Objective To explore the role of architecture of the human muscle in treatment of spasticity after stroke with BTX.Methods40 patients with spasticity hemiplegia after stroke were involved,whose scores of Modified Ashworth Scale beyond 3.They were divided in 2 groups:control group and observed group,in which BTX dose and injection points designed without or with architecture of the human muscle.All muscles injected were located with electrical stimulator.They were evaluated with Modified Ashworth Scale and the incidence of brace wearing were observed 2 weeks after treatment.ResultsThe Ashworth scores for wrist flexors were(1.3±0.9234)in observed group,(1.9±0.8522)in control group(P<0.05);for the triceps surae,they were(1.6±0.8826)and(2.25±0.7864)respectively(P<0.05).10 cases wore brace for upper limbs in observed group and 14 cases in control group;for the brace for lower limbs,there were 12 in observed group and 16 in control group(P>0.05).ConclusionBTX dose and injection points designed by Architecture of the Human Muscle in Treatment of spasticity after stroke is better than routine way,but the brace wearing for patients showed no significant improvement.

The treatment of Parkinson's disease remains a problem in neurology, and rehabilitation can play a certain role. Recently, some new rehabilitation approaches are being studied and applied in the treatment of Parkinson's disease. This article reviewed these advancement.

Objective: Small-cell esophageal cancer (SCEC) is a rare malignant tumor. Radiotherapy and chemotherapy have been considered as standard treatments for limited-stage SCEC (LS-SCEC). This study aimed to analyze the comprehensive treatment and prognosis of extensive-stage SCEC (ES-SCEC). Methods: We retrospectively analyzed the clinical data of 35 Patients with ES-SCEC from the Cancer Hospital of Tianjin Medical University between January 1989 and April 2012. Results:A total of 33 patients (94.3%) participated in follow-up visits. The overall survival of the patients ranged between 0.6 and 42.4 months with a median of 9.5 months. All of the patients suffered from extensive metastasis. Among these patients, 33 manifested metastasis at diagnosis and 2 showed metastasis after surgery. One-and two-year survival rates were 27.2%(9/33) and 9.0%(3/33), respectively. Univariate and mul-tivariate analysis results revealed that the number of chemotherapy cycles (≥4) is a risk factor of OS (P=0.02) and the only indepen-dent risk factor (P=0.049). Conclusions:ES-SCEC is a malignant tumor with poor prognosis. Radiotherapy could not improve patient survival. Chemotherapy combined other therapeutic procedures could be considered as an effective treatment.

Objective:To investigate the effects and underlying mechanisms of XRCC3 on esophageal squamous-cell carcinoma (ESCC) radiotherapy response. Methods:Expression levels of XRCC3 were detected by reverse transcription PCR, Western blot, and immunohistochemistry. We knocked down XRCC3 with lentiviral infection in ESCC cells. Cell apoptosis was examined by flow cytom-etry. DNA damage and telomere dysfunction-induced foci were determined by immunofluorescence. Results:The expression levels of XRCC3 in ESCC cells and tissues were higher than those in normal esophageal epithelial cells and corresponding adjacent noncancer-ous esophageal tissues. Knockdown of XRCC3 in ESCC cells substantially increased the therapeutic efficacy of radiation. We demon-strated that the radiation resistance of XRCC3 was attributed to the XRCC3-maintaining telomere stability, which reduced ESCC cell death through radiation-induced apoptosis. Conclusion: Our data suggested that XRCC3 protects ESCC cells from ionizing radia-tion-induced DNA damage and death by enhancing telomere stability. Thus, XRCC3 can be used as a promising therapeutic target for ESCCs.

Objective To investigate the impacts of pyruvate kinase M2 isoform (PKM2) silencing on the radiosensitivity of lung adenocarcinoma cell line (A549 cells) and the radiation synergy of xenografts, and to explore their mechanisms. Methods Plasmid pshRNA?PKM2 for interference with PKM2 expression was transfected into A549 cells, and empty vector?transfected cells and untransfected cells were set as con?trols. The silencing efficiency of pshRNA?PKM2 and the expression level of microtubule?associated protein 1 light chain 3(LC3) were measured by Western blot assay. The radiosensitizing effects in A549 cells and xen?ografts after PKM2 silencing were determined by colony?forming assay and xenografts growth curves. Autoph?agy formation in A549 cells and xenografts was analyzed by transmission electron microscopy, and the ex?pression level of PKM2 in xenografts was measured by immunohistochemistry. Comparison between groups was made by Student′s t?test, and the body weights of nude mice and xenograft volumes were subjected to a?nalysis of variance for continuous variables. Results Stable A549 cell lines transfected with pshRNA?PKM2 were successfully produced. Transfection with pshRNA?PKM2 significantly down?regulated PKM2 expression in A549 cells and xenografts (P= 0?? 001;P= 0?? 000). The sensitizer enhancement ratios for A549 cells and xenografts were 1?? 47 and 2?? 00, respectively. Interference with PKM2 expression enhanced radiation?in duced autophagy formation and significantly increased the ratio of LC 3 ? II / I ( P= 0.000 1 ) . Conclusions Silencing of PKM2 expression may enhance the radiosensitivity of A549 cells and xenografts by regulation of autophagy, which holds promise for becoming an effective radiosensitizing target for non?small cell lung canc?er, but still needs to be confirmed by further studies.

