Neurogenic bowel is a syndrome that resulted from the denervation after spinal cord injury (SCI), and may influence the quality of life of SCI patients for the constipation and incontinence. It might be benefit of multidimensional bowel management including nu-trition, medicine and liquid, as well as stimulation, clyster etc. Surgery could be considered if necessary.

Objectives:This paper at measuring the inequity and its influencing factors of medical care utiliza-tion of elderly aged above 60 ( inclusive) . Methods:data comes from 2013 China Health and Retirement Longitudinal Study ( CHARLS) where the population aged 60 and above was selected as the research object. Concentration index ( CI) and its decomposition or centralized curve was used to measure the inequity of medical care services utilization of the elderly, and then the influencing factors of inequity were analyzed by means of the centralized index. Results:The concentration index for outpatient and inpatient service utilization for the elderly was 0 . 0619 and 0 . 1050 , re-spectively, and the concentration curves were below the absolute fair line. The top 2 factors that showed positive con-tribution to the outpatient service utilization included annual per capita consumption expenditure and the pension a-mount. The top 2 factors that showed negative contribution and larger contribution rate to the outpatient service utiliza-tion included New Rural Cooperative Medical Insurance (NRCMI), and Physical Ability in Daily Life (PADL). The top 2 factors that positively and highly contributed to the inpatient service utilization included the household per capita consumption expenditure and the Urban Employees' Basic Medical Insurance (UEBMI). The top 2 factors that nega-tively contributed to the inpatient service utilization included the New Rural Cooperative Medical Insurance ( NRCMI) and the Physical Ability in Daily Life ( PADL) . The horizontal inequity of outpatient and inpatient service utilization was 0. 0739 and 0. 1339, respectively, indicating that there was unfairness in the use of outpatient and inpatient services among elderly. Conclusion:There is inequity of medical care service utilization among the elderly in China. The economic status contributes the largest part of inequity, meaning that it is unfair to the first contribution factor;while the Needs-based fac-tors and New Rural Cooperative Medical Insurance (NRCMI) showed an inequity, narrowing the unfair gap.

Spinal cord injury has changed the function of human body and the way of life, and reduced the reserve capacity of the organs of various systems, which exceeded the body's repair ability itself, and overlapped with physiological aging and premature senescence appeared. This paper reviewed recent studies and analyzed the relation of the injured age, the chronological age, number of years after injury with dysfunction, predicted the function changes of them, and identified the factors related with their quality of life.

Objective:Anti-synthase syndrome (ASS) is a rare autoimmune disease. To increase the understanding of the disease and reduce the rate of miss diagnosis.Methods:The clinical data of 8 patients with positive anti-synthase antibody afterprimary Sj?gren's syndrome (pSS) were retrospectively analyzed and descriptive statistical analysis was carried out.Results:The diagnosis of Sjogren's syndrome (SS) was in accordance with the revised European criteriaof SS issued by the US-Europe consensus Group in 2002 or the classification criteria of American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) SS in 2016, and the diagnostic ASS was in accordance with the diagnostic criteria of Conners in 2010 or Solomon in 2011. Eight(100%) patients had a history of interstitial lung disease, and 7 (88%) patients had fever (oral temperature >38.5 ℃). All patients were positive for anti-Ro-52 antibody, 4 patients were positive for anti-PL-7 antibody, 2 patients were positive for anti-EJ antibody, 1 patient was positive for both anti-PL-7 antibody and anti-EJ antibody, and 1 patient was positive for anti-PL-12.Conclusion:pSS patients with severe interstitial lung disease or high fever of unknown causes should be screened for anti-synthase antibodies and the possibility of ASS.

Objective To initially understand the condition of quality of life (QOL) and depression as well as the correlation between them in the stroke inpatients. Methods 56 stroke patients from September 2014 to January 2015 in our hospital were included. Their QOL and depression status were evaluated with Stroke-Specific Quality of Life Scale (SS-QOL) and Self-rating Depression Scale (SDS). The de-pression was as the dependent variable, the score of SS-QOL, gender, age, education background, and the duration of stroke were as the inde-pendent variables, and analyzed with Logistic regression. Results Depression correlated with SS-QOL score (OR=0.955, P<0.05), but not with gender, age, education background, and the duration of stroke (P>0.05). Conclusion The depression status correlated with the QOL of stroke patients, but did not with gender, age, education background and the duration of stroke.

