Objective To investigate the symptom characteristis as well as the clinical assessment methods of dysphagia and oral motor function in children with cerebral palsy(CP).Methods A total of 116 children with CP,aged 18 months to 96 months(66 boys and 50 girls),treated in Qingdao Rehabilitation Center for Disabled Children from June 2009 to September 2010,were included in the study.Diagnosis and subtype of CP were determined by neuropaediatrician,the dysphagia disorders survey(DDS)as well as oral motor assessment were conducted by the speech therapists.Results Of the 116 cases,22.4％ of the cases were with mild dysphagia and 34.5％ with moderate to severe dysphagia,resulting in a prevalence of dysphagia of 56.9％.The main problems of these cases occurred during oral phase and pharyngeal phase,including inadequate feeding skills(involving sucking,biting,chewing or/and swallowing),coughing,vomiting and choking during feeding,cry/overextension of neck and head during feeding,drooling,hypertonic tongue and inadequate tongue lateralization.The severe dysphagia was encountered frequently in children with spastic quadriplegic,dyskinetic or mixed type CP children.Of the 116 cases,90 cases(77.59％)were with oral motor dysfunction(including all spastic quadriplegic,dyskinetic or mixed type children).The oral motor scores of CP children were significantly lower than those of the controls(P ＜ 0.01).Conclusions Oral phase dysphagia and oral motor disorder might be considered as the common clinical problems among the patients with CP,and could be assessed by using DDS combined with oral motor assessment,but for dysphagia during pharyngeal or esophagus phase,the videofluoroscopic modified barium swallow should be used for further evaluation.

Objective To investigate the effects of neurotrophics and rehabilitation on the neural function recovery after the hypoxic-ischemic brain injury in rats. Methods Model rats of hypoxic-ischemic brain injury were given monosialotetrahexosylganglioside sodium(GM1, n=8), mouse nerve growth factor (NGF, n=8), both drugs (n=8), rehabilitation (n=8), both drugs+rehabilitation (n=8) and control (nointervention, n=8). The other 7 rats was as sham group. They were assessed with hanging and inclined plane test when 30 days old. ResultsIn the factorial design, main effect of GM1 was significant (P<0.05) but NGF (P>0.05) in hanging test; while both were significant in inclinedplane test. The interaction was not significant (P>0.05) in both tests. The main effects of drugs and rehabilitation were significant (P<0.05), as well as the interaction (P<0.05) in both tests. Conclusion GM1 may significantly improve muscle strength, voluntary movement,balance and coordination functions, and NGF may improve the balance and coordination functions. No interaction is found when combinedwith the two therapies. Rehabilitation may significantly improve muscle strength, voluntary movement, coordination and balance, and synergyeffects can be gained when combined with the drugs.

ObjectiveTo analyze the characteristics of dysphagia in children with cerebral palsy and explore the relation with the gross motor function classification.MethodsThe children with cerebral palsy in our rehabilitation center from June 2009 to June 2010 were assessed by Dysphagia Disorders Survey(DDS), Oral Motor Assessment and Gross Motor Function Classification System (GMFCS) to explore the relationship between the dysphagia disorders and different gross motor levels.ResultsOf all 105 children with cerebral palsy, 21.9% were mild dysphagia, and 34.3% were moderate to severe dysphagia, resulting in a prevalence of dysphagia of 56.2%. DDS and oral motor scores were changed by GMFCS levels. The correlation coefficient were 0.767 and -0.504 between DDS, oral motor scores and GMFCS, 0.55 and 0.27 between dysphagia, oral motor disorder and the gross motor functions, respectively(P<0.01).ConclusionDysphagia was positively related to severity of motor impairment. Children in GMFCS levels Ⅳ～Ⅴ almost with problems in the pharyngeal and esophageal phases, apparently on the DDS, should be referred for appropriate clinical evaluation of swallowing function.

