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 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 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.

Adolescent ; Adult ; Aged ; Endocrine Surgical Procedures ; methods ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Parathyroid Neoplasms ; surgery ; Thyroid Neoplasms ; surgery ; Young Adult

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 species and drug resistance of pathogens causing bloodstream infections in hospitalized patients,and provide scientific evidence for antimicrobial use and control of healthcare-associated blood-stream infection.Methods From January 1 to December 31,2012,16 428 blood specimens were performed blood culture,pathogens were isolated and performed antimicrobial susceptibility testing.Results Of 16 428 blood speci-mens from 5 546 patients,384 (6.92%)were positive for blood culture,398 pathogenic isolates were detected,of which gram-positive bacteria,gram-negative bacteria,and fungi accounted for 23.62% (n=94),68.34% (n=272),and 8.04% (n=32)respectively,positive rate of blood culture were highest in 61-80 age group(8.26%), the top five departments of positive rate of blood culture were departments of burn,traditional Chinese medicine, cardiac intensive care unit,transplantation and traumatology;gram-positive cocci were highly susceptible to vanco-mycin,teicoplanin and linezolid,one Enterococcus faecium strain was found to be resistant to vancomycin;Among gram-negative bacilli,Enterobacteriaceae were highly susceptible to amikacin and carbapenems;drug resistance rates of Acinetobacterbaumannii and Pseudomonasaeruginosa to carbapenems was 70.97% and 35.90% respective-ly.Conclusion Gram-negative bacteria are the major pathogens causing bloodstream infection,positive rate of blood culture of elderly people is high.It is necessary to conduct regular surveillance on distribution and drug resistance of pathogens.

Objective To assess the accuracy of histological type and molecular subtype observed in preoperative 11-gauge vacuum-assisted core needle biopsy(VACNB) specimens in breast cancer.Methods Patients diagnosed by preoperative 1 l-gauge VACNB and received subsequent open excisional biopsy (OEB) from Mar 1 st 2014 to Mar 31 st 2015 were included.Kappa testing was used to test the concordance rate of histological type,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(Her-2),Ki-67 and molecular subgroups between VACNB and paired OEB specimens.ER,PgR,Her-2,and Ki-67 were determined by immunohistochemistry (IHC).Patients with Her-2 IHC (+ +) were further examined by FISH.Molecular subtypes were classified as follows:LuminalA,LuminalB,Triple Negative,and Her-2 positive.Results There were 36 patients analyzed(32 of them had invasive breast cancer).Between VACNB and paired OEB specimens,concordance rate of histological type,ER,PR,Her-2,Ki-67 and molecular group were 94.4％ (κ =0.934),96.9％ (κ =0.904),87.5％ (κ =0.710),100％ (κ =1.000),84.4％ (κ =0.570),78.1％ (κ =0.621).No significant difference was detected in the expression of ER,PR and Ki-67 between VACNB and OEB specimens according to paired t-test results.Concordance rate of each molecular subtype between VACNB and OEB specimens were 100％ for Her-2 positive subtype,94.1％ for LuminalB subtype,50％ for LuminalA,and 33.3％ for TNBC.When the threshold for ER/PR positivity was upgraded from ≥1％ to ≥10％ and Ki-67 cutoff value to≥20％,the concordance rate for ER,PR,Ki-67 and molecular subtype reached to 100％,93.8％,87.5％,81.3％.Conclusions 11 G vacuum-assisted core needle biopsy was accurate in determining histological type and molecular subtype in breast cancer.

Objective To study the effects of diazepam and sodium valproate infusion with CRRT in treatment of patients with tetramethylene disulfotetramine poisoning. Methods Diazepam and sodium valproate were continuously infused to patients by infusion pump. Meanwhile, CRRT was used to eliminate tetramethylene disulfotetramine. Results Convulsion was effectively controlled within one hour in 7 patients. After treatment with CRRT for 1 to 4 times, all patients recovered. Conclusion CRRT with diazepam and sodium valproate infusion were effective in patients with tetramethylene disulfotetramine poisoning.