The objectives of this paper are to help specialists in Physical and Rehabilitation Medicine plan their careers, influence the future of the PRM specialty and advocate effectively for those with limitations of functioning. The experiences of the authors are the sources of its observations and suggestions. The senior author has had extensive national and international experience in the specialty as a clinician, teacher, researcher, manager, leader and advocate. The junior author adds the insights of one who only recently has become immersed in PRM. The following are suggestions and observations the authors believe could contribute to the future success of individual PRM specialists and the PRM specialty. ①Review and reinforce the significant accomplishments of PRM over the last 70 years. It has significantly expanded the focus of health care to include the importance of functioning. ②Identify the specialty's current strengths, weaknesses, threats and opportunities. As a clinical specialty, it has expanded nationally and internationally, yet its research contributions remain limited. The absence of an evidence base for much of its activity risks reduced support from payers, yet the population needing its services continues to expand. ③Develop strategies to increase the ability of PRM specialists and PRM to improve the lives of people with or likely to have limitations of functioning. These strategies could include sharing best practices, supporting effectiveness research and developing expert consensus guidelines. The need for physicians who are experts in the strategies of improving the lives of those with complex problems of functioning will continue to expand. This need will assure the continuation of the specialty of PRM as long as it improves the abilities of its members to help those with problems of functioning, and it advocates for those whom its members serve.

Objective:To explore the influences of different sexes and ages on children static balance at the basis of quantitative comparison study of static postural balance of children aged 6-8(-year-odl).Method:A total of 499 children aged 6-8-year-old were recruited,which include 254 boys and 245 girls.Static postural balance test of these subjects was performed by using KY-1112 system for stabilometric analysis with subjects opening and closing eyes situations.Result:①There was a significant gender difference in static balance.At gender comparison,there was a significant difference on 3 indicators at the situations with eyes opening(P<0.05),and 3 indicators at the situations with eyes closing(P<0,01).②A significant difference Was shown in age comparison on 5 indicators(P<0.05).The mean of 5 indicators decreased with age growing.As compared with the value among Eve Area(with eyes opening and closing)and Track location Variance (with eyes opening).there Was a significant difference between children aged 8-year-old and 6-7-year-old(P<0.01),and no significant difference between 6-year-old and 7-year-old.There was a very significant difference on the LNG indicators at the situations with eyes opening and closing(P<0.01).③The value R indicator Was less than 1.Conclusion:To the children aged 6-8-year-old,there was significant gender difference in static balance,the balance function of girls was better than that of boys;there was significant age difference in static balance,with age growing the static balance rose also;relatively speaking,the gravity center shaking area was larger at forward and backward than that at leftward and rishtward.

Objective:To investigate the effects of U0126 of different doses on the ability of low frequency magnetic stimulation promoting astrocyte migration and to select suitable dose of U0126.Method:Twenty-four adult healthy SD rats were selected to receive Injection of 0.5ml of 1% ethidium bromide(EB) in PBS into the dorsal spinal cord funiculus on the left side at T10-11 level to make located spinal cord injury models and randomly divided into four groups.The four groups were exposed to magnetic stimulation(1Hz,1.52T.30pulses)at the following dose respectively:Omg/kg U0126(control group).0.1mg/kg U0126(low-dose group), 0.2mg/kg U0126(middle-dose group),0.4mg/kg U0126(high-dose group).On the day 14 after stimulation,the rats were sacrificed and the expressions of glial fibfillary acidic protein(GFAP),microtubule associated protein-2(MAP-2),extracellular signal-regulated kinase1/2(ERg1/2)and the volume of holes were detected with immunohistochemistry.Quantitative analysis 0f the expressions of GFAP,MAP-2 and ERK1/2 were performed with the image analysis system.Result:With the increase of U0126 dose,the volume of hole increased on day 14(p<0.05).In the lesion area,the expressions of GFAP and ERK1/2 could be found,while MAP-2 could not.Significant differences were revealed in the expressions of GFAP、ERK1/2 among the four groups,it Was significantly lower in U0126 groups than that in control greup(P<0.05).while the middle-dose group had similar effect with the high-dose group(P>0.05).Conclusion:U0126 of different doses all could resupinate astrocyte migrations which were coused by low frequency magnetic stimulation,and 0.2mg/kg was the suitable dose.

