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Objective:To investigate the clinical efficacy of psychotherapy combined with early comprehensive rehabilitation therapy in the treatment of acute cerebral infarction and the possible mechanism of action.Methods:Eighty-four patients with acute cerebral infarction who received treatment in Yuhang Fifth People's Hospital, China between June 2018 and February 2020 were included in this study. They were randomly divided into an observation group ( n = 44) and a control group ( n = 40). The control group was treated with conventional therapy. The observation group was subjected to early comprehensive rehabilitation therapy combined with psychotherapy based on conventional therapy. All patients were treated for 1 month. Clinical efficacy, the percentage of highly glycosylated type I transmembrane glycoprotein-positive cells and vascular endothelial growth factor receptor-2-positive cells (CD 34+KDR +) in monocytes, and serum level of stromal cell-derived factor-1α were compared between the observation and control groups. Results:After treatment, the scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and National Institutes of Health Stroke Scale (NIHSS) were (16.4 ± 3.8) points, (17.9 ± 5.2) points, (3.56 ± 0.46) points, respectively, which were significantly lower than those in the control group [(23.4 ± 5.6) points, (23.7 ± 6.4) points, (5.39 ± 0.87) points, t = 7.896, 7.258, 6.935, all P < 0.05]. Barthel Index, Fugl-Meyer score, and Functional Independence Score in the observation group were (79.7 ± 20.8) points, (54.6 ± 17.2) points, (96.8 ± 8.5) points, respectively, which were significantly higher than those in the control group [(60.4 ± 17.6) points, (39.6 ± 14.8) points, (83.1 ± 9.7) points, t = 8.123, 7.251, 8.009, all P < 0.05]. After treatment, the percentage of CD34 +KDR + in monocytes and serum level of stromal cell-derived factor-1α in the observation group were (1.58 ± 0.19)% and (1.84 ± 0.11) μg/L, respectively, which were significantly higher than those in the control group [(0.73 ± 0.20)% and (1.34 ± 0.09) μg/L, t = 7.125, 6.983, both P < 0.05). Conclusion:Based on conventional treatment, psychotherapy combined with early rehabilitation treatment can improve the clinical efficacy in the treatment of acute cerebral infarction possibly through increasing the percentage of CD 34+KDR + in monocytes and the serum level of stromal cell-derived factor-1α.
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Objective:After using proximal femoral nail antirotation (PFNA) fixation to treat femoral intertro-chanteric fractures (ITFs), closed negative pressure drainage systems are often used for drainage, but the clinical effect of this method is uncertain. A prospective randomized controlled trial study was conducted to analyze the negative effects of negative pressure drainage systems after PFNA fixation.Methods:Sixty patients with ITFs and underwent PFNA fixation were randomly divided into two groups. Patients in the drainage group were equipped with negative pressure drainage systems after PFNA fixation. At 4, 10, and 90 days after the surgery, the visual analog scale (VAS) score, analgesic dosage, thigh swelling width, wound and infection status, hemoglobin, hematocrit level, total blood loss and transfusion blood volume of the patients were recorded to evaluate the prognosis.Results:The total blood loss of the drainage group [(579.1±236.7) ml] was greater than that of the non-drainage group [(427.8±239.8) ml; P=0.01]. The transfusion blood volume of the drainage group [(443.3±176.3) ml] was greater than that of the non-drainage group [(307.8±155.4) ml; P=0.01]. Compared with the non-drainage group, the drainage group had a higher VAS score at 4 days after the surgery (2.3±0.6, P=0.02). There was no difference between the two groups in analgesic dosage, thigh swelling width, wound infection and hematoma, hospital stay and the total number of complications (all P>0.05). Conclusions:In the patients with ITFs treated with PFNA fixation, the transfusion blood volume and total blood loss of the patients in the drainage group are higher than those in the non-drainage group. In addition, drainage systems may not have short-term benefits for postoperative wound conditions.
