Objective To evaluate the effects of robot-assisted gait training on the lower limb motor functions of in hemiplegic stroke patients.Methods Forty stroke patients with hemiplegia were randomly divided into a treatment group and a control group.Both groups were treated with routine rehabilitation therapies for 60 min daily in 6 weeks.The patients in the treatment group were given robot-assisted gait training for 30 min daily for 6 weeks.The lower limb part of Fugl-Meyer assessment (FMA) , the Ueda Satoshi standardized hemiplegic function scale and the functional ambulation categories (FAC) were used to evaluate the lower limb motor function before and after the sixweeks of therapies.Results There were no significant difference between the two groups before treatment with regard to all the three assessment measurements.After 6 weeks of treatment, both groups significantly improved in terms of the scores with FMA, the grade of Ueda Satoshi standardized hemiplegic function scale and the FAC (P ＜0.05).But the treatment group had significantly greater improvement than the control group (P ＜ 0.05).Conclusions The robot-assisted gait training can supplement the routine rehabilitation therapies in improving lower limb motor function in stroke patients.

Objective To investigate the effect of repetitive transcranial stimulation (rTMS) on learning and memory and on the neuron and synapse ultrastructures of the CA3 region of the hippocampus.Methods Forty Sprague-Dawley (SD) rats were randomly divided into 4 groups (n =l0 in each group):a normal control group,a depression group,an rTMS group and a sham group.Unpredictable mild stress was used to establish depression models in the rats of the latter3 groups.The sucrose water consumption test and open-field test were used to evaluate any depressive behavior of each group.The rTMS group rats were given 15 Hz rTMS for 21 days while the sham group received sham stimulation.The orientational navigation and spatial probe tests were performed on each group using a Morris water maze to evaluate their learning and memory abilities.In addition,changes in the ultrastructure of the CA3 region of the hippocampus were detected using transmission electron microscopy.Results The modelling induced significant differences in the sucrose water consumption test results and in horizontal and vertical behavior in the open-field tests.Escape latency and spatial probe time were significantly different between the rTMS group and the sham and depression groups.There was no significant difference in the behavioral indexes between the depression group and the sham group.Electron microscopy showed pathological changes in the ultrastructures of the neurons and synapses in the CA3 region of the hippocampus among the depression group,while in the rTMS group those ultrastructures tended to be basically normal.Conclusion rTMS can improve learning and memory during depression,at least in rats.A possible mechanism is that rTMS can induce changes in the ultrastructures of neurons and synapses in the CA3 region of the hippocampus.

AIM:To improve accuracy of the diagnosis of primary conjunctival masses(PCM) through analyze the clinicopathological characteristics and pathogenic causes of 422 cases of PCM.METHODS:Clinical manifestations, histological characteristics and immunopheno types were reviewed.Relevant literatures were reviewed.RESULTS:Benign conjunctival masses were 403 cases (95.5%).Those included masses from squamous cell papilloma (71 cases, 17.6%), conjunctival cyst (68 cases, 16.9%), inflammatory masses (62 cases, 15.4%), pigmented nevus (60 cases, 14.9%), lipoma (58 cases, 14.4%).Malignant conjunctival neoplasms were 19 cases (4.5%).Those included tumors from B Cell Lymphoma (6 cases,31.6%), melanoma (6 cases,31.6%), and squamous cell carcinoma (5 cases, 26.3%).Different types of primary conjunctival masses were induced by the same cause.CONCLUSION:The pathological types of primary conjunctival masses are various and the majority of which is benign.For the diagnosis of primary conjunctival masses, morphological analysis, immunohistochemical examination shoud be combined to increase the diagnostic accuracy and decrease misdiagnosis rate.

Objective To study the influence of Apo E gene knockout on the lymphocytes . Methods Cells from the peripheral blood, spleen and bone marrow of Apo E knockout and wildtype mice were stained with kinds of antibodies , and analyzed by flow cytometry .Results Compared with wildtype mice , significant differences were found in B and T lymphoctes in the peripheral blood and spleen , but there was no significant difference in pre B cells , T lymphocytes in the thymus and long term hematopoietic stem cell in the Apo E knockout mice .Conclusion Numbers of B lymphocytes decreased in the peripheral blood and spleen , but there was no significant difference in B , T lymphocytes development , and numbers of long term hematopoietic stem cell in Apo E gene knockout mice .

