Community-based rehabilitation (CBR) is positioned to provide various strategies for people with disabilities for achieving the embracing development of the community. CBR is also the terminal of the three-level rehabilitation service system. This paper analyzed the status of domestic community-based rehabilitation based on the document, discussed the possible problems referred to the international concepts about CBR, and suggested a new service pattern of CBR based on the internet and information technology.

It is very common that the number of neurons in the brain is progressively decreasing in the neurodegen-erative diseases such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease, etc.Moreover, it is much more important that there is a decline in the neurogenesis of adult brain in such neurodegenerative diseases. In treating neurodegenerative diseases, it is a potential therapeutic modality to promote endogenous neurogenesis in the brain.

OBJECTIVE To evaluate the protective effect of Agaricus bisporus intracellular polysaccharides(IPS) and exopolysaccharides (EPS) on immunological liver injury induced by concanavalin A (Con A). METHODS Mice were pretreated with IPS and EPS (100, 200 and 400 mg kg- 1, ig) daily for 12 d. Immunological liver injury was induced by Con A 25 mg·kg-1 byinjection via the tail vein of mice.Eight hours after injection of Con A, the indexes of the liver, spleen and thymus, serum level of glutamicpyruvic transaminase (GPT), glutamic-oxalacetic transaminase (GOT), tumor necrosis factor-α (TNF-α) and interferon- γ (IFN- γ), splenic lymphocyte percentages of CD4 + and CD8 + , and liver homogenate content of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured. Liver pathological changes were observed by HE staining. RESULTS Compared with normal group, the autoimmune liver injury in mice induced by Con A resulted in an increase in the liver index (P<0.01) , spleen index (P<0.01), the activity of GPT (P<0.01) and GOT (P<0.01), the content of TNF- α (P<0.01) and IFN- γ (P< 0.01), and the level of MDA (P<0.01), but a decrease in the thymus index (P<0.01), the percentage of CD4+ (P<0.01) , the ratio of CD4+/CD8+ (P<0.01), and SOD activity (P<0.01). Compared with model group, treatment with IPS (200 and 400 mg·kg-1) and EPS (200 and 400 mg·kg-1 ) respectively resulted in an increase in the thymus index (P<0.01) but in a decrease in the liver index and spleen index (P<0.01). Similarly, the activity of GOT and GPT was decreased obviously (P<0.01), and the content of TNF-α and IFN-γ in IPS and EPS 200 and 400 mg·kg-1 groups was decreased. Compared with model group, the activity of SOD in IPS and EPS (200 and 400 mg·kg- 1) group was increased (P<0.01) while MDA was decreased (P<0.01). Moreover, the percentage of CD4 + Iymphocytes decreased (P<0.01), whereas no significant difference was found in the ratio of CD4 +/CD8 + .Pathological changes of the liver were observed under a microscope. Pretreatment with IPS and EPS could effectively reduce the liver injury induced by Con A. CONCLUSION IPS and EPS have certain protective effect on immunological liver injury, which may be related to their ability to clean up free radicals, control lipid peroxidation and regulate the balance of the immune system.

Objective To evaluate the effect of nimodipine combined with 7.5％ hypertonic saline (HS) on postoperative cognitive function in aged rats.Methods Ninety-six healthy male Wistar rats,aged 18 months,weighing 450-500 g,were assigned into 4 groups (n=24 each) using a random number table:splenectomy group (group S),nimodipine group (group N),group HS and nimodipine plus HS group (group N+HS).Nimodipine 1 mg/kg was intraperitoneally injected in group N.In group HS,7.5％ HS 4 ml/kg was injected via the caudal vein.The equal volume of normal saline was injected intraperitoneally or via the caudal vein in group S.Splenectomy was performed under sevoflurane anesthesia at 30 min after the end of administration.On 1 day before operation and 3 and 7 days after operation,Morris water maze test was performed,and blood sainples from the caudal vein were simultaneously collected for determination of the concentrations of serum S100β protein and neuron-specific enolase (NSE) by enzyme-linked immunosorbent assay.Results Compared with group S,the frequency of crossing the original platform was significantly increased,the escape latency was shortened,and the concentrations of serum S100β protein and NSE were decreased at each time point after operation in N,HS and N+HS groups (P＜0.05).Compared with group N or group HS,the frequency of crossing the original platform was significantly increased,the escape latency was shortened,and the concentrations of serum S100β protein and NSE were decreased at each time point after operation in group N+HS (P＜0.05).Conclusion Nimodipine combined with 7.5％ HS exerts better efficacy than either alone in improving postoperative cognitive function in aged rats.

