Association of serum ferritin and all-cause mortality in AKI patients: a retrospective cohort study.

Background: Serum ferritin (SF) is clinically found to be elevated in many disease conditions, and our research examines serum ferritin in patients with acute kidney injury (AKI) and its implication on the risk of short-term mortality in AKI. Methods: Data were extracted from the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV 2.2) database. Adult patients with AKI who had serum ferritin tested on the first day of ICU admission were included. The primary outcome was 28-day mortality. Kaplan-Meier survival curves and Cox proportional hazards models were used to test the relationship between SF and clinical outcomes. Subgroup analyses based on the Cox model were further conducted. Results: Kaplan-Meier survival curves showed that a higher SF value was significantly associated with an enhanced risk of 28-day mortality, 90-day mortality, ICU mortality and hospital mortality (log-rank test: p < 0.001 for all clinical outcomes). In multivariate Cox regression analysis, high level of SF with mortality was significantly positive in all four outcome events (all p < 0.001). This result remains robust after adjusting for all variables. Subgroup analysis of SF with 28-day mortality based on Cox model-4 showed that high level of SF was associated with high risk of 28-day mortality in patients regardless of the presence or absence of sepsis (p for interaction = 0.730). Positive correlations of SF and 28-day mortality were confirmed in all other subgroups (p for interaction>0.05). Conclusion: High level of SF is an independent prognostic predictor of 28-day mortality in patients with AKI.

Construction of Cyan Blue Fluorescence Probe based on Nitrogen-Doped Carbon Dots for Detecting Nitrite Ion in Ham Sausage.

Nitrite ion is one of the materials widely used in human life, and the accurate, sensitive and stable detection of nitrite ions is of great significance to people's healthy life. In this study, nitrogen-doped fluorescent carbon dots (N-CDs) for detecting nitrite salt solutions were prepared using citric acid monohydrate and Chrysoidin as precursors through a one-pot hydrothermal method. Under the condition of pH = 3, a noticeable quenching phenomenon occurred in the carbon dot solution with the increase in nitrite ion concentration. This quenching effect might be attributed to the diazonium effect. N-CDs have been successfully used as fluorescence probes for NO2- detection. NO2- can effectively quench the fluorescence intensity of N-CDs, providing a linear response to fluorescence quenching efficiency with respect to NO2- concentration within the range of 0-10µM and 10-30µM, and a detection limit of 52nM, showing high sensitivity. In addition, the probe was applied to the determination of NO2- in ham sausage samples with a detection limit of 0.67µM and recoveries in the range of 99.5-102.3%, the fluorescent probe showed satisfactory reliability.

Mussel inspired 3D elastomer enabled rapid calvarial bone regeneration through recruiting more osteoprogenitors from the dura mater.

Currently, the successful healing of critical-sized calvarial bone defects remains a considerable challenge. The immune response plays a key role in regulating bone regeneration after material grafting. Previous studies mainly focused on the relationship between macrophages and bone marrow mesenchymal stem cells (BMSCs), while dural cells were recently found to play a vital role in the calvarial bone healing. In this study, a series of 3D elastomers with different proportions of polycaprolactone (PCL) and poly(glycerol sebacate) (PGS) were fabricated, which were further supplemented with polydopamine (PDA) coating. The physicochemical properties of the PCL/PGS and PCL/PGS/PDA grafts were measured, and then they were implanted as filling materials for 8 mm calvarial bone defects. The results showed that a matched and effective PDA interface formed on a well-proportioned elastomer, which effectively modulated the polarization of M2 macrophages and promoted the recruitment of dural cells to achieve full-thickness bone repair through both intramembranous and endochondral ossification. Single-cell RNA sequencing analysis revealed the predominance of dural cells during bone healing and their close relationship with macrophages. The findings illustrated that the crosstalk between dural cells and macrophages determined the vertical full-thickness bone repair for the first time, which may be the new target for designing bone grafts for calvarial bone healing.

Three-dimensional electrochemical-magnetic-thermal coupling model for lithium-ion batteries and its application in battery health monitoring and fault diagnosis.

