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The key advances in personalized perioperative nursing practice for hepatobiliary surgery patients include the implementation of evidence-based nursing strategies, the development of individualized care plans, the adoption of multimodal analgesia and recovery after surgery protocols, enhanced monitoring techniques, a multidisciplinary approach to care, and a strong emphasis on patient education and engagement. These advancements collectively aim to improve patient safety, reduce complications, and enhance recovery following complex surgical procedures.

Background: Botulinum toxin is an attenuated neurotoxin of Clostridium Botulinum gram positive bacterial, which is used in medication sialorrhea, cervical dystonia, hyperhidrosis and non-surgical cosmetic operation (aesthetic) such as facial wrinkles and reduced the bulky appearance hypertrophied of masseter muscle. This study was designed to revealed the effect of zygomiticus inoculation of botulinum toxin B in zygomatic muscle of rats on zygomatic bone.

Methods: A total of 25 male albino rats (200-260 gm) were injected facial intramuscular by a single dose of 2.5 U/ botulinum toxin B. All experimental groups (4 groups, 5 each) were kept survived to the end period and sacrificed by time period [group 1 (G1)=14; group 2 (G2)=30; group 3 (G3)=45, and group 4 (G4)=60 days] post injection, moreover, 5 animals were administered nothing and kept as a control group till 60 days elapsed. Animals were killed by intense dose of chloroform and rats facial zygomatic bone removed.

Results: Zygomatic bone of G1 showed irregular boney border, degenerated osteocytes, woven collagen bundles within collar bone, reddish bone matrix and detachment of fibrous layer of periosteum in G2 results showed disappearance of osteogenic cells, lacunae devoid osteocytes, and aggregated of necrotic elements of bone tissue. In G3 groups showed great crack, disorganization of collagen bundles atrophied osteocytes the matrix of bone had necrotic areas of osteocytes, fragments of bone also demonstrated. G4 group showed massive crack underneath degenerated periosteum of bone, tunnel like furrow, filled up with cellular debris and osteogenic debris within Howship's lacunae.

Conclusion: In this present study we summarized the effect of paralyzed facial muscle by botulinum toxin B on facial bone of rats induced, secondary osteoporosis represented as irregular bone border degeneration of osteocytes, crack appeared in bony matrix, decreases in amounts of collagen bundles and separation of periosteum.

Background: Total hip arthroplasty (THA) is a highly successful orthopedic procedure increasingly performed on younger, obese patients due to its ability to improve functional outcomes and quality of life. However, obesity presents challenges related to implant selection and long-term outcomes, particularly with the use of short femoral stems. While short stems offer benefits such as bone preservation and reduced stress shielding, their reliability in obese patients remains underreported.

Aim: Compare functional and radiographic results of THA in obese versus non obese young patients.

Methods: This single-center case-control study evaluated clinical and radiographic outcomes of obese patients (BMI ≥30 kg/m²) undergoing primary uncemented THA with short femoral stems. A total of 120 patients (60 obese, 60 nonobese) were enrolled, matched 1:1. Outcomes assessed included surgical parameters, Harris Hip Score (HHS), Roles and Maudsley satisfaction score, and radiographic implant evaluations at a minimum follow-up of two years. Statistical comparisons were performed using SPSS, with a significant threshold of p<0.05.

Results: Operative times and incision lengths were modestly longer in obese patients (p<0.05). Mean postoperative HHS improved significantly in both groups, with scores of 91±3.7 (obese) and 93±2.5 (nonobese). Radiographic analysis showed excellent implant positioning, with all components within the Lewinnek safe zone. Minor radiolucencies and subsidence (≤2 mm) were observed in a small subset of obese patients but were clinically insignificant. Complication rates were low and comparable between groups, with one superficial infection in the obese group and one deep venous thrombosis in the nonobese group.

Conclusions: Short femoral stems in uncemented THA demonstrate safe and effective performance in obese patients, yielding clinical and radiographic outcomes comparable to nonobese patients. Short stems provide the added advantage of bone preservation, which is critical for revision surgery in younger, obese populations. Larger studies with longer follow-up are needed to validate these findings and assess long-term implant survival.

