There are many ways to prepare middle cerebral artery occlusion (MCAO) rat model. The focal cerebral ischemia model es-tablished by the suture-occluded method is widely accepted as an ideal focal cerebral ischemia model, which can be used in the basic and clinical study of cerebral vascular diseases. However, it still has the defects of high technical requirement, large model difference and high animal mortality. A variety of focal cerebral ischemia models were established by changing the retention time of the thread, the road the thread plugging into, the type of thread bolt and the depth of the thread plugging. This article compared different suture-occluded method, as well as the suture-occluded method to other modeling methods, different cerebral ischemia models may be different in the pathophysiology of cerebral infarction, and the effects may also be different.

Objective To investigate the effect of attention training on cortical activation area and lateralization index in interference effect of dual-task paradigm as the poststroke nonfluent aphasiacs processing the Chinese character tasks. Methods 20 cases with nonfluent aphasia after stroke were divided into the training group and the control group, who accepted attention training and cognitive training respectively, 30 min a time, 5 times a week, for 4 weeks. They were investigated the cortical activation area and lateralization index caused by interference effect of dual-task paradigm under block design. Results The right inferior frontal gyrus, bilateral parietal and cerebellar cortex were activated before training in both groups, and more activated after attention training, but no change after cognitive training. Lateralization index suggested that the right brain was more activated before training, while the left side was activated after attention training, but no change after cognitive training. Conclusion The right inferior frontal gyrus, bilateral parietal and cerebellar cortex are very important in solving the dual task interference in the attention stage, and they are activated after attention training. It indicates that attention training makes a significant functional reorganization on Chinese character processing in poststroke nonfluent aphasiacs.

Objective To explore the influence of attention training on Chinese character processing capability in poststroke nonfluent aphasiacs. Methods 60 stroke patients with nonfluent aphasia and cognition dysfunction were divided into control group (n=30) and experimental group (n=30). The trainings (attention training and cognition training) were respectively 30 minutes each time, 5 times each week for 4 weeks. The change of reaction time and error rate were compared before and after they were performing the orthographic, semantic and phonological tasks. Results In the dual-task paradigm the change of reaction time and error rate in orthographic and semantic tasks of the experimental group were all higher than the control group (P<0.001). But there was no difference between the two groups in the phonological task (P>0.05). In the single task paradigm there was no difference between the two groups (P>0.05). Conclusion 1. Attention training can improve the processing capacity significantly in orthographic and semantic tasks in the dual-task paradigm because the volume and distributive ability of attention improve significantly. 2. Attention training can't improve the processing capacity in phonological tasks in the dual- task paradigm because reading aloud and judging are required to process the vowel simultaneously. So that the competion intensifies and it is more difficult to finish the task. 3. In the single task paradigm, there is no significant difference between the influence of the two trainings in poststroke nonfluent aphasiac because the single task needs little attention and the change in the control group is enough.

Objective To investigate the Chinese characters processing in healthy subjects with functional magnetic resonance imaging (fMRI). Methods 10 healthy subjects were asked to finish the dual-task paradigm Keying/Reading and single-task paradign Keying or Reading.The active area and partial lateralization index in brains of them were investigated with fMRI with block design. Results and onclusion The tasks activated the right inferior frontal gyrus, bilateral parietal and cerebellar cortex. The laterality index showed that the left brains were more active in the tasks.

Objective To explore the effects of early exercise on motor function and the mechanism in rats after focal cerebral ischemia. Methods 21 Sprague-Dawley male rats were divided into control group (n=7), natural recovery group (n=7) and exercise training group (n=7), and the latter 2 groups were modeled with middle cerebral artery occlusion. The exercise training group received wheel running exercise 24 hours after modeling for 14 days. They were assessed with Rogers score and beam balance test 21 days after modeling. 4 rats in each group received routine MRI and diffusion tensor imaging (DTI) scanning. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of ischemic (L) and contralateral side (R) were measured, and the rate of them (L/R, r) was calculated. Results There was significant difference in Rogers score among the groups (Z=-0.786, P<0.001), but no significant difference between the natural recovery group and the exercise training group (P>0.05). Beam balance score of the natural recovery group was significantly different from the control group and the exercise training group (F=38.11, P<0.001), but there was no significant difference between the latters (P>0.05). The LFA of the natural recovery group was significantly different from the control group (P<0.05), but not significantly different from the exercise training group (P>0.05);while the rFA of the natural recovery group was significantly different from the control group and the exercise training group (F=19.30, P<0.05). LADC and rADC might be different between the control group and the natural recovery group (P=0.056, P=0.057), but not significantly different between the natural recovery group and the exercise training group (P>0.05). LFA and rFA strongly correlated with all the behavior scores (r=-0.90--0.70, P<0.01); while LADC and rADC moderately correlated with the behavior scores (r=0.50-0.75, P<0.05), except balance (P>0.05). DTT showed that the direction and density of neural fibers were significantly asymmetrical in the natural re-covery group and the exercise training group, and more symmetrical in the exercise training group. Conclusion Early exercise can promote the neural functional recovery in rats after focal cerebral ischemia, which may associate with the improve of conduction of fibers.

