ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.

ObjectiveTo investigate the effect of arterial stiffness on systolic deformation in hypertensive disease.MethodsSixty essential hypertensive patients were enrolled, including 25 cases with left ventricular normal geometric (group LVN) and 35 cases with left ventricular hypertrophy (group LVH) in the Affiliated Hospital of Qingdao University during July 2013 to March 2014. Thirty patients in the control group were enrolled in the same period. The peak systolic strains and strain rates were determined by using velocity vector imaging. Stroke volume was obtained by using real-time three-dimensional echocardiography. And pulse pressure/stroke volume was used as a surrogate index of arterial stiffness. Pulse pressure/stroke volume, the differences of strain and strain rate in three groups were compared by analysis of variance, and SNK-q test was used for further comparison between two groups. Multiple linear regression was performed to estimate predictors for systolic longitudinal deformation. Pearson?s correlation was used to analysis the relevance of systolic longitudinal strain and body mass index, triglyceride, left ventricular ejection fraction, age, left ventricular mass index, pulse pressure/stroke volume.ResultsPulse pressure/stroke volume were (1.26±0.45) mmHg·m2·ml-1, (1.53±0.59) mmHg·m2·ml-1, (1.82±0.43) mmHg·m2·ml-1 (1 mmHg=0.133 kPa) in the control group, LVN, LVH respectively. The systolic strains and strain rates in the control group, LVN, LVH were recorded as follows:systolic longitudinal strains were (23.60±1.94)%, (19.69±2.56)%, (17.34±2.48)%, the systolic longitudinal strain rates were (1.64±0.17) s-1, (1.52±0.14) s-1, (1.38±0.18) s-1; the systolic radial strains were (28.69±5.2)%, (30.81±4.14)%, (26.53±3.50)%, the systolic radial strain rates were (2.51±0.56) s-1, (2.60±0.45) s-1, (2.00±0.41) s-1; the circumferential strains were (24.50±5.21)%, (24.01±4.60)%, (21.00±3.70)%, the circumferential strain rates were (1.38±0.38) s-1, (1.30±0.30) s-1, (1.10±0.26) s-1. Pulse pressure/stroke volume was higher in LVN and was more pronounced in the LVH group compared with the control (LVN/LVH with the control group:q=2.90, 6.56, LVN with LVH:q=3.22, allP<0.05). The strains and strain rates in LVH were lower than those of LVN and the control group, and the differences were statistically significant. (longitudinal strains:q=15.22, 5.43; longitudinal strain rates:q=8.88, 4.54; radial strains:q=2.85, 5.36; radial strain rates:q=6.10, 6.81; circumferential strains:q=4.42, 3.61; circumferential strain rates:q=5.04, 3.42; allP<0.05). The strains and strain rates in LVN were lower than the normal group, the signiifcant differences of the longitudinal strains and longitudinal strain rates were found (q=8.73, 3.77, bothP<0.05) while there were no statistically signiifcant differences of radial strains and radial strain rates, circumferential rates and circumferential strain rates. In a multivariate analysis, LVMI and AS were found to be predictors for systolic longitudinal strain. Body mass index, triglyceride, left ventricular ejection fraction, age, left ventricular mass index and pulse pressure/stroke volume were negatively related to systolic longitudinal strain (r=-0.10,-0.09,-0.14,-0.42,-0.56, allP<0.05) by Pearson?s correlation, while LVEF was positively related to mean systolic longitudinal strain (r=0.13,P<0.05).ConclusionArterial stiffness is suitable as an predictor for left ventricular systolic deformation in hypertensive disease.

Objective To evaluate the efficacy of ancient classical prescriptions treating middle and advanced primary liver cancer.Methods Articles were searched from Pubmed, Embase, SCI, Cochrane Liarary and CNKI, VIP, WanFang Data, CBM databases. Randomized controlled trials about ancient classical prescriptions treating advanced primary liver cancer were collected. Results 17 studies were included, a total of 994 patients. The recent efficiency of ancient classical prescription combined with symptomatic therapy increased by 28% compared with single supportive and symptomatic therapy;the stable rate of life quality increased by 23%;the efficiency of TCM syndrome increased by 29%;the survival rates of 3 months, 6 months and 1 year increased by 16%, 36.7% and 58.5% respectively;the life quality score of later increased by 6.29 on average. Conclusion Ancient classical prescription combined with supportive and symptomatic therapy in advanced primary liver cancers is superior to single supportive and symptomatic therapy on recent efficiency, survival rate (3 months/6 months/1 year), quality of life and TCM syndrome. The conclusion of this study needs randomized controlled trials with larger samples, multicenter and high quality for further verification.

