Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients' activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity after stroke through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.
Humans ; Lower Extremity/physiopathology* ; Upper Extremity/physiopathology* ; Muscle Spasticity/physiopathology* ; Stroke/physiopathology* ; Magnetic Field Therapy/methods* ; Spasm/etiology* ; Stroke Rehabilitation ; Randomized Controlled Trials as Topic

Objective:To prepare the virus-like particle (VLP) of the GII.3[P12] human norovirus (HuNoV) strain GZ2013-L20 in Guangzhou and its polyclonal antibody, and systematically characterize its immunogenicity and receptor binding ability, which would provide data for prevention and control of HuNoV.Methods:ORF2 gene was amplified from the genome of the GZ2013-L20 strain to construct the recombinant transposon vector, which was further transformed into Escherichia coli DH10 Bac to develop the recombinant baculovirus Bacmid-L20-ORF2. VLP was expressed in the sf9 insect cells and then purified. Transmission electron microscopy, SDS-PAGE, Western blot (WB), and receptor binding experiments were performed to characterize the purified VLP. In addition, the polyclonal antibody from the immunized mice was evaluated by indirect enzyme-linked immunosorbent assay (ELISA) and the blocking test of receptor binding. Results:The recombinant baculovirus plasmid Bacmid-L20-ORF2 was constructed, and the target VLP was successfully obtained. The result by the transmission electron microscope demonstrated that the VLP were about 30 nm in diameter. SDS-PAGE and WB analyses showed that the protein’s relative molecular mass (Mr. ×10 3) was about 58. The result of receptor binding experiments showed that the VLP could bind to the secretory salivary receptors (types of A, B, AB and O), non-secretory salivary receptors (O type) and the porcine gastric mucin. The polyclonal antibody with a titer of 2 × 10 5 was detected in the immunized mice, which showed strong cross-immunoreactivity with capsid proteins of 20 (20/28) HuNoV genotypes. In addition, the result of blocking tests of receptor binding showed that the VLP polyclonal antibody only blocked the viral VLP of the same genotype, but had no neutralizing effects on the VLPs of GII.2, GII.4, GII.8 and GII.17. Conclusions:The VLP of GII.3[P12] HuNoV Guangzhou strain showed strong binding ability to both secretory and non-secretory salivary receptors, and its polyclonal antibody showed a broad spectrum of immunobinding, but its neutralization blocking feature was effective only against the virus of the same genotype. The result provide basic data for rational design of vaccine development.

Objective To evaluate the association between metabolic syndrome and colorectal carcino-ma. Methods A total of 900 patients with colorectal carcinoma from 2013 to 2016 in Qianfoshan Hospital Af-filiated to Shandong University were selected as the case group and 1774 non-colorectal carcinoma participants from health management center as the control group. Logistic regression model was used to identify the relation-ship between metabolic syndrome and colorectal carcinoma. Results Compared with the controls (27. 0％), metabolic syndrome was more prevalent among cases (35. 4％). The difference was statistically significant (χ2 = 20. 33,P < 0. 01). Multivariate logistic regression analyses showed that metabolic syndrome as an entity increased colorectal carcinoma risk (OR = 1. 38,95％ CI:1. 08-1. 75,χ2 = 17. 68,P < 0. 01). Subjects with 2 and 3 or more components of the metabolic syndrome had an increased risk of colorectal carcinoma,and the ORs of colorectal carcinoma were 1. 37 and 1. 60,respectively. Gender-specific patterns were also observed in the association between metabolic syndrome,component and colorectal carcinoma (χ2 = 5. 40,P = 0. 02;χ2 =8. 66,P < 0. 01). Conclusion Metabolic syndrome is associated with the occurrence of colorectal carcinoma. An increasing trend in risk of colorectal carcinoma with the number of metabolic syndrome components is observed.

