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Objective :To explore rehabilitative effect of low—frequency (1Hz ,LF) repetitive transcranial magnetic stimulation (rTMS) combined functional electrical stimulation (FES) on lower limb spasm and motor function in pa—tients with subacute ischemic stroke (SAIS).Methods : A total of 92 SAIS patients with lower limb spasm and motor dysfunction hospitalized in our department were randomly divided into sham stimulation + FES group (sham stimu—lation group ,n＝45) and low—frequency rTMS + FES group (LF—rTMS group ,n＝47) ,both groups were continu—ously treated for three weeks .Lower limb motor function and spasm severity were assessed by Fugl—Meyer motor as—sessment (FMA) and modified Ashworth scale (MAS) respectively before and after treatment ,and motor evoked potential (MEP) was detected .Results : Compared with before treatment ,there was significant rise in FMA score , and significant reductions in MAS score and MEP in two groups after three—week treatment , P＝ 0.001 all ;com—pared with sham stimulation group ,there was significant rise in FMA score [16. 0 (13.0 ,23. 5 ) scores vs. 19. 0 (16.0 ,27.0) scores] ,and significant reductions in MAS score [1. 5 (1. 3 ,1.5) scores vs. 1. 0 (0. 5 ,1. 5) scores] and MEP [ (24.64 ± 0. 39) ms vs. (24.43 ± 0.31) ms] in LF—rTMS group after treatment , P＜0.05 or ＜ 0. 01 . Conclusion : Compared with sham stimulation + FES ,LF—rTMS + FES can more significantly improve lower limb spasm and motor function in patients with subacute ischemic stroke .
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<p><b>OBJECTIVE</b>To analyze the cost effectiveness of HIV screening project in three Guangxi infectious disease special demonstration project countries in 2013.</p><p><b>METHODS</b>To calculate the funds used for the HIV screening project and to study the data on HIV/AIDS and HAART. A five-tree markov model was used to evaluate the quality adjusted life year (QALY) of this HIV screening project and to analyze the related cost effectiveness of the project.</p><p><b>RESULTS</b>The cost of HIV screening in Guangxi infectious disease special demonstration project areas was 19.205 million Yuan and having identified 1 218 HIV/AIDS patients. The average costs for HIV/AIDS positive detection in three project countries were 14.562, 18.424 and 14.042 thousand Yuan per case. The QALYs gained from finding a HIV/AIDS case were 12.736, 8.523 and 8.321 on average, with the total number of QALYs gained from the project as 5 973.184, 3 613.752 and 2 704.325. The overall cost effectiveness ratio of the project was 1.562 thousand Yuan per QALY, and 1.143, 2.162 and 1.688 thousand Yuan per QALY in these three project countries. Project country "A" showed better cost effectiveness index than country B and C.</p><p><b>CONCLUSION</b>The HIV screening project in Guangxi seemed relatively cost-effective but the average cost of HIV/AIDS positive detection was expensive. To strengthen HAART work for HIV/AIDS could improve the cost-effective of the project.</p>
Subject(s)
Humans , Antiretroviral Therapy, Highly Active , China , Cost-Benefit Analysis , HIV Infections , Diagnosis , Drug Therapy , Mass Screening , Economics , Program Evaluation , Quality-Adjusted Life YearsABSTRACT
Objective To investigate the clinical effect of proximal femoral nail anti-rotation (PFNA) on femoral intertrochanteric fracture in the elderly.Methods Eighty-seven elderly patients from June 2007 to March 2012,who had femoral intertrochanter fracture and received treatment of PFNA,were enrolled in this study.Patients were comprised by forty seven people with stable fracture and forty people with unstable fracture.Results They were all followed up from 4.5months to 14 months,with the average time of 7.2 months.No death were found in hospital.The operation time was 25 min in average.During operation,losing blood was 80 ml.Ambulation time was 5.5 d,and the fracture healing time was 22 weeks in average.However,there were significant differences in intraoperative resetpostoperative position of the blade between the stable and unstable fracture patients (P＜0.01).Conclusions PFNA is one of the effective methods in the treatment of intertrochanter fracture,and it has shorter operation time,less losing blood,earlier ambulation,and hardly has complications.
