Objective To discuss the clinical value of intercostal arterial embolization for the treatment of hemoptysis.Methods A total of 91 patients with hemoptysis were enrolled in this study.Intercostal arterial embolization was performed using gelatin sponge.The patients were closely observed after the operation.For recurrent cases,re-embolization was carried out after identifying the causes of relapse.Results A total of 111 operations were performed on the 91 patients,including embolization of the bronchial and intercostal arteries in 74 cases,and simple embolization of the intercostal artery in 17.The rate of immediate hemostasis was 98.9%(90/91).The patients were followed up for 8 to 14 months,during which the recurrent rate was 15.4%(14/91).No serious complication occurred during the follow-up.Conclusion By embolizing both bronchial and intercostal arteries,the efficacy of the procedure can be increased and the rate the recurrence decreased,as long as proper measures have been taken to avoid serious complications.

BACKGROUND: The rehabilitative intervention accelerates the recombination and reconstruction of cerebral structure and function and then promotes the amelioration of function.OBJECTIVE: To evaluate the influence of early and late rehabilitative interventions on the motor function and activities of daily living (ADL) with neurologic deficit score (NDS), Fugl-Meyer assessment (FMA) and modified Barthel index in patients with cerebral infarction.DESIGN: A randomized controlled trial.SETTING: Department of Neurology, Qilu Hospital of Shandong University; Department of Rehabilitation, Jinan Great Wall Hospital; Department of Neurology, the Third People' s Hospital of Heze.PARTICIPANTS: Totally 216 inpatients with cerebral infarction (125 males and 91 females, aged 60-75 years), who were selected from Qilu Hospital of Shandong University, Jinan Great Wall Hospital and the Third People's Hospital of Heze from December 2000 to December 2003, were randomly divided into early rehabilitation group (n=108) and late rehabilitation group (n=108) after admission.INTERVENTIONS: In the early rehabilitation group, the patients began to receive rehabilitation at 48 hours to 14 days after the stability of vital signs and absence of the progress of neurological signs. In the late rehabilitation group, the patients began to receive rehabilitation at 15-30 days after attack. They were trained with Bobath method and motor relearning program, once a day, 45 minutes for each time, and 6 times every week.Before and 30 days after the rehabilitative treatment, the rehabilitation was evaluated with modified Barthel index (100 points as normal, 0-20 as extremely severe functional defect, 25-45 as severe functional defect, 50 -70 as moderate functional defect, 75-95 as mild functional defect), FMA (total score was 100 points, including the highest scores of upper and lower limb movement were 66 and 34 points respectively) and NDS (the highest and lowest scores were 45 and 0 point, 0-15 as mild, 16-30 as moderate, 31-45as severe).ter treatment.RESULTS: All the 216 patients with cerebral infarction were involved in obviously lower than that before treatment in both groups (P ＜ 0.01), lower in the early rehabilitation group than in the late rehabilitation group score at 30 days after treatment was obviously higher than that before treat ment in both groups (P ＜ 0.01), higher in the early rehabilitation group than in the late rehabilitation group [upper limb: (32.43±21.52), (26.69±19.79)dex: The modified Barthel index at 30 days after treatment was obviously higher than that before treatment in both groups (P ＜ 0.01), higher in the early rehabilitation group than in the late rehabilitation group [(54.23±30.33),(46.57±29.85) points, P ＜ 0.05].CONCLUSION: Both early and late rehabilitative interventions can obviously accelerate the recovery of neurological function, motor function and ADL, but the effect of early rehabilitative intervention is superior to that of the late one.

Objective To compare the efficacy of sevoflurane-remifentanil and propofol-remifentanil anesthesia in elderly patients undergoing radical gastrectomy for cancer.Methods Sixty ASA Ⅱ - Ⅲ patients aged 65-80 years old with gastric cancer were divided into sevoflurane group(group S) and propofol group (group P), 30 cases in each group.Perioperative hemodynamic variables, bispectral index( BIS ) values and the time of recovery from anesthesia, extubation and awake were recorded as well.Results Compared with those before anesthesia,diastolic blood pressure(DBP),mean arterial pressure(MAP), heart rate(HR) and BItS were signifieanfly decreased (P < 0.05 or < 0.01 ).SBP was higher at cutting skin in group S than that in group P (P < 0.05 ).The depths of anesthesia in both groups were maintained well with BIS in 45-60 and vital signs were stable during operation.The time of recovery from anesthesia, extubafion and awake were shorter in group S [(4.1±2.2),(5.4±2.1),(7.3±2.1)min]thanthoseingroupP [(7.5±3.2),(8.6± 4.2), ( 11.2 ± 4.1 ) min]( P < 0.05 or < 0.01 ).Conclusions Either sevoflurane-remifentanil and propofol-remifentanil anesthesia can be used safely in elderly patients undergoing radical gastrectomy for cancer.Sevotlurane-remifentanil combined with anesthesia provides better hemodynamic stability and faster recovery than propofol-remifentanil combined with anesthesia in elderly patients.

