ObjectiveTo observe the effects of a modified version of constraint-induced movement therapy (CIMT) on upper-extremity function of children with hemiplegic cerebral palsy.Methods22 patients were divided randomly into treatment group (n=10) and control group (n=12). Cases of control group received routine rehabilitation therapy, otherwise, those of treatment group were treated with CIMT. It involved restraining the unimpaired extremity with a restraining-instrument, and having the child engage in activities with the involved extremity 4 hours a day for 2 months repeatedly. Before and after treatment, affected upper-extremity function of all children were assessed with the Fine Motor Function Measure (FMFM) scale.ResultsThe fine motor function of all children in two groups improved significantly(P<0.05), but effect of treatment group was better than that of control group (P<0.05).ConclusionThe treatment of CIMT can improve upper-extremity function of children with hemiplegic cerebral palsy.

ObjectiveTo investigate the correlation between the gross motor function and the clinical types and complications of children with cerebral palsy (CP).MethodsThe gross motor function of 126 CP children were measured by Gross Motor Function Classification System (GMFCS). Then the correlation between gross motor function, and clinical types and complications was analyzed.ResultsThere was a strong correlation between GMFCS and clinical types and complications ( P<0.001). GMFCS evaluation showed that 55.1% spastic children were categorized into levels Ⅰ and Ⅱ; 53.8% of dyskinetic and 85.7% of mixed children were categorized into levels Ⅳ and Ⅴ; 55.4% of diplegic and total hemiplegic children were categorized into levels Ⅰ and Ⅱ; 67.4% of tetraplegic and 55.6% complex hemiplegic children were categorized into levels Ⅳ and Ⅴ; 100% children with normal developmental quotient (DQ) and 91.6% above borderline of DQ were classified into levels Ⅰ and Ⅱ. The mental impairment was more severe; the levels of GMFCS were more higher. There were more visual impairment, hearing disorder, speech disability, feeding problem and epilepsy in children with levels Ⅲ, Ⅳ and Ⅴ than that with levels Ⅰ and Ⅱ.ConclusionThere is a significant correlation between GMFCS and clinical type and complications of CP, and the categorization of GMFCS is higher, the complications are more.

OBJECTIVETo investigate the effect of Qianjin Fubao (QJFB) on behavior and estradiol level in femal chronic stress model rats.

METHODTwenty four female Wistar rats (2 month old) were evenly randomized into normal control, animal model and QJFB (0.7 g x kg(-1) x d(-1)) group. The QIFB group and the stress group were exposed to a chronic unpredictable stress for 21 days. Rats of the QJFB group received perfusion of Qianjin Fubao, and rats of stress and control group were perfused with normal saline. The behavior of three groups were determined with the method of Open-field before and after right stress respectively. Serum level of estradiol was detected with radioim munoassay.

RESULTThe behavioral score and the serum level of estradiol of the stressed group were significantly lower than those of the control group after stress (P < 0.05). There were no significant differences of behavioral score and the serum level of estradiol between QJFB group and control group.

CONCLUSIONThe chronic unpredictable stress can induce the stressful change of behavior, and QJFB may recover the rats'abnormal behavior and improve the serum level of estradiol. QJFB may have protective effect on stress.

Animals ; Behavior, Animal ; drug effects ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Estradiol ; blood ; Female ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Stress, Psychological ; blood ; physiopathology

