Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

Objective To investigate the expression and significance of RANK/RANKL/OPG signaling path-way in gerbil external auditory canal cholesteatoma(EACC).Methods Twenty-five mongolian long-clawed gerbils were divided into an experimental group(n=15)and a control group(n=10),and an EACC model was constructed by external auditory canal ligation method in the experimental group.Three months later,the external auditory ca-nal tissues of the control group and the experimental group(10 ears)were collected,and RT-qPCR and Western blot were performed to detect the expression levels of receptor activator of NF-κB(RANK),receptor activator of NF-κB ligand(RANKL),osteoprotegerin(OPG)mRNA and protein in the signaling pathway.Results Two ger-bils in the experimental group died during the modeling process,and cholesteatoma of the external auditory canal was formed in 10 ears 3 months after the operation,with a modeling success rate of 76.9％(10/13).Compared with the normal control group,there was no statistically significant difference in the expression of RANK mRNA in gerbil external auditory canal tissues(P=0.08).The expression of RANK protein was upregulated,the expression of RANKL mRNA and protein was upregulated,while the expression of OPG mRNA and protein was downregulat-ed,the ratio of RANKL/OPG was upregulated,with a statistically significant difference between the two groups(P＜0.01).Conclusion The RANK/RANKL/OPG signaling system may play an important role in the formation of gerbil EACC and bone destruction.

Objective To investigate the expression and significance of RANK/RANKL/OPG signaling path-way in gerbil external auditory canal cholesteatoma(EACC).Methods Twenty-five mongolian long-clawed gerbils were divided into an experimental group(n=15)and a control group(n=10),and an EACC model was constructed by external auditory canal ligation method in the experimental group.Three months later,the external auditory ca-nal tissues of the control group and the experimental group(10 ears)were collected,and RT-qPCR and Western blot were performed to detect the expression levels of receptor activator of NF-κB(RANK),receptor activator of NF-κB ligand(RANKL),osteoprotegerin(OPG)mRNA and protein in the signaling pathway.Results Two ger-bils in the experimental group died during the modeling process,and cholesteatoma of the external auditory canal was formed in 10 ears 3 months after the operation,with a modeling success rate of 76.9％(10/13).Compared with the normal control group,there was no statistically significant difference in the expression of RANK mRNA in gerbil external auditory canal tissues(P=0.08).The expression of RANK protein was upregulated,the expression of RANKL mRNA and protein was upregulated,while the expression of OPG mRNA and protein was downregulat-ed,the ratio of RANKL/OPG was upregulated,with a statistically significant difference between the two groups(P＜0.01).Conclusion The RANK/RANKL/OPG signaling system may play an important role in the formation of gerbil EACC and bone destruction.

Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

OBJECTIVE To investigate the effects of recombinant human epidermal growth factor (rhEGF) on wound healing of chronic sinusitis patients after functional endoscopic sinus surgery. METHODS A total of 110 patients with chronic sinusitis underwent functional endoscopic sinus surgery with both sides of their nose. The right side of their nasal cavity (control group) treated by nasal irrigation and steroid nasal spray, the left side of their nasal cavity (study group) treated by nasal irrigation and the nasal spray of steroid hormones and rhEGF. Surgical effect was evaluated under nasal endoscope at 2, 4, 12 and 24 weeks after surgery, while subjective symptom was evaluated depending on visual analogue scale (VAS). Both the score of endoscopic examination and VAS, also the rates of epithelization of the two groups were compared. RESULTS The score of endoscopic examination of the study group at 2 weeks after surgery was better than that of the control group, which had statistical significance, while the score of VAS had no statistical difference. The score of endoscopic examination and VAS, the rate of epithelization in study group at 4 and 12 weeks after surgery were better than those in control group, and the difference was statistically significant, but they were no statistical difference at 24 weeks after surgery. CONCLUSION The using of rhEGF nasal spray on chronic sinusitis patients with functional endoscopic sinus surgery can shorten the time of epithelization, improve the situation of nasal mucosa and patients' subjective symptoms, it is worthy of clinical application.

OBJECTIVE: In order to investigate the interaction between the cytokines and keratinocyte and determine the role of cytokines in hyperproliferative of chronic otitis media with cholesteatoma, we observe the expression of matrix metalloproteinase 9 (MMP9), vascular endothelial growth factor (VEGF), keratinocyte growth factor (KGF) and its receptor (KGFR) in middle ear cholesteatoma. METHOD: We examined the expression of MMP9, VEGF, KGF, KGFR and Ki-67 by immunohistochemistry in 50 specimens from chronic otitis media with cholesteatoma and 15 specimens from the normal skin of external auditory meatus. Ki-67 as an evaluation of cholesteatoma proliferation markers were used to detect the keratinocyte proliferative activity. RESULT: (1) The expression of VEGF and MMP9 in cholesteatoma specimens was higher than normal skin, and the difference was statistically significant (t = 4.914, P < 0.01; t = 3.284, P < 0.01). (2) The expression of KGF and KGFR in middle ear tissues was higher than normal skin, and the difference was statistically significant (t = 4.814, P < 0.01; t = 3.104, P < 0.01); The expression of KGF and KGFR increased, and the expression of Ki-67 also correspondly increased in the cholesteatoma. (3) In the tissue MMP9 and VEGF were positive. Mean optical density increased as well. KGF expression also increased accordingly. CONCLUSION MMP9, VEGF, KGF and KGFR proteins played an important role in hyperproliferation of cholesteatoma tissues. VEGF, MMP9 and KGF had a synergistic effect in hyperproliferation of cholesteatoma tissues.
Cholesteatoma, Middle Ear ; pathology ; Cytokines ; metabolism ; Ear Canal ; metabolism ; Ear, Middle ; metabolism ; Fibroblast Growth Factor 7 ; metabolism ; Humans ; Immunohistochemistry ; Keratinocytes ; cytology ; Ki-67 Antigen ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Otitis Media ; pathology ; Receptor, Fibroblast Growth Factor, Type 2 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism