Objective To explore ways of enhancing the therapeutic level of the neurology department and reducing the economic burdens of patients. Methods Relevant materials were collected by means of evidence based medicine to optimize therapeutic schedules, with cerebral infarction being the pitching in point. Results Prior to the adoption of evidence based medicine, the average length of stay, the effective rate of treatment and the expenses for single entity diseases were respectively 17.83?13.44, 89.91% and 4 550.70 yuan, whereas after the adoption of evidence based medicine, they were respectively 15.38?11.37, 94.16% and 3 942.88 yuan. Conclusion Evidence based management is a means of scientific management. Its application in the department of neurology has produced a marked effect and it is worthy to be spread.

OBJECTIVE:To test the static balance function of boys aged from 6 to 8 years and then to establish a system of evaluating the static balance function.METHODS:A total of 388 boys aged from 6 to 8 years were randomly selected from 16 kindergartens of 8 counties(cities)in 4regions of Hebei Province.The inclusive cdteria were as follows:no systematic training of sports,no myopia,normal body shape and no obvious obesity.The balance force-measuring plates made by Hefei Institute of Intelligent of Chinese Academy of Sciences,computer and the supporting software were adopted.The subjects received an indoor test of 6 testing postures,namely,standing on two feet with eyes open(and closed),standing on left leg with eyes open(and closed),standing on right leg with eyes open(and closed).Six indexes relating to balance abilities including the mean of X direction,the mean of Y direction,R value,track length per unit time and track location variance of the envelop area.RESULTS:The original screening of all indexes showed that 6 kinds of postures reduced to 4 and that indexes reduced from 36 to 24.The second screening with cluster analysis which was conducted to the 4 kinds of postures showed that 24 indexes reduced to 17 when selecting typical indexes from each cluster.The third screening with factor analysis showed that 7 out of the 17 indexes were remained.Seven representative indexes corresponding to these 7 factors were concluded and considered as the comprehensive evaluation indexes of the static balance.The comprehensive static balance evaluation index systems for 6-year-old.7-year-old and 8-year-old boys were established respectively.CONCLUSION:Three systems for evaluating the static balance function of the boys aged from 6 to 8 years are established successfully based on 7 indexes.The evaluation of static balance function should be based on the comprehensive evaluation of multiple indexes.The evaluation indexes for 6-year-old,7-year-old and 8-year-old boys are identical in number,but different in content.Accordingly,a specific evaluation index system should be established for them separately.

Early lymph node metastasis is a common clinical phenomenon in many human cancers, which is associated with both aggressive disease and poor prognosis. Clearly, treatments to specifically block dissemination through the lymphatic network would be desirable either as independent therapies or as adjuncts to existing chemotherapy. At the present stage the target vessels for invasion by lymph-metastasizing tumor cells include preexisting tissue lymphatics abutting the tumor mass through either coincidence or mutual chemoattraction, as well as new lymphatic vessels that proliferate either within or around the tumor as a result of lymphangiogenesis. The lymphangiogenesis is regulated primarily by the lymphangiogenic growth factors VEGF-C and VEGF-D generated by tumor cells or host cells including tissue macrophages. Nevertheless, it remains controversial as to whether this metastasis-enhancing effect simply results from an increase of the number of target vessels due to mitogenesis or from other properties of the newly dividing tumor lymphatics.

