Objective To explore the functional impairment characteristics of acute stroke patients and cor- relate them to the functional independence after rehabilitation therapy. Methods Seventy-nine inpatients with stroke were divided into hemorrhage group and infarct group according to their condition.They are assessed by using measures of ESS,MBI,MMSE,Sheikh,Fugl-Meyer Balance and Fugl-Meyer motor assessment before rehabilitation treatment.After 1 month of treatment,all the patients were evaluated again using FIM.Correlation analysis was con- ducted with all the parameters. Results It was found that patients in the hemorrhage group scored lower with MBI, Sheikh,Fugl-Meyer Balance and FIM than those in the infarct group (P

Purpose To analyze the imaging manifestations of solitary fibrous tumors (SFT) so as to improve its diagnosis. Materials and Methods The CT and MRI findings of 24 patients with SFT confirmed pathologically were analyzed retrospectively and compared respectively with their pathological results in terms of lesion's location, size, shape, density (signal), type of enhancement and relationship with the surrounding tissues. Seven patients underwent MRI scan, 5 were with enhanced scan; 17 patients were carried out plain CT scan and 11 were with enhanced CT scan. Results The lesions in the 23 cases were solid and 1 was solid and cystic. Through the imaging diagnosis, 20 cases were diagnosed as benign tumors, 2 cases were diagnosed as malignancies, and 2 benign tumors were misdiagnosed, which showed that the diagnose accordance rate was 91.7%(22/24). On plain CT scans, 5 lesions (maximum diameter<4 cm) showed homogeneous density; 7 cases (maximum diameter>5 cm) showed heterogeneous density, 4 of which had calcification and 7 had necrosis; the shapes were round-like or lobulated. On enhanced CT scans, 5 cases presented progressive enhancement pattern, 5 cases showed fast-in and slow-out pattern, 1 case showed slight enhancement pattern. On MRI scan, 4 cases of the solid part of tumors showed isointensity signals on T1WI and isointensity or slight hyperintensity signals on T2WI, 3 cases showed isointensity or low signals on T1WI and low, isointensity or slight hyperintensity signals on T2WI, and slight hyperintensity signal on DWI, the solid part of tumors were strongly enhanced. Two malignant tumors presented features like heterogeneous density, unclear boundary, invasive growth and progressive enhancement pattern. The pathological findings demonstrated that the tumor tissues mainly consisted of spindle cells with rich fibers and vessels. Conclusion The imaging findings of benign and malignant SFT have certain features, malignant SFT have invasive growth signs. The obvious progressive enhancement of solid component which shows isointensity and hyperintensity on T1WI or T2WI may be helpful in the diagnosis of SFT; however, the final diagnosis should be confirmed with histopathology.

OBJECTIVETo search for the optimal strategies for sperm collection from the patient with temporary penile erectile dysfunction (ED) on the day of oocyte pick-up ( OPU) in in vitro fertilization embryo transfer (IVF-ET).

METHODSWe retrospectively analyzed 93 cases of temporary ED on the OPU day of IVF-ET from January 2011 to May 2014, with fresh semen for 45 cases (group A), cryopreserved sperm before oocyte retrieval for 30 cases (group B), and frozen oocytes for 18 cases (group C). Group A was again subdivided into A1 (n = 18) and A2 n = 27) , the former intervened with oral sildenafil while the latter left untreated. We compared the rates of fertilization, high-quality embryo, and pregnancy among different groups.

RESULTSNo statistically significant differences were found among groups A, B and C in the age of the males and females, duration of infertility, numbers of obtained and mature oocytes, and rates of cleavage, or in the percentages of normal fertilization (80.78% vs 80.43% vs 84.77%), high-quality embryo (53.27% vs 52.97% vs 47.69%) and pregnancy (60.00% vs 56.77% vs 44.44%) (all P > 0.05). The rate of 3PN was markedly lower in group C (0.63%) than in A (9. 61%) and B (4.34%) (P < 0.05). There were no significant differences between groups A1 and A2 in the age of the males and females, duration of infertility, numbers of obtained and mature oocytes, and the rates of fertilization, cleavage, high-quality embryo, and pregnancy (all P > 0.05).

CONCLUSIONOn the OPU day of IVF-ET, oral sildenafil can help temporary ED men to achieve penile erection and ejaculation without affecting the outcomes of assisted reproduction. Cryopreserved sperm can be used in case of predicted temporary ED and frozen oocytes can also be employed if sperm retrieval fails. However, to avoid puncture injury to the epididymis or testis, fresh semen should be the first choice.