OBJECTIVE: To investigate the effect of pre-amputation pain block on the N-methyl-D-aspartate receptor activation in the central nervous system of amputated rats, and the association between pre-amputation pain block and chronic amputation-related pain. METHODS: Thirty-six adult male SD rats were randomly assigned to an NA group (n=12), a PA group (n=12) and a PAB group (n=12). Group NA was intraplantarly injected saline l00 μL while group PA and group PAB were intraplantarly injected complete Freund adjuvant (CFA) 100 μL. The sciatic nerve of group NA and group PA were freed from surrounding tissue, and that of group PAB was blocked by bupivacaine under pentobarbital sodium anesthesia 5 days after the injection. Thermal withdrawal latency (TWL) was measured before and after the injection. All rats were amputated at the scheduled survival time. The expression of N-methyl-D-aspartate receptor (NR2B) was measured by immunohistochemistry in L4-6 of the spinal cord and the anterior cingulated cortex 7 days after the amputation procedure. RESULTS: The TWL after intraplantar administration of CFA in group PA and group PAB decreased significantly compared with the baseline value (P<0.05), while the saline treated control group remained unchanged. Besides the basic value, the TWL of group PA was shorter than that of group NA at the above-mentioned time-points (P<0.05). Compared with the basic value and group NA, the TWL of group PAB after the block increased significantly (P<0.05). Compared with group NA and group PAB, group PA had a remarkably high expression of NR2B (P<0.05), while there was no difference between group PA and group PAB. CONCLUSION Pre-amputation pain may activate N-methyl-D-aspartate receptor of the central nervous system, which may lead acute postoperative pain to chronic pain. It is necessary to treat pre-amputation pain.
Amputation ; Animals ; Bupivacaine ; administration & dosage ; Freund's Adjuvant ; administration & dosage ; Gyrus Cinguli ; metabolism ; Male ; Nerve Block ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Sciatic Nerve ; Spinal Cord ; metabolism

Objective To evaluate the outcome of 1iver transplantation for acute-on-chronic liver failure (ACLF) patients .Methods We included 453 consecutive patients with previously cirrhosis who underwent liver transplantation between January 2013 and December 2017 .Patients were categorized as no ACLF (n=294) and ACLF(n=159) according to EASL-CLIF consortium criteria .Furthermore ,we used ACLF grades to categorize the ACLF patients .Their clinical data were reviewed and their 90-days survival outcomes were compared .Results Compared with the no ACLF group ,the length of stay in the ICU was significantly prolonged for all patients with ACLF ,and the 90-days survival rate after transplantation was significantly reduced in ACLF group .The length of stay in the ICU was shorter in Grade 1 and Grade 2 group when compared to Grade 3 group .The 90-days survival rate of no ACLF ,Grade 1 ,Grade 2 and Grade 3 group were 93 .20％ ,92 .59％ ,93 .33％ and 73 .68％ ,respectively .There were no statistically significant differences in 90-days survival rate among the no ACLF ,Grade 1 and Grade 2 group .However , the 90-days survive rate of Grade 3 group was lower than that of other groups .Conclusions Liver transplantation has been shown to be safe and effective with good outcome in patients with ACLF and should be offered in early course of ACLF before onset of multi-organ failure .

