Rehabilitation medicine is a comprehensive multi-discipline. It is important to use varied Methods , modern and traditional, rationally in teaching rehabilitation medicine to improve the quality and efficiency. Some of these Methods were discussed.

BACKGROUND: Physical therapy is an effective treatment for movement disorder caused by central nerve system injury, while incorrect rehabilitative method will exacerbate the movement disorders in patients.OBJECTIVE: To investigate the effect of physical therapy on movement and daily activity of the patients suffering from brain injury.DESIGN: Randomized controlled study based on patients with a confirmativediagnosis.SETTING: Rehabilitation department in a university hospital.PARTICIPANTS: From September 2001 to August 2002, 78 patients hospitalized in the Rehabilitation Department of the Hospital Affiliated to Luzhou Medical College, with hemiplegia caused by brain injury, were selected into this study. The patients with severe brain injury, severe understanding disability, and severe heart diseases, lung diseases and kidney diseases were excluded.METHODS: The eligible patients were divided into two groups: the physical therapy group(48 patients) and the control group(30 patients) . All the patients in these two groups received medication and the hyperbaric oxygen therapy (HBOT), while the patients in the physical therapy group received an extra physical therapy.MAIN OUTCOMES MEASURES: A Fugl-Meyer assessment(FMA) and a modified barthel index(MBI) were adopted to evaluate the pre-and post-treatment statuses of the patients in these two groups.RESULTS: No significant difference in age, sex and disease course between the physical therapy group and the control group was found. In the physical therapy group, the FMA scale before and after the therapy were 40.43 ± 21.78 and 68.35 ±23.39, and the corresponding MBI scale were 32.82 ± 17.40 and 78.84 ± 25.31 respectively. In the control group,meanwhile, the FMA scales were 41.71 ± 19. 13 and 51.48 ± 22.58, and the MBI scales were 33.02 ± 12.48 and 56.65 ± 26.53. Before the therapy,comparison of FMA and MBI between the two groups showed no significant difference. While after the therapy, significant difference of FMA and MBI between the two groups could be confirmed( t = 2. 14, 2.21, P ＜ 0.05).CONCLUSION: Physical therapy could apparently enhance the rehabilitation of movement ability in patients with brain injury.

Objective To investigate the effect of atorvastatin calcium on serum endothelin-1(ET-1), polyamine oxidase(PAO), heart-type fatty acid binding protein(H-FABP), vascular endothelial growth factor(VEGF), 100β, inflammatory cytokines and nerve function in patients with acute cerebral infarction.Methods According to the random number table, 113 patients were randomly divided into two groups (n=61) and control group (n=52).The control group received conventional treatment methods, and observation group received atorvastatin calcium on the basis of control group. The treatment course was two weeks.Serum ET-1, PAO, H-FABP, VEGF, S100β, inflammatory cytokines and NIHSS score were compared between two groups before treatment, 7d and 14d after treatment.Results The serum levels of ET-1, PAO, H-FABP after 7d, 14d treatment of observation group was significantly lower than that of control group, respectively (P<0.05).The VEGF level of observation group after 7 d, 14 d treatment of observation group was significantly higher than that of control group, respectively (P<0.05).The S100βlevel after 7 d, 14 d treatment of observation group was significantly lower than that of control group, respectively (P<0.05).The hs-CRP, IL-8, TNF-αlevels after 7 d, 14 d treatment of observation group was significantly lower than that of control group, respectively (P<0.05).NIHSS score after treatment of observation group was significantly lower than that of control group (P<0.05).Conclusion The atorvastatin calcium can improve neurological function in patients with brain injury through reducing serum ET-1, PAO, H-FABP and S100βlevels, promote angiogenesis through increasing VEGF expression, and alleviate inflammation and ischemia-reperfusion injury through reducing inflammatory cytokines, thereby promote neurological functional recovery.

