Objective To explore the effect of electroacupuncture plus rehabilitation on shoulder-hand syndrome (SHS). Method Eighty SHS patients were randomized into an experimental group and a control group, 40 cases in each group. The experimental group was intervened by electroacupuncture plus rehabilitation training and basic Western medicine treatment, while the control group was by rehabilitation training and Western medicine treatment, 3 sessions a week, 4 weeks in total. The pain intensity of the affected shoulder and upper-limb motor function were observed before and after the treatment. The therapeutic efficacy was also evaluated. Result The Visual Analogue Scale (VAS) score of the shoulder pain and Fugl-Meyer Assessment (FMA) score of the upper-limb motor function were significantly improved after the intervention in the two groups (P<0.01), and the improvements of VAS and FMA in the experimental group were more significant than that in the control group (P<0.01). Conclusion Based on the basic treatment of Western medicine, electroacupuncture plus rehabilitation training can markedly improve the pain intensity of the affected shoulder and upper-limb motor function in post-stroke shoulder-hand syndrome.

Objective To evaluate the procedure of surgical treatment of intrahepatic biliary calculi with blood vessel variation in hepatic hilus. Method The clinical data of 57 patients with intrahepatic biliary calculi and blood vessel variation in hepatic hilus treated by biliary operation were retrospectively analyzed.Results The simply biliary operation was performed on 13 cases ; variant blood vessels were cut off and ligated in 14 cases;The bile duct and blood vessel across conversion operation were performed on 22 cases;and the intrahepatic cholangiojejunostomy was carried out in 8 cases. There were no severe postoperative complications and perioperative mortality.51 patients(89.6%) were followed up for 4 to 15 years with the exellent results in 43(84.3%)cases. There were residual stones in 7 cases,of them,5 patients had intermittent abdominal pain in the right upper quadrant; reoperation was performed on another 2 cases because of recurrent cholangitis. One died of variceal bleeding 1.5 years after operation. Conclusions In order to accomplish the complex operations of biliary tract and avoid ischemic damage of liver, proper operation should be chosen for patients with intrahepatic biliary calculi with blood vessel variation in hepatic hilus.

BACKGROUND: Scleroderma is a multisystem disease in which tissue fibrosis is caused by inflammation and vascular damage. The mortality of scleroderma has remained high due to a lack of effective treatments. However, exosomes derived from human umbilical cord mesenchymal stem cells (HUMSCs)-Ex have been regarded as potential treatments for various autoimmune diseases, and may also act as candidates for treating scleroderma. METHODS: Mice with scleroderma received a single 50 lg HUMSCs-Ex. HUMSCs-Ex was characterized using transmission electron microscopy, nanoparticle tracking analysis and nanoflow cytometry. The therapeutic efficacy was assessed using histopathology, immunohistochemistry, immunofluorescence, quantitative real-time polymerase chain reaction, enzyme-linked immunosorbent assay and western blot. RESULTS: HUMSCs-Ex ameliorated the deposition of extracellular matrix and suppressed the epithelial-mesenchymal transition process, and the effects lasted at least three weeks. In addition, HUMSCs-Ex promoted M1 macrophage polarization and inhibited M2 macrophage polarization, leading to the restoration of the balance of M1/M2 macrophages. CONCLUSION We investigated the potential antifibrotic and anti-inflammatory effects of HUMSCs-Ex in a bleomycininduced mouse model of scleroderma. So HUMSCs-Ex could be considered as a candidate therapy for scleroderma.

Objective To analysis of multiple myeloma (MM) and non-MM patients with the same clinical manifestations but significant differences in laboratory findings at the first visit to the Emergency Medicine Department suggesting that patient should be rule out the possibilities of suffering from MM by the attending physicians engaging in a specialty other than hematology as soon as possible to avoid misdiagnosis of MM.Methods Retrospective analysis of clinical features of MM cases from February 2013 to December 2016.Patients with renal dysfunction (serum creatinine ≥ 177 mmol/L),infection,bone pain and anemia were divided into four groups.The non-MM patients with the same clinical symptoms were enrolled as control group.SPSS22.0 and Medcalce 15.10 software were used for analyzing the distinct difference and diagnostic validity of routine laboratory tests in patients with MM and non-MM.Results ①The patients with serum creatinine≥ 177 mmol/L,and unexplained renal insufficiency with blood Ca2+ ＞ 2.39mmol/L,ALB ≤ 30.31 g/L and Hb≤84 g/L should be investigated the possibility of MM.②The patient with poor response to the conventional treatment and unexplained infection with IgM ＜0.42 g/L and ALB≤32.7 g/L or ESR ＞ 82 mm/h and Hb ＜ 100 g/L should be investigated the possibility of MM.③The male patients with the first symptom in bone and joint pain associated with bone damage with urinary protein and blood,and the emergence of Ca2+ ＞ 2.39 mmol/L,ALB ＜ 37.5 g/L,Hb ＜ 104 g/L and TT ＞ 19.8 s were suggested to detect MM.④The poor respose to conventional treatment,unexplained anemia (Hb≤90 g/L),IgM ＜ 0.51 g/L,ALB ＜ 34.1 g/L and GLB ＞ 46.4 g/L suggested to detect MM.Conclusions On the basis of symptoms such as renal insufficiency,infection,bone pain,anemia,routine blood laboratory findings of high calcium,low IgM,low albumin,and high globulin,it was recommended that bone marrow biopsy be made to detect MM.

? Objective? To explore the application of tsusanli warming moxibustion in early rehabilitation in patients with cerebral infarction. Methods? Totally 120 patients with cerebral infarction and stable vital signs treated in the Department of Neurology of the First People's Hospital of Huzhou from January 2018 to March 2019 were selected using convenient sampling and divided into control (n=60) and observation (n=60) groups according to the random number table. Patients in the control group received routine drug therapy and rehabilitation care, while patients in the observation group received warming moxibustion, routine drug therapy and rehabilitation care. Bathel Index (BI), National Institute of Health Stroke Scale (NIHSS) and myodynamia were used to compare the effects of intervention. Results? The total effective rate in the observation group was 91.3%, higher than 66.7% in the control group, and there was statistically significant difference between the two groups (P＜0.05). The number of patients with a BI ≥ 75 in the observation group were more than that in the control group 2 and 3 months after treatment, and there was statistically significant difference between the two groups (P＜0.05). The NIHSS score of the observation group was lower than that of the control group 2 and 3 months after treatment, and there was statistically significant difference between the two groups (P＜0.05). Conclusions? Tsusanli warming moxibustion combined with integrated Chinese and Western medical methods in routine rehabilitation care show an obvious effect on the neurological function in patients with cerebral stroke during early rehabilitation, which can also improve their activities of daily living.

Objective:To investigate the effect of tele-rehabilitation program on ataxic dysarthria following stroke.Methods:A total of 101 patients with stroke and dysarthria who received treatment at The First People's Hospital of Huzhou between January 2021 and October 2023 were included in this study. They were divided into an observation group ( n = 51) and a control group ( n = 50) using the random number table method. Patients in the control group received conventional family rehabilitation guidance, while those in the observation group participated in a tele-rehabilitation program. All patients were treated for 12 weeks. Before and 12 weeks after the intervention, the Frenchay Dysarthria Assessment (FDA) and speech clarity tests were used to assess speech function. Changes in FDA scores and speech clarity scores post-intervention were compared with pre-intervention scores. The observation group was further divided into mild, moderate, and severe groups based on FDA scores, and the differences in effect of tele-rehabilitation program on ataxic dysarthria among the three groups after the intervention were compared. Results:At 12 weeks after intervention, both the observation and control groups showed improvements in FDA scores and speech clarity [observation group: (43.88 ± 16.13) points, (68.65 ± 16.99)%; control group: (49.68 ± 12.09) points, (62.36 ± 14.20)%] compared with their baseline measurements [observation group: (55.12 ± 12.63) points, (57.96 ± 13.48)%; control group: (54.16 ± 10.69) points, (57.84 ± 12.78)%] ( t = 12.23, -14.01, 12.42, -13.86, all P < 0.001). Moreover, the observation group showed significant improvements compared with the control group ( t = 2.04, -2.01, both P < 0.05). At 12 weeks after intervention, both the mild and moderate groups showed improvements in FDA scores and speech clarity score [mild group: (31.41 ± 3.08) points, (82.94 ± 6.97)%, moderate group: (40.08 ± 4.67) points, (70.92 ± 6.26)%] compared with their baseline measurements [mild group: (42.24 ± 6.78) points, (70.53 ± 7.98)%, moderate group: (56.17 ± 4.65) points, (57.58 ± 6.54)%, t = 10.06, -20.25, 45.21, -21.34, all P < 0.001]. There were no significant improvements in the severe group for FDA scores and speech clarity score [(74.20 ± 4.29) points, (38.90 ± 5.80)%] compared with their baseline measurements [(74.50 ± 4.01) points, (37.50 ± 4.74)%, t = 1.96, -1.44, both P > 0.05]. Conclusion:The tele-rehabilitation program can improve post-stroke ataxic dysarthria, particularly showing significant effectiveness for patients with mild to moderate ataxic dysarthria.

