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简介：BACKGROUND:Strokepresentsasatransientorchronicbraindysfunctionandisassociatedwithhighmorbidityandhighmortality.Thedoctorsandscientistswouldliketoarguehowtoenhancethevalidityoftherehabilitationtreatmentandhowtofurtherimprovetheleveloftreatmentonstroke.OBJECTIVE:TheaimofthisstudywastoquantitativelyanalyzethecurrentworldwideprogressinresearchonstrokerehabilitationtreatmentbasedonWebofSciencedatabaseandClinicalTrial.govinthepast10years.METHODS:WeconductedaquantitativeanalysisofclinicaltrialarticlesregardingstrokerehabilitationpublishedinEnglishfrom2003to2013andindexedintheNationalInstitutesofHealthClinicalTrialsregistryandWebofSciencedatabases.DataweredownloadedonMarch15,2013.RESULTS:(1)From2003to2013,2654clinicaltrialsinvestigatingstrokewereindexedinClinicalTrials.gov.Therewereonly58clinicaltrialsregisteredin2003,andtherewasamarkedincreasefrom2005.Atotalof605clinicaltrialsontherehabilitationofstrokewereconductedinthepast10years.(2)TheanalysisshowedthatmostofthetrialsinthefieldwereregisteredbyNorthAmericaninstitutions.WithrespecttotheAsiancountries,ChinaandTaiwanareaofChinaalsopublishedareasonableproportionofthetrials,butcomparativelyspeaking,thenumberoftrialsisreallyrare.Mostoftheinterventionsweredrugs,followedbythedevices,andbehavioralinterventionswererankedthird.(3)Inthepast10years,therewere4052studiesonstrokeindexedbyWebofSciencedatabase.CONCLUSION:Fromperspectiveofresearchprogress,wefoundthatthenumberofclinicaltrialsandpapersonstrokerehabilitationhasincreasedsignificantlyinthepast10years,betweenthemaremarkablepositivecorrelationexists.

简介：Auditoryneuropathy(AN)isahearingdisordercharacterizedbyabsenceofauditorybrainstemresponsesdespitepreservationofouterhaircellfunction,andhasattractedattentionsfromresearchersandaudiologistssincereportedbyStarretal[1].ClinicalmanifestationsinANpatientsincludeabnormalauditorybrainstemresponsesnormalotoacousticemissions,lackofacousticreflexeslargecochlearmicrophonics,speechperceptiondeteriora

简介：DuringGHtherapyfor2.3-9.6years,maleadult-onsetGH-deficientpatientswithadiagnosisofanonfunctioningadenomahavenoincreasedall-causemortality.However,womenwithadult-onsetGHdeficiency(GHD)arestillatslightlyhigherrisk.Thisgeneralimprovementinmortalityisduetoamorecontemporaryregimenofcardiovasculardrugs,arefinementofsurgicalprocedures,besidestheintroductionofGHtherapyimprovedhormonereplacementregimenswithloweredglucocorticoidreplacement,updatedapproachesofsexsteroidsforwomen,andlessuseofcranialradiotherapy.Theunderlyingdiseaseisthemostimportantpredictorformortality:eg,acraniopharyngioma,malignantcausesofhypopituitarism,previousCushing'sdisease,andthepresenceofdiabetesinsipidus/

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简介：AIM:Todescribetheresultsof5consecutivecasesofclearlensextractioninangleclosurepatientsforthetreatmentofelevatedintraocularpressure(IOP).·METHODS:Retrospectiveobservationalcaseseries.Allangleclosurepatientswereontwoormoretopicalglaucomamedicationsandhadpriorlaseriridotomy.Eyesunderwentclearlensextractionbyphacoemu-lsificationwithintraocularlensimplantation.·RESULTS:Allfivepatientsinthiscaseseriescarriedthediagnosisofangle-closureglaucomaandhaduncontrolledIOPpriortosurgerydespitetopicalmedications.AfterclearlensextractionthreeofthecaseshadgoodIOPcontrol(IOP<22mmHg)withouttheneedfortopicalmedications.InonecasetheIOPwasbettercontrolledaftersurgery,however,topicalmedicationswererequired.ThedesiredIOPwasnotmetinonecasedespiterestartingmaximumtopicaltherapy.·CONCLUSION:Thiscaseseriessuggeststhattheremaybearolefortherapeuticclearlensextractioninselectcasesofangle-closureglaucoma.

