Centromere protein L (CENPL) is involved in the mitotic process of eukaryotic cells and the development of various types of cancer. However, its role in hepatocellular carcinoma (HCC) remains unclear. This study aimed to investigate the expression and clinical significance of CENPL in HCC, and explore its involvement in regulating HCC cell proliferation, apoptosis, cell cycle, and glycolysis both in vivo and in vitro. CENPL expression was analyzed in HCC and normal liver tissues using The Cancer Genome Atlas, Gene Expression Omnibus mining, real-time quantitative polymerase chain reaction, and immunohistochemistry. Functional assays were used to assess the role of CENPL in HCC cell proliferation, apoptosis, cell cycle, and glycolysis. The potential pathways underlying the regulatory effects of CENPL, as well as the expression of mitogen-activated protein kinase (MAPK) signaling pathway-related molecules and markers of proliferation and glycolysis were investigated. CENPL was significantly upregulated in HCC tissue and associated with multiple clinicopathological features and poor patient prognosis. Univariate and multivariate analyses demonstrated that CENPL may serve as an independent prognostic factor for HCC. Upregulation of CENPL in HCC regulated tumor proliferation and glycolytic processes. Mechanistic studies revealed that differentially expressed genes between the CENPL-overexpressing and control groups were mainly concentrated in the MAPK signaling pathway. Pathway inhibition analysis indicated that CENPL activated the MEK1/2-ERK1/2 signaling pathway to promote proliferation and glycolysis in HCC cells. This study elucidated the role of CENPL in regulating cell proliferation, apoptosis, cell cycle, and glycolysis in HCC. CENPL may represent a therapeutic target and prognostic biomarker for HCC.

This study aims to develop and validate a predictive nomogram for severe postoperative pleural effusion (SPOPE) in patients undergoing hepatectomy for liver cancer. A total of 536 liver cancer patients who underwent hepatectomy at the Department of Hepatobiliary Surgery I of the Affiliated Hospital of North Sichuan Medical College from January 1, 2018, to December 31, 2022, were enrolled in a retrospective observational study and comprised the training dataset. Lasso regression and logistic regression analyses were employed to construct a predictive nomogram. The nomogram was internally validated using Bootstrapping and externally validated with a dataset of 203 patients who underwent liver cancer resection at the Department of General Surgery III of the same hospital from January 1, 2020, to December 31, 2022. We evaluated the nomogram using the receiver operating characteristic curve, calibration curve, and decision curve analysis. Variables such as drinking history, postoperative serum albumin, postoperative total bilirubin, right hepatectomy, diaphragm incision, and intraoperative blood loss were observed to be associated with SPOPE. These factors were integrated into our nomogram. The C-index of the nomogram was 0.736 (95% CI: 0.692-0.781) in the training set and 0.916 (95% CI: 0.872-0.961) in the validation set. The nomogram was then evaluated using sensitivity, specificity, positive predictive value, negative predictive value, calibration curve, and decision curve analysis. The nomogram demonstrates good discriminative ability, calibration, and clinical utility.

