BACKGROUND: Physical therapy is an effective treatment for movement disorder caused by central nerve system injury, while incorrect rehabilitative method will exacerbate the movement disorders in patients.OBJECTIVE: To investigate the effect of physical therapy on movement and daily activity of the patients suffering from brain injury.DESIGN: Randomized controlled study based on patients with a confirmativediagnosis.SETTING: Rehabilitation department in a university hospital.PARTICIPANTS: From September 2001 to August 2002, 78 patients hospitalized in the Rehabilitation Department of the Hospital Affiliated to Luzhou Medical College, with hemiplegia caused by brain injury, were selected into this study. The patients with severe brain injury, severe understanding disability, and severe heart diseases, lung diseases and kidney diseases were excluded.METHODS: The eligible patients were divided into two groups: the physical therapy group(48 patients) and the control group(30 patients) . All the patients in these two groups received medication and the hyperbaric oxygen therapy (HBOT), while the patients in the physical therapy group received an extra physical therapy.MAIN OUTCOMES MEASURES: A Fugl-Meyer assessment(FMA) and a modified barthel index(MBI) were adopted to evaluate the pre-and post-treatment statuses of the patients in these two groups.RESULTS: No significant difference in age, sex and disease course between the physical therapy group and the control group was found. In the physical therapy group, the FMA scale before and after the therapy were 40.43 ± 21.78 and 68.35 ±23.39, and the corresponding MBI scale were 32.82 ± 17.40 and 78.84 ± 25.31 respectively. In the control group,meanwhile, the FMA scales were 41.71 ± 19. 13 and 51.48 ± 22.58, and the MBI scales were 33.02 ± 12.48 and 56.65 ± 26.53. Before the therapy,comparison of FMA and MBI between the two groups showed no significant difference. While after the therapy, significant difference of FMA and MBI between the two groups could be confirmed( t = 2. 14, 2.21, P ＜ 0.05).CONCLUSION: Physical therapy could apparently enhance the rehabilitation of movement ability in patients with brain injury.

Objective To evaluate the therapeutic effect of transcatheter closure of perimenbranous ventricular septal defect (PMVSD) with membranous VSD occluder device and compare the effect of transcatheter closure of VSD with surgery. Methods The therapeutic effect of transcatheter occlusion in 48 children with VSD is compared with that of other 73 cases who had received surgical treatment. Age, height, weight, pulmmary artery pressure, size of the defect, time for hospitalization, success rate as well as complications after operations are compared between the 2 groups. All the data are proccessed either by means of t test or ? 2 test statistically. Results There are no statistical differences between the two groups in age, height, weight, pulmonary systolic pressure and the rate of success. But the size of VSD is smaller and the time for operation and hospitalization is shorter in the group of transcatheter occlusion. There are no significant differences between the two groups in the rate of complications including the second surgery, residual shunt, bleeding, nerve injury, hemolysis, Ⅲ atrioventricular block, pneumothorax, hydrothorax, hydropericardium, aortic valve insufficiency and infection. But left anterior bundle branch block and complete left bundle branch block occur more often in the group of the catheter interventions during or after the occlusion. Conclusion Transcatheter occlusion shows a promising therapeutic effect on VSD. To prevent complications, therapeutic rules and technical criterias should be obeyed and close monitoring after the closure should be carried out.

Objective To explore the method and therapeutic principle of transcatheter closure of coronary artery fistula, aortopulmonary collaterals and aortopulmonary window. Methods Interventional occlusion of 4 cases of coronary artery fistulas and 1 case of aortopulmonary collaterals with Cook coils, 1 case of coronary artery fistulas and 1 case of aortopulmonary window with AGA Amplatzer duct occluder. The mean age of 7 children were 8.5 years. Results Transcatheter closure of 7 cases of vascular malformations were successful. During the follow-up period of 1 month to 5 years, no residual shunt and other complications appeared. Conclusion The curative effect of transcatheter closure of vascular malformations was good. But for the occlusions′ success and prevention from complications occurrence, the indications of closure should be obeyed, the time of X-ray exposure should be less than 60 minutes.

