Objective To study the risk factors for cognitive impaurment in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with ischemic stroke.Methods Three hundred and twenty-eight OSAHS patients with ischemic stroke were divided into cognitive impairment group (n=158) and cognitive impairment-free group (n=170) according to their MMSE score.The risk factors for their cognitive impairment were analyzed by multivariate logistic regression analysis and stratification analysis respectively.Results The blood glucose and lipid,AHI,LSaO2,infarction size and site,HIF-1 and Ngb level were significantly different between the two groups (P＜0.01).Multivariate logistic regression analysis showed that blood glucose and lipid,AHI,infarction site and Ngb level were the independent risk factors for cognitive impairment (OR=3.527,95％CI:1.559-7.983,P=0.002;OR=6.413,95 ％CI:2.766-14.865,P=0.000;OR=4.099,95％CI:1.694-9.918,P=0.002;OR=4.484,95％CI:1.950-10.310,P=0.000;OR=3.891,95 ％CI:1.759-8.606,P=0.001).Stratification analysis showed that high HIF-1 and Ngb levels were positively related with cognitive impairment in patients with AHI＞20 times/h,frontotemporal infarction,hyperglycosemia or hypoglycosemia,and dyslipidemia.Conclusion High HIF-1 and Ngb levels are independently related with cognitive impairment in OSAHS patients with ischemic stroke.

Objective To investigate the effect of Lokomat gait training rehabilitation robot on joint motion and lower limb function in hemiplegic patients after stroke.Methods Forty hemiplegic patients after stroke were randomized equally into a robotic group and a control group (20 cases in each group).The robotic group received robotic rehabilitation therapy in addition to routine rehabilitation training,while the control group was only given instructions for routine rehabilitation training.All the patients were assessed at the beginning of the training and at the end of 4,8 and 10 weeks of treatment.The Fugl-Meyer Assessment of lower extremities (FMA),range of motion (ROM) in hip and knee,force and tone of bilateral hip/knee flexors and extensors were used to evaluate stepping function before training,and after 4,8 and 10 weeks of treatment.Results There was no significant difference between the 2 groups with regard to FMA scores,the ROM in hip and knee,as well as force and tone of bilateral hip/ knee flexors and extensors (P ＞ 0.05).After treatment,the robotic group was significantly improved with all the evaluation indexes when compared to its baseline values (P ＜ 0.05).It was also shown that the robotic group improved to a significantly greater extent than the control group (P ＜ 0.05).Pearson's correlation analysis demonstrated a positive relationship between the ROM of knee or hip and lower limb function (P ＜ 0.05).Conclusions The Lokomat gait training rehabilitation robot can improve the lower extremities functions,as indicated by increase of ROM and muscle strength as well as decrease in muscle spasticity in hemiplegic patients after stroke.

Objective To explore the influence of self-efficacy training on the memory and executive function of patients with ischemic stroke in the recovery stage.Methods A total of 80 cases were randomly divided into a self-efficacy training group and a control group,with 40 cases in each.The control group was given routine cognitive therapy,while the self-efficacy group was given cognitive interventions plus efficacy training.Before training and after training for 3 months,self-efficacy levels were examined using the general self-efficacy scale (GSES),memory and executive function were measured using the Behavioral Assessment of Dysexecutive Syndrome (BADS) and the Wechsler Memory Scale (WMS).Anxiety and depression were evaluated using the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).Results Inter-group comparison showed no significant differences in terms of GSES or BADS scores before treatment between the control and self-efficacy groups.After training,the total GSES and BADS scores in both groups were significantly higher than before.Both the average GSES and BADS scores in the self-efficacy group were significantly higher than in the control group.There were similarly no significant differences in WMS scores before treatment,but after training the WMS results were significantly better in the self-efficacy training group than in the control group.After training,the SDS and SAS scores had improved to a significantly greater extent in the self-efficacy group than in the control group.Conclusion Self-efficacy training can facilitate the recovery of memory and promote executive function in patients with ischemic stroke.

