Objective To observe the effects of early intelligent feedback rehabilitation training system of lower extremities on walking ability in stroke patients with hemiplegia. Methods Forty post-stroke hemiplegic patients (onset <1 month)were enrolled. They were randomly divided into either an intelligent feedback rehabilitation group or a conventional rehabilitation group by the admission numbers (n=20 in each group). The rehabilitation training began at 48 hours after patient′s condition stabled. The conventional rehabilitation group received conventional rehabilitation training only,and on this basis,the patients of intelligent rehabilitation group underwent walking ability training using intellectual feedback rehabilitation training system of lower extremities. The walking ability of lower-extremity of the patients was evaluated with the Fugl-Meyer Assessment Scale (FMA-L)and Holden Walking Classification. The changes of the tension and strength of tibialis anterior muscle and gastrocnemius muscle were evaluated by the surface myoelectric signals. Results Before treatment,there were no significant differences in FMA-L scores and Holden walking function classification between the two groups (P>0. 05). Four weeks after treatment, the FMA-L scores were improved in both the intelligent and conventional rehabilitation groups compared to before treatment (P<0. 01);the differences were 20. 0 ± 6. 2 and 5. 1 ± 1. 6 respectively before and after treatment. The degree of improvement of the intelligent rehabilitation group was better than that of the conventional rehabilitation group (P<0. 01). Holden walking function classification showed that only the intelligent rehabilitation group was improved as compared to before treatment (P<0. 01). Four weeks after treatment ,the strength and tone of the tibialis anterior muscle and gastrocnemius muscle of both groups were increased compared to before treatment (P <0. 01 ). The differences of the strength and tone of the tibialis anterior muscle were 20 +7 and 12 +4μV respectively in the rehabilitation groups before and after treatment,and those were 12+4 and 9+3μV in the conventional rehabilitation group;the differences of the strength and tone of the gastrocnemius muscle of the intelligent rehabilitation group were 25+8 and 19+6μV respectively before and after treatment,and those of the conventional rehabilitation group were 10+3 and 11+2μV respectively. There was significant difference between the intelligent rehabilitation group and the conventional rehabilitation group (P <0. 01 ). Conclusion The treatment of early intelligent feedback rehabilitation training system of the lower extremities may significantly improve the walking ability of the lower extremities in stroke patients with hemiplegia.

Classical description of central pathways has been that there are segregated routes for visceral and somatic inputs, for pain and tactile processing. Ample evidence in recent studies however calls for a revision of this traditional view. It has been demonstrated that visceral nociceptive inputs may travel in the dorsal column-medial lemnicus system along with skin tactile inputs, and convergence and interactions between the two distinct modalities have been demonstrated in route to the high brain centers. In the spinal cord and thalamus, skin inputs may inhibit noxious colorectal inputs; on the other hand pre-existing visceral nociception may cause abnormally high discharge of single neurons. These recent findings shine light on mechanisms of central processing of visceral nociception and its associated allodynia and referred pain, as well as for the effects of some traditional therapies such as acupuncture and massage.

AIM: To study the interactions between skin tactile and visceral nociceptive inputs in the ventroposterior lateral (VPL) nucleus of the rat thalamus. METHODS: Visceral nociceptive inputs were generated by colorectal distension (CRD). Skin tactile inputs were generated by 10 Hz skin puff. They were delivered in sequence to investigate the changes in reaction to the test stimulus after the conditioning stimulation. RESULTS: Among the isolated 78 single VPL neurons that had response to both CRD and skin tactile stimuli, 44% (31/70) had their response to CRD reduced by the preceding conditioning tactile stimulation, and 54% (38/70) had their tactile response enhanced by the preceding CRD. The skin receptive fields of the majority of the cells were located along the caudal part of the Meridians of Stomach and Gallbladder of Chinese medicine. CONCLUSIONS: (1) Conditioning tactile inputs may inhibit noxious colorectal inputs, but this effect was short-lasting and limited at single neuron level. (2) On the other hand, pre-existing visceral nociception may cause abnormally high discharge of thalamic neurons, a phenomenon that may be related to the clinically seen allodynia on the body surface in visceral lesions.