Objective To observe the clinical efficacy of alogliptin combined with metformin in the treatment of elderly patients with type 2 diabetes mellitus(T2DM).Methods Patients with type 2 diabetes were divided into control group and treatment group according to the treatment plan.The control group was given metformin,the initial dose was 0.5 g each time,qd,and the dose was gradually increased according to blood glucose control and tolerance,the maximum dose was 2.0 g per day.The treatment group was supplemented with alogliptin on the basis of metformin group,the initial dose was 25 mg each time,and the dose was gradually increased to 50 mg per day according to tolerance.The treatment course of the two groups were 3 months.The blood glucose level,blood glucose fluctuation and islet β cell function indexes of the two groups were compared,and the occurrence of adverse drug reactions were evaluated.Results There were 48 cases in the control group and 42 cases in the treatment group.Fasting blood glucose(FBG)in treatment group and control group after treatment were(6.07±0.89)and(6.87±0.82)mmol·L-1;and 2 h postprandial blood glucose(2 h PG)were(7.86±1.59)and(8.92±1.65)mmol·L-1,respectively;hemoglobin A1e(HbA1c)were(6.45±0.53)％,(7.01±0.58)％,respectively;mean amplituse of glycemic excusions(MAGE)were(2.76±0.83)and(3.37±0.89)mmol·L-1,respectively;the mean absolute value of daily blood glucose(MODD)were(1.51±0.44)and(1.98±0.52)mmol·L-1,and the standard deviation(SD)were(1.07±0.27)and(1.41±0.33)mmol·L-1,respectively;fasting insulin(FINS)were(14.64±2.47)and(9.40±2.85)μU·L-1;C-peptide(1.82±0.45)and(1.41±0.49)μg·L-1,respectively;insulin resistance index(HOMA-IR)were 2.34±0.52 and 2.87±0.64,respectively;compared with control group,the above indexes in treatment group had statistical significance(all P＜0.05).During treatment,3 cases of hypoglycemia,5 cases of digestive system reaction,2 cases of dizziness(4.76％),and 2 cases of rash occurred in the test group,while 2 cases of hypoglycemia,4 cases of digestive system reaction,1 case of dizziness,and 1 case of rash occurred in the control group.The incidence of adverse drug reactions in the test group and the control group were 28.57％and 16.67％,respectively.The difference was not statistically significant(P＞0.05).Conclusion Alogliptin combined with metformin in the treatment of elderly T2DM can improve the function of islet βcells,and has a significant effect on controlling and maintaining blood glucose stability.

OBJECTIVETo investigate the failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old retrospectively inorder to pay more attention to the treatment of these fractures.

METHODSFrom Junary 2007 to June 2010,18 failed cases of internal fixation on displaced femoral neck fractures in adults under fifty-five years old were treated,there were 13 males and 5 females with an average age of (48.0 +/- 6.0) years old ranging from 27 to 55. Among them, 17 patients were treated with cannulated screws and 1 patient was treated with intramedullary nail; 16 patients were diagnosed as osteonecrosis and 2 patients as osteonecrosis associated with nonunion.

RESULTSThe average time from internal fixation to failure was 23 months (ranged, 8 to 32 months). The quality of fracture reduction in Garden index was poor. The Harris Hip Score was (56.0 +/- 12.5) (ranged,33 to 80). Eight cases of osteonecrosis and 2 cases of nonunion combinated osteonecrosis were received total hip arthroplasty. Hip resurfacing arthroplasty were performed for other 5 osteonecrosis. Because of no evident clinical symptoms,the other 3 cases received conservative treatment. The patients with total hip arthroplasty and hip resurfacing arthroplasty were followed-up for 34 months ranging from 12 to 53 months. After operation,the Harris score was (94.0 +/- 3.0) ranged 89 to 96.

CONCLUSIONOsteonecrosis is a common complication after internal fixation on displaced femoral neck fracture in adults under fifty-five years old. More attention should be paid to the treatment of displaced femoral neck fracture in those patients.

Adult ; Female ; Femoral Neck Fractures ; diagnostic imaging ; physiopathology ; surgery ; Fracture Fixation, Internal ; adverse effects ; Humans ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Failure

OBJECTIVETo study the method and effect of endoscopic two-portal one-way releasing procedure for cut of transverse carpal ligament and decompression of median nerve.