BACKGROUND; Authors have proposed the hypothesis that, the mechanism change may result in the mismatch between the energy production and energy consumption during the aerobic exercise, and pyruvate can be transformed into lactic acid, which may prevent the accumulation of pyruvate in cytoplasm and in the energy production of glycolysis so as to ensure the fast energy supply in zymolysis; the mechanism of this biochemical event may be the adjustment of energizing velocity via glycomechanism zymolysis.OBJECTIVE: To observe the effect of oxygen inhalation on metabolic transition, study the mechanism of metabolic transition under the lactate threshold intensity in human body and animal, and verify the result consistency between the two.DESIGN: Randomized control observation.SETTING: Department of Physical Education, Hebei Normal University; Department of Physical Education, Langfang Teachers College.PARTICIPANTS: A total of 24 male university students majoring physical education were adopted, weight (58±4) kg,height (175±6) cm, age (21 ±2) years. They were consisted of 12 Level B national athletes and12 common students.Additionally 30 SD male rats were used.METHODS: The experiment was carried out in the Laboratory of Physical and Physiological Function, Department of Physical Education in Hebei Normal University from April to June in 2006. Twenty-four students were recruited to exercise incrementally in ergometer; in addition, thirty SD rats were assigned to swim incrementally, 15 rats in each group. First, the intensities of metabolic transition were determined, then the exercise protocol was repeated on the conditions of inhaling and not inhaling oxygen. For student group, 50 W loading was incremented every 2 minutes, while the rats were added with 1% of their weights until unacceptable. Gradually incremented loading was used to transform the aerobic mechanism to anaerobic mechanism. The vein blood oxygen partial pressure, pyruvate and lactate contents were measured before and during the exercise (lactate threshold intensity) to evidence the reliability and validity of hypothesis.MAIN OUTCOME MEASURES: The vein blood oxygen partial pressure, pyruvate and lactate contents under lactate threshold intensity and oxygen inhaling supplementary.RESULTS: All 24 testees and 30 rats were involved in the result analysis. ①During the gradually incremented exercise,the lactic acid curve obtained at the end of 2-minute loading showed the difference of metabolic transition intensity and training level in accordance with individual lactic acid threshold, which was obviously lower in the trained exercisers.②Under the lactate threshold intensity, the blood lactate was not correlated to the oxygen partial pressure whether in human body or rats and whether inhaling oxygen or not [(3.61±0.56), (5.43±0.55) mmol/L; (4.46±0.86), (7.80±0.27) kPa,r =0.31, 0.31, P ＞ 0.05]; there was significant difference between the blood lactate and pyruvate contents [(1.04±0.16),(0.91±0.37) mmol/L, P ＜ 0.001]. The human body's saturation of blood oxygen was no less than 98% during the entire protocol. ③Under the repeated exercise and lactate threshold intensity, the pyruvate average value was (0.97±0.17),(1.04±0.16) mmol/L; (0.93±0.25), (0.91 ±0.37) mmol/L, respectively. There was no significant difference between the blood pyruvate before the exercise and under the lactate threshold intensity in both human body and animals (P ＞ 0.05).CONCLUSION: There is no hypoxia at the transition from aerobic to anaerobic metabolism. Oxygen inhaling supplementary has no influence on the mechanism transition; It is not easy for the pyruvate to pass the myocyte membrane, but the lactate can. The result demonstrates that the pyruvate can transform to lactate directly, which can also prevent the accumulation of pyruvate in kytoplasm.

Through comparing problem-based learning and lecture-based learning, the PBL teaching can improve the learning interest and self-learning ability of students and also can accomplish the task of teaching better.

Objective To access the effectiveness of withdrawing iodized salt on correcting the iodine excess in the population living in high iodine areas.Methods Before withdrawing iodized salt,2 twons were selected from each of 5 cities with water-borne iodine excess areas in Hebei province.All the selected towns were divided into 7 groups according to their iodine content in drinking water.Two villages wereselected from each group where urine samples of children aged 8 to 10 years old were collected to investigate the change of urinary iodine content of these children before and after withdrawing iodized salt.The urinary iodine content was determined using the method for determination of ammonium persulfate digestion arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Correlation between children's urinary iodine and drinking water iodine was analyzed.Results Before and after withdrawing iodized salt,744 and 771 urine samples were collected from the examined children aged 8-10 years respectively.The overall median urinary iodine content (MUIC) of the examined children after withdrawing iodized salt (350.1 μg/L) decreased significantly than that of before withdrawing iodized salt (460.8 μg/L,U =3 127.8,P ＜ 0.05).After withdrawing iodized salt,the MUIC of the children decreased significantly in 8 of 12 villages (P ＜ 0.05).Before and after withdrawing iodized salt,the percentage of urine samples with iodine content above 300 μg/L was 76.7％ (571/744),58.5％ (451/771) respectively,with significant statistical difference (x2 =57.7,P ＜ 0.05).After withdrawing iodized salt,Children's MUIC also decreased significantly across gender and age (boys:558.5,351.6 μg/L,U =960,P ＜ 0.05; girls:522.9,355.5 μg/L,U =698,P ＜ 0.05; 8 years old:536.0,295.5 μg/L,U =529.5,P ＜ 0.01; 9 years old:386.2,323.2 μg/L,U =753.5,P ＜ 0.01; 10 years old:525.5,368.8 μg/L,U =521.5,P ＜ 0.05).The children's MUIC correlated positively with the median water iodine contert (MWIC) in the villages where they lived (r =0.951,P ＜ 0.01).Analyzed by linear regression,approximately 89％ of the variability in MUIC was associated with variability in MWIC.Conclusions Withdrawing iodized salt could only correct the iodine excess caused by consuming iodized salt in the population living in the areas with MWIC below 100 μg/L.In the areas with water iodine above 100 μg/L,intervention should be focused on seeking water with proper iodine content.

