BACKGROUND: The rehabilitation outcome varies in stroke patients,and there are differences in the literatures about the influence of factors on the functional recovery in such patients.,OBJECTIVE: To evaluate the pre-rehabilitative and post-rehabilitative effects of stroke patients by functional independence measure (FIM) that is widely used, and analyze the influence of gender, age, motor and cognitive functions at admission, time interval from stroke onset to arrival at rehabilitative admission, comorbidity occurrence, laterality of lesion on the functional recovery of stroke patients.DESIGN: Before-after control observationSETTING: Center of Rehabilitation Medicine, Shandong Provincial Hospital; Faculty of Rehabilitation Medicine, Capital University of Medical SciencesPARTICIPANTS: From March 2000 to December 2002, 55 stroke patients were selected from Shandong Provincial Hospital. They were all first episode, and patients whose bilateral cerebral hemisphere were involved were excluded.METHODS: After the vital signs were steady, the stroke patients got through risk phase (31-75 days) and were treated with medicine improving microcirculation and providing neurotrophic factor for nerves. In addition, they accepted comprehensive rehabilitation training of Bobath technique, PNF technique and Rood method mainly, with 1-2 hours per day and five times per week.MAIN OUTCOME MEASURES: The patients were evaluated within 7days after admission and reassessed 3 days before discharge using FIM,including 18 items of motor and cognitive functions and 126 total scores (108-126 as elementarily or completely independent, 72-107 as mildly dependent, 54-71 as moderately dependent, 36-53 as severely dependent,18-35 as extremely or completely dependent). Multiple stepwise regression equation was applied to analyze the relation of above factors and functional recovery (increased value of FIM total score).RESULTS: Totally 55 patients were involved into the result analysis.①FIM total score of patients was significantly higher at discharge than at admission (93.8±12.0, 68.8±11.6, P ＜ 0.001), and motor function and cognitive function at discharge also increased compare with at admission (P ＜ 0.001).②Mean value of FIM motor score increased everyday was identical with that of total score (0.56±0.21, 0.59±0.21), and higher than mean value of cognitive score (0.03±0.03).Multiple stepwise regression analysis showed,scores of motor and cognitive status at admission, age, time interval from stroke onset to arrival at rehabilitative admission all affected the increased value of FIM total scores. No significant association between gender, comorbidity, laterality lesion of paralysis and functional recovery was observed (P ＞ 0.05). The most influential factors were orderly motor function,cognitive function at admission, age and time interval from stroke onset to arrival at rehabilitation admission.CONCLUSION: Motor and cognitive function at admission, age and time interval from stroke onset to arrival at rehabilitative admission have a no table relationship with functional recovery of stroke patients, especially motor function at admission is positively related. Thus we should not neglect the influence of these factors when conducting rehabilitative treatment.

Objective To study the clinical effects of YangGanYiShui granule(YGYSG) on treating early renal damage induced by essential hypertension(EH)and observe the corresponding changes of total cholesterol(TC)、low-density lipoprotein cholesterol(LDL-C)、 C-reactive protein(CRP) and serum uric acid(UA).Methods Eighty EH patients with early renal damage were randomly divided into 2 groups: treatment group(n=40) and control group(n=40).Both two groups were treated with conventionally therapeutic methods of antihypertensive for four weeks.Besides,the YGYSG was added Simultaneously into the treatment group.The levels of TC、LDL-C、UA、CRP in 80 cases were measured and compared.Results After the therapy with YGYSG,the levels of TC、LDL-C、UA、CRP were significantly decreased.The difference between two groups was prominent(P

Objective To express the immunodominant epitopes of the branched chain 2 oxo acid dehydrogenase complex (BCOADC), the pyruvate dehydrogenase complex (PDC), the 2 oxo glutarate dehydrogenase complex (OGDC) and a triple hybrid clone (designated as BPO), and use BPO as a tool for the detection of M2 specific for primary biliary cirrhosis (PBC). Methods The cDNA fragments encoding the M2 reactive epitopes of BCOADC, PDC and OGDC were amplified using PCR with total RNA extracted from human peripheral mononuclear blood cell. The fragments were cloned into pQE 30 and then transformed into plasmid E.coli M15. Its products were induced by isopropylthio ? D galactoside and confirmed with SDS PAGE and Western blot. Results Four specific proteins induced from the transformants containing the fused plasmid were shown to have antigenic reactivity with PBC sera, but not with normal control sera. Conclusions We succeeded in expressing three immunodominant epitopes and a hybrid clone which can be used as a powerful and specific method for the diagnosis of PBC.

Invasion and metastasis are the most important characteristic of malignant tumors,and is the direct reason of the high mortality rate. Matrix metalloproteinases (MMPs) are involved in the degradation of the extracellular matrix, a central element of tumor invasion and metastasis, so it is important to discuss the mechanism of MMPs′ release and activation for invasion and metastasis of malignant tumor.