Objective:To explore the predictive value of tumor burden score (TBS) combined with lymph node staging (TBS-N staging) for postoperative survival of patients with intrahepatic cholangiocarcinoma (ICC).Methods:Clinical data of 335 ICC patients who underwent hepatectomy in Zhongda Hospital of Southeast University School of Medicine, Eastern Hepatobiliary Surgery Hospital and Affiliated Hospital of North Sichuan Medical College from January, 2013 to December, 2019 were retrospectively analyzed. Among them, 169 patients were male and 166 female, aged from 23 to 87 years, with a median age of 62 years. The informed consents of all patients were obtained and the local ethical committee approval was received. The TBS of all patients was calculated. All the patients were divided into stageⅠ, Ⅱ and Ⅲ according to TBS score and lymph node metastasis. The predictive ability of TBS-N staging for clinical prognosis of ICC patients after hepatectomy was analyzed by the receiver operating characteristic (ROC) curve. The risk factors of clinical prognosis of ICC patients after hepatectomy were identified by Cox proportional hazard regression model.Results:The optimal cut-off value of TBS was 4.22, including84 cases of TBS-N stageⅠ, 202 cases of stageⅡand 49 cases of stage Ⅲ. TBS-N staging was correlated with tumor diameter (F=77.639, P<0.05), intraoperative blood loss (Z=11.385, P<0.05), HBV infection rate (χ2=6.590, P<0.05), surgical resection range (χ2=9.796, P<0.05), vascular invasion (χ2=12.332, P<0.05), TNM staging (P<0.05) and postoperative complications (χ2=7.210, P<0.05) of ICC patients. Cox multivariate analysis showed that TBS>4.22, N1 stage and poor tumor differentiation were the independent risk factors for clinical prognosis of ICC patients after hepatectomy (HR=1.529, 2.100, 1.724; P<0.05). The median overall survival of patients with TBS-N stage Ⅰ, Ⅱ and Ⅲ was 51.4, 22.7 and 12.0 months, respectively, where significant differences were observed (χ2=25.797, P<0.05). The area under ROC curve (AUC) of TBS, N staging and TBS-N model for predicting clinical prognosis of ICC patients after hepatectomy was 0.596, 0.602 and 0.660, respectively.Conclusions:TBS and N staging are the independent risk factors for clinical prognosis of ICC patients after hepatectomy. Compared with TBS or N staging alone, TBS-N staging can better evaluate the clinical prognosis of ICC patients after hepatectomy.

目的 构建可有效预测转移性胆囊癌(metastatic gallbladder carcinoma,MGBC)病人预后的列线图模型.方法 提取2004-2017年美国国立癌症研究所的监测、流行病学和结果(SEER)数据库所登记的709例MGBC病人临床病理资料.采用简单随机法,按7:3的比例分为发现集(n=496)与验证集(n=213).使用Cox比例风险回归模型筛选影响胆囊癌肿瘤特异性生存期(gallbladder carcinoma cancer-specific survival,GCSS)的影响因素.发现集数据中根据GCSS的独立影响因素构建列线图模型,然后利用验证集完成外部验证.利用一致性指数、绘制校准曲线及受试者工作特征曲线评估模型的预测精度.利用Kaplan-Meier生存分析和log-rank检验分析高、低风险组间的生存差异.结果 多因素分析提示年龄、肿瘤分化程度、是否手术、是否放疗、是否化疗是独立的危险因素.发现集一致性指数为0.704,验证集一致性指数为0.732.根据列线图模型进行风险分层,Kaplan-Meier生存分析显示:发现集和验证集的低风险组的预后均明显优于高风险组.结论 建立的列线图模型可准确、直观地预测MGBC病人的生存概率.

探讨围术期口服益生菌预防肝胆管结石患者术后感染的临床效果.2019年1月至2020年12月,手术治疗的134例肝胆管结石患者随机分为两组,干预组在围手术期护理中指导口服益生菌制剂(n=72),对照组则使用安慰剂(n=62).比较两组患者的临床指标,分析患者术后感染的影响因素.结果显示,134例术后并发症发生率为26.1％,术后感染的发生率为18.7％,以腹腔感染和伤口感染为主,分别占29.6％和41.3％.干预组总体并发症发生率(18.1％)、术后感染的发生率(12.5％)、术后排气时间(2.1±0.8)d和术后拔管时间(5.8±3.9)d均低于对照组[35.5％、25.8％、(3.2±1.0)d、(6.1±4.3)d](P值均小于0.05).术前白蛋白水平<30g/L、术后胆漏是术后感染的独立危险因素(P值均小于0.05).术后感染细菌培养的阳性率为44％～75％,大肠杆菌感染占58.1％.结果表明,围术期患者口服益生菌预防术后感染安全有效.针对营养不良、术后胆漏等感染等高危因素,围术期口服益生菌制剂、控制血糖、加强营养以及做好术后引流管护理等一些列精准护理措施的实施是有必要的.

