Objective To systematically review the clinical efficacy of botulinum toxin A for the treatment of upper limb spasticity after stroke. Methods PubMed,EMbase,Cochrane Library,CBM, China National Knowledge Internet (CNKI),and Wanfang Data were retrieved by a computer. The randomized controlled trials and Case-control study of comparing botulinum toxin A combined with rehabilitation training and routine rehabilitation treatment for upper limb spasticity after stroke were collected. The retrieval time was from the foundation of the database to September 1,2016. At least two reviewers conducted literature screening,data extraction,and quality evaluation according to the inclusion and exclusion criteria. The Rev-Man 5. 3 software provided by the Cochrane Collaboration was used to conduct the Meta-analysis. Results A total of 356 articles were retrieved. Finally,11 articles met the inclusion criteria. The modified Jadad score showed that the scores of 9 articles were more than 4,which belonged to high-quality literature. Eleven articles included 614 patients,in which 316 were treated with botulinum toxin A. There were 298 patients in the control group. The results of Meta-analysis indicated that the Fugl-Meyer score (SMD =0. 94,95% CI 0. 75 to 1. 12),modified Ashworth score (SMD = - 1. 59,95% CI - 1. 78 to - 1. 40),and modified Barthel index (SMD = 0. 86,95% CI 0. 65 to 1. 08)in the botulinum toxin treatment group were superior to the control group. There were significant differences (all P < 0. 05). The incidence of adverse events (RR = 1. 06,95% CI 0. 78 to 1. 45)was similar in both groups. There was no significant difference (P > 0. 05). Conclusion The efficacy of treatment of upper limb spasticity after stroke with botulinum toxin A is exact,and the security is high. The appropriate rehabilitation training can effectively improve the limb motor function,muscle tension,and quality of life of patients.

Quality of care and safety are the lifeline of hospital performance and hospital management.With reference to the KTQ hospital quality certification system of Germany,Tongji Hospital built platforms to supervise outpatient,emergency,inpatient,surgical operation,nursing, hospital-acquired infection,and pharmacy management.By the connection and reaction of both online and offline systems,Tongji Hospital has built a systematic,informationized and precise medical quality and safety system for large public hospitals,safeguarding quality of care and safety of patients.

OBJECTIVE: To observe the effect of lidocaine on respiratory failure and the airway peak pressure in patients with severe asthma. METHODS: The severe bronchial asthma patients treated with mechanical ventilation were randomly divided into treatment group and control group. The change in airway peak pressure, man-machine counteraction, and the correcting time of respiratory failure of the two groups were recorded. RESULTS: The average airway peak pressure was(41.18?10.66) cmH2O in the control group vs.(29.23?9.07) cmH2O in the treatment group; the incidence of man-machine counteraction was 100% for the control group vs. only 40% for the treatment group; the correcting time of respiratory failure was(6.42?1.73) h for the control group vs.(3.31?1.08) h for the treatment group. There were significant differences between the two groups in the above mentioned indexes(P

Objective To observe the clinical significance and laboratory diagnostic values of Pre-S1 antigens (Pre-S1)and its relativity to HBeAg and HBV-DNA after using interferon in association with kurarinone.Methods The content of Pre-S1 and HBV-M was detected by ELISA and the levels of HBV-DNA were detected by flores- cence quantitative PCR(FQ-PCR)in 100 serum samples of patients with HBV infection and patients after an antivi- ral treatment.Results Matched control in 50 serum of HBsAg-positive and detectable HBV-DNA cases,both 29 samples in 30 HBeAg-positive cases and 17 samples in 20 HBeAg-negative cases Pre-S1s were positive.Treatment set 50 serum of patients after taking two courses of an antiviral treatment for HBV infection,drawing blood to observe related markers,5 cases of effect set were turned into negative for serologic markers and virologic markers.19 cases of valid set,serologic markers were various and the HBV-DNA copies descended 2-3 orders of magnitude.26 cases of invalid set,serologic markers were not various,and 30 % samples of the HBV-DNA copies descended 1～2 orders of magnitude.Conclusion It was supplementary for Pre-S1 to indicate HBV expression when the HBeAg varied.It also provided detcctable laboratory markers in HBV infectivity,replication and therapeutic efficiency evaluation.

OBJECTIVETo apply the Wright-Giemsa stain in micronucleus test and to explore the stain outcomes of Wright-Giemsa dye of various proportions and staining times.

METHODSUse Wright-Giemsa dye, Wright dye (staining time 3 min) and Giemsa dye (staining time 5 min) to stain HepG2 and then observe the staining effect. The Wright-Giemsa dye was applied under 5 different proportions (3:1-1:3) and different staining times (1, 3, 5, 10, 15 min).

RESULTSAfter stained for 3-5 min with the proportion ratio of 3:1 of Wright-Giemsa dye, the HepG2 cells showed much better staining outcomes compared with the single stain of either Wright or Giemsa.

CONCLUSIONSWright-Giemsa stain can be used in cell micronucleus test to obtain good staining outcomes.

