CD3 Complex ; metabolism ; CD5 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Leukocyte Common Antigens ; metabolism ; Leukosialin ; metabolism ; Lymphoma, T-Cell, Cutaneous ; metabolism ; pathology ; Middle Aged ; Skin Diseases ; pathology

Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in con-valescent stroke patients. Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and ran-domized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted thera-py was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Func-tional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FMA-UE and FIM were bet-ter in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05);for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890,P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better. Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Objective To comment the severity of severe hand,foot and mouth disease(HFMD)by pediatric risk of mortality score(PRISM),and assess the performance of PRISM in predicting mortality or complication probability in HFMD.Methods Four hundred and twenty-four severe HFMD pediatric patients were recruited in the study from 1th Jan 2010 to 31th June 2013.Information on the outcome and the varia-bles required to calculate PRISM score were collected.The logistic regression model developed in the learning sample was evaluated in the test sample by calculating the area under the receiver operating characteristic (ROC)curve to assess discrimination pneumorrhagia and death.Calibration across deciles of risk was evalua-ted using the Hosmer-Lemeshow goodness-of-fit χ2 test.Results The area under the ROC curve were 0.87 (95%CI 0.80~0.94 )for PRISM in predicting pneumorrhagia probability.The area under the ROC curve were 0.87(95%CI 0.80~0.95)for PRISM in predicting mortality probability.The PRISM in observed and expected pneumorrhagia did not demonstrate good calibration at ten mortality risk intervals (χ2 =36.66, P<0.001 ).The PRISM in observed and expected mortality did not demonstrate good calibration at ten mortali-ty risk intervals(χ2 =41.11,P<0.001).Conclusion The PRISM score is demonstrated good discrimination of pneumorrhagia and death in HFMD pediatric patients,but the performance of calibration is not good.

Objective To compare intramedullary nail (IN) and dynamic hip screw (DHS) regarding their effects on hip abduction following fixation of intertrochanteric fractures.Methods From January 2008 to December 2015,310 patients with intertrochanteric firacture were treated at our department.They were divided into 2 groups depending on the manner of treatment.198 patients (71 males and 127 females) were subjected to intramedullary nailing,with an average age of 74.7 ± 5.6 years;there were 50 cases of 31-A 1,134 ones of 3 1-A2 and 14 ones of 3 1-A3 according to the AO classification.112 patients (35 males and 77 females) were subjected to dynamic hip screwing,with an average age of 74.1 ± 6.7 years;there were 24 cases of 31-A1,78 ones of 31-A2 and 10 ones of 31-A3.The 2 groups were compared in terms of time for weight-bearing ambulation and stand on one leg,gait,pelvic tilt,range of hip active abduction,muscle strength of the abductor and hip function at the final follow-up.Results Of this series,284 patients were followed up for 1.5 to 8.5 years (average,3.6 years) and 26 patients died.The IN group achieved significantly better outcomes in terms of time for weight-bearing ambulation (37.6 ±4.9 d),time for stand on one leg (60.1 ± 9.5 d),cases of normal gait and normal pelvic tilt (171 and 179),muscle strength of the abductor (62.3 ±4.4 N · m),and range of hip active abduction than the DHS group (53.0 ±8.4 d;71.0 ± 12.0 d;67 and 85;56.6 ± 3.3 N · m,respectively) (P ＜ 0.05).There was no significant difference between the 2 groups in the hip function at the final follow-up(91.4％ versus 84.5％ in the excellent and good rate)(P ＞ 0.05).Conclusion Compared with dynamic hip screwing,intramedullary nailing has a limited effect on hip abduction so that the patients may benefit from quicker functional recovery and faster improvement in quality of life.

In view of problems such as students in clinical orthopedic practice lack of basic theoretical knowledge and practical ability, both teachers and students' lack of preparations for clinical practice and their insufficient attention etc., this paper attempts to strengthen the standardized management of department teaching. Some measures were adopted to stimulate the potential of students, such as teaching based on case combination, department discussion, strengthening education of humanities, improving examination methods and so on, so as to improve students' comprehensive ability and achieve teaching goals. The results showed that by changing the above teaching methods, students can improve their mastery of knowledge, proficiency in basic operation, clinical thinking ability, communication and coordination ability, subjective initiative and so on. At the same time, students' problem-solving ability, learning interests, self-confidence and the satisfaction with teaching effect have also been improved, which promoted the performance of students in clinical practice.

Objective To investigate the influence of acute hypervolemic hemodilution(HHD)on pharmacokinetics of propofol.Methods Sixteen ASA Ⅰ or Ⅱ patients aged 20-55 yrs undergoing elective surgery under general anesthesia combined with epidural analgesia were randomly allocated into 2 groups(n=8 each);Ⅰ control group and Ⅱ HHD group.The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg.Right internal jugular vein was cannulated for CVP monitoring and blood sampling.Radial artery was cannulated for BP monitoring.All patients in both groups received lactated Ringer's solution(0.7 ml?kg~(-1)? number of hours of fasting before operation)before induction of general anesthesia.In HHD group 4% gelofusine 20 ml?kg~(-1) was infused at the rate of 20 ml?kg~(-1)?h~(-1).Anesthesia was induced with midazolam 0.04 mg?kg~(-1),fentanyl 4 ?g?kg~(-1) and propofol 1.5 mg?kg~(-1).Tracheal intubation was facilitated by succinylcholine 2 mg?kg~(-1).Anesthesia was maintained with isoflurane,fentanyl,vecuronium and epidural analgesia.ECG,BP, SpO_2,P_(ET)CO_2 and CVP were continuously monitored.Blood samples were taken at 1,2,4,6,10,15,30,45, 60,75,90,120,150,180,240,300 and 360 min after propofol was given Ⅳ for determination of plasma concentration of propofol(HPLC).Pharmacokinetic data were analyzed by 3P97 pharmacokinetic software.Results The two groups were comparable with respect to demographic data.Blood propofol concentrations were significantly lower in HHD group than in control group at 1,2,4,6,10 min after propofol injection(P＜0.01), thereafter there was no significant difference in plasma propofol concentration between the two groups(P＞0.05). The pharmacokinetic profile of propofol was well described by a standard three-compartment model.In HHD group V_C was significantly increased,K_(10) and Cl were significantly decreased and T_(1/2?) was significantly prolonged as compared with control group.Conclusion Acute HHD increases V_C,prolongs the T_(1/2?) and decreases K_(10) and Cl, suggesting that the effect of propofol may be potentiated by acute HHD.