简介：Objective:Toanalyzethecorrelationsamongcomorbidityandoverallsurvival(OS),biochemicalprogression-freesurvival(b-PFS)andtoxicityinelderlypatientswithlocalizedprostatecancertreatedwith125Ibrachytherapy.Methods:Elderlymen,aged≥65years,withlow-intermediateriskprostatecancer,weretreatedwithpermanent125Ibrachytherapyasmonotherapy.Comorbiditydatawereobtainedfrommedicalreportsusingage-adjustedCharlsoncomorbidityindex(a-CCI).Thepatientswerecategorizedintotwoagegroups(<75and≥75yearsold),andtwocomorbidityscoregroups(a-CCI≤3and>3).ToxicitywasscoredwithRadiationTherapyOncologyGroup(RTOG)scale.Results:FromJune2003toOctober2009,atotalof92elderlypatientsunderwentprostatebrachytherapy,including57men(62%)withlow-riskprostatecancer,and35men(38%)withintermediate-riskprostatecancer.Themedianageofpatientswas75years(range,65-87years).Forty-sevenpatients(51%)hada-CCI≤3and45patients(49%)a-CCI>3.Withamedianfollow-upperiodof56months(range,24-103months),the5-yearactuarialOSandb-PFSwere91.3%and92.4%respectively,withoutstatisticalsignificancebetweentwoCharlsonscoregroups.Toxicitywasmild.Noneofthepatientsexperiencedgastrointestinal(GI)toxicity,andonly4patiens(4%)experiencedlategenitourinary(GU)grade-3(G3)toxicity.NocorrelationbetweenacuteGUandGItoxicityandcomorbiditywasshowed(P=0.50andP=0.70,respectively).Conclusions:Ourdatasuggestthatelderlymenwithlow-intermediateriskprostatecancerandcomorbiditycanbeconsideredforaradicaltreatmentas125Ilow-doseratebrachytherapy.

简介：Maintainingstandingposturalbalanceisimportantforwalkingandhandlingabilitiesinpatientswithcerebralpalsy.Thisstudyincluded23patientswithcerebralpalsy(sevenwithspasticdiplegiaand16withspastichemiplegia),agedfrom7to16yearsofage.StandingposturebalancemeasurementswereperformedusinganAMTImodelOR6-7forceplatformwiththeeyesopenandclosed.Patientswithdiplegiccerebralpalsyexhibitedgreatercenterofpressuredisplacementareaswiththeeyesopenandgreatercenterofpressureswayinthemedial-lateraldirectionwiththeeyesopenandclosedcomparedwithhemiplegicpatients.Thus,diplegicpatientsexhibitedweakerposturalbalancecontrolabilityandlessstandingstabilitycomparedwithhemiplegiccerebralpalsypatients.