Objective:To observe the therapeutic effect of nerve block therapy guided by electric stimulation on the relief of pain and the improvement of function in patients with low back pain(LBP).Method:A total of 78 LBP patients were divided into nerve block treatment group(n=40)and traditional treatment group(n=38)randomly.The nerve block treatment group was injected with Betamethasone compound 2mg and Lidocaine 2ml guided by electric stimulation.The physical modalities and exercises therapy were applied in the traditional treatment group.The pain was evaluated with visual analogue scale(VAS)before treatment and 1 d,1 and 2 weeks after treatment.The function of lumbar was assessed before and after the treatment with performance assessment scale for the treatment of lumbar vertebral diseases.Result:The effective rate in treatment group was 100.0%,in traditional group was 86.8%:the improvement rate in treatment group was 96.6%.in traditional group was 64.3%:there were significant differences between two groups (P<0.01).Conclusion:Nerve block therapy guided by electric stimulation display significant effect on relief the low back pain and improve the function of lumbar vertebrae.

Objective:To study the Clinical efficacy of combined therapy of adenosylcobalamin and transcutaneous eletrical nerve stimulation(TENS)in the treatment of postherpetic neuralgia(PHN).Method:Sixty patients with PHN were randomly divided into 3 groups:group A treated with TENS.group B treated with adenosylcobalamin,group C treated with adenosylcobalamin and TENS based on the management of groups A and B.The three groups had all been treated for 10d.Result:In observation,visual analogue scale(VAS)and 5 grade pain scores of group C were lower than those of groups A and B;VAS and 5 grade pain scores differences of group C were higher than those of groups A and B:The effective rate of group C(100%)was higher than that of groups A and B respectively.The differences were significant(P<0.05).Conclusion:Combined therapy of adenosylcobalamin and TENS is effective for the treatment of PHN and can alleviate pain and improve sleep.

Objective:To explore the long-term effects of physical exercises on penicillin induced recurrent convulsion with learning and memory deficits in developing rata and its mechanism.Method:Fifty-six male SD rats(postnatal days [PD]21)were randomly divided into four groups:control group (CONT1),control plus exercises group(CONT2),convulsion group(EXP1)and convulsion plus exercises group(EXP2) ,rwenty rats were assigned for two control groups,each n=10;the surplus 36 rats were kindled by penicilln onceper d,consecutive 6d for creating convulsion models.Control rats were injected equal amount of normal sodium(NS) into abdominal cavity at the same time.The 20 qualified models of convulsion rats were randomly divided into two EXP groups.On PD39-PD43 and PD61-PD64,subjects of the four groups were tested with Morris water maze,and from PD49 to PD54.the rats of CONT2 and EXP2 were given exercises of running wheels,twice a d for consecutive 6d.The expression of glutamicacid receptor 2(GluR2)in hippocampus was detected. Result:①In the first Morris water maze test,there were significant differences of latency among four groups(F=5.56,P<0.01),and the latency of two EXP groups were significantly longer than two CONT groups(P<0.05);In the probe trial,the frequency of two EXP groups passing through target area were significantly less than that of two CONT groups.②In the second water maze test.there were significant effects of exercises on the latency of EXF2 group comparing to EXP1 group (P<0.05);the frequency of two EXP groups passing through target area were still significantly less than that of two CONT groups after exercises training(P<0.05),and there Was no significant difference between EXP1 and EXP2 groups.③In the immanohistochemical staining of GluR2,the gray values in hipocampus of two convulsion groups were significantly lower than that of two control groups(P<0.05). Conclusion:Penicillin induced recurrent convulsion could cause long-term effects on learning and memory in rats,which may be associated with down-regulated GluR2 expression in hippocampus.Physical exercises could improve learning capacity,of convulsion rats but not memory capacity.

Objective: To establish normative value of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve, including motor nerve conduction velocity (MCV)、latency (LAT)and amplitude (AMP). Method: Two hundred normal volunteers were divided into 5 groups according to different ages. Median nerve was examined at multiple points: palm, wrist, elbow, axilla and Erb's. Ulnar nerve was examined at multiple points: wrist, below elbow, above elbow, axilla and Erb's. The values of segmental MCV, LAT and AMP were recorded. Result: Gender and sidedness had no effect on MCV, LAT and AMP of median nerve and ulnar nerve. However, age had significant effects on MCV, LAT and AMP of median nerve and AMP of ulnar nerve. Conclusion: The examination of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve possess important value in diagnosis.

