Objective To investigate the efficacy and safety of intramuscular injection botulinum toxin A (CBTX-A) made in China. Methods 43 post-stroke patents with upper extremity refractory spasticity were recruited in the study. The patients were randomly divided into two groups: injection combined with rehabilitation therapy (treatment group) and simple rehabilitation therapy (control group). CBTX-A was injected to the biceps brachii. The efficacy was assessed by modified Ashworth scale (MAS), range of motion (ROM),Fugl-Meyer Assessment-upper limb (FMA-upper limb) and motor-Functional Independence Measure-upper limb (mot-FIM-upper limb) at the baseline,2-week,4-week,8-week and 12- week after treatment by a physical therapist who was blind so as to which treatment they received. Results In the treatment group,85.7%(18/21) patients were benefited from the CBTX-A injection. Both groups improved on MAS,ROM,FMA-upper and mot-FIM-upper post-treatment. The score of MAS of treatment group were respectively 1.74?0.41,1.62?0.35,1.60?0.41 at weeks 2,4,8,while that of control group were respectively 2.50?0.51,2.27?0.53,2.18?0.55. The differences were significant(P0.05). After treatment,the ROM of treatment group were respectively 57.81?57.60,66.43?64.38,68.14?65.99 at 4,8, 12-week, and that of control group were respectively 27.91?30. 13,30.73?34.03, 33.73?34.50. The differences were significant (P0.05). Conclusion The result of the present study indicates CBTX-A injection combined with rehabilitation therapy decreases in local spasticity,enlarges the ROM of elbow joint. It is efficient,safe and well-tolerated. CBTX-A injection provides an additional alternative procedure for treatment of adult acquired refractory focal spasticity.

0.05),but all the outcome measures at 1 month in the treatment group were significantly improved as compared with control group(P0.05).The mean light sensitivity in the treatment group was better than in control group(P

Various central nerve system lesions involved cerebral hemisphere and nerve fiber tract such as cerebral infarction and hemorrhage can cause Wallerian degeneration,which is similar to the pathological change of peripheral nerve cut.There is a clear correlation between the degree of recovery and the degree of Wallerian degeneration.This article reviews the advances in feature of poststroke Wallerian degeneration and the correlation between post-stroke Wallerian degeneration and rehabilitation outcome.

BACKGROUND: Inhaled glucocorticoids(IGC) are powerful anti_inflammatory agents used in the treatment of asthma. But it is still uncertain whether long-term use of the IGC affects bone metabolism in asthmatic patients, especially women.OBJECTIVE: To investigate if the prolonged treatment with IGC to Chinese asthmatic woman has a detrimental effect on bone mass and metabolism.DESIGN: A matched controlled study based on the patients SETTING:Clinical Laboratory and the Department of Respiratory Medicine, First Affiliated Hospital, Nanjing Medical University.PARTICIPANTS: From February 1998 to February 2002, forty female Chinese patients with bronchial asthma, regularly followed up at our outpatient clinic, all in the Nanjing area, none of them having a history of chronic systemic GC use, agreed to take part in the study, were selected and divided into two groups: therapeutic group (IGC group): 20 asthmatic women, aged 18-63 years, 5 menopausals, received IGC therapy regularly for at least 5 months; Control group: 20 asthmatic women, aged 18-60 years, 5 menopausals, never received IGC received conventional bronchodilators . They were matched individually for sex, age and menopausal status.METHODS: Bone mineral density (BMD) at the lumbar spine (2-4),femoral neck, trochanter, ward's triangle and total body of femur were measured by dual energy X-ray absorptiometry, BMD were expressed as a absolute value and a T score considered as a SD from peak bone mass respectively. Meanwhile, BMD was also expressed as a percentage (%), which was defined by comparing the BMD absolute value of subjects and BMD normal value of isosexual age cohorts. Osteocalcin and some other markers of bone metabolism were measured by radio immunoassay in two groups.daily dose and accumulative total dose of IGC and BMD in the IGC group.RESULTS: There were no significant difference between two groups in BMD and T score (including the lumbar spine (2-4), femoral neck,trochanter, ward' s triangle and total body of femur) (P ＞ 0.05). There were also no significant correlation between daily dose of IGC and BMD of above 5 parts in the IGC group (r=-0.325 to -0.1102, P ＞ 0.05). But,there were significantly negative correlation between the accumulative total dose of IGC and BMD at lumbar spine2-4,femoral neck and ward's triangle(r=-0.495 ,-0.517,-0.531 ,P ＜ 0.05).There were no significant correlation between the accumulative total dose of IGC and T score of above 5 parts in the IGC group (r=0.443to 0.295 ,P ＞ 0.05). There was negative correlation between the age and the BMD at ward's triangle in the IGC group(r=-0.506,P ＜ 0.05). However ,BMD at 5 locus were not correlated with the age in control group (r=-0.079 to 0.326, P ＞ 0.05).Osteocalcin and some other markers of bone metabolism were no significant difference between two groups (P ＞ 0.05).CONCLUSION: The data suggests that there is no significant influence of IGC on bone mineral density and bone metabolism in asthmatic women,but if continuing exposures to high doses over many years,there may be a detrimental effect on bone mass and metabolism in women, especially elder or postmenopausal asthmatic women treated with IGC who may be more susceptible to any bone mineral loss caused by IGC.