简介：OBJECT:Optimummanagementforelderlypatientswithnewlydiagnosedglioblastoma(GBM)inthetemozolomide(TMZ)eraisnotwelldefined.Theobjectofthisstudywastoclarifyoutcomesinthispopulation.METHODS:Theauthorsretrospectivelyreviewed105consecutivecasesinvolvingelderlypatients(age≥65years)withnewlydiagnosedGBMwhoweretreatedattheMayoClinicbetween2003and2008.RESULTS:Thepatients'medianagewas74years(range66-87years),andthemedianKarnofskyPerformanceStatus(KPS)scorewas80(range40-90).Halfofthepatientsunderwentbiopsyandhalfunderwentresection.Patientswithdeep-seatedlesions(19patients[18%])ormultifocallesions(34patients[32%])weremorelikelytohavebiopsythanresection(p=0.0001and0.0009,respectively).Newpersistentneurologicaldeficitsdevelopedin7patients(6.7%).Postoperativehemorrhageoccurredin6patients(5.7%),allofwhomunderwentbiopsy.Completefollow-updataregardingadjuvanttreatmentwasavailablein84patients.Forty-one(49%)weretreatedwithchemotherapy(mostlyTMZ)andradiationtherapy(RT),and23(27%)withRTalone.Nineteen(23%)receivedonlypalliativecareaftersurgery(morecommonwithbiopsy,p=0.03).Chemotherapycomplicationsoccurredin28.6%(Grade3or4hematologicalcomplicationsin11.9%).Themedianvaluesforprogression-freesurvival(PFS)andoverallsurvival(OS)were3.5and5.5months.Inamultivariateanalysis,youngerage(p=0.03,riskratio[RR]0.34,95%CI0.13-0.89),singlelesion(p=0.02,RR0.51,95%CI0.30-0.89),resection(p=0.04,RR0.54,95%CI0.31-0.94),andadjuvanttreatment(p=0.0001,RR0.24,95%CI0.11-0.49)wereassociatedwithbetterOS.OnlyadjuvanttreatmentwassignificantlyassociatedwithprolongedPFS(p=0.0007,RR0.27,95%CI0.13-0.57).Withcombinedtherapywithresection,RT,andchemotherapy,themedianPFSandOSwere8and12.5months,respectively.CONCLUSIONS:TheprognosisforGBMworsenswithincreasingageinelderlypatients.Withimportantrisks,resectionandadjuvanttreatmen

简介：BackgroundVocalcordmovementdisorder(VCMD)isalaryngealdisordercharacterizedbyparadoxicaladductionofthevocalcordsduringininspiration,expirationorboth.ThenursingexperienceofpatientswithVCMDafteraorticdissectionsurgeryislimited.MethodsWeretrospectivelyanalyzedtheclinicaldataandnursingrecordsof269patientsafteraorticdissectionsurgeryinGuangdongGeneralHospitalbetweenMay2010andMay2012.Weobservedthepatients’pronunciation,andjudgediftherewasdysphagiaundergoingwaterdrinkingtesttwohoursafterextubation,toconfirmwhetherpatientshadVCMD.ResultsSeventeenpatientshadVCMDafteraorticdissectionsurgery,ofwhom2sufferedhoarseness,3haddysphasiaand12hadbothhoarsenessanddysphasia.Aftertimelytreatmentandcarefullynursing,allthepatientsrecoveredwell.ConclusionsWiththeenhancedcareofpatientswithaorticdissection,observinghoarsenessappearanceanddrinkingexperimentimmediatelyafterextubationcandetectVCMDassoonaspossible.Furtherrehabilitationtrainingandpsychologycarecanpreventbuckingandaspirationeffectively,andpromotingrecoveryandimprovingpatient’slifequality.

简介：Background:NostudieshavecomparedeffectivenessofresistancetrainingandTaiJiexerciseonrelievingsymptomsofkneeosteoarthritis(OA).Thepurposeofthestudywastoevaluateeffectsofa10-weekTaiJiandresistancetraininginterventiononimprovingOAsymptomsandmobilityinseniorswithkneeOA.Methods:Thirty-oneseniors(60-85years)wererandomlyassignedtoaTaiJiprogram(n=12),aresistancetrainingprogram(n=13),andacontrolgroup(n=6).AllparticipantscompletedtheWesternOntarioandMcMaster(WOMAC)OsteoarthritisIndexandperformedthreephysicalperformancetests(6-minwalk,timed-up-and-go,andtimedstairclimbanddescent)beforeandafterthe10-weekintervention.Results:Theparticipantsintheresistancetraininggroupsignificantlyimprovedonthetimed-up-and-gotest(p<0.001),theWOMACpainsubscore(p=0.006),WOMACstiffnesssub-score(p<0.001),andWOMACphysicalfunctionsub-score(p=0.011).TheTaiJigroupsignificantlyimprovedonthetimed-up-and-gotest(p<0.001),butnotontheWOMACscores.Conclusion:ResistancetrainingwaseffectiveforimprovingmobilityandimprovingthesymptomsofkneeOA.TaiJiwasalsoeffectiveforimprovingmobility,butdidnotimprovekneeOAsymptoms.

