Objective To investigate if anodal transcranial direct current stimulation (atDCS) of the right cerebellum improves verbal working memory in amnesic persons with mild cognitive impairment (aMCI).Methods Thirty-nine aMCI were randomly divided into an observation and a control group using a random number table.The observation group was given atDCS at 1.2 mA for 20 minutes every day for 5 days,while the control group was provid ed with fake atDCS in the same way.Before and after the treatment,both groups were tested using forward and back ward digit spans,word reading,visually cued sensorimotor tests and finger tapping.Results After the treatment,the forward and backward digit spans of the observation group had improved significantly compared with before the treatment and with the control group's improvements.Significant improvement was observed in the average backward digit span of the control group,but not in their forward digit span after the treatment.No significant differences be tween the two groups were observed in the other measurements before or after the treatment.Conclusion Direct current stimulation of the cerebellum may improve the verbal working memory deficits of aMCI.Further research should be conducted to find the mechanism.

Objective To explore the effect of an in-hospital cardiac rehabilitation program on exercise capacity after cardiac surgery.Methods Forty-two patients with valvular heart disease or coronary heart disease were recruited and randomly divided into a rehabilitation group (n=22) and a control group (n=20).Both groups were given preoperative education and breathing guidance on the basis of conventional clinical treatment,but the rehabilitation group was also provided with in-hospital cardiac rehabilitation after the operation.The two-minute stepping test (2-MST) and the left ventricular ejection fraction test (LVEF) were performed before and after the intervention for both groups.Their hospital stays were also compared.One month after discharge,the exercise capacity of both groups was followed-up by telephone using the Veterans-specific Activity Questionnaire (VSAQ).Results After the intervention,there was no significant difference in average LVEF between the two groups (53.73±9.29％ and 56.25± 11.01％ respectively).The average 2-MST stepping frequency of the rehabilitation group was significantly greater than the control group (79.41± 10.99 times and 71.25± 14.21 times respectively,P＜0.05).One month after discharge,the exercise capacity of the rehabilitation group was also significantly higher than the control group for (5.77± 1.46 METs versus 4.75± 1.34 METs,P＜0.05).Stepping frequency at discharge and exercise capacity at one month after discharge were both positively correlated to 2-MST stepping frequency at admission(r =0.869,P＜0.01;r=0.752,P＜O.01).The average hospital stay of the rehabilitation group was significantly shorter (by about 3 days) than the control group (15.59±3.08 days versus 18.45±3.63 days,P＜0.01).Conclusions In-hospital cardiac rehabilitation can significantly improve exercise capacity after cardiac surgery and reduce the length of hospital stays.The 2-minute step test is a simple and practical way to assess the exercise capacity of patients early after cardiac surgery.

Objective To observe any effect of intensive training on the degree of depression and the expression of Kalirin-7 in the hippocampus of rats modeling with post-stroke depression,and to investigatc possible mechanisms.Methods Forty male Wistar rats were randomly divided into a post-stroke depression (PSD) group,a routine training group,an intensive training group and a sham-operation group (n =10 for each group).All except the sham-operation group were given the middle cerebral artery occlusion using the intraluminal thread method,and chronic mild stress was applied.The PSD group and the sham-operation group were not given any training.The routine training group was trained oncc a day,and the intensive training group was trained twice a day.The sucrose preference test,open field test and forced swimming test were conducted at the outset and after 14 and 28 days of training.The expression of Kalirin-7 in the left hippocampus was detected using Western blotting.Results After 14 days of training,significant differences were found in the test results of the sham-operation group compared with the other groups (P＜0.05).There were also significant differences in the average results on all 3 tests among all of the groups except the sham-operation group.At both 14 and 28 days after training,the average expression of Kalirin-7 in both the routine and intensive training groups was significantly higher than in the PSD group (P＜0.05),and that of the intensive training group was significantly higher than that of the routine training group at the same time points (P＜0.05).Conclusion Intensive training can relieve depression and increase the expression of the Kalirin-7 in the hippocampus,at least in rats.

Objective To explore the effectiveness of the timed up and go test (TUGT) and the maximum walking speed test (MWST) in evaluating stroke patients' motor function.Methods Twenty-two stroke patients were assessed using the TUGT and MWST,and the temporal-spatial parameters of their gait were also assessed.The correlations among the TUGT times,walking speed and the gait parameters were quantified using Pearson correlation coefficients.Results The TUGT time was (18.57±7.41) s,significantly correlated with step length and velocity (P＜0.05).Walking speed showed a significant positive correlation with step length,velocity and step length (P＜ 0.05).The TUGT times were negatively correlated with walking speed (r=-0.712,P=0.000).Conclusion The MWST and TUGT both can assess stroke patients' motor function effectively.

