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 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.