This article introduced the form of the rehabilitation evaluation discussion, which was moderated by the rehabilitation doctors, together with relevant therapists and nurses, aiming to discuss the obstacles and the rehabilitation plan for a difficult patient. This case showed the importance of early rehabilitation after stroke.

Objective To investigate the characteristics of mental rotation in stroke patients and the relationship between mental rotation and visual-spatial cognitive function. Methods From March, 2012 to October, 2013, 30 stroke patients were selected as experimental group and 30 healthy subjects as control group. They were tested with hand mental rotation task, and assessed with visuospatial abilities from Mon-treal Cognitive Assessment (MoCA). Results The reaction time of hand mental rotation task was significantly longer in the experimental group than in the control group (F=95.6, P<0.001). The reaction time was longer with the increase of rotation angle in both groups, and was the longest as 180° of rotation (F=345.672, P<0.001). The response accuracy rate of hand mental rotation task was significantly lower in the experimental group than in the control group (F=6.444, P<0.05). The response accuracy rate was lower with the increase of rotation angle in both groups, and was the least as 180° of rotation (F=102.911, P<0.001). The reaction time negatively correlated with the score of visuospa-tial abilities, while the response accuracy rate positively correlated with it in the stroke patients (P<0.05). Conclusion The mental rotation ability is impaired in stroke patients, however, the respondent pattern is similar to healthy people. The mental rotation ability is correlated with visual-spatial cognitive functions in stroke patients.

Objective To study the mechanisms of extrarenal arterial blood supply of renal malignancy for its interventional therapy.Methods Routine abdominal aortography and selective questionable feeding arteriography were performed in 141 patients with renal malignancy.The characteristics and formation mechanisms of extrarenal arterial blood supply for renal malignancy were analyzed.Results Of the 141 patients,extrarenal arterial blood supply of renal malignancy were found in 51 patients and there were 87 branchs.The breakthrough of renal capsule with malignancy were found in those 51 patients.No extrarena]arterial blood supply of renal malignancy was found in 90 patients,including 50 patients with and 40 patients without the renal capsule breakthrough with malignancy.The emerge of extrarenal arterial blood supply of renal malignancy were significantly different(x~2 = 31.64,P

Objective To assess the effectiveness and safety of embolic protection device in renal angioplasty and stenting.Methods From March 2003 through Feb 2005,renal angioplasty and stenting (RAS)were performed in 73 patients with severe renal artery stenosis,14 of them were done with use of distal embolic protection device(EPD,in 17 arteries ).Technical success included not only the stent placement but also the successful use of EPD.Results The EPD and stents were delivered and deployed successfully in all target arteries.The average percentage of renal artery stenosis before and after stent placement were 80.1%?9.0%,and 6.0%?4.2% respectively.The cholesterol particles were found in the EPD grossly in 2 and microscopically in 9 cases.Conclusion The use of embolic protection device during renal angioplasty and stenting is technically feasible and appears to be effective in preventing procedure-related embolization complications.

Objective To study the influence of obesity on outcome of rehabilitation for the hemiplegic post stroke. Methods 118 hospitalized stroke patients were divided into the normal weight, overweight and obesity groups according to the Body Mass Index. All the patients received rehabilitation for 12 weeks. They were assessed with National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after rehabilitation. Results The scores of NIHSS, FMA, BBS and MBI improved significantly after rehabilitation in all the groups (P<0.001), and improved the lest in the obesity group in the scores of NIHSS, BBS and MBI (P<0.05). There was no significant difference in FMA score among groups (P>0.05). Conclusion Obesity influences the outcome of rehabilitation, results in poor functioning.

Objective To analyze the clinical features and prognosis of central pontine myelinolysis. Methods 20 cases with CPM diagnosed in last 10 years were reviewed and compared with those patients of foreign studies. Results 10 patients with hemoptysis were treated with hypophysin, which resulted in severe hyponatremia and osmotic myelinolysis. The main syndrom were dysarthria and dysphagia (secondary to corticobulbar fiber involvement), flaccid quadriparesis (as corticospinal tract involved) which later became spastic. The myelinolysis distrubuted symmetrically along the myelin disruption in the center basal, as well as independently in other brain areas (extrapontine myelinolysis or EPM), including the cerebellar and neocortical white/gray junctional areas, thalamus and striatum. Conclusion Supplement of sodium should be slower and more persistent for hyponatremia, the selection of drugs should be based on the patients' specific conditions.

