Because of the population aging,the increase of the stroke patients and the need for rehabilitation,the treatment only in the rehabilitation department of the hospital is far from the satisfaction of people's demands of the service of rehabilitation.It is important to extend the community-based rehabilitation.Compared with the rehabilitation in hospitals,it is more economy,efficiency and convenience for stroke patients in community-based rehabilitation services,and further improve the rehabilitation effect of stroke patients.

Aim To explore the effects of anti-HER-2 chimeric antibody chA 21 on proliferation and apoptosis of SKBR3 cells.Methods MTT colorometric assay,HE staining,transmission electron microscopy,flow cytometry,and TUNEL were used to study the proliferation inhibition and apoptosis induction of SKBR3 cells by chA 21 in vitro.Results Proliferative inhibition rates and apoptotic index of SKBR3 cells were increased in a dose and time dependent manner after exposure to chA21(0.2～5.4 mg?L~(-1)).Conclusion chA 21 could remarkably inhibit proliferation of SKBR3 cells in vitro and apoptosis induction may be one of its main mechanisms.

Objective To describe the treatment experience of post-operative complications after total arch replacement for acute type A aortic dissection in 34 cases.Methods The subjects were 34 consecutive patients (Twenty-eight males and 6 females,age 34.0 -60.0 yrs) who received total arch replacement for acute Stanford type A aortic dissection from Jan.2005 to Oct.2010 in our hospital.The duration from the onset of the symptoms to the hospitalization ranged from 4 - 18 hrs.Pre-operative 2-D Echo revealed aortic valve regurgitation in 8 patients and mitral valve regurgitation in 1 patient.Results Three patients died after operation ( mortality 8.8％ ).Severe complications included acute kidney injury in 13 cases,respiratory dysfunction in 12 cases,paraplegia in 1 case,mental disorder in 10 cases and excessive post-operative bleeding in 2 cases.Conclusion The incidence of the complications after total arch replacement is still high and severe.Intensive care should be stressed peri-operatively and early diagnosis and treatment for post-operative complications are important procedures.

Objective To evaluate the clinical significance of the change of serum matrix metalloproteinases (MMP)-1,-2,-3 and -9 in acute and chronic aortic diseases and acute myocardial ischemia.Methods The blood serum levels of MMP-1,-2,-3 and -9 were detected in 30 patients with acute aortic dissection,19 patients with chronic aortic dissection,19 patients with aortic aneurysm and in 12 patients with acute myocardial ischemia,as well as in 16 healthy individuals who served as the control group.Serum MMP levels were measured by using an ELISA technique.Results There were significantly higher levels of MMP-3 in patients with acute myocardial ischemia as compared to acute aortic dissection ( [19.10 ± 3.11 ] μg/L vs [11.89 ± 1.31 ] μg/L,P =0.02).Significantly lower levels of MMP-1 were found in healthy controls compared to the groups of patients ( [1.30 ± 0.56 ] μg/L vs [2.99 ± 0.78 ] μg/L in acute aortic dissection,P =0.03,[3.12 ±0.78] μg/L in chronic dissection,P =0.02,[3.01 ± 1.01 ] μg/L in thoracic aortic aneurysm,P =0.03 and [5.01 ± 0.98 ] μg/L in acute myocardial ischemia,P =0.01 ).Higher levels of M MP-1 and MMP-3 were detected on males.There was a positive correlation between MMP-1 and increasing age ( r =0.38,P ＜ 0.05 ).In patients operated for acute type A aortic dissection,the levels of MMP-1,MMP-3 and MMP-9 increased immediately after surgery,while the levels of MMP-2 decreased.Twenty-four hours after surgery levels of MMP-1,-2 and -9 were almost equal to the preoperative ones( P ＞ 0.05 ).Conclusion Measurement of serum MMP levels in thoracic aortic disease and acute myocardial ischemia is a simple and relatively rapid laboratory test that could be used as a biochemical indicator of aortic disease or acute myocardial ischemia,when evaluated in combination with imaging techniques.

