Objective To analyze the prevalence of lower urinary tract dysfunction in stroke patients in the convalescent stage,its risk factors and the characteristics of urodynamics.Methods One hundred and thirty-one stroke patients in the convalescent stage were included in this study.Their general information,neurological system reviewing and past history were obtained,especially detailed micturitional histories.In patients with urinary symptoms,diagnosis and classification were made and relevant analysis and urodynamic study were performed.Results The prevalence of lower urinary tract dysfunction is 44.3%.The most common symptom was urinary incontinence(frequency,urgency and nocturia)followed by hesitancy,straining and urinary retention.The incidence of micturitional disturbance is higher 1.8 times in cognitive disfunction group than normal cognitive function group(χ~2=18.683,P=0.000);it was higher 1.2 times in patients with modified Bathel index scale≤20 than those with≥25(χ~2=16.832,P=0.000).Logistic multivariate analyses suggested that age(OR=1.622,95%CI 1.183-2.224),the during of urethral catheterization(OR=3.236,95%CI 1.335-7.840)and single or multiple lesions (OR=1.296.95%CI 1.083-1.550)to be the risk factors of lower urinary tract dysfunction at the convalescent stage in stroke patients.The urodynamics study found detrusor over activity in 78.5% patients,normal in 10.5%and detrusor areflexia in 10.5% patients.There was no detrusor-sphincter dyssynergia.Conclusions Lower urinary tract dysfunction is common after stroke with the storage symptoms to be the most common.Patients with lower urinary tract dysfunction show impaired cognitive function and poor ability in daily life.Age,during of urethral catheterization and single or multiple lesions are among risk factors of lower urinary tract dysfunction.Detruser overactivity is the most common finding in urodynamic study.Because the clinic symptoms are not often in accordance with the findings in urodynamics study,further urodynamics study are needed to benefit the treatment.

As a kind of abnormal phenomena,mirror movement occurred after both stroke and Parkinson's disease,and influence the rehabilitation prognosis was uncertain.Recently,bilateral training has been used in the stroke patients and showed some effect.

Objective To investigate the effect and safety of a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone on treatment of moderate and severe IgA nephropathy (IgAN).Methods Fifty-seven patients with IgAN confirmed by biopsy combining with clinical presentations were enrolled,with their ages ranged from 15 to 55,proteinuria excretion ≥ 1.0 g/24 h,serum creatinine (SCr) ≤ 265.20 μmol/L,grade Ⅲ or above in Hass histologic grading systems for renal biopsy.The patients were randomly divided into trial group( n =28 ) and control group( n =29 ) and received treatment for six months.The patients in trial group were treated with a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone,while those in control group were treated with prednisone and fosinopril.Results ( 1 ) After 6 months of treatment,the rates of complete remission (CR) and partial remission (PR) were 52.0％ and 40.0％ respectively in trial group,and 20.8％ and 54.2％ respectively in control group.The total remission rate(TR)and CR in trial group were significantly higher than those in control group ( TR x2 =0.47,P ＜ 0.05 ; CR x2 =5.11,P ＜ 0.05 ).( 2 ) The SCr level was decreased in trial group ( [ 115.83 ± 16.78 ] μmol/L v.s.(93.29 ±12.41 ) μmol/L,P ＜ 0.05 ),while increased in control group ( [ 112.79 ± 12.79 ] μmol/L v.s.( 136.99 ±25.97 )μmol/L,P ＜ 0.05 ).The two groups had significant difference on SCr clearance rate after treatment( P ＜0.05).There was no significant difference between the two groups on the endogenous creatinine clearance rate (Ccr) ( P =0.52 ),and no significant difference within trial group ( [ 79.34 ± 6.09 ] ml/min v.s.[ 85.12 ±12.26] ml/min,P =0.05)and within control group( [80.18 ±6.51 ] mi/min v.s.[84.22 ±8.39] ml/min,P =0.67 ).The levels of 24-hour proteinuria excretion after 6 months were decreased in both groups ( trial group:[1.93 ±0.55]g/24 hv.s.[0.78 ±0.42]g/24 h,P＜0.05;control group:[1.85 ±0.51]g/24 h v.s.[1.30±0.35 ] g/24 h,P ＜ 0.05 ),and the treatment effect was better in trial group ( P =0.04 ).Conclusion Treatment of moderate and severe IgA nephropathy with low-dosed urokinase combined with fosinopri plus leflunomide and prednisone is effective and safe by improving renal function and decreasing proteinuria.

