Objective:To explore the effect of combining hand-brain perception training with hand-brain motor training based on mirror neuron theory on the recovery of upper limb function after a stroke.Methods:A group of 105 stroke survivors with upper limb dysfunction were randomly divided into a hand-brain perception (HP) group, a hand-brain motor (HM) group, and a combination (C) group, each of 35. In addition to conventional rehabilitation treatment (including exercise therapy, occupational therapy and physical factor therapy), the HP and HM groups were given hand-brain perception training and hand-brain motor training respectively, while group C was provided with both. Before the intervention and after 4 weeks, the upper limb motor functioning of all of the participants was assessed using the simplified version of the Fugl-Meyer upper limb motor function scale (FMA-UE). Sensory functioning was quantified using the tactile Semmes Weinstein monofilament examination (SWME), and the modified Barthel index (MBI) was used to quantify the participants′ ability in the activities of daily living.Results:After the intervention the average FMA-UE, MBI and SWME scores of all three groups had improved significantly, with group C′s average FMA-UE and MBI scores significantly better than the other two groups′ averages. The average SWME score of group C was then significantly better than that of group HM.Conclusions:Hand-brain perception combined with hand-brain motor training based on mirror neuron theory can further promote the recovery of upper limb sensory and motor functioning of stroke survivors., Such therapy is worthy of clinical promotion and application.

The Philippines’ medical system is mainly based on the provincial responsibility system and the limited hierarchical. The Philippine government implement Philhealth program which can provide medical insurance for most people. The top 10 fatal diseases in this country includes ischemic heart disease, stroke, lower respiratory tract infection and so on. Of these diseases, the increasing rate of hypertensive heart disease, chronic kidney disease and diabetes are fast. Bone setting, massage and herbal medicine are the major form of traditional medicine in the Philippines. The acceptance of acupuncture and moxibustion by the government and local people is relatively high acupuncture and moxibustion therapy has been included in its medical insurance. There are many limitations on the development of Traditional Chinese Medicine (TCM) theory and Chinese herbal medicine in the Philippines, and the clinical application of acupuncture and Chinese herbal medicine is still limited. TCM education in the Philippines is still not systematic. Therefore, it is suggested to improve the education system of TCM, strengthen the promotion of acupuncture and moxibustion, give full play of the advantages of TCM for native high-risk diseases, and to make use of modern technologies such as telemedicine.

Abstract During the yellow fever epidemic in Angola in 2016, cases of yellow fever were reported in China for the first time. The 11 cases, all Chinese nationals returning from Angola, were identified in March and April 2016, one to two weeks after the peak of the Angolan epidemic. One patient died; the other 10 cases recovered after treatment. This paper reviews the epidemiological characteristics of the 11 yellow fever cases imported into China. It examines case detection and disease control and surveillance, and presents recommendations for further action to prevent additional importation of yellow fever into China.

Objective:To assess the effect of stone and urine bacteria culture on the treatment of postoperative infection in percutaneous nephrolithotomy (PCNL).Methods:Between September 2016 and September 2018, 1060 patients with kidney stones treated with first-stage PCNL were included in the study. There were 614 male and 446 female patients, with the mean age (52.4±12.2) years. The mean stone burden was (1 499.6±1 435.3) mm 2. The midstream urine sample and the stone sample were sent for bacterial culture, identification of bacterial strain and antimicrobial susceptibility tests. The results of urine culture (UC), stone culture (SC) and their antimicrobial susceptibility, the details of perioperatively administered antibiotics and postoperative infections were recorded. The relationship between the postoperative infection and the SC was analyzed. Results:In 1 060 patients, 22 bacterial species were identified in UC and 52 bacterial species were identified in SC. The positive rate was higher in SC than in UC[31.8%(337/1 060)vs. 20.9%(222/1 060), P<0.001]. Escherichia coli was the most common bacteria in both UC and SC, but was more prevalent in UC than in SC [52.3%(116/222)vs. 43.6%(147/337), P<0.05]. E. coli cultured from UC and SC had high resistance to ampicillin, cefazolin, ceftriaxone, cefotaxime, levofloxacin, ciprofloxacin (all resistance rate >40%), but were sensitive to meropenem, cefoperazone/sulbactam, piperacillin/tazobactam, and amikacin (all resistance rate <10%). There was no statistical difference in the antibiotic resistance rates of E. coli from the UC and SC (all P >0.05). There were 111 (10.5%) patients who developed fever and 22 (2.1%) who developed urosepsis postoperatively. The incidences of postoperative fever and urosepsis were higher in the patients with positive SC than the patients with negative SC [23.7%(80/337)vs. 4.3%(31/723); 4.2%(14/337)vs. 1.1%(8/723), P<0.05]. Even in patients with negative UC, The incidence of postoperative fever was higher in the group with positive SC than the group with negative SC [17.9%(30/168) vs. 4.2%(28/670), P<0.05]. The incidence of postoperative fever in SC positive patients was lower if they were treated with sensitive antibiotics to the bacteria in stone than those treated with nonsensitive antibiotics [17.5%(22/126) vs. 27.5%(58/211), P<0.05]. Conclusions:The SC had high rate of culture positive, complicated bacterial species and high rate of multi-drug resistant. Positive SC was associated with increased incidence of postoperative infection even if the patients had negative UC. The SC might have a importance clinical value in the treatment of postoperative infection in PCNL.

