Two hundred and forty patients with post-stroke hemiplegia, discharged from October 2009 to January 2010, were randomly divided into two groups. One hundred twenty patients received home-based rehabilitation training, another 120 patients received conventional treatment and non-specific home rehabilitation. Brunnstrom rating and Barthel index ( BI) evaluation of motor function and activities of daily living (ADL) were performed in both groups before and after training program; Hamilton anxiety scale (HAMA) , Hospital Anxiety and Depression Scale (HAD) Assessment of anxiety and depression were also performed. Results showed that the lower limb function and ADL ability in home rehabilitation group were significantly increased, the anxiety and depression were significantly improved after home rehabilitation training ( P < 0. 005 ) ; but those indicators in control group were not significantly changed ( P > 0. 05 ).

Objective:To observe the effect of Chinese herbal fumigation combined with three-step tuina manipulation on concentration of endothelin (ET) and calcitonin gene-related peptide (CGRP) and vertigo in patients with vertebral artery cervical spondylosis (VACS).
Methods:A total of 120 eligible cases were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Chinese herbal fumigation combined with three-step tuina manipulation, whereas cases in the control group were treated with oral Flunarizine Hydrochloride Capsules.
Results: After treatment, vertigo in both groups was alleviated; there were intra-group significant differences in ET decrease and CGRP increase (P<0.01, P<0.05);and there were also inter-group significant differences (both P<0.05).
Conclusion: Chinese herbal fumigation combined with three-step tuina manipulation can regulate the levels of ET and CGRP and improve vertigo in patients with VACS. Its therapeutic efficacy is superior to oral Flunarizine Hydrochloride Capsules.

AIM:To investigate the relationship between the thrombin-activatable fibrinolysis inhibitor (TAFI) level in plasma and atherosclerosis, the TAFI level in plasma and blood fat and blood clotting index.METHODS: Totally 40 healthy male Wistar rats were randomly divided into 4 groups (n=10), control group, high lipid group, high lipid +vitamin D3 overload group, and high lipid +vitamin D3+endothelium injure group by treating the animals with normal diet, high lipid, high lipid+ vitamin D overload, and high lipid+vitamin D overload+endothelium injury, respectively, for inducing three stages of AS in rats. Then, the total cholesterol (TC), total triglyeride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), and prothrombin time (PT), activated partial thromboplasin time (APTT), fibrinogen (Fib), the activity of TAFI were measured.RESULTS: TC, TG, LDL-C, Fib and the activity level of TAFI in plasma in three model groups increased gradually compared with the control (P

Objective To discuss the early stage treatment of reduction and the curative effect in coxa dislo- cation with acetabular fracture. Methods According to the different type of coxa dislocation with aeetsbular frac- ture,22 patients were given the distinctive operation and drawn reduction. As to 22 cases combination with acetabu- lar fracture and basis of difference type of the fracture were selected the method of suitable operative entrance or in- ner fixation. In this gronp,22 patients were followed up about 6 month to 3 years(average 15.3 months) after opera- tion. According to the standard of America orthopedic surgery study were commented on curative effect. Results Excellent 15 cases,well 4 casea,pass 2 cases,bad 1 case. Total fine rate were 86% .Conclusion Each kinds type of the hip dislocation cases should needed emergency reduction. The operation treatments were selected first method to settlement the bone shatter displacement in acetabular fracture or unsuitable joint and unsteady joint.

Objective To explore the changes of MR diffusion imaging (DWI) appearance in newborn rats with hypoxic‐ischemic brain damage(HIBD) ,and its relationship with the changes of Triphenyl tetrazolium chloride (TTC) staining .Methods Using liga‐tion of the left carotid artery method to establish three different degrees of HIBD animal models ;DWI was performed at each time point(6-12 h ,12-24 h ,3 d ,7 d);Fresh brain tissue taken from another model groups of newborn rats in 12 h ,24 h ,3 d ,7 d were staining in TTC ,then we observed its relationship with DWI .Results The lesion location of three model groups mainly distributed in the left side of cortex and subcortical region ,with prolonged hypoxia time ,hippocampus ,lateral side white matter ,thalamus were also have varying degrees of involvement .The right side of the cortex and subcortical in some cases involved .TTC staining showed posi‐tive results in 3 d ,its loss stained area were consistent with DWI abnormal signal area .Conclusion DWI can be evaluation of HIBD lesions early .The early lesions of HIBD mainly distributed in the left side of cortex and subcortical region .