Objective To investigate the value of CD5 molecule-like protein(CD5L) and partial pressure of CO2 in arterial blood(PaCO2) in predicting the survival of patients with severe asthma and mechanical ventilation.Methods From Jan.2013 to Jan.2016,a total of 38 patients with severe asthma and mechanical ventilation were enrolled.Acute Physiology and Chronic Health EvaluationⅡ(APACHE II)were used to assess the severity.Enzyme linked immunosorbent assay was used to detect serum levels of CD5L at admission and 6 h after treatment.PaCO2 were also detected.Pearson correlation analysis was used to analyze the correlation between APACHEⅡ score and CD5L and PaCO2 levels.Receiver operation characteristic(ROC) curve was used to evaluate the value of CD5L and PaCO2 in predicting the survival of patients.Results APACHEⅡscores of survival patients were significantly higher than dead patients(P<0.05).CD5L level of survival patients after treatment was significantly lower than dead patients,while PaCO2 level was significantly higher(P<0.05).APACHEⅡ score was negatively correlated with serum CD5L level(r=-0.347,P<0.05),while positively correlated with PaCO2 level(r=0.573,P<0.05).ROC curve analysis showed that serum CD5L and PaCO2 were with predictive value for prediction the survival of patients,with sensitivity of 93.33%,specificity of 75.00%,accuracy of 89.47%,positive predictive value of 93.33%,and negative predictive value of 75.00% for CD5L,and those for PaCO2 were 90.00%,87.50%,89.47%,97.42% and 70.00%.Conclusion With the decreasing of CD5L level and increasing of PaCO2 level,severity of disease in patients with severe asthma and mechanical ventilation could be more serious condition,indicating poor prognosis.CD5L and PaCO2 could be with fine predictive value of survival of patients with severe asthma and mechanical ventilation.

Objective: To observe the effect of sequential colon dialysis in patients with chronic renal failure(CRF) in early and medium stage.Methods: One hundred and forty-two CRF patients in early and medium stage were treated with sequential colon dialysis and traditional Chinese medicine according to(traditional) Chinese medical syndrome differentiation and typing,and clinical syndromes were observed.(Sixty-three) patients with CRF were selected as controls treated with low protein diet plus essential amino acids.The serum levels of blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),the creatinine(clearance) rate(CCr),electrolyte and medium molecular substance(MMS) were measured before and after treatment.Results: The clinical symptoms of the 142 patients were improved,the serum levels of BUN,Cr,UA and MMS were decreased significantly(BUN:(15.3?4.5)mmol/L vs.(8.6?3.3)mmol/L;Cr:((443.6?73.5)?mol/L) vs.(283.5?38.7) ?mol/L;UA:(512.6?86.5)?mol/L vs.(243.1?33.6)?mol/L;MMS: 0.44?0.06 vs.0.32?0.04),and CCr increased markedly((9.87?3.31)ml/min vs.(15.60?(4.63)ml/min)).The difference between treatment group and control group was significant.The changes in electrolyte levels were not significant before and after treatment in both groups.Conclusion: Sequential colon dialysis has obviously curative effects on CRF patients in early and medium stage,and could ameliorate the(develope) of CRF in early and medium stage.

