In May 2005,269 patients with cnnfirmed stroke were enrolled in this studv and completed questionnaire survey or interview to explore the risk factors of the disease.Our results showed that Hypertension,tobacco smoking,alcohol intake,hyperlipidemia and diabetes mellitus were significant risk factors of stroke for patients.An earlier onset trend seemed to be found.According to these results.we proposed some effective interventions and standardized management to reduce the recurrence rate of stroke.

Objective:To investigate the clinical significance of the detection of cell surface marker and chromosome in diagnosis,treatment and prognosis of leukemia. Methods:Morphologic typing and immunophenotyping were carried out in 22 untreated patients with leukemia respectively with FAB criteria and monoclonal antibodies(McAb) which were used to label cell surface marker. Chromosomal specimens were prepared by 48-hour culture method. Chromosome was analysed by G-banding technique. Results:All the 22 cases were diagnosed as leukemia by combined detection of morphology and immunology. Among them there were 8 acute lymphocytic leukemia(ALL) in which 2 cases expressed myeloid lineage-associated antigens(My+ ALL),9 acute meylocytic leukemia(AML) and 3 chronic lymphocytic leukemia(CLL). In addition,2 cases were diagnosed as acute undifferentiated leukemia(AUL). Chromosomal karyotype analysis was carried out in 17 cases,among which chromosomal abnormalities were found in 11 cases in which 2 cases with complex chromosomal deformity had non-remission(NR). With the exception of the 2 cases aforementioned,others had complete remission(CR). Conclusion:The proper detection of cell surface marker and chromosome on limited condition is helpful for the diagnosis of leukemia,which would provide an experimental evidence for personalized treatment and prognosis.

With increasing novel technology and new materials in the artificial limb, titanium alloy, carbon fiber and computer-based intelligentized control greatly improve quality of life of patients undergoing amputation. Depression, anxiety, self-concept change, increased compulsive sensitivity, and social adaptation changes are common mental problems in amputation and artificial limb treatments. Therefore, the rehabilitation therapy of amputation and artificial limb should involve both physical and mental aspects. The physicians should dredge and help the patients to face the reality and back to the life and society according to different disease conditions, various ages, social cultural background and economic conditions.

Problem-based learning(PBL) has become new teaching model.It is considered that PBL is beneficial to practicing scientific logical thinking of clinical affairs,and to increasing their capabilities of learning,oral expression,communication and cooperation.To train new type of doctors in century 21st,it is necessary to use kinds of new learning methods,including PBL methods and standardized patient(SP) in clinical teaching.

BACKGROUND: The most commonly used physiotherapies for osteoporosis include low-frequency pulsed electromagnetic field, ultrashort wave therapy, and extracorporeal shock wave therapy. Because of the uncertain intensity of extracorporeal shock wave and uncertain efficacy of ultrasound therapy, low-frequency pulsed electromagnetic fields have become the most widely used treatment for osteoporosis in clinic. OBJECTIVE: To review the mechanism and clinical application of low-frequency pulsed electromagnetic fields in the treatment of osteoporosis. METHODS: A computer search by the first author of PubMed and CNKI databases was performed for relevant articles using the keywords of “pulsed electromagnetic fields and osteoporosis” or “osteoblast or osteoclast” in English and “osteoporosis; pulsed pulsed electromagnetic fields; osteoblasts; osteoclasts” in Chinese, respectively. After initial search, there were 169 articles, and according to the inclusion criteria, 29 highly relevant articles that are authentic and have clear views were analyzed. RESULTS AND CONCLUSION: The pulsed electromagnetic field as a non-drug therapy is characterized by no trauma, no infection, simple operation, low cost, long-term use, and good safety. Its efficacy has been increasingly affirmed by researchers and clinicians. Pulsed electromagnetic fields can promote the synthesis of DNA, influence the proliferation and differentiation of osteoblasts, increase the apoptosis of osteoclasts, and have a certain window effect. Pulsed electromagnetic fields can effectively relieve pain and increase bone density level in patients with osteoporosis, which can increase its efficacy in combination with other drugs and have a wide range of clinical applications.

BACKGROUND:Artificial biomaterials are used instead of the existing joints with obvious lesion, which is defined as artificial joint replacement, for the purpose of easing pain, correcting deformities, restoring and improving the joint function. OBJECTIVE: To investigate the effect of joint prosthesis materials and physical therapy after joint replacement. METHODS:Wanfang, CNKI and PubMed databases were retrieved for articles related to joint prosthesis materials and physical therapy after joint replacement published from 2000 to 2014 using the keywords of “artificial joints, joint materials, physical therapy” in Chinese and English, respectively. Papers published recently or in authoritative journals were preferred in the same field. Based on inclusion and exclusion criteria, 15 papers were included in result analysis. RESULTS AND CONCLUSION:Artificial joint prosthesis materials have their own rehabilitation programs. Physical therapy after joint replacement includes physical factor therapy and exercise therapy. Physical factor therapy can reduce the release of inflammatory factors and promote the absorption of inflammatory factors factor, effectively relive pain, and facilitate the drug release from bone cement containing antibiotic drugs under low-frequency ultrasound intervention. Exercise rehabilitation therapy assisted by continuous passive motion machine can promote lymphatic return, reduce limb sweling, avoid the occurrence of venous thromboembolism, prevent and treat joint contractures, strengthen the muscle and promote recovery of joint function after joint replacement. Appropriate joint prosthesis and reasonable physical therapy after joint replacement can accelerate patient’s rehabilitation, reduce complications and achieve a good joint range of motion.