Storage batteries with elevated energy density, superior safety and economic costs continues to escalate. Batteries can pose safety hazards due to internal short circuits, open circuits and other malfunctions during usage, hence real-time surveillance and error diagnosis of the battery's operational state is imperative. In this paper, a three-dimensional model of electrochemical-magnetic field-thermal coupling is formulated with lithium-ion pouch cells as the research focus, and the spatial distribution pattern of the physical field such as magnetic field and temperature when the battery is operational is acquired. Furthermore, this manuscript also investigates the diagnostic methodology for defective batteries with internal short circuits and fissures, that is, the operational state of the battery is evaluated and diagnosed by the distribution of the magnetic field surrounding the battery. To substantiate the method's practical viability, the present study extends its examination to the 18650-battery pack. We obtained the magnetic field images of the normal operation of the battery pack and the failure state of some batteries and analyzed the relationship between the magnetic field distribution characteristics and the performance of the battery pack, providing a new method for the health monitoring and fault diagnosis of the battery pack. This non-contact method incurs no damage to the battery, concurrently exhibiting elevated sensitivity and extremely rapid response time. Meanwhile, it provides an effective means for non-destructive research on the batteries and can be applied to areas such as battery safety screening and non-destructive testing. This research not only helps to facilitate our understanding of the battery's operating mechanism, but also provides robust support for safe operation and optimal battery design.

Carbon quantum dots as a turn-on fluorescent probe for the sensitive detection of Cd2.

In this study, fluorescent carbon dots were synthesized for the first time using ammonium citrate and glutamic acid as precursors via a one-pot hydrothermal method. The synthesized carbon dots emit blue fluorescence at 436 nm (excited at 320 nm) and demonstrate excellent photobleaching resistance and fluorescence stability in high salt environments. Within the range of 1-25 µM, the fluorescence of CDs gradually increases with the increasing concentration of Cd2+, reaching a limit of detection as low as 13 nM. This phenomenon could be ascribed to the chelation-enhanced fluorescence, a result of Cd2+ forming complexes with the abundant surface functional groups such as CN-, -COOH, -OH, -NH2 in CDs. Furthermore, this turn-on fluorescent probe has been successfully used for the detection of Cd2+ in tap water and lake water, providing an efficient and sensitive method for the analysis of environmental metals.

Heterophase Intermetallic Compounds for Electrocatalytic Hydrogen Production at Industrial-Scale Current Densities.

Heterophase nanomaterials have sparked significant research interest in catalysis due to their distinctive properties arising from synergistic effects of different components and the formed phase boundary. However, challenges persist in the controlled synthesis of heterophase intermetallic compounds (IMCs), primarily due to the lattice mismatch of distinct crystal phases and the difficulty in achieving precise control of the phase transitions. Herein, orthorhombic/cubic Ru2Ge3/RuGe IMCs with engineered boundary architecture are synthesized and anchored on the reduced graphene oxide. The Ru2Ge3/RuGe IMCs exhibit excellent hydrogen evolution reaction (HER) performance with a high current density of 1000 mA cm-2 at a low overpotential of 135 mV. The presence of phase boundaries enhances charge transfer and improves the kinetics of water dissociation while optimizing the processes of hydrogen adsorption/desorption, thus boosting the HER performance. Moreover, an anion exchange membrane electrolyzer is constructed using Ru2Ge3/RuGe as the cathode electrocatalyst, which achieves a current density of 1000 mA cm-2 at a low voltage of 1.73 V, and the activity remains virtually undiminished over 500 h.

Bioinspired Superhydrophobic All-In-One Coating for Adaptive Thermoregulation.

The development of scalable and passive coatings that can adapt to seasonal temperature changes while maintaining superhydrophobic self-cleaning functions is crucial for their practical applications. However, the incorporation of passive cooling and heating functions with conflicting optical properties in a superhydrophobic coating is still challenging. Herein, an all-in-one coating inspired by the hierarchical structure of a lotus leaf that combines surface wettability, optical structure, and temperature self-adaptation is obtained through a simple one-step phase separation process. This coating exhibits an asymmetrical gradient structure with surface-embedded hydrophobic SiO2 particles and subsurface thermochromic microcapsules within vertically distributed hierarchical porous structures. Moreover, the coating imparts superhydrophobicity, high infrared emission, and thermo-switchable sunlight reflectivity, enabling autonomous transitions between radiative cooling and solar warming. The all-in-one coating prevents contamination and over-cooling caused by traditional radiative cooling materials, opening up new prospects for the large-scale manufacturing of intelligent thermoregulatory coatings.

Circulating tumor cell-derived exosome-transmitted long non-coding RNA TTN-AS1 can promote the proliferation and migration of cholangiocarcinoma cells.

