Objective To investigate activation patterns in the motor cortex of patients with cerebral infarction by blood oxygen level dependent-functional magnetic resonance imaging ( BOLD-fMRI) , and to explore the brain's functional reorganization mechanism. Methods Sixteen patients ( 12 men and 4 women, age 37 to 80, mean 61.0±11.3) who had suffered a subcortical infarction within the previous 3 months were studied. All the patients received fMRI scanning during passive flexion-extension movement of both the affected and unaffected wrist separately.Brain functional mapping was acquired with SPM2 software. Activation patterns in the brain were compared between the affected and unaffected hands. Results The volume and intensity of the activated areas were diverse, but showed some order. When the affected hand moved, the fMRI map showed general hyperactivation. When the unaffected hand moved, the contralateral M1 and S1 were activated. Conclusions After cerebral infarction, the brain cortex showed compensatory changes. As the main motor cortex (M1) was deactivated, the subsidiary motor areas such as the PMC, SMA, CMA, IPL, PFC and CRB were activated. The activated motor areas could shift to the area around the lesion, and the non-motor area was activated also.

Objective To investigate the common initial clinical presentations of primary Sj(o)gren's syndrome (pSS) with pulmonary complications,and to explore the differences between patients with extraglandular manifestations at disease onset (EGM) and those with glandular manifestations at disease onset (GM).Methods A total of 1 341 hospitalized SS patients from 2003 to 2012 were retrospectively reviewed.Of them,102 hospitalized patients with pSS'associated lung disease were analyzed and included.Case control study was performed to explore the differences between the EGM group and the GM group.Results Fifty-one percent of patients were presented with EGM at onset,with significantly shorter disease duration [36 (12,156) m vs 102 (48,159) m,x2=-2.41,P=0.016].Although the mean diagnose time was similiar,only 4％ of the EGM group could be confirmed the pSS diagnose at onset,which was significantly less frequently than that of the GM group (34％,22=15.29,P＜0.01).Case control study revealed that hyperglobulinemia,elevated RF titers and anti-SSA and/or anti-SSB test positive were less predominant in the EGM group [IgG 16(12,21) g/L vs 21 (15,28) g/L,x2=-2.15,P=0.032;22 (20,171) U/ml vs 104 (20,238) U/ml,x2=-l.98,P=0.048;33％ vs 72％,x2=15.78,P＜0.01].The predicted value of TLC and FVC were lower [(87±23)％ vs (97±20)％,x2=-1.96,P=0.050;(8±28)％ vs (100±27)％,x2=-1.70,P=0.089] and HRCT score was higher in EMG group [12(88,15) vs 8(5,13),x2=-1.82,P=0.070].Conclusion EMG at onset is the common initial manifestation of pSS'associated lung involvement.Pulmonary complication is more progressively and severe than those with MG at onset.Anti'SSA positive,elevated RF titer and hyperglobulinemia are not predominant for patients with EMG at onset.

Objective To explore the effect of hierarchical executive function training on executive dysfunction among stroke survivors.Methods Thirty-six recovering stroke survivors with executive dysfunction were randomly divided into an experimental group (n=18) and a control group (n=18).Both groups received routine rehabilitation training and medication for three weeks,but the experimental group also received working memory training,inhibitory control training,set shifting training,and central executive function training.Before and after the training,everyone's cognitive functioning was screened using the Montreal Cognitive Assessment (MoCA),and executive functioning was evaluated using the digit span test (DST),the color trail test (CTT),the complex fluency test and the simple fluency test.Results Before the training there were no significant differences in clinical indicators between the two groups.After the treatment,the average MoCA,DST,CTT complex fluency test and simple fluency test scores of the experimental group had all improved significantly,but no significant improvement in any of the measurements was observed in the control group except for a significant improvement in their average MoCA score.Conclusion Hierarchical executive function training can improve the sub-components of executive function among recovering stroke survivors,including working memory,set shifting and fluency.