Objective: To investigate the status of the quality of life (QOL) and its related factors of graduate students in military medical universities. Methods: 189 graduate students of a military medical university were assessed with WHO Quality of Life-BREF, Eysenck Personality Questionnaire (EPQ), Life Event Scale, Perceived Social Support Scale, and Simplified Coping Style Questionnaire. Results: The scores of QOL of graduate students in the military medical university were higher than average; The four domains of QOL were significantly correlated with introversion- extroversion, neuroticism, life event, social support, and coping style. The result from multiple regression showed that introversion- extroversion, neuroticism, social support, life event, and negative coping style were main factors influencing QOL. Conclusion: The status of the QOL of graduate students in military medical universities was pretty good; Their QOL could be improved by these factors, such as keeping stable emotion, developing extroversion, seeking social support, relieving the influence of bad life event, reducing negative coping behavior.

Objective: To investigate the coping strategies and it’s relationship with self- rated health state of military personnel in Tibet. Methods: 490 military personnel in Tibet were assessed by Simplified Coping Style Questionnaire and Self- rated Health Measurement Scale. Results: Military personnel in Tibet adopting positive strategies (23.3%) were more than those adopting negative strategies(16.2%) when facing stresses. The most common coping strategies they adopted were "restraining negative emotion(36.9%)" and "consoling themselve(s41.2%)". The scores of positive coping style had signifi- cant correlation with the scores of three subscales and the total scores of the self- rated health. Conclusion: Different cop- ing strategies have different effects on self- rated health of military personnel in Tibet, and the positive strategies could im- prove their status of self- rated health, but negative ones had contrary effect to health.

Objective: To investigate the relationship between the cognition and the self-rated health in military personnel in high altitude area. Methods: 490 military personnel in high altitude area were assessed with Self-rated Health Measurement Scale and the questionnaire of cognitive appraisal to environment and service. Results: The scores of the self-rated health in military personnel in high altitude area were higher than average(6.5~7.9, full score is 10); The main factors perceived by soldiers as having negative influence on health were poor communication with outside (53.6%), lack of opportunity of contact with opposite sex(51.8%), lack of amusement(48.4%)and service of hygiene(46.2%). Correlation analysis showed the cognitive appraisal factors were correlated with the self-rated health significantly(P

Objective To investigate the effect of grape seed proanthocyanidin extract (GSPE) on learning and memory ability after cerebral ischemia/reperfusion injury in rats and its mechanism. Methods 72 healthy male Sprague-Dawley rats were divided into sham group (n=18), model group (n=18) and GSPE groups (20 mg/kg, 200 mg/kg, n=18 for each group). The GSPE groups were administered GSPE orally for 4 weeks, while the sham group and model group were given water 10 ml/kg. Then their middle cerebral arteries were obstructed for 2 h and reperfused, excepted the sham group. 6 rats from each group were selected to test with Morris water maze 12 h, 24 h and 48 h after reperfusion respectively. And then, their brain tissues were stained with Hematoxylin-Eosin staining to observe under optical microscope. The level of superoxide dismutase (SOD) and malondialdehyde (MDA) in the brain tissues were measured. Results Compared with the sham group, the latency significantly prolonged, and the incidence of crossing the area the platform located reduced in the model group in the Morris water maze test, with the SOD decreasing and MDA increasing (P<0.05). Compared with the model group, the latency reduced and the incidence of crossing the area increased in the GSPE 200 mg/kg group, with the SOD increasing and MDA decreasing (P<0.05). Conclusion GSPE may suppress peroxidation after the cerebral ischemia/reperfusion to protect brain and learning and memory ability from injury.

Objective To review the efficacy of different rehabilitation training on walking locomotion for chronic incomplete spinal cord injury (SCI) by Meta-analysis. Methods PubMed, CNKI, Wanfang Database, and Google academic search were applied to search for clinical trials on chronic incomplete spinal cord injury to review the efficacy of gait training. Meta-analysis was to assess the clinical trials by Rev-Man 4.2. Results Gait training improved the walking speed for chronic incomplete spinal cord injury. The efficacy of partial body weight support treadmill training combined with functional electrical stimulation was confirmed. The efficacy of artificial aided training and robot-aided training remained uncertain. Conclusion Gait training was effective to improve walking ability for chronic incomplete spinal cord injury, but the evidence was insufficient.

