The purpose of this paper is to introduce the advance of J.Carr and R. Shepherd's A Motor Relearning Programme for Stroke. In the neurosciences, it has been typical to consider the dyscontrol characteristics associated with the upper motor neuron syndrome as positive features and negative features for a long time. Recently Dr. Carr and Dr. Shepherd have proposed another group of characteristics which they call adaptive features, since it appears likely that adaptive changes to neural system, muscles and other soft tissues and adaptive motor behaviors underline some clinical signs. They point out that early rehabilitation and active life should be arranged for the stroke patient. It is the author's suggestion that we should pay more attention to the “disuse syndrome”in training of the stroke patient according to the adaptive features, and we should understand the “misuse syndrome” correctly and we should not neglect to train the muscle strength in correcting the patient's abnormal movement pattern, since the negative features are major reasons for functional disability, together with the adaptive changes that occur in soft tissues as a result of denervation, immobility and disuse.

?Objective:To study the influence of composite Danshen droplet pills on hemorheology in peripheral blood of patients with oral lichen planus (OLP).Methods:46 patients with OLP were treated by composite Danshen droplet pills for 8 weeks (oral administration,3 times/day,10 granules/time).The venous blood was taken and the hemorheology was studied with a LBY N6A hemorheology test machine before and after the treatment.Results:Effective results were observed in 33 patient and obvious effective results in 5,while no treating effect was found in 8 after treatment.Whole blood viscosity,blood plasm viscosity,erythrocyte aggregation indexs,thrombocyte aggregation rate,fibrinogen and ESR of the OLP patients were decreased ( P 0.05).Conclusion:The composite Danshen droplet pills may improve the hemorheology of OLP patients.

Background and purpose:There is controversial about dissecting the laryngeal nerve in operation of thyroid tumour in clinic. We adopted the methods of exposure of recurrent laryngeal nerve(RLN) to study their deficiencies and benefits. Methods:We reviewed review 456 cases of thyroid tumour who were operated. In 266 cases, RLN was unveiled generally. In 190 cases that RLN was not exposed, had subtotal thyroidectomy with protection of amatomical region.Results:RLN injury did not occur in the exposure group. 4 cases occurred in non-exposure group(3 cases of temporary RLN injury and 1 case of permanent RLN injury). Among the 3 cases of temporary RLN injury, one was caused by the large size of tumour, the other two were caused by the location of thyroid tumor. One case of permanent RLN injury was a case of reoperation for recurrence.Conclusions:The familiarity of the anatomy and variation of RLN, and the exposure of RLN in thyroid operation, can reduce the rate of the RLN injury.

[Objective] To explore the effects of angongniuhuang pill on the synthesis of apolipoprotein E in brains of rats after traumatic brain injury.[Methods] Using reverse transcription-polymerase chain reaction(RT-PCR) and enzyme linked immunosorbent assay(ELISA),the apolipoprotein E’s mRNA of contused brain tissue and the concentration of apolipoprotein E in CSF at different phases after traumatic brain injury were detected of rats fed with angongniuhuang pills.[Results]High expression of apolipoprotein E mRNA and high concentration of apolipoprotein E were found in rats fed with angongniuhuang pills compared with controls.[Conclusion]Angongniuhuang pills may increase the expression of apolipoprotein E mRNA in brains after traumatic brain injury,thus promote the synthesizing and secreting of apolipoprotein E.

Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.

Bilingnal teaching has been practiced to undergraduate eduction at medical university.At the initial period,the bilingual teaching to undergraduate.eduction is not so acceptable for lack of the experionce,textbooks and insufficient commnication between teachers and students.This paper discussed the benefits and applience of bilinqual teahing to undergraduate eduction at ncedica university.

ObjectiveTo investigate the status of job satisfaction and the influencing factors of the disabled in order to know their employment quality.Methods79 disabled employees of one company in Hunan province were randomly interviewed with Minnesota Satisfaction Questionnaire.ResultsThe overall satisfaction scores of 74 disabled workers was 67.78, which inner satisfaction was better than external satisfaction. The most satisfied was job independence and colleagues' relationships and the most unsatisfied was work flexibility and conditions. There were statistically significant differences between gender, age, disabled species and job satisfaction. In personal level, most influencing factors of disabled job satisfaction were gender, age, disability and salary types.ConclusionVocational rehabilitation such as the high-risk population could be performed specifically on the basis of the job satisfaction survey.

