ObjectiveTo investigate the effect of early intervention on shoulder pain in patients with hemiplegia after stroke. MethodsStroke patients were treated with bedside physical therapy on the shoulder 7 d after onset. They were assessed with short-form McGill pain questionnaire and Fugl-Meyer assessment of upper extremity before and 40 d after treatment. ResultsThe score of MPQ in the treatment group was significantly lower than that in the control group, while the score of FMA was significantly higher(P<0.01). ConclusionEarly intervention can reduce the pain and improve the function of the shoulder in patients with shoulder pain after stroke.

Objective To investigate the impact of tumor necrosis factor-α (TNF-α) on intestinal mucosa permeability and the protective effect of probiotics in mice with acute liver failure (ALF).Methods Thirty male BALB/c mice aged 6-8 weeks were randomly divided into normal control,ALF and intervention groups (10 for each group).Mice in intervention group were fed with live combined bifidobacterium and lactobacillus (900 mg · kg-1 · d-1) by gavage,while those in normal control and ALF groups were fed with normal saline (9 mL · kg-1 · d-1).After two weeks,mice in ALF and intervention groups were given an intraperitoneal injection of D-galactosamine (3.0 g/kg) to induce liver failure,and all mice were sacrificed 9 h after the injection.Biochemical markers were tested,expressions of TNF-α mRNA in liver tissues and zonula occluden-1 (ZO-1) mRNA in ileum tissues were detected by real-time PCR,and the expression of ZO-1 protein in ileum tissues was detected by Western blotting.One-way analysis of variance or Kraskal-Wallis test was performed to explore the differences in biochemical markers,TNF-α mRNA,ZO-1 mRNA and ZO-1 protein expressions among groups,and Pearson test was used to analyze the correlations between the expression of ZO-1 protein in ileum tissues and serum level of TNF-α or plasma levels of endotoxins.Results Serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),TNF-α and plasma level of endotoxins in ALF group were significantly higher than those in normal control group (P ＜0.01) ; while compared with ALF group,the above biomarkers were significantly decreased in the intervention group (P ＜ 0.01).The expression of TNF-α mRNA in liver tissues in ALF group was higher than that in the normal control group (Z =4.038,P ＜ 0.01) ; while compared with ALF group,it was decreased in intervention group (Z =3.780,P ＜ 0.01).The expressions of ZO-1 mRNA and ZO-1 protein in ileum tissues in ALF group were lower than those in normal control group (P ＜ 0.01) ; while compared with ALF group,those in intervention group were increased (P ＜ 0.01).Pearson analysis showed that the expression of ZO-1 protein in ileum tissues was negatively correlated with serum level of TNF-α level and plasma level of endotoxin (r =-0.946 and-0.919,both P ＜ 0.01).Conclusions TNF-α may be involved in the increased permeability of intestinal mucosa in mice with ALF.Live combined bifidobacterium and lactobacillus may relieve liver damages through inhibiting endotoxin synthesis and release,and ameliorate the permeability of intestinal mucosa through up-regulating ZO-1 protein expression.

Objective A systematic review of implementation outcomes of the essential medicine system in China to identify scientific evidences for a better system.Methods A systematic review is made to extract data from the research papers on outcomes of the essential medicine system,followed by an analysis and description of such data.Results Of the 87 papers included,most of them focused on primary care institutions,while four of them on residents or patients,and one of them on pharmaceutical enterprises.The study found the medical institutions with rising availability of essential drugs,lowered medicine costs,rising or dropping business volume,and apparent drop of out-of-pocket expenses for patients.These have encouraged rational drug use.Evidences in hand indicate expected outcomes from the essential medicine system.Conclusion Current researches on the system focus on primary care institutions in developed areas in China,lacking rigorous design.Studies of broader scale,further depth and more rigorous designs of the implementations of the system are recommended for evaluation of the impacts and outcomes of the system on various stakeholders of the policy.

Objective To compare the biomechanical properties between the two-level fixation by im- plantation of pedicle-screws into the adjacent upper and lower vertebrae of the fractured vertebra and the three-level fixation by implantation of pedicle screws into the fractured vertebra and its adjacent upper and lower vertebrae in the treatment of thoracolumbar burst fractures.Methods Eight fresh frozen calf spines were used in this study.Each specimen was tested in four models:intact model as the control,L1 burst fracture model,two-level fixation model, and three-level fixation model.The L1 burst fracture model was created on a biaxial material testing machine (MTS858 Bionix test system,America).During the experiment,the flexion,extension,bilateral bending and axial rotation loadings were applied to the specimens and the range of motion(ROM)was measured with a three-dimensional laser analysis apparatus and the stiffness was calculated subsequently.One-way statistical analysis was used.Results The ROMs under six different loadings in the fracture model became larger obviously(P＜0.05)and the stiffness decreased(P＜0.05).The ROMs in both fixation models were smaller than those in the other models(P＜0.01)and the stiffness increased distinctly(P＜0.05).There were no significant differences in ROMs and stiffness between the two-level fixation and three-level fixation models(P＞0.05).Conclusion Two-level fixation provides similar biomechanical stability as three-level fixation does in the reconstruction of unstable thoracolumbar fractures.

