Objective To discuss the application of Chinese version of Stanford Acute Stress Reaction Questionnaire (SASRQ) in trau-matic fracture patients. Methods 96 patients with traumatic fracture in the Second Hospital of Tangshan City were recruited in the early stage. All the subjects were assessed with SASRQ in 2 weeks after trauma for the first time, and then they were assessed with SASRQ for the second time after an interval of 2 days. 496 patients with traumatic fracture completed SASRQ and Abbreviated Injury Scale-Injury Se-verity Score (AIS-ISS) assessment. Results The Cronbach's alpha was 0.930 in SASRQ, and were 0.729~0.812 in each dimension (P<0.01). Test-retest reliability at 2-day intervals was 0.980 (P<0.01). 133 cases (26.8%) were detected with acute stress disorder (ASD). According to a single entry≥3 as a positive screening, 31.7%suffered separation symptoms, 49.6%suffered re-experience traumatic symptoms, 39.5%suffered avoidance symptoms, 75.6%suffered symptoms of anxiety or increased awareness. The scores of SASRQ (t=37.807, P<0.05) and each dimension (t=36.503, 29.019, 31.111, 19.369, respectively, P<0.001) was significantly higher in the ASD positive group than in the neg-ative group. There was significantly difference in the score of SASRQ and each dimension in different age groups (F=112.319, 94.109, 95.099, 103.291, 61.497, respectively, P<0.001), the acute stress symptoms were lighter in the older group than in the other groups. There was significantly difference in the score of SASRQ and each dimension between men and women (t=7.707,-6.190,-8.944,-7.221,-9.949, respectively, P<0.001), the acute stress symptoms were lighter in men than women. There was sig-nificantly difference in the score of SASRQ and each dimension in different trauma types (F=68.516, 44.464, 59.725, 48.966, 54.827, P<0.001), the acute stress symptoms were severer in the traffic accident patients group than in the other groups. There was significantly differ-ence in the score of SASRQ and each dimension in different trauma degrees (F=63.584, 69.704, 51.569, 43.669, 33.911, respectively, P<0.001), the acute stress symptoms were lighter in the lighter group than in the other groups. Conclusion There is a high incidence and clear gender and age differences of ASD in patients with traumatic fracture.

Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.

Objective To investigate the incidence of the cognitive disorder in cerebrovascular patients and to its risk factors.Methods Cerebrovascular patients were surveyed with Mini-Mental State Examination(MMSE)Chinese-version in county or above hospitals among 23 provinces(cities).Results 915 cerebrovascular patients were surveyed and 281 patients(30.71%)were of cognitive disorder.And the incidence of the patients with hypertension or/and diabetes mellitus was significantly higher than the others(P<0.01).Conclusion The incidence of cognitive disorder is high in cerebrovascular patients,and the hypertension and diabetes mellitus are both the risk factors.

Objective To explore the impact of executive function intervention on the executive functioning of elderly patients with cerebral infarction,and to seek the best way to improve executive function in such patients.Methods Eighty elderly patients with cerebral infarction were randomly divided into an intervention group and a control group.A series of executive function interventions were administered to those in the intervention group with no intervention in the control group.The two groups were given the same conventional medication.The Behavioral Assessment of the Dysexecutive Syndrome (BADS) was taken before the intervention,then 3 months and 6 months after recruitment.Results In the intervention group the average score and the total standard score had increased significantly after 3 months except for the action program test and the modified six elements test.Both indicators were still significantly increased from the baseline afar 6 months except for the modified six elements test.The average score and the total standard score had increased significantly between 3 months and 6 months except on the key search test.Both the time determination test and the total standard score had statistically significant average differences.The control group showed no significant differences.After 3 months,the average scores and the total test standard scores in the intervention group were signifieantiy higher than those in control group except on the action program test.The rules conversion card test,the time determination test and the total standard score difference all showed statistically significant differences between the groups.After 6 months the intervention group's scores remained significantly higher than those of the control group except on the action program test.Conclusions Executive function interventions are effective in delaying the progress and improving the prognosis of executive dysfunction in elderly patients with cerebral infarction,and the therapy has persistent effects.

