Objective To investigate the feasibility of implementing the 24 hours treatment and management model of children with cerebral palsy in Shanghai,in order to provide a set of effective and saving manpower,material and financial rehabilitation and management model for children with cerebral palsy.Methods Firstly,the 10 exports engaged in cerebral palsy rehabilitation were selected as the in depth interviewees by the sampling method of grounded theory.Secondly,applying in depth interviews,the 10 exports were interviewed by designing interview outline and subjects.Last,the interview data were collected and analyzed.Results By analyzing the interview data in three-stage coding mode,three factors affecting the feasibility of 24 hours treatment and management model of children with cerebral palsy in Shanghai were obtained,including the favorable factors,obstacles and necessary factors.Conclusions The 24-hour treatment and management model of children with cerebral palsy in Shanghai is feasible,but it will encounter some obstacles in the implementation process.Through the policy support for health care and education sectors,the feasibility of the pattern will be greatly enhanced.

Purpose To investigate the value of strain ratio (SR) measure and improved 5-scoring system of ultrasonic elastography in the differentiation of benign and malignant breast tumors.Materials and Methods The data of 213 patients with breast cancer confirmed by pathology or surgery were retrospectively studied.All the patients underwent ultrasonic elasticity imaging examination and were evaluated by strain ratio (SR) method and improved 5-scoring system.Taking pathology as gold standard,we measured the sensitivity,specificity and accuracy of the two methods and evaluated the diagnostic efficiency.Results The area under curve (AUC) and 95％ CI of SR measure was 0.926,0.871-0.980 and that of improved 5-scoring system was 0.921,0.870-0.973.The best diagnostic limit of SR was 3.055,when SR ＞ 3.055,the lesions was malignant,when SR＜3.055,the lesions was benign.The sensitivity,specificity and accuracy of SR and improved 5-scoring system in diagnosing malignant breast lesions were 92.1％,92.7％,92.5％ and 85.5％,83.9％,84.5％,respectively.The specificity and accuracy of SR was higher than the improved 5-scoring method,the difference was statistically significant (P＜0.05),but there was no significant difference in sensitivity (P＞0.05).Conclusion SR is more objective in diagnosing malignant breast tumors,which has higher diagnostic value than improved 5-scoring system.

In this paper, 6 kinds of SCI-indexed international rehabilitation journals and all the articles published in 3 kinds of China Rehabilitation Source Journals in recent 1 year were counted. This article compared the difference of research methods and topics of the direction between our country and foreign countries were compared, analyzed the basic principles of rehabilitation medicine and influencing factors about the topics, and the future trends in rehabilitation research.