Objective To observe the clinical effect of emergency operative treatment on thoracolumbar compression or burst fractures using pedicle screw instrument through posterior approach and indirect reduction.Methods53 acute thoracolumbar compression or burst fractures cases injured within 4 days were accepted the emergency operation of indirect reduction, decompression and fixation using pedicle screw instrument through posterior approach. The mean percentage of traumatic vertebral body height, sagittal diameter of spinal canal, degrees of kyphosis and Frankel scoring of nerve function were evaluated before and after operation.ResultsAll cases received two weeks following-up, 47 cases had more than one-year following-up. The mean percentage of traumatic vertebral height restored from 42.28% (pre-operation) to 93.46% (post-operation); the mean degrees of kyphosis recovered from 26.44° (pre-operation) to 17.73° (post-operation); the mean percentage of sagittal diameter of spinal canal changed from 63.14% (pre-operation) to 78.55% (post-operation). All but cases with completely spinal cord injury got more than one grade nerve functional restoration. Neither later spinal cord injury nor back pain existed among the patients. Three cases emerged partial internal fixation device failure, but neither symptoms nor abnormality correction missed.ConclusionEmergency operation using pedicle screw instrument through posterior approach is a feasible and confirmatory choice in treatment of the acute thoracolumbar compression or burst fractures if the cases are selected properly.

Objective To evaluate the correlations of red blood cell distribution width (RDW) and short term prognosis of patients with acute coronary syndrome.Methods 179 patients with acute coronary syndrome (ACS) treated in our hospital between Jan.2008 to Apr.2009 were grouped by cutoff value of 14.4%.The incidence of acute myocardiac infarct( AMI),malignant arrhythmia,heart falure,sudden cardiac death(SCD) were compared in the two groups when patients were hospitalized and in half years of discharged.High-sensitivity C-reactive protein.(hs-CRP) ,BNP were also compared between the two groups.Results The incidences of cardiac adverse event were different between the two groups(AMI:39.47% vs.15.53% ,HF:22.22% vs.6.80% ,SCD:9.21% vs.1.94% and malignant arrhythmia:11.84% vs.3.90%,P values all less than 0.05 ).hs-CRP were ( 9.44 ± 8.03 ),(4.64 ±4.42) mg/L and BNP were (357.07 ± 161.60),(233.17 ± 134.76) ng/L in the two groups ( P ＜ 0.05 ).RDW is positively correlated with hs-CRP and BNP (r is 0.42 and 0.58 respectively,P-value all less than 0.05).Conclusions The RDW is related to the short term progonosis in patients with ACS,and also positively correllated with plasma hs-CRP and BNP levels.

Objective To investigate the clinical efficacy of plasma exchange (PE)in the treatment of liver failure.Methods A retro-spective analysis was performed on the clinical data of patients with liver failure who were treated from January 2012 to June 2013 in our hos-pital.Thirty -three patients in PE group received PE in addition to medical comprehensive treatment,and 30 patients in control group were treated with medical comprehensive treatment.Clinical symptoms,complications,and the changes in biochemical markers of liver function were observed after 2 weeks of treatment,post -treatment outcomes were evaluated by 3 -month followed -up,and the influential factors for efficacy were analyzed.Experimental data were expressed as mean ±standard deviation,continuous data were compared by t test,and cate-gorical data were analyzed by chi -square test or Fisher′s exact test.Results Symptoms such as fatigue,poor appetite,and abdominal dis-tension were significantly relieved after PE.Post -treatment serum alanine aminotransferase (ALT)and total bilirubin (TBil)levels were significantly lower compared with pre -treatment levels (390.48 ±536.52 U /L vs 81.03 ±47.58 U /L and 479.27 ±130.01 μmol /L vs 244.64 ±151.05 μmol /L,P <0.005),whereas post -treatment levels of albumin (Alb)and cholesterol (CHO)and prothrombin activity (PTA)were significantly higher than those measured before the treatment (33.06 ±5.42 g/L vs 35.24 ±3.68 g/L,2.50 ±1.24 mmol /L vs 3.59 ±0.86 mmol /L,and 34.16% ±5.33% vs 73.98% ±27.23%,P <0.005).No significant differences were identified between pre-and post -treatment levels of ALT,TBil ,Alb,CHO,and PTA (P >0.05).Patients in PE group had a significantly higher improve-ment rate (χ2 =8.276,P <0.005)and a significantly lower mortality rate (χ2 =13.258,P <0.005)compared with the control group.The efficacy of PE was found to be correlated with pre -treatment TBil level,complications,bilirubin enzyme separation,and age ≥40 years (P <0.05).TBil and bilirubin enzyme separation were independent risk factors affecting the efficacy of PE (P <0.05,OR =1.01 and 8.75).Adverse reactions occurred in 8 cases during PE treatment,and disappeared after symptomatic treatment.Conclusion PE is a safe and effective treatment for liver failure,and holds promise for clinical application.TBil level and bilirubin enzyme separation are independ-ent risk factors affecting the efficacy of PE.