Objective To identify the differences in the status of rehabilitation demands of adults with different disability grades so as to seek out the beneficial strategies of rehabilitation for them.Methods The data on the rehabilitation demands of persons with different disability grades in every category of disabilities had been collected from the province of Guangdong in the Second National Sampling Survey of People with Disability.Results There were significant differences in the rehabilitation needs among persons with different disabilities grade in visual, hearing, physical, intelligence disabilities. There were no significant differences in the rehabilitation needs among persons with different disabilities grade in speech, mental disabilities.Conclusion The more severe disability the persons have the more medicine services they need，however，they little asked for other rehabilitation demands such as rehabilitation services, assistive device and so on.

Objective To investigate the effect of local injection of Botulinum toxin type A(BTXA) on spasticity and function of the affected upper limb in stroke patients.Methods A total of 32 stroke patients were re- cruited and randomly divided into two groups:a BTXA group and a control group.All the patients had spasticity of upper limb muscles,which scored grade 2 to 3 with the Modified Ashworth Scale(MAS) ,and decreased elbow joint range of motion.The 16 patients in the BTXA group received BTXA injection in the biceps brachii muscles and flexor muscles of forearm on 10～15 points,while those in the control group did not.All the patients in both groups were treated with rehabilitation training techniques.The MAS,Fugl-Meyer upper limb function assessment and Barthel In- dex were employed to evaluate the changes of muscle tone,upper limb function and activity of living (ADL)perform- ance of the patients before injection and at 1st,2nd,6th 12th weeks after injection.Results The therapeutic effect between the BTXA group anti control group was significantly different in terms of biceps muscle tone,the scores of Fugl-Meyer upper limb function assessment and Barthel Index.Compared with preinjection,muscle tone was de- creased significantly and ADL performance was improved after injection in BTXA group.The effects of BTXA lasted more than 12 weeks.Conclusion Intramuscular muhipoint injection of BTXA was useful in reducing muscle spas- ticity,and was helpful for increasing motor ability of the affected upper limb and ADL performance of the stroke pa- tients.

Objective To analyze and compare the imaging characteristics of contrast-enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance imaging (CEMRI) in diagnosing hepatic epithelioid hemangioendothelioma (HEHE) for improving radiological diagnostic accuracy.Methods The imaging characteristics of CEUS and dynamic CEMRI in 17 patients with histopathological diagnosis of HEHE on specimens obtained after surgical resection or fine needle biopsy were retrospectively analyzed and compared.Results On CEUS,20 lesions in 13 patients demonstrated different enhancement patterns in the arterial phase:13 lesions (65.0％) displayed gross enhancement and 7 lesions (35.0％) displayed a rimlike enhancement.Synchronous enhancement was observed in 17 lesions (85.0％) and rapid enhancement was observed in 3 lesions (15.0％).All these 20 lesions manifested as a hypoechoic mass in the portal venous and delayed phases.Other characteristics included speculated enhancement in the inner margin of the lesions and a vessel sign.On CEMRI,45 lesions (71.4％) manifested slight enhancement in the arterial phase and continuous enhancement in the portal venous and delayed phases.The remaining 18 lesions (28.6％) manifested no enhancement in the arterial phase but progressive enhancement in the portal venous and delayed phases.47 lesions (74.6％) displayed a rim-like enhancement and 16 lesions (25.4％) displayed gross enhancement.Other imaging characteristics included a halo sign,a lollipop sign,a capsular retraction sign or avessel sign.Conclusions On CEUS,characteristic manifestations of HEHE were synchronous enhancement with a quick wash-out.At peak time,the enhancement degree was equal to the normal liver parenchyma.On CEMRI,the main radiological feature of HEHE was a rim-like enhancement.In the arterial phase,the enhancement degree was not high and there was either a continuous enhancement or a progressive enhancement in the portal venous and delayed phases.Furthermore,HEHE lesions always occurred under the liver capsule and showed acapsular retraction sign,ahalo sign,a lollipop sign or a vessel sign.The combination of CEUS and CEMRI helped to improve the diagnostic rate and contributed to selection of clinical treatment.

OBJECTIVETo investigate the feasibility of dynamic magnetic resonance diffusion tensor imaging (DTI) in rabbit models with implanted VX2 hepatic tumor grafts.

METHODSMRI and DTI images were obtained from 16 rabbit models with implanted VX2 hepatic tumor grafts (14, 18, 22, and 26 days after tumor implantation, respectively) and 4 normal rabbits. The average diffusion coefficient (ADC) and exponential ADC (eADC) were estimated and compared against pathological findings.