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BACKGROUND:Muscle transposition is a conventional method to treat muscle tissue defects,but it results in damage to another piece of muscle.For this reason,we designed this study to search for a method to in situ repair muscle tissue defects.OBJECTIVE:To investigate the conditions for in vitro induced differentiation of rat bone marrow mesenchymal stem calls(BMSCs)into skeletal muscle cells.METHODS:Following isolation and culture,passage 3 BMSCs were induced to differentiate in vitro by a combination of5-azacytidine,myogenic differentiation factor,transforming growth factor β1,and insulin like growth factor.At 9 days after induction,cells were harvested and identified by immunohistochemistry.RESULTS AND CONCLUSION:Primary cultured BMSCs exhibited an adherent,colony-like growth.After 5-7 days,multi-synaptic calls,thin and fiat polygonal cells,polygonal cells,and triangle-shaped cells were observed.After 12 days,calls confluenced and covered the whole bottom of culture flask,with slightly altered morphology of BMSCs.After 5-azacytidine induction,some calls died and grew slowly.After 7 days,cells markedly grew and soma was gradually enlarged,presenting with an oval,spindle-shaped,or irregular appearance.After 14 days,spindle-shaped calls become more.After 18-22 days,myotubes were increased in number and enlarged in volume,and myotube nucleuses were also increased.The newly formed myotubes and spindle-shaped fibroblasts were distributed in parallel interval.The immunohistochemistry of BMSCs revealed that cells were positive for CD44,with dark brown granules in the cytoplasm,especially around the nucleus,but they were negative for CD34.The immunohistochemistry of induced BMSCs demonstrated that calls were positive for desmin and skeletal muscle myosins.These findings indicate that myogenic differentiation factors and 5-azacytidine could induce the oriented differentiation of BMSCs into skeletal cells,with the presence of positive expression of desmin and skeletal muscle myosins.
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Objective To retrospectively review clinical results of combined coronary artery bypass grafting (CABG) and other heart surgical procedures.Methods Combined CABG and other heart surgical procedures have been done in 134 consecutive cases (male 114, female 20), aged from 48 to 76 years with a mean of 61.7. Coronary angiograph showed that all patients have coronary stenosis with left main involved in 20 cases, and 41 cases have diffused coronary artery disease. 56 patients have post myocardial infarction left ventrical aneurysms, and 42 patients have valve dysfunction which need surgical correction. Left ventricular ejection fraction (EF) were equal to or lower than 45% in 63 patients and in 13 patients EF is less than 30%. All the patients received combined CABG under the support of cardiopulmonary bypass (CPB) and other heart surgical procedures (Transmyocardial laser revascularization in 36, valve procedures in 42, and left ventricle aneurysm resection or plasty in 56 patients simultaneously). Results The mean number of grafts was 2.46 per patient. Intra-aortic balloon pump was required in 6 cases for 11 to 54 hours Postoperative. 3 patients died postoperatively with mortality rate 2.2% (two from low cardiac output syndrome, and one from multiple organs failure). 131 patients recovered and discharged.Conclusion Combined CABG and other heart surgical procedures in more demanding than CABG along but can be done with acceptable morbidity and mortality if good surgical plan can be designed and all the heart abnormalities can be corrected simultaneously.
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Objective To design a new animal model for end-to-side anastomosis of peripheral nerves and analyze the efficiency. Methods The experiment involved 28 Wistar rats,of which the left legs were set as experimental group and the right ones as control group based on mode of nerve anastomosis.In experimental group,the tibial nerves were cut off for anastomosis of the proximal end of the tibial nerves with the distolateral side of the common peroneal nerve.While in control group,the common peroneal nerves were cut off to anostmose the distal end of the peroneal nerve with the distolateral side of the tibial nerves.Electrophysiological examination was done three months later to observe and compare wave amplitude,latent period and maximal wave amplitude at set stimulus volume in both groups and compare the fiber number at distal and proximal ends of the common peroneal nerves. Results There was no significant statistical difference in regard of amplitude,latent period and maximal wave amplitude in both groups.However,the fiber number at distal end of the stoma was much more than that at proximal end in the experimental group,with statistical difference(P