OBJECTIVETo study the effects of transcutaneous electrical nerve stimulation on multimodal analgesia after total knee arthroplasty.

METHODSSixty patients diagnosed as knee osteoarthritis and suffered unilateral total knee arthroplasty in the department of orthopedics, Zhejiang Traditional Chinese Medicine Hospital from March 2009 to May 2012 were randomly divided into control group and test group, 30 cases in each group. All the patients received celecoxib preoperatively, knee periarticular injection with the drug mixture intraoperatively, and celecoxib and morphine sulfate controlled-release tablets postoperatively. The patients in the test group were also treated with transcutaneous electrical nerve stimulation each day after operation. All the patients started doing functional exercises at 24 h after operation. Postoperative visual analogue scales(VAS), passive and active range of motion of knee joint,and complications were recorded.

RESULTSThe VAS scores of test group during postoperative 24 h to 1 week were 3.39 +/- 0.69, 2.79 +/- 0.51, 2.16 +/- 0.52, and 1.07 +/- 0.57 separately,which were lower than 3.80 +/- 0.86, 3.22 +/- 0.58, 2.53 +/- 0.54 and 1.38 +/- 0.52 in the control group. The passive and active range of knee joint motion in the test group during postoperative 24 h to 2 weeks were (30.67 +/- 3.65) degrees, (39.17 +/- 3.96) degrees, (47.83 +/- 4.86) degrees, (93.67 +/- 7.30) degrees, (107.67 +/- 7.51) degrees and (29.83 +/- 5.33) degrees, (78.33 +/- 8.24) degrees, (95.17 +/- 5.94) degrees respectively,which were higher than (28.67 +/- 3.92) degrees, (36.83 +/- 4.25) degrees, (45.17 +/- 5.17) degrees, (89.83 +/- 7.25) degrees, (103.17 +/- 7.37) degrees and (24.17 +/- 10.26) degrees, (73.83 +/- 9.07) degrees, (91.33 +/- 7.42) degrees in the control group. In the test group, 19 patients had ring-shaped haemostasis impression to some extent in the skin of knee joint to different degree, and 5 patients had blister formation.

CONCLUSIONIt is meaningful to apply transcutaneous electrical nerve stimulation for treating multimodal analgesia after total knee arthroplasty,which can not only relieve patients' postoperative pain, and also promote the rehabilitation of knee function as far as possible.

Aged ; Aged, 80 and over ; Analgesia ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Transcutaneous Electric Nerve Stimulation ; Treatment Outcome

Objective To explore the effect of exercise training on learning and memory ability in rats with focal cerebral ischemia, and to analyze the changes of brain tissue structure of rats after exercise training through diffusion tensor imaging (DTI). Methods Twenty-four SPF male Sprague-Dawley rats were randomly divided into sham operation group (n=8), natural recovery group (n=8) and exercise training group (n=8). The left middle cerebral artery occlusion (MCAO) model was established. The exercise training group received running wheel training 24 hours after modeling, for 14 days. All groups were tested by the Morris water maze 15 days after modeling. The latency in the navigation experiment, as well as the first latency, boundary swimming time ratio, the boundary swimming distance ratio, the average speed and the swimming path in the space exploration experiment were recorded. Four rats with similar Longa scores in each group received rou-tine magnetic resonance imaging and DTI scanning, the fractional anisotropy (FA), axial diffusivity (λ‖), and radial diffusivity (λ⊥) of isch-emic cortex and hippocampal lesion and contralateral side were measured. Results In the navigation experiment, the latency of three groups showed a downward trend along with training days (P<0.05). The latency was longer in all the time points in the natural recovery group than in the sham operation group (P<0.05), and was longer in the first three days in the exercise training group than in the sham operation group (P<0.05), however, there was no significant difference between them in the last two days (P>0.05), while it was shorter in the exercise train-ing group than in the natural recovery group in the same time (P<0.05). In the space exploration experiment, the latency, the boundary swim-ming time ratio and the boundary swimming distance ratio were more in the natural recovery group than in the sham operation group (Z>2.627, P<0.01), and the latter two indexes were also higher in the natural recovery group than in the exercise training group (Z>2.521, P<0.05). No significant difference was found in the average speed among three groups (P>0.05). The swimming paths in the exercise training group and the sham operation group were better than that of the natural recovery group. The FA and rFA in the left cortical area were higher in the sham operation group than in the exercise training group and the natural recovery group (P<0.05), however, no significant difference was found between the exercise training group and the natural recovery group (P>0.05). There was no significant difference in the FA in the right cortical area among three groups (F=0.532, P=0.607). Theλ⊥,λ‖, rλ‖and rλ⊥in the left cortical area were lower in the sham opera-tion group than in the natural recovery group (P<0.05), and no significant difference was found from the exercise training group to the natu-ral recovery group, nor to the sham operation group (P>0.05). There was no significant difference in theλ⊥andλ‖in the right cortical area among three groups (F<1.030, P>0.05). There was no significant difference in the FA,λ⊥,λ‖and rFA, rλ⊥and rλ‖in the bilateral hippo-campal interest area among three groups (F<1.845, P>0.05). The rFA, rλ‖, rλ⊥and leftλ⊥ were correlated with the latency in the space ex-ploration experiment in the Morris water maze test (P<0.05), in which the correlation coefficient of rλ⊥was the highest (r=0.761, P<0.01). Conclusion Proper exercise training can improve the learning and memory ability of rats with focal cerebral ischemia, and can promote the repair of nerve fiber damage and reduce the vascular edema. In addition, the rFA, rλ‖, rλ⊥andλ⊥of ischemic cortex may be predictors of cognitive function recovery in rats after focal cerebral ischemia, especially rλ⊥.

