Critical Illness ; therapy ; Humans ; Nutritional Support

Gait problems in cerebral palsy patients are usually caused by spasticity or contracture of two joints muscles,and the imbalance between synergic muscles and antagonistic muscles. The knee problems are the most common seen in cerebral palsy patients. The paper discusses the common abnormalities of the knee in cere-bral palsy and the development in treatment of the deformities.

Program monitoring and evaluation (M & E) is the major method used in the international collaboration programs on disease control and prevention in China in recent years. It functions in the progress overseeing,problem finding and solving in terms of enhancing the program quality,managing the work plan,summing up the experiences,auditing the performance and finally achieving the expected goal. The indicators and implementation progress based on M & E serve as a scientific tool to measure the program implementation outcome periodically.

Objective To analyze the relationship between volume,conductivity,laser light scatter (VCS) of lymphocytes and monocytes and atypical lymphocyte.Methods The clinical data of 129 patients with virus infection and 50 healthy controls received blood routine examination by Sysmex-800i hematology analyzer in our hospital were retrospectively analyzed.The lymphocyte volume (MLV),distribution width,(LDW),conductance rate (MLC),laser scattering(MLS) and monocyte cell volume (MMV),distribution width,(MDW),electrical conductivity (MMC),laser scattering(MMS) were analyzed.And according to the heterotypic lymphocyte ratio,the virus infection patients were divided into group 1 (abnormal rate 2％-5％),group 2 (abnormal rate ＞ 5％-10％),group 3 (abnormal rate ＞10％).The healthy controls were selected as control group.The VCS parameters of the four groups were compared.Results The LDW of group 1 was (17.2 ± 2.5) FL,that of the control group was (14.1 ± 2.7) FL,the difference was statistically significant(t =2.362,P ＜0.05).The MLV,LDW,MMV,MDW of group 2 were (85.3 ±5.6) ×109/L,(19 ±3.1) FL,(185.9 ±9.2) × 109/L,(22 ±2.9) FL,which were significantly higher than those of the control group (t =2.557,3.086,2.735,4.269,P ＜ 0.05).The MLV,LDW,MMV,MDW of group 3 were (89.5 ±6.8) ×109/L,(22.3 ±3.6) FL,(194.5 ±9.6) ×109/L,(24.5 ±3.4) FL,which were significantly higher than those in the control group (t =2.982,3.569,2.945,4.863,P ＜ 0.05).The MLC,MLS,MMC,MMS of group 1 were (112.3 ±7.8) μs/cm,(54.8 ±4.9) NTU,(112.3 ±7.8)μs/cm,(83.6 ±4.7) NTU,those in group 2 were (104.7 ±6.9)μs/cm,(52.6 ± 4.5) NTU,(104.7 ± 6.9) μs/cm; (81.1 ± 4.3) NTU,those in group 3 were (96.5 ± 6.2) μs/cm,(50.5 ± 4.3) NTU,(96.5 ± 6.2) μs/cm,(78.7 ± 3.8) NTU,those in the three groups were significantly lower than in the control group (t =2.623,3.195,2.247,5.829,2.457,2.956,2.371,6.715,2.573,3.044,4.395,7.386,P ＜ 0.05).Conclusion VCS parameters of lymphocytes and mononuclear cells of two types of white blood cells can reflect to a certain extent,peripheral blood heterotypic lymphocyte morphology changes of clinical infection,has the reference value of diagnosis and treatment of disease.

Objective To investigate the indications and clinical values of percutaneous transthoracic biopsy guided by different locating means respectively on pulmonary lesions. Methods Patients were divided into different groups according the locating methods,which included X -ray, type -B ultrasonography, and CT. Pathologic diagnosis and complications were retrospectively analysed between groups. Conclusion Each locating method has its own advantages and disadvantages. Results we should choose the optimistic one according the patients′ condition.

Spastic diplegia and hemiplegia are the common types of cerebral palsy which needs treat-ment in clinic. The paper discusses the classification of gait problems in these two types of cerebral palsy and ac-cording to gait analysis,recommended the management for them. Through the understanding of the classification, the treatment plan could be made individually regarding the GMFCS level of the patient and improve their functions.

Objective To explore the effect of DNA methylation inhibitor 5-aza-2'-deoxycytidine (5-Aza-CdR) on proliferation and tumor suppressor gene PRDM1α expression in Burkitt's lymphoma cell line NAMALWA. Methods MTT was used to study the impact of DNA methylation inhibitor on proliferation in NAMALWA cells,and comparative real-time reverse transcription-polymerase chain reaction (RQ-PCR) with SYBR Green assay was used to detect PRDM1α gene expression. Results MTT results showed that 5-AzaCdR inhibited proliferation of NAMALWA cells in a dose-dependent manner.After treated with 5-Aza-CdR for 72 h at 0.01,0.0625,0.1,0.125,0.25,0.5,1,2 and 4 μmol/L,the inhibition rates were 21.93 ％,39.23 ％,47.69 ％,50.37 ％,53.54 ％,57.72 ％,62.31％,65.68 ％,67.87 ％,respectively,and the differences of absorbance among the groups were also statistically significant (all P＜ 0.01). Meanwhile, 5-Aza-CdR could induce the re-expression of PRDM1α, and △Ct of 0.5, 1, 2 μmol/L groups showed significant differences compared with control group (all P ＜ 0.05). Conclusion DNA methylation inhibitor 5-Aza-CdR can significantly inhibit the proliferation of Burkitt' s lymphoma cell line NAM ALWA,and the possible mechanism of this inhibition may be induction of demethylation and re-expression of PRDM 1α.

