Spasticity is a common problem in upper motor neuron lesions.Assessment of spasticity is extremely valuable in quantifying the effects of a therapeutic intervention.But it is,in other hand,a difficult and challenging problem.Objective:The present study was undertaken to determine the feasibility of quantifying spasticity by the pendulum test using the isokinetic dynamometric technique.We suggest that this machine can be used to perform pendulum test to quantify spasticity.Method:We studied the lower limb muscle tone in 34 spastic subjects,and in 9 flaccid paralysis control subjects,and 10 normal control subjects.Result:Typical pendulun test goniograms of each group were obtained and 5 parameters are extracted from the goniograms to evaluate the degree of spasticity. They are:Al(the flexion angle of the first drop)、R1(relaxation index)、R2(amplitude ratio)、T(time of swings)、F(frequency of swings).The correlation coefficients are calculated to determine the reliability of the parameters(>0.90 for three consecutive test;>0.80 for different days).The validity is determined by t test(p<0.01).Conclusion:The method of using isokinetic dynamometric technique combining pendulum test to quantify spasticity is a reliable,valid,accurate and convenient method of assessing spasticity.

9scores). Results Fifty-five of fifty-seven cases with CT between 0～6 scores,which considered to be resected,underwent tumor resection . The accuracy of prediction of CT was 96.5%. Conclusions Preoperative CT scord could accurately predict the resectability and difficulty of pancreatic cancer.

Objective To investigate therapeutic effect and mechanism of hyperbaric oxygen and ulinastatin respectively or combinatively used to treat acute necrotizing pancreatitis (ANP). Methods One hundred and twenty SD rats were divided into 6 groups randomly: group of normal control, group receiving sham operation, group of untreated acute necrotizing pancreatitis (ANP group), group of acute necrotizing pancreatitis treated with hyperbaric oxygen (HBO group), group of acute necrotizing pancreatitis treated with ulinastatin (ULT group), and group of acute necrotizing pancreatitis treated with combined hyperbaric oxygen and ulinastatin (HBO+ULT group). The rat model of acute necrotizing pancreatitis was established according to Aho HJ et al. Concentrations of amylase, TNF?, TXB-2 and 6-keto-PGF- 1? in blood were measured through ELISA or radioimmunoassay. Changes of pancreatic histopathology were investigated. SPSS 10.0 was used in statistical analysis. Results The concentrations of amylase, TNF?, TXB-2 in the ANP-treated groups were significantly lower than those of ANP group (P

Objective To investigate the application of selective hepatopetal blood occlusion techniques in anatomic hepatectomy.Methods We retrospectively reviewed the clinical data of 259 patients with hepatolithiasis or liver tumor undergoing anatomic hepatectomy under selective hepatopetal blood occlusion from January 2006 to December 2009.Results Totally,183 cases with hepatolithiasis and 76 cases with liver tumor underwent anatomic hepatectomy under selective hepatopetal blood occlusion.The average intra-operation blood loss was 210 mL(120-1 600 mL);post-operation incidence of complications and the rate of residual stones was 10.9% and 4.2%,respectively.Thre was no operative death in this series.The intrahepatic recurrence and metastasis rate of liver tumor was 23.6% and the median recurrence was 16.3 months.Conclusions The use of a appropriate selective hepatopetal blood occlusion during anatomic hepatectomy for hepatolithiasis and liver tumors is an effective measure to reduce surgical complications and improve outcome.

Objective To study the values of serum CA19-9,CA242,CEA,alone or in combination in the diagnosis and prognosis of combined hepatobiliary calculus and cholangiocarcinoma (HCWC).Method Serum CA19-9,CA242,CEA in 100 patients with HCWC,70 patients with hepatobiliary calculus combined with cholangitis and 30 patients with hepatic hemangioma (normal bile duct group) were preoperatively studied.Results When the serum levels of CA19-9,CA242,CEA were separately used in the diagnosis of HCWC,the sensitivity of CA19 9 was highest,but its specificity was significantly lower than that of CA242 and CEA (P＜0.01).Patients with all the three tumor markers raised had significantly lower survival than those of patients with only one or two raised markers (P＜0.05).Conclusions The diagnostic rate for CA19 9 in HCWC was better than that of CEA and CA242.A joint detection improved the diagnostic specificity.Raised tumor markers were associated with progression of HCWC.Survival was worse in patients with 3 raised markers than those with 2 or 1 raised markers.

Objective To assess the causes and methods of surgical treatment of hepatolithiasis reoperation Methods The clinical data of 81 cases of hepatolith reoperation were analyzed retrospectively. Results The main causes of hepatolith reoperation include biliary stricture,biliary tract variation,cholangiocarcinoma, etc. The chief reoperation patterns were hepatic lobectomy, Roux-en-Y hepaticojejunostomy, and lobectomy combined with Roux-en-Y hepaticojejunostomy.A follow-up of 2 months to 12 months showed excellent (outcome) of 93.8% of cases. According to postoperative cholangiograph,the retained stone rate was 6.2%. Conclusions When treating cholelithiasis ,we should follow the following principles: remove stones, relieve biliary stricture, correct biliary variation, resect abnormal liver, and establish adeguate biliary drainage.

