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 performances in line bisection(LB)and line cancellation(LC)tasks of patients with unilateral neglect.Methods The unilateral neglect patients,performances in LB and LC tasks before and after rehabilitation treatment were retrospectively analyzed.Results Before treatment,statistical analyses revealed the patients,performances in LC and LB tasks did not differ from each other(P =0.902).After treatment,statistical analyses revealed a significant difference between the two tasks(P =0.007).With LB only,29/30(97%)patients with neglect were detected;with LC only,22/30(73%)patients with neglect were detected.Conclusions As the performances of unilateral neglect patients improved,patients revealed difference between the performances in LB and in LC tasks.One test alone would miss some subjects with neglect.Combinative use of the two tests was more sensitive than either of the 2 tests alone.

purpose: to investigate the adhesive properties of renal tubular epithelial cells on matrigel and compared with the following three cases: ischemia、hypoxia and ischemia & hypoxia(I/H).materials and methods: A micropipette aspiration technique was adopted to determine the adhesive mechanics of renal tubular epithelial cells on matrige. results: it showed that the adhesion of renal tubular epithelial cells on matrigel was higher than that of those three model, further more, a different factor was followed by different adhesive mechanic. conclusion: the adhesion of I/H is lower, the ischemia is higher, but all were lower compared with control. It suggested that effect of hypoxia on adhesive properties of renal tubular epithelial cells on matrigel is bigger than that of ichemia.

Objective Toinvestigatetheeffectofpowerelectricalstimulation(PES)incombination withtask-specifictrainingonlowerextremitymotorfunctioninstrokepatientswithfootdrop.Methods Fifty patients with poststroke foot drop were enrolled retrospectively. They were divided into either an experimental group or a control group (n=25 in each group). The control group received routine rehabilitation treatment. On this basis,the experimental group was given PES in combination with task-oriented training. Both groups of patients were trained 2 times a day,once for 40 minutes,5 days a week for 6 weeks. The ankle active range of motion,plantar flexor muscle tension,and tibialis anterior muscle strength were determined before and after treatment. The balance and lower extremity motor function of the patients were assessed by using Berg balance scale score,Fugl-Meyer lower extremity score,modified Barthel index,and Holden walk grading. At thesametime,thewalkingspeedandsteplengthbeforeandaftertreatmentwerecompared.Results Six weeks after treatment,the ankle activity,plantar flexors tension,and tibialis anterior muscle strength scores in patients of the experimental group were improved compared with before treatment,and each indicator was significant better than the control group (t=6. 261,-6. 163,and 2. 968,respectively;all P<0. 05). Berg balance scale,walking speed and step length scores were also improved as compared with before treatment, and each indicator was better than the control group (t=10. 733,9. 074,and 9. 013,respectively;all P<0.01). The lower limb motion scores,modified Barthel indexes,and Holden walk grading scores were improved compared with before treatment,and each indicator was significantly better than the control group (t=3.261,7.573,and4.010,respectively;allP<0.05).Conclusion Usingpowerelectricalstimulation in combination with task-oriented training may effectively improve the lower extremity motor function in stroke patients with foot drop.

Objective To investigate the effect of lower limb rehabilitation training robot combined with task-oriented training on walking ability after stroke. Methods From February 2014 to August 2015,74 consecutive patients with post-stroke who received rehabilitation therapy and met the inclusion criteria admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were collected prospectively. They were all the patients with the first-ever stroke for 1 to 12 months. They were divided into either an observation group (n = 39)or a control group (n = 35)according to whether they were treated with the lower-limb rehabilitation robot. The patients of both groups received task-oriented training,2 times a day,once for 20 min,5 days a week for 12 weeks. The observation group was also treated with the lower-limb rehabilitation training robot,1 time a day,once for 30 min,5 days a week. Berg balance scale,Fugl-Meyer assessment (FMA),timed up-and-go test (TUG)and knee flexion active range of motion (KFAROM)were used to assess the efficacy. Results (1)After treatment,the Berg scale and FMA scale scores were increased in the observation group and the control group compared with before treatment. There was significant difference (Berg scale:28 ±9 vs. 22 ±9,29 ±9 vs. 24 ±9;FMA scores:47 ± 8 vs. 36 ± 8,40 ± 6 vs. 36 ± 7;all P < 0. 01),however,there was no significant difference between the two groups (P <0. 05),and there was significant difference in FMA scores between the 2 groups (P < 0. 01 ). The differences of Berg scale scores in the observation group and the control group were 10. 75 + 0. 30 and 4. 71 + 0. 14 respectively before and after treatment. There was no significant difference between the 2 groups (t = 0. 95,P = 0. 345). The differences of FMA scores in the observation group and the control group were 5. 8 ±0. 6 and 4. 9 ±0. 8 before and after treatment (t =5. 16,P <0. 01). (2)After treatment,the tug test and KFAROM of the observation group and the control group were better than those before treatment. There were significant differences (TUG test:35 ± 13 s vs. 56 ± 18 s,53 ± 17 s vs. 58 ± 18 s;KFAROM:82 ± 24° vs. 60 ± 23°,63 ± 23° vs. 57 ± 26°;all P < 0. 01),and there were significant differences between the 2 groups (all P < 0. 01). The differences of the TUG test in the observation group and the control group before and after treatment were 21. 5 ± 5. 0 and 4. 6 ± 0. 6 s respectively. There was significant difference between the 2 groups (t = 9. 55,P < 0. 01);the differences of KFAROM in the observation group and control group before and after treatment were 5.8 ±0.6° vs. 4.9 ±0.8° respectively. There was significant differences between the 2groups (t =4.17,P <0. .01). Conclusion Lower limb rehabilitation training robot combined with task-oriented training may improve the lower extremity motor function,walking ability,knee flexion joint activity of the patients after stroke,but the improvement effect of the lower limb balance is not obvious.

