Objective:To investigate the anatomic mechanism and risk factors of intracranial embolism caused by injection at temporal region.Methods:(1) Latex perfusion was performed on the vessels of 8 cranial specimens. The vessels from the superficial temporal artery to the carotid artery were dissected to measure the length, the diameter of starting point and ending point and the volume of vessels (drainage method). (2) Cranial CT angiography of 20 patients (excluding patients with cervical diseases) were obtained from the database of Zhejiang Provincial People’s Hospital from January 2021 to December 2022. The length, the diameter of starting point and ending point, and the volume of vessels were measured. (3) 5 plastic surgeons used pressure simulation measuring equipment to vigorously press the temporal region of the real skull model according to the clinical practice and maintain 2 s to obtain the maximum pressure value. The additional pressure on the temporal region was obtained by subtracting the common carotid artery base pressure [set at 90, 120, 150 and 200 mmHg (1 mmHg = 0.133 kPa)] from the maximum pressure.Results:(1) 8 arteries were collected from 4 skull specimens. The length of vessels was (169.5±7.2) mm, the diameter of the starting point of vessel was (4.29±0.28) mm, the diameter of the ending point of vessel was (1.31±0.15) mm, and the volume was (1.56±0.21) ml. (2) There were 11 males and 9 females among 20 patients aged 23-53 years. The length of vessels was (172.2±7.6) mm, the diameter of the starting point of vessel was (5.63±0.43) mm, the diameter of the ending point of vessel was (1.77±0.16) mm, and the volume was (1.59±0.23) ml. (3) The mean value of additional pressure generated by local pressure on the temporal region by 5 physicians was (127.2±10.1) mmHg (113.8-138.6 mmHg).Conclusion:When the injection volume into the superficial temporal artery was more than 1.6 ml, the artery was damaged, and the temporal area was pressed strongly (the local pressure was more than 110 mmHg above the basic pressure), the injection material might flow into the intracranial from the junction of the common carotid artery and into the internal carotid artery, which was the possible mechanism of the temporal filling leading to intracranial embolism.

Objective:To investigate the anatomic mechanism and risk factors of intracranial embolism caused by injection at temporal region.Methods:(1) Latex perfusion was performed on the vessels of 8 cranial specimens. The vessels from the superficial temporal artery to the carotid artery were dissected to measure the length, the diameter of starting point and ending point and the volume of vessels (drainage method). (2) Cranial CT angiography of 20 patients (excluding patients with cervical diseases) were obtained from the database of Zhejiang Provincial People’s Hospital from January 2021 to December 2022. The length, the diameter of starting point and ending point, and the volume of vessels were measured. (3) 5 plastic surgeons used pressure simulation measuring equipment to vigorously press the temporal region of the real skull model according to the clinical practice and maintain 2 s to obtain the maximum pressure value. The additional pressure on the temporal region was obtained by subtracting the common carotid artery base pressure [set at 90, 120, 150 and 200 mmHg (1 mmHg = 0.133 kPa)] from the maximum pressure.Results:(1) 8 arteries were collected from 4 skull specimens. The length of vessels was (169.5±7.2) mm, the diameter of the starting point of vessel was (4.29±0.28) mm, the diameter of the ending point of vessel was (1.31±0.15) mm, and the volume was (1.56±0.21) ml. (2) There were 11 males and 9 females among 20 patients aged 23-53 years. The length of vessels was (172.2±7.6) mm, the diameter of the starting point of vessel was (5.63±0.43) mm, the diameter of the ending point of vessel was (1.77±0.16) mm, and the volume was (1.59±0.23) ml. (3) The mean value of additional pressure generated by local pressure on the temporal region by 5 physicians was (127.2±10.1) mmHg (113.8-138.6 mmHg).Conclusion:When the injection volume into the superficial temporal artery was more than 1.6 ml, the artery was damaged, and the temporal area was pressed strongly (the local pressure was more than 110 mmHg above the basic pressure), the injection material might flow into the intracranial from the junction of the common carotid artery and into the internal carotid artery, which was the possible mechanism of the temporal filling leading to intracranial embolism.