Objective To evaluate the clinical efficacy of en-bloc kidney transplantation from pediatric organ donation after death. Methods Clinical data of donors and recipients undergoing en-bloc kidney transplantation from pediatric donor kidneys were retrospectively analyzed. The 1-year survival rates of the recipient and grafted kidney were calculated. The recovery of renal function at postoperative 1 year was observed. The changes in the length of grafted kidney and incidence of postoperative adverse events were monitored. Results The 1-year survival rate of the recipients was 8/9, and 72% for the grafted kidney. During 1-year follow-up, the serum creatinine (Scr) level was down-regulated from (747± 170) μmol/L before transplantation to (83±27) μmol/L post-transplantation, the blood urea nitrogen concentration was decreased from (24.5±4.9) mmol/L to (6.8±2.0) mmol/L, and the length of transplanted kidney was increased from (61.1±9.8) mm to (100.3±1.7) mm. Two recipients suffered from delayed graft function(DGF) and restored after hemodialysis. Two cases developed acute rejection and healed after methylprednisolone shock therapy. One recipient presented with lung fungal infection at postoperative 2 weeks after transplantation, and was treated by the withdrawal of immunosuppressive agents and antibacterial treatment with poor clinical efficacy. Then the recipient died at 3rd month. One case had renal arterial thrombosis at postoperative 7 d, underwent nephrectomy at postoperative 10 d and returned to hemodialysis. At postoperative 1st month, one recipient suffered from thrombosis of unilateral renal artery. The grafted kidney in other side normally functioned and significantly grew in size at postoperative 6 months. In addition, two cases had ureterostenosis of the transplanted kidney, albuminuria in 2, abdominal aortic stenosis in 1 and urinary fistula in 1. All these symptoms were cured or alleviated after corresponding treatment. Conclusions The incidence of perioperative complications is relatively high in en-bloc kidney transplantation from pediatric organ donation after death, whereas the clinical efficacy of such kidney transplantation can be gradually increased along with the accumulation of clinical experience.

