Objective To investigate the expression of NF-?B,TNF-?,ICAM-1 in rat's brain tissue and the sequential changes of serum IL-1?,IL-6,IL-10 after focal cerebral ischemia-reperfusion,and to observe the influence of the Shenxiong Injection.Methods Fifty-four male rats were randomly divided into control,Ligustrazin-treated and Shenxiong-treated group.Rats models of focal cerebral ischemia-reperfusion(I/R)were made by using suture.Drew back sutures 1 hour after the blood supply were blocked.A series of brain and blood samples were obtained directly 6,12 and 24 hours respectively after reperfusion in three groups.The expression of NF-?B,TNF-? and ICAM-1 in the brain tissue was determined by immuno-histochemical method.Serum levels of IL-1?,IL-6 and IL-10 were measured by enzyme linked immunosorbent assay (ELISA).Results As time of I/R prolonged,the expression of TNF-?,ICAM-1 upregulated,but NF-?B reached the maximum at R12 h in three groups.Compared with control group,expression of NF-?B,TNF-?,ICAM-1 in Shenxiong-treated group decreased significantly(P

To provide more objective basis for traditional Chinese medicine (TCM) syndrome differentiation of deficiency and excess by collecting and analyzing voice signals and extracting characteristic parameters.

BACKGROUND: The traditional ankle-foot orthosis focuses on the protection, correction, stability, and compensation;therefore, it is important to explore a new rehabilitation method for ankle joint dysfunction.OBJECTIVE: To explore the effect of computer-aided movable and measurable ankle-foot orthosis that designed by the Department of Rehabilitation in Longgang Central Hospital of Shenzhen on postoperative dysfunction after ankle fracture.METHODS: Fifty-two patients with ankle fractures at 3 weeks after internal fixation were selected and equivalently randomized into two groups. Both groups received conventional oral medication and rehabilitation therapy. In addition,the patients in control group were given joint mobilization treatment, while those in experimental group were given computer-aided movable and measurable of ankle-foot orthosis, 20 minutes daily, 6 days weekly for consecutive 4 weeks. The efficacy was evaluated by muscle strength, active range of motion, Kofoed ankle score and visual analogue scale on computer at baseline, 7, 14, and 28 days after training.RESULTS AND CONCLUSION: (1) There were no significant differences in baseline data and ankle function scores between two groups before training (P > 0.05), and all above indicators were significantly improved in both two groups at 4 weeks after training (P < 0.05). (2) Compared with the control group, the muscle strength, Kofoed ankle score and visual analogue scale scores on computer in the experimental group were significantly improved at 7, 14 and 28 days after training (P < 0.05). (3) The active plantar flexion angle in the experimental group was significantly larger than that in the control group at 28 days after training (P < 0.05).The active plantar flexion and dorsiflexion angles at 7 and 14 days after training, and active dorsiflexion angle at 28 days after training did not differ significantly between two groups (P >0.05). To conclude, the unique ankle-foot orthosis can reduce postoperative pain, enhance muscle strength and improve ankle mobility after ankle fracture.

Objective To study the incidence of depression in essential tremor (ET) and associated factors. Methods Depression in 62 ET patients and 60 healthy subjects as control was evaluated by means of Hamilton Depression Scale ( HAMD ) , as well as Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and Pittsburgh Sleep Quality Index (PSQI). Results Fifty-three point two percent(33/62) of ET patients and 11.7% (7/60) of healthy subjects were found to have at least mildly depression (HAMD score of 8 or higher), 35. 5% (22/62) of ET patients and 8. 3% (5/60) of healthy subjects fell into the mildly-to-mederately depression (HAMD score between 8 and 20 ), 17.7% (11/62) of ET patients and 3.3% (2/60) of healthy subjects were classified into moderately-to-severely depressed range (HAMD score between 21 and 35). There were statistical differences in ET group and healthy subjects group (X2= 23.898, 13.043, 6.649, all P <0.01). Additionally, there were statistical differences in anxiety/ somatization (t=-6.747, P<0.01), cognitive impairment (t=-2.017, P=0.05), block(t= -4.145, P<0.01), sleep disorders (t=-4.500, P<0.01) and despair (t=-3.591, P<0.01) between depression group and non-depression group. There were marked differences in PSQI total score ( t =-3.196, P=0.003 ), subjective sleep ( F1, t=-3.037, P=0.004), quality sleep latency (F2, t= -4.674, P<0.01) and sleep disturbances (F5, t=-2.594, P=0.013 ) between depression disorder group and non-depression disorder group. Meanwhile, the score of TRS, PSQI and sex were closely correlated with HAMD (β=0.589, P=0.000 ;β=0.469,P=0.000 ;β=0.256, P=0.027 ). Conclusions The incidence of depression is high in ET. Manifestation of depression are anxiety, reduced interest in work, sleep disorders, retardneas, inferiority complex, etc. The degree of symptoms relates to the severity of ET, sleep quality and gender.