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Objective To investigate the correlation between clinical phenotype,electroencephalogram(EEG) characteristics and genotype in children with Angelman syndrome(AS). Methods A total of 103 children with AS at Department of Neurology,Children′s Hospital of Fudan University from June 2017 to June 2018,were included in this study. The information of clinical characteristics,EEG manifestations,genotypes as well as the epileptic outcome were collected retrospectively. The correlations between clinical phenotype,genotype,and epileptic outcome were evaluated. Results (1)Of the 103 cases,48 were male(46. 6﹪)and 55 were female(53. 4﹪).(2)Genotypes on AS criti﹣cal region were maternal chromosome 15q11. 2－q13[86. 4﹪(89/103 cases)],paternal uniparental disomy[3. 9﹪(4/103 cases)],imprinting defects[1. 9﹪(2/103 cases)],and mutations in the maternal copy of UBE3A[7. 8﹪(8/103 cases)].(3)Apparent happy demeanor or smile and general developmental delay were observed in all AS children. Dyskinesia accounted for 98. 1﹪(101/103 cases),followed by oral movement or suck disorders[97. 1﹪(100/103 cases)]and abnormal posture[67. 0﹪(69/103 cases)]. The proportion of acquired small head circumfe﹣rence or microcephaly,flat occiput or occipital groove and wide－spaced teeth were 61. 2﹪(63/103 cases),85. 4﹪(88/103 cases)and 44. 7﹪(46/103 cases),respectively.(4)Behavioral problems like fascination with water,sleep problems and feeding difficulties were found in 86. 4﹪(89/103 cases),89. 3﹪(92/103 cases)and 85. 5﹪(88/103 cases)of the children,respectively. Sleep disorders[94. 4﹪(84/89 cases)νs. 57. 1﹪(8/14 cases)]and feeding difficulties[93. 3﹪(83/89 cases)νs. 35. 7﹪(5/14 cases)]were more frequently seen in children with maternal ab﹣sence group,compared those with no absence,and the differences were statistically significant(all P＜0. 05).(5)Epi﹣lepsy was present in 77. 7﹪(80/103 cases)of children with onset age varying from 8 to 72 months and 80. 8﹪(59/73 cases)were developing seizures prior to 3 years old. Children with maternal absence showed more multiple seizure types than those with no absence[41. 7﹪(32/68 cases)νs. 0(0 case)],and the difference was statistically significant (P＜0. 05). Children with well－controlled epilepsy had more atonic seizure,compared with those with poorly con﹣ trolled seizure[48. 3﹪(14/29 cases)νs. 18. 5﹪(4/27 cases)],and the difference was statistically significant( P＜0. 05). Conclusions Sleep disorders,feeding difficulties in infancy and multiple seizure types are more commonly seen in AS children with maternal absence. Atonic seizure is easier to be controlled over other types of seizures.
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Objective@#To investigate the correlation between clinical phenotype, electroencephalogram (EEG) characteristics and genotype in children with Angelman syndrome(AS).@*Methods@#A total of 103 children with AS at Department of Neurology, Children′s Hospital of Fudan University from June 2017 to June 2018, were included in this study.The information of clinical characteristics, EEG manifestations, genotypes as well as the epileptic outcome were collected retrospectively.The correlations between clinical phenotype, genotype, and epileptic outcome were evaluated.@*Results@#(1) Of the 103 cases, 48 were male (46.6%) and 55 were female (53.4%). (2) Genotypes on AS critical region were maternal chromosome 15q11.2-q13 [86.4%(89/103 cases)], paternal uniparental disomy [3.9%(4/103 cases)], imprinting defects [1.9%(2/103 cases)], and mutations in the maternal copy of UBE3A [7.8%(8/103 cases)]. (3) Apparent happy demeanor or smile and general developmental delay were observed in all AS children.Dyskinesia accounted for 98.1% (101/103 cases), followed by oral movement or suck disorders [97.1%(100/103 cases)] and abnormal posture [67.0%(69/103 cases)]. The proportion of acquired small head circumfe-rence or microcephaly, flat occiput or occipital groove and wide-spaced teeth were 61.2%(63/103 cases), 85.4%(88/103 cases) and 44.7%(46/103 cases), respectively.(4) Behavioral problems like fascination with water, sleep problems and feeding difficulties were found in 86.4%(89/103 cases), 89.3%(92/103 cases) and 85.5%(88/103 cases) of the children, respectively.Sleep disorders [94.4%(84/89 cases) vs.57.1%(8/14 cases)] and feeding difficulties [93.3%(83/89 cases) vs.35.7%(5/14 cases)] were more frequently seen in children with maternal absence group, compared those with no absence, and the differences were statistically significant (all P<0.05). (5) Epilepsy was present in 77.7% (80/103 cases) of children with onset age varying from 8 to 72 months and 80.8% (59/73 cases) were developing seizures prior to 3 years old.Children with maternal absence showed more multiple seizure types than those with no absence[41.7%(32/68 cases) vs.0(0 case)], and the difference was statistically significant(P<0.05). Children with well-controlled epilepsy had more atonic seizure, compared with those with poorly controlled seizure [48.3%(14/29 cases) vs.18.5%(4/27 cases)], and the difference was statistically significant(P<0.05).@*Conclusions@#Sleep disorders, feeding difficulties in infancy and multiple seizure types are more commonly seen in AS children with maternal absence.Atonic seizure is easier to be controlled over other types of seizures.
