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.

Antirheumatic Agents ; therapeutic use ; Arthritis, Juvenile ; therapy ; Biological Products ; therapeutic use ; Child ; Humans

The clinical and fundamental research for intrahepatic and extrahepatic biliary stones were still inadequate currently.It was difficult for treat and has the following clinical features:extensive he-patic lesion,complex conditions,more complications,higher recurrence rate,etc.Satisfactory results were hard to gained if just depend on conventional surgery recently.As the methods of diagnosis and treatment are continuously increasing:Ultrasound,CT,MRCP,Choledochoscope,Cholangiography and 3D imaging of hepa-tobiliary system.From the traditional open operation to a variety of minimally invasive treatment.Different examination and treatment methods has its advantages and disadvantages.How to choose the effective,less trauma,appropriate pathway method is the main direction for the current research.

Objective: To investigate the trends in mortality and life lost due to female breast cancer among in Suzhou City from 2007 to 2021, so as to provide insights into improvements of breast cancer control strategy in Suzhou City. Methods: The epidemiological and clinical data pertaining to dead female breast cancer cases in Suzhou City from 2007 to 2021 were collected from Suzhou Municipal Chronic Disease Surveillance System, including gender, age and cause of death. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), standardized YPLL (SYPLL), standardized YPLLR (SYPLLR) and average years of life lost (AYLL) due to female breast cancer were calculated. All data were standardized by the Fifth National Population Census in 2000, and the trends in mortality of breast cancer were estimated using average annual percent change (AAPC). Results: Totally 4 425 death occurred due to female breast cancer in Suzhou City from 2007 to 2021, with a crude mortality rate of 8.67/105, which appeared a tendency towards a rise (AAPC=1.83%, t=5.080, P=0.001), and the standardized mortality was 4.68/105, which appeared no significant changes (AAPC=0.13%, t=0.356, P=0.727). The crude mortality rates of female breast cancer were 0.62/105, 10.33/105 and 21.69/105 among women at ages of 15 to 34, 35 to 64 years and 65 years and older, respectively, which appeared a tendency towards a rise (χ2trend=2 315.683, P=0.001). The crude mortality of female breast cancer was 8.66/105 in urban areas and 8.86/105 in rural areas, both appearing a tendency towards a rise (urban areas: AAPC=1.73%, t=3.290, P=0.006; rural areas: AAPC=2.68%, t=6.565, P=0.001). The YPLL, SYPLL, YPLLR, SYPLLR and AYLL of female breast cancer were 44 485 person-years, 30 387 person-years, 0.99‰, 0.68‰ and 14.94 years per person, and both YPLLR (AAPC=-1.06%, t=-2.193, P=0.047) and AYLL (AAPC=-1.53%, t=-4.783, P=0.001) appeared a tendency towards a reduction, respectively. Conclusion The crude mortality of female breast cancer appeared a tendency towards a rise and the life loss appeared a tendency towards a decline in Suzhou City from 2007 to 2021. The elderly population should be given a high priority for breast cancer control.

Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Cell Membrane ; metabolism ; Cell Nucleus ; metabolism ; Cytoplasm ; metabolism ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Signal Transduction ; TCF Transcription Factors ; metabolism ; Transcription Factor 7-Like 2 Protein ; Wnt Proteins ; physiology ; beta Catenin ; metabolism

Objective To investigate the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy,in order to provide a theoretical basis for prevention and treatment of this complication.Methods The term DGE was searched in Pubmed,Medline,EMBASE,Cochrane Library,CNKI,Wanfang,and published literatures were collected to determine the risk factors of DGE after pancreaticoduodenectomy.The Review Manager 5.3 software was used in the analysis.Results A total of 52 articles were included.The results of Meta-analysis showed that age and preoperative bilirubin levels did not significantly influence the incidence of DGE.Preoperative cholangitis (OR =3.39,95％ CI 1.97 ～ 5.82),hypoalbuminemia (OR =2.53,95％ CI 1.59 ～4.02),and intraoperative blood loss of more than 1 L (OR =1.98,95％ CI 1.18 ～ 3.33) significantly increased the incidence of DGE.Pyloric resection (RR =2.06,95％ CI 1.05 ～4.05),antecolic reconstruction (RR =0.74,95％ CI 0.56 ～ 0.99) and Braun enteroenterostomy (OR =0.36,95％ CI 0.17 ～0.77) significantly decreased the risk of DGE.When compared with Roux-enY enteroenterostomy,Billroth Ⅱ enteroenterostomy reduced the incidence of clinically relevant DGE (RR =0.30,95 ％ CI 0.11 ～ 0.79).Postoperative pancreatic fistula (OR =3.84,95 ％ CI 2.71 ～ 5.44) and intraabdominal infection/abscess (OR =3.95,95％ CI 2.87 ～ 5.43) were significantly associated with a high incidence of DGE.Conclusions Hypoalbuminemia,cholangitis,large blood loss,and postoperative abdominal complications were the risk factors of DGE.Pyloric resection,antecolic reconstruction,Billroth Ⅱ enteroenterostomy,and Braun enteroenterostomy significantly reduced the incidence of DGE.Subgroup analysis showed that differences on DGE definition in studies might be an important cause for the heterogeneity in the results of the different studies.

