Objective To observe the effect of crawling exercise and bilateral electrical stimulation on the upper limb motor after stroke. Methods 60 stroke patients were divided into experimental group (n=30) and control group (n=30). Both groups received routine therapy. The control group received unilateral electrical stimulation on the upper limbs, and the experimental group received electrical stimulation on bilateral upper limbs and crawling exercise. All the patients were assessed with the modified Ashworth scale (MAS), the Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) before and after treatment. Results After 8 weeks of treatment, the scores of MAS, FMA and MBI improved in both groups (P<0.05), and improved more in the experimental group than in the control group (P<0.05). Conclusion The crawling exercise and bilateral electrical stimulation can improve the motor of upper limbs and activities of daily living more effectively than the unilateral electrical stimulation after stroke.

There is still evident gap between the humanity education of medical college in China and the foreign country's.We can find the heart of the matter and explore ways of solving the problem,by comparing the present condition of the humanity education of medical college in China and the foreign country's.

OBJECTIVETo evaluate the clinical effects of minimal invasion and closed reduction with external fixation in treating elderly femoral intertrochanteric fracture.

METHODSFrom August 2007 and September 2013, 43 patients with elderly femoral intertrochanteric fracture were treated by minimal invasion and closed reduction with external fixation. There were 26 males and 17 females with an average age of 78 years old ranging from 68 to 92 years. Durations from injury to operation ranged from 1 to 8 days with an average of 3 days. According to AO classification, there were 22 cases with type A1, 15 with type A2, 6 with type A3. The time of bone healing were observed after operation and the clinical effects were evaluated by Harris scoring standard.

RESULTSAll patients were followed up from 10 to 18 months with an average of 13 months. The incisions obtained one-stage healing after removal of external fixation. All the fractures were healed and the mean healing time was 16 weeks (ranged, 12 to 18 weeks). Two patiens complicated with the thread needle loosening in the femoral trochanteric, 2 cases with the hip varus deformity and 1 case with the delayed union. No bone nonunion, external fixer breakage, blood vessel or nerve damage were found. According to the Harris scoring standard,the average Harris score of hip joint function was 85.89±7.36, and 18 cases got excellent results, 19 good.

CONCLUSIONMinimal invasion and closed reduction with external fixation can obtain satisfactory results in treating elderly femoral intertrochanteric fractures. It is a simple and effective method for elderly patients who cannot tolerate anesthesia and surgery trauma.

Aged ; Aged, 80 and over ; External Fixators ; Female ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; methods

Periodontitis is a chronic infective disease characterized as the destruction of the supporting tissues of the teeth. Bone marrow mesenchymal stem cells, which are ideal adult stem cells for the regeneration of supporting tissues, may play important roles in restoring the structure and function of the periodontium and in promoting the treatment of periodontal disease. As a consequence, the characteristics, especially osteogenic differentiation mechanism, of these stem cells have been extensively investigated. The regulation of the physiological behavior of these stem cells is associated with BMAL1 gene. This gene is a potential treatment target for periodontal disease, although the specific mechanism remains inconclusive. This study aimed to describe the characteristics of BMAL1 gene and its ability to regulate the osteogenic differentiation of stem cells.
ARNTL Transcription Factors ; genetics ; Adult ; Adult Stem Cells ; Bone Marrow Cells ; physiology ; Cell Differentiation ; Hematopoietic Stem Cells ; Humans ; Mesenchymal Stromal Cells ; physiology ; Osteogenesis ; physiology ; Periodontal Ligament ; Periodontitis ; Periodontium ; Regeneration ; Tooth

Child ; Humans ; Liver Failure ; therapy ; Liver Transplantation ; Male ; Plasma Exchange

Objective:To evaluate the neurologic complications associated with posterior lumbar interbody fusion (PLIF).Method:From March 2003 to May 2008,a total of 178 patients experienced PLIF procedure due to lumbar disease.Of these,forty two had lumbar disc herniation,39 had lumbar spine stenosis,61 had degenerative spondylolisthesis, 22 had isthmic spondylolisthesis and 14 had post-laminectomy/discectomy syndrome. One hundred and thirty patients had single level fused,of these,8 at L3/4.64 at L4/5 and 58 at L5/S1.Forty six cases had two levels fused,of these, 19 at L3/4 and L4/5,27 at L4/5 and L5/Sl.Two patients had three levels fused,all at the L3/4.L4/5 and L5/S1.A11 causes possibly related to the neurologic complications were documented.Result: 13 cases(7.3%) were noted to have neurologic complications,of these,one at L4,7 at L5 and 5 at S1.6 cases had nerve root stretch injury,3 cases had nerve root injury from instrument maneuver, 1 case had nerve root deformity, 1 case had developed epidural hematoma, 1 case had nerve root injury from pedicle fracture and 1 case had secondary lateral recess stenosis.2 cases had complete neurological injury,and 11 cases had incomplete injury.According to American Spinal Injury Association (ASIA) criteria,there was complete recovery of neurologic function in 7 cases, incomplete recovery in 4 cases and no change in 2 cas-es.Conclusion: Many causes may be associated with the neurologic complications due to posterior lumbar interbody fusion,nerve root stretch injury is the most common.