Objective To explore the long-term clinical effect of kidney transplantation in children.Methods The clinical data of 53 children with kidney transplantation from March 2008 to September 2014 were retrospectively analyzed.The influence of the dependent factors on the estimated glomerular filtration rate (eGFR) (greater than 90 mL/min/1.73 m2 or ＜90 mL/min/1.73 m2) was estimated in the three years after the operation,and the influencing factors were analyzed by the dual logistic regression equation.Results There were 19 cases of living donors,17 cases of organ donors after death,and 6 others.The 53 patients were followed up for 3-9 years.The level of blood creatinine was decreased from the preoperative (820.1 ± 323.1) μmol/L to (51.6 ± 24.9) μmol/L 3 years after the operation (P＜0.05).eGFR was increased to (103.5 ± 11.4) mL/min/1.73 m2at 3rd year after the operation from the preoperative (17.1 ± 7.8) mL/min/1.73 m2 (P＜0.05).The age of recipients,preoperative dialysis time,number of HLA mismatching and postoperative delayed graft function healing (DGF),rejection and infection were the influencing factors of eGFR at 3rd year postoperation (P＜0.05).The multi-factor binary logistic regression equation analysis showed that only rejection was the risk factor for eGFR at 3rd year p0ostoperation.Eight cases of DGF (8/53,15.1％) recovered rapidly.There were 6 cases of acute rejection (6/47,12.8 ％) and 1 case of chronic rejection (1/47,2.1％).There were 9 cases of infection (9/47,19.1％).There were 6 cases of recurrence after surgery.The 3-year recipient and kidney survival rate was 94.3％ (50/53) and 88.7％ (47/53) respectively.The average height of the patients in the first,second and third year after the surgery was increased by (4.6 ± 1.9) cm (0.5-19.1 cm),(3.7 ± 1.8) cm (0.7-14.3 cm) and (2.8± 1.2) cm (0.3-8.7 cm) respectively.Conclusion The long-term effect of children kidney transplantation is satisfactory.

Objective:To observe the effect of auricular point press needle on sleep quality of patients with gastric cancer after operation.Methods:From October 2017 to March 2019, a total of 80 patients underwent radical gastrectomy for gastric cancer in the First People's Hospital of Huzhou, Zhejiang Province were selected by using convenience sampling method, and divided into observation group and control group by random number table method, with 40 cases in each group. The control group received routine nursing, while the observation group received auricular point press needle on the basis of routine nursing. Sleep quality was monitored in both groups using sleep monitoring bracelets. In the course of the study, 2 patients in the observation group had surgical complications, and finally 35 patients completed the experiment; 2 patients in the control group had surgical complications, and a total of 33 patients completed the experiment.Results:From the 6th day of intervention (the 4th day after operation) , the sleep duration of the observation group was longer than that of the control group, and the difference was statistically significant ( P<0.05) , the group effect, time effect and interaction effect were statistically significant ( P<0.05) . From the 6th day of intervention (the 4th day after operation) , the proportion of deep sleep of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) , the group effect, time effect and interaction effect were statistically significant ( P<0.05) . Conclusions:Auricular point press needle can effectively improve the sleep quality of patients with gastric cancer after operation.

Objective To investigate the effect of magnetic resonance diffusion tensor imaging(DTI)combined with Buyang Huanwu decoction on limb rehabilitation of patients with spontaneous hypertensive cerebral hemorrhage in basal ganglia.Methods A total of 68 patients with spontaneous hypertensive intracerebral hemorrhage in basal from March 2022 to March 2023 were selected from the department of neurosurgery of the First People's Hospital of Huzhou as research object.According to the random number table method,the patients were divided into control group(30 cases)and experimental group(38 cases).The control group was diagnosed with hypertensive intracerebral hemorrhage and received conventional therapy,and the experimental group was treated with DTI combined with Buyang Huanwu decoction.After 4 weeks of treatment,the overall treatment effect of the two groups was compared,and the differences of Fugl-Meyer assessment(FMA),National Institutes of Health Stroke Scale(NIHSS),Berg balance scale(BBS),and modified Barthel index(MBI)scores were compared.Results The overall therapeutic effect of experimental group was significantly higher than that of control group[86.8%(33/38)vs.56.7%(17/30),P<0.05].After 4 weeks of treatment,FMA,BBS and MBI scores were significantly increased in both groups,NIHSS scores were significantly decreased in both groups,and the improvement degree of the experimental group was significantly better than that of the control group(FMA score:74.21±9.07 vs.66.73±12.76,NIHSS score:15.16±3.73 vs.20.27±6.15,MBI score:69.29±14.68 vs.60.63±19.10,BBS score:43.55±4.30 vs.36.90±3.86,all P<0.05).Conclusion DTI combined with Buyang Huanwu decoction can improve the motor function of the limbs of patients in the basal ganglia area and enhance their ability to perform activities of daily living.