Objective To investigate the effect of integrated swallowing function rehabilitation training on nasal feeding patients with pseudobulbar palsy or bulbar palsy after acute ischemic stroke. Methods A total of 54 patients met the diagnosis criteria were enrolled prospectively. They were divided into either an integrated group (n=31)or a control group (n=23)using a random number table method. The patients of the control group received routine treatment of stroke,including brain protection therapy,improvement of cerebral circulation,dehydration,regulating blood pressure,and symptomatic treatment,etc;in addition to conventional treatment,those of the integrated group also received integrated swallowing function rehabilitation training,including neuromuscular electrical stimulation plus swallowing reflex facilitation technique,and oral facial glossopharyngeal function training,etc. The oral intake function in patients of the integration and pseudobulbar palsy or bulbar palsy (according to MRI and signs)was compared between the two groups. The evaluation index was the Functional Oral Intake Scale (FOIS)score. Results (1)The FOIS score (median 4)of the integrated group was higher than that of the control group (median 2). There was significant difference between the two groups (P<0. 01). There was also significant difference before and after comparison between the two groups. (2)The FOIS score of pseudobulbar palsy in the integrated group was higher than that of the control group (median scores 4 and 2 ). There was significant difference (P<0.01);There was no significant difference in the FOIS scores of bulbar palsy between the two groups,but the FOIS score of the integrated group was higher than that of the control group (median scores 4 and 3). (3)The median differences between the integrated group and the control group were 2 and 1 respectively. The increased amplitude of FOIS of the integrated group was higher than that of the control group. There was significant difference (P<0. 01). Conclusion The integrated swallowing function rehabilitation training can improve the oral intake function,significantly reduce irritating cough,increase the capacity of oral intake,and increase the types of food. The effect of the improvement of pseudobulbar palsy is more significant in the integrated group.

Objective To explore the application of evidence-based medicine in rehabilitation therapy in clinical teaching. Methods 45 interns were divided into 2 groups. The interns during July, 2011 to April, 2012 as the control group (n=23) received the traditional teaching method and the interns during July, 2012 to April, 2013 as the test group (n=22) accepted the evidence-based medicine teaching method in addition. They were assessed with the test scores of theory and operation, and questionnaires. Results The operation scores and the total scores were higher in the test group than in the control group (P<0.05). The satisfaction was better in the test group than in the control group in the items of improving the ability of self-study, taking the initiative, developing clinical thinking, improving the ability of obtaining information, improving the ability of selecting literature, improving the ability of analyzing and summarizing, improving their overall level and degree of satisfaction with this teaching method (P<0.05). Conclusion The evidence-based medicine teaching method can facilitate to improve the practical skills, cultivate the clinical thinking and improve the overall level for students in rehabilitation therapy in clinical practice.

Difference between transcranial magnetic stimulation and transcranial direct current stimulation in theory, safety, detection of brain function and clinic treatment were reviewed in order to help reasonably select and effectively apply them in clinic.

Objective To study the potential mechanism of recovery from dysphagia after surface electrical stimulation. Methods 3 cases recovery from dysphagia caused by lower brainstem infarction after surface electrical stimulation of lower mandible and trigeminal nerves were analyzed. Results After 3～16 weeks surface electrical stimulation, the swallow assessment scores reached from 0 to 6 in all the 3 patients. Conclusion Surface electrical stimulation can facilitate the recovery of swallow function, which may be involved with the sensory input, especially the integration of nucleus of the solitary tract (NTS).

Objective To explore the effect of goal-oriented repetitive training on motor function of upper limb in patients with stroke. Methods From March, 2014 to February, 2016, a total of 60 stroke patients were randomly divided into experiment group (n=30) and con-trol group (n=30). Both groups received routine rehabilitation, while the experiment group received goal-oriented repetitive training in addi-tion, 30 minutes once a day, 5 days a week for 4 weeks. They were assessed with simple Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel index (MBI) before and after training. Results There was no difference in the scores of FMA-UE and MBI between two groups before training (Z<1.153, P>0.05). The scores of FMA-UE and MBI significantly improved in both groups after treat-ment (Z>5.645, P<0.001), in which the scores were higher in the experiment group than in the control group (Z>2.275, P<0.05), as well as the D-value of scores before and after training (t>5.770, P<0.001). Conclusion Goal-oriented repetitive training could promote the recovery of upper limb motor function in patients with stroke.