The aim of this study was to propose and validate "a great variety of animals may be released" and "attitudes toward animal releasing". To achieve this goal, the self-developed Likert-typed questionnaire and demographic data were adapted. The demographic data collected from both stages were analyzed. Only the beliefs, knowledge, attitudes, and behaviors of the participants from the first stage were examined. Regression and path analysis were done for the data from both stages. The questionnaire research was divided into two stages. At the first stage, the questionnaire was answered by people from schools or private businesses in the northern, middle, and southern parts of Taiwan. A total of 1225 valid questionnaires were collected, among which only 9.3% of the participants were found to have ever joined animal releasing activities. At the second stage, the participants were chosen from the religious groups in northern Taiwan that offered animal releasing activities. A total of 151 valid questionnaires were collected. By the regression analysis of demographic data and beliefs of animal releasing, the result shows that "the experience of participating in religious ceremony to be one of the groups" is the strongest predictor; the "participants gender" and "their mother's religions" influence knowledge of animal releasing most. The beliefs of animal releasing can account for much of attitudes than knowledge variables can do. "Beliefs of animal releasing" is more important than "significant others' support" and "significant others' support" is more important than "knowledge of animal releasing." The main findings of the correlation among beliefs, knowledge, attitudes, and behaviors of animal releasing include the following: 1) through attitude, beliefs mediate behaviors; 2) through attitude, knowledge mediate behaviors; 3) knowledge influences behaviors directly; 4) attitude influences behaviors directly.

Background Hepatitis B core antibody (HBcAb) positivity is considered a prior hepatitis B virus (HBV) infection. However, little is known about the effect of HBcAb positivity on surgical safety for hilar cholangiocarcinoma (hCCA). The present study aims to investigate the role of HBcAb positivity on postoperative complications of hCCA. Methods A retrospective analysis was performed on the status of HBcAb positivity, liver fibrosis, perioperative surgical complications, and long‐term outcomes of hCCA patients with Hepatitis B surface antigen (HBsAg) negativity who underwent surgical treatment in Tongji Hospital from April 2012 to September 2019. Results HBcAb positivity with negative HBsAg occurs in 137 hCCA patients (63.1%). A total of 99 hCCA patients with negative HBsAg underwent extended hemihepatectomy, of whom 69 (69.7%) and 30 (30.3%) were HBcAb‐positive and HBcAb‐negative, respectively. Significant fibrosis was detected in 63.8% of the patients with HBcAb‐positive, which was markedly higher than those with HBcAb‐negative (36.7%) ( p = 0.016). The postoperative complications and 90‐day mortality rates were 37.4% (37/99) and 8.1% (8/99), respectively. The incidence of postoperative complications in HBcAb‐positive patients (44.9%) was significantly higher than that in HBcAb‐negative patients (20.0%) ( p = 0.018). All the patients who died within 30‐day after surgery were HBcAb‐positive. Multivariate analysis showed that the independent risk factors for complications were HBcAb positivity, preoperative cholangitis, portal occlusion >15 min, and significant fibrosis. There were no significant differences in recurrence‐free survival (RFS) and overall survival (OS) between HBcAb‐positive and HBcAb‐negative patients ( p = 0.642 and p = 0.400, respectively). Conclusions HBcAb positivity is a common phenomenon in hCCA patients from China, a country with highly prevalent HBcAb positivity. The status of HBcAb‐positive markedly increases the incidence of postoperative complications after extended hemihepatectomy for hCCA patients.

Background: Hepatitis B virus (HBV) may be a risk factor for cholangiocarcinoma, but it is not yet clear that the relationship between hepatitis B core antibody (HBcAb)-positive and hilar cholangiocarcinoma (hCCA). In addition, we evaluated the impact of HBcAb-positive on the safety of major hepatectomy for hCCA. Methods：A retrospective analysis was performed on the status of hepatitis B infection, liver fibrosis, surgical safety, and long-term postoperative survival of 111 patients who underwent major hepatectomy in Tongji Hospital from April 2012 to September 2019.Results: HBsAg-positive was identified in 10.6%, HBcAb-positive was found in 73.7% of the patients. A high-grade of liver fibrosis was detected in 67.9% of the patients with HBcAb-positive, which was markedly higher than that in the patients with HBcAb-negative (43.3%) (P=0.018). The incidence rates of postoperative complications and 30-day mortality were 38.7% (43/111) and 5.4% (6/111), respectively. Multivariate analysis showed that the independent risk factors for complications were HBcAb, vascular reconstruction, lymphadenectomy, HBcAb-positive correlated with a higher incidence of complications after major hepatectomy for hCCA (adjusted hazard ratio [HR] 3.984, 95%CI 1.354-11.73; P = 0.012). All the patients who died within 30-day after surgery were HBcAb-positive. However, there was no correlation between HBcAb and long-term prognosis of major hepatectomy for hCCA.Conclusions: HBcAb-positive is closely correlated with hCCA. HBcAb-positive markedly increased the incidence of postoperative complications and mortality of major hepatectomy for hCCA.