Objective To investigate the expressions of proliferating cell nuclear antigen (PCNA), bcl-2, and c-myc protein, and to explore diagnostic value of DNA ploidy in benign and malignant thyroid neoplasms. Methods The expressions of PCNA, bcl-2 and c-myc proteins in 36 cases of thyroid adenomas and 37 cases of thyroid carcinomas were examined by immunohistochemistry technique. DNA ploidy was measured by imaging analysis technique in 8 cases of thyroid adenomas and 17 cases of thyroid carcinomas. Results Among thyroid carcinomas, the positive rates of PCNA (43.02?31.16)% and c-myc protein 89.2% were significantly higher than those of thyroid adenomas (16.15?9.28)% and 50.0% respectively (both P

Objective To design a smoke purifier for laparoscopic surgery, and to test its application in reducing the use of carbon dioxide gas and reducing the concentration of harmful substances in laparoscopic surgery exhaust gas. Methods From April to September 2017, a total of 136 cases of hysterectomy and bilateral salpingo oophorectomy and pelvic lymph node dissection were divided into control group and experimental group by random number table method, with 68 cases in each group. Independent negative pressure suction pipeline was applied in the control group for direct suction. In the experimental group, the surgery exhaust gas first passed laparoscopic surgical smoke purifier, the intake pipe of which was transformed from an aseptic transfusion device. Gas would emit a sound alert when passing the double-valve one-way valve. After passing KP100 grade, KN100 grade filter element and a certain amount of protective coal pellet activated carbon, the smoke would be managed by the independent negative pressure suction pipeline. The amount of carbon dioxide gas used in the two groups and the concentration of harmful substances in the smoke of the experimental group before and after the operation were recorded. Results The amount of carbon dioxide gas used in the control group was (656.95±70.11) L, which was higher than that in the experimental group (613.70±75.63) L, and the difference was statistically significant (P< 0.01). In the experimental group, PM10, PM2.5, PM1.0, formaldehyde and total volatile organic compounds (TVOC) before the application of purifier were (206.90±30.48) μg/m3, (195.74±27.23) μg/m3, (220.22±37.60) μg/m3, (0.52±0.02) mg/m3 and (4.35±1.79) mg/m3, which were all higher than those after the application of purifier (4.26±1.02) μg/m3, (6.54±2.05) μg/m3, (7.89±3.38) μg/m3, (0.34±0.01) mg/m3and (0.31±0.17) mg/m3respectively, and the differences were statistically significant (P<0.01). Conclusions The purifier can reduce the amount of carbon dioxide gas used in laparoscopic surgery, reduce the harmful substances in surgical exhaust gas and reduce the harm to the environment and medical staff.

Objective To examine short-term outcomes and long-term survival of elderly patients (aged over 80 years) with colorectal cancer who received laparoscopic versus open surgery. Methods A total of 313 patients over 80 years old with colorectal cancer who underwent radical surgery were included.According to the surgical method, all patients were divided into open-surgery group (n=143) and laparoscopic surgery group (n=170).Baseline data were balanced between the two groups by using propensity score matching.Kaplan-Meier was used to draw the survival curve, and survival was compared by Log rank tests.Cox proportional risk model was used to analyze the effects of all factors on overall survival (OS) and disease-free survival (DFS). Results After matching, 93 patients were included in each group.The mean intraoperative blood loss, the incidence of overall postoperative complications and gradeⅠ-Ⅱ complications in the laparoscopic surgery group were significantly lower than those in the open surgery group (all P < 0.05).The time to first flatus, the time to oral feeding, and postoperative hospital stays in the laparoscopic surgery group were significantly shorter than those in the open surgery group (all P < 0.05).The mean number of lymph-node dissection was also significantly higher in the laparoscopic surgery group than in the open surgery group (P=0.030).Patients in both groups had similar 5-year OS (P=0.594) and DFS (P=0.295).Multivariate Cox prognostic analysis showed that CEA level > 5 ng/ml, pathological TNM stage Ⅲ, and perineural invasion were independent risk factors for poor OS and DFS. Conclusion Compared with open surgery, laparoscopic surgery can provide better short-term advantages and similar long-term outcomes for colorectal cancer patients over 80 years of age.