Objective To study the meaning of breast cancer staging system by AJCC eighth edition to invasive lobular carcinoma and analysis the clinical pathological characteristics.Methods According to the eighth edition of the AJCC staging to evaluate the TNM stage and prognosis evaluation of invasive lobular carcinoma cancer patient in Peking University Shenzhen Hospital from 2011 to 2016,and compared with others in clinical pathological data.Results There were 21 cases of invasive lobular carcinoma,accounting for 2.7％ of all invasive breast cancer.We found that invasive lobular carcinoma shows no significant difference (P ＞ 0.05) in ages,menstrual status,molecular features and anatomic staging and prognosis staging with others;histological grade were significantly different (P ＜ 0.05).There were significant differences in the prognosis and staging of invasive lobular carcinoma.Conclusions Eighth AJCC staging systemn provides a new reference for the clinical treatment of breast cancer,should be evaluated with anatomic stage.Histological grade is relatively good in invasive lobular carcinoma and the prognosis is good,needs more research to the individualized treatment of invasive lobular carcinoma.

Aged, 80 and over ; Chronic Disease ; Female ; Humans ; Mucor ; pathogenicity ; Mucormycosis ; microbiology ; pathology ; Orbit ; pathology ; Sinusitis ; microbiology ; pathology

Objective To know the current conditions of institution set-up,personnels allocated and equipment supplied in county-,city-and country-level in endemic disease prevention and control.Methods Questionnaires,regarding institution set-up,personnels allocated and equipment supplied,was performed among staffs from administrative apartment and professional apartment.Results There were 31 institutions for endemic disease prevention and control in province level of our country(except Hainan Province),with one institution in each province.There were 308 institutions for endemic disease prevention and control in city level,and 23 cities did not have one.There were 2340 institutions for endemic disease prevention and control in county level,none in 502 counties.There were 20 provinces which had the professional crew of the endemic disease administration,but other provinces did not.The proportion of high-grade professional staff of province,city,county level was 24.84% (310/1248),17.05%(481/2821),5.31%(598/11 256)respectively.The averaged size of wdrking place at province-,city-and county-level was 2603.9,324.6,1227 m2.The averaged area of laboratory of province,city,county level was 1093.8,147.4 and 46.6 m2 respectively.The average quantity of equipments valued over ten thousand yuan at province-,city-and county-level is 15.5,2.2,0.6 respectively.Conclusions After the innovation of organizations for endemic disease prevention and control,the number of personnels devoting to this work has been curtailed,working place and equipment is insufficient,which hinders the prevention and control.

Objective To explore the possible mechanisms of Arsenic Trioxide in treating rheumatoid arthritis(RA)by observing the changes of HE staining and NF-KB expression as well as the apoptosis of syn- oviocytes in adjuvant-induced arthritis rats.Methods After the animal model was set up on Wistar rats sue- cessfully,they were randomly divided into AA model group and arsenic trioxide treatment group.The treat- ment group were injected with 4 mg'kg~(-1)9?d~(-1)arsenic trioxid fluid for 7 days.All of the rats were killed 3 days after the complete of injections.The joint specimens were exposed,fixed,decalcified,wrapped and cut into slices.All slices were examined by HE stain and immunohistological evaluation.Results HE staining showed that when compared with the normal control group,the layers of synoviocytes of the AA group were increased to 6-8,and the arrangement of synoviocytes was disordered and heavy inflammatory cell infiltration were found in the AA group.In the arsenic trioxide treatment group,the layers of synoviocytes increased to 3～4,and medi- um amount of inflammatory cell infiltration were found.The intensity of synovial NF-kB(p65)positive stain in AA model group was significantly higher than that in the normal control group.The synovial expression and ac- tivation of NF-kB in the treatment group were decreased markedly,and did not return to normal level.The average gray scale calculation showed that there were significant differences between the three groups(P

Objective To investigate the clinical features and genetic basis of cryopyrin-associated periodic syndrome (CAPS). Methods The clinical manifestations, laboratory tests, and genetic tests of one case of CAPS were retrospectively analyzed. The related literatures were reviewed. Results A 7 year and eight month old male patient had recurrent fever for 7 years and his whole body was covered with patchy red rash which was itchy and faded with pressure. The limbs and joints were normal. The levels of high-sensitivity C-reactive protein, erythrocyte sedimentation rate, rheumatoid factors were increased. The patient had fundus arteriosclerosis, double conjunctival lesions and nerve deafness on both sides. There was no mutation found in NLRP3 gene coding region, but a heterozygous mutation (-2667G>T) had been found in 5 ' untranslated region. Compared with normal control, the mRNA level of NLRP3 increased 4.2 times and the expressions of IL-1βand IL-18 gene increased 2.2 (P=0.002) and 1.2 times (P>0.05). Conclusions The clinical features of CAPS can be recurrent fever, rash, and joint involved. The oph-thalmologic abnormalities and varying degrees of deafness may occur during the progression. The test of NLRP3 gene may help diagnosis.

Objective To establish the HPLC fingerprint of Disporum cantoniense. Methods HPLC analysis was performed on Agilent Zorbax SB-C18 chromatographic column ( 250 mm × 4. 6 mm, 5 μm) with the mobile phase consisting of methanol-0.05% phosphoric acid in gradient mode.The flow rate was 1.0 mL·min-1, the detection wavelength was 256 nm and the column temperature was 30 ℃. Results The HPLC fingerprint of 15 batches of Disporum cantoniense was established. Thirteen common peaks in the fingerprint were demarcated, four of which were identified by reference substances. Chemical pattern recognition of fingerprint was performed by hierarchical cluster analysis and principal component analysis. Conclusion The method is simple, accurate and has a good repeatability, and can be used for quality control of Disporum cantoniense.