Music and speech may share the same neural pathway, and the role of music therapy in speech rehabilitation gradually attracts the attention from the rehabilitation medical profession in recent years. This article reviewed the effect, mechanism, and strategy of music therapy in speech rehabilitation.

Objective To explore the effects of impaired glucose metabolism and impaired blood lipoprotein metabolism on heart rate variability(HRV) in aged male hypertension patients and to have an insight into the correlation between the years of impaired glucose metabolism and the patients’ HRV. Methods 120 male subjects were divided into three groups: simple hypertension patients (group A, 40 people), hypertension patients with diabetes mellitus (group B, 40 people), and hypertension patients with diabetes mellitus and impaired blood lipoprotein metabolism (group C, 40 people). All subjects had 24h recordings of ECG. The data of HRV time domain were collected and analyzed to gain an insight into the effects of the impaired glucose metabolism and impaired blood lipoprotein metabolism on patients’ HRV. In group C, patients were divided into normal TC subgroup and high TC subgroup according to the index of TC (TC

Objective To evaluated the feasibility and accuracy of obtaining the myocardial perfusion image and coronary artery image of pig models of acute myocardial infarction by the second generation dual-source CT dual-energy myocardial perfusion one-stop scanning. Methods The pig models of acute myocardial infarction was established by using the interventional gelatin sponge embolism method on 5 pigs. The myocardial perfusion scanning and coronary angiography were respectively used 20 min before and 24-48 h after modeling. The heart were taken out immediately after the inspection for multiple punch biopsy and HE staining, then the heart was sliced for triphenyltetrazolium chloride (TTC) staining. According to the gold standard of coronary angiography and pathological staining, the sensibility and speciifcity of the coronary artery image of acute myocardial infarction of pig reconstructed by myocardial perfusion scanning and the myocardial perfusion image were respectively evaluated, and the consistency of the results was veriifed by Kappa test. Results Compared with the pathologic gold standard, the sensitivity, speciifcity, of myocardial perfusion iodine image obtained by myocardial perfusion scanning were 93%, 91%; and Kappa value was 0.68. Compared with the coronary angiography gold standard, the sensitivity and speciifcity of coronary artery image obtained by myocardial perfusion scanning were 93%, 81%, and Kappa value was 0.71. Conclusions The second generation dual-source CT dual-energy myocardial perfusionone-stopscanning can accurately get the coronary artery and myocardial perfusion images of the pig models of acute myocardial infarction.

Objective To explore the characteristics and the clinical application of MR perfusion weighted imaging(PWI)in the normal kidneys and the renal diseases.Methods Thirty-one subjects including 9 cases without urinary diseases,14 cases with renal carcinoma,6 cases with renal cyst and 2 cases witll renal tuberculosis who had been examined with T1WI,T2WI and PWI were analyzed retrospectively.All the data were processed by a workstation to obtain time-signal intensity curves,color perfusion maps and relative perfusion value.The relative renal blood volume(RBV),relative renal blood flow(RBF),mean transition time(MTT)and the time to peak(TTP)in the normal renal cortex and medulla and the renal lesions were calculated.Comparisons between the right and the left normal kidneys,and between the cortex and the medulla of the normal kidneys were performed using t test,and comparisons between the normal and the abnormal kidneys were performed using q test.Results Relative RBV and relative RBF of the cortex were 1.33±0.08 and 1.44±0.09 respectively,and for medulla were 0.58±0.05 and 0.78±0.13 respectively(t=9.2241 and 5.0336,P＜0.01);MTT(1.11±0.08)and TTP (1.04±0.06)of the cortex has no difference with that of the medulla(0.97±0.04 and 0.94±0.03)in the normal kidneys(t=2.2551 and 2.2613.P＞0.05).The values of relative RBF of the renal carcinoma (1.35±0.34)were significantly higher than that of the normal tissues(1.02±0.06)(q=3.0882,P＜0.01).Conclusion PWI is able to demonstrate the hemodynamic change of the normal renal tissues and the renal lesions,and it maybe an ideal method for showing the functional changes of the kidney and for differentiating the renal diseases.