Objective To investigate the significance of tumor markers CEA and CA19-9 in predicting the clinicopathologic characteristics and prognosis of primary duodenal carcinoma.Methods A retrospective analysis of 110 cases with primary duodenal carcinoma treated in our hospital from January 1999 to December 2016 was conducted.ROC analysis,univariate and multivariate analysiswere performed to investigate the relationship between CEA,CA19-9 and the clinicopathologic characteristics of primary duodenal carcinoma.Kaplain-Meier method was used to analyze the relationship between CEA and CA19-9 and the prognosis of primary duodenal carcinoma.Results CEA level was of value for predicting the depth of infiltration,lymphatic involvement,metastasis and TNM stage.The receiver operating characteristic was 0.629,0.672,0.749,0.692 respectively.Univariate analysis showed serum CA19-9 lever was related to the depth of infiltration and serum CEA lever were related to tumor differentiation,lymphatic invasion,metastasis and TNM stage.Logistic analysis showed that CEA value was only associated with metastasis (OR:9.853,P ＜ 0.01).Patients with elevated serum CEA level had a significant worse prognosis than patients with normal serum CEA level (P ＜ 0.05).Conclusion Serum CEA level was closely associated with the clinicopathologic characteristics and prognosis of primary duodenal carcinoma.

Objective:To explore the effects of online supportive disclosure therapy on the self-expression level, professional identity, dimission intention, and turnover rate of pre-dimission nurses, in order to provide a reference for nursing managers to stabilize the nursing team.Methods:A quasi experimental research method was used, and a convenient sampling method was used to select 192 pre resigned nurses from Shandong Provincial Third Hospital, the First Affiliated Hospital of Shandong First Medical University, and Shandong First Medical University Affiliated Provincial Hospital from October 2021 to December 2022 as the research subjects. They were divided into a control group and an experimental group by random number table method, with 96 nurses in each group. The control group received routine exit interviews, while the experimental group received online supportive disclosure therapy intervention based on this. The self-expression level, professional identity, dimission intention, and turnover rate of two groups of nurses before and 1, 2 months after the intervention were evaluated.Results:Finally, 94 nurses in the control group and 92 nurses in the experimental group completed the study. There were no significant differences in the self-expression level, professional identity, dimission intention before the intervention between the two groups ( P>0.05). After 1 and 2 months of the intervention, the scores of the Pain Self Disclosure Index, Nurse Professional Identity Rating Scale, and Resignation Intention Scale of the experimental group were 36.33 ± 5.13, 73.88 ± 8.72, 14.18 ± 1.12 and 34.22 ± 6.78, 98.26 ± 11.29, 6.16 ± 1.19, respectively,and the control group were 28.06 ± 8.23, 64.72 ± 10.39, 17.82 ± 1.37 and 44.26 ± 7.62, 79.82 ± 8.66, 9.18 ± 1.06, there were statistically significant differences between the two groups ( t values were -13.54 to -2.11, all P<0.05); there were statistically significant differences in the inter group effects, time effects, and interaction effects of the scores on the Pain Self Disclosure Index, Professional Identity Rating Scale, and Resignation Intention Scale between the two groups ( F values were 5.12 to 14.82, all P<0.05). The turnover rate of nurses in the experimental group was 1.09% (1/92), lower than 8.51% (8/94) in the control group, and the difference between the two groups was statistically significant ( χ2=1.59, P<0.05). Conclusions:Online supportive disclosure therapy can improve the self-expression level and professional identity of pre-dimission nurses, and reduce their willingness to resign and turnover rate.

Objective To investigate the neurodevelopmental toxicity of ACR by studying the expression of DCX and GAP-43 in the hippocampal dentate gyrus of rats after maternal exposure to acrylamide. Methods Pregnant rats were randomly divided into low-dose ACR(4.5 mg/kg),medium-dose(9 mg/kg),high dose groups(18 mg/kg)and the control group(0 mg/kg),8 in each group,and were exposed to toxicant from gestation-al day 15 to postnatal day 13. All rats and their pups were killed on postnatal day 14. ABC immunohistochemistry was used to detect the expression of GFAP in the hippocampus of mother rats and offspring. Results Compared with the control group,the expression of DCX and GAP-43 in hippocampus dentate gyrus of the pregnant rats in middle and high dose groups was significantly decreased(P < 0.05). Conclusion ACR may interfere with the growth and development of neurons by reducing the expression of DCX and GAP-43.

Objective To investigate the complication and risk factors in elderly patients undergoing pancreaticoduodenectomy (PD).Methods From Jan 2005 to Dec 2016,358 consecutive patients undergoing PD were divided into ≥ 70 years group (98 cases) and ＜ 70 years group (260patients).Perioperative complications were compared and risk factors explored between the two groups.Results There were differences in coronary heart disease between the two groups in the preoperative medical comorbidities (P =0.008),and that of albumin,alanine aminotransferase,alkaline phosphatase and creatinine (all P ＜ 0.05).Perioperative mortality was higher in the elderly group than in the younger group (P =0.038),probably related to higher systemic complications (P =0.001).The independent risk factors influencing the postoperative medical complications were preoperative total bilirubin ≥ 171 μmol/L and intraoperative blood loss ≥ 1 000 ml.Conclusions Patients over 70 years old have a comparatively higher perioperative mortality rate after pancreaticoduodenectomy,which were probably derived from a higher postoperative vital organ dysfunction.