OBJECTIVE: To explore the effect of treating periarthritis of shoulder with manipulation through evaluating clinical reports with the theory of evidence-based medicine (EMB). METHODS: By retrieval of some main medical literature databases in the past 5 years, 242 articles on treating periarthritis of shoulder with manipulation were available. Selected by admission standard, 10 of them were evaluated with EBM theory. RESULTS: Both single-application and union-application of manipulation were effective to periarthritis of shoulder, but the evaluated articles were all low-quality articles. CONCLUSION: Because of low quality clinic test and larvaceous publication bias, the extant evidence is not enough to recommend replacing other therapeutic methods by manipulation. The low quality of evaluated articles suggests that there exist some methodology problems in the clinic test on treating periarthritis of shoulder with manipulation.

Objective To investigate the feasibility of implementing the 24 hours treatment and management model of children with cerebral palsy in Shanghai,in order to provide a set of effective and saving manpower,material and financial rehabilitation and management model for children with cerebral palsy.Methods Firstly,the 10 exports engaged in cerebral palsy rehabilitation were selected as the in depth interviewees by the sampling method of grounded theory.Secondly,applying in depth interviews,the 10 exports were interviewed by designing interview outline and subjects.Last,the interview data were collected and analyzed.Results By analyzing the interview data in three-stage coding mode,three factors affecting the feasibility of 24 hours treatment and management model of children with cerebral palsy in Shanghai were obtained,including the favorable factors,obstacles and necessary factors.Conclusions The 24-hour treatment and management model of children with cerebral palsy in Shanghai is feasible,but it will encounter some obstacles in the implementation process.Through the policy support for health care and education sectors,the feasibility of the pattern will be greatly enhanced.

Objective: To study the mechanism of Tuina in the treatment of skeletal muscle injury. Methods: Rabbits were heavily beaten at gastrocnemius muscle to make acute contusion model and then treated respectively by early Tuina and routine Tuina. The number of satellite cells of skeletal muscles was observed. Results: The number of the satellite cells continued to grow in both groups, and it began to increase significantly 3-5 days after Tuina treatment. Early Tuina treatment produces larger number of satellite cells than routine Tuina treatment.Conclusion: Early Tuina treatment is helpful to the marked recovery of skeletal muscles by increasing the number of satellite cell.

Objective To observe the effect of electroacupuncture(EA) on the hippocampal expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in rats with vascular dementia(VD),so as to find out the underlying mo lecular mechanisms of EA in treating VD.Methods Thirty-two Wistar rats were randomly divided into a shamoperation group,a model group,a sham-acupuncture group,and an EA group (8 in each group).Permanent bilateral common carotid artery occlusion was performed to model vascular dementia in the model group,the shamacupuncture group and the EA group,while exposure but no occlusion of the bilateral common carotid were performed in the sham-operating group.Novel object recognition test was adopted to prove the establishment of VD rat model.All the rats were kept in an immobilization apparatus while receiving treatments.EA was applied ontoBaihui (GV20) and Zusanli (ST36) in EA group for 30 min,once daily for 7 days.Sham-acupuncture group were treated with needles inserted 0.5 mm superficially.And the sham-operation group and the model group were only immobilized.The protein expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in hippocampal tissue was detected by western blotting.Results The expression of GluA1 in the model group (1.216 ± 0.102) was significantly less than in the sham-operating group (1.918 ± 0.137) (P ＜ 0.05).The expression of GluA1 in the EA group (1.653 ± 0.169) was significantly higher than in the model group (1.216 ± 0.102) and in sham-acupuncture group (1.231 ±0.188) (P＜0.05).The expression of CaMKⅡ in the model group (1.516±0.392) was less than in the sham-operating group (2.187 ± 0.231) (P ＜ 0.05).The expression of CaMK Ⅱ in the EA group (2.733 ±0.387) was significantly higher than in the model group (1.516 ±0.392) and sham-acupuncture group (1.493 ±0.205) (P＜0.05).The expression ofpGluA1 in the model group (1.502 ±0.419) was less than in the sham-operating group (2.253 ± 0.244) (P ＜ 0.05).The expression of pGluA1 in the EA group (2.382 ± 0.308) was significantly higher than in the model group (1.502 ± 0.419) and the sham-acupuncture group (1.498 ± 0.223) (P ＜ 0.05).The expression of pCaMK Ⅱ in the model group (0.394 ± 0.227) was less than in the sham-operating group (0.667 ±0.175) (P＜0.05).The expression ofpCaMKⅡ in the EA group (1.189± 0.346) was significantly higher than in the model group (0.394 ± 0.227) and the sham-acupuncture group (0.408 ± 0.231) (P ＜ 0.05).Conclusion EA can enhance the protein expression and phosporylation of GluA1 and CaMK Ⅱ,causing silent synapses transforming into functional synapses,and consequently,long term potentiation was facilitated and cognitive impairment was improved by EA.