Background and purpose:Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Intrahepatic recurrence is the main factor affecting its medium-term survival rate. Therefore, the search for the markers of metastasis is essential. This study aimed to evaluate the relationship of expression of tyrosine kinase phosphorylation Tyr416 of sarcoma (SRC pY416) in HCC with clinical parameters and prognosis. Methods:Immunohistochemical method and Western blot were used to detect the expression of non-receptor tyrosine kinase (SRC pY416) in 112 cases of HCC tissues and 40 cases of corresponding cancer adjacent normal liver tissues. Hepatitis B virus (HBV) DNA and alpha fetoprotein (AFP) in patients were detected with chemiluminescence. In the 12 months Follow-up of the study,the association between SRC pY416 expression and clinical parameters was analyzed. Results:SRC pY416 expressions in HCC (65.40±15.69) were higher than those in cancer adjacent normal liver tissues (11.25±2.73,P<0.001). The expressions of SRC pY416 were all associated with the age, the liver cirrhosis, the complete capsule, the tumor differentiation, the HBV DNA and the AFP value of the patients (P<0.01). 12 months after operation, single factor analysis showed that the recurrence was associated with the tumor differentiation, the HBV DNA, the AFP value and the expression of SRC pY416 of the patient (P<0.01). Multivariate analysis showed that the expression of SRC pY416 was an independent prognostic factor for recurrence and metastasis in patients with HCC in 12 months. Conclusion:SRC pY416 may play an important role in the metastasis of HCC. The expression of SRC pY416 may be the marker for HCC liver metastasis.

Depending on Shanghai medical big data center and taking the medical big data after quality control and before data utilization as research object,the paper establishes the data cleaning frame,gives the evaluation method for data availability,finds out the corresponding cleaning strategies according to the clustering analysis of data characteristics and repeatedly deduces the accuracy,reliability of the strategy,thus providing a strong support for the analysis and utilization of medical big data.

Abstract: Objective　To evaluate the value and significance of rifampicin-resistant real-time fluorescence quantitative nucleic acid amplification detection technology (GeneXpert MTB/RIF) in the diagnosis of pulmonary tuberculosis. 　　Methods　The clinical data of 228 patients with suspected pulmonary tuberculosis, who admitted to Hebei Chest Hospital from January 2018 to December 2019, were analyzed retrospectively. The sputum was collected for GeneXpert MTB/RIF, sandwich cup liquid-based bacterial acid-fast staining smear microscopy (referred to as “sandwich cup method”) and Loop-Mediated isothermal amplification (referred to as “LAMP method”) and the results were statistically analyzed by SPSS 17.0 software. Results　Among the 228 patients with suspected cases, 200 cases were clinically diagnosed as pulmonary tuberculosis and 28 were non-tuberculosis. The positive detection rate of GeneXpert MTB/RIF (81.0%, 162/200) was significantly higher than that of sandwich cup method (62.5%, 125/200) and LAMP method (72.5%,145/200) (χ2=16.885, 4.049, P<0.05). Taking clinical diagnosis as gold standard, the sensitivity of GeneXpert MTB/RIF (80.00%,160/200) was significantly higher than that of sandwich cup method (60.00%, 120/200) and LAMP method (70.50%, 141/200) (χ2=19.048, 4.846, P<0.05). The diagnostic consistency of GeneXpert MTB/RIF (K=0.73) was higher than that of sandwich cup method (K=0.39) and LAMP method (K=0.56). Conclusions The GeneXpert MTB/RIF detection method is rapid and simple, and can diagnose pulmonary tuberculosis rapidly and simultaneously detect rifampicin resistance of Mycobacterium tuberculosis with high sensitivity. It has high clinical value for early diagnosis of pulmonary tuberculosis and guidance of treatment in general and specialized hospitals.

OBJECTIVE: To explore the effect of masking therapy for the early stage of the patients with noise-induced tinnitus,and imply the treatment for patients with noise-induced tinnitus. METHOD: Sixty-eight cases with tinnitus were studied. All the patients took the audiological examinations and tinnitus tests firstly, and accepted the masking therapy for 6 months. The therapeutic effiency was evaluated according to tinnitus handicap inventory (THI) and subjective visual-analogue scale (VAS). The minimum masking intensity was also evaluated. RESULT: The majority of the patients with noise-induced tinnitus (59 cases, 86. 8%) had tinnitus frequency of 4 kHz,and most of them (44 cases, 64. 7%) had positive residual inhibition tests. Tinnitus completely disappeared in 3 cases after masking therapy, and the efficiency of this treatment is 83. 8%. There was significant difference in the scores of THI and VAS before and after therapy(P<0. 01), and there was also significant difference in the minimum masking intensity (P<0. 01). CONCLUSION Masking therapy is the most important treatment for the patients in the early stage of noise-induced tinnitus. The therapeutic effiency is significant and should be promoted.
Humans ; Noise ; adverse effects ; Tinnitus ; etiology ; therapy