简介：Agiantcelltumoroccursmainlyintheproximaltibia,humerus,distalradiusboneandthepelvicbone.Itisrarelyobservedinsuchsitesastheribsandthetemporalbone.Theconditionisprimarilytreatedwithsurgicalexcisionandfunctionalreconstruction.Theeffectofchemotherapyonlungmetastasesandlocallyadvancedgiantcelltumorshasremainedunknown.Wecollectedandanalyzedthedataofsixpatientswithraregiantcelltumorslocatedintheheadandneckpatients.Afteranaveragefollow-upof42.6monthsaftersurgery(14to90months),nolocalrecurrenceormetastasiswasobserved.Wealsocollectedandanalyzedthedataoffivepatientswithmetastaticgiantcelltumorswhowereundergoingsurgeryfortheprimarytumorbefore;ofthreepatientswhohadexperiencedmultiplechemotherapycycles,onehadspontaneousregression,andonesurvivedforlongtimerdespiteprogression.Theothertwopatientshadtheirmajormetastaticlesionsresectedbysurgery,andpresentedlong-termsurvivalduringthefollowup.Inaddition,thisstudyreportsonepatientwithlocallyadvancedgiantcelltumoroftherib,whohasundergonesuccessfulsurgicalresectionfollowingtwocyclesofchemotherapywithifosfamideandliposomaldoxorubicin.Completeresectionofthelesionattheheadandneckisthekeytorelapse-freesurvival.Theprognosisoflungmetastasesinpatientswithgiantcelltumorsisrelativelysatisfying.Neoadjuvantchemotherapyisalsoconducivetothesurgeryforlocallyadvancedlesionsandimprovementofthequalityoflife.

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简介：Objective:Correctnutritionalassessmentisessentialforleukemiapatientsafterhematopoieticstemcelltransplantation(HSCT).ThisstudyaimedtoinvestigatethebestnutritionalassessmentmethodforleukemiapatientsafterHSCT,andfindthepossiblenutritionalriskofthepatientsduringthetransplantationprocessinordertointerveneinthepatientswithnutritionalrisksandundernourishedpatientstimely,sothattheentiretransplantationprocesscouldbesuccessfullycompleted.Methods:Aprospectivestudywasperformedin108leukemiapatientsafterHSCT,anddifferentnutritionalassessmentmethods,includingnutritionalriskscreening2002(NRS2002),mininutritionalassessment(MNA),subjectiveglobeassessment(SGA)andmalnutritionaluniversalscreeningtools(MUST),wereused.Theassociationsbetweennutritionalstatusofthesepatientsandnutritionalassessmentmethodswereanalyzed.Results:Atotalof108patientscompletedSGA,and99patientscompletedNRS2002,MNAandMUST.Duringthetreatmentprocess,85.2%ofthepatientslostweight,wherein,50%lostweightgreaterthan5%,and42.6%hadsignificantlyreducedfoodintake.Fornutritionalriskassessment,thepositiveratesofNRS2002,MNAandMUSTwere100%,74.7%and63.6%,respectively.Therewasasignificantdifference(P<0.05)amongthepositiveratesofNRS2002,MNAandMUST.Inundernutritionassessment,thepositiverateofSGA(83.3%)wassignificantlyhigherthanthatofMNA(17.2%)(P<0.05),andtheincidencerateofnutritionalriskamongleukemiapatients≤30yearsoldwasgreaterthanthatofpatients>30yearsold(P<0.05).Conclusions:PatientswithleukemiawereinpoornutritionalstatusduringandafterHSCT.Theleukemiapatients≤30yearsoldhadagreaterincidencerateofnutritionalrisk.Asnutritionalriskscreeningtool,thespecificityofNRS2002isnothigh,butitcanbeusedforevaluatingnutritionaldeficiencies.MNAisagoodnutritionalriskscreeningtool,butnotanadequatetoolfornutritionalassessment.Ifassessmentofundernutritionisneces

