Objective To observe the effects of psychological supportive therapy on the activities of daily living (ADL) and depression after cerebral hemorrhage. Methods 60 cases with mild or medium depression according to 17 items Hamilton Rating Scale for Depression (HAMD-17) after cerebral hemorrhage were divided into treatment group (n=30) and control group (n=30). All of them accepted physical exercise, and those in the treatment group accepted psychological supportive therapy in addition. They were assessed with Functional Independence Measure (FIM) and HAMD-17 before and after the treatment. Results After 2 months of treatment, the score of FIM increased more in the treatment group than in the control group (P<0.001), and the score of HAMD-17 decreased (P<0.001). Conclusion Psychological supportive therapy may promote the recovery of ADL and depression for patients post cerebral hemorrhage.

In order to obtain higher L-lactic acid yield industrial strain, the original strain Rhizopus oryzae PW352 was mutated by means of N+ ions implantation and a mutant strain Rhizopus oryzae RE3303 was obtained. Its lactic acid yield was increased by 75% than that of the original one. The acid producing condition was optimized by orthogonal design. The concentration of L-lactic acid reached to 131～136g/L and the conversion rate of glucose was as high as 86%～90% under the optimum condition.

Objective To explore the effects of action observation therapy on upper-extremity motor function after ischemic stroke and on the motor cortex using functional magnetic resonance imaging (fMRI).Methods Forty patients with ischemic stroke were randomly assigned to an observational group (n =20) or a control group (n =20).Both groups received conventional rehabilitation,while the observational group was additionally provided with action observation therapy for 8 weeks.Both groups were assessed using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) before and after the 8 weeks of treatment and functional magnetic resonance imaging was performed before treatment.Two months after the treatment,nine patients of the experimental group and 8 of the control group who continued to receive their respective treatments after discharge were again assessed using functional magnetic resonance imaging.Results After the treatment the average FMA score and BI score of both the observational group and the control group had increased significantly.The increase in the average FMA score of the observational group was significantly greater than that of the control group.However,there was no significant difference between the two groups in the increases in BI score after 8 weeks of treatment.The fMRI results showed that there was a significantly greater rise in activity in the bilateral precentral gyrus,parietal lobe and the supplementary motor area of the patients in the observational group after the treatment compared with the control group.Conclusion Action observation therapy can improve upper extremity motor function and performance in the activities of daily living after ischemic stroke and induce changes in the excitability of the cerebral motor cortex.

Objective To explore the effects of action observation therapy on upper-extremity motor function and ability in the activities of daily living after cerebral infarction.Methods Forty-one cerebral infarction survivors were randomly assigned to an observation group (n =21) or a control group (n =20).Both groups were given the conventional rehabilitation treatment,while the observation group additionally received action observation therapy 20 mins per day,6 times per week for 8 weeks.Before and after the 8 weeks of treatment,both groups were assessed using the Fugl-Meyer assessment (FMA),Wolf's motor function test (WMFT) and the modified Barthel index (MBI).Results Before the intervention there was no significant difference between the groups in any of the measurements.After the 8 weeks of treatment,all of the results in the treatment group were significantly better,on average,than those of the control group.Conclusions Action observation therapy can improve upper-extremity motor function and ability in the activities of daily living after stroke.

OBJECTIVETo investigate the occult lymph node metastasis in the middle and lower third rectal cancer after neoadjuvant radiotherapy.

METHODSFrom June 2003 to December 2006, 74 rectal cancer patients received neoadjuvant radiotherapy (30 Gy/10 f/2 w, CACA-CRC-001) and underwent total mesorectal excision (TME) two weeks later. Fat clearance technique was used in all the samples. Occult lymph node metastasis was detected in the mesorectum using the anti-CK antibody.

