Immediate and short-term effects of virtual games on balance function in patients with functional ankle instability / 中国综合临床

Objective:To investigate the immediate and short-term effects of virtual games on balance function in patients with functional ankle instability(FAI).Methods:Fifty-six FAI subjects from North China University of Science and Technology from September 2020 to December 2020 were selected by cruamberland ankle instability tool(CAIT). According to the computer random number method,the 56 subjects were randomly divided into the control group and the observation group with 28 subjects in each group,and the prospective cohort study method was used for this study. Control group accepted routine balance training,observation group based in the control group carries on the virtual game training. Before and immediately after intervention and 4 weeks after intervention,the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test(SEBT),and the CAIT score of subjects in the two groups was recorded and compared. The measurement data conforming to normal is expressed in xˉ ± s means independent sample t-test or paired t-test. χ2 test was used for counting data. Results:Immediately after intervention,the 8 directions of SEBT scores in the observation group are significantly improved compared with those before intervention: Anterior(69.06±7.57)% and (63.69±8.05)%, Anterolateral (61.14±6.68)% and (55.77±7.39)%, Lateral (67.71±7.99)% and (62.93±7.56)%, Posterolateral (76.43±6.98)% and (71.31±7.86)%, Posterior (75.45±6.78)% and (68.72±6.65)%, Posteromedial (79.13±8.09)% and (72.72±9.03)%, Medial(72.67±7.43)% and (65.67±8.16)%, Anteromedial (67.75±8.30)% and (63.18±8.95)% ( t values were 8.03, 11.88, 9.72, 6.43, 19.53, 9.36, 11.06 and 6.46, respectively; all P<0.001), and the observation group was significantly better than the control group (63.24±6.72)%, (55.41±7.74)%, (61.49±8.37)%, (70.02±6.81)%, (69.06±9.46)%, (72.41±7.20)%, (66.37±6.57)% and (62.15±6.89)%. There were significant differences between the two groups ( t values were 3.04, 2.97, 2.84, 3.47, 2.90, 3.28, 3.36 and 2.75, respectively; P values were 0.004, 0.004, 0.006, 0.001, 0.005, 0.002, 0.001 and 0.008,respectively). After 4 weeks of intervention,the static balance parameters in the observation group were significantly reduced compared with before intervention under the condition of opened eyes and closed eyes (open eyes: average AP speed of COP (24.68±6.85) mm/s and (27.57±7.15) mm/s,average ML speed of COP (26.25±6.20) mm/s and (30.61±6.99) mm/s, ellipse area of COP (915.75±356.08) mm and (1 286.54±530.05) mm, perimeter of COP (823.82±173.80) mm and (1 142.89±297.03) mm ( t values were 4.02, 3.09, 4.89 and 6.74, respectively; all P<0.001); closed eyes:average AP speed of COP (66.82±15.02) mm/s and (73.71±11.12) mm/s, average ML speed of COP (76.93±13.36) mm/s and (84.39±10.05) mm/s, ellipse area of COP (3 318.54±958.75) mm and (4 174.21±1 310.54) mm, perimeter of COP (2 156.96±665.80) mm and (2 817.75±528.22) mm ( t values were 3.23,3.29,4.95,5.02, respectively; P values were 0.003, 0.003,<0.001,<0.001,respectively). Average ML speed of COP (open eyes:(26.25±6.20) mm/s), ellipse area of COP (open eyes: (915.75±356.08) mm;closed eyes: (3 318.54±958.75) mm and perimeter of COP (open eyes: (823.82±173.80) mm; closed eyes: (2 156.96±665.80) mm) in the observation group were lower than those of the control group(30.68±9.81) mm/s, (1 137.25±423.27) mm, (3 973.36±1 306.61) mm, (1 038.79±242.90) mm, (2 603.43±703.81) mm, the differences were statistically significant ( t values were 2.02,2.12,2.14,3.81,2.44,respectively; P values were 0.049,0.039,0.037, <0.001,=0.018, respectively). After 4 weeks of intervention,the 8 directions of SEBT scores in both groups were significantly improved compared with those before intervention (Anterior:observation group (72.84±6.76)% and (63.69±8.05)%,control group (69.05±6.16)% and (62.96±6.56)%. Anterolateral:observation group (65.24±7.68)% and (55.77±7.39)%,control group (60.65±8.11)% and (54.65±8.98)%. Lateral: observation group(73.97±8.80)% and (62.93±7.56)%, control group (68.34±9.14)% and (61.24±9.42)%. Posterolateral: observation group (81.68±6.69)% and (71.31±7.86)%, control group (76.39±6.78)% and (69.74±8.11)%. Posterior: observation group (81.41±7.86)% and (68.72±6.65)%, control group (75.21±8.48)% and (68.45±9.96)%. Posteromedial: observation group (82.77±8.69)% and (72.72±9.03)%,control group (78.38±6.84)% and (72.36±7.34)%. Medial:observation group (77.47±7.85)% and(65.67±8.16)%, control group (72.66±6.93)% and (65.95±7.09)%. Anteromedial:observation group(73.33±8.91)% and (63.18±8.95)%, control group (68.35±6.53)% and (61.66±6.80)% ( t values were 14.19, 10.17, 12.71, 12.35, 12.32, 8.99, 11.38, 6.95, 12.66, 7.94, 9.54, 11.53, 11.89, 12.87, 11.69 and 12.53, respectively; all P<0.001)), and the observation group was significantly better than the control group,the differences were statistically significant ( t values were 2.19, 2.18, 2.35, 2.94, 2.84, 2.10, 2.43 and 2.38, respectively; P values were 0.033, 0.034, 0.023, 0.005, 0.006, 0.040, 0.018 and 0.021, respectively). After 4 weeks of intervention,the CAIT score of subjects in both groups was significantly improved compared with before intervention (observation group (18.89±3.62) points and (14.93±4.09) points,control group (16.96±3.18) points and (15.25±3.81) points ( t values were 10.54 and 5.65; all P<0.001), and The CAIT score in observation group was higher than that in control group,the differences were statistically significant ( t=2.12, P=0.039). Conclusion:Virtual games could immediately improve the dynamic balance ability of FAI patients,which combined with conventional balance training intervention for 4 weeks significantly also improved the balance ability and ankle joint stability of FAI patients.

