Objective To observe the effects of standardized three stage rehabilitation treatment on the neu- rological deficit scores (NDS) and ADL performance of ischemic stroke patients.Methods A total of 164 ischemic stroke patients were recruited and randomly divided into a rehabilitation group and a control group.The neurological function and ADL performance of the patients were assessed by using NDS and Modified Barthcl Index (MBI) at the admission,at the end of 1st,3rd and 6th months post stroke.Results No significant differences were found be- tween the rehabilitative and the control groups with regard to NDS and MBI at admission.The NDS demonstrated a decreasing tendency,while the MBI score an increasing tendency in both groups.In the control group,significant difference of NDS was found between admission and the end of 1st month as well as between the end of the 1 st and the 3rd months.In rehabilitation group,significant difference was revealed between all the time points with regard to NDS and MBI scores.At the end of the 1st,3rd and 6th months,the MBI scores of the rehabilitation group were signifi- cantly higher than those of the control group,indicating that the ADL performance of those treated with standardized three-stage rehabilitation protocol was improved quicker than those without the protocol.Conclusion Standardized three-stage rehabilitation treatment could improve the neurological function and ADL performance of the ischemic stroke patients.

OBJECTIVE: To evaluate decision regret among patients receiving penile girth enhancement with acellular dermal matrix (PGE with ADM) and to investigate the potential indicators for decisional regret so as to facilitate the decision-making process for this special group. METHODS: In the study, 78 patients receiving PGE with ADM from Jun. 2016 to Jan. 2019 at Peking University People's Hospital and cooperative hospitals were eligible. Penile girth was taken by only one surgeon 1 week before surgery. Hospital anxiety and depression scale (HAD), international index of erectile function (IIEF) and a 10 cm long visual analogue scale named visualized penile image (VPI) were applied to measure psychological burden, erectile function and satisfaction with penile image respectively at the same time. All the patients were followed up for 3 months. Decision regret scale (DRS) was adopted for measuring decisional regret. Multivariate analysis of variance was applied to investigate the potential indicators for regret. Data analysis process was conducted with SPSS (version 24.0; SPSS, Chicago, IL, USA). RESULTS: Mean penile girth recorded before intervention was (8.29±0.30) cm and increased to (9.46±0.29) cm post surgery (t=76.28, P < 0.01). As for both subscales of HAD measuring psychological burden, a signi-ficant reduction in the mean score was seen, that is, 2.8±1.3 (t=19.28, P < 0.05) for anxiety and 3.0±1.2 (t=20.67, P < 0.05) for depression, respectively. The average score of VPI increased by 3.7±1.1 (t=30.63, P < 0.05). There was no significant change in the average score of IIEF measuring erectile satisfaction (t=1.60, P=0.11). Twenty-nine (38.2%) patients expressed regret to some degree, and the mean DRS score was 23.4±14.8. The scores of DRS correlated negatively with scores of visualized penis image (r=-0.348, P < 0.01), and positively with scores of anxiety (r=0.760, P < 0.01) and depression subscale (r=0.471, P < 0.01). The scores of DRS was irrelevant to those of IIEF (r=0.02, P=0.867). The patients with high annual income (> 120 000 yuan) and education level above undergraduate were more prone to experience decision regret after intervention (P < 0.01). CONCLUSION PGE with ADM did augment penile girth and lower psychological burden, the regret rate of which was acceptably low among the patients. High income and good education might indicate more post-operative regret. Additional decision-making aids should be offered to patients with high income and education level above high school.
Acellular Dermis ; Emotions ; Humans ; Male ; Patient Satisfaction ; Penile Erection ; Penis ; Reconstructive Surgical Procedures

Objective To evaluate the functional changes in the isometric,concentric and eccentric muscle strength of the knee extensors and flexors in patients with knee osteoarthritis,and to explore the relationship among these contractions.Methods A Biodex System-3 isokinetic test system was used to assess the isometric,concentric and eccentric strength of the knee extensors and flexors of the involved and uninvolved limbs of 54 patients suffering from osteoarthritis.Results The strength of the knee extensors and flexors of the involved limbs was significantly less than that of the uninvolved legs in the different contraction modes(P＜0.05).The difference was especially marked in concentric and eccentric contraction at low angular velocity.The hamstrings/quadriceps ratio and the dy- namic control ratio showed abnormalities in the muscle balance of the hamstrings and quadriceps.Conclusion Iso- kinetic testing should be applied and the hamstrings/quadriceps ratio and the dynamic control ratio should be analyzed in evaluating patients with knee osteoarthritis.