This study was to explore the value of maternal serum screen in identification of fetal abnormal chromosome and neural tube defect(NTD). By using time-distinguished fluorescence immunoassay, serum levels of free-β-HCG and alpha fetal protein(AFP)were obtained in 7698 pregnant women at 15～20 +6weeks. and 483 were found at a higher risk of fetal abnormal chromosome. Based on amniotic fluid examination or cord blood testing on 344 high. Risk participants. Fetal abnormal chromosome was found in 18 women with a positive rate of 5. 2%. Twenty-five pregnant women were NTD high-risk, and their positive rate was 0. 3%. B-mode ultrasound identified 6 fetal malformations and 2 fetal deaths ( positive rate of 32. 0%). In high-risk or low-risk group, there were 25. 6%and 7. 7%subjects developed adverse outcome, respectively(P＜0. 05). Our findings suggested that maternal serum screen is an effective prediction factor for fetal abnormal chromosome and NTD.

Objective To examine the impact of case management on hospitalizations of the chronically and severely mentally ill patients in Zhongshan. Methods Patients with severe and chronic mental illness,aged ≥ 15 years and living in pilot area were divided into two groups naturally since the program of case management launched, 65 cases in the group of case management and 112 patients in the group of standard management. Hospitalizations of the two groups before and after case management were compared. Results Data were analysised with MIXED procedure. Length of stay in days per admission (LOS) of both groups decreased with time in years (F=11.02, P=0.001), and the decline in LOS of case management group was greater than that of standard management group (F=9.02, P=0.003). The average admissions of case management group was more than that of standard management group (F=4.98,P=0.03). There was no significant differences in average hospitalization incidents before and after case management in both groups(case management group 5.13%vs. 5.38%, standard management group 7.14%vs. 8.92%, P>0.05). Conclusions Case management was effective in reducing hospitalizations for a group of Chinese with chronic and severe mental illness, and may contribute to the balance on mental health resources between community and hospital.

Objective To investigate the effects of enteral nutrition support with different doses of glutamine on nutritional status and gastrointestinal function in elderly critically ill patients.Methods Totally 90 critically ill patients were randomly divided into three group:the control group without glutamine (group A),enteral nutrition with low glutamine [0.3 g/(kg· d)] (group B),and high glutamine [0.6 g/(kg· d)] groups (group C).Fasting blood samples were collected on days 1,7,and 14 after the initiation of study,and then the indicators including serum diamine oxidase,glutamine,transferin (TF),prealbumin (PA),hemoglobin (HGB),albunin,and nitrogen balance were determined.In addition,the gastrointestinal complications including bloating,diarrhea,and gastric retention were recorded.Results On the 7th and 14th days,the serum glutamine levels in groups B and C were (1 886.8 ±420.5),(2 228.6 ±440.2) μg/L;(1 889.6 ± 436.1),(2 174.3 ± 440.8) μg/L,respectively,which were significantly higher than those in group A [(1 612.0 ±493.5),(1 869.7 ±559.8) μg/L] (P =0.027,P =0.008).The serum diamine oxidase levels were also significantly lower in group B [(2 310 ± 1 271),(1 602.5 ± 1 137.9) U/L] and group C [(2 076.3 ±567),(1 586.3 ±530.9) U/L] than in group A [(3 250 ±923),(2 476 ±862) U/L] (P =0.000,P =0.000).The serum TF and PA levels were significantly increased on the 7th day (P =0.023,P =0.047),and the HGB was significantly higher on 14th day (P =0.003),The number of patients who had undergone successful implementation of enteral nutrition were 4 and 3 in groups B and C,and the number of patients who had achieved the target volume of enterral nutrition was 25 and 27 in groups B and C,which were significantly larger than those in group A (12 and 13,respectively) (P =0.008,P =0.000).The gastrointestinal complication was also significantly decreased after the administration of enterral nutrition with glutamine.Conclusions Enteral nutrition with glutamine can improve intestinal mueosa barrier and nutritional status in elderly critically ill patients.Thus,it helps to reduce gastrointestinal complications and transition time of total enteral nutrition.

