Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability in patients suffering from mild cognitive impairment (MCI) after ischemic stroke.Methods Forty five ischemic stroke survivors with MCI but not meeting the criterion for diagnosis as dementia were recruited, and were randomly assigned into an rTMS group (32 patients) and a control group (30 patients) according to a random number table.Both groups received the routine drug therapy of medicine and cognitive function training, and the rTMS group was additionally given rTMS over the left dorsolateral prefrontal cortex at 5 Hz and 80％ motor threshold.The treatments lasted for 4 weeks.The Montreal Cognitive Assessment (MoCA) and auditory event related potential (ERP) were tested for both group before and after the treatment.Results After the treatment, two groups showed significant improvements in the average score of MoCA compared to that before the treatment, and that of the rTMS group was significantly higher than that of the control group.For both groups, the P300 latency shortened and the amplitude increased after the treatment.Moreover, the latency and amplitude of the rTMS group increased to 355.67 ± 16.43 ms and 8.69 ± 1.65 μV, respectively, after the treatment, significantly shortened and lengthened than that of the control group [(372.76 ± 23.35 ms and 7.03 ± 3.04 μV), respectively].Conclusions rTMS can significantly improve the cognitive ability of ischemic stroke survivors in a relatively safe way.

With the increasing international exchange of medical education , frequent exchanges increasingly of medical personnel through the cross-border and trans-regional .It caused widespread concern about the quality of medical education in different countries .This review focus on quality performance on the certification requirements of the standard of medical education .We take it as an opportunity to assess international medical education accredi-tation, and promote the reformation of teaching and examination .We tried to explore and establish the full quality assessment system for biochemistry .

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability of patients after ischemic stroke. Methods 45 patients with mild cognitive impairment (MCI) after ischemic stroke were randomly assigned into control group (n=22) and observation group (n=23). Both groups received routine drugs and cognitive training. The observation group received rTMS over the left dorsolateral prefrontal cortex (DLPFC) (5 Hz, 80% motor threshold) in addition for 4 weeks. Results The score of Montreal Cognitive Assessment (MoCA), P300 latencies and amplitudes improved after treatment in both groups (P<0.001), and were better in the observation group than in the control group (P<0.05). The MoCA score was negatively related with P300 latency (r=-0.851, P<0.05). There was no severe adverse effect during the treatment. Conclusion rTMS could improve the cognitive ability of patients with MCI after stroke, with little side effect.

Objective To evaluate the efficacy of pregabalin on painful radiation-induced brachial plexus injury.Methods A total of forty-five patients with painful radiation-induced brachial plexus injury were assigned to treatment group with pregabalin 150-600 mg/d combined with conventional therapy, and to control group with conventional treatment for 12 weeks.The visual analogue scale (VAS) and neuropathic pain symptom inventory (NPSI) were evaluated.The response rate (proportion of subjects with at least a 30％ to 50％ reduction in visual analogue scale) was evaluated as the primary endpoint.Results The response rate of the pregabalin group(36.4％) was significantly higher than that of the control group (9.1％) (x2 =4.98, P ＜ 0.05).Although hospital anxiety and depression level, clinical global impression of change, and clinical global impression of change (CGIC) did not differ significantly between pregabalin group and control group (P ＞ 0.05), improvements in neuropathic pain symptom inventory (NPSI), patient global impression of change (PGIC) and the sleep interference score(t =-6.62,-5.65,-6.16, P ＜ 0.05)suggested some utility in the management of radiation-induced brachial plexus.Conclusions Pregabalin treatment combined with conventional treatment exerts efficacy on patients with painful radiation-induced brachial plexus and patients are well tolerated.