This study investigated impacts of hyperoside on viabilities and apoptosis of gastric cancer (GC) cells. CCK-8 and flow cytometry were applied for examining HGC-27 cell viabilities and apoptosis, indicating that hyperoside treatment suppressed cell viabilities but facilitated cell apoptosis. Additionally, RT-qPCR results revealed that mRNA expressions of Bcl-2 in HGC-27 cells were downregulated while Bax and caspase-3 were elevated with hyperoside treatment. Furthermore, ELISA examined changes about protein concentrations of NF-κB/PTEN/JAK signalling pathway in HGC-27 cells after being treated by hyperoside. Results showed that protein concentrations of phosphorylated NF-κB/ p65 were reduced with hyperoside treatment while PTEN and JAK2 protein concentrations were promoted.

"网约护士"是指利用现代科学技术将专业护理服务从医疗机构延续到患者家中,本文采用SWOT分析对"网约护士"为患者提供延续性护理服务进行探讨.结果显示,政府和民众的支持以及互联网的普及为"网约护士"实施延续性护理服务提供了较好的发展契机."网约护士"可促进护理资源优化配置,提高患者居家生活质量.但目前"网约护士"水平参差不齐、服务收费标准较高等弊端也在一定程度上制约其发展.建议应加强"网约护士"的管理与培训,制定有效的风险防控制度,统一收费标准,维护患者和护士双方的权益,实现"共赢".

Background and purpose Index cholecystectomy is insufficient for curing T3 incidental gallbladder cancer (IGC), and once residual cancer (RC) is found, the prognosis is often poor. The purpose of this study was to investigate the effect of RC on the prognosis and the optimal choice of adjuvant therapy for R0 reresection patients with T3 IGC. Methods We retrospectively reviewed data from patients with T3 IGC who underwent radical reresection from January 2013 to December 2018. RC was defined as histologically proven cancer at reresection. Demographics and tumour treatment-related variables were analysed in correlation with RC and survival. Adjuvant (Adj) chemoradiotherapy (CRT) was correlated with overall survival (OS) and disease-free survival (DFS). Results Of the 167 patients with IGC who underwent surgery, 102 underwent radical extended resection. Thirty-two (31.4%) RCs were found. Hepatic side tumours (T3h) and both side tumours (T3h + T3p) were associated with the presence of RC. In multivariate analysis, RC and lymph node metastasis were independent prognostic factors for DFS and OS (P < 0.05). RC was associated with a significantly shorter median OS (20 vs. 53 months; P < 0.01) and DFS (11 vs. 40 months; P < 0.001) despite R0 resection. For R0 reresection patients with RC and/or lymph node metastasis, Adj CRT significantly improved OS (P = 0.024). Conclusion Residual cancer and lymphatic metastasis are important factors for the poor prognosis of T3 IGC despite R0 resection, and these patients should actively receive adjuvant therapy.

目的 探讨孕期孕妇接受婴儿睡眠健康教育,对促进出生后婴儿睡眠质量的作用效果.方法 采用整群抽样方法,选取城区、近郊、远郊各两家有孕妇学校的妇幼保健机构,在2015年开展婴儿睡眠健康教育课程,2015年12月15日-2016年1月15日期间调查在以上机构进行健康体检的1月龄孩子家长1009人,采用自填式问卷,调查妈妈孕期上课及婴儿睡眠情况,用x2检验进行分析.结果 将调查对象按照是否在孕期参加过孕妇学校睡眠课程分为孕期上课组、孕期未上课组两组人群,在妈妈学历、抚养方式、婴儿性别和产次方面比较,差异无统计学意义,说明两组具有可比性.家长在孕期参加过睡眠课程的,在产后被调查的时候,睡眠知识回答正确率43.8％,高于未上课组的正确率36.7％ (P ＜0.05).上课组记录婴儿睡眠(26.5％)、呼吸(35.7％)、大小便(70.0％)、奶量(61.0％)等发育细节方面,好于未上课组(17.7％、16.1％、20.0％、60.8％、50.4％、11.9％),差异均有统计学意义(P＜0.05).上课组在树立宝宝固定睡眠仪式(68.5％)、营造睡眠环境(52.1％)、调整适宜房间温度(80.8％)、在孩子动眼睡眠时能够正确处理(66.1％)方面,都好于未上课组(42.8％、41.7％、71.2％、58.9％),差异均有统计学意义(P＜0.05).在睡眠问题方面,经常发生至少一种睡眠问题(入睡困难、睡眠节律紊乱、张口呼吸、打鼾)的比率,上课组11.9％,小于没有上课组19.4％,差异有统计学意义(P＜0.05).结论 孕期开展婴儿睡眠知识教育,可以有效提高家长的相关知识,树立婴儿睡眠健康行为,是提高出生后婴儿睡眠质量的有效方法.