Objective To describe the follow-up data of 34 patients receiving total arch replacement with an open stent graft for acute type Ⅰ aortic dissection.Methods The subjects were 34 consecutive patients with type Ⅰ acute aortic dissection ( Twenty-eight males and 6 females,aged 34.0 - 46.0 yrs) who received total arch replacement with an open stent graft in our hospital from Jan.2005 to Oct.2010.Thirty of the 34 patients were followed up for 2 - 70 months.CT scanning was performed at the 3 and 12 months and then yearly after operation to detect the thrombus formation,absorption of thrombus,and obliteration of the false lumen after its exclusion by the stent graft.Results Three patients died peri-operatively with the mortality of 8.8％.One patient died during the follow-up period.Obliteration was recognized in all the patients at the distal side of the stent graft during the follow-up period.The false lumen remained in 10 patients at the distal part of descending aorta,but the diameter of the false lumen was not enlarged.Conclusion In patients with acute type Ⅰ aortic dissection,it is relative safe to perform extensive primary repair of the thoracic aorta by stent grafting.This method may enhance the obliteration of the false lumen and reduce the possibility for further operations to manage a residual false lumen.

Objective To investigate the detectable rate and correlative factors of behavior problems among Hui nationality left-behind children in Ningxia rural area.Methods 1394 children,between 6 and 15 years old,of which 282 were Hui nationality children and 112 were Hui left-behind children,were selected from six primary schools and two junior middle schools using cluster random sampling method in Yongning,Ningxia.All of them were assessed by the Achenbach 's Child Behavior Checklist (CBCL) and self-designed General Information Questionnaire.Logistic regression method was used to analyze the correlative factors of behavior problems.Results The detectable rate of behavior problems among Hui nationality children between 6 and 15 years old was 31.25％,which was higher than the Han nationality left-behind children' s(17.84％) and Hui nationality nonleft-behind children' s (14.12％).Among the Hui left-behind children,those who between 6 and 11 years old,had been left alone between 5 and 7,and whose parents exchanging ideas with teachers less than one time a month had higher detectable rates (x2 =14.904,6.327,7.904,P ＜ 0.05).Among the Hui ethnic children,the detectable rates of those who between 6 and 11 yeas old were higher than that of the non-left-behind children' s(P ＜ 0.05).Logistic regression analysis showed that Hui ethnic left-behind children between 12 and 15 years old (OR =0.179) and those whose parents contacted with their teachers frequently(OR =0.362) had less possibilities to attach behavior problems.Conclusion The detectable rate of behavior problems among Hui nationality left-behind Children between 6 andl5 years old in Ningxia is higher,and the correlative factors are complex.

Objective To investigate and analyze the clinical and imageological features of skull base erosion in nasopharyngeal carcinoma( NPC). Methods 67 NPC patients proved by pathology were retrospectively reviewed. All patients underwent both CT and MRI plain plus enhancement scan. Scan slices were performed from oral pharynx (lower border of second cervical vertebra) to suprasellar cistern by axial CT scans and axial, sagittal and coronal MRI scans. Results (1) 52 patients with skull base erosion were found with MRI, and only 35 patients with CT. The following structures and figures were difined with CT and MRI respectively: pterygoid plates 8,14; clivus 22,25 ; petrous apex 25 ,28 ; sphenoid body or sinus 19,25; sphenoid wing 9, 12; cavernous sinus 14,17. The display difference between CT and MRI had statistical significance ( x2= 9. 47 , P = 0. 02). (2) CT- defined skull base erosion was most bone destruction , however, not only bone destruction but also tumor crossing skull base structure could be defined by MRI. (3) The incidence of headache was 82.7% (43/52) , cranial nerve palsy was 67. 3% (35/52) , both headache and cranial nerve palsy was 57. 7% (30/52). Conclusion Headache and cranial nerve palsy are primary characteristics of the skull base erosion in NPC. MRI is superior to CT in defining both bone erosion and brain tissue abnormality.