Objective To investigate the intervention of Chinese herb Shengjiang San(SJS)for the imbal-ances of serum Th1/Th2 cells and related regulatory factors in sepsis patients. Methods Fifty-five sepsis patients were randomly divided into two groups:conventional treatment group of 27 cases and SJS group of 28 cases. Nine cases of healthy volunteers were enrolled as control group in the study. Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS (100 mL twice one day). The therapy course of both groups was 3 days. Score of Chinese medical syndromes ,se-rum level of leukocyte count,C reactive protein(CRP)and procalcitonin(PCT),serum T-bet,GATA-3,Th1&Th2 cells in the proportion of whole CD4+Th cells and Th1/Th2 ratio were compared respectively in each group be-fore and after treatment. Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1&Th2 cells in the pro-portion of whole CD4+Th cells and Th1/Th2 ratio(P<0.05 or P<0.01). There were no significant differences be-tween the two groups in serum level of CRP,PCT and GATA3. Compared with control group,there were signifi-cant differences in all indicators except GATA3 of the two groups(P<0.01). Conclusion Chinese herb Shengji-ang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors(T-bet&GATA-3)in sepsis patients.

Child ; Community-Acquired Infections ; microbiology ; Humans ; Pneumonia, Bacterial ; microbiology

BACKGROUND:Palatal rugae assist for consonantal formation;however,effect of palatal rugae on phonetics has been previously reported to be involved in different complete denture base plates of recipients.OBJECTIVE:To qualitatively analyze the effe-cts of different palate base plate morphology on phonetics of edentulous jaw patients using a computerized speech lab.DESIGN,TIME AND SETTING:A contrast study was performed at the Department of Stomatology,Beijing Hospital of Healthy Administration,and at the Department of Otorhinolaryngology,Beijing Friendship Hospital affiliated to Capital Medical University between February 2007 and February 2008.PARTICIPANTS:Ten edentulous jaw patients wore complete denture with smooth surface and palatal rugae complete denture base.METHODS:Spike,voice onset time and transition of 10 edentulous iaw patients were measured by computerized speech lab when/da/,/ta/,/sa/,and/na/were pronounced.MAIN OUTCOME MEASURES:Spike.voice onset time and transition.RESULTS:Spikes were observed in all syllables.When/da/and/ta,were pronounced.voice onset time in the smooth surface group was significantly shorter than palatal rugae group(P<0.05):voice onset time of/d/and/t/in the palatal rugae group was similar to normal value(P>0.05).When/da/and/ta/ were pronounced,transition frequency in the smooth surface group was significantly lower than palatal rugae group(P<0.05),while that in the palatal rugae group was similar to normal value(P>0.05).CONCLUSION:As an anatomical landmark,palatal rugae contribute to phonetic restoration and consonant articulation of edentulous jaw patients.Computerized speech lab can quantitatively analyze phonetic changes after complete denture restoration and may be used as guidance for clinical dental prosthetics.

