Objective To investigate the effect of drugs in combination with rehabilitative training on motor function and the expression of survivin in the ischemic penumbra after focal cerebral ischemia.Methods One hundred and twenty male,adult,Sprague-Dawley rats were subjected to left middle cerebral artery occlusion (MCAO)by suturing.Ninety-six of them were then randomly divided into a control group,a drug group,a rehabilitative trainiug group,and a drugs in combination with rehabilitative training group,with 24 in each.For three days the rats in the control group received no treatment,while those in the drug group received 500 mg/kg of citicoline daily,those in the rehabilitative training group received motor training including balancing,grasping,rotating and walking exercises,aud those in the drug and rehabilitative training group received both citicoline and the motor training.Behavioral tests were administered to all groups,and immunohistochemistry was used to detect the expression of survivin in the ischemic penumbra.Results Average behavior scores in the drug group and the control group were not significantly different at day 7,14 or 21 after the MCAO.Average behavior scores in the rehabilitative training and drug in combination with rehabilitative training groups were significantly superior to those of the control and drug groups at day 14 and 21.At those time points the average scores in the drug in combination with rehabilitative training group were also significantly better than those of the rehabilitation training group.Compared with control group,at the 7th,14th and 21st day after MCAO,expression of survivin in the other three groups had increased significantly.Expression of survivin in the group where drug treatment was combined with rehabilitative training was significantly greater than in the drug and rehabilitative training groups.Conclusions Citicoline in combination with rehabilitative training can improve the recovery of motor function in rats significantly better than the other approaches.This might be partially attributed to the up-regulation of survivin expression in the peri-ischemic cortex.

Objective To explore the factors affecting the prognosis for a child in a persistent vegetative state (PVS).Methods Forty-three PVS children were selected and provided with comprehensive rehabilitation training.It included physical therapy such as Rood approach and range of joint movement training,medication and hydro-acupuncture at the head points.After three months,each patient's state of consciousness was quantified,and multiple-factor unconditional logistic regression was conducted to identify factors relating to any changes.Results By the end of the intervention,29 of the patients had regained consciousness,a recovery rate of 67％.Logistic regression revealed that age,brainstem auditory evoked potentials (BAEP) and PVS score at admission all were closely related with whether a child regained consciousness.Gender,type of damage,EEG score,and the initial time of intervention had no significant relationship with regaining consciousness.Conclusions Older PVS patients with higher BAEPs and PVS scores at admission are more likely to regain consciousness.

Objective To investigate the pathogenesis of avascular necrosis of femoral head (ANFH) and to compare the effectiveness of ultrashort wave diathermy and Chinese medicine in the treatment of avascular necrosis of femoral head (ANFH) through animal experiment. Methods A total of 40 New Zealand white rabbits were divided into four groups: a control group, a model group, an ultrashort wave group, a Chinese me-dicine group. All the groups were injected with horse blood serum and methyl-prednisolone, which can induce ANFH. The TXB_2, 6-keto-PGF_ 1? , TG, TCh and hemorheology index were observed in the study. Results When compared with control group, the difference of model group was significant (P0.05) between ultrashort wave group and Chinese group. Conclusion Both ultrashort wave diathermy and Chinese medicine were effective for the treatment of ANTH in the early stage.

Objective To study the effects of uhrashortwave and low frequency pulsed electromagnetic fields on the expression of vascular endothelial growth factor(VEGF) in fracture healing. Methods Fifty-six New Zeal-and rabbits with artificial fractures were randomly divided into 4 groups:a control group,an ultrashortwave group,a low frequency pulsed electromagnetic field group and an ultrashortwave combined with low frequency pulsed electro-magnetic field group(combined group),with 14 in each group.Radiographic evaluation of callus formation and frac-ture healing,pathohistological examination and detection of VEGF expression through immunohistochemical staining were performed at the 1 st,2nd,4th and 6th week after the operation. Results Radiographic examination showed that there was significantly greater callus formation in the combined group than in the other groups throughout the healing process. Pathohistological examination also revealed significantly more cartilage islets and callus formation in the combined group.At the 1 st,2nd and 4th week after the operation,VEGF positive indexes in the combined group were significantly higher than in the other groups. Conclusion Uhrashortwave combined with low frequency pulsed electromagnetic field exposure can up-regulate the expression of VEGF and thus can accelerate fracture healing.