Objective To study the incidence of ventilator-associated pneumonia(VAP)and antimicrobial resistance of pathogens in an intensive care unit(ICU).Methods The occurrence of VAP in hospitalized patients with mechan-ical ventilation>48 hours between January 2011 and December 2012 were investigated,species and antimicrobial re-sistance of pathogens causing early onset-VAP (E-VAP,mechanical ventilation≤4 d)and late-onset VAP(L-VAP, mechanical ventilation>4 d)were compared.Results A total of 1 76 patients were investigated,incidence of VAP was 44.32% (78 cases);With the prolongation of mechical ventilation,incidence of VAP increased gradually (χ2=52.561,P<0.001).The incidence of L-VAP was significantly higher than E-VAP (58.33% [70/120]vs 14.29%[8/56])(χ2= 30.02,P<0.001).A total of 178 pathogens were isolated,gram-negative bacteria,gram-positive bac-teria and fungi were 104(58.43% ),46(25.84% ),and 28(15.73% )isolates respectively;97(54.49% )multidrug-resistance/pandrug resistance organisms (MDRO)were isolated. MDRO isolation rate in L-VAP patients was high-er than E-VAP patients([58.86% ,n= 93]vs [20.00% ,n= 4]),resistance rate of major pathogens causing L-VAP was significantly higher than E-VAP patients(allP<0.05).Fungi infection only occurred in L-VAP patients,the total antimicrobial resistance rate was 12.14% .Conclusion The prolongation of mechanical ventilation can increase the incidence of VAP,and resistance rate of pathogen in L-VAP is high.

Objective To investigate the substantia nigra (SN) and brainstem raphe (BR) echogenic features of Parkinson's disease (PD) patients with musculoskeletal pain.Methods A total of 115 PD patients recruited in the Second Affiliated Hospital of Soochow University from October 2014 to May 2016 were assessed with the following rating scales:Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn and Yahr Staging Scale (H/Y),Hamilton Rating Scale for Depression (HRSD),Beck Depression Inventory Ⅱ (BDI-Ⅱ) and Visual Analogue Scale (VAS).All the subjects underwent transcranial sonography during the clinical evaluation.And the patients were divided into PD with musculoskeletal pain (n =54) and PD without musculoskeletal pain (n =61) groups,or PD with depression(n =74) and PD without depression(n =41) groups.Results Compared with PD patients without pain,PD patients with musculoskeletal pain had higher scores of UPDRS-Ⅱ,-Ⅲ,HRSD,BDI,NMSQ and H/Y (UPDRS-Ⅱ score:12.56 ±6.01 vs 8.79 ±4.38,t =-3.801,P ＜0.01;UPDRS-Ⅲ score:24.43 ± 12.43 vs 20.07 ± 11.12,t=-1.986,P=0.049;HRSD score:11.65-±6.94 vs 8.38-±5.36,t=-2.844,P=0.005;BDI score:14.09 ±6.20 vs 9.74 ±6.00,t =-3.826,P ＜0.01;NMSQ score:8.57 ± 4.06 vs 5.60 ± 3.38,t=4.193,P＜0.01;H/Y:2.0(1.5,2.6) vs 1.5(1.0,2.0),Z=-3.011,P=0.003).Positive BR was more frequent in depressed than in non-depressed PD patients without pain (63.6％ vs 14.3％;x2 =15.25,P ＜0.01).Positive BR was positively associated with sex(r =0.228,P =0.014),age(r =0.184,P =0.049),disease duration (r =0.196,P =0.035),and depression (r =0.396,P ＜ 0.01).However,positive BR did not correlate with musculoskeletal pain.No correlation was found between positive SN and clinical characteristics of PD patients.Conclusions PD patients with musculoskeletal pain have worse activity of daily living,more severe motor symptoms,more non-motor symptoms,and are more depressed.SN and BR echogenecity do not correlate with musculoskeletal pain,however,hypoechogenic or interrupted BR is associated with depression in PD patients.

