BACKGROUND: With the development of China, quality of life (QOL) is getting more and more attention, however, there are few studies on QOL, especially in Mainland China.OBJECTIVE: To observe the situation of combinative application of Functional Independence Measure (FIM) and QOL assessment in rehabilitation clinical practice.DESIGN: Case analysis.SETTING: Zhongshan Hospital of Fudan University.PARTICIPANTS: Totally 83 rehabilitation patients selected from Shanghai Zhongshan Hospital from January to December 2003,consenting to take part in the study, were divided into 4 groups: bone & joint rehabilitation(n=42), stroke rehabilitation (n=17), internal medicine (n=15), and cancer rehabilitation (n=9).METHODS: Every patient carried out functional independence assessment and quality of life measurement within 24 hours of admission. FIM was adopted for functional independence assessment which included 13 items of motor (ranged from 13 to 91 points) and 5 items of cognition (ranged from 5to 35 points), and FAQ for quality of life included making telephone call,self-care economy, shopping, using vehicle, housework, jobs, entertainment,etc. with 100 in total. The author performed all the assessment.MAIN OUTCOME MEASURES: Every patient carried out FIM and FAQ assessment after admission and discharge.RESULTS: All data of totally 83 patients entered the final analysis. [1]The average age and length of hospital stay in stroke group were higher than those in other groups (P ＜ 0.01). [2] FIM motor and cognitive scores in stroke group were higher at discharge than those at admission (5.276,3.624;6.200,5.941,P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (1.253, 1.547, P ＜ 0.01). [3]In bone joint group, the FIM cognitive scores were coincidence in general, while motor scores were higher at discharge than those at admission (6.220,5.388, P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (0.610, 0.912, P ＜ 0.01). [4] Only scores of functional activity in tumor group were lower at discharge than those at admission (0.722, 0.989, P ＜ 0.05). [5] All items in internal medicine group were coincidence in general (P ＞ 0.05).CONCLUSION: FAQ is more sensitive than FIM in rehabilitation practice, but cannot replace FIM, and should be used with FIM.

Aim To explore the effect of N-acetyl-L-cysteine ( NAC ) on β amyloid peptide 25 - 35 ( Aβ25-35 )-induced the increase of calpain activity and its possible mechanism. Methods The activity of cal-pain was induced by 20μmol·L-1 Aβ 25-35 in primary cortical neuron. Neurons were incubated in the absent or present Aβ25-35 , or pre-incubated NAC ( 10 mmol ·L-1 ) , then co-incubated with Aβ25-35 . The meas-urement of calpain activity, H2 O2 level and mitochon-drial membrane potential was performed on a micro-plate fluorometer. The ATP level was detected using a luciferin/luciferase based ATP assay kit. Results In Aβ25-35 treated group, the activity of calpain and H2 O2 was obviously higher than that in control group. How-ever, in neurons pre-incubated in NAC and then co-in-cubated in Aβ25-35 , the calpain activity and H2 O2 level were significantly decreased compared with that in Aβ25-35 group. Upon Aβ25-35 exposure for 12 h, corti-cal neurons showed a significant decrease in mitochon-drial membrane potential and ATP level when com-pared to the control group. Pre-treatment with NAC showed an increase in mitochondrial membrane poten-tial and ATP level as compared to neurons treated with Aβ25-35 alone for 12h. Conclusion This result sug-gests that NAC can attenuate calpain activity induced by Aβ25-35 through protecting mitochondria.

Objective To study the effect improvation of lung function and prognosis of singulair and seretide for moderate to severe AECOPD . Methods 78 patients associated with moderate to severe AECOPD from January 2014 to June 2016 in our hospital were researched.They were divided randomly into observation and control groups according to the order of admission, 39 cases in each group.In the control group, they were treated by conventional anti-infective, expectorant, oxygen, suction seretide.In the observation group, using singulair on the basis of the control group.Clinical data, clinical efficacy, clinical symptoms begin to improve time, hospitalization time, blood gas analysis (PaO2, PaCO2) after five days and pulmonary function after treatment forced expiratory volume in one second ( FEV1 ) , call gas peak velocity ( PEF) , forced expiratory volume in one second than the forced vital capacity (FEV1/FVC), maximum mid-expiratory flow rate (MMEF) were compared with each other.Results Their clinical data of patients and other general information and basic condition had no significant difference between each other.The effective rate of observation group and control group were 97.44%and 87.18%, clinical effecicy of observation group was better than the control group, the difference was statistically significant (u=2.2805, P<0.05).Postoperative hospital stay, time of symptoms began to improve of the observation group were shorter than the control group, the difference was statistically significant (P<0.05), PaO2 of 5-day post-treatment of observation group was higher, and PaCO2 was lower, the difference was statistically significant (P<0.05).Lung function of two groups of patients had no significant difference before treatment, after treatment, pulmonary function in the observation group (including FEV1, PEF, FEV1/FVC, MMEF) was better than the control group, the difference was statistically significant (P<0.05).Conclusion Seretide combined with singulair to treat severe AECOPD has a good effect, it can significantly improve the therapeutic effect and improve the patient's lung function.