Objective To study the clinical value of bedside ultrasound in predicting the fluid responsiveness in pa?tients with septic shock in intensive care unit (ICU). Methods Forty-two mechanically ventilated patients with septic shock who admitted to ICU of the Affiliated Hospital of North China University of Science and Technology from January 2015 to April 2015 were included in this study. All patients were treated with volume expansion (VE) text. Hemodynamics in?dexes were obtained by ultrasound before and after each test, including stroke volume (SV), aortic peak blood flow velocity variation rate of breathing (△VpeakAO), inferior vena cava expansion index (△IVC) and brachial artery maximum speed vari?ation rate (△VpeakBA). Clinical data and central venous pressure (CVP) were recorded. Based on the responsiveness of SV, patients were divided into responsive group (R) and non-responsive group (NR), respectively. The differences of the above in?dexes were compared between two groups. The correlation of△IVC,△VpeakAO,△VpeakBA and△SV was determined. The role of the hemodynamic index for predicting volume responsiveness was evaluated by receiver operating characteristic ROC curves. Results A total of 47 VE tests were performed in 42 patients, 25 in R group and 22 in NR group. Before VE test, the hemodynamics indicators of△IVC,△VpeakAO and△VpeakBA were significantly higher in R group compared with those of NR group (P<0.05). The values of△IVC,△VpeakAO and△VpeakBA were positively correlated with△SV in two groups. The areas under the ROC curve of the hemodynamics indicators were 0.825, 0.853 and 0.866 for △IVC, △VpeakAO and△VpeakBA, and they all showed high sensitivity and specificity. Conclusion The hemodynamic index measured by bedside ultrasound can predict the volume responsiveness in mechanically ventilated patients with septic shock fluid therapy, and which can be used to fluid therapy with a high degree of specific and sensitivity in clinical practice.

Objective: To investigate the ultrasound evaluation on lfuid responsiveness in patients with septic shock. Methods: There 42 septic shock patients treated by mechanical ventilation in our hospital from 2015-01 to 2015-04 were studied. All patients received volume expansion (VE) text, ultrasound examination was conducted to measure hemodynamic parameters of inferior vena cava variation rate of breathing (ΔIVC), aortic peak blood lfow velocity variation rate of breathing (ΔVpeakAO), brachial artery maximum speed variation rate (ΔVpeakBA) and stroke volume (ΔSV) at before and after text. Based on the response to VE text, the patients were divided into 2 groups as Responsive group and Non-responsive group, the above indexes and their correlations to ΔSV were analyzed. The clinical values of those parameters for predicting volume responsiveness were evaluated by ROC curves. Results: A total of 47 VE tests were conducted in 42 patients including 25 cases in Responsive group and 22 cases in Non-responsive group. Before VE test, the parameters of ΔIVC, ΔVpeakAO and ΔVpeakBA were higher in Responsive group than Non-responsive group; ΔIVC, ΔVpeakAO and ΔVpeakBA were obviously related to ΔSV (r=0.631, 0.668 and 0.619). The area of ΔIVC, ΔVpeakAO and ΔVpeakBA under ROC curves were 0.817, 0.853 and 0.866 respectively, they were all with the high sensitivity and speciifcity. Conclusion: Ultrasound monitored hemodynamic parameters may predict the volume responsiveness in septic shock patients with mechanical ventilation, it could be used for guiding liquid treatment in relevant patients.

Objective To investigate the effect of different reference transducer positions measurement on intra-abdominal pressure (IAP) in ICU patients. Methods 31 cases of patients in ICU in need of measuring IAP were studied from January 2015 to July 2015 in this study. In each patient, transvesical and the direct methods were both used to measure IAP. Three sets of IAP measurements were obtained in the supine position, using the different reference levels and kept as IAPpubis, IAPmidax, IAPphlebostatic. The results were compared using Spearman rank correlation,paired t test and Bland–Altman statistics. Results When symphysis pubis was uesd, the result of direct method was (9.82±4.01) mmHg, the result of indirect method was (8.77 ± 4.48)mmHg (P<0.05), the correction between two methods was 0.967, P<0.05. When midaxillary level was uesd to measure, the result of direct method was (11.74 ± 4.71) mmHg, the result of indirect method was (11.65 ± 4.63)mmHg, the correction between two methods was 0.972, P=0.10. When phlebostatic was uesd, the result of direct method was (10.98 ± 4.65) mmHg, the result of indirect method was (10.38 ± 4.75)mmHg, the correction between two methods was 0.970, P<0.05. The calculated bias between IAPmidax and IAPpubis was 2.9 mmHg, 95%agreement of limits was (-0.8-6.5) mmHg, and the maximum difference value was 11 mmHg. The calculated bias between IAPmidax and IAPphlebostatic was1.3 mmHg, 95%agreement of limits was-1.4-4.0 mmHg, and the maximum difference value was 4.2 mmHg. Conclusion In supine position, the value obtained via the bladder can reflect the true IAP, and the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.