· AIM: To explore the dynamic expression and correlation among telomerase catalytic subunit (TERT), proliferating cell nuclear antigen ( PCNA) and antiapoptosis protein Bd-2 which relate to cell proliferation in epiretinal membrane of rat traumatic proliferative vitreoretinopathy(PVR).· METHODS: S-P technique was applied for immunohistochemical staining of epiretinal membrane of traumatic PVR with TERT, PCNA and Bcl-2 antibody. HE staining was also carried out. The staining results were analyzed with image analysis system.· RESULTS: The positive rate and average A of PCNA protein were upregulated at first and then down-regulated, with the peak value in 14d Group, which was significantly different from those in 7d Group and 28d Group.The positive rate and average A of TERT and Bcl-2 were also upregulated at first and then down-regulated, with the peak value in 14d Group and 21d Group, which were significantly different from those in 7d Group. There was significant correlation among PCNA, Bcl-2 and TERT protein expression (P≤0.01).· CONCLUSTON: TERT and Bcl-2 take part in the regulation of proliferative cells in epiretinal membrane of traumatic proliferative PVR, with high correlation with the dynamic changes of cell proliferation.

Objective To evaluate the release of leucine-enkephalin (L-EK) in the cerebrospinal fluid induced by intrathecal human embryonic kidney (HEK293) cells modified with human preproenkephalin (hPPE)gene and the analgesic efficacy of L-EK for bone cancer pain.Methods Forty CIBP female Sprague-Dawley rats were randomized into transplantation (CIBP+ hPPE/HEK293,n =20) and control (CIBP + HEK293,n =20)groups using a random number table.At 1 day before inoculation of cancer cells (T1,baseline) and 8,15,21,25,32 and 35 days after inoculation (T2-7),thermal paw withdrawal latency (TWL) was measured,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were recorded.After observation at T4,10 rats were chosen from each group and sacrificed and the cerebrospinal fluid of rats was collected in an ice bath for detection of hPPE expression using radioimmunoassay.Results Compared with control group,TWL was significantly prolonged,the concentration of L-EK in the cerebrospinal fluid was increased,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were decreased at T4-7 in transplantation group.Conclusion Intrathecal HEK293 cells modified with hPPE gene can continuously secrete L-EK and mitigate bone cancer pain.

Objective To detect the value of autoantibedy profile in primary biliary cirrhosis (PBC). Methods 96 serum samples of patients with primiary biliary cirrhosis, 100 serum samples of other antoimmune disease and 49 serum samples of healthy were tested for anti- M2, anti-3E(BPO), anti-Sp100,anti-PML,anti-gp210,anti-LKM-1 ,anti-LC-1 ,anti-SLA/LP by EUROLine. Results The positive of the anti-M2,anti-BPO, anti-Sp100, anti-PML and anti-gp210 for PBC was 76. 0%, 84.4%, 32. 3%, 28. 1% and 35.4% ,respectively. The positive of the anti-M2, anti-BPO, anti-Sp100, anti-PML and anti-gp210 for other autoimmune disease was 13.0% ,9. 0% ,3.0% ,2.0% and 1. 0%, respectively. The sensitivity of the anti-M2 for PBC was 76. 0% ,with specificity of 87. 0%. The sensitivity of the anti-BPO for PBC was 84. 4%, with specificity of 91.0% ;the sensitivity of the anti-Sp100 for PBC was 32. 3%, with specificity of 97.0%. The sensitivity of the anti-PML for PBC was 28. 1% ,with specificity of 98.0%. The sensitivity of the anti-gp210 for PBC was 35.4%, with specificity of 99. 0% . Anti-LKM-1, anti-LC-1, anti-SLA/LP positive patients with PBC were not detected;the incidence rate of liver function failure in anti-gp210 positive serum higher than anti-gp210 negative serum (χ2 = 11.17, P < 0. 01). Conclusions Multiple autoantibedies can be detected in the sera of PBC patients. The detection of autoantibody profile is useful for the diagnosis and differential diagnosis of PBC, and may he helpful for therapy and prognosis of PBC.