ObjectiveTo study the effects of early rehabilitation on symptom, range of motion (ROM) and motor function of upper extremity of patients with shoulder-hand syndrome after stroke.Methods47 patients were divided into two groups,early rehabilitation group and non-early rehabilitation group.Two groups were treated with comprehensive rehabilitation. The passive ROM, the pain and motor function of affected limb was assessed by Fugl-Meyer Assessment.The evalution was done in pre-treatment and post-treatment respectively. Results1.The passive ROM decreased and the pain of affected limb of the early rehabilitation group were less than the non-early rehabilitation gronp when the shoulder-hand syndrome occour.2.After comprehensive rehabilitation treatment,their clinical symptom ROM and motor function of upper extremity impoved significantly in patients with shoulder-hand syndrome after stroke( P<0.05).The early rehabilitation treatment has better effects. Conclusions The early rehabilitation treatment could decrease the degree of their passive ROM decrease and the pain of affected limb in patients with shoulder-hand syndrome after stroke,and the patients who accepted earlyrehabilitation seemed easly to improve by comprehensive treatment.

OBJECTIVETo explore the effect of Qiling Decoction (QD) combined highly active antiretroviral treatment (HAART) on expression levels of peripheral blood Th17 and Treg cells in HIV/AIDS patients.

METHODSTotally 55 HIV/AIDS patients were randomly assigned to the treatment group (28 cases) and the combination group (27 cases). Besides, 21 HIV negative patients were recruited as the healthy control group. Those in the treatment group received HARRT alone, while those in the combination group received HAART combined QD. The observation lasted for 24 weeks. Meanwhile, according to peripheral blood CD4+ T cell counts before treatment, HIV/AIDS patients were assigned to three subgroups. For patients in subgroup 1, 1 cells/microL < CD4+ T cell counts < or = 100 cells/microL; For patients in subgroup 2, 101 cells/microL < CD4+ T cell counts < or = 200 cells/lL; For patients in subgroup 3, 201 cells/microL < CD4+ T cell counts < or = 350 cells/microL. Expression of peripheral blood Th17 and Treg cells, and number of CD4+ T cell counts were detected using flow cytometry (FCM)in HIV/AIDS patients at the pre-treatment baseline, week 4, 12, and 24, as well as those in the healthy control group.

RESULTSCompared with the healthy control group, CD4+ T cell counts and the baseline expression level of Th17 cells in the peripheral blood of HIV/AIDS patients significantly decreased, the expression level of Treg cells significantly increased P < 0.01). Compared with before treatment in the same group, CD4+ T cell counts all increased at week 4, 12, and 24 in the two treatment groups, showing statistical difference (P < 0.05, P < 0.01). There was no statistical difference in the effective rate at various CD4+ T cell levels between the two groups (P > 0.05). There was no statistical difference in expression levels of Th17 and Treg cells between the combination group and the treatment group at any time point (all P >0.05). The Th17/Treg ration significantly increased in the combination group after 24 weeks of treatment, showing statistical difference when compared with the treatment group (U = 2.135, P = 0.038).

CONCLUSIONQD could improve the immune balance of Th17/Treg cells, which might be one of its mechanisms for improving HIV/AIDS patients' immunity.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; Adult ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; HIV Infections ; drug therapy ; immunology ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

OBJECTIVETo investigate the feasibility of using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people.

METHODSFrom June 2011 to May 2013, 91 patients with closed and fresh Barton fracture were analyzed retrospectively which information was complete. According to different methods these patients were divided into three groups: 33 patients in group A were treated by simplex fixation of gypsum or splint after manipulative reduction, including 20 males and 13 females with an average age of (63.27 ± 5.83) years old; 35 patients in group B were treated by percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation, including 23 males and 12 females with an average age of (64.25 ± 4.53) years old; 23 patients in group C were treated by open reduction and internal fixation including 15 males and 8 females with an average age of (64.04 ± 4.83) years old.

