Objective:To investigate the impact of group-based rehabilitation exercise on motor and non-movement symptoms of Parkinson's disease(PD).Methods:A total of 88 patients from out-patient and in-patient services at our hospital were randomly assigned to an early exercise group(E-EG), a late exercise group(L-EG), and a control group(CG)using a randomized delayed-start design.Patients in the E-EG carried out a rigorous, formal group exercise program, one hour per session, twice per week, for 18 months(May 2018-November 2019). Patients in the L-EG took part in the exercise program in the final 6-12 months of the study.We assessed outcomes using the Unified Parkinson's Disease Rating Scale(UPDRS), Parkinson's disease questionnaire-39(PDQ-39 Q), trail-making test part A & B, nine-hole peg test(9-HPT), 30 second sit to stand test(30s SST), 10 m walk test(10 m W), mini-balance evaluation systems test(Mini-BEST), Fullerton Advanced Balance(FAB)Scale and time up and go(TUG)test.Results:Compared with pre-exercise levels, patients with PD in the E-EG had lower performance in UPDRS(17.5±8.3 vs.20.0±8.6, t=-2.2, P=0.02)and lower performance in PDQ-39(27.2±2.1 vs.29.0±9.8, t=-2.6, P=0.001)after exercise.Moreover, compared with pre-exercise levels, patients with PD in the E-EG showed decreased post-exercise performance in trail-making test part B(114.2±25.5 vs.129.8±28.4, t=-2.3, P=0.02)and in 9-HPT(33.7±7.3 vs.39.6±9.3, t=-2.6, P=0.001). Conclusions:The practice of group-based rehabilitation exercise can improve movement abilities and quality of life in PD patients, especially if implemented early.Targeted rehabilitation exercise should be taken as part of the treatment strategy for PD patients as early as possible to deliver the best benefits.

Objective:To summarize the institutional experiences of treating vascular complications caused by donor-derived infection(DDI)after kidney transplantation(KT).Methods:From January 1, 2015 to December 31, 2020, clinical data were retrospectively reviewed for 6 cases of vascular complications caused by DDI.Age, gender, surgical approaches, immunity induction therapy, immune suppression therapy, infection prevention, onset time of complication, type of complications, infection pathogens, therapeutic protocols and prognoses were summarized.Results:Six patients developed vascular complications caused by DDI in 997 KT recipients with an overall morbidity rate of 0.6%.In 3 cases, carbapenem resistant Klebsiella pneumoniae were positive in culture of secretion and blood samples.And Candida albicans was detected by blood cultures and pathological examinations.One case of antibiotic resistant Staphylococcus aureus was detected by blood culture.Among 3 cases of transplant kidney artery pseudoaneurysm on interventional therapy, there were curing(1 case)and immediate recurrent infection(2 cases). The latter two eventually died by cardiac complications.In 2 cases of arterial hemorrhage, graft nephrectomy was followed by hemodialysis.One case of transplanted renal artery stenosis was successfully cured by artery stenting and survived with normal graft function so far.Conclusions:Interventional endovascular therapy and open surgery are indicated for vascular complications caused by DDI post-KT.Interventional therapy may boost the odds of rescuing transplant kidney.However, clinicians should watch out for the risk of recurrent infection.Open surgery is an effective tool of eliminating infected focus.Preserving transplant kidney or nephrectomy may be adopted on the basis of specific conditions.

Objective: To investigate the clinical experience of patients with novel coronavirus (2019-ncov) infection after kidney transplantation. Method: Clinical data of two patients with 2019-nCoV infection after renal transplantationin Jan 2020 Renmin Hospital of Wuhan Universiyt were retrospectively analyzed.Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months after transplantation. CT imaging showed multiple patchy ground-glass images of both lungs. Case 2 was a 59-year-old male, who was screened positive for 2019-nCoV nucleic acid due to fever at 9 days after renal transplantation and showed no clinical manifestations of pneumonia. After diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium + linezolid to resist infection, gamma globulin to enhance immunity function, methylprednisolone to control inflammatory response, antiviral regimens including arbidol tablets + lopina-velitonavir tablets. Case 2 was treated with isolated treatment in a single room. The treatment plan included anti-infection (cefoperazone sulbactam sodium), enhancing immunity function (gamma globulin), antivirus therapy with arbidol and other symptomatic treatment. Result: Follow up with 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test with nasopharyngeal swabs turned negative, and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms, and the nucleic acid test of nasopharyngeal swabs turned negative for 3 times. Conclusion Renal transplant recipients should receive fine protection to avoid exposure to high-risk environments. Diagnosis should be defined with combination of clinical manifestations, nucleic acid test and pulmonary imaging. At present, there are no antiviral drugs and symptomatic treatment is the main choice.