Objective To explore the effects and mechanism of repetitive transcranial magnetic stimulation (rTMS) applied to the right Broca's homologue of stroke patients with non-fluent aphasia.Methods One stroke patient with non-fluent aphasia received rTMS at 1 Hz and another received the same treatment at 10 Hz.The western aphasia battery (WAB) and functional magnetic resonance imaging (fMRI) were used to evaluate their language function before and after the intervention.Results After treatment,language function in both patients had improved significantly.The aphasia quotient (AQ) score of patient 1 had improved from 37.2 to 66.6,and the AQ score of patient 2 had improved from 36.2 to 60.8.Before treatment,patient 1's activated brain areas during a vocabulary reading task were the left anterior central gyrus and the left gyrus frontalis medius.After the 1 Hz rTMS treatment the activated brain areas were the left medial surface of the lobus frontalis,the left gyrus frontalis inferior,the left prefrontal area,the left preinsula,the left lobulus parietalis inferior,and the left middle/inferior temporal gyrus.Before the 10 Hz rTMS treatment,patient 2's activated brain areas with the same vocabulary reading task were the bilateral medial surface of the temporal lobe,and the bilateral anterior central gyrus.After treatment the bilateral medial surface gyrus,the frontalis medius and lobus frontalis,the right gyrus frontalis inferior,the left prefrontal area,the bilateral lobulus parietalis superior,and the right superior/middle temporal gyrus were activated.Conclusion rTMS can significantly improve language function in stroke patients with non-fluent aphasia.Patients with smaller lesions in the left hemisphere language area can achieve hemisphere function restructuring.Larger lesions in the left hemisphere language area will probably yield bilateral restructuring in both hemispheres.

Objective To study the effects of constraint-induced movement train (CIMT) on the neurological medullary sheath in the rats after middle cerebral artery occlusion (MCAO). Methods 55 SD rats were randomly divided into CIMT group and nature recovery (NR) group after MCAO. The CIMT group were trained with balance beam and rolling cage everyday, with restrictting the movement of the intact upper limbs. The NR group lived in the same condition. The rats in CIMT group were assessed with ethology 5 d, 10 d, 15 d, 30 d and 60 d after operation respectively. At last, 5 rats of each group were checked with MRI, then they were immolated for myelin staining. Results The balance and muscle strength of CIMT group improved better compared with the NR ones (P<0.05), as well as the diameter and the demyelination of neurofibril in the infarcted area. Conclusion CIMT can collect more functional neurofibra and decrease myelinolysis.

Objective To compare the reliability of modificatory method and traditional method in preparing ischemic stroke rat model in rehabilitation period.Methods 173 female SD rats were divided into traditional method group(n=63),modificatory method group(n=109) and control group(n=37).In the traditional method group,the thread embolus was inserted through the left external carotid artery(ECA),and then left ECA and pterygopalatine artery(PPA) were ligated.In the modificatory method group,the thread embolus was inserted through the left internal carotid artery(ICA) and only left common carotid artery(CCA) was ligated.In the control group,the thread embolus was not inserted,only CCA was ligated.Results There was no significant difference in neurofunction score between the modificatory method group and the traditional method group(P>0.05).The operating time was significantly shortened(P<0.01) and the survival time was significantly prolonged in the modificatory method group compared with that of the traditional method group(P<0.01).The two-month survival rate was 54.13% in the modificatory method group and 31.75% in the traditional method group receptively,the former was significantly longer than the latter(P<0.01).Conclusion The ischemic stroke model established by modificatory methods is not only precisely and reliable but also save operating time and improve survival rate of the animals compared with the traditional method.The main death causes of animals are large-area cerebral edema and electrolyte imbalance after operation.