Objective:To observe the clinical efficacy of combining repeated transcranial magnetic stimulation (rTMS) with radiofrequency ablation (RF) of dorsal root ganglia in treating herpes zoster infection and neuralgia.Methods:Eighty-four individuals with a herpes zoster infection who had suffered from neuralgia for no more than 7 days were divided randomly into a control group, an rTMS group, an RF group, and an observation group, each of 21. All were treated with gabapentin, valciclovir and mecobalamin. The rTMS group received rTMS treatment, 5 days per week, for 2 consecutive weeks. The RF group received RF treatment of the dorsal root ganglia on the 15th day after enrollment, while the observation group received only the medication. Before the experiment as well as after 3, 7, 16, 30 and 60 days, all of the subjects self-assessed their discomfort using a pain visual analog scale (VAS). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Quality of Life Assessment Scale (QOL-SF36), and Pittsburgh Sleep Quality Index (PSQI) were also administered.Results:The average VAS, HAMA, HAMD, QOL-SF36, and PSQI scores of the observation group improved continuously and significantly during and after the treatment. Beyond 16 days all of those results were significantly better than the control group′s averages, and the observation group′s average VAS, HAMA and HAMD results were also significantly better than those of the rTMS group. The observation group′s average VAS, HAMA, HAMD and PSQI scores had improved significantly more than the RF group′s averages beyond 30 days.Conclusion:Combining rTMS and dorsal root ganglion RF can effectively alleviate the early pain symptoms of herpes zoster infection and neuralgia, relieve anxiety and depression, and significantly improve sleep and life quality. Such therapy is worthy of clinical promotion and application.

Objective:To explore any effect of on the limb and cardiopulmonary functioning of stroke survivors of combining new Bobath technique with cardiopulmonary rehabilitation.Methods:A total of 160 stroke survivors with limb disorders were randomly divided into an observation group and a control group, each of 80. Both groups were given routine rehabilitation and the new version of Bobath training, but the observation group was additionally provided with 12 weeks of cardiopulmonary rehabilitation. Before and after the treatment the limb functioning of both groups was evaluated along with their ability in the activities of daily living and the recovery of damaged nerve function, using the simplified Fugl-Meyer (FMA) motor function scoring, the modified Barthel index (MBI) and the Chinese stroke scale (CSS). Peak oxygen uptake (VO 2peak), peak metabolic equivalent (METpeak), peak heart rate (HRpeak) and anaerobic thresholds (ATs) were documented. Results:After the treatment the average FMA, MBI and CSS scores and cardiopulmonary indexes had improved significantly in both groups. All were then significantly better in the observation group than in the control group.Conclusions:Combining the new Bobath technique with cardiopulmonary rehabilitation can significantly improve the limb and cardiopulmonary functioning of stroke survivors, as well as their skill in the activities of daily living and the recovery of the damaged nerve functionality. This combination is therefore worthy of clinical promotion and application.

Objective:To observe any effect of repeated transcranial magnetic stimulation (rTMS) in the treatment of diabetic peripheral neuropathic pain (DPNP).Methods:Eighty-six persons with type 2 diabetes mellitus and DPNP were randomly divided into an observation group and a control group, each of 43. Both groups were given basic treatment to control plasma glucose and blood pressure, while the observation group was additionally provided with daily 10Hz rTMS of the primary motor cortex (M1 area) of the non-dominant hand 5 days a week for 4 weeks. Before and after the treatment, pain in both groups was evaluated using a visual analog scale (VAS) and the Patient′s Global Impression Change scale (PGIC). The motor conduction velocity (MCV) and sensory conduction velocity of the median and the common peroneal nerves were also tested.Results:After treatment, the average VAS pain rating and PGIC score of the observation group were significantly lower than the control group′s averages and those before treatment. The observation group′s treatment effectiveness rate (79.07%) was then much better than that of the control group (23.26%). After the treatment, the average MCV of the median and common peroneal nerves of the observation group (47.65±1.94 m/s and 46.98±3.26 m/s, respectively) were significantly faster than before treatment, and those of the control group.Conclusions:rTMS based on routine intervention can significantly relieve DPNP and promote the recovery of injured nerves, bettering diabetics′ physical condition and life quality.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Giant thoracic tumor is currently one of the diagnostic and therapeutic challenges of thoracic surgery, with no established guideline or standard for diagnosis and treatment. The quality control of individualized surgical strategy and perioperative management with multi-disciplinary participation is the key to ensure the safety and improve the prognosis of patients. Based on the clinical experience of our institution and others, we hereby discussed and summarized the basic principles, surgical strategies and perioperative management of giant thoracic tumor, aiming to provide a reference of quality control.