Objective:To observe effects of lower-limb rehabilitation robots on the lower limb spasticity,motor function and ADL of hemiplegic patients after stroke.Method:40 cases of hemiplegic patients were randomly allocated to experiment and control groups (n=20 in each).The experiment group received training assisted by a leg rehabilitation robot LR2 for 30 min once daily for 6 weeks in addition to conventional treatments.The control group was given conventional treatments once daily for 6 weeks.Their lower limbs spasticity,motor function and ADL were assessed with the modified Ashworth rating scale(MAS),Simplified Fugl-Meyer Movement Scale (FMA) and Modified Barthel Index assessment method (MBI) before and after training.Result:After treatment,the lower limb spasticity was significantly lowered (P＜0.05),lower limb motor function and ADL were significantly improved (P＜0.05),and the experimental group was significantly better than the control group (P＜0.05).Conclusion:Leg rehabilitation robot LR2 can lower the spasticity of lower limb muscle and improve lower limb motor function and the ability of daily living in stroke patients,and the short term effect is better than conventional rehabilitation.

ABSTRACT:Objective To assess the effect of prolonged laparoscopic surgery on peritoneal mesothelial cells and fibrinolysis in humans.Methods We examined prospectively 1 6 consecutive patients who underwent laparoscopic surgery (LAP)and 2 1 patients who underwent conventional open surgery (OP)for high-medium rectal cancer with curative intent.During the procedure,biopsy of the parietal peritoneum was made before operation and at 45 min,90 min,and 120 min after operation.The tissue-type plasminogen activator (tPA)and plasminogen activator inhibitor-1 (PAI-1 )were determined by enzyme-linked immunosorbent assay in peritoneal tissues.The cellular injury was detected by LDH assay.The proliferation was quantified by MTT assay.Results PAI-1 activity in the peritoneal tissue was significantly lower in LAP group than in the OP group.tPA activity decreased after 45min of open surgery,but there was no significant change in the LAP group.With time extension,the LDH activity increased and the proliferation of the mesothelial cells decreased.Conclusion Preservation of a prolonged hypofibrinolytic state by inhibition of PAI-1 up-regulation during LAP may predispose patients to less postoperative peritoneal adhesion. The cellular injury becomes apparent and the proliferation is inhibited during prolonged laparoscopic surgery.

Objective To explore the effect of leg rehabilitation robot training on motor and activities of daily living in hemiplegic pa-tients after stroke. Methods From June, 2015 to July, 2016, 40 hemiplegic patients were randomly divided into control group (n=20) and ex-perimental group (n=20). Both groups received routine rehabilitation, and the experimental group received leg rehabilitation robot training in addition for six weeks. The Fugl-Meyer Assessment-Lower Limb (FMA-L), the Fugl-Meyer Assessment-Balance (FMA-B), Holden walk-ing function classification and modified Barthel Index (MBI) were used to access the motor function, balance function, walking ability and activities of daily living (ADL), respectively. Results After treatment, the scores of FMA-L, FMA-B, Holden walking function classification and MBI improved (χ2>8.980, t>3.902, P<0.01), and were higher in the experimental group than in the control group (χ2=7.632, t>2.075, P<0.05). Conclusion Leg rehabilitation robot could facilitate to improve lower extremity motor function, balance function, walking ability and ADL in hemiplegic patients after stroke.

