene， （-）-isoledene and citral all increased to different degrees， the contents of p-cymene， 1（10）-4-cadinadien-15-ol and β-eudesmol all decreased to different degrees. ConclusionThe irritation of MOC is reduced after heating and processing with ginger juice， and the synergistic effect of both is more effective for reducing irritation. Among the differential markers associated with changes in irritation， the increase in the relative content of citral is closely related to the addition of ginger juice， while the decrease in the relative contents of cis-cinnamaldehyde， p-cymene， 1（10）-4-cadinadien-15-ol is related to heating， and the changes of other components may be related to the synergistic effect of heating and ginger juice.

The heterogeneity of exhausted T cells (Tex) is a critical determinant of immune checkpoint blockade therapy efficacy. However, few studies have explored exhausted T cell subpopulations in human cancers. In the present study, we examined samples from two cohorts of 175 patients with head and neck squamous cell cancer (HNSCC) by multiplex immunohistochemistry (mIHC) to investigate two subsets of Tex, CD8⁺PD1⁺TCF1⁺ progenitor exhausted T cells (TCF1⁺Tex^prog) and CD8⁺PD1⁺TCF1^- terminally exhausted T cells (TCF1^-Tex^term). Moreover, fresh tumor samples from 34 patients with HNSCC were examined by flow cytometry and immunohistochemistry to further investigate their properties and cytotoxic capabilities and their correlation with regulatory T cells (Tregs) in the tumor immune microenvironment (TIME). mIHC and flow cytometry analysis showed that TCF1^-Tex^term represented a greater proportion of CD8⁺PD1⁺Tex than TCF1⁺Tex^prog in most patients. TCF1⁺Tex^prog produced abundant TNFα, while TCF1^-Tex^term expressed higher levels of CD103, TIM-3, CTLA-4, and TIGIT. TCF1^-Tex^term exhibited a polyfunctional TNFα⁺GZMB⁺IFNγ⁺ phenotype; and were associated with better overall survival and recurrence-free survival. The results also indicated that larger proportions of TCF1^-Tex^term were accompanied by an increase in the proportion of Tregs. Therefore, it was concluded that TCF1^-Tex^term was the major CD8⁺PD1⁺Tex subset in the HNSCC TIME and that these cells favor patient survival. A high proportion of TCF1^-Tex^term was associated with greater Treg abundance.
CD8-Positive T-Lymphocytes ; Head and Neck Neoplasms/therapy* ; Humans ; Immunotherapy/methods* ; Prognosis ; Programmed Cell Death 1 Receptor ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Tumor Microenvironment ; Tumor Necrosis Factor-alpha

Objective:To observe the results of electroacupuncture (EA) on the resuscitation of a rat model of asphyxia cardiac arrest (CA). And to explore its effect on the neurologic deficits and hemodynamic instability of post-cardiac arrest syndrome (PCAS).Methods:A total of 107 male SD rats were randomly divided into sham, CA, and EA groups. Each group received arterial catheterization and tracheal intubation. The sham group was not induced asphyxia. Asphyxial cardiac arrest was established by endotracheal tube clamping. Rats in the CA group received basic respiratory support and fluid resuscitation in return of spontaneous circulation (ROSC) and rats in the EA group received EA at Baihui based on the treatment of CA group after ROSC, with a dense-dispersed wave at frequencies of 4-20 Hz, while the current intensity was adjusted minimum to induce a twitch of the scalp, the course of treatment was 30 minutes. The baseline data, hemodynamics after ROSC, neurological deficit score (NDS), pathological changes of brain tissue, and levels of serum biomarker were recorded and compared among the three groups. The 72-hour survival of rats was analyzed by Kaplan-Meier survival curve. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of necrotic neurons in the hippocampal CA1 region of rat brain. Meanwhile, Nissl staining and TdT-mediated dUTP nick-end labeling (TUNEL) were used to detect cell apoptosis and injury.Results:Compared with the CA group, the mean arterial pressure (MAP) in the EA group increased significantly at 15 minutes after ROSC [mmHg (1 mmHg≈0.133 kPa): 125.00 (94.00, 136.25) vs. 92.00 (72.00, 122.50), P < 0.05]. There was no significant difference in the NDS score between the EA group and the sham group. Still, the NDS score of the rats in the CA group at 6 hours after ROSC were significantly lower than that in the sham group (46.00±10.61 vs. 80.00±0.00, P < 0.05). Kaplan-Meier survival curve analysis showed that EA did not improve the 72-hour survival rate of rats (100% in the sham group, 25% in the CA group, and 30% in the EA group, P > 0.05). The analysis by TUNEL showed that the apoptosis rate of neurons in CA1 region of the hippocampus in EA group at 6 hours after ROSC was significantly lower than that in CA group [(62.84±2.67)% vs. (71.29±3.70)%, P < 0.05]. Compared with the CA group, the level of serum S100 calcium binding protein B (S100B) in the EA group at 6 hours after ROSC was significantly lower (ng/L: 19.30±13.87 vs. 132.28±31.67, P < 0.05), but there were no significant differences in the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) between these two groups. Conclusions:In the present study, EA at Baihui can stabilize the hemodynamic, moreover, it has a particular neuroprotective effect on PCAS rats. Still, EA at Baihui does not reduce the systemic inflammatory response and improve the survival rate of rats, and its mechanism remains to be verified in further research.

