Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) on motor and ambulatory function in incomplete spinal cord injury (SCI) patients. Methods 18 incomplete SCI patients (AIS D) were randomized to treatment group (n=10) and control group (n=8). The treatment group received rTMS while the control group received sham stimulation for 2 weeks. All the patients received routine rehabilitation. They were assessed with Lower Extremity Motor Score (LEMS), 10 m Walking Test for Walking Speed, modified Ashworth scale (MAS), Walking Index for SCI Scale II(WISCI II), and Spinal Cord Independence Measure (SCIM) before and after treatment, and followed up for 2 weeks after treatment. Results The treatment group significantly improved in LEMS, walking speed, and SCIM after treatment and during follow up (P<0.05), while the control group improved only in SCIM (P<0.05). There was more significant improvement in LEMS in the treatment group than in the control group (P<0.05) after treantment and during follow up. There was no difference between two groups in MAS, walking speed, WISCI II and SCIM. Conclusion rTMS can further improve the motor of lowere limbs for incomplete SCI patients.

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.

Objective: To evaluate the outcome and postoperative reaction of dural substitute (Neuropatch) applying in the treatment of Chiari I malformation(CMI) associated with syringomyelia(SM). Methods:Forty patients of CMI associated with SM were operated in our department from Jul. 2002 to Jul. 2004. All patients underwent posterior cranial fossa decompression and duraplasty. They were divided into two groups, 20 patients being repaired with Neuropatch (Neuropatch group), and the others with autologous fascia lata (fascia group). There were 6 males and 14 females in Neuropatch group and 10 males and 10 females in fascia group. The operations were performed under general anesthesia via suboccipital approach and the extent of posterior cranial fossa decompression ranged from 20 cm2 (5 cm×4 cm) to 35 cm2 (5 cm×7 cm). The removal of posterior arch of atlas depended on the extent of tonsillar herniation, and the dura was opened in Y shape. The Neuropatch was cut into triangular shape, and the same sized autologous fascia lata was used in fascia group. The patches were sutured tightly to the dura matter in each group. The incision was closed layer by layer and drainage was used, if necessary. Antibiotics and hormone were routinely used. The duration of operation, postoperative fever were evaluated, the outcome of the operation was evaluated by Tator scale, and the data were analyzed with statistic software SPSS 10.0. Results: There were12 patients (60%) who suffered from postoperative fever in the Neuropatch group, and 9 patients (45%) in the fascia group(χ2=0.902,P=0.342). Seventeen patients in each group were improved postoperatively. The duration of operation, postoperative fever and antibiotics used were compared between the two groups. No significant difference was found, but the duration of postoperative fever and the time of hormone used were different. There were no postoperative infections that occurred after the follow up for 1 to 2 years, except for one patient in fascia group who developed infective granuloma and recovered later by treatment. Conclusion: Neuropatch is a useful dural substitute for the repair of dural defects in the treatment of CMI associated with syringomyelia.

Adolescent ; Adult ; Athletic Performance ; psychology ; Back ; physiology ; Electromyography ; Exercise ; physiology ; Humans ; Imagery (Psychotherapy) ; Male ; Young Adult

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints.

METHODSFrom March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31.8 +/- 8.1) years old (ranged, 20 to 49 years old). All the patients were performed with X-ray and MRI examination, and the results showed that 10 patients had combined with injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL); 4 patients had ALC,PCL and posterolateral corner (PLC) injuries. Four patients had medial meniscus injuries and 2 patients had lateral meniscus injuries. The MCL,PLC and meniscus injuries were treated with operation on the first stage, and functional exercises were performed 3 weeks after fixation. The reconstruction operation of ACL and (or) PCL was performed at the second stage under arthroscopy 3 to 6 months later when the movement range of knee joint recovered to the normal level with obvious relaxation.

