Objective To investigate the relationship of apolipoprotein E (ApoE) allelic frequency and serum lipid levels in patients with Alzheimer′s disease (AD). Methods DNA microarray was used to detect the ApoE genotypes of AD patients (n = 200) and age-matched non-demented elderly control subjects (n = 159). Serum lipid levels was measured by Immunoturbidimetric assay at the same time. We analyzed the ApoE genotype distribution and the relationship of apolipoprotein E ( ApoE ) allelic frequency and serum lipid levels . Results The ApoE ε4 allelic frequencies (25.5%) in AD group is higher than that of the control group (7.9%) (P < 0.05). The ε2 allele was associated with a higher ApoE concentration, whereas with a mediate concentration in ε3 and the lowest concentration ( P < 0 . 05 ) in ε4 . Serum concentrations of ApoE showed no significant difference between AD patients and the healthy population who were with the same genotype (P > 0.05). Conclusion The ApoE levels are negatively related to ApoE ε4 allele frequency and have no significant differences with the same genotype in AD and the control group,which suggests that lower serum ApoE levels in AD patients is caused by higher ApoE ε4 allelic frequency in AD than in healthy population.

Objective To investigate the application value of apolipoprotein E (ApoE) genotyping by DNA microarray technology and the relationship between ApoE allelic frequency and serum ApoE levels in both healthy individuals and patients with Alzheimer ′s disease (AD).Methods This research is case-control study.DNA microarray was used to detect the ApoE genotypes of AD patients (n =280) and age-matched non-demented elderly control subjects ( n =230) .The cases and controls were collected in Guangzhou Huiai Hospital during July 2014 to September 2015.The accuracy of genotype results was verified by DNA sequencing.Serum ApoE levels were measured by immunoturbidimetric assay .The ApoE genotype distribution and the relationship between ApoE allelic frequency and serum ApoE levels were analyzed.The “t” test was used to compare the ApoE levels of AD patients and controls , variance analysis was used to analyze ApoE levels in the persons with different genotype .Results DNA microarray technology genotyping results were completely consistent with the results of DNA sequencing .In AD group, the ApoE genotype distribution were 2.9%(8 /280) for ε2ε3, 1.8% (5/280) for ε2ε4, 46.8% (131/280)for ε3ε3,45.4%(127 /280) for ε3ε4 and 3.1%(9 /280) for ε4ε4.While in the control group, the ApoE genotype distribution were 0.9%(2 /230) for ε2ε2, 12.6% (29/230)for ε2ε3, 1.3%(3 /230) forε2ε4, 70.0% (161 /230) for ε3ε3 and 15.2% (35 /230) for ε3ε4.The average serum concentrations of ApoE were (33.29 ±10.87)mg/L in AD patients and (41.28 ±10.95)mg/L in the controls.Among all participants, the average serum levels of ApoE were (50.86 ±6.21) mg/L for ε2 carriers, (38.78 ± 12.07)mg/L for ε3 carriers and (30.47 ±7.68)mg/L for ε4 carriers.In AD group,ApoE level of ε2, ε3,ε4 carriers is (50.31 ±9.08)mg/L, (38.30 ±7.60) mg/L and (32.86 ±5.93)mg/L respectively.In the control group, the ApoE level of ε2, ε3, ε4 carriers is (51.00 ±5.53)mg/L, (41.01 ±10.09)mg/L and (32.86 ±5.93)mg/L respectively.The ApoE levels of persons with different ApoE alleles are ε2 >ε3 >ε4. The difference is significant (F =89.6, P <0.05).However, the ApoE levels in persons with the same ApoE genotype between healthy individuals and AD patients have no significant difference ( t =0.981, 2.878 and 1.732 respectively, P >0.05) .Conclusions DNA microarray technology possesses high efficiency and favorable accuracy.The ε2 allele is associated with a higher ApoE concentration , ε3 allele with a mediate concentration and ε4 allele with a lowest concentration.Serum concentrations of ApoE showed no significant difference between AD patients and the healthy groups who have the same genotype .The primary cause of the low serum ApoE levels in AD patients is that the ApoE ε4 allelic frequencies of them are higher than that of the healthy persons.

Music and speech may share the same neural pathway, and the role of music therapy in speech rehabilitation gradually attracts the attention from the rehabilitation medical profession in recent years. This article reviewed the effect, mechanism, and strategy of music therapy in speech rehabilitation.

