Objective:To observe any effect of dynamic motor instability training on the balance and postural control of stroke survivors.Methods:Forty stroke survivors with poor balance were randomly divided into a control group and an observation group, each of 20. In addition to routine rehabilitation, the observation group was given 20 minutes of dynamic motor instability training, 5 days a week for 8 weeks, while the control group underwent routine rehabilitation for the same length of time. Before and after the intervention, surface electromyogram of the rectus femoris, biceps femoris, and erector spinae were recorded during perturbation. Activation time and the intensity of the anticipatory and complementary postural adjustments (APAs and CPAs) were also observed. Balance and lower limb motor functioning were assessed using the Berg balance scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), and GaitWatch analysis.Results:After the treatment the average activation time of the rectus femoris, biceps femoris in the affected side and those of the biceps femoris [(-84.31±5.74)s] and erector spinae in the intact side in APAs were all significantly shorter in the observation group than in the control group, while the average activation intensity of the rectus femoris and erector spinae was significantly greater. There was no significant difference in the activation intensity of each muscle group in CPAs after the treatment. After the intervention the average BBS score, FMA-LE score, stride length and walking speed of the observation group all were significantly better than the control group′s averages.Conclusions:Supplementing traditional rehabilitation training with dynamic motor instability training can further improve the posture control of stroke survivors and promote recovery of their balance and walking ability.

Objective To observe the effect of hyperbaric oxygen (HBO) therapy combined with repeated transcranial magnetic stimulation (rTMS) on patients with cognitive dysfunction after cerebral infarction.Methods A total of 81 patients with cognitive dysfunction after cerebral infarction were randomly divided into a control group,an HBO group and a combined treatment group,each of 27.In addition to basic medication and traditional rehabilitation therapy,the HBO group was also treated with hyperbaric oxygen,while the combined treatment group received both HBO and rTMS.The mini-mental state examination (MMSE) and the Montreal cognitive assessment (MoCA) were administered before and after the four weeks of treatment.Results The average MMSE scores of the HBO and combined treatment groups were both significantly higher than that of the control group,with the former significantly higher than the latter.Moreover,the average MoCA score of the HBO group was also significantly higher than that of the combined treatment group,and both were significantly higher than that of the control group.Conclusion Hyperbaric oxygen therapy can more effectively improve the cognitive function of patients with cognitive dysfunction after the cerebral infarction when it is combined with repeated transcranial magnetic stimulation.

Objective To correlate the isokinetic strength of stroke survivors' trunk flexors and extensors with the kinematic parameters of their gait.Methods Thirty stroke survivors and 30 healthy counterparts formed an observation group and a control group.The strength of everyone's trunk flexors and extensors was measured isokinetically,including the flexor peak torque (FPT),extensor peak torque (EPT) and the ratio of the two (F/E).The test velocities were 30°/s,60°/s and 90°/s.And the kinematic parameters of their gait,including the step length,stride,velocity,frequency,width and cycle time were measured using a 3D gait analysis system,as well as the percentage of stance phase,swing phase,double support phase and single support phase.Results No significant differences were found between the average FPT,EPT or F/E of the two groups at any of the three test velocities.At the 30°/s test velocity the average FPT,EPT and F/E of the observation group were all positively correlated with the average step length,stride,velocity,steps/min,width and cycle time,as well as with the stance phase,swing phase,double support phase and single support phase percentages.The strongest correlation was between F/E and velocity (r=0.57),followed by frequency (r=0.54).Conclusion litating the walking ability of stroke survivors and correcting their gait should focus on strengthening the trunk muscles and optimizing their coordination.

