The consensus has been reached on the benefits of surgical drainage. However, catheter-related blockage and retrograde infection remain bottleneck problems in the treatment process. To this end, with Huashan Hospital, Fudan University, as the main inventors, a drainage tube dredging umbrella and anti-retrograde infection kit have been designed and applied for the national utility model patent (patent number: ZL 2023 2 1300036.2). The main body of the kit consists of a catheter dredging umbrella, drainage tube, and drainage bag. Several isolation layers are installed in the drainage bag to form a maze structure and a reflux valve is added, thereby increasing the distance and resistance of liquid reflux, greatly reducing the possibility of liquid reflux entering the drainage tube, so as to reduce the risk of retrograde infection through physical means. When the drainage tube is blocked, the drainage tube and joint tube of the drainage bag can be separated, the unblocking umbrella can be inserted into the blockage through the guide wire, the cannula can be inserted along the guide wire, the guide wire is pulled to release the dredging umbrella in the contraction state, and the dredging umbrella can be pulled back in the expansion state until the blockage is removed from the drainage tube. The operating procedure is standardized and simple. While preventing retrograde infection (anti-retrograde infection kit), the catheter dredging umbrella could effectively address the issue of catheter blockage. It has certain clinical promotion and application value.

[摘 要] 目的：采用基于中国人群单核苷酸多态性位点开发的同源重组缺陷（HRD）检测工具评估云南地区卵巢癌患者的HRD状态和BRCA1/2基因突变频率并探讨其临床意义。方法：共纳入2021年1月至2023年5月间在云南省肿瘤医院收治的卵巢癌患者248例，HRD状态采用基因组瘢痕评分法（GSS）（主要依据拷贝数的长度、类型、位置及基因组断片）或HRD评分法（杂合性缺失、端粒等位基因失衡及大片段移位等基因组不稳定事件的总和）进行评估，当组织样本的GSS≥50分或HRD评分≥42分者或检测到有害的BRCA1/2基因突变时HRD被定义为阳性。分析患者HRD状态与临床病理特征的关系。结果：248名卵巢癌患者中70.97%的患者HRD呈阳性，其中BRCA1/2基因突变率为30.65%。Ⅲ~Ⅵ期、高级别浆液腺癌的卵巢癌患者具有更高的HRD阳性率（均P<0.01），HRD评分更高的患者其合并其他基因突变的频率也越高（P<0.05）。HRD状态与卵巢癌的病理类型、临床分期和其他基因突变均有关联（均P<0.01）。结论：云南地区卵巢癌患者HRD阳性率较高，HRD阳性的卵巢癌患者可以从聚ADP核糖聚合酶（PARP）抑制剂治疗中获得更大的收益。

Objective:To observe the ratio of helper T cells 17 (Th17)/regulatory T cells (Treg) in peripheral blood of patients with Hashimoto's thyroiditis (HT) and the expression changes of related cytokines in serum, and to explore their role in the occurrence and development of HT.Methods:Using the case-control study method, 35 HT patients examined in the General Hospital of Heilongjiang Beidahuang Group from February to November 2019 were selected as HT group, and 39 healthy people in the same period were selected as control group. Early morning fasting venous blood samples of the two groups were collected to test the levels of thyroid stimulating hormone (TSH), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The expressions of serum interleukin (IL)-6, IL-17 and transforming growth factor β (TGF-β) were tested by enzyme-linked immunosorbent assay (ELISA); the number of Th17, Treg in peripheral blood were determined by flow cytometry. Results:The levels of TPOAb, TgAb and TSH in HT group [130.60 (43.37, 714.40), 368.10 (136.90, 1 103.00) U/ml, 9.05 (6.62, 15.23) μU/ml] were significantly higher than those in control group [2.66 (1.52, 4.69), 12.63 (11.43, 14.60) U/ml, 1.87 (1.36, 2.23) μU/ml, U = 6.87, 6.62, 4.85, P < 0.001], and the FT 4 level [0.76 (0.63, 1.04) ng/dl] was lower than that in control group [1.14 (1.02, 1.26) ng/dl, U = 7.39, P < 0.001]. The expressions of IL-6, IL-17 and TGF-β in HT group were higher than those in control group ( t = 2.41, 9.04, 2.44, P < 0.05). The number of Th17 and the ratio of Th17/Treg in HT group were higher than those in control group ( t = 4.20, 3.50, P < 0.05), and the number of Treg was lower than that in control group ( t = 4.45, P = 0.001). Conclusion:In HT patients, Th17 are increased, Treg decreased, Th17/Treg ratio increased, and the expressions of IL-6, IL-17 and TGF-β are increased.