BACKGROUND: Non-invasive vascular ultrasound is used to assess in tima-media thickness (IMT) and atheromatous plaque, of which the result is better correlated to that of pathological examination. OBJECTIVE: Non-invasive vascular ultrasound was used to assess the hemodynamical changes of external and internal carotid in hypertensive elders, so as to investigate the relationship between pulse pressures, left ventricular mass index (LVMI), vascular resistance index (VRI) and shearing ratio. DESIGN: Randomized, controlled, correlative analyzedstudy. SETTING: Ultrasound Department of Affiliated Hospital of Jiangshu University. PARTICIPANTS: Totally 54 hypertensive elders, including 33 males and 21 females, were recruited from the Ultrasound Department of Affiliated Hospital of Jiangshu University, from September 30th 2000 to March 30th 2002. Meanwhile 26 normotensive elders (systolic pressure ＜ 130 mm Hg and/or diastolic pressure ＜ 85 mm Hg), including 16 males and 10 females, were selected as controls, METHODS: Color duplex blood flow imaging technique was used to assess the left ventricular end-diastolic diameter (LVEDD) and the interventricular septum thickness (IVST), so as to calculate the LVMI. The insiddiameter of bilateral common carotid artery (CCA) and internal carotid,IMT, the systolic peak flow velocity and resistance index were measured in order to calculate the vascular shearing ratio and atheromatous plaque index,moreover arterial pressure, LVMI, as well as resistance index and shearing ratio were subjected to linear correlative analysis,of which the results were compared with that of control group. MAIN OUTCOME MEASURES: ① Pulse pressure, LVMI and atheromatous plaque index of CCA. ② The inside diameter of bilateral CCA and internal carotid, IMT and the systolic peak flow velocity and resistance index were measured in order to calculate the atheromatous plaque index and maximum vascular shearing ratio. RESULTS: According to the experimental objective,data of all 80 cases were analyzed without loss. ① The pulse pressure and LVMI, the incidence of atheromatous plaque and plaque index of CCA in hypertensive elder group were obviously higher than that of control group [(64.36±7.44) mm Hg,(45.78±8.72) mm Hg; (131.47±18.73) g/m2, (83.28±12.34) g/m2; 5.62 ±1.78,3.44±1.10; 66.7％, 23.1％, (x2=13.37, t=5.730-13.234, P ＜ 0.01)]. ② The inside diameter of bilateral CCA and internal carotid, IMT and resistance index in hypertensive elders were significantly higher than that of control group [CCA: (8.96±1.20) mm, (8.08±0.96) mm; (1.28±0.88) mm, (0.91±0.17) mm;0.75±0.05, 0.69±0.06; ICA: (6.82±1.12) mm, (5.72±0.92) mm; (1.06±0.17) mm,(0.76±0.15) mm; 0.70±0.07, 0.64±0.06, t=2.872-10.850, P ＜ 0.01], but the systolic peak flow velocity and shearing ratio were markedly lower than that of control group [CCA: (47.44±12.85) cm/s, (60.20±14.32) cm/s;(225.78 ±95.76)/s, (300.26 ±110.42)/s. ICA: (41.22 ±10.18) cm/s,(48.64±11.58) cm/s; (268.54±112.56)/s, (324.52±121.42)/s, t=2.872-10.850, P ＜ 0.01]. ③ The pulse pressure, LVMI, the resistance index of CCA and ICA and shearing ratio were linearly correlated (r=0.30-0.36, P ＜ 0.05). CONCLUSION: Pulse pressure and LVMI were found increased in hypertensive elders, together with carotid vessels dilated, IMT and resistance index increased, as well as shearing ratio decreased, atheromatous plaque formed, vascular stiffness increased, which resulted in consequently decrease of vascular compliance.

Objective To explore the effects of motor imaginary therapy combined with occupational therapy on the function of upperlimbs hands and activities of daily living for stroke patients with hemiplegia. Methods 62 stroke patients with hemiplegia were divided intoobservation group (n=31) and control group (n=31). Both groups were treated with basic medication and occupational therapy while the observationgroup was treated additionally with motor imaginary therapy. The function of upper limbs and hands was assessed by Fugl-MeyerAssessment (FMA), and activities of daily living was assessed by Functional Independence Measurement (FIM) before and 2 months aftertreatment. Results There were significant difference between the two groups in the scores of FMA in the function of upper limbs and hands,and FIM 2 months after the treatment (P<0.01). Conclusion Motor imaginary therapy combined with occupational therapy can effectivelyimprove the functional outcomes of upper limbs and hands for stroke patients with hemiplegic, and can even effectively improve the functionalactivities of daily living.

Objective To study the clinical features and spirometry of children with chronic cough and positive findings by bronchial provocation test.Methods Four hundred and fifty children with chronic cough from 3 hospitals of Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong Medical University School of Medicine,Gong Li Hospital of Pudong New Area,Pudong Hospital,were enrolled in this study from December 2012 to December 2014,and among them,373 cases completed the questionnaires,spirometry and bronchial provocation test.The differences in clinical features and spirometry between the bronchial provocation test positive group and negative group were compared.And the further evaluation of their clinical value was performed.Results Two hundred and thirty-six cases of children with bronchial provocation tests positive showed much higher rate of dry [72.03％ (170/236 cases)] and night cough[58.90％ (139/236 cases)] than those in the negative group[27.00％ (37/137 cases),22.63％ (31/137cases)],and the differences were significant (x2 =71.154,45.973,all P ＜0.01).Children in positive group also had higher morbidity of eczema[52.12％ (123/236 cases)],allergic conjunctivitis [24.15％ (57/236 cases)] and inhaled allergy history[40.25％ (95/236 cases)] than those in negative group[32.85％ (45/137 cases),10.95％ (15/137cases),18.98％ (26/137 cases)],and there existed significant differences (x2 =13.006,9.701,17.904,all P ＜0.01).And they also had higher asthma heredity [18.22％ (43/236 cases)] than that in negative group [9.49％(13/137 cases)],and the difference was significant (x2 =5.179,P =0.023);with worse small airway function [50.85％ (120/137 cases) vs 36.50％ (50/137 cases)] (x2 =7.197,P =0.007).For further study,the sensitivity and specificity for dry cough were both high(72.03％ and 72.99％).For specificity,family history was the most highest one (90.51％),and night cough and allergic conjunctivitis were also high.Conclusions Pulmonary function tests to reflect small airway function abnormalities,combined with a family history of asthma and chronic cough in children related to eczema,allergic conjunctivitis,and inhalation allergy history clinical features,can better predict airway hyperresponsiveness.

