Paget's disease of the breast is an uncommon disorder that accounts for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget's disease has been reported in 82% to 100% of cases. The finding of underlying carcinoma reaches almost 100% when a palpable lump is also present. In this rare case, we described a patient presenting with Paget's disease but no palpable lump. However, we found 11 independent regions which were all invasive ductal carcinoma after the operation. Considering this patient, we should pay more attention to a multifocal and multicentric breast carcinoma associated with Paget's disease. Furthermore, we believe the mammography examination and a modified radical mastectomy are the most appropriate treatments for this population in clinical practice.

Objective To observe the effect of the early reinforced control ability training of the trunk and pelvis on the motor function of patients with stroke.MethodsFifty-six patients with stroke were randomly divided into the therapy group and control group with 28 cases in each group. The patients of two groups were treated with regular rehabilitation training, forty-five minutes at a time, twice one day; at the same time the patients of the therapy group were administrated with the control ability training in the trunk and pelvis, twenty minutes at a time, twice one day. The Fugl-Meyer Assessment scale (FMA), the Barthel Index (BI) and functionality ambulation category (FAC) were used to assess the motor function of the patients, before and after the treatment.ResultsTwo months after treatment, there was a significant increasing in the FMA, BI, FAC and hemiplegia gait analysis assessment in the both groups ( P<0.05～0.01), but the walking ability of the therapy group was significantly better than that of the control group ( P<0.05).ConclusionCombined the early reinforced control ability training of the trunk and pelvis with routine rehabilitation training is obvious effect on the motor function of the patients with stroke.

ObjectiveTo study effects of treating acute progressive cerebral infarction by the brain-located mild hypothermia therapy.Methods60 patients were randomly divided into the treatment group (30 cases) and the control group (30 cases). Drugs were used in both groups, and the located mild hypothermia therapy was only applied in the treatment group. After 72 hours and 7 days, the volume of cerebral infarction and the nerve function deficiency (NFD) scores of hemiplegic limbs were compared.ResultsThe volume of cerebral infarction of the treatment group was significantly smaller than that of the control group (P<0.01).There were significant differences on the neurological impairment scores between two groups (P<0.01).Conclusions The brain-located mild hypothermia therapy can reduce hydrocephalus of patients with acute progressive cerebral infarction, and have brain protection. These results provide an important theoretical foundation for the treatment of cerebral infraction with low-temperature therapy.

ObjectiveTo observe the effect of constraint-induced movement therapy (CIMT) combined with motor imagery therapy (MIT) on the upper extremity function of stroke patients with hemiplegia.Methods120 hemiplegic patients caused by brain injury were randomly divided into the control group, CIMT group, MIT group and combined therapy group with 30 cases in each group. The every group was treated with commensurate rehabilitation management respectively, 4 weeks as one course of treatment. All patients were assessed with the Simple Test for Evaluating Hand Function (STEF), the upper limb movement Fugl-Meyer Assessment (FMA), and Modified Barthel Index (MBI) before and after the treatment.ResultsBefore the treatment, there was no significant difference in STEF, scores of upper limb movement FMA and MBI among the four groups ( P>0.05). After the treatment, the STEF, scores of upper limb movement FMA and MBI of the CIMT group and MIT group improved ( P<0.05), that of the combined therapy group were superior to any other group ( P<0.01).ConclusionCIMT and MIT can promote the recovery of upper extremity function of hemiplegic patient, but the better therapeutic effect will be obtained when these two therapies combined.

ObjectiveTo investigate the clinical effects and side-effect of mesenchymal stem cell(MSCs) transplantation on spinal cord injury(SCI),traumatic brain injury(TBI),multiple sclerosis(MS) or Parkinson's disease(PD).MethodsThe bone marrow(222～350 ml) of 11 patients with SCI(n=6),TBI(n=3),MS(n=1) or PD(n=1) were harvested from the patients' ilia and then MNCs were isolated.The MNCs were injected intravenously or into subarachnoid space by lumbar puncture.The neural function and side-effect were observed before and after MSCs transplantation and the patients were followed up.ResultsThe data demonstrated the improvement of sense and motor function in 5 patients with SCI,one had no improvement by 2 months following-up.These patients' sense and motor levels improved obviously.Their muscle strength of lower extremity increased,the muscular tone decreased and urinary bladder function improved.Changes in neurological deficits and improvements in function may appear within 2 days after transplantation,most of them within 2 weeks.There were significantly amelioration in 3 patients with TBI treated with MSCs transplantation,one of them could walk with cane independently after 3 months.One's PVS score elevated from 5 to 8 scales after transplantation.The tremor was alleviated after 1 week,and the muscular tone decreased,which lead to reduce the dose of Madopar after 3 months,in patient with PD.The patient with MS showed no improvement in short time.The side-effect included fever(7/11),headache(2/11) and abdominal dissension(1/11).1 patient feel numb in his legs while injection into subarachnoid,and appeared meningeal stimulation after injection.ConclusionThere were significantly clinical effects in treatment of SCI,TBI,MS,and PD with MSCs transplantation in short time,and with few side-effect. The long-term clinical effects need more observation with larger samples.

Paget's disease of the breast is an uncommon disorder that accounts for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget's disease has been re-ported in 82% to 100% of cases. The finding of underlying carcinoma reaches almost 100% when a palpable lump is also present. In this rare case, we described a patient presenting with Paget's disease but no palpable lump. However, we found 11 independent regions which were all invasive ductal carci-noma after the operation. Considering this patient, we should pay more attention to a multifocal and multicentric breast carcinoma associated with Paget's disease. Furthermore, we believe the mammog-raphy examination and a modified radical mastectomy are the most appropriate treatments for this population in clinical practice.