Rehabilitation treatment after cerebral infarction establishes on the basis of plastic changes in the central nervous system,which can compensate the functions lost in the affected brain regions.Neurorehabilitation training realizes neurological function recovery partly by enhancing cortical reorganization.Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive approach that can effectively improve the cortical excitability,This article reviews the application of rTMS in the clinical studies of motor function recovery in patients with hemiplegia after cerebral infarction.

Purpoes: To discuss the MRI manifestation and classification of discoid lateral meniscus and improve the accuracy of MRI diagnosis for discoid meniscus.Materials and Methods: 70 cases of discoid meniscus verified by arthroscopy were divided into impuberal group(n=30) and adult group (n =40).Following three quantitative parameters were measured.The meniscal width and tibial plateau width on the coronal slice showing the inttercondyloid spine( a),the number of the spine showing butterfly change when the layer thickness was 4mm(b) and the maximum width showing butterfly change on the sagittal slice(c).The discoid meniscus were classified as slab type (n=33),wedge type(n = 19),hypertrophied - horn type(n= 18) according to their shape.Results:69 cases had torn in different extent,a>or =20% (P<0.01) in all of cases.No significant difference in the incidence of each type existed between two groups(P>0.05).Significant difference in the incidence of each type existed in c(P<0.05).Conclusions: a >or = 20% is the most reliable criterion to diagnose discoid meniscus.Using b as the criterion of discoid meniscus is easy to occur missed diagnosis,c in the wedge type is bigger than the one in the hypertrophied type.Age can impact the classification of discoid meniscus.

The safety of Chuangyuling (CYL) dressing-a multifunctional medicine carrying biomaterial was evaluated in order to provide foundation for the application of CYL as material used in the wound healing. The traditional Chinese medicine (TCM) extract solution was compounded with scaffolds (gelatin and Bletilla hyacinthine gum), and then frozen and dried to form spongy and porous material CYL. According to the standard of biological evaluation of medical devices that was instituted by the ministry of health of China, the biological evaluation of CYL dressing was conducted. The results showed that all the contents of biological evaluation test consisting of acute toxicity, skin irritation, sensitization and cytotoxicity met the requirement of standards. It was concluded that the biomaterial carrying TCM (CYL dressing) is safe for application of wound healing.
Drugs, Chinese Herbal/*administration & dosage ; Drugs, Chinese Herbal/toxicity ; Gelatin ; Occlusive Dressings ; Phytotherapy ; Salvia miltiorrhiza ; Wound Healing/*drug effects

Carcinoma in Situ ; diagnosis ; pathology ; surgery ; Carcinoma, Transitional Cell ; diagnosis ; pathology ; surgery ; Cystectomy ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; methods ; Urinary Bladder ; pathology ; surgery ; Urinary Bladder Neoplasms ; diagnosis ; pathology ; surgery

Antineoplastic Agents ; therapeutic use ; Apoptosis ; drug effects ; Caspases ; metabolism ; physiology ; Enzyme Activation ; Fas Ligand Protein ; metabolism ; Humans ; NF-kappa B ; metabolism ; Neoplasms ; metabolism ; therapy ; Neovascularization, Pathologic ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Signal Transduction

Objective To investigate the incidence and risk factors of acute kidney injury (AKI) after cardiopulmonary bypass(CRB) in children with non cyanotic congenital heart disease. Methods A total of 150 children who underwent cardiopulmonary bypass operation from 2012 May to 2014 May were analyzed retrospectively. The patients were divided into two groups:AKI group (n=29) and non AKI group (n=121). Clinical data were collected and compared between two groups, including gender, age and baseline serum creatinine level. Multivariate Logistic regression analysis was used to evaluate the risk factors for AKI after operation. Results There was no death in the 150 cases. Comparison between groups, there were significant differences in age, history of heart failure and (or)pneumonia, baseline serum creatinine level, baseline uric acid, body mass, CPB) time, aortic clamping time, mechanical ventilation time, postoperative transfusion and hypotension. Multivariate Logistic regression analysis showed that age (≤1 years old), the history of pneumonia and (or) heart failure, CPB time (＞40 min), aortic clamping time (＞30 min) were the independent risk factors for AKI after operation. Conclusion It is important to choose the best age for surgery in children, actively prevent preoperative complications and shorten the CPB and aorta blocking time for preventing the occurrence of AKI.