Objective To discuss the implementation effects of the team-based learning combined with situational simulation in the standardized training in psychiatric.Methods A total of 70 psychiatric nurses in the standard training period from June to August 2015 were randomly divided into control group and experimental group, 35 respectively. Nurses in the control group received traditional teaching mode, while nurses in the experimental group used the teaching mode of the team-based learning combined with situational simulation. After the training, the theoretical knowledge, the comprehensive ability of emergency response, and the ability of team work of nurse in two groups were evaluated.Results After 6 months of standardized training, the scores of theoretical knowledge (87.13±7.50) and comprehensive ability of emergency response (95.57±4.19) of nurses in the experimental group were significantly higher than those in the control group (t=8.52, 7.81;P<0.01). The scores of different dimensions of team work ability were (6.58±2.11) of gregariousness, (5.16±2.65) of antorhythmicity, (4.73±2.18) of belongingness and (5.84±1.87) of valuable, which were significantly better than those in the control group (t=-3.36, -6.55, -5.89, -4.51;P<0.05).Conclusions The team-based learning combined with situational simulation model not only increases the knowledge level and comprehensive ability of emergency of nurses, but also improves the team work ability, which can enrich the forms and contents in psychiatric standardized training.

Objective To investigate the implementing effect of team-based learning combined with situational simulation in clinical teaching of psychiatry.Methods A compendium was selected from "Psychiatric nursing",which was about the prevention and nursing of psychiatric crisis. We designed curriculums and wrote the scripts,and organized professional scenario walkthroughs. Eventually,we made them into videos and audio data. Firstly,60 nursing students were given team-based learning combined with situational simulation based on traditional teaching for 4 weeks. After teaching,the results of the theory and emergency skills examination and teaching satisfaction were compared.Results After 4 weeks,the professional theoretical examination of nursing students was (88.93±8.20) pints,and it was significantly higher than (83.27±5.31) points before teaching;meanwhile the emergency skills examination was (93.48±5.99) points,which was significantly higher than (85.87±7.34) points before training (t=-7.91,-9.12;P<0.01). The score of satisfaction of nursing students with teaching was (97.21±1.75),which was higher than (83.82±8.23) before training (t=10.78,P<0.01).Conclusions The team-based learning combined with situational simulation teaching not only cultivates nursing students' autonomous learning interest,which could improve independent study ability and effectiveness,but also improves their teamwork skills,which could improve clinical teaching quality and satisfaction.

OBJECTIVETo study the expression and significance of tumor suppressor in lung cancer 1 (TSLC1) gene methylation, the expression of TSLC1 protein in cervix cancer and precancerous lesions as well as their relationship with HR-HPV DNA infection.

METHODSThe clinicopathological data of 92 cases of different cervical lesions during March 2011 to August 2012 treated in our hospital were collected. There were pathologically confirmed 10 cases of normal cervix, 26 cases of cervical intraepithelial neoplasia (CIN) I, 20 cases of CIN II, 15 cases of CIN III, and 21 cases of cervical cancer. Methylation-specific polymerase chain reaction (MSP) was used to detect the TSLC1 gene methylation status in cervical lesions, immunohistochemistry (SP) was used to detect the expressions of TSLC1 protein in cervical lesions, and the second generation hybrid capture (HC2) method was used to detect the high-risk HPV in cervical lesions.

RESULTSThe expression rate of TSLC1 gene methylation in normal cervical tissue, CIN I, CIN II, CIN III and SCC were 10.0%, 30.8%, 55.0%, 60.0%, 66.7%, respectively, showing a statistically significant difference (P = 0.004). The positive expression rate of TSLC1 protein in normal cervical tissue, CIN I, CIN II, CIN III and SCC were 100.0%, 80.8%, 65.0%, 33.3%, and 23.8%, respectively, with a significant difference (P = 0.004). In the progression from CIN to invasive cervical cancer, there was no significant correlation between TSLC1 gene methylation and HR-HPV DNA infection (P = 0.919), TSLC1 protein expression and HR-HPV DNA infection (P = 0.664). The correlation analysis showed a negative correlation between TSLC1 gene methylation and TSLC1 protein expression (r = -0.674, P < 0.001).

CONCLUSIONSTSLC1 gene promoter methylation may be an early event in the cervical carcinogenesis, become an early sensitive marker, and serve the early prevention and prognostic prediction for cervical cancer.