RESULTSAll the patients were followed up for 10 to 16 months with an average of 12 months by the method of recheckging in outpatient clinic. According Dienst scoring system: in group A, the result was excellent in 15 cases, good in 7 cases, fair in 11 cases; in group B, excellent in 25 cases, good in 6 cases, fair in 4 cases; in group C, excellent in 16 cases, good in 5 cases, fair in 2 cases. The excellent and good rate of group C was better than that of group B and A, further more group B is better than group A. According to X- ray standard, in group A, 26 patients were acceptable, 7 patients were unacceptable; in group B,28 patients were acceptable, 7 patients were uacceptable; in group C, 19 patients were acceptable,4 patients were unacceptable; there were no statistical significant difference (P > 0.05). There were 18 patients with emerging recrispation in group A, 10 patients in group B, 6 patients in group C, the result of group B and C was better than that of group A, and there was no statistically significant between group B and C (P > 0.05).

CONCLUSIONUsing percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people is an effective method, it has advantages of micro-invasived, reliable fixation, less complication, not need to fix wrist joint and early functional exercise.

Aged ; Bone Wires ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Radius Fractures ; therapy ; Retrospective Studies ; Splints

Interaction teaching model of teaching and studying exchanging,simulation scenes,and clinical scientific research training were developed in medical interns.With the helps of such teaching model,rapid progresses of studying interests,activi- ties,and abilities were found in such pediatric interns.Under grasping basic pediatrics knowledge according to teaching program, they all have multiple abilities of clinical practices,medical teaching,and scientific research to a degree.The interaction teaching model which regards student as principal part plays a very important role in the development of pediatric probation quality.

Objective To prepare controlled release microspheres of vascular endothelial growth factor(VEGF)& calcium alginate and observe their effect on proliferation of human umbilical vein endo- thelial cells(HUVEC)in order to provide theoretical basis for controlled release of VEGF facilitating an- giogenesis of tissue engineering bone.Methods VEGF-calcium alginate microspheres were prepared by using the needle extrusion/external gelation method to investigate physicochemical character and in vitro release of VEGF.According to the different ingredients added into the culture medium,the seconda- ry cultured HUVEC were divided into four groups,ie,control group,microsphere group,VEGF group and VEGF-calcium alginate microsphere group,in which the proliferation of the cultured HUVEC was ob- served with cell counting method,MTT method and flow cytometry.Results The calcium alginate mi- crospheres were revealed as spherical shape and evenly distributed,with mean grain diameter of(560?50)?m,carrying capacity of 0.72 ng/mg and the encapsulation efficiency of 54%.Smooth controlled re- lease in VEGF-alginate microspheres lasted for more than 10 days.Proliferation of the cultured HUVEC was accelerated the most in VEGF group at the beginning but in EGF-calcium alginate microsphere group at midanaphase compared with other groups,with statistical difference(P＜0.05).There was no statis- tical difference upon cell counting,cell activity and time point of cell cycle between control group and mi- crosphere group.Conclusion VEGF-sodium alginate microapheres can continue activity of VEGF,re- lease VEGF for over 10 days and promote proliferation cultured HUVEC for a long time.

The role of general practitioners in the UK was analyzed and we found that in the UK, there was normalized general medical education system, perfect general practitioner training sys-tem, specific responsibilities and assessment index, close liaison group between primary and secondary care, strong economic supporting measures and high degree of recognition. Therefore, to deepen med-ical reform and improve basic medical service, we must accelerate general practitioners training, im-prove practice ability of general practitioners, establish the first-treatment system in community, reit-erate role of gatekeeper, enhance the payment of general practitioner and increase their sense of iden-tity. At the same time, we must strengthen the informatization construction, set up the first-treatment in the community and the patency of two-way referral system.