The present higher education curriculum gets adrift from the present modern anesthesiology development seriously.Clinical young doctors generally lack anaesthesia knowledge and first aid skill.It's impossible for them to gain anesthesiology knowledge and the skill through continuing medical education.We should adjust education curriculum to increase the teaching hours of anesthesiology course for clinical medicine undergraduate.

Objective To observe the effects of comprehensive rehabilitation program on severe traumatic brain injury young patients when the time from injury to admission was delayed. Methods Eleven severe traumatic brain injury young patients received comprehensive rehabilitation program, including the neurodevelopmental techniques. They were evaluated with Functional Independence Measure (FIM) and Berg Balance Scale. One Way ANOVA was used to assess the functional status of patients during the course of treatment. Results After 6 to 12 months' treatment, the motor, cognitive and total scores of FIM and the Berg scores of all patients increased significantly ( P

Objective To observe the effects of comprehensive rehabilitation treatment on ambulation and balance function in patients with heavy brain injury when the starting time of rehabilitation was delayed.Methods Twelve heavy brain-injured patients received comprehensive rehabilitation treatment,including ambulation and balance training.They were evaluated with Fugl-Meyer Lower Extremity Assessment Scale,Functional Independence Measure(FIM)Ambulation Function Scale,Berg Balance Scale and Modified Barthel Index(MBI).One-way ANOVA was used to assess the functional status of patients during the course of treatment.Results After 3～6 months of treatment,All the scores of the assessment items above scales in all of the patients increased significantly compared with those at first evaluation(P<0.05).Conclusion The heavy brain-injured patients can still acquire contented ambulation and balance function after accepting comprehensive rehabilitation,though the starting time of rehabilitation is delayed.

Skeletal muscle contractile properties are determined by their myosin heavy chain (MHC) expression profiles partly. Spinal cord injury induced the adaptation change in MHC isoform mRNAs and protein expression of skeletal muscle below the injured level, leading to the increased expression of fast and decreased expression of slow MHC isoforms. The adaptations in the MHC-mRNAs preceded the changes in proteins. The degree and velocity of MHC isoform adaptation were dependent on differenrt muscle and animal species. Short-term training could not induce the significant change of the transformation of MHC isoform, whereas long-term stepping training which emphasized load bearing could attenuate the MHC shift from slow toward faster isoforms.

Objective To evaluate the clinical features of osteoarticular damage of patients with brucellosis,and to enhance the knowledge of clinical doctors.Methods The demographic characteristics,clinical presentations,accessory examination of 265 patients with brucellosis admitted from January 2011 to April 2014 in Ji'nan Infectious Diseases Hospital were retrospectively analyzed.Patients were classified into two groups:Patients with osteoarticular complications and patients without osteoarticular complications.Results Of the 265 patients,forty-six patients (17.36％) had osteoarticular complications.Spondylitis was the most common complication [50.00％ (23/46)],followed by sacroiliitis [41.30％ (19/46)] and peripheral arthritis [26.09％ (12/46)].Sacroiliitis was more common than other types of osteoarticular damage in females [21.74％ (10/46)],whereas in males spondylitis was more common [36.96％ (17/46)].Peripheral arthritis was more common in individuals under the age of 17 years old [4.35％ (2/46)],and sacroiliitis were more common in the ages of 18-60 years old group [23.91％(11/46)] and spondylitis were more common in over 60-year age group [30.43％ (14/46)].Patients with osteoarticular complications showed longer duration of illness from the onset of the symptoms to its diagnosis (median 45 days),compared to those non-osteoarticular brucellosis (median 30 days,Z =5.74,P ＜ 0.05).Conclusion Due to diversity of osteoarticular damage in patients with brucellosis,in case of a patient with long-term fever and osteoarticular symptoms,medical and epidemiological history should be inquired so as to strengthen early diagnosis and treatment of the disease based on combination with radiological findings.

Objective To study the radiological,clinicopathological features and prognosis of metanephric adenoma.Methods Two cases were selected,which underwent partial and radical renal resection.Examined the microscopic,immunohistochemical and radiological features of 2 metanephric adenoma cases.All patients were examined by ultrasound,CT and magnetic resonance imaging.Results They were lack of blood supply in imaging examination.The tumor cells were uniform with few eosinophilic cytoplasm.The chromatin is exquisite and lack pathological mitotic figure.The tumor cells were arranged in small tube or alveolar and locally showed papillary hyperplasia.Sometimes psammoma bodies were shown..Metanephric adenoma showed positive to Vimentin and CK.Conclusions Metanephric adenoma is a rare renal tumor mostly occur in single renal.And its morphological characteristic is diversity,so it's easy being misdiagnosed as malignant tumor.The pathologists should be careful and have the concept of metanephric adenoma when diagnosis.