Objective:To construct a shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach and to explore its effectiveness.Methods:The first draft of the shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach was constructed through literature review, and two rounds of expert consultation were conducted with 20 experts to determine the final draft of the program with the results of the pretest. A total of 98 patients who underwent endoscopic thyroidectomy by a gasless unilateral axillary approach in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were selected for the study using the convenience sampling method. Patients from September to December 2023 were set up as control group and patients from October 2023 to January 2024 were set up as experimental group, with 49 patients in each group. Control group implemented routine nursing, and experimental group received the shoulder and neck functional exercise program developed in this study on the basis of control group. Constant-Murley Score score, occurrence of numbness in the chest wall access area, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores in cancer patients were compared between the two groups at one week, one month, and three months post-intervention.Results:In the two rounds of expert consultation, the effective questionnaire recovery rates were 85.00% (17/20) and 94.12% (16/17), and the coefficient of the expert familiarity was 0.938, the coefficient of basis of judgment was 0.891, and the coefficient of authority was 0.915. The coefficients of variation for the importance ratings of the entries in the second round of consultation were 0.096 to 0.190 and Kendall's harmony coefficient was 0.155 ( P<0.01). The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach included three first-level items, five second-level items, and 13 third-level items. At one week post-intervention, the difference in occurrence of numbness in the chest wall access area was statistically significant in both groups ( P<0.05). At one month post-intervention, the differences in shoulder function scores, occurrence of numbness in the chest wall access area, and quality of life scores between the two groups were statistically significant (all P<0.05). At three months post-intervention, the differences in shoulder function scores and quality of life scores between the two groups were statistically significant (all P<0.05) . Conclusions:The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach has certain scientific validity and feasibility, which can improve the shoulder and neck function of patients undergoing endoscopic thyroidectomy by axillary approach, reduce the numbness in the chest wall access area, and improve the quality of life of the patients in the postoperative period.

Objective:To construct a shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach and to explore its effectiveness.Methods:The first draft of the shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach was constructed through literature review, and two rounds of expert consultation were conducted with 20 experts to determine the final draft of the program with the results of the pretest. A total of 98 patients who underwent endoscopic thyroidectomy by a gasless unilateral axillary approach in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were selected for the study using the convenience sampling method. Patients from September to December 2023 were set up as control group and patients from October 2023 to January 2024 were set up as experimental group, with 49 patients in each group. Control group implemented routine nursing, and experimental group received the shoulder and neck functional exercise program developed in this study on the basis of control group. Constant-Murley Score score, occurrence of numbness in the chest wall access area, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores in cancer patients were compared between the two groups at one week, one month, and three months post-intervention.Results:In the two rounds of expert consultation, the effective questionnaire recovery rates were 85.00% (17/20) and 94.12% (16/17), and the coefficient of the expert familiarity was 0.938, the coefficient of basis of judgment was 0.891, and the coefficient of authority was 0.915. The coefficients of variation for the importance ratings of the entries in the second round of consultation were 0.096 to 0.190 and Kendall's harmony coefficient was 0.155 ( P<0.01). The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach included three first-level items, five second-level items, and 13 third-level items. At one week post-intervention, the difference in occurrence of numbness in the chest wall access area was statistically significant in both groups ( P<0.05). At one month post-intervention, the differences in shoulder function scores, occurrence of numbness in the chest wall access area, and quality of life scores between the two groups were statistically significant (all P<0.05). At three months post-intervention, the differences in shoulder function scores and quality of life scores between the two groups were statistically significant (all P<0.05) . Conclusions:The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach has certain scientific validity and feasibility, which can improve the shoulder and neck function of patients undergoing endoscopic thyroidectomy by axillary approach, reduce the numbness in the chest wall access area, and improve the quality of life of the patients in the postoperative period.

Objective:To investigate the discomfort of chest wall approach area in patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach (GUA), and to analyze its influencing factors. To provide a basis for the development of targeted improvement measures.Methods:A total of 153 patients with GUA from May. 2023 to Aug. 2023 in the Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. The general information questionnaire was collected one day before operation, the pain scales were assessed one day and three days after operation, and the pain and numbness scales were assessed one month after operation. The t test or χ2 test was used for comparison of baseline data between groups according to different types of variables. The patients were divided into two groups: less than moderate pain group (two postoperative average VAS scores<4) and more than moderate pain group (two postoperative average VAS scores ≥4). Mild numbness group (postoperative VAS score<4) ; Moderate and severe numbness group (postoperative VAS score ≥4). Multivariate binary Logistic regression was performed with pain discomfort and numbness discomfort as dependent variables to find possible influencing factors. Results:A total of 153 valid questionnaires were collected. There were 125 patients in the moderate pain group; There were 28 patients in the moderate and above pain group. There were 94 patients in the mild numbness group. There were 59 patients in the moderate to severe numbness group. Multivariate binary Logistic regression results showed that, exercise habits ( OR=0.07 95% CI=0.006, 0.409), operation duration ( OR=1.026 95% CI=1.001, 1.054), total drainage volume ( OR=1.122 95% CI=1.07, P<0.05), 1.198), and drainage tube indwelling time ( OR=0.012 95% CI=0.0, 0.187) had an impact on the discomfort of the chest wall approach area, and the difference was statistically significant ( P<0.05). Gender, BMI, marital status, education, occupation, handed-side surgery, handed-side axillary surgery, smokess and alcohol history, intraoperative blood loss, and length of hospital stay had no effect on the discomfort of chest wall approach area, and the difference was not statistically significant ( P>0.05) . Conclusion:Exercise habits, operation duration, total drainage volume, and drainage duration are independent predictors of discomfort in GUA patients.

