Objective To economically investigate tertiary stroke rehabilitation treatment.Methods 3 tertiary rehabilitation networks were set up in Beijing.82 patients with acute cerebrovascular diseases were enrolled into the study according to standardized criteria in all centers and randomized into rehabilitation group and control group.Rehabilitation training was implemented according to standardized procedures.The patients in rehabilitation group were given rehabilitation training in acute stage for 28 days and then underwent long term rehabilitation'program for 6 months in rehabilitation centers or community rehabilitation settings.The patients in control group were only given rehabilitation training in acute stage for 28 days. Altogether 4 evaluations were conducted in one week after the onset and at the end of 1,3,6 months, respectively.Results Significant differences of motor function,ability of daily activities,quality of life evaluation and cost were found in the 1st,3rd and 6th month after the onset of diseases.The rehabilitation group surpassed the control group significantly.At the end of 6 months,the average of Barthel Index of rehabilitation group was 83.18?18.22 while that of control group was 63.69?12.73.At the end of 6 months,total cost of rehabilitation group was(56 420.0?17 831.8)Yuan and that of control group was (64 864.2?18 267.5)Yuan.The rehabilitation group had better cost/effectiveness and cost/utility.There was a significant difference of cost between two groups.The total rehabilitation cost of rehabilitation group was 4613 Yuan,accounting for 15.3%of all the cost.Conclusion The tertiary rehabilitation treatment for stroke patients has achieved better cost/effectiveness and cost/utility.In China pharmaceutical cost constitutes the major part of the stroke therapy while the rehabilitation cost only a small portion,which is significantly different from the situation in developed countries.

Alcoholism ; therapy ; Humans ; Methanol ; poisoning

Objective To observe the cerebral activation by functional MRI(F MRI) during the thumb movement in different motor fashion. Methods Four stroke patients with hemiplegia were involved in this study During the examination by F MRI, these patients were asked to move thumbs in passive, active and overcoming resistance fashion. Results (1) During the thumb at unaffected side moving in active fashion, functional activity was observed in the contralateral primary motor cortex In passive fashion, however, functional activity was observed in contralateral somatosensory cortex The overcoming resistance motor test was associated with activity in bilateral primary motor cortex and somatosensory cortex (2) The same motor tests were made in movement of the thumb at affected side , functional activity appeared not only in primary motor cortex, somatosensory cortex of affected side, but also in basal ganglia(affected area), frontal lobe, supplementary motor cortex, somatosensory cortex, and contralateral primary motor cortex. Conclusion These results have proved the neurorehabilitation theory such as neuroplasticity and so on

Objective Investigating the expression of TLR3 and TLR7 mRNA in peripheral blood mononuclear cells (PBMC) of patients with chronic hepatitis C infection (CHC),to explore the effects of gender and age on Toll-like receptor expres-sion.Methods Peripheral blood was collected from 1 1 5 patients of chronic hepatitis C infection,1 1 3 healthy individuals.Ex-pression levels of TLR3 and TLR7 mRNA were detected by real-time quantitative PCR.Results The expression of TLR3 and TLR7 mRNA were significant difference between patients with CHC infection and healthy individuals (t=38.73,6.16, P<0.05),respectively.The expression of TLR3 and TLR7 mRNA were significant difference between premenopausal fe-males with CHC infection,postmenopausal females and young males of CHC infection (t=61.210,6.464,P<0.05;t=24.166,26.266,P<0.05),respectively.The expression of TLR3 and TLR7 mRNA were significant differences between old males and young males of chronic hepatitis CHC infection (t=86.349,19.583,P<0.05).The expression of TLR3 mRNA was significant differences between old males and postmenopausal females of CHC infection (t=122.941,P<0.05).There was no correlation between the expressions of TLR3 and TLR7 and HCV-RNA load of CHC patents of Gender and age dis-crepancies (|r|<0.40,P>0.05).The HCV-RNA load of premenopausal females was significant lower than young males and old females (t=3.49,2.51,P<0.05),the load of old males was lower than old females (t=2.35,P<0.05),however, there was no significant differences between old males and old females (t=1.20,P<0.05).Conclusion Gender and age dis-crepancies have a relationship with the expression of Toll-like receptors of patients with CHC infection,which may provide a theoretical basis and a new method for CHC.

Renal interstitial fibrosis is the common pathway for a variety of chronic renal disease to final stage renal failure,the main feature of it is the large accumulation of extra cellular matrix (ECM).Myofibroblasts is the major effector cells which lead to the synthesis of ECM,an important source of myofibroblasts is epithelial-mesenchymal transition(EMT).Wnt/β-catenin signaling pathway take part in the regulation of EMT,which make it become a potential site of anti-fibrosis therapy.

