In this paper we will discuss the architecture and functions of the VR vehicle for rehabilitation. There is no such report about this kind of VR vehicle for rehabilitation in open literature. Patients can select exercise modes for rehabilitation according to their individual health conditions. Patients can get rehabilitation faster and less painfully with the aid of this VR vehicle with which psychological treatment can be better introduced during the rehabilitation.

Objective To investigate the influence of fixation of both lower limbs with negative pressure vacuum cushion and fixation of both ankles with self-made foam mat on setup errors in radiotherapy for rectal cancer.Methods A total of 12 patients with rectal cancer were enrolled in 2014 and randomly divided into group A (using negative pressure vacuum cushion) and group B (using self-made foam mat).An offline registration analysis was performed for the images of 108 times (A,B group of 54 times) of kilovoltage cone-beam CT (CBCT) before and after treatment.Grey scale translation error registration was used,and the results of registration were analyzed.The setup errors in x-axis (left-right direction),y-axis (cranial-caudal direction),and z-axis (anterior-posterior direction) were compared between the two groups.Results There was no significant difference in the absolute setup error in the y-axis between the two groups (2.13±0.64 mm vs.2.61±1.17 mm,P=0.399),while group A showed significantly lower absolute setup errors in the x-axis and z-axis than group B (x-axis:1.51±0.28 mm vs.2.70±1.05 mm,P=0.039;with an error rate of 7.41％ vs.42.59％;z-axis:1.10±0.29 mm vs.2.37±0.71 mm,P=0.002;with an error rate of 1.85％ vs.35.19％).Conclusions In the radiotherapy positioning for rectal cancer,fixation of both lower limbs with negative pressure vacuum cushion effectively avoids the translation and rotation of both lower limbs,reduces absolute setup errors,and has higher accuracy than fixation of both ankles with self-made foam mat.

Objective To study the effect and possible mechanism of diazoxide on myocardial ischemia/reperfusion (I/R) injury in diabetic rats, and the influence of insulin intervention which aims to maintain blood sugar levels within the normal range on the protective function of cardiomyocytes. Methods 126 health male Sprague-Dawley (SD) rats were intraperitoneally injected with one dose of 60 mg/kg streptozotocin (STZ) to reproduce diabetic model. The diabetic rats were randomly divided into seven groups, with 18 rats in each group. Myocardial I/R model was established by 30 minutes ligation of the left anterior descending branch of the coronary artery, and 120 minutes blood circulation recover. Sham group was only threaded without ligation. Rats in I/R group, diazoxide group (DZ group), and Ottawa vine penicillin (WNT) group were infused intravenously with 2 mL of 0.1% dimethyl sulphoxide (DMSO), DZ (7 mg/kg), and WNT (15 μg/kg), respectively, after 25 minutes of ischemia. Sham group was only injected with 2 mL of 0.1% DMSO. DZ+WNT group was infused with WNT 5 minutes before the injection of DZ. Insulin intervention (RI) group received a continuous insulin infusion to maintain the blood sugar at the level of 4-6 mmol/L. RI+DZ group was infused with DZ after ischemia for 25 minutes based on blood sugar control. Hemodynamic parameters in each group were monitored continuously. The pathological changes of myocardium were observed with hematoxylin and eosin (HE) staining. The expressions of phosphorylated protein kinase B (p-Akt) and phosphorylated glycogen synthase kinase-3β (p-GSK-3β) were determined by Western Blot. Results Compared with sham group, the cardiac functions of the intervention groups were significantly decreased, and severe myocardial injury was observed. Compared with I/R group, the cardiac functions of intervention groups were not obviously improved. However, after insulin intervention by which blood sugar was maintained within normal range, the cardiac function and myocardial injury were further aggravated. Compared with sham group (the expression value of sham group was set as 1), the expressions of p-Akt in other groups including I/R group, DZ group, RI group, and RI+DZ group showed no statistically significant difference (gray value: 1.07±0.09, 1.03±0.07, 1.07±0.07, 1.02±0.08 vs. 1.00, all P > 0.05). However, the expressions of p-Akt were decreased in WNT group and DZ+WNT group as compared with those of sham group and I/R group (gray value: 0.54±0.06, 0.51±0.05 vs. 1.00 and 1.07±0.09, all P < 0.05). The expressions of p-GSK-3βshowed no statistically significant difference in I/R group, DZ group, WNT group, and DZ+WNT group as compared with sham group (gray value: 0.97±0.08, 1.00±0.11, 0.98±0.06, 0.97±0.09 vs. 1.00, all P > 0.05). However, the expression of pGSK-3β was increased in RI group, RI+DZ group as compared with sham group and I/R group (gray value: 1.68±0.08, 1.70±0.05 vs. 1.00 and 0.97±0.08, all P < 0.05), and it was significantly higher in RI+DZ group than that of DZ group (gray value: 1.70±0.05 vs. 1.00±0.11, P < 0.05). Conclusions Diazoxide after myocardial injury could not protect the myocardium from I/R injury in diabetic rats, and did not trigger the activation of the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Insulin intervention by which blood sugar was maintaine d within the normal range exacerbates myocardial I/R injury in diabetic rats.

