Objective To study the effect of motor imagery therapy combined with conventional physical training on hemiplegia lower extremity function in stroke patients with hemiplegia.Methods Thirty hemiplegic patients meeting the eligible criterions were randomly divided into two groups: a treatment group (n = 13 ) and a control group ( n = 17).All subjects accepted conventional rehabilitative treatment.Patients in treatment group were treated with motor imagery therapy after physical training, while the patients in control group were treated with physical training only.Motor function was measured by the percentages of changes in maximum loading on affected lower limb (PL%), Barthel index (BI), 5m maximum back and forth walking speed (5m MBFWS), Berg balance scale ( BBS), Fugl-Meyer motor assessment ( lower limb) (FMA-L) before the beginning of training and at the end of sixweek training.Results In both groups, all measurements at the end of training improved significantly ( P < 0.01 )compared to that at the beginning of training.After the whole training course, PL% and 5m MBFWS (m/s) in treatment group were significantly better compared to those in control group( P < 0.05 ), and the other measurements were not statistically significant between two groups( P > 0.05 ).Conclusion Motor imagery therapy had positive effect on hemiplegia lower extremity function of sub-acute stroke patients.

Objective To explore the effect of valasartan, an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, on the plasma levels of calcitonin gene-related peptide (CGRP) in patients with essential hypertension. Methods 29 outpatients with essential hypertension were treated with valasartan 80mg/day for 6 weeks. 28 age-matched normal blood pressure people were taken as controls. The plasma levels of CGRP were measured in all patients before and after treatment and in controls. Results The plasma levels of CGRP in hypertensive patients were significantly lower than those in controls (minimal value: 0.00 vs 39.95pg/ml; maximal value: 24.07 vs 155.59pg/ml; P

Objective To explore the clinical features of drug hypersensitivity syndrome(DHS). Method Retrospective analysis of 18 cases of DHS was made in detail including clinical situation, laboratory examination, treatment instance,duration and prognosis. Results The earliest symptoms of all patients were skin rash and fever, which occurred in 2 to 8 weeks after the administration of the drugs, accompanied with superficial lymphadenopathy in 13 patients, liver dysfunction in 14 patients, renal impairment in 11 patients, leukocytosis in 13 patients and eosinophilia in 10 patients. The skin lesions were multiform. The common eruption was purpura-like erythemas, accompanied with swelling and repeated desquamation. The suspected drugs were as follows: allopurinol in 11 cases, carbamazepine in 4 cases, phenytoin in 2 cases and minocycline in 1 case. Corticosteroid was the first line of treatment Conclusions DHS is a clinical syndrome to have characteristic symptom and a relatively severe disease. It is crucial to discontinue the suspected drugs promptly and to start sufficient dose of corticosteroid.

Objective To find a new material for biomedical scaffold.Methods Composite films from poly-L-lactic acid(PLLA)and opal powder were fabricated.Osteoblasts seeded on the composite films and control ones were examined.Cell densities and morphologies on these films were studied by scanning electron microscopy(SEM).Cell growth and differential function were assessed by 3-(4,5-dimethyltyiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT)test.Results SEM study showed that the addition of powder could improve the adhesion between osteoblasts and the composite films.MTT test proved that cell proliferation was improved when opal powder was added.This improvement came from the negative ion given off by the opal powder.The negative ions either accumulate at the cell membrane or enter into the cells.Accumulation of negative ions at the cell membrane leads to a change of electric potential difference across the cell membrane which should be in a proper range for the cells to perform their normal physiological function.If the negative ions enter the cells,they may take part in biochemical reactions whenever possible.In this way,the ions also affect the cell normal metabolism.Conclusion Osteoblasts grow well on opal/PLLA composites and the negative ion from opal powder is responsible for the enhancement of cell growth.This study provides a new material for biomedical scaffold.