Objective To explore the clinical results of minimally invasive therapy for femoral intertrochanteric fractures with proximal femoral nail anti-rotation(PFNA) in 25 elderly patients.Methods A total of 25 patients with intertrochanteric fractures were treated by PFNA in our hospital from February 2007 to June 2008.The patients received close reduction and minimal invasive operation.Based upon the Tronzo-Evans classification,type Ⅰ fractures were diagnosed in 2 cases,type Ⅱ fractures in 2 cases,type Ⅲ in 16,and type Ⅳ in 5.Results The mean operation time in this series was 50.3 min(30-70 min),an the mean intraoperative blood loss was 100.2 ml(70-200 ml).All the 25 patients completed a follow-up of 3 to 12 months(average time 7.1 months),during which all the fractures healed in 10 to 14 weeks with a mean of 11 weeks,without occurrence of varus deformity,hardware loosening or hardware cutting.According to the Harris Hip Score,20 cases achieved excellent results,4 were good,and 1 was fair. Conclusions It is a reliable and ideal method to treat intertrochanteric fractures with PFNA in elderly patients,for the procedure is convenient and minimally invasive,resulting in firm fixation,less blood loss,short operation time,and high healing rate.

Objective To study the chemical constituents of marine sponge Craniella australiensis collected from the South China Sea.Methods Compounds were isolated and purified by column chromatography and their structures were identified based on spectral analyses and chemical evidence.Results Four compounds were isolated from the ethanol extract and identified as: ?-sitosterol(Ⅰ),3?,6?-stigmast-4-en-3,6-diol(Ⅱ),1,12-diazacyclodocosane-2,11-dione(Ⅲ),uracil(Ⅳ).Conclusion All these compounds were isolated from this sponge for the first time.

Acute undifferentiated leukemia (AUL) is a clinically rare subtype of acute leukemia (AL). AUL lacks the serial specific antigen expressions, and the blasts have no morphological features of myeloid differentiation. Due to the rarity of AUL in clinic, there is no unified understanding of clinical and biological characteristics. It′s difficult to diagnose and choose the optimal treatment for AUL patients. And the prognosis of patients with AUL is poorer compared with other types of AL. Thanks to the big development of biotechnology in recent years, the related researchers have a better understanding of this rare disease. This article reviews the progress of diagnosis and treatment in AUL.

Balance function is one of injured functions needed rehabilitation after stroke. It is also the considerable signal of the restoration for motor function, which being thought highly in the field of rehabilitation. In some aspect, the restoration of balance function cannot be substituted by stance. The authors mainly discussed the mechanism and issues of balance training by which the balance function of stroke patients in chronic period improved, based on nerve compensative mechanism.

Abstract?AlM: To evaluate the efficacy of intravitreal injection with Ranibizumab combined with sub-Tenon injection with Triamcinolone acetonide ( TA ) for macular edema ( ME) due to central retinal venous occlusions ( CRVO) .?METHODS:Forty-six patients (46 eyes) were diagnosed ischemic CRVO with significant macular edema by fundus fluorescence-angiography ( FFA ) and optical coherence tomography ( OCT ) . All the patients had panretinal photocoagulation ( PRP ) , a week after the four times therapies. Twenty-three patients ( 23 eyes ) in group A were randomly chosen to receive intravitreal injection with ranibizumab ( lVR ) , another 23 patients ( 23 eyes ) in group B to treat with both lVR and sub-Tenon injection with TA ( PSTT ) . There was no significant difference on macular edema and best corrected visual activity ( BCVA) between the two groups. The changes in BCVA and central macular thickness ( CMT) before and 1wk; 1, 3, 6mo after treatments were analyzed.?RESULTS: One week after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B (P<0. 05). BCVA and CMT changes between two groups were statistically significant differences (P<0. 05). One month and three months after the treatment:the BCVA increased while the CMT decreased compared with that of pretreatment in group A and B (P<0. 05), the difference was significant between two groups ( P< 0. 05 ). Six month after the treatment:the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B. Compare BCVA difference between the groups was statistically significant change (P<0. 05), CMT difference was not statistically significant (P>0. 05).?CONCLUSlON:Not only lVR can decrease ME caused by CRVO and increase the BCVA, but also lVR combined with PSTT can. But combined therapies can be more rapidly and have more positive effect on decreasing the ME and protecting the visual function.