METHODSEleven female patients (13 sides) with primary carpal tunnel synrome underwent endoscopic two-portal one-way releasing procedure, there were 3 left hands, 6 right, and 2 both. All the subjects had hypesthesia in the radial three and half finger's tip with a positive, Tinel sign of median nerve at wrist; 11 cases had thenar myatrophy in which 4 had opposition dysfunction. Under local anaesthesia, the proximal incision was located at the point of the proximal carpal transverse striation level between palmaris longus and flexor carpi radialis. The outlet was chosed the junction of the parallel line of the ulnar side of thumb and proximal extending line of middle ring fingers' long axis while the thumb was in abduction position. The length of each incision was only one centimeter. The hook knife was inserted to the proximate of the transverse carpal ligament, then, the transverse carpal ligament was completely released form the proximal to the distal end by hook knife under the endoscope monitor.

RESULTSThe results showed that both pinch and grip function was satisfied and no complications occurred at 4 to 20 months followed-up. S3+ M3 or more has been reached in 3 months after operation.

CONCLUSIONThe endoscopic two-portal one-way releasing procedure is an easy and effective method for the treatment of carpal tunnel syndrome.

Adult ; Aged ; Carpal Tunnel Syndrome ; pathology ; physiopathology ; surgery ; Decompression, Surgical ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Ligaments ; surgery ; Median Nerve ; surgery ; Middle Aged ; Recovery of Function

Objective To assess the diagnostic accuracy of 64-slice computed tomography coronary angiography (64-SCTCA) in individuals with suspected coronary artery disease (CAD). Methods The study enrolled 285 individuals undergoing 64-SCTCA with calcium scoring and thereafter invasive coronary angiography (CAG) within 4 weeks for suspected CAD. Pretest probability of having obstructive CAD was determined using the Duke clinical score, which was estimated by type of chest discomfort, age, gender,and traditional risk factors and stratified into 3 levels of probability: low ( ≤ 30%, n = 80), intermediate (31% to 70%, n =92), and high ( ≥71%, n = 113). CAD was defined as the presence of at least one vessel of ≥50% coronary stenosis on CAG. Results The patient-based diagnostic accuracy of 64-SCTCA for detecting CAD according to CAG revealed a sensitivity of 81.2%, a specificity of 93.3%, a positive predictive value of 68.0% and negative predictive value of 96.6%. The CAD prevalence in the low,intermediate and high risk groups according to Duke probability was 46.3%, 72.8% and 82.3%,respectively. The sensitivity and positive predictive value were lower in the low probability group than those in the intermediate and high probability groups. For those with coronary artery Agatston calcium score ＞400, the diagnostic accuracy was linked with a higher sensitivity but lower specificity. The diagnostic value of 64-SCTCA for proximal and mid-segment of coronary artery was superior to that for distal segment. Conclusions 64-SCTCA is mainly indicated in individuals with an intermediate probability of having CAD. The diagnostic value of 64-SCTCA could be affected by coronary artery calcium, lesion location and vessel diameter.

Objective:To investigate the clinical characteristics, efficacy and prognostic influencing factors of IgD multiple myeloma (MM) in the new immunotherapy era.Methods:The clinical data of 29 patients diagnosed with IgD MM in the Affiliated Hospital of Xuzhou Medical University from March 2014 to February 2021 were retrospectively collected. The clinical characteristics, treatment regimens and efficacy, especially the efficacy of new drugs and immunotherapy for the disease were analyzed. Kaplan-Meier method was used to analyze the overall survival (OS) and progression-free survival (PFS). Multivariate Cox proportional risk model was used for analysis of prognostic influencing factors.Results:The median age of patients was 58 years. There were 20 cases (69.0%) below 65 years, 12 cases (41.4%) of complicated with stomach function damage, 6 cases (20.7%) of extramedullary invasion. All patients were treated with combined therapy containing proteasome inhibitor bortezomib in the first-line therapy, and the overall response rate was 82.8% (24/29). Among 21 relapsed/refractory patients, 12 patients were treated with the second-line or above treatment regimen chimeric antigen receptor T cell (CAR-T) immunotherapy, including 9 cases achieving very good partial remission (VGPR) or above; 5 patients were treated with the new drug daratozumab, including 1 case achieving complete remission (CR). The median OS time of 29 patients was 48 months (95% CI 17-79 months), the median PFS time after the first-line treatment was 9 months (95% CI 3-15 months), and the median PFS time after the second-line treatment was 11 months (95% CI 1-21 months). Multivariate Cox regression results showed that CAR-T therapy is an independent influencing factor of the prognosis of relapsed/ refractory IgD MM patients ( HR = 0.094, 95% CI 0.019-0.473, P = 0.004). Conclusions:IgD MM patients are characterized with lower onset age, more renal function damage and a high incidence of extramedullary invasion. The first-line therapy containing proteasome inhibitor has a better short-term efficacy, and CAR-T therapy can improve the remission rate and survival rate of relapsed/refractory IgD MM to a certain extent.