0.05) . Tube re-adhesion rate was 10.7% and 17.9% (P

Objective To investigate the features of the memory function disturbance in patients of generalized seizures and the correlation between the memory function and proton magnetic resonance spectroscopy(1H-MRS).Methods The clinical memory scale of 45 general seizures and 20 normal age and sex-matched controls wss measured and a1 H-MRs was performed in the bilateral hippoeampal.The levels of NAA.Cho.Cr and the ratios of NAA/Cr+Cho were compared between these two groups.Meanwhile,tHe correlation coefficients was calculated and the results of clinical memory scale scoreB and the level of NAA,Cho.Cr and the ratios of NAA/Cr+Cho in groups were compared.Results As compared with the controls.the scores of pointing memory(17.19±5.86),associational learning(20.00±6.77),image free memory(18.44±6.62),association memory of portrait(13.19±6.62)and memory quotient (MQ,79.07±20.20)excepts insignificant figure recognition wcrc significandy decreased in patients of seizures(t=4.794-10.224,all P<0.01);The scores of scale and MQ of both the group of patients who wok antiepileptic drugs(AEDs)and the group of patients whose frequency exceeded 3 per month were significantly lower than the group who didn't take AEDs and the group whose frequency was lower than 3 per month(t=3.267-6.537,all P<0.01).The volumes of hippocampal formations(2.45 ±0.25 on left and 2.56 ±0.31 on right),the level of NAA(12.93 ±1.73 on left and 11.88 ±1.69 on right),Cho(15.02 ±0.86 on left and 14.94 ±0.96 on right),Cr(11.86 ±0.71 on left and 10.71 ±0.42 on right)and the ratios of NAA/Cr+Cho(0.48 ±0.08 on left and 0.39 ±0.07 on riht)in the group of pailents of generalized seizures were significantly difference than those in the controls(t=4.103-5.768,all P<0.01).Patients with seizures showed significant correlation between tlle scores of all items.MQ in clinical memory scale and NAA,NAA/Cr+Cho ratio(r=0.489-0.727,all P<0.01),and inverse correlation between the scores and MQ and Cho of in the bilateral hippocampal(r=-0.604-0.484,all P<0.01).However,there was no correlation between the scores and MQ and Cr of in the bilateral hippocampal.Condusions The patients of the general seizures do have the problem of the disturbance of short-term memory including acoustic memory and some visual memory.Both the high frequency of seizure and AEDs could affect the short-term memory function.The correlation between the scores of all the items and MQ in clinical memory scale proved that lack of nerve cell and hyperplasia of gliocyte was one of the reasons of the short-term memory disorder in epileptic.

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.

Objective To evaluate the application of modified Abbe flap in repairing moderate defects of the upper lip and time point to divide the pedicle.Methods Classic Abbe flap was modified in its design,pedicle cutting and dividing time,which was used to repair moderate defect of the upper lip in 12 cases.Surgery was divided into two phases:one with modified Abbe flap surgery was performed for the combined nasal deformity repair simultaneously,and then the pedicle was divided 9days after surgery.Results 12 patients underwent modified Abbe flap.No vascular complications were found in these flaps.Upper lip shape was well and satisfactory functional recovery,corresponding improvement in nasal appearance.Conclusions The surgery that the modified Abbe flap with the pedicle is divided 9 days after surgery is very simple.On one hand,it greatly improves the patient's appearance and function of the upper lip,improve the overall shape of midface,on the other hand,dividing pedicle time is significantly shorter than in the past,specially reducing the suffering of patients and duration.It is particularly suitable for unilateral and bilateral cleft lip of the upper lip on secondary moderate deformities and combined nasal deformities.

