The rehabilitation therapeutic method of dysphagia after stroke included movement therapy and compensatory technology (including neurodevelopmental therapy), neuromuscular electrical stimulation, surface electromygraphy biofeedback training, non-invasive brain stimulation, balloon ductal dilatation technique, acupuncture and moxibustion, drug, and surgical treatment. The movement therapy and compensatory technology were the basis of therapy and the upward and forward movements of tongue-throat complex were the core of therapy. The combined treatments of early, initiative, individual, and various methods were emphasized, while the nutrition and the preven-tion and cure of aspiration pneumonia of patients should be paid attention to.

Objective To systemically evaluate the quality of randomized controlled trials(RCTs) of recurrent oral ulcer(ROU) treated by traditional Chinese medicine.Methods The randomized controlled trials of TCM treatment on ROU were retrieved,and the related information from database was retrieved and assessed with Cochrane Handbook.Results Fifty-three articles in 41 journals were found.There were 12 diagnostic criteria and 8 effect criteria.Base-line comparision in 39 articles,blind methods in 3 articles,follow-up survey in 2 articles,adverse reaction in 10 articles,no case loss in all articles were reported.Conclusions The quality of RCTs of TCM for ROU should be improved.

AIM To investigate the effect of cisplatin on apoptosis in Scaber cell. METHODS The apoptotic cells were detected by TUNEL,HE,eletronic micrpscopy. RESULTS Treatment of Scaber cells with CDDP resulted in characteristics typical of apoptosis. CDDP induced apoptosis of Scaber cells in time and concentration dependent manner. To further investigate the mechanism of apoptosis induced by CDDP, the expressions and activity of apoptosis associated proteins such as bcl 2, bax and caspase 3 were examined using S P method.The results showed: CDDP caused time and concentration dependent decreases in bcl 2 and increased in bax proteins.CDDP bcl 2 and its translocation to perinuclei and nuclei. The expression of caspase 3 in Scaber cell were determined during apoptosis induced by CDDP. CONCLUSION Our investigetion showed that the apoptosis induced by CDDP is related to the increase of bax protein, and the decrease of bcl 2 protein. and its translocation to perinuclei and nuclei.

Objective To study the association of the expression of bone morphogenetic protein (BMP) antagonist gremlin and vascular calcification in radial arteries of patients with stage 5 of chronic kidney disease (CKD).Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group,which were trimmed off during arterial venous fistula operations.Splenic trabecular arteries were collected as specimens of the control group,which were removed from 38 patients with simple traumatic splenic rupture.All the arteries were examined histologically for calcification with yon Kossa stain.Expressions of gremlin and BMP-2,-7were detected by immunohistochemistry and their serum concentrations were detected by ELISA.Images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6.0.SPSS 19.0software was used to perform statistical analysis.Results Significantly positive von Kossa stain was found in radial arteries from 12 of 40 patients (30％) in study group,which located in the layer of medial smooth muscle cells.However,there was no obvious positive stain in control group.Additionally,in study group,significant expressions of gremlin and BMP-2 were detected in those radial arteries of positive yon Kossa stain,which also located in the layer of medial smooth muscle cells.Positive correlations were found among gremlin expression level,BMP-2 expression level and yon Kossa stain intensity.However,the BMP-7 expression intensity in arteries of study group was much weaker as compared to control group.Conclusions Both gremlin and BMP-2 may be involved in the process that the smooth muscle cells of radial arteries in patients with stage 5 of CKD phenotypically transform into osteoblast-like cells.However,BMP-7 possibly prevents this process.

Objective To evaluate early diagnosis by gastroscopy for the causes of gastroduodenal perforation after successful non-surgical treatment.Method Gastroduodenal perforation patients suspected of benign ulcer in origin on hospital admission undergoing successful non-surgical treatment were examined by gastroscopy within days after the closure.Results Among 284 patients undergoing gastroscopy,277 cases (97.5％) were diagnosed as gastroduodenal ulcer,3 cases (1.1％) as gastric carcinoma,1 case (0.4％) of duodenal diverticulum.There were not major complications developing after gastroscopy.Conclusion Early gastroscopy performed after closure by non-surgical treatment in gastroduodenal perforation patients is safe,helping make definite diagnosis for the cause of perforation.

