Objective:To explore the effect of combining hand-brain perception training with hand-brain motor training based on mirror neuron theory on the recovery of upper limb function after a stroke.Methods:A group of 105 stroke survivors with upper limb dysfunction were randomly divided into a hand-brain perception (HP) group, a hand-brain motor (HM) group, and a combination (C) group, each of 35. In addition to conventional rehabilitation treatment (including exercise therapy, occupational therapy and physical factor therapy), the HP and HM groups were given hand-brain perception training and hand-brain motor training respectively, while group C was provided with both. Before the intervention and after 4 weeks, the upper limb motor functioning of all of the participants was assessed using the simplified version of the Fugl-Meyer upper limb motor function scale (FMA-UE). Sensory functioning was quantified using the tactile Semmes Weinstein monofilament examination (SWME), and the modified Barthel index (MBI) was used to quantify the participants′ ability in the activities of daily living.Results:After the intervention the average FMA-UE, MBI and SWME scores of all three groups had improved significantly, with group C′s average FMA-UE and MBI scores significantly better than the other two groups′ averages. The average SWME score of group C was then significantly better than that of group HM.Conclusions:Hand-brain perception combined with hand-brain motor training based on mirror neuron theory can further promote the recovery of upper limb sensory and motor functioning of stroke survivors., Such therapy is worthy of clinical promotion and application.

Objective:To investigate the clinical efficacy of Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 404 patients with esophageal cancer who underwent Da Vinci robot-assisted esophagectomy in Tianjin Medical University Cancer Hospital and Institute from June 2017 to June 2022 were collected. There were 349 males and 55 females, aged (62±8)years. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) comparison of clinical features in patients who were admitted in different time periods. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the one way ANOVA. Measurement data with skewed distribution were represented as M(IQR), and comparison among multiple groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers or percentages, and com-parison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Intraoperative conditions. The operation time, volume of intraoperative blood loss, the total number of lymph node dissected, the number of thoracic lymph node dissected, left recurrent laryngeal nerve lymph node dissection rate, the number of left recurrent laryngeal nerve lymph node dissected, left recurrent laryngeal nerve lymph node metastasis rate, right recurrent laryngeal nerve lymph node dissection rate, the number of right recurrent laryngeal nerve lymph node dissected, right recurrent laryngeal nerve lymph node metastasis rate were (306±56)minutes,200(100)mL, 29.9±13.1, 18.5±9.7, 78.47%(317/404), 4.0(3.0), 17.35%(55/317), 94.55%(382/404), 3.0(2.0), 21.20%(81/382). (2) Postoperative conditions. The tumor histopathological type (squamous cell carcinoma, neuroendocrine carcinoma, adenocarcinoma, carcinosarcoma, adenosquamous carcinoma, malignant melanoma), incidence rate of overall complications, cases with recurrent laryngeal nerve paralysis, cases with pulmonary complications, cases with anastomotic fistula, cases with incision infection, cases with chylothorax, cases with arrhythmia, cases with deep vein thrombosis, cases with other complications, incidence of re-admission to the intensive care unit, duration of postoperative hospital stay, 90-day mortality were 377, 11, 7, 5, 3, 1, 27.48%(111/404), 8.91%(36/404), 10.64%(43/404), 6.93%(28/404), 0.99%(4/404), 2.48%(10/404), 1.73%(7/404), 0.50%(2/404), 1.98%(8/404), 6.93%(28/404), 16(11)days, 0.50%(2/404). (3) Comparison of clinical features in patients who were admi-tted in different time periods. The number of patients who were admitted from June 2017 to May 2018, from June 2018 to May 2019, from June 2019 to May 2020, from June 2020 to May 2021, from June 2021 to June 2022 was 40, 56, 57, 116, 135, respectively. There were significant differences in age, tumor histopathological type, pT staging, neoadjuvant therapy, operation time, volume of intra-operative blood loss, the total number of lymph node dissected, the number of thoracic lymph node dissected, left recurrent laryngeal nerve lymph node dissection rate, the number of left recurrent laryngeal nerve lymph node dissected, the number of right recurrent laryngeal nerve lymph node dissected, incidence rate of overall complications among patients who were admitted in different time periods ( P<0.05). Conclusion:The Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve is safe and feasible, which can achieve good short-term efficacy.

