Objective To observe the effect of core stability training on the associated reaction of upper limbs in stroke patients with hemiplegia. Methods From November, 2014 to May, 2016, sixty stroke patients with hemiplegia were randomly divided into control group (n=30) and treatment group (n=30). Both groups accepted routine rehabilitation, while the treatment group received core stability training for 20 minutes during exercise. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Fugl-Meyer Assess-ment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Associated Reaction Rating Scale (ARRS) before and 6 weeks after treatment. Results The scores of FMA-UE, FMA-LE, BBS and ARRS improved significantly in both groups after treatment (t>12.158, P<0.001), and improved more in the treatment group than in the control group (t>2.317, P<0.05). Conclusion Core stability training can re-lieve the associated reaction of upper limb in stroke patients with hemiplegia.

The paper gives an account of the new ideas in trauma care and the transition of emergency care of trauma from the traditional model to the modern model,viz.the transition of emergency care of trauma by the emergency department from a paradigm of general practice to a paradigm of specialized care;the transition of trauma physicians training from a paradigm of general practitioners to a paradigm of specialists;and the transition of the flow of emergency care of trauma from a paradigm of "links" to a paradigm of "whole course".Based on the practice of the emergency department of the hospital the authors work with in setting up a quick clinical response mechanism of emergency care of trauma,a mechanism of priority to emergency care of trauma,a hospital-wide linking and coordinating mechanism of emergency care of trauma,a standardized management mechanism of wards for emergency care of trauma,and an operational mechanism of the team of emergency care of trauma,the paper discusses building an integrated model of emergency care of trauma on the basis of the "three links theory" by the emergency department.

The three links theory" refers to the three key links in an emergency medical services system, viz. pre-hospital first-aid system, hospital emergency care system, and the ICU system. The construction of an emergency medical services system in China ought to be guided by the three links theory so as to set up a practical and highly efficient emergency medical services system, an instantly operating monitoring system, a smooth and real-time information system, a rational and long-lasting system of laws and contingency plans, and a system for cultivating universalists. The goal is to build an emergency green passage in the hospital.

0.05). However, compared with group II, group I had higher cardiac event rates (34.6% vs 20.4%, P =0.020). Conclusion Coronary stenting in ostial lesions may have similar procedural success rate, but less late benefit, compared with that in nonostial lesions.

Objective To evaluate potential clinical risk factors for the development of early-onset myocardial damage following multiple trauma (MT), and to determine whether early-onset myocardial damage was caused by the combined effects of thoracic and systemic injury factors in MT patients.Methods A total of 231 patients with MT over the last 3 years were retrospectively reviewed. With myocardial damage being a dependent variable and other twenty factors being independent variables, univariate and multivariate logistic regressions were applied to investigate the risk factors for early-onset myocardial damage and to identify the association of thoracic and systemic risk factors with early-onset myocardial damage.Results Multivariable logistic regressions showed that acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score ≥10, injury severity score (ISS) ≥ 25, shock index ≥ 2,coexisting chest trauma, abbreviated injury scale (AIS) of chest≥3, and hypoxia time ≥ 0.5 h were risk factors. The risk of earlyonset myocardial damage following MT obviously increased when thoracic and systemic injury risk factors were coexisting.Conclusion Our results indicated that thoracic injury combined with systemic injury increased the overall risk of early-onset myocardial damage following MT. Prospective validation of these findings in other clinical settings is warranted.

Objective To investigate the effect of calcitonin gene-related peptide ( CGRP ) in inducing os-teogenic differentiation of rat precartilaginous stem cells in vitro and the underlying mechanisms. Methods Rat pre-cartilaginous stem cells ( PSCs) were cultured in complete osteogenesis medium containing DMEM/F-12 medium and different concentrations (0, 10-8,10-9,10-10mol/L) of CGRP, the morphology changes of PSCs were observed. The proliferation of PSCs was examined at different time points by CCK-8. All the PSCs were then randomly assigned to an experimental group and a control group. The PSCs in the experimental group were cultured in complete osteogenesis medium with 10-10 mol/L CGRP , while the control group cultured merely in complete osteogenesis medium was re-ceived no special intervention. Both groups were stained by Alizarin Red and the expression of alkaline phosphatase (ALP) was detected. The osteogenic genes (RUNX2,OPN and BGP) were measured by use of RT-PCR. The activa-tion of Wnt/β-catenin signaling pathway was tested by using Western blotting to evaluate the effect of CGRP . Results Compared to the control group ( the concentration of CGRP was 0 mol/L) , the concentration of ALP was significantly higher in the experimental group, calcium deposition was significantly more obvious, and the expression of the osteogenic genes such as RUNX2,OPN and BGP as well as theβ-catenin protein expression were up-regulated significantly. However, CGRP had no effect on cell proliferation. Conclusion CGRP activated Wnt/β-catenin sig-nal pathway and induced osteogenic differentiation of precartilaginous stem cells.