Objective To investigate the value of the adaptive statistical iterative reconstruction (ASIR) algorithm for reducing the radiation dose and optimizing the image quality in the low-dose spectral CT scanning in GSl (Gemstone spectral imaging) of the liver.Methods A total of 60 patients who underwent hepatic spectral CT scanning in GSI were enrolled in this study.The patients were randomly divided into two groups according to priority with 30 cases per group.Low-dose spectral CT scanning was used for group A, and images were reconstructed by ASIR 0 and 50％ , marked as A1 and A2.Group B was scanned with conventional dose of spectral CT, and images were reconstructed by Filtered back projection (FBP).Effective doses (E) for each group were calculated.Image quality was assessed by two radiologists, and the radiation doses were compared between groups A and B.Results All image quality of each group were good enough for clinical diagnosis.E for group A and B were (3.2 ±0.2) and (5.8 ± 0.2) mSv, respectively.There was statistical difference with image noise between group A and B(Z =-6.784,P ＜ 0.05).The image noise, SNR and CNR had statistical differences between group A and B (F =24.013, 15.646, 8.285, P ＜0.05).Compared with group A1, the image noise was lower, and the SNR and CNR were higher in groups A2 and B(P ＜ 0.05).There were no statistical differences of image noise, SNR and CNR between groups A2 and B (P ＞ 0.05).There were no statistical differences of the image quality score between groups A1, A2 and B (F =102.38,105.768, P ＜ 0.05).Conclusions ASIR combined with low-dose spectral CT scanning was helpful to reduce radiation dose and could obtain better image quality in hepatic CT examination.

Objective This study was designed to compare the safety and efficacy of fast track surgery (FTS) with conventional perioperative management in colonl cancer patients undergoing radical resection.Methods From May 2011 to May 2013,66 patients with colorectal cancer were randomly assigned to FTS group and control group.Outcomes were assessed by length of postoperative hospital stay,medical cost,nutritional status,gut function,and postoperative complication.Results FTS group was associated with a significantly shorter postoperative hospital stay,lessmedical cost,earlier first passage of flatus,less loss of body weight in the postoperative period compared with control group,and there were no differences in morbidity or mortality between two groups.Conclusion The radical resection under the guidence of fast track rehabilitation is safe and effective method.Significantly reduce patients' perioparative stess response and accelerate the recovery.

OBJECTIVETo investigate the correlation of the expression of progesterone receptor membrane component-1 to the clinicopathological features of breast cancer.

METHODSThe expression of PGRMC1 was detected immunohistochemically in 60 surgical specimens of breast cancer, and the association of PGRMC1 with the histological grade, lymphatic metastasis, TNM stage and prognosis was assessed.

RESULTSPositive CA-9 expression was detected in 37 (61.67%) of the cases. PGRMC1 expression was significantly correlated to lymph node metastasis (P=0.004), tumor size (P=0.03), TNM stage (P=0.039), overall survival rate (Log-rank=10.378, P=0.0001), and tumor-free survival (Log-rank=4.443, P=0.035), but not to the patients' age (P=0.196) or histological grade (P=0.526). Multivariate survival analysis indicated that PGRMC1 was an independent prognostic factor of breast cancer (P=0.002).

CONCLUSIONSThe expression of PGRMC1 is strongly associated with the progression of breast cancer, and may serve as a useful prognostic indicator of the malignancy.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Membrane Proteins ; metabolism ; Middle Aged ; Neoplasm Staging ; Prognosis ; Receptors, Progesterone ; metabolism ; Survival Rate

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Objective Base on the neighborhood activation model(NAM), to develop the Mandarin monosyllable lexical neighborhood test(M-LNT-monosyllable), which is expected to be useful for evaluating speech perception performance in children with hearing loss. Methods Test items were based on the lexical characteristics of word frequency and neighborhood density which addressed in the neighborhood activation model (NAM). M-LNT -monosyllable consisted of two parts: Lexically "easy" words with high word frequency, which were low phonemically similar to the target word and lexically "hard" words with low word frequency, which were high phonemically similar to the target word. 34 children of 3～5 year old with normal hearing were choosed as subjects to verify easy word and hard word lists. Results 1 979 words for children contained 487 easy words and 419 hard words. Three easy word lists and three hard word lists were developed to estimate the performance of word recognition among normal- hearing children. There were no differences among scores of three easy words lists(P＞0.05), and no difference among scores of three hard words lists(P＞0.05). But there were significant differences between scores of easy and hard words lists(P＜0.01). Conclusion The development of the lexicon was affected by the lexical characteristics. Normal-hearing children with some lexical techniques were affected by the lexical characteristics when they recognized the spoken words, but children with less lexical technique didn't show the same result because the recognition was processed on the phonetic level.