Objective To evaluate the ability of force control of elbow and shoulder during isometric contraction in patients with chronic stroke. Methods From January to December, 2015, 22 chronic stroke patients and 12 healthy people were measured the maximum force dur-ing shoulder abduction/adduction and elbow flexion/extension with instrument for measuring force of upper extremity. The coefficient of variation was calculated. Results The maximum force was less in the patients than in the healthy controls (t>2.349, P<0.05), and the coeffi-cient of variation increased (t>1.974, P<0.05), except those of elbow extension. Conclusion The force measure and the coefficient of varia-tion can reflect the force control in shoulder and elbow motion in stroke patients.

Objective:To investigate the characteristics of perceived stress and coping style and their relationship withsymptoms in college students with psychosis-risk syndrome (PRS).Methods:A two-stage screening process was conducted in 3160 college students.Participants were screened with 16-Item Version of the Prodromal Questionnaire (PQ-16).The students with scores of PQ-16 ≥9 were further interviewed with Structured Interview for Prodromal Syndromes (SIPS).Twenty-two individuals who met the criteria of PRS on SIPS were enrolled as the PRS group.The control group (n =22) were randomly selected from the participants with scores of PQ-16 ＜9 who were matched with age,gender and education level.Two groups were assessed with Chinese Perceived Stress Scale (CPSS),Trait Coping Style Questionnaire (TCSQ) and Self-rating depression scale (SDS) to measure subjective stress,coping style and depressive symptoms.Results:PRS group reported higher CPSS total scores [(34 ± 8)vs.(22 ± 8)] and negative coping styles scores [(35 ± 5)vs.(28 ± 7)],and lowerTCSQ positive coping styles scores [(31 ±6)vs.(37 ±4)] than the controls (Ps ＜0.05).The CPSS scores in PRS group were positively correlated with the scores of negative coping style (r =0.57,P ＜0.01),and the SDS scores were positively correlated with CPSS total scores and scores of negative coping style (r--0.86,0.66,Ps ＜ 0.01).There was no significant relation of psychosis-risk symptoms to scores of CPSS and TCSQ (P ＞0.05).Conclusion:It suggests that college students with PRS have a higher perceived stress and tend to use more negative coping style,which may be positively correlated with depression.

Objective To investigate the effect of lean management on emergency biochemistry test turnaround time(TAT) in clinical laboratories.Methods Based on the approaches of standardized operations,5S on-site management,the efficiency evaluation of batch processing and one piece flow,and visual management,the median time of each workflow,the qualified rate of emergency biochemistry test TAT,the unqualified rate in a relatively concentrated period of TAT timeout and the unqualified rate of collected samples were compared before and after optimization.Results The median times (interquartile ranges) of each workflow including sample receipt and storage,result audit and sample storage-result report before and after lean management were 30 (35) min,7 (13) min,17 (8) min and 16(19) min,5(9) min,16(7) min,respectively,and there were significant differences in the former two(all P ＜0.01) but not the third (P ＞ 0.05).The median times (interquartile ranges) of TAT before and after lean management were 63 (51) min and 46 (33) min,respectively(P ＜ 0.05).The qualified rate of TAT increased from 86.00％ to 95.37％ after lean management(P ＜ 0.01).The unqualified rates in a relatively concentrated period of TAT timeout and collected samples decreased from 3.42％ to 1.00％ (P ＜0.01) and from 0.24％ to 0.17％ (P ＜ 0.01),respectively.Conclusion Lean management may improve process efficiency,reduce errors,and shorten emergency biochemistry test TAT in clinical laboratories.