BACKGROUND:Stem cel transplantation has gained considerable support recently. It provides new opportunities for treating diabetic neurogenic bladder. OBJECTIVE:To summarize the research progress in bone marrow mesenchymal stem cel s (BMSCs)transplantation in the treatment of diabetic neurogenic bladder. METHODS:The first author retrieved Sciencedirect, PubMed, Embase, Wangfang and CNKI databases, for relevant articles of BMSCs transplantation in the treatment of diabetic neurogenic bladder, published from 2000 to 2016. The key words were“bone marrow mesenchymal stem cel s, diabetic neurogenic bladder, differentiation, transplantation”in Chinese and English, respectively. RESULTS AND CONCLUSION:In patients with diabetic neurogenic bladder, the transplantation of BMSCs may provide safer and longer-lasting outcomes by repairing the damaged bladder and urethra. And it can produce various bioactive substances, which wil have nutritional paracrine effects on the bladder microenvironment, including anti-inflammation, promoting cel proliferation and improving cel survival. On the one hand, the BMSCs have the ability to migrate to the injury site via the blood circulation. On the other hand, BMSCs can produce various growth factors, as wel as the cytokines that can inhibit the inflammatory response. While the current clinical studies are lacking, its efficacy and safety needs further verification.

Objective To profile the differentially expressed genes in the muscle of polymyositis (PM) patients.Methods A mRNA microarray analysis was performed to profile mRNAs from 5 treatment-naive PM patients and 5 healthy controls.Gene Ontology and KEGG pathway analyses were applied to delineate the functional roles of the differentially expressed mRNAs.Quantitative real-time PCR analysis was conducted to validate the microarray data.The Student's t-test was used to analyze the statistical significance of the microarray results,and Benjamini-Hochberg FDR was used for multiple-test correction.Results Microarray analysis revealed that a total of 1 905 mRNAs (787 up-regulated and 1 118 down-regulated) were significantly differentially expressed in PM patients compared with the healthy controls (fold change＞2,P＜0.05).Six mRNAs were selected to analyze by quantitative RT-PCR to validate their expression levels and the results were consistent with that of the microarray analysis,and thus provide reliable validation for the microarray results.Gene ontology and KEGG pathway analysis for the differentially expressed mRNAs revealed that these genes were mainly involved in the biological process of infection and cytotoxic effect.In addition,there were some common signaling pathways that shared by PM and other autoimmune diseases.Conclusion There are differences in gene expressions between PM patients and healthy controls.The muscle damage in PM patients may be due to multi gene involvement and multi gene regulation.

Objective To investigate the accuracy and applied value of measurement of pulmonary flow velocity with phase-contrast MRI(PC-MRI).Methods ①42 healthy volunteers were divided into 2 groups randomly,one group was examined by PC-MRI,another was examined by doppler ultrasound.The inner diameter,maximum velocity and mean velocity of main pulmonary artery(MPA) were measured;②The flow volume of MPA in a cardiac cycle was calculated with formulation.Results ①The inner diameters of MPA measured with PC-MRI and doppler ultrasound were(24.4?3.41) mm and(21.5?2.55) mm respectively;②The maximum velocity and mean velocity of MPA measured by PC MRI were(79.9?24.0) cm/s and(50.3?7.71) cm/s respectively;③The maximum velocity and mean velocity of MPA gained by doppler ultrasound was(88.8?8.33) cm/s and(53.7? 5.04) cm/s resepectively;④The flow volume of MPA in a cardiac cycle measured by PC MRI and doppler ultrasound was(73.5?6.60) ml and(69.0?10.6) ml respectively.The results were analyzed by group sample t-test,and the level of test was 0.05.Conclusion The blood flow velocity and volume of pulmonary artery can be measured accurately by PC-MRI,it is of certain applied value in assessing the pulmonary blood flow dynamics changes.

Background:Gastroesophageal reflux disease(GERD)is a common disorder of digestive system,however,some of patients are not responding to conventional 4-8 weeks proton pump inhibitor therapy. Aims:To investigate the effect of digital music gastric electrical pacing on clinical symptoms,anxiety and depression and esophageal motility in patients with refractory GERD. Methods:Fifty-three patients with refractory GERD from Jan. 2014 to Oct. 2015 at the Third Affiliated Hospital,the Third Military Medical University were recruited. All of them fulfilled the Montreal definition of GERD. Digital music gastric electrical pacing was performed for 15 days and the efficacy was evaluated by clinical symptom scoring,Hamilton anxiety scale( HAMA),Hamilton depression scale( HAMD)and esophageal motility manometry. Results:After 15-day treatment,the main symptoms,including heartburn,daytime and nocturnal acid reflux,upper abdominal pain,nausea,and sleep disorder were significantly improved(P < 0. 001). A great proportion of patients were complicated with anxiety and/ or depression at recruitment,and after treatment the scores of HAMA and HAMD were decreased significantly(P < 0. 001). Meanwhile,the lower esophageal sphincter resting pressure(LESP),distal wave amplitude,peristaltic wave duration,speed of peristaltic wave and distal contraction integral after treatment were significantly increased as compared with the baseline values(P < 0. 05). Conclusions:Digital music gastric electrical pacing is effective for treatment of refractory GERD with increase of LESP and esophageal body motility. The clinical symptoms and anxiety and depression are improved simultaneously. Digital music gastric electrical pacing is expected to be a new choice of non-medicine treatment for esophageal motility disorders.