Objective To observe the effect of bilateral movement training on upper extremities dysfunction in stroke patients in convalescent phase. Methods 52 patients with hemiplegia were randomly divided into treatment group (n=26) and control group (n=26). The treatment group accepted bilateral upper extremities movement training, and the control group accepted routine neurodevelopment training mainly with affected upper extremities, for 6 weeks. They were assessed with Fugl-Meyer Assessment upper-extremity section (FMA-UE) and modified Barthel Index (MBI) before and after treatment. Results The FMA-UE and MBI scores improved in both groups after treatment (P<0.01), and improved more in the treatment group than in the control group (P<0.001). Conclusion Bilateral movement training may improve upper extremity function and activities of daily living more effectively for stroke patients in convalescent phase.

OBJECTIVETo explore the cause and pathogenesis of migraine based on TCM theory and modern researches to seek for new thinking and effective drugs in treating migraine.

METHODSNinety patients with migraine were divided into three groups, the treated group treated with Shutianing Granule (STNG) 9 g, three times a day, the control A group treated with composite Yangjiao capsule, 5 capsules each time, three times a day and the control B group treated with flunarizine hydrochloride capsule, 5 mg, once a day. The treatment lasted for 28 days to observe the degree, lasting time and frequency of pain attack, and the headache index was calculated. Transcranial Doppler examination, serum beta evoked potential (beta-EP) and neuropeptide (NPY) determination were also performed before and after treatment. In the experimental study, effect of treatment of cerebral NPY and beta-EP were tested in SD rats with chronic pain in the treated or the control groups.

RESULTSIn the treated group, the markedly effective rate was 56.67% and the total effective rate was 90.00%, significant difference was shown in comparison with those in the control B group (P < 0.05), but with no difference in comparison with those in the control A group. Cerebral beta-EP level was raised and plasma NPY level was lowered in all the three treated groups. Compared with the normal saline group, there was significant difference (P < 0.05 or P < 0.01).

CONCLUSIONSTNG could improve the cerebrovascular function effectively, raise plasma beta-EP level, lower plasma NPY level and alleviate vascular tension in patients with migraine.

Adult ; Animals ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Migraine Disorders ; drug therapy ; Neuropeptide Y ; blood ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; beta-Endorphin ; blood

Objective To explore the investigate of X-chromosome-linked inhibitor of apoptosis pro- tein(XIAP)and its effect on chemotherapeutic sensitivity in bladder carcinoma.Methods Using immu- nohistochemistry methods,the expression of XIAP was evaluated in 47 bladder carcinomas and 6 normal bladder tissues.The XIAP gene was transfected into bladder cancer cell line T24 by liposome and the positive clone was screened by G418.Cellular XIAP mRNA level was detected by RT-PCR.The apoptosis of T24 cells was induced by low-dose of mitocycin C(0.005 mg/ml and 0.05 mg/ml,respectively).The in vitro cellular growth activities were assayed by MTT color imetry;and the apoptosis rate was assayed by TUNEL methods. Results The expression rate of XIAP was 78.7%(37/47)in bladder carcinoma samples,with no corre- lation with carcinoma stages and grades(P＞0.05).XIAP mRNA level in transfected T24 ceils was signifi- cantly increased by 3.8 times.Treated with 0.005 mg/ml and 0.05 mg/ml of mitomycin C,the growth rates of XIAP transfected T24 cells were increased [(11.60?0.25)% and(16.51?0.87)% ,respectively,P＜0.05];and the apoptosis rates were decreased [(10.1?0.2)% and( 11.9?0.2)% ,respectively,P＜0.05]compared with those in control cells.Conclusions XIAP is highly expressed in humun bladder car- cinoma samples.Overexpression of XIAP in T24 cells results in decrease in bladder carcinoma cell apoptosis induced by MMC,which may decrease the chemotherapeutic sensitivity of T24 cells.

Objective To evaluate the effectiveness of minimally invasive therapy on treating hypertensive cerebral hemorrhage.Methods 40 cases hypertensive cerebral hemorrhage were randomly divided into two groups, 20 cases were received the minimally invasive drainage therapy and 20 cases medicine therapy.Results Effective rate was high(P