Objective To observe the effect of progressive resistance exercise combined with alendronate sodium on bone mineral density(BMD)of lumbar spine in patients with postmenopausal osteoporosis.Methods 20 patients with postmenopausal osteoporosis were randomly divided into the A and B group with 10 cases in each group.The cases of the group A were treated with progressive resistance exercises combined with alendronate sodium.Those of the group B only took alendronate sodium orally.The course of two groups was 3 months.BMD of lumbar spine was measured by dual-energy X-ray absorptiometry before and 3 months after treatment.Results Before treatment,BMD of two groups was not different.After 3 months treatment,BMD of lumbar spine were significantly improved in group A(raised 4.520±0.68%)than group B(raised 0.100±0.01%),there was a significant difference between two groups(P<0.01).Conclusion Progressive resistance exercises combined with alendronate is more efficacious than alendronate alone in restoring lumbar spine BMD in patients with postmenopausal osteoporosis.

Objective To explore the nursing experience of cerebral infarction patients with limb hemiplegia.Methods A total of 110 cerebral infarction cases with hemiplegia were randomly divided into nursing group and control group,given nursing intervention and conventional treatment,respectively.The Barthel index score and physical recovery condition before and after the nursing in two groups were compared.Results Nursing group had higher Barthel index score than treatment before,and showed a significant difference when compared to the control group (P ＜ 0.05);The recovery rate of physical activity ability was 91.0％ in nursing group,which was obviously better than 78.2％ in the control group (P ＜ 0.05).Conclusion Limb rehabilitation training,psychological nursing,nutritional support and electrical therapy for cerebral infarction limb hemiplegia patients can better improve hemiplegia and patients'quality of life.

Objective To explore the nursing experience of cerebral infarction patients with limb hemiplegia.Methods A total of 110 cerebral infarction cases with hemiplegia were randomly divided into nursing group and control group,given nursing intervention and conventional treatment,respectively.The Barthel index score and physical recovery condition before and after the nursing in two groups were compared.Results Nursing group had higher Barthel index score than treatment before,and showed a significant difference when compared to the control group (P ＜ 0.05);The recovery rate of physical activity ability was 91.0％ in nursing group,which was obviously better than 78.2％ in the control group (P ＜ 0.05).Conclusion Limb rehabilitation training,psychological nursing,nutritional support and electrical therapy for cerebral infarction limb hemiplegia patients can better improve hemiplegia and patients'quality of life.

Objective To explore the value of automated function imaging (AFI) based on two-dimensional speckle tracking imaging (2D-STI) technique longitudinal strain for predicting severe stenosis of left anterior descending (LAD) coronary artery in patients with suspected coronary heart disease (CHD).Methods Ninety-two patients with suspected CHD were divided into two groups according to the coronary angiography (CAG) results.There were 49 cases in group A (LAD stenosis rate ＜70％) and 43 cases in group B (LAD stenosis rate ≥70％).The two dimensional gray scale dynamic images were obtained in apical four-chamber view,apical two-chamber view and long axis of left ventricle (LV) view.Eighteen segments of LV longitudinal peak systolic strain,global longitudinal strain (GLS) and territorial longitudinal strain (TLS) supplied with LAD were measured with AFI software.The conventional ultrasonic parameters and the two-dimensional longitudinal strain parameters were compared between the two groups and ROC curve analysis of these parameters was used to predict LAD severe stenosis.Results There was no significant difference in the conventional ultrasonic parameters between the two groups (all P＞0.05).The group B had lower GLS,TLS than group A (both P＜0.001).GLS and TLS showed the highest area under ROC curve (0.715 and 0.705) for predicting LAD severe stenosis.The cut-off value,sensitivity and specificity for predicting LAD severe stenosis were-19.58 ％,63.3 ％,67.4 ％ in TLS,and-20.85 ％,74.4 ％,61.2 ％ in GLS respectively.Conclusion The longitudinal strain parameters measured with AFI based on 2D-STI technique can be used to predict LAD severe stenosis in patients with CHD,and GLS is more sensitive than TLS.

Objective To explore the effects of mirror therapy on the lower-limb muscles of hemiplegic stroke survivors. Methods Sixty-two hemiplegic stroke survivors were divided by stratified random grouping into a mirror group and a control group, each of 31. Both groups accepted routine rehabilitation training, while the mirror group was additionally provided with mirror therapy to train the non-paretic limb for 30 min per day, 5 days a week, lasting 4 weeks. Before and after the 4 weeks of training, integrated electromyography was performed and the maximum voluntary contraction force (MVC) of the tibialis anterior, rectus femoris and biceps femoris of the paretic limb were recorded and compared. Results Compared with before the training, the average root mean square values of the electromyographs and the average MVCs of all three muscles had improved significantly in both groups after training. Compared with the control group, the improvements were significantly greater in the mirror group. Conclusion Mirror therapy can promote the activation and synchronization of motor units, as well as increase the number discharging and the total discharge, promoting the recovery of muscle strength.