BACKGROUND: Exosomes assume a pivotal role as essential mediators of intercellular communication within tumor microenvironments. Within this context, long noncoding RNAs (LncRNAs) have been observed to be preferentially sorted into exosomes, thus exerting regulatory control over the initiation and progression of cancer through diverse mechanisms. RESULTS: Exosomes were successfully isolated from cholangiocarcinoma (CCA) CTCs organoid and healthy human serum. Notably, the LncRNA titin-antisense RNA1 (TTN-AS1) exhibited a conspicuous up-regulation within CCA CTCs organoid derived exosomes. Furthermore, a significant elevation of TTN-AS1 expression was observed in tumor tissues, as well as in blood and serum exosomes from patients afflicted with CCA. Importantly, this hightened TTN-AS1 expression in serum exosomes of CCA patients manifested a strong correlation with both lymph node metastasis and TNM staging. Remarkably, both CCA CTCs organoid-derived exosomes and CCA cells-derived exosomes featuring pronounced TTN-AS1 expression demonstrated the capability to the proliferation and migratory potential of CCA cells. Validation of these outcomes was conducted in vivo experiments. CONCLUSIONS: In conclusion, our study elucidating that CCA CTCs-derived exosomes possess the capacity to bolster the metastasis tendencies of CCA cells by transporting TTN-AS1. These observations underscore the potential of TTN-AS1 within CTCs-derived exosomes to serve as a promising biomarker for the diagnosis and therapeutic management of CCA.

The core competencies in disaster nursing of new graduate nurses in Guangdong, China: A cross-sectional study.

AIM: This study aimed to assess the level of core competencies in disaster nursing of New Graduate Nurses (NGNs) and explore its influencing factors. BACKGROUND: In recent years, the overall frequency of disasters around the world has been on the rise. As the emerging workforce in clinical settings, NGNs play an integral role in future disaster relief efforts. NGNs' level and influencing impact of core competencies in disaster nursing need to be understood. DESIGN: A cross-sectional design. METHODS: From June to September 2023, the Core Competencies in Disaster Nursing Scale - General Professional Nurse (CCDNS-GPN), designed according to the CCDN V2.0, was used to collect data from NGNs of six nursing schools and 15 hospitals in Guangdong, China. Descriptive analysis was conducted to examine the scores of core competencies in disaster nursing. Furthermore, one-way analysis of variance and multivariate linear regression analysis were used to explore the influencing factors. RESULTS: A total of 607 NGNs participated in this study. The scores of CCDNS-GPN of NGNs were 90.23 (SD 15.09) (score ratio: 51.56%), indicating a low level of core competencies in disaster nursing. The highest competency was the recovery (score ratio: 55.00%), while the lowest competency was the communication (score ratio: 45.44%). The predictor for core competencies in disaster nursing of NGNs were male (ß = 0.091, p < 0.05), below bachelor's degree (ß = -0.109, p < 0.05), had received disaster nursing education at school (ß = 0.087, p < 0.05), had participated in a disaster rescue drill at school (ß = 0.140, p < 0.05), had been to the ICU during internship (ß = 0.135, p < 0.05) and had the intention to be a disaster specialized nurse (ß = 0.114, p < 0.05). CONCLUSIONS: The NGNs exhibited insufficient core competencies in disaster nursing in Guangdong, China. Nursing schools and clinical institutions should collaborate and play their respective roles to enhance nurses' core competencies in disaster nursing, ensuring they can timely, safely and efficiently participate in disaster medical relief efforts.

Dual-mode colorimetric and fluorescent detection of cobalt ions based on N, B co-doped carbon quantum dots and p-phenylenediamine derived nanoparticles.

Nitrogen, boron co-doped carbon quantum dots (gCQDs), and a coloration probe (PPD-NPs) with response to cobalt ions (Co2+) were prepared by using 4-hydroxyphenylboric acid as the common precursor, with ethylenediamine and p-phenylenediamine (PPD) adopted as nitrogen-doped reagents, respectively. A noticeable brown-to-purple color change can be observed with the addition of Co2+, and a broad absorption band emerges at 535 nm. At the same time, gCQDs, which is introduced as the fluorescence signal source, will be significantly quenched due to the enhanced inner filtration effect, induced by the overlap between the emission spectrum of gCQDs and the emerging absorption band. Therefore, a colorimetric/fluorescent dual-mode sensing probe for Co2+ is constructed by combining the recognition unit PPD-NPs and the fluorescent gCQDs into PPD-NP/gCQD. Under the optimized experimental conditions, the calculated limits of detection are 1.51 × 10-7 M and 3.75 × 10-7 M for the colorimetric mode and the fluorescence mode, respectively, well qualified for the determination of Co2+ maximum permitted level in drinking water. The feasibility of the proposed method has been verified in tap water, lake water, and black tea samples.

