Objective To investigate the curative effects of selected proprioceptive neuromuscular facilitation (PNF) patterns and techniques on shoulder subluxation soon after strokd. Methods Forty-one stroke patients with shoulder subluxation were randomly divided into a treatment group(n=22) and a control group (n=19). The patients in the treatment group receiveed the selected PNF techniques daily for 4 weeks, while the patients in the control group were treated with their previous therapeutic protocol. The shortest distance from the lower border of the acromion to the nearest point of the humeral head(AHH) was measured. Brunnstron grading was used to evaluate motor function in the affected upper linb, and a visual analogue scale (VAS) to assess subLuxation. Shoulder pain before and after treatment was also assessd. Results There was no significant difference in general condition between the patients in the two groups before treatment. In the treatment group, a significant improvement in AHH distance of the affected shoulder was observed after 4 weeks. Shoulder subluxation waw cured in 13 patients, with AHH distance ＜0.75 cm after 4 weeks of treatment. Conclusion The PNF technique applied was effective for the early treatment of subluxation after stroke. Motor function in the affected upper limb could be improved significantly and pain alleviated.

Objective:To explore the urgent management strategy for quadriplegia following China Wenchuan earthquake under filed condition.Methods:The 57-year-old male patient was sent to the earthquake relief team of Changzheng Hospital,Second Military Medical University.He was hit by heavy object during the Sichuan earthquake 6 days ago.Physical examination revealed cervical spinal cord injury accompanied by incomplete paralysis.The patient underwent cervical 3-7 laminectomy under general anesthesia.Results: After surgery,the muscle strength of lower limbs recovered to grade four from grade one;the muscle strength of upper limbs recovered to grade five from grade three.Sensory loss was found below the nipple level and totally recovered after operation.Conclusion:Early surgery for quadriplegia following earthquake trauma can timely relieve compression to the spinal cord and therefore improve prognosis of patients.Under field condition where facilities are not readily available,decompression of spinal cord can be achieved by lamineetomy via posterior approach.The key to successful operation is correct diagnosis and skillful manipulation.

Background: Creatine transporter (CRTR) deficiency is the most common creatine deficiency syndrome, of which the final diagnosis relies on mutation in the X-linked CRTR gene. To date, more than 90 mutations in the SLC6A8 gene have been reported. This paper discusses a novel mutation detected via the thorough sequencing of all the X-chromosome-specific exons investigated in a four and a half year old boy with an intellectual disability, speech and language delay and motor disturbance. Methods: A brain magnetic resonance imaging (MRI) and a proton magnetic resonance spectroscopy (MRS) were carried out, the creatine and creatinine concentrations in the urine were checked and all exons were sequenced. Results: A detailed clinical investigation revealed a reduction in the cerebral creatine levels in the brain by the MRS, elevated creatine and creatinine concentrations in the urine and signal abnormalities in the left frontal cortex of the brain by the MRI. A novel change was identified in the heterozygosity of the exon 10: c.1395-c.1401 deletion. Conclusion: The use of a combination of powerful new technologies, such as thorough exome-nextgeneration sequencing and a brain MRS, should be considered, in order to determine any neurometabolic diseases, especially when the signal abnormalities in the brain MRI cannot be explained by any other factors. This mutation results most likely in a dysfunction of the creatine transport and synthesis, hence causing central nervous system symptoms.
Carrier Proteins

Objective To observe the effects of standardized three stage rehabilitation treatment on the neu- rological deficit scores (NDS) and ADL performance of ischemic stroke patients.Methods A total of 164 ischemic stroke patients were recruited and randomly divided into a rehabilitation group and a control group.The neurological function and ADL performance of the patients were assessed by using NDS and Modified Barthcl Index (MBI) at the admission,at the end of 1st,3rd and 6th months post stroke.Results No significant differences were found be- tween the rehabilitative and the control groups with regard to NDS and MBI at admission.The NDS demonstrated a decreasing tendency,while the MBI score an increasing tendency in both groups.In the control group,significant difference of NDS was found between admission and the end of 1st month as well as between the end of the 1 st and the 3rd months.In rehabilitation group,significant difference was revealed between all the time points with regard to NDS and MBI scores.At the end of the 1st,3rd and 6th months,the MBI scores of the rehabilitation group were signifi- cantly higher than those of the control group,indicating that the ADL performance of those treated with standardized three-stage rehabilitation protocol was improved quicker than those without the protocol.Conclusion Standardized three-stage rehabilitation treatment could improve the neurological function and ADL performance of the ischemic stroke patients.

: Objective To evaluate the value of rehabilitation direction for the treatment of the children with spastic cerebral palsy. Methods 116 children with spastic cerebral palsy were investigated. 56 children who accepted rehabilitation direction and training in family participated in study group and 60 children who wouldn't accept rehabilitation direction participated in control group. All the children received comprehensive rehabilitation treatment in hospital, including physical therapy, acupuncture, low frequency electrotherapy and occupational therapy. All the children were assessed with Gross Motor Function Measure-88 (GMFM) before and 3 months after treatment. Results There was a significant difference before and after treatment in scores of GMFM in each dimension and total in both groups (P<0.01), and the treatment group improved more than control group(P<0.05). Conclusion Rehabilitation direction can facilitate the recovery of spastic cerebral palsy children.

