ObjectiveTo study the effect of electromygraphic biofeedback on upper extremity function in patients with hemiplegia after stroke.Methods79 patients were randomly divided into experimental group(40 cases) and control group(39 cases).Patients in each group were given clinical treatment and regularly physical therapy, while those in experimental group were given electromygraphic biofeedback training. All patients were evaluated with electromyography amplitude and active range of motion(AROM) of wrist dorsiflexion and upper extremity Fugl-Meyer assessment pre-treatment and 3 months after stroke.ResultsAll the patients gained improvement after treating(P<0.05).Compared with the controls, patients in experimental group significantly improved their function in all measured item(P<0.01).ConclusionThe electromygraphic biofeedback can improve the arm function of hemiplegic patients.

Attention Deficit Disorder with Hyperactivity ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; methods

Objective To investigate the value of cluster cate forpatients with ventilator-associated pneumo-nia (VAP) in the intensive care unit. Method Three hundred fifty-four consecutive patients with mechanical ven-tilation support in the Emergency Intensive Care Unit of Nanjing First Hospital from January 2006 to September 2007 were included in this study. The cluster care included elevating patient's head and chest to at least 30 de-grecs to the horizontal level, intensiving frequency of oral-pharyngeal nursing with thorough suction, washing hands, changing ventialtor tube at shorter regular interval, closely observing temperature, sputmn, WBC count, pu-turn, white blood cell count, chest X-ray examination and respiratory tract bacterial culture etc. Another 398 me-chanical ventilated patients with conventional care in the Hospital from January 2004 to November 2005 were taken as control. The t -test and X2 -test were used for analysis. Results The morbidity of VAP was significantly de-creased after cluster care(16.6 % vs. 24.6% P<0.01), the length of intensive care unit stay (LOS) was shorter in patients with cluster care than those in patients of control [(10.75±5.86) d vs. (14.26±9.40) d, P <0.05]. Conclusions Pneumonia associated with mechanical ventilation can be effectively reduced by the cluster care.

Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy.Methods One patient was hospitalized due to headache and twitch.Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy.During the treatment,the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy,assessed drug interaction between omeprazole-escitalopram and mannitoldexamethasone,monitored the adverse drug reaction of valproate,and provided medication education to the patient.Results Physician adopted clinical pharmacist's suggestion.The patient discharged with stable condition.Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.

Objective To evaluate the prognostic significance of metastastic lymph node ratio in patients with gastric cancer. Methods Clinical data of 319 patients with gastric cancer who underwent radical gastrectomy with at least 15 lymph nodes dissected per patient were analyzed retrospectively. Patients were divided into 4 groups according to the TNM staging system (1997,5th edition): pN0 (no positive lymph node), pN1(with 1～6 metastatic lymph nodes), pN2 group (with 7～15 metastatic lymph nodes), and pN3 group (with more than 15 metastatic lymph nodes), or into 4 groups according to the lymph node metastatic ratio: rN0 group (without metastasis of lymph node), rN1 group (with a lymph node metastatic ratio of <30%), rN2 group (with a lymph node metastatic ratio of 30%～60%), and rN3 group ( with a lymph node metastatic ratio of >60%). Survival was determined by the Kaplan-Meier method and differences were assessed by the Log-rank test. Multivariate analysis was performed using the COX proportional hazard regression model in forward stepwise regression with SPSS 13.0. Results Kaplan-Meier survival analysis demonstrated that the metastatic lymph node ratio significantly influenced the postoperative survival time. According to the lymph node metastasis system 77 patients were in group 1, 109in group 2, 60 in group 3, and 73 in group 4. The 2-year survival rate was 84.4%,66.1%, 35.0%,and 15.1% respectively, 3-year survival rate was 80.5%,45.0%,15.0% and 5.5% respectively, and 4-year survival rate was 71.4%,33.0%,5.0% and 1.4% respectively. If cases with the same positive number of lymph node (pN) group were stratified futher by lymph node metastatic ratio, there were no significant differences in the 3-year survival rate among the new rN groups (P>0.05), but there was a great difference in the distribution of prognosis among different groups. COX proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent factor for poor prognosis. Lymph node metastatic ratio was closely related with the location, modality of the operation and infiltration depth. Conclusions The staging system based on metastatic lymph node ratio is more reliable than the system based on the number of metastatic lymph nodes in the prediction of the prognosis of gastric cancer.

