Objective To discuss the technical points and clinical effectiveness of the guidewire looping technique for re-canalizing chronic and total long-segment occlusions of femoropopliteal arteries.Methods The guidewire tip was formed into a U-shaped loop and then the guidewire loop was advanced to the occluded artery and was manipulated to re-open the occluded vessel. The catheter followed the guidewire gradually until the tip of the guidewire came into the true lumen of the outflow tract. Results The chronic long-segment occlusions of femoropopliteal arteries were successfully re-canalized in all 48 patients with a technical successful rate of 92.31% (48/51). The re-canalization procedure was failed in three cases.Conclusion Guidewire looping technique is an effective, safe and simple practical skill for re-canalizing chronic long-segment occlusions of femoropopliteal arteries.

ObjectiveTo evaluate the clinical application of endovascular treatment for severe Takayasu's arteritis (TA).MethodsIn this study,35 target lesions in 32 patients [28 women,mean age (30 ±8) years] with severe Takayasu's arteritis were treated with endovascular merthod.The average length of lesion was 3.1 cm( range 2.7 -5.3).The overall average degree of diameter stenosis was 90％ ± 11％ (range 70- 100)in which 15 lesions were completely occlusive.There were 10 patients whose ESR were higher than 20 mm/h( range 25 -37).Follow-up included physical examination and patency evaluated by color duplex souography/computed tomography angiography/angiography at 6 months and then annually.ResultsRecanalization was unsuccessful in 3 completely occlusive lesions,with a successful rate of 80％(12/15).There was one case in which embolization leading to acute thrombogenesis developed during interventional procedure and resulting in severe stroke.The technical successful rate ( residual stenosis ＜ 50％ ) was 88.6％ ( 31/35 ).The transient cerebral ischemia attack ( TIA ) symptoms disappeared in 31 cases.26 cases were followed up for an average of (19 ± 10) months (range 13 -40).Occipital infarction following severe in-stent restenosis developed 13 months later in one case.Symptomatic in-stent restenosis18monthslaterwasfoundin2cases. Patencyratewas88.5％( 23/26 ).ConclusionsEndovascular treatment is safe and effective for severe TA.Strict indication and accurate targeting the lesions help ensure the success of management.

Objective To observe the changes of behavior,blood cortisol level,glucocorticoid receptors (Grs) and mineralocorticoid receptors (MRs) in hippocampus area after four weeks of unpredictable chronic mild stress,and to investigate the probable role of hypothalamus-pituitary-adrenal (HPA) axis in the pathogenesis of depression in aged people.Methods Aged male Wister rats were randomly assigned to control group and model group.The model group received unpredictable mild stress,including food and water deprivation,restrain,tail clipping,forced swimming,white noise,cage titling and cage rotating for 4 weeks,while the control group was undisturbed unless routine feeding and cage changing.After 4 weeks of procedure,the behavior changes were assessed by sucrose intake test,open-field test and state evaluation,serum cortisol level was measured by chemiluminescent assay,the qualitation and quantitation of GRs and MRs in hippocampus area were evaluated by immunohistochemistry and Western blotting respectively.All data were analyzed by using t-test.Results Body weight,the grooming score,activities in openfield test,food intake and sucrose intake were decreased in model group as compared with control group after 2 weeks of chronic mild stress (all P＜0.01),suggesting the stress induced depressive-like behavior effects on aged rats.Serum cortisol level was elevated in model group as compared with control group after 4 weeks of chronic mild stress (P＜0.01).A decrease of the neurons was found in CA3 of hippocampus,but not in DG area.In CA3 area,GR positive neurons were decreased,but no significant decrease was found in MR positive neurons.Conclusions The chronic mild stress leading to depressive-like behavior effects in aged rats induces overall HPA axis dysfunction,elevation of serum cortisol level,impairment of hippocampus neurons and decrease of GR positive neurons.The HPA axis dysfunction induced by chronic mild stress may play an important role in the pathogenesis of depression.

Objective To investigate the factors influencing basic rehabilitation service needs of people with disability at Zhabei District in Shanghai .Methods Primary rehabilitation demands and services of 10 311 disabled persons in Zhabei District were surveyed.Results The screening rate of persons with disability having primary rehabilitation demands was 83.5%. And the gender, age, type of disability, disability level, education, employment might be the factors affecting the primary rehabilitation demands of people with disability.Conclusion The primary rehabilitation service demands vary in deferent types of people with disability. The various services based on the extensive rehabilitation services should be provided to deferent categories of people with disability.

