Objective To investigate the effect of transcranial direct current stimulation combined with motor relearning program on the recovery of upper limb motor function after stroke.Methods From September 2015 to June 2016,40 patients with first-ever stroke received rehabilitation therapy at the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were enrolled prospectively.Their course of disease was 1 to 6 months.They were divided into either a combined treatment group or a control group according to the odd and even numbers in hospital (n =20 in each group).The patients of both groups received traditional rehabilitation training and motor relearning program for upper lindb recovery,2 times a day,once for 30 min,5 days a week for 6 weeks.The combined treatment group was also given transcranial direct current stimulation,2 times a day,once for 20 min,5 days a week,while the control group was only treated with sham stimulation treatment.The patients were assessed before treatment and at 6 weeks after treatment.Fugl-Meyer Assessment (FMA) scores and Action Research Arm Test (ARAT) were used to assess upper limb motor function.The modified Barthel index (MBI) was used to evaluate the activities of daily living.Results There was no significant difference in the observation indices before treatment between the 2 groups (P ＞ 0.05).Six weeks after treatment,the differences of the upper limb FMA score and ARAT score before treatment were superior to the control group,they were 13 ± 3,10 ± 3 and 10 ± 2,8 ± 2,respectively (t =3.503 and 3.244 respectively,all P ＜ 0.01).There was no significant difference in the MBI score between the 2 groups (P ＞ 0.05).Conclusion Transcranial direct current stimulation combined with motor relearning program may effectively improve the upper limb motor function in patients with stroke and promote the improvement of the activities of daily living.

Objective: To investigate the characteristics of breakthrough cases of varicella in Haishu District, Ningbo City, Zhejiang Province from 2017 to 2022, so as to provide the evidence for varicella prevention and control. Methods: Information on reported cases of varicella and vaccination in Haishu District from 2017 to 2022 were collected through the China Infectious Disease Reporting Management Information System and the Immunization Program Information Management System of Zhejiang Province. The breakthrough cases who had received 1 or 2 doses of varicella vaccine 42 days before the onset of disease were selected. The distribution of sex, age, region and the interval between onset and last immunization were descriptively analyzed. Results: A total of 1 563 varicella cases were reported from 2017 to 2022. There were 928 breakthrough cases (59.37%), of which 660 cases with 1-dose immunization history (42.23%) and 268 cases with 2-dose immunization history (17.15%). The proportion of 1-dose breakthrough cases in total annual cases showed a decreasing trend (P<0.05) from 2017 to 2022, while there was no significant tendency on the proportion of cases with 2-dose immunization history (P>0.05). There were 392 males (59.39%) and 268 females (40.61%) with 1-dose immunization history. There were 150 males (55.97%) and 118 females (44.03%) with 2-dose immunization history. Breakthrough cases with 1- and 2- dose immunization history had an median age of 13.00 (interquartile range, 4.00) and 9.00 (4.00) years, respectively, and the difference was statistically significant (P<0.05). The regional distribution of the breakthrough cases with 1- and 2- dose immunization history was mainly in the rural-urban fringe, with 319 cases (48.33%) and 137 cases (51.12%), respectively, and the difference was statistically significant (P<0.05). The median interval between onset and last immunization was 12.00 (interquartile range, 3.00) and 4.00 (3.00) years, respectively, and the difference was statistically significant (P<0.05). Conclusions The breakthrough cases of varicella in Haishu District from 2017 to 2022 were mainly cases with 1-dose immunization history, males, and residents in rural-urban fringe. The age was older and the interval between onset and the last immunization was longer in cases with 1-dose immunization history than in cases with 2-dose immunization history.

Objective To investigate the epidemiological and clinical features of acute hepatitis E (AHE).Methods All the data of AHE patients from April 2005 to October 2011 were collected and their epidemiological features were retrospectively analyzed.Patients were divided into two groups:patients with single hepatitis E virus (HEV ) infection and patients with HEV/hepatitis B virus (HBV ) coinfection,to compare the biochemical parameters and outcomes and to find out the risk factors for AHE related liver failure.Kruskal-Wallis test,Chi square test,and Logistical regression analysis were used for statistical analysis.Results A total of 621 cases were included in the present study and most patients were elderly male and happened from February to May every year.The incidence of AHE related liver failure and mortality was 18.68% and 1 .93%,respectively.Compared to the single HEV group (n=331 ),the HEV/HBV group (n = 280 )had a longer hospital stay (46 d vs 40 d,Z = - 4.591 ,P < 0.01 ),a significantly lower prothrombin activity (55 .5 % vs 78.7%,Z =-7.998,P <0.01 )and a significantly higher incidence of AHE related liver failure (30.7% vs 9.1 %,χ2 =46.229,P <0.01 ).In single HEV related liver failure group (n=30),the percentages of early-stage,interim-stage and end-stage live failure were 53.33%,23.33% and 23.33%,respectively.While in the HEV/HBV related liver failure group (n=86),the corresponding numbers were 34.88%,31 .40% and 33.72%,respectively.The differences were not statistically significant (χ2 = 3.176,P = 0.204 ).Additionally,the clinical outcome between these two groups was also comparable (83.33% vs 91 .86%,χ2 =0.945 ,P = 0.331 ).The Logistic analysis showed that age over 50 years (OR=2.080,P =0.002)and coinfection with HBV (OR=5 .632, P <0.01)were risk factors for AHE related liver failure.Conclusions AHE is seasonal and mainly occurs in elderly male.Advanced age and HBV coinfection may be risk factors of severe AHE.

