Objective: To explore therapeutic effect of modified constraint-induced movement therapy on rehabilitation in patients with stroke hemiplegia.Methods: A total of 136 patients with stroke hemiplegia were selected and divided into routine rehabilitation group and modified rehabilitation group.After 12 weeks, scores of Fugal-Meyer motor assessment (FMA), modified Barthel index (MBI) and Berg balance scale (BBS), 6min walking distance (6MWD), psychological state and quality of life (QOL) were compared between two groups.Results: After 12 weeks, there were significant rise in scores of FMA, MBI and BBS and 6MWD, and significant reductions in scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in two groups, P<0.05 all.Compared with routine rehabilitation group, there were significant rise in scores of FMA [(53.23±5.13) scores vs.(60.67±5.67) scores], MBI [(57.83±6.11) scores vs.(69.93±6.74) scores] and BBS [(41.45±4.12) scores vs.(50.53±4.56) scores] and 6MWD [(179.46±24.62)m vs.(211.34±26.71)m], and significant reductions in scores of SAS [(50.75±2.56) scores vs.(41.11±1.53) scores] and SDS [(51.34±3.35) scores vs.(40.78±2.11) scores] in modified rehabilitation group, P<0.05 all.Compared with before rehabilitation, there were significant rise in physiological, psychological, social and setting dimension scores in both groups after rehabilitation, and those of modified rehabilitation group were significantly higher than those of routine rehabilitation group, P<0.05 all.Conclusion:Modified constraint-induced movement therapy can significantly improve movement, balance function, and anxiety, depression and daily living capacities in patients with stroke hemiplegia.

Objective:To analyse the causes of early implantation failure and the therapeutic measures with re-implantation after the failures.Methods:6 cases of implantation failure including early infections,loosening and non-osteointegration were reviewed and trea-ted by re-implantation therapy,and the causes of failure were discussed and the effects of re-treatment were evaluated.Results:2 cases were found to be with infection of adjacent teeth after implantation and were treated by removal of the implant,socket curettage,root ca-nal therapy(RCT)and antibiotics followed by reimplantation.Implant loosening and non-osteointegration were observed in 4 cases, which were treated by the similar methods for the implant socket.Reimplantation was successful in all 6 cases followed-up for 1 -3 years.Conclusion:Preventive measure for implantation failure should include indication selection,control of infections in adjacent teeth and periodontosis,use of GBR technic and so on.Re-implantation following proper treatment of adjacent teeth and the socket of implant is effective for the treatment of implantation failure.

Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa?tients with indexed TIA/minor stroke (NIHSS≤3) in a Chinese hospital-based cohort. Methods We recruited all consec?utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and 18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com?pared with that at 3 months. Results A total of 209 consecutive Chinese TIA/minor stroke cases completed their fol?low-up investigation. Among them, 24 (11.5%) exhibited significantly cognitive decline. The independent risk factors of cognitive decline post TIA/minor stroke were education years (OR=0.869,P=0.021), atrial fibrillation(OR=5.950, P=0.001) and multiple silent lacunar infarcts (OR=5.179,P=0.020). Conclusion It is necessary to evaluate the cognition among TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la?cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.

Objective To Analyze the clinical outcomes of pediatric liver transplantation (LT) for liver-based metabolic disorders.Methods We conducted a retrospective analysis on 42 pediatric patients with liver-based metabolic disorders from June 2013 to March 2017,and analyzed the pediatric end stage liver disease model (PELD),growth and development,type of transplant,postoperative complications and prognosis of patients.Results There were 42 children with liver-based metabolic disorders (15.56%) out of all the 270 children who underwent LT.The median age was 51.0 months (range,3.4-160.9 months).Of the 42 children,19 received living donor liver transplantation (LDLT),18 cases received deceased donor liver transplantation (DDLT) and 5 cases received domino liver transplantation.1-,2-and 3-year cumulative survival rate of 42 recipients was 97.7%,93.6% and 93.6%,and that of the grafts was 95.3%,91.4% and 91.4%,respectively.As compared with the 194 children with biliary atresia who underwent LT,significant difference was found in PELD and weight Z-score between the two groups.Conclusion Liver transplantation is a valuable option for children with metabolic disorders,and it has gained a better prognosis.

Objective To analyze the donor specific antibody (DSA) in liver transplantation,and discuss the therapeutic schemes.Methods We retrospectively analyzed prospectively collected samples from 139 cases of liver transplantation from September 1,2013 to July 1,2015.Luminex assays were applied to determine human leukocyte antigen,panel reactive antibody (PRA).For PRA positive cases,DSA,C1q and C4d were detected,and liver biopsy was done.Results Of 139 cases enrolled,there were 12 cases positive for DSAs,including 2 cases of PreDSA:1 case of Ⅰ DSA (HLA-A mismatch),and 1 case of Ⅱ DSA (HLA-DQ mismatch).Ten cases of de novo DSA (including 1 case of PreDSA) all were HLA-DQ mismatch.The liver biopsy on 5 cases showed hepatic fibrosis,early rejection and intrahepatic cholestasis,and only 2 cases showed positive C4d.Of 6 cases of DSA,5 cases showed positive C1q.In the patients positive for DSA,tacrolimus dose was adjusted postoperatively,adding mycophenolatemofetil or increasing its dose,or methylprednisolone and immunoglobulin given.Conclusion DSAs are important indicators of sensitized recipients in liver transplantation,associated with trends toward worse outcomes in patients or allografts.The monitoring of DSA is requisite in order to adjust the immunosuppressant.