Objective:To summarize the clinical experiences of managing patients with novel coronavirus(2019-nCoV) infection after kidney transplantation.Methods:Clinical data were retrospectively analyzed for two patients with 2019-nCoV infection after renal transplantation in January 2020. Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months post-transplantation. CT imaging showed multiple patchy ground-glass opacities of both lungs. Case 2 was a 59-year-old male who screened positive for 2019-nCoV nucleic acid due to fever at 9 days post-transplantation and he showed no clinical manifestations of pneumonia. After a definite diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium plus linezolid for anti-infection, gamma globulin for enhancing immunity, methylprednisolone for controlling inflammatory responses and antiviral regimens of arbidol tablets plus lopina-velitonavir tablets. Case 2 was isolated in a single room. The treatment plan included cefoperazone sulbactam sodium for anti-infection, gamma globulin for enhancing immunity, arbidol for antiviral therapy and other symptomatic measures.Results:During a follow-up period of 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test of nasopharyngeal swab turned negative and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms and nucleic acid test of nasopharyngeal swab turned negative thrice.Conclusions:Renal transplant recipients should take precautions to avoid exposure to high-risk environments. A definite diagnosis should be made on the basis of clinical manifestations and results of nucleic acid test and pulmonary imaging. Currently there is no effective antiviral agent and symptomatic treatment is a major option.

Objective:To investigate the types of cervical epithelial cells and the Human Papillomavirus (HPV) infection subtypes of 7 646 women specimens in Anhui province, and provide evidence for cervical cancer prevention.Methods:Thinprep cytologic test (TCT) and flow fluorescence hybridization technique were used to detect cervical epithelial lesions and HPV subtypes.Results:The total positive rate for TCT was 20.25%, and the positive rate was the highest in ≥ 60 age group (28.41%), followed by 10 to ≤ 19 age group (26.32%). The atypical squamous cells-undetermined significance (ASC-US), cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and HSIL positive rates were the highest in the ≥60 age group, and the low-grade squamous intraepithelial lesions (LSIL) positive rate was highest in the 10-19 age group. The proportion of patients with 40-49 age group was the highest, and that of ≥60 age group was the highest. The single infection rate of different cervical epithelial cell lesions was higher than that of multiple infection rates. As the deepening degree of the lesion, the high-risk single infection rate of HPV showed a increasing trend from ASCUS, LSIL, ASC-H to high-grade squamous intraepithelial lesions (HSIL); The common subtypes of HPV infection in negative for intraepithelial lesion or malignancy (NILM) are 52, 16, 58, 53 and 6. The common subtypes of ASCUS are 52, 16, 53, 58 and 51. The common subtypes of ASC-H are 18, 58 and16. LSIL common subtypes are 16, 52, 56, 58, 53 and 66, HSIL common subtypes are16, 58, 33, 52 and 59 type.Conclusions:The high risk and single genotypes of infection were dominant in different cervical epithelial cell lesions in Anhui. Women who aged ≥60 should pay attention and regularly undergo HPV testing and cervical cancer screening. The HPV infection subtypes of different cervical epithelial cell lesions are different, and the common subtypes are HPV52, 16, 58, 53, among which types 16, 58 and 33 are common infection subtypes detected in different lesions.

At present, there still exist some limitations in the laparoscopic surgery robot represented by da Vinci surgical robot, such as the lack of force feedback function. Doctor can not feel the force feedback while operating. In this paper, a new minimally invasive laparoscopic surgery robot system is designed. Based on the master side surgeon's console, stereo vision subsystem and the slave side surgical cart, the multi-dimensional instrument force feedback technology and force feedback based safety protection strategy are introduced. The design realizes the force sensing function of full state operation. Besides, a number of different live pig experiments are carried out. The amount of bleeding in these experiments is relatively small compared with the data of the same kind of surgical robots, which effectively validates the force feedback and surgical safety protection strategies of the new robot system.
Animals ; Equipment Design ; Laparoscopy ; instrumentation ; Minimally Invasive Surgical Procedures ; Robotic Surgical Procedures ; instrumentation ; Robotics ; Swine

