ObjectiveTo explore relation of muscle tension on recovery of upper limbs motor function of patients with hemiplegia after stroke.Methods102 hemiplegia patients were divided into 4 groups according to the degree of muscle tension,and treated with routine rehabilitation training. After one month,upper limbs motor ability and activities of daily living (ADL) of patients were assessed.ResultsAfter treatment,upper limbs motor ability and ADL of all patients were raised,but patients with light muscle tension had a better effect compared with those with serious muscle tension (P<0.01).ConclusionExcessive muscle tension will block the motor functional recovery of patients with hemiplegia after stroke.

ObjectiveTo explore the best applying time and effect of baclofen on recovery of motor function of stroke patients with hemiplegia.Methods83 stroke patients with hemiplegia were divided into group A and group B according to the degree of muscle tension, every group was divided into the treatment group and control group. Patients of the four groups were treated with routine rehabilitation training, and baclofen was added to the patients of two treatment groups. Motor ability and activities of daily living (ADL) of patients were evaluated before and after one month treatment.ResultsAfter one month treatment, motor ability and ADL of all patients were improved, but in group A, there were not significant differences existed between treatment group and control group (P>0.05), while, there was a significant difference existed in group B(P<0.01).ConclusionBaclofen is necessary to stroke patients with hemiplegia only when the muscle tension increased obviously (≥Asworth 3).

In the United States of America, the physician group practice has become one of the most common practice models, and has a relatively perfect and clear system of laws and regulations in its monitoring.In view of the policy side, the federal government has published the Stark Law to regulate the registration, properties, operation, service contents in details for the physician group practice.Taking the market side, it is practiced to protect the physician groups and medical practice behaviors through medical insurance policies.In China, the emergence of physician group has received widespread attention and concern.But since the short development time and unclear development path, the relevant laws and regulations for physician groups are still are not perfect.This paper aims to summarize the development and status quo of the American physician group as well as the regulations related to the groups` operating system, which will provide a good reference to China.The purpose is to provide policy recommendations for the standardized development and perfect regulations of physician groups in China.The following recommendations were put forward: improve the relevant laws and regulations;promote the establishment of the corresponding security policies;speed up and enhance the research and development of medical liability insurance;do continuous tracking and timely summarize practices.

Child ; Humans ; Kartagener Syndrome ; diagnosis ; therapy ; Male

Objective: To investigate the role of human umbilical vein endothelial cells (HUVEC) in supporting hematopoiesis and the expansion of hematopoietic stem/progenitor cells in vitro. Methods: According to the fact that HUVEC supernatant has colony stimulating activity shown by methylcellulose colony-forming assay and HUVEC can maintain the survival of mononuclear cells for at least four weeks in vitro, CD34+ cells from umbilical cord blood were seeded with (HUVEC group) or without (control group) HUVEC monolayer. Every week cells were collected and counted, the frequency of CFU-GM was measured by using methylcellulose colony-forming assay, and the percentage of CD34+ and CD41a+ cells was measured by flow cytometry. Results: In control group，all the CD34+ cells died in two weeks. However, in HUVEC group,most nucleated cells and CD34+ cells were expanded by 68.1±14.8 fold and 6.6±1.4 fold，respectively at the third week while CFU-GM expansion reached its peak (5.7±2.1 fold) at the week 2. Moreover, the percentage of CD41a+ cells was enhanced significantly, reaching a maximum (15.6%) at the week 3. Conclusions:HUVEC can support hematopoiesis in vitro and expand the hematopoietic progenitor cells and CD41a+ cells in direct contact coculture.

Background and purpose:Antracycline combined with paclitaxel is more widely applied in breast cancer as neoadjuvant chemotherapy.There are differences in applications of different paclita~els.In this research,the efficacy and toxicity of neoadjuvant chemotherapy with ET,ED regimen were compared for the patients with stageⅢbreast cancer.Methods:64 cases of stageⅢbreast cancer patients were divided in two groups.Before surgery,one group had received ET(EPI ivgtt 60 mg/m~2 d_1?21,PTX ivgtt 175 mg/m~2 d_2?21),the other group had received ED(EPI ivgtt 60 mg/m~2 d_2?21,DOC ivgtt 75 mg/m~2 d_2?21)neoadjuvant chemotherapy for three weeks. Curative effect and side effects were evaluated after 2-4 cycles.Results:Total effective rate was 87.5%.Effective rate in ED group was 92.9%,and effective rate in ET group was 83.5%.There was no significant difference(P=0.253).In pCR cases,8 cases in ED group achieved pathologically complete response compared to 3 cases in ET group(P=0.033). The number of patients in ED group(24 cases)hadⅣ-Ⅴgrade pathology evaluation after chemotherapy,it was higher than that in ET patients(21 cases).There was a significant difference(P=0.017).In both groups side effects including hair loss,nausea and vomiting,liver dysfunction were similar.Incidence rate of peripheral neurotoxicity in ET group was higher than that in ED group(P=0.002).Incidence rates of leukopenia,skin rash and phlebitis in ED group were higher than that in ET group.There was a significant difference between two groups in the leukopenia(P=0.034). Conclusions:For the patients with stageⅢbreast cancer patients,both two regimens could achieve better curative effect.ET and ED regimen have similar effect.But in ED regimen,the number ofpCR cases was obviously higher than in ET group.In both groups side effects were similar.There were significant differences in terms of leukopenia and peripheral neurotoxicity,but the side effects could be tolerated.

