Importance and Utility of the Principle of Ayurveda for Community Health

A nation is built by its citizens and these citizens with their good health, hard work determines the future of a nation. To ensure a bright and prosperous future we need to focus on the health of a community. Community health is defined as simple services that are delivered by common men outside hospitals and clinics. Community health services can be classified into Preventive Health Services, Promotive Health Services, Curative Health Services, and Rehabilitative Health Services. Preventive health services include measures by which we can avoid the disease before its occurrence Dincharya, Ritucharya, Sadvrit, Tryoupstham, and Vegdharan can be included in this category. Similarly, promotive heath care services include Rasayan, Vaajikaran, Ashtaaharvidhi vishesh ayatan, Sadvrit, Tryoupstham. Curative health services include single-drug therapy for the different diseases called Ekal dravya and treatment of Kaas, Swash, Atisaar, Amlapita which are very common. Rehabilitative health services such as physical therapy, counseling, and other mental health services can be provided by Ashwashan chikitsa, Medhya rasaayan, Yoga, Pathya palan, Padansikkarm palan.

Enfoque rehabilitador de paciente con artritis reumatoide evolucionada e ictus / Rehabilitation approach to patients with advanced rheumatoid arthritis and stroke

La artritis reumatoide es una enfermedad crónica, sistémica, inflamatoria, que afecta de forma predominante a las articulaciones periféricas y produce una sinovitis inflamatoria con distribución simétrica. El objetivo de este artículo es describir una experiencia en el tratamiento rehabilitador de una paciente con artritis reumatoide evolucionada e ictus. Se presenta el caso de una mujer de 71 años que ingresó en la unidad de recuperación funcional tras un ictus agudo de perfil lacunar, con clínica sensitivomotora de miembro inferior derecho y antecedentes de artritis reumatoide evolucionada. Se incluyó en un programa de rehabilitación, donde se constató la mejoría de la funcionalidad y reeducación de la marcha con ayudas técnicas. La rehabilitación es fundamental en la atención integral de pacientes con artritis reumatoide e ictus(AU)

Rheumatoid arthritis is a chronic, systemic, inflammatory disease that predominantly affects the peripheral joints producing an inflammatory synovitis with a symmetrical distribution. The objective of this article is to describe an experience in the rehabilitative treatment of a patient with advanced rheumatoid arthritis and stroke. We present a 71-year-old woman who was admitted to the functional recovery unit after acute lacunar-profile stroke, with sensorimotor symptoms of the right lower limb and a history of advanced rheumatoid arthritis. He was included in a rehabilitation program, where functional improvement and gait reeducation with technical aids were observed. Rehabilitation is essential in the comprehensive management of patients with rheumatoid arthritis and stroke(AU)

Caracterización clínica, radiológica y epidemiológica de niños con secuelas de tortícolis muscular congénita / Clinical, radiological, and epidemiological characterization of children with sequelae of congenital muscular torticollis / Caracterização clínica, radiológica e epidemiológica de crianças com sequelas de torcicolo muscular congênito

RESUMEN Introducción: Las secuelas de la tortícolis muscular congénita en niños tiene un amplio espectro, algunas de las cuales, una vez establecidas pueden requerir complejas y costosas correcciones quirúrgicas. Objetivo: Caracterizar las secuelas de tortícolis muscular congénita según elementos clínicos, radiológicos y epidemiológicos en niños atendidos en Santiago de Cuba en el periodo 2017-2020. Método: Estudio prospectivo-analítico de caso-control en 112 niños con dicha enfermedad, separados en casos (24 niños) y controles (88 niños). El procesamiento de datos implicó análisis de frecuencias, cálculo de Ji-cuadrado, identificación de factores asociados a variable dependiente, cálculo del valor de p y Odds ratio. Resultados: Se obtuvo predominio de población masculina en casos (70,8 %) y controles (68,2 %), con asociación estadística entre edad ≥ 6 meses al momento del diagnóstico y presencia de complicaciones (OR: 2,4-20,4; p=0,00). Existió asociación estadística entre macrosomía al nacer y presencia de complicaciones en 25,0 % de casos y 11,4 % de controles (OR: 1,9-12,5; p=0,02). Hubo asociación estadística entre inicio tardío del tratamiento rehabilitador y complicaciones (OR: 2,86-21,3; p=0,00). Conclusiones: Se observó predominio de complicaciones orgánicas o comorbilidades en varones, siendo más probable el incremento significativo de secuelas en estos y cuando se inicia el tratamiento médico después de los 6 meses de edad. Las complicaciones más frecuentes fueron: asimetría facial, plagiocefalia y asociación de dos o más secuelas.