Objective To investigate the effects and the possible mechanism of Ganglioside-1 (GM1) and rehabilitation on neurologic behaviors of rats with hypoxic-ischemic brain damage (HIBD). Methods 48 immature rats developed as model of HIBD were divided into 5 groups: control group, GM1 group, rehabilitation training group (R group), GM1+R group, and sham group. They were evaluated with Climb, Slope and Water Maze Tests. The expressions of activated caspase-3 in neurons were detected with immunohistochemistry. Results The achievement of Climb and Slope Test were significantly different among groups (P<0.001), which ranked as the sham group> GM1+R group> R group> GM1 group> control group (P<0.05). The latency of Water Maze Test was significantly different among groups (P<0.01),which was longer in the control and GM1 groups than in the sham group (P<0.05). The activated caspase-3 expressed in hippocampus and frontal cortex was less in the GM1 and R groups than in the sham group (P<0.05), more in the GM1 group, R group and GM1+R group than in the control group in hippocampus (P<0.05), more in the R group and GM1+R group than in the control group in frontal cortex (P<0.05).The expression of activated caspase-3 in both hippocampus and frontal cortex correlated with the achievement of Climb and Slope Test (P<0.05), but not with the latency of Water Maze Test (P>0.05). Conclusion Rehabilitation training and GM1 are effective on recovery of neural function in rats with HIBD with synergia, which may associated with the activated caspase-3 in terminal synapse.

Objective To investigate the current status of moral distress in clinical nurses,and analyze its influential factors.Methods A total of 240 clinical nurses were recruited by stratified sampling method.They were investigated with general situation questionnaire and moral distress scale.Results The average score of moral distress was (2.66±0.41).Multiple linear regression analysis showed that department of work and qualification were influencing factors on moral distress of clinical nurses.Conclusions This study found that nurses' moral distress was above the middle level.Some targeted measures should be taken by nursing managers,in order to help decrease nurses' moral distress.

Objective To explore the effect of CD40 small interfering RNA(siRNA)on the expressions of pe-ripheral blood interleukin(IL)-21 and IL -35 in rats with experimental autoimmune myocarditis (EAM)and its sig-nificance.Methods Twenty 6 -8 week male Lewis rats were divided into normal group,EAMgroup,CD40 siRNA group and siRNA group by using random number table,with 5 rats in each group.The normal rats were induced with phos-phate buffer saline in double foot pads on day 0 and day 7,while the rest 3 groups were induced with cardiac myosin protein to establish EAMmodels.The rats in CD40 siRNA group and siRNA group were respectively injected with CD40 siRNA and siRNA slow virus expression vector through the tail vein of rats on day 7.The rats were executed on 21 day after echocardiogram examination was made.The histopathologic changes were observed by using light microscope and the myocardial histopathology scores were calculated.Enzyme -linked immunosorbent assay was used to determine the levels of IL -21 and IL -35 in peripheral blood.Results (1)Except the normal group,the total incidence rate of rats of each group was 100%,and there was no rat death.(2)Compared with EAM group,the heart mass/body ratio and myocardial histopathology scores were lower in CD40 siRNA group,and the differences were significant (3.13 ±0.21 vs 3.80 ±0.29,2.22 ±0.43 vs 3.32 ±0.51,F =0.332,0.456,all P <0.05).(3)The echocardiogram showed that there was only 1 rat in EAM group with massive pericardial effusion,and there was no pericardial effusion in CD40 siRNA group.EAMgroup,CD40 siRNA group and siRNA group displayed hypertrophy of the ventricular septum and left ventricular wall,narrow heart cavity and weakening of ventricular wall motion.The left ventricular shortening rate in CD40 siRNA group was significantly higher than that in the EAMgroup[(63.34 ±11.06)% vs (38.56 ±6.98)%,F =16.080,P <0.05].(4)The peripheral blood level of IL -21 in CD40 siRNA group was lower than that in EAM group [(141.19 ±17.46)ng/L vs (157.81 ±17.58)ng/L,F =57.008,P <0.05],while its level of IL -35 was signifi-cantly higher than that in the EAMgroup [(195.96 ±18.26)ng/L vs (174.78 ±13.91 )ng/L,F =31.727,P <0.05].(5)The level of IL -21 in peripheral blood was positively correlated with myocardial histopathology scores in EAM group (r = 0.69,P < 0.05 ),but IL -35 was negatively correlated with myocardial histopathology scores (r =-0.64,P <0.05).Conclusions CD40 siRNA might relieve the myocardial inflammation and reduce the myocar-dial injury of EAMrats.The levels of IL -21 and IL -35 can partly reflect the degree of myocardial injury.The mecha-nism may be related to down -regulating the expression IL -21 and up -regulating the expression of IL -35.

