Objective To observe the effect of botulinum toxin A (BTX-A) on spasticity of upper extremity with different functional status after stroke.Methods 32 post-stroke patents with upper extremity spasticity were divided into the good function group (n=13) and poor function group (n=19) according to the function of upper extremity. All patients in two groups were treated with injection of domestic BTX-A at the biceps brachii and rehabilitation therapy. The efficacy was assessed with rang of motion, Modified Ashowrth Scale (MAS), Fugl-Meyer Assessment (FMA) and Mot-FIM upper extremity before and 8-week after treatment.Results After treatment, the rang of motion and FMA scores of patients in two groups improved ( P<0.05), but the good function group was superior to the poor function group; the scores of MAS of two groups were not different ( P>0.05); the scores of Mot-FIM upper extremity of the patients in two groups increased ( P<0.05), and there was no significant difference between two groups ( P>0.05).Conclusion The effect of BTX-A injection at the biceps brachii on post-stroke patients with good function of upper extremity is superior to the patients with poor function of upper extremity.

Objective To evaluate the effects of hydroxyapatite (HA) extensively-coated prosthesis on elderly patients undergoing hip arthroplasty.Methods From February 1997 to May 1999,96 patients Were treated with hydroxyapatite (HA) coated prosthesis and followed up for their hip arthroplasty.Their results were studied clinically and roentgengraphically to evaluate chiefly their Harris scores,complications and thigh pain.The survival of prosthesis was evaluated according to Kaplan-Meier methods.Results The 60 cases were followed up for eight years on average(range,sevon to nine years).Their mean Harris scores were improved from 42 preoperatively to 90 postoperatively.Fifty-eihgt cases felt no pain at their hip,but two did at their thigh.No radiolucent lines were observed.All the prostheses achieved bony stabilization and remolding.Conclusions HA coated prosthesis can achieve fine fixation,because it helps bone conduction,resists axial force and torsion,and reduces operative risks.

Child ; Child Welfare ; China ; Health Services, Indigenous ; Humans

Aged, 80 and over ; Aorta, Abdominal ; pathology ; Embolism, Cholesterol ; therapy ; Female ; Humans

Health Promotion ; Outcome and Process Assessment (Health Care) ; Workplace

Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

0.05) in incidence rate for bone marrow suppression,gastrointestinal reaction,hepatic damage and mucosa damage and infection between different therapic courses.Central nervous system leukemia(CNSL) occured in one high risk case followed up at 12 month after complete remission(CR);the incidence rate was 12.5%.Conclusions HD-MTX is practicable in basic-level hospitals,as long as there are perfect preparation,fitness hydration and alkalization and leucovorin rescue being used in time.

Cerebral Infarction ; etiology ; Dextrocardia ; etiology ; Female ; Humans ; Infant ; Spleen ; abnormalities ; Syndrome

Objective To explore the origin and etiopathogenesis of antrochoanal polyp (ACP)based on the clinical data.Methods Twenty-six patients with ACP were included in the study.All the ACP patients were documented by preoperative endoscopy and computer tomographic (CT) scans.All patients were treated under endonasal endoscopic surgery.The relationship between polyp in middle meatus and lesions in the antrum was observed during the surgery.Following surgical removal,the polyps and lesions in the antrum were studied under macroscopy and microscopy.Results Among 26 cases with ACP,17 cases were confirmed by preoperative endoscopic examination that polyp originating from antrum ostium,19 cases showed intimate relationship between the polyp and antrum lesions in CT scan,and 23 cases were found that the polyp originating from the antrum cyst.The pedicle of polyp connected the cyst through autrum ostium,and the polyp existed as a part of capsule wall.Conclusion Based on the data obtained,it is tempting to suggest that the ACP mainly develops from antral cyst,an increase in pressure in cyst forced capsule wall to herniate to middle meatus through the antral ostium,and the continuous herniation and hyperplasy leading to the formation of ACP.