Cryopreservation ; Embryo Transfer ; Erectile Dysfunction ; drug therapy ; physiopathology ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Male ; Oocyte Retrieval ; Oocytes ; Penis ; Pregnancy ; Retrospective Studies ; Sildenafil Citrate ; therapeutic use ; Sperm Retrieval ; Spermatozoa

Objective To investigate the role of heme oxygenase-1 ( HO-1 ) and carbon monoxide ( CO) in children with mycoplasma pneumoniae infection. Methods A total of 198 cases with mycoplasma pneumoniae infection under 3 years were enrolled in this study. According to whether with wheezing,all cases were divided into wheezing group( n=58 ) and no wheezing group ( n=140 ) . According to having hypox-emia,wheezing group was divided into mild wheezing group(n=34) and severe wheezing group(n=24). And no wheezing group was set as control group. The serum COHb levels were measured by dual-wavelength spectrophotometry. The serum HO-1 were measured by ELISA. Results The levels of serum HO-1 and COHb% in severe wheezing group were ( 2 734. 10 ± 707. 59 ) ng/L, ( 3. 88 ± 0. 83 )%, and ( 1 130. 03 ± 671. 02) ng/L,(1. 16 ± 0. 63)% in mild wheezing group,and(931. 32 ± 451. 67) ng/L,(1. 04 ± 0. 37)% in no wheezing group,respectively. There were significant differences in serum HO-1 and COHb% between se-vere wheezing group and mild wheezing group(P<0. 01,respectively),and there were no significan differ-ences in serum HO-1 and COHb% between mild wheezing group and no wheezing group( P>0. 05,respec-tively). There was significant positive correlation between serum HO-1 and COHb%(r=0. 875,P<0. 01). Conclusion With mycoplasma pneumoniae infection,the expression of HO-1 and COHb% increase by the wheezing disease progression. HO-1 and CO may participate in the development process of infantile wheezing diseases.

Objective To investigate the effect of berberine on insulin resistance induced by free fatty acid in 3T3-L1 adipocytes and the possible molecular mechanism.Methods 3T3-L1 adipocytes were treated with 0.5 mmol/L palmitic acid to induce insulin resistance.Berberine was used for treatment and aspirin for positive control.Glucose oxidase method was employed for measuring the glucose consumption in the medium and 2-deoxy- [~3H]-D-glucose method was used for the determination of glucose uptake.Western blot was used for the determination of IKB kinase(IKK)?SerlS1 phosphorylation,insulin receptor substrance-1(IRS-1)Ser307 phosphorylation,the protein expression of IKK?,IRS-1,phosphatidylinositol 3-kinase(PI-3K)p85 and glucose transporter 4(Glut4).Results After the treatment with 0. 5 mmol/L of palmitic acid for 24 h,glucose consumption by 3T3-L1 adipocytes was decreased by 41%,insulin-stimulated glucose transport was inhibited by 67%,IRS-1 and PI-3K p85 proteins were reduced, and phosphorylations of IKK?Ser181 and IRS-1 Ser307 were induced.The above results were reversed by adding berberine or aspirin.But Glut4 and IKK?protein abundance was not changed during this study.Conclusion Berberine significantly improves insulin resistance induced by free fatty acid in 3T3-L1 adipocytes via inhibiting IKK?serine phosphorylation.

Background A multitude of studies reported statins prevent the myocardial hypertrophy induced by pressure overload,but the mechanism is unclear.Objective To study the protective effect of atorvastatin on the myocardial hypertrophy caused by pressure overload and it's anti-inflammation effect.Methods Forty Wistar rats were randomized to untreated group(n=10),atorvastatin group(2 mg/kg?d,by gavage,n=10),sham op- eration group(n=10)and control group(n=10).Ventricular hypertrophy model was achieved by surgical con- stricting the abdominal aorta.All rats were sacrificed 8 weeks after the operation and the heart weight to body ratio,left ventricular weight to body ratio,and the size of cardiomyocyte were determined.The expressions of interleukin 18(IL-18)and cardiotrophin 1(CT-1)in the cadiocyte were assessed by reverse transcription polymer- ase chain reaction(RT-PCR).Results Compared with control group,SBP in myocardial hypertrophy group was significantly increased(174?9 vs control 112?15 mmHg,P

Introduction：Neonatal tetanus is a major cause of neonatal mortality in many developing countries and remains a major public health problem. This study aimed to determine risk factors associated with neonatal tetanus in Wenzhou, China.Methodology：Medical records of neonatal tetanus cases from 17 hospitals over a 13-year period (2000–2012) were reviewed for potential risk factors. Controls were selected from neonates with diseases other than tetanus who were admitted to the same facility during the same period. The potential risk factors of the neonatal tetanus group were compared with the control group using univariate analysis and an unconditional logistic regression model.Results：A total of 246 neonates with tetanus and 257 controls were included in this study. Univariate analysis showed that having untrained birth attendants, home delivery, an unsterile method of delivery and being a migrant to Wenzhou were significantly different between the two groups (P < 0.001). Logistic regression analysis revealed that the odds of having an untrained birth attendant, home delivery and an unsterile method of delivery were significantly higher in the tetanus group than the control group (odds ratio: 1371.0; 95% confidence interval: 206.0, 9123.5).Conclusion：This study identified that the main risks of neonatal tetanus in cases from Wenzhou were having an untrained birth attendant, home delivery and an unsterile method of delivery. Preventive measures directed to these risk factors may reduce the occurrence of neonatal tetanus in the studied area.