RESULTSThe ADC values increased after tumor implantation but then decreased in the rabbit models, whereas eADC exhibited a pattern of reverse changes. These changes significantly differed from those in the control group. Coagulation necrosis and fibrous hyperplasia showed obvious increase as found by pathological examination.

CONCLUSIONDynamic MR DTI quantitative analysis of rabbit models of implanted VX2 hepatic tumor can partially describe the growth behaviors of implanted liver cancer.

Animals ; Carcinoma, Hepatocellular ; pathology ; Diffusion Magnetic Resonance Imaging ; Female ; Image Enhancement ; methods ; Liver Neoplasms ; pathology ; Male ; Neoplasm Transplantation ; Rabbits ; Random Allocation

BACKGROUND: Pancreatic damage in critically ill patients is associated with the progressive failure of multiple organs, but little is known about its clinical characteristics. At present, no guidelines are available for the diagnosis and management of pancreatic damage. This study was undertaken to analyze the clinical and pathologic characteristics of pancreatic necrosis in critically ill children, and to find some biological markers of pancreatic damage or pancreatic necrosis. METHODS: We retrospectively reviewed the clinical data, laboratory results, and autopsy findings of 25 children, who were admitted to Hunan Children's Hospital, China from 2003 to 2009, and died of multiple organ failure. The autopsy revealed pancreatic necrosis in 5 children, in whom sectional or gross autopsy was performed. RESULTS: The 5 children had acute onset and a fever. Two children had abdominal pain and 2 had abdominal bulging, flatulence and gastrointestinal bleeding. Four children had abnormal liver function, characterized by decreased albumin and 3 children had elevated level of C-reactive protein (CRP). B-ultrasonography revealed abnormal acoustic image of the pancreas in all children, and autopsy confirmed pancreatic necrosis, which may be associated with the damage of the adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other organs. Children 1 and 2 died of acute hemorrhagic necrotizing pancreatitis (AHNP);children 3-5 died of multiple organ dysfunction syndrome (MODS) due to pancreatic necrosis. CONCLUSION: Pancreatic damage or pancreatic necrosis in critically ill children is characterized by acute onset, severity, short course, multiple organ damage or failure. It may be asymptomatic in early stage, and easy to be ignored.

Objective　To explore the relationship between hemolymph phenol oxidase and the melanization of Plasmodium yoelii oocysts in Anopheles dirus. Methods　An Anopheles dirus-Plasmodium yoelii system was used Anopheles dirus were divided into 3 groups, that is, non-blood-fedding (N), normal-blood-fedding (B) and infected-blood-fedding (I). The activities of MPO and o-DPO in hemolymph from 3 groups were determined with native polyacrylamide gel electrophoresis (PAGE) and density scanning at 5, 7, 11 and 15 d after blood feeding. Results　Both MPO and o-DPO activity were significantly higher in group I than group N and B (P<0.05). But with the melanization of Plasmodium yoelii oocysts, both MPO and o-DPO activity in group I were decreased in comparison with group N, especially on the 15 th day after infected-blood feeding. MPO and o-DPO activity in group B were significantly stronger than those of group N. Conclusion　Blood feeding and infection of Plasmodium yoelii both can activate the cascade. The heamolymph phenol oxidase may play an important role in the melanization of Plasmodium yoelii oocysts in Anopheles dirus.

【Objective】 To investigate the clinical staffs′ knowledge about blood transfusion and their demands, so as to provide evidence for arranging the content for continuing education of blood transfusion medicine. 【Methods】 A self-designed questionnaire was used to investigate the blood transfusion related knowledge of 652 clinical staffs from other cities or counties/districts in Shaanxi Province, who came to our hospital to attend meetings, further training and study from July to August 2019. 【Results】 Clinical stsffs investigated lacked a deep understanding of blood transfusion and blood donation related knowledge, and even were ignorant of certain knowledge. The awareness rate of relevant knowledge was the highest among doctors, followed by laboratory technicians and the lowest among nurses. 【Conclusion】 The awareness rate of blood transfusion related knowledge among medical staffs is relatively low, suggesting the training of blood transfusion related knowledge should be enhanced.

BACKGROUNDMedical ozone therapy system was reported to have certain effects on the treatment of severe hepatitis, but its mechanism is not very clear. One of the causes of death of severe hepatitis is complication of renal damage or hepatorenal syndrome. The present study aimed to observe effects of medical ozone therapy system on plasma renin activity (PRA), angiotensin II (AII), aldosterone (ALD), renal blood flow and renal function of patients with chronic severe hepatitis and explore mechanisms of medical ozone therapy in the treatment of severe hepatitis.