Objective To explore the resilience characteristics of the traumatic fracture patients and its influence on acute stress disorder(ASD),and provide the basis for improving the population's ability to cope with stressful events and resilience level for clinic.Methods 440 cases of traumatic fracture patients hospitalized in Tangshan Second Hospital were selected in this study.All subjects were assessed with SAS-RQ,CD-RISC,AIS-ISS,VAS and the general condition of investigations.Results The resilience level of traumatic fracture patients was at the middle,the resilience total score was(51.13±14.81) points,and lower than that of the national norm(t=-20.217,P＜0.01).Sex,age,personality and injury severity had the impact on resilience (P＜0.05).Resilience dimensions and total scores had negative correlation with SASRQ dimen sions and its total score (r=-0.587--0.739,P＜0.01).High-leveled resilience patients have lower ASD scores and lighter symptoms(P＜ 0.05).The multivariate analysis appeaed that resilience and the degree of pain were the main factors affecting ASD (P＜ 0.05).Conclusion The resilience level of the traumatic frac ture patients should be further improved and the construction of resilience should be strengthened in order to prevent the occurrence of ASD.

Objective To investigate the effects of Edaravone (Ed) on p38mitogen-activated protein kinases/Caspase-3 (p38MAPK/Caspase-3) pathway following the diffuse injury of brain (DIB) in rats, as well as the protective effects of Edaravone on traumatic injury of brain (TIB). Method The TIB models were established by using Marmarou's method in adult male Spraque-Dawlley rats. A total of 250 rats were divided (random number)9nto control group, model group, low-dose Edaravone treatment group and high-dose Edaravone treatment group.The rats were sacrificed separately 1, 6, 24, 48 and 72 hours after DIB and the brain tissues of rats were taken.The morphological changes of neuron in hippocampus region were observed by using Nissl staining. The levels of phosphorylated p38MAPK and Caspase-3 were detected by using immunohistochemistry and Western blot. The learning and memory functions were determined with Morris water maze test from the 3rd to 7th day after injury.Results Compared with control group, some neurons displayed histopathological changes of necrosis and apoptosis in rats of model group. The levels of phosphorylated p38MAPK significantly increased in 1, 6, 24, and 48 hours after injury in rats of model group ( P ＜ 0.05), but there was no statistic significance in increase 72 hours later ( P＞ 0.05). The levels of Caspase-3 significantly increased in 6, 24, 48 and 72 hours after injury in rats of model group ( P ＜ 0.05), but there was no significant difference in increase in one hour after injury (0.59±0.29 vs.0.40±0.17, P ＞0.05).In the Morris water maze test from the 3rd to 6th day, the latency to find the platform significantly prolonged in rats of model group ( P ＜ 0.05), and the numbers of passing the platform by rats decreased on the 7th day (2.28 ± 1.18 vs. 8.20 ± 1.52, P ＜ 0.05). Compared with model group, the levels of phosphorylated p38MAPK in 6, 24 and 48 hours after injury in low-dose Edaravone group were lower (P ＜0.05), but there was no statistical difference in one hour after injury ( P ＞ 0.05). The levels of Caspase-3 in 6,24, 48 and 72 hours after injury in rats of low-dose Edaravone group were lower than those of model group ( P ＜0.05). The latency to find the platform significantly shortened ( P ＜ 0.05) and the numbers of passing the platform by rats increased (4.17 ± 1.15 vs. 2.28 ± 1.18, P ＜ 0.05) in low-dose Edaravone group. The above variables changed more prominently in high-dose Edaravone group. Conclusions Edaravone attenuates p38MAPK pathway activation, lowers the level of Caspase-3 following DIB and protects the rats against the traumatic injury of brain.

Objective To study the utility of sleep intervention combined with memory training for alleviating dysmnesia in the elderly and provide a basis for improving memory function. Methods A total of 647 community-dwelling elderly people were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Rivermead behavioral memory test ( RBMT). One hundred and fifty elderly persons with sleep disorders and dysmnesia were divided into three groups; the control group, the memory intervention group, and the sleep plus memory training group. Sleep quality and dysmnesia were evaluated again after 3 months of intervention. Results Among the 647 elderly people, the incidence of sleep disorders was 38. 8% , and of dysmnesia was 78. 4%. Dysmnesia was significantly more prevalent among subjects who also had sleep disorders. After three months of intervention, instant recall scores had declined in the control group while scores on 7 kinds of memory function had improved significantly in the memory intervention group. Scores on 10 measures of memory and sleep quality improved in the sleep plus memory intervention group. Compared to the control group, scores on 9 kinds of memory improved significantly in the memory intervention group and scores on 11 kinds of memory improved in the sleep plus memory intervention group. Compared to the memory intervention group, scores on 5 kinds of memory had improved significantly in the sleep plus memory intervention group. Conclusions The occurrence of dysmnesia in elderly people is influenced by sleep quality. Memory training can improve their memory function, but sleep intervention combined with memory training is even more effective.