Cell Adhesion Molecule-1 ; Cell Adhesion Molecules ; genetics ; metabolism ; Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; DNA Methylation ; Disease Progression ; Female ; Humans ; Immunoglobulins ; genetics ; metabolism ; Immunohistochemistry ; Methylation ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Uterine Cervical Neoplasms ; genetics ; metabolism

The paper described the necessity of social capital utilization for public hospitals, and analyzed the model and characteristics of public hospital financing. It is pointed out that the key to the public-benefit nature in the financing calls for distinguishing responsibilities of the government and the market, defining the reasonable level and manner for investors' return, and building corresponding incentive mechanism and supervision mechanism.

BACKGROUND: Cognitive function of simple leukoaraeosis (LA) and subcortical arterioselerotic encephalopathy (SAE) is a part of research in cerebrovascular neuropsychology, however, there is no contrast study on cognitive function between the two diseases. OBJECTIVE: To investigate the different features in cognitive function among patients with simple leukoaraeosis, subcortical arterioselerotic encephalopathy and simple leukoaraeosis combined with cerebral infarction. DESIGN: Randomized controlled observation SETTING: Department of Neurological Medicine, Qilu Hospital, ShandongUniversity. PARTICIPANTS: A total of 91 cases of patients with cerebrovasculardisease diagnosed in Department of Neurological Medicine of Qilu Hospital of Shandong University from March 1997 to May 2000 were selected. All the patients participated in the observation voluntarily. They were divided into 3 groups according to the type of disease, with 27 cases in simple leukoaraeosis group, 33 cases in subcortical arterioselerotic encephalopathygroup and 31 cases in simple leukoaraeosis + cerebral infarction group.Additionally, 30 healthy cases were selected as control group. All the subjects in the above groups participated in the observation voluntarily. METHODS: Assessment on cognitive function and memory ability was conducted on the subjects in each group, and contrast analysis was performed. Mini-mental state examination was used for detecting cognitive function. Patients whose score was less than 17, 20, 22, 23 respectively according to different educational degree (illiteracy, primary school, middle school, university), would be diagnosed as dementia. Clinical me mory scale A edited by Psychology Institute of Chinese Academy of Medical Sciences was used for detecting memory ability including associative learning, directive memory, recognition of nonsense figure, image free recall and portrait characteristics associative recall. Conversed the above 5 items of detecting results to scores of scales and calculated out the memory quotients. MAIN OUTCOME MEASURES: State of cognitive disorder and scoresof mini-mental state examination and clinical memory scale of subjects in each group. RESULTS: All the 91 cases of patients with cerebrovascular disease and 30 healthy control cases entered results analysis without any drop out. ① Comparison of the state of cognitive disorder among subjects in each group: There were 21 cases of mild cognitive disorder (77.8%) in simpleleukoaraeosis group, 8 cases of moderate cognitive disorder (24.2%) and 25 cases of dementia (75.8%) in subcortical arterioselerotic encephalopathy group, 6 cases of moderate cognitive disorder (19.4%) and 24 cases of dementia (77.4%) in simple leukoaraeosis + cerebral infarction group. ② Comparison of the scores of mini-mental state examination among and clinical memory scale: Scores of the two scales in simple leukoaraeosis group, subcortical arterioselerotic encephalopathy group and simple leukoaraeosis + cerebral infarction group were significantly lower than those in healthy control group (t=2.14-3.81, P ＜ 0.05-0.01). The scores in subcortical arterioselerotic encephalopathy group and simple leukoaraeosis+ cerebral infarction group were significantly lower than those in simple leukoaraeosis group (t=2.13-3.37, P ＜ 0.05-0.01).CONCLUSION: ① The cognitive impairment in simple leukoaraeosis is mainly mild cognitive disorder. ② The cognitive impairments in subcortical arterioselerotic encephalopathy and simple leukoaraeosis + cerebral infarction are mainly moderate cognitive disorder and dementia which are obviously severer than mild cognitive disorder. Cognitive function can be used as reference indicator for assessing simple leukoaraeosis and subcortical arterioselerotic encephalopathy.Liang LP, He Y, Guo HZ.A contrast between the cognitive function of patients with simple leukoaraeosis and subcortical arterioselerotic encephalopathy.