Objective:To study clinical characteristics and risk factors of young patients with coronary heart disease (CHD) complicated metabolic syndrome (MS).Methods: A total of 200 CHD young patients were selected from our hospital, including 100 patients with MS (CHD+MS group) and 100 patients without MS (CHD control group).Lesion severity was evaluated according to coronary lesion score.General data were compared between two groups,and risk factors were assessed CHD+MS group.Results: Compared with CHD control group, there were significant rise in body mass index (BMI), levels of total cholesterol (TC), 2h postprandial blood glucose (2hPG), fasting blood glucose (FBG), triglyceride (TG), blood pressure, serum uric acid (UA) and creatinine (Cr) and homeostasis model-insulin resistance index (HOMA-IR), and significant reduction in level of high density lipoprotein cholesterol (HDL-C) in CHD+MS group, P<0.01 all.Compared with CHD control group, there were significant rise in incidence rate of multi-vessel coronary disease (6% vs.32%) and Gensini score of coronary angiography [(5.1±2.0) scores vs.(8.4±5.3) scores] in CHD+MS group, P<0.01 both.Logistic regression analysis indicated that low HDL-C, HOMA-IR, hypertension and diabetes mellitus history were risk factors for CHD complicated MS in young patients(OR=1.097~2.246,P<0.01 all).Conclusion:There are much risk factors and abnormal metabolism,and coronary disease are more serious in young patients with CHD complicated MS.

Objective: To investigate the serum anti-mumps IgG antibody levels among children aged 0 to 4 years in Haishu District, Ningbo City, Zhejiang Province, so as to provide insights into improvements for mumps vaccination program. Methods: Children aged 0 to 4 years were sampled from Haishu District using a stratified random sampling method in 2016 (before adjustment of the mumps vaccination program) and 2022 (after adjustment of the mumps vaccination program). Participants' demographics were collected using questionnaires, and the coverage of mumps-containing vaccines was collected from the Ningbo Municipal Immunization Information System. Serum anti-mumps IgG antibody was measured using enzyme-linked immunosorbent assay (ELISA), and the seroprevalence of anti-mumps IgG antibody and geometric mean concentration (GMC) were estimated among children aged 0 to 4 years in 2016 and 2022. Results: A total of 464 children were enrolled in 2016, including 250 boys (53.88%) and 214 girls (46.12%), and there were 301 children receiving mumps-containing vaccines (64.87%). The seroprevalence of anti-mumps IgG antibody were 48.08%, 34.44%, 81.11%, 84.44% and 84.44%, and GMC were 233.86, 351.77, 333.66, 362.29 and 410.72 U/mL. A total of 456 children were recruited in 2022, including 236 boys (51.75%) and 220 girls (48.25%), and there were 427 children receiving mumps-containing vaccines (93.64%). The seroprevalence of anti-mumps IgG antibody were 72.73%, 95.00%, 100.00%, 98.68% and 99.04%, and GMC were 524.05, 1 229.69, 1 623.64, 788.01 and 738.41 U/mL. Higher seroprevalence and GMC of anti-mumps IgG antibody was seen in 2022 than in 2016 among children at all age groups (P<0.05). Conclusion Following adjustment for vaccination programs, the seroprevalence and GMC of anti-mumps IgG antibody significantly increased among children at ages of 0 to 4 years in Haishu District.