Objective To study the relationships between the standing balance and walking ability of hemiplegic stroke survivors.Methods Eighty-eight post-stroke hemiplegic patients who could walk independently for more than 10 metres were selected into a patient group,while 88 healthy counterparts were recruited into a control group.Descriptors of the gait and balance function of both groups were collected using a gait and balance training and evahuation apparatus (Model:AL-600).The gait parameters were step width,walking speed,step length asymmetry (SLA),swing time asymmetry (SWTA) and stand time asymmetry (STA).The balance parameters studied were total trajectory length of the center of plantar pressure (COPD),the average left and right deviation of the center of plantar pressure (COPD-X) and the average anterio-posterior deviation of the center of plantar pressure (COPD-Y).Differences in indexes of gait and balance function between the two groups were analyzed using t-tests,and the relationships between the gait and balance indicators were analyzed using Pearson correlation coefficients.Results The walking speed,step width,COPD,COPD-X,COPD-Y,SLA,SWTA and STA of the patient group [(37.64± 18.29)cm/s,(14.45±4.17)cm,(66.75±29.04)cm,(2.04±1.41)cm,(2.48±1.28)cm,(1.30±0.46),(1.65±0.67) and (1.18±0.16),respectively] all increased significantly more compared to the control group [(90.76±14.72)cm/s,(8.70±2.62) cm,(27.84±6.54) cm,(1.30±0.53) cm,(1.68±0.40) cm,(1.07±0.06),(1.07±0.08) and (1.05±0.06),respectively],though the walking speed was significantly slower than that in the control group (P＜0.05).The patient group's average COPD-X showed slightly and moderately negative correlation with their walking speed,step width,SLA and SWTA (P＜0.05).COPD-Y was weakly related with step width (P＜0.05).Conclusion The standing balance of hemiplegic patients after stroke is related to their walking speed,step width and gait asymmetry.Especially significant correlation is observed between standing balance parameters such as COPD-X and gait parameters.

Objective To compare the clinical effects of open kinetic chain (OKC) exercises with those of closed kinetic chain (CKC) exercises and limited open kinetic chain combined with closed kinetic chain exercises on rehabilitation after the anterior cruciate ligament reconstruction.Methods Ninety-four patients recovering from single-bundle anterior ligament reconstructions were enrolled and randomly divided into an OKC group (n =33),a CKC group (n =30) or a limited open kinetic chain combined with closed kinetic chain group (combined group) (n =31).Lysholm score,International Knee Documentation Committee (IKDC) score,KT-1000,and active and passive range of motion were evaluated for the 3 groups three and six months after the surgery.Results Three months after surgery,significant differences were found among the 3 groups in Lysholm scores [(87.00±4.79),(83.67± 3.55) and (86.71±3.62) respectively],IKDC scores [(89.45±4.79),(86.40±3.76) and (88.58±3.60) respectively],KT-1000[(1.99±0.30),(1.05±0.26) and (1.02±0.24) mm],as well as active and passive range of motion [(10.06±2.06),(7.73±1.41) and (8.10±1.35) mm;(9.76±2.26),(7.87±1.89) and (8.39±1.62) mm] (P＜ 0.05).Six months after surgery,no significant differences were found in Lysholm scores and IKDC scores(P＞0.05),but significant differences were found in KT-1000,and active and passive range of motion(P＜0.05) compared to those at 3 months after surgery.Moreover,there were no significant differences between the OKC and combined groups in Lysholm scores and IKDC scores(P＞0.05),but significant differences between them in active and passive range of motion (P＜0.05).There were no significant differences between the CKC and combined groups in Lysholm scores,IKDC scores,KT-1000,and active and passive range of motion(P＜0.05).Conclusion Combining limited open kinetic chain exercise with closed kinetic chain exercise is safe and reliable in the rehabilitation after anterior cruciate ligament reconstruction.

Objective To compare the static standing balance of stroke patients after different biofeedback protocols.Methods Thirty-two stroke patients were randomly divided into a knowledge of performance (KP) group,a knowledge of results (KR) group and a control group.All 3 groups received 4 weeks of conventional rehabilitation training plus another 30min of static standing balance training per day.The KP group received audio-visual feedback in real time during the training.The KR group received section result feedback.The control group received no feedback during the extra balance training.Before and after the training,the performance of the 3 groups was evaluated using Berg's Balance Scale (BBS) and a portable biofeedback device.Results Average BBS performance improved significantly more in the KP group (3.08± 1.08) than in KR group (1.30±0.67) and control group (1.20± 0.79) (P＜0.05).No significant difference was detected between the KR and control groups (P＞0.05).The average improvements of the KP group in terms of Standing with Eyes Closed and Tandem Standing (0.92±0.79 and 0.83± 0.39) were significantly highcr than those in the KR (0.30± 0.48 and 0.20± 0.42) and control groups (0.01 ± 0.01 and 0.40±0.52) (P＜0.05).Average trunk angular displacements in all four directions [Anterior (2.83±0.93;6.15± 1.85),Posterior (2.56±0.88;5.97±1.74);Left (2.86±1.16;6.49±2.42),Right (2.68±1.43;5.98±2.05)] in the KP group was significantly higher than in the others (P＜0.05).No significant differences were detected between the KR and control groups in BBS results or in posture.Conclusions Static standing training should incorporate real time biofeedback.It is then more effective than conventional standing training or training with section results feedback.It is worth spreading in clinical applications.