Objective To analyze territorial and global longitudinal layer-specific strain of left ventricle by two-dimensional speckle tracking imaging (2D-STI) in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) and to explore the value of layer-specific strain parameters for prediction of significant coronary artery stenosis. Methods Seventy-five patients with suspected NSTE-ACS in People′s Hosptial of Subei from September 2016 to January 2017 were enrolled and all patients underwent coronary arteriography (CAG). Among them, there were 24 subjects in control group (coronary artery without stenosis or stenosis rate <50%) and 51 subjects in coronary atherosclerotic heart disease group (coronary heart disease, CHD). According to whether coronary artery occlusion, the CHD group was divided into coronary stenosis group (32 subjects) and coronary occlusion group (19 subjects). Using EchoPAC software, two-dimensional dynamic images were analyzed to obtain left ventricle 18-segment systolic longitudinal layer-specific strain and to calculate the territorial longitudinal strain (TLS) of endocadium, mid-myocardium and epicardium (TLSendo, TLSmid, TLSepi) and left ventricle global longitudinal strain (GLS) of endocadium, mid-myocardium and epicardium (GLSendo, GLSmid, GLSepi). The differences of left ventricle territorial and global longitudinal layer-specific strain parameters among 3 groups were compared by one-way analysis of variance and the differences between two groups were compared by LSD-t test. The receiver operating characteristic (ROC) curve of each parameter was constructed to predict significant coronary stenosis by using the results of CAG as the gold standard. Results Compared with control group and coronary stenosis group, TLSendo, TLSmid, TLSepi and GLSendo, GLSmid, GLSepi all decreased in patients with coronary occlusion, and the differences were statistically significant (coronary occlusion group vs. control group: t values were -5.819, -5.049, -4.845, -5.955, -5.036 and -4.724, respectively, P values were all less than 0.01;coronary occlusion group vs.coronary stenosis group:t values were-2.983,-3.059, -2.903, -2.989, -3.192 and -3.387, respectively, P values were all less than 0.01). And compared with control group, only TLSendo and GLSendo decreased in patients with coronary stenosis, and the differences were statistically significant (t values were -3.981 and -4.164, respectively, P values were all less than 0.01). TLSendo, TLSmid, TLSepi and GLSendo, GLSmid, GLSepi showed a gradient decrease in all 3 groups, but only in the control group the comparison between two of the three layers showed statistically significant differences(TLSepi vs. TLSendo,GLSepi vs. GLSendo:t values were both-10.083,P values were all less than 0.01;TLSepi vs.TLSmid,GLSepi vs.GLSmid:t values were both-4.559,P values were all less than 0.01;TLSmid vs.TLSendo,GLSmid vs.GLSendo:t values were both-5.549,P values were all less than 0.01). The absolute differences between endocardial and epicardial TLS and GLS (?TLS and?GLS) decreased gradually from the control group, to coronary stenosis group and to coronary occlusion group,and the differences were statistically significant(coronary occlusion group vs.control group:t values were 6.915 and 7.489, respectively, P values were all less than 0.01; coronary stenosis group vs. control group: t values were 4.923 and 7.202, respectively, P values were all less than 0.01; ?TLS of patients in the coronary occlusion group vs.coronary stenosis group:t value was 2.250,P value was less than 0.05),which reflected a pronounced decrease in endocardial function. By ROC curve analysis, GLSendo and TLSendo showed the highest area under the curve in predicting significant coronary artery stenosis, which were better than strain parameters of mid-myocardium, epicardium and the entire wall thickness of the myocardium. Conclusions Left ventricle showed systolic dysfunction in all three layers in suspected NSTE-ACS patients with CHD, especially the endocardium. The longitudinal layer-specific strain parameters by 2D-STI can be used for quantitative evaluation of the territorial and global systolic dysfunction differences of left ventricle in all layers in suspected NSTE-ACS patients with CHD, which can also be used for prediction of significant coronary artery stenosis.

Objective To investigate the difference of styrofoam and breast carrier in postposition fixation of intensity-modulated radiotherapy after breast conservative surgery for breast cancer patients.Methods From February 2018 to August 2018,tweenty-four patients with breast cancer in Sun Yet-Sen Memorial Hospital of Sun Yet-sen University were selected for this study,who underwent hypofactionationed radiotherapy after breast conservative surgery with total dose 42.56 Gy/16Fractions.They were randomized into styrofoam test group and breastcarrier control group.Cone beam CT as used to record the positioning error under the directions of left and right (x),head and foot (y),abdomen and back (y) within two groups at the first,third,fifth,seventh,eleventh time before irradiation.Furthermore,the PTV extension margin was calculated and the positioning time of two groups was recorded.Two sets of pendulum errors were analyzed by independent sample T-test,and the outspread value of inter-fractional set up error of the PTV was calculated.Results The errors of the test group and the control group in the direction of x,y,z were as follows:(2.36±1.89) and (2.56±2.05) mm (P=0.49),(1.76± 1.78) and (3.28±2.79) mm (P＜0.05),(1.47± 1.49) and (1.73± 1.81) mm (P=0.28).The extension values of inter-fractional set up error of CTV to PTV were 2.97,2.92,2.21 mm and 3.41,4.09,2.59 mm respectively.The time of single positioning was (3.4± 1.1) and (5.5 ± 3.1) min respectively (P=0.01).Conclusion Styrofoam has better positioning accuracy and efficiency compared with breast carrier.