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.

AIMTo determine insulin and its related substances in insulin powder for inhalation by reversed phase high performance liquid chromatography method.

METHODSThe initial mobile phase was solution A (0.1% trifluoroacetic acid-acetonitril 70:30) and changed to solution B (0.1% trifluoroacetic acid-acetonitril 60:40) in 30 minutes. The flow rate was 2.0 mL.min-1, the column temperature was 30 degrees C, the wave length was 280 nm, the injected volume was 20 microL.

RESULTSInsulin was well separated from other peaks induced in different conditions. There was good linear relationship between the amount of insulin and its peak area, the RSD was 1.1%, the insulin solution for determination was stable in 12 hours, and the quantity detected was near the added.

CONCLUSIONThe method is simple and accurate to detect insulin and its related substances in insulin and its preparations.

Administration, Inhalation ; Chromatography, High Pressure Liquid ; methods ; Insulin ; administration & dosage ; analysis ; Powders ; analysis

OBJECTIVETo summarize the phenotypes and identify SCN1A mutations in families with generalized epilepsy with febrile seizures plus (GEFS(+)), and analyze the genotype- phenotype correlations in GEFS(+) families.

METHODGenomic DNA was extracted from peripheral blood lymphocytes of the proband and other available members in the GEFS(+) families. The phenotypes of the affected members were analyzed. The coding regions and flanking intronic regions of the SCN1A gene were screened for mutations using PCR and direct DNA sequencing.

RESULTIn 39 GEFS(+) families, there were 196 affected members, ranging from 2 to 22 affected members in each family. Their phenotypes included febrile seizures (FS) in 92(46.9%), febrile seizures plus (FS(+)) in 62(31.6%), FS or FS(+) with partial seizures in 12(6.1%), afebrile generalized tonic-clonic seizures (AGTCS) in 11(5.6%), myoclonic atonic epilepsy in 8(4.1%), Dravet syndrome in 2(1.0%), childhood absence epilepsy in 1 (0.5%), FS(+) with myoclonic seizures in 1(0.5%), AGTCS and myoclonic seizures in 1 (0.5%), partial seizures in 1 (0.5%), unclassified seizures in 5 (2.6%). Four families were found with SCN1A mutations, including three families with missense mutation (N935H, R101Q, G1382R) and one family with truncation mutation (C373fsx378). In three families with missense mutations, the phenotypes include FS, FS(+), FS(+) with partial seizures, and AGTCS. In one family with truncation mutation, the phenotypes included FS, FS(+), and Dravet syndrome. The mother of proband in the family with missense mutation (R101Q) and the father of proband in the family with truncation mutation (C373fsx378) were both somatic mosaicism. Both of their phenotypes were FS(+).

CONCLUSIONThe most common phenotypes of GEFS(+) were FS and FS(+), followed by the FS/FS(+) with partial seizures and AGTCS. The most severe phenotype was Dravet syndrome. SCN1A mutation rate in GEFS(+) was about 10%. Missense mutation was common in GEFS(+) families, few with truncation mutation. Few members of GEFS(+) families had somatic mosaicism of SCN1A mutations and their phenotypes were relatively mild.

Base Sequence ; Child, Preschool ; DNA Mutational Analysis ; Epilepsies, Myoclonic ; genetics ; Epilepsy, Generalized ; genetics ; Female ; Genotype ; Humans ; Infant ; Male ; Molecular Sequence Data ; Mutation ; genetics ; Mutation, Missense ; NAV1.1 Voltage-Gated Sodium Channel ; genetics ; Pedigree ; Phenotype ; Seizures, Febrile ; genetics

The positioning error in radiotherapy is one of the most important factors that influence the location precision of the tumor. Based on the CT-on-rails technology, this paper describes the research on measuring the positioning error in radiotherapy by comparing the planning CT images with the treatment CT images using 3-dimension (3D) methods. It can help doctors to measure positioning errors more accurately than 2D methods. It also supports the powerful 3D interaction such as drag-dropping, rotating and picking-up the object, so that doctors can visualize and measure the positioning errors intuitively.
Humans ; Imaging, Three-Dimensional ; Radiotherapy ; methods