腹腔镜肝切除术因具有切口小、出血量少、住院时间短等优势,目前已成为肝胆外科的主流发展趋势[1] ,但全腹腔镜复杂肝切除术仍存在巨大挑战.近年我科从护理工作实际出发,依据腹腔镜肝切除术中配合的实践经验,对术中护理程序进行精确细化,并强调精准配合,采取精准护理的配合模式展开了一系列工作.为探讨最佳的护理配合方法,现将我院为46例复杂肝脏肿瘤患者行全腹腔镜肝切除术的临床资料及护理配合体会报道如下.

Objective To understand the current situation of sleep of infants aged 1～3 months in Beijing,and to analyze possible associated factors.Methods Two institutions of maternal and child health care were selected from urban,suburban,and exurban areas respectively from December 15th,2015 to January 15th,2016 by using the cluster sampling method.The survey was conducted among 1 152 parents with infants aged 1～3 months,and the general information,parenting and family environment,sleep environment,sleep problems were collected by self-designed questionnaire.Chi-squared test and multivariate Logistic regression analysis were used to explore associated factors.Results Of the 1 152 infants,the percentage of sleeping with adults was 73.8％,the percentages of shaking or patting to sleep and sleeping with a nipple were 72.9 ％ and 59.8 ％ respectively,and keeping a nightlight on was 52.0％.The rates of difficulty in falling asleep and circadian rhythm disorder were 50.3％ and 60.4％ respectively.The rates of mouth breathing,snoring and apnea in sleep breathing disorders were 33.0 ％,26.5 ％ and 3.5 ％ respectively.Significant predictors of increased odds of difficulty in falling asleep included the children older age (days)(OR =1.013,95 ％ CI:1.002 ～ 1.023),caesarean birth (OR =1.509,95 ％CI:1.101～2.068),mixed feeding(OR =1.401,95 ％ CI:1.036 ～ 1.894),improper sleep environment(OR =1.602,2.587,2.278,95％CI:1.177～2.180,1.113～6.011,1.217～4.263),lack of pre-sleep ritual (OR=1.611,95％CI:1.198～2.168)and rocking or patting baby to sleep (OR=3.397,95％CI:2.419～4.768).Conclusion Sleep problems and poor sleep behaviors of young infants are common in Beijing,so it is supposed to improve related knowledge of caregivers.

走进性医学门诊的患者大部分都有难言之隐.在我治疗过的患者中,刘女士给我留下的印象比较深—— 刘女士45岁左右,是一名知识分子,爱好广泛,性格开朗,丈夫也是一位科技人员,两人感情很好,生活过得有滋有味.可是在去年的单位体检中发现,刘女士的宫颈出现癌前病变,并怀疑有人乳头瘤状病毒(HPV)感染.