BACKGROUND: There is much clinical datum analysis on multi-organ dysfunction syndromes induced by cerebral hemorrhage, but there is lack of experiment on dysfunction of peripheral organs induced by acute cerebral vascular disease.OBJECTIVE: Collagenase of two dosages together with proper amount of heparin were used to duplicate animal model of multi-organ dysfunction syndromes induced by cerebral hemorrhage so as to probe into the best experimental prerequisite.DESIGN: Complete randomized control experiment.SETTING: Departments of Dermatology, Neurology and Cardiac Surgery of Qilu Hospital Affiliated to Shandong University and Department of Neurology of Jinan Railway Center Hospital.MATERIALS: The experiment was performed in Institute of Basic Medicine of Shandong Medical Scientific Academy from September to December 2002. Totally 96 adult healthy male Wistar rats were employed and randomized into normal control (6 rats), sham-operation group (6 rats), first hemorrhage group (42 rats) and second hemorrhage group (42 rats). Seven sub-groups of 4 hours, 8 hours, 12 hours, 24 hours, 36 hours, 48 hours and 72 hours successively were divided in first and second hemorrhage groups respectively, 6 rats in each sub-group.INTERVENTIONS: In the first hemorrhage group, mixed solution 2 μL of Ⅶ collagenase 0.4 U and heparin sodium 3.2 IU was infused slowly to the brain. In the second hemorrhage group, mixed solution 2 μL of Ⅶ collagenase 0.8 U and heparin sodium 3.2 IU was infused slowly to the brain. In sham-operation group, physiological saline of same volume was injected. The general situation of animals at every phasic point was observed after operation, including consciousness, mental state and limb movement, as well as the alternations on body temperature, respiration and heart rate. Examinations were done on blood routine, liver function (alanine aminopherase, ALT;aspartic acid translocase, AST), kidney function (urea nitrogen, BUN; creatinine CRE) and myocardial zymology (creatine kinase, CK; lactic dehydrogenase, LDH). Modified matrix coloration method was used to determine endotoxin content in plasma. Pathological alternations were observed optic microscopically on brain, lung, liver, small intestine and kidney.ternations on main organs of experimental animals.experimental animals after operation: In the first and second hemorrhage groups, body temperature, respiration, heart rate and leukocyte content were all higher remarkably than normal group and sham-operation group (P ＜ 0.05).Those in the first hemorrhage group were higher than second group [(39.56±0.59)C, (37.98±0.52)C;(124.23±4.12) times/minute, (92.56±2.95)times/minute; (325.96±84.53) times/minute, (258.16±75.42) times/minute,(P ＜ 0.05)], and the difference in peripheral leukocyte content was specially nation of ALT activity, AST activity, BUN content, CRE content, CK activity,LDH activity and endotoxin content in plasma: Those in the first and second hemorrhage groups were higher than normal group and sham-operation group (P ＜ 0.05 -0.01). Those in the first hemorrhage group were higher than second hemorrhage group [(35.04±7.54) μkat /L, (24.25±5.42) μkat/L;(51.61±10.47) μkat/L, (33.77±7.44) μkat/L; (21.12±2.93) mmol/L,(9.78±1.45) nmol/L; (68.57±5.24) μnol/L, (40.54±3.95) μmol/L; (706.44±44.92) μkat/L, (189.23±25.08) μkat/L; (357.96±40.95) μkat/L, (149.60±19.10)(P ＜ 0.05)] and the difference was especially remarkable in endotoxin content logical alternations on main organs of experimental animals: Inflammatory damage of various degrees presented in all of animal organ tissues at various phasic points during cerebral hemorrhage in rats. In the first hemorrhage group, pathological change of organs reached the peak in 24-36 hours, which recovered to be normal in 72 hours. In the second hemorrhage group, the inflammatory damage was more remarkable and persistent compared with first group, in which, pathological change of organs reached the peak in 24-48hours and inflammatory damage was still visible in 72 hours.CONCLUSION: It is indicated that 0.8 U collagenase model is a successful model of multi-organ dysfunction syndromes induced by cerebral hemorrhage. Such model is in conformity with the common induced factors in clinic and various index changes of functions in every organ and can reflect dynamically the occurrence of multi-organ dysfunction syndromes.