Objectives To investigate the changes of erythropoietin(EPO)expression in rats after focal cerebral ischemia/reperfusion injury.Methods Male Sprague-Dawley rats were randomly divided into normal,sham,cerebral ischemic/reperfusion(CIR)groups.Middle cerebral artery occlusion(MACO)model was established by Longa's method,and reperfusion was followed 2 hours after occlusion in CIR group.The rats' brain neurological deficit scores were evaluated at 24 h,48 h,72 h and 96 h after reperfusion.The protein expression of EPO was determined by immunohistochemistry staining and Western blotting in each time points.Results The rats' brain neurological deficit scores at 48 h,72 h and 96 h were significantly increased(3.40±0.32,3.60±0.17,3.70±0.21,all P<0.05)compared with those at 24 h(3.00±0.22)after reperfusion in CIR group.The results of immunohistochemistry staining and Western blotting showed that the positive expression of EPO proteins in rats started at 24 h(0.36±0.05,140.20±0.30)after cerebral ischemic/reperfusion injury,increased significantly at 48 h(1.09±0.10,145.40±0.16),reached the peak at 72 h(1.29±0.09,156.23±0.12),began to decline at 96 h(0.98±0.04,141.56±0.36).Conclusions Cerebral ischemia and reperfusion injury can induce increased expression of EPO protein,which suggests that EPO may have protective effect on nerve cells under the condition of ischemia and reperfusion.

Objective To investigate status and epidemiological characteristics of Mycoplasma pneumoniae (MP) infection in hospitalized children with respiratory tract infections from 2007 to 2013 in Suzhou region .Methods MP was determined by fluores‐cence quantitative polymerase chain reaction(PCR) in 34 332 sputum specimens of hospitalized children with respiratory tract infec‐tions in the Children′s Hospital Affiliated to Soochow University from 2007 to 2013 .Results The total detection rate of MP was 19 .01% in children with respiratory tract infections in Suzhou from 2007 to 2013 .Annual MP infection rates from 2007 to 2013 were 5 .45% ,6 .95% ,14 .06% ,18 .51% ,4 .85% ,25 .94% and 28 .68% respectively ,among which the infection rates of MP in 2012 and 2013 were significantly higher than that in other years (P<0 .05) .The infection rates of MP in female children(21 .01% )was higher than that in male children(17 .81% ) ,there was statistically significant difference(P<0 .05) .The infection rates of MP in children <1 years old ,1- <4 years old ,4- <7 years old and 7-14 years old were 8 .88% ,18 .05% ,35 .28% and 52 .39% respec‐tively ,and significant differences of infection rates of MP were observed among the age groups(P<0 .05) .The infection rates of MP in spring ,summer ,autumn and winter were 15 .96% ,28 .38% ,21 .71% and 11 .01% respectively ,and significant differences of in‐fection rates of MP were observed among the seasons(P<0 .05) .Conclusion MP is one of the most common pathogens responsible for respiratory tract infection in children ,which shows gender ,age and season differences in infection rate .Children aged 7 to 14 years old are susceptible to be infected by MP in summer and autumn ,especially in July and August ,so it is necessary to strengthen the prevention of MP infection .