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Objective Evaluating the effect of Shugan-Jieyu capsule combined with pramipexole on depressive symptoms in parkinson's disease(PD) patients.MethodsAccording to the criteria of including and excluding, we collected 63 PD depression cases who visited doctors at neurological outpatient room between June 2014 and April 2016.35 cases only treated with pramipexole, designed as pramipexole group, and 28 cases treated with pramipexole and Shugan-Jieyu capsule, designed as combined treatment group.The Hamilton depression scale(HAMD), activities of daily living scale(ADL) and unified Parkinson's disease rating scale-part III(UPDRS-III) were assessed at baseling, week 6 and week 9.ResultsAt week 9, HAMD was (17.71±6.78) in pramipexole group versus (14.32±4.81) in combined treatment group, there was significant difference between the two groups(P=0.029), As for HAMDΔ9, analysis did show a significant difference(pramipexole group (-11.06±3.27) vs combined group (-14.93±6.24);P=0.002).Analysis showed a significant difference as for ADLΔ6(pramipexole group (-2.37±1.31) vs combined group (-3.57±2.04);P=0.006) at week 6.There was no significant difference between groups for the reduction in total UPDRS-III scale.No serious adverse event was recorded during treatment of depression.ConclusionShugan-Jieyu capsule combined with pramipexole did have significant effects versus pramipexole on depressive symptoms in PD patients.
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Objective To study the variation of serum Hcy and UA of Parkinson's disease.Methods 46 pa-tients with Parkinson's disease in our hospital from April 2015 to March 2016 were selected as observation group,and 57 patients with other disease at the same time were selected as control group.The contents of serum Hcy and UA of the two groups were analyzed and compared.Results The contents of serum Hcy and UA of the observation group were (17.82 ±3.12)μmol/L,(321.42 ±79.42)μmol/L.Those of the control group were (10.12 ±3.05)μmol/L, (420.15 ±70.18)μmol/L.The content of serum Hcy of observation group was higher than the control group,the con-tent of serum UA of the observation group was lower than the control group(t =12.608,P <0.01).Hcy content of middle and late patients[(18.86 ±3.12)μmol/L]was higher than early patients[(16.16 ±3.04)μmol/L](t =2.378,P <0.05),serum Hcy level was positively correlated with UPDRS(r =0.462,P =0.037),the differences were significant.Conclusion Changes of serum Hcy and UA levels were related to the occurrence of Parkinson's disease.
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BACKGROUND:The self-renew and regeneration capacity of the injured spinal cord is thought to be limited. Accordingly, cel transplantation is one potential strategy for promoting functional recovery after spinal cord injury. OBJECTIVE:To explore the effects ofPTEN silencing on the biological properties of bone marrow mesenchymal stem cels, hoping to offer better seed cels for tissue engineering. METHODS:Bone marrow mesenchymal stem cels were transfected with specific siRNA-silencedPTEN gene using the liposome method, and then RT-PCR was used to detect the mRNA expression ofPTEN. Variation of biological properties ofPTEN-transfected cels were detected by the way of MTT assay, cel cycle analysis, and Transwel assay. RESULTS AND CONCLUSION:PTEN is expressed highly in bone marrow mesenchymal stem cels, which is successfuly interfered by siRNA.PTEN-silenced cels have stronger survival, proliferation and migration abilities, which become a kind of better seed cels for tissue engineering.