Integrative analysis of bioinformatics and machine learning to identify cuprotosis-related biomarkers and immunological characteristics in heart failure.

Backgrounds: Cuprotosis is a newly discovered programmed cell death by modulating tricarboxylic acid cycle. Emerging evidence showed that cuprotosis-related genes (CRGs) are implicated in the occurrence and progression of multiple diseases. However, the mechanism of cuprotosis in heart failure (HF) has not been investigated yet. Methods: The HF microarray datasets GSE16499, GSE26887, GSE42955, GSE57338, GSE76701, and GSE79962 were downloaded from the Gene Expression Omnibus (GEO) database to identify differentially expressed CRGs between HF patients and nonfailing donors (NFDs). Four machine learning models were used to identify key CRGs features for HF diagnosis. The expression profiles of key CRGs were further validated in a merged GEO external validation dataset and human samples through quantitative reverse-transcription polymerase chain reaction (qRT-PCR). In addition, Gene Ontology (GO) function enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, and immune infiltration analysis were used to investigate potential biological functions of key CRGs. Results: We discovered nine differentially expressed CRGs in heart tissues from HF patients and NFDs. With the aid of four machine learning algorithms, we identified three indicators of cuprotosis (DLAT, SLC31A1, and DLST) in HF, which showed good diagnostic properties. In addition, their differential expression between HF patients and NFDs was confirmed through qRT-PCR. Moreover, the results of enrichment analyses and immune infiltration exhibited that these diagnostic markers of CRGs were strongly correlated to energy metabolism and immune activity. Conclusions: Our study discovered that cuprotosis was strongly related to the pathogenesis of HF, probably by regulating energy metabolism-associated and immune-associated signaling pathways.

Breaking Highly Ordered PtPbBi Intermetallic with Disordered Amorphous Phase for Boosting Electrocatalytic Hydrogen Evolution and Alcohol Oxidation.

Constructing amorphous/intermetallic (A/IMC) heterophase structures by breaking the highly ordered IMC phase with disordered amorphous phase is an effective way to improve the electrocatalytic performance of noble metal-based IMC electrocatalysts because of the optimized electronic structure and abundant heterophase boundaries as active sites. In this study, we report the synthesis of ultrathin A/IMC PtPbBi nanosheets (NSs) for boosting hydrogen evolution reaction (HER) and alcohol oxidation reactions. The resulting A/IMC PtPbBi NSs exhibit a remarkably low overpotential of only 25 mV at 10 mA cm-2 for the HER in an acidic electrolyte, together with outstanding stability for 100 h. In addition, the PtPbBi NSs show high mass activities for methanol oxidation reaction (MOR) and ethanol oxidation reaction (EOR), which are 13.2 and 14.5 times higher than those of commercial Pt/C, respectively. Density functional theory calculations demonstrate that the synergistic effect of amorphous/intermetallic components and multimetallic composition facilitate the electron transfer from the catalyst to key intermediates, thus improving the catalytic activity of MOR. This work establishes a novel pathway for the synthesis of heterophase two-dimensional nanomaterials with high electrocatalytic performance across a wide range of electrochemical applications.

Non-enzymatic Detection of Uric Acid in Serum and Urine by Fluorescent and Visual Dual-Mode Sensor Based on 3-aminophenylboric Acid Functionalized Carbon Dots.

Herein, we developed a sophisticated dual-mode sensor that utilized 3-aminophenylboric acid functionalized carbon dots (APBA-CDs) to accurately detect uric acid (UA). Our innovative process involved synthesizing APBA-CDs that emitted at 369 nm using a one-step hydrothermal method with 3-aminophenylboric acid and L-glutamine as precursors, ethanol and deionized water as solvents. Once UA was introduced to the APBA-CDs, the fluorescence of the system became visibly quenched. The results of Zeta potential, Fourier transformed infrared (FTIR) spectra, fluorescence lifetime, and other characteristics were analyzed to determine that the reaction mechanism was static quenching. This meant that after UA was mixed with APBA-CDs, it combined with the boric acid function on the surface to form complexes, resulting in a decrease in fluorescence intensity and a blue shift in the absorption peak at about 295 nm in the Ultraviolet-visible (UV-vis) absorption spectra. We were pleased to report that we have successfully used the dual-reading platform to accurately detect UA in serum and human urine. It provided a superior quantitative and visual analysis of UA without the involvement of enzymes. We firmly believe that our innovative dual-mode sensor has immense potential in the fields of biosensing and health monitoring.