Objective To observe the effect of intensive training on lower extremity motor function and depression after stroke.Methods Thirty patients with post-stroke depression were randomly divided into an intensive training group and a control group,each of 15.Both groups received conventional anti-stroke and antidepressant drug therapy,and rehabilitation training.The intensive training group,however,was additionally provided with lower extremity motor function training each day.Hamilton Depression Rating Scale,the Fugl-Meyer assessment (FMA),10-meter maximum walking speed test (10MWT) and the Holden functional ambulation categories (FAC) were conducted before treatment,and 2 and 4 weeks after the treatment.The level of human β-endophin (β-EP) and brain derived neurotrophic factor (BDNF) in the serum were also detected.Results After 4 weeks of treatment,the FAM,10MWT,BDNF and β-EP were significantly improved in both groups compared to those before the treatment (P＜ 0.05).No significant differences,however,were found between the 2 groups in the above measurements after 2 weeks of treatment (P＞0.05).After 4 weeks of treatment,the FAM (20.67±6.79),10MWT [(0.48±0.22)m/s],BDNF [(10.81±2.33)μg/L] and β-EP [(164.02±42.15)ng/L] of the intensive training group were significantly improved compared to those of the control group (P＜0.05).Both after 2 weeks and 4 weeks treatment,the HAMD scores of the intensive training group (16.33±6.74 and 12.13±5.44) were significantly better than those of the control group (P＜ 0.05).However,there was no significant difference in terms of FAC between the two groups either after 2 weeks or 4 weeks of treatment (P＞0.05).Conclusion The intensive training can improve motor function and relieve poststroke depression of stroke survivors.It is worth promoting and applying in clinical practice.

Objective To study the effect of cold and heat treatment on metastasis and the peripheral blood immune response in patients with breast cancer. Methods A total of 124 breast cancer patients were randomly di-vided into a hot and cold therapy group and a control group, each of 62. Both groups were given conventional surgical resections, and the hot and cold therapy group was given cooling and heating physical therapy for one month before the operation. The efficacy of the treatment and the patients′ spiritual state were compared after the treatment. The effect on lung metastases was evaluated using tomographic images of the chest, and the changes in immune cell levels in the peripheral blood were detected using flow cytometry. Results After the treatment, the remission rate (54.8%), spiritual life ratings on the Karnofsky scale and the area of lung cancer nodule transfer were significantly better in the hot and cold therapy group than in the control group. Twelve weeks after the treatment, the percentage of MDSCs in the control group patients was 72.5%, significantly higher than the 5.3% of the therapy group. The CD4+and CD8+ T cells were 2.2% and 1.8%, significantly lower than the 26.7% and 13.9% of the control group. Con-clusion Cold and hot therapy before a mastectomy can effectively inhibit the metastasis of breast cancer and promote patients′physical rehabilitation and spiritual life. It may regulate the microenvironment of their immunosuppression and stimulate antitumor immunity.

Objective To observe the effect of low-frequency, repetitive transcranial magnetic stimulation ( rTMS) at different frequencies on the cognitive function of traumatic brain injury patients with a history of epilepsy. Methods Sixty traumatic brain injury patients were randomly divided into a 0. 5 Hz group, a 1. 0 Hz group and a control group, each of 20. In addition to routine drug therapy and cognition training, the control group was given fake stimulation, the 0.5 Hz group was treated with 0.5 Hz rTMS, and the 1.0 Hz group was provided with 1.0 Hz rTMS for 4 weeks, eleven times per week. Before and after treatment, the cognitive function of all three groups was assessed using the Montreal cognitive assessment ( MOCA) , the Rivermead behavior memory test ( RBMT) and a symbol can-cellation test. The number of patients reporting headache or epilepsy during the treatment period was also counted. Results During the treatment, there was no headache case in any of the groups, and no significant difference was found in the occurrence of seizures. After the treatment, all of the measurements in all 3 groups had improved signifi-cantly. The average MOCA and RBMT scores in the 1.0 Hz group were all significantly better than those in the control group, but there was no significant difference between the 0.5 Hz group and the control group. The symbol cancella-tion test efficiency of the 1. 0 Hz group was not significantly better than that of the 0. 5 Hz and control groups. Conclusions Repeated 1.0 Hz transcranial magnetic stimulation can significantly improve cognition after traumatic brain injury among patients with a history of epilepsy without increasing the risk of seizures.