Objective To compare the clinical application effects of needle-catheter jejunostomy and nasojejunal tube feeding in the combined thoracoscopic and laparoscopic esophagectomy.Methods The study enrolled 50 patients from Department of Thoracic Surgery, the First Affiliated Hospital of Anhui Medical University, who received the combined thoracoscopic and laparoscopic esophagectomy from May to December 2015. According to the different nutritional approaches, patients under-covered the needle-catheter jejunostomy were assigned into observation group (n=25), and patients under-covered the nasojejunal tube feeding were assigned into control group (n=25), then by the different nutrition pathway patients were given the same nutritional approaches. The cannulation how easily or comfortably, nutritional condition and incidence of postoperative recovery were compared between two groups.Results The nutrient tube withdrawal rate, nasopharyngeal discomfort rate and nausea and vomiting rate in observation group were significantly less than that in control group (Z=2.673, 5.041, 3.271;P<0.05); the value of serum protein was higher in the observation group compared with that of control group 7 days after operation (t=3.841,P<0.001); the time of enteral nutritional, length of hospital stay and the exsufflation time of anus in observation group all were better than the control group (t=-6.171, -4.246, 5.128;P<0.001). There is no significantly difference of the morbidity related to nutrient tube, the number of white cells and the total protein level between two groups (P>0.05).Conclusions The needle-catheter jejunostomy and nasojejunal feeding are both safe work and effective, but the needle-catheter jejunostomy feeding is better.

Objective To investigate the value of high-resolution magnetic resonance imaging (HRMRI)in diagnosis of extramural vascular invasion (EMVI)of rectal cancer.Methods 33 patients with rectal cancer were reviewed preoperatively.The MRI findings of EMVI of all cases were scored and compared with the postoperative pathological results.Results The MRI EMVI scores were consistent with histopathology findings (k=0.324,P=0.039).The accuracy rate of MRI in diagnosis of EMVI was 66.7% (22/33).The MRI EMVI scores rose up with increased pT stage,meanwhile there was a high correlation between both (r=0.546).The percentage of MRI EMVI positive number was increased with elevated pT stage,and there was also a high correlation between both (r=0.469). ROC curve showed that MRI EMVI scoring was an effective method in diagnosis of rectal cancer EMVI (AUC=0.757).Conclusion HRMRI is a valuable method in diagnosis of EMVI of rectal cancer.

Objective To explore the value of fascial tail sign at MR images in the detection of nodular fasciitis (NF). Methods A retrospective analysis of MR images was performed in 19 patients with pathologically proven NF of the soft tissue and 53 patients with a variety of other fibrous-predominant tumors. MR manifestations of all cases were reviewed by two experienced musculoskeletal radiologists using a single blind method. The presence of fascial tail on MR images were evaluated. ROC was used to assess the value of fascial tail sign in the detection of NF. Sensitivity, specificity, Youden index and area under ROC curve were calculated. The association between the presence of fascial tail sign on MRI and pathological classification of NF was analyzed by Pearson chi-square test for independence . Results Fascial tail was present in 17 cases (89.5%) of the study group and in 6 cases (11.3%) of the control group, respectively, yielding a sensitivity of 89.5%, a specificity of 88.7%, a Youden index of 0.782 and an area under ROC curve of 0.891. The fascial tail sign was significantly associated with NF (c2=39.294,P<0.05,r=0.594). Conclusions Fascial tail sign at MRI is a moderately specific and sensitive for the diagnosis of NF relative to fibrous-predominant tumors. It can be used in differentiate between NF and aggressive soft tissue tumors.

BACKGROUND:Metabolic syndrome greatly harms the human body, and is affected by many factors. Through constructing diet-induced animal models, we can better analyze the relationship between nutritional factor and metabolic syndrome, and provide reliable references for the clinical treatment of this disorder. OBJECTIVE:To construct obese mouse models with high-fat diet feeding and discuss the relationship between nutritional factor and metabolic syndrome. METHODS:Thirty mice were selected and randomly divided into model group (n=20) and control group (n=10), and were fed with high-fat and normal animal feeds for 10 consecutive weeks. RESULTS AND CONCLUSION:Compared with the control group, after 1 week of feeding with high-fat animal feeds, body weight of mice in the model group raised, and differences gradualy increased with the feeding time increased. After 8 weeks of feeding, body mass index of mice in the model group significantly raised (P < 0.05). After 4 weeks of feeding, fasting venous blood glucose level of mice in the model group significantly raised, and showed a gradual rise trend with feeding time. After 5 weeks of feeding, fasting insulin level of mice in the model group also began to rise. The oral glucose tolerance test showed that mice in the model group showed a gradual downward trend of glucose tolerance with feeding time. After 8 weeks of feeding, serum levels of total cholesterol and high density lipoprotein cholesterol in the model group significantly raised (P < 0.05). After 10 weeks of feeding, serum levels of triacylglycerol, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol in the model group raised (P< 0.05). The results demonstrate that obese mouse models were successfuly constructed with high-fat diet feeding, which can simulate the natural progression of metabolic syndrome in human, moreover, the nutritional factor is closely related to metabolic syndrome.