Objectives To investigate the treatment effect of endothelin A receptor antagonist BQ-123 on early brain injury of subarachnoid hemorrhage (SAH ) in rats and its mechanism. Methods According to the random number table method,120 SD rats were divided into four groups:a sham operation (sham),a SAH,a high-dose BQ-123 (75 μg/ kg),and a low-dose BQ-123 (50 μg/ kg)(n = 30 in each group). A rat model was induced by using the injection of blood into cisterna magna twice. After establishing models at hours 6,24,72,and 144,the rats were further divided into four subgroups. Light and electron microscopes were used to observe the changes of the morphological structure in hippocampal area. Immunohistochemistry and RT-PCR were used to detect the expression levels of phosphoinositide 3 kina (PI3-K),protein kinase B (PKB/ Akt),and mammal target of rapamycin (mTOR). Results (1)In the process of model making,7 rats died and 1 model did not meet the criteria and was excluded from the SAH group. Six rats died in the high-dose BQ-123 group and the low-dose BQ-123 group respectively. One rat in each group did not meet the criteria and was excluded. The rats were included in the final statistical analysis:30 in the sham group,22 in the SAH group,23 in the high-dose BQ-123 group,and 23 in the low-dose BQ-123 group. (2)Compared with the sham group,the expression levels of PI3-K,AKt and mTOR were increased signifi-cantly (all P < 0. 05). Compared with SAH group,the hippocampal neuronal morphology and structure damage were alleviated in the low-dose BQ-123 group. The number of surviving neurons at each time point was increased ([132 ±18],[110 ±16],[84 ±13],[92 ± 10]cells/ HP,all P < 0. 05). The tensile force values of rats were increased at each time point and the learning and memory function were improved. The expression levels of PI3-K and Akt were further increased (all P < 0. 05). The expression level of mTOR was decreased (all P < 0. 05). (3)Compared with the low-dose BQ-123 group,the morphological and structural damage of hippocampal neurons were alleviated. The number of surviving neurons at each time point ([153 ±20],[131 ± 18],[137 ±19]and [135 ± 17]cells/ HP)was increased (all P < 0. 05). The tensile force values of the rats were increased at each time point. The learning and memory function of the animals were improved. The expression levels of PI3-K (3. 8 ± 0. 8,8. 9 ± 2. 4,8. 6 ± 2. 4,and 6. 2 ± 2. 0)and Akt (4. 86 ± 1. 74, 8. 64 ± 1. 62,7. 94 ± 1. 70,and 6. 48 ± 1. 58)were further increased (all P < 0. 05). The expression levels of mTOR (2. 89 ± 0. 26,2. 14 ± 0. 18,1. 94 ± 0. 17,and 1. 62 ± 0. 12)were decreased (all P < 0. 05). Conclusions BQ-123 has as a good therapeutic effect for early brain injury after SAH. Its mechanism may be associated with the regulation of PI3-K/ Akt signaling pathway.

Objective To explore the regulation of PI3K-mTOR signaling pathways on autophagy of hippocampus nerve cells after subarachnoid hemorrhage (SAH)in rats.Methods We randomly divided 72 male Sprague-Dawley rats into sham group,SAH model group and LY294002 group with 24 rats in each group.We established SAH model with the secondary injection of blood method while the sham group was not injected with blood.PI3K signaling pathways specific inhibitor LY294002 was injected with 500μmol per rat 30 minutes before modeling.After 6,24,72 and 144 h morphologic changes of hippocampus CA1 neural cells were observed by microscopy;the expression levels of PI3K,mTOR,Beclin-1 and LC3-Ⅱ were detected by immunohistochemical method.Results The density of survival neurons in the SAH group was significantly lower than that in the control group (P<0.05),PI3K-mTOR signaling pathways were activated obviously,and the expressions of Beclin 1 and LC3-Ⅱ were significantly higher than those in the control group (P<0.05 ).The number of survival neurons significantly decreased in the LY294002 group compared with the SAH group at each time point (P<0.05),PI3K-mTOR signaling pathways were suppressed.The expressions of Beclin-1 and LC3-Ⅱ were significantly lower than those in the SAH group (P<0.05).Conclusion PI3K-mTOR signaling pathways protect neurons by activating the autophagy of neurons after SAH.