Objective To investigate factors and neonatal outcomes associated with histologic chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM).MethodsFrom Jan.2008 to Jun.2011,230 women with PPROM at 28 -33 +6 weeks of gestation undergoing deliveries in the Second Affiliated Hospital of Wenzhou Medical College were studied retrospectively.According to placental histopathologic findings,those patients were categorized into two groups,including 138 cases in histologic chorioamnionitis (HCA group ) and 65 cases in non-chorioamnionitis (control)group.Age,parity,gestational age of PPROM and delivery,latency period,oligohydramnios,white blood cell (WBC) count and serum C-reactive protein (CRP) level at admission and before delivery,the incidence of neonatal respiratory distress syndrome (NRDS),neonatal pneumonia,bronchopulmonary dysplasia,necrotizing enterocolitis,early-onset neonatal sepsis,abnormal brain sonography findings and mortality were compared between two groups.Results( 1 ) The incidence of HCA was 68.0.％ ( 138/203 ) in all 203 cases with PPROM.(2) The occurring ruptured membrane gestation in HCA group was ( 31.1 ± 1.5 ) weeks,which were significantly earlier than (32.0 ± 1.3 ) weeks in control group ( P ＜ 0.05 ).The level of CRP of (8.2 ± 14.9) mg/L before delivery in HCA group was significantly higher than (5.5 ±7.2) mg/L in control group (P ＜ 0.05).The rate of oligohydramnios and cesearean sections were 55.1％ (76/138) and 45.7％ (63/138) in HCA group,which were significantly higher than 30.8％ (20/65) and 29.2％ (19/65) in control group (P ＜0.05).There were no significant difference in patient's age,parity,WBC count and CRP at admission between two groups (P ＞ 0.05 ).The latency period did not show significant difference between (140± 116) hours in HCA group and (129 ± 125) hours in control group (P ＞ 0.05).(3) Using multivariable logistic regression models,oligohydramnios ( OR =2.937 ),gestational age of PPROM ＜ 32 weeks ( OR =2.352),serum CRP level ＞ 8 mg/L before delivery ( OR =4.923 ) and latency period ＞ 48 -168 hours (OR =4.439) were significantly associated with HCA (P ＜0.05).(4) The gestational age of delivery and birth weight of HCA group were significantly lower than those of control group [ ( 32.0 ± 1.5 ) weeks vs.( 32.7 ± 1.5 ) weeks,( 1680 ± 379) g vs.(2017 ± 333) g,respectively,P ＜ 0.05 ].The incidence of Apgar ＜7,abnormal brain sonograhy findings, neonatal pneumonia,bronchopulmonary dysplasia,early-onset neonatal sepsis and mortality in HCA group were significantly higher than those in control group [20.3％ (28/138) vs.7.7％ (5/65),14.5％ (20/138) vs.4.6％ (3/65),12.3％ (17/138) vs.3.1％(2/65),5.8％ (8/138) vs.0,6.5％ (9/138) vs.0,12.3％ (17/138) vs.3.1％ (2/65),respectively,P ＜ 0.05 ].The incidence of necrotizing enterocolitis ( 1.5％,2/138 ) in HCA group was higher than that of controlgroup(0) and the incidence of NRDS ( 18.8％,26/138) in HCA group did not show statistical difference with 21.4％ ( 14/65 ) in control group ( P ＞ 0.05 ).ConclusionsIt was found that HCA was significantly correlated with lower gestational age of PPROM,higher serum CRP level before delivery,prolonged latency period and oligohydramnios in PPROM.HCA could increase the neonatal morbidity and mortality.

OBJECTIVE:To optimize the formulation of Dimemorfan phosphate tablets. METHODS:Using 60 min dissolution rate of dimemorfan phosphate as index,L9(34) orthogonal test was used to optimize the amount of starch,microcrystalline cellu-lose,croscarmellose sodium and concentration of HPMC E5 solution. The friability,hardness,60 min dissolution rate and main component were detected. The similarity of dissolution curves of Dimemorfan phosphate tablets was compared with that of imported tablets in 0.1 mol/L hydrochloric acid,pH 6.8 phosphate buffer,water and pH 4.0 acetate buffer. RESULTS:The optimized formu-lation of Dimemorfan phosphate tablet(1 000 tablets)was composed of dimemorfan phosphate 10 g,starch 60 g,microcrystalline cellulose 40 g,10% HPMC E5 solution and croscarmellose sodium 25 g. The friability,hardness,60 min dissolution rate and main component of 3 batches of Dimemorfan phosphate tablets prepared by optimized prescription were 0.42%-0.58%,9.8-10.5 kg,94.89%-96.21% and 99.21%-99.52%,respectively. In 4 dissolution mediums,similar factors f2 of dissolution curves between prepared tablets and imported tablets were above 50. CONCLUSIONS:Dimemorfan phosphate tablets were prepared successfully. The optimized formulation is rational. The dissolution behavior of prepared tablets is similar to that of imported tablets in vitro.

Objective To construct a scientific,valid evaluation system for excellent clinical nurses.Methods Based on the framework of competency theory,systematic literature reviewing,nursing experts discussion and the Delphi method were used to determine the primary indexes for the evaluation system.The evaluation system was determined from three perspectives,doctors',nurses' and patients'.Analytic Hierarchy Process (AHP) was then used to determine the weight of each index.Results The weight of doctors',nurses' and patients' perspective was 0.2,0.4,0.4 respectively.Doctors' and nurses' perspective(hereinafter referred to as staff's perspective) had the same evaluating indexes,which both consisted of 5first-dimensions,22 second-dimensions.The patients' perspective contained 3 first-dimensions,14 seconddimensions.In two-round Delphi technique,the rates of questionnaire retrieve were 91.2％ (31/34),100.0％(31/31),respectively;the colleagues' coordination coefficients were 0.784,0.858,respectively,and the patients' coordination coefficients were 0.05,0.216,respectively.Conclusions A evaluation system of high reliability and validity for excellent clinical nurseshas been successfully constructed.It may be utilized as a tool to for nursing administrator selection,training,assessment of excellent clinical nurses.