Objective: To explore the diagnosis and treatment of BKV nephropathy after renal transplantation. Methods: A total of 62 patients with progressive creatinine elevation were routinely examined by blood and urine BKV-DNA. And 21 patients with positive results underwent graft biopsies for confirming a diagnosis. Results: Among 21 cases of BKV infection, 20 cases received leflunomide in replacing mycophenolate mofetil (MMF) and a lower dose of tacrolimus. One case with urine (-) & blood (+ ) received sirolimus in replacing tacrolimus and a lower dose of MMF. Among 11 cases with urine (+ ) and blood (-), urinary BKV-DNA turned negative & creatinine decreased markedly (n=4), urinary BKV-DNA load decreased & creatinine stablized (n=4), death from pulmonary infection with hepatic & renal failure (n=1), urine BKV-DNA load decreased & creatine increased (n=1), BKV–DNA load was not re-examined in 1 case of acute rejection and hydronephrosis with elevated creatine; Among 9 cases with urine (+ ) & blood (+ ), blood BKV-DNA turned negative with urinary BKV-DNA load & creatine decreased (n=6), blood BKV-DNA load decreased & creatine stablized (n=2) and no re-examination with a stable level of creatine (n=1); One case with urine (-) & blood (+ ) was not timely treated and ultimately leading to graft loss after an onset of acute rejection. Conclusions BKV nephropathy may be effectively treated by decreasing immunosuppressive intensity. However, clinicians should stay on a high alert for acute rejection due to an excessive reduction of immunosuppressive agents.

Objective To summarzie the experiences of kidney transplantation from rhabdomyolysis.Methods The surgical procedures and treatment protocols of the kidney transplantation in 3 cases from DD donors who suffered from anuria due to rhabdomyolysis were retrospectively analyzed.Results Three recipients were donated by two donors.When the blood of kidneys is washed out,the color of the kidneys was brown,and when the kidneys restored the blood perfusion,the transplanted kidneys were dark brown.All of these 3 cases had delayed renal function,and 2 recipients who received the kidneys from the same donor secreted the urine 3 weeks after surgery.The creatinine gradually decreased,and they discharged when the renal function was normal.The urine volume in the another recipient was 3000 ml or more per day in the first two days,gradually decreased from the third day,until anuria.We conducted an exploration of the transplanted kidney due to the area of transplantation uplift.We found that the kidney was bright red during the operation,the hematoma was removed and hemostasis was done,the urine volume gradually increased from one week after surgery,and the creatinine levels gradually decreased.After two months the creatinine levels were 103μmol/L.Conclusion For the patients with rhabdomyolysis,their kidneys can be transplanted after active preservation,evaluation of the donor kidney function and blood flow,and the short-term outcome is satisfactory.

Objective To analyze the reasons and outcomes of the unplanned re-operation in renal transplant recipients during perioperative period,and to summarize the corresponding strategies.Methods From January 2014 to September 2017,the clinical data of 20 cases of kidney transplantation which had a total of 22 unplanned re-operations were retrospectively analyzed.All patients were given quadruple immunosuppression with antibody induction and tacrolimus (TAC) and mycophenolate mofetil (MMF) plus prednisone (Pred).We analyzed the reasons,occurrence time,effect of re-operation and the renal function,as well as survival rate of all graft and recipient.The delayed graft function (DGF),acute rejection (AR) and incidence of pulmonary infection were monitored as well.Results Up to September 2017,during the follow-up of 1-36 months,the overall rate of unplanned re-operation was 4.6％,and 2 patients underwent 3 operations.For the reasons of re-operation,there were 18 cases of bleeding (13 cases of blood oozing from the wound surface,3 cases of renal parenchyma rupture because of rejection,and 2 cases of rupture of renal artery infection),2 cases of renal artery thrombosis and 2 cases of the repair of leakage of urine.Two operations were performed within 1 days for 9 cases,2-5 days for 5 cases,6-10 days for 3 cases,above 10 days for 45 cases.There was no deaths during the perioperative period.One patient died of rupture of exiliac aneurysm 3 months after the operation.One patient died of cerebral hemorrhage 6 months postoperation.The death censored graft survival rate was 72.2％ (13/18) and the incidence of DGF was 55 ％.Conclusion The major reason of unplanned re-operation for renal transplantation is associated with bleeding of various causes.And the incidence of DGF is high.If the secondary operation was performed with the correct decision,the kidney allograft recovers well.

Objective To observe the short-term curative effect and toxicity reactions of elemene in combination with three-dimensional conformal radiotherapy for advanced esophageal cancer.Methods A total of 57 patients with advanced esophageal cancer were divided into radiotherapy group (28 cases) and elemene combined with radiotherapy group (29 cases).The control group was given conventional irradiation,and the treatment group received intravenous infusion of elemene on the basis of the control group.Changes of clinical symptoms were recorded.Results The effective rates in the control group and the treatment group were 60.7％ and 75.9％,respectively,when follow-up at the 8th week after radiotherapy (P ＜ 0.05).The patients of 2 groups were generally well tolerated,no grade Ⅳ toxicity occurred.Conclusion The efficacy of elemene combined with threedimensional conformal radiotherapy in the treatment of advanced esophageal cancer is better than radiotherapy alone,and it is safe and effective and had fewer side effects.