Objective To understand the current situation of adversity quotient (AQ) of senior nursing students,then to provide reference for nursing educators to conduct AQ education and improve the comprehensive quality of nursing students.Methods 474 senior nursing students in Fuzhou were investigated with the Lusi Scale.Results AQ of senior nursing students was (67.84±5.62),the five dimensions were between 50 and 89.Gender,education qualifications,grades and academic performance had a significant impact on AQ of nursing students,among which gender and grade had certain prediction effect for nursing students' AQ.Conclusions AQ level needs of senior nursing students need to be further improved; Nursing educators should take targeted interventions and personalized measures to enhance the ability of anti-frustration,lay the foundation for better adaptation of clinical care.

Objective To investigate the correlation between the CD40 gene( - 1 C/T)single nucleotide polymorphism(SNP) and acute coronary syndromes(ACS), and the expression of CD40 on platelets. Method A total of 562 patients with ACS canfirmed by coronary angiography were divided into 3 groups according to the clinical characteristics, namely ACS patients( n = 210), stable angina(SA) patients( n = 189) and control group( n = 163).ACS was defined as ischemic chest pain at rest resulting in admission to hospital and > 50% stenosis in a major coronary artery with or without a rise in troponin Ⅰ. SA was defined as stable effort-related angina without change in angina pattern in 3 months. Patients with infection, tumor, or liver or kidney disease were excluded The gene polymorphism was measured by the polymerase chain reaction and restriction fragment length polymorphism(PCR-RFIP) and identiffed by sequencing. The expression of CD40 on platelets was detected by flow cytometry. The frequency, distribution of genotypes was compared using cross-tabulation and standard X~2 test. Result The CC genotype(31% ) and C allele of frequency(57.9%)of CD40 gene in ACS patients were significantly higher than those in SA(15.9%, 43.1% ) and control groups( 16.1%, 42.6% ). No significant difference of the genotypes or allele frequencies was found between SA and control group(X~2 = 0.053, P = 0.974;X~2 = 0.017, P = 0.897). 1he expression of CD40 on platelets in patients with C alleles carries was significandy higher than that of T allele carries in each group( P <0.0001). Conclusions CD40- 1C/T polymorphism was associated with ACS in Chinese Han nationallity.

ObjectiveTo analyze the literature characteristics on essential hypertension treated by external therapy of traditional Chinese medicine, summarize the current research situation and trend in the field, and to provide a reference for relative researches.MethodsThe papers relevant to treatingessential hypertension with external therapy of TCM included inSinoMedwere statistically analyzed from the aspects of publishing year, journals distribution,author’s unit and districtdistribution,research funds and literature content with bibliometrics method.ResultsThe total number of the literature for analyzing was 226, the number of papers increased gradually.Authors of the papers were mainly from TCM universities or colleges.Papersdistributedmainly in the more economically developed regions,which issued the largest amountinGuangdongprovince.Papers supported by research funds accounted for 16.81% in all the literature. Most literaturewasclinical research and the most commonly used for external therapywasacupuncture.ConclusionThe research and clinical work of essential hypertension treatment with external therapy of traditional Chinese medicinewerepaid more close attention in recent years, but therewerestill some problems that need to be solvedto form a viable, effective treatment system.

Objective To compare two effective preparation methods for paclitaxel-loaded lipid microbubbles, and to evaluate the physiochemical properties as for acoustic activated drug delivery. Methods Paclitaxel-loaded lipid microbubbles were prepared with two methods: one was mixed with phospholipids directly (Ⅰ); the other was added in triacetin, then mixed with phospholipids (Ⅱ). Concent ration, size, pH, drug entrapment efficiency, drug-loading amounts of these two kinds of paclitaxel-loaded lipid microbubbles were studied, while drug release with ultrasound and tumor imaging enhanced on rabbit breast tumor were observed. Results There was no significant difference in tumor imaging between two kinds of microbubbles which could be ruptured by low energy ultrasound. Compared with Ⅰ, the mean diameter of Ⅱ decreased significantly ([ 1.07±0.38] μm vs [2.79± 0.41] μm, P<0.01), the surface potencial was higher ([19.10±0.32] mV vs [-5.90±0.21] mV, P<0.01), whereas entrapment efficiency and drug-loading amounts increased markedly ([ 95.00±1.22]% vs [36.10±4.74]%, P<0.01; [5.60±0.11]% vs [0.50±0.04]%, P<0.01). Conclusion The Ⅱ paclitaxel-loaded lipid microbubbles added triacetin have an important clinical value.