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ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.
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@#Objective To investigate the incidence of Holmes tremor (HT) after stroke and its outcome after medication and rehabilitation. Methods Patients diagnosed as HT after stroke in the ward of neurorehabilitation department from October, 2019 to September, 2021 were reviewed the clinical features, imaging manifestations, drug treatment plan, rehabilitation evaluation scales scores, rehabilitation plan and outcome. Results There were five inpatients with HT (0.7%, 5/715), and all were hemorrhagic stroke, accounting for 1.7% of hemorrhagic stroke. The lesions were located in the midbrain and pons in three cases, cerebellum in one case and thalamus in one case. The tremor appeared 1.5 to seven months after stroke, limited on head and limbs, with other neurological dysfunction. After the comprehensive treatment of drugs and rehabilitation, tremor improved in four cases, and ineffective in one case. The motor and balance function improved less, and the activities of daily living improved somehow. Conclusion The incidence of Holmes tremor is low in stroke patients. The tremor might respond to the treatment, but motor function would not.
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@#Objective To explore the risk of venous thromboembolism (VTE), especially lower-extremity deep vein thrombosis (DVT) and pulmonary embolism (PE), for stroke patients in rehabilitating, and the functional outcome. Methods A total of 3 557 stroke patients in the neurological rehabilitation center of Beijing Bo'ai Hospital for stroke rehabilitation from January, 2015 to October, 2020 were reviewed through the electronic medical record system. Demographic characteristics, stroke characteristics (type and location), laboratory data (D-dimer polymer and arterial partial pressure of oxygen), motor function (Brunnstrom stage, Fugl-Meyer Assessment of motor and balance, modified Ashworth Scale score of triceps crus, and Holden Walking Ability Classification), activities of daily living (Barthel Index), and anticoagulant/antiplatelet treatment data were collected and analyzed. Results The incidence of DVT and PE was 28.5% and 1.29%, respectively. Most were found 30 days later after onset. The incidence of PE was higher after ischemic stroke (χ2 = 12.49, P < 0.001) rather than hemorrhagic stroke. The patients with hemispheric stroke, severe lower-extremity paralysis, and poor activities of daily living were more prone to complications associated with VTE. After rehabilitation, the function of stroke patients with PE could be improved (|t| > 4.302, P < 0.001). Conclusion The risk of DVT and PE in patients during stroke convalescence may not be negligible, and those with older age, previous history of thrombosis, severe stroke, and severe limb paralysis may be stratified in high-risk. Following anticoagulation treatment, early individualized comprehensive rehabilitation can be done for patients with PE to improve their function and activities of daily living.
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Objective:To investigate the ultrasonographic features of thyroid lymphoma and its different pathological types.Methods:The clinical manifestations and sonographic findings were analyzed retrospectively in 30 patients with pathological confirmed thyroid lymphoma from January 2014 to November 2019 in Ruijin Hospital Affiliated to the Shanghai Jiao Tong University of Medicine. Ultrasonographic features of different pathological types of thyroid lymphoma were compared.Results:There were 30 patients included in the study. All the lesions were pathologically diagnosed as diffuse large B-cell lymphoma(17/30, 56.7%), mucosa-associated lymphoma(8/30, 26.7%), follicular lymphoma(3/30, 10.0%), gray zone lymphoma(1/30, 3.3%), and lymphoblastic lymphoma(1/30, 3.3%). Clinical features included short-term neck enlargement (60.0%), with compression symptoms (46.7%), Ⅲ/Ⅳ cervical region lymphadenopathy (63.3%), thyroid dysfunction (10.0%), combined with Hashimoto′s thyroiditis (63.3%). Statistical differences were found in the longitudinal diameter of the lesion ( P=0.036), ultrasonographic features ( P=0.036), and the margin of the lesion ( P=0.005) between diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma.Ultrasonographic features ( P=0.005) and lesion edges ( P=0.020) differed significantly between different aggressiveness. Conclusions:Patients with Hashimoto′s who have noticed a short-term enlargement of extremely low echogenic mass in the thyroid gland and lymphadenopathy in the neck Ⅲ/Ⅳ region should be suspected of having thyroid lymphoma. Very low echo lesions with irregular edges and flaky hyperechoes are characteristic features of diffuse large B cell lymphoma, and very low echo lesions with rims and grid echoes are characteristics of mucosa-associated lymphoma.