简介：Objective:Thisstudyaimstoexploretheclinicopathologiccharacteristicsandprognosticfactorsofgastriccancerpatientswithmetachronousovarianmetastasis.Methods:Clinicopathologicdatawerecollectedfrom63post-operativegastriccancerpatientswithmetachronousovarianmetastasis.ThepatientswereadmittedtotheCancerInstituteandHospital,ChineseAcademyofMedicalScienceandPekingUnionMedicalCollegebetweenJanuary1999andDecember2011.Alog-ranktestwasconductedforsurvivalanalysis.Possibleprognosticfactorsthataffectsurvivalwereexaminedbyunivariateanalysis.ACoxregressionmodelwasusedformultivariateanalysis.Results:Theincidenceofovarianmetastasiswas3.4%withameanageof45years.Upto65.1%ofthepatientswerepre-menopausal.Themeanintervalbetweenovarianmetastasisandprimarycancerwas16months.Lowlydifferentiatedcarcinomarankedfirstintheprimarygastriccancers.Themajorityoflesionsoccurredintheserousmembrane(87.3%).ThemetastaticsitesincludedN2-3lymphnodes(68.3%),bilateralovaries(85.7%),andperitonealmembrane(73%).Totalresectionofmetastaticsiteswasperformed(31.7%).Theoverallmediansurvivalwas13.6months,whereastheoverall1-,2-,and3-yearsurvivalrateswere52.5%,22.0%,and9.8%,respectively.The5-yearsurvivalratewaszero.Univariateanalysisshowedthatthepatientprognosiswascorrelatedwithmetastaticperitonealseeding,vasculartumorembolus,rangeoflesionexcision,andmodeofcomprehensivetreatmentwithadjuvantchemotherapy(P<0.05).Multivariateanalysisindicatedthatmetastaticperitonealseedingwasanindependentprognosticfactorforgastriccancerpatientswithovarianmetastasis(P<0.01).Conclusion:Effectivecontrolofperitonealseeding-inducedmetastasisisimportantforimprovingtheprognosisofgastriccancerpatientswithovarianmetastasis.

简介：BackgroundTheremaybedysregulationofcirculatingmicroRNAsinacutemyocardialinfarction(AMI),whichisanaging-relatedprocess.However,thedifferencebetweenyoungandelderlypeopleinexpressionlevelofcirculatingmiR-21inAMIpatientshasnotbeeninvestigated.MethodsThestudyincluded72consecutivepatientswithAMI.ThegroupIconsistedof43patientsagedequaltoorabove65yearsandthegroupIIconsistedof29patientsagedequaltoorbelow45years.Real-timeRT-PCRwasappliedtodetectserummiR-21expressionlevelsatthetimeofmechanicalreperfusionand12h,D1,D3andD7afterPCI,respectively.ResultsTheexpressionlevelofmiR-21inAMIpatientsincreasedmarkedly12hafterPCIandreachedthepeakatD1afterPCIinbothgroups.TherewasnodifferenceofmiR-21expressionbetweenGroupⅠandⅡatthetimeofmechanicalreperfusion(5.12±0.73vs.4.98±0.87)andD7afterPCI(1.28±0.75vs.1.94±0.89),However,groupⅠpatientsexhibitedhighermiR-21expressionlevelthangroupⅡat12h(7.96±0.78vs.4.23±0.77,P<0.05),D1(9.32±0.89vs.6.12±0.92,P<0.05)andD3(4.78±0.91vs.2.97±0.77,P<0.05)afterPCI,respectively.ConclusionOurdatarevealanincreaseofmiR-21inpatientswithAMImaybeamechanismofmyocardialischemiareperfusioninjury.TheexpressionofmiR-21wasrelatedtothedevelopmentandprogressionofAMI,andthereisanage-relatedchangeintheexpressionofmiR-21inacutemyocardialinfarctionpatients.