Objective To evaluate the correlation between spiral CT ( SCT ) features and expression of cyclooxygenase-2 , nm23 in esophageal carcinoma.Methods Spiral CT scans were preformed in 44 patients with esophageal carcinoma before operation, and the results were compared with that of operation and pathology. Immunohistochemical streptavidin peroxidase conjugate method was used to analyze the expression of Cox-2 and nm23 in esophageal carcinoma. Statistical analysis was performed with SPSS 12.0 software. Results (1) The accuracy of spiral CT scan in judging adjacent- infiltration and lymph node metastasis in 44 patients was 88.6%(39 of 44) and 90.9% (40 of 44) respectively,there was significant coincidence with operation and pathology(P

Objective To investigate the clinicopathologic characteristics and prognosis of triple negative breast cancer patients. Methods A retrospective analysis was performed for 1042 primary breast cancer patients admitted in the First Affiliated Hospital of Nanjing Medical University from January 2003 to December 2009.All breast cancer patients were categorized into three subgroups by immunohistochemistry:ERBB2 +,HR +/ERBB2 - and triple negative. Results Of 1042 breast cancer patients recruited,183 patients were in triple negative group.The rate of larger tumors ( greater than 2 cm in diameter) and grade Ⅲ in triple negative patients was higher than that in ERBB2 + and HR +/ERBB2 - patients (P ＜0.01 ).The positive rate of p53 status in ERBB2 + patients was higher than that in triple negative and HR +/ERBB2- patients (P ＜ 0.01 ).No significant differences were observed in other clinical variables.In survival analysis,more bone metastases were observed in HR +/ERBB2 - patients than in ERBB2 + and triple negative patients (P =0.006).However,no significant difference was observed in visceral metastases among the subgroups.There were significantly different recurrence-free survivals (RFS) among the three subgroups throughout the follow-up period ( P =0.029),the 5-year RFS of ERBB2 + was 80.3％,which was the worst in three groups. Conclusions Triple negative patients had higher rate of larger tumors (greater than 2 cm in diameter) and grade Ⅲ than that in ERBB2 + and HR +/ERBB2 - patients,while its 5-year RFS was higher than ERBB2 + patients.

ObjectiveTo study the scope of excison in breast-conserving surgery for breast carcinoma.MethodsClinical data of 275 breast cancer patients undergoing breast-conserving surgery in t he First Affiliated Hospital of Nanjing Medical University,the Affiliated Zhenjiang Hospital of Jiangsu University and Changzhou Traditional ChineseMedicine Hospital were retrospectively analyzed.The operation procedure and postoperative adjuvant therapy were carried out with the same protocol.Local and general conditions of patients were followed up regularly.Results271 out of 275 patients got follow-up.The follow-up rate was 98.5％.The follow-up time ranged from 1 month to 117 months,median follow-up time was 34 months.Six patients died of distant metastasis,2 with local recurrence.The 1-year,3-year,and 5-year overall survival rates were 99.5％,98.1％,and 95.7％,respectively.ConclusionsIt is safe to excise 1 cm normal breast tissue with clear margin confirmed by frozen section,followed by postoperative adjuvant therapy,endocrine therapy,and radiotherapy,this improves the life quality of patients with breast cancer.It is safe and effective to determine whether the disease is multicentric or multifocal by mammogram plus clinical breast examination.

Objective To assess the value of primary resection and anastomosis without intraoperative irrigation in the patients with obstructive left colonic cancer. Method Between January 2000 and January 2008, 93patients underwent primary resection and anastomosis for colonic cancers were analyzed retrospectively. Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) was performed in 43 patients with obstructive left colonic caner and traditional left-sided colectomy in 50 cases without obstruction. Both groups of patients were comparable in terms of gender, nutritional status, underlaying disease, tumor location and stage, etc ( P = 0.83,0.13,0.29,0.51,0.38). The average age of the patients with colonic obstruction was significant older than that of the cases without obstruction (61.2 ± 8.6 vs. 58.1 ±7.8, P =0.010).The operative results were compared between patients with obstructive colonic cancer and cases without obstruction.Results The mean hospital stay of the primary anastomosis group and traditional left-sided colectomy group were (16.6±7.8) d and (12.4±5.4) d respectively, and the former was significant longer than the latter (P =0.002). The costs of hospitalization in the two groups were (50192.8 ± 39727.4) RMB and (46489.3 ±29543.1)RMB respectively (P = 0.04) . The morbidity and mortality in the two groups were 25.6% (11/43) vs. 18%(9/50) (P =0.375) and 2.3% (1/43) vs. 2.0% (1/50) (P =0.714) respectively, and there were no significant difference between the two groups. Conclusions Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) compares favorably with traditional left-sided colectomy in safety and efficiency for left colonic cancer with obstruction.

Objective To assess the value of primary resection and anastomosis with intraoperative colonic defecation in the patients with obstructive left colonic cancer. Methods From January 2000 to January 2008, 39 patients undergoing emergency laparotomy for left colonic cancers with complete obstruction were analyzed retrospectively. Results The patients were 25 males and 14 females, with a median age of 68.5 years (range: 57～78 years). The primary tumors were located at splenic flexure (3/7.7%), descending colon (8/20.5%), sigmoid colon (15/38.5%), boundary of sigmoid colon and rectum (8/20.5%), and superior segment of rectum (5/12.8%). Primary resection and anastomosis with intraoperative colonic de-fection were performed in 18 patients with left hemicolectomy, 13 patients with sigmoid colectomy and 8 pa-tients with anterior resection. Early complications included wound infection in 4 patients (wound disruption in 1 patient) and pulmonary infection in 5 patients. One patient complicated with anastomotic leakage and intra-abdominal abscess died of tumor metastasis after reoperation. Another one died of respiratory failure secondary to pulmonary infection. Morbidity and mortality was 25.6% and 5.1% respectively. Conclusion Primary resection with intraoperative colonic defecation can be applied to patients with malignant colonic complete obstruction with good operative results.