ObjectiveTo observe the effect of multidisciplinary rehabilitation on prognosis of patients with stroke hemiplegia.Methods100 patients with stroke hemiplegia were divided into the rehabilitation group and control group with 50 cases in each group. The patients of the rehabilitation group were treated not only with routine medication,but also with rehabilitation therapy, which included nerve-muscle promoting technology, functional electric stimulation and Channel Balance-Inducing instrument therapy, and etc, over six mouths. The cases of the control group were treated only with routine medication. The motor function of patients was assessed with Fugl-Meyer Assessment (FMA), and activities of daily living (ADL) was assessed with Barthel Index (BI) before and after treatment.ResultsThe FMA and BI scores of the patients in the rehabilitation group increased obviously, having a significantly difference with that of the control group (P<0.01).ConclusionThe prognosis of patients with stroke hemiplegia treated with multidisciplinary rehabilitation is superior to that with simple medication.

Objective To explore the application value of end-to-side closed in situ pancreaticojejunostomy in pancreaticoduodenectomy.Methods The clinical data of 22 patients with obstructive jaundice who were admitted to the Second Affiliated Hospital of Harbin Medical University from January to March 2014 were retrospectively analyzed.All the patients were explored whether tumors invaded inferior vena cava, superior mesenteric vein and portal vein after gallbladder decompression under general anesthesia by tracheal intubation.The standard or extended pancreaticoduodenectomy was applied according to the intraoperative results.The method of pancreaticojejunostomy was end-to-side closed in situ anastomosis of pancreatic duct and jejunal seromuscular layer.The operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time, amylase concentration of drainage at postoperative day 1,3,5, postoperative complication, pathological classification and duration of hospital stay were observed.Patients were followed up by outpatient examination and telephone interview till May 2014.The out-patient follow-up included color Doppler ultrasound examination of effusion near the pancreatic stump, and the telephone interview included whether there were diarrhea of exocrine pancreatic insufficiency.Measurement data with normal distribution were presented as-x ± s (range) , and measurement data with skewed distribution as M(range).Results All the 22 patients underwent successfully the operation, including 17 undergoing standard pancreaticoduodenectomy and 5 undergoing extended pancreaticoduodenectomy, with end-to-side closed in situ anastomosis of pancreatic duct and jejuna seromuscular layer.The operation time of pancreaticoduodenectomy and end-to-side closed in situ pancreaticojejunostomy were (313 ± 37)minutes (range, 228-360 minutes) and(13 ± 4) minutes (7-22 minutes) , respectively.The intraoperative blood loss was (400 ± 207) mL (range, 100-800 mL).The mean tumor size was 3.69 cm2(range, 0.72-1.68 cm2).The recovery time of gastrointestinal function was (5 ±2)days (range, 4-7 days).The serum amylase at postoperative day 1, 3, 5 in the 21 patients was (145±30)U/L (range, 116-180 U/L), (136±40)U/L (range, 105-176 U/L), (147 ±38)U/L(range, 110-175 U/L), and the drainage amylase was (220 ±56)U/L (range, 172-289 U/L), (240 ±54)U/L (range, 192-300 U/L) , (245 ± 52) U/L (range, 190-298 U/L) , respectively.The serum amylase at postoperative day 1, 3, 5 in the patient with pancreatic fistula was 156 U/L, 178 U/L and 177 U/L, and the drainage fluid amylase was 500 U/L, 620 U/L and 605 U/L, respectively.There was 1 patient in the 22 patients with pancreatic duct stent and without death.Among the 4 patients with postoperative complications, 1 patient with grade A postoperative pancreatic fistula recovered after continuous external drainage, the other 3 including 1 case of infection,1 case of pneumonia and 1 of stress ulcer bleeding also recovered after symptomatic and supportive treatment.Postoperative pathological examinations of the 22 patients showed 12 cases of ductal adenoeareinoma, 2 of neuroendocine tumors, 1 of simple cyst, 1 of cystadenocarcinoma, 1 of squamous carcinoma, 1 of adenocarcinoma, 1 of ampullary carcinoma, 1 of tubular adenoma, 1 of leiomyoma and 1 of atypical intraductal hyperplasia.The average length of hospital stay was (11 ±3)days (range, 2-15 days).There were no effusion near the pancreatic stump showed in color Doppler ultrasound examination and diarrhea of exoerine pancreatic insufficiency.Conclusion End-to-side closed in situ pancreaticojejunostomy is safe and feasible, and can be applied to any pancreatic duct size and texture.

