Objective To observe periventricular white matter changes and matrix metalloproteinase-3 (MMP-3) expression after two-vessel occlusion in rats.Methods A total of 40 Wistar rats were randomly divided into four groups:sham operation group,model group 1 (20 days after operation),model group 2 (40 days after operation),model group 3 (60 days after operation)(n =10 per group).Model of chronic cerebral hypoperfusion was induced by permanent ligation of the bilateral common carotid arteries in the rat.The change of periventricular white matter was observed by electron microscope.The myelin basic protein (MBP) levels was determined by Western blotting,and the expression of MMP-3 was analysed by immunohistochemical stain and Western blotting.Results Permanent ligation of the bilateral common carotid arteries resulted in demyelination in the corpus callosum and internal capsule in rats.The expressions of MMP-3 in model groups were markedly elevated compared with sham group (model group 1,39.17± 4.167; model group 2,43.33±3.502; model group 3,54.16±2.787; sham group,26.67±3.830; all P＜0.01).The content of MBP in model groups was gradually decreased compared with sham group (model group 1,54.50±4.087; model group 2,47.83±4.875; model group 3,36.50±4.231; sham group,65.01±7.688; all P＜0.01).Additionally,the upregulation of MMP-3 had significant correlation with the loss of MBP in the periventricular white matter (r =-0.883,P＜0.01).Conclusions Chronic cerebral hypoperfusion induces progressive periventricular white matter demyelination,and the upregulation of MMP-3 may involve in the pathological process.

Objective To investigate the effect of acupuncture at Huatuo jiaji points plus virtual balancing game on balance function in stroke patients.Methods Fifty patients with poststroke balance dysfunction were randomly allocated: 25 cases to the treatment group and 25 cases to the control groups. The treatment group received acupuncture at Huatuo jiaji points plus virtual balancing game-based rehabilitation training and the control group, virtual balancing game-based rehabilitation training alone. The Berg Balance Scale (BBS) score, the Timed Up and Go Test (TUGT) score, the COP offset distance indices (EO2, EC2, EOTS and EO1) and the modified Barthel Index (MBI) score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score in the two groups of patients (P<0.05). There were statistically significant post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score between the treatment and control groups (P<0.05).Conclusion Acupuncture at Huatuo jiaji points plus virtual balancing game is an effective way to treat poststroke balance dysfunction.

Objective To observe the effect of digital acupressure plus mechanical sputum expectoration on the rehabilitation of patients with stroke-associated pneumonia. Method Forty-six patients with stroke-associated pneumonia were randomized into a treatment group of 22 cases and a control group of 24 cases. The treatment group was intervened by digital acupressure plus mechanical sputum expectoration, while the control group was by mechanical sputum expectoration alone. The simplified version of Clinical Pulmonary Infection Score (CPIS), Fugl-Meyer assessment scale, and modified Barthel Index (BI) were adopted for evaluation before and after intervention. Result After treatment, CPIS, Fugl-Meyer and BI scores were changed significantly in both groups (P<0.01). There were significant differences in comparing the CPIS, Fugl-Meyer and BI scores between the two groups after intervention (P<0.05). After intervention, the two groups showed a negative correlation between CPIS score and Fugl-Meyer score, as well as between CPIS score and BI score. Conclusion Digital acupressure plus mechanical sputum expectoration can effectively improve the pulmonary symptoms in patients with stroke-associated pneumonia, benefiting the rehabilitation of the post-stroke patients.

Objective To evaluate the efficacy of gait training and assessment system of Lokomat automatic robot (Lokomat robot) in patients with Parkinson's disease (PD).Methods Based on Hoehn-Yahr scale, 30 PD patients ranging from stage 2.5 to 3 were included and randomly assigned to Lokomat robot group ( n＝15) and control group ( n＝15).Lokomat robot system was employed in the training session of the Lokomat robot group, whereas patients in the control group were trained under auditory and visual guidance.Each training session lasted for 20 minutes, and repeated three days per week.Three motor assessments were performed before and after the four weeks training , including timed up and go test (TUGT), Unified Parkinson's Disease Rating Scale Ⅲ(UPDRS-Ⅲ) and three-dimensional gait analysis. Repeated measure analysis was performed under general linear mode , using SPSS 20.0.Results Gender, age, height and age of onset were matched in the Lokomat robot and the control groups .Scores of UPDRS-Ⅲ(Lokomat robot group , 23.46 ±2.72 vs 15.87 ±2.07; control group, 23.73 ±1.98 vs 18.07 ±0.80) and results of TUGT (Lokomat robot group, (15.42 ±5.59) vs (10.06 ±4.88) min; control group, (15.75 ± 4.67) vs (12.98 ±3.24) min) showed statistically significant differences before and after the gait training (UPDRS-Ⅲ, F＝258.598, P＝0.000; TUGT, F＝64.998, P＝0.000), and between the two groups (UPDRS-Ⅲ, F＝5.492, P＝0.026; TUGT, F＝6.522, P＝0.016).The step length (Lokomat robot group, (40.00 ±7.05) vs (52.70 ±7.62) cm; control group, (39.16 ±4.52) vs (46.72 ±7.29) cm), stride length (Lokomat robot group, (76.03 ±12.50) vs (90.60 ±12.46) cm; control group, (77.25 ± 8.07 ) vs (88.21 ±8.17) cm), walking pace ( Lokomat robot group, (67.16 ±12.79) vs (83.72 ± 10.96) m/min; control group, (65.35 ±11.56) vs (77.18 ±10.60) m/min), and total supporting phase (Lokomat robot group, 62.31% ±3.32% vs 56.05% ±3.98%; control group, 62.52% ±3.73% vs 57.96%±3.51%) showed significant improvement after training ( step length, F＝90.866, P＝0.000;stride length, F＝218.152, P＝0.000; walking pace, F＝172.236, P＝0.000; total supporting phase , F＝197.945, P＝0.000).Meanwhile, these improvements were more significant in the Lokomat robot group than the control group ( step length, F＝5.853, P＝0.022; stride length, F＝4.346, P＝0.046;walking pace, F＝4.904, P＝0.035; total supporting phase, F＝4.845, P＝0.036).No significant difference in step frequency was found before and after gait training.Conclusion Both gait trainings improved walking ability in PD patients , and Lokomat robot system guided training showed more obvious improvement than the traditional training under hearing and visual cue.