Objective To evaluate the clinical efficacy and safety of different courses of topical tacrolimus 0.1％ ointment in facial corticosteroid-dependent dermatitis and to observe the rebound in patients after treatment with these regimens.Methods A total of 104 patients with facial corticosteroid-dependent dermatitis were randomly divided into 3 groups to be treated with topical tacrolimus 0.1％ ointment twice daily for 4,8 and 16 weeks respectively.The patients were followed up every 2 weeks within the early 4 weeks of treatment and every 4 weeks thereafter.The rebound phenomena was observed in patients on week 4 after the withdrawal of tacrolimus.Results Finally,90 patients completed this trial,including 32 patients in the 4-week group,29 patients in the 8-week group and 29 patients in the 16-week group.No significant differences were observed between the 4-,8- and 16-week groups in the total reponse rate (75.00％,82.76％,86.21％,respectively,x2 =1.35,P ＞ 0.05).The rebound rate in the 16-week group significantly differed from that in the 4- and 8-week group (20.69％ vs.46.88％ and 41.38％,both P＜ 0.05),while no statistical difference was noted between the 4- and 8-week groups.Local burning and itching were reported in 31.73％ of these patients,and all of these irritant reactions occurred within the first week of treatment.Conclusions Topical tacrolimus 0.1％ ointment is safe and effective for the treatment of facial corticosteroid-dependent dermatitis.The total response rate does not increase with the extended treatment course,and 4 weeks of treatment is enough for the marked and stable improvement of facial corticosteroid-dependent dermatitis,but the rebound rate is likely to be reduced by extended treatment course.

Objective To analyze the results of syphilis serology test among inpatients and to provide information for the control of syphilis.Methods Syphilis serology test results of inpatients from Jan.2010 to Nov.2012 in a tertiary general hospital were collected and retrospectively analyzed.The serum samples were screened by Treponema pallidum (TP) antibody enzyme linked immunosorbent assay (ELISA) and syphilis toluidine red unheated serum reagin test (TRUST) simultaneously.The TP-ELISA positive samples were confirmed by Treponema pallidum particle agglutination test (TPPA).Difference of measurement data was compared with analysis of variance.Results A total of 81 946 cases were collected,among which 1618 cases were positive of anti-TP.The positive rate of anti-TP was 2.27％ in the year 2010,1.58％ in 2011,and 2.11％ in 2012.For male and female patients,the positive rates of anti-TP were 2.38％ and 1.69％,respectively (x2 =48.97,P=0.00).The positive rates of anti-TP in the age groups of ≤19 years,20-39 years,40-59 years,60-79 years,and ≥80 years were 2.83％,0.94％,2.14％,2.37％,and 3.63％,respectively.The titer of TRUST was relatively lower in anti-TP positive inpatients.The anti-TP positive patients with TRUST titer ＜ 1∶8 accounted for 84.65％ in the age group of ≤19 years,79.69％ in the 20-39 years group,81.69％ in the 40-59 years group,86.12％ in the 60-79 years group,and 87.45％ in the age group of ≥80 years.The highest anti-TP positive rate (3.63％) was observed in the age group of ≥80 years with the lowest percentage (12.55 ％) of TRUST titer ≥1∶8.The lowest anti-TP positive rate (0.94％) was observed in the 20-39 years group with the highest percentage (20.31％) of TRUST titer ≥1∶8.Conclusions The characteristics of syphilis serological positivity vary depending on genders and ages.The prevention and control measures for syphilis should be strengthened,especially in the senior population.