Objective To observe the clinical efficacy of duloxetine in the treatment of malignant neuropathic pain with depression.Methods 60 patients were randomly divided into two groups as study group(30 cases) and contrdl group(30 cases) and treated for 4 weeks.The patients of study group were treated with duloxetine and oxycontin,and the patients of control group were treated with oxycontin only.Numberical rating scale (NRS) on pain,criteria of pain relief and Hamilton depression scale(HAMD,17 items) score were used to assess the therapeutic effect before and after treatment.Results By the end of the fourth week of treatment,the average usage of oxycontin of the study group was significantly less than control group((45.6±8.5) mg vs (88.2±5.2)mg,P＜0.05).The effective rate of pain relief in the study group was significantly higher than that in control group (93.3％ vs 73.3％,P＜0.05).Comparing pre-treatment,the score of HAMD of the study group had a remarkable decrease ((11.45±4.56) vs (23.07±5.47),P＜0.01).In comparison to the score of control group,study group had a significant effect ((11.45±4.56) vs (18.75±4.21),P＜0.01).Conclusion Duloxetine is one of effective agents in the treatment of malignant neuropathic pain with depression,which can alleviate depression and relieve pain.Duloxetine have mild adverse effects and good tolerance.

BACKGROUND:It has been an urgent problem of how to promote cartilage repair of the knee and shorten the total course through a tissue engineering approach. Fortunately, microfracture plus stem cel transplantation may open up a new path for this issue. OBJECTIVE:To investigate the clinic feasibility of arthroscopic microfracture technique plus stem cel transplantation for repair of articular cartilage injury of the knee. METHODS:From October 2010 to March 2012, a total of 16 patients with articular cartilage injury of the knee were enrol ed, including 12 males and 4 females, with the average age of 38.6 years (16-52). Al cases of cartilage injury were confirmed by arthroscopy. Autologous bone marrow was extracted from patients at 2 weeks before treatment to isolate, culture and amplify bone marrow mesenchymal stem cel s in vitro. The cel culture solution of 3-5 mL (about 107 cel s) was harvested. The articular cavity was clean by arthroscopy and microfracture technique was performed at the area of cartilage injury that was then covered with hemostatic gauze through a minimal y invasive incision and the prepared bone marrow mesenchymal stem cel s were injected. The knee was bandaged with the elastic bandage after aspirating the joint cavity effusion by vacuum suction. Functional exercises were performed early by CPM.RESULTS AND CONCLUSION:After fol ow-up of 4-18 months, there were 13 cases of excel ent, 2 cases of valid and 1 case of ineffective. According to Lysholm knee scores, the average scores were improved from 42 points (33-67 points) to 89 points (75-99 points) at 4 weeks after treatment. The function was satisfied and al patients were fol owed up without recurrence or worse. Under the arthroscopy, the combination of microfracture technique and autologous bone marrow mesenchymal stem cel transplantation is proved to be effective for articular cartilage injury of the knee and it can notably improve the clinic symptoms and recover the function of the knee.

Objective To explore the factors influencing the functional recovery of patients with spinal cord injury (SCI) at discharge. Methods A total of 105 patients with SCI admitted to the rehabilitation medicine department at Huashan Hospital between December 2004 and October 2009 were studied. Data on eleven variables were collected including the patients' medical history, physical examination results and American Spinal Injury Association (ASIA) scores at admission. Functional status was registered according to the modified Barthel index (MBI) assessed at admission and before discharge. Linear regression analysis was used to assess the influence of the variables.Results After rehabilitation, average MBI and ASIA scores were significantly higher. The multiple regression analysis revealed that injury grade, motor and pinprick sensation scores at admission were related to MBI before discharge.The duration of rehabilitation, the rehabilitation treatment course and motor scores at admission were related to MBI increases during hospitalization. Conclusions Patients with different ages, injury levels and severity can improve their functional abilities through rehabilitation treatment, especially patients with better initial motor ability, longer treatment and earlier intervention.

Objective To investigate the clinical efficacy of lumbar-sacurm-iliac screws fixation in the treatment of complicated sacral fractures.Methods From January 2012 to October 2012,18 complicated sacrum fracture patients with unstable pelvic fractures and cauda equina dysfunctionwere retrospectively studied,which Gibbons score were all 4 points.Surgical treatment was performed by posterior lumbar-sacurm-iliac screw fixation combined with sacral decompression.The fixation stage can be extended to L4,S2 level by fracture.According to the patient's nerve injury and fracture displacement surgery sacral decompression and observation of nerve root injury.Ater full decompression,correct the vertical displacement and rotate the displacement,and then place the cross further fixed.The first 3 months after surgery,the patient reviewed once a month,3 months after the patient review once every six months.Results 18 patients underwent surgery for 2-21 d after injury,with an average of 10.2 d.The operation time is 150-240 min,an average of 180 min.Intraoperative blood loss of 600-2 000ml,an average of 1 100ml.The time of follow-up was 13-34 months,with an average of 23.4 months.Gibbons score averaged 4 points from preoperative to 2.78 points,the difference was statistically significant.Preoperative patients with an average angle of 42.89,postoperative 21.94,the difference was statistically significant.Postoperative Majeed scores averaged 64.5 points.Excellent in 3 cases,good in 3 cases,can be 7 cases,poor in 5 cases,excellent rate was 33.33％.Preoperative visual analogue scale (VAS) score averaged from 8.78 points before surgery to 2.22 points,this difference was statistically significant.The results of Tometta and Matto method were excellent in 5 cases,3 cases were good,7 cases were available,5 cases were poor,excellent and good rate was 44.44％.Conclusion Lumbarsacurm-iliac screw fixation in the treatment of complex sacral fractures can achieve a good reduction of fracture and attain satisfied nerve decompression,and more conducive to oatients faster and better recovery.

