China ; epidemiology ; Disease Management ; Hepatitis ; epidemiology ; prevention & control ; therapy ; Humans

Animals ; Humans ; Vaccines, Virus-Like Particle ; genetics ; immunology ; Viral Vaccines ; genetics ; immunology ; Virus Diseases ; immunology ; prevention & control ; virology

BACKGROUND: Although angiography is the gold standard for the diagnosis of cerebrovascular disease, it cannot be used widely because of its traumatotaxis. Transcranial Doppler ultrasound (TCD) and MRA are both non-invasive examinations, which can be used to evaluate intracranial large artery vascular trunks and hemodynamics.OBJECTIVE: To investigate the reliability of diagnosis with TCD on hemodynamic changes of ischemic cerebrovascular disease (ICVD) and the relativity between TCD and MRA.DESIGN: Case analysis based on patients.SETTING: Neurological Department of the First Affiliated Clinical Hos-pital, Harbin Medical University.PARTICIPANTS: From April 2001 to February 2002,totally 45 patients with stroke,selected from outpatients and inpatients of Neurological Department of First Affiliated Clinical Hospital of Harbin Medical University,examined by CT, to be told the fact and accepted, were taken part in the study.METHODS: Patients were examined with TC-2021 TCD instrument produced by German EME Corporation and VISART1.5T superconduct MR instrument produced by Toshiba. Totally 45 patients had TCD and MRI examinations, and the alternation between two examinations was 1 to 15 days. The hemodynamics and morphological changes were observed including middle cerebral artery (MCA), end of internal carotid artery (ICA),anterior cerebral artery (ACA), posterior cerebral artery (PCA), basal artery (BA), and vertebral artery (VA).large artery vascular trunks and hemodynamic results with TCD and MRA;ty, false positive and false negative with TCD with those of MRA.TCD and MRA: Theory data was Tmin=9.91; χ2=107.92, P ＜ 0.005, it was considered that the results with the rate of TCD were related with that of MRA. The detection rate of TCD was 19.06%, and that of MRA was 15.25%. There were significant differences between the detection rate of standard, the sensibility of diagnosing abnormal vessels by TCD was 78.10%, specificity 94.22%, false positive 7.46%, false negative 23.31%,and the coincidence rate 89.36%.CONCLUSION: TCD can assess exactly the functional status of the vessels. It can also reflect early and sensitively the change of hemodynamics of cerebral blood flow. While MRA can display the change of vascular appearance directly so that the combination of TCD and MRA will be improve sensibility and specificity of diagnosis.

Plastic and Aesthetic surgery is a science which creates beauty by combining know-ledge and art. Combined with the professional characteristics of plastic surgery, we reformed the cur-riculum content and teaching mode of continuous education, including a established interactive theoret-ical learning model based on Journal club, the strengthening of clinical practice integrated with multiple related disciplines, the expanding the knowledge of Sociology, Psychology and Ethics, and the construc-tion of a long-term platform of network resources. Therefore, a comprehensive and specialized continu-ous education model in the department of plastic and aesthetic surgery was ultimately formed, whose preliminary assessment was favorable, and could be helpful in the cultivation of high-quality plastic and aesthetic surgeons in the future.

Objective To investigate the application of hepatitis C virus RNA and antibody detection method in population screening.Methods The colloidal gold rapid test method and the enzyme-linked immunosorbent assay (ELISA)were adopted to detect hepatitis C virus (HCV)antibodies,and the real-time quantitative PCR (RT-PCR)was adopted to detect HCV-RNA viral load.Results (1)Among 539 samples,266 cases were antibody negative and 263 cases were antibody positive.(2)Among 67 cases in the HCV-RNA viral load <103 IU/mL group,60 cases were HCV antibody positive by ELISA and 30 cases were HCV antibody positive by colloidal gold rapid test.Among 208 cases in the HCV-RNA viral load ≥ 103 IU/mL,199 cases were antibody positive by ELISA,but only 181cases were antibody positive by the colloidal gold rapid method.Other 6 cases of were 2 kinds of antibody negative had the HCV-RNA viral load ≥ 103 IU/mL.(3)208 cases of HCV-RNA viral load ≥ 103 IU/mL sample were divided in-to four groups.GGT,ALT and AST were statistically significantly different P <0.05),while ALB and S/CO values hadno statisti-cal difference (P >0.05).Conclusion In order to reduce the missed diagnosis rate and diagnose hepatitis C as early as possible,the above laboratory detection methods should be jointly applied and the comprehensive analysis should be conducted in population screening.

ObjectiveTo investigate the therapeutic effects of modified constraint-induced movememt therapy(mCIMT) on upper extremity motor function of stroke patients with hemiparasis, and to compare the effects of mCIMT with those of conventional rehabilitation.MethodsThirty stroke patients with hemiparesis were divided into mCIMT group and control group (conventional rehabilitalion), 15 cases in each group. The mCIMT group received mCIMT (by shaping) in the affected extremity without restriction of movement of intact upper extremity, 6 h a day, five times a week, for two weeks while the control group was treated with traditional rehabilitation in upper-limb and hands functional exercises. Motor activity logs(MAL) score and simple test for evaluating hand function(STEF ) score were measured in two groups before treatment and 2 weeks, 1 month and 3 months after treatment.ResultsThere were improvement in MAL and STEF scores in both mCIMT group and control group 2 weeks after treatment compared with pre-treatment(P<0-01), and the scores of MAL and STEF on post-treatment 1 month and 3 months were higher than those of pre-treatment in mCIMT group (P<0-05, P<0-01), but there was no significant difference in MAL and STEF score between pre-treatment and post-treatment 1 month and 3 months in control group(P>0-05).ConclusionSignificant improvement in the affected hand function could be achieved with modified constraint-induced movement therapy in stroke patients, better than conventional rehabilitation therapy.