Observation of therapeutic effect of neuromuscular joint facilitation on functional ankle instability / 中国综合临床

Objective:To observe the intervention effect of neuromuscular joint facilitation (NJF)in patients with functional ankle instability (FAI).Methods:Fifty-three FAI subjects from North China University of Science and Technology from October 2020 to January 2021 were selected by cruamberland ankle instability tool (CAIT). According to the computer random number method, the 53 subjects were randomly divided into the control group (27 cases) and NJF group (26 cases). The control group received routine rehabilitation training, while the NJF group received NJF manipulation intervention on the basis of routine rehabilitation training. Before intervention and 8 weeks after intervention,ankle joint isokinetic muscle strength (invertor\evertor relative reak tergue) and the ratio of invertor to evertor of subjects in the two groups was evaluated and compared by Biodex isokinetic test training system, and the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test (SEBT), and the two groups were recorded and compared using the CAIT. A prospective cohort study was used. The measurement data of normal distribution are expressed by ± s. The mean between the two groups is compared by independent sample t-test, and the comparison before and after Intervention in the group is compared by paired t-test; The counting data were expressed in cases (%), and the comparison between groups was adopted χ 2 inspection. Results:After intervention, the NJF group at 60°/s angular velocity: invertor relative reak tergue (30.28±5.17) 0%, evertor relative reak tergue (28.93±5.15)%, the ratio of invertor to evertor (1.05±0.08) and 180°/s angular velocity: invertor relative reak tergue (27.17±5.24)%, evertor relative reak tergue (24.62±3.57)%, the ratio of invertor to evertor (1.10±0.12) were better than control group (27.05±5.95)%, (23.90±3.81)%, (1.13±0.15) and (24.12±5.36)%, (20.35±3.74)%, (1.19±0.18), and the differences were statistically significant ( t value were 2.11, 4.06, 2.35, 2.09, 4.25, 2.10, respectively; P value were 0.040, <0.001, 0.024, 0.042, <0.001, 0.040, respectively). After intervention, average AP speed of COP in the NJF group (open eyes: (23.19±5.25) mm/s; closed eyes: (65.65±10.51) mm/s), average ML speed of COP (open eyes: (23.73±4.73) mm/s; closed eyes: (72.08±10.28) mm/s), ellipse area of COP (open eyes: (913.77±348.90) mm 2; closed eyes: (3 271.65±1 024.48) mm 2) and perimeter of COP (open eyes: (845.04±146.68) mm; closed eyes: (2 055.42±548.89) mm) were lower than those of the control group (26.41±4.89) mm/s, (71.52±9.85) mm/s, (27.56±7.68) mm/s, (78.67±11.74) mm/s, (1 174.33±424.20) mm 2, (3 989.41±1 410.00) mm 2, (1 041.93±291.28) mm, (2 490.93±541.94) mm, the differences were statistically significant ( t value were 2.31, 2.10, 2.17, 2.17, 2.44, 2.11, 3.13, 2.97, respectively; P value were 0.025, 0.041, 0.034, 0.035, 0.018, 0.040, 0.003, 0.005, respectively). After intervention,the 8 directions of SEBT scores in the NJF group:Anterior (73.16±6.04)%, Anterolateral (65.90±5.54)%, Lateral (74.36±7.77)%, Posterolateral (88.05±6.76)%, Posterior (83.31±6.64)%, Posteromedial (86.01±7.62)%, Medial (77.39±8.44)% and Anteromedial (72.36±6.74)% were all higher than the control group (67.65±6.03)%, (61.08±5.96)%, (67.72±8.28)%, (78.33±8.06)%, (76.22±8.71)%, (79.31±7.24)%, (71.36±7.00)%, and (67.12±7.21)%,the differences were statistically significant ( t value were 3.32, 3.05, 3.01, 4.75, 3.33, 3.28, 2.83, 2.73, respectively; P value were 0.002 ,0.004, 0.004, <0.001, 0.002, 0.002, 0.007, 0.009, respectively). After intervention, the CAIT score of NJF group (23.04±3.96) points was higher than that of control group (19.15±3.56) points, and the difference was statistically significant ( t=3.76, P<0.001). Conclusion:NJF can significantly improve the internal and external muscle strength of the ankle joint and enhance the coordination of the internal and external muscle group, and effectively improve the static and dynamic balance ability of FAI patients.