Objective To investigate the relationship between HBV mutations in the precore (PC)/core promoter region and the liver histological changes in HBeAg negative CHB patients. Method A total of 71 HBeAg negative CHB patients with liver biopsy from April 2012 to Dec 2013 were enrolled. DNA was extracted from blood serum, then the HBV S gene and PC/core promoter region were amplified by semi-nested PCR and sequenced. The relationship between significant liver histological changes and viral factors were analyzed by Logistic regression analysis. Results The incidence of significant necroinflammation (15.8% vs. 27.3%, χ2 =1.398, P = 0.237) and significant fibrosis (71.1% vs. 84.4%, χ2= 1.926, P = 0.165) were found to be similar between patients infected with HBV genotype B and genotype C . By Logistic regression analysis including risk factors of age, sex, HBV genotype and mutations (T1753V,A1762T/G1764A,A1846T and G1896A), the A1762T/G1764A mutation in HBV associated with significant necroinflammation (OR = 4.296, P = 0.037), while factors of age, sex, genotype and other mutation were not associated with significant liver histological changes. (all P > 0.05). Conclusion Mutation in PC/core promoter region of HBV may act as a marker to evaluate the liver histological changes.

Objective To evaluate the preventive effect of entecavir on liver injury in chronic HBV infected patients complicated with tuberculosis receiving anti-tuberculosis treatment.Methods A total of 102 chronic HBV infected patients complicated with tuberculosis were collected from Guangzhou Eighth People' s Hospital and Guangzhou Chest Hospital during January 2011 and May 2012.Patients were divided into three groups:group A (n =33) received entecavir plus anti-tuberculosis treatment,group B (n =29) received lamivudine plus anti-tuberculosis treatment,and group C (n =40) received anti-tuberculosis treatment only.Liver injury,termination of treatment,liver function and HBV DNA load before and after treatment were observed.SPSS 13.0 was used for statistial analysis.Results Two cases (6.1％) in group A,6 cases (20.6％) in group B and 22 cases (55.0％) in group C had liver injury,and the difference among three groups was of statistical difference (x2 =22.126,P ＜ 0.01),but the difference between group A and group B was not significant (x2 =3.024,P＞0.05).One case (3.0％) in group A,3 cases (10.3％) in group B and 15 cases (37.5％) in group C terminated the treatment,and the difference among three groups was of statistical significance (x2 =16.008,P ＜ 0.01),but the difference between group A and group B was not significant (x2 =1.410,P ＞0.05).ALT and AST in group A and group B were not of significant differences before and after anti-tuberculosis treatment,but those in group C were significantly higher (Z =18.306,16.821,P ＜ 0.01).There was no significant difference in HBV DNA load among three groups before the treatment (Z =0.460,P ＞ 0.05),while HBV DNA loads in group A and group B significantly decreased during the treatment,and the difference among three groups after the treatment was significant (Z =23.213,P ＜0.01).In addition,lower HBV DNA load was observed in group A compared with group B after one month anti-tuberculosis treatment (Z =8.109,P ＜ 0.01).Conclusion Early use of entecavir can effectively prevent liver injury during anti-tuberculosis treatment,ensuring anti-tuberculosis treatment and anti-HBV treatment carried out as planned.