Objective To explore the effect of health education management model (BJPHE-OPEC Model) in pregnancy and puerperal period so as to provide objective basis for health education in the whole country.Methods In 2013 and 2016, all pregnant women in pregnant woemen's school and some pregnant women attending course in Beijing were selected as subjects of study.The quantitative and qualitative investigation was conducted on spot, files, questionnaires and interviews.Beijing City maternal health education management mode (BJPHE-OPEC Model) referred to maternal health education in Beijing city (Beijing Prenatal Health Educating, referred to as BJPHE) and the organization of teachers evaluating curriculum management model (orgnization and management/teachers and pregnant women management/effect evaluation/curriculum and classroom facilities, called OPEC).The effect of this management model was evaluated before and after intervention.Results Through intervention with BJPHE-OPEC Model, the proportion of full-time management in pregnant women school increased by 50.8%, management staff ratio increased by 33.8%, management system ratio increased by 61.9%, and the standardization ratio of archives management increased by 55.7%.Standard rate of teachers increased to 96% (55.0% before intervention), proportion of institutions with required attending course was 97.0% (72.0% before intervention), and the institutions with satisfacted teachers accounted for 95.0% (70.0% before intervention).On curriculum and classroom facilities, institutions with satisfaction accounted for 91.0% (65.0% before intervention).There were 99.0% pregnant women whose awareness rate met requirement (78.0% before intervention).Institutions with assessment and corrective measures accounted for 87.0% (30.0% before intervention).Differences before and after the intervention were statistically significant (χ2 value was 96.451, 36.69, 123.631, 95.897, 542.789, 59.053, 31.458, 27.925, 111.579 and 95.364, repectively, all P<0.01).Intervention group was improved significantly.Conclusion BJPHE-OPEC Model is the first management model of health education in Beijing.Through O (organization and management), P (teachers and pregnant women management), E (effect evaluation), C (curriculum and classroom facilities), the model plays a demonstrative role.BJPHE-OPEC Model is an effective management model, and it is worth promoting.

Objective:To investigate the effect of Cinobufacini Capsule on analgesic effect and quality of life in patients with advanced cancer.Methods:The 90 cases of patients with advanced cancer were selected and randomly divided into the control and treatment groups,45 cases in each.The patients were treated with Morphine Sulfate Sustained-release Tabelets treatment in control group,and Cinobufacini capsule in treatment group.The analgesic effect,quality of life,adverse reactions and clinical efficacy were observed in the two groups.Results:The NRS score decreased after treatment in the two groups (P＜0.05),while the KPS increased in the two groups (P＜0.05);The treatment group showed higher KPS scores than the control group after treatment (P＜0.05).After treatment,the value of life,negative emotions and life pain scores increased in the two groups (P＜0.05),and the treatment group showed higher negative emotions and life pain scores than the control group (P＜0.05).The total effective rate was 91.1％ in the control group and 86.7％ in treatment group,and the difference was not statistically significant (P＞0.05).The total adverse reaction rate is 31.1％ in the control group and 6.7％ in treatment group,and the difference was statistically significant (P＜0.01).Conclusion:The Cinobufacini Capsule shows pain relief effect and less adverse reaction on patients with advanced cancer,and it can effectively improve the quality of life of patients.

Objective:To investigate the knowledge,attitude and practice of diabetes mellitus in pregnant women with gestational diabetes mellitus (GDM)in perinatal nutrition clinic in Beijing.Methods:From January to August in 2016,according to the representative method of stratified random sampling,extraction,comprehensive urban and suburban hospitals of maternal and child health hospitals,a total of 8 perinatal nutrition clinics were entrolled.Women of 242 cases,24-28 weeks of pregnancy and diagnosed as GDM were in GDM group,other 228 cases of pregnant women with normal glucose tolerance were in control group.Two groups of pregnant women were questionnaired and the answers were compared and analyzed.Results:Pregnancy nutrition KAP score of GDM group(31.16±2.21)was lower than that of the control group(36.72±2.4,P＜0.05).The nutrition knowledge score,nutrition professional knowledge score and nutrition behavior score of GDM group were significantly lower than those of the control group (all P＜0.05).Significant differences were also seen in both groups about access to nutrition knowledge and their willingness.They want to obtain nutrition knowledge from hospital,WeChat and pregnant women school nutrition clinic lectures etc.Conclusion:GDM pregnant women in perinatal nutrition clinic in Beijing generally pay attention to nutrition during pregnancy,but their professional knowledge of nutrition and nutritional behavior need to be improved.Perinatal nutrition clinics need to provide a variety of forms and precise health education guidance for GDM pregnant women.

孕期运动的好处 1运动可以改善母体内的血液循环,增加肌肉组织的营养,使肌肉储备较大的力量. 2锻炼有助于髋关节的打开,利于自然分娩. 3适当运动可以缓解孕妇生活和情绪上的压力和焦虑,促进睡眠. 4适度运动能够增强血液循环,减轻下肢水肿,预防静脉曲张,缓解腰腿疼痛,并可使肠蠕动加快,降低便秘的发生率.

