OBJECTIVE:To investigate the effects of hyperbaric oxygen combined with flupentixol and melitracen on depres-sion improvement,extremity motor function and ability of daily living and activity in patients with post-stroke depression (PSD). METHODS:60 PSD patients were divided into control group and observation group according to random number table,with 30 cases in each group. Both groups received routine clinical treatment,comprehensive rehabilitation therapy and psychotherapy. The control group was additionally given Flupentixol and melitracen tablets,orally,one tablet each time,in the morning;3 days later, one tablet each time,in the morning and noon,for 4 weeks. Other anti-depressive agents were not given during treatment. Observa-tion group was additionally given hyperbaric oxygen,0.12 MPa,for 90 min,qd,5 times a week,for 4 weeks,on the basis of control group. Depression degree [Hamilton depression scale (HAMD) and Self-rating depression scale(SDS)],extremity motor function [Fugl-Mayer motor function assessment (FMA)] and ability of daily living and activity [modified Barthel index (MBI)] were scored in 2 groups before and after treatment,and ADR was observed. RESULTS:After 4 weeks of treatment,HAMD and SDS of 2 groups were decreased significantly compared to before treatment,while FMA and MBI were increased significantly;the improvement of observation group was significantly better than that of control group,with statistical significance(P<0.05). No ob-vious ADR was found in 2 groups. CONCLUSIONS:Hyperbaric oxygen combined with flupentixol and melitracen can effectively improve PSD,relieve negative emotion and improve extremity motor function and ability of daily living and activity.

Objective To study the effectsof rehabilitative training on neural function and the expression of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule-1 (Iba-1) in rats after traumatic brain injury.Methods A left hemisphere traumatic brain injury model was established in ninety Sprague-Dawley rats.They were then randomly divided into a rehabilitation training group,an immobilization group and a free-running group,with 30 rats in each group.Another thirty rats received sham injury as the shamoperated group.Beginning 4 days post-operation the rats of the rehabilitation training group were given balancing,rotating and walking exercises three times daily,15 min/time,6 d/week.The immobilization group was fixed in mesh cages.The rats of the free-running and sham-operated groups were reared in normal cages without any special training exercise.The rats of all 4 groups were given neural and motor function tests to assess the functional outcome.Immunofluorescence staining was used to evaluate the expressions of GFAP (the marker of astrocytes) and Iba-1 (the marker of microglia) in the cortex close to the iujured region at 3 days,1 week,2 weeks,3 weeks and 4 weeks after injury.Results The average neural and motor function test scores in the rehabilitation training group were significantly better than those in the immobilization and free-running groups at the 2nd week and thereafter.The average scores in the free-running group were significantly better than those in the immobilization group at the 4th week after injury.The immunofluorescence staining showed that the expression of GFAP was lowest in the rehabilitation group at the 2nd week and thereafter.Iba-1 expression was significantly lower only at the 3rd week and beyond.Conclusion Rehabilitative training can improve nerve function recovery in rats after traumatic brain injury,and the functional enhancement may be partially attributed to the downregulation of activated astrocytes and microglia.

Objective To explore the effect of applying problem-based learning (PBL) and case-based learning (CBL) in the kinesiology experiments. Methods Totally 534-year program undergraduates of Nantong University Medical School were divided into control group (n=26) and experimental group (n=27). The control group received traditional teaching and the experimental group received PBL and CBL teaching. The teaching effect was evaluated by examination and questionnaire. Data were analyzed by SPSS 19.0 and t test was used to compared the average scores of theory and questionnaire, α=0.05. Results The theoretical examination results (89.81 ±1.32) were better than the control group (84.82 ±1.75) (P=0.028). Meanwhile questionnaire survey showed that the experimental group students' evaluation of their teaching methods in promoting learning interest and initiative, combining theory with practice and teamwork con-sciousness were better than the control group students' evaluation of traditional teaching methods (P<0.05). Conclusion The teaching effect of integration of PBL and CBL teaching methods is better than traditional teaching in kinesiology experiments.

Objective:To observe the functional differences in the key brain areas in patients with different levels of consciousness after severe brain injury, and provide reference for confirming the objective diagnosis indicators for prolonged disorders of consciousness.Methods:Thirty right handedness patients with different levels of consciousness after severe brain injury (initial post-traumatic Glasgow coma scale scores<9), admitted to our hospital from January 2016 to December 2020, were chosen in our study. The levels of consciousness of these patients were assessed by revised Coma Recovery Scale (CRS-R); according to the diagnostic criteria of prolonged disorders of consciousness, 8 patients were into group of unresponsive wakefulness syndrome/vegetative state (UWS/VS), 8 patients were into group of micro-conscious state (MCS), 6 patients were into group of emergence from MCS (eMCS), and 8 were into group of locked-in syndrome (LIS). The regional homogeneity (ReHo) was used to analyze resting-state functional MRI (rs-fMRI) data to explore the differences of brain functional activity in patients with different levels of consciousness.Results:Strong resting-state activities were noted in the right middle temporal gyrus of the UWS/VS patients, the left culmen and inferior parietal lobule of the MCS patients, the left superior occipital gyrus and inferior frontal gyrus of eMCS patients, and the left inferior temporal gyrus and cingulate gyrus of the LIS patients. As compared with that in the UWS/VS patients, the ReHo value of the left insula in the MCS patients was significantly enhanced (voxel=1 341, t=-5.380, P<0.05); as compared with the those in the eMCS patients, the peak brain area with reduced ReHo value in the MCS patients was the left culmen (voxel=549, t=-5.377, P<0.05), while the peak brain area with enhanced ReHo value was the left insula (voxel=438, t=3.751, P<0.05); as compared with that in the LIS patients, the peak brain areas of enhanced ReHo in the MCS patients were the left medial frontal gyrus (voxel=1 014, t=5.406, P< 0.05) and left extra-nuclear (voxel=229, t=4.115, P<0.05), while the peak brain areas of enhanced ReHo in the eMCS patients was the left medial frontal gyrus (voxel=421, t=3.397, P<0.05). Conclusion:In the resting state, there are functional differences in the key brain regions of patients with different levels of consciousness, mainly in the predominant hemisphere, left insula and cerebellum; these regions may be the target regions for objective evaluation of prolonged disorders of consciousness.