Balance function assessments for stroke patients include instruments and scales. The instruments consist of static balance test systems and dynamic balance test systems. The commonly used static balance test systems include balance performance monitor (BPM) and Tetrax balance test system, and the dynamic balance test systems include Active Balancer EAB-100 and Pro-Kin 254. The balance scales contained Berg Balance Scale, Postural Assessment Scale for Stroke Patients, Timed Up and Go Test, Fugl-Meyer Assessment-Bal-ance, Tinetti Performance Oriented Mobility Assessment, and Five-Times-Sit-to-Stand Test, etc. This article reviewed the features and indi-cations of them.

BACKGROUND: Knowing the pathological changes of the lungs after the wallop from the bullet wound helps to improve the method or mean of dealing with the wound or to reduce the damage to lung functions after the wound.OBJECTIVE: To probe into the functional and pathological changes of the lung tissues after bullet wound.DESIGN: Open experimental study of the animals.SETTING: Department of the Integrated Traditional Chinese and Western Medicine, General Hospital of the Chinese People's Armed Police Forces.MATERIALS: The experiment was completed from June 2003 to December 2003 at the General Hospital of the Armed Police Forces. Six healthy grown-up cross-bred dogs, half male and half female, weighing ( 16.3 ± 0.58 ) kg, aged (8 - 12) months old, were provided by the Experimental Animal Center of the Military Academy of Sciences of Chinese PLA. Animal Center's license No. Was SCXK(army)2002-001. The animals were fed with water and food with no restrictions in an environment in which the temperature was 22 to 23 ℃ and the humidity was 74% - 80%.METHODS: Grown-up healthy domestic dogs were shot at the thick muscular part of their left hind legs with a size 81 automatic rifles, 7.62 mm in caliber and bullet of type-560. Caution was taken to avoid damage to the major vessels and the bone tissues. The shooting distance was 5 meters. Immediate hemostasis and bandaging were performed after shooting. And 6 hours later, pathological examination of the lungs was carTied out.MAIN OUTCOME MEASURES: Pathological changes of the lungs.RESULTS: After the bullet wound, the main pathological manifestations of the lungs were detelectasis of the pulmonary alveoli and the decrease of air volume complicated with inflammatory alveoli infiltration, lung edema, obscure structure of pulmonary alveoli, passive congestion of the small blood vessels, etc.CONCLUSION: The lung wound was obvious after bullet wound and its mechanism was associated with stress, inflammatory reaction of the adjacent tissues and far domino effect. Blood rheological changes after the wound were one of the most important factors to affect the microcirculation of the cerebral and lung tissues. It was found that clear blood rheological changes occurred at the earlier stage after the wound, and the chief manifestations included the increase of the whole blood viscosity and the index of the erythrocyte aggregation at the time of low sheering rate. The changes reached their peaks 6hours after the wound. On the one hand, because of the increase of whole blood viscosity and the index of erythrocyte aggregation, stasis of red blood cells might happen. And embolism of micro blood vessels in the brain and lungs would change the microcirculation of the brain and lungs. On the other hand, when serious injury of local tissues happens, the body's stress reaction would be strong and secretion and the release of stress hormones and certain active biological small molecular substances would increase, such as nitrogen monoxide(NO), tumor necrosis factor(TNF), endothelin(ET), etc. Their increase would stimulate the micro blood vessels of the brain and lungs and disturb their diastole and constriction functions. After the wound by high-speed projectile, blood flow volume in the animal's cerebral and lung tissues reduced sharply. The micrangium of the brain and lung dilated, and its diameter increased, which resulted in ischemia and hypoxia of the brain and lung tissues, and therefore edema of the brain and lung tissues and hypofunction of the lungs. Therefore, for the bullet wound of the limbs, in addition to dealing with local damage, the brain, the lungs and other important organs should be protected. This provides a theoretical basis for improving the brain and lung function after the bullet wound.

Objective To investigate the effect of combination low-dose of methotrexate (MTX) and cy-clophosphamide (CTX) intermittent therapy on the synovial cell p53 expression of collagen-indued arthritis Rats. The possible synergistic effect is examined and the possible meehaniams are evaluated. Methods Models of CIA were successfully established in 75 female Wistar rats. The CIA rats were then randomized into controls. At the end of this 24-week study the synovium of ankle joints were obtained, fixed, decalcified, wrapped and cut into slices. The intensity of p53 mutations expressions was examined by immunohistochemi-stry method. Results The intensity of p53 mutations expression of synoviocytes in CIA model group was significantly higher than that in the controls. In addition, the p53 mutations expressions in the synoviocytes of the treatment groups were decreased markedly, which did not return to the baseline level. The improvement of p53 mutations in the combination treatment group was higher than the single treatment groups and the difference was statistically significant (P<0.05). However, the difference between the combination treatment group and high-dose MTX treatment group was not significant. Conclusion Low-dose of MTX combined with CTX has the same efficacy comparing to high-dose of MTX in inhibiting p53 expression of CIA rats synoviocytes, but it is superior to low-dose single drug group. The results suggest that the combination of MTX and CTX may be synergistic in the treatment of RA.

