目的观察肌电图导引下应用A型肉毒毒素治疗脑卒中偏瘫患者肢体痉挛的临床疗效。方法65例脑卒中痉挛性偏瘫患者按FMA量表评定分为3组,应用肌电图纪录痉挛肢体在功能位时的运动单元电位数,确定治疗肌肉,每一部位注射5U,0.2ml国产A型肉毒毒素,治疗3天后由康复训练师亲自或指导家属进行肢体功能训练。采用改良AshWorth分度评分评定痉挛状态,FMA量表评定日常生活能力(上下肢分别统计)。结果治疗后,中、轻度运动障碍者恢复至基本正常;严重运动障碍者恢复至明显运动障碍;严重运动障碍合并挛缩者可改善其生存质量;所有患者增高的肌张力均有明显改善。结论在肌电图导引下,A型肉毒毒素作为缓解痉挛药物使用安全、有效,对肢体功能的恢复有显著的辅助作用。

Objective To investigate the clinical effect of compound Qianglizhenxian pill on epilepsy. Methods 94 patients with epilepsy were treated with compound Qianglizhenxian pill, and every course lasted three months. After treatment, checking patients' electroencephalogram again, evaluating the clinical effect according to degrees and numbers of attack. Results After 12 months of treatment, 90.43% of patients got an obvious improvement, while 6.38% for better, 3.19% for validity and no invalid. Conclusions There is a great improvement for patients with epilepsy after taking the medicine. The effective control rate is 92.62% with no toxication on blood system, liver and kidney.

OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

Objective To investigate the current status, performance,challenges and demands of the health management service-related institutions in China so as to provide evidence for effective policy-making. Methods A cross-sectional study design was used in this report. The health management service-related institutions were identified based on web site searching and government business registration records. Web or mail-based questionnaire was used for data collection. Telephone interview was conducted to confirm the validity and reliability of the data. Results Of 5744 health management service-related institutions in China,585 were investigated for type of organization, personnel profile, business strategy and investment. Since 2000, the number of health management service-related institutions in China had kept increasing in an average rate of 52%. The services included physical check, health education, and disease intervention,etc. Conclusions In China,health management is still at its early stage although an increasing trend could be found and a large number of related- institutions have emerged. However, health management system in China still faces the challenge of poor professional services and insufficient healthcare providers.

Objective To study the diagnosis, treatment and prognosis of mixed thyroid malignant tumors. Methods Clinical data of 7 cases with merged different histological types of thyroid malignant tumor treated from January 1977 to December 2006 were retrospectively analyzed. Results Merged different histologic types of thyroid malignant tumor accounted for 0. 14% of all thyroid malignant tumors treated during this period. Preoperative imaging and laboratory data had no specific value in the diagnosis of this merged different histologic types of thyroid malignant tumors. Radical resection in combination of hormonal therapy and 131I radiotherapy achieved a satisfactory result, though thyroid malignant tumor combined with thyroid cancer usually predict a poor prognosis. Conclusions Merged different histologic types of thyroid malignant tumor is a rare clinical entity, with the pathogenesis being obscure and no consensus of opinion on its nomenclature. The prognosis depends on the highest ～ade among an individual group of malignant tumors.

Objective To establish an LC-MS/MS method for the detection of landiolol concentration in human blood.Methods After pretreatment with neostigmine and a deproteinization procedure, landiolol and the internal standard venlafaxine were eluted isocratically using a mobile phase consisting of acetonitrile and 10 mmoL·L-1 ammonium acetate with 0. 1% formic acid in a ratio of 3664 ( V/V ) . Separation of the respective compounds was achieved on a Waters XTerra? RP18 column (150 mmí4. 6 mm,5 μm). Quantitative analysis of landiolol was conducted by a triple-quadrupole mass spectrometer with positive-electrospray ionization source,monitored under a multiple reaction monitoring ( MRM) mode. The extracted ions monitored following MRM transitions were m/z 510. 5→423. 1 for landiolol and m/z 278. 2→215. 1 for the internal standard venlafaxine. ResultsThe calibration curve of landiolol in human blood showed good linear relationship in the range of 1. 010-2 020 μg·L-1 . The lower limit of quantitation was 1. 010 μg · L-1 . The RSD of within-day and between-day precision was less than 6. 5% and 4. 8%, respectively. The recovery rate was 92. 6%-100. 9%. Conclusion The method is proven to be simple,rapid and reliable,and can be applied to study the pharmacokinetics of landiolol hydrochloride in healthy Chinese volunteers.

