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ObjectiveTo observe the effect of augmented reality training based on enriched environment on walking dysfunction after stroke. MethodsFrom January, 2021 to June, 2022, 36 stroke patients in the Affiliated Suzhou Hospital of Nanjing University Medical School were randomly divided into control group (n = 18) and experimental group (n = 18). Both groups received conventional rehabilitation treatment. The control group was supplemented with conventional walking training, and the experimental group was supplemented with augmented reality training based on enriched environment, for four weeks. They were assessed with Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), 10-meter walk test (10MWT) and Barthel Index (BI) before and after treatment, and the gait parameter was compared. ResultsNo adverse event occurred during treatment. After treatment, the BBS score, TUGT time, 10MWT speed, BI, gait speed, gait frequency and the proportion of single-leg support on the affected side significantly improved in both groups (|t| > 5.161, P < 0.001). All the above indexes were better in the experimental group than in the control group (|t| > 2.106, P < 0.05), except for BI (t = 1.099, P = 0.282). ConclusionAugmented reality training based on enriched environment could improve the walking function of paitents after stroke, which is better than conventional walking training.
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Objective To observe the influence of the clinical pathway management intervention on medical service behaviors.Methods The clinical cases data in a grade A class 3 hospital of Zhangjiakou City,Hebei Province during 2011-2013 were retrospectively analyzed.The influence of implementing the clinical pathway management on the diagnosis results,medical records writing quality,clinical medication,operation,hospitalization time,medical costs,assisted examination items selection were observed and analyzed.Results The admission and discharge diagnosis coincidence rate and preoperative and postoperative diagnostic coincidence rate of 3 diseases entities in the two groups were 100%,the difference had no statistical significance (P>0.05);the medical record grade-A rate in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the medical record grade-B rate was significantly lower than that in the non-implementing clinical pathway group,the difference was statistically significant (P0.05);the average hospitalization time,total costs,drug costs,laboratory fee and examination fee in the implementing clinical pathway group were lower than those in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the operation fee,healthy material fee and nursing fee had no statistically significant difference was statistically significant(P<0.05).Conclusion Implementing the clinical pathway can standardize the doctor′s diagnosis and treatment behaviors and makes the medical work to develop to be more favorable for patients.
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Objective To investigate the relationship between serum resistin,leptin and adiponectin with microangiopathy in the patients with type-2 diabetes mellitus(T2DM).Methods One hundred and twenty patients with T2DM in our hospital were selected and divided into the non-microangiopathy group (NON-MAP,60 cases) and microangiopathy group (MAP,60 cases) according to whether complicating microangiopathy.Other 60 individuals undergoing healthy physical examination were selected as the normal control group(NC).Fasting serum resistin,adiponectin and leptin levels were detected in each group.Fasting blood glucose,insulin and blood lipid levels were also detected.The insulin resistance was evaluated by using insulin resistance index(HOMA-IR).Results The levels of serum resistin,leptin,free fat acid(FFA) and hs-CRP in the NON-MVP group and MVP group were signifi cantly higher than those in the NC group,while the adiponectin level was sigrnificantly lower than that in the NC group,the difference was statistically significant(P＜0.05).The correlation analysis showed that serum resistin and leptin levels had positive correlation with hs-CRP,FFA,HOMA-IR and TG(P＜0.05),and had negative correlation with HDL-C(P＜0.05);the adiponectin level was negatively correlated with hs-CRP,FFA,HOMA-IR and TG,while positively correlated with HDL-C(P＜0.05);serum resistin and leptin levels had positive correlation,both had significantly negative correlation with adiponectin;with serum resistin,leptin and adiponectin as the dependent variables,the multiple stepwise linear regression analysis showed that HOMA-IR and waist to hip ratio had maximal influence on them.Conclusion Serum resistin and leptin levels increase and adiponectin level decrease in T2DM patients suggests that serum resistin,leptin and adiponectin are correlated with T2DM occurrence as well as microangiopathy occurrence.