Effects of cognitive-walking dual-task training on executive and walking function in patients with stroke / 中国综合临床

Objective:To explore the intervention effect of cognitive-walking dual-task training on executive and walking function in patients with cerebral apoplexy.Methods:A total of 70 stroke patients who were hospitalized in the Department of Rehabilitation Medicine of Baoding Taihe Rehabilitation Hospital from June 2020 to October 2020 were selected as the study subjects.All 70 hemiplegic patients with stroke were randomly divided into control group ( n=35) and test group ( n=35) by random number table method, and a prospective study was conducted.The control group was given routine walking training, and the test group was given cognitive-walking dual-task training at the same time and frequency as the control group.E-Prime software was used to evaluate the executive function of patients before and 4 weeks after intervention, including three sub-tests of Flanker, 1-back and More-odd shifting, and the reaction time of each test was recorded.The score changes of Mini-Mental Status Examination (MMSE) and Modified Rankin Scale (MRS) were recorded.The single-task walking time, dual-task walking time and dual-task walking time cost during 10 m Walk Test were calculated.Finally, 33 cases in the experimental group and 31 cases in the control group completed the study.Finally, 33 cases in the experimental group and 31 cases in the control group completed the study. Results:After 4 weeks of intervention, the MMSE scores of the experimental group and the control group were improved compared with those before intervention (the experimental group (26.39±1.90) and (24.42±2.69), t=10.824, P<0.001; the control group (25.45±1.77) and (24.61±2.16), t=7.325, P<0.001), and the experimental group was significantly better than the control group ( t=2.049, P=0.045)). The duration of three tests of executive function in the experimental group and the control group was significantly shorter than that before the intervention (Flanker task: the experimental group (752.38±178.28) ms and (939.42±260.11) ms, t=10.467, P<0.001; the control group (863.40±227.86) ms and (951.67±265.93) ms, t=8.140, P<0.001.1-back task: the experimental group (983.31±314.16) ms and (1 242.10±444.77) ms, t=10.386, P<0.001; the control group (1 186.89±293.80) ms and (1 238.27±305.95) ms, t=9.569, P<0.001.More odd shifting task: the experimental group (1 121.29±260.17) ms and (1 362.32±352.80) ms, t=13.084, P<0.001; the control group (1 255.81±269.41) ms and (1 351.37±287.46) ms, t=8.550, P<0.001), and the experimental group was significantly better than the control group (Flanker task: t=2.198, P=0.032; 1-back task: t=2.691, P=0.009; more odd shifting task: t=2.044, P=0.045). The results of 10 m walking test in the experimental group and the control group were improved compared with those before the intervention (single task walking time: the experimental group (20.71±9.61) s and (26.10±13.88) s, t=6.312, P<0.001; the control group (22.42±9.60) s and (25.62±10.97) s, t=13.009, P<0.001). The duration of dual task walking: the experimental group (22.73±10.28) s and (31.64±16.07) s, t=7.931, P<0.001; the control group (28.30±11.72) s and (31.89±13.65) s, t=9.348, P<0.001.The cost of dual task walking: the experimental group (10.32±6.87)% and (23.26±11.40)%, t=10.602, P<0.001; the control group (27.39±7.38)% and (24.94±7.48)%, t=2.719, P=0.011). The 10 m walking test time of the experimental group was shorter than that of the control group ( t=2.027, P=0.047), and the walking time cost of the experimental group was lower than that of the control group ( t=9.583, P<0.001). Conclusion:Cognitive walking dual task training can improve the walking function of patients, which is more conducive to the recovery of executive function than conventional walking training.