Objective To evaluate the nursing effect of warming feeding formulation of the enteral nutrition associated diarrhea in the critically ill tube-fed patients. Methods A total of 60 patients with enteral feeding were enrolled and divided randomly into the warming group and the room temperature group with 30 cases in each group by random digits table method. The room temperature group received room temperature oral feeding by nutrition pump. The warming group used nutrition pump and heating rod was placed on the nutritional tube 50 cm far from patient's nose. A semi-quantitative scale based on stool volume and consistency was used for daily assessment of diarrhea. Results Patients were tube-fed for a mean duration of (11.20±2.98) and (10.93±2.69) days, respectively in the room temperature group and the warming group. There was no significant difference in these two groups (U=425.000, P > 0.05). The diarrhea score was 4.88 ±3.41 in the room temperature group and 5.51±4.44 in the warming group. There was no significant difference in these two groups (U=436.500, P > 0.05). The diarrhea per total feeding days was 10.42%(35/336) in the room temperature group and 16.24%(51/314)in the warming group. There was no significant difference in these two groups (χ2=4.862, P < 0.05). Conclusions The airtight enteral nutrition does not need warming when it is infused with the enteral nutrition pump at room temperature.

Objective To explore the effects of repetitive transcranial magnetic stimulation on behaviors and hippocampus neuronal apoptosis in rats with chronic stress-induced depression.Methods 40 male SD rats of SPF grade were randomly divided into normol control group (n =8) and model preparation group (n =30) after screening.Rats in model preparation group were singly housed and given chronic unpredictable mild stress(CUMS) to build depression model.Excluding unsuccessful modeling rats,the model preparation group was divided into three groups:model group(n=8,without any treatment),rTMS group (n=8,with the intervention of 10 Hz rTMS) and shame group (n=8,simulation of rTMS environment without rTMS stimulus).The changes of behaviors in each group were detected by weight measurement,sucrose consumption test and open-field test.The changes of morphology of hippocampal neurons were detected by Nissl's staining.The changes of Bax in hippocampal neuron were detected by Immunohistochemical staining.Results (1) Behavioral results showed stress for 21 d could make rat behavior scores decrease significantly(all P＜0.05),and rTMS intervention could significantly improve their behavior scores (all P＜0.01).Compared with model group,the weight reduction rate (0.32±0.05)％,the score of sucrose consumption test(7.03 ± 1.02) and the score of open field test(8212.41 ± 1416.15,8.75 ± 1.58) in rTMS group was higher(P ＜0.01).(2) Nissl staining showed stress for 21 d could make the number of hippocampal CA3 neurons was reduced,cell morphology was poor,and the number of Nissl bodies was reduced.rTMS intervention could increase the number of hippocampal CA3 neurons,cell morphology was integral and the number of Nissl bodies was increased.(3) Immunohistochemistry results showed stress for 21 d could cause the number of Bax cell were significantly increased(P＜0.01),and rTMS intervention can make the number of Bax cell were significantly lower(P＜0.01).Conclusion rTMS intervention improves the depressive behavior in chronic stress depression model rats and inhibits the apoptosis,which might work through inhibition of neuron apoptosis and decline of Bax expression in hippoeampal neurons.

Objective To analyse and explore the situation and causes of misdiagnosed primary hyperparathyroidism(PHPT),so as to develop some strategies for preventing and reducing misdiagnosis.Methods Clinical data of 94 misdiagnosed patients with PHPT treated in Beijing Jishuitan Hospital from November 1992 to April 2009 were collected and analyzed retrospectively.Results All cases were confirmed by operation and pathology.Among the 94 cases,90 cases were of parathyroid adenoma,and 4 cases of parathyroid carcinoma.The rate of misdiagnosis was 97.9%(94/96).The length of time of misdiagnosis was 2 months to 20 years;