Objective To investigate the value of rosuvastatin in alleviating early inflammatory reaction and in preventing early recurrence of persistent atrial fibrillation (AF) after catheter ablation treatment. Methods A total of 84 patients with persistent AF who had received catheter ablation were enrolled in this study. The patients were randomly and equally divided into group A (n = 42, study group) and group B (n = 42, control group). Rosuvastatin therapy (10 mg/d, 42 patients) was employed in the patients of group A, while no medication was used in the patients of group B. One month after the ablation treatment, the serum lipid level, hs-CRP and IL-6, as well as the recurrence rate of all kinds of arrhythmia were determined. The preoperative and postoperative levels of inflammatory markers were also determined, the results were compared between the two groups, and its correlation with the early recurrence of AF was evaluated. Results One month after the ablation treatment, the levels of inflammatory markers, including hs-CRP and IL-6, in the study group were significantly lower than those in the control group, as well as lower than those determined before treatment, while in the control group the serum hs-CRP and IL-6 levels became significantly higher than the preoperative ones. Sinus rhythm was successfully maintained in 29 cases (69%) of the study group and in 25 cases (59.5%) of the control group, while the difference was not statistically significant (P = 0.362). The patients of the study group were further divided into non-recurrence sub-group (n = 29) and recurrence sub-group (n = 13). The reduction in inflammatory marker level in the non-recurrence sub-group was greater than that in the recurrence sub-group although the difference was not statistically significant. Conclusion There is remarkable inflammatory reactions during the early period after catheter ablation. Rosuvastatin can effectively relieve the degree of inflammatory reaction, although it has only a slight effect in reducing the early recurrence rate after catheter ablation of AF. The greater the inflammatory markers levels are reduced, the lower the recurrence rate of AF will be, although the difference is not statistically significant.

OBJECTIVE To investigate resistant genes encoding ?-lactamases and aminoglycoside modifying enzymes in Pseudomonas aeruginosa isolated from clinical specimens,and phylogenetic analysis was performed.METHODS Antimicrobial susceptibility test was performed by PhoenixTM-100 system.Resistant genes encoding ?-lactamases,aminoglycoside modifying enzymes and antiseptic resistance were detected by PCR amplification and verified by DNA sequencer.RESULTS The resistant rates of ?-lactams including ampicillin/sulbactam,piperacillin,piperacillin/tazobactam,cefotaxime,ceftazidime,cefepime,imipenem and meropenem in 190 strains of P.aeruginosa were 98.9%,59.5%,45.8%,77.4%,34.2%,38.4%,15.3% and 6.8%,respectively.Ciprofloxacin and levofloxacin still showed powerful activities with resistance being 15.3% and 21.0%.The positive rates of blaVEB, blaGES and blaCARB genes were 9.5%,9.5% and 57.1% in 21 isolates.Twenty strains lost oprD2 genes.However,the ?-lactamase genes of TEM,SHV,OXA,PER,IMP,VIM,SPM,GIM and DHA were not found.Three resistant genes encoding aminoglycoside-modifying enzymes were found in 21 isolates,such as aac(6′)-Ⅰ,aac(6′)-Ⅱ and ant(2″)-Ⅰ,and they accounted for 9.5%,61.9% and 66.7%,respectively.The positive rate of qacE△1-sul1 genes was 66.7% in 21 isolates.CONCLUSIONS P.aeruginosa isolated in clinic has carried many resistant genes.The loss of oprD2 gene may be the important cause of P.aeruginosa resistant to imipenem.Cluster analysis indicates that the spread of clones occurred in our hospital.

Objective To investigate blocking ascending branch of uterine arteries in operation of hysteromyomas rejecting by laparoscope.Methods 60 petients(except cervix myoma,intraligamentary myoma,submucosa myoma),randomly devided to reseach group(30 cases)and control group(30 cases).Blocking ascending branch of uterine arteries before rejecting hysteromyomas by laparoscope in reseach group,directly rejecting hysteromyomas by laparoscope in control group.The volumes of blood loss in operation,the duration of operation,postoperative recovery(Time of passing flatus,wound healing,length of stay)were compared between two groups.During the follow-up months,observing hysteromyoma recidivism and improvement of menstruation.Results All patient were rejected hysteromyomas by laparoscope.The volumes of blood loss in research group were less than that in control group(P0.05),All wounds were well healed in both groups,the rate of hypermenorrhea improvement was 100%(26/26)in research group,but That in control group was 80%(16/20),There was significant difference between two group.Conclusions Blocking ascending branch of uterine arteries may obviously decrease the volumes of blood loss in operation of hysteromyomas rejecting by laparoscope,It presents rapider convalescence,higher rate of symptom improvement and less complication operation.

Objective To analyze the effect of bifrontal decompressive craniectomy on patients with refractory diffusing of brain swelling after severe traumatic brain injury.Methods The clinical data of 68 patients with refractory diffusing of brain swelling after severe traumatic brain injury were analyzed retrospectively.Thirty-five patients were performed with bifrontal decompressive craniectomy as observed group,continued intracranial pressure monitoring after surgery.Thirty-three patients were treated conservatively to reduce intracranial pressure as control group,continued intracranial pressure monitoring.The Glasgow outcome scale after discharge 6 months were assessed.The efficacy,the incidence of complications were observed in observed group.Results The admission intracranial pressure in observed group was significantly higher than that after surgery [(35.9 ±6.9) mmHg (1 mmHg =0.133 kPa) vs.(17.5 ±5.2) mmHg,P ＜0.05].The admission intracranial pressure in control group was (34.2 ± 8.6) mmHg,after admission 10.5 h was (32.0 ±4.8) mmHg (P ＜0.05),difference was no statistically significant (P＞ 0.05).The intracranial pressure after admission 10.5 h in control group was significantly higher than that in observed group after surgery (P ＜0.05).Two cases of subdural effusion,1 case of postoperative hydrocephalus in observed group.The better prognosis rate in observed group was significantly higher than that in control group [45.7％ (16/35) vs.18.2％ (6/33),P ＜ 0.05].Conclusions Bifrontal decompressive craniectomy is a suitable measure to decrease the intracranial pressure in the patients with refractory diffusing of brain swelling.If carried out early,it could provide better outcome for these patients.