Objective:To study the inductive effect of recombinant MUC1-MBP fusion protein combined with R848 on the immune activity of T cells in the mice,and to provide experimental basis for searching the suitable adjuvants of recombinant MUC1-MBP fusion protein.Methods:A total of 21 C57BL/6 mice were randomly divided into control group(treat with normal saline),MUC1-MBP+R848 group (treated with MUC1-MBP+R848),and MUC1-MBP+baillus calmette guerin(BCG) group(treated with MUC1-MBP+BCG)(n=7).After immunized for 4-7 d,the spleen tissue was taken and the spleen indexes of the mice in various groups were measured;the stimmulus index(SI) of the mice was detected by lymphocyte proliferation response;the levels of tumor necrosis factor-γ(TNF-γ) and interleukin-4(IL-4) were detected by ELISA method;the proprotions of T lymphocyte subsets in spleen cells were analyzed by flow cytometry.Results:Compared with control group,the spleen indexes,SI,and TNF-γ levels of the mice in MUC1-MBP+ R848 and MUC1-MBP+BCG groups were significantly increased (P<0.05 or P<0.01);the indexes metioned above of the mice in MUC1-MBP+ R848 were higher than those in MUC1-MBP+BCG group;the IL-4 levels had no significant difference(P>0.05).Compared with control group,the proprotions of CD3+T,CD4+T,and CD8+ T cells of the mice in MUC1-MBP+ R848 group and MUC1-MBP+BCG group were significantly increased(P<0.05 or P<0.01).Conclusion:Both MUC1-MBP fusion protein combined with R848 and BCG can induce the Th1 type of immune activity in the mice,and R848 is the potential candidate adjuvant for MUC1-MBP.

A total of 166 women with intrahepatic cholestasis in pregnancy (ICP) participated in the study. Serum levels of thyroid stimulating hormone (TSH), free thyroxine 4 (FT4) and thyroid peroxidase antibody (TPOAb) were quantified for all of them with electrochemiluminescence (ECL) technique, and compared with those in normal pregnant women. Results showed that serum TSH and TPOAb [22. 9%(38/166)] increased significantly, but no significant change in serum level of FT4 was observed in women with ICP, as compared to those in normal pregnant women. Overall prevalence of thyroid diseases in ICP women was 35.5% (59/166), significantly higher than that in normal population screened for thyroid disease (17. 1%, 143/837) at the same time period. It suggests that thyroid dysfunction may be involved in pathogenesis of ICP.

Objective To approach the changes of cytosol phospholipase A2α(cPLA2α)and nitric oxide (NO)in patients with chronic obstructive pulmonary disease(COPD)and its significance. Methods One hundred patients with COPD admitted into Department of Critical Care Medicine of Affiliated Wuqing Traditional Chinese Medicine(TCM)Hospital of Tianjin University of TCM were enrolled,and according to the COPD severity grading standards,they were divided into mild group(25 cases),moderate group(25 cases),severe group(26 cases) and extremely severe group(24 cases);simultaneously,90 cases with normal pulmonary function who had taken health examination were chosen and assigned to the healthy control group. The cPLA2α level was detected by enzyme linked immunosorbent assay(ELISA),the level of uric acid(UA),total cholesterol(TC),triacylglycerol (TG)were detected by enzymatic method,and serum NO metabolites(NOx)level was detected by nitrate reductase method. Results Compared with the healthy control group,the serum levels of cPLA2α and UA in patients with different severity of COPD were significantly increased;along with the increase of patient's COPD grade of severity,the cPLA2α,UA levels were gradually increased,while NOx level was gradually decreased in mild, moderate, severe, extremely severe groups〔cPLA2α(ng/L):125.60±8.17, 155.20±6.42, 190.20±9.32, 255.80±11.28 vs. 88.50±7.99;UA(μmol/L):381.23±32.22,434.95±87.71,464.81±52.65,487.45±82.61 vs. 241.95±52.33;NOx(μmol/L):59.90±17.52,45.60±6.17,38.20±4.08,25.70±3.04 vs. 74.90±18.31,all P<0.05〕. The differences in blood cPLA2αand serum NOx level among groups with different severity of COPD were of statistical significance(P<0.05). The levels of TC,TG among these different severity groups had no statistical significance(all P>0.05). The cPLA2αand NOx levels presented significant negative correlation(rs=-0.798,P=0.013). Conclusion The combined examination of blood cPLA2αand serum NOx levels can evaluate the severity degree of COPD patients,and cPLA2αcan be used as a new target index for COPD grading.