Objective To explore the changes of alveolar morphology and alveolar epithelial cells in rats with hyperoxia-induced chronic lung diseases (CLD). Methods CLD model in neonatal rats was established by inhalation of high concentration oxygen(85%～90% ). Eighty neonatal rats were randomly exposed to hyperoxia (model group) and to room air (control group) (n =40 each). Radical alveolar counts and the alveolar septum thickness were used to evaluate alveolar development. The site and intensity of expression of SPC,AQP5 protein were detected by immunohistochemical staining,the dynamic expression of SPC mRNA,AQP5mRNA was detected by RT-PCR on day 1,3,7,14 and 21 after exposure. Results There were no significant differences about alveolar wall thickness and RAC between experimental groups and control group on day 1～3 ( P > 0. 05 ). But there was significant difference between the model group and the control groups on day 7 and 14 (P <0. 01 ). For model group,alveolar septum thickness peaked on day 21, the difference was significant compared with control group ( 10. 62±5.01 vs 3.62±0. 88, P < 0. 001 ), but RAC decreased to the lowest level, the difference was significant compared with control group ( 3.57±1.24 vs 10. 47±0. 88,P <0. 001 ). The expression of SPC decreased on day 3 manifestedly but increased on day 7 and the levels of SPC were higher than that in the control group. Experimental group showed gradual decrease in AQP5 expression as the lung impairment devastated. Conclusion Alveolar development was delayed and alveolar epithelial cell (AEC) was damaged in the neonatal CLD rats. The changes of SPC,AQP5 expression suggested AECI was severely damaged and failed in full recovery, meanwhile the quantity of AEC Ⅱ was increased but the ability of its differentiation and transformation was decreased.

Objective To investigate the effects of preconditioning with 3-nitropropionie acid on myocardial apoptosis induced by ischemia-reperfusion injury.Method Twenty-four rabbits were randomly divided into control group(group C,n=8),precondition group(group 3-NPA,n=8)and 5-HD group(group 5-HD,n=8).The group 5-HD was treated intravenously with 5 mg·kg-1 5-HD(ATP-sensitive potassium channels blocker),group C and group 3-NPA received normal saline instead of 5-HD.Ten minutes later,5-HD group and 3-NPA group were injected with 3-NPA(3 mg·kg-1)and the group C was injected with normal saline.Twenty-four hours later,the left anterior descending coronary artery was ligated for 30 min and then unclamped for 120 min to estabhsh ischemi-a-reperfitsion injury model.After reperfusion,the infarct sizes of ventricular myocardium,apoptotic myocardial cells and the expressions of Bcl-2 and Bax protein were measured.Results Infarct sizes and apoptotic myocardial cells in group 3-NPA were less than those in the others(P＜0.01).The expressions of Bcl-2 in group 3-NPA.in-creased as compared with group C(P＜0.05)and group 5-HD(P＜0.05),whereas the expressions of Bax in group 3-NPA decreased as compared with group C(P＜0.05)and group 5-HD(P＜0.05).Conclusions Preconditioning with 3-nitmpropionie acid reduces myocardial apoptosis induced by isehemia-reporfusion injury which is attributed to the opening of mitochondrial KATP channels.

Objective:To investigate the clinical effect of ginger-partitioned moxibustion combined with manual repositioning for benign paroxysmal positional vertigo (BPPV). Methods:A total of 76 BPPV cases were randomly allocated into an observation group (n=38) and a control group (n=38). Patients in the observation group received ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning, whereas patients in the control group received the same manual repositioning alone. Results: After 48 h of treatment, the total effective rate was 94.7% in the observation group, versus 86.8% in the control group; after 7 d of treatment, the total effective rate was 78.9% in the observation group, versus 73.7% in the control group, both showing between-group statistical differences (P<0.05). The follow-up after 3 months showed that 2 cases (6.7%) got relapse in the observation group, versus 8 cases (28.6%) in the control group, showing a statistical difference (P<0.05). The adverse reaction rate was 2.6% in the observation group, versus 21.1% in the control group, showing a statistical difference (P<0.05).Conclusion: Ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning can obtain better effect for BPPV than manual repositioning alone. In addition, this therapy has stable efficacy and causes less adverse reactions.

OBJECTIVE To investigate the ESBLs produced by clinical strains of Enterobacter cloacae.METHODS Production of ESBLs was identified with modification of the double-disk test(MDDT).Eight kinds of primers(CTXM,CTXM-1,CTX-M-2,CTX-M-9,SHV,TEM,VEB,and PER)were used for the PCR amplification.Gene clone and DNA sequencing were performed then.RESULTS The result of MDDT was positive,amplicons were gained by PCR amplification with CTXM-1.DNA sequencing of amplicons of this strain revealed ESBLs of CTX-M-3.CONCLUSIONS ESBLs are the important reason for E.cloacae resisting to the third-generation cephalosporins.

Objective To investigate the correlation between gene polymorphisms in IL-10 promoter region and the susceptibility and clinical phenotypes of HCV infection. Methods Two groups of subjects were studied. Group 1 included 85 treatment naive patients with chronic HCV infection, and group 2 included 75 healthy blood donors. Genotyping of IL-10 promoter-592 was performed by PCR-RFLP. Results No significant difference was found in IL-10 promoter-592 genotypes between the healthy individuals and HCV-infected patients. However, IL-10 promoter-592 genetype A/A appeared more frequently in patients with ALT≥80U/L than in those with ALT