Objective To analyzes the situation and influential factors of participation in physical activities for the people with disabilities. Methods The Administration Data of 2017 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed. Results There were 4% of the people with disabilities participation in physical activities. The main reasons for failing participation in physical activity included lack of suitable events, inadequate places and facilities, incomplete organization and guidance, and lack of family and social support. The participation in physical activities was influenced by factors as genders, ages, types of disability, grades of disability and household registration (P < 0.05). Conclusion The rate of participation of physical activity is low and the factors of gender, age, category and severity of disabilities may influence on it.

Objective To investigate the needs and service of rehabilitation status of the people with intellectual disability, to support rehabilitation service for them. Methods A total of 167,872 cases with intellectual disability from the Administration Data of 2017 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed and rehabilitation needs included medical service and support, assistive productions, and rehabilitation training. Results 56.4% of the people with intellectual disability reported their rehabilitation needs. The rehabilitation needs were different with their ages, levels of disability and household registration (χ2 > 976.42, P < 0.001). Only 19.0% of the people with intellectual disability accessed rehabilitation services, and the influential factors included demographic variables, family economic status, transportation, knowledge and information, etc. Conclusion There are huge needs of rehabilitation services for the people with intellectual disability needed to be tailored. It is necessary to increase the supply of rehabilitation services using approach of precise rehabilitation, and improve the quality of rehabilitation services.

Objective To evaluate the clinical diagnostic value of color Doppler ultrasound in diagnosis brucellosis with orchitis.Methods Hospital-based case-control study was used.We selected the patients with brucellosis orchitis who were hospitalized in Heilongjiang Land Reclamation Bureau General Hospital from 2014 to 2016 as a case group.At the same time,selected healthy people as the control group.Bilateral testicular size,parenchyma echo,flow signals in parenchyma,depth of bilateral testicular sheath membrane cavity effusion,testicular artery peak systolic velocity (PSV),end-diastolic velocity (EDV),pulsatility index,resistance index,peak systolic velocity/end-diastolic velocity,were measured and analyzed using color Doppler ultrasound.Results The case group included 62 patients;the health control group included 41 persons.The testicular volume of case group was compared to that of healthy control group,there was no statistical significant difference (cm3:15.81 ± 3.27 vs 15.82 ± 2.77,t =0.015,P ＞ 0.05).By analyzing the correlation between the course of the disease and the testicular volume,a negative relationship was found (r =-0.594,P ＜ 0.01).In the case group,the deep diameter of the testicular sheath was higher than that of the healthy control group,and the difference was statistically significant (cm:1.50 ± 0.53 vs 0.84 ± 0.21,t =10.777,P＜ 0.01).The PSV and EDV were higher than those in the control group (cn/s:(9.73 ± 3.25 vs 6.00 ± 1.38,2.89 ± 0.77 vs 2.46 ± 0.36,t =9.810,4.691,P ＜ 0.01).The pulsation index and resistance index were higher than that in the control group (1.06 ± 0.12 vs 0.82 ± 0.08,0.69 ± 0.05 vs 0.58 ± 0.04,t =15.678,12.763,P ＜ 0.01).Conclusions There are specific changes in Brucella patients with orchitis.The blood flow spectrum and testicular sheath membrane cavity effusion are specific changes.The color Doppler ultrasound can effectively evaluate Brucella orchitis patients with testicular injury,provide a reliable imaging basis for clinical treatment.