Objective To compare the dijference of prostate cancer detection rate (PCDR) between 12 + 1-core biopsy and 6-core biopsy of the prostate system guided by transrectal ultrasonography (TRUS).Methods The clinical data of 2 707 patients with prostate biopsy from July 1999 to June 2012 were retrospectively analyzed.These patients were 54 to 92 years old,mean age was 69 years old.The range of PSA was 0.02-158.56 ng/ml,with an average of 16.97 ng/mt.People in the range of PSA 0-4.00,4.01-10.00,10.01-20.00,20.01-30.00,and ＞ 30.00 were 161,826,827,312,581,respectively.The volume of the prostate ranged from 14.1 to 82.6 cm3,mean 47.9 cm3.The 1 603 cases before the July 2009 were performed 6-core biopsy guided by the finger,followed by 1104 TRUS-guided 12 + 1-core biopsy.In addition,after March 2012,60 patients accepeted the MRI examination before prostate biopsy.The strategy of prostate biopsy was medial 6-core,lateral 6-core,the 13th core was positioned at abnormal signal area of TRUS and MRI.Explore the difference of PCDR medial 6-core,lateral 6-core,systematic 12-and 12 + 1-core,and the difference of 13th core and the other 12 cores,with the cut off value of PSA quartile of 30 ng/ml and PV quartile of 46 cm3.Results Comparison of clinical characteristics of prostate biopsy between positive group and negative group was performed,and the result suggested that The positive outcome of prostate cancer biopsy was related with element such as high PSA,old age [(71.7 ±7.1)vs.(68.3 ± 8.1),P =0.008],large fPSA [(8.5 ± 36.4) vs.(2.3 ± 3.4),P ＜ 0.001],small prostate volume [(41.3 ±22.9) vs.(52.3 ±29.3),P ＜0.001],small value of f/t[(0.12 ± 0.07) vs.(0.17 ±0.10,P ＜0.001)],high density of PSA [(2.04 ± 9.36) vs.(0.32 ± 0.42),P ＜ 0.001],digital rectal examination [72.0％ (522/725) vs.23.1％ (457/1 982),P ＜ 0.001],irregular echo level [41.1％ (695/1 693) vs.28.0％ (284/1 014),P ＜ 0.001],hypoechoic [64.3％ (695/1 081) vs.17.5％ (284/1 626),P ＜ 0.001],microcalcifcation[56.8％ (586/1 032) vs.23.5％ (393/ 675),P ＜ 0.001].PCDR of 12 + 1-core biopsy was significantly higher than lateral 6-core biopsy[41.5％ (458/1 104)vs.37.0％ (408/1 104),P =0.033].However,PCDR of 12-core biopsy had no statistical differences with 6-core biopsy[40.7％ (449/1 104) vs.37.0％ (408/1 104),P =0.081].PCDR of TRUS-guided biopsy was higher than that of finger-guided biopsy in patients with PSA≤30 ng/ml and PV ＞46 cm3 [30.0％ (254/846)vs.22.2％ (284/1 280),P ＜0.001;31.7％ (124/391)vs.18.1％ (131/723),P ＜0.001].PCDR of the 13th core positioned at abnormal signal area of TRUS and MRI was higher than the average PCDR of other 12 cores [70.9％ (107/151) vs.56.6％ (3 109/5 496),P ＜ 0.001].Conclusion PCDR of TRUS-guided biopsy was higher than that of finger-guided biopsy in patients with PSA≤30 ng/ml and PV ＞46 cm3.PCDR of 12 + 1-core biopsy was significantly higher than that of lateral 6-core biopsy.However,PCDR of 12-core biopsy had no statistical differences with that of 6-core biopsy.PCDR of the 13th core positioned at abnormal signal area of TRUS was higher than the average PCDR of other 12 cores.