【Objective】 To understand the current status of medical staff’s awareness of hospital infection prevention and control during the epidemic of COVID-19 in Shaanxi Province and analyze its influencing factors. 【Methods】 The questionnaire was designed on the "Questionnaire Star" website. Based on the WeChat platform, a voluntary sampling method was used to invite online questionnaires. From March 13 to 29, we collected a total of 8037 questionnaires, 30 of which did not meet the requirements and had logical problems, and finally 8 007 valid questionnaires were obtained. 【Results】 A total of 8 007 medical staff were surveyed. Among them, Medical staff of Grade 3A, Grade 3B, Grade 2A, and Grade 2B hospital accounted for 39.6%, 2.3%, 55.3%, and 2.6%, respectively. The average age of the respondents was (32.1±7.2) years old, including 7 199 nurses and 501 doctors. The training effect was statistically significant in different regions, different hospital levels, whether it was a designated hospital and whether there were sensor control supervisors, as well as medical staff of different specialty, professional title, and work area (all P<0.01). The basic cognitive situation of the surveyed subjects showed that most medical staff in Shaanxi Province had a correct rate of less than 30% in whether they needed to disinfect before de-protection and how to disinfect the hospital environment. Multivariate linear regression analysis showed that the cognition level of medical staff in Grade A hospitals was significantly lower than that in Grade A hospitals (P<0.01). The cognition level of medical staff in designated hospitals was significantly higher than that of others (P<0.01). The cognition level of medical staff in hospitals with sensory control supervisors was significantly higher than that of others (P<0.01). The cognition level of people aged 25-34 and 35-44 was significantly lower than those aged 45 and above (all P<0.01). The cognition level of medical technicians and service personnel was significantly lower than that of doctors (P=0.02 and <0.01, respectively). The cognition level of medical staff with intermediate, associate senior, and senior professional titles was significantly higher than the cognition level of those with junior and below professional titles (all P<0.01). The cognition level of medical staff in fever clinics, emergency departments, isolation wards, ICU and other surgeries was significantly higher than that of those working in ordinary outpatient department (P=0.01, 0.03, <0.01, 0.02, and <0.01 respectively). 【Conclusion】 Most medical staff in Shaanxi Province have misunderstandings about whether they need to disinfect before de-protection and how to disinfect the hospital environment. Moreover, we found that the awareness of medical staff in Shaanxi Province of hospital infection prevention and control during the epidemic of COVID-19 was affected by the hospital’s level, whether it was a designated hospital, whether there were sensor control supervisors, as well as the age, specialty, professional title and work area of the medical staff.

Under the policy background of zero addition of drugs and consumables in public hospitals, with clinical practice as the guide and information platform as the means, the hospital constructed an intelligent management system for hospitals′ drugs and consumables through the Internet of things. The hospital adopted the intelligent medicine cabinet extended ward management, consumables " one material, one code" two-level warehouse management mode, reengineering the material supply process.Finally, it can realize the whole process traceability of information, unify the flow of goods and data, save human resources, improve the efficiency of operation and management, and achieve the purpose of ensuring safety, reducing costs and increasing benefits.