Objective To evaluates the impact of early application of neuromuscular electrical stimulation(NMES)on muscle strength,clinical outcomes,and long-term quality of life improvements in patients with severe acute pancreatitis(SAP)complicated with acute respiratory distress syndrome(ARDS).Methods A total of 75 patients diagnosed with SAP and ARDS admitted in Department of Critical Care Medicine of our hospital from September 2022 to August 2023 were recruited and then randomly divided into NMES group(n=37)and control group(n=38).After 16 patients were excluded,including 8 died during treatment,3 discharged and 5 received palliative care,there were finally 29 patients in the NMES group and 30 in the control group.Within 48 h after ICU admission,the NMES group received NMES 1 h per day,for 7 d in addition to standard rehabilitation intervention.While,the control group were given conventional interventions for rehabilitation.Assessments at baseline and post-treatment included the incidence of ICU-acquired weakness(ICU-AW),Medical Research Council(MRC)score,duration of mechanical ventilation,lengths of ICU and total hospital stays,and activity,thickness and thickening fraction of the diaphragm.Mortality rates and Barthel index(BI)for self-care ability in 1,3 and 6 months after discharge were recorded for follow-up assessments.Results The NMES group had significantly lower incidence of ICU-AW(P＜0.05),higher upper and lower limb MRC scores and overall MRC score at ICU discharge(P＜0.05),shorter durations of mechanical ventilation,ICU stay,and total hospital stay when compared with the control group(P＜0.05).There was no statistical difference in the BI at 1 month post-discharge between the 2 groups,but the indexes at 3 and 6 months were notably higher in the NMES group than the control group(P＜0.05).No obvious differences were observed between the 2 groups in terms of diaphragm activity,thickness,or thickening scores at enrollment,ICU discharge,or hospital discharge,nor in mortality rates at 1,3,and 6 months after discharge.Conclusion Combined NMES and early rehabilitation therapy can improve muscle strength and reduce length of hospital stay in SAP patients complicated with ARDS,and may enhance long-term quality of life.However,it does not significantly affect diaphragm function or mortality rates.

Objective To investigate the effects of different salt ion concentration, polyethylene glycol (PEG) and force on structure of double DNAs braids. Methods Taking the 10 kb DNA as the research object, the effects of different concentrations of salt ions(Na+, K+, Mg2+), PEG and different forces on variation of relative extension of twisted double DNAs with rotation turns were investigated by flow chamber experiment of magnetic tweezers. Results The structure of double DNAs braids was sensitive to salt ion concentration but insensitive to PEG. With the increase of ion concentration, the extension of braids changed more gently with the rotation turns, and the electrostatic shielding saturation concentration of Mg 2+ was much lower than that of the monovalent cation. The effect of crowded environment on DNA was mainly the compression of contour length. The twisted structure of DNA was more stable under high force (above 4 pN), and fluctuated greatly under low force (lower than 2 pN). Conclusions The braiding structure and mechanical properties of DNA are affected by ion concentration in the solution and forces. The results may help to elucidate the mechanism of chromatin torsional torque affected by solution environment, and provide references for the function of topoisomerase under different solution conditions.

Objective: To summarized the experience in laparoscopic duodenum-preserving pancreatic head resection (LDPPHR). Methods: The clinical data of four patients who underwent LDPPHR from February 2017 to June 2018 in Hunan Provincial People’s Hospital were retrospectively analyzed. The Clinical characteristics, operation time, intraoperative blood loss, biliary fistula rate, pancreatic fistula rate and follow-up data were analyzed. Results: The four patients included one patient with a solid pseudopapillary tumor and three patients with a serous cystadenoma. Two patients underwent duodenum-preserving total pancreatic head resection, and two patients underwent duodenum-preserving subtotal pancreatic head resection. The operation time of the four patients was (525.8±121.8) minutes, and the blood loss (250.0±191.5) ml. Biliary duct drainage was carried out in 2 patients: one patient developed biochemical bile leakage, while another had no postoperative complication. The two patients without biliary drainage developed grade B pancreatic leakage, delayed bile leakage, abdominal bleeding and infection. All the three patients who developed postoperative complications were treated conservatively and they recovered well. Conclusions LDPPHR was designed to better preserve the integrity and function of digestive tract. However, the perioperative complications were high. This operation should only be carried out in large pancreatic centers. Routine biliary drainage is recommended to surgeons with little experience in this operation.

Objective To explore the application of space sand as filling material in the prevention of pressure sore in the lateral position surgery in Neurosurgery Department.Methods A total of 130 cases of lateral decubitus position surgery in Second Hospital of Hebei Medical University from October 2016 to March 2017 were selected and randomly divided into control group (n=65) and observation group (n=65) by random number table method.The control group used traditional gel position pad for lateral decubitus position,while the observation group used self-made space sand position pad for lateral position.The incidence of pressure sores of patients with lateral decubitus surgery of two groups were compared.Results The incidence of pressure sores in the control group was 12.31％,while it was 3.07％ in the observation group.The difference was statistically significant (x2=3.900,P ＜ 0.05).Conclusions The use of space sand position pad can effectively prevent the occurrence of pressure sore in the lateral decubitus position in Neurosurgery Department.