Aim of study: The pathological examination is one of the longest in the list of medical tests. Most of this time is spent on preparation for the slide. In addition, part of the chemical reagents needed for processing is not safe for the environment and the personal working in the laboratory. The goal of our project was to develop a new, cost-effective and eco-friendly tissue processing technology by integrating a new hardware component - an ultrasound device - into the processing protocol.

Material and methods: 28 experimental protocols were developed to create a new tissue material processing protocol. A selected broad panel of tissues was used for each experiment. 168 autopsy tissue samples with a standard set of organs were used in the examination. Processing was carried out manually under conditions of ultrasonic treatment (UP200HT). All slides were stained with hematoxylin-eosin technology. The quality of the slides was evaluated through 5 points evaluation system by 2 pathologists.

Results: Application of ultrasound technology in the processing of histological material will: reduce processing time and number of reagents required for processing; increase the cost efficiency of processing; remove harmful component xylene from the processing protocol; better preserve tissue antigenic structure at the expense of reduced tissue retention time in reagents.

Conclusions: So, the interdisciplinary use of engineering and medicine will be of great benefit to both the medical staff and the environment, as well as to patients (they will receive better research quality and reduced waiting time for examination results).

Objective: The purpose of this study is to explore the application effect of early risk factor warning model of acute kidney injury combined with continuous renal replacement therapy in patients with severe acute pancreatitis, and to comprehensively evaluate the effects of this combined treatment model on patients'renal function recovery and complications through prospective studies.

Methods: This study adopted a rigorous random grouping method to ensure the balance and randomness of the grouping and minimize the interference of confounding factors on the research results. Specifically, with the help of a computer-generated random number sequence, patients who met the inclusion criteria were randomly assigned to the combined treatment group and the traditional treatment group.

Results: The incidence of acute kidney injury differed significantly between the two groups. The incidence of acute kidney injury in the traditional treatment group is as high as 35%, which is closely related to the natural course of the development of severe acute pancreatitis and the limitations of traditional treatment methods.

Conclusions: The application of early risk factor warning model of acute kidney injury combined with continuous renal replacement therapy in patients with severe acute pancreatitis has excellent performance in improving patient prognosis, guiding clinical decision-making, and optimizing the allocation of medical resources.

Parkinson disease (PD) is a common neurodegenerative condition. It affects the central nervous system, and it impairs cognitive processes, motor skills and other functions. The aim of this study was to determine the synaptic processes in medial Entorhinal cortex (mENT) under High frequency stimulation of Basolateral Amygdala on the model of Parkinson's disease under the influence of Hydrocortisone. Rotenone is involved in the degeneration of dopaminergic neurons. We investigated whether hydrocortison protects against rotenone-induced dopaminergic neurotoxicity in a rat model by in vivo electrical recording from medial Entorhinal cortex. Hydrocortison significantly improved electrical activity of neurons in the mENT of rotenone-induced PD model rats.

Aim: The aim of the study is to determine the effect of anti-inflammatory biological drugs (adalimumab, infliximab and rituximab) on the cardiovascular system during the treatment of patients with rheumatoid arthritis.

Methods: Involved in research 70 women aged 18 to 60 years with a confirmed diagnosis of rheumatoid arthritis (diagnosis confirmed by the American College of Rheumatology 2010 (ACR) and European League of Rheumatology (EULAR) classification criteria). Patients on standard treatment and biological drugs were divided into 3 groups, and the third group was divided into two subgroups. The study lasted for 30 weeks. Studies were conducted before and after treatment.

Results: After 30 weeks of treatment with biological drugs, the following changes were observed in all groups: DAS28-ESR and HAQ score values, RF, CRP, and ESR concentrations were significantly lower compared to the control group. A significant increase in TC and HDL-C, without significant changes in LDL-C and TG, was observed in all groups against the background of treatment with biological drugs, as a result of which the atherogenicity index decreased. Decreases in CRP levels at 30 weeks were inversely correlated with increases in HDL-cholesterol. Insignificant changes were observed in fasting blood glucose SBP, DBP and BMI data compared to the control group. Combined therapy with biological drugs led to a significant improvement in the elastic properties of arterial walls.