Nitrogen and Sulfur co-doped Carbon dots as an "on-off-on" Fluorescent Sensor for the Detection of Hg2+ and Ampicillin.

Herein, a fluorescent "on-off-on" nanosensor based on N,S-CDs was developed for highly precise and sensitive recognition of Hg2+ and ampicillin (AMP). Nitrogen and sulfur co-doped carbon dots with blue fluorescence were synthesized by one-pot hydrothermal method using ammonium citrate and DL-methionine as precursors. N,S-CDs exhibited a surface abundant in -OH, -COOH, and -NH2 groups, aiding in creating non-fluorescent ground state complexes when combined with Hg2+, leading to the suppression of N,S-CDs' fluorescence. Subsequent to additional AMP application, the mixed system's fluorescence was restored. Based on this N,S-CDs sensing system, the thresholds for detection for AMP and Hg2+ were discovered to be 0.121 µM and 0.493 µM, respectively. Furthermore, this methodology proved effective in identifying AMP in real samples of tap and lake water, yielding satisfactory results. Consequently, in the area of bioanalysis in intricate environmental sample work, the sensing system showed tremendous promise.

SERS substrate based on COF@Ag for detecting amoxicillin in honey and lake water.

This study presents the design of a Surface-enhanced Raman scattering (SERS) substrate, COF@Ag, for the sensitive detection of Amoxicillin (AMX) in lake water and honey. Furthermore, the study investigates the role of covalent organic frameworks (COFs) in SERS detection. The characterization results demonstrate the capability of COFs to efficiently enrich Ag nanoparticles (AgNPs), resulting in a more concentrated distribution of hotspots and an enhanced electromagnetic field on the substrate. By employing density functional theory (DFT) simulation, the frontier electronic orbitals of COFs and AMX were analyzed, and the chemical bonds and weak interactions in the system were examined using the Interaction Region Indicator (IRI) method to propose potential enhancement mechanisms. In aqueous solutions, the linear range is 1 µg/L-30 µg/L, with a limit of detection (LOD) 0.279 µg/L. In lake water, the linear range span from 100 µg/L to 500 µg/L, with a detection limit of 8.244 µg/L. For honey, the linear range extend from 20 ng/g to 100 ng/g, with a detection limit of 2.917 ng/g. This method holds key significance in facilitating the rapid detection of amoxicillin and advancing the application of COFs in SERS.

Underlying Mechanism of Traditional Herbal Formula Chuang-Ling-Ye in the Treatment of Diabetic Foot Ulcer through Network Pharmacology and Molecular Docking.

BACKGROUND: Chuang-Ling-Ye (CLY) has been clinically proven to be an effective Chinese medicine for the treatment of diabetic foot ulcers (DFU). OBJECTIVES: This study aimed to investigate the possible mechanism of CLY in relation to DFU using network pharmacology and molecular docking. MATERIALS AND METHODS: Firstly, relevant targets of CLY against DFU were obtained from TCMSP, Swiss Target Prediction database and GEO database. Then, topological analysis was employed by Cytoscape to screen the top 6 core active ingredients and the top 8 hub targets. Furthermore, the OmicShare Tools were applied for gene ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis. Finally, the results of network pharmacology were verified by molecular docking method. RESULTS: CLY has 61 active compounds and 361 targets after de-duplication, and the top 8 hub targets were EGFR, TP53, CCND1, IL-1B, CREBBP, AR, PTGS2 and PGR. GO enrichment analysis is mainly related to signal transducer activity, receptor activity, and molecular transducer activity. KEGG pathway analysis indicated that these shared targets were primarily focused on AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, IL-17 signaling pathway, and JAK-STAT signaling pathway. Molecular docking results showed that physciondiglucoside, 2-cinnamoyl-glucose and kinobeon A were well bound with EGFR, IL-1B, AR and PTGS2. CONCLUSION: This study demonstrated that CLY has anti-oxidative stress and anti-inflammatory effects in the treatment of DFU through various constituents, multiple targets, and multiple pathways, which provides a valuable point of reference for future investigations on CLY.

Uncovering hub genes and immunological characteristics for heart failure utilizing RRA, WGCNA and Machine learning.