Objective: To investigate the clinical features of anti-signal recognition particle (SRP) antibody-positive patients with dermatomyositis/clinically amyopathic dermatomyositis (DM/CADM) . Methods: Clinical data were collected from 90 patients with DM/CADM, who were hospitalized at the Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2015 to July 2017. Immunoblotting assay was performed to determine the serum level of anti-SRP antibody in these patients. Statistical analysis was carried out using t test and Chi-square test. Results: Of the 90 patients with DM/CADM, 11 (12.2%) were positive for serum anti-SRP antibody, including 6 with DM and 5 with CADM. Among 82 adult patients with DM/CADM, the prevalence of malignant tumors was significantly higher in the patients with anti-SRP antibody than in those without (7/9 vs. 31.5%[23/73], χ² = 7.394, P = 0.006) . The 11 patients with anti-SRP antibody had typical DM skin lesions, and their cutaneous dermatomyositis disease area and severity index (CDASI) was 18.1 ± 2.9. The prevalence of "angel wings sign" (aliform erythema on the trunk) was significantly higher in the patients with anti-SRP antibody than in those without (7/11 vs. 29.9%[20/67], Fisher′s exact test, P = 0.028) . The positive rate of antinuclear antibody was significantly higher in the patients with anti-SRP antibody than in those without (4/8 vs. 16.7%[13/78], χ² = 6.053, P = 0.014) . Magnetic resonance imaging of muscles of both thighs of the 10 patients with anti-SRP antibody (6 with DM and 4 with CADM) showed the presence of abnormal signals in the thigh muscle group in 8, swelling of the muscle group in 2, subcutaneous edema in 2, myofascial swelling in 1, and no abnormities in 2. No interstitial lung disease or myocardial involvement was observed in the patients with anti-SRP antibody. Conclusions The anti-SRP antibody-positive patients with DM/CADM showed a high prevalence of "angel wings sign" , and a high risk of malignant tumors. Early detection of the anti-SRP antibody in patients with DM/CADM is helpful to predict the occurrence of malignant tumors.

Objective To explore the effects of multidisciplinary teamwork continuity of care for community-dwelling patients with advanced renal cell carcinoma treated with targeted drugs.Methods A total of 80 patients with stage IV renal cell carcinoma treated in our hospital from February 2014 to February 2017 were enrolled using convenience sampling method,and were randomly divided into the experimental group and the control group using random number table,with 40 cases in each group.Both groups were given routine nursing care,and multidisciplinary teamwork continuity of care was adopted in the experimental group additionally.Results One month after intervention,the patients' score of medication compliance questionnaire in the experimental group was significantly higher than that in the control group(P＜0.05);three months after intervention,the quality of life(QLQ-C30) score of the experimental group was significantly improved than that of the control group(P＜0.05),and the number of rehospitalization was significantly less than that in the control group(P＜0.05).The number and severity of adverse effects in the experimental group were lower than those in the control group,and no case of stopping medication or decreasing doses occurred.Conclusion The multidisciplinary teamwork continuity of care model can enhance health status of community-dwelling patients,improve medication compliance and quality of life,and reduce readmission.

