Objective:To investigate the safety and outcomes of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma (HCC).Methods:The clinical data of HCC patients who underwent hepatectomy at the University of Hongkong-Shenzhen Hospital from April 2014 to December 2020 were retrospectively analyzed. Of 57 HCC patients who were enrolled, there were 43 males and 14 females, aged (51±14) years old. According to the surgical method, the patients were divided into two groups: patients with pre-operative residual liver volume/standard liver volume <30% who underwent ALPPS procedure by anterior approach formed the study group ( n=20), and patients who underwent right hepatectomy with residual liver volume/standard liver volume ≥35% formed the control group ( n=37). Clinicopathological data and prognosis were reviewed and compared between the two groups. The patients were followed up via outpatient service and telephone. Results:There were more patients with well-moderately differentiated HCC in the study group than in the control group, and the difference was statistically significant ( P<0.05). All patients in the study group successfully completed two-step hepatectomy. Compared with the control group, the operative duration [644(535, 780) vs. 352 (269, 401) min], intraoperative blood loss [1 650 (1 338, 2 200) vs. 650 (500, 925) ml], and proportion of patients requiring blood transfusion (60.0% vs. 29.7%) were increased in the study group. The difference was statistically significant ( P<0.05). There was no significant difference in the incidence of grade III or higher complications between the study group and the control group [30.0% (6/20) vs. 18.9% (7/37), χ 2=0.91, P=0.341]. The 1-, 2- and 3-year overall survival rates were 90.0%, 63.8% and 46.4% respectively, and the corresponding tumor-free survival rates were 53.3%, 35.6%, and 35.6% respectively for the study group. The 1-, 2-, and 3-year overall survival rates were 71.4%, 63.4%, 51.7%, and tumor-free survival rates were 39.0%, 18.5%, 9.3% in the control group respectively. There was no significant difference in the postoperative survival rate and tumor-free survival rate between the two groups ( P>0.05). Conclusion:ALPPS was safe and feasible for treatment of right hepatocellular carcinoma with insufficient residual liver volume, and its survival outcomes was similar with one-stage right hepatectomy for HCC patients.

Objective:To investigate the correlation between serum calcitonin gene-related peptide (CGRP) and the culture outcome of in vitro fertilization embryo in male patients with infertility.Methods:In this study, the randomized samples from 25 male patients who received in vitro fertilization-embryo transfer (IVF-ET) in the 1st Affiliated Hospital of Fujian Medical University from June 2019 to October 2019 were analyzed by multiple linear stepwise regression, with some important clinical outcomes, such as the logarithmic conversion index of serum CGRP, fertilization method, masturbation difficulty, age, infertility duration, and prolactin, as independent variables, while total fertilization rate, normal fertilization rate, high quality embryo rate at day 3, blastocyst formation rate as dependent variables.Results:The Pearson correlation analysis showed that the D3 high-quality embryo rate was related to the normal sperm morphology rate in the primary infertility group ( r=0.537, P=0.048), the blastocyst formation rate was correlated with sperm density ( r=0.760, P=0.002), the CGRP logarithm was correlated with the total fertilization rate ( r=0.693, P=0.006). The logarithmic conversion index of serum CGRP was related to the total fertilization rate and normal fertilization rate in the secondary infertility group ( r=0.614, P=0.042 and r=0.611, P=0.046). In the secondary infertility group, there was a linear relationship between normal fertilization rate and total sperm count, serum CGRP log conversion, and sperm normal morphology rate, with standardized regression coefficients of 0.2, -0.729, and 6.8, respectively. Conclusion:Serum CGRP level, together with total sperm count and normal sperm morphology rate may affects normal fertilization rate in male patients with infertility.