[Summary] The aim of this study was to examine the association between obstructive sleep apnea-hypopnea syndrome ( OSAHS ) and microalbuminuria in type 2 diabetes mellitus patients. We found that severe OSAHS significantly increases the risk of early renal damage in type 2 diabetes mellitus patients with HbA1C<7% ( lowest oxygen saturation:OR=2. 41, 95% CI 1. 19-8. 08; apnea hyponea index: OR=2. 91, 95% CI 1. 50-9. 11), suggesting that OSAHS may increase the risk for early renal damage in type 2 diabetes mellitus, especially in those with successful control of glucose.

AIM: To explore the effect of Buddleia flavonoids drug-containing plasma and androgen receptor(AR) blocker on the expression of STAT1 phosphoprotein.METHODS: In vitro lacrimal gland epithelial cells were cultivated with H2O2 to establish the dry eye apoptosis state. Blank plasma group, Buddleia officinalis plasma total flavonoids interfere with drug-containing group, and the intervention group of testosterone propionate were set. The expressions of STAT1 phosphoprotein of each group were observed by Western blot and AR blocker flutamide was used to explore the intended androgen effect of Buddleia flavonoids.RESULTS: After the intervention of drug-containing plasma, the expression of STAT1 Phosphoprotein in Buddleja officinalis drug-containing plasma intervention group(0.353±0.494) and testosterone propionate intervention group(0.502±0.036) were enhanced and the differences between the two groups were significant (P<0.01). After using the AR blocker in all groups, the expression of STAT1 phosphoprotein in each group (0.268±0.061,0.283±0.106,0.213±0.071) had no difference.CONCLUSION: Buddleja officinalis drug-containing plasma total flavonoids can promote the expression of STAT1 phosphorylation.

Background The fundus autofluorescence (FAF)can reflect the function of retinal pigment epithelium(RPE) cell.As an invasive examination,it has been extensive used in retina disease,but there has not any report in syphilitic posterior uveitis.Objective This study was to characterize and contrast the FAF and fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) findings in patients with syphilitic posterior uveitis.Methods A retrospective series of cases observational study was designed.The clinical data of 27 eyes from 18 patients with syphilitic posterior uveitis were included in Shanghai First People's Hospital from 2010 May to 2012 October,and all the patients were diagnosed by serologic and ophthalmic tests.The patients were assigned to acute stage group(with the course ＜2 months)and chronic stage group(with the course ≥ 2 months).FFA,ICGA and FAF were performed respectively on all the patients,and the examination results were compared and analyzed.Results In the affected eyes with syphilitic posterior uveitis,the FFA image showed a retinal vasculitis sign and mottle-like fluorescence appearance in posterior pole and equator zone,and some affected eyes exhibited edema of optic disc and macula.Hypoautofluorescence zone was seen in the acute stage group and cystoid macular edema was found in the chronic stage group.ICGA presented with a wider damage of RPE,especially in the later phase of ICGA.A confluent of hyperautofluorescence with hypoautofluorescence in the posterior fundus,punctiform hyperautofluorescence as well as hypoautofluorescence in papillitis and macular edema were found on the FAF image.Conclusions The pathological basis of syphilitic posterior uveitis is retinal vasculitis and papillitis.ICGA indicates the damage of choroid membranes and RPE,and FAF reflects a metabolism disorder of RPE in the acute stage and atrophy and loss of RPE in the chronic stage.FAF is helpful for the diagnosis of syphilitic posterior uveitis as an assistant index.

Objective To explore genes expression of adiponectin receptors during differentiation of SW872 preadipocytes. Met-(hods) SW872 preadipocytes were cultured in vitro and induced to differentiate by 0.6 mmol/L oleic acid. During the progress of diffe-(rentiation), the morphological changes of SW872 cells were observed and the differentiation rate was assayed by oil-red O staining. Adiponectin receptors mRNA was measured by reverse transcription-polymerase chain reaction during differentiation of SW872 preadipocytes. Results 1.After stimulated by 0.6 mmol/L oleic acid for 72 hours, almost all SW872 cells were differentiated,and there were lots of fat droplets in the cells.2.There were adiponectin receptors genes expressions in SW872 preadipocytes.After 72 hours,and the levels of adiponectin receptor(AdipoR) 1 mRNA and AdipoR 2 mRNA were markedly increased up to 2.54 and 4.09 times,respectively. Conclusion There are AdipoR1 and AdipoR2 genes expressions in fat cells and the expressions are differentiation-dependent.

Objective To study the effect of oleic acid on the differentiation of SW872 preadipocytes.Methods SW872 prea-(dipocytes) were cultured and induced to differentiate by 0.6 mmol/L oleic acid in vitro.After 24 h,48 h and 72 h of differentiation,the morphological changes of SW872 preadipocytes were observed and the differentiation rate was assayed by oil-red O staining.In addition,triglyceride(TG) mass was detected by chemical colorimetry methods.During the differentiation of SW872 preadipocytes,transcription factors including peroxisome proliferator activated receptor-?_2(PPAR-?_2) and CAAT/enhancer binding protein-?(C/EBP-?)(mRNA) were also measured by reverse transcription-polymerase chain reaction(RT-PCR).Results 1.SW872 preadipocytes were fibroblastic and had no obvious fat droplet in cytoplasm.However,when stimulated for 72 hby 0.6 mmol/L oleic acid,SW872 preadipocytes became more bigger and rounder and differentiated into mature adipocytes with lots of fat droplets in the cells.2.Compared with that of predifferentiation,the concentration of TG mass increased by 14 folds after 72-hour differentiation(P