Objective To study the effects of flunarizine on the contents of SOD、 MDA、 NO、 NOS in serum and brain tissue and pathological changes in gerbils of ischemia-reperfusion cerebral injury. Methods Twentyone gerbils were randomly divided into three groups: ischemia-reperfusion group, flunarizine pretreatment group and control group. There were seven gerbils in each group. The levels of SOD, MDA, NO and NOS in the serum and brain tissue were determined, and pathological changes of brain were observed by microscopy. Results It was found that the group of ischemia-reperfusion had characteristic changes of ischemia-reperfusion injury. Compared with the control group, serum and brain contents of MDA, NO and NOS were higher but the content of SOD was lower,and the differences were significant(all P

Objective:To evaluate the value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT-based heterogeneity for early prediction of targeted therapy outcome in patients with human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer. Methods:From May 2012 to April 2018, 29 patients (all females, median age: 52 (32-69) years) who had HER2 positive metastatic breast cancer and underwent pretreatment 18F-FDG PET/CT in Fudan University Shanghai Cancer Center were retrospectively enrolled. All patients received trastuzumab as first-line treatment and were followed up for 6-87 (median time: 35) months. The relations between clinicopathologic parameters or PET/CT-based parameters and progression-free survival (PFS)/overall survival (OS) were analyzed with Cox univariate analysis. The parameters with P≤0.01 were further analyzed with Cox multivariate analysis. Optimal cut-off values were determined by time-dependent receiver operating characteristic (ROC) curve analysis. The survival analyses were estimated by Kaplan-Meier method and log-rank test. Results:The median OS of the 29 patients was 30 (6-83) months, and the median PFS was 10 (2-29) months. The PET/CT-based heterogeneity index(HI), including the maximum standardized uptake value (SUV max) ratio (SUV max-R; hazard ratio ( HR)=8.6, 95% CI: 2.7-27.8, P<0.001), the mean standardized uptake value (SUV mean)-2.5 (the cut-off value of standardized uptake value (SUV)=2.5) ratio (SUV mean-2.5-R; HR=2.6, 95% CI: 1.2-5.9, P=0.020), the metabolic tumor volume(MTV)-2.5 ratio(MTV-2.5-R; HR=2.4, 95% CI: 1.1-5.2, P=0.030), and the total lesion glycolysis(TLG)-2.5 ratio(TLG-2.5-R; HR=3.2, 95% CI: 1.4-7.4, P=0.008) of the lesion with the highest SUV max to that with the lowest SUV max, were significantly associated with PFS. None of the parameters was significantly associated with OS (all P>0.05). Multivariate analysis showed that the SUV max-R was the only independent predictor for PFS ( HR=6.8, 95% CI: 1.8-26.1, P<0.01). Area under the ROC curve for SUV max-R was 0.747. With a cut-off value of 1.8, SUV max-R could effectively distinguish the benefit from non-benefit population treated with trastuzumab (15.0 vs 7.0 months; χ2=18.68, P<0.01). Conclusion:Pretreatment 18F-FDG PET/CT-based HI has potential value for early prediction of first-line trastuzumab treatment outcome in patients with HER2 positive metastatic breast cancer.

Objective To investigate the effect of electroacupuncture (EA) combined with repetitive transcranial magnetic stimulation ( rTMS) on postsynaptic density 95 ( PSD- 95) in the hippocampus of rats after cerebral ischemia. Methods Sixty healthy male Wistar rats were divided into normal, model, EA, rTMS and EA + rTMS groups randomly, and the rats in each group were further divided into 7 d, 14 d and 28 d subgroups. A model of middle cerebral artery occlusion ( MCAO) was established, followed by EA, rTMS or EA + rTMS treat-ment. The expression of PSD-95 in the dentate gyros and area CA3 of the hippocampus of the ischemic cerebral hemisphere were investigated. Results The expression of PSD-95 in the dentate gyrus and area CA3 of the ische-mic cerebral hemisphere had decreased 7 d after cerebral ischemia. The expression of PSD-95 in the three treat-ment groups increased after 14 d of treatment and was significantly greater compared with the model group after 28 d of treatment. The EA + rTMS group was especially superior to the EA and rTMS groups in terms of the expression of PSD-95 in area CA3 by the 28th day. Conclusions EA + rTMS can significantly increase the expression of PSD-95 in the hippocampus after cerebral ischemia. This may help explain how EA + rTMS improves learning and mem-ory after cerebral ischemia.

Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression, fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 ～ 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group (P ＜ 0.05), and no significant difference between two compressive segments and three compressive segments(P ＞ 0.05), and significant difference between four compressive segments groups (P ＜0.05). Conclusion For single compressive segment, the anterior surgery has a good surgical result,for two or three compressive segments, anterior and posterior surgery had same effect, for the four compressive segments, posterior surgical effect was good.

Objective To analysis the effect of salbutamol combined with noninvasive ventilator on TNF-α,IL-6,IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure.Methods 60 patients who were diagnosed with chronic obstructive pulmonary disease with respiratory failure were collected.All patients were randomly divided into experimental group and control group,30 cases in each group. Patients in the control group received noninvasive ventilator treatment, patients in the experimental group were given salbutamol treatment on the basis of control group treatment, after the treatment, the serum levels of TNF-α,IL-6,IL-8 and serum CK-MB activity were detected in all patients.Results After treatment, compared with control group, the serum level of TNFαwas lower in the experimental group,and the difference was statistically significant(P<0.05); the serum level of IL-6 and IL-8 were lower in the experimental group(P<0.05); the serum CK-MB activity was lower in the experimental group(P<0.05).Conclusion The salbutamol combined with noninvasive ventilator can significantly reduce the serum levels of TNF-α, IL-6, IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure, reduce the inflammatory reaction and reduce the myocardial damage,and have a guiding significance for clinica.

Objective To observe the therapeutic efficacy of focal vibration on shoulder-hand syndrome (SHS) in stroke patients.Methods Two stroke patients with SHS were observed.Both patients were treated with routine interventions including exercises,manipulation,intermittent sequential pneumatic compression,medications etc at the beginning,but got no significant improvement after 4 weeks of treatment.Focal vibration was then added on by applying it on the affected side for 10-12 minutes,once daily for 2 weeks.The SHS scoring system developed by Braus and colleagues was used to evaluate the outcome.Results It was found that after 2 weeks of treatment with focal vibration,both patients were improved significantly,in terms of pain,edema and shoulder range of movement,as reflected by the changes of SHS scores.The SHS scores of both patients were 12 before treatment with focal vibration and reduced to 5 after the treatment.Conclusions Focal vibration could be an effective option for the management of SHS in stroke patients.

In order to improve the management efficiency of standardized residency training for rehabilitation medicine and ensure the quality of training for trainees, we have conducted a precise management exploration of standardized residency training for rehabilitation medicine residents based on mobile phone platforms. An highly efficient and precise rehabilitation medicine residents training system has been constructed by applying some widely used APPs and network functions in China, such as WeChat, Sojump, Teachermate, Ding Talk, etc. With the mobile phone WeChat as the medium, the management framework of the residency training base has been built. The student information input, assessment, evaluation and feedback system have been completed through the questionnaire star as the medium. The Internet extension of teaching and training activities has been realized by the teachermate. Through the Ding Talk, the individualized precise graduation examination arrangements for the trainees have been achieved, and the customized skill training arrangements and records have also been achieved. Through the use of these modern teaching techniques and training methods, the precise and efficient management of the rehabilitation medicine standardized residency training has been basically realized.