Suggestions for prevention and nursing techniques of venous thromboembolism in patients with corona virus 2019 combined with trauma / 中华创伤杂志

Corona virus disease 2019 (COVID-19) patients with trauma are at high risk of venous thromboembolism (VTE), which must be taken seriously in the therapeutic processes. Hypercoagulable state is induced by 2019 novel coronavirus (2019-nCoV) in many ways, such as increasing the level of inflammatory factors and fibrinogen, and inducing endothelial cell injury. The venous wall injuries from trauma and operation directly or indirectly trigger off the exogenous coagulation pathway and the microcirculation can be damaged at the same time, which may initiate the exogenous pathway of VTE. Immobilization of limbs and forced bed rest during the treatment of traumatic patients will slow venous blood flow. Chronic non-communicable diseases such as diabetes in the elderly were independent risk factors for VTE. Furthermore, the persistent fever, severe lung disease, respiratory failure, sepsis and invasive technology application add the risk of VTE and the difficulty of treatment. In order to help effective prevention VTE of for COVID-19 patients with trauma, the authors put forward relevant technical suggestions for prevention and nursing of VTE to provide basis for nursing work during pandemic of COVID-19.

Converted auditory training can improve executive function among breast cancer patients undergoing chemotherapy / 中华物理医学与康复杂志

Objective To observe the effect of Tomatis converted auditory training on the executive functioning of breast cancer patients undergoing chemotherapy.Methods Eighty breast cancer patients with the executive dysfunction who were undergoing chemotherapy were divided into a control group and an experimental group,each of 40.The experimental group was given Tomatis high and low frequency auditory training,while the control group was given ordinary music training.The patients in both groups were treated in 4 stages,each of 5 consecutive days with intervals of 21 days.The Chinese Version of the Behavioral Assessment of Dysexecutive Syndrome (BADS) was used to evaluate both groups before and after the intervention,including rule transformation ability,problem solving ability,planning ability,supervising ability and organizing ability.Results After the intervention,the experimental group had a significantly higher average score than before the intervention in the rule-switching card test,the action planning test,the key-finding test,and the modified six-element test.Their average BADS score was also significantly improved.The control group showed a significantly better average score only in the key-finding test and in its average BADS total score.After the intervention,the experimental group had a significantly higher average score than the control group in the rule-switching card test and the action planning and six-element tests.Its average BADS rating was also significantly better.Conclusion Tomatis high and low frequency auditory training can improve the executive function of patients undergoing chemotherapy for breast cancer.Its effect is better than that of ordinary music training.

Analysis and validation of PI3K/AKT signaling pathway associated with overall survival time of patients with HER2-positive breast cancer / 解放军医学杂志

Objective To analyze and validate the key molecular targets correlated with the overall survival of patients with HER2-positive breast cancer.Methods First,the survival time and transcriptome data of patients with HER2-positive breast cancer in stage Ⅰ / Ⅱ and Ⅲ/Ⅳ were downloaded from the TCGA database.The significantly differential genes between overall survival ＜2 years and ＞8.5 years in stage Ⅰ / Ⅱ were picked out by edgeR package,and the pathways were enriched by KEGG.Similarly,the differential genes between overall survival ＜2 years and ＞7 years in stage Ⅲ/Ⅳ were analyzed.Furthermore,KEGG pathway analysis was performed using the differential genes overlapped by stage Ⅰ /Ⅱ and Ⅲ/Ⅳ.Second,the relationships between the expression levels of key node genes and other genes in enriched pathway and the overall survival of patients with HER2-positive breast cancer were validated by KMplot database.Last,the correlation between the activity of pathway enriched in KEGG and the resistance to anti-HER2 treatment was validated in HER2-positive breast cancer cell line BT474.Results In patients with stage Ⅰ / Ⅱ HER2-positive breast cancer whose overall survival was ＜2 years,PI3K/AKT was the 9th signaling pathway enriched by up-regulated differential genes.In patients with stage Ⅲ/Ⅳ whose overall survival was ＜2 years,PI3K/AKT was the 2nd signaling pathway enriched by up-regulated differential genes.Furthermore,PI3K/AKT was the first signal pathway enriched by the overlapping upregulated genes of patients in stage Ⅰ / Ⅱ and Ⅲ / Ⅳ whose overall survival was ＜2 years.Patients with high expression of PI3K and AKT (key node genes) or CFAP221 and COL4A6 (other genes) of PI3K/AKT pathway had shorter overall survival than those with low expression.PI3K inhibitors could enhance the growth inhibitory effect of HER2 small molecule inhibitor on HER2-positive breast cancer cell line BT474.Conclusions The overexpression of PI3K/AKT pathway is associated with the shorter overall survival in HER2-positive breast cancer patients,and associated with anti-HER2 resistance in HER2-positive breast cancer cell line.