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Objective To investigate the risk and value of the dissection of bursectomy in T2 gastric cancer. Methods A total of 86 T2 gastric cancer patients were divided into dissection of bursectomy group (46 cases) and non-dissection of bursectomy group (40 cases) according to the random number table method. The age, Borrman type, tumor location, degree of differentiation, vascular tumor thrombus, operation type, lymph nodes metastasis, number of dissected lymph nodes, tumor size, blood loss during operation, operation time and postoperative complications were observed. The patients were followed up for 1 year, and the local recurrence, metastasis and survive were compared between 2 groups. Results There were no statistical differences in age, Borrman type, tumor location, degree of differentiation, vascular tumor thrombus, operation type, lymph nodes metastasis, number of dissected lymph nodes, tumor size, blood loss during operation and postoperative complications (P>0.05). No metastasis was found in anterior layer of transverse colon and pancreatic capsule in 2 groups. The operation time in dissection of bursectomy group was significantly longer than that in non- dissection of bursectomy group: (169.13 ± 37.94) min vs. (147.45 ± 30.27) min, and there was statistical difference (P<0.05). The patients were followed up for 1 year, and there was no local recurrence in 2 groups. There was 1 case with liver metastasis in dissection of bursectomy group, and 1 case with bony metastasis in non- dissection of bursectomy group. There was no death in 2 groups. Conclusions The dissection of bursectomy in T2 gastric cancer could be abandoned, in order to reduce the operation time, blood loss during operation, and postoperative complications.
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Objective:To study the expression of caveolin-1 in colorectal adenocarcinoma tissues and its correlation with microlymphatic vessel density (LMVD), and to investigate the clinical pathological prognostic significance of caveolin-1 and LMVD in patients with colorectal cancer.Methods:The expression of caveolin-1 and LMVD in 45 specimens of normal colorectal tissues, and 90 specimens of colorectal adenocarcinoma tissues were detected by immunohistochemistry technique. The correlation between their expression and the clinicopathologic features was analyzed. Muhivariable Cox regression was used to analyze the association between the laboratory indices and overall survival time.Results:The positive rates of caveolin-1 in colorectal adenocarcinoma tissues were significantly higher than those in normal colorectal tissues (P<0.01). LMVD in colorectal adenocarcinoma tissues were significantly higher than those in normal colorectal tissues (P<0.01). Mean LMVD in group with caveolin-1 positive was significantly higher than in that with caveolin-1 negative. The median survival time was 26.7 months. Cox regression analysis showed that the caveolin-1 expression, invation depth, lymph nodemetastasis, TNM stage, liver metastasis and LMVD were independent risk factors of overall survival time of patients with colorectal carcinoma. Conclusions:Caveolin-1 may contribute to the lymphangiogenesis in the tumor. During the occurrence and development of colorectal adenocarcinoma, there is a close relationship between the expression of caveolin-1 and lymphatic microvessel of tumor. Caveolin-1 expression and microlymphatic vessel density are significant prognostic value of colorectal carcinoma.
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Objective To investigate the influence of fast track surgery(FTS) on the concentrations of serum IL‐6 ,IL‐10 , and TNF‐αin pancreatic cancer patients ,and its clinical significance .Methods Eighty patients undergoing pancreatic cancer opera‐tion were divided into FTS nursing group and traditional nursing group .The concentrations of serum IL‐6 ,IL‐10 ,and TNF‐αin dif‐ferent times before and after operation ,and the same period between groups were measured .Results (1)The concentrations of ser‐um IL‐6 ,IL‐10 ,and TNF‐αwere no significantly difference in two groups before operation(P>0 .05);the concentrations of serum IL‐6 in the first and third postoperative day were higher than those before operation in the observation group (P0 .05);the concentrations of serum IL‐6 after operation were higher than those before operation in the control group(P0 .05);the concentrations of serum TNF‐αin the first and third postoperative day were higher than those before operation in the control group(P0 .05);the concentrations of serum TNF‐α in the first and third postoperative day in the observation were lower than those in the control group(P<0 .05) .Conclusion FTS could significantly reduce inflammatory reaction ,improve immunosuppres‐sion and helps to recover .