Objective To explore the effects of continuing care on the quality of sleep and neurological function rehabilitation in patients after stroke. Methods 60 patients with sleep disorder and hemiplegia after stroke discharging from our hospital during January to December 2014 were randomly assigned to control group (n=30) and intervention group (n=30). The control group received routine discharge instruction, while the intervention group received continuing care. They were assessed with Pittsburgh Sleep Quality Index (PSQI), simplified Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were when discharged and 3 months after intervention. Results The scores of PSQI were lower, the scores of FMA and MBI were higher in the intervention group than in the control group 3 months after intervention (P<0.05). The nursing satisfaction was higher in the intervention group than in the control group (P<0.001). Conclusion Continuing care could improve the sleep quality, and promote the neurological function recovery for patients with sleep disorder after stroke.

Objective To observe the effect of Huangqi granules combined with external treatment on the clinical therapeutic effects of typeⅡand Ⅲ stress injuries. Methods A total of 240 patients with typeⅡ andⅢ pressure injuries admitted to the Hengshui People's Hospital from January 2017 to March 2019 were enrolled. According to difference in therapeutic methods, the patients were divided into astragalus mongholicus granule group and routine treatment of Western medicine group, with 120 cases in each group. In both groups, the patients were given routine nursing treatment such as air cushion bed, regular body turn-over, nutrition support, health education, etc;in routine Western medicine treatment group, according to the principle of aseptic dressing change, the wounds were treated and covered with foam dressing; while in the astragalus mongholicus granule group, the routine nursing care and sterile dressing as above mentioned were also applied, additionally 3 bags of oral astragalus mongholicus granules mixed with boiled water each time, twice a day (equivalent to 10 g for each bag of Chinese herbal slices), 7 days as one course of treatment; at the same time, the wound was sterilized, debrided and washed with normal saline, and after drying, the rubber Shengji ointment for promoting growth of tissue was evenly spread on the wound and covered with foam dressing. In the two groups, the changes of pressure ulcer healing evaluation scale (PUSH) scores before treatment and 7, 14, 21 and 28 days after treatment, as well as the differences in wound healing time and clinical efficacy between the two groups after treatment were observed, and the recurrence rate was followed up for 10 weeks. Results Compared with routine Western medicine group, the Ⅱand Ⅲ wound healing times were significantly reduced in the astragalus mongholicus granule group [the days of wound healing for Ⅱ stress injury (days): 7.81±1.40 vs. 16.52±1.89, the days of wound healing for Ⅲ stress injury (days): 14.60±1.50 vs. 20.23±1.27, both P < 0.05]. With the prolongation of therapeutic time, the PUSH scores of two groups decreased gradually, there was no significant difference in the PUSH scores between the two groups before treatment and 7 days after treatment (both P > 0.05); after 14 days of treatment, the PUSH score of astragalus mongholicus granule group was significantly lower than that of the routine western medicine group (7.82±1.93 vs. 9.96±1.89), and lasted until 28 days (4.16±0.47 vs. 5.29±0.57), the differences being statistically significant (both P < 0.05). The total effective rate of the astragalus mongholicus granule group was significantly higher than that of the routine western medicine treatment group [99.41% (171/172) vs. 74.51% (114/153), P < 0.05], and the recurrence rate of the mongholicus granule group was obviously lower than the routine Western medicine treatment [3.60% (5/139) vs. 17.74% (11/62), P < 0.05]. Conclusion Oral astragalus mongholicus granules combined with myocreatic ointment external therapy can effectively shorten the healing time of type Ⅱand Ⅲ stress injury, improve the cure rate and reduce the recurrence rate.