Objective:To investigate the application value of one-stitch prophylactic ileostomy in late ileostomy closure.Methods:The prospective randomized control study was conducted. The clinicopathological data of 141 patients with rectal cancer who underwent low anterior resection combined with prophylactic ileostomy in the Affiliated Tumor Hospital of Zhengzhou University from January 2016 to July 2020 were selected. There were 127 patients being selected after excluding 14 cases who did not undergo ileostomy closure. Patients undergoing one-stitch prophylactic ileostomy were divided into observation group, and patients undergoing traditional ileostomy were divided into control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) surgical situations of ileostomy closure; (3) postoperative situations; (4) follow-up. Follow-up was conducted using outpatient examination and telephone interview once a month after low anterior resection combined with prophylactic ileostomy to detect complication and death of patients. The end point was at 3 months after ileostomy closure. The follow-up was up to July 2020. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( P25, P75) or M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Results:(1) Grouping situations of the enrolled patients: a total of 127 patients were selected for eligibility, aged from 31 to 83 years, with a median age of 64 years. Of 127 patients, there were 66 cases in observation group and 61 cases in control group. (2) Surgical situations of ileostomy closure: all patients from the two groups underwent ileostomy closure successfully. The incision length, operation time, volume of intraoperative blood loss, cases with abdominal adhesion degree as slight adhesion or obvious adhesion were 4.25 cm(4.00 cm, 5.00 cm), 48.00 minutes(33.75 minutes, 58.00 minutes), 30 mL(20 mL, 50 mL), 34, 32 of the observation group, versus 7.50 cm(7.00 cm, 8.50 cm), 70.00 minutes(57.00 minutes, 80.00 minutes), 30 mL(30 mL, 50 mL), 13, 48 of the control group, showing significant differences between the two groups ( Z=-9.549, -6.133, -2.758, χ2=12.405, P<0.05). (3) Postoperative situations: cases with incision infection of the observation group and the control group were 5 and 13, respectively, showing a significant difference between the two groups ( χ2=4.917, P<0.05). (4) Follow-up: all the 127 patients were followed up for 6-21 months, with a median follow-up time of 10 months. During the follow-up, 3 cases of the control group had postoperative incisional hernia and were cured after conservative treatment. None of patient had anastomotic leakage related complications or died during the follow-up. Conclusion:The one-stitch preventive ileostomy has the advantage of ileostomy closure, which can reduce the operation time, volume of intraoperative blood loss and shorten the incision length effectively, so as to reduce the incidence of postoperative incision infection related complications.

Objective:To evaluate a nano-carbon lymphatic tracing method for patients with rectal cancer after neoadjuvant radiotherapy and chemotherapy .Method:Retrospective analysis was made on 88 patients of rectal cancer undergoing neoadjuvant chemoradiation at the Department of General Surgery, He′nan Cancer Hospital from Jan 2016 to May 2020.According to whether nano-carbon lymph node was used or not, patients were divided into nanocarbon tracer group (study group) and non-nanocarbon tracer group (control group).Results:There was statistically significant in the number of havested lymph nodes between the two groups [15(11-19) vs.9(5-12), Z=5.227, P<0.001], There was no statistically significant in the number of positive lymph nodes between the two groups [0(0-0.25) vs.0(0-1), Z=1.199, P=0.231]. There were significant differences in the ratio of patients with less than 7 lymph nodes(0/34 vs.18/54, χ 2=14.248, P<0.001) and patients with less than 10 lymph nodes (4/34 vs.29/54, χ 2=15.657, P<0.001). Conclusions:The injection of nanocarbon after neoadjuvant chemoradiotherapy can increase the number of harvested postoperative lymph nodes and the ratio of patients with lymph nodes ≥7 and ≥10, which is more beneficial for prediction of the prognosis of patients.

