Recent researches have shown that gut microbiota play an important role in pathogenesis of immune-related disorders.Type 1 diabetes mellitus,as an autoimmune disease,has received increasing attention,especially in terms of the relationship between the pathogenesis and intestinal microbiota.Change of gut microbiota is an important risk factor of the pathogenesis of type 1 diabetes mellitus which have been confirmed with the animal model studies.This article reviews the role of gut microbiota in the pathogenesis of type 1 diabetes mellitus,and the influence of gut microbiota on host immune response for possible prevention and treatment of type 1 diabetes mellitus in the future.

Objective To explore the effects of mental practice on upper extremity function after stroke. Methods Thirty sub-acute stroke patients were randomly divided into a treatment group ( n=15 ) and a control group (n=15). The patients in the control group were treated with conventional therapy. The patients in the treat-ment group were treated with motor imagery therapy in addition. All patients were assessed using the Fugl-Meyer mo-tor assessment (FMA) and the motor assessment scale (bIAS) before treatment and after 2, 4 and 8 weeks of treat-ment. Results After 2 weeks of treatment, average MAS scores in the treatment group improved significantly com-pared with before treatment, but there was no significant difference between the two groups. After 4 weeks, FMA and MAS scores in the two groups had improved, and the FMA scores in the treatment group were significantly higher than those of the control group. After 8 weeks, the FMA and MAS scores of both groups had further improved significant-ly, but the average FMA and MAS scores in the treatment group were now significantly higher than those in the control group. Conclusions Mental practice can improve the functional performance of the upper extremities of stroke pa-tients.

Objective To explore possible mechanisms of the cross-over observed in stroke patients comple-ting a line bisection test. Methods Twenty-five stroke patients with left neglect and twenty normal subjects were studied.In the ordinary line bisection test,there are two papers presenting 20 mm and 100 mm lines respectively.On each paper,three lines with the same length are presented at the left,middle and right of the paper.In the line im-age test,the two papers are the same as in line bisection test,but here subjects are asked to set endpoints of each re-al line. Results Replicating earlier findings,length cross-over was observed in the patients with neglect.In the hline image test,those patients neglected lines on both sides but with a much larger proportion on the left.The patientsunderestimated long lines as in previous studies,but they also underestimated very short lines in contrast to earlier findings. Conclusion Foveal neglect sparing may explain these observations.For very short lines,the left end of the line falls into foveal vision and the left part of the line was not neglected.As a result,the crossover effect of line length occurs.

Objective To observe the effects of intensive training at different intensities on the expressions of semaphorin 3A ( Sema 3A) and its receptor neuropilin ( NP-1 ) and the cell apoptosis in cerebrum after cerebral ischemia-reperfusion in rats,and to investigate the possible mechanism of intensive training in recovery of motor function after cerebral ischemia-reperfusion in rats.Methods To establish animal model of cerebral ischemia-reperfusion in rats,the intraluminal thread method was applied to cause left middle cerebral artery occlusion (MCAO) for 2 h and before reperfusion.After cerebral ischemia-reperfusion model were established for 24 h,60 male model Wistar rats were randomly divided into training group 1 ( swimming for 5 min once a day),training group 2 ( swimming for 10 min once a day),training group 3 (swimming for 10 min twice a day) and control group (no training) ; another 15 rats assigned to the sham-operation group were subject to no MCAO and no training.Neurological function was evaluated by Garcia scores,and terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) was performed to dectect the cortical cell apoptosis.Expressions of neural growth inhibition factor Sema 3A and its receptor NP-1 were detected by immunohistochemistry.Results The neurological function in sham-operation group was normal.The differences of Garcia scores at different time points beween sham-operation group and control group were significant (P ＜ 0.01 ).Garcia scores in all training groups,were significantly higher than those in controls at the 7th and 14th d after swimming training ( P ＜ 0.01 ),especially in training group 3 the Garcia scores were ( 12.80 ± 0.45 ),( 15.20 ± 0.45 ),( 16.80 ± 0.45 ),respectively,at the 3rd,7th and 14th d after swimming training.The rates of positive cell of Sema 3A,NP-1 and TUNEL indexes in all training groups were lower than those in controls at the 3rd,7th and 14th d after swimming training (P ＜ 0.01 ),especially in the training group 3.At the 3rd,7th and 14th d after swimming training in training group 3,the rates of TUNEL indexes positive apoptosis cells were ( 29.43 ± 1.38 ) ％,( 22.30 ± 1.21 ) ％,( 17.58 ± 1.70) ％,respectively,the positive cell rates of Sema 3A were ( 19.64 ± 1.17) ％,(9.73 ± 3.83)％,(8.24 ± 0.87)％,respectively,the positive cell rates of NP-1 were ( 33.95 ± 6.86) ％,( 27.95 ± 1.29 ) ％,( 18.90 ± 1.44 ) ％,respectively,the reduction of positive cells expressions in training group 3 was significantly more obvious compared with other training groups (P ＜ 0.01 or 0.05).Conclusions Rehabilitation training can reduce the expression of positive cell of Sema 3A,NP-1 and TUNEL indexes in rats after cerebral ischemia-reperfusion and can improve motor function recovery and facilitate neural plasticity.The more intensive the training,the better the effects.