ObjectiveTo investigate the efficacy and safety of Shengxiantang in the treatment of early Parkinson's disease with autonomic dysfunction of Qi deficiency pattern. MethodA total of 82 eligible patients were randomized into control group （41 cases） and traditional Chinese medicine （TCM） group （41 cases）. On the basis of standardized treatment of western medicine， TCM group was prescribed Shengxiantang while control group were treated with placebo for 12 consecutive weeks additionally. Scale for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT） questionnaire， Unified Parkinson's Disease Rating Scale （UPDRS）， Traditional Chinese Medicine Qi Deficiency Symptom Score of Parkinson's Disease （TCMQDSSPD）， serum levels of glutathione peroxidase （GPx） and superoxide dismutase （SOD）， daily dosage of pramipexole and levodopa and benserazide hydrochloride， and safety index were evaluated both before and after treatment. ResultAfter treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the control group were higher than those before treatment （P<0.01）， while the above sores in the TCM group were lower than those before treatment （P<0.05， P<0.01）. In addition， the cardiovascular score， pupillomotor score， and sexual score in two groups showed no significant difference from those before treatment. After treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the TCM group were lower than those in the control group （P<0.05， P<0.01）， and cardiovascular score， pupillomotor score， and sexual score showed no significant difference between two groups. After treatment， the total score of TCMQDSSPD， main symptom scores， and minor symptom scores in the control group had no significant difference from those before treatment. The total score of TCMQDSSPD and minor symptom scores of TCM group were lower than those before treatment （P<0.01）， while the main symptom scores of the TCM group showed no significant difference from those before treatment. After treatment， the UPDRS score， serum GPx and SOD levels， and daily dosage of pramipexole and levodopa and benserazide hydrochloride demonstrated no significant difference from those before treatment in the two groups and between the two groups. No abnormality was found in the safety indexes. ConclusionBased on the standardized treatment of western medicine， Shengxiantang can effectively and safely improve the autonomic symptoms of gastrointestinal system， urinary system， and thermoregulation， as well as the symptoms of Qi deficiency syndrome in early Parkinson's disease with autonomic dysfunction.

Esophagectomy and lymph node dissection are the cornerstones for the treatment of esophageal cancer. Upper mediastinal lymph node dissection is of great value for accurate staging and improving the prognosis of patients. Lymph node dissection along the left recurrent laryngeal nerve is the most challenging procedures in esophageal surgery, and there has been no relevant consensus on the scope and boundary of lymph node dissection. In recent years, with the application of endoscopic technology, especially robotic surgery system in esophagectomy, and the introduction of the concept of superior mediastinal microdissection, the authors have proposed the border of lymph node dissection along the left recurrent laryngeal nerve, so as to achieve precise, radical and standardized dissection. Combined with their own experiences, the authors elaborate on the anatomic boundary, extent and technique of lymph node dissection along the left recurrent laryngeal nerve.

Objective: To investigate the serum expression and influencing factors of hepcidinin patients with classical paroxysmal nocturnal hemoglobinuria (PNH) . Methods: Retrospective analysis of 36 classical PNH patients from 2016.3 to 2017.3. Serum hepcidin concentration was measured by ELISA method. The relationship between serum hepcidin concentration and erythropoiesis and iron homeostasis parameters was evaluated. Results: The median serum hepcidin level of 36 classical PNH patients was 32.03 (23.11, 118.48) μg/L, it was significantly lower than of 181.42 (106.80, 250.53) μg/L in 292 normal control subjects (z=-5.107, P<0.001) . The median serum hepcidin of 56.41 (44.60, 95.06) μg/L in PNH patients with normal ferritin was significantly lower than that in normal controls. The median serum hepcidin concentration 23.75 (21.77, 30.35) μg/L in iron deficiency PNH patients was lower than that in the normal ferritin PNH patients. However, the median serum hepcidin level of classical PNH with elevated ferritin patients 336.19 (304.19, 375.08) μg/L was significantly higher not only than that of normal ferritin and iron deficiency PNH ones, but also than that of normal control subjects. Regression analysis showed that serum ferritin, transferrin saturation and serum albumin level were independent influencing factors of serum hepcidin level in patients with classical PNH. Conclusion The decreased serum hepcidin level in patients with classical PNH was mainly influenced by iron metabolism factors.

BACKGROUND: Bone marrow mesenchymal stem cells have been induced into islet-like cell mass in vitro. However, little researches reported on the morphological changes of cells, the types of endocrine cells in the islet-like cell mass and their relationships. OBJECTIVE: To investigate the morphological changes of cells in the differentiation of bone marrow mesenchymal stem cells into islet-like structure and to explore the composition and distribution of endocrine cells. METHODS: Passage 3 bone marrow mesenchymal stem cells growing well were cultured and expanded until the cell colonies occupies 80% of the bottom of the culture bottle, and the pancreatic tissue lysate was added for continuous induction. Dithizone staining was used to screen the islet-like cell mass directly differentiated from bone marrow mesenchymal stem cells. The types and distribution of endocrine cells were identified by Mallory staining. Expressions of insulin, C-peptide, glucagon and somatostatin protein were detected by immunofluorescence cytochemical staining. RESULTS AND CONCLUSION: (1) Dithizone staining showed that the number of positive cells was increased over the induction time. (2) Mallory staining showed the red α-like cells were located in the periphery of the islet-like cell mass, the yellow β-like cells located in the center and periphery, and the light blue fibroblasts were distributed around the cell mass. (3) Immunofluorescence staining showed insulin, C-peptide, glucagon and somatostatin positive cells in the islet-like cell mass. To conclude, under certain microenvironment, bone marrow mesenchymal stem cells can differentiate into islet-like structures which containing α, β, δ-like cells, and are surrounded by fibroblast-like cells.