BACKGROUND: Leukoaraiosis is a group of changes in image. Since the firm pathogenic mechanism on leukoaraiosis has been unknown, the evaluation at the earlier stage of the disease has not been emphasized commonly and there is rather less recognition of the alternations on its electrophysiological system.OBJECTIVE: To probe into the clinical characteristics and alternations on image and evoked potential in simple leukoaraiosis and subcortical arteriosclerotic encephalopathy(Binswanger' s disease) and carry on the comparison with healthy people.DESIGN: Retrospective comparative study based on patients and healthy people.SETTING: Department of neurological internal medicine of one university hospital and department of neurological internal medicine of one railway central hospital.PARTICIPANTS: Outpatients or inpatients with cerebral vascular disorders in Qilu Hospital Affiliated to Shandong University were collected from August 1995 to March 2000. Totally 114 cases were leukoaraiosis, of which, 79 cases were males and 35 cases females. And 41 cases were Binswanger' s disease,of which, 28 cases were males and 13 cases females. Fifty healthy aged people who received routine physical check were randomized from the clinic of the hospital as the control.METHODS: The analysis was carried on the risk factors, clinical characteristics and CT exam in 114 cases of leukoaraiosis and 41 cases of Binswanger' s disease, of which, 74 leukoaraiosis cases and 35 Binswanger' s disease cases had received cranial MRI exam. Of those, 43 cases of simple leukoaraiosis associated with hypertension, 30 cases of Binswanger' s disease and 50 cases in the normal control were selected to carry on the examinations of body-sensory evoked potential, brain stem auditory evoked potential and visual evoked potential.coronary heart disease, diabetes, hyperlipemia, smoke, cerebral apoplexy,evoked potential and visual evoked potential.RESULTS: According to practical management analysis, 114 cases of leukoaraiosis, 41 cases of Binswanger' s disease and 50 cases in the control were diversification, mainly characterized as slightly declining of memory and loss of gait stability. Hypertension is predominated anong risk factors in Binswanger' s disease group (95.1% ), mainly characterized as physical signs of local neural focus, obvious cognitive disturbance and cerebral in CT exam that 70.2% (80/114) of cases presented brain whiter-matter abnormity in type Ⅰ. It was indicated in MRI exam that 72% (53/74) of cases presented brain whiter-matter abnormity, type Ⅰ, 27% (20/74) presented type Ⅱ and 1% (1/74) presented type Ⅲ. For Binswanger's disease patients, it was indicated in MRI exam that 54% (19/35) of cases presented brain white-matter abnormity, type Ⅲ, and 46% (16/35) presented type Ⅳ.Symmetrical extension of bilateral ventricles presented in Binswanger' s disbody-sensory evoked potential was 84% (36/43), of which, the mild abnormity occupied 60% (26/43) and moderate abnormity 23% (10/43); The abnormity rate of brain stem auditory evoked potential was 63% (27/43) and that of visual evoked potential was 54% (23/43). In Binswanger' s disease group, the abnormity rate of body-sensory evoked potential was 97% (29/30),of which, mild abnormity was 7% (2/30), moderate abnormity was 47%(14/30) and severe abnormity was 43% (13/30); The abnormity rate of brain stem auditory evoked potential was 87% (26/30) and that of auditory evoked potential was 83% (25/30).CONCLUSION: The risk factors of simple leukoaraiosis are diversified,without obvious physical signs of local neural focus. The diagnosis of it is mainly depended on abnormity Ⅰ of brain white matter described in images,manifested as remarkable dysfunction of cerebral eletrophysiology. Binswanger' s disease patients are mainly characterized as hypertension, relevantly obvious cognitive disturbance and common seizure of cerebral apoplexy. Abnormity Ⅲ of brain white matter indicated in CT exam, abnormity Ⅲ or Ⅳ of that in MRI exam are the image evidence for diagnosis. Remarkable abnormity also presents in cerabral electrophysiology, in which, abnormal body-sensory evoked potential is especially significant.