Objective To investigate the effects of intensive motor mental practice (MP) on the recovery of upper limb function in hemiplegic stroke patients.Methods Thirty-nine stroke patients were randomly divided into an intensive group,a conventional group and a control group (13 cases in each group).All received regular rehabilitation therapy for 6 weeks (40 min a day,5 d a week).In the following 6 weeks,patients in the intensive and conventional groups received MP-twice a day for the intensive group and once a day for the conventional group.The patients in the control group instead listened to music daily.Motor function was assessed using the Fugl-Meyer assessment (FMA)and the action research arm test (ARAT),which were carried out before treatment and after 2,4 and 6 weeks of treatment.Results There was no significant difference in FMA or ARAT scores among the 3 groups after 2 weeks of therapy.After four weeks FMA improvement was significantly greater in the intensive group than in the conventional or control group.There were also significant differences in FMA between the conventional and control groups.ARAT score improvement was significantly better in the intensive group than in the control group,But there was no significant difference in ARAT results between the conventional and control groups.After 6 weeks FMA and ARAT scores had improved significantly more in the intensive and conventional groups than that in the control group.There were also significant differences in FMA and ARAT scores between conventional and control groups.Conclusion Intensive motor mental practice can improve the upper limb motor function of stroke patients more effectively than less aggressive treatment.

Objective To observe the effects of neuromuscular stimulation (NMES) intensity on post-stroke dysphagia.Methods Thirty patients with dysphagia resulting from a stroke were randomly divided into a control group,an NMES group,and an intensive NMES group,with 10 patients in each.The 3 groups all received conven-tional swallowing training.Patients in the NMES group also received NMES once a day and those in the intensive NMES group received it twice a day.Kubota's water drinking test and videofluoroscopy were used to assess the subjects' swallowing function before treatment and after 2 and 4 weeks of treatment.Results After 2 weeks,the average water drinking test score was significantly better in the intensive NMES group than in the control group.The fluoroscopic results of all three groups had improved significantly,but the results in the NMES group and the intensive NMES group were significantly better than those of the control group.The intensive NMES group also scored significantly higher than the NMES group.Conclusion NMES can improve the swallowing reflex and the contraction of the suprahyoid muscles.It can strengthen the effect of re-learning swallowing.Two NMES sessions a day are better than one.

Objective To explore the effect of neuromuscular electrical stimulation(NMES) on hyolaryngeal structural movement in post-stroke dysphagia.Methods Thirty patients with post-stroke dysphagia were randomly divided into 3 groups (n =10) namely group A,group B and group C.On the basis of routine swallowing training,medication and rehabiliation given to group C,group A was provided with VitalStim therapy on both suprahyoid and infrahyoid muscles,while group B was only on suprahyoid muscles lasting 2 weeks.Before and after treatment,the Video Fluoroscopy Swallowing Study (VFSS) was carried out and the upward and forward displacement distances of the hyoid and thyroid cartilage when swallowing pap were measured.Moreover,water swallow test,dysphagia severity scale and DOSS scores were used to assess the swallowing function.Results After 2 weeks' treatment,the water drinking test score,dysphagia severity scale and DOSS scores increased significantly in all groups than before treatment.The water drinking test score of group A (2.40 ± 1.26) and group B (2.10 ± 0.99),dysphagia severity scale of group A (5.30 ± 1.89) and group B(5.20 ± 1.69),as well as the DOSS level of group A (5.20 ± 1.40) and group B (5.10 ± 1.45) were significantly better than the control group.However,no significant difference was observed in all measurements between group A and group B.The group B revealed a significantly increase in anterior hyoid excursion distance of (12.15 ± 7.59) mm,much bigger than that before treatment and that of group A and B after treatment.Conclusion NMES on the basis of traditional swallowing training can improve the swallowing function of post-stroke dysphagia patients,and NMES on suprahyoid muscles can further induce an increase in anterior hyoid excursion.