Objective To systematically assess the efficacy of memantine on moderate to severe Alzheimer's disease (AD).Methods With the evaluation method of the Cochrane system,searches were made in the Cochrane Library,MEDLINE,Embase,Forest Laboratories,CNKI,Wanfang Data,and VIP Data up to February 2013 for double blind,randomized,and placebo-controlled trials (RCTs) evaluating the efficacy of memantine for moderate to severe AD.A meta-analysis of included clinical trials was conducted using the Revman 5.2 software to evaluate the efficacy of memantine on overall clinical status,cognitive function activities of daily living,and behavioral and psychological disturbances.Results A total of 8 RCTs were included (2 527 patients with moderate to severe AD).Results of the meta-analysis showed that,for patients with moderate to severe AD,memantine had better efficacy than placebo on overall clinical status,cognitive function,and activities of daily living (MD=-0.24,95％CI:0.340.15;SMD=-0.26,95％CI:-0.340.18;SMD=-0.13,95％CI:-0.21-0.05),but there was no significant difference in efficacy on behavioral and psychological function between memantine and placebo (P =0.08).Analysis of subgroups showed that memantine had better efficacy than placebo on cognitive function in moderate AD patients (SMD =-0.22,95％CI:-0.37 0.06) and on overall clinical status,cognitive function,and activities of daily living in severe AD patients (MD-0.29,95％CI:-0.40 0.18;SMD=-0.31,95％CI:0.46-0.15;SMD=-0.16,95％ CI:-0.25 0.06;MD=-3.13,95％ CI:-4.88-1.39;respectively).Conclusions Memantine has efficacy on overall clinical status,cognitive function and activities of daily living in patients with moderate to severe AD,especially in patients with severe AD.

Objective To explore the incidence of olfactory dysfunction in patients with Parkinson disease and the characteristic as well as its possible influencing factors. Methods The SS-12 was used to evaluate the olfactory function of 106 patients with Parkinson's disease and 110 healthy volunteers. The data was then compared between the two groups to investigate the correlation of olfactory function with age, gender, education, smoking, disease duration, Hohn-Yahr stage, UPDRSⅢscores, the dosage of levodopao and olfactory scores. Results Mean identification scores were significantly lower in patients(5.97 ± 2.27)than in controls(8.04 ± 2.00)(t=7.108, P=7.108). Parkinson's disease group did worse than the control group in identifying some odors including peppermint, bananas,liquorice,coffee,pineap?ple,rose and fish (P<0.05). Receiver Operating Characteristic curves revealed that 7.5 was the best olfactory dysfunc?tion diagnostic boundary value with 67.3%sensitivity and 73.6%specificity. Thus, the incidence of olfactory dysfunc?tion in Parkinson's disease was 73.6%. Correlation analysis showed that gender(rs=0.243, P=0.012), education(rs=0.208, P=0.032) and smoking(rs=0.279, P=0.279) were associated with odor identification ability, while age, disease du?ration, Hohn-Yahr stage, UPDRSⅢscores and the dosage of levodopa were not related with odor identification abilityin Parkinson disease (P>0.05). Conclusion Olfactory dysfunction occurs in Parkinson disease with an hign incidence rate. Olfactory function has nothing to do with disease duration, Hohn-Yahr stage, UPDRSⅢscores and the dosage of levodopa in Parkinson disease.

Objective To investigate the impact of hypoxia on the expression of early growth response-1 (Egr-1) and monocyte chemoattractant protein-1 (MCP-1) in mouse aorta,and to probe the underlying mechanism involving receptor for advanced glycation end-products (RAGE).Methods 3-month-old C57BL/6 mice were subjected to hypoxia [(6.0±0.5) ％ oxygen] to establish the global hypoxia model(n=6 rats for each).Aortas were dissected,Egr-1 mRNA and MCP-1 mRNA were detected by real time RT-PCR,Egr-1 and RAGE proteins were tested by Western blot,and Egr-1 DNA binding activity was assayed by electrophoretic mobility shift assay (EMSA).For blockade of RAGE,mice were pretreated with soluble RAGE (sRAGE) for 1 h by intra-peritoneal injection before they were exposed to hypoxia.Mice with normoxia were used as controls.Results After 30 minutes of hypoxic exposure,Egr-1 mRNA in aorta was increased to (28.3±0.9)folds compared with normoxic controls (F=617.17,P＜0.01),and the induction persisted for at least 3 hours.After 45 minutes of hypoxic exposure,Egr-1 proteins in aorta was increased to (5.7 ± 0.3) folds compared with normoxic controls (F =57.18,P＜ 0.01); the enhanced DNA binding activity of Egr-1 by hypoxia was attenuated by pretreatment with anti-Egr-1 lgG.After 4 hours of hypoxic exposure,MCP-1 mRNA expression in aorta was increased to(4.0±0.3)folds compared with normoxic controls (F=30.68,P＜0.01).RAGE antigen was increased significantly within 30 minutes of hypoxic exposure,with the peak at 15 minutes; hypoxia-induced Egr-1 mRNA expression was significantly attenuated by pretreatment with sRAGE (3.3 ± 0.2) folds compared with normoxic controls (F =30.20,P＜0.01).Conclusions Hypoxia significantly induces Egr-1 and MCP-1 upregulation expressions in mouse aorta,and blockade of RAGE significantly attenuates hypoxia-induced Egr-1 expression.Thcsc findings suggest RAGE signaling is involved in hypoxia-induced vascular inflammatory stress,and highlight this receptor as a potential therapeutic target to protect tissues injured by hypoxia.