Objective To evaluate different surgical repairments for iatrogenic bile duct injury Methods Clinical data of 145 patients with iatrogenic bile duct injury surgically treated in our department from Mar 1990 to Sep 2002 were retrospectively analyzed Results Bile duct end to end anastomosis、 or bile duct repair using the patient′s own tissues and medical glue, or Roux en Y bile duct jejunostomy were used in these 145 cases The average follow up time was 3 6 years (3 months to 11 years) in 130 cases The eutherapeutic rate was 94 6% Conclusion With good surgical expertise iatrogenic bile duct injury could be repaired by a variety of methods with a satisfactory results

Objective:To understand the levels of selenium and T-2 toxin in the historical critical disease area of Kashin-Beck disease in Aba State of Sichuan Province.Methods:From July 2018 to February 2019, in five cities (counties) of historical critical Kashin-Beck disease areas, namely, Ma'erkang, Rangtang, Aba, Ruo'ergai and Hongyuan, one township was selected, respectively, and then one village in the historical critical disease area and one village in non-disease area were selected from the selected townships. Hair samples from 30 children aged 6 to 12 years old were collected to test selenium content in each village. Staple food samples of 10 households were collected to test the selenium and T-2 toxin contents in each village. Ten soil samples were collected from each village to test the selenium content.Results:The medians selenium of children's hair in the diseased and non-diseased villages ( n= 180, 120) were 0.260 0 and 0.330 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 6.319, P < 0.01). In Ma'erkang and Hongyuan, the medians selenium in the diseased villages were lower than those in non-diseased villages ( Z = - 3.327, - 4.939, P < 0.01), and there were no statistically significant differences between the diseased villages and non-diseased villages in Rangtang and Ruo'ergai ( P > 0.05). The medians selenium of staple food in the diseased and non-diseased villages ( n = 110, 70) were 0.005 8 and 0.018 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 2.263, P < 0.05). In Ruo'ergai, the median selenium in the diseased village was lower than that in non-diseased village ( Z = - 2.306, P < 0.05), and there were no statistically significant differences between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Hongyuan ( P > 0.05). The T-2 toxin contents in staple food were all less than detection limit (1 μg/kg) in the diseased and non-diseased villages ( n = 103, 65). The soil selenium contents in the diseased and non-diseased villages ( n = 60, 40) were (0.045 3 ± 0.021 5) and (0.065 8 ± 0.045 4) mg/kg, respectively, and the diseased village was lower than non-diseased village ( t = 2.672, P < 0.05). The soil selenium content in the diseased village was lower than that in non-diseased village in Hongyuan ( t = 14.838, P < 0.01). There were no statistically significant differences in the soil selenium content between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Ruo'ergai ( P > 0.05). Conclusions:The overall selenium level of children's hair is at a medium level (0.25 - < 0.50 mg/kg) in the historical critical disease area of Aba State of Sichuan Province, the selenium levels of staple food and soil are at a deficiency level (< 0.025, < 0.125 mg/kg), and the diseased villages are lower than non-diseased villages. No T-2 toxin is detected in staple food.

Objective To summarize the experience in surgical management of bile duct injury. Methods The clinical data of 683 patients with bile duct injury who were admitted to the Hunan People's Hospital from August 1990 to December 2008 were retrospectively analyzed. Of all the patients, seven received hepatectomy +T tube drainage, two received liver repair + T tube drainage, four received external biliary drainage + hepatectomy,27 received liver repair or hepatectomy + silicone support, 233 received temporary portal triad clamping + gelatin sponge hemostasis, 72 received biliary repair + T tube drainage, 248 received hepatobiliary basin Roux-en-Y anastomosis, 22 received external biliary drainage, 61 received long arm T tube drainage, two received pancreaticoduodenectomy and five received hepatectomy + T tube drainage. The surgical outcomes were evaluated by analyzing the results of the follow-up. Results The surgical outcomes were ranked excellent, good and poor according to the condition of patients and the results of imaging examination. Six hundred and twelve patients were followed up for 8 months to 19 years, and the surgical outcomes were excellent in 337 patients (55.1%), good in 214 patients (35.0%) and poor in 61 patients ( 10.0% ). Conclusion The surgical outcome of bile duct injury could be satisfactory if the approach of the surgery is properly selected.

Objective To summarize the experience in operation manner and surgical technique of refractory cholelithiasis.Methods A total of five hundred and twenty one patients with refractory cholelithiasis admitted to Hunan Provincial People's Hospital from Jan.1990 to Dec.2007 were involved in this study for retrospective analysis.Results All patients in this group accepted surgery.Apart from three cases of perioperative death with liver and kidney failure,the remaining five hundred and eighteen cases had no serious complications,were cured and discharged.The imaging examination showed residual stone in seventy cases,accounting for fifteen percent.Four hundred and twenty one patients were followed up.The mean time of follow-up was seven years and six months (range 5 months - 17 years).Good result rate was 90.1%(381/423).Conclusions Most intractable cholelithiasis can be cured radically.Individual surgery programme,fine and standard surgical procedure are the key to treatment effect.