Objective To explore the risk factors of shoulder-hand syndrome after first onset of the stroke. Method The likely related factors of the post-stroke shoulder-hand syndrome of 103 patients who suffer from stroke within first 3 months during January 2001 to April 2003 were regressively analyzed. Results The incidence of the post-stroke shoulder-hand syndrome is about 30.1%. The results showed that shoulder subluxtion and age are two independent risk factors. Conclusion Shoulder-hand syndrome is a common complication occurring within 3 months after stroke. It is nesessary for clinicians to pay more attentions to these factors and to take preventive procedure at early stage in order to reduce the incidence as much as possible.

ObjectiveTo analyze the prevalence of urinary incontinence in stroke patients in the convalescent stage, and the characteristics of different type of incontinence. Methods176 stroke patients in the convalescent stage were classified as urinary incontinence and continence, the former were classified as with and without awareness of the need to void. Their features were reviewed. ResultsThe incidence of urinary incontinence was 26.1%. No differences were observed for sex, types, and locations of the focus. There was statistic difference of the single/multiple lesions between the incontinence and the continence （P<0.05）. There was statistic difference in parietal lobe lesions and cognitive dysfunction among the patients with and without awareness of the need to void （P<0.05）. ConclusionThe urinary incontinence in stroke patients in the convalescent stage tend to occur in the patients with multiple lesions, and those without awareness of the need to void is associated with parietal lobe and the cognitive dysfunction.

Objective To explore the characteristics of hemiparetic gait for stroke patients. Methods 49 stroke patients were allocated to two groups: experimental group (n=33) received 3D-video gait analysis, and control group (n=16) received the gait analysis with ankle-foot orthosis (AFO). The kinematic parameters were compared between two groups, and the experimental group with normal gaits. Results Compared with the normal gaits, the step, stride, step frequency, gait velocity, and the percentage single support in gait cycle decreased significantly,and gait width, and the percentage in gait cycle of double support increased significantly in the experimental group (P<0.01). There was no significant difference in kinematic parameters beween the experimental group and the control group (P>0.05). Conclusion The major kinematic characteristics of hemiparetic gait are slow velocity, long cycle, relative decrease of single support of weak limb, and increase of double support.

Objective To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke disfunction of cognition and memory by stimulating right dorsolateral prefrontal cortex. Methods 40 patients were randomized into the rTMS (n=19) and sham (n=21) groups. The function of cognition and memory were measured before treatment, after treatment and 2 months post-treatment with Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and Rivermead Behaviour Memory Test (RBMT). Results All scores improved in both groups after treatment and 2 months post-treatment (P< 0.001), and improved more in the rTMS group than in the sham group (P<0.01). Conclusion Low-frequency rTMS may improve the function of memory and cognition after stoke.

Objective To explore the associated factors influencing the prognosis of upper limb function and ability of activities daily living(ADL)in stroke patients with left side hemiplegia.Methods 64 stroke patients with left side hemiplegia were treated regularly last for 1 month.At admission,the assessment procedure for cognitive function were performed with scales of Mini-Mental State Examination(MMSE),Loewenstein Occupational Therapy Cognitive Assessment(LOTCA),Motor Impersistence(MI),Schenkenberg Line Bisection Test.Brunnstrom stage,Modified Barthel Index(MBI),Ueda,Bin Hemiplegic Finger Function Assessment Scale,Upper Limb Function Assessment Scale were graded for the upper limb function and ADL ability before and after training.The multinominal logistic regression analysis was used to analyze the relationship between those factors and the upper limb function and ADL ability.Results The extent of resumption of upper limb function of patients was positively correlated with the ability of formal operational thinking(P<0.01)in LOTCA score before training.However,the extent of resumption of hand was negatively correlated with MI score before training(P<0.01).The extent of resumption of the hand practicability was positively correlated with the ability of operational thinking and score of ADL in LOTCA before training(P<0.01).The extent of the resumption of ADL was positively correlated with the ability score of operational thinking in LOTCA and diseased region.It was negatively correlated with the score of Schenkenberg line bisection(P<0.01).Conclusion The ability of operational thinking in LOTCA before training and the scores of Schenkenberg line bisection,ADL and MI are helpful in prognosis for the upper limb function in stroke patients with left side hemiplegia.