Objective:To investigate the feasibility and efficacy of transcystic injection of indocyanine green during laparoscopic cholecystectomy (LC) surgery in the treatment of patients with gallbladder stones combined with liver cirrhosis.Methods:The clinical data of 96 patients with cirrhosis who underwent LC for gallbladder stones with cholecystitis attacks in the Department of Hepatobiliary and Pancreatic Surgery of the Second People′s Hospital of Changzhou City from January 2018 to May 2022 were retrospectively analyzed. All patients were diagnosed by clinical history and auxiliary examination before surgery and underwent cholecystectomy according to their groups, which were divided into fluorescence group ( n=49) and white light group ( n=47) according to whether ICG was used or not, where the fluorescence group underwent LC in fluorescence mode after direct intraoperative injection of ICG via gallbladder. The two groups were compared in terms of identification time of the three tubes, operation time, intraoperative bleeding, intraoperative injury, intraoperative open abdomen and blood transfusion, postoperative drainage time, postoperative hospitalization time, postoperative complications and changes in infection and liver function indexes before and after surgery. The measurement data obeying normal distribution were expressed as mean±standard deviation( ± s), and independent sample t-test was used for comparison between groups. The measurement data obeying the skewed distribution were expressed by M( Q1, Q3), and the Mann-Whitney U test was used for comparison between groups. Count data were expressed as rates (%), and the chi-square test or Fisher′s exact probability method was used for comparison between groups. Results:The procedure was successfully performed in both groups, and the identification of triple-tube time, operative time, intraoperative bleeding, postoperative drainage time, postoperative hospital stay, postoperative ALT, postoperative GGT, and postoperative TBIL in the fluorescent group were (14.96±1.49) min, (52.14±7.36) min, 5(5, 10) mL, (1.61±0.61) d, (2.37±0.49) d, 31.5(22.0, 44.8) U/L, 38.0(21.0, 91.5) U/L, 18.0(11.5, 22.8) μmol/L, and (29.87±3.37) min, (84.36±13.25) min, 10(10, 20) mL, (2.70±0.69) d, (3.15±0.42) d, 45.0(28.0, 64.8) U/L, 73.0(32.0, 132.0) U/L, 23.0(16.1, 29.3) μmol/L in the white light group and the differences were statistically significant compared with the two groups( P<0.05). In the fluorescence group, there was no intraoperative injury and no cases of intraoperative opening, and there were 2 cases of postoperative complications, while in the white light group, there were 2 cases of intraoperative injury, 1 case of intraoperative opening, and 5 cases of postoperative complications, and there were no cases of blood transfusion in both groups. There was no statistically significant difference between the fluorescence group and the white light group when comparing the preoperative laboratory indexes of both groups ( P>0.05). When comparing the first postoperative white blood cell count, C-reactive protein, aspartate aminotransferase, and alkaline phosphatase indexes in the fluorescence group and the white light group, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:When LC is performed in patients with symptomatic gallbladder stones combined with cirrhosis, intraoperative injection of indocyanine green via the gallbladder to visualize the gallbladder and bile duct structures is simple and easy to perform, and the safe and efficient dissection of extrahepatic bile ducts and gallbladder bed speeds up the procedure while reducing postoperative trauma.

Objectives:To explore the impact of intensive lipid-lowering strategy on short-term prognosis of acute coronary syndrome(ACS)patients with multi-vessel disease. Methods:A total of 136 ACS patients with multi-vessel disease who received coronary stenting at Zhongnan Hospital of Wuhan University from August 2019 to November 2020 were enrolled in this study.Patients were divided into intensive lipid-lowering group(control low density lipoprotein cholesterol[LDL-C]below 1.0 mmol/L within 3 months,and continuously meet the standards within 12 months,n=69)or standard lipid-lowering group(gradually control LDL-C below 1.4 mmol/L within one year,n=67).The total cholesterol(TC),triglycerides(TG),LDL-C,high-density lipoprotein cholesterol(HDL-C),and lipoprotein(a)(Lp[a])data were collected.Incidence of major adverse cardiovascular events(MACE,including cardiac death,myocardial infarction,target vessel revascularization and stroke)were observed during 12 months of follow up. Results:The baseline data of the intensive lipid-lowering group and the standard lipid-lowering group were consistent before intervention.At the timeline of enrollment,there was no statistically significant difference in the blood lipid profiles(including TC,TG,LDL-C,HDL-C)between the two groups.After 3-months,patients in the intensive lipid-lowering group experienced significantly lower TC,TG,LDL-C and Lp(a)compared with baseline values(all P<0.05),while HDL-C remained unchanged(P>0.05).The standard lipid-lowering group showed a significant decrease in TC and LDL-C compared with baseline values(both P<0.05).The TC and LDL-C levels were significantly lower in the intensive lipid-lowering group than in the standard lipid-lowering group at 3/6/12 months follow up after discharge(all P<0.01).At 12 months follow-up,Kaplan-Meier survival analysis showed that the incidence of MACE was significantly lower in the intensive lipid-lowering group than in the standard lipid-lowering group(2.90%vs.14.93%,χ2=6.090,P=0.014).Multiple Cox regression analysis revealed that the intensive lipid-lowering strategy significantly reduced the risk of MACE compared with the standard lipid-lowering strategy(HR=0.177,95%CI:0.037-0.838,P=0.029). Conclusions:Our data show that intensive lipid-lowering strategy may probably reduce the incidence of short-term MACE in ASC patients with multi-vessel disease.Large-scale prospective multi-center studies are needed to further validate these results.