RESULTSAll incisions healed by primary intention. All the patients were followed up with a mean duration of 48.9 months (ranged, 24 to 80 months). The Lysholm score was improved from preoperative 19.6 +/- 0.9 to the latest follow-up 87.1 +/- 2.8 (t=12.3, P<0.01). The International Knee Documentation Committee (IKDC) rating: 9 cases nearly recovered to normal, 5 cases were abnormal.

CONCLUSIONFor multiple ligament injuries in the knee, staged repair and reconstruction can effectively restore knee joint stability and function.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the epidemiological characteristics and patterns of extra-pulmonary tuberculosis wounds in order to provide reliable data for further clinical research.

METHODSRecords of patients with extra-pulmonary tuberculosis wounds hospitalized from January 2010 to December 2012 were retrospectively analyzed, including gender, age, nationality, family background, Bacille Calmette-Guerin (BCG) vaccination, primary lesion, and history of injury.

RESULTSTuberculosis wounds were found in 235 patients among 5 863 patients with extra-pulmonary tuberculosis, accounting for 4.0%. Among the patients with tuberculosis wounds, there were 139 male and 96 female, and the ratio of male to female was 1.4: 1.0. The age of patients ranged from 1 to 87 (37 +/- 18) years old, and the highest incidence occurred in patients older than 15 and younger than or equal to 30 years old (100 cases, accounting for 42.6%). Most patients with tuberculosis wounds were Han, and only 11 patients were minorities, accounting for 4.7%. Tuberculosis wounds were more prevalent in rural areas (163 cases, accounting for 69.4%), with a smaller number in urban areas (72 cases, accounting for 30.6%). The BCG vaccination rate was 13.6%. The main primary lesions were lymph node infection (112 cases, accounting for 47.7%), among which involvement of cervical lymph nodes accounted for the highest ratio ( 99 cases, accounting for 88.4%). Twenty-one patients had the traffic accident etc. injury history recently, among which 19 were male and 2 were female.

CONCLUSIONSTuberculosis wound, with certain incidence, was more frequently found among young adults from rural areas. The BCG vaccination rate was low among the patients and the main primary lesion was tuberculosis of cervical lymph nodes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; ethnology ; statistics & numerical data ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Lymph Nodes ; microbiology ; Male ; Middle Aged ; Population Surveillance ; Prevalence ; Retrospective Studies ; Rural Population ; Tuberculosis ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; epidemiology ; Urban Population ; Wounds and Injuries ; complications ; epidemiology ; Young Adult

Objective To analyze the high resolution CT(HRCT)appearance and its clinical significance in patients with post-traumatic visual loss.Design Retrospective study.Participants 150 patients with post-traumatic visual loss.Methods The optic canal HRCT of 150 patients admitted from March to June of 2007 by Department of Emergency for post-traumatic visual loss were ana- lyzed retrospectively.Main Outcome Measures Pedilection sites and their incidence rates of optic canal and orbital apex region. Results Optic canal fractures were found in 78 patients,manifesting as rupture and displacement of optic canal wall,accompanied with or without adjacent structure fractures.(1)Among 88 sides of fractures,22 sides presented with single fracture,and 66 sides with multi- ple fractures,revolving several optic canal walls.(2)156 sites of fractures were displayed in 78 patients,and the most frequent types were displacement fractures(47.4%).(3)Accompanied adjacent structure fractures were found in 73 cases of the 78 patients,while 40 cases were found in 72 patients without optic canal fracture.Totally,283 sites of adjacent structure fractures were discovered with the most frequent sites of orbital apex region,accounting for 44.5%.Conclusion HRCT could well display optic canal fractures and accom- panied fractures of adjacent structures,providing important informations for diagnosis and intervention of traumatic visual loss.(Oph- thalmol CHN,2007,16:326-329)