Objective:To investigate whether adjuvant chemotherapy could be beneficial for patients with pT1N1M0 (stage ⅠB) gastric cancer.Methods:From Jan 2010 to Dec 2016, 185 patients with pT1N1M0 gastric cancer who were surgically resected at Henan Cancer Hospital were retrospectively analyzed. The patients were divided into chemotherapy group ( n=100) and non chemotherapy group ( n=85). Results:For disease-free survival (DFS) analysis, univariate survival analysis showed that age, examined lymph nodes, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DFS (all P<0.05); multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.363, 95% CI: 0.160-0.827, P=0.016), vascular invasion ( HR=4.117, 95% CI: 1.796-9.436, P=0.001) and postoperative chemotherapy ( HR=4.530, 95% CI: 1.932-10.622, P=0.001) were independent risk factors for DFS. For disease-specific survival (DSS) analysis, univariate survival analysis showed that lymph node resection, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DSS; multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.344, 95% CI: 0.144-0.822, P=0.016), vascular invasion ( HR=5.113, 95% CI: 2.029-12.887, P=0.001) and postoperative chemotherapy ( HR=4.694, 95% CI: 1.854-11.888, P=0.001)were independent risk factors for DSS. According to examined lymph nodes and vascular invasion , pT1N1M0 patients were divided into three risk categories (high, medium and low). DFS and DSS were significantly different among the three risk groups (all P<0.001, respectively). Conclusion:pT1N1M0 gastric cancer patients are expected to benefit from adjuvant chemotherapy. Patients with less than 16 lymph nodes and vascular invasion may be particularly suitable for adjuvant chemotherapy.

Objective To observe the autophagy induced by heavy ion and X-ray radiations in SW480 cells and its effect in radiation responses.Methods The cellular ultrastructure was observed with a transmission electron microscope (TEM).The autophagy vesicles were labeled by monodansylcadaverin (MDC) fluorescence.The levels of LC3 which were induced by radiation and rapamycin were measured by Western blot assay.Cell proliferation was detected by MTT assay.The invasion of SW480 colon cells was measured with a Transwell.Cell wound healing assay was used to observe the migration of SW480 colon cells.Results Heavy ion and X-ray radiation could induce autophagy in SW480 cells in a dose dependent manner i.e., the autophagy level increased along with irradiation dose (F =458.526, P ＜ 0.05) , but this induction of autophagy was inhibited by chloroquine.Rapamycin could also induce autophagy in SW480 cells and it had a synergistic effect with irradiation (F =189.393, P ＜ 0.05).The abilities of invasion, migration and proliferation of SW480 cells were reduced by irradiation and the combination treatment of irradiation and rapamycin (F =194.692, 629.917, 302.903, P ＜ 0.05) , but they were enhanced by chloroquine (F =194.692, 629.917, 302.903, P ＜ 0.05).Conclusions Ionization radiation causes cell death by inducing autophagy.

Objective To investigate the effects ofYangyin Yiqi Mixture on pulmonary fibrosis caused by bleomycin in rats;To discuss its possible mechanism.Methods SD rats were randomly divided into normal control group, model group, dexamethasone acetate group, low-dose, middle-dose and high-doseYangyin Yiqi Mixture groups. Bleomycin was used to establish pulmonary fibrosis rat models through endotracheal instillation. One day after molding, each medication group received gavage with relevant medicine. Lung tissues were taken on the 7th, 14th and 28th day. Masson staining was used to observe pathological change;alkalinehydrolysis was used to detect HYP content;Western blot was used to detect the protein expressions of MMP-2 and TIMP-1.Results Compared with the normal control group, on 7th day, collagen in lung tissue of rats in model group markedly increased;the content of HYP in lung tissue significantly increased (P<0.01). On 28th day, collagen was deposited diffusely and the alveolar was destroyed;content of HYP in lung tissue increased significantly (P<0.01). Compared with model group, deposited collagen in lung tissue was alleviated, and the content of HYP were remarkable reduced in middle and high doseYangyin Yiqi Mixture groups and displayed dose-dependent. Western blot results showed that the protein expressions of MMP-2 and TIMP-1 increased quickly compared with the low expression of normal lung tissue in the 7th day of molding (P<0.05), and reached high expression in the 28th day. Compared with the model group, the level of MMP-9 in high-dose Yangyin Yiqi Mixture group decreased significantly in the 14th day;the expression of TIMP-1 decreased significantly in the 7th, 14th and 28th day (P<0.05).ConclusionYangyin Yiqi Mixture can effectively resist pulmonary fibrosis, which may be realized by inhibiting the expressions of TIMP-1 and MMP-9, regulating and promoting collagenic hydrolysis and restraining deposition of collagen.