Objective To evaluate the predictors of maternal and fetal outcome of pregnancy for systemic lupus erythematosus(SLE)patients.MethodsNinety-four patients with 96 pregnancies which were evaluated retrospectively from Jan 1990 to Jan 2008 in Peking Union Medicai College Hospital were divided into two groups:disease stable during pregnancy(group A)and lupus flares during pregnancy (group B).Statistical analysis was performed by X2 or Fisher exact test and Student's t-test.A binary logistic regression model was used to evaluate the predictors of matemal and fetal outcome.Results There were 36 pregnancies with stable lupus disease(group A)and 60 pregnancies with lupus flares(group B).of the 96 pregnancies.18 resulted in therapeutic abortion and 7 in fetal loss,71 resulted in a live birth,3 in neonatal death.The rates of preterm delivery,small gestational age(SGA)and neonatal asphyxia in group B were higher than those in group A(P＜0.05).By binary logistic regression analysis,preeclampsia/eclampsia low serum platelet count and SLE flares were associated with poor fetal outcome(β=2.463,2.228.2.769 respectively.P＜0.05).,rhere were 56 pregnancies with stable lupus disease at the conception with 22(39.3%)occurred lupus flares during pregnancies.Twenty-four preeclampsia and 2 eclampsia were seen in all the pregnancies.Fifty-two pregnancies were complicated with lupus nephritis,and 25 pregnancies(48.1%,25/52)of which were disease stable at the conception,and among 22 pregnancies with disease stable over one year.twelve of which occurred lupus nephritis flares.Three pregnancies which have disease activity within one year before pregnancy all occurred lupus nephritis flares.There were four maternal death which all occurred at the postpartum.By binary logistic regression analysis,lupus nephritis flares were associated with preeclampsia/eclampsia(B=2.658,P＜0.05),and proteinuria at the conception before dilivery were significantly associated with SLE flares(13=3.263,P＜0.05).Conclusion An increase of fetal loss,preterm delivery,SGA and neonatal asphyxia was seen in patients with lupus flares during pregnancy compared with those with stable disease.About 1/3 lupus activity may increase after pregnancy.Preeclampsia and eclampsia were increased when there were lupus nephritis flares.

Chronic obstructive pulmonary (COPD) has significant extra pulmonary effects, which could induce atrophy of peripheral skeletal muscle and respiratory muscles, and significantly influence the respiratory function and quality of life. Muscle nuclear factor (NF)-κB activation plays a key role in the skeletal muscle atrophy. This article discussed the potential mechanisms on how NF-κB signaling pathway increasing protein breakdown and reducing muscle regeneration. On this basis, we explored the role of NF-κB in skeletal muscle at-rophy in patients with COPD during exercise.

Objective To investigate whether functional electrical stimulation (FES) can improve the expression of proteins in the NMDAR1-pGLuR1 pathway so as to promote the recovery of motor function and sensation after stroke.Methods Eighty-one Wistar rats were used to make a photochemical brain model of local ischemia.Rats were randomly assigned into a sham, placebo stimulation or FES group.Rats in the placebo and FES groups had local ischemia induced in the M1 zone of the brain using the photosensitive dye Bengal rose.It was administered intravenously and a laser beam was then stereotactically positioned on the skull.The rats in the FES groups were stimulated for 30 minutes (10 minutes on, 10 minutes off, then 10 minutes on).The placebo group's treatment was similar, but without the electric current.The rats in the sham group received no intervention.The cylinder test and the adhesive-removal test were used to test the rats' motor function and sensation before the operation and before they were sacrificed.Cohorts were sacrificed after 3, 7 and 14 days of intervention.NMDA receptor and AMPA receptor were detected in the peri-ischemic cortex using western blotting.Results After 7 and 14 days the index of forelimb motor function in the cylinder test of the FES group was significantly better than that of the placebo group.The average adhesive-removal time of the FES group was also significantly faster compared with the placebo group.After 7 days the average expression of NMDAR1 in the FES group was significantly higher than in the placebo group.The average expression of GluR1 and pGluR1 in the FES group was significantly higher than in the placebo group after 14 days.Conclusion Functional electrical stimulation can improve motor function after ischemia through the NMDARAMPAR signal pathway, at least in rats.

Objective:To study the tuina effect on sleep disorder and emotional problems of chronic fatigue syndrome (CFS) cases.Method:Thirty CFS cases were treated in the treatment group,by applying one-thumb pushing,rolling and pressing-kneading manipulations along the Governor Vessel,Bladder and Yangming Meridians.The intended major points include Fengfu (GV 16),Yaoyangguan (GV 3),Xinshu (BL 15),Pishu (BL 20),Ganshu (BL 18),Hegu (LI 4) and Taixi (KI 3).The treatment was done once every other day;10 times constitute a course of treatment.Another 30 healthy cases were selected in the control group,without any intervention.The sleep quality and mental state in the two groups were evaluated by PSQI,HAMA and HAMD.In addition,the pre-treatment and post-treatment score changes were observed.Results:Before treatment,the total score of PSQI,sleep quality,time of falling asleep,sleep efficiency,sleep disorder,daytime functional impairment,and scores of HAMD and HAMA in treatment group were all substantially higher than the control group (P＜0.01).After 10 tuina treatments,the total score of PSQI,time of falling asleep,sleep disorder and daytime functional impairment as well as scores of HAMD and HAMA in treatment group were significantly changed,compared with before treatment,P＜0.05.Conclusion:Those with CFS may present with sleep disorder and mental or psychological abnormality,tuina can improve their sleep quality and adjust their mental conditions.