Background: Heart failure (HF) is a major public health issue with high mortality and morbidity. This study aimed to find potential diagnostic markers for HF by the combination of bioinformatics analysis and machine learning, as well as analyze the role of immune infiltration in the pathological process of HF. Methods: The gene expression profiles of 124 HF patients and 135 nonfailing donors (NFDs) were obtained from six datasets in the NCBI Gene Expression Omnibus (GEO) public database. We applied robust rank aggregation (RRA) and weighted gene co-expression network analysis (WGCNA) method to identify critical genes in HF. To discover novel diagnostic markers in HF, three machine learning methods were employed, including best subset regression, regularization technique, and support vector machine-recursive feature elimination (SVM-RFE). Besides, immune infiltration was investigated in HF by single-sample gene set enrichment analysis (ssGSEA). Results: Combining RRA with WGCNA method, we recognized 39 critical genes associated with HF. Through integrating three machine learning methods, FCN3 and SMOC2 were determined as novel diagnostic markers in HF. Differences in immune infiltration signature were also found between HF patients and NFDs. Moreover, we explored the potential associations between two diagnostic markers and immune response in the pathogenesis of HF. Conclusions: In summary, FCN3 and SMOC2 can be used as diagnostic markers of HF, and immune infiltration plays an important role in the initiation and progression of HF.

Investigation of the Application and Mechanism of Nitrogen and Phosphorus Co-doped Carbon Dots for Mercury Ion Detection.

In this paper, we obtained nitrogen and phosphorus co-doped carbon dots through a hydrothermal method using o-phenylenediamine and citric acid in a 40% phosphoric acid environment. The carbon dots emitted fluorescence at 476 nm under excitation at 408 nm and exhibited good selectivity and high sensitivity towards mercury ions. These carbon dots showed excellent dispersibility in water and maintained stable fluorescence even in high concentration salt environments. The interaction between mercury ions and functional groups on the carbon dots surface through electrostatic interaction resulted in static quenching. Simultaneously, by detecting the lifetime and transient absorption spectra of the carbon dots, we observed that the coordination of mercury ions with the carbon dots broadened the band structure of the carbon dots, and the existing photoinduced electron transfer process increased the non-radiative transition channel. The combined effect of dynamic quenching and static quenching significantly reduced the fluorescence intensity of the carbon dots at 476 nm. The carbon dots exhibited linear detection of mercury ions in the range of 0.01-1 µM, with a detection limit as low as 0.0245 µM. In terms of practical water environmental detection applications, these carbon dots were able to effectively detect mercury ions in tap water and lake water, demonstrating their broad application prospects in the field of environmental metal analysis.

The learning curve for laparoscopic pancreaticoduodenectomy by a proficient laparoscopic surgeon: a retrospective study at a single center.

BACKGROUND: To explore the learning curve of single center laparoscopic pancreaticoduodenectomy (LPD) and evaluate the safety and efficacy of the operation at different stages. METHODS: A detailed review was conducted on the clinical data of 120 cases of laparoscopic pancreatoduodenectomy performed by the same surgeon between June 2018 and June 2022. Cases that did not provide insights into the learning curve of the procedure were excluded. The cumulative sum (CUSUM) analysis and the best fitting curve methods were employed to delineate the learning curve based on operation time and intraoperative blood loss. The study further evaluated the number of surgeries required to traverse the learning curve. Outcome measures, including operation time, intraoperative blood loss, length of stay, complications, and other relevant indicators, were extracted and compared across different phases of the learning curve. RESULT: The maximum turning point of the fitting curve was found in 35 cases by the cumulative sum method of operation time, after which the learning curve could be considered to have passed. The fitting curve obtained by the cumulative sum method of intraoperative blood loss was stable in 30 cases and proficient in 60 cases, which was basically consistent with the fitting curve of operation time. Taking 35 cases as the boundary, the learning curve is divided into learning improvement stage and mastering stage. There was no statistical significance in the general data of the two stage patients (P > 0.05). Hospitalization days decreased from 19 to 15 days (P < 0.05);Pancreatic fistula decreased from 20.0% of grade B and 8.6% of grade C to 7.1% of grade B and 3.5% of grade C (P < 0.05), and the operative time decreased from (376.9 ± 48.2) minutes to (294.4 ± 18.7) minutes (P < 0.05). Intraoperative blood loss decreased from 375 to 241 ml (P < 0.05). CONCLUSION: Thirty-five patients with LPD can reach the proficiency stage and the perioperative indexes can be improved.