Objective To understand the anxiety,depression and social support of gestational diabetes mellitus(GDM)women in perinatal nutrition clinic in Beijing. Methods In accordance with the representative method of stratified random sampling,extraction,comprehensive urban suburban hospital,a to-tal of 456 pregnant women with GDM who were diagnosed for the first time in perinatal nutrition clinic at 24-28 gestational weeks in January to August,2016 were selected in this study for questionnaire survey. Survey includ-ed questionnaire on general information,Self-rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS) and Social Support Scale. The results were statistically analyzed. Results The SAS score of pregnant women with GDM was(57.12±4.61),SDS score was(59.62±4.38). Anxiety and depression of GDM patients were negatively correlated with social support utilize degree,social support scores and subjective support(P<0.05). Elderly primi-para,pre-pregnancy BMI≥25kg/m2,higher education,adverse pregnancy,living in the city were risk factors of the occurrence of anxiety and depression in pregnant women with GDM. However,social support was a protective factor. And the social support of GDM pregnant women who lived in country was lower. Conclusions Pregnant women with GDM are easy to be anxiety and depression. It is suggested that health education classes should be set up in peri-natal nutrition clinic to provide psychological guidance and strengthen social support to pay attention to mental health of pregnant women with GDM.

Objective To explore the correlation between self-management ability and self-efficacy of patients with mixed vaginitis and seek nursing countermeasures to improve the self-management ability of patients with vaginitis.Methods Chronic disease self-efficacy scale prepared by Chronic Disease Education Research Center of Stanford University in the United States and a self-designed questionnaire for self-management ability of patients with vaginitis were used to investigate 192 cases of vaginitis.Spearman's correlation analysis was conducted to determine the relationship between these two facotrs.Results The total score of self-efficacy of patients with vaginitis was 5.47 ±1.64, which was in low level.Self-management ability score was 10.64 ±2.63 and in the middle low level.They had significantly positive correlation (r=0.276, P <0.01).Conclusion Self-efficacy of patients with mixed vaginitis can be improved in the clinical nursing work by enhancing patients' self-efficacy, and thus their self-management ability can be improved to reduce the recurrence of disease.

“吃饭,影响人的一生”——这个观点,越来越得到现代父母的认同.关于孩子吃饭的问题,常有人会拿中国父母和美国父母进行比较. 中国人重视吃饭,家长对孩子的爱,尤其体现在吃饭上.首先是让孩子多吃,不分青红皂白,使劲喂,只要孩子多吃就好,经常可见爷爷奶奶端着碗,四处追赶孙儿喊叫着喂一口饭.

The pregnant women were divided into low score and high score groups in accordance with the related anxiety condition in pregnancy of pregnant women ,and according to whether to participate in exercise intervention or not ,they were then respectively divided into four groups ,high score sporting group ,high score but not sporting group (control group ) ,low score group and low score but not sporting group (control group) .Then ,the sporting group were doing pregnant women health exercises ,finally ,by comparing with the control group ,it was verified that the effects of sports exercise intervention on the pregnant women anxiety and depression and blood pressure and other related indicators in different groups .The results showed that the sports exercise intervention didn't have a significant impact on anxiety and de-pression of pregnant women with high score ;for pregnant women with low score ,the sports exercise intervention could significantly reduce the anxiety and depression state in second and third trimesters and the postpartum period .For Pregnant women with high score and low score ,exercise could lower the pregnant woman's fetal heart in third trimester .For Pregnant women with high score ,sports exercise intervention could reduce systolic blood pressure in third trimester and postnatal diastolic blood pressure ;For Pregnant women with low score , sports exercise intervention could reduce the systolic blood pressure in third trimester and post-partum period .Therefore ,sports exercise intervention could improve the physical health condi-tion of the pregnant women(fetal heart ,blood pressure) ,there were differences in the effects of sports exercise intervention on anxiety and depression state of differences for Pregnant women with high and low score ,the effect was more obvious for Pregnant women with low score .So the research group recommended that pregnant women should do proper exercise to relieve the anxiety state and improve the physical health condition .