Objective:To summarize the surgery effect of tongue volume reduction for macroglossia patients with Beckwith-Wiedemann syndrome (BWS).Methods:The clinical data of children diagnosed as BWS based on clinic symptoms and gene tests, who received operation in Department of Plastic Surgery, Children’s Hospital of Fudan University from July 2012 to December 2019 were analyzed retrospectively. All the patients underwent dorsal tongue bell-shaped resection and ventral V-shaped resection. By pulling tongue tip, the tongue body was cut and dissected along the marking line followed by suturing the muscle layer of the central part of the tongue tissue. Intermittent mattress suture of the dorsal and ventral mucous wounds of the tongue. After operation, all patients kept the trachea intubation and were transferred to PICU for further treatment and received early nasal feeding. The short-term postoperative complications, and long-term follow-up of the tongue body shape and clinical symptoms were recorded.The clinical effect was evaluated by onesurgeon and the parents.The effect was graded into four levels: dissatisifaction, average, satisifaction and great satisifaction.Results:A total of 61 children were included in this study, including 30 males and 31 females, with an average age of 8.5 months. The length of the tongue exposed outside at the resting state was 1.34-2.62 cm, with a median of 1.87 cm. Symmetric hypertrophy was found in 52 cases (85.2%), lateral hypertrophy in 9 cases (14.8%). There were 3 cases with respiratory obstruction (4.9%), 35 cases with salivation (57.4%), 4 cases suffering difficulty of feeding and dysphagia (6.6%). All children underwent the operation successfully, and the average operation time was 35.8 min. Among the short-term complications, there were 3 ventral wounds dehiscence, none of which needed sutured again. By prolonging nasal feeding time, the wounds were all healed in the secondary stage. Respiratory obstruction occurred in 1 patient after operation, and the symptoms were relieved after tongue retraction. The mean follow-up time was 3.3 years (2 months to 7 years), and 1 patient was inadequately corrected and good condition was got after second aryoperation. The remaining children obtained satisfactory resting tongue position and appearance, and the postoperative clinical symptoms were improved. In the long-term follow-up, the comprehensive evaluation results of the resting tongue position and clinical symptoms of the children by surgeon and parents were satisfied in 10 cases (16.4%), very satisfied in 50 cases (82.0%), and average in 1 case (insufficient correction after the first operation).Conclusions:Central resection and volume reduction of tongue body is a simple, effective and safe surgical technique in children with giant tongue diagnosed as BWS.

Objective:To summarize the surgery effect of tongue volume reduction for macroglossia patients with Beckwith-Wiedemann syndrome (BWS).Methods:The clinical data of children diagnosed as BWS based on clinic symptoms and gene tests, who received operation in Department of Plastic Surgery, Children’s Hospital of Fudan University from July 2012 to December 2019 were analyzed retrospectively. All the patients underwent dorsal tongue bell-shaped resection and ventral V-shaped resection. By pulling tongue tip, the tongue body was cut and dissected along the marking line followed by suturing the muscle layer of the central part of the tongue tissue. Intermittent mattress suture of the dorsal and ventral mucous wounds of the tongue. After operation, all patients kept the trachea intubation and were transferred to PICU for further treatment and received early nasal feeding. The short-term postoperative complications, and long-term follow-up of the tongue body shape and clinical symptoms were recorded.The clinical effect was evaluated by onesurgeon and the parents.The effect was graded into four levels: dissatisifaction, average, satisifaction and great satisifaction.Results:A total of 61 children were included in this study, including 30 males and 31 females, with an average age of 8.5 months. The length of the tongue exposed outside at the resting state was 1.34-2.62 cm, with a median of 1.87 cm. Symmetric hypertrophy was found in 52 cases (85.2%), lateral hypertrophy in 9 cases (14.8%). There were 3 cases with respiratory obstruction (4.9%), 35 cases with salivation (57.4%), 4 cases suffering difficulty of feeding and dysphagia (6.6%). All children underwent the operation successfully, and the average operation time was 35.8 min. Among the short-term complications, there were 3 ventral wounds dehiscence, none of which needed sutured again. By prolonging nasal feeding time, the wounds were all healed in the secondary stage. Respiratory obstruction occurred in 1 patient after operation, and the symptoms were relieved after tongue retraction. The mean follow-up time was 3.3 years (2 months to 7 years), and 1 patient was inadequately corrected and good condition was got after second aryoperation. The remaining children obtained satisfactory resting tongue position and appearance, and the postoperative clinical symptoms were improved. In the long-term follow-up, the comprehensive evaluation results of the resting tongue position and clinical symptoms of the children by surgeon and parents were satisfied in 10 cases (16.4%), very satisfied in 50 cases (82.0%), and average in 1 case (insufficient correction after the first operation).Conclusions:Central resection and volume reduction of tongue body is a simple, effective and safe surgical technique in children with giant tongue diagnosed as BWS.