OBJECTIVETo evaluate the effectiveness of unilateral versus bilateral pedicle screw fixation in lumbar spinal fusion.

METHODSStudies on comparison between unilateral and bilateral pedicle screw fixation in lumbar spinal fusion were identified from Medline, EMBASE, Cochrane CENTRAL (Third Quarter 2011), ScienceDirect, OVID, SpringerLink and The China Biological Medicine Database, and searched several related journals by hand. The included trials were screened out according to the criterion of inclusion and exclusion. The quality of included trials was evaluated. Data were extracted by two reviewers independently. RevMan 5.1.1 was used for data analysis.

RESULTSSeven studies involving 480 patients were included, 246 in unilateral group, and 234 in bilateral group. The results of meta-analysis indicated that statistically significant difference were observed between the two fixation procedures in mean operation time (MD = -24.39, 95%CI: -33.16 to 15.61, P < 0.01), the amount of bleeding (MD = -118.73, 95%CI: -143.43 to -94.03, P < 0.01). There were no difference in inpatient stay, fusion rate, complication rate and excellent and good rate.

CONCLUSIONSBoth unilateral and bilateral pedicle screw fixation are effective in lumbar spinal fusion. To compare with bilateral fixation, unilateral fixation can shorten operation time, reduce amount of bleeding and medical expenses. And there is a similar effect of inpatient stay, fusion rate, complication rate and excellent and good rate.

Bone Screws ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Spinal Fusion ; methods ; Treatment Outcome

AIMTo compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia.

METHODSTwenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith (AG) number and the Schaer linear nomogram.

RESULTSThere were statistically significant differences between the methods in the mean values of maximum flow rate (P < 0.05), detrusor pressure at the maximum flow (P < 0.01), urethral resistance algorithm (P < 0.01), AG number (P < 0.01) and maximum cystic capacity (P < 0.01). Of the men in the study, 10 (43.5%) remained in the same Schaer class with both methods and 18 (78.3%) in the same AG number area. Using the transurethral method, 12 (52.2%) men increased their Schaer class by one and 1 (4.3%) by two. There were also differences between the suprapubic and transurethral methods using the AG number: 4 (17.4%) men moved from a classification of equivocal to obstructed and 1 (4.3%) from unobstructed to equivocal.

CONCLUSIONThe differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.

Aged ; Humans ; Male ; Middle Aged ; Pressure ; Prostatic Hyperplasia ; physiopathology ; Punctures ; Urinary Bladder Neck Obstruction ; diagnosis ; Urinary Catheterization ; Urination ; physiology ; Urodynamics

OBJECTIVETo study the etiology, diagnosis and treatment of transverse testicular ectopia (TTE).

METHODSA case of TTE was treated with orchidopexy.

RESULTSSix months after the operation, both of the two testes were in proper positions with normal vascular supply.

CONCLUSIONTTE is a rare congenital abnormality of the male reproductive system with unknown etiology, and surgical correction remains the best option for treatment.

Child ; Humans ; Male ; Testicular Diseases ; diagnosis ; therapy ; Testis ; abnormalities

OBJECTIVETo analyze the magnetic resonance imaging (MRI) findings of radiation-induced liver injury following three-dimensional conformal radiotherapy.

METHODSA retrospective review of the MRI data was conducted in 20 patients treated between September 2000 and October 2005, who suffered liver injuries induced by 1 or 2 three-dimensional conformal radiotherapy sessions for liver neoplasm. The patients underwent MR scans with T2-weighted sequences and T1-weighted sequences in both plain and Gd-DTPA enhanced MRI. Four patients with suspected tumor relapse suggested by MRI were pathologically confirmed to have radiation-induced liver injury.

RESULTSAcute radiation-induced liver injury was represented by large patches of liver edema consistent with the irradiation volume, showing low signal intensity on T1-weighted images (T1WI) and high signal intensity on T2-weighted images (T2WI) without arterial phase enhancement after Gd-DTPA injection. Delayed radiation-induced liver injury was manifested by slightly low-intensity signal on plain T1WI and slightly high-intensity signal on T2WI without obvious arterial phase enhancement following Gd-DTPA injection but with marked enhancement during the portal-venous and delayed phases.

CONCLUSIONRadiation-induced liver injury presents characteristic MRI features, and plain and dynamic enhanced MRI can be of great value for its diagnosis.

Adolescent ; Adult ; Aged ; Female ; Humans ; Liver Diseases ; diagnosis ; etiology ; Liver Neoplasms ; pathology ; radiotherapy ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Radiation Injuries ; diagnosis ; pathology ; Radiotherapy Dosage ; Radiotherapy, Conformal ; adverse effects ; methods ; Sensitivity and Specificity