Objective To study the effects of community-based rehabilitation on cerebral apoplexy patients with cognitive disorders.Methods 30 cases of cerebral apoplexy patients were enrolled according to relevant standards,who were given standard rehabihtation care in Community Health Service Center(training group) ,while another 30 similar cases from subordinate health service stations (control group) given only rehabilitation guidance once a week.Two groups were not do professional cognitive training.All patients were assessed with Mini Mental State Examination( MMSE), Fugl-Meyer Assessment(FMA) and modified Bathel index rating scale(MBI) to evaluate their cognition ,movement function and activity of daily living(ADL) before training as well as after 4-week and 8-week training.Results There was no signficant difference in cognition,movement functions and ADL between training group and control group before treatment(P>0.05).The differences in the assessment of Brounnstrom scale and MBI between two groups after 4-week training were not significant( P > 0.05 ).The scores of Fugl-Meyer scale, MMSE and Barthel index of the training group after 8-week training were significantly higher than those of control group( all P < 0.05 ).Conclusion Community-based rehabilitation training could improve the movement functions and ADL,and cognitive functions of cerebral apoplexy patients.

Objective To assess the test-retest reliability of the Chinese version of Overactive Bladder Symptom Score (OABSS) and its correlation with other overactive bladder symptom (OAB)evaluation tools among Chinese OAB patients. Methods Fifty OAB patients completed the OABSS,PPBC, IPSS forms and a three-day voiding diary card for twice in day 0 and day 14±2, respectively.Test-retest reliability was examined using internal correlation coefficient (ICC) and weighted Kappa coefficients between first and second application of OABSS. The internal reliability was evaluated using Cronbach's α coefficient method. Pearson or/and Spearman correlation coefficients were calculated for testing the correlation between OABSS and IPSS, IPSS QOL, PPBC as well as clinical variables in the three-day voiding diary cards. Results ICC of OABSS total score was 0.9172, weighted Kap-pa coefficients of individual scores in OABSS were 0.5902-0.9274;Cronbach's α coefficients were 0. 3069 and 0. 3285, respectively. In the first and second application of OABSS, the Pearson correlation coefficients were 0. 2643-0. 6900 between OABSS and clinical variables in the three-day voiding diary card (except for average daily frequency of urination);the Pearson correlation coefficients were 0. 4734 and 0. 4929, and the Spearman correlation coefficients were 0. 4133 and 0. 4149 between OABSS and IPSS total score;the Spearman correlation coefficients were 0.4083 and 0.4127 between OABSS and PPBC. Conclusions The Chinese version of OABSS manifest test-retest reliability among Chinese OAB patients. It has also a high correlation with IPSS total score, PPBC and clinical variables in the three-day voiding diary cards.