Objective　To investigate the dynamic changes of psychological states and the results of delivery in pregnant women,simultaneously,study the effective way to reduce the rate of cesarean section.Methods　Through applying the self-compiled test paper,the self-evaluating state table(SCL-90)and the table of overall feeling of happiness,we assessed the psychological states of 89 pregnant women.The results were recorded at 35 and 38 weeks of gestation and 72 hours postpartum.Results　48 delivered vaginally(53.93%).4 were managed by cesarean section(46.07%),including 12 non-indicated cesarean section(29.27%).The mark of anxiety,terror and depression factors increased in the group of non-indicated cesarean section before and after dilivery compared with the group of vaginal delivery and indicated cesarean section.There was remarkable difference(P＜0.01).The value of overall feeling of happiness in the group of non-indicated cesarean section was less than that in the group of vaginal delivery.The difference was extremely significant(P＜0.001).The rdevant analysis showed that the feeling of happiness,the desire of labor and educational level were related negatively to the level of symptom during pregnancy(P＜0.01).The mode of delivery was related positively to the psychological state of pregnant women(P＜0.01).Conclusion　Non-indicated cesarean section is mainly interrelated to anxiety,terror and depression that proceed gradually during pregnancy and delivery.So it is suggested that the aimed psychological education be beneficial to decrease the rate of cesarean section.

Objective To observe the analgesic effect and its complications of flurbiprofen axetil for spastic pain after transurethral re-section of prostate( TUR-P) . Methods 40 patients who were clinically diagnosed as benign prostatic hyperplasia and underwent TUR-P were randomly divided into the experimental group (n=20)and the control group(n=20). When the postsurgical spastic bladder pain happened, the patients in the experimental group received intravenous drip of flurbiprofen axetil 100 mg with saline 500 mL,and the patients in the con-trol group received intramuscular injection of pethidine hydrochloride 100 mg. If its effect is not good,100 mg bucinnazine hydrochloride were injected. Analgesia efficacy was assessed by visual analog scales( VAS) at 30 min,1 h,2 h,4 h,6 h and 8 h after medication. At the same time,the side-effects and complications were observed and recorded. Results There is no statistical difference between the experimental group and the control group at 30 min,1 h, and 2 h after medication(P>0. 05),but at 4 h,6 h and 8 h after medication,VAS score of the experimental group is obviously lower than that of the control group(P<0. 05). And the incidence of adverse reaction of the experimental group, such as thirst,dizziness,nausea and emesia,was lower than that of the control group(P<0. 05). But there is no significant difference in incidence of the secondary bleeding between the two groups(P>0. 05). Conclusion Intravenous drip of flurbiprofen axetil can be an ef-fective and safe way of curing postsurgical spastic bladder pain after TUR-P.

Objective To investigate the effect of nicergoline on cognitive ability and executive function for patients with vascular cognitive impairment without dementia (VCIND).Methods Totally 68 patients with VCIND were divided into conventional treatment group (33 cases) and nicergoline treatment group (35 cases,nicergoline 10 mg,tid added on basal conventional treatment).All of cases were continuously treated for 12 weeks.Cognitive ability and executive function before and after treatments were evaluated.Results Test scores of immediate free recall of a list of words,the numbers and symbols transformation,the word fluency,clocks and watches painting,and minimental state examination (MMSE) were significantly higher in nicergoline treatment group than in conventional treatment group (P＜0.05).Conclusions Nicergoline may improve attention and memory as well as cognitive ability in patients with vascular cognitive impairment without dementia.

Objective To investigate the relationship between preterm delivery and anterior myometrial (MA) thickness measured by ultrasound in the second trimester. Methods The general information and pregnancy outcome of singleton pregnant women who had antenatal visit in the Hunan Provincial People′s Hospital between Oct 2010 and Sep 2013 were collected prospectively. The MA thickness was measured at 20-27+6 gestational weeks. The cases were divided into preterm delivery group and term delivery group. Results (1)A total of 1 031 pregnant women were recruited in this study. 147 pregnant women were in the preterm delivery group(14.26%,147/1 031) and 884 women were in the term delivery group(85.74%,884/1 031). The gestation age at delivery of the preterm delivery group was significantly earlier than the term delivery group [(34.57 ± 2.39) vs (39.23 ± 0.92) weeks,P<0.05]. No significant difference was observed in the age, gravidity, parity, history of preterm delivery, cesarean delivery rate and gestational age at the time of MA measurement between the two groups(P>0.05). The incidence of premature rupture of membrane(PROM) in the preterm delivery group and in the term delivery group were 49.0%(72/147) and 15.8%(140/884),respectively, with statistically significant diffrence(P<0.01). (2) The mean value of MA thickness in the term delivery group was (5.49±1.39) mm, while in the preterm delivery group it was (5.60 ± 0.87) mm. There was no statistically significant difference between the two groups(P>0.05). The mean value of MA thickness in the spontaneous preterm delivery group was(5.15±0.75) mm, and was (5.61±1.38 ) mm in the term delivery group, with statistically significant difference(P<0.01). The mean value of MA thickness in the preterm premature rupture of membrane (PPROM) cases was( 5.96±0.78 ) mm, and in term delivery group with PROM it was(5.38±1.12) mm. The difference between the two groups were statistically significant (P< 0.01). (3) Among the 1 031 pregnant women, 212 women had PROM, with the mean value of MA thickness of (5.67±1.32) mm. For those who did not have PROM, the mean value of MA thickness was (5.56±1.10) mm. There was no statistically significant difference between the two groups(P>0.05). No correlation was found among PROM and MA thickness(r=0.058,P>0.05). However, in the preterm delivery group, the mean value of MA in PPROM was significantly thicker than the spontaneous preterm delivery cases(P<0.01). There was a positive correlation between the MA thickness and PPROM (r=0.457,P<0.01). Conclusion The MA thickness had some correlation with spontaneous preterm delivery and PPROM, while the MA thickness should not be considered as an independent factor of preterm delivery.