RESULTSIn total 1883 retrieved lymph nodes, 172 metastasis lymph nodes were harvested by HE examination with the mean diameter [(4.9+/-2.6) mm] being larger than that (2.7+/-1.4) mm of the 1711 negative nodes (P<0.01). In HE negative nodes, occult metastasis was found in 40 lymph nodes (2.33%) from 24 patients. Most of these nodes were less than 5 mm (90.0%) with a mean diameter of (3.2+/-1.2)mm, smaller than those of HE-positive metastasis nodes (P<0.01). Occult metastasis was found in 23.1% (9/39) of HE-negative patients. Occult metastasis incidence was higher in patients with HE-positive nodes (42.8%,P<0.01). No correlation of lymph node occult metastasis with tumor differentiation, age, or surgical procedures was found. There was no significant difference in recurrence-free survival between ypN(0) patients with and without occult metastasis (P=0.157).

CONCLUSIONIt is not necessary to include occult lymph node metastasis in the TNM staging in patients with ypN(0) rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; pathology ; radiotherapy

Objective To explore whether the degree of 99Tcm-methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) could be correlated with the treatment response to three-dimensional conformal radiotherapy.Methods A total of 102 patients with NSCLC were studied with 99Tcm-MIBI SPECT before radiotherapy.The patients were classified by a follow-up CT as responders (complete or partial remission) and non-responders (stable or progressive disease).After intravenous administration of 740 MBq 99Tcm-MIBI, SPECT imaging at 10-30 min (early) and 2-3 h (delayed) were performed.Region of interest (ROI) was placed over the tumors and contralateral normal lung tissue.The uptake ratio of tumor to contralateral normal lung (T/N) was obtained from both early (ER) and delayed (DR) SPECT images.The retention index (RI) was measured as:RI = (DR - ER)/ER×100%.Statistical analysis was performed by two independent-sample t-test and Mann-Whitney U test using software SPSS 13.0.Results 99Tcm-MIBI uptake was significantly higher in responders than in non-responders:2.36 ±0.17 vs 1.82 ±0.14 (ER) and 2.48 ± 0.20 vs 1.94 ± 0.16 (DR), respectively (t = - 13.1,- 12.7, both P＜ 0.05).The median RI in the responders group was also significantly higher than that in the non-responders group (6.60% vs 5.13%, z = - 6.83, P ＜ 0.05).Conclusion ER, DR and RI of 99Tcm-MIBI SPECT might be useful to estimate the treatment response to three-dimensional conformal radiotherapy in patients with NSCLC.

OBJECTIVE:To observe therapeutic efficacy and safety of modified Longdan xiegan tang in the treatment of psoria-sis vulgaris(blood heat type). METHODS:A total of 80 patients with psoriasis vulgaris(blood heat type)were randomly divided into control group(38 cases)and observation group(42 cases),other 30 healthy volunteers were included in healthy control group. Control group was given Xiaoyin tablet 1.6 g orally,3 times a day for 4 weeks. Observation group was given modified Longdan xiegan tang,400 mL after detected with water,1 h after breakfast and supper,7 d as a treatment course,for 4 courses. Clinical ef-ficacies and PASI score were observed before and after treatment. The levels of inflammatory factors(IL-1,IL-6,IL-8,TNF-α), the expression of NF-κB protein and NF-κB gene were observed in observation group before and after treatment,and then were compared with healthy control group. The relationship of inflammatory factor levels with NF-κB protein expression in observation group before treatment,the relationship of PASI score with inflammatory factor and NF-κB expression were observed in observa-tion group before and after treatment,and the occurrence of ADR was recorded. RESULTS:Total response rate of observation group(85.7%)was significantly higher than that of control group(52.6%),with statistical significance(P<0.05). Before treat-ment,there was no statistical significance in PASI score between 2 groups (P>0.05). After treatment,PASI score of 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statis-tical significance (P<0.05). After treatment,The levels of IL-1,IL-6,IL-8 and TNF-α in observation group were significantly lower than before treatment,but there was no statistical significance with healthy control group(P>0.05);the expression of NF-κB protein and NF-κB gene in observation group were significantly higher than healthy control group,with statistical significance(P<0.01 or P<0.05). The levels of IL-1, IL-6, IL-8 and TNF-α were positively associated with the expression of NF-κB protein in observation group before treatment. The levels of IL-1,IL-6,IL-8 and TNF-α and the expression of NF-κB pro-tein were both positively associated with PASI score in observa-tion group before and after treatment. CONCLUSIONS:Modified Longdan xiegan tang show significant therapeutic efficacy for psoriasis vulgaris(blood heat type),can reduce PASI score,the levels of NF-κB protein expression and inflammatory factors.