Objective To observe the effects of citalopram and physical therapy on poststroke depression(PSD).Methods72 patients with PSD were randomly divided into medicine group(n=36)and control group(n=36).The patients in the control group were treated only with physical therapy and the patients in the medicine group were treated with Citalopram and physical therapy.All patients were assessed with Zung Self-Rating Depression Scale(ZSDS)and Modified Barthel index(MBI)before and after treatment.ResultsAfter treatment,the Zung score in both groups decreased significantly(P<0.01).Meanwhile,the medicine group showed significantly less depression than the control group(P<0.05).The score of MBI was also significantly increased after treatment(P<0.01)in both group,but there was no significant difference between two groups(P>0.05).ConclusionCitalopram combined with physical therapy is effective on PSD.

Objective To observe the effect of intensive training on lower extremity motor function and depression after stroke.Methods Thirty patients with post-stroke depression were randomly divided into an intensive training group and a control group,each of 15.Both groups received conventional anti-stroke and antidepressant drug therapy,and rehabilitation training.The intensive training group,however,was additionally provided with lower extremity motor function training each day.Hamilton Depression Rating Scale,the Fugl-Meyer assessment (FMA),10-meter maximum walking speed test (10MWT) and the Holden functional ambulation categories (FAC) were conducted before treatment,and 2 and 4 weeks after the treatment.The level of human β-endophin (β-EP) and brain derived neurotrophic factor (BDNF) in the serum were also detected.Results After 4 weeks of treatment,the FAM,10MWT,BDNF and β-EP were significantly improved in both groups compared to those before the treatment (P＜ 0.05).No significant differences,however,were found between the 2 groups in the above measurements after 2 weeks of treatment (P＞0.05).After 4 weeks of treatment,the FAM (20.67±6.79),10MWT [(0.48±0.22)m/s],BDNF [(10.81±2.33)μg/L] and β-EP [(164.02±42.15)ng/L] of the intensive training group were significantly improved compared to those of the control group (P＜0.05).Both after 2 weeks and 4 weeks treatment,the HAMD scores of the intensive training group (16.33±6.74 and 12.13±5.44) were significantly better than those of the control group (P＜ 0.05).However,there was no significant difference in terms of FAC between the two groups either after 2 weeks or 4 weeks of treatment (P＞0.05).Conclusion The intensive training can improve motor function and relieve poststroke depression of stroke survivors.It is worth promoting and applying in clinical practice.

Objective To make students at different levels not only learn theoretical knowledge of acupuncture-moxibustion manipulation skills but also achieve full operating training, strengthen the combination of theory and practice and improve the teaching quality of clinical disciplines by applyingmultimedia-subject participationteaching method to acupuncture-moxibustion manipulation techniques in the experimental teaching of acupuncture and moxibustion. Method The students were randomized, according to grade, into experiment (n=114) and control (n=115) groups. The teaching content was the same in the two groups. The experiment group received multimedia-subject participationteaching method. After the multimedia teaching, the students did an independent demonstration and made a self-evaluation, the teachers made a comment and the students did independent practice again in groups. The control group received conventional theory teaching and did practice under demonstration in the experimental lesson. The examination and questionnaire were used as assessment indicators to evaluate the effect ofmultimedia-subject participationteaching method applied to acupuncture-moxibustion technique teaching. Result Statistical analysis was made using the SPSS11.5 statistical software package. The independent samples t-test is used for a between-groups comparison. The statistical result showed that satisfaction was 100%in the experiment group and 75.7%in the control group;there was a statistically significant difference between the two groups (P<0.05). Conclusion Multimedia-subject participationteaching method is an innovation in acupuncture-moxibustion technique teaching and helps the students to better master acupuncture-moxibustion manipulation skills. Mastery of theoretical knowledge before real practice is the key to proficient manipulation. The combination of the two in classroom teaching yields twice the result with half the effort. Carrying out multimedia-subject participation teaching method will help to further deepen the teaching reform and to improve the level and quality of“Acupuncture and Moxibustion”teaching.