Objectives To observe the effect of rehabilitation robots with routine rehabilitation training on walking func -tion after stroke .Methods Sixty patients with stroke were randomly divided into treatment group and control group , 30 ca-ses in each group .The control group received routine rehabilitation training while the treatment group received routine reha -bilitation training by rehabilitation robots .The lower extremity functions ,balance and walking ability were assessed with a simplified Fugl-Meyer Assessment(FMA) and using the Berg Balance Scale (BBS) before treatment and after 12 weeks. Results Before treatment , neither the treatment group nor the control group showed any statistically significant difference in terms of FMA and BBS results (P>0.05).After 12 weeks′training, both groups showed significant improvement in terms of FMA and BBS results(P<0.05).The treatment group showed significantly better improvement in lower extremity function, balance and walking function than the control group (P<0.05).Conclusion Rehabilitation robots can signifi-cantly improve walking function in patients after stroke .

OBJECTIVETo evaluate the clinical efficacy of electroacupuncture (EA) combined with transperineal injection of botulinum toxin-A (BTX-A) on neurogenic bladder caused by spinal cord injury.

METHODSOne day af ter surgery, 35 cases of spinal cord injury accompanied with neurogenic bladder were randomly divided into a BTX-A plus EA group (20 cases, group A) and a BTX-A group (15 cases, group B). The two groups were both treated with regular rehabilitation training of bladder function and injection of 200 IU (4 ml) BTX-A through perineum external urethral sphincter; the group A was additionally treated with EA at Zhongji (CV 3), Guanyuan (CV 4), Shenshu (3BL 23), Huiyang (BL 35) and Baliao (Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33), Xialiao (BL 34)), once a day, 40 min per treatment. The treatment was given 6 times per week for 4 weeks. The urination status in two groups before and after treatment was observed, and urodynamics examination and urethral pressure test were also made.

RESULTSAfter 4-week treatment, mean times of urinary incontinence, mean urethral catheter output, pressure of bladder and volume of urinary incontinence were all improved in two groups (all P<0.05), which were more significant in the group A (all P<0.05). The residual urine, maximum bladder capacity, maximum urethral closure pressure and maximum urine flow rate were all improved in two groups after treatment (all P<0.01); the improvement of residual urine, maximum bladder capacity, maximum urethral closure pressure in the group A was more significant than that in the group B (all P<0.05).

CONCLUSIONElectroacupuncture com bined with transperineal injection of BTX-A could effectively improve the urination dysfunction in patients with neurogenic bladder after spinal cord injury.

Adolescent ; Adult ; Botulinum Toxins, Type A ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Injections ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Treatment Outcome ; Urinary Bladder, Neurogenic ; drug therapy ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Objective To explore the effect of sling exercise therapy (SET) for improving the balance and walking ability of patients with incomplete paraplegia.Methods The 37 patients were randomly divided into two groups:19 patients in the observation group and 18 cases in the control group.Both groups were given conventional rehabilitation training,including bridge training on the mat,kneeling position training,sit-stand training and orthosis walking training.The observation group was additionally provided with sling exercise therapy with multi-point,muhi axis sling suspension supine,prone with a neutral lumbar spine,supine with pelvic elevation and in a lateral position like an arch.Before the treatment and 6 weeks after the treatment,trunk control tests (TCTs) were administered.The Berg balance scale (BBS) and Holden's walking function classification were used to assess the subjects' balance and walking ability.Results There were no significant differences in the two groups' average TCT and BBS scores before the treatment.After 6 weeks of treatment the average scores of both groups had increased significantly,with a significantly bigger increase observed in the observation group.After the treatment,the average Holden classification of the observation group was significantly superior to that of the control group.Conclusion SET in addition to conventional rehabilitation training can significantly improve the balance and walking ability of patients with incomplete paraplegia.It is worthy of application in clinical practice.

Objective To observe the effect of scalp acupuncture plus body weight support treadmill (BWST) training on motor function and ambulation of lower limbs in spastic cerebral palsy. Method Sixty-six eligible subjects with cerebral palsy were divided by using random number table into group A (n=20), group B (n=23), and group C (n=23). Group A was intervened by regular rehabilitation training, group B was by BWST in addition to the treatment given to group A, and group C was intervened by scalp acupuncture in addition to the treatment given to group B. The dimension D and E of Gross Motor Function Measure (GMFM) scale and Activities of Daily Living (ADL) were adopted for evaluation before treatment and after 3-month treatment. Result Before treatment, there were no significant differences in comparing the indexes among the three groups (P>0.05). After 3-month treatment, the D-dimension scores of GMFM were respectively (25.38±4.85), (29.54±5.70), and (32.37±6.58) in the three groups; the E-dimension scores were respectively (55.35±11.64), (60.80±12.47), and (65.74±13.50); the ADL scores were (60.24±14.49), (68.25±13.74), and (76.30±14.58); the scores were significantly increased in all three groups after intervention (P＜0.01), and the D-dimension and E-dimension scores of group B and C were significantly higher than those of group A (P＜0.05), and the scores of group C were significantly higher than those of group B (P＜0.05). Conclusion Scalp acupuncture plus BWST can improve the motor function and walking ability of lower limbs in spastic cerebral palsy, and thus enhance of ADL of the patients.

