Objective To explore the effect of virtual reality based early rehabilitation on the physical and cognitive function rehabilitation of patients with ischemic stroke.Methods A total of 150 ischemic stroke patients were randomly divided into a control group and an observation group:the patients in control group were treated with conventional care and those in the intervention group with early rehabilitation training based on virtual reality.The two groups were compared in regard to the differences in cognitive function,motor function and ability of daily living(ABL),with and without the intervention.Result In comparison with the control group,patients in the observation group presented significantly higher scores in cognitive function,motor function and ABL and the difference before and after the intervention(all P<0.05).Conclusions The virtual reality based early rehabilitation for the patients with ischemic stroke can remarkably improve the recovery of their cognitive function and motor function as well as to enhance the ability of daily living of the patients.Further studies are required to confirm the effectiveness of virtual reality based early rehabilitation.

BACKGROUND: The development of safe and powerful antidepressant agents from traditional Chinese herbs has become a hotspot in studies on anti-depression therapy. OBJECTIVE: To investigate the anti-depressive effect and possible mechanism of curcumin by behavioral and neurochemical procedures. DESIGN: Randomized grouping design and controlled experiment. SETTING: Depart, ment of Pharmacology, School of Basic Medical Sciences of Peking University.MATERIALS: This study was carried out in the laboratory of the Department of Pharmacology, School of Basic Medical Sciences of Peking University, between November 2003 and October 2004. A total of 240 male ICR mice were recruited. METHODS: The whole experiment was divided into 4 tests. ① Antagonism of reserpine-induced hypothermia: Totally 60 mice were randomly chosen and divided into 6 groups: normal control group, groups of various doses of curcumin (1.25, 2.50, 5.00 and 10.00 mg/kg), and positive control group (imipramine 10 mg/kg). Normal temperature of the mice was measured before experiment. The animals were given a single injection of reserpine (2.5 mg/kg). The mice were administered with drugs 18 hours later, namely, curcumin of different concentrations by gastric perfusion, groundnut oil (0.1 mL/10g by gastric perfusion) as well as imipramine (10 mg/kg by intraperitoneal injection). Rectal temperature was measured 60, 90, 120,150 and 180 minutes after administration, respectively. ② Potentiation of 5-hydroxytryptophan (5-HTP)-induced head twitches: animal grouping was the same as above, and the drug in positive control group was replaced by fluoxetine. The mice received gastric perfusion and the dose of curcumin given was the same as above. Groundnut oil and fluoxetine (10 mg/kg) and 5-HTP (70 mg/kg) were injected into the vein of the tail one hour later.The number of head twitches was counted within 5-10 minutes after 5-HTP treatment. ③ Antagonism of apomorphine-induced hypothermia: Mice grouping was the same as above; the drug in positive control group was replaced by imipramine. Curcumin was give as above at 4 doses, and groundnut oil and imipramine were also given. Large-dose apomorphine was injected subcutaneously (16 mg/kg). Rectal temperature was measured before injection, as well as 30 minutes and 60 minutes after injection. ④Determination of monoamine and metabolites: Mice grouping was the same as above. The drug in positive control group was replaced by imipramine.Curcumin was give as above at 4 doses, and groundnut oil and imipramine were also given. The content of monoamine and metabolites in the mice was measured with high performance liquid chromatography. ⑤ Dunnett's t test was used for comparison between groups.MAIN OUTCOME MEASURES: ① In reserpine-induced hypothermia test, the change of body temperature before and after administration. ② In 5-HTP-induced head twitches test, whether the times of head twitches were increased. ③ In apomorphine-induced hypothermia test, the change of body temperature after administration. ④ Effect of drugs on the content of monoamine.RESULTS: Totally 240 mice entered the result analysis. ① Experiment results of reserpine-induced hypothermia: Curcumin (5 mg/kg and 10 mg/kg)produced an antagonism against reserpine-induced hypothermia, and the results were significantly different from those in control group (P ＜ 0.05,P＜0.01). Curcumin of 10.00 mg/kg produced the similar effect compared as that of imipramine in positive control group. ② Results of 5-HTPinduced head twitches: Curcumin (5 and 10 mg/kg) could significantly increase the times of 5-HTP-induced head twitches (P ＜0.05, P＜0.01). ③Results of apomorphine-induced hypothermia test: 2.50, 5.00 mg/kg and 10.00 mg/kg of curcumin could significantly increase the content of 5-HTP, and 10 mg/kg of curcumin could significantly increase the content of norepinephrine and dopamine. There was significant difference from that in control group (P ＜ 0.05). By contrast, curcumin had no obvious effect on the content of metabolite 5-hydroxyindol acetic acid and 3,4-dihydroxyphenylacetic acid. Imipramine of 10 mg/kg as the positive control drug could significantly increase the content of 5-hydroxyindol acetic acid and norepinephrine (P＜0.05).CONCLUSION: Curcumin has an antidepressant effect and the effect exerted may be related to monoaminergic neurotransmitter system.