Objective To investigate the effects of respiratory training on motor function in patients with acute stroke. Methods From 2012 to 2014, 80 patients with acute stroke were randomly assigned into treatment group and control group equally. The control group re-ceived routine rehabilitation training, while the treatment group received respiratory training in addition. All the patients were assessed with Fugl-Meyer Assessment (FMA) and modified Bathel Index (MBI) before and eight weeks after treatment. Results The scores of FMA and MBI improved more in the treatment group than in the control group (t>3.938, P<0.001) after treatment. Conclusion Respiratory training may promote the recovery of motor function in acute stroke patients.

Objective:To search for the optimum formula for the self emulsification of evening primrose oil. Methods: Through solubility experiment, orthogonal screen and drawing phase diagram, taking the degree of emulsifying, the volume of the rest oil and emulsion particle size as parameters,the oil, non ionic surfactant and flux for the optimum formulation were screened. Results: In the formulation of evening primrose oil, taking Tween 85 as the non ionic surfactant and propylene glycol as the co surfactant can get the best effect of emulsifying. Conclusion: The optimum formula for self emulsification of evening primrose oil is evening primrose oil, Tween 85 and propylene glycol,with their proportion being 5∶7∶3.

Acute traumatic central cord syndrome ( ATCCS) is the most common incomplete cervical spinal cord injury .Its di-agnosis mainly depends on the mechanism of injury , physical signs and imaging examination .The main treatment method is conserva-tion or surgery.Here we reviews the progress of its pathogenesis , pathophysiological changes , and surgical treatment advances .

BACKGROUND:Infection is the catastrophic complication after total hip arthroplasty, moreover, its diagnostic criteria has not been unified, and treatment options were also controversial. The removal of the focus of infection was complete or not determines whether the joint could be reconstructed and the joint function could be restored. OBJECTIVE:To analyze the experience and efficacy of thorough debridement in two-stage revision surgery for treatment of infection after hip arthroplasty. METHODS:Total y 23 (24 hips) patients with infection after hip arthroplasty were treated at the Department of Orthopedics, Nanjing General Hospital of Nanjing Military Area Command of PLA from August 2008 to January 2013. The diagnostic criteria were in line with consensus. The repair options defined as two phrases:the first phrase was thorough debridement plus antibiotic-containing bone cement implanted with intervals;the second phrase was joint reconstruction. If the infection persisted in interval, debridement could be repeated, and then underwent joint reconstruction after the thorough control of infection. Harris scores of hip function were determined after revision during fol ow-up. Infection control condition was evaluated. RESULTS AND CONCLUSION:Al the patients were fol owed up, ranged from 1 to 5 years. The Harris scores increased from an average of 36.5 (27-45 scores) before treatment to an average of 88.6 (76-98 scores) after treatment. There was no infection recurrence. Infection control rates reached to 100%. These results suggest that two-stage revision is an effective method for treatment of infection after total hip arthroplasty. Thorough debridement plays a crucial role, and it can effectively control infection recurrence, improve prosthesis stability, so as to reconstruct joint function.

ObjectiveTo discuss the diagnosis and treatment of spontaneous carotid artery dissection (SCAD).Methods Clinical diagnosis and treatment data of 9 patients with SCAD were analyzed retrospectively.ResultsVascular ultrasound showed stenoses or occlusions of carotid artery.Angiography showed “flame-shaped ” sign in totally occluded proximal section and free intimal flap in stenoses section.One patient with total occlusion of bilateral internal carotid artery and 6 patients with total occlusion of unilateral internal carotid artery were treated with antiplatelet therapy.Two patients with incomplete occlusion of the carotid were operated with stent implantation in carotid arteries,and the clinical effect of both operations was satisfactory.ConclusionAngiography remains the gold standard in diagnosing SCAD,and stent implantation is an effective treatment of this disease.

Objective To assess follow-up work status for the patients with breast cancer and analyze the impact factor of the follow-up rate.Methods 331 female patients with complete clinical data in diagnosis and treatment with breast cancer from December 2006 to November 2008 in Shanxi Cancer Hospital were follow-up investigated by telephone.With Logistic regression method,the analysis was preformed on the impact related factors of follow-up effect.Results Telephone follow-up rate was 82.8 ％ (274/331).There was significant difference on the long-term residence between follow-up group and missing group (Fisher exact probability method,P =0.045),the results of regression analysis showed that follow-up results were influenced by the patient's occupation (β=-0.279,s-x =0.116,Wald =5.806,P =0.016,OR =0.757,95 ％ CI 0.603-0.949).Conclusion The telephone investigation for breast cancer patients is an important way for postoperative follow-up.The occupation of patient might influence the investigate results.