Objective To evaluate the efficacy and safety and to analyze related complications and potential prognostic factors of allogeneic hematopoietic stem cell transplantation(allo-HSCT ) on hematological malignancies .Methods Patients with hemato-logical malignancies who underwent allo-HSCT from June 2010 to June 2015 were investigated in this retrospective study .Accord-ing to the donor types ,it was divided into compatriots sibling-matched transplantation group (n = 52) and haploid transplantation group (n= 98) .The preconditioning regimens were busulfan/cyclophosphamide ,and anti-thymocyte globulin were needed in haploid transplantation group .Short-term methotrexate + cyclosporine A + mycophenolate mofetil were used for prevention of graft-ver-sus-host disease .The efficacy and safety and related complications of allo-HSCT were analyzed .Results All patients achieved full donor type engraftment ,which was identified by blood type ,chromosome test and DNA polymorphism .The mean times of neutro-phil and platelet engraftment were 12 d and 16 d in compatriots sibling-matched transplantation group and 13 d and 16 d in haploid transplantation group ,respectively .59 cases (39 .3% ) patients were oral mucosa ulcer ,47 patients (31 .3% ) were bacteria and/or fungal infection ,41 cases (27 .3% ) patients were CMV infection ,48 cases (32 .0% ) were acute GVHD ,43 patients (28 .7% ) were chronic GVHD .The median follow-up time of 23 months (1 - 60 months) ,115 patients (76 .7% ,115/150) were disease-free sur-vival ,including 38 cases (73 .1% ,38/52) in compatriots sibling-matched transplantation group ,77 cases (78 .6% ,77/98) in haploid transplantation group ;35 cases (23 .3% ,35/150) patients were died ,including 14 cases (26 .9% ,14/52) in compatriots sibling-matched transplantation group ,21 cases (21 .4% ,21/98) in haploid transplantation group .Death cause analysis showed that 12 ca-ses (8 .0% ) complications from transplantation related death ,of which 5 cases (3 .3% ) were severe infection ,7 cases (4 .7% ) caused by acute GVHD ,23 cases (8 .7% ) patients died because of the primary disease recurrence .The survival rate and mortality was similar between the two groups (P> 0 .05) .Conclusion Allo-HSCT is safe and effective treatment in hematological malignan-cies .The curative effect and security with haploid transplantation were similar to compatriots sibling-matched transplantation .It is necessary to prevent prognostic impact factors such as acute GVHD and infection early .

Objective To analyse the 24 h ambulatory blood pressure monitoring(ABPM)character-istics and effect of health education in children with orthostatic hypertension (OHT)retrospectively.Methods A total of 19 children[1 1 males and 8 females with mean age of (1 1.26 ±2.16)years]who were outpa-tients or had been hospitalized in the Second Xiangya Hospital of Central South University due to unexplained syncope,presyncope,and finally diagnosed as OHT after head up tilt test(HUTT).HUTT and ABPM were reexamined at 12 ~190(47 ±48 )days after receiving health education (including psychological guidance, avoiding sudden changes in posture,increasing the amount of water,avoiding syncope inducement,etc). Results (1 )ABPM parameters:there were no significant differences of ABPM parameters before and after health education respectively(P ﹥0.05,respectively).(2)After the health education,HUTT 3 min diastolic pressure[(71.89 ±1.60)mmHg vs.(76.47 ±8.49)mmHg,1 mmHg =0.133 kPa,t =2.785,P ﹤0.05]and diastolic blood pressure change[(7.37 ±4.98)mmHg vs.(12.42 ±3.27)mmHg,t =3.560,P ﹤0.05]de-creased than those before health education.(3 )Blood pressure pattern changes:after the health education,“dipper blood pressure”increased and “non-dipper blood pressure”decreased[42.1 %(8 /19)vs.31.6%(6 /19)and 57.9%(1 1 /19)vs.68.4%(13 /19),χ2 =0.452,P ﹥0.05,respectively].(4)OHT cure rate:after health education,to review the HUTT,within 3 minutes in HUTT,blood pressure changes of 14 cases were normal range.The cure rate was 73.7%.Conclusion OHT children's blood type is given priority to with “non-dipper blood pressure”,and the ratio of“dipper blood pressure”increase and the HUTT 3 min di-astolic pressure and diastolic blood pressure change decrease after health education.It suggests that the health education of OHT children has a certain clinical effect.