Objective To investigate the role of PKCι, YAP1 and high-risk HPV infection in the local immune microenvironment of cervical cancer. Methods We chose 80 cases of normal tissue of the cervix (NCT), cervical low-grade squamous intraepithelial lesion (LSIL), cervical high-grade squamous intraepithelial lesion (HSIL) and early cervical squamous cell carcinoma (SCC) each. Four groups were collected.The infection rate of high-risk HPV in four groups was determined by real-time fluorescence PCR method. The expression levels of PKCι, YAP1, CD4 and CD8 in four groups were measured and correlated by IHC and clinicopathologic features were also analyzed. Results The differences of high-risk HPV infection rate and PKCι, YAP1, CD4, CD8 positive rate among groups of NCT, LSIL, HSIL and SCC had statistical significance (P < 0.05). The level of cervical lesions was positively associated with high-risk HPV infection and positive PKCι, YAP1, CD8 expression (P < 0.05), while negatively associated with positive CD4 expression (P < 0.05). HPV infection and positive PKCι, YAP1, CD8 expression were positively correlated with each other in SCC, while were all negatively correlated with positive CD4 expression(P < 0.05). The differences of HPV infection, PKCι, YAP1 and CD8 positive expression were significant in different levels of differentiation and vascular invasion of SCC (P < 0.05). Conclusion The patients with cervical lesions are often accompanied by high-risk HPV infection and abnormal expression of PKCι, YAP1, CD4 and CD8, which may have synergistic effects on each other, causing the local immunosuppression microenvironment of SCC. It provides a possible strategy for the study of pathogenesis, diagnosis and treatment of cervical cancer.

Objective:To explore the clinical significance of classification and grading of ovarian serous tumors (OST) and the correlation of classification and grading with expressions of p53 and Ki-67 proteins, so as to provide a basis for accurate diagnosis and reasonable treatment of OST.Methods:A total of 100 paraffin-embedded ovarian tissues were collected from Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2012 to November 2017. The classification and grading of OST was based on the World Health Organization (WHO) ovarian tumor tissue classification, the work conference on borderline ovarian tumors which was held in August 2013 in Maryland, United States, and the two-level tissue classification system of the United States MD Anderson Cancer Center. The 100 cases of ovarian tissues included 10 cases of normal ovarian tissues (NOT), 12 cases of ovarian serous cystadenoma (OSA), 18 cases of ovarian serous borderline tumor (OSBT), 22 cases of low-grade serous carcinoma (LGSC), and 38 cases of high-grade serous carcinoma (HGSC). The expressions of p53 and Ki-67 proteins in paraffin-embedded tissues were detected by immunohistochemistry. The clinical characteristics of patients with different types of OST and their relationships with the expression of p53 protein and Ki-67 positive index were analyzed.Results:Among OSBT, LGSC and HGSC groups, the proportion of patients with onset age > 50 years old [38.9% (7/18), 45.5% (10/22), 73.7% (28/38)], poor differentiation [0 (0/18), 0 (0/22), 100.0% (38/38)], stage Ⅲ-Ⅳ [5.6% (1/18), 27.3% (6/22), 39.5% (15/38)] increased sequentially, and the differences were statistically significant (all P < 0.05). Among NOT, OSA, OSBT, LGSC and HGSC groups, there were significant differences in the positive rate of p53 protein [20.0% (2/10), 25.0% (3/12), 27.8% (5/18), 31.8% (7/22), 57.9% (22/38)] and Ki-67 positive index [(10.40±0.00)%, (31.49±6.53)%, (42.81±6.84)%, (74.29±6.54)%, (77.04±8.88)%] (all P < 0.05). In the patients with ovarian serous carcinoma (LGSC + HGSC), there was no significant difference in the positive rate of p53 protein and Ki-67 positive index between the onset age ≤ 50 years old and > 50 years old groups (both P > 0.05), but there were significant differences between the patients with different tissue differentiation grade, clinical stage and metastasis (all P < 0.05). There was significant difference in Ki-67 positive index among NOT, OSA, OSBT, LGSC and HGSC patients with positive expression of p53 protein ( P < 0.01). Conclusions:The classification and grading of OST is related to onset age, tissue differentiation and clinical stage, which can be used to guide treatment and judge prognosis. The positive rate of p53 protein and Ki-67 positive index increase with advancing grade of breast lesions, which may be related to the occurrence and development of OST.

