Objective Neuromuscular electrical stimulation(NMES)-evoked kinesthetic information in muscle spindle can be purely extracted from the mixed motor and sensory afferents using Ischemic nerve block(INB).This study aims to investigate the somatosensory cortical response evoked by NMES activating muscle spindle afferents in forearm.Methods All subjects performed four experimental tasks designed according to a 2×2 factors,including one factor of the INB state(without INB and within INB)and the other of the stimulation intensity(above and below motor threshold).During the experiment,we recorded EEG data with 64 channels and then beta event-related desynchronization(Beta ERD)were utilized quantize somatosensory cortical excitability evoked by the tasks.The subjective perception about the sensation and movement of the right hand were evaluated by a psychophysical test after the right wrist was performed by INB.Results INB significantly reduced beta ERD on the contralateral somatosensory cortex evoked by NMES above the motor threshold,and there was significant difference of NMES-evoked beta ERD values on the contralateral somatosensory cortex between above and below motor threshold.Meanwhile,contralateral dominance of NMES-evoked beta ERD on the somatosensory cortex was transferred to ipsilateral hemisphere under INB.Conclusion INB can significantly reduce NMES-evoked somatosensory cortical response above motor threshold and decrease cortical perception on the stimulus intensity,which may be due to INB resulting in rapid functional reorganization of somatosensory cortex.

Objective To investigate the vowel acoustic characteristics of patients with voice disorders and the reasonable way of administering vocal space area(VSA)and language in the Mandarin system.Methods A total of 40 subjects(20 males and 20 females)with voice disorder and normal healthy controls were recruited.The differ-ences in VSA between the disorder and healthy control groups were analyzed under different corpora and different vowel vertex numbers.Results The differences in VSA between the voice disorder and the control groups were highly significant in both the vowel and long sentence corpus.The differences in VSA between 4 vowels and 3 vow-els and 5 vowels were not significant,and 5 vowels were more suitable for VSA measurement in Mandarin.Conclu-sion The vowel articulation of patients with voice disorder is less clear than that of normal speakers.It is more ac-curate to use 5 vowels to measure VSA under the Mandarin system and it is better for measuring oral motility.Both single vowels and continuous speech are suitable for the measurement of VSA.

Objective:To evaluate the efficacy and safety of sodium hyaluronate gel in preventing adhesion after prophylactic enterostomy.Methods:One hundred and twenty four patients from 6 hospitals were enrolled in this prospective multi-center randomized controlled trial. Patients were randomized into the study group ( n=59) or the control group ( n=65).All patients underwent prophylactic enterostomy. Patients of study group received odium hyaluronate gel for adhesion-prevention,while those in control group did not receive any adhesion-prevention treatment. The incidence of moderate to severe adhesion around the incision in the stoma area were evalutated during stoma reduction surgery. Results:The incidence of moderate to severe adhesion around the incision in the stoma area was 6.3% in the study group, the difference was statistically significant ( P<0.05) compared to that of the control group (32.6%). Conclusion:Sodium hyaluronate gel can safely and effectively reduce the incidence of moderate and severe adhesions after abdominal surgery.