Objective To investigate the significance of DNA ploidy analysis in diagnosis of atypical squamous cell of undetermined significance ( ASCUS).Methods From Jan.2009 to Jul.2011,875 women with ASCUS confirmed by liquid based thin layer cytology technique underwent DNA ploid analysis in Hubei Maternal and Child Health Hospital.Among 294 women underwent high risk HPV detection.All subjective were examined colposcopy directed biopsy at day 3 to 10 after menstruation.Results Among 875 ASCUS cases,553 cases with histologically as chronic cervicitis (63.2％),165 cases with cervical intraepithelial neoplasia (CIN) Ⅰ (18.9％ ),45 cases with CIN Ⅱ (5.1％),79 cases with CIN Ⅲ (9.0％) and 33 cases with cervical invasive cancer (3.8％) were confirmed by colposcopy.Totally 532 cases were observed with DNA heteroploid,and 343 were not observed with DNA heteroploid.When DNA heteroploid negative and more than or equal to three ploid were used to predict CIN Ⅱ or more severe cervical diseases,the sensitivity,specificity,positive predictive values and negative predictive values were 98.7％ and 90.3％,47.5％ and 46.1％,29.1％ and 40.8％,99.4％ and 92.1％,respectively.The amount of heteroploid cells ＞2.5c and ＞ 5c among every 100 detected cells in chronic cervicitis and CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and cervix cancer were respectively 2.53 ± 1.99 and 0.10 ±0.07,2.24 ± 1.69 and 0.20 ±0.11,4.10 ± 1.91 and 0.28 ±0.19,7.97 ±7.33 and 1.27 ± 1.23,8.99 ±7.33 and 0.36 ±0.33,there was no statistical difference in amount of heteropolid cells between ＞ 2.5c and ＞ 5c at group of chronic cervicitis and CIN Ⅰ,CIN Ⅲ and cervix cancer (P ＞ 0.05).However,the amount of heteroploid cells at ＞2.5c and＞ 5c at group of chronic cervicitis,CINⅠ,CIN Ⅲ and cervical were higher than that of CIN Ⅱ significantly (P ＜0.05).Among 294 cases with high risk (HR) HPV detection,216 cases were HR-HPV positive,and 78 cases were HR-HPV negative.The pathology result by colposcopy at group of negative heteroploid,heteroploid ＜ 3,or ≥ 3 showed statistical distribution (x2 =115.2775,P ＜ 0.01).ConclusionDNA ploidy analysis can be used for ASCUS diagnosis,which can avoid excessive biopsy under colposcopy,in the mean time,CIN and cervical cancer could decrease missed diagnosis.

Defecography was performed in 110 patients without any anorectal symptoms which included 57 male and 53 female with an average age of 43. 15. Normal defecography was found in 82 cases and abnormal one in 28. The normal features of defecography in 82 patients were as follows;1.There was an increase of anorectal angle during defecation. The increase was 21. 27 degrees measured-with precise axis method and 36. 72 degrees with approximate axis method.2. Reduction or obliteration of the impression of the puborectal muscle.3. There was a shortening of the anal canal by 1. 20 cm and a widening of the caliber of the anal canal to an average of 2. 23 cm.4. The resistance of the pelvic floor was good and the decending of the perineum was smaller than 3 cm during straining. The rectovaginal septum of female subjects was not deformed during straining.5. The barium paste in the distal rectum was largely or totally evacuated with an average e-vacuation rate of 90. 55%.

Objective To observe the anti-aging effect of Shenqi Wangjiang preparation on the old rats by the research on measuring serum testosterone and estradiol. Methods Measurate serum testosterone and estradiol of the old rats by the means of RIA, and observe the prevention and cure effects of Shenqi Wangjiang preparation by comparing with other groups. Result Shenqi Wangjiang preparation can enhance the serum testosterone and estradiol of the old rats. Large and middle dose have obvious effect (P

Objective To analyze the factors contributing to local recurrence following body gamma knife radiotherapy in patients with non-small cell lung cancer(NSCLC),and to explore a standard therapeutic scheme under the circumstance.Methods 332 patients with NSCLC received body gamma knife therapy and subsequent regular follow-up.Dose per fraction and total dosage used were dependent on disease condition,tumor location,tumor features and tumor size,etc.On the basis of patients' conditions and adverse effects,biological effective dose(BED) was 56-90Gy calculated with LQ model.Univariate analyses were performed including sex,age,Karnofsky performance score,clinical stage,pathological type,tumor differentiation degree,tumor size,tumor location,target volume delineation,dose per fraction,BED and chemotherapy scheme,etc.with X2 or t test.By selecting significant clinical factors in univariate analysis,multivariate analyses were performed with COX regression model.Results Of the 332 patients,local recurrence occurred in 22 cases during regular follow-up period,with average recurrence time of 10 months,and the local recurrence rate was 6.63%.The results of multivariate analysis showed that low BED,low Karnofsky score,old age,too small delineation for target volume range and central type of lung cancer were the factors related to local recurrence.Conclusions Low BED in body gamma knife radiotherapy is the significant factor of local recurrence for patients with NSCLC.BED in body gamma knife radiotherapy should be more than 80Gy for NSCLC patients who receive the radical treatment.