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Parkinson's disease is characterized by progressive motor dysfunction owing to degeneration of dopaminergic neurons in the substantia nigra and other nuclei.Recently,the bilateral high frequency stimulation of the subthalamic nucleus deep brain stimula tion (STN-DBS) as the treatment of PD was famous with good curative effect.But postoperative apathy as its side-effect impact on the therapeutic effect and the quality of life of patients seriously,which drawn the attention of clinicians.In this article,we summarized the incidence,manifestation and treatment of postoperative apathy and tried to provide some ideas for clinicians.
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Objective To explore the feasibility of tubeless 2 μm laser vaporesection in treating pediatric ureter cysts by ureteroscopy.MethodsClinical data of 33 ureter cysts patients who received tubeless 2 μm laser vaporesections by ureteroscopy were reviewed. The median age of patients was 4 years with a range from 1 to 7 years. The operations were carried out by RevoLix 2 μm laser through ureteroscopy without ureter stents and catheters indwelling.ResultsAll operations were successfully performed. And no serious complications occurred after the operations.ConclusionsTubeless transurethral 2 μm laser treatment by ureteroscopy was a superior micro-invasive surgery method for pediatrics with ureter cysts, with advantages of little blood loss, high safety, convenient operation and infrequent complications.
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Objective To investigate the clinical efficacy of RevoLix 2 μm continuous wave laser treatment on bladder neck contracture after benign prostatic hyperplasia operation. Methods A total of 21 cases were enrolled in current research and they all accepted 2 μm continuous wave laser treatment of bladder neck contracture after benign prostatic hyperplasia operation in the 252th Hospital of the Chinese People's Liberation Army. The clinical efficacy was recorded. Results The operation of the 2 μm continuous wave laser vaporesections were successfully performed on 21 cases. The maximum urine flow rate was increased from(6. 86 ± 1. 97)ml/ s to(16. 31 ± 1. 61)ml/ s,and the difference was significant(t = 15. 49,P < 0. 01). After 3 to 23 months(median 14 months)follow-up,20 cases were cured and 1 case was combined with bladder residual urine 110 ml. Conclusion The therapy of 2 μm continuous wave laser is a superior micro-invasive surgery method for patients with Bladder neck contracture,which shows little blood loss,high level safety,convenient operation and infrequent complications.
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Objective Through detecting the levels of von willebrand factor (vWF) ,vWF-cleaving protease (vWF-cp)before and after percataneous coronary intervention (PCI) in patients with coronary atherosclerotic heart disease ,to evaluate the relationship between them .Methods According to the results of coronary angiography ,study objects were divided into control group (normal) and PCI group ( the diagnosis of coronary heart disease with PCI operation ) .Enzyme-linked immunosorbent assay (ELISA) was carrout to determin the levels of plasma vWF concentration and vWF-cp activity in plasma and statistical analysis .Results The pre-operative ,postoperative vWF levels in plasma in PCI group were significantly higher than that in the normal control group ;The plasma vWF levels after PCI were significantly higher than that in the group before PCI (P< 0 .05) ;vWF-cp level of the PCI group were lower than in the control group ,and postoperation is lower than preoperation ( P < 0 .05) .With the coronary artery lesion worsen ,the plasma level of vWF increased ,while the level of vWF-cp activity decreased .Conclusion vWF and vWF-cp levels with the severity of coronary atherosclerosis and thrombosis risk was increased in different decreased ,which may play an important role in the pathogenesis of acute coronary syndromes .Changes of vWF and vWF-cp level after PCI indicate that interventional therapy can increase the risk of thrombosis to some extent .
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BACKGROUND:Femoral head avascular necrosis is common in children and elderly. Though, there are many methods can be used for the treatment, it has been inconclusive in the treatment according to the age and stage of the patients. OBJECTIVE:To treat the femoral head avascular necrosis with different methods according to the age and stage, and to retrospectively analyze the fol ow-up results. METHODS:Total y 202 patients (242 hips) with femoral head avascular necrosis were included from October 1998 to October 2008. The patients were divided into groups according to age, included child group (4-14 years old, n=45, 47 hips);youth group (15-45 years old, n=100, 125 hips);and elderly group (46-81 years old, n=57, 70 hips). The patients in the child group were treated with vascularized greater trochanter or iliac periosteal flap displacement, the patients in the youth group were treated with vascularized greater trochanter or iliac periosteal flap displacement, and the patients in the elderly group were treated with hybrid or cementless total hip arthroplasty. RESULTS AND CONCLUSION:Al the 202 patients were fol owed-up for 6 months to 10 years, average 6.3 years. The excellent and good rate of the child group, youth group and elderly group were 87%, 89%and 86%respectively, and al the patients obtained the satisfactory clinical effect;the Harris score of the youth group was increased to (88.1±0.9) points, and the visual analog scale score was decreased to (0.9±0.4) points;the Harris score of the elderly group was increased to (91.5±1.0) points, and the visual analog scale score was decreased to (0.60±0.07) points. The results indicate that vascularized greater trochanter or iliac periosteal flap displacement is suitable for the children and the youths with femoral head avascular necrosis, especial y the patients with the age of 15-45 years in Ficat Ⅱ and Ⅲstage;hybrid or cementless total hip arthroplasty is suitable for the elder patients with femoral head avascular necrosis, as wel as the patients with failure femoral head retention treatment.