Objective To evaluate the result of early repair for urinary fistula caused by iatrogenic injury to ureter,bladder and urethra during resection of rectal cancer.Methods We retrospectively analyzed 26 cases of urinary fistula after resection of rectal cancer patients encountered in Department of General Surgery,Henan Tumor Hospital from October 2005 to May 2016.Urinary fistula was divided into four types according to the site of fistula.Results Surgery was performed ever after the diagnosis of the fistula was identified.In type Ⅰ fistula (6 cases of posterior urethral fistula) the treatment was stent placement and packing of the greater omentum.2 cases of bladder top fistula (type Ⅱ),were treated by fistula repair and cystostomy.Type Ⅲ involved 12 cases (bladder triangle fistula).The treatment was ureter stenting replantation,and cystostomy Type Ⅳ:ureteral fistula in 6 cases,the treatment was end-to-end anastomosis and stenting.After surgery 24 cases were cured and 2 cases (all of type Ⅲ fistula) ended up with permanent bilateral ureterocutaneostomy.Conclusion It is safe and effective to make early remedy repair for ureter,bladder and urethral fistula iatrogenically during rectal cancer resection.

Objective To investigate the application value of the curved cutter stapler device combined with trans-orally inserted anvil (OrVil) in the radical resection of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 206 patients with Siewert type Ⅱ AEG who were admitted to the Henan Tumor Hospital between March 2011 and March 2016 were collected.All the 206 patients underwent radical resection and 3-step clock wise total gastrectomy + D2 lymph node dissection.Observation indicators:(1) surgery and postoperative recovery situations:surgical approach,overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation,postoperative complications and duration of postoperative hospital stay;(2) postoperative pathological examination and chemotherapy;(3) follow-up and survival situations.Follow-up using telephone interview and outpatient examination was performed to detect tumor-free survival of patients up to April 2016.Measurement data with normal distribution were represented as x±s.The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgery and postoperative recovery situations:all the 206 patients received successful operations,including 85 with abdominal operation,50 with abdominal incision through the diaphragmatic muscle into thoracic surgery and 71 with thoracic-abdominal surgery.Overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation and duration of hospital stay were (113.7± 15.4)minutes,(3.5± 1.2)minutes,(10.4±2.9)minutes,(128±25) mL,32± 6,(2.4 ± 0.9) days and (12.3 ± 1.9) days,respectively.Of 206 patients,15 with postoperative complications were cured by conservative treatment,including 6 with implicit anastomotic fistula,3 with dominant anastomotic fistula,2 with pancreatic leakage,2 with intestinal obstruction,1 with anastomotic stenosis and 1 with thoracic and abdominal infection.There was no reoperation due to perioperative complications.(2) Postoperative pathological examination and chemotherapy:postoperative pathological results showed that distance from resection margin of the esophagus to tumor was (5.2±0.4) cm,without cancer cells in the resection margin.Among 206 patients,171 received postoperative chemotherapy by S1 single agent combined with oxaliplatin for 6-8 cycles or oral S1 single agent for 1 year.(3) Follow-up and survival situations:206 patients were followed up for (2.7± 0.3)years,with a tumor-free 3-year survival rate of 58％.During the follow-up,there was no recurrent anastomotic tumor.Conclusion The curved cutter stapler device combined with OrVil in the radical resection of Siewert type Ⅱ AEG can simplify the difficulty of esophagojejunal anastomosis and guarantee the safe resection margin of the lower esophagus.