OBJECTIVE: To assess the application value of mapping allele with resolved carrier status (MaReCs) technique for preimplantation genetic testing (PGT). METHODS: The characteristics of MaReCs for PGT and outcome of patients were retrospectively analyzed. RESULTS: Compared with those who could not use the technique, carriers who have used the MaReCs technique were younger, had significantly higher level of anti-Mullerian hormone, more antral follicles, occytes, mature occytes, biopsied embryos and euploid embryos, and lower risks for de novo chromosomal abnormality (P<0.05). It was necessary for couples with fewer oocytes, mature oocytes and balstocyst to preserve discarded embryos to facilitate the test. Carriers who have used the MaReCs technique had higher clinical pregnancy rate and abortion rate compared with those undergoing routine PGT, albeit no significant difference was found between the two groups (P> 0.05). Carriers undergoing MaReCs test could preferentially select embryos with normal chromosome structures for the transfer. CONCLUSION Application of MaReCs has a prerequisite for having a minimum number of occytes and biopsied embryos and using discarded embryos sometimes. MaReCs is efficient for the detection of carrier status of embryos and attaining higher rate of pregnancy and live birth, which can significantly improve the outcome for couples carrying chromosomal translocations.
Alleles ; Aneuploidy ; Blastocyst ; Female ; Fertilization in Vitro ; Genetic Testing ; Humans ; Pregnancy ; Preimplantation Diagnosis ; Retrospective Studies ; Translocation, Genetic

Objective:To deeply understand needs and problems of on-site nursing service training for "network nurses", so as to provide a reference for the construction of "Internet + Nursing Service" training content system standards.Methods:Using the purposive sampling method and based on principle of maximum differentiation, a total of 12 "network nurses" in Ningbo were selected from March to May in 2020 to conduct semi-structured interviews. Braun thematic analysis method was used to analyze data and extract themes.Results:A total of 4 themes were obtained. The first was that the requirements of practicing safety education and training included risk prevention training, adverse event handling process training, emergency response plans and complication handling training. The second was the needs of humanistic care education and training, including on-site service language, code of conduct training, nurse-patient communication training and health education knowledge training. The third was the demand for diversified training forms. Fourthly, factors affecting training quality.Conclusions:"Network nurses" have a greater demand for occupational safety education and humanistic care education. It is recommended that multiple parties should cooperate to improve the "Internet +Nursing Service" emergency laws and regulations as soon as possible, provide diversified training models, reserve high-quality "Internet + Nursing Service" talents and promote continuous and standardized development of "Internet + Nursing Service".

Objective:To explore the changing characteristics of self-efficacy, social support, psychological stress in patients with osteoporotic vertebral compression fractures (OVCFs) receiving conservative treatment at different treatment stages and their correlations with the recovery of lower back function.Methods:A total of 116 patients with acute OVCFs who were admitted to the Affiliated Hospital of Medical School, Ningbo University were selected from January 2017 to May 2019. Oswestry Disability Index (ODI) Questionnaire, General Self Efficacy Scale (GSES) , Perceived Social Support Scale (PSSS) and Perceived Stress Scale (PSS) were used to assess the lower back function, self-efficacy, social support and psychological stress of OVCFs patients. Questionnaires were filled out during outpatient reexamination or in-home follow-up, and the evaluation time was at the time of treatment and 1, 3, 6, and 12 months after conservative treatment. Analysis of variance and SNK- q test were used to explore the characteristics of each score over time, and linear regression analysis was used to explore the effects of GSES, PSSS, and PSS on ODI. Results:With the prolongation of treatment time, ODI, GSES, PSSS and PSS scores of OVCFS patients under conservative treatment showed a downward trend, and the scores at 3, 6 and 12 months after treatment were lower than those at 1 month after conservative treatment ( P<0.05) . The scores at 6 and 12 months after conservative treatment were lower than those at 3 months after conservative treatment ( P<0.05) . The scores at 12 months after conservative treatment were lower than that those at 6 months after conservative treatment ( P<0.05) . GSES, PSSS (total score, in-family support, out-of-family support) and PSS were independent influencing factors of ODI at one month after treatment ( P<0.05) . GSES, PSSS (total score, in-family support) and PSS were the influencing factors of ODI at 3 months after treatment ( P<0.05) . Conclusions:The self-efficacy and social support of conservatively treated patients with OVCFs are positively correlated with their lower back function, while psychological stress will reduce lower back function of such patients. It is suggested to add these non-physical factors to the rehabilitation nursing model and take appropriate intervention measures.