A method for determination of PCDD/Fs, PCBs and PCNs in soil sample was developed by using accelerated solvent extraction (ASE)-silica gel column cleanup-basic alumina column separation coupled with GC-MS/MS.The sample was extracted by ASE with Hexane-methylene chloride (Hex-DCM, 50∶50, V/V) at 120℃.The basic alumina column was used to separate PCDD/Fs, PCBs and PCNs.The extracts were eluted with Hex-DCM (95∶5, V/V) to obtain PCBs and PCNs, followed by Hex-DCM (50∶50, V/V) to obtain PCDD/Fs.The limits of detection (LOD) were in the range of 0.04-0.25 μg/L, 0.10-0.20 μg/L and 0.01-0.05 μg/L for PCDD/Fs, PCBs, PCNs, respectively.The relative standard deviations (RSDs) of average relative response factors (RRF) were below 13%.The recoveries of 13C-labeled internal standards of the three classes of analytes were 50%-95%, 51%-103% and 49%-74%, respectively.Concentrations of ∑PCDD/Fs, ∑PCBs and ∑PCNs in soil samples were 16.1-1148 pg/g, 6.6-152.6 pg/g and 10.9-99.5 pg/g, respectively.The results were consistent with that of high resolution mass spectrometer.

Objective To investigate whether physical training can activate the PI3K/Akt (phosphatidyli-nositol 3-kinase/Protein Kinase B) signal transduction pathway after focal brain isehemia, leading to the reduction ofendothelial cell apoptosis. Methods Twenty-four male adult Sprague-Dawley rats (2 ～ 3 month old, n = 24) weresubjected to 60-min right middle cerebral artery occlusion (MCAO). All rats were randomly assigned to one of thethree groups: physical training group, control group and sham operation group. 24 hours after MCAO ,physical train-ing group underwent 30 min treadmill training per day for 2 weeks. Results After two weeks, the phosphorylationlevel of PI3K/Akt in the physical training group was significantly higher when compared with that in the control group(P <0.05), while the expression level of Bax in physical training group was lower when compared with that in thecontrol group( P < 0.05 ). Conclusion Physical training can activate PI3K/Akt signal transduction pathway,which may be associated with the neurological recovery.

Objective To evaluate the effectiveness of standardized three-stage rehabilitation program on spasticity and motor function in the upper extremities after cerebral hemorrhage.Methods A total of 364 patients were included and randomly assigned to a control group (n =181) and a rehabilitation group (n =183).The standardized three-stage rehabilitation program,which included early-stage bedside rehabilitation,specialized treatment in rehabilitation ward during recovery and rehabilitation follow-up at regular intervals was applied in the rehabilitation group,but only rehabilitation guidance and follow-up after discharge were provided for the control group.The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were performed at the time of recruitment,1 month (M1),3 months(M3) and 6 months(M6) later.Results There was no statistical difference between the groups at recruitment.The occurrence rate of spasticity was 22.7％ in the control and 23.5％ in the rehabilitation group.At M6 the occurrence rate of spasticity was about 59.7％ and 43.2％ in control group and rehabilitation group respectively,and the number of patients grade 1 + and grade 2 on the MAS was 50/181 in the control group,significantly more than in the rehabilitation group (25/183).At all time points,MAS grade 0 accounted for a large proportion of both groups.At M6,both MAS distributions and scores of the two groups were different statistically (P ＜ 0.01).FMA scores in both groups increased significantly (P ＜ 0.01) with time,with the score being (17.13 ± 16.46),(24.87±18.36),(30.68±19.41) at M1,M3 and M6 in the control group and (24.71 ±19.80),(39.83 ± 19.50),(48.87 ± 18.25) in the rehabilitation group,but the average scores of the latter were consistently significantly higher than the former (P ＜ 0.01).Conclusions Standardized three-stage rehabilitation can alleviate spasticity and improve motor function of the upper extremities in cerebral hemorrhage patients.