The control strategy of rehabilitation robots should not only adapt to patients with different levels of motor function but also encourage patients to participate voluntarily in rehabilitation training.However,existing control strategies usually consider only one of these aspects.This study proposes a voluntary and adaptive control strategy that solves both questions.Firstly,the controller switched to the corresponding working modes(including challenge,free,assistant,and robot-dominant modes)based on the trajectory tracking error of human-robot cooperative movement.To encourage patient participation,a musculoskeletal model was used to estimate the patient's active torque.The robot's output torque was designed as the product of the active torque and a coefficient,with the coefficient adaptively changing according to the working mode.Experiments were conducted on two healthy subjects and four hemiplegic patients using an ankle rehabilitation robot.The results showed that this controller not only provided adaptive the robot's output torque based on the movement performance of patients but also encouraged patients to complete movement tasks themselves.Therefore,the control strategy has high application value in the field of rehabilitation.

Objective To explore the influence of family-integrated transition care on the daily living ability of discharged patients with stroke.Methods Seventy-eight patients with stroke who were admitted to Renmin Hospital of Wuhan University from May 2016 to October 2017 were selected by convenience sampling and were divided into a control group and a family-integrated transition care group (hereinafter referred to as transition care group).The patients in the control group received routine neurological health education,while those in the transition care group received a family-integrated transition care intervention in addition to routine neurological health education.The family-integrated transition care included team building,skills training for family members,family-integrated guidance for discharged patients,and regular visits.The scores of the modified Barthel index were compared between the two groups of patients at discharge,three months after intervention,and six months after intervention.Results Among the 71 patients that were finally included,35 cases were included in the control group,of which 17 cases were men (49％),18 cases were women (51％),and their mean age was (70.1±3.7) years;the transition care group comprised 36 cases,of which 18 cases were men (50％),18 cases were women (50％),and their mean age was (69.8±4.5) years.The baseline scores of the control group and transition care group on the day of discharge were (49.1 ± 7.5) and (49.7 ± 7.9),respectively,with no significant difference (P＞0.05).In terms of time effects,the scores of the patients in the two groups had statistically significantly improved at six months after discharge (P＜0.05).In the group comparison,the scores of the patients in the transition care group after the intervention were significantly higher compared to the scores of those in the control group (P＜0.05).In terms of time and inter-group effects,there was an interaction (P＜0.05),and therefore,the influence of time effects was excluded and the same timepoint was compared between the two groups.The scores at three months (63.9±8.8) and six months (76.9± 10.1) in the transition care group were higher than those in the control group (58.1 ±8.1 and 66.0 ±9.3,respectively).The difference was statistically significant (P ＜ 0.05).Conclusion Family-integrated transition care can effectively improve daily living ability and isworthy of promoting.

Objective To investigate feasibility of bowel preparation for colonoscopy in endoscopic ambulatory surgery ward. Methods A total of 352 patients at endoscopic ambulatory surgery ward receiving colonoscopy at Zhongshan Hospital, Fudan University from May 25, 2018 to July 13, 2018 were surveyed by questionnaires. Data of 344 patients, including patient demographics, bowel preparation information and Boston bowel preparation scores and subjective perception of patients were analyzed. Data of 8 others were excluded because they did not complete colonoscopy for the first time due to failure of bowel preparation. Chi-square test and logistic regression analysis were conducted to analyze the quality of bowel preparation and its influencing factors. Results A total of 18. 0％( 62/344) of bowel preparations were inadequate. Morning colonoscopy ( P = 0. 005, OR = 2. 505, 95％CI:1. 312-4. 781 ) and yellow residual last stool before colonoscopy (P=0. 045,OR=0. 475,95％CI:0. 230-0. 982) were independent risk factors for inadequate bowel preparation. Patients' tolerance was 88. 1％(303/344), satisfaction was 77. 9％(268/344), and 54. 9％(189/344) were willing to be hospitalized in ambulatory surgery ward again if necessary. Conclusion Bowel preparation before colonoscopy in endoscopic ambulatory surgery ward is feasible but not optimal.