According to the recent years’ review of international and domestic relating journals and collections, the conception, mechanism, and treatment of sympathetic cervical spondylosis are summarized.All authors have agreed that posterior cervical nerve syndrome proposed by Barre-Lieou and addressed in this paper, whose mechanism mainly is cervical vertebral degeneration stimulus, or oppression upon sympathetic nervous fiber, or spasm of vertebral artery, is generally treated by non-operative methods and cautious operative methods.The main cause of sympathetic cervical spondylosis is cervical vertebral instability, which stimulates sympathetic nervous fiber to make vertebral artery to convulse. And its treatment is mainly conservative treatment and supplementary operation. But it is usually subject to reoccurrence. Operative methods include cervical disk excision, cervical inter-body fusion and bone grafting and inner fixation, instable factor elimination. But eligible condition is relatively short.

Objective: To monitor the blood concentration of high-dosage of methotrexate (HD-MTX) during chemotheraphy in the treatment of patients with osteosarcoma and discuss its clinical significance. Methods: Thirty-five patients with osteosarcoma who received high dosages of MTX (6 g/m2) for 50 times were involved in our study. The serum concentration of MTX was determined at each time point by improved RP-HPLC. The relationship between the serum concentration of MTX and the adverse reaction was analyzed. Results: The mean peak MTX level was (348.60 ± 200.47) μmol/L. The serum concentrations of MTX were significantly higher at 24 h and/or 48 h than safe levels (105 μmol to 106 μmol) in 15 cases (30%). The incidence rates of adverse reactions such as neutropenia, oral mucositis and rash were 40.0%, 33.3%, and 20%, respectively. Conclusion: There is significant variability in the MTX serum levels. The incidence rates of ad reactions are relatively higher in those patients whose 24-h and/or 48-h serum MTX concentrations are higher than the safe levels.

Objective To study the effect of adjuvant transcatheter arterial chemoembolization (TACE) on intrahepatic recurrence after curative liver resection for primary hepatocellular carcinoma (PHC).Methods 130 PHC patients who underwent curative liver resection from June 2010 to February 2013 were selected and randomly allocated to the study group (n =67) and the control group (n =63).The study group underwent adjuvant TACE for 1 ～ 4 times,and the control group did not receive any adjuvant therapy.On follow-up for 36 months,the postoperative recurrence rates,tumour free survival time and tumor free survival rates of the two groups were compared.Results At 6 months after surgery,the serum AFP level [(379.8 ±91.7) μg/L vs.(414.5 ±84.3) μg/L] and the IGFBP-2 level [(2 855.3 ±727.5) μg/L vs.(3 259.6 ± 894.1) μg/L] in the study group were significantly lower than the control group (P ＜ 0.05).The 1-year cumulative recurrence rate in the study group (10.4％ vs.28.6％) was significantly lower than the control group (P ＜ 0.05).However,the 2-year and 3-year cumulative recurrence rates were not significantly different between the two groups (P ＞ 0.05).The 3-year cumulative tumor free survival rate of the study group (81.0％ vs.73.2％) was significantly higher than the control group (P ＜ 0.05).Patients in the study group with portal vein tumor thrombus had an 1-year cumulative recurrence rate of (12.8％ vs.31.6％) and a 2-year rate of (28.2％ vs.50.0％).In patients with a preoperative AFP ≥400 μg/L,the 1-year cumulative recurrence rates were (8.8％ vs.30.6％).When the tumor diameter was ≥10 cm,the 1-year,2 year and 3-year cumulative recurrence rates were significantly lower than the control group (P ＜ 0.05,11.8％ vs.46.7％),(35.3％ vs.75.3％) and (47.1％ vs.86.7％),respectively.The recurrence rates in patients who had no cancer thrombus,a preoperative AFP ≤400 μg/L and a tumor diameter ＜ 10 cm were not significantly different between the two groups (P ＞ 0.05).The recurrent rates of patients who underwent TACE 1 time and those who did not receive TACE showed no significant difference (P ＞0.05).In patients who had TACE twice,the 1-year (4.3％ vs.28.6％),2-year (15.2％ vs.41.3％) and 3-year (26.1％ vs.49.2) cumulative recurrence rates were significantly lower than patients who did not receive TACE (P ＜ 0.05).In patients who had TACE for more than three times,the cumulative recurrence rate was similar to patients who had TACE twice (P ＞ 0.05).Conclusions Adjuvant TACE helped to reduce PHC recurrence after curative liver resection during the high-risk period for recurrence.A 1-time TACE did not significantly reduce postoperative recurrence rate,and ≥ 3 times TACE did not significantly improve tumor-free survival rates.Adjuvant TACE and the number of TACE should be reasonably carried out based on the indications and pathological characteristics.