METHODSEighty-five cases with chronic severe hepatitis were randomly divided into ozone therapy group (43 cases) and control group (42 cases). The patients in the ozone therapy group were treated with basic treatments plus ozone therapy system. Basic autohemotherapy was used. One hundred milliliter venous blood was drawn from each patient, and was mixed with 100 ml (35 µg/ml) medical ozone and then was returned the blood to the patient intravenously, once every other day for 20 days. Only the basic treatments were given to the control group. PRA, AII, ALD, renal blood flow and damage to renal function of the two groups before treatment and 20 days after treatment were compared. Survival rates were also compared.

RESULTSTwenty days after the treatment, in ozone therapy group, PRA was (1.31 ± 0.12) ng·ml⁻¹·h⁻¹, AII (111.25 ± 17.35) pg/ml, ALD (251.31 ± 22.60) pg/ml, which decreased significantly compared with those before treatment (PRA (2.23 ± 0.13) ng·ml⁻¹·h⁻¹, AII (155.18 ± 19.13) pg/ml, ALD (405.31 ± 29.88) pg/ml, t = 4.67 - 14.23, P < 0.01), also lower than those of control group 20 days after the treatment (PRA (2.02 ± 0.11) ng·ml⁻¹·h⁻¹, AII (162.21 ± 15.32) pg/ml, ALD (401.20 ± 35.02) pg/ml, t = 4.97 - 15.61, P < 0.01); renal blood flow was (175.15 ± 28.20) ml/min, which increased compared with that before the treatment ((125.68 ± 21.25) ml/min) and was higher than that of control group 20 days after the treatment ((128.59 ± 23.15) ml/min, t = 4.78, 4.61, P < 0.01). Renal damage occurred in 2 cases (5%) in ozone therapy group, less than that in control group (9 cases, 21%) (χ² = 5.295, P < 0.05). Thirty-three cases (77%) in ozone therapy group vs. 16 cases (38%) in control group survived (χ² = 12.993, P < 0.01).

CONCLUSIONSBasic treatment plus medical ozone therapy for patients with chronic severe hepatitis could decrease PRA, AII and ALD levels significantly increase renal blood flow, prevent renal damage to certain extent and improve survival rate of the patients.

Adult ; Female ; Hepatitis, Chronic ; drug therapy ; Humans ; Kidney ; blood supply ; drug effects ; metabolism ; Male ; Middle Aged ; Ozone ; therapeutic use ; Renal Circulation ; drug effects

Female ; Humans ; Manipulation, Orthopedic ; Middle Aged ; Radius Fractures ; surgery ; Ulna Fractures ; surgery ; Ulnar Nerve Compression Syndromes ; surgery

OBJECTIVEThe aim of this investigation was to study the expression of collagen type II in the cartilage of mandibular condyle following asymmetric inter-maxillary traction.

METHODSTwo hundred and twenty SD rats were used in this study (one hundred and four rats loading 0.39 N elastic force, another one hundred and four rats loading 1.18 N elastic force, while twelve rats for control). The extra-joint device was fixed on the right side by surgery. Half of the experimental group was killed at 3, 7, 14, 28 days. The devices were removed at the 28th day in the rest rats, and the rats were sacrificed at 3, 7, 14, 28 days after removing the device. The type II collagen expression levels of all the joints were measured using immunohistochemical techniques.

RESULTSThe positive expression of the type II collagen was mainly observed in the cytoplasm of chondrocyte, especially in maturative and hypertrophic layer. The expression intensity was different in different stages and different sides. Both of the two experimental groups showed the same tendency, while the changes in the light force group were more obviously than the heavy force group. In the right side (force-loading side), the type II collagen expression decreased at the early force-loading period. After the device was removed, the expressions increased immediately but then reach the lowest level. The expression almost recovered to normal level at the end of experiment. In the left side (none force-loading side), the expression remained increasing after force-loading and reached the peak at the 14th day.

CONCLUSIONThese results suggest that even in the adult individuals, the chondrocyte showed reaction to the mechanical force by altering type II collagen expression patterns and it may be the cause of the cartilage remolding after asymmetric inter-maxillary traction. A forward elastic force showed a depressant effect in matrix synthesis, and heavy force had stronger effect. But the rotation of condyle accelerated the matrix synthesis.

Animals ; Cartilage ; Chondrocytes ; Collagen Type II ; Mandibular Condyle ; Rats ; Rats, Sprague-Dawley ; Traction