OBJECTIVETo discuss diagnosis and treatment of post traumatic spasmodic flat foot.

METHODSFrom 2002 to 2007, 7 diagnosed patients were recruited and underwent following procedures: under epidural anesthesia or common peroneal nerve block anesthesia, massage was performed on the peroneal muscles for about 5 minutes, then ankle joint was underwent with passive functional exercise. Feeling muscle relaxation, we held the wounded foot in varus and adducted position forcefully, then immobilized it with short leg cast. After 3 weeks of continuous immobilization, the cast was removed and patients were given physical treatment and functional training.

RESULTSSymptoms of these patients such as claudication and pain in foot were improved, the foot deformity was corrected and foot arch restored to normal. After a follow-up of 6 months,no obvious recurrence was observed.

CONCLUSIONThe diagnosis of post traumatic spasmodic flat foot is based on the careful inquiry of traumatic history,physical examination and X-ray results. Manipulative reduction under common peroneal nerve block anesthesia and cast immobilization is a simple and effective method to treat this disease.

Adolescent ; Adult ; Anesthesia ; Female ; Flatfoot ; diagnosis ; etiology ; therapy ; Foot Injuries ; complications ; Humans ; Male ; Middle Aged ; Spasm ; diagnosis ; etiology ; therapy

Child, Preschool ; Chondromatosis, Synovial ; diagnosis ; diagnostic imaging ; surgery ; Diagnostic Errors ; Female ; Humans ; Tibial Fractures ; diagnosis ; Tomography, X-Ray Computed

Objective To evaluate the running status of the water-improving projects in Gansu Province in order to further improve the supervising mechanism and raise the efficiency of defluoridation in drinking water.Methods The water-improving projects,either being normal,or intermittent,or discarded and the cause of abnormal running in 33 counties in Gansu Province were surveyed with unified standard method.Fluoride content in water was determined by F-ion selective electrode.Results 993 water improving projects covering 3389 fluorosis villages were surveyed,682 projects worked well[68.68%(682/993)]and had supplied water with normal fluoride contents to 2174 villages[64.15%(2174/3389)]and benefited 116.56 hundred thousand populations.And the rest 311[31.32%(311/993)]projects worked abnormally or supplied unqualified fluoride water.The main causes were the exceeded lasting life,insufficiency of water resources,high fluoride content in water and unqualified administration.Conclusions Most of the water-improving projects in Gansu Province are basically running normally,but about 1/3 of the projects do not function well,so the management of the projects must be improved and consummated.

OBJECTIVETo analyse protein alterations in the seminal plasma of non-obstructive azoospermia patients.

METHODSSemen samples were collected from 11 healthy fertile and 6 azoospermia male volunteers respectively and tested by SELDI-TOF-MS with CM10 protein chip to get protein spectra maps, which were automatically treated with the special softwares of Ciphergen Inc.

RESULTSThe mean peak heights of 28 proteins expressed in the seminal plasma of the azoospermia patients were statistically different from those of the healthy fertile males (P < 0.05 ), of which 24 were of lower contents than in the normal controls, 4 with remarkably significant difference, M/Z 7 196.058, 7 630.573, 7 547.610 and 7 709.833 (P < 0.01).

CONCLUSIONThe seminal plasma proteins of the azoospermia patients were significantly different from those of the healthy fertile males, with decreased contents of most of the different proteins, which might be significantly correlated with the development of azoospermia.

Adult ; Azoospermia ; metabolism ; Humans ; Male ; Proteins ; analysis ; Proteomics ; methods ; Semen ; chemistry ; cytology ; Spectrometry, Mass, Electrospray Ionization ; Sperm Count ; Sperm Motility

OBJECTIVETo analyse the variability of proteins in the seminal plasma of severe oligospermic and healthy fertile men.

METHODSSpermatic fluid samples were collected from 11 healthy fertile men and 6 severe oligospermic male volunteers and tested by SELDI-TOF-MS with the CM10 protein chip to get the protein spectra maps, which were automatically treated with the special softwares of Ciphergen Inc.