Objective To analyze the treatment outcomes of patients with primary sphenoid sinus malignancies. Methods Sixteen patients with primary sphenoid sinus malignancies admitted to our hospital from 2000 to 2013 were analyzed retrospectively. No patients were newly diagnosed with cervical lymph node metastasis. One patient had stageⅣA disease, while fifteen had stageⅣB disease. Eleven patients received surgery followed by radiotherapy, one surgery alone, three radiotherapy alone, and one chemotherapy alone. All surgeries were cytoreductive . The median dose of radiotherapy was 69. 96 Gy ( 56.00?80. 56 Gy ) . Results The 3?year local control ( LC) , distant metastasis?free survival ( DMFS) , disease?free survival ( DFS) , and disease?specific survival ( DSS) rates were 67%, 69%, 44%, and 58%, respectively, in all patients, and 67%, 55%, 30%, and 41%, respectively, in patients treated with cytoreductive surgery followed by radiotherapy. All orbital contents and skull base were preserved. In all patients, the local recurrence, distant metastasis, and lymph node recurrence rates were 25%, 37%, and 6%, respectively. There were no independent predictors for the LC and DSS rates based on the prognostic analysis. Conclusions With the orbital contents and skull base preserved, the cytoreductive surgery followed by radiotherapy yields satisfactory outcomes and a low lymph node recurrence rate in the treatment of sphenoid sinus malignancies. The prophylactic irradiation of cervical lymph nodes is not recommended in clinical practice.

Objective To explore the safety and efficacy of policosanol in elder patients with high on-treatment platelet reactivity ( HPR) after drug-eluting stent ( DES) implantation. Methods This study was a prespecified subgroup analysis of the multicenter, randomized SPIRIT trial,in which there were a total of 169 elder patients (≥60 years old) with HPR. Among these patients, 30 patients were in group A ( given clopidogrel 75 mg/d for one year) , 75 patients in group B ( given clopidogrel 150 mg/d for 30 days followed by 75 mg/d until one year ) and 64 patients in group C ( given policosanol 40 mg/d for 6 month and clopidgrel 75 mg/d for one year ) . All patients were treated with aspirin at the same time. The primary endpoint was the reversion rate of HPR at 30 days (reversion was defined as platelet aggregation ﹤65%). The secondary endpoint was 2-year major adverse cardiac events ( MACE ) rate, which included cardiac death, non-fatal myocardial infarction and ischemic symptoms driven target vessel revascularization. The safety endpoint was any bleeding as defined by the Bleeding Academic Research Consortium ( BARC ) definition. Results At 30 days, the reversion rate of HPR in group C was numerically higher as compared with group A ( 42. 9% vs. 23. 3. 0%, P=0. 068 ) , and similar with group B ( 42. 9% vs. 49. 3%, P=0.447). MACE occurred in 4 (13.3%), 5(6.7%) and 3(4.7%) patients in group A, B and C respictively ( P=0. 352). Bleeding events in group A and group C were both markedly lower in comparison to group B (3. 3% vs. 17. 3% vs. 1. 6%, P=0. 001). At the 24-month follow-up, the MACE-free survival rates were not significantly different (95. 3% vs. 93. 3% vs. 86. 7%, P=0. 146). Conclusions For elder patients with HPR, policosanol reduced platelet reactivity to a similar extent in comparison of high maintenance dose of clopidogrel without increasing bleeding risk.

Objective To investigate the treatment outcome of primary mucosal melanoma of the nasal cavity and paranasal sinuses and the role of radiotherapy in the treatment of this disease .Methods The clinical data of 52 patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses who were admitted to our hospital from 2001 to 2014 were analyzed retrospectively.Among these patients, 18 received surgery alone, 31 received surgery combined with radiotherapy ( 24 received surgery and postoperative radiotherapy and 7 received preoperative radiotherapy and surgery ) , and 3 received radiotherapy alone.The surgery+radiotherapy group and the surgery group were matched using propensity score matching.Results The median follow-up was 59 months.The 5-year local control ( LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) of all patients were 49%, 48%, 22%, and 45%, respectively.After matching, the surgery+radiotherapy group had a significantly higher LC than the surgery group (88%vs.43%, P=0.028), but the two groups had similar 5-year DMFS (67%vs.57%, P=0.955), 5-year DFS (58%vs.24%, P=0.131), and 5-year OS (67%vs. 67%, P=0.727 ) .The negative margin rates in the preoperative radiotherapy+surgery subgroup and the surgery+postoperative radiotherapy subgroup were 100%and 50%, respectively ( P=0.004) .Conclusions Surgery combined with radiotherapy can improve the LC rate in patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses, and preoperative radiotherapy can increase the negative margin rate.