Objective To evaluate the effect of individualized and quantified rehabilitation exercise after te-nosuture of the digital flexor tendon. Methods One hundred and eighty cases of digital flexor tendon tenosuture were randomly divided into a quantification group and a control group. For the quantification group, the maximal ten-sile strength against rupture (Fmax) was measured during the operation. After splinting, the length of an elastic bandwas measured when there was a 2 mm clearance between the 2 ends of the sutured tendon, and the protective device was then fixed with all its parameters unchanged in the whole study. For the control group, Fmax was not measured and there was no protective device during training. Both groups were subdivided into subgroups A and B according to the daily training frequency. Training frequencies of 3 or 6 times per day were applied to the two subgroups. Results After 3 months of rehabilitation treatment, there was no re-rupture in the quantification group, but 6 cases of re-rup-ture occurred in the control group. 91% of the eases in the quantification group were evaluated as excellent or good, while in the control group 80% of the cases were evaluated as excellent or good. Clinical efficacy was significantly better in the quantification subgroup receiving 6 treatments per day than in any other subgroup. Conclusions Indi-vidualized and quantified rehabilitation exercise can prevent tendon re-rupture after tenosuture. 6 sessions of training per day may be better than 3 sessions per day.

Objective To observe the effects of electroacupuncture on expression of caspase-3 in the is- chemic penumbra in the early stage of cerebral ischemia in rats. Methods 100 Wistar rats were randomly divid- ed into a sham-operated group, a model group and an electroacupuncture group. The middle cerebral artery was ex- perimentally occluded in the rats in the model and electroacupuncture groups, while a sham operation without cere- bral artery occlusion was carried out on the rats in the sham-operated group. Immunocytochemistry was employed to detect the expression of caspase-3 in the ischemic penumbra at 24 h, 48 h and 72 h after cerebral ischemia. Re- suits There was almost no positive expression of caspase-3 in the sham-operated rats. Numerous caspase 3-posi- tive cells were found in the ischemic penumbra in the model and electroacupuncture groups. The peak of expression was reached 24 hours after cerebral ischemia. The number of caspase 3-positive cells was significantly greater in the model group than in the electroacupuncture group at 24 h and 48 h. Conclusion The increase of caspase 3-posi- tive cells in the ischemic penumbra is time-dependent. Electroacupuncture can significantly decrease the expression of caspase-3.

Objective To observe the effect of ultrashortwave therapy on the expression of BMP-2 in steroid-induced avascular necrosis of the femoral head(SANFH). Methods Thirty New-Zealand white rabbits were randomly divided into two groups:a normal group(4 rabbits)and an intervention group(26 rabbits).An animal model of steroid-induced avascular necrosis of the femoral head was induced through the intravenous injection of horse blood serum and the intraperitoneal injection of methylprednisolone in the intervention group.X-ray examination confirmed the successful induction of SANFH in 20 of the rabbits,who were then subdivided at random into an uhrashortwave therapy group(1 0 rabbits)and a model group(1 0 rabbits).The rabbits in the ultrashortwave group were treated with ultrashortwave therapy in two 1 5-day courses,with a 5-day interval between them. Non-thermal ultrashortwave therapy was given in the first course,then mild thermal uhrashortwave therapy was given in the second.Those in the model group were reared without ultrashortwave therapy.All the animals were sacrificed immediately after the end of the last treatment,and their femoral heads were sampled to observe the expression of BMP-2 using real time fluorescent quantitative PCR. Results The expression of BMP-2 mRNA in the intervention group was only one fifth of that observed in the normal group.It was 2.7 to 10 times that observed in the model group.Both differences were significant at the 1% confidence level. Conclusion Ultrashortwave therapy can promote the expression of BMP-2 and improve reactivation in avascular necrosis of the femoral head.

