The more and more application of assistive technology in special education not only makes education placement of student with disability diversification, but also provides more opportunity for them to participate in instruction. However, there are some problems remained, such as the application is still in low level, the lack of the systematic evaluation for their efficacy and so on. It is necessary to pay more attention on the assistive technology, cultivate more specialists and other related persons on assistive technology, create assistive technology system, and perfect the service system.

Objective To explore the changes and the clinical relevance of plasma p-selectin (PS) and vascular endothelial cell function in patients with carotid stenosis (CS) before and after carotid artery stenting (CAS). Methods The plasma levels of PS, yon willebrand (vWF) and endothelin-1 (ET-1) before CAS and 1hour,6 hours,24 hours,2 months after CAS in 67 patients with carotid stenosis and 54 cases of TIA with negative result from cerebral angiography were measured. The patients of the therapy group were further divided into group A and group B according to complexity of CAS. The plasma levels of PS and vWF were determined by enzyme linked immunosorbent assay,and the level of ET-1 was measured by radioimmunoassay. Results The plasma levels of PS,vWF and ET-1 all increased in the patients group after CAS. In the therapy group,the level of PS reached peak value (29.23 ± 6.98) ng/ml 1 hour after CAS, and the levels of vWF and ET-1 reached peak value (119.63 ±16.75) %, (79.71 ± 9.78) ng/L 6 hour after CAS. In therapy group, there was significant difference in the levels of PS and ET-1 between each time points after CAS and before CAS (P＜0.05,P ＜0.01 respectively). There was significant difference in the level of vWF between 1 hour, 6 hours, 24 hours after CAS and before CAS (P ＜ 0.05 orP ＜ 0.01). There was significant difference in tihe levels of PS 1 hour after CAS and ET-1 at 6 hours after CAS (P ＜0.05) ,and in the level of vWF at 1 hour,6 hours after CAS between control group and therapy group (P ＜0.01).There was significant difference in the level of vWF at every time point after CAS (P ＜ 0.05 or P ＜ 0.01), and in the level of ET-1 at 1 hour,6 hours,24 hours between A group and B group(P ＜0.05 or P ＜0.01). Conclusions PS, vWF and ET-1 were activated to some extent and related to pathological changes degree and complexity of CAS. Monitoring these biological indexes after CAS maybe of great value in predicting risk, evaluating clinical therapy and judging prognosis.

Objective:To investigate oxidative modification of β2-glycoprotein Ⅰ in vit ro.Methods:Rat β2-glycoprotein Ⅰ was purified and characterized,then oxidize d by hypoxanthine plus xanthine oxidase as a supreroxide free radical generating system;carbonl groups of β2-glycoprotein Ⅰ were detected by the reaction w ith 2,4-dinitrophenylhudrazine.Results:There was a significant increase of carbonyl groups formation in β2- glycoprotein Ⅰ oxidized in comparison with native β2-glycoprotein Ⅰ (P <0.05). Conclusion:Carbonyl groups have been formed in vitro on rat β2-glycoprotein Ⅰ after oxidative modification using hypoxanthine plus xanthine oxidase system.

Employment related with the quality of life and the development of occupation of the people with mental retardation(MR).This paper compared the employment of MR native and abroad,suggested the strategy referencing to the supportive employment theory.

Objective:To explore the practical role of massive open online course (MOOC) mode based on the cultivation of creativity and thinking ability in clinical human anatomy teaching.Methods:Two classes of clinical medicine students of Batch 2019 were selected in the study, and one class was control group ( n=73), which adopted the traditional teaching mode of face-to-face teaching; the other class was research group ( n=79) and the MOOC mode based on the cultivation of creativity and thinking ability for teaching was adopted. After the teaching, the students' creativity, thinking ability, self-learning ability and learning interest were compared, and the mastery of knowledge (theoretical scores and anatomical operation assessment) and satisfaction with teaching were compared between the two groups. SPSS 19.0 was used for t test, chi-square test and rank sum test. Results:The scores of creativity, thinking ability, self-study ability and learning interest of the research group were significantly higher than those of the control group after the teaching ( P<0.05). The scores of theoretical knowledge[(91.41±6.28) points] and anatomical operation[(87.41±7.25) points] in the research group were significantly higher than those in the control group after the teaching[(85.24±7.36) points and (80.26±6.38) points] ( P<0.05). There was significant difference in the distribution of teaching satisfaction between the two groups ( P<0.05), and the total satisfaction rate for teaching of the research group (94.94%) was higher than that of the control group (83.56%). Conclusion:The MOOC mode based on the cultivation of creativity and thinking ability in clinical human anatomy teaching can significantly improve students' creativity, thinking ability and self-learning ability, improve their learning interest and mastery of human anatomy knowledge, and improve their satisfaction with teaching.

Objective:To assess the efficacy and safety of cinepazide maleate injection in the treatment of patients with acute ischemic stroke.Methods:A multicenter, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial, led by Peking Union Medical College Hospital, was conducted in 65 Hospitals in China. The efficacy of cinepazide maleate injection in patients with acute anterior circulation cerebral infarction with onset time of ≤48 hours, 7≤National Institute of Health stroke scale (NIHSS) score ≤25 was assessed from August 2016 to February 2019, using the proportion of modified Rankin scale (mRS) score≤1 and Barthel index (BI) score≤95 on day 14 as efficacy endpoint. The patients were divided into treatment group who were treated with cinepazide maleate injection and control group who were treated with placebo.Results:A total 937 patients were involved in the final efficacy analysis (466 in treatment group and 471 in control group). The proportion of subjects with mRS score≤1 on day 14 after treatment were higher in the treatment group than that in the control group (102/466(21.89%) vs76/471(16.14%)). Logistic regression analysis showed that patients treated with cinepazide maleate were significantly more likely to have a favorable outcome (mRS score≤1) than patients treated with placebo on day 14 ( OR=0.677, 95% CI 0.484-0.948 , P=0.023), and patients treated with cinepazide maleate were more likely to reach independence in activities of daily living (Barthel Index ≥95) than those treated with placebo on day 14 (125/466(26.82%) vs 91/471(19.32%); OR=0.632, 95% CI0.459-0.869, P=0.005). The rate of adverse events was similar between the treatment and control groups. Conclusion:The 14-day treatment with cinepazide maleate injection could reduce the degree of disability whereas did not increase the risk of adverse events.

Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.

Objective:To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection.Methods:This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes.Results:This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P>0.05) between cinepazide maleate group and control group. Conclusion:Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.