Objective To obtain the elasticity value of solid breast lesions with supersonic shear wave elastrography (SWE) and apply the binary Logistic regression in order to evaluate the value of SWE in differential diagnosis of benign and malignant breast lesions. Methods SWE quantitative elastography was preformed in 91 breast lesions of 91 patients in Zhenghai Longsai Hospital to obtain the maximum and mean elasticity value (Emax, Emean). And receiver operating characteristic (ROC) curves were used to assess the diagnostic performance. A Logistic regression for the gray scale ultrasound and the elastic modulus was conducted with multiple variables including Emax, Emean, border, echo, form, calcification. Results Pathological examination showed 73 benign lesions and 18 malignant lesions. Emax and Emean of malignant lesions were obviously higher than those of benign lesions [(99.73±41.15) kPa vs (38.59±14.28) kPa, (61.45±24.88) kPa vs (23.46±11.44) kPa, t=-15.05,-14.12, both P=0.000]. The area under the ROC curve of Emax and Emean were 0.932 and 0.915. Taking 63.70 kPa as the threshold of Emax, the sensitivity was 77.8%and the speciifcity was 97.3%. Then taking 44.22 kPa as the threshold of Emean, the sensitivity was 83.3%and the speciifcity was 94.5%. The results of Logistic regression analysis showed:the 3 most effective variables were Emax, border of the lesions and Emean. Conclusions The multivariate analysis model of binary Logistic regression can select the valuable indexes of differential diagnosis of benign and malignant breast lesions. SWE plays an important role in differentiating benign and malignant lesions and it is valuable in clinical practice.

OBJECTIVETo evaluate the role of high risk factors in octogenarians and nonagenarians with hip trauma, which may lead to excessive mortality and morbi- dity postoperatively.

METHODSFifty-four octogenarians and nonagenarians patients were enrolled in the study, receiving surgical repair of hip fracture in our hospital from January 2006 to January 2010. High risk factors were recorded preoperatively in detail. Complications and survival state were followed up by telephone for 2 years postoperatively. All the data were analyzed by Chi-square test with SPSS 13.0.

RESULTSTwenty-six males (48.1%), aged from 80 to 94 years with a mean age of 84.2 years, and twenty-eight females (51.9%), aged from 80 to 95 years with a mean age of 83.4 years, were presented in the cohort study. The hip traumas were caused by daily slight injuries (52 cases) and car accidents (2 cases), respectively. Twenty-eight patients (51.9%) with femoral neck fracture while 26 patients (48.1%) with intertrochanteric fracture were diagnosed through an anterior-posterior pelvic radiophotograph. In this series, 39 patients (72.2%) suffered from one or more comorbidities preoperatively. The morbidity was 48.1% and the major cause was urinary tract infection, while a significant difference was noted between females and males. The mortality was 20.4% with a predominant cause of acute renal failure.

CONCLUSIONSThe gender should be considered as a critical high risk factor in octogenarians and nonagenarians with hip trauma postoperatively. Females are more likely to suffer complications postoperatively, which is especially obvious in senile patients over 80 years (P less than 0.05). Urinary tract infection is the most frequent complication after hip surgery, followed by low limb embolism and malnutrition. The mortality is dramatically greater in patients over 80 years old than those below, and major causes are acute renal failure, multiple organ dysfunction syndrome and mental deterioration. Multidisciplinary consultations and mental assessment are encouraged in patients over 80 years old after hip trauma and surgery. Hip fractures in octogenarians and nonagenarians deserve special attention because of their advanced age and comorbidities.

Aged, 80 and over ; Cohort Studies ; Femoral Neck Fractures ; surgery ; Hip Fractures ; surgery ; Humans ; Risk Factors ; Treatment Outcome