Study of chemotherapy related symptoms among breast cancer patients in different chemotherapy periods / 中国综合临床

Objective To investigate the occurrence of common symptoms in breast cancer patients in different chemotherapy periods and to analyze the relationship with the chemotherapy periods. Methods A total of four hundred and fifty?six breast cancer patients receiving chemotherapy in Tangshan Cancer Hospital from August 2016 to August 2017 were investigated via common symptom questionnaire among breast cancer patients. The results of the investigation were statistically analyzed, and the relationship between chemotherapy related symptoms and chemotherapy periods was analyzed by multiple Logistic regression analysis. Results In terms of the 20 kinds of chemotherapy symptoms, among the patients whose incidence rate was >50％ had 9 kinds of symptoms. Multivariate Logistic regression analysis showed that alopecia (95％ CI=5. 820～562. 784,P=0. 001) ,skin allergy ( 95％ CI=0. 002～0. 157,P<0. 001) ,cancer caused insomnia( 95％ CI=1. 179～25. 638, P=0. 030) ,dry mouth ( 95％ CI=0. 008～0. 470,P=0. 007) ,vaginal dryness or burning heat ( 95％ CI=13. 368～647. 615 P<0. 001) ,oral ulcer ( 95％CI=0. 026～0. 654,P=0. 013) ,abnormal defecation ( 95％ CI=0. 025～0. 749,P=0. 022),memory loss (95％CI=1. 065～19. 415,P=0. 041),distal phalanges numbness (95％ CI=0. 004～0. 421,P=0. 007),poor appetite (95％ CI=1. 189～65. 964,P=0. 033),local skin irritation /ulceration ( 95％ CI=0. 003～0. 143, P<0. 001 ) were associated with the chemotherapy, the difference was statistically significant. The above symptoms can be divided into 3 symptom groups by factor analysis,and they were respectively medicine side effect symptom cluster, neuropsychiatric symptom cluster and mucocutaneous symptom cluster. Conclusion There are many symptom clusters that affect the life and rehabilitation level in patients with breast cancer during chemotherapy, and are closely related with the chemotherap cycle. Doctors should adopt a scientific model of symptom management and take measures to improve the survival state of the patients.

Influencing factors of mental fatigue in patients with stroke / 中华行为医学与脑科学杂志

Objective To investigate the influencing factors of mental fatigue in patients with cere-bral apoplexy. Methods Using a hospital-based case-control method,total 358 patients with cerebral apo-plexy from Tangshan Gong Ren Hospital were recruited from October 2016 to May 2017. A total of 175 sub-jects were fatigue group(MFS≥10. 5),the remaining 183 individuals were non-fatigue group (MFS<10. 5). All the patients with stroke were investigated with MFS,MMSE,SAS,SDS and homemade general scale. Re-sults The total MFS score(17. 68±5. 06)vs(5. 70±2. 15) and dimensions score of fatigue perception(6. 86 ±2. 17)vs(2. 12±1. 15),cognition fatigue(3. 58±1. 54)vs(1. 12±0. 93),increased sensitivity(5. 90±2. 05) vs(1. 95±1. 20),changes of sleep(1. 35±0. 82)vs(0. 51±0. 62) in the fatigue group were higher than those of the non-fatigue group,total score. Multivariate Logistic regression showed that income below expenditure (β=0. 608,OR=1. 836,95%CI=1. 037-3. 252),cognitive dysfunction (β=1. 886,OR=6. 594,95%CI=3. 276-13. 275),mild anxiety(β=0. 770,OR=2. 160,95%CI=1. 069-4. 364),moderate anxiety(β=1. 157, OR=3. 181,95%CI=1. 230-8. 228),severe anxiety (β=1. 295,OR=3. 651,95%CI=1. 096-12. 160),mod-erate and severe depression (β=1. 318,OR=3. 738,95%CI=1. 318-10. 602) were the influencing factors of mental fatigue in stroke patients. Conclusion Income below expenditure,cognitive dysfunction,mild anxie-ty,moderate anxiety,severe anxiety,moderate and severe depression are the potential risk factors of mental fatigue in stroke patients.

Effect of TOMATIS auditory training on cognition and post-traumatic stress disorder in breast canc-er chemotherapy patients / 中华行为医学与脑科学杂志