Objective:To explore the current status of rumination in inpatients with metastatic prostate cancer (mPCa) under the disease coping mechanism, and analyzing its influencing factors.Methods:From March 2021 to December 2022, 267 mPCa inpatients at the Tenth People's Hospital of Tongji University were selected as the study subject using convenience sampling. The survey was conducted using the General Information Questionnaire, Chinese Version of Event Relate Rumination Inventory (C-ERI), Medical Coping Modes Questionnaire (MCMQ), International Prostate Symptom Score (IPSS), and Social Support Revalued Scale (SSRS), and the factors influencing the rumination in patients were analyzed.Results:This study collected 260 valid questionnaires, with an effective response rate of 97.4% (260/267). The total score of rumination in 260 mPCa patients was (31.08±6.46), with invasive rumination and purposeful rumination scores of (14.13±4.44) and (16.95±4.55), respectively. The initial prostate-specific antigen index, confrontation medical coping modes were the influencing factors of invasive rumination in mPCa patients ( P<0.05). The initial prostate-specific antigen index, course of disease, social support, and confrontation medical coping style were the influencing factors of purposeful rumination in mPCa patients ( P<0.05) . Conclusions:The rumination of mPCa patients is above the medium level, and is influenced by multiple factors under the disease coping mechanism. Clinical medical and nursing staff should combine the clinical situation and characteristics of mPCa patients, provide personalized interventions as early as possible, and assist patients in improving their positive cognitive processing abilities.

Objective To introduce our experiences in ear reconstruction with Ba Da Chu Method during the past 10 years, and to summarize the operative skills and key points .Methods Generally, Ba Da Chu Method for ear reconstruction includes 3 stages:Stage 1, skin expansion in mastoid region .Stage 2, auricular reconstruction), consisting of tissue expander removal, earlobe transposition, expanded skin flap and temporal fascia flap formation , autologous costal cartilage harvest , framework fabrication and transplantation , and the wound closure .Stage 3: tragus formation , conchoplasty , and refinement of the reconstructed ear.Results From January, 2006 to December, 2015, we performed 5628 reconstructed ears for 5267 patients with congenital microtia .Follow-up period ranged from 1 to 10 years.Complications in stage 1 included hematoma , infection and expander exposure sporadically arising , which were treated properly and stage2 operations were carried out on time or delayed .5202 (92.4％) reconstructed ears were demonstrated with fine substructure landmarks .236(4.2％) reconstructed ears with poor blood circulation at the margin of skin flap , were cured completely and ended up with acceptable outcomes;108 ( 1.9％) reconstructed ears , manifestedwith mild cartilage framework exposure due to partial necrosis of skin graft , were repaired in stage 3.61 (1.1％) of them with severe exposure , needed additional operations to cover the framework with axial fascial flap immediately .21 ( 0.3％) reconstructed ears lost the normal contour because of cartilage infection , which a secondary operation was needed to repair .The complications of stage 3 occurred rarely , which could be cured in the end .Conclusions Ba Da Chu Method is well adapted to treat congenital microtia , and it is flexible to adjust surgical skills when microtia was combined with other complicated soft tissue deformities or craniofacial bone defects;Satisfactory result were achieved in 92.4％reconstructed ears in this study with fine substructures;During approximate 2-month skin expansion , great attention must be paid to ensure successful expansion , which is based on extensive clinical experiences from doctors, appropriate nursing management from nurses , and careful observation from patients or their families.