Objective:To compare the effect of O-arm assisted and free-hand pedicle screw placement in the treatment of AO type C thoracolumbar fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 34 patients with type C thoracolumbar fracture admitted to Henan Provincial People′s Hospital from January 2018 to June 2021, including 23 males and 11 females; aged 42-63 years [(50.4±7.4)years]. The fracture was located at T 11 in 4 patients, T 12 in 10, L 1 in 12, L 2 in 6, T 11~12/L 1 in 1 and T 12/L 1 in 1. Posterior reduction and internal fixation was carried out for all patients, of whom 18 were treated with O-arm assisted pedicle screw placement (navigation group) and 16 with free-hand pedicle screw placement (free-hand group). The operation time, single screw placement time, intraoperative bleeding volume, operation mode and screw placement accuracy were compared between the two groups. The kyphotic Cobb angle, visual analogue score (VAS) and American Spinal Injury Association (ASIA) score were compared between the two groups before operation, at 1 week after operation, at 3 months after operation and at the last follow-up. Postoperative complications were observed. Results:All patients were followed up for 12-29 months [(16.8±6.1)months]. There was no significant difference between the two groups in the operation time, intraoperative bleeding volume and operation mode (all P>0.05). The single screw placement time was (9.4±1.6)minutes in navigation group, but was (10.8±1.5)minutes in free-hand group ( P<0.05). The screw placement accuracy was 97.4% in navigation group, but was 81.5% in free-hand group ( P<0.01). The kyphotic Cobb angle and VAS had no significant differences between the two groups before operation (all P>0.05). The kyphotic Cobb angle in navigation group and free-hand group was (4.3±1.1)° and (5.9±1.1)° at 1 week after operation, (4.4±1.2)° and (5.7±1.3)° at 3 months after operation, and (4.4±1.2)° and (6.8±0.9)° at the last follow-up, decreased significantly from that before operation [(21.8±3.1)°, (22.2±3.2)°] (all P<0.01). The kyphotic Cobb angle in navigation group was significantly lower than that in free-hand group at 1 week, 3 months after operation and at the last follow-up (all P<0.01). The VAS in navigation group and free-hand group was (3.2±0.7)points and (4.1±0.7)points at 1 week after operation, (2.4±0.6)points and (3.0±0.8)points at 3 months after operation, and (1.8±0.9)points and (2.6±0.7)points at the last follow-up, decreased significantly from that before operation [(8.4±0.8)points, (8.3±0.9)points] (all P<0.01). The VAS in navigation group was significantly lower than that in free-hand group at 1 week, 3 months after operation and at the last follow-up (all P<0.01). The ASIA score showed no significant difference within and between the two groups before operation, at 1 week, 3 months after operation and at the last follow-up (all P>0.05). Postoperative incision infection occurred in 1 patient in both groups ( P>0.05). Implant failure such as loosening or displacement was not observed in navigation group, and only occurred in 2 patients in free-hand group ( P>0.05). Conclusion:Compared with free-hand pedicle screw placement, O-arm assisted pedicle screw placement in the treatment of AO type C thoracolumbar fracture has advantages of rapid and accurate screw placement, good reduction and notable pain relief.

Objective:To evaluate the feasibility, accuracy, effectiveness and safety of a novel manual placement of cervical 7 pedicle screws via the posterior approach of cervicothoracic junction.Methods:A retrospective case series study was conducted to analyze the 35 patients with injury to the lower cervical spine or cervicothoracic junction who had been treated by a novel manual placement of cervical 7 pedicle screws at Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University from March 2015 to July 2021. There were 16 males and 19 females, with an age of (52.7±13.2) years. The core of this placement was to determine the entry point of cervical 7 pedicle screws. After the intersection of the upper edge of the cervical 7 lamina and the medial edge of the superior articular process was recorded as point A while the intersection of the lateral edge of the inferior articular process and the lower edge of the transverse process as point B, the intersection of the outer and middle 1/3 of the AB line was taken as the screw entry point, with the screw placement angle perpendicular to the lamina line or slightly inclined from 30° to 40° to the head side and outward. The length, diameter and placement angle of the cervical 7 pedicle screws were recorded and compared postoperatively between the left and right sides to explore the feasibility of this novel manual placement. According to the Rampersaud method, the screw positions were graded 1 week and 6 months after operation to evaluate the accuracy of this manual placement. The visual analogue scale (VAS) and the Japanese Orthopaedic Association (JOA) score were compared between preoperation, 1 week and 6 months after operation to evaluate the effectiveness of this placement. The postoperative complications were counted to evaluate the safety of this method. Loosening, displacement and breakage of the screws were observed by CT scanning at 6 months after operation.Results:This case series was followed up for (9.8±1.7) months. There was no significant difference in the length, diameter or placement angle of the screws between the left and right sides ( P>0.05). A total of 66 cervical 7 pedicle screws were placed. There was no change in the screw position grading at 1 week or 6 months after surgery. Grade A was achieved in 64 screws, Grade B in 2 screws, and Grade C or D in none. The VAS scores before operation, 1 week and 6 months after operation were respectively 4.4±1.7, 3.8±1.0 and 1.1±1.1, and the JOA scores respectively 6.7±2.2, 13.2±1.5 and 15.3±1.2. The VAS and JOA scores at 1 week and 6 months after operation were significantly improved compared with the preoperative values ( P<0.05). The improvement rates in JOA at 1 week and 6 months after operation were 62.7%±13.3 % and 83.9%±11.6%, respectively. There were no complications related to the placement of cervical 7 pedicle screws; there was no wound hematoma or infection. No loosening, displacement or breakage of the screws was observed by the 6-month follow-up. Conclusion:The novel manual placement of cervical 7 pedicle screws via the posterior approach of cervicothoracic junction is feasible, accurate, effective and safe.