Objective To observe the effects of early rehabilitation on the motor function of post-stroke hemiplegic patients treated with intravenous thrombolysis.Methods Thirty-six post-stroke hemiplegic patients after intravenous thrombolysis with rtPA were recruited in this study.They were randomly divided into the early rehabilitation group (with the course less than three days) and the control group (with the course between three and seven days),18 cases in each group.Both group received a two-week rehabilitation programme.They were assessed using the Fugl-Meyer assessment (FMA) of up extremity,FMA of lower extremity and ADL score (modified Barthel index,MBI) before and after treatment,as well as at the 3rd month after treatment (during the following-up).Results After treatment and at the following-up,FMA scores of up extremity,FMA scores of lower extremity and MBI scores had improved significantly compared with before treatment in both groups.Furthermore,after treatment,in the early rehabilitation group the average FMA score of lower extremity and MBI score reached (23.33 ± 4.37) and (56.11 ± 22.27) respectively,significantly higher than those of the control group [(17.06 ± 4.70) and (40.00 ± 15.81) respectively].Conclusion Early rehabilitation contributes to short-term recovery of lower extremity motor function and ability in the activities of daily living in post-stroke hemiplegic patients after intravenous thrombolysis.

Objective To explore the potential of creating a cat model of spinal cord infarction initiated by a photochemical reaction in terms of the neuroethology, motor evoked potential, and morphological outcomes. Meth-ods Fifteen cats were divided into three groups at random. T_13 in the spinal cord was photochemically irradiated for 40 min, 60 min or 80 min in different groups. A photochemically-induced infarction was produced by intravenous in-jection of rose Bengal (35 mg/kg) combined with immediate cold light irradiation (3000 klx) of the spinal cord.Neuroethology changes were observed every day after the surgery far 21 days, and morphological changes were exam-ined at day 21, before which the motor evoked potential was examined and compared with measurements taken before injury. Results The spinal cord infarctions induced by intravenous injection of rose Bengal plus cold light irradia-tion for 40 min were stable by day 8, while the other two groups were stable by day 12. The size of the infarction area in the spinal cord was stable, while the neuroethology, electrophysiological and histopathological changes in the cats were significant. Conclusions All of the cats demonstrated decreased functional mobility after photochemically in-duced thrombosis of the spinal cord, with corresponding pathomorphological and electrophysiologic changes. The model of infarction was stable and reliable.

Objective To investigate the effects of epidural spinal cord electrical stimulation (ESCES) on spinal cord reflexes in normal adult rats, and to find out where and how the spinal cord reflexes are generated. Methods Ten adult female Sprague Dawley rats were anaesthetized and an electrode was placed at the S, spinal cord segment. Single electric pulses with 200 μs pulse width and voltages of 400 mV, 600 mV and 1200 mV were used in the ESCES. 1200 mV voltages with 50 Hz, 60 Hz, 80 Hz, 100 Hz frequency were also tested. EMG signals were re-corded with concentric needle electrodes in the rats' semitendinosus muscles to observe the characteristics of spinal cord reflexes. Results The voltage threshold for generating semitendinosus muscle response was 300 mV. The three ESCES voltages induced 2 kinds of spinal cord reflexes. The 400 mV and 600 mV stimulation induced spinal cord reflexes with short latency (5.27±0.36 ms and 5.19±0.67 ms respectively). The 1200 mV stimulation volt-age induced spinal cord reflexes with long latency (2.57±0.23 ms). Spinal cord reflexes could be generated by 50 Hz, 60 Hz, 80 Hz, and 100 Hz ESCES. At the higher frequencies, spinal cord reflexes declined late in the ex-periments and then appeared irregular. In some of the rats, spinal cord reflexes vanished entirely late in the stimula-tion experiments. The latency and duration of the spinal cord reflexes induced by 50 Hz ESCES were (4.46 ± 1.07) ms and (7.33±1.00)ms respectively. These were significantly different from the latency and duration initia-ted by 60 Hz, 80 Hz or 100 Hz ESCES. Conclusions Different ESCES voltages induce different spinal cord refle-xes generated differently. The long latency reflexes might be monosynaptic responses mediated by dorsal root excite-ment, while the short latency reflexes might be sarcous exciting electric activity mediated by direct excitement of mo-tor neurons or motor fibers. The irregular spinal cord reflexes induced by higher frequency ESCES might be one kind of monosynaptic response. Irregularly appearing spinal cord reflexes induced by higher frequency stimulation might due to the inhibitory effect of higher frequency stimulation.