Conclusion: Before starting the treatment of biological drugs in patients with rheumatoid arthritis, the risk of cardiovascular evaluation is full and according to this we need to choose biological drugs and this way we can increase the side effects of drugs.

Objective: The integration of physical therapy (PT), occupational therapy (OT), and speech therapy (ST) into a triple therapy approach has gained recognition in the rehabilitation of patients. The integration of PT-OT-ST triple therapy with accelerated recovery strategies in pulmonary rehabilitation for elderly mechanically ventilated patients is anticipated to overcome the limitations of traditional rehabilitation approaches.

Methods: By applying stringent inclusion and exclusion criteria, a total of 60 elderly patients over 60 years old requiring mechanical ventilation were selected. These patients were then divided into an observation group and a control group using a random number table method, with 30 cases in each group. Quality of life indicators were assessed using the Short Form Health Survey (SF-36) to evaluate changes in the patients' quality of life before the intervention and four weeks post-intervention.

Results: Before the intervention, there was no significant difference in the SF-36 scores between the two groups (P＞0.05). After 4 weeks of intervention, the SF-36 scores of the observation group were significantly higher than those of the control group (P＜0.05).

Conclusions: This study demonstrates that the combination of PT-OT-ST triple therapy with an accelerated recovery strategy is effective in pulmonary rehabilitation for elderly patients on mechanical ventilation.

Parkinson's disease (PD) is a complicated neurodegenerative disease that is the most prevalent severe movement disorder worldwide. The research includes studying the levels of hydrogen sulphide (H2S) and cystathionine γ-lyase (CSE) with some biochemical parameters in the serum of patients with PD in Mosul City (Iraq), which include Serotonin (SERT), dopamine (DA), sphingomyelin (SM), vitamin B12, Acetylcholine esterase (AChE), monoamine oxidase (MAO), creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT). Samples reached (100), which included: (40) for the Parkinson's patients group, and (60) for the control group. The results showed there was a significant decrease in the levels of H2S, CSE, SERT, DA, SM, B12 and CK and a significant increase in the activity of MAO, AST, and ALT and no significant difference in AChE activity in serum for Parkinson's patients when compared with the control group. The effect of periods PD revealed, a significant decline of H2S, CSE, SERT, DA, B12, and AChE, while MAO, CK, AST, and ALT showed a significant rise with increased periods of disease, SM showed a non-significant change with periods of disease. The study concluded that H2S gas produced within the body and CSE suffer from low levels within the body, and they also decrease with the increase in the duration of the disease as a result of their use as protective functions in the body against Parkinson's disease. And developing it by observing the levels of the variables measured with it, and stimulating the body to increase their levels (H2S, CSE) in various ways can lead to improving the health condition of patients.

Background: Breast cancer, the world's most prevalent cancerous disease that threatens women, is mainly dependent upon ovarian endocrine secretion for its growth and development. Telomerase inhibitors have been widely studied for their use to treat various tumors. BIBR1591 is the first highly effective small molecule telomerase inhibitor that could inhibit telomerase of many types of cancer cells at sub micromolar concentration Aim: Our research aimed to study the molecular mechanism and action of BIBR1591, trying to understand the telomerase inhibitor in breast cancer, focusing on its ability to induce apoptosis and alter the expression of specific genes.

Material and methods: The MCF-7 breast cancer cell line was treated with BIBR1591 at different concentrations for 48 hours, and the effects on cell viability and apoptosis were evaluated using MTT and flow cytometry assays, respectively. The DAPK1, and NR4A3 gene expression levels were assessed by qPCR.

Results: Treatment with BIBR1591 resulted in a dose-dependent decrease in cell viability and a significant increase in apoptosis in the MCF-7 cells. Furthermore, the expression levels of CDH13, DAPK1, and NR4A3 genes were upregulated following treatment with BIBR1591.

Conclusion: Our research concludes that BIBR1591 has unique molecular anticancer effect as its expression of CDH13, DAPK1, and NR4A3 genes. These results support the potential use of BIBR1591 as a therapeutic option for breast cancer treatment.