Objective To construct nursing needs scale for school-age children with acute leukemia (AL) during lumbar puncture by using Delphi technique.Methods A certain number of experts were chosen for consulting to form a consulting scale.Two-round consultations were conducted and the results were analyzed.Results The effective response rate of the experts' questionnaire for 2 rounds was 100％ (17/17).The specialist group authority coefficient was 0.85.The coordination coefficients for 2 rounds were 0.437 and 0.516 respectively (P ＜ 0.01).The nursing needs scale for school-age children with AL during lumbar puncture comprised of 5 first-level indicators and 30 second-level indicators.Conclusions This scale can scientifically and quickly evaluate the nursing needs of school-age children with AL during lumbar puncture,it provides a research tool to develop individualized interventions with demand as the direction.

Objective To explore effects and possible mechanisms of combination therapy with methotrexate (MTX) and low dose cyclophosphamide (CTX) intermittently on the cyclin D 1 expression in the synovium of collagen induced arthritis rats.The outcome is analyzed.Methods After CIA experimental models were successfully established in female Wistar rats,they were randomly divided into CIA model group,low-dose MTX treatment group (0.9 mg·kg-1·W-1),high-dose MTX treatment group (2.7 mg·kg-1·W-1),Jowdose CTX treatment group [24 mg·kg-1·(3W)-1],and" low-dose MTX + low-dose CTX treatment group (MTX 0.9 mg·kg-1·W-1,CTX [24 mg·kg-1·(3W)-1].All of the rats were sacrificed 24 weeks after the first immunization,the specimens of ankle joints were exposed,fixed,decalcified,wrapped and cut into slices.The Cyclin D1 mRNA levels were examined by situ hybridization.Results The mRNA level of cyelin D1 in CIA synovial lining layer was significantly higher than that of normal controls,which suggested that in situ proliferation of synoviocytes might contribute to the thickening of rheumatoid synovial lining layer.The synovial expression intensity of the mRNA level of cyclin D1 in the treatment groups was decreased evidently.The mRNA level of cyclin D1 of the combination treatment group was higher than other groups,which was statistically significant (P＜0.05).Conclusion This is the first research on the effects of MTX combined with CTX intermittently based on cell cycles in CIA animal model.Combination therapy seems to be more effective than single-agent therapy.The results suggest that combining cell cycle stage specific agent MTX with cell cycle stage nonspecific agent CTX may be synergistic in the treatment of RA.Inhibition of the increased expression of the synovial cyclin D1 mRNA maybe an important mechanism of the MTX and CTX combination treatment for RA.

Objective To investigate the prevalence and influential factors of workplace violence (WPV) against nurses in general hospitals of Suzhou. Methods A total of 2110 staff nurses from 13 general hospitals in Suzhou were investigated with the Modified Version of Hospital Workplace Violence Questionnaire. Results During the past one year,68.9% (1454/2110) nurses investigated suffered from WPV.Working departments,marital status, strong support,etc,were the leading impact factors of WPV. Conclusions Nurses′experience of WPV is a prevalent phenomenon in general hospitals of Suzhou. It is urgent for hospital administration to raise attention to WPV and take effective measures,to reduce the occurrence of WPV.

Objective To explore the reliability of handgrip strength test for evaluating mobility in patients with stable chronic obstructive pulmonary disease.Methods Sixty-one COPD patients in stable stage were measured for handgrip strength and 6-minute walking test(6MWT).The receiver operating characteristic curve(ROC) was calculated to determine the best cutoff points of handgrip strength.Results Handgrip strength was (33.72-±7.47) kgf,6MWD was (437.06±97.96) m,handgrip strength was moderately correlated with 6MWD (r=0.404,P=0.001).6MWD≥350 m was used to classify two groups,and there was significant difference between two groups(P＜0.05).Area under the curv e was 0.722,and the best cutoff points was 32.8 kgf.Conclusion Handgrip strength test can be a useful tool to quickly identify mobility in patients with stable COPD.

Objective:To analyze the clinical characteristics and risk factors of rheumatic diseases complicated with Pneumomediastinum (PnM).Methods:A retrospective analysis of 94 inpatients with rheumatic diseases associated PnM from Peking Union Medical College Hospital and Shanxi Bethune Hospital between January 1998 and October 2018 was carried out. Patients were divided into idiopathic inflammatory myopathies (IIM) and the non-IIM group. Clinical features, laboratory examinations and treatment were compared between the two groups. Cox proportional hazard model was used to investigate the risk factors for prognosis.Results:A total of 94 patients were included in the study, with an average age of (45±14) years. Forty-five (48%) of them were male. There were 62 patients in the IIM group and the other 32 were in the non-IIM group. Sixty-nine patients had predisposing factors before PnM. Severe cough and assisted mechanical ventilation were the most common causes. Compared with the non-IIM group, the incidence of digital vasculitis (29% vs 6%, χ2=6.540, P=0.008), arthritis (60% vs 28%, χ2=8.409, P=0.004), interstitial lung disease (ILD)(98% vs 78%, χ2=11.129, P=0.002) were higher in the IIM group, treatment with cyclophosphamide was higher in the IIM group ( χ2=4.458, P=0.035). There was non-significant difference in mortality between the two groups during hospitalization (50% vs 59%) and 6 months after PnM (64% vs72%) ( P>0.05). Pulmonary infection was the only risk factor for poor prognosis [ HR=3.131, 95% CI (1.025, 9.561), P=0.045], in which bacteria infection was the most common cause (65/75, 86.7%). Conclusion:PnM is a severe complication of rheumatic diseases. To get a good prognosis, rheumatol-ogists should balance the benefit and risk of infection of immunosuppressive therapy.