Objective To investigate the short-term treatment effectiveness of the auditory integrative training(AIT) on intelligence, language and gross motor function in children with spastic cerebral palsy (CP).Methods Sixty patients with spastic CP, aged 2 to 4 years old,who had been given all the routine conventional rehabilitation at the Rehabilitation Department of the People's Hospital of Guangxi Zhuang Autonomous Region from January 2011 to December 2013 were randomly divided into AIT treatment group (30 cases) and control group without AIT (30 cases), all patients were investigated by using Gesell Developmental Scales and the Gross Motor Function Measure (GMFM)-66 before and after 3-month therapy, and the changes in the regional cerebral blood flow of children (rCBF) were detected by single photon emission computed tomography (SPECT) before and after treatment.Results The scores of development quotient (DQ) of the treatment group after the AIT in areas of adaptive behavior, personal-social behavior,language(52.44 ± 13.43,52.07 ± 11.57,57.19 ± 6.18) were higher than those of the control group (45.09 ± 11.02,45.86 ± 9.66,53.44 ± 5.49), and the differences between the 2 groups were greatly significant statistically(t =-2.32,-2.26,-2.49, all P ＜ 0.05).There were no significant difference in DQ of gross motor, fine motor and scores on the GMFM-66 in the treatment group before and after treatment [40.40 ± 8.57,49.50 ± 14.20, (55.81 ±8.72) scores vs 44.03 ±11.90,46.34±9.78,(58.81 ±7.86) scores,t=-1.42,1.08,-0.52,all P＞ 0.05].SPECT detected abnormalities in all patients (100.00％) both in the 2 groups, compared with the control group,the rCBF was improved significantly after treatment in the treatment group (86.67％) (x2 =35.49 ,P ＜ 0.05).Conclusions The treatment of AIT can greatly improve the intelligence, language development and the brain function in children with spastic CP.It is an effective adjutant of rehabilitation method for children with spastic CP to improve intelligence and language development, and has less influence on motor function.

Objective To observe the effect of acupuncture plus thunder fire moxibustion plus deglutition training plus VitalStim electrical stimulation on patients with deglutition disorder of early stroke.Methods 80 patients with deglutition disorder of early stroke were randomly divided into treatment group and control group,40 cases in each group.The treatment group was treated with acupuncture plus thunder fire moxibustion plus deglutition training plus VitalStim electrical stimulation,while the control group was only treated with deglutition training.The therapeutic effects of all patients were assessed by using drinking experiment before therapy and twenty times after therapy. Results The total effective rate of the treatment group was 97.5%,which was significantly higher than 82.5% of the control group,the difference was statistically significant(χ2 =12.50,P <0.05).Watian integration of the two groups were decreased after treatment,the difference was significant(t =5.606,9.056,all P <0.05),which of the treatment group was significantly lower than the control group,the difference was statistically significant(t =3.044,P <0.05). The lung infection rate and malnutrition rates in the control group were 10.0% and 20.0%,which were significantly higher than those in the treatment group(2.5% and 5.0%),the differences were statistically significance(χ2 =4.80, 10.29,all P <0.05).Conclusion Acupuncture plus thunder fire moxibustion plus deglutition training plus VitalS-tim electrical stimulation are beneficial to the recovery of swallowing functions to early swallowing disorder in patients and could avoid the incidence of aspiration pneumonia and malnutrition.

Objective: This research is conducted to analyze the background, the main practices and the results of the synergistic service of health institutions in Changzhou city, as well as to provide references for promoting the construction of integrated medical and health service system.Methods: This paper uses qualitative interviews and questionnaires to collect information and analyzes the data based on synergetic management theory.Results:Changzhou city has tentatively achieved the synergy of its health institutions by introducing relevant policies, setting up healthcare unions at the municipal level, integrating internal resources among healthcare unions, establishing health information platform and feedback mechanism, etc.Conclusion: The regional synergistic service of health institutions can be effectively promoted by introducing policies at the municipal level, promoting the mutual sharing and communication on information, and integrating internal resources among healthcare unions.But, as there still exist problems such as the distribution of benefits is not perfect, the degree of synergy is not close, etc., thus, the government is suggested to expand the implementation scope of the close-type medical service synergy and further improve the distribution policy of benefits.