Objective To discuss the neuroimaging characteristics of transcranial ultrasound in Parkinson's disease (PD) patients with or without depression.Methods Transcranial sonography (TCS) was performed in PD patients with depression (PDD +,n =50),PD patients without depression (PDD-,n =50),depression patients (D,n =50) and healthy controls (n =50),who were enrolled in the Second Affiliated Hospital of Soochow University from September 2010 to July 2016.The differences of the neuroimaging characteristics of TCS in brainstem raphe (BR) and substantia nigra (SN) in four groups were analyzed.According to the degree of depression,PDD + and D groups were divided into three subgroups:mild,moderate and severe depression,and the differences of echo characteristics in BR were analyzed among the subgroups.Results The rate of abnormal BR echogenicity was significantly higher in PDD + (78.0％,39/50) and D (82.0％,41/50) groups than that in PDD-(18.0％,9/50) and healthy control (10.0％,5/50) groups (x2 =87.80,P ＜0.01),and there was no statistically significant difference among the subgroups (PDD + group,P =0.98;D group,P =0.57).The rate of SN hyperechogenicity was significantly higher in PDD + (80.0％,40/50) and PDD-(86.0％,43/50) groups than that in D (8.0％,4/50) and healthy control (10.0％,5/50) groups (x2 =110.07,P＜ 0.01).Conclusion The echogenicity changes of BR and SN on TCS could provide some useful neuroimaging information for the diagnosis and differential diagnosis of PDD-from PDD +.

AIM To establish the quality standard for Tibeten medicine Ershiwuwei Feibing Pills [Inula racemosa Hook.f.,Swertia bimaculata (Sieb.et Zucc.) Hook.Thors.ex Clarke,Phyllanthus emblica Linn.,Terminalia billerica (Gaertn.) Roxb.,etc.].METHODS TLC was applied to the qualitative identification of L racemosa,S.bimaculata,P.emblica and T.billerica,and HPLC was adopted in the quantitative determination of alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A.RESULTS The TLC spots were clear without negative interference.Alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A showed good linear relationships within the ranges of 4.324-216.2 μg/mL (r =0.999 9),32.222-1 611.1 μg/mL (r =0.999 9),4.072-203.6 μg/mL (r =0.999 9) and 4.266-213.3 μg/mL (r =0.999 9),whose average recoveries (RSDs) were 100.6％ (0.93％),100.3％ (2.1％),101.5％ (3.0％) and 100.1％ (1.8％),respectively.CONCLUSION This simple method can be used for the rapid quality control of Ershiwuwei Feibing Pills.

Objective To survey the prevalence, distribution of non-motor symptoms (NMS) in essential tremor (ET) and the relationship with disease severity and duration.Methods Fahn-Tolosa-Matin Tremor Rating Scale (TRS) was used to assess motor symptoms in 62 patients with ET.The Parkinson's disease (PD) NMS Questionnaire and T&T olfacmeter and Mini-mental State Examination (MMSE) were used to explore non-motor symptoms in ET patients.Results In ET, a range of NMS occurred across all disease stages.More than half patients (51.6%, 32/62) had olfactory dysfunction,significantly higher than the healthy control group (30.0%, 18/60, x~2=12.371, P<0.05).A third had hyposmia.16.1% had partial olfactory loss.Each ET patient had 5 different NMS on average.Seven NMS were more common in ET patients than in control, including remembering, olfactory dysfunction, intense vivid dreams, anhedonia, depression, anxiety, sleep disorders.The incidences of remembering, olfactory dysfunction,intense vivid dreams were 58.1% (36/62),51.6% (32/62),48.4% (30/62), ranked top 3 in ET patients.Olfaction had inverse correlation with age, while there was a negative correlation between NMS score and TRS score, gender, disease duration and weather to be treated.Conclusion Besides posture tremor and kinetic tremor,NMS occur in ET,and should be well recognized and treated.

Objective To investigate the detection rate of malnutrition among post-stroke patients in community hospitals and unravel the relevant factors that precipitate malnutrition after stroke. Methods Based on 438 post-stroke patients who were admitted in community hospitals, we examined the demographic characteristics, the nutritional indices and the possible malnutrition related factors through a cross-sectional study.Results The detection rate of malnutrition among post-stroke patients was 52.7%. Group comparison through multivariate logistic regression analysis showed that there was a higher malnutrition detection rate in the post-stroke patients with multiple stroke attacks (three stroke attackes and above, OR = 11.00,95%CI 1. 14-106.34), higher NIHSS scores (group with NIHSS≥15, OR=7.09, 95% CI 2.90-17.36) , higher modified Rankin scales (group mRS 4-5, OR = 15. 77,95% CI 6.61-37.59) (trend test P<0.0001) .The risk of malnutrition was also correlated with the post-stroke depression, poorer family care, no early-stage rehabilitation, history of malignant tumors and severe alcoholism. Conclusions There is a high detection rate of malnutrition among post-stroke patients in community hospitals. There are many factors related to malnutrition among post-stroke patients in the community. More attention to controllable influencing factors would improve the prognosis of post-stroke patients.