This study was aimed to compare the mechanical characteristics under different physiological load conditions with three-dimensional finite element model of rigid fixation and elastic fixation in the lumbar. We observed the stress distribution characteristics of a sample of healthy male volunteer modeling under vertical, flexion and extension torque situation. The outcomes showed that there existed 4-6 times pressure on the connecting rod of rigid fixation compared with the elastic fixations under different loads, and the stress peak and area of force on elastic fixation were much higher than that of the rigid fixations. The elastic fixation has more biomechanical advantages than rigid fixation in promoting interbody lumbar fusion after surgery.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Models, Theoretical ; Pressure ; Range of Motion, Articular ; Spinal Fusion

Objective To investigate the clinical efficacy and indication of surgical treatment of L5S1 tuberculosis us?ing a medial edge of rectus abdominal muscle and retroperitoneal approach. Methods From Jan. 2010 to Nov. 2014, totally 18 cases of L5S1 tuberculosis were surgically cured by debridement, fusion and internal fixation via a medial edge of rectus ab?dominal muscle and retroperitoneal approach. There were 10 males and 8 females, with an average age of 35.6±10.1 years (21 to 55). The mean course of disease was 5.3±2.2 months. The primary destruction lesions were located at L5S1, and one patient of whom L4 was also involved, three cases S2 involved, and one S3 involved. Abscess pre sacrum was noticed in all cases. Six patients were combined with abscess in vertebral canal. Neural deficiency was detected in 3 patients, all grading as Frankel D. Dubousset's lumbosacral angle was 104°-126°, mean 114.6°±6.0°. Formal anti?tuberculosis medicine treatment was given for at least 2-3 weeks. All patients were treated using a medial edge of rectus abdominal muscle and retroperitoneal approach. Af?ter debridement, a tri?cortical iliac bone was used for structural inter?vertebrae fusion. The iliac bone was fixed to the sacrum by one cortical screw. Operation time, volume of blood loss, and surgery complications, including wound infection, looseness and shift of internal fixation, sinus occurrence, vascular injury, retrograde ejaculation in male patients were evaluated. The X?ray and 3D CT of lumbosacral spine, together with ESR and CRP were used to evaluate the control of tuberculosis during fol?low?up. The Dubousset's lumbosacral angle, visual analogue score, and the Frankel grade were compared between preoperative and postoperative. The bone graft fusion were also observed. Results The operation time was 147±16 min in average. The mean blood lose was 275 ± 77 ml. No vascular or neurological injury was noticed. There was also no retrograde ejaculation happened in this group. All patients were followed up from 18 to 28 months. Dubousset's lumbosacral angle was 122.4°±3.8° post?operatively and 121.4°±3.7° at the final follow?up. There was a significant difference between the lumbosacral angles pre and post operation, whereas no statistical difference between the post operation and the final follow?up. Bone fusion was noticed in all cases. All pa? tients have intact neurological function at the final follow?up. No screw breakage or graft bone migration occurred. VAS was 5.6± 1.09 pre?operation and 0.83±0.71 at the 3rd month's follow?up, and there was a significant difference between them. Conclusion Surgical treatment of L5S1 tuberculosis by debridement, fusion and internal fixation via a medial edge of rectus abdominal muscle and retroperitoneal approach is an effective method in terms of minimal trauma, low rate of modality, good ability in restore and maintenance of lumbosacral junction alignment and high fusion rate.

BACKGROUND:Umbilical cord blood stem cel s can be differentiated into functional liver cel s in vivo, instead of mature liver cel s in the treatment of liver diseases. OBJECTIVE:To observe the effect of umbilical cord blood stem cel transplantation on decompensated cirrhosis in rats. METHODS:Twenty Sprague-Dawley rats were enrol ed and given 40%carbon tetrachloride peanut oil to make decompensated cirrhosis models. Eight weeks after modeling, model rats were randomized into control and experimental groups (n=10 per group), and subjected to injection of umbilical cord blood stem cel suspension (2 mL, 1.0×107/L) or cel culture medium (2 mL) via the tail vein, respectively. At 4 weeks after injection, levels of serum aspartate aminotransferase, alanine aminotransferase, albumin, total bilirubin, hyaluronic acid, laminin, procol agen III and type IV col agen were detected;rat liver tissues were sliced for pathological observation. RESULTS AND CONCLUSION:Compared with the control group, the albumin level was significantly increased but the levels of serum aspartate aminotransferase, alanine aminotransferase, total bilirubin, hyaluronic acid, laminin, procol agen III and type IV col agen decreased significantly in the experimental group (P<0.05). From the pathological view, severity of liver cirrhosis was lower in the experimental group than the control group. Therefore, umbilical cord blood stem cel transplantation can effectively restore the liver function of decompensated cirrhosis in rats.