BACKGROUND:Tai Chi exercise can relieve the decreasing lung function and increase exercise tolerance in patients with chronic obstructive pulmonary disease, but some studies found that Tai Chi exercise did not achieve the desired improvement effect in patients. OBJECTIVE:To objectively evaluate the rehabilitation effects in lung function and exercise endurance of Tai Chi exercise on old patients with stable chronic obstructive pulmonary disease. METHODS:A computer-based online retrieval of PubMed, EMBASE, Web of Science, The Cochrane Library, CNKI, VIP and WanFang databases between January 1980 and July 2014 were searched. Randomized control ed trials of Tai Chi intervening in old patients with chronic obstructive pulmonary disease were col ected, including Tai Chi exercise intervention group and drug or physical education control group. RESULTS AND CONCLUSION:A total of 6 randomized control ed trials were included, with 406 patients. The results of Meta-analyses showed that, compared with the control group, Tai Chi exercise obviously improved the percentage of forced expiratory volume in one second/forced vital capacity (MD=4.62, 95%CI:0.73-8.51, P=0.02), the percentage of forced expiratory volume in one second to the prediction value (MD=4.95, 95%CI:0.33-9.57, P=0.04) and 6-minutes walking distance (MD=33.81, 95%CI:6.00-61.62, P=0.02) in patients with chronic obstructive pulmonary disease. Forced expiratory volume in one second showed no significant difference between Tai Chi exercise intervention group and control group (MD=0.02, 95%CI:-0.10, 0.14, P=0.76). Tai Chi exercise could improve the lung function and exercise endurance in old patients with stable chronic obstructive pulmonary disease, and has positive rehabilitation effects.

Objective To investigate the effect of labetalol in treatment of severe preeclampsia clinical effect.Methods The control group of severe preeclampsia patients received routine clinical treatment,the study group were treated with labetalol,two groups of patients with severe preeclampsia were treated for 7 d.Results After treatment,the two groups of DBP,SBP,HR,and 24 HUP were significantly lower than before,the study group improved the above indicators better(P<0.05).The study group of patients with severe preeclampsia premature delivery rate,postpartum hemorrhage rate,neonatal asphyxia rate(10.20%,8.16%,6.12%)were significantly lower than the control group(28.57%,34.69%,20.41%)(P<0.05).Conclusion The application of conventional therapy combined with labetalol can significantly improve the hypotensive effect of severe preeclampsia,is conducive to the protection of maternal physical and mental health and life safety.

Objective To investigate the learning styles of students for rehabilitation therapy. Methods 265 students of 4 grades were investigated with VARK Questionnaire (version 7.0). Results and Conclusion The maximums distributed mainly in the K dimension, with multi-style, mild tendency. For those with single-style, it was tended to K. The learning styles of the students transferred from mainly multi-style (quaternity the most) to single-style with the grades.

Objective To explore the effect of β-amyloid protein (Aβ) on S100β expression in rat hippocampus and its mechanisms. Methods At 7 days after bilateral stereotaxis injection of different dose of fibrillar Aβ 25-35 and interluekin-1 receptor antagonist (IL-1ra) into the rat CA1 region, the learning and memory abilities of rats were tested with passive avoidance task. Amyloid deposition was detected by using Congo red staining technique. Nissl staining and immunohistochemical techniques were used to analyze the number of neurons, and GFAP and the S100β expression in hippocampal CA1 region , respectively. Results After fibrillar Aβ injection, the step-through latency of rats was significantly shortened compared to that of the control group. The GFAP positive astrocytes were found surrounding amyloid deposition. Neuronal loss occurred in the pyramidal cell layer of CA1 region. The number of S100β positive cells in Aβ-treated group was significantly increased compared with that in the control group. After IL-1ra injection, the number of S100β positive cells was significantly decreased. Conclusion Intrahippocampal injection of Aβ 25-35 could cause similar pathologic changes of Alzheimer's disease. Aβ 25-35 was capable of up-regulating S100β expression in a dose-dependent manner. The injection of IL-1ra could attenuate the effect of Aβ on S100β expression.