Objective To observe the effect of biofeedback therapy combined with electrical stimulation in patients with traumatic faecal incontinence.Methods Eishty-two patients with traumatic faecal incontinence were treated once daily with electric stimulation delivered via an intra-anal electrode.They also followed a biofeedback regimen including strengthening,sensory and coordination biofeedback.The whole progrtun consisted of 3 sessions of supervised treatment in hospital followed by 3 sessions of home therapy(10 days per session with an interval of 7days between the sessions).Clinical scores and anorectal function were assessed before and after the program.Results Before treatment,there were 9 patients with good clinical scores,and the general rate of fair and poor clinical scores Was 89%.After therapy,61 patients had good scores,and the general rate of fair and poor Was 26%.Anorectal squeeze pressure and sphincter electromyographic amplitude had improved significantly,the rectal sensory threshold Was decreased significantly,and 76%of the patients who had no external anal sphincter reflex recovered.At the two years follow-up,68% of the patients had maintained the clinical outcomes.Conclusion Biofeedback therapy in conjunction with electrical stimulation has significant therapeutic effects on patients with traumatic faecal incontinence.

Objective To observe the effectiveness of early intervention with ultrashort wave diathermy in the treatment of experimental avascular necrosis of femoral head (ANFH). Methods Thirty New Zealand white rabbits were divided into three groups:a normal group(group A),a model group(group B) and an ultrashort wave diathermy group(group C). The animals in groups B and C were subject to injection of horse blood serum and methyl prednisolone to induce ANFH, while those in group A were administered with injection of normal saline. The TXA 2, PGI 2, TG, TCh and hemorrheological indice were tested with all the rats. Results The animals in the model group were found with ANFH manifesting avasular necrosis of femoral head bone cells, decrease of bone marrow cells, high blood viscosity and imbalance of TXA 2 PGI 2. The ultrashort wave diathermy group demonstrated significant improvement with regard to the blood supply, the TG level and blood viscosity,as well as the PLT activity and the TXA 2 PGI 2 ratio. Conclusion The ultrashort wave diathermy could be an effective treatment method for preventing ANTH when used in the early stage of development of the condition.

Objective To investigate the effects of citicoline combined with rehabilitative training on motor function after focal cerebral ischemia. Methods One hundred and twenty male adult Sprague-Dawley rats ( 3 months old) were subjected to left middle cerebral artery occlusion (MCAO) by suturing. Ninety-six of them were randomly divided into four groups of 24: a control group, a drug group, a rehabilitative training group, and a drug combined with rehabilitative training group. The rats in the control group did not receive any treatment. Three days after reperfusion, those in the drug group received 500 mg/kg of citicoline daily; those in the rehabilitative training group received motor training including balancing, grasping, rotating and walking exercises; those in the combined group received both citicoline and the motor training program. Behavioral tests were administered at the 7th, 14th and 21st days after MCAO. At the same time points, immunohistochemistry was used to detect calcium-binding protein S100 and β-tubulin expression in the peri-ischemia region of the cortex. Results ①As compared with the control group, the drug group at the 7th, 14th and 21st day after MCAO and the other two groups at the 7th day after MCAO showed no significant difference in average behavior scores. But at the 14th and 21st day the rehabilitative training group as well as the drug combined with rehabilitative training group had average behavior scores significantly superior to those of the control group, especially in the drug combined with rehabilitative training group. ②As compared with the control group, the expression of S100 and β-tubulin in the drug and rehabilitative training groups at the 7th day after MCAO showed no significant difference. In the drug combined with rehabilitative training group the average score was significantly higher than in the other groups at the 7th day after MCAO. All the other groups had average scores significantly higher than that of the controls at the 14th and 21st day after MCAO, especially the drug combined with rehabilitative training group. Conclusions Citicoline combined with rehabilitative training can significantly improve motor function recovery in rats. The effect of the combined modalities was more obvious, and the functional enhancement might be partially attributable to the up-regulation of S100 and β-tubulin in the cortex.