BACKGROUND:Previous studies of our research group have confirmed that the texture of porcine reticular dermis at lateral ventral part is softer and has more extensibility than other parts. Therefore, it may serve as the raw material of xenogenic aceluar dermal matrix. However, its comparison with human and rat reticular dermis has not been reported systematicaly in aspects of histomorphology and material characterization. OBJECTIVE:To compare the reticular dermis from the lateral region of porcine abdomen and rat dorsal part with the reticular dermis from human in histology, biomechanics, molecular structure, thermal stability and other properties. METHODS:The reticular dermis samples were taken from adult human, the lateral region of porcine abdomen, the back of rats, for gross observation. Paraffin sections were observed by hematoxylin and eosin staining and sirius red staining under a light microscopy. The relevant data of micrograph were measured by imagine analysis software. These samples were also vacuum-freezing dried and rehydrated, and then their mechanical properties were tested with a electronic tensile machine to calculate the Young’s modulus. Some vacuum-freezing dried samples were powdered and detected by Fourier transform infrared spectrometer and simultaneous thermal analyzer. RESULTS AND CONCLUSION:There were no differences in colagen fiber bundle diameter of the reticular dermis from adult human and the lateral region of porcine abdomen, but the reticular dermis from the back of rats was thinner than that from adult human (P < 0.01). The gap between the reticular layer of the dermis of the lateral region of porcine abdomen was lower than that from adult human (P < 0.0.1); however, there was no difference in the gap between the reticular layers of the dermis of the rat back and adult human (P=0.17). Colagen fibers of porcine reticular dermis were arranged tightly in disorder; the content of type I colagen and ratio of type I/III colagen were higher than those in the reticular dermis from adult human (P < 0.05), but the content of type III colagen was less than that in the reticular dermis from adult human (P < 0.05). Contents of type I and III colagen and their ratio were similar between the reticular dermis of rats and adult human (P > 0.05). There was no significant difference in the Young’s modulus of the three kinds of reticular dermises. Hydrogen bonds involved in the reticular dermal colagen molecules ranged as folows: rats > swine > human. Rat reticular dermis has better thermal stability than that of swine and adult human.

Objective:To compare the clinical effects of high volume zero-balanced ultraifltration (ZBUF) with different replacement lfuid in infant patients.
Methods: A total of 40 infant patients who received aortic coarctation with deep hypothermic circulatory arrest operation in our hospital from 2012-11 to 2014-02 were summarized. The patients were randomized into 2 groups, Group A, the patients had ZBUF with plasmalyte A, n=21 and Group B, the patients had ZBUF with modiifed replacement lfuid n=19. All patients received ZBUF (15-20) ml/kg during re-warming period until the temperature reached 34°C at rectum. Blood gas analysis were conducted at 4 time points as T1 (before CPB), T2 (open ascending aorta and 5 min after calcium perfusion), T3 (ifnishing ZBUF) and T4 (end of CPB). The intra-operative CPB time and the post-operative recovery with the complication were recorded in all patients.
Results: For blood gas analysis, the calcium concentration was higher in Group B than that in Group A at T3 time point, P<0.01 and the base excess was higher in Group A than that in Group B at T3 time point, P<0.05. Those indexes were similar at T1, T2 and T4, all P>0.05. The other indexes were similar between 2 groups, P>0.05 and the post-operative recovery was similar between 2 groups, P>0.05.
Conclusion: ZBUF with modiifed replacement lfuid could avoid decreased calcium concentration and acidosis, therefore, provide a relative stable homeostasis in infant patients.

OBJECTIVE To study the cause of bacterial infection of ventilator-associated pneumonia(VAP) in intensive care unit(ICU) and summarize effective methods to prevent and control the infection.METHODS Epidemiologic study on 300 patients with VAP in ICU from Dec 1,2003 to Jul 13,2006.Preventing and controlling strategy was as follows.RESULTS Pathogenic bacteria of VAP in ICU mostly were multidrug-resistant ones,of which the G-were 56.3%,G+ were 23% and fungi were 13.7%.CONCLUSIONS To control VAP in ICU proper technique and method are important.Management of hospital infection and related training of staff in ICU are the basic way.

Objective:Analyze the perioperative data of children undergoing cardiopulmonary bypass(CPB) for congenital heart disease under the management of ultra-fast track anesthesia(UFTA), the factors of CPB are discussed.Methods:1 034 children who underwent CPB from May 2018 to August 2019 were analyzed retrospectively. According to the success of anesthesia, they were divided into two groups: UFTA group and UFTA failure group. Propensity score matching was used to screen the children with preoperative baseline data matching. Finally 346 cases in each group. The possible CPB factors of the two groups were analyzed by single factor analysis, and the statistically significant factors were analyzed by logistic regression analysis. Results:Univariate analysis showed that the CPB and aortic occlusion time, the lowest temperature and lowest hematocrit in CPB, the dosage of crystalloid and suspended erythrocytes, the second or more times of CPB, and the blood lactate after CPB were the factors influencing the ultra-fast track anesthesia. Logistic regression analysis showed that the time of CPB and aortic occlusion, the value of blood lactate, the dosage of suspended erythrocytes, and the second or more times of CPB were the independent influencing factors of ultra-fast track anesthesia. In the UFTA failure group, the postoperative hospitalization time, the length of stay in the ICU and the hospitalization cost were all higher than those in the ultra-fast track group. Conclusion:CPB time, aortic occlusion time, blood lactate after CPB, the dosage of suspended erythrocytes, secondary or multiple CPB were independent risk factors for UFTA.UFTA is beneficial to shorten the postoperative hospital stay, the ICU stay and the cost of hospitalization.