Objective To explore the influence on the JNK signal transduction pathway by BaiHui-QuBin Scalp-acupuncture in rats of experimental acute intercerebral hemorrhage. Methods 192 healthy Wistar male rats were assigned into 3groups randomly:model group, model add pinprick group (to abbreviate:pinprick group), model add suppressor group(to abbreviate:suppressor group) ,containing 60 rats in each. All rats were induced be the intercerebral hemorrage model. Another 12 rats were assigned as the matched blank group. The pinprick group were acupunctured on the "Baihui" penetrating "Qubin". The influence surrounding the hamatoma of the proteinum expression of p-JNK of each group in deferent time phase point with the method of Western blot was observed. Results The results of expression of the proteinum p-JNK with the method of Western blot: all the rats after being made model appeared the phenomenon of the expression of p-JNK of rat's brain tissue surrounding the hematoma and increased to the peak in 2 days,but decreased gradually in 7days. In the same time phase point,compared with the model group,the expression of p-JNK of the pinprick group and the suppressor group were lower obviously (P ＜ 0.01). The pinprick group compared with the suppressor group, the expression of p-JNK showed no significant difference (P ＞ 0.05). Conclusion The therapy of BaiHui-QuBin Scalp-acupuncture could block the JNK signal tranaduction pathway, inhibit the expression of the proteinum p-JNK and so on have the function of protecting the nerve cell and inhibiting apoptosis.

Objective To understand the status of the life mcaning among medical students.Methods Totally 300 students in our school were measured by the scale of purpose in life test (PIL)to analyze the status and influencing factors of life meaning.The questionnaire data were analyzed by using two independent samples t-test,One-way ANOVA and multiple linear regression.Results The average score of the life meaning survey of medical students was 84,the life goal and life value dimension scores were relatively high and the life attitude and life independent dimension scores were low.Meanwhile,the life mean in scores were higher in senior students than in junior students ( P =0.003 ),higher in undergraduate students than in college students (P =0.021 ),higher in students from urban cities than in students from rural areas ( P =0.004),higher in student leaders than in non student leaders (P =0.001 ),higher in students liking their majors than in students disliking their majors (P =0.003).Conclusions The formation of medical students' life meaning is influenced by a variety of factors.Educators need to seize the important period of students' growth and launch some targeted educational activities.Meanwhile,in order to enhance the medical students' life meaning,it is also necessary to consolidate the professional education,increase students' self-identity and guide them to correctlv view social problems.

Objective To explore the expression of silencer of death domains(SODD) and its clinical significance and relationship with phospho-NF-?B-p65 proteins in bone marrow cells of acute lymphoblastic leukemia(ALL)in children,and the expression of SODD and phospho-NF-?B-p65 in Jurkat cells treated with chemotherapeutic drugs in order to find a new chemotherapeutic target.Methods The expressions of SODD and phospho-NF-?B-p65 proteins in bone marrow cells were detected by immunohistochemistry in 25 children with ALL.The apoptosis incidence was measured by Annexin-V-Fluorescence/PI double-labeling flow cytometry and the expression of SODD and phospho-NF-?B-p65 proteins were determined by Western blotting in Jurkat cells.Results It was found that the expression of SODD and active p65 expression in ALL were significantly higher than those in healthy control group.The expression of SODD and phospho-NF-?B-p65 proteins in the high-risk(HR) group was significantly higher than those in standard-risk(SR) group(Pa