OBJECTIVETo study the chemical constituents from the whole plant of Aster poliothamnus.

METHODSeparating the chemical constituents by means of chromatography and identifying ther structures on basis of chemical and spectral tecnology.

RESULT AND CONCLUSIONA new triterpene saponin was isolated and identified.

Aster Plant ; chemistry ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Saponins ; chemistry ; isolation & purification

Impairment of neuronal mitochondria following hypoxia of brain not only result in nerve cell's energy-deprivation and dysfunction, mitochondria also play key roles in apoptosis of neurons. A central step being the release of cytochrome c (cyt c) across the outer mitochondrial membrane into the cytoplasm through opening of the mitochondrial permeability transition pore. Releasing of cytochrome c induce to downstream consequences of specific caspase activation. The antiapoptotic and proapoptotic members of the Bcl-2 family regulate mitochondrial activities relevant to apoptotic signaling by influencing the realaseing of cyt c.
Apoptosis ; Caspases/metabolism* ; Cytochrome c Group/metabolism* ; Humans ; Hypoxia, Brain/pathology* ; Membrane Proteins/metabolism* ; Mitochondria/metabolism* ; Neurons/pathology* ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Signal Transduction

OBJECTIVETo explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy.

METHODSFrom March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment.

RESULTSAll patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P < 0.01).

CONCLUSIONSelective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy was used to treat spastic cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.

Adolescent ; Arm ; physiopathology ; Cerebral Palsy ; complications ; Cervical Vertebrae ; surgery ; Exercise Therapy ; Female ; Humans ; Male ; Muscle Spasticity ; etiology ; physiopathology ; surgery ; therapy ; Paralysis ; etiology ; physiopathology ; surgery ; therapy ; Spinal Nerve Roots ; surgery ; Young Adult

BACKGROUNDAwake fiberoptic intubation (AFOI) is usually performed in the management of the predicted difficult airway. The aim of this study was to evaluate the feasibility of dexmedetomidine with midazolam (DM) and sufentanil with midazolam (SM) for sedation for awake fiberoptic nasotracheal intubation.

METHODSFifty patients with limited mouth opening scheduled for AFOI were randomly assigned to two groups (n = 25 per group) by a computer-generated randomization schedule. All subjects received midazolam 0.02 mg/kg as premedication and airway topical anesthesia with a modified "spray-as-you-go" technique. Group DM received dexmedetomidine at a loading dose of 0.5 μg/kg over 10 min followed by a continuous infusion of 0.25 μg·kg-1·h-1, whereas Group SM received sufentanil at a loading dose of 0.2 μg/kg over 10 min followed by a continuous infusion of 0.1 μg·kg-1·h-1. As necessary, since the end of the administration of the loading dose of the study drug, an additional dose of midazolam 0.5 mg at 2-min intervals was given to achieve a modified Observers' Assessment of Alertness/Sedation of 2-3. The quality of intubation conditions and adverse events were observed.

RESULTSThe scores of ease of the AFOI procedure, patient's reaction during AFOI, coughing severity, tolerance after intubation, recall of the procedure and discomfort during the procedure were comparable in both groups (z = 0.572, 0.664, 1.297, 0.467, 0.895, and 0.188, respectively, P > 0.05). Hypoxic episodes similarly occurred in the two groups, but the first partial pressure of end-tidal CO2after intubation was higher in Group SM than that in Group DM (45.2 ± 4.2 mmHg vs. 42.2 ± 4.3 mmHg, t = 2.495, P < 0.05).

CONCLUSIONSBoth dexmedetomidine and sufentanil are effective as an adjuvant for AFOI under airway topical anesthesia combined with midazolam sedation, but respiratory depression is still a potential risk in the sufentanil regimen.

Adult ; Conscious Sedation ; methods ; Dexmedetomidine ; adverse effects ; therapeutic use ; Double-Blind Method ; Female ; Fiber Optic Technology ; methods ; Humans ; Hypnotics and Sedatives ; adverse effects ; therapeutic use ; Intubation, Intratracheal ; methods ; Male ; Midazolam ; adverse effects ; therapeutic use ; Middle Aged ; Sufentanil ; adverse effects ; therapeutic use ; Wakefulness