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Objective To examine clusters of anti-nuclear antibodies (ANA) and their associations with clinical features in patients with systemic lupus erythematosus (SLE).Methods It was a retrospective study.113 SLE patients were reviewed from March 2010 to May 2012 in Department of Rheumatology,Jinhua Central Hospital.ANA and specific autoantibodies to 15 kinds of nuclear antigens were tested by indirect immunofluorescence assay (IIF) and line immunoassay (LIA) respectively.Hierarchical clustering method was performed to analyze specific clusters of ANA profiles in SLE.Chi-square tests were used to investigate relationship between antibody clusters and clinical features of SLE.Results The positive rate of LIA for ANA was 97.3％,consistent with IIF method,and the total accordance rate of the both methods was 98.2％.Thirteen kinds of antigen-specific antibodies were detected in SLE patients by LIA.Clustering analysis for these antibodies showed three specific clusters in SLE,Nuc/His/dsDNA cluster (C1),low-Ro/low-La cluster (C2),and Ro/Sm/RNP cluster (C3),accounting for 36.3％,24.8％,38.9％ of the total cases respectively.There were significant difference of AST levels among three clusters [(32.62 ± 21.92)U/L,(25.56 ± 16.63) U/L,(50.41 ± 60.86) U/L respectively for C1,C2 and C3].High incidences of chronic cutaneous lupus,abnormal renal indicators and inflammatory synovitis were found in all three clusters.Besides,there were significant differences among three clusters for the incidences of chronic cutaneous lupus (39.0％,39.3％,63.6％ respectively for C1,C2,C3) and leukopenia/lymphopenia (56.1％,25.0％,56.8％ respectively for C1,C2,C3) (P ＜ 0.05).Patients in Ro/Sm/RNP cluster showed higher incidences of lupus nephritis (43.2％/26.8％ or 39.3％); patients in low-Ro/low-La cluster showed low risk of hypertension (7.1％/19.5％ or 22.7％) ; patients in Nuc/His/dsDNA cluster showed high incidences of thrombocytopenia (41.5％/21.4％ or 25.0％) and high risk of lung or upper respiratory tract infection (46.3％/28.6％ or 29.5％),but low incidence of neurologic symptoms (0％/ 3.6％ ％ or 11.4％).Conclusion Three characterized ANA clusters are identified in SLE patients in this pilot study.Different clusters are associated with certain clinical features and complications ofSLE.However,the correlations found in this study need to be investigated further in larger populations.
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Biomaterials are commonly applied in regenerative therapy and tissue engineering in bone.Generally,nanoparticles interact distinctively with bone cells and tissue,depending on their com-position,size,and shape.Therefore,detailed analyses of nanoparticle effects on cellular functions have been performed to select the most suitable candidates for supporting bone regeneration.This review will highlight potential nanoparticle applications in bone.We found that mesenchymal stem cells (MSCs) display exceptional regenerative potential.The delivery of genetic material with nanoparticulate carriers offers the possibility of overcoming certain disadvantages of standard protein delivery approaches.Moreover,nanoparticles are already clinically applied in cancer treatment.Thus,corresponding efforts could lead to new therapeutic strategies to improve bone regeneration or to treat bone disorders.
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Objective To evaluate significance of the quantification of bcr-abl mRNA in diagnosis and therapy of chronic myeloid leukemia (CML),essentiality significance for monitoring minimal residual disease. Methods Bcr-abl mRNA of 518 CML patients were detected using real-time PCR. Results Expression of bcr-abl mRNA was gradually increased among blastic phase (BP) (12.6 %),accelerated phase (AP) (25.4 %) and chronic phase (CP) (57.2 %) (P<0.05). Quantification of bcr-abl mRNA was cut down gradually after allotransplantation in the patients and becomes normal after treatment for 6 months. But quantification of bcr-abl mRNA inpatients treated with imatinib mesylate became normal after 12 months. Conclusion Real-time PCR was reliable and can be used for diagnosis,monitoring the treatment outcome,detecting the minimal residual disease,and predicting blast crisis.
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To observe the expressions of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in rats with pulmonary fibrosis (PF) induced by bleomycin, and to explore the mechanisms of Shenlong Decoction in preventing and treating PF.