Objective To study normal flora components of conjunctiva, explore the relationship between normal flora and ocu- lar bacterial infections.Methods The data of 1 198 bacterial cultures of conjunctiva in non-infectious cataract patients were re- viewed and compared with the results of 985 specimens of conjunctivitis, keratitis and endophthalmitis from January 2000 to December 2004.Results Positive culture of conjunctiva in non-infectious cataract patients was 628 in 1 198 specimens (52.4%).These bacteria including gram-positive cocci and gram-neganve bacilli constituted the normal flora of conjunctiva. Staphylococcus epidermidis was the predominant bacteria (51.1%, 341/667) and its prevalence increased during this 5-year period.S.epidermidis and S.aureus were also the most frequently isolated pathogens in specimens of conjunctivitis, keratitis and endophthalmitis.The correlation was statistically significant between the positive rate in normal eye and conjunctivitis or keratitis in terms of these two species, but not statistically significant between normal eye and endophthalmitis.The resistance rate of normal flora of conjunctiva to ampicillin, amikacin, tobramycin, ciprofloxacin, and ofloxacin increased year by year. The resistance rate to gentamicin and the combination of two drugs decreased.The changing resistant pattern was similar in pa- tients with eye infection.Conclusions There is a close relationship between the normal flora S.aureus and S.epidermidis of conjunctiva and the bacterial infection of ocular surface, but no significant correlation between normal flora and the pathogen of endophthalmitis.

Objective To investigate the mental health and its correlated factors for senile dementia caregivers in nursing homes in Shenyang. Methods Questionnaire survey was conducted among 174 senile dementia caregivers recruited from the Nursing Home of Shenyang and Shenyang Social Welfare Institute by using Symptom Check-List-90 (SCL-90), Social Support Rating Scale (SSRS) and self-designed general information questionnaire and to analyze the scores of self rating scale of nursing staff, the total score of social support scale, and the factors affecting the mental health status of nursing staff. Results The SCL-90 scores of senile dementia caregivers with education levels from illiteracy, primary school or junior high school, high school or secondary school, college or above were 130.50 ± 10.11, 132.70±12.55, 135.06±9.15, 129.24±8.83, the difference was statistically significant (F=15.05, P<0.01). The SCL-90 scores of senile dementia caregivers with poor, general and good perceived health status were 133.40±10.52, 132.60±11.32, 128.00 ±10.02, the differences were statistically significant (F=9.07, P<0.01). The SCL-90 scores of family monthly income of 1001 to 3000 yuan, 3001 to 5000 yuan and more than 5001 yuan were 132.90 ± 10.39, 132.80 ± 11.52, 131.50 ± 8.20, the difference was statistically significant (F=12.11, P<0.01). The multivariate linear regression analysis showed that the regression coefficient of perceived health status was-0.168 (t=2.880, P<0.01), monthly family income was-0.145 (t=-2.512, P<0.05), SSRS was 0.121 (t=2.112, P<0.05). Conclusions Mental health status of senile dementia caregivers in Shenyang is poor. The health sector should take some measures to improve the degree of social support, nursing staff wages and to ensure their health in order to promote physical and mental health of nursing staff and the nursing level so as to improve the quality of life of the senile dementia elderly.

OBJECTIVE: To investigate the features of adverse drug reaction(ADR) in our hospital and evaluate the quality of ADR report in order to promote rational clinical drug use and find out the existing problems in the report. METHODS: Microsoft Excel was designed to analyze statistically the sex and age of the patients,category of the used drugs and the clinical manifestations of ADR in 311 cases of ADR report collected between 2002 and 2005.RESULTS: The occurrence of ADR induced by antibacterials ranked the first.ADR affecting skin and its appendages counted for 50% of the total.The numbers of ADR reports were found to be less than expected.CONCLUSIONS: Professional staff training should be strengthened,the use of antibacterials should be rationalized to lessen and avoid the occurrence of ADR.

Objective To evaluate engraftment status of patients after allogeneic hematopoietic stem cell transplantation(Allo-HSCT) and prompt relapse of disease based on DNA polymorphism analysis technique.Methods Sixty-six cases were detected by DNA polymorphism analysis technique and 25 cases were monitored and analyzed dynamically during this period.Results After Allo-HSCT,48 patients obtained type of donors,but 13 patients did not; 5 patients showed mixed chimerism.Two cases of type of donors converted into mixed chimerism and 4 cases of mixed chimerism converted into type of donors after some time. The others' engraftment status did not change.Conclusion DNA polymorphism analysis technique can detect engraftment status of patients exactly, rapidly, which provides effective evidences of constitution for more clinical therapy projects.