BACKGROUND:Skin and soft tissue defects of hands are easy to appear due to different factors, such as trauma. Flap transplantation is a clinical treatment for soft tissue defects of hands. Dorsal foot flap, which is thicker with constant vessel traveling, is very suitable for repair of hand soft tissue defects. OBJECTIVE: To explore the success rate and survival rate of dorsal foot flap transplantation in the repair of hand skin and soft tissue defects. METHODS: A retrospective analysis was performed on the clinical data of 86 patients with skin and soft tissue defect of hands. These patients were respectively given conventional skin wound skin grafting (control group) and dorsal foot flap transplantation (observational group). Hand appearance, infection rate, perception recovery and complications were observed during the postoperative folow-up. RESULTS AND CONCLUSION:Skin flaps al survived after grafting, and the texture of flaps was good. Patients were satisfied with hand shape and the recovery of hand function. After flap transplantation, one patient had local skin necrosis at the donor region, and the scar healed after dressing; another patient had venous crisis, and was given vascular re-anastomosis. In the observation group, the postoperative appearance was better than that of the control group, the infection rate was lower than that of the control group, the perception recovery was better, and there were fewer complications (P < 0.05). These findings suggest that the dorsal foot flap transplantation is better to repair skin and soft tissue defects in the hand.

Objective To explore the methods and effectiveness of using nurses as standardized patient ( NSP) in junior nurses′hanging and choking rescue care training. Methods This study selected four nurses as NSPs, based on Huaxi Hospital′s NSP screening criteria. A total of 60 nurses whose psychiatric nursing age were beyond three years were randomly divided into experimental group and control group, with 30 members each. The nurses in the experimental group were treated with NSP method, while the control group was trained in the regular way. After that, the effects of training were evaluated by Dundee Ready Education Environment Measure ( DREEM ) . The theory and clinical skills examination and training satisfaction were surveyed. Results The theory test scores of the two groups after training were significantly higher than those before training (P<0. 05), and the scores of the experimental group was higher than that of the control group, but there was no significant difference (P>0. 05). The total score of DREEM, and the perception of learning, course organizers and academic self-perception score of DREEM of the experimental group were significantly higher than those of the control group (t=7. 086, 9. 443, 10. 462, 8. 620, respectively;P<0. 05). The score of choking rescue skills of the experimental group was significantly higher than that of the control group ( t=2. 759,P<0. 05). But the score of hanging rescue skills of the experimental group was not significantly higher than that of the control group (P>0. 05). There was no significant difference in the satisfaction between the two groups (P>0. 05). Conclusions The application of NSP in hanging and choking rescue care training can improve the teaching environment, increase nurses′choking rescue care skills, but no difference is found in the theory examination and hanging rescue care skills between the two groups.

Objective To find out the effects of modularized medical database in hanging rescue care training. Methods A total of 281 nurses in 2012 and 312 nurses in 2013 who joined in the hanging rescue care training were enrolled in this study. Nurses in 2013 were trained by using modularized medical database, while nurses in 2012 were trained by using regular medical database. The examination score and related survey findings in the two groups were compared. Results The examination scores was (91. 22 ± 3. 30) in 2013, which was significantly higher than that (90.65 ±2.16) in 2012 (t=2.442,P<0.05). 93.7% interviewees agreed that the modularized medical database was better mapping in the clinical practice. 89. 9% participants thought the modularized medical database was more helpful. 82. 3% nurses were more satisfied with the new training method and 77. 2% of them regarded that it was a higher request in teaching staffs and schedule arrangement than the regular training method. Conclusions The use of modularized medical database in the hanging rescue care training has a better improvement of the effect on gaining the nurses′acknowledgment, but it is also a higher demanding for the teachers compared with the regular database.