Background:Matrix metalloproteinase-9(MMP-9)is known to play a key role in tumor invasion and metastasis by mediating the degradation of extracellular matrix. It has been revealed that neutrophil gelatinase-associated lipocalin ( NGAL)is capable of protecting MMP-9 from degradation and thereby preserving its enzymatic activity. Aims:To explore the MMP-9 and NGAL levels in peripheral blood of gastric cancer patients and their clinical significance. Methods:Serum levels of MMP-9 and NGAL were determined by ELISA in 76 gastric cancer patients and 50 healthy controls. Correlations of serum MMP-9 and NGAL levels with clinicopathological features of gastric cancer were analyzed,and their diagnostic performance for screening gastric cancer was evaluated by ROC curve. Results:Serum levels of MMP-9 and NGAL in patients with gastric cancer were significantly higher than those in healthy controls(P<0. 01),and either of them was positively correlated with the TNM stage of gastric cancer. Furthermore,MMP-9 was correlated with lymph node metastasis and serosal invasion,while NGAL was correlated with distant metastasis. However,tumor differentiation was not correlated with either MMP-9 or NGAL. By ROC curve,608. 19 ng/mL and 14. 71 ng/mL were identified as the cutoff value of serum MMP-9 and NGAL,respectively,for screening gastric cancer. Sensitivity and specificity of MMP-9 were 64. 5% and 90. 0%,and those of NGAL were 85. 5% and 90. 0%,respectively. When parallel test was taken,the sensitivity would be increased to 94. 7% and specificity being 82. 0%. Conclusions:Serum levels of MMP-9 and NGAL are elevated and associated with tumor progression in patients with gastric cancer. Both of them might be used as potential markers for screening,disease assessment and prognosis prediction of gastric cancer.

Objective To investigate the correlation between brain natriuretic peptide(BNP)and left ventricular diastolic function in the elderly patients with diabetes mellitus and hypertension.Methods 128 elderly patients with diabetes mellitus were divided into diabetes without hypertension (n=63)and with hypertension(n=65),and other 62 normal subjects were selected as control group.Plasma BNP levels and indexes of echocardiography,including left ventricular mass index(LVMI),the mitral peak flow velocity during early(E)and late diastole(A),ratio of E/A,average peak velocities at mitral annuluses of six sites in left ventricular wall during early(MEm)and late diastole (MAm),and relative E/MEm were measured in all patients.Results LVMI,E/MEm and the levels of BNP were significantly higher in groups of diabetes without and with hypertension[(91.6 ±17.3)g/m2 and(116.7±20.5)g/m2,(10.3±1.8)and(12.5±1.4),(47.7±29.4)ng/L and(105.7±32.5)ng/L]than in control group[(78.7±19.5)g/m2,(8.9± 1.6)and(20.8±11.63)ng/L,respectively](F=11.54,13.83 and 9.75,all P＜0.05),while MEm in two diabetes groups[(6.8±1.0)and(5.4±0.9)cm/s]were decreased as compared with control group[(8.0± 1.1)cm/s,F=11.26,P＜0.05].The BNP levels were negatively correlated with E/A and MEm(r =-0.42 and -0.51,all P＜0.01),and positively correlated with LVMI and E/MEm(r=0.48 and 0.58,all P＜0.01).Conclusions Left ventricular diastolic function is impaired in diabetes mellitus and more severely impaired in diabetic patients with hypertension.A combination of plasma BNP and echocardiography parameter may be helpful to accurately evaluate left ventricular diastolic function in the elderly patients with diabetes mellitus and hypertension.