ObjectiveTo retrospectively analyse the data of patients with suspected primary aldosteronism (PA) during the last five years.The receiver operating characteristic (ROC) curve was used to evaluate the value of aldosterone to renin ratio (ARR) in screening primary aldosteronism.MethodsThe clinical data of ARR in supine and upright positions were collected in 590 patients with suspected during January 2006 to August 2010.There were 357 patients diagnosed as primary aldosteronism and 233 patients as essential hypertension among these patients.100 patients with suspected primary aldosteronism took the upright and random ARR during September 2010 to April 2011 ; Among these patients,29 patients were diagnosed as primary aldosteronism and 71 as cases of essential hypertension.ROC curve was made to retrospectively define the method and the cut-off value of the supine,upright or random ARR.ResultsThe area under the curve(AUC) of the supine ARR in the 590 patients who took the supine and upright ARR during January 2006 to August 2010 was 0.838 (0.805-0.867 ) and the AUC of the upright ARR was 0.873 (0.843-0.899 ).There was significant difference between these two AUC readings (P＜0.01 ).The AUC in the upright ARR of the 100 patients who took the upright and random ARR during Septeuder 2010 to April 2011 was 0.962 (0.928 -0.995 ) and the AUC of the random ARR was 0.944 (0.893-0.994 ).There was no significant difference between these two AUC readings (P＞0.05).The upright ARR cutoff value with 400 ( pg · ml-1 )/( ng· ml-1 · h 1 ) yielded a sensitivity of 91.9％ and a specificity of 64.2％ to diagnosis of PA.ConclusionUpright ARR value was more suitable in the screening test than supine ARR value.Random ARR showed similar effect as the upright ARR.In our research,under strict control of the drug,position and detection time,ARR value with 400 ( pg · ml-1 )/( ng· ml-1 · h-1 ) can be the cutoff point in screening the suspcctcd PA patients.

ObjectiveTo develop the interacting learning mode in simulative situation on sex and health courses for college students and evaluate the effect of it.MethodsThe core curriculum for general education of sex and health was open to all the students in Shanghai Jiao Tong University from Feb.2010 to Jun.2011.The courses imported simulative-situation-learning method.At the end of the semester,the feedbaick and the suggestion of the students were collected and sorted.ResultsAll groups from the course involved the simulative situation seriously,which included homosexuality of college students,undesired pregnancy and contraception knowledge,etc.According to the feedback of the courses,most of the students acceptted this kind of teaching method.ConclusionInteracting learning in simulative situation can obviously increase the interest and enthusiasm of students.Meanwhile,the new courses not only improve students' understanding of knowledge,but also improve their communication skills and team work ability.

Objective:To investigate age related changes in urodynamic parameters of women with uri-nary incontinence.Methods:From May 2008 to October 2015,a total of 214 patients diagnosed with urinary incontinence in Peking University People’s Hospital was involved in this study.Average age was (56.97 ±10.68)years,ranging from 30 to 82 years,and average history was (8.44 ±8.85)years, ranging from one month to 50 years.Urodynamic examinations of each patient were taken before operation routinely in Department of Urology,Peking University People’s Hospital.The urodynamic study was composed of non-invasive and invasive procedures.Analysis included maximal flow rate (Qmax ),average flow rate,time to Qmax ,voiding time,detrusor pressure at Qmax ,maximal detrusor pressure,voided volume,post-void residual urine volume (PVR),the total capacity of bladder,first-,strong-,and urge-desire to void,cough leak point pressure (CLPP),and Valsalva leak point pressure (VLPP).Patients were divided into four groups according to age,Kolmogorov-Smirnov test and one-way ANOVA were used for data analysis.Results:A total of 214 patients were enrolled in this study.The data of Qmax ,average flow rate,voided volume,and total capacity of bladder decreased with statistical significance.The value of residual urine volume and voiding time increased without statistical significance,while the value of maximal detrusor pressure decreased.Conclusion:Urodynamic examination data of females with urinary incontinence changes along with the elapse of age,which was mainly observed as age ascends,and the changes in urodynamic parameters of women with urinary incontinence suggest that the value of Qmax , average flow rate,voided volume,and total capacity of bladder decreased significantly,while the value of PVR and the voiding time increased and the value of maximal detrusor pressure decreased.

Duchenne muscular dystrophy(DMD)is an X-linked recessive muscular disorder that affects mainly males.With its low incidence, insidious onset, and rapid progression, DMD is characterized by proximal muscle weakness, gastrocnemius hypertrophy, and markedly elevated serum creatine kinase.In addition to severe motor dysfunction, it also causes cardiac involvement in children, mainly manifested as dilated cardiomyopathy and arrhythmias.The mutations of DMD gene lead to the absence of dystrophin, which results in cytoskeletal defects and the impairment of the integrity of myocardial cell membrane.Meanwhile, calcium overload makes the myocytes more susceptible to damage.Exon deletion is the most common type of gene mutations in children with DMD, followed by point mutations, duplications and small insertion or deletion.The relationship among the clinical manifestations, pathogenesis, evaluation of cardiac damage in DMD and its genotype has not been clarified, which still needs further research and exploration, although some advances have been made recently.