Objective To explore the effects of luteolin on cognition function in pentylenetetrazol (PTZ)-induced epileptic rats and related mechanism.Methods Fifty male SD rats were randomly divided into a normal control group(n=8), a model group(n=12), and groups of 25, 50 mg/kg luteolin(both ofn=11), as well as 100 mg/kg luteolin group(n=8). Those rats were given different doses of luteolin (25, 50 and 100 mg/kg, daily, intragastric administration) for 36 consecutive days. Similarly, rats of the normal control group and the model group were given 0.5% sodium carboxymethyl cellulose suspension liquid via intragastric administration. Thirty minutes later, a model of epilepsy was induced using PTZ (40 mg/kg, daily) via intraperitoneal injection except the control group. Learning and memory of rats were evaluated by Morris water maze and novel objective recognition trials(including escape latency and recognition index). The levels of CaM and CaMPK were determined by ELISA methods, and expression of Ras proteins in the hippocampus were detected by Western Blot.Results Compared with the model group, luteolin treatment groups significantly shorten the escape latency(28.51 ± 3.84 s, 19.77 ± 5.41 s, 14.86 ± 2.76 svs. 37.08 ± 5.18 s) in the Morris water maze, and increased recognition index(18.77% ± 2.02%, 25.06% ± 4.32%, 31.92% ± 2.65%vs. 13.87% ± 2.14%) in the novel objection trial(P<0.05 orP<0.01). Meanwhile, CaM(140.33 ± 13.52 ng/L, 124.26 ± 9.97 ng/L, 113.52 ± 11.57 ng/Lvs. 158.36 ± 10.68 ng/L) and CaMPK(8.25 ± 1.37 ng/ml, 7.69 ± 0.84 ng/ml, 6.74 ± 0.93 ng/mlvs. 9.87 ± 1.02 ng/ml) were significantly decreased(P<0.05 orP<0.01). What’s more, the expression of Ras proteins(0.99 ± 0.08, 0.76 ± 0.07, 0.52 ± 0.07vs. 1.58 ± 0.12) was obviously decreased compared with the model group(P<0.05 orP<0.01).Conclusion Luteolin could effectively improve the cognition dysfunction of epileptic rats, and the mechanism might be relevant to regulate the CaM-CaMPK signaling pathway via down-regulation of CaM, CaMPK, as well as Ras protein.

OBJECTIVE:To systematically review the efficacy of Berberine hydrochloride tablet in the treatment of non-alco-holic fatty liver disease(NAFLD),and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from CJFD,Wanfang Database,VIP,CBM and PubMed,observational studies about Berberine hydrochloride tablet in the treatment of NAFLD were collected. After data extraction and quality evaluation,Meta-analysis was performed by using Rev Man 5.3 statistics software. RESULTS:A total of 6 studies were included,involving 294 patients. Results of Meta-analysis showed Berberine hydro-chloride tablet could significantly reduce the levels of AST[WMD=18.97,95%CI(2.25,35.70),P=0.03],ALT[WMD=31.04, 95%CI(7.17,54.91),P=0.01],TG[WMD=1.07,95%CI(0.39,1.74),P=0.002] and TC[WMD=1.31,95%CI(0.79,1.84),P<0.001] in the serum of patients with NAFLD. There were significant differences. CONCLUSIONS:Berberine hydrochloride tablet can significantly improve the liver function and blood lipid levels of patients with NAFLD,and the clinical efficacy is relatively pre-cise. Due to the limit of methodological quality,it remains to be further verified by large-scale and high quality RCT.

Objective Study and analyze the benefits and risks of unilateral thyroidectomy for 1 to 4 cm thyroid cancer in primary surgery.Methods The patients who underwent thyroidectomy for 1 to 4 centimeters WDTC (May 2014 to June 2015) were retrospectively reviewed,and the patients with preoperatively known high-risk characteristics were excluded.One hundred and seventy-one patients would have been eligible for lobectomy as the initial operation based on current American Thyroid Association guidelines.The proportion of patients who need secondary surgery was estimated basing on pathological characteristics.Result In this group,49％ patients would have to undergo a secondary surgery if they took lobectomy as the initial operation.Conclusions Patients with 1 to 4 centimeters WDTC who accept unilateral thyroidectomy may take the risk of secondary surgery.Surgeons and patients need to balance the relative benefits and risks of initial TT versus lobectomy before the operation.