Objective To observe the intervention effect of BrainHQ visual training on depressive symptom in patients with post stroke depression.Methods Eighty patients with post stroke depression were divided into control group(n=40)and intervention group(n=40).The control group accepted routine drug therapy and conventional rehabilitation, while intervention group received BrainHQ visual training additionally.They were assessed with Hamilton depression scale(HAMD) before and 4 weeks after intervention.Results Before intervention the HAMD score between control group and intervention group(respectively(19.80±3.96), (18.43±2.94)) had no statistical difference (P＞0.05).After 4-week intervention, the HAMD score of intervention group(9.58±5.42) was significantly lower than that of control group (13.85±5.73)(P＜0.01).Before the intervention, depression level of two groups had no difference(P＞0.05).After 4-week intervention,the difference of depression level was statistically significant in two groups(P＜0.05).Conclusion BrainHQ visual training can improve depressive symptom in patients with post stroke depression.

Objective To study the effects of 3-n-butylphthalide (NBP) on motor function and learning and memory ability in rats with diffuse brain injury (DBI). Methods 128 male Sprague-Dawley rats were randomly divided into sham operation group, traumatic group,low-dose NBP treatment group and high-dose NBP treatment group with 32 rats in each group. Every group was divided into 24 h, 48 h and 72 h subgroups. DBI rat model was established according to the description of Marmarou's diffused brain injury. The histopathologic changes of cerebral tissue (0.2 cm bilateralis coronal line) were observed by light and electron microscope at 24 h, 48 h and 72 h after injury. Morris water maze and rolling test were performed daily at 24, 48 and 72 h (time points). Results Compared with the model group, the damage of brain tissue decreased, and the survival nerve cells increased (P<0.01). The behavioral tests showed that the latency to find the platform shortened (P<0.01) and the frequency of crossing the platform increased in the 72 h subgroup (P<0.01). The general movement ability enhanced in NBP groups (P<0.05). All the indexes were more significant in high-dose NBP treatment group. Conclusion NBP can improve neurological function and learning and memory function after brain injury and the molecular mechanisms is related to the decrease of the nerve cells lose and traumatic cerebral ultrastructure damage.

Objective To explore and analyze the executive function of patients with traumatic brain injury in recovery phase and reveal its influential factors.Methods Behavioral Assessment of Dysexecutive Syndrome (BADS) was conducted in 104 patients with brain injury at 5 ～ 6 months after discharging and matched healthy comparison subjects in this study.Basic information in patients with the clinical data were collected by self-designed questionnaire to analyze the relevant factors.Results BADS findings showed that the individual scores and total standard scores of brain injury patients( 12.05 ± 2.54 ) were significantly lower than those of health population ( 19.02 ± 3.77 ) (P ＜ 0.05 ).Action program test, temporal judgment test, modified six elements test and total sub-standard scores ( 14.83 ±3.86)in junior high school education level and below group were significantly lower than that in high school and higher education group ( 17.67 ± 4.10 ).The individual scores and total standard scores ( 10.13 ± 3.86 )in heavier group were significantly lower than that in the lighter group ( 15.68 ± 4.10 ).The group without complication' action program test, key search test, zoo map test, modified six elements test were significantly lower than the group with complication.The BADS scores were related to education, illness condition,and complication (hypertension, hyperglykemia, hyperlipemia) (P＜0.05).Conclusion There is executive dysfunction in traumatic brain injury patients.The executive dysfunction is mainly correlated with education, illnesscondition and complication.Medical staff should provide pertinent intervention and treatment according to the above aspects, in order to obtain better effects of rehabilitation therapy .