Objective:To express fusion protein of mouse thymic stromal lymphopoietin (TSLP) and HIV-1 gp120BAL V1/V2 subdomain in 293F cell.Methods:Full length of the V1V2 sequence from BAL isolate was fused with the C-terminus of mouse thymic stromal lymphopoietin (TSLP) and sub-cloned into pCEP-Pu vector to construct the eukaryotic expression plasmid-pCTV1V2BAL.The recombinant plasmid was confirmed by enzyme digestion and sequencing , then transfected into 293 F cells using PEI as a transfection reagent .The fusion protein was purified by metal chelate affinity chromatography and characterized by SDS -PAGE and Western blot . The epitopes of V1/V2 in fusion protein were identified by ELISA .Results:The SDS-PAGE and Western blot results showed that there were highly heterogeneous glycoprotein bands at the site between 35 kD and 55 kD, which reacted with anti-mTSLP rabbit polyclonal antibody and anti-His tag mouse monoclonal antibody .The ELISA analysis showed that antibodies to V 1/V2BAL existed in the sera of HIV-1 positive patients.Conclusion:The mTSLP-V1/V2 fusion protein was successfully expressed in 293F cells, which may be useful for HIV-1 vaccine research .

Coinfection ; Hepatitis B, Chronic ; pathology ; Hepatitis E ; pathology ; Hepatitis E virus ; Humans

Objective To investigate the influence of fat suppression technique on the parameters obtained with introvoxel incoherent motion (IVIM)for the normal hip.Methods 47 female volunteers were randomly selected to perform 1.5T MR examination with common sequence and IVIM sequence.The three different Fat suppression techniques:Fat sat,SPAIR and Water Excit were utilized respectively in T2WI sequence and IVIM sequence.The value of signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),coefficient of variation(CV), ADC,Dfast,Dslowand F values for three methods were calculated and compared quantitatively.The consistency evaluation of these methods were also conducted.Results (1)ADC value and Dslowvalue obtained with the Water Excit method were higher than those with Fat sat and SPAIR statistically(P<0.05),however there was no significant differences between the SNR,CNR,CV,Dfastand F values measured in three fat suppression methods(P>0.05).(2)The results of Fat sat and SPAIR techniques exhibited good consistency.Conclusion In Water Excit technique,overestimation of the ADC and Dslowvalues may be presented,while the IVIM measurement results are not influenced by the use of Fat sat or SPAIR method.

Objective:To investigate any effect of combining mirror visual feedback (MVF) training with robot-assisted gait training (RGT) in promoting the recovery of lower limb motor function among stroke survivors.Methods:Sixty stroke survivors were randomly divided into a combined treatment group, an RGT group and a control group, each of 20. In addition to traditional rehabilitation, the RGT group received 30min of RGT 5 days a week for 4 weeks, while the combined treatment group underwent 30min of RGT and also 20min of MVF training with the same frequency and duration. Before and after the treatment, the lower extremities motor functioning and walking ability of all of the patients were assessed using the Fugl-Meyer Assessment for the lower extremities (FMA-LE), the Berg Balance Scale (BBS) and Functional Ambulation Categories (FAC).Results:There were no systematic differences in any of the measurements before the treatment. After the 4 weeks, however, the average FMA-LE, BBS and FAC scores of the combined treatment and RGT groups were significantly better than the control group′s averages, and those of the combined treatment group were significantly superior to the RGT group′s. All of the groups had, however, improved significantly compared with before the treatment.Conclusions:Robot-assisted gait training is more effective in enhancing the motor functioning of the lower extremities and walking ability when it is combined with MVF.

ObjectiveTo study the effect of anodal transcranial direct current stimulation (atDCS) combined with mirror therapy (MT) on upper limb function for stroke patients. MethodsFrom July, 2018 to June, 2019, 54 stroke patients from the Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, were randomly divided into groups A, B and C, with 18 cases in each group. All the patients received routine medication and rehabilitation training, while group A accepted 60 minutes of MT, group B accepted 20 minuts of atDCS first and then 40 minuts of MT, and group C accepted 40 minutes of MT first and then 20 minuts of atDCS in addittion; for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), Motor Assessment Scale (MAS) and modified Barthel Index (MBI) before and after treatment. ResultsThe main effect of time was significant in scores of FMA-UE (F = 159.811, P < 0.001), ARAT (F = 353.227, P < 0.001), MAS (F = 513.494, P < 0.001) and MBI (F = 85.982, P < 0.001), and all of them improved after treatment. The main effect of groups was significant in scores of FMA-UE (F = 12.502, P < 0.001), ARAT (F = 20.095, P < 0.001), MAS (F = 16.371, P < 0.001) and MBI (F = 11.882, P < 0.001). The interacted-effect between time and groups was significant in scores of FMA-UE (F = 37.659, P < 0.001), ARAT (F = 78.681, P < 0.001), MAS (F = 97.997, P < 0.001) and MBI (F = 48.015, P < 0.001); while all the scores were the best in group B (P < 0.01), and there was no significant difference between groups A and C (P > 0.05). ConclusionThe combination of atDCS first and then MT can promote the recovery of motor function of the affected limbs for stroke patients.