Objective To observe the effects of electroacupuncture at Zusanli (ST36) on lower limbs motor function in patients with stroke. Methods 63 patients were evenly randomized into electroacupuncture group and control group. All the patients received routine rehabilitation training and at the same time,patients in electroacupuncture group, received electroacupuncture at zusanli (ST36). They were assessed with Fugl-Meyer Assessment (lower limb, hip, knee and ankle), gait analysis (gait frequency, gait speed and step length of both sides) and lower limb Composite Spasm Scale (CSS) before and after treatment. Results The scores of Fugl-Meyer Measure, gait analysis, and CSS improved in both groups, and more significantly in electroacupuncture group. Conclusion Electroacupuncture at zusanli (ST36) can significantly improved lower limb motor function without worsening the spasm.

Objective To investigate current dietary and dyslipidemia status of air force pilots.Methods Energy expenditure was calculated by using daily-activity-recording method.Dietary survey was performed through weighing method.Body measurements were carried out according to military criteria.Double agent enzymic method was used to detect blood lipid profiles.The results were compared in 1997 and 1982.t or x2 test was used for data analysis.Results Excessive energy consumption and highprotein and fat or low-carbohydrate intake was found in the participants.Energy from fat or carbohydrate accounted for 47.3％ and 37.9％,respectively.Obesity and overweight was found in 20.8％ air force pilots,and hypertriglyceridemia and hypercholesterolemia occurred in 47.9％ and 17.7％,respectively.Conclusion Dietary pattern and energy metabolism are inappropriate in air force pilots as a result of dyslipidemia.

Objective To observe the effect and safety of home-made metallic stent implantation in the treatment of malignant esophageal stricture. Methods Among 47 cases with malignant esophageal stricture, there were 8 cases in superior esophagus, 12 cases in middle esophagus,27 cases in inferior esophagus, and 12 cases with gastric cardia carcinoma. Those cases were not suitable or willing to accept surgical operation. Before stenting, radiotherapies were not done in all cases. Different shape home-made metallic stents were used to place the segment of structure via mouth according to the positions and diameters of esophageal stricture. The follow-up periods was 5 ～ 16 months. Results 48 stents were implanted successfully in 47 patients. After operation,swallow was improved in all patients. No major complications occurred in these groups. Restenosis occurred in the third month post-operation in 1 case owing to tumor relapsed and grew at proximal stent, and another stent was implanted successfully. Conclusions Stents implantation for malignant stricture can effectively and safely relieve the dysphasia.

Objective To explore the diagnostic value of combined bedside detection of aminoterminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) in the diagnosis of cardiac dyspnea. Methods A total of 120 patients with dyspnea admitted in our department from June 2014 to February 2016 were included in this study. At the time of admission, NT-proBNP and cTnI levels were measured by bedside test. Values of NT-proBNP>300 ng/L or cTnI>0.16 mg/L were defined as positive for cardiac dyspnea. According to the final diagnosis, patients were divided into two groups:cardiac dyspnea group (n=68) and pulmonary dyspnea group (n=52). At the same time, 30 healthy people were selected as control group. Values of NT-proBNP and cTnI were used for statistical analysis between the three groups. The sensitivity and specificity of NT-proBNP, cTnI and cTnI+NT-proBNP were compared between three groups. Results The levels of NT-proBNP and cTnI were significantly higher in pulmonary dyspnea group and cardiac dyspnea group than those in the control group, and the levels were significantly higher in cardiac dyspnea group than those of pulmonary dyspnea group (P<0.01). The detection sensitivity of NT-proBNP and cTnI alone was 67.65% and 52.94%, combined detection of both was up to 94.12%. The specificity of NT-proBNP and cTnI detection alone was 70.00% and 53.33%, respectively, and combined detection of both was up to 86.67%. The sensitivity of NT-proBNP+cTnI was significantly higher than that of NT-proBNP and cTnI alone (P<0.05), but there was no significant difference in the specificity between combined detection andindividual detection of NT-proBNP. The positive predictive value of the combined detection in the diagnosis of cardiac dyspnea was 94.12%(64/68), and the negative predictive value was 86.67%(26/30). Conclusion Bedside detection with combination of cTnI and NT-proBNP has important clinical application value in the rapid diagnosis of cardiac dyspnea, which is a rapid clinical testing method.