Objective To observe the effect of TOMATIS auditory training on improving cognitive and post-traumatic stress disorder in patients after breast cancer chemotherapy. Methods Eighty invasive ductal carcinoma of breast cancer patients with cognition and psychological disorders were selected in the breast department of Tangshan People's Hospital from October 2016 to September 2017. All patients were randomly divided into control group ( n=40) and experimental group ( n=40) . The experimental group was given the TOMATIS high and low audio frequency auditory training,and the control group was given ordinary music training. Before and after the intervention, the Chinese version of the Montreal cognitive assessment scale ( MoCA) and the post-traumatic stress disorder scale ( PTSD-SS) were evaluated for both groups of pa-tients. Results After the intervention,the experimental group had significantly higher scores in visual struc-ture skills((3. 83±0. 71)vs(2. 68±0. 57)),executive function ((2. 23±0. 53)vs(1. 55±0. 50)),attention and concentration((1. 55±0. 78)vs(1. 23±0. 53)),language((1. 50±0. 75)vs(1. 08±0. 47)),calculation ((2. 00±0. 60)vs(1. 45±0. 75)),abstract thinking((1. 63±0. 54)vs(1. 00±0. 51)),memory((4. 68± 0. 47)vs(2. 70±0. 72)),directive force((5. 25±0. 54)vs(3. 90±0. 81)) and total score((22. 65±2. 89)vs (15. 58±2. 10))than the control group(all P<0. 05). After intervention,the scores of subjective assessment of traumatic events((2. 60±0. 63)vs(3. 98±0. 62)),repeated recurring experiences((24.05±2.72)vs (26. 70±2. 28)),avoidance symptoms((24. 35±1. 64)vs(26. 40±1. 19)),increased alertness((24. 23± 1. 80)vs(25. 45±1. 20)),impaired social function((7. 28±1. 01)vs(8. 68±0. 66)),and total scores((85. 85±5. 13)vs(94. 63±2. 92)) in the experimental group were significantly lower than those in the control group,and the differences were statistically significant ( all P<0. 01) . Conclusion TOMATIS auditory train-ing can effectively improve the cognitive function and psychological state in breast cancer chemotherapy pa-tients,which is worthy of popularization and application.

Effect of inhibition of P38MAPK phosphorylation on learning and memory and autophagy in hippo-campus of rats after cerebral ischemic postconditioning / 中华行为医学与脑科学杂志

Objective To investigate the effect of ischemic postconditioning on autophagy and learning and memory impairment in rats with ischemia-reperfusion injury by P38MAPK.Methods Ninty-six rats were randomly divided into sham group ( Sham group), cerebral ischemia reperfusion group ( CIR group),cerebral ischemic postconditioning group ( CIP group) and cerebral ischemic postconditioning com-bined with SB203580 group (CIP + SB203580 group),and 24 rats in each group. The rat model of cerebral ischemia was established by Pulsinelli four-vessel occlusion. The learning and memory abilities of rats were measured by Morris water maze. HE staining were used to detect the morphological changes of hippocampal neurons. The phosphorylation of P38MAPK and Beclin-1,LC3-Ⅱexpression were observed by immunohisto-chemistry. Results Compared with the Sham group,the number of crossing the platform decreased(24 h: (3.04±0.20)times),and the escape latency was longer in CIR group(24 h:(58.38±1.52) s) (all P＜0.05). The number of survival neurons reduced (24 h:70.93±1.86),and the expression of P38MAPK,LC3-Ⅱ,Bec-lin-1 in immunohistochemistry were increased in CIR group(all P＜0.05). Compared with CIR group,the number of crossing the platform at each time point increased (24 h:(5.46±0.50)times),the escape latency was shorter (24 h:(52.42±1.53)s),the number of survival neurons increased at each time point(24 h:(83.07±5.30)) and the expression level of P38MAPK decreased in the CIP group,while the expression lev-el of LC3-II,Beclin-1 increased (all P＜0.05).Compared with the CIP group,the number of crossing the plat-form((24 h:(7.13±0.33)times),the escape latency was shorter (24 h:(48.04±1.39)s),the number of survival neurons increased at each time point(24 h:(91.40±1.74)),and the expression of P38MAPK was down-regulated,while the expression of LC3-II,Beclin-1 were up-regulated in CIP +SB203580 group(all P＜0.05). Conclusion Ischemic postconditioning can improve learning and memory impairment in rats with is-chemia-reperfusion injury by P38MAPK regulating autophagy.

Effect of speech auditory feedback training on cognitive function in patients with post stroke / 中华行为医学与脑科学杂志

Objective To observe the intervention effect of Forbrain speech auditory feedback training on cognitive dysfunction in patients with stroke.methods 120 patients with cognitive dysfunction after stroke were divided into experimental group 1(n=40),experimental group 2 (n=40)and control group(n=40).The control group accepted conventional rehabilitation,while the experimental group 1 received Forbrain speech auditory feedback training additionally,and the experimental group 2 received the non-standard Forbrain speech auditory feedback training additionally.All the cases were assessed with Montreal cognitive assessment scale (MoCA)before and 10 weeks after intervention.Result sAfter 10-week intervention,the scores of structure skills(2.05±0.50),attention and concentration(2.15±0.36),memory(2.18±0.59) and the total score of MoCA(17.53±2.41) in experimental group 1 were higher than those in experimental group 2 (1.80±0.46,1.90±0.44,1.90±0.55,17.53±2.41) and control group(1.78±0.53),1.85±0.36,1.70±0.56,17.18±2.37) (all P<0.05).The Scores of language in experimental group 1(2.03±0.48)and experimental group 2(1.85±0.53) were higher than those in control group(1.70±0.46) (all P<0.05).Conclusion Forbrain speech auditory feedback training can improve cognitive function of patients with stroke.