Objective To understand the status of special rehabilitation service demands of people with disability at Zhabei District in Shanghai and to provide the basis for the policy development.Methods Screen rate (SR) was used to indicate the level of demand of rehabilitation service, the data were analyzed with SPSS 13.0 statistical software.Results There were 4 349 persons with disability who demanded the special rehabilitation service; the SR of “on-site rehabilitation service” demands was the highest among the whole persons with disability; the SR of “personalized allotment of supplies and appliances” demands of the intellectual disability and mental disability was lower than the other types; the SR of special rehabilitation service demands of the female, the elderly, the low cultural level, the unemployed and the people with severe disability were relatively higher.Conclusion The form of “on-site rehabilitation services” needs to improve based on the demand of the disabilities; “personalized supplies and appliances” for the intellectual disability and mental disability needs to further develop; the rehabilitation services targeted to the female, the elderly, the low cultural level, the unemployed and the people with severe disability need to improve.

Objective To provide the advice on how to optimize the allocation of resources and make other policy through the analysis factors affecting rehabilitation services needs of people with disability at Zhabei district in Shanghai.Methods The factors affecting rehabilitation services needs such as types of disability, disability levels, education, employment, marital status, age and sex were analyzed with Logistic analysis.Results The factors affecting primary rehabilitation services were types of disability, education, employment situation, marital status and sex. And people with disability had the characters of female, hearing disability, retired returned to more primary rehabilitation services, with OR values being 1.219, 1.544 and 1.533 respectively compared with itself controls. And the high educational disable people' will, returning to primary rehabilitation services, was weaker compared with low educational disable people. The factors affecting special rehabilitation services were types of disability and employment situation. And people with disability had the characters of hearing disability, unemployment returned to more special rehabilitation services, with OR values being 2.380 and 1.310 respectively compared with itself controls.Conclusion The rehabilitation needs are different among different groups people with disability, so the factors affecting rehabilitation services needs such as types of disability, education, employment situation, marital status and sex should be taken into consideration while activating primary rehabilitation services, while the types of disability and employment situation should be taken into more consideration while activating special rehabilitation services.

Objective To evaluate the internal reliability of Psychosocial Function Evaluation for mental disabled people in day care unit. Methods 16 participants were evaluated twice by the same rater (social worker) in the unit at the Permanent stage and the Steering stage. Results Cronbach's α was greater than 0.7 in the both evaluation. The Spearman correlation coefficient between each dimension and total score were between 0.502 and 0.869. Conclusion The internal reliability of Psychosocial Function Evaluation is satisfactory for mental disabilities.

Objective To investigate the quality of life and analyze related factors of all the disabled at the entry of the Home Service Program in Zhabei district, Shanghai. Methods All the disabled were surveyed using the Chinese version of Short-Form 36 Health Survey(SF-36). Results 280 disabled people finished the survey, the total score was (59.72±20.03). There were significant differences in the scores among different ages, types of disabilities and status of subsistence allowances (P<0.01). The age was negatively correlated with quality of life (P<0.01). The education degree and the status of subsistence allowances were positively correlated with quality of life (P<0.05, P<0.01).Conclusion People with disability have poor quality of life in Zhabei district, Shanghai.

Objective To assess the influence of overall nursing intervention and lumbar and abdominal muscle strength training on the lumbar vertebral function of patients with lumbar intervertebral disc protrusion. Methods Seventy-six patients with lumbar intervertebral disc protrusion treated in our hospital from May 2013 to December 2014 were ran-domly divided into the control group and the observation group. The control group was given simple lumbar and ab-dominal muscle strength training, and the observation group was given additional overall nursing intervention on the ba-sis of lumbar and abdominal muscle strength training. The changes of lumbar vertebral function scores and the patient satisfaction rates of the two groups were compared. Results Before nursing training, the two groups were not signifi-cantly different in the lumbar vertebral function score (P>0.05); after nursing training, the observation group was sig-nificantly higher than the control group in the lumbar vertebral function score, with statistically significant difference(P<0.05). The observation group was significantly higher than the control group in the patient satisfaction rate, with statistically significant difference between the two groups (P<0.05). Conclusion Overall nursing intervention and lum-bar and abdominal muscle strength training can effectively improve the patients' awareness of disease,gain their treat-ment compliance and show remarkable effects and high patient satisfaction rate,thereby worthy of clinical promotion.

The Assistive Devices Program was funded and supported sufficiently, and improved the qulity of life of the disabled persons significantly (scores of SF-36). Most disabled users were satisfied with the Program. Some problems, such as inefficient way of working,undefined screening standards, lack of integrity of the assessment content, limited categories of assistive devices and home modifications,unavailable follow-up services, needed to be improved.