Objective To investigate the different radioprotective effects of total flavonoids of Astragalus (TFA) on human normal mesenchymal stem cells(hMSCs) and hepatoma cells injured by 60 Coγ-ray radiation.Methods hMSCs and HepG-2 cells were cultured and randomly divided into TFA-treated and untreated groups.The cells of different groups were irradiated with 60 Co γ-rays at the dose of 6 Gy.MTT method was utilized to detect the survival rates of the hMSCs and HepG-2 cells pretreated or untreated with TFA before irradiation.Cell clone formation test was used to measure the cellular radiosensitivity.The apoptosis rates of different groups were determined by flow cytometer assay.The expression rates of the apoptosis-promoting proteins Fas and Bax and the apoptosis-inhibiting protein Bcl-2 were analyzed by Western blotting.Results MTT showed that the survival rates of hMSCs pretreated by TFA were 1.15-1.95 times higher than that of the pure irradiation group.On the contrary,the survival rates of the TFA pretreated HepG-2 cells were only 0.53-0.23 times that of the pure irradiation group.There was a good dose-effect relationship between the cell survival rate and the TFA concentration.Cell clone formation rate indicated that combined treatment of TFA and radiation inhibited the cell proliferation more effectively than single TFA or pure radiation.Flow cytometry showed that 6,24 and,48 h post-irradiation to 6 Gy,the apoptosis rates of the hMSCs were 23.3% ,11.2% ,and 2.9% ,respectively in the TFA pretreated group and were 29.3% ,24.9% ,and 13.6% in the pure radiation group.However,the apoptosis rates of the HepG-2 cells at 6,24,and 48 h post-irradiation to 6 Gy were 11.6% ,17.3% ,and 20.1% ,respectively in the TFA pretreated group and were 6.9% ,9.3% ,and 15.8% ,respectively in the direct radiation group.Western blotting showed that the expression levels of Fas and Bax proteins in the HepG-2 cells were significantly higher in the TFA pretreated group than in the pure radiation group.On the contrary,the expression level of the apoptosis inhibiting protein Bcl-2 was significantly lower in the TFA pretreated group than in the pure radiation group.Conclusions TFA has obvious effects of radiological protection on human hMSCs and has no effects of radiological protection but effects of apoptosis enhancement on hepatoma cells.The promotion of apoptosis of TFA on hepatoma cells is primarily through increasing the expression of apoptotic proteins such as Fas and Bax and reducing the expression of anti-apoptotic protein Bcl-2.

Objective To establish thyrotropin( TSH) and thyroid hormones reference ranges during the neonatal period for the healthy term newborns in Suqian. Methods Blood samples from a heel-prick were collected from 500 healthy newborns 72 hours after birth to determine the level of TSH. 200 healthy newborns were chosen to determine the levels of serum TSH and thyroid hormones on the 14th day of life, and then compared with the results from 120 healthy adults. Results The reference range of TSH at 72 hours after birth was 0. 46-6. 59 mIU/ L. The reference ranges of TT3 , TT4 , TSH, FT3 , FT4 on the 14th day of life were 1. 10-2. 62 nmol/ L, 81. 10-158. 28 nmol/ L, 0. 83-6. 39 mIU/ L, 3. 76-6. 66 pmol/ L, and 10. 67-22. 27 pmol/ L, respectively. There was no significant difference in the interval of TSH between newborns and adluts, whereas there were significant difference in the intervals of TT3 , TT4 , FT3 , and FT4 between the two groups. Conclusions The establishment of TSH and thyroid hormone reference ranges during the neonatal period for the healthy term newborns could improve our understanding of the thyroid function during the neonatal period for the healthy term newborns, and our data suggests lowing the initiatory screening cut-off point of congential hypothyroidism.

Objective To find a simple, sensitive and effective method to predict the occurrence of cogni-tive impairment in patients after a transient ischemic attack ( TIA) . Methods Thirty-six persons who had survived a first TIA and could walk independently were selected into a TIA group, with another 36 healthy counterparts chosen to form a control group. Those in both groups were given a gait analysis during dual-task walking at the outset and then assessed using the MoCA scale 12 months later. Statistical analyses were conducted to assess the reliability of gait pa-rameters in predicting cognitive dysfunction, and the area under the receiver operating characteristics curve was calcu-lated. Results On the day after enrollment the variation in step length among the TIA patients with an abnormal step length was compared with variation among the normal controls and among the TIA patients with non-abnormal step-size. The differences were significant. The average walking speed of the TIA patients with an abnormal average walking speed was significantly different from that of the control group and that of the TIA patients with non-abnormal average speed. On the day after enrolling, the accuracy rate of the control group in the dual-task walking test was sig-nificantly better than that of any of the TIA patients, and the accuracy rate of the TIA patients with an abnormal gait in the dual-task walking test was significantly lower than that of the patients with a non-abnormal gait. Twelve months later the number of patients whose MoCA scores were less than 26 in the abnormal gait group was compared with that in the normal gait group, and the difference was statistically significant. The area under the receiver operating charac-teristics curve suggests that both the incidence of step length variation and the average stepping speed could signifi-cantly predict the occurrence of cognitive dysfunction 12 months later. Conclusion Quantitative analysis of gait while dual-task walking can effectively predict the occurrence of cognitive impairment in patients with TIA, and can detect abnormalities earlier than the MoCA scale test.