Objective To evaluate the characteristics of spatial distribution and time accumulation of impact acceleration at different parts of human body during backward falling process. Methods Four healthy men and four healthy women (20-20 years old) were enrolled. The tri-axial acceleration on head, chest, left/right arm/hand/foot, left/right front/back hip, left/right femur head, sacrum and coccyx throughout the backward falling were measured by ADXL335 tri-axial acceleration sensor. Systemic acceleration distribution of backward falling was polynomial fitted by signal magnitude vector (SMV) of its first peak. Besides, parameters of impulse mechanics such as zero-g time, total falling time, peak SMV, relative pressure impulse of the vulnerable sites (head, hip and its related sites) were also calculated. Results Compared with the other parts of the body, the peak SMV and relative impulses of left/right back hip and head were significantly higher (P＜0.05). Acceleration that paralleled to the ground in left/right back hip was also relatively large. The rotational transform angles of left/right back hip, left/right femur head, sacrum and coccyx were significantly larger (P＜0.05). In addition, during the process of falling backward to the ground, a sliding tendency toward the sagittal plane 53.58°±6.75° occurred at all testing sites. Conclusions Head and hips are vulnerable during backward falling, and their zero-g time (0.26±0.05) s can be used as the longest starting time of falling protection devices. The large change angle of left/right hip, left/right femoral head, sacrum and coccyx may be the important cause of the sprain during backward falling.

Objective To investigate the association of rs579459 polymorphism in ABO gene with clinical severity of coronary heart disease (CHD) in Chinese Han population. Methods Based on the results of study on the association with CHD conducted by our team ,the rs579459 polymorphism in ABO gene and clinical data of 515 Chinese Han patients with CHD and 908 healthy individuals were collected and analyzed with Plink 1.07 software. Results The rs579459 polymorphism in ABO gene using allele model showed a statistically significant difference between CHD and control group (OR :1.28 ,95％ CI :1.11-1.65 ;P=0.027).When stratified by the severity of CHD ,the rs579459 polymorphism in ABO gene using allele model showed statistically significant difference between the severe CHD group and control group (OR :1.78 ,95％ CI :1.25-2.34 ;P=1.85 × 10-4 ). Conclusions The rs579459 polymorphism of ABO gene is associated with susceptibility to CHD in Chinese Han population ,and also with the severity of CHD.

OBJECTIVETo study the clinicopathologic features and pathologic diagnosis and differential diagnosis of angioimmunoblastic T-cell lymphoma with HRS-like cells.

METHODSSix cases of angioimmunoblastic T-cell lymphoma with HRS-like cells were examined histologically and immunohistochemically (EliVision method) and in-situ hybridization for Epstein-Barr virus-encoded RNA (EBER), and the literature was reviewed.

RESULTSThe cytologic and microscopic features of these imprints and lymph node samples showed a heterogeneous population of hematolymphoid cells, including small to intermediate lymphoid cells, immunoblasts, plasma cells, dendritic cells, and eosinophils, as well as small vessels that were surrounded by some of the abnormal cells. The neoplastic T-cells expressed CD3 and CD5 and partly positive for CD10 and bcl-6, CD21 showed expanded and irregular follicular dendritic cell (FDC) meshworks that surrounding the high HEV. The HRS-like cells were positive for MUM-1 and Ki-67, variable intensity positive for CD30, CD20, and PAX-5, but negative for CD15. EBV-positive cells included HRS-like cells and small to large-sized neoplastic T-cells, which formed small clusters or scattering in the background of the disease.