Objective: To analyze the influence of long-term swimming training on spatial learning-memory in rats and its relationship with cyclic adenosine monophosphate(cAMP) and cyclic guanosine monophosphate(cGMP) signal transduction pathway. Method: After 3 times adaptable swimming exercises (30min each time), 40 male SD rats were divided into 2 groups: control group (CR, n=20) and exercises, group (TR, n=20). CR group didn't swim, and TR group swam without burden (6 times/week, 60 min each time). After 8 weeks training, 10 rats were selected from both groups respectively for examing of Morris water maze test. Radioimmunoassay was used to measure the levels of cAMP and cGMP in hippocampus and prefrontal cortex of rats. Result: ①Compared with CR group, in TR group learning-memory improved in a certain extent: ②Compared with CR group, in TR group, the level of cAMP in hippocampus enhanced very obviously (P＜0.01), the cAMP/cGMP ratio enhanced obviously (P＜0.05); in prefrontal cortex the levels of cAMP and cAMP/cGMP ratio enhanced obviously (P＜0.05). Conclusion: Swimming training for 8 weeks improved the spatial learning-memory of rats in a certain extent, and elevated the level of cAMP and cAMP/cGMP ratio in hippocampus and prefrontal cortex of rats obviously. It is suggested that exercises might affect learning-memory by cAMP and cGMP signal transduction pathway.

Objective: To investigate the influence of electroacupuncture (EA) combined with repetitive transeranial magnetic stimulation(rTMS) on the temporal profile of nestin expression after induction of focal cerebral isehemia in adult rats and to explore the mechanism of EA combined with rTMS in treating ischemic brain injury. Method: The model of transient focal ischemia was produced by occlusion of middle cerebral artery. Seventy-five Wistar rats were randomly divided into normal group, model group, EA group, rTMS group and EA +rTMS group. The neurologic impairment rating and ability of learning and memory were observed at the 7th、14th and 28th d after infarction respectively. Meanwhile, Western blotting was used to observe the number of nestin expression positive cells. Result: Nestin-positive cells were found in cortex, subgranular zone (SGZ), subventricular zone (SVZ) of the ipsilateral side at different time points after cerebral isehemia. The number of nestin-positive cells peaked at the 7th d, began to decrease at the 14th d and was significantly higher in EA+rTMS group than that in model group (P<0.05), then almost reached normal at the 28th d. The improvement of neural motor function deficits as well as the indexes of learning and memory were more obvious in EA+rTMS group compared with model group (P<0.01, P<0.05). These effects were most obvious in EA+rTMS group compared with the EA and rTMS group (P<0.05). Conclusion: EA and rTMS possess the potency of building up and can increase the number of nestin-positive cells in some brain regions after focal cerebral ischemia, which might be one of the important mechanisms of EA combined with rTMS in treating ischemia brain injury.

Objective: To compare the balance ability between normal people and non-specific low back pain (nsLBP) patients and explore the relationship between balance ability and muscle function in nsLBP patients. Method: Ten nsLBP patients as nsLBP group and 10 age and gender-matched healthy control subjects as control group were investigated. Posturography on balance platform and surface electromyography (sEMG) were performed to assess all the subjects' function of equilibrium and muscle activities of erector spinea(ES), muhifidus(MF), abdominal external oblique (EO), hamstring (HS) and maximal gluteus (MG) bilaterally. Result: The nsLBP subjects had greater sway on anterior-posterior direction (Y-speed and Y-extension, P=0.05) on feet-together posture and bigger main axis (P=0.023) on nature standing with eyes closed when compared with controls. The iEMG ratios of right MG in nature standing (eyes closed)/ nature standing (eyes open) and feet-together (eyes open)/nature standing (eyes open) in control group were significant higher than that in nsLBP group (P=0.03 and P=0.013). Conclusion: Balance evaluation combined with sEMG measurement on trank and lower limb muscles provided some quantitative information about functional deficits such as pestural control and muscle activities in nsLBP patients. This relationship should be emphasized in prevention and rehabilitation of nsLBP.