Objective To investigate the characteristics of coronary's pathological changes in patients with impaired glucose tolerance. Methods Four-hundred and ninety patients who were suspected with ischemic chest pain were divided into three groups according to their OGTT results: (1) IGT group: n = 161,(2) 12DM group:n = 159, (3) NGT group: n = 170. Serum levels of triglyceride (TG) , total cholesterol (TC) , highdensity lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) and high sensitive Creactive protein (hs-CRP) were detected, their body mass indexes (BMI) were calculated. General clinical information (including gender, age, history of smoking, history of hypertension) were collected. All the CAG results were analyzed and Gensini scores were assessed as well. Results The TG levels in the T2DM group and IGT group ([2. 41 ± 1.70] mmol/L and [2. 26 ± 1. 20] mmol/L) were significantly higher than that of the NGT group (1.95 ± 1.14) mmol/L, the differences were significant (t=0.4610,0.3124, P<0. 01 and 0.05,respectively),whereas there was no significant difference between the IGT group and T2DM group (P >0.05);No significant difference was found among the three groups about TC, HDL-C, LDL-C levels (either P > 0.05). The levels of hs-CRP in T2DM group ([2. 38 ± 1. 76] mg/L and IGT group [2. 33 ± 2. 03] mg/L) were higher compared with the NGT group ([1. 54 ± 1. 32] mg/L), the differences were significant (t = 0. 8391,0. 7815, Ps < 0. 01), whereas there was no significant difference between the IGT group and T2 DM group (P >0.05). BMIs of the IGT group ([25.50 ± 3.04]kg/m2) and T2DM group ([26.09 ± 2.86]kg/m2) were higher than that of the NGT group ([24. 70 ± 3. 27] kg/m2), the differences were significant (t = 0. 8063,1. 3947, P<0. 05 and <0.01, respectively),whereas no significant difference was found between the T2DM group and IGT group (P > 0. 05). The incidence of single coronary pathological changes was 44.7% in the NGT group,it was higher than that of the IGT group (23. 6%) and T2DM group (18. 9%) (x2 = 16. 310,25. 116,Ps < 0. 05), whereas there was no significant difference between the IGT group' and T2DM group (P > 0. 05);The incidences of 2 branches pathological changes in the T2DM group (37. 1%) and IGT group (39. 8%) were higher compared with NGT group (23. 5%) ,the differences were significant (x2 =1. 200,10. 099,Ps <0. 05),whereas there was no significant difference between the IGT group and T2DM group (P >0. 05) ;The incidences of 3 vessels pathological changes in the T2DM group (40.9%) and IGT group (33. 5%) were higher than that of the NGT group (20. 0%) , the differences were significant (x2 = 7. 767,17. 028, Ps < 0.05), there was no significant difference between the IGT group and T2DM group (P > 0. 05). The incidence of subtotal or total occlusion of the T2DM group and IGT group were 22. 6% and 18.0% respectively,both were higher than that of the NGT group(7. 6%) (x2 = 14. 573,8. 019 ,Pa < 0.05) , whereas no significant difference was found between the T2DM group and IGT group (P > 0. 05). The incidences of vascular diffusing pathological change in the IGT group (24. 8%) and T2DM group (30. 8%) were higher compared with the NGT group (12.4%) (x2 =8.583,16.724, Ps < 0.05), whereas there was no significant difference between the IGT group and T2DM group (P >0.05). The Gensini scores in the IGT group (55. 05 ± 22. 99) and T2DM group(56. 15 ± 24. 87) were significnatly higher than that of the NGT group (38. 03 ± 17. 38), the differences were significant ((t =17.0142,18. 1186,Ps <0.01),whereas there was no significant difference between the IGT group and T2DM group (P>0.05). Conclusion The incidences of 2 and 3 vessels pathological changes increase significantly in patients with IGT. Moreover, the incidences of occlusion and diffuse stenosis increase significantly. This is similar to the coronary artery pathological charactersitics in patients with diabetes, which indicates that IGT is closely related to the pathological severity of coronary artery. We should pay much attention to those patients with IGT in the clinical work.

Objective: To revise the Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS), which are self-related social anxiety measurements developed by Mattick and his colleagues. Methods: Data were collected from a sample of more than 1,300 college students of Beijing and analyzed by Confirmatory Factor Analysis, reliability test and validity test. Results: The results of Confirmatory Factor Analysis showed that the revised SIAS and SPS were single-factor construct and had good construct validities. The Cronbach's ? coefficient of the SIAS scale was 0.874, the reliability coefficient of split-half was 0.862, and the test-retest stability coefficient was 0.863. The Cronbach's ? coefficient of the SPS scale was 0.904, the reliability coefficient of split-half was 0.865, and the test-retest stability coefficient was 0.849. The correlation between total score of SIAS and that of Fear of Negative Evaluation Scale(FNE) was 0.514, and the correlation between total score of SPS and that of FNE was 0.479. Conclusion: The revised scales of SIAS and SPS has good psychometric quality and can be used in Chinese college students.