CONCLUSIONSThe clinical course of angioimmunoblastic T-cell lymphoma with HRS-like cells is aggressive. Which present with histomorphology overlap with classical Hodgkin lymphoma (CHL), similar to CHL in EBER and immunophenotype, however, it is easy to misdiagnosis as HL. Thus, angioimmunoblastic T-cell lymphoma pathology diagnosis should comprehensive analysis of different kinds of materials, including clinical features, and histological structure, and EBER, and immunophenotype, and gene rearrangement.

Diagnosis, Differential ; Herpesvirus 4, Human ; Hodgkin Disease ; pathology ; Humans ; Immunoblastic Lymphadenopathy ; diagnosis ; pathology ; Immunohistochemistry ; Immunophenotyping ; In Situ Hybridization ; Lymphoma, T-Cell ; diagnosis ; pathology ; RNA, Viral ; Reed-Sternberg Cells ; pathology ; T-Lymphocytes ; pathology

Objective To study the clinicopathologic features and pathologic diagnosis and differential diagnosis of angioimmunoblastic T-cell lymphoma with HRS-like cells.Methods Six cases of angioimmunoblastic T-cell lymphoma with HRS-like cells were examined histologically and immunohistochemically ( EliVision method ) and in-situ hybridization for Epstein-Barr virus-encoded RNA (EBER), and the literature was reviewed.Results The cytologic and microscopic features of these imprints and lymph node samples showed a heterogeneous population of hematolymphoid cells , including small to intermediate lymphoid cells, immunoblasts, plasma cells, dendritic cells, and eosinophils, as well as small vessels that were surrounded by some of the abnormal cells.The neoplastic T-cells expressed CD3 and CD5 and partly positive for CD10 and bcl-6, CD21 showed expanded and irregular follicular dendritic cell ( FDC) meshworks that surrounding the high HEV.The HRS-like cells were positive for MUM-1 and Ki-67, variable intensity positive for CD30, CD20, and PAX-5, but negative for CD15.EBV-positive cells included HRS-like cells and small to large-sized neoplastic T-cells, which formed small clusters or scattering in the background of the disease.Conclusions The clinical course of angioimmunoblastic T-cell lymphoma with HRS-like cells is aggressive.Which present with histomorphology overlap with classical Hodgkin lymphoma ( CHL) , similar to CHL in EBER and immunophenotype , however, it is easy to misdiagnosis as HL.Thus, angioimmunoblastic T-cell lymphoma pathology diagnosis should comprehensive analysis of different kinds of materials , including clinical features , and histological structure , and EBER , and immunophenotype , and gene rearrangement .

Objective:To analyze the benefit incidence and evaluate the implementation effects on catastrophic disease insurance under the New Rural Cooperative Medical System ( NRCMS) in Jilin Province and put forward sug-gestions to perfect the catastrophic disease insurance under NRCMS. Method: In-depth interviews with related staff were conducted to gain an understanding of the operating status of catastrophic disease insurance under NRCMS;cat-astrophic disease patient data of Jilin Province from 2013 were collected, with a comparative analysis of implementa-tion effects among nine districts;the benefit incidence was analyzed by means of the Sperman rank correlation analy-sis; Results: The policy of catastrophic disease insurance under the NRCMS exhibited sound implementation effects and played an important role in reducing the economic burden of catastrophic disease patients. The average individual expenditure decreased by 4336. 52 yuan, while the reimbursement rate increased by 11. 15% after NRCMS cata-strophic disease insurance reimbursements. Additionally, statistical analysis results showed that there was a weak cor-relation between benefit incidence and economic level, the benefit equality of catastrophic disease insurance under NRCMS was relatively good, but the benefit level of rich patients was slightly higher. Conclusion:The reimbursement scheme of catastrophic disease insurance under NRCMS should be refined and improved, and the benefit fairness of different districts must be ensured, thus achieving the goal of relieving the“poverty caused by illness” phenomenon.