Objective To investigate the clinical efficacy of intraoperative methylprednisolone used in combination with perioperative enteral nutrition support in improving liver synthetic function after hepatectomy and postoperative recovery.Methods In this prospective controlled trial,79 patients treated with hepatectomy at Departement of Hepatobiliary Pancreatic Surgery in Drum Tower Hospital between June 2013 and May 2014 were included and divided into control group (n =39) and steroid group (n =40) according to the order of surgery.The control group underwent hepatectomy only,while the steroid group received intraoperative methylprednisolone (500 mg) at the start of liver excision.Both of the two groups were given the same perioperative enteral nutrition support.Liver function,prealbumin (PA),and C-reactive protein (CRP) levels were measured before and on days 1,3,and 5 after the operation.Human blood albumin infusion volume,postoperative gas passing,postoperative hospital stay,and incidence of complications were recorded.Results The serum level of PA on day 3 after hepatectomy was significantly higher in the steroid group than in the control group [(101.26 ±61.17) mg/L vs.(81.84 ±43.58) mg/L,t =-1.607,P =0.049].The serum level of cholinesterase on day 1 after hepatectomy was significantly higher in the steroid group than in the control group [(5.60±1.54) kU/Lvs.(4.68±1.01) kU/L,t=-3.136,P=0.004].On day1 and day 3 after hepatectomy,the serum levels of CRP were significantly lower in the steroid group than in the control group [(41.79 ±20.86) mg/L vs.(62.08 ±38.33) mg/L,t =2.933,P=0.027;(64.14 ±32.38) mg/L vs.(102.64 ± 49.05) mg/L,t =4.127,P =0.006].The postoperative hospital stay was significantly shorter in the steroid group than in the control group [(12.62 ±5.74) d vs.(15.41 ± 10.00)d,t =1.514,P =0.002].Conclusion Intraoperative use of methylprednisolone combined with perioperative enteral nutrition support may inhibit postoperative inflammatory response,promote early recovery of liver synthetic function,and help to promote rehabilitation after hepatectomy.

@@

Objective To investigate the correlation between the serum ferritin levels and the post-stroke depression (PSD). Methods From July 2014 to October 2015, the inpatients with the first-ever acute ischemic stroke were colected consecutively. Chemiluminescence microparticle immune assay was used to measure the serum ferritin levels within 24 h after admission. Depressive symptoms were screened by using the 17-item Hamilton depression scale (HAMD-17) at 3 months after onset. In patients with a HAMD-17 score ≥7, the depression was further diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Results A total of 200 patients with the first-ever acute ischemic stroke were enroled, 55 (27. 5% ) of them were diagnosed as PSD. There were significant differences in the body mass index (BMI), years of education, waist circumference, high sensitive-C-reactive protein, homocysteine, National Institutes of Health Stroke Scale score (at baseline, discharge, and day 90), mRs score (at discharge and day 90), BI (at discharge and day 90), and the proportions of widowed or solitary patients between the PSD group and the non-PSD group (al P < 0. 05 ). The serum ferritin level in the PSD group was significantly higher than that in the non-PSD group ( median [ interquartile range], 261. 90[142. 10-364. 90] μg/L vs. 164. 40[132. 50- 195. 10] μg/L; Z = - 4. 814, P < 0. 001 ). Multivariate logistic regression analysis adjusted for confounding factors showed that the baseline serum ferritin level >136. 375 μg/L was an independent risk factor for PSD (odds ratio 1. 041 per 1-quartile increase, 95%confidence interval 1. 009-1. 239; P = 0. 045). Conclusions The elevated baseline serum ferritin level is associated with PSD.

AIM:To study the type, degree and axial distribution of low vision astigmatism in preschool children.METHODS:A group of 3-6 years old children were selected for astigmatism screening, and statistical analysis was performed on the detected 445 eyes of 308 people.RESULTS:With more than 0.50D astigmatism criteria, astigmatism examination of 308 people, accounting for 36.2%, of which 137 eyes astigmatism, astigmatism 171 monocular.The five types of astigmatism were compound hyperopia 40.7%, mixed 35.5%, compound myopia 8.5%, myopia 8.3%, simple hyperopia astigmatism degree 7.0%;69.0% were mild, 16.6% moderate, 14.4% severe.Astigmatism axial distribution was with the rule for 54.9%, against the rule 28.8%, oblique 16.6%.In binocular astigmatism eyes, axial symmetry was in 35.8%, asymmetry in 64.2%.CONCLUSION:The main type of astigmatism in preschool children are compound hyperopia and mixed astigmatism.Astigmatism degree is mainly mild.With the increase of age, the detection rate of moderate and high astigmatism increased.