Constraint-induced movement therapy (CIMT) is a new approach to rehabilitation of movement in patients after neurological injury and increase their functional independence. This approach has been demonstrated to successfully transfer improvement in the quality and amount of upper extremity use from clinic to the real-life setting. The main purpose of this article is to describe the component and unique aspects of CIMT protocol according to the author's observation in CIMT laboratory at the University of Alabama at Birmingham (UAB).

BACKGROUND:Burned rat serum has been reported as an inducer that can induce differentiation of mesenchymal stem cells into epidermal cells.
OBJECTIVE:To induce in vitro differentiation of bone marrow mesenchymal stem cells into epidermal cells that were transplanted alone or combined with inducers for the repair of skin wound defect and epidermal reconstruction.
METHODS:Under aseptic environment, rat bone marrow was harvested to culture adherent cells using low-glucose Dulbecco’s modified Eagle’s medium. Culture cells at passage 4 were confirmed as mesenchymal stem cells by flow cytometry. Bone marrow mesenchymal stem cells were induced by Dulbecco’s modified Eagle’s medium/Ham’s nutrient mixture F-12 containing 20%burned rat serum to differentiate into epidermal cells that were identified by immunohistochemistry. Wistar rat models of ful-thickness skin wounds were prepared and divided into three groups. The 5-bromo-2-deoxyuridine-labeled autologous bone marrow mesenchymal stem cells and induced bone marrow mesenchymal stem cells were coated singly onto a rat model of burn wounds, and rat models of burn wounds with no treatment served as controls. Wound contraction and regeneration of epidermal cells and skin appendages were observed.
RESULTS AND CONCLUSION:After isolation and culture of cells for 24 hours, a few of adherent cells grew as fibroblast-like cells with fusiform shape. At 16 days, cells completely covered the bottom of bottle, exhibiting a fish or reticular arrangement. After detection by flow cytometry, cells were cultured in Dulbecco’s modified Eagle’s medium/Ham’s nutrient mixture F-12 containing 20%burned rat serum, and fusiform-shaped cells gradual y became round or oval cells. Flow cytometry analysis and immunocytochemistry results showed that cells expressed keratin, which were confirmed as epidermal cells. The results show that both the bone marrow mesenchymal stem cells transplantation alone or with necessary inductor is better for skin repair than natural healing, exhibiting a faster regeneration of skin and skin appendages. Bone marrow mesenchymal stem cells are deduced preliminarily to be involved in epidermis and hair fol icle regeneration, thereby improving skin healing.

Post traumatic depression (PTD) is a serious complication after traumatic brain injury, with high incidence rate; PTD seriously affects the rehabilitation, outcome and quality of life of patients. Due to unclear pathogenesis of PTD, effective treatments have not yet been found in clinical practice. Repetitive transcranial magnetic stimulation (rTMS), as a new non-invasive neuroregulatory technique, has been used in major depression disorder (MDD). Few clinical evidence on PTD treated by rTMS is noted and optimal rTMS treatment regimen has not yet been defined.This article reviews the clinical studies of rTMS in PTD in recent years, with a view to provide references for clinical application.

Objective:To discuss the effect of the force feedback perceptual rehabilitation training on finger motor function of the patients with finger motor dysfunction after stroke,and to provide the basis for the clinical application and promotion of the force feedback perceptual rehabilitation training.Methods:A total of 86 patients with hand dysfunction after stroke were randomly divided into experimental group(n=43)and control group(n=43),and 3 cases in each group fell off from the experiment,and 80 cases were ultimately completed.On this basis,the patients in two groups received the conventional rehabilitation training for 40 min.The patients in control group received the conventional hand function training for 20 min,while the patients in experimental group received the force feedback perception rehabilitation training for 20 min,once per day,5 days per week,for a total of 6 weeks.The hand function recovery of the patients were evaluated before and after treatment by Action Research Arm Test(ARAT),grip strength,modified Ashworth scale(MAS),total active motion(TAM),Fugl-Meyer motor function assessment-upper limb(FMA-UL)finger motor part score,and Barthel index(BI).Results:Before treatment,there were no statistically significant differences in ARAT total score,grip strength,MAS grade,TAM,FMA-UL finger motor part score,and BI score of the patients between two groups(P＞0.05).After treated for 6 weeks,the ARAT scores,grip strengths,TAM,FMA-UL finger motor part scores,and BI scores of the patients in two groups were all increased than those before treatment(P＜0.05),while the MAS grades of the patients had no significant differences(P＞0.05).After treated for 6 weeks,compared with control group,the grasp score and grip score in ARAT score,and the difference of total ARAT score of the patients in experimental group were increased(P＜0.05),the TAM after treatment and the differences of grip strength,TAM,and FMA-UL finger motor part score of the patients before and after treatment were increased(P＜0.05),while the pinch scores and gross movement scores in ARAT score,MAS grades,and the differences of BI score before and after treatment had no significant differences(P＞0.05).Conclusion:Force feedback perceptual rehabilitation training is helpful in improving the finger motor function of the patients with finger motor dysfunction after stroke.