Objective: To explore the early diagnostic value of thrombus molecular markers in thrombosis ofpatients with malignant tumors and to evaluate their risk factors. Methods: Diagnostic research.A total of 1366 patients (including lung cancer, breast cancer and colorectal cancer,) were randomly selected in the Red Flag Hospital of Mudanjiang Medical College and Mudanjiang Cancer Hospitalfrom September 2009 to February 1919. Among them, 562 were males and 804 were females with average age (59.45±15.10) years old. The control group consisted of 70healthy donors (35 males and 35 females, with an average age of (49.60±19.12) years old), including 69 cases of venous thrombosis (thrombotic group, 32 males and37 females, with an average age of (61.20±15.71) years old).Chemoluminescent enzyme immunoassay was used to detect thromboregulatory proteins(TM), thrombin-antithrombin complexes(TAT), tissue plasminogen activators/inhibitors -1 complexes(t-PAIC), plasminase-anti-fibrinolysis complexes(PIC) in venous plasma. According to the sensitivity and specificity of each marker, the receiver′s work characteristic curve was drawn to evaluate its diagnostic performance. Cox regression analysis was used for single-factor and multi-factor risk analysis. Results: The incidence of venous thromboembolism(VTE) in patients with different types of malignant tumors was statistically significant, with lung cancer being the highest, followed by colorectal cancer and breast cancer(P<0.05). The levels of TM, TAT, t-PAIC and PIC were significantly higher in the lung, breast and colorectal thrombosis group than in the control group. The differences were statistically significant(all P<0.05). The optimal cut-off level for TM is 10.57 IU/ml(sensitivity 50.30%, specificity 75.50%, AUC=0.671), and the optimal cut-off level for TAT is 4.16 ng/ml(sensitivity is 80.30%, specificity is 62.80%, AUC=0.757).The optimal truncation level for t-PAIC is 11.44 ng/ml(sensitivity 52.50%, specificity 84.00%, AUC=0.682), and the optimal truncation level for PIC is 1.18μg/ml(sensitivity 67.20%, specificity is 79.50%, AUC=0.790). The combined detection of the four molecular markers has the best sensitivity and diagnostic performance(86.90%, AUC=0.807). Age, stage, metastasis, surgery, tumor diameter, and PIC levels are independent factors that affect the occurrence of VTE in malignant tumors (all P<0.05). Conclusions Different types of malignant tumors have different rates of thrombosis. The combined detection ofTM, TAT, t-PAIC and PIC have the best diagnostic performance, and can be used as a new early diagnosis method for VTE in malignant tumors. Age, stage, metastasis, surgery, and tumor diameter are risk factors for VTE in malignant tumors. PIC levels can be used as a reliable markerfor the risk of VTE in patients with malignant tumors within 6 months.

Thirteen compounds were isolated from the stem bark of Bombax ceiba L. by silica gel, and Sephadex LH-20 column chromatography. Their structures were identified by spectroscopic analysis as: lupeol(1), lupeone(2), betulinic acid(3), zeorin(4), oleanolic acid(5), 3-oxooleanolic acid(6), cleomiscosin A(7), (±)-lyoniresinol(8), desmosterol(9), stigma-3, 6-dione(10), (+)-lasiodiploidin(11), aurantiamide acetate(12), and(2S, 3S, 4R, 10E)-2-［(2R)-2-hydroxytetracosanoylamino］-10-octadecene-1, 3, 4-triol(13). Among them, compounds 3, 4, 6, 7-13 were isolated from this plant for the first time.