Objective To explore the effect of repeated transcranial magnetic stimulation ( rTMS) com-bined with rehabilitation training on the motor and non-motor symptoms of Parkinson's disease. Methods A total of 150 persons with Parkinson's disease were randomly divided into an rTMS group, a rehabilitation training group and an observation group, each of 50. The rTMS group received only repeated magnetic stimulation. The rehabilita-tion training group received only standard rehabilitation training. The observation group was given both for 4 weeks. The overall efficacy of each treatment was evaluated using the unified Parkinson's disease rating scale ( UPDRS) , while the motor symptoms were assessed using the 10 m back-and-forth run test, a simple test for evaluating hand function ( STEF) and Berg's balance scale. Non-motor symptoms were evaluated using a questionnaire ( NMSQ) , the mini-mental state examination ( MMSE) , the Hamilton depression scale ( HAMD) , the Hamilton anxiety scale ( HAMA) and the Parkinson's disease sleep scale ( PDSS) . Moreover, a comprehensive quality of life assessment questionnaire ( SF-36) was used to evaluate the life quality of patients before and after the treatment. Results Compared with before the treatment, the average UPDRS scores of all three groups were lower after the treatment. Moreover, the average UPDRS score of the observation group was significantly lower than those of the other two groups. Significant improvement was observed in the mean 10 m run time and in the average STEF and Berg scores of the rehabilitation training and observation groups, but not in the rTMS group's averages. After the treatment, the mean NMSQ, MMSE, HAMD, HAMA and PDSS results of the rTMS and observation groups were significantly bet-ter than those before treatment, with the observation group's averages significantly better than those of the rehabili-tation training group. The average PDSS and SF-36 scores of the observation group were also significantly better than those of the other groups. Conclusion rTMS combined with rehabilitation training can significantly improve the motor and non-motor symptoms of Parkinson's disease patients, and its efficacy is superior to that of rTMS or reha-bilitation training alone.

Objective To observe the effect of injecting botulinum toxin type A on muscle tension,disability level and ability in the activities of daily living in patients with post-stroke dystonia.Methods Thirty-two patients with post-stroke dystonia were divided into an observation group (n =16) and a control group (n =15).The patients in the observation group were injected with 200-600 U of botulinum toxin type A in the relevant muscles,while the patients in the control group were given 12 mg diphenhydrazole hydrochloride tablets orally.Before and 2,6 and 12 weeks after the treatment,spasticity,disability and daily living ability were evaluated in both groups using the modified Ashworth scale (MAS),a disability assessment scale (DAS) and the modified Barthel index (MBI).Results After the treatment,the average MAS,DAS and MBI scores of both groups were significantly better than before the treatment.And the average MAS,DAS and MBI scores of the observation group were significantly better than those of the control group.Conclusion Botulinum toxin A injection can significantly improve dystonia and relieve disability among stroke survivors.