Objective To evaluated the role of postoperative radiotherapy (PR) after surgery in patients with uterine sarcoma,and analyzed the prognostic factors.Methods A total of 182 patients with uterine sarcoma were included between June 1994 and October 2014.Radiotherapy dose were 30-50 Gy/10-25 fractions/5 fractions/week.The LRFFS and OS were calculated with Kaplan-Meier method,and difference was analyzed with log-rank method.Cox regression analyses were used to determine prognosticators.Results There were 114 patients which survived more than 5-years in this whole group,including PR 24 cases and no PR 90 cases.The 5-year LRRFS and OS were 62.1％ and 56.2％,respectively.The 5-year LRRFS were 78.0％ and 55.3％ on PR and no PR (P=0.013);with OS 64.1％ and 51.7％ on PR and no PR (P=0.070).A multivariate analysis showed that pathological types,histological grade and clinical stage were associated with LRRFS and OS (P=0.032,0.008,0.000 and 0.046,0.000,0.000).PR was significant influencing factor for OS (P=0.013).Conclusions Uterine sarcoma patients treated with PR after surgery had an improved LRRFS compared to those treated with surgery,especially those with leiomyosarcoma.The role of PR personalized radiation for uterine sarcoma still needs to be further discussed.

把社区康复纳入社区卫生服务是“人人享有康复服务”的重要保证,而社区卫生服务康复专业人员的规范化上岗培训是提高社区康复服务质量和可持续发展的关键。北京市在社区卫生服务康复专业人员规范化上岗培训方面已取得一定经验,要搞好此项工作,涉及培训的目的和职称、指导思想、师资队伍、培训基地、组织领导等方面的问题。

Objective To observe the effect of magnetic stimulation of sacral roots on detrusor overactivity and urge incontinence after spinal cord disease.Methods 15 cases with detrusor overactivity and urge incontinence after spinal cord disease were treated with magnetic stimulation of sacral roots for 10 d.Voiding diary,quality of life scale and urodynamic investigation were applied to evaluate the effect.Results The mean frequency of voiding in 24 h after treatment decreased,urine volume increased,frequency of incontinence decreased and the quality of life score improved.Urge incontinence improved in 85.7% cases.The results of urodynamic investigation showed bladder capacity at first desire to void and maximum cystometric capacity significantly increased after stimulation,while the detrusor pressure at storage decreased.Conclusion Magnetic stimulation of sacral roots can improve urinary frequency and urge incontinence of patients with detrusor overactivity after spinal cord disease by inhibiting detrusor overactivity,increasing cystometric capacity.Magnetic stimulation of sacral roots may be an alternative promising rehabilitation technique.

Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on motor recovery in patients with incomplete spinal cord injury （SCI）. Methods 22 patients with T5～T12 incomplete spinal cord injury (ASIA C) were randomly divided into rTMS group and control group. 12 ptients in rTMS group were treated with 10Hz rTMS （10×5 s with 2 min interval) on motor cortex and rehabilitation. 10 patients in control group treated with rehabilitation only. They were assessed with ASIA motor score, ASIA pin prick score, ASIA light touch score, range of motion (ROM) of legs in antigravitation position, walking index for spinal cord injury Ⅱ (WISCIⅡ) and functional independence measure (FIM) score before and 4 weeks after treatment. Results There was no difference between two groups with the clinical assessment before treatment （P>0.05）. The ASIA motor score, ROM of legs and FIM score improved in both groups after treatment （P<0.05）. The score of WISCIⅡ also improved in rTMS group （P<0.05）, and ASIA motor score improved more in rTMS group than that of control group （P<0.05）. Conclusion rTMS can facilitate the recovery of the motor and walking function in patient with incomplete spinal cord injury.