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Objective To investigate the novel V617F point mutation of JAK2 gene by real-time PGR in the patients with chronic myeloproliferative disease (CMPD) and evaluate its clinical significance. Methods Genomic DNA from bone marrow or peripheral blood mononuclear cells was extracted from 56 patients with CMPD, including 26 cases of polycythemia vera (PV), 24 cases of essential thrombocythemia (ET), 5 cases of chronic idiopathicmyelofibrosis (CIMF) and 1 case of high eosinophilic syndrome (HES). The exon 14 of JAK2 gene which harbourd V617F mutation were screened by real-time PGR. Results JAK2 V617F mutation was measured in 29 of the 56 patients with CMPD. The prevalence of mutation was 65.38 %(17/26) in PV,37.50 % in ET and 60.00 %(3/5) in CIMF. The proportion of mutation in PV, ET and CIMF are respectively 53.85 %(14/26), 29.17 %(7/24), 40.0 %(2/5) in heterozygotes and 11.54 %(3/26), 8.33 %(2/24), 20.00 %(1/5)in homozygotes. JAK2 mutation was negative in one patient with HES. JAK2 V617F allele burden in PV, ET and CIMF are respectively 2.14×102-1.5×107, 9.80×102-4.4×107 and 4.10×103-3.70×106 copies. Conclusion Real-time PCR is a useful tool for pre cisely assess the grade of mutant allele burden as well as to screen JAK2V617F mutation simultaneously, which is simple and convenient to carry out in clinical laboratories for diagnosis and further evaluations of minimal residual disease in CMPD patients.
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Objective To explore the effect of adriamycin, bleomyein, vincristine and dacarbazinum (ABVD) chemotherapy scheme executed at day I and day 8 for primary Hodgkin's lymphomas (HL). Methods 62 patients with primary HL in stages Ⅱ-Ⅳ treated in our department from October 2005 to October 2006 were divided into group A and B at random with 31 patients in each group. The patients in group A received ABVD chemotherapy scheme executed at day 1 and day 8 for 6-8 cycles. The patients in group B received ABVD chemotherapy scheme executed at day 1 and day 15 for 6-8 cycles. The patients of the groups received radiotherapy by the same doctor after chemotherapy according to the patients condition and the radiotherapy regimens were not affected by the grouping. Results The complete remission rate (CR)in group A after chemotherapy was 90. 3% (28/31);the one-year and two-year disease free survival (DFS) rates were 87. 1% (27/31) and 80.0% (20/25)respectively. The CR rate in group B after chemotherapy was 83.9% (26/31);the one-year and two-year DFS rates were 80. 6% (25/31)and 72. 0% (18/25) respectively. The discrepancy of CR rates and the one-year and two-year DFS rates between the two groups was not significant (P>0.05). The incidences of therapeutic side effecte such as myocardial iscnemia grade Ⅲ-Ⅳ liver function impair-ment,pulmonary fibrosis and serious marrow inhibition between the two groups were not significant too (P > 0.05). Average chemotherapy period for the patients in group A was 159 days; it was 69 days shorter than that in group B. Conclusion The CR rate,1-year DFS rate and 2-year DFS rate of ABVD chemotherapy scheme executed at day 1 and 8 are similar to those of ABVD chemotherapy scheme executed at day Ⅰ and 15 for primary HL in stages Ⅱ-Ⅳ. The side-effects of chemoterapy between group A and B are similar too. The chemotherapy period in group A is shortened significantly.
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Objective: To study the therapeutic effects of Xuesaitong injections on senile coronary heart disease ( CHD) . Methods: Retired veteran cadres and their relations in our unit were enrolled in this study. They were divied into Xuesaitong treatment group (58 cases) and control group ( Salvia Miltiorrhi-za Compound Injections and Venoruton, 34 cases). Follow-up time was 10 days per period of treatment. The symptoms, ECG, serum cholesterol and triglyceride before and after treatment were compared. Results :ECG and serum lipids were significantly improved in Xuesaitong treatment group (P 0.05). Conclusion: Xuesaitong injections have therapeutic effects on senile CHD.