Objective To observe the therapeutic effect of surface functional electrical stimulation combined with electroacupuncture on neurogenic bladder after the spinal cord injury.Methods Forty cases of neurogenic bladder after the spinal cord injury were randomly divided into a control group (n =20) and a combination group (n =20).The combination group was treated with surface functional electrical stimulation combined with electroacupuncture on the basis of internal urethral catheterization,while the control group was treated with surface functional electrical stimulation on the basis of internal urethral catheterization.The bladder urination was tested using urodynamic study before and after two months of treatment.Results There was no significant difference between the 2 groups in the average maximum bladder capacity,detrusor pressure at filling time,maximal urethral closure pressure,maximum urine flow rate and residual urine volume before the treatment.After the treatment,however,the average maximum bladder capacity,maximal urethral closure pressure and maximum urine flow rate in the combination group were significantly higher than those of the control group,while the average detrusor pressure at filling time and the residual urine volume of the combination group were significantly lower than the control group.Conclusion Surface functional electrical stimulation combined with electroacupuncture could remarkably improve bladder function of patients with the neurogenic bladder after the spinal cord injury.

OBJECTIVE To investigate the effect of injection of β2-adrenergic receptor agonist clenbuterol into the infralimbic cortex(IL) on drug-seeking behavior triggered by conditioned cues. METHODS Adult male SD rats were trained to self-administer heroin under a FR1 schedule for consecutive 14 d,followed by 2-h extinction training. Cue-induced heroin seeking was measured for 2 h. Clenbuterol was microinjected bilaterally into the IL(8 ng/side)of rats 15 min prior to reinstatement test. Meanwhile,locomotor activity was detected 15 min after clenbuterol or artifial cerebrospinal fluid(mod?el group) was microinjected bilaterally into IL. Western blotting was used to detect the expression of phosphorylated cyclic AMP response element-binding protein(p-CREB)in the prelimbic cortex(PL), IL,nucleus accumbens core (NACc) and shell (NACsh) of rats immediately after reinstatement test. RESULTS After heroin administration training for 14 consecutive days,these animals exhibited reliable heroin self-administration,indicated by the increase in active nose poke responses and infusions. The rats that had received infusion of clenbuterol into the IL had significantly lower active pokes (8 ± 3)than those in model group(45±10)in cue-induced reinstatement(P<0.01),but there was no significant differ?ence between clenbuterol group and vehicle group in the locomotor activity. The expression of p-CREB in either IL or NACsh was significantly decreased in clenbuterol group compared with model group(P<0.01,P<0.05),but significantly increased in NACc(P<0.01). CONCLUSION Microinjection of clenb?uterol into the IL can attenuate the cue-induced reinstatement of heroin-seeking behavior in rats. The underlying mechanism might be related to the regulation of p-CREB expression in the NACc and NACsh.

Objective To identify the risk factors for deep vein thrombosis(DVT) in the lower extremities during hospitalization for acute spinal cord injury(SCI).Methods Retrospective data analyses were performed for 49 SCI patients admitted within a week after they were diagnosed.The patients were divided into a DVT-free(n =40) group and a DVT group(n =9) according to their lower limbs' color Doppler ultrasound results.And the subjects' gender,age,chronic diseases (diabetes,hypertension and hyperlipidemia,etc.),complications (pulmonary infection,urinary tract infections and pressure sores,etc.),the history of cancer,smoking history and lower extremity fractures were recorded.Intermittent pneumatic compression treatment,the early rehabilitation intervention,antithrombotic therapy,history of venous catheterization,operative intervention,blood transfusion history,muscle strength of lower extremity and time from onset to being transfered to rehabilitation department were also recorded Single factor analysis,was conducted,followed by Binary logistic regression to pick out the risk factors for DVT.Results The result of the binary logistic regression analysis showed that gender (OR 6.87 ; 95％ CI 1.09-43.22 ;P ＜ 0.05) and intermittent pneumatic compression treatment (OR 12.47 ; 95％ CI 1.09-142.36 ; P ＜ 0.05) were significant predictors of DVT.Conclusion Gender and intermittent pneumatic compression treatment are related with DVT risk for patients with acute SCI.