RESULTSThe mean peak heights of 2 lower-abundance proteins expressed in the seminal plasma of the severe oligospermic men were statistically different from the healthy fertile males (P<0.05). Fifteen different proteins existed between the nonobstructive azoospermic and the severe oligospermic group, 7 of which, with m/z of 7,196.058, 7,547.610, 5,780.493, 7,059.844, 7,409.589, 5,379.173 and 10,778.810, also between the non-obstructive azoospermic and the healthy fertile males (P<0.05). Except the latter two, the contents of the other 5 proteins were decreased in the non-obstructive azoospermic men (P<0.05).

CONCLUSIONThe finger prints of the seminal plasma proteins of the severe oligospermic group were similar to those of the healthy fertile males, both significantly different from the non-obstructive azoospermic men. It is suggested that pathogenesis mechanisms differ exist between non-obstructive azoospermia and severe oligospermia but are not the simple accumulation of genetic factors.

Adult ; Humans ; Male ; Oligospermia ; metabolism ; Semen ; metabolism ; Seminal Plasma Proteins ; analysis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVEDefining the margin of clinical target volume (CTV) is very important for three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (IMRT). In this study, according to the comparison between gross tumor volume (GTV) silhouetted by radiology and pathology in non-small-cell lung cancer (NSCLC), we tried to define the correlation of GTV by radiology and pathology, and assess the degree of correlation to local microscopic extension (ME) among different pathologic types of NSCLC, so as to define the margin of CTV precisely.

METHODSFrom February 2001 to February 2002, forty-three NSCLC patients after surgical resection were studied. All patients had had CT scans of the chest before surgery and routine pathology examination after surgery. The tumor size at X (lateral direction), Y (ventrodorsal direction) and Z (craniocaudal direction) axes were measured on CT. Also by pathology examination, the tumor size at X, Y, Z axes and the degree of ME at X, Y, Z axes were measured, respectively.

RESULTSWithout taking into account the value of ME, there was almost total agreement on the GTV by radiology and pathology in three dimensions. The mean value of ME was 2.18 mm for adenocarcinoma (ADC) and 1.33 mm for squamous cell carcinoma (SCC) (P = 0.001). But, taking into account 95% of the ME, a margin of 7 mm and 5 mm must be allowed for ADC and SCC, respectively.

CONCLUSIONThere exists a correlation of GTV by radiology and pathology. In the target volume defining for 3DCRT and IMRT, we could use the GTV by radiology instead of the GTV by pathology, with the ME being different for ADC and SCC. To cover 95% of the ME, the margin from GTV to CTV must be extended to 7 mm and 5 mm for ADC and SCC, respectively.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; pathology ; radiotherapy ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; radiotherapy ; Male ; Microscopy, Electron ; Middle Aged ; Neoplasm Invasiveness ; Tomography, X-Ray Computed

OBJECTIVETo investigate the relationship between hemostatic changes in liver cirrhosis patients with different degrees of their liver lesions.

METHODSForty-three patients (35 men, 8 women; age: 25 to 71 yr) with liver cirrhosis were divided into three subgroups (A, B, and C) on the basis of Child-Pugh classification. Among the patients, 13 were classified as Child-Pugh class A, 15 were class B, 15 were class C. 16 healthy individuals served as controls. A series of hemostatic tests and parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), factors II, V, VII, VIII, IX, X, vWF assay, antithrombin-III (AT-III), protein C (PC), D-dimer, tissue plasminogen activator antigen (t-PA), plasminogen activator inhibitor activity (PAI) were performed on 43 patients and the 16 healthy controls.

RESULTSPT and APTT were progressively prolonged from A to B and then to C. In comparison to the controls there was a significant difference. Fibrinolytic activity and the activities of factors II, V, VII, IX, X were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference . AT-III and PC activity were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference. D-dimer and t-PA-antigen were progressively increased from A to B and then to C. In comparison to the controls there was significant difference. PAI activity did not display significant changes in the four groups.

CONCLUSIONWe found that there is a close relationship between the severity of cirrhosis and the hemostatic changes. Because the deterioration of the coagulation function and increasing fibrinolytic activity parallel the severity of liver cirrhosis, adequate treatment for cirrhotic bleeding should not only correct the coagulation defects, but also lower the increased fibrinolytic activity.

Adult ; Aged ; Antithrombins ; metabolism ; Blood Coagulation Factors ; metabolism ; Female ; Fibrinogen ; metabolism ; Hemostasis ; Hepatitis B, Chronic ; blood ; complications ; Humans ; Liver Cirrhosis ; blood ; diagnosis ; etiology ; Male ; Middle Aged ; Prothrombin Time ; Severity of Illness Index