BACKGROUND:Transcranial direct current stimulation(tDCS),as a non-invasive brain stimulation technique,can enhance human muscle strength or improve single-leg landing stability instantly,but no relevant research has demonstrated this yet. OBJECTIVE:To investigate the effect of tDCS on the stability of single-leg landings in human subjects. METHODS:Male undergraduate students from Wuhan Sports University were recruited as study participants.They were divided into two groups,A(n=6)and B(n=5),using a random number table.Group A underwent a sham stimulation session followed by a 3-day washout period,after which they received tDCS.Conversely,Group B received tDCS initially,followed by a 3-day washout period,and subsequently underwent the sham stimulation session.Following the respective stimulation sessions,an immediate single-leg landing test was administered to assess and collect biomechanical parameters.Data resulting from the tDCS intervention were aggregated and analyzed as the experimental group dataset,whereas data stemming from the sham stimulation were consolidated as the control group dataset. RESULTS AND CONCLUSION:Regarding core stability,the tDCS intervention showed a significant interaction with landing height on the maximal trunk flexion angle(P＜0.05).A paired comparison of the data showed a significant decrease in the maximum trunk flexion angle following true stimulation compared to sham stimulation at a 30-cm landing height.Additionally,the tDCS intervention had a significant main effect on the maximum trunk lateral bending angle and the mean trunk lateral bending angular velocity(P＜0.05).Following true stimulation,there was a significant decrease in the maximum trunk lateral bending angle and the mean trunk lateral bending angular velocity compared to sham stimulation.In terms of lower limb joint stability,the tDCS intervention had a significant main effect on the maximum dynamic ankle valgus angle(P＜0.05).This resulted in a significant decrease in the angle following true stimulation compared to sham stimulation.In addition,the tDCS intervention had a significant main effect on the peak muscle activation of the lateral head of the gastrocnemius lateralis(P＜0.05).This showed a significant increase after true stimulation compared to sham stimulation.An interaction between the tDCS intervention and landing height was observed for the peak muscle activation of the tibialis anterior(P＜0.05).Paired comparison analyses revealed a significant increase in muscle activation after true stimulation specifically at a 60-cm landing height.Regarding center of pressure stability,there were no significant interactions or main effects of the tDCS intervention on the mean lateral displacement,mean lateral displacement velocity,mean anterior-posterior displacement,or mean anterior-posterior displacement velocity at the center of pressure(P＞0.05).Furthermore,the tDCS intervention had no significant main effects on any of the center of pressure indicators(P＞0.05).In conclusion,tDCS can immediately improve core stability and lower limb joint stability during single-leg landing,making it an effective warm-up technique for improving single-leg landing stability and reducing the risk of lower limb injuries.

Objective To find an effective and convenient restraint band for the upper limb of the non-compression side for the patients in the lateral decubitus operation in the Neurosurgery Department. Methods From August 2017 to March 2018, patients in the lateral decubitus operation in the Neurosurgery Department,who from the Second Hospital of Hebei Medical University, were selected as the research objects. The self-made posture restraint belt was made of professional exercise shoulder, forearm sheath, binding band and magic stick. By using random number table produced by SPSS 22.0 edition, 160 patients who underwent lateral decubitus operation in the Neurosurgery Department were randomly divided into the control group and the observation group, with 80 cases in each group. In the control group, the conventional shoulder straps and wrist restraint bands were used, while the self-made lateral decubitus upper limb restraint band was used in the observation group. The differences of the time of lateral decubitus placement, the incidence of pressure sore in the non-compression side of the upper limb and the efficiency of restraint were observed and compared between the two groups. Results The time of lateral decubitus placement (365.97±42.08) s and the incidence of pressure sore in the non-compression side upper limb (10.0%) were higher than those of the observation group[ (302.69± 38.25)s, 1.3%]. The differences were statistically significant (P＜0.05). The efficiency (100.0%) of the non-compression side upper limb restraint in the observation group was higher than that in the control group (91.3%). The difference was statistically significant (P＜0.05). Conclusions The self-made upper limb restraint band for neurosurgery lateral position can effectively expose the surgical field, improve the comfort degree of patients, and improve the efficiency of posture placement and restraint.

Objective:To construct the competency evaluation index system for endoscopic specialized nurses and provide basis for training, assessment and performance evaluation of endoscopic specialized nurses.Methods:In March 2021, through literature review, research group discussion, expert interview and satisfaction questionnaire, the competency evaluation system for endoscopic specialized nurses was initially established. From March to December 2021, experts from four provinces were selected by convenient sampling for two rounds of Delphi expert consultation. The weight of each indicator was determined by the method of precedence chart and analytic hierarchy process.Results:Among two rounds of consultation, the effective recovery rates of the questionnaire were 86.36% (19/22) and 89.47% (17/19) respectively, and the authority coefficients of experts were 0.82 and 0.86 respectively. The Kendall concordance coefficients of experts' opinions on the first, second and third level indicators were 0.40, 0.50 and 0.48 respectively ( P<0.05) . The final index system included 4 first level indicators (professional knowledge, professional skills, professional development ability, personal characteristics) , 18 second level indicators and 73 third level indicators. Conclusions:The competency evaluation index system for endoscopic specialized nurses has high reliability, comprehensive and practical contents, and has certain reference significance for the management and training of endoscopic specialized nurses.