Objective To compare the cost-effectiveness of non-intubated general anesthesia with conventional general anesthesia for thoracoscopic bulla resection. Methods Sixty patients scheduled for elective thoracoscopic bulla resection, were divided into two groups (30 each) using a random number table: the conventional general anesthesia group (T group) and the non-intubated general anesthesia group (NT group). Patients in group T were induced with conventional general anesthetic, single-lung ventilated after intubation with double-lumen bronchial catheters. Patients in group NT were induced with general anesthesia combined nerve block, and spontaneous breathings were retained. The results of blood gas analysis, anesthesia time, operation time, intraoperative blood loss, time for orientation recovery and modified Aldrete score ≥ 9 minutes were recorded. The intraoperative and postoperative complications, postoperative hospital stay time, VAS and PC A scores 48 h after operation were recorded. Calculate the cost of anesthesia and the total cost of hospitalization. Results Compared with T group, NT group had lower pH value and higher PCO2 at 30 min before and after the thoracic closure, oxygenation index in the NT group increased at 30 min after the thoracic closure (P < 0.05). Compared with T group, anesthesia time, time for orientation recovery and modified Aldrete score ≥ 9 minutes, incidence of postoperative sore throat, postoperative hospital stay time, VAS scores at 6, 12 h and PC A at 48 h after the operation, anesthesia costs, and total hospitalization costs in the NT group were all reduced (P < 0.05). Conclusions Fully considering the safety, compared with the traditional tracheal intubation general anesthesia, non-intubation general anesthesia can not only promote postoperative outcomes but also improve the cost-effectiveness in the patients undergoing thoracoscopic bulla resection.

Objective To investigate the expression and significance of FBXW7 and ENO1 in ovarian serous adenocarcinoma of different grades. Methods Immunohistochemistry was used to study the expression of FBXW7 and ENO1 in 60 cases of ovarian serous adenocarcinoma. The relationship between FBXW7 and ENO1 proteins and the prognosis of ovarian serous adenocarcinoma was analyzed. Results The positive rate of FBXW7 expression was 22. 5％ ( 9/40) in 40 cases of ovarian high grade adenocarcinoma and 10 cases in 15 cases of normal oviduct. The positive rate of FBXW7 expression was 66. 7％ ( 10/15) ,and the difference was statistically significant ( P=0. 003) . The expression of FBXW7 in 20 cases of low grade adenocarcinoma was 5 cases,and the positive rate was 25. 0％( 5/20) . In 15 cases of normal ovarian tissue,9 cases were positive,and the positive rate was 60. 0％( 9/15) . The difference was statistically significant ( P=0. 04) . The expression of ENO1 protein was 27 in 40 cases of high grade adenocarcinoma,and the positive rate of expression was 67. 5％( 27/40) . 5 cases were positive in 15 normal fallopian tubes, and the positive rate was 33. 3％( 5/15 ) . The difference was statistically significant ( P = 0. 024 ) . The expression of ENO1 protein was 15 in 20 cases of low grade adenocarcinoma,and the positive rate of expression was 75. 0％( 15/20) . In 15 cases of normal ovarian tissue,4 cases were positive, and the positive rate was 26. 7％( 4/15 ) . The difference was statistically significant ( P=0. 006) . There was no correlation between the low expression of FBXW7 and the high expression of ENO1 in high grade ovarian adenocarcinoma ( P= 0. 199 ) , but there was a significant correlation between the low expression of FBXW7 and the high expression of ENO1 in low grade ovarian adenocarcinoma ( P<0. 05) . In low grade serous adenocarcinoma,the 5-year survival rates were 44. 4％ and 32. 1％ respectively,with no significant difference ( P = 0. 052 ) . In ovarian high-grade serous adenocarcinoma, the 5-year survival rates of high-expression group and low-expression group were 20. 0％ and 7. 7％, respectively, with no significant difference ( P=0. 097) . In low grade ovarian serous adenocarcinoma,the 5-year survival rate was 7. 4％ in high expression group and 50. 0％ in low expression group ( P=0. 023) . The 5-year survival rates of ENO1 in high-grade serous adenocarcinoma were 0％ and 40. 0％ in high-expression group and low-expression group respectively ( P=0. 001) . Conclusion The low expression of FBXW7 in ovarian adenocarcinoma suggests that FBXW7 may be a tumor suppressor gene in ovarian serous adenocarcinoma, and ENO1 may be an oncogene in ovarian adenocarcinoma. The high expression of FBXW7 in serous adenocarcinoma indicates that ENO1 may be an oncogene,and the survival rate of FBXW7 in serous adenocarcinoma is higher than that in low expression group. The survival rate of the high-expression group was lower than that of the low-expression group. Therefore, they may become a new diagnostic index and therapeutic target for ovarian serous adenocarcinoma.

Since its establishment for 60 years, Department of Burns of the Second Affiliated Hospital of Zhejiang University School of Medicine has grown into a famous regional burn center in China under the leading of the pioneers and through the efforts of several generations. The department has distinctive disciplinary features in burn care, nutritional support, scar prevention and treatments, standard management of chronic wound, and skin tissue engineering research, making positive contribution to the development of burn medicine in China.