Scene teaching is to simulate the clinical scene in class.To cultivate the studnts’abilities of thinking,search and practice in clinical practice,the second clinical college ap-plied the problem-base learning(PBL) in surgery teaching,creating the scene with the standard-ized patients and teachers and drawing out the content from the problems.This article is to summarize the teaching practice.

Objective To study the effects of permissive hypercapnia (PHC) on inflammatory factors of pulmonary tuberculosis patients with one-lung ventilation (OLV).Methods Sixty pulmonary tuberculosis patients with selective thoracic operation who were hospitalized at Hangzhou Red-cross Hospital from October 2010 to October 2013 were randomized into three groups by means of random digits table.Twenty patients were enrolled as control group whose arterial partial pressure of carbon dioxide (PaCO2) was maintained at 35-45 mmHg (1 mmHg=0.133 kPa),20 patients as lower PHC group whose PaCO2 were maintained at 50-55 mmHg,and 20 patients as higher PHC group whose PaCO2 were maintained at 56-60 mmHg.The concentrations of serum interleukin (IL)-6 and IL-8 were measured at the time when the patients were in supine position by two-lung ventilation after induction of anesthesia (T1),15 minutes (T2) and 30 minutes after OLV (T3) in lateral position,two hours (T4) and 6 hours after operation (T5).Quantitative data were analyzed by t-test.Results IL-6 at T3 time point in the three groups increased significantly compared with T1 time point (control group:[4.94± 1.60] pg/mL vs [3.32±1.34] pg/mL,t=3.47,P＜0.01; lower PHC group:[5.38±1.42] pg/mL vs [3.69±1.35] pg/mL,t=3.86,P＜0.01; higher PHC group:[5.57±± 1.34] pg/mL vs [3.50 ± 1.22] pg/mL,t=5.11,P＜0.01).IL-8 at T4 time point increased significantly compared with T1 time point (control group:[342.09±56.12] pg/mL vs [194.58 ± 30.07] pg/mL,t =10.36,P＜0.01; lower PHC group:[349.48±43.49] pg/mL vs [193.16±26.27] pg/mL,t=13.80,P＜0.01; higher PHC group:[351.55±38.13] pg/mL vs [186.02±21.08] pg/mL,t=16.99,P＜0.01).IL-6 at the T4 and T5 time points in both lower PHC group and higher PHC group decreased significantly compared with control groupatthe same time points (T4..[38.49± 9.70] and [43.41± 9.01] pg/mL vs [62.35±7.83] pg/mL,t=8.56 and 7.10,both P＜0.01; T5:[56.39±7.47] and [54.77±7.12] pg/mL vs [107.32± 13.97] pg/mL,t=-14.38 and-14.99,both P＜0.01].Conclusions The serum IL-6 and IL-8 levels in pulmonary tuberculosis patients with OLV increase after selective thoracic operation.PHC through low tidal volume could decrease the release of IL-6 and attenuate the pulmonary inflammatory injury in the tuberculosis patients with operation.

Objective To compare the pulmonary complications between the double lumen tube and the single lumen tube,and to determine whether there are objective advantages of one over the other in one-lung ventilation during minimally invasive esophagectomy(MIE).Methods From January 2012 to November 2013,165 patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.Results Between the single lumen tube and the double lumen tube:patients with pulmonary infection is 11 (16.42％),34(34.69％) (P =0.010).The average intubation time is(1.45 ±0.22)min,(6.53 ±0.59) min,P =0.000.The number of harvested lymph nodes of total is (42.76 ± 18.11) and (34.32 ± 15.80),P =0.002.The number of harvested lymph nodes of the cervix and the left laryngeal recurrent nerve chain was (3.19 ± 2.53) and (1.30 ± 2.14),P =0.000.Conclusion In the minimally invasive esophagectomy,single lumen tube is simpler and easier than the double lumen tube,and with the low incidence of postoperative pulmonary complications,at the same time there are more advantageous in the meditational lymph nodes cleaning.