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Objective To explore the expression of Survivin in colorectal cancer tissue and its relationship with clinicopathological features.Methods In situ hybridization was used to examine the expression of Survivin mRNA,and immunohistochemical method was used to detect the expression of Survivin protein in 60 cases of colorectal cancer and 30 cases of colorectal normal mucos tissue.The relationship of the expression of Survivin protein with clinicopathological features of colorectal cancer was analyzed.Results The positive expression rate of Survivin protein in colorectal normal mucos tissue (10.00％,3/30) was lower than that in colorectal cancer tissue (73.33％,44/60),and there was significant difference (P ＜ 0.05).The positive expression rate of Survivin mRNA in colorectal normal mucos tissue (6.67％,2/30) was lower than that in colorectal cancer tissue (63.33％,38/60),and there was significant difference (P ＜ 0.05).The expression of Survivin mRNA was positively correlated with depth of invasion,lymph node metastasis,liver metastasis,peritoneal micrometastasis and TNM stage in patients with colorectal cancer (P ＜ 0.01),but had no correlation with gender,age,tumor size,location,degree of differentiation and histological type (P ＞ 0.05).Conclusions The specific high expression of Survivin protein has a high correlation with the occurrence,development,infiltration of colorectal cancer.Survivin may be used as a marker for prognosis of patients with colorectal cancer.
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Objective To analyze and compare the fluorescence in situ hybridization(FISH) and immunohistochemical(IHC) for detecting HER-2 gene amplification and protein expression in breast cancer tissues .Methods 110 cases of breast cancer from Janu-ary 2008 to May 2012 receiving the modified radical mastectomy were selected .The resected breast cancer tissue was detected by FISH and IHC and the detected results were performed the comparative analysis .Results Among 110 cases of breast cancer tissue , 25 cases(22 .73% ) were the HER-2 protein expression(+ + + ) ,44 cases(40 .00% ) were(+ + ) ,26 cases(23 .64% ) were(+ ) and 15 cases(13 .64% ) were(-) .Among 110 cases ,the gene amplification was in 28 cases(25 .45% ) and no gene amplification was in 82 cases(74 .55% ) .The positive(+ + + ) of the IHC detection was coincident with that of FISH ,and the negative(+ /-) of the IHC detection was also coincident with that of FISH ,there was statistical difference between the suspicious positive of the IHC de-tection and the results of FISH (P<0 .05) .But the total coincidence of the IHC detection results and FISH test results was 89 .29%(25/28) ,and the two detection methods had the positive correlation (χ2 =84 .89 ,P<0 .01) .Conclusion The positive and negative expression of the IHC detection has better consistency with that of the FISH detection .However ,the coincidence of the IHC suspi-cious positive expression and the FISH results is poor ,indicating that the suspicious positive sample of the IHC detection needs to be detected by the FISH detection .
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Objective To investigate the relationship between expression of Her-2 gene and the transfer number of axillary lymph node and its influence on prognosis.Methods A total of 351 cases with primary breast cancer from January 2008 to January 2011 were selected.The expression of Her-2 gene was detected by immunohistochemical method,and analyzed the relationship between it and the transfer number of axillary lymph node and its influence on prognosis.Results The expression of Her-2-,+,++ had no correlation with the transfer number of axillary lymph node (x2 =3.757,1.650,2.379,P ＞ 0.05),while the expression of Her-2 +++ had correlation with the transfer number of axillary lymph node (x2 =8.681,P ＜ 0.05).The 2 years survival rates in the expression of Her-2-,+,++,+++ were 77.01％ (201/261),85.00％ (34/40),29.17％(7/24),1 1.54％ (3/26),and which in the expression of Her-2--+ was significantly higher than that in the expression of Her-2 ++-+++ (x2 =61.605,P ＜ 0.01).The transfer number of axillary lymph node was 0 and 1-3,the 2 years survival rate in the expression of Her-2--+ was significantly higher than that in the expression of Her-2 ++-+++,and there was significant difference (x2 =61.605,14.747,P ＜ 0.05).The transfer number of axillary lymph node was 4-9 and ≥ 10,there was no significant difference in the 2 years survival rate between the expression of Her-2--+ and Her-2 ++-+++ (x2 =3.691,3.482,P ＞ 0.05).Conclusions The expression of Her-2-,+,++ has no correlation with axillary lymph node metastasis,and the 2 years survival rate in the expression of Her-2--+ is higher than that in the expression of Her-2 ++-+++,while Her-2-has no difference with Her-2 + in prognosis.While the transfer number of axillary lymph node ≤ 3,the expression of Her-2 gene may be an important prognostic factor.