Objective To establish the quality control system of the Capital's Funds for Health(CFH),strengthen the process management,and improve the clinical research capacity.Methods The framework,contents and implementation method of the quality control system were developed with comprehensively adopting methodologies of literature analysis,expert discussion,summaries of policy and practice experiences.Results This quality control system of the Capital's Funds for Health is comprised of three tiers.The first tier is self-assessment,the principle investigator takes the responsibility;the second tier is the sponsor verification,the sponsor organization takes the responsibility;the third tier is the independent audit,the CFH office takes the responsibility.The contents of quality control focus on the compliance with ethical approval and informed consent,data authenticity,protocol deviation,progress of project,and quality assurance methods taken during the project implementation.Conclusions This three-tier quality control system of the Capital's Funds for Health provides a new idea and scheme for the quality control of clinical research projects supported by funding agencies in China,and its impacts will be evaluated in next implementation practices.

Objective: To analyze the prevalence of obesity and its influencing factors among residents aged 40 years and over in Taizhou,so as to provide reference for obesity prevention and control. Methods: From June 2014 to May 2015,people who were aged 40 years or above and received routine physical examination in six centers for disease control and prevention in Taizhou were recruited. Demographic characteristics and health relates behaviors were collected by a questionnaire survey;height,weight,waist circumference and hip circumference were collected by physical examination. Logistic regression analysis was conducted to explore the influencing factors for overall obesity and central obesity. Results : Totally 1 216 people were investigated,and 1 192 (98.03%) questionnaires were valid. The age of them ranged from 40 to 86 years old,with （51.92±8.91） years old on average. There were 547 males （45.89%） and 645 females （54.11%）. The prevalence rates of overall obesity and central obesity were 6.54% and 60.32%,respectively. The Results of multivariate logistic regression analysis showed that regular physical exercise （OR=0.597, 95%CI： 0.359-0.992） was a protective factor for overall obesity;female （OR=2.352,95%CI： 1.685-3.283）was a risk factor of central obesity;public servants or staff from enterprise and institution（OR=0.508, 95%CI： 0.289-0.892）,drinking （OR=0.637,95%CI：0.471-0.860）,salt intake of less than five grams per day （OR=0.590,95%CI：0.434-0.802）and regular physical exercise （OR=0.760,95%CI：0.583-0.991） were protective factors for central obesity. Conclusion The prevalence rates of overall obesity and central obesity among residents aged 40 years or above in Taizhou were 6.54% and 60.32%, respectively. Gender,occupation,drinking,salt intake and physical exercise were the influencing factors for obesity.

In order to effectively increase capacity of Cu2+ absorption by Penicillium from Cu2+-containing aqueous solution and to study the mechanisms of absorption, effects of eight pre-treatment methods on Cu2+ absorption of Penicillium janthinellum strain GXCR were compared. The results showed that the efficiency of Cu2+ absorption obviously increased through pre-treatment by homogenization, homogenization-basification (NaOH), oven dry (80 degrees C), homogenization-salinification (NaCl), homogenization-detergent and homogenization-polarization (C2H6SO), but significantly decreased after acidification pretreatment with H2SO4. In comparison with the previous reports, the pretreatment in a homogenization-NaOH way could more efficiently enhance the Cu2+ absorption capacity of this fungus. Homogenization-basification (0.5 mol/L NaOH) increased Cu2+ biosorption by 47.95%. The Cu2+ absorption of the mycelia treated by homogenization-basification followed Langmuir isotherm equation, suggesting a surface absorption process. After four cycles of absorption-desorption, mycelia pretreated by homogenization-alkalization still had 70.82% of Cu2+ biosorption efficiency. Infrared reflectance analysis indicated that alkalization treatment made marked effects on molecular groups of C-H, C=O, and C=O in COOH on the mycelial surfaces, and -OH was a key Cu2+-binding group. It is therefore suggested that the Cu2+ absorption by the GXCR is likely to be a chemical absorption process through Cu2+ binding with -OH group on the mycelia.
Adsorption ; Biodegradation, Environmental ; Copper ; metabolism ; Penicillium ; metabolism ; Physical Phenomena ; Sodium Hydroxide ; chemistry ; Waste Disposal, Fluid ; methods ; Water Pollutants, Chemical ; metabolism