Objective To research the unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan, China. Methods The data of 2016 Basic Service Status and Unmet Needs for People with Disabilities in Henan, China were ana-lyzed. Results A total of 1,028,598 people with physical disabilities from all 19 cities had been surveyed, accounting for 61.7% male. In terms of rehabilitation needs, there were 19,348 (1.9%) responsed surgery, 202,855 (19.7%) responsed medical treatment, 197,592 (19.2%) responsed functional training, 360,754 (35.1%) responsed assistive products, and 158,012 (15.4%) responsed nursing, there were significant differences in the number of people who needed rehabilitation among different disability levels (χ2>18.080, P<0.001). For rehabilitation ser-vice, there were 6061 (0.6%) reported surgery, 93,905 (9.1%) reported medicine, 62,967 (6.1%) reported function training, 81,437 (7.9%) reported assistive products, and 34,595 (3.4%) reported nursing, there were significant differences in the number of people who got rehabili-tation among different disability levels (χ2>15.920, P<0.01). For the people without rehabilitation services, there were 165,172 (20.3%) per-son-times lack of understanding of rehabilitation policy, 151,448 (18.6%) reported lack of rehabilitation financial support, 20,369 (2.5%) re-ported not to access rehabilitation institutions, 540,971 (66.5%) reported lack of rehabilitation professionals or services, there were signifi-cant differences in the number of people who did not get rehabilitation services among different disability levels (χ2>19.182, P<0.001). Con-clusion The unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan were explicated. It recom-mended to train rehabilitation professionals and improve the service delivery capacity, to raise awareness, increase investment in rehabilita-tion services and provide reasonable accommodation for people with disabilities.

Objective To explore the ultrasonic imaging features of malignant thyroid nodules risk fac-tors by logistic regression.Methods Two hundreds and forty patients with thyroid nodules by ultrasonic examina-tion and surgical treatment for patients with definited pathological diagnosis were included in this study.The pre-operative sonographic features of the nodules were put into the logistic regression model to explore the risk factors of ultrasonic imaging features of malignant thyroid nodules.Results By logistic regression model analysis,hypoe-cho,taller than wide≥1 and micro calcification were found to be significantly statistical variables for thyroid car-cinoma.Micro calcification could predict thyroid cancer for lymph node metastases.Conclusoin During clinical diagnosis,hypoecho,taller than wide more than 1 and micro calcification could be used as indicators by ultrasound doctors to judge malignant thyroid nodules and lymph node metastases.Prospective larger similar research is still very necessary to explore the indicator for thyroid carcinoma in the future.

Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.

Objective To establish the proposals of clinic and rehabilitation pathway for spine and spinal cord injury. Methods The experiences in clinic and rehabilitation treatment fields, the flow path of admission and the costs of hospitalization for spine and spinal cord injury patients in Chinese Rehabilitation Research Center were retrospectively summarized and analyzed. Related data in International Classification of Functioning, Disability and Health (ICF) core sets were also referred. Results The present proposals were applied to patients suffered from thoracic, lumbar or sacral spine injury with spinal cord injury. The proposals consisted of two parts: the surgical interventions in acute stage (within 2 weeks after injury) and clinic and rehabilitation treatments of spinal cord injury in sub acute and later stages (2 weeks to 6 months after injury). The criteria of surgical interventions in acute stage materialized the core therapies such as reconstruction of spine stability and neural decompression, etc. The criteria of treating spinal cord injury in subacute and later stages demonstrated the characteristic of combined therapy in which rehabilitation was the central element. Conclusion The establishment and implement of the present pathways were based on the time course of disease development and the staging feature of neural recovery and treatment after spinal cord injury. The purpose of this work is to improve the quality of medical service and reduce medical consumption.