Objective To evaluate the short-term results of ARCH plate in cerical expansive open-door laminoplasty(ELAP)for OPLL.Methods From June 2010 to September 2011,a total of 12 cases with OPLL underwent open-door ELAP by ARCH plate fixation and were followed up in our hospital.8 cases were males and 4 cases were female.The average age was 60.5 years.The neurological effect was evaluated by use Japanese Orthopedic Association(JOA)scoring criteria for cervical myelopathy.The ana-tomical effect was analyzed by compare roentgenogram and CT before and after surgery.Results The JOA scores were improved for 39% after the operation,while the saggital diameters of the cervical spinal canaldural after operation was enlarged for 82%(P<0.05).X-ray films and CT scan after operation that there was no occurrence of re-close of door,there was no occurrence of anchor loosing.Conclusion For OPLL,ELAP using ARCH plate fixation bring less occurrence of re-close of door,slight postoperative neck AS,and satisfactory clinical outcomes.

Objective To compare the effects of every-other-day dose simvastatin administration with that of daily therapy of same dose.Methods This was a randomized,prospective,nonblinded clinical trial.The 186 patients with high low-density lipoproteim cholesterol(LDL-C) and/or high total cholesterol (TC),triglycerides (TG),low high-density lipoprotein cholesterol(HDL-C)was studied.All patients were randomized into two groups.The every-other-day do- sing group recerived 20mg of simvastatin in alternate-day and daily dosing group received 20mg of simvastatin every day.Before and after 6 weeks,12 weeks of treatment,serum lipoprotein,Live function tests and ereatine kinase con centra- tion and so on were drawn and bad-side effect were studies.Results The two groups significantly reduce LDL-C,TC, TG and a little increased HDL-C compared with baseline.No stalistically significant differences existed between the two groups in percentage in decrease in lipoprotain at 6 weeks,12 weeks compared with baseline.The bad-side effect in the two groups also had not a singnificant different.Conclusion The every-other-day dose of simvastatin have similar effi- cacious and safe to daily dosing in patients with hyperlipidemia and some cost savings.It can take a primary prevention to coronary heart disease in patients with relatively low-risk hyperlipidemia.

Objective To evaluate the therapy and turnover of Kawasaki disease(KD)with glucose-6-phosphate dehydrogenase(G-6-PD)deficiency.Methods Six hundred and twenty-four patients with KD were selected including 32 patients who had G-6-PD defected.The same dose intravenous immunoglobulin(IVIG)was used in all 624 patients(2 g/kg),but used Dipyridamole in 32 patients had G-6-PD deficiency which replaced the role of acetylsalicylic acid(ASA)after acute period.The coronary artery of these patients were checked and followed-up through echocardiograph.The turnover of 32 patients with G-6-PD deficiency and 356 case selected randomly from all the KD patients were compared.SPSS 10.0 software was used to analyze the data.Results In 32 cases of KD with G-6-PD deficiency,4 children had coronary aneurysm(12.5%).After 6-12 months follow-up,the coronary lesions were recovered in 62.5% children,improved in 21.9% children and not improved in 15.6% childern,which were not significantly different from all the KD patients(Z=-1.604 P=1.09).Conclusions IVIG and Dipyridamole are feasible in treating KD with G-6-PD deficiency.J Appl Clin Pediatr,2009,24(1):26-27

Objective To explore the effects of coincident infection on treatment response and coronary artery lesion (CAL) outcome in children with Kawasaki disease(KD).Methods A retrospective study of 141 children diagnosed on KD between Jul.2005 and Dec.2006 were performed.Standardized clinical assessments,laboratory examinations microbiology test results plus treatment regimens were reviewed.CAL were visualized by using echocardiography.Infectious agents positive (INF+) and negative (INF-) groups were identified,and clinical assessments,laboratory and treatment data were analyzed.Results 1.Concurrent infections:41%(58/141) of children had one of above confirmed infection at KD diagnosis.2.Treatment response:the presence of infection did not alter the response to treatment with intravenous immunoglobulin (IVIG),with resolution of fever within 72 h in 85% (120/141) children after 1 dose of IVIG (2 g/kg) together with aspirin administration regardless of present or absent infection.3.CAL outcome:in total,56.0% (79/141) of children developed CAL at the time of diagnosis,involving dilatation (91.1%,72/79 cases) and aneurysm (8.9%,7/79 cases),and no giant aneurysm was found.Most CAL were recovered within 1 year after treatment.Incidence of aneurysm in INF+ group was significantly higher than that in INF-group (P=0.019).Conclusions Coincident infection would not affect on the clinical assessment,laboratory test results and treatment response to IVIG in children with KD,but would result in higher risk of serious CAL.Therefore,children with infection at diagnosis on KD will not only accept active treatment in acute phase,but also insist on convalescent care and follow-up visit.