Objective To study the inter-rater reliability of Wisconsin Gait Scale (WGS) and Gait Abnormality Rating Scale (GARS) in patients with stroke. Methods 20 hemiplegic patients were required to walk on their comfortable speed and videotaped from frontal, backward and lateral. The video recordings were scored with WGS and GARS by 2 experienced physical therapists. Intraclass correlation coefficient (ICC) was calculated for the scores in each category and the total score. Results ICC for the WGS were 0.372~1, and were 0~0.875 for the GARS. Conclusion WGS is more appropriater to assess the gait of hemiplegic stroke patients than GARS.

ObjectiveTo analyze the effect of temporal distance parameters on comfortable and maximal walking speed of hemiplegic stroke patients.MethodsThe comfortable and maximal walking speed of 85 hemiplegic stroke patients were tested by 10 m walking speed and temporal distance parameters of gait cycle were obtained. The effect of step length and walking rate on comfortable and maximal walking speed was analyzed.ResultsStep length and walking rate were significantly positive related to comfortable and maximal walking speed (r=0.849-0.915,P<0.001).The step regression analysis selected step length as a significant variable for comfortable and maximal walking speed (R2=0.835,R2=0.827,respectively). ConclusionThe important parameter that influences comfortable and maximal walking speed of hemiplegic stroke patients is step length.

OBJECTIVETo evaluate the effect of length of tibial stump on proprioceptive recovery after anterior cruciate ligament (ACL) reconstruction.

METHODSFrom March 2011 to December 2011,42 patients with ACL tear were performed with reconstruction. The patients were divided randomly into three groups: group A, the patients with remained length of tibial stump ranging from 15 to 20 mm, including 8 males and 6 females, with an average age of (28.2 ± 6.6) years old; group B, the patients with remained length of tibial stump ranging from 5 to 10 mm, including 9 males and 5 females, with an average age of (27.9 ± 6.4) years old; group C, the patients with remained length of tibial stump less than 2 mm, including 9 males and 5 females, with an average age of (28.6 ± 6.8) years, old. The stability of knee were assessed by Lanchman test and anterior drawer test. The function of knee was assessed by Lysholm score and Tegner activity rating. The proprioceptive recovery was evaluated by assessing the passive reproduction of the angles with limb movement into flexion and extension in no weight bearing position.

RESULTSLanchman test and anterior drawer test of all patients were negative at 6 months postoperatively., and there was one case of positive outcome in each group at 12 month and 18 month postoperatively. Lysholm score and Tegner activity score of all patients at 18 month postoperatively were significantly better than that preoperatively, and there were no significant difference among three groups at 18 month postoperatively. There were no significant difference in the production of the angles at flexion to 20° and extention to 80° and 20° among these groups before and after operation. The reproduction of the angles of group A and B at flexion to 50° and extention to 50° at 6 month postoperatively were significantly better than that of group A and B preoperatively and that of group C at 6 month postoperatively, and there were no significant difference among three groups at 18 month postoperatively. The reproduction of the angles of group A and B at flexion to 80° at 12 month postoperatively were significantly better than that of group A and B preoperatively and that of group C at 12 month postoperatively, and there were no significant difference among three groups at 18 month postoperatively.

CONCLUSIONPreservation of tibial stump in ACL reconstruction has benefit in proprioceptive recovery at early stage postoperatively and the length of tibial stump should be reserved with a range from 5 to 10 mm.

Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Proprioception ; Range of Motion, Articular ; Tibia ; chemistry ; physiopathology ; surgery ; Young Adult

Objective To observe the influences of modified constraint-induced movement therapy (mCIMT)on lower-extremity walking ability and femoral artery blood flow among elderly patients with stroke. Methods Totally 67 patients with stroke were randomly divided into mCIMT group(n =35) aged ( 73.2 ± 5.2 ) years and neurodevelopmental treatment (NDT) group ( n =32) as control aged(76.4 ± 3.8) years.Patients in control group exercised by NDT 2 h/time,2 times/d,5 d/week for 6 weeks. Patients in mCIMT group exercised including: up and down exercise,100-120 times/d; movement flatbed exercise for 16-20 min/d; upstairs and downstairs exercise,balance training,standing in a single leg exercise,mandatory exercise time of lower-extremity about 4 h/d,5 d/week for 6 weeks.The patients were assessed for lower-extremities motor function using maximum walking speed (MWS),Berg balance scale (BBS),timed up to go test (TUGT) and Fugl-Meyer(FMA-L) at pre-treatment and post-treatment.The change of femoral artery blood flow velocity and lumen diameter on the affected lower limb were observed by color Doppler. Results There were no differences in the above scores,lumen diameter and blood flow velocity before treatment between the two groups (P＞ 0.05).After treatment,the scores of MWS (56.68 ± 6.57vs.45.61 ± 5.34),BBS(46.84 ± 4.05vs.29.84 ± 4.05),TUGT ( 14.55 ± 8.25vs.25.35 ± 8.70)were higher in mCIMT group than in NDT control group (t=15.09,17.38,15.25,all P=0.001)while no difference in FMA-L score between the two groups was found (35.24 ± 7.62 vs.31.32 ±3.28,t=19.99,P＞0.05).Lumen diameter of femoral artery [(9.05±1.15) mm vs.(8.05±0.68)mm,t=6.72,P=0.001] and blood flow velocity[(92.55±18.25)cm/s vs.(69.35 8.7)cm/s,t=6.83,P=0.001] were increased in mCIMT group as compared with NDT group. Conclusions The mCIMT therapy is better in improving the lower-extremity walking function and blood flow velocity of femoral artery.