Objective To evaluate the effect of nimodipine pretreatment on postoperative cognitive function in rats with chronic cerebral ischemia.Methods Sixty healthy male Sprague-Dawley rats,aged 3 months,weighing 250-350 g,were divided into 2 groups (n =30 each) using a random number table method:chronic cerebral ischemia operation group (group H) and nimodipine plus chronic cerebral ischemia operation group (group N+H).The chronic cerebral ischemia model was established by permanently ligating bilateral common carotid arteries of chloral hydrate-anesthetized rats.Rats underwent Morris water maze adaptive training for 5 days 2 weeks later.Nimodipine 1 mg/kg was intraperitoneally injected on 1st day after the end of adaptive training in group N+H,while the equal volume of normal saline was given instead in group H,and 30 min later splenectomy was performed under sevoflurane anesthesia in two groups.Ten rats in each group were selected on 1 day before operation and 3 and 7 days after operation and underwent Morris water maze test to assess cognitive function.The rats were then sacrificed,brains were removed,and hippocampal tissues were isolated for determination of apoptosis in hippocampal neurons and intracellular Ca2+concentrations([Ca2+]i) in cytoplasm and expression of Bcl-2 and Bax mRNA (by realtime polymerase chain reaction).The ratio of Bax mRNA to Bcl-2 mRNA was calculated.Results Compared with the baseline at 1 day before operation,the escape latency was significantly prolonged,the frequency of crossing the original platform was decreased,the apoptotic rate and [Ca2+] i were increased,Bcl2 mRNA expression was down-regulated,and Bax mRNA expression was up-regulated,and Bax mRNA/Bcl-2 mRNA ratio was increased at each time point after operation in two groups (P＜0.05).Compared with group H,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the apoptotic rate and [Ca2+]iwere decreased,Bcl-2 mRNA expression was up-regulated,and Bax mRNA expression was down-regulated,and Bax mRNA/Bcl-2 mRNA ratio was decreased at each time point after operation in group N+ H (P＜ 0.05).Conclusion Nimodipine pretreatment can improve the postoperative cognitive function of rats with chronic cerebral ischemia,and the mechanism may be related to inhibiting calcium overload-induced apoptosis in hippocampal neurons.

Objective To evaluate the effect of nimodipine pretreatment on postoperative cognitive function in diabetic rats. Methods One hundred and eighty healthy male Wistar rats, aged 3-4 months, weighing 260-310 g, were divided into 6 groups ( n=30 each) using a random number table method: op-eration group ( O group) , diabetes mellitus group ( DM group) , diabetic cognitive impairment group ( DCI group) , nimodipine plus operation group ( N+O group) , nimodipine plus diabetes mellitus group ( N+DM group) and nimodipine plus diabetic cognitive impairment group ( N+DCI group) . Diabetes mellitus model was established by intraperitoneal injection of streptozotocin 55 mg∕kg. Nimodipine 1 mg∕kg was intraperito-neally injected at 6 weeks after establishing the model in DCI and N+DCI groups and at 2 weeks after estab-lishing the model in DM and N+DM groups, and laparotomy was performed under sevoflurane anesthesia at 30 min after the end of administration. Morris water maze test was performed at 1 day before operation and 3 and 7 days after operation. Then rats were sacrificed, and hippocampal tissues were taken for determination of the apoptotic rate of neurons, cytoplasmic calcium concentrations ( by flow cytometry) and expression of caspase-3 in hippocampus ( by Western blot) . Results Compared with the baseline at 1 day before opera-tion, the escape latency was significantly prolonged, the number of crossing the original platform was re-duced, the apoptotic rate of hippocampal neurons and cytosolic calcium concentrations were increased, and the expression of caspase-3 was up-regulated at each time point after operation in six groups ( P<0. 05 ) . Compared with group O, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the apoptotic rate of hippocampal neurons and cytosolic calcium concentrations were increased, and the expression of caspase-3 was up-regulated at each time point after operation in DM and DCI groups ( P<0. 05) . The escape latency was significantly shortened, the number of crossing the original platform was increased, the apoptotic rate of hippocampal neurons and cytosolic calcium concentrations were decreased, and the expression of caspase-3 was down-regulated at each time point after operation in group N+DM as compared with group DM and in group N+DCI as compared with group DCI ( P<0. 05) . Conclu-sion Nimodipine pretreatment can improve postoperative cognitive function in diabetic rats, and the mech-anism may be related to inhibiting calcium overload-induced apoptosis in neurons.