Objective: To explore the correlation between serum high density lipoprotein (HDL) levels and cognitive function in patients with bipolar disorder. Methods: A total of 99 patients with bipolar disorder were enrolled from the inpatient of Suzhou Guangji Hospital.Serum HDL levels were measured by enzymatic colourimetry.Cognitive function was assessed by the repeatable battery for the assessment of neuropsychological status (RBANS). The relationship between serum high density lipoprotein and cognitive function was analyzed by correlation analysis and stepwise multiple regression analysis. Results: Serum HDL levels ((1.39±0.55)mmol/L)were positively correlated with the RBANS total score (68.92±12.48)(r=0.238, P=0.034) and language score(80.59±15.97) (r=0.239, P=0.033) in patients with bipolar disorder.Stepwise multiple regression analysis showed that serum HDL level was the influencing factor of total score of RBANS(β=4.791, t=2.151, P=0.035)and speech function(β=7.363, t=2.247, P=0.027). Conclusion Serum HDL levels can influence cognitive function, especially speech function in patients with bipolar disorder.

Objective This paper aims to observe and analyze the effect of hepatic arterial chemoemboliza-tion combined with arsenic trioxide injection in the patients with primary liver cancer.Methods This study includ-ed Ninety patients with primary liver cancer who were treated in our hospital from January 2013 to June 2016.The patients were divided into the study group and control group and the two groups were given different treatment proto-cols. The patients in the control group were treated with hepatic arterial chemoembolization and the patients in the study group were treated with arsenic trioxide injection.On the basis of the treatment effect was observed and com-pared. Results There was no significant difference between the two groups in recent curative effect(P > 0.05);the study group had higher one year survival rate than the control group(P<0.05).There was no significant differ-ence between the two groups in adverse reactions(P>0.05);the study group was superior to the control group in terms of improvement of quality of life(P < 0.05). Conclusions Hepatic arterial chemoembolization combined with arsenic trioxide injection can improve one year survival rate of primary liver cancer patients,and provide good long-term survival rate without obvious adverse reactions,and improve quality of life of patients.

Objective To explore the role of decorin (DCN) on the pathogenesis of schizophrenia by analyzing the correlation between serum DCN levels and cognitive impairment in the first-episode drug-native (FEDN) patients with schizophrenia.Methods 30 FEDN patients with schizophrenia and 30 age and gender matched healthy volunteers (control group) were enrolled.The psychopathological symptoms were assessed by the PANSS and the cognitive function was assessed by the MATRICS Consensus Cognitive Battery (MCCB).The serum DCN levels were measured by using enzyme linked immunosorbent assay (ELISA).The difference of DCN levels between the two groups were compared and the correlations of serum DCN levels to age,sex,the score of the MCCB and PANSS were analyzed.Results The serum DCN levels were lower in patients with schizophrenia than those in control group ((1.56±0.96) ng/ml vs (3.35± 1.71) ng/ml,P＜ 0.01).The serum DCN levels were positively correlated with the positive symptom score (r=0.41,P=0.03).The serum DCN levels were significantly negatively correlated with MCCB verbal fluency (r =-0.40,P =0.04),verbal memory (r=-0.42,P=0.02),visual memory (r=-0.39,P=0.04),continuous operation (r=-0.41,P=0.03),encoding symbols (r=-0.49,P=0.01),T line (r=-0.42,P=0.02) and total score (r=-0.55,P＜0.01),and after controlling the age and gender,the relationships were still exist.Conclusion It suggests that serum DCN levels are associated with cognitive function in first-episode patients with schizophrenia,and that DCN may be involved in the pathogenesis of schizophrenia.