BACKGROUND: Dopamine is closely associated with occurrence of epilepsy and transmission in central nerval system, and its various functions are determined by specific receptors.OBJECTIVE: To establish temporal epilepsy model so as to probe into the influences of SCH23390, the antagonist of dopamine D1 receptors and haloperidol, the antagonist of dopamine D2 receptors injected in substantia nigra on temporal epileptic seizure induced by kainic acid and on electroencephalic activityDESIGN: Randomized controlled verified experiment.SETTING: Neurology Medicine Institute of Zhujiang Hospital Affiliated to Southern Medical University.MATERIALS: The experiment was performed in General Military Neurology Medicine Institute of Zhujiang Hospital Affiliated to First Military University of Chinese PLA from August to December 2004, in which, 30SD adult male rats were employed, massed varied from 250 to 300 g.METHODS: ① 30 rats were randomized into physiological saline (control) group (6 rats), kainic acid (KA) group (6 rats) and experimental group (18 rats). The experimental group was divided into 3 subgroups, named the antagonist of dopamine D1 receptors, SCH23390 + kainic acid group (D1 +KA group), the antagonist of dopamine D2 receptors,haloperidol + kainic acid group (D2+KA group) and physiological saline + kainic acid group (PS + KA group), 6 rats in each. In the control, physi ological saline 2 μL was injected in the right cerebral ventricle unilaterally. In KA group, kainic acid 2 μL was injected in the right ventricle. In each of experimental group, SCH23390, the antagonist of dopamine D1 re ceptors, haloperidol, the antagonist of dopamine D2 receptors and physio logical saline 1 μL for each was injected in substantia nigra on the right side successively and simultaneously, kainic acid 2 μL was injected in the right ventricle. ② Observed items: alters of EEG on the 0.5th 1st, 2nd, 6th and 24th hours after medication in each experimental group (compared with EEG of non-epileptic behavior, appearance of sharp wave, spike wave,sharp (spike) slow comprehensive wave and multi-spike slow wave determines epileptic activity) and changes in animal behaviors (0 grade: normal; Ⅰ grade: wet dog-like trembling, paroxysmal facial spasm, like winking,beard moving, rhythmic chawing; Ⅱ grade: rhythmic nodding; Ⅲ grade:paroxysmal spasm of anterior limbs; Ⅳ grade: paroxysmal spasm of bilateral anterior limbs when standing; Ⅴ grade: falling down, loss of balance and convulsion of four limbs). Cerebral hippocampal neural cell apoptosis was observed and the rats were sacrificed on the 5' day of medication. Cerebral hippocampal section was prepared and determined after in situ end labeling staining.MAIN OUTCOME MEAUSRES: ① Changes in behavior in rats before and after epilepsy and electroencephalogram (EEG) alters. ② Results of cerebra hippocampal neural cell apoptosis.RESULTS: Thirty rats entered result analysis. ① Epilepsy seizure: In the control group, there was no epilepsy attacked. In KA group, all of rats ap pear seizure, which attacked 10 minutes after KA injected in brain ventricle, reached the peak in 1 hour and stopped in 3 to 6 hours. ② EEG record: In the control group, there was not epileptic activity manifestations,like sharp wave, spike wave, spike slow comprehensive wave, etc. In KA group, epileptic wave presented in 10 minutes after injection, the seizure developed to the peak in about 1 hour, the wave amplitude was decreased in 3 to 6 hours, presenting paroxysmal slow and spike slow waves and no epileptic wave appeared after 12 hours. ③ Neuronal apoptosis: In the control group, few neural cell apoptosis was visible in hippocampus after injection.In KA group, neural cell apoptosis was visible obviously in hippocampus in 5 days after injection (P =0.00). With SCH23390, the antagonist of dopamine D1 receptors, hippocampal cell apoptosis was not reduced remarkably (P ＞0.05) and with haloperidol, the antagonist of dopamine D2 receptors injected in substantia nigra, hippocampal cell apoptosis was aggravated (P =0.00).CONCLUSION: Injection of SCH23390, the antagonist of dopamine D1 receptors in substantia nigra cannot block kainic acid inducing epilepsy and epileptic electroencephalic activity is not weakened remarkably. Injection of haloperidol,the antagonist of dopamine D2 receptors enhances epileptic electroencephalic activity in kainic acid induced epilepsy and increases cell apoptosis remarkably in cerebral hippocampal CA3 area.It is to explain that it is dopamine D2 acceptor that is involved in regulation of temporal epilepsy in substantia nigra rather than D1 acceptor.