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简介：Objective:Thisretrospectivestudyexaminedriskfactorsforcytomegalovirus(CMV)infectionafterumbilicalcordbloodtransplantation(UCBT)andtheimpactofCMVinfectiononpatientsurvival.Methods:Inall176patients,plasmaCMVDNAwasnegativepriortothetransplantation,andexaminedtwiceaweekfor100d,andthenonceweeklyforadditional300d.Preemptiveantiviraltherapy(ganciclovirorfoscarnet)wasstartedinpatientswith>1,000/mLcopiesofCMVDNAbutnofull-blownCMVdisease,andwasdiscontinuedupontwoconsecutivenegativereportsofbloodCMVDNAtest.ThesurvivalandriskfactorsforCMVinfectionordiseasewereexaminedusinglogisticregression.Results:CMVinfectiondevelopedin71%(125/176)ofthepatients,withamedianonsetof32d.Fourpatients(2.3%)developedCMVdisease.Neitherthe5-yearoverallsurvival(OS)norevent-freesurvival(EFS)differedsignificantlyininfectedpatientsvs.thosewithnoinfection(59.4%vs.64.8%,P=0.194;53.4%vs.59.1%,P=0.226).AstepwisemultivariateanalysisindicatedanassociationofCMVinfectionwithage,high-doseglucocorticoids,thenumberoftransplantedCD34+cells,andthenumberofplatelettransfusion,butnotwithgender,theconditioningregimen,andthedayofneutrophilrecoveryandchronicgraft-versushostdisease(cGVHD).Conclusions:CMVinfectionisverycommonafterUCBT,butdoesnotseemtoaffectlong-termsurvivalwithpreemptiveantiviraltreatment.

简介：Objective:Thisstudyinvestigatedthecapabilityofdual-energyspectralcomputedtomography(CT)toquantitativelyevaluatelungperfusiondefectsthatareinducedbycentrallungcancer.Methods:Thirty-twopatientswithcentrallungcancerunderwentCTangiographyusingspectralimaging.Aunivariategenerallinearmodelwasconductedtoanalyzethevarianceofiodineconcentration/CTvaluewiththreefactorsoflungfields.Apairedt-testwasusedtocompareiodineconcentrationsandCTvaluesbetweenthedistalendoflungcancerandthecorrespondingareainthecontralateralnormallung.Results:Iodineconcentrationsincreasedprogressivelyinthefar,intermediateandneargroundsidesinthenormallungfieldsat0.60±0.28,0.93±0.27and1.25±0.38mg/mL,respectively(P<0.001).ThesametrendwasobservedfortheCTvalues[–(840.64±49.08),–(812.66±50.85)and–(760.83±89.17)HU,P<0.001].Theiodineconcentration(0.70±0.42mg/mL)ofthelungfieldinthedistalendoflungcancerwassignificantlylowerthanthecorrespondingareainthecontralateralnormallung(1.19±0.62mg/mL)(t=–7.23,P<0.001).However,theCTvalueoflungfieldinthedistalendoflungcancerwassignificantlyhigherthanthecorrespondingareainthecontralateralnormallung[–(765.29±93.34)HUvs.–(800.07±76.18)HU,t=3.564,P=0.001].Conclusions:SpectralCTimagingbasedonthespectraldifferentiationofiodineisfeasibleandcanquantitativelyevaluatepulmonaryperfusionandidentifyperfusiondefectsthatareinducedbycentrallungcancer.SpectralCTseemstobeapromisingtechniqueforthesimultaneousevaluationofbothmorphologicalandfunctionallunginformation.