Aim To investigate the damage of mitochondria in HUVECs cells by iron overload and the role of ADMA/eNOS/DDAHⅡ in it.Methods HUVECs cells were cultured and randomly divided into normal control (Ctrl) group, dextran iron (Iron) group and L-arginine (L-Arg) group.After 48 h, the survival rate of cells was detected by MTT assay;ADMA content and DDAHⅡactivity were measured by HPLC method;the expression of eNOS was determined by Western blot;LDH activity, MDA and NO content, and mitochondrial permeability transition pores(mPTP) openness were determined by colorimetric assay;ROS generation, mitochondrial membrane potential and apoptosis were determined by flow cytometry.Results After 48 h treatment with iron, the survival rate of HUVECs significantly decreased, while the activity of LDH in culture medium increased.The results showed that ADMA and MDA content significantly increased, NO content, DDAHⅡactivity, and the expression of eNOS markedly decreased, the generation of ROS was evidently elevated, mitochondrial membrane potential was lost apparently, mPTP openness was obvious, and the apoptosis of the HUVECs were worsened.However, as ADMA physiological antagonist, L-Arg significantly attenuated the above effects of iron.Conclusion Iron overload could damage mitochondrial function by eNOS and induce the apoptosis of HUVECs, in which ADMA/DDAHⅡ mechanism may also be engaged.

Aim To investigate the relationship be-tween the cardioprotection of apigenin ( Api ) from an-oxia/reoxygenation ( A/R) injury and Bcl-2 pathway. Methods H9 c2 cardiomyocytes were cultured and di-vided into normal control group, A/R group, Api pre-treatment group ( Api ) , Api + Bcl-2 inhibitor group ( Api + ABT-737 ) . Expression of Bcl-2 was deter-mined by Western blot,and cell viability was measured by MTT method. LDH, SOD, GSH-Px, MDA activity were determined by chromometry. ROS generation, mi-tochondrial membrane potential and apoptosis were de-termined by flow cytometry. Results 25h after apige-nin precondition,the expression of Bcl-2 was upregulat-ed in cardiomyocytes ( P <0. 01 ) . In the group pre-treated with 40 μmol · L-1 apigenin before A/R, the activity of LDH in culture medium decreased; the ac-tivity of intracellular SOD, GSH-Px increased; the content of MDA and ROS generation decreased; cell viability increased; mitochondrial membrane potential could be more stable and cell apoptosis decreased ( P<0. 01 ) . However, all these protective effects were attenuated significantly in the group pretreated with apigenin and Bcl-2 inhibitor ABT-737 . Conclusion The effect of apigenin against A/R injury in cardiomyo-cytes involves Bcl-2 pathway, and at least partly de-pends on its effect on upregulating the expression of Bcl-2 .

AIM:To investigate the effects of seipin gene deficiency on renal injury and the possible mecha-nisms in seipin-/-mice.METHODS:Six-month-old male seipin knockout ( seipin-/-) and wild-type ( WT) mice ( n=8) were used to study 24 h urinary albumin excretion ( UAE) , renal functions, pathological changes, and plasma leptin and adiponectin levels.Seipin mRNA expression in different tissues and each part of the kidney was also measured in WT mice.RESULTS:Real-time PCR analysis showed seipin mRNA expression in WT mice was higher in adipose tissue and testicles, and was also found in the kidney, which was mainly in glomeruli.Compared with control group, seipin-/-group showed increased kidney weight/tibia length (P<0.01), 24 h UAE (P<0.01), creatinine clearance (P<0.01), and glomerular and mesangial surface area (P<0.05).Both plasma leptin (P<0.01) and adiponectin (P<0.05) levels were significantly decreased in seipin-/-mice.CONCLUSION:Seipin gene deficiency in mice leads to renal injury prob-ably by decreasing plasma leptin and adiponectin levels due to lack of adipose tissue.

Objective To analyze the distribution of image noise in low-dose chest CT scan and optimize the relative scanning parameters.Methods The CT images of the Chinese anthropomorphic chest phantom( CDP-1 C) were simulated into six groups of low-dose images with different noise indexs by using an image noise addition tool.The difference between the preset noise index and analog noise value was compared.The CT images of 20 volunteers were also simulated into nine groups of low dose scans with the tube currents of 10,30,50,80,100,120,150,180 and 240 mA.The noise values of images were recorded and analyzed.Results There was no statistical difference between the analog noise value and the noise index.The image noise of low-dose chest scan was increased with the decrease of tube current.The noise was increased quickly when the current was decreased from 50 to 30 mA ( F =24.09 - 40.79,P ＜ 0.05),but the noise increased slowly when the current decreased from 240 to 80 mA.There was no statistical difference between the noise of 80 mA group and that of 120 mA(P ＞ 0.05).Conclusions The noise addition tool can be used to evaluate the image noise of low-dose chest CT scan.Adoption of 80 mA in chest CT scan would result in low radiation dose without adding image noise.

Brain Diseases ; diagnosis ; Child, Preschool ; Epilepsy ; diagnosis ; Female ; Fever ; Humans ; Infant ; Male ; Skin ; pathology ; Tomography, X-Ray Computed ; Tuberous Sclerosis ; diagnosis