Objective To study the pharmacokinetic features of ferulaic acid, senkyunolide A and ligustilide in Buyang Huanwu associated prescriptions (Buyang HuanwuDecoction andNaojianTablets).MethodsHPLC-DAD was applied for simultaneous determination plasma concentration of three ingredients with jugular venous cannula rats after intragastric administration ofBuyang Huanwu associated prescriptions. The pharmacolinetic parameters of each ingredient was calculated by DAS2.0, and then the total quantum statistical moment (TQSM) standard similarity was used to measure the overall pharmacokinetics behaviors.Results There were great differences in the three ingredients after the administration of two prescriptions, while the total quantum statistical parameters were very closely. The TQSM pharmacokinetic parameters of the three components inBuyang HuanwuDecoction andNaojian Tablets showed that AUC, MRT, VRT were 240.6 and 133.0, 3.192 min and 3.259 min, 21.59 min2and 19.75 min2, respectively.The similarity was up to 0.977 8.Conclusion The metabolic processes in vivo ofBuyang Huanwu Decoction andNaojianTablets have similarities. The efficacy of Chinese herbal compounds mostly depends on the multi-components overall contributions.

A survey on professional knowledge levels was conducted from April to October 2019 among 388 general practitioners (GPs) from 46 community health service centers and 30 township health centers of 6 provinces selected by stratified random sampling method. The overall knowledge test score was 31.82—84.09(56.94±9.19) points, and the pass rate was 36.3% (141/388). There were significant differences in test scores among participants with different types of work units, regions, provinces, marital status, educational background, professional titles, types of employment, length of service, and training status (all P<0.05). Multivariate regression analysis showed that educational background ( B=-2.835), professional title ( B=-8.867), and participation in professional course training ( B=2.214) were the influencing factors of knowledge level (all P<0.05). The pass rates in knowledge of prevention/health management (13.7%, 53/388) and policies and regulations (12.1%, 47/388) were low. The results show that the levels of professional knowledge among GPs working in grassroots health institutions are relatively low, and suggest that continuing education should be strengthened to improve the professional knowledge level of GPs in primary care institutions, particularly, knowledge of health policies and regulations, disease prevention and health management.

Based on the analysis of survey results and random interviews on medical students , this paper dis-cussed from the perspective of medical students under the present situation of doctor -patient relationship:satisfied with prescriptions basic medical quality , but there are still a large room to improve;to cure medical ethics appraisal is higher , but still need to strengthen medical ethics education; the parties are still lack of trust in the prescrip-tions;the doctor-patient relationship nervous .And put forward the following countermeasures on how to relieve the strain on the doctor -patient relationship , strengthening medical ethics education , strengthen the study and practice of doctor-patient communication , pay attention to legal consciousness propaganda and training , use media power to improve direction of publit opinion .

BACKGROUND:Studies have found that vascular endothelial growth factor and hypoxia inducible factor are involved in the development process of osteoarthritis, but their correlation is rarely reported. OBJECTIVE:To observe the expression and correlation of hypoxia inducible factor-2α and vascular endothelial growth factor in chondrocytes of articular cartilages in human osteoarthritis. METHODS: Articular cartilage specimens were colected from 50 patients with knee osteoarthritis undergoing total knee joint replacement. According to the joint Kelgren-Lawrance (K-L) X-ray grouping classification standard, there were 18 cases of K-LIII level and 32 cases of K-LIV level. Besides, articular cartilage specimens from 10 patients undergoing amputation for legs tumor or traffic accident served as control group. Hematoxylin-eosin staining, Safranin O-Fast Green staining and Mankin scoring were performed to observe and evaluate the histological characteristics of articular cartilages of each group, immunohistochemical staining was conducted to detect the expression of hypoxia inducible factor-2α and vascular endothelial growth factor in chondrocytes of articular cartilages, and their correlations were analyzed. RESULTS AND CONCLUSION:The Mankin score of K-LIV group was significantly higher than those of K-LIII group and control group. Immunohistochemical staining revealed that the number of chondrocytes with positive expression of hypoxia inducible factor-2α or vascular endothelial growth factor in K-LIV group was significantly higher than that in K-LIII group and control group (P < 0.05). The expression of hypoxia inducible factor-2α and vascular endothelial growth factor increased in chondrocytes of articular cartilages of osteoarthritis patients, and to up-regulate the expression of vascular endothelial growth factor may be the regulatory mechanism of hypoxia inducible factor-2αinthe pathogenesis of osteoarthritis.