Objective To analyze the survival rate of HIV /AIDS patients receiving highly active antiretroviral therapy(HAART)since the implementation of the national Four Free and One Carepolicy against HIV in Hangzhou.Methods Clinical data of 2370 AIDS patients were collected from National AIDS Comprehensive Treatment Information System Treatment Library from 2004 to 2014.The data, including basic information,viral load,CD4 +T lymphocyte counts,starting time of treatment,WHO clinical stage,infection pathways and follow-up were respectively analyzed.Kaplan-Meier and Cox proportional hazards models were used to analyze the survival rate and the factors affecting survival.Results The total follow-up time was 3968.14 person years and 57 patients died in 2370 patients with a mortality rate of 1 .44 /100 person years (57 /3968.14).Kaplan-Meier method showed that the cumulative survival rates of the first,third and fifth year were 98.08%,96.20% and 95.24%,respectively.The overall mortality rate fell from 6.06 /100 person years in 2006 to 1 .44 /100 person years in 2014.The mortality rate of AIDS-related disease declined from 1 .10 /100 person years in 2009 to 0.90 /100 person years in 2014.Multivariate Cox regression analysis showed that the risk of death for patients with CD4 +T 200-349 cells/μL was 0.466 times(95%CI 0.246-0.882)as that for patients with CD4 +T cells <200 /μL.The risk of death was 3.408 times(95%CI 1 .365-8.506)in patients aged≥ 50 years,3.788 times(95%CI 1 .645-8.718)in patients aged 40 to <50 years,and 2.593 times(95%CI 1 .139-5.905)in patients aged 30 to 40 years as that in patients aged <30 years.The mortality risk for patients with baseline WHO stage Ⅲ and Ⅳ was 1 .960 times as patients with WHO stage Ⅰ and Ⅱ (95% CI 1 .117-3.439 ).Conclusions Patients with increased age,low CD4 +T counts and baseline WHO stage Ⅲ or Ⅳ are main risk factors affecting survival rate of HIV /AIDS patients,early antiviral therapy is the key for improving the survival rate of patients.

AIM: To study a novel gene that probably related with liver regeneration, which was found by representational difference analysis(RDA). METHODS: cDNA sequence, tissue distribution and functions of the novel gene were studied by slot blot, Northern blot, RT-PCR, cDNA library screening and sequence analyzing. RESULTS: Two full-length clones were isolated from cDNA library of rat fetal livers and the sequence analysis identified that the positive cDNA encoded 76 amino acids only; Using the cDNA as a probe, the novel gene showed a specific liver distribution, a moment increasing expression in one hour after partial hepatectomy (PH) and high expression in fetal liver or liver tumor by Northern blot; EGF quickly induced its high expression in primary culture rat hepatocytes(FCS free).CONCLUSION: These results show that the novel gene is an early phase response gene that is closely related to a liver regeneration adjustment. It may encode peptide or has longer sequence at N tip.

Objective To investigate the causations, management and prevention methods on the complications of hysteroscopic procedures. Methods Retrospective analysis of 36 cases with hysteroscopic complication, focusing on their characteristics and clinical management as well as prevention methods during the ten years from 1993 to 2004. Results Among 36 cases, 11 cases with uterine perforation and incomplete perforation, which happened during the complicated procedures, were treated by both laparoscopy and laparotomy. Five cases with heavy bleeding were encountered because of the deeply injury to the uterine wall and Foley catheter was inserted into uterine cavity and it stopped the bleeding successfully except in one case done by hysterectomy. Three cases with fluid overload syndrome were cured by using diuretic agent and saline infusion. There is no serious consequence in one case with air embolism due to prompt diagnosis and treatment. Four cases with postablation-sterilization syndrome were treated effectively by performing hysterectomy plus single or bilateral salpingectomy, dilating cervical canal as well as resecting adhesions. Twelve cases with adhesion inside uterine cavity followed hysteroscopy were also treated by dilating cervical canal, underwent adhesionlysis and hysterectomy. Conclusions The potential factors causing complications of hysteroscopy include complicated procedures inside uterine cavity, higher pressure of irrigation, deep injury of endometrium as well as incomplete removal of endometrium during hysteroscopic operations. It is the necessary measures to reduce the complications by performing laparoscopy or B ultrasound monitoring simultaneously, standardizing the procedure and strengthening postoperation management.