BrainHQ visual training can improve the memory of stroke survivors / 中华物理医学与康复杂志

Objective To investigate the efficacy of BrainHQ visual training in rehabilitating memory function among stroke survivors.Methods Sixty stroke patients with memory disorders were recruited from the rehabilitation center of Tangshan Workers' Hospital.They were randomly assigned to a control group or an intervention group,each of 30.Both groups accepted conventional rehabilitation,while the intervention group was additionally given BrainHQ visual training five times a week for 30 minutes,lasting four weeks.Before and after the treatment,both groups completed the Rivermead behavioral memory test.Results After the 4 weeks of treatment,the average scores in recalling full names,recalling hidden items,recalling appointments,recognizing pictures,recognizing faces,recalling a story immediately,delayed story recall,recalling a route promptly,delayed route recall and the average total score in both groups were all significantly higher than before the treatment.The treatment group scored significantly better than the control group except in recalling hidden items,and recognizing faces and pictures.Conclusion BrainHQ visual training can improve the memory of stroke survivors.

The validity and responsiveness of the Chinese version of the mini-Balance Evaluation Systems Test / 中华物理医学与康复杂志

Objective To evaluate the validity and responsiveness of the Chinese version of the miniBalance Evaluation Systems Test(mini-BESTest).Methods A total of 208 stroke patients were evaluated by 2 professionals using both mini-BESTest and Berg balance scale (BBS).All data were analyzed using Pearson correlation,t-test and descriptive statistical analysis.Results Significant correlation was observed between each entry of the mini-BESTest and its domain,with correlation coefficients ranging from 0.78 to 0.93 (P ＜ 0.05).The scores of whole assessment and the three related domains were significantly correlated between mini-BESTest and BBS results,the correlation coefficients ranging from 0.68 to 0.87 (P ＜ 0.05).After 2 weeks of treatment,there was significant improvement in each domain and in the total assessment score (P ＜ 0.05).No floor or ceiling effects were observed in the total mini-BESTest scores,but there was a slight ceiling effect in the anticipatory and sensory orientation domains,and a slight floor effect in the reactive postural control domain.Conclusion The mini-BESTest has good validity and responsiveness,and can be applied to evaluate patients after stroke.

Effects of Somatic Sense Interactive Game on Balance and Walking Function in Stroke / 中国康复理论与实践

@#Objective To research the effects of somatic sense interactive game Kinect on balance and walking function in stroke patients.Methods 40 patients with stroke were divided into control group (n=20) and experimental group (n=20), who accepted conventional rehabilitation and additional somatic sense interactive game Kinect. They were evaluated with gait analysis, Berg Balance Scale, Holden Walking Function Rating Scale and Barthel Index before and after treatment. Results Both groups improved in all the indices after 4 weeks of treatment (P<0.001), and improved more in the experimental group than in the control group (P<0.05). Conclusion The somatic sense interactive game Kinect could further improve the balance and walking function of stroke patients.

Relationship between Homer1a and nerve cell loss in hippocampus after severe diffuse brain injury in rats / 医学研究生学报

(DBI) in rats by observation on the changes of Homer 1a expression and apoptotic nerve cells . Methods Spraque-Dawlley(SD) rats were randomly ( random number ) divided into control group and severe DBI group .DBI rat model was established according to the de-scription of Marmarou′s diffused brain injury .No injury was done on control group .The changes of neuron pathology were observed by light microscopy and electron microscope .The expression of Homer1a was observed by immunohistochemistry and western blot .The quan-tity of apoptotic cells was measured by terminal deoxynucleotidyl transfernase medicated nick end labeling ( TUNEL) method. Results The death rate of rats in severe DBI group was 49.3%.Compared with the control group , the ultrastructures in hippocampal neurons in-cluding organelle , axonal and capillary were damaged seriously after injury , the survival rate of nerve cells decreased significantly at 1 h after injury ([99.4 ±0.6]%vs [94.4 ±5.6]%, P<0.05), and peaked at 72 h ([99.2 ±0.8]%vs [54.7 ±33.8]%, P<0 .05) in DBI group.The expression of Homer1a protein increased significantly at 1 h after injury(0 .136 ±0.024 )and peaked at6 h(0.178 ± 0.028) and maintained to 24 h (0.176 ±0.027), while decreased at 48 h (0.145 ±0.02)and 72 h (0.117 ±0.012) in DBI group;the expression of Homer 1a was obviously higher at each time point in DBI group than that in control group (P <0.05).The apoptoticindex of TUNEL positive cells increased at 6 h and demonstrated significant difference at 72h in comparison to control group ([41.78 ±3 .96]%vs [1.92 ±0.22]%, P<0.05).The correlation analysis indicated that Homer1a expression from 1~24 h and 24 h~72 h was related to the survival rate of nerve cells ( r=-0.726, P<0.05; r=0.842, P<0.05) and the quantity of TUNE positive cells(r=0.738, P<0.0;5 r=-0.898, P<0.05). Conclusion The dynamic expression of Homer1a in hippocampus after severe DBI can reflect nerve cell loss.