Tertiary lymphoid structures (TLS) are ectopic lymphoid structures in cancers that are largely associated with favourable prognosis. However, the prognostic value of TLSs in oral squamous cell carcinoma (OSCC) is largely unknown, and the association between tumour infiltrating lymphocytes (TILs) and TLSs has been rarely explored in OSCC. In this study, associated markers of TLS, including peripheral node address (PNAd) in high endothelial venules, CD20 in B cells and CD3 in T cells, were examined in 168 OSCC patients, and survival analysis was performed between TLS-positive and TLS-negative cohorts. We detected the presence of TILs by staining CD8+ cytotoxic T cells and CD57+ NK cells as well. TLSs appeared as highly organized structures in 45 (26.8%) cases. TLS-positive patients had a better 5-year overall survival (OS) rate (88.9% vs. 56.1%, P < 0.001) and relapse-free survival (RFS) rate (88.9% vs. 63.4%, P = 0.002). Moreover, the presence of TLS was an independent prognostic factor for both the 5-year OS rate (hazard ratio [HR] = 3.784; 95% confidence interval [CI], 1.498-9.562) and RFS rate (HR = 3.296; 95% CI, 1.279-8.490) in multivariate analysis. Furthermore, a higher density of CD8+ T cells and CD57+ NK cells was found in TLS-positive sections than in TLS-negative counterparts (P < 0.001), and their combination provided a higher predictive accuracy (AUC = 0.730; 95% CI, 0.654-0.805). In conclusion, our results suggest that TLS is an independent positive prognostic factor for OSCC patients. These findings provide a theoretical basis for the future diagnostic and therapeutic value of TLSs in OSCC treatment.

Objective: This study is to investigate the effectiveness of philtrum repairment for-microform cleft lip, using muscle tension line group reconstruction. Methods: This is a retrospective study of 19 consecutively primary microform cleft lip repairment patients, from January 2015 to December 2017. All the patients were provided muscle tension line reconstruction (group 1) or traditional muscle repairment by horizontal mattress sutures (group 2). The philtral ridge and dimple were evaluated by scores. The statistical analyses were performed using unpaired t-test by Prism 6.0 software. Results: The philtral ridge score was higher in group 1 than group 2 (4.15±0.56 vs. 2.73±0.32, P<0.01). The philtral dimple score of group 1 increased either, when compared with group 2 (2.36±0.50 vs.1.45±0.28, P=0.0004). Conclusions Functional reconstruction of philtrum, using muscle tension line group repair, has satisfactory results in philtral ridge and philtral dimple.

Objective: In clinical, cephalic index is the most common method to evaluate scaphocephaly. However, cephalic index alone is not sufficient to describe the nuances of skull shape. The authors hypothesize that the location of euryon could be a valuable and practical index as the supplement of cephalic index to better describe the skull. Methods: This is a retrospective study. CT scans of 17 scaphocephaly patients and 17 normal controls were included. Eight of 17 scaphocephaly patients have 6 months postoperative CT scan. The preoperative location of euryon of scaphocephaly patients was compared to that of the controls and postoperative. The horizontal location of euryon was defined as the ratio of the distance, from the most prominent point of forehead to euryon, to anteroposterior cranial length. The vertical location of euryon was defined as the ratio of the vertical distance, from the nasion to euryon, to cranial height. Results: Both the horizontal and vertical locations of euryon of preoperative scaphocephaly patients were significantly decreased compared to normals (46.50%±4.02% vs. 50.39%±2.21%, t=3.49, P=0.0014; 35.78%±8.62% vs. 52.6%±8.08%, t=5.86, P<0.001). Both the postoperative horizontal vertical locations of euryon were significantly increased, when compared to preoperative (47.25%±4.23% vs. 44.02%±3.72%, t=2.42, P=0.045; 42.39%±9.06% vs. 35.18%±5.36%, t=2.554, P=0.0379). Conclusions The location of euryon could be a practical and valuable index to describe the nuances of skull shape.