Objective To investigate the clinical efficacy of extracorporeal shock wave therapy combined with traditional Chinese medicine iontophoresis in elderly patients with knee osteoarthritis (KOA). Methods Fifty-six patients with KOA were randomized into the drug therapy group(n=28) receiving only traditional Chinese medicine iontophoresis therapy for four weeks and the combined treatment group(n= 28)receiving extracorporeal shock wave therapy combined with traditional Chinese medicine iontophoresis therapy for four weeks.WOMAC score as an specific severity-of-illness score was used to evaluate knee joint function of patients before and four-week after treatment. Results WOMAC scores of all patients were significantly decreased which indicated states of an illness were improved after four-week treatment as compared with pre-treatment(all P< 0.05).The combined treatment group versus the drug therapy group showed markedly lower WOMAC scores,including pain score(3.17 ± 1.03 vs.5.27 ± 1.58,t= 7.316,P< 0.05),morning stiffness score(2.23 ± 0.91 vs.3.32 ± 1.14,t= 3.440,P< 0.05),activity restrict of daily living score(20.13 ± 6.46 vs.27.35 ± 13.28,t= 4.691,P< 0.05)and total score(28.37 ± 11.62 vs.40.16 ± 5.93,t=8.015,P<0.05). Conclusions Compared with single traditional Chinese medicine iontophoresis, the extracorporeal shock wave therapy combined with traditional Chinese medicine iontophoresis therapy may significantly reduce the pain and morning stiffness degree,and enhance activities of daily living in elderly patients with KOA.

Accurate identification of cell types from single-cell RNA sequencing (scRNA-seq) data plays a critical role in a variety of scRNA-seq analysis studies.This task corresponds to solving an unsupervised clustering problem,in which the similarity measurement between cells affects the result significantly.Although many approaches for cell type identification have been proposed,the accuracy still needs to be improved.In this study,we proposed a novel single-cell clustering framework based on similarity learning,called SSRE.SSRE models the relationships between cells based on subspace assumption,and generates a sparse representation of the cell-to-cell similarity.The sparse representation retains the most similar neighbors for each cell.Besides,three classical pairwise similarities are incorporated with a gene selection and enhancement strategy to further improve the effectiveness of SSRE.Tested on ten real scRNA-seq datasets and five simulated data-sets,SSRE achieved the superior performance in most cases compared to several state-of-the-art single-cell clustering methods.In addition,SSRE can be extended to visualization of scRNA-seq data and identification of differentially expressed genes.The matlab and python implementations of SSRE are available at https://github.com/CSUBioGroup/SSRE.

Objective To evaluate whether perinatal personalized self-efficacy can improve the rate of breastfeeding six months after delivery in primiparas by applying it in the breastfeeding by primiparas. Methods Totally 76 pregnant women who were admitted by the outpatient service of the Obstetrics Department from January to February 2016 were selected as the object of intervention by convenience sampling. Pregnant women admitted in January 2016 were divided into the control group (n=38) and received conventional nursing, while those admitted in February 2016 were divided into the observation group (n=38) and received perinatal personalized breastfeeding self-efficacy intervention. Then the breastfeeding self-efficacy one week and one month after delivery and the rate of pure breastfeeding one week, one month, three months and six months after delivery were compared between two groups.Results The pregnant women in the observation group showed higher breastfeeding self-efficacy than the pregnant women in the control group (t=25.43,22.78;P<0.05). The rates of pure breastfeeding one week, one month, three months and six months after delivery were 88.57％, 85.71％, 80.00％ and 77.14％, respectively, higher than those of the pregnant in the control group, which were 66.67％, 55.56％, 47.22％ and 36.11％, respectively (χ2=4.878, 7.749, 8.215, 12.146;P<0.05). Conclusions Perinatal personalized self-efficacy intervention can improve the breastfeeding self-efficacy and the rate of pure breastfeeding six months after delivery.