Objective:To explore the influence of prognostic nutritional index (PNI) and controlling nutritional status (CONUT) on the prognosis of patients with multiple myeloma.Methods:Data of 157 patients with multiple myeloma (MM) at the affiliated hospital of Xuzhou medical university from January 2014 to December 2018 were retrospectively evaluated. The operating characteristic (ROC) curve analysis was adopted as the optimal cut-off point. PNI and CONUT were grouped based on the cut-off points of 44.45 and 3.5, respectively, and the differences between age, gender, serum calcium, β 2-microglobulin, serum creatinine, lactate dehydrogenase, and hemoglobin were analyzed. The prognostic factors were analyzed via univariate and Cox multivariate regression analyses. Results:The level of PNI and CONUT is the influencing factor of OS time. The univariate analysis revealed that age, LDH, plasma cell ratio, β 2-microglobulin, ISS stage, PNI, and CONUT were the risk factors for the prognosis of patients with MM. The multivariate analysis revealed that age ( HR=1.636, 95% CI 1.014-2.640) , plasma cell ratio ( HR=1.953, 95% CI 1.232-3.096) , and PNI ( HR=0.513, 95% CI 0.287-0.917) were the independent prognostic risk factors of patients with MM. Conclusion:Low PNI in patients with MM indicates a poor prognosis, which is an independent prognosis risk factor.

BACKGROUNDThe neuroprotective effect of the cyclooxygenase (COX) inhibitor has been demonstrated in acute and chronic neurodegenerative processes. But its function under cerebral ischemic conditions is unclear. This study was designed to evaluate the neuroprotective efficacy of emulsified flurbiprofen axetil (FA, COX inhibitor) and its therapeutic time window in a model of transient middle cerebral artery occlusion (MCAO) in rats.

METHODSForty-eight male SD rats were randomly assigned into six groups (n = 8 in each group); three FA groups, vehicle, sham and ischemia/reperfusion (I/R) groups. Three doses of FA (5, 10 or 20 mg/kg, intravenous infusion) were administered just after cerebral ischemia/reperfusion (I/R). The degree of neurological outcome was measured by the neurologic deficit score (NDS) at 24, 48 and 72 hours after I/R. Mean brain infarct volume percentage (MBIVP) was determined with 2, 3, 5-triphenyltetrazolium chloride (TTC) staining at 72 hours after I/R. In three other groups (n = 8 in each group), the selected dosage of 10 mg/kg was administrated intravenously at 6, 12 and 24 hours after I/R.

RESULTSThe three different doses of FA improved NDS at 24, 48 and 72 hours after I/R and significantly reduced MBIVP. However, the degree of MBIVP in the FA 20 mg/kg group differed from that in FA 10 mg/kg group. Of interest is the finding that the neuroprotective effect conferred by 10 mg/kg of FA was also observed when treatment was delayed until 12 - 24 hours after ischemia reperfusion.

CONCLUSIONCOX inhibitor FA is a promising therapeutic strategy for cerebral ischemia and its therapeutic time window could last for 12 - 24 hours after cerebral ischemia reperfusion, which would help in lessening the initial ischemic brain damage.

Animals ; Cyclooxygenase Inhibitors ; administration & dosage ; pharmacology ; Disease Models, Animal ; Flurbiprofen ; administration & dosage ; analogs & derivatives ; pharmacology ; Infusions, Intravenous ; Ischemic Attack, Transient ; chemically induced ; drug therapy ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Time Factors