Objective To observe the effects of high fat diet on ulcerative colitis(UC)and atypical hyperplasia in different periods induced by azoxymethane(AOM)/dextran sodium sulfate(DSS)and the changes of interleukin-6(IL-6)level in blood. Methods The mice in DSS,DSS+AOM,DSS+high fat diet,and DSS+AOM+high fat diet groups were given DSS for 3 days and sterilization water for 4 days as one cycle for 9 cycles, and the mice in normal control group were given sterilization water(n=12 in each group). The mice in DSS+AOM and DSS+AOM+high fat diet groups received intraperitoneal injection of AOM(10 mg/kg)in the every first day of the first 3 cycles. The mice in each group were sacrificed at different time points,and the disease activity index and pathohistological index were used to determine the degree of inflammation. ELISA method was used for the detection of serum IL-6 level. Results Simple administration of DSS could induce UC in the mouse model. After 9 circles of treatment,atypical hyperplasia was not found in normal control and DSS groups,and the rate of atypical hyperplasia was 25%(1/4)in DSS+high fat diet group,50%(2/4)in DSS+AOM group,and 75%(3/4)in DSS+AOM+high fat diet group. However,there were no significant differences in the rate of atypical hyperplasia between DSS and DSS+AOM groups ,DSS+high fat diet and DSS+AOM+high fat diet groups ,DSS and DSS+high fat diet groups,and DSS+AOM and DSS+AOM+high fat diet groups(all P>0.05). The histopathological score and the disease activity index in DSS+high fat diet and DSS+AOM+high fat diet groups were higher than those in DSS and DSS+AOM groups(P<0.05). The IL-6 level in DSS+high fat diet and DSS+AOM+high fat diet groups was higher than that in DSS and DSS+AOM groups ,but the difference was not statistically signifi-cant(P>0.05). Conclusion High fat diet may be one of the stimulating factors of UC and atypical hyperplasia.

Either injury or reconstruction of anterior cruciate ligament (ACL) may damage proprioceptive sense, remodel central ner-vous system and impair motor control. It is necessary to systematically remodel neuromuscular function, including proprioceptive sense cor-rection, central nervous system remodeling and motor control strengthening etc., for patients after ACL reconstruction.

Objective:To observe the effect of ankle stretching on ankle biomechanics, balance, walking ability and ability in the activities of daily living among stroke survivors.Methods:Eighteen hemiplegic stroke survivors were randomly divided into an experimental group ( n=9) and a control group ( n=9). In addition to routine medication and rehabilitation training, the experimental group received 20 minutes of ankle joint stretching daily while the control group underwent an additional twenty minutes of routine rehabilitation training. Before and after the treatment, both groups′ ankle joint stiffness (K), muscle strength, active range of motion (AROM) and passive range of motion (PROM) were evaluated. They were also assessed using the modified Ashworth scale (MAS), the Fugl-Meyer lower extremity assessment (FMA-LE), the Berg balance scale (BBS), the 6-minute walking test (6MWT) and the modified Barthel Index (MBI). Results:After two weeks of treatment significant improvement was observed in the AROM and muscle strength of both groups in dorsiflexion and plantarflexion. The average BBS and FMA-LE scores of both groups had also improved significantly. Significant improvement in the average PROM of plantarflexion and the K of dorsiflexion, as well as in average MBI score was observed only in the treatment group. After two weeks the treatment group′s average muscle strength in plantarflexion and dorsiflexion was significantly better than the control group′s.Conclusions:Stretching can reduce ankle stiffness, improve the range of motion, muscle strength, and ability of in the activities of daily living after a stroke.

Objective This study was to evaluate the usefulness of the model of end-stage liver disease (MELD) score in comparison with the Child-Pugh classification to predict postoperative mortality and short-term survival in liver transplant patients. MethodsMELD score and Child-Pugh score were computed for each patient according to the original formula on admission day. Kaplan-Meier survival curves were made using the cut-off points calculated by Youden index. ResultsSix out of 40 patients died within three months, MELD scores and Child-Pugh scores for non-survivors (32.2?8.0, 12.3?2.0) were higher than those for survivors (13.4?6, 9.12?2.31) significantly (P

Although previous studies have shown functional efficacy of myelotomy for the treatment of spinal cord injury (SCI), the underlying mechanism remained unknown. This study aimed to determine the relationship between myelotomy-mediated neuroprotection and autophagy following SCI by evaluating the expression of microtubule-associated protein light chain 3 (LC3-II) and mammalian target of rapamycin complex 1 (mTORC1). Ninety-nine adult female rats were randomly assigned to either sham-operated group (SG), model group (MG), or 24 h-myelotomy group (MTG). SCI at T10 was induced with a New York University impactor, and myelotomy was performed 24 h after SCI. Functional recovery was evaluated via the open-field test. The protein expression of LC3-II was analyzed by Western blot, and the mRNA expression of LC3-II and mTORC1 were detected by real-time quantitative reverse transcriptase polymerase chain reaction. Rats in the MTG exhibited significantly better performance in the hind limbs compared to those in the MG on day seven and fourteen post-injury. Myelotomy suppressed the protein and mRNA expression of LC3-II on day three, seven and fourteen post-injury and increased the mRNA expression of mTORC1 in the MTG on day three and seven post-injury. The LC3-II protein expression was significantly and negatively correlated with BBB scores at day seven and fourteen post-injury. These results showed that myelotomy-induced neuroprotection in a rat model of SCI was likely mediated by inhibition of autophagy by activation of the mTORC1 signaling pathway