BACKGROUND:ABO-incompatibility between donor and recipient is not a barrier for Successful allogeneic hematopoietic stem cell transplantation even though it is well established that major ABO incompatibility may lead to prolonged destruction of donor-derived erythrocytos and prolonged transfusioil requirements.OBJECTIVE:To explore the effect of ABO.incompatible on clinical characteristics in allogeneic-hematopoietic stem cell transplantation.DESIGN:A retrospective observation.SETTING:Department of Hematology.the Affiliated Drum Tower Hospital of Nanjing University Medical School.PARTICIPANTS:Fourteen patients(11 males and 3 feiliales,aged 15-60 years old)with malignant hematologic diseases who received ABO-incompatible allogeneic hematopoietic stem cell transplantation in the Affiliated Drum Tower Hospital of Nanjing University Medical School from May 2002 to September 2007 Were recruited for this study.Of the 14 patients,7 were human leukocyte antigen(HLA).matched,and the other 7 were HLA-half-matched.Controls were 11 patients who received ABO-compatibility bone marrow transplantation during the same period.Written informed consents for receiving allogeneic hematopoietic stem cell transplantation were obtained from each reciplent.The donors were sibling sister,sibling brother.son and mother,and they all agreed to provide marrow for transplantation.T1lis experiment was given an approval by the Ethics Committees of the hospital.METHODS:Regimen conditioning:HLA-matched transplantation regimen conditioning consisted of busulfan(Bu)and cyclophosphamide(Cy).HLA-half-matched transplantation regimen conditioning adopted GIAC program from Beijing People's Hospital.The GIAC program consisted of 4 parts:G:granulocyte colony-stimulating factors used for donors;I:stronger immunosuppressive regimen conditioning used for recipients;A: antihuman thymocyte globulin added:C: combined transplantation of bone marrow and peripheral blood;Perfusion of hematopoietic stem cells:The marrow from ABO-incompatible donor depleted erythrocytes by hydroxyethyl starch sedimentation.MAIN OUTCOME MEASURES:Adverse reaction.complication and hematologic recovery after ABO-incompatibility stem cell transplantation.RESULTS:One out of fourteen recipients developed pure red cell aplasia(PRCA)and dropped out of final analysis.Hematologic recovery:The median time of erythrocyte recovery after ABO-incompatible stem cell transplantation was delayed compared with ABO compatible stem cell transplantation (t=2.352.P＜0.05).There were no significant difieFences in the recovery of neutrophils and platelets between ABO-incompatible group and ABO-compatible group(P＞0.05).The median time of recovery of the erythrocyte and the blood type switching was delayed in HLA-mis-matched allogeneic hematopoietic stem cell transplantation compared with HLA-matched allogeneic hematopoietic stem cell transplantation,but without significant difference(P＞0.05).Complications:During the stem cell transfusion following transplantation.none of 14 Patieats had hemolytic complications or delayed haemolysis.CONCLUSION:There was no evidence of ABO-incompatibility between donor and recipient is a barrier for successful allogeneic hematopoietic stem cell transplantation.

Objective To construct cDNA entry library and cDNA expression library of Armillifer agkistrodontis (A.) nymphs and make a preliminary immunoscreening for the cDNA expression library.Methods The nymphs were collected from the Kunming mice infected experimentally with A.agkistrodontis eggs and the total RNA were extracted from the nymphs using TRIzol Reagent.After purifying the mRNA,the synthesized cDNAs were cloned into the donor vector pDONR222 by BP reaction of Gateway technology and the recombinants were transformed into the DH10B cells by electroporation,the cDNA entry library was obtained.Next,the expression vector pDEST17 was ligated with entry clones by LR reaction,and the recombinants were transformed into the BL21 (DE3) cells.Hence,the cDNA expression library was constructed.Then,the expression library was immunoscreened with the mixed sera of mice infected with A.agkistrodontis,and the insertions of positive clones were sequenced.After that,the open reading frame(ORF) of positive slone sequence,the homology of the screened genes and their encoded proteins were analyzed by Finder and BLAST (basic local alignment search tool) program of National Center of Biotechnology Information(NCBI),and the discovered new genes were submitted into the GenBank.Besides,the physico-chemical properties,secondary structure and B cell epitopes of encoded proteins were also analyzed by bioinformatics software.Results The average titer and total clones of the cDNA entry library were 1.45 × 105 CFU/ml(colony-forming unit,CFU) and 1.74 × 106 CFU,respectively,and the range of fragment length of the inserted cDNA was between 0.2-4.0 kb,with an average of 1.4 kb.The total clones of cDNA expression library were 1.00 × 105 CFU,and the fragment length of the inserted cDNA was between 0.3-2.2 kb,with an average of 1.0 kb.Five positive clones,coded S1,S5,A1,D1 and F1,respectively,were obtained through preliminary immunoscreening.The sequence and homology of the five positive clones were sequenced and analyzed by BLAST program.No significant similarities were found in pentastomida species,which meant that they were all novel genes of A.agkistrodontis.The gene sequences were submitted to GenBank,with the accession number from JQ180451 to JQ180455.Also,results obtained by bioinformatics software showed that the predictive encoding proteins were all potential to be valuable recombinant diagnostic antigens.Conclusions The cDNA library of A.agkistrodontis nymphs is successfully constructed,and five new genes of A.agkistrodontis are discovered.The establishment of cDNA library and the discovery of the new genes will lay a foundation for further studying the gene functions and screening the immunodiagnostic antigens.