Objective To investigate the effects of mobile APP combined with WeChat group on the self-efficacy, self-management and medical adherence of the elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 96 cases of elderly patients with COPD, who had been treated in Harrison International Peace Hospital of Hengshui in Hebei Province and finished 1 year follow-up from January 2013 to May 2016, were selected as the research objects by convenience sampling method, and divided into observation group and control group by random number table method, with 48 cases in each. The patients of the control group were given regular telephone follow-up as continuous nursing measures, while the patients of the observation group were given continuous nursing by mobile APP "317 nurse" combined with WeChat group. After 1 year follow-up, COPD severity distribution, the score of modified Medical Research Council (mMRC) scale, patients' self-efficacy and self-management and medication adherence were compared between the two groups. Results After the 1 year follow-up, the difference of the COPD severity distribution between the two groups was statistically significant (P< 0.05), but there was no significant difference in the score of mMRC scale between the two groups (P> 0.05). The score of each dimension in the self-management scale and the self-efficacy scale of the observation group was significantly higher than that of the control group (P< 0.05). Additionally, the medication compliance score of observation group was significantly higher than that of the control group (P<0.05). Conclusions It can effectively enhance patients' self-efficacy and self-management level and improve patients' medical compliance by the application mobile APP "317 nurse" combined with WeChat group as continuous nursing measures for elderly patients with COPD, so as to improve patients' clinical symptoms.

Objective To explore the clinical distribution states of human papillomavirus genotypes in tissues of 691 women with vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province and genotyping clinical significance.Methods Polymerase chain reaction(PCR)and gene-chips technology were utilized for the detection of 23 kinds of HPV genotypes in tissue specimens from 619 women of vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province.And related materials of all subjects were analyzed.Results In 691 women of vulva condyloma acuminates,597 women of HPV infecton,total infection rate of HPV was 86.40％(597/691),including single genotype infection rate of HPV was 51.38％(355/691),11、6 and 16 genotypes are the most common in single genotypes,they are successively 51.55％(183/355)、41.97％(149/355)and 3.38％(12/355).multiple genotypes infection rate of HPV was 35.02％(242/691),6+11、11+18、6+16 and 11+16 genotypes are the most common in multiple genotypes,they are successively 9.92％(24/242)、9.09％(22/242)、4.96％(12/242)and 4.13％(10/242).Conclusion The low-risk HPV types are the main factors to cause the female vulva CA,a few high-risk HPV types may cause warts as well in tissues of women with vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province.The vulva examine of HPV types should be held to the vulva CA patients.This precaution will has extremely important meaning to the prevention and treatment of the female vulva CA and cervical lesion in our nation.

Objective To study the effect of artesunate on inflammatory responses to severe pneumonia by regulating macrophage migration inhibitory factor (MIF) in rats.Methods Total of 100 SD by random (random number) assigned,20 rats were control group,80 SD rats with severe pneumonia were caused by Klebsiella pneumoniae,60 SD rats were treated with different concentrations (20,40,80 mk/kg) of artesunate after modeling.The pathological changes of lung tissue,the level of MIF myeloperoxidase activity and inflammatory cell infiltration in lung tissue of rats were evaluated.Results After treatment with artesunate,the severity of inflammation was significantly alleviated in rats with severe pneumonia evidenced by decrease in myeloperoxidase activity [severe pneumonia:(17.5 ± 1.5) vs.treatment group:(7.5 ±2.0)] and reduction in inflammatory cell infiltration (severe pneumonia:27 × 106 vs.treatment group:12.5 × 106).Similarly,the artesunate also reduced the production of inflammatory cytokines significantly in bronchoalveolar lavage fluid (IL-1 in severe pneumonia group:(1 100 ± 50) pg/ml vs.treatment group:(400 ± 60) pg/ml;IL-6 in severe pneumonia group:(700-± 30) pg/ml vs.treatment group:(200 ±40) pg/ml;IL-10 in severe pneumonia group:(500 ± 70) pg/ml vs.treatment group:(200 ± 40) pg/ml;TNF-αin severe pneumonia group:(500 ± 80) pg/ml vs.treatment group:(150 ± 50) pg/ml.In addition,artesunate inhibited the level and production of MIF,thus inhibiting the inflammatory responses mediated by MIF.Conclusions Artesunate had a protective effect on pneumonia caused by Klebsiella pneumoniae in rats via inhibiting the inflammation responses mediated by MIF.This study provided a molecular basis for newly developed drugs applied to the treatment of pneumonia caused by Klebsiella pneumoniae in rats.

This article introduced basic information of production composition, health preservation functions and main raw materials of authorized vinum health food. It also made comparison and analysis among vinum health food, medicinal liquor and compound wine on the basis of product orientation, raw materials, and evaluation system. It conducted analysis on turmoil and main problems in health preservation wine market. Combined with the problems in the supervision of health preservation, it proposed the policy suggestions of strehgthening administration of vinum health food and identify the production orientation of vinum health food, medicinal liquor and compound wine from the aspects of raw materials, function claimation and management. It also put forward rational consumption suggestions, with a purpose to offer references to related authorities, researchers, and consumers.