[Objective]Discussion on clinical experience and academic ideas of Professor FU Weimin in treatment of viral encephalitis sequela.[ Method] From the etiology and pathogenesis, and the treatment method to expound the clinical experience and academic viewpoints of Prpfessor FU Weimin, summarize his law of characteristic medication and diagnosis thought,and put an example to exemplify that. [Results] Professor FU Weimin is good at treating this disease from phlegm and blood. He believes that the real standard based on six exogenous pathogenic factors or plague pathogen and other than evil not clear, long into the blood collaterals, phlegm heat and blood stasis obstruction, disturbing the brain orifices, are the symptoms of disease;and the virtual caused by the empty brains, heart and kidney failure and the losed senses and deities, are the causative organism. The pathological features are mainly composed of real or virtual inclusions.Treatment with the kaiqiao huatan tongyu methods are the basic principles, combined with tonifying the kidney and marrow, trafficing heart and kidney, which embodies the compatibility characteristics of eliminating pathogen without forgetting the acual. [Conclusion] Professor FU Weimin 's treatment of viral encephalitis sequela is effective, and can effectively control the disease, reduce the recurrence rate and improve patients ' self-care ability and quality of life.It's worthy of our study and promotion.

Objective To observe the influence of low or middle power microwave radiation on tissues adja-cent to titanium alloy implants. Methods Titanium alloy internal fixation plates were implanted into the upper femur of the right side of New Zealand white rabbits, the left femurs served as the control. Then the femurs were exposed to 20, 40, 60, or 80 W of microwave radiation at a frequency of 2450 MHz for 30 minutes, and real-time temperature of the implants and its adjacent muscles were recorded. The nerve conduction study of the sciatic nerve was performed by stimulating the nerve and recording from gastrocnemius in both groups. Finally, all the rabbits were sacrificed and histo-logical studies were performed on nerve and muscle sections. Results Compared to the control limbs, temperatures of limbs with titanium alloy implants increased significantly when exposed to microwave radiation at 60 and 80 W ( P<0.05) but no significant differences were revealed when exposed to radiation at 20 and 40 W ( P<0.05) . For the sciatic nerve conduction, significantly prolonged distal latency of CMAP ( P<0.05) and slower nerve conduction velocity ( P<0.05) were observed in the experimental limbs when exposed to microwave radiation at 60 and 80 W, but the decrease of CMAP amplitude was not significant (P>0.05). Pathological examination showed obvious congestion and bleeding in the intercellular spaces of skeletal muscle cells in the experiment group when exposed to radiation at 60 W, with no ob-vious pathological changes found in the sciatic nerve. However, when exposed to radiation at 80 W, vacuoles appeared in myocytes, the cellular structure was destroyed and the myelin sheath of the sciatic nerve swelled. Conclusion Ex-posure to microwave irradiation at 20 and 40 W, but not 60 and 80 W exerts no adverse effects on nerves and muscles adjacent to titanium alloy internal fixation plates. Consequently, continuous wave microwave irradiation at low powers (20~40 W) is a safer auxiliary treatment for limbs with titanium alloy implants.

Objective:To explore a better practicing scheme of totally implantable venous access ports (TIVAP) maintenance . Methods :From Apr .to Aug .in 2015 ,25 General Surgery nurses in North District of Zhongshan Hospital ,Fudan University , were under a phased quality review of TIVAP maintenance , meanwhile “Nurses Knowledge Questionnaire”and “Patient Questionnaire Notes”were handed ,and complications of patients under maintenance were monitored .Following the standards of JBI ,at first baseline quality maintenance review was practiced ,then evidence‐based scheme was practiced to receive the quality after invitation .Results:After this scheme practiced ,in 5 of 9 standards ,for JBI TIVAP maintenance quality review completing rates were highly increased .Two questionnaires correct rates were improved to some extent .One complication was found in 25 patients in previous baseline quality review ,while after intervention ,no complication was found .Conclusions :The evidence‐based standards of JBI TIVAP maintenance can highly improve nurses , s maintenance skills and patients , self‐management abilities ,reduce the risk of complications ,but it still need to be improved .

Objective To evaluate the efficacy and diagnostic value of NT-proBNP and homocysteine (Hcy) levels in the serum of elderly depression with chronic heart failure. Methods The clinical diagnosis of depression in the elderly patients with chronic heart failure (NYHAⅠ-Ⅳ grade)80 cases (group A)and 50 cases of healthy subjects(group B), NT-proBNP and Hcy levels were detected. Well which were detected in group A,comparative analysis of results before and after conventional therapy. Results The levels of NT-proBNP(u=9.55) and Hcy (u=9.24) was significantly higher in group A than those in group B, the difference was statistically significant (P<0.01). And the levels of NT-proBNP (u=4.83)and Hcy (u=7.65)were significantly lower in group A after treatment than those of before treatment,the difference was statistically significant(P<0.01). Conclusion NT-proBNP and Hcy joint detection can help diagnose depression in the elderly patients with chronic heart failure,and as a short-term effect evaluation.