Oxidative stress induced by free fatty acid aggravates endothelial injury, which leads to diabetic cardiovascular complications. Reduction of intracellular oxidative stress may attenuate these pathogenic processes. The dietary polyphenol resveratrol reportedly exerts potential protective effects against endothelial injury. This study determined whether resveratrol can reduce the palmitic acid (PA)-induced generation of reactive oxygen species (ROS) and further explored the underlying molecular mechanisms. We found that resveratrol significantly reduced the PA-induced endothelial ROS levels in human aortic endothelial cells. Resveratrol also induced endothelial cell autophagy, which mediated the effect of resveratrol on ROS reduction. Resveratrol stimulated autophagy via the AMP-activated protein kinase (AMPK)-mTOR pathway. Taken together, these data suggest that resveratrol prevents PA-induced intracellular ROS by autophagy regulation via the AMPK-mTOR pathway. Thus, the induction of autophagy by resveratrol may provide a novel therapeutic candidate for cardioprotection in metabolic syndrome.
AMP-Activated Protein Kinases ; metabolism ; Animals ; Antioxidants ; pharmacology ; Autophagy ; drug effects ; Cells, Cultured ; Endothelial Cells ; Humans ; Male ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Resveratrol ; pharmacology ; Signal Transduction ; drug effects ; TOR Serine-Threonine Kinases ; metabolism

Objective To explore the effect of continuity of care in reducing domestic symptomatic hypoglycemia of children with type 1 diabetes. Methods A total of 50 first diagnosed type 1 diabetic children who were admitted in a classⅢgrade A hospital from May 2014 to December 2015 were selected and divided into observation group and control group randomly with 25 cases in each. The two groups were given the same clinical nursing, while the observation group was given continuity of care after discharge. The observation period last for 12 months from the time of discharge. Observed the average weekly incidence of symptomatic hypoglycemia, admission, HbA1c. Results A total of 45 cases completed the research, 21 of which were from the control group, and the last were from the observation group. Compared with the control group, the occurrence of domestic symptomatic hypoglycemia in observation group was significantly reduced (P< 0.05). Meanwhile, the number of readmission in the observation group was significantly lower than that in the control group (P< 0.05). Conclusions Continuity of nursing can effectively reduce the symptomatic hypoglycemia occurrence of type 1 diabetic children who were first diagnosed within 12 months. It can also reduce readmission rate, medical expenses and family financial burden.

Objective:To evaluate the safety and efficacy of dosing transdermal fentanyl patch by patient-controlled intravenous anal-gesia (PCIA) with fentanyl to treat opioid-naive patients suffering from cancer-related pain. Methods:In this open non-controlled trial, 30 patients with moderate to severe cancer pain were enrolled in the study. Titration conditions, pain score (NRS), and pain of life im-pact scores were assessed and recorded during four periods of treatment, as follows:before fentanyl-PCIA;during fentanyl-PCIA treat-ment;during Duragesic with fentanyl-PCIA treatment;and during Duragesic treatment. Adverse reactions were assessed and recorded during the two periods of treatment (the period before fentanyl-PCIA and the period after fentanyl-PCIA). Results:A total of 20 cases of titration were a success, whereas 10 cases failed. The general pain score, the most serious pain score, activity pain score, resting pain score, and the pain of life impact scores were all significantly reduced during fentanyl-PCIA treatment, during Duragesic with fen-tanyl-PCIA treatment, and during Duragesic treatment compared with the period before fentanyl-PCIA treatment (P<0.05). Nausea was the only adverse reaction that occurred during treatment. Obvious muscle rigidity, loss of consciousness, cough, respiratory depres-sion, and bradycardia were not observed. Conclusion:Dose titration of transdermal fentanyl patch with fentanyl administrated by PCIA for opioid-naive patients provides an effective and convenient method for pain relief treatment.

Objective To observe the role of the health education model in pain self- efficacy for patients with cancer pain. Methods Sixty- four patients suffering from cancer pain were enrolled into the study and self- contrast experiment was made on each patient. The health education model was set up and health education for each patient with cancer pain was implemented. The pain, self- efficacy, cancer pain knowledge before and after the intervention were observed by Numerical Rating Scale (NRS),Chronic Pain Self- efficacy Scale(CPSS) and Cancer Pain Knowledge Questionnaire. Results NRS score were (5.38 ±0.19) points and (1.05 ± 0.11) points before and after the intervention, and there was significant difference (t =25.288, P = 0.000). Before intervention, pain management self- efficacy, physical function self- efficacy, symptom coping self- efficacy of CPSS scores were (10.38 ±0.37) , (20.97±0.81) , (16.86 ± 0.49) points, while after the intervention, the scores were (19.31± 0.30) , (33.25 ± 0.60) , (29.75 ±0.51) points, there were significant differences ( t = -33.225, -18.236, -18.235, all P = 0.000). Before and after the intervention, the answer rate of Cancer Pain Knowledge Questionnaire was 50.00%(32/64) and 87.50%(56/64), there was significant difference( χ2=20.51, P < 0.01). Conclusions To set up the health education model and implement health education for each patient with cancer pain can improve the patient′s pain management and enhance self-efficacy.