Effects of integrative body-mind training with cognitive rehabilitation based on the sensory integration training theory on executive function and anxiety and depression mood in patients with traumatic brain injury / 中国实用护理杂志

Objective To study the effects of integrative body-mind training with cognitive rehabilitation based on the sensory integration training theory on executive function and anxiety and depression mood in patients with traumatic brain injury.Methods 85 cases were randomly divided into the control group (42 cases) and the treatment group (43 cases).The control group took targeted cognitive rehabilitation with sensory integration training theory and the treatment group was given targeted integrative bodymind training based on this training.Before training and after 3 months,the cognitive function and executive function were detected by the Behavioral Assessment of Dysexecutive Syndrome (BADS); the cognitive dysfunction were evaluated by Loewenstein Occupation Therapy Cognitive Assessment (LOTCA); Anxiety and Depression were evaluated by Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).Results There was no marked differences in BADS,LOTCA,SDS and SAS scores before treatment; Compared with the control group,they were much improved after training; Moreover,they were much more improved in the treatment group than those of the control group.Conclusions Integrative bodymind training with cognitive rehabilitation based on the sensory integration training theory can improve the executive function and regulate the mood on cognitive dysfunction in patients with traumatic brain injury.

Relationship between Cardiovascular Health Behavior and Health Factor and Executive Function in Newly Acute Cerebral Infarction Patients / 中国康复理论与实践

@#Objective To explore the relationship between the cardiovascular health behavior and health factor and the executive function in newly acute cerebral infarction patients. Methods Wisconsin Card Sorting Test (WCST) and Clock Drawing Task (CDT) were used to evaluate the executive function of 1440 patients with newly acute cerebral infarction, with 240 cases in each subgroup respectively in 0-1,2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factor. The impact of ideal cardiovascular health behaviors and factors on the executive function was analyzed combined with the general clinical data. Results The incurrence rates of executive function impairment in cerebral infarction patient with 0-1, 2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factor were 90.8%,85%, 66.7%, 42.5%, 20.8%, 13.4% respectively; compared with the patients with 0-1 of cardiovascular health behavior and health factors,the scores of WCST significantly changed in the patients with 2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factor (P<0.05).There was no significant difference in gender and infarction location among 6 groups (P>0.05), but was in age, ducation degree,infarction size and complications (P<0.05). After adjusting the age, infarction size, infarction location and complications, multivariate logistic regression analysis showed that compared with the patients with 0-1 of cardiovascular health behavior and health factors, 2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factors were protective factors for the executive dysfunction of cerebral infarction patients, the OR were 0.686, 0.564, 0.369, 0.232, 0.116 respectively. Conclusion The cardiovascular health behavior and health factor protect the executive function in new acute cerebral infarction.

Advance in Dynamic Neuromuscular Stabilization Training (review) / 中国康复理论与实践

@#This article mainly discussed the concept and application of dynamic neuromuscular stabilization in order to make up for the defect that some of the traditional training only focus on large muscle groups, and ignore the deep trunk muscles, especially the small deep muscles.

康复治疗学本科教学中学生临床思维和实践能力的培养 / 中国康复理论与实践

@#目的探讨以问题为基础的教学法(PBL)和康复病例实验报告两种教学法在运动疗法(PT)模块中的应用效果。方法选择2008 级四年制康复治疗学专业本科学生88 名，1 班采用PBL教学模式，2 班采用理论、实践相结合的康复病例采集与书写模式，采用自制教学效果评价表、学生实习跟踪调查进行评价。结果两班学生综合素质和分析问题的能力均有提高。2 班在观察能力、动手能力、理论与实践结合、疾病信息采集、分析判断能力、临床适应能力、服务态度与同情心、康复评定的全面性等方面好于1 班(P<0.05)，1 班在信息技术利用方面优于2 班(P<0.05)。结论融基础知识、专业知识、临床实践于一体，以书写康复病例为学科综合，培养学生以功能障碍为纲的临床思维，可以提高学生的动手能力、分析判断能力、医患沟通能力和临床适应能力，做到了课堂-见习-实习密切连接。

Application of Motor Imagery Therapy in Stroke (review) / 中国康复理论与实践

@# Motor imagery therapy is based on the theory of plasticity in the central nervous system. Movement with imagery improved reconstruction of damaged motor conduction pathway, and made restoration of central nervous system. Motor imagery adapts to recovery mode of stroke, and was proved to be effective on motor function when applied with physical therapy for stroke patients. This article would review its background, mechanisms, Methods and effects, etc.