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This paper discusses the present situation of the air-station medical equipment digital construction,and analyzes the common problems at present.According to the integration spirit of superior department,this paper designs air-station medical database and presents the solutions to realize resource integration and information sharing.
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Objective To study the changes with aging of lung density parameters on inspiratory and expiratory HRCT in asymptomatic nonsmokers,and the correlation with pulmonary function test(PFT).Methods Lung HRCT scans were performed at end inspiratory and end expiratory in 63 subjects,and PFT were performed in 32 of them.All the subjects were divided into 5 groups according to the ages.Lung HRCT quantitative parameters of each groups were measured,and the correlation with PFT results was assessed.Results In each age group,the mean lung density of expiratory lung HRCT and the overall lung density difference between inspiratory and expiratory HRCT was significant decrease(P
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Objective To research the appearances of CT and pathology in pulmonary hamartoma so as to improve the CT diagnostic accuracy.Methods The CT and pathological findings of 25 cases of pulmonary hamartoma were analyzed. Dynamic contrast enhancement CT scanning were performed in 17 cases without calcification. All cases were confirmed by surgical operation and pathology.Results All hamartomas had smooth edge on CT. Focal fat without calcification inside were present in 8 of 25 cases, focal fat and calcification inside in 6 of 25 cases (24%), calcification without fat inside in 2 of 25 cases (8%). The CT contrasted value was less than 20 HU in16 of 17 cases (88.24% ). Contrast-enhancing septa were present in 13 of 17 cases(76.47%). The enhancing septa corresponded to loose connective tissue between cartilaginous core. Pathologically, all hamartomas had complete fibrous capsule around them. Cartilage ,broncheal gland, smooth muscle and fibrous connective tissue were found in all cases, and fat and calcification were found in 13 (52%) and 8 (32%) respectively.Conclusion Some specific CT features, including smooth edge, calcification and fat inside, are useful for diagnosis of pulmonary hamartoma. Dynamic contrast enhancement CT scanning is useful for differentiating pulmonary hamartoma with peripheral lung carcinoma.
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Objective To establish the quality standard for Zaizao Nongsuo Wan. Methods Artificial Calculus Bovis, Radix Paeoniae Rubra, Rhizoma Coptidis and Herba Ephedrae were identified by TLC. The content of Muscone was determined by GC. Results Under the selected conditions, the clear and distinguished spots were obtained. For content determination, the linear range of Muscone was 0.101 2 ? g～ 1.012 ? g, r=0.999 9, the average recovery was 99.11 % ( n=5) and RSD was 3.59 % . Conclusion The methods are proved to be simple, specialization with a good reproducibility, and can be used to control the quality of Zaizao Nongsuo Wan.
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The effects of metoclopramide( MCP ) on the physiologic properties of guinea pig papillary muscles and the hemodynamics in anesthetic dogs were studied. MCP decreased contractility, increased the epinephrine concentration inducing automaticity and shifted the voltage-time plot to the right. But the functional refractory period was prolonged. Furthermore, the contractility and automaticity of the right auricle were decreased. MCP 5 mg/kg iv increased cardiac index (CI), systolic blood pressure ( SBP ), diastolic blood pressure ( DBP ), left ventricular systolic pressure ( LVSP ), maximal rate of change of intraventricular pressure ( dP/dtmax ), and total peripheral resistance ( TPR ) while MCP 10mg/kg iv decreased SBP, DBP, LVSP, dP/dtmax and TPR except increase of CI.
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Metoclopramide ( MCP ) is similar to Procainamide in structure. In rats anaesthetized by ip chloral hydrate 300 mg/kg, arrhythmia induced by BaCl 3 mg/kg was shown to be antagonized by injecting iv MCP 30 mg/kg. It was also found that MCP 10 mg/kg injected iv protected rabbits against a'rrhythmia induced by chloroform-adrenaline . In anaesthetized rats, MCP 30 mg/kg injected iv raised the dose of aconitine required to induce first arrhythmia, ventricular fibrillation ( VF ) and heart arrest, while in anaesthetized guinea pigs, the same amount of MCP injected iv showed no significant action on the dose of ouabain inducing these effects. Ventricular tachycardia produced by occlusion of coronary artery in rats could not be prevnted by injecting iv MCP 30 mg/kg. It was found that MCP has local anaesthesia action.