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[Objective]To investigate the pathological change of articular cartilage after impacting injury.[Method]Fifty-six New Zealand adult rabbits were divided randomly into low-energy and high-energy groups,with 28 rabbits in each group.One side of hind limb was designed as experimental side and the opposite one as control side.Four rabbits were killed at 4 days,1,2,4,8,16 weeks after impacting injury.Histological sections of the specimens were observed and stained by HE and Safranin O.the values of gray scale were obtained by imaging analysis.[Result]In low-energy group,the Mankin's score and the value of gray scale of Safranin O in experiment side was not significantly different from the control side.In high-energy group,the Mankin's score and the value of gray scale of Safranin O in experiment side increased gradually,and was significantly different from the control side.[Conclusion]In the low-energy group,the cartilage returned to the normal level at 4 weeks.In the high-energy group,the cartilage failed to be restored.The degeneration of articular cartilage was very obvious after 4 weeks.
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[Objective]To investigate the discrepancy on biological characteristics of different subculture osteoblasts in vitro.[Methods] Compare the morphology,AKP activities and mineralization nodules of 1,3,5,7 and 9 subculture osteoblasts,and make statistic of the result.[Results] There was no discrepancy within 1,3 and 5 subculture osteoblasts,but the 7,9 subculture was significantly worse than subculture 1 in the morphology,AKP activities and mineralization nodules.[Conclusion] The osteoblasts within 5 subculture were suitable for experiment in vitro.
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Objective To investigate the effects of nonadrenergic noncholinergic (NANC) neuro transmitter on the frequency and strength of the automatic contractility of detrusor strip. Methods Cystometry was performed to observe the occurance of detrusor instability (DI) after 6 weeks of Wistar rats LUT. Then the rats were sacrified and their detrusors were made into strips to observe the effect of NANC vasoactive intestinal peptide (VIP) and adenosine triphoate(ATP) on the frequency and the strength of automatic contractility. Results The occurrence rate of DI was 62% after 6 weeks of obstruction of LUT; VIP and ATP could significantly inhibit the automatic contraction ability of detrusor strip, decreasing the frequency and the strength of the automatic contraction of detrusor ( P 0.05). Conclusions VIP and ATP can significantly inhibit the frequency and strength of the automatic contractibility of normal and obstructive detrusor.
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ObjectiveTo evaluate the inhibiting effects of mitomycin C（MMC） on fibroblasts of human pterygium （HPF） in vitro．MethodsThe fibroblasts derived from the 5 th to 8 th generation of the cultured tissues in human pterygium．These fibroblasts were exposed to culture plates with MMC at 6 gradient concentrations，adjusting the concentration value of the culture medium to 105，104，103，102，10 and 1 μg/L．The cells had been treated with PBS in the control group．After 48 h of incubation，the absorbency had been determined individually by MTT［3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyl-tetrazolium bromide］ method.The inhibitory rates were calculated accordingly．All the data were analyzed with student t test and linear regression．ResultsThe extensive breakage of fibroblasts was observed．There was a statistical difference between the tested group and control group in absorbency (P＜0.05)，especially at the concentrations of more than 100 μg/L (P＜0.01)．The degree of growth inhibition increased with exposure of cells to MMC over 48 h．It showed that there is a positive correlation between the doses of MMC and the antiproliferative effects on HPF．ConclusionMMC significantly inhibites the proliferation of HPF in a dose-dependent manner．
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AIM: To observe the effect of diterpenoid compound 5F of Pteris semipinnate L on apoptosis in cultured human pterygium body fibroblasts(HPFs).METHODS: Fibroblasts collected from human pterygium body were cultured in vitro with 5F at different time point.Transmission electron microscope(TEM) was used to observe the ultrastructure changes of the HPFs.The changes of the cell cycle and apoptosis of HPFs were evaluated with flow cytometry(FCM).RESULTS: 5F at the concentration of 32 mg/L induced HPF apoptosis at various time points.CONCLUSION: 5F induces HPFs apoptosis.Apoptotic cells are evolved to necrosis with the prolongation of the time.These findings indicate that 5F has a potential clinical value.