Tramadol and its metabolites in rat urine were identified by LC-MS(n). Rat urine samples of 0-36 h were collected after ip 9.0 mg x kg(-1) tramadol, then the samples were enriched and purified through solid-phase extraction cartridge. Purified samples were analyzed by LC-MS(n). Possible metabolites were discovered by comparing the full scan and SIM chromatograms of the test samples with the corresponding blanks and analyzing the retention time, quasi-molecular ion and fragment ion of all chromatograms. Nine phase I metabolites and four phase II metabolites were identified in rat urine. One of the metabolites was found first time in living body. The metabolites were formed via the following metabolic pathways: O-demethylation, N-demethylation, hydroxylation, N-oxidation and conjugation. The method can be used to identify tramadol and its metabolites in other animals and human.

Objective To investigate the expression of microRNA let-7a in formalin-fixed paraffinembedded (FFPE) melanoma tissue and its effect on the proliferation of A375 cell lines. Methods Tissue samples were obtained from 13 patients with malignant melanoma and 10 with congenital pigmented nevus,then fixed with formalin and embeded with paraffin. microRNAs were isolated from these samples and reversely transcripted to cDNA with stem-loop primer. Then, real time quantitative PGR was performed with Taqman MGB probe and matched primers to measure the expression of microRNA let-7a. cy3-Labeled negative control siRNA was transfected into A375 cells followed by the examination of transfection efficiency under fluorescense microscopy. Subsequently, hsa-let-7a mimics were transfected into A375 cells to observe their effect on the proliferation of these cells. Results microRNAs were successfully isolated from FFPE tissues, and quantitative PGR showed a significant reduction in the expression of microRNA let-7a in melanoma tissue compared with nevus tissue (t = 2.364, P ＜ 0.05). The transfection efficiency was found to be about 80% ～90%. After transfection with hsa-let-7a mimics, the proliferation of A375 cells was inhibited and the inhibition rate amounted to 32.7% at 24 hours. Conclusions The expression of microRNA-let-7a is attenuated in melanoma, and overexpression of let-7a can inhibit the proliferation of A375 cells, which implies that let-7a functions as a tumor suppressor gene in melanoma.

Objective To investigate the relationship between dyslipidemia,obesity,insulin resistance (IR)and various degrees of non.alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus (T2DM), and the risk factors of NAFLD.Methods Two hundred and sixty-eight patients were divided into three groups(non-NAFLD group,mild NAFLD group,moderate and severe NAFLD group)by liver ultrasonography.Body height(H),weight(W),waist circumference(WC),hip circumference(H)were measured.The levels of fasting blood glucose (FBG),glycosylated hemoglobin A_1c(GHbA_1C),serum total cholesterol(TC),serunl high density lipoprotein(HDL-C),serum low density lipoprotein(LDL-C),serum triglyceride (TG),alanine aminotransferase (ALT)and fasting serum insulin(FINS)were measured.Body mass index(BMI),the waist to hip ratio(WHR)and insulin resistance index(HOMA-IR)were calculated.Unconditional logistic regression model was used to test for the risk factors of NAFLD.Results BMI、WC、WHR、HNS、HOMA.IR、TC、LDL-C、TG and ALT in NAFLD group were significantly higher than those in non-NAFLD group (P<0.05).The levels of BMI、WC、WHR、HNS、HOMA-IR、 TG and ALT increased significantly in moderate and severe NAFLD group compared with mild NAFLD group(P<0.05).TG、WHR and HOMA.IR were the risk factors of NAFLD(P<0.05,OR=2.394,3.273,5.256).Conclusions NAFLD in patients with T2DM had remarkable dyslipidemia,overweight,central obesity and insulin resistance.TG、WHR and HOMA.IR were risk factors of NAFLD.

Though Runx2 and Osterix are both key transcription factors in the pathway of osteoblast differentiation, whether Runx2 positively regulates Osterix being unknown. It was showed that Runx2 induced the gene expression of Osterix both in the non-osteoblastic cell lines, either pluripotent or differentiated, and in the osteoblastic cell lines. At the same time, the results also indicated that Runx2 up-regulated the activity of the 3.2 kb human Osterix promoter. Further experiments identified a highly conserved and functional Runx2 binding site "AGTGGTT" within the promoter. Thus the results support the hypothesis that Runx2 is involved in the regulation of the Osterix gene expression. Moreover, the transient transfection and dual-luciferase assay showed Osterix up-regulated the activity of the 2.3 kb type Ⅰ collagen promoter in the non-osteoblastic cells, but Runx2 did not. This difference implies that Osterix, the down stream transcription factor of Runx2 during osteoblast differentiation, is needed to stimulate the osteoblast-specific gene expression of type Ⅰ collagen.