Objective To explore the effect of acupuncture combined with facilitated technique on lower limb function and activities of daily living of stroke patients.Methods 120 stroke patients with lower limb palsy were divided into the group Ⅰ (treated with acupuncture combined with facilitated technique), group Ⅱ (treated with acupuncture), third group Ⅲ (treated with facilitated technique) and the group Ⅳ (treated with medicine). The lower limb function and ADL of four groups were evaluated with Functional Ambulation Classification (FAC), Fugl-Meyer Assessment (FMA), Modified Barthel Index (MBI) before and 10 weeks after treatment.Results The scores of FAC, FMA and MBI of all the groups improved significantly, but it was more significantly in the first group than the in other groups (P<0.01), in group Ⅰ, Ⅱ, Ⅲ than in group Ⅳ (P<0.01). The difference between the group Ⅱ and Ⅲ was insignificantly(P>0.05).Conclusion Acupuncture combined with facilitated technique can improve the lower limb function and activities of daily living of stroke patients more effectively.

To study the pulse diagram parameters of subjects with subhealth state and to find the pulse parameters for subhealth state evaluation.

Purpose To study the clinicalpathologic features,diagnosis,differential diagnosis and prognosis of cervical adenoid basal carcinoma (ABC) for improving further recognition and avoiding the likelihood of unnecessarily aggressive treatment to this disease.Methods Clinical presentations and pathological features of 4 cases of cervical ABC were analyzed by hematoxylin and eosin staining,immunohistochemical EnVision staining and in situ hybridization technology.The relevant literatures were reviewed.Results The age of 4 cases with cervical ABC ranged from 53 to 67 years (mean:61.5 years).All of the 4 patients underwent hysterectomy with bilateral salpingo-oophorectomy.Microscopically,the tumors were composed of small,well-differentiated and uniform basaloid cells and the tumor cells formed rounded nests or cords.The tumor cells arranged in palisading at the periphery of the nests.Some of the nests had central cystic spaces and there may also be focal glandular or squamous differentiation in the centre of the nests.Cervical intraepithelial neoplasia (CIN) lesions were observed in all 4 cases.Immunohistochemically,all the tumor cells were negative for CK7,ER,CEA,CD117 and S-100,while CK5/6,CK8/18,CK19,p16,p53,BCL-2 and p63 were positive.HPV 16/18 DNA were positive by in situ hybridization.The patients remained alive without recurrence and metastasis after follow-up 19 to 62 months.Conclusion ABC of the uterine cervix is a rare neoplasm with excellent prognosis.Differentiation of ABC from adenoid cystic carcinoma,basaloid squamous carcinoma,neuroendocrine carcinoma and adenosquamous carcinoma is important due to their different prognosis.Treatment is predominantly hysterectomy or laser electrocantery excision procedure (Leep).Radiotherapy or chemotherapy is not recommeded.

Objective To investigate the effect of leg cycle ergometer on walking ability of stroke patients with hemiplegia at convalescent period.Methods Seventy patients with hemiplegia after stroke for 3 to 6 months with a certain walking capability were randomly divided into the treatment group and control group with 35 cases in each group.The control group was treated with routine rehabilitation training;the treatment group was added with leg cycle ergometer training.All patients in the two groups were assessed with simplified Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS),ambulation capacity(walking time in 10 meters and walking distance in 6 minutes and Holden's functional ambulance classification),changes of spasticity,and the ability of daily living(ADL)at the time of begin and 6 weeks later.Results The motor function of lower extremity,balance performance,walking capability and ADL of the patients in two groups improved(P<0.05)after 6 weeks' treatment,but the therapeutic effect of the treatment group was better than the control group(P<0.05).Conclusion The application of leg cycle ergometer combined with routine rehabilitation training can distinctly improve the motor function of lower extremity,balance performance,walking ability and ADL for patients after stroke.