Objective: To observe the efficacy and safety of Brucea javanica oil injection combined with S-1 in the treatment of elderly patients with advanced gastric cancer. Methods: The clinical data of 62 elderly patients with advanced gastric cancer who were admitted to Shanxi Provincial Cancer Hospital from May 2017 to May 2018 were retrospectively analyzed. Thirty-one patients in the control group treated with S-1 alone, and 31 patients in the observation group treated with S-1 combined with Brucea oil emulsion injection. The clinical efficacy, adverse reactions, immune function and quality of life of the two groups were compared. Results: The total effective rates of the observation group and the control group were 70.97% (22/31) and 48.39% (15/31), respectively, and the difference was statistically significant (χ ² = 11.889, P < 0.01). The incidence rates of gastrointestinal reaction and peripheral neurotoxicity in the observation group were 9.68% (3/31) and 3.23% (1/31), and the rates in the control group were 35.48% (11/31) and 25.81% (8/31), respectively, the differences between the two groups were statistically significant (both P < 0.05); the incidence rates of hepatotoxicity, nephrotoxicity and myelosuppression in the observation group were 3.23% (1/31), 3.23% (1/31), and 3.23% (1/31), and the rates in the control group were 22.58% (7/31), 16.13% (5/31), and 12.90% (4/31), respectively, and the differences between the two groups were not statistically significant (all P > 0.05). The Karnofsky scores of the observation group and the control group after treatment were (92±4) points and (86±3) points, respectively, and the difference was statistically significant (t = -2.075, P = 0.042). The serum levels of interleukin-2 (IL-2) and interferon-γ in the observation group after treatment were (38±4) ng/L and (51±4) ng/L, and the levels in the control group were (31±3) ng/L and (40±4) ng/L, respectively, and the differences were statistically significant (t values were -2.097 and -2.293, both P < 0.05), and the serum levels of IL-4, IL-6 and IL-10 in the observation group after treatment were (42±5) ng/L, (34±4) ng/L and (22±2) ng/L, and the levels in the control group were (59±6) ng/L, (50±5) ng/L and (30±3) ng/L, respectively, and the differences were statistically significant (t values were 2.109, 2.867 and 4.278, all P < 0.05). There was no statistical difference in the serum levels of tumor necrosis factor-α between the observation group and the control group after treatment (t = -0.922, P = 0.360). Conclusion Compared with monotherapy of S-1, the treatment of Brucea javanica oil emulsion injection combined with S-1 can improve the clinical efficacy, reduce the incidence of adverse reactions, enhance the immune function and effectively improve the quality of life of elderly patients with advanced gastric cancer.

Objective: To investigate the expression of long non-coding RNA (lncRNA) SNHG8 in EB virus related gastric cancer and their correlation prognosis. Methods: The expression of SNHG8 in 93 gastric cancers and 93 cancer-free controls, matched by age and sex, were determined by real-time PCR. EB virus expression was detected by EBER in situ hybridization. Results: Forty-one gastric cancers were EB virus associated. For all gastric cancers, SNHG8 expression was 14 times higher (P=0.001) than that in non-cancer controls; in the EB virus related gastric cancers, SNHG8 expression was increased 25 times (P<0.05) over EB virus negative gastric cancers. SNHG8 expression level was also significantly associated with TNM staging (P<0.05). Conclusions SNHG8 may act as a proto-oncogene, participating in gastric carcinogenesis.EB virus infection of gastric mucosa may promote SNHG8 expression.

Objective:To explore the clinicopathologic features of 112 patients with mantle cell lymphoma (MCL). Methods:Da-ta from 112 MCL cases were collected, and immunohistochemical assay was conducted. A break in the CCND1 gene was detected by fluorescence in situ hybridization (FISH). The t-test was used in the statistical analysis. Results:All tumor cells in the 112 cases ex-pressed B cell-related antigen, including 1 blastoid subtype and 1 polymorphic subtype. Among all the cases, 106 expressed CD5 and 104 expressed cyclinD1. A break in the CCND1 gene was not found in 3 cases with CD5-MCL. IgH/CCND1 polyploid was found in 2 classical cases. Conclusion:MCL is a type of special immunophenotypic B-cell lymphoma. The prognoses of blastoid and polymorphic subtypes are poor. Special subtypes should be classified during diagnosis.

ObjectiveTo investigate the feasibility of extended hepatectomy for huge hepatic carcinoma.MethodsA retrospective analysis was made on the clinical data of 28 patients with huge hepatic carcinoma who underwent extended hepatectomy from December 2006 to June 2011.Twenty-two cases were Child-Pugh grade A,6 cases were Child-Pugh grade B,19 cases were indocyanine green retention at 15 minutes (ICGR15)≤10％,5 cases were 10％ ＜ ICGR15 ≤15％,4 cases were 15％ ＜ ICGR15 ≤20％.ResultsThe operative death rate was 7.1％ (2/28) with Child-Pugh grade B,15％ ＜ ICGR15 ≤20％ and liver resection volume 60％-70％.Postoperative complications were found on 15 cases,but all recovered after treatment.ConclusionExtended hepatectomy for huge hepatic carcinoma can be feasible in the patients with enough reserve of the liver function provided.

Objective To analyze the normal hepatic contrast perfusion blocked by ultrasound excited microbubble cavitation using the visual scoring method. Methods Twenty-four healthy New Zealand rabbits were divided into the microbubbles group (MB + US), the simple ultrasound group (US) and the sham group. The MB + US group was insonated by US and intravenous injection of lipid microbubbles. Microbubble was replaced by saline in the US group and sham US exposure was used in the sham group. US contrast liver perfusion imaging was performed before and 0 min,15 min,30 min,45 min,60 min,24 h after treatment in each group. Results The visual perfusion scores of each group before treatment were no statistical difference ( P >0. 05). The visual score of pre-treatment significantly higher than that of post 0 min, 15 min in the MB+ US group ( P<0. 05), but no difference with post 30 min,45 min,60 min and 24 h ( P >0. 05). There were no statistical significance between all the time points of the US and the sham groups. Conclusions Ultrasound excited microbubble cavitation can temporarily and significantly interrupt liver blood perfusion in the visual score analysis.