ABSTRACT Introduction: Sequelae of congenital muscular torticollis in children have a wide spectrum, some of which, set already, may require complex and costly surgical corrections. Objective: To characterize the sequelae of congenital muscular torticollis according to clinical, radiological, and epidemiological elements in children attended in Santiago de Cuba from 2017 to 2020. Method: Prospective-analytical case-control study in 112 children with this disease, separated in cases (24 children) and controls (88 children). Data processing involved frequency analysis, calculation of chi-square, identification of factors associated with dependent variable, calculation of the p-value and OR. Results: The male population predominated in cases (70.8%) and controls (68.2%), with a statistical association between age ≥ 6 months at diagnosis and the presence of complications (OR: 2.4-20.4; p=0.00). There was a statistical association between macrosomia at birth and the presence of complications in 25.0 % of cases and 11.4 % of controls (OR: 1.9-12.5; p=0.02). There was a statistical association between late initiation of rehabilitation treatment and complications (OR: 2.86-21.3; p=0.00). Conclusions: A predominance of organic complications or comorbidities was observed in males, with a significant increase of sequelae in this group and also when medical treatment is started after 6 months of age. The most frequent complications were facial asymmetry, plagiocephaly and association of two or more sequelae.

RESUMO Introdução: As sequelas do torcicolo muscular congênito em crianças têm amplo espectro, algumas das quais, uma vez estabelecidas, podem exigir correções cirúrgicas complexas e onerosas. Objetivo: Caracterizar as sequelas do torcicolo muscular congênito segundo elementos clínicos, radiológicos e epidemiológicos em crianças atendidas em Santiago de Cuba no período 2017-2020. Método: Estudo prospectivo-analítico caso-controle em 112 crianças com essa doença, separadas em casos (24 crianças) e controles (88 crianças). O processamento dos dados envolveu análise de frequência, cálculo do Qui-quadrado, identificação dos fatores associados à variável dependente, cálculo do valor de p e Odss ratio. Resultados: Obteve-se predominância da população masculina nos casos (70,8%) e controles (68,2%), com associação estatística entre idade ≥ 6 meses no momento do diagnóstico e presença de complicações (OR: 2,4-20,4; p=0,00). Houve associação estatística entre macrossomia ao nascimento e presença de complicações em 25,0% dos casos e 11,4% dos controles (OR: 1,9-12,5; p=0,02). Houve associação estatística entre início tardio do tratamento de reabilitação e complicações (OR: 2,86-21,3; p=0,00). Conclusões: Observou-se predominância de complicações orgânicas ou comorbidades no sexo masculino, com aumento significativo de sequelas sendo mais provável nestes e quando o tratamento médico é iniciado após os 6 meses de idade. As complicações mais frequentes foram: assimetria facial, plagiocefalia e associação de duas ou mais sequelas.

Expert Consensus on Assessment for Rehabilitation and Treatment of Musculoskeletal Complications of Hemophilia in China / 罕见病研究

@#Hemophilia is a group of hereditary hemorrhagic diseases. Hemorrhages mostly occur in musculoskeletal system and is the main cause for disability. Rehabilitation plays an important role in the comprehensive management in hemophilia. In recent years, researches on rehabilitative assessment and treatment of hemophilia have made a lot of progress in China. Using evidence-based method, experts from different disciplines have reached a consensus on the rehabilitation assessment and treatment of hemophilia skeletal muscle complications, providing an important reference to the clinical practice.

Evaluación de resultados del tratamiento aplicado a adultos mayores con entidades del SOMA en Sala de Rehabilitación Integral / Evaluation of the results of the treatment applied to older adults with OMAS entities in the Comprehensive Rehabilitation Room

RESUMEN Introducción: el paciente anciano está expuesto a múltiples problemáticas con el envejecimiento que van a condicionar en gran manera su independencia y que de forma obligatoria hay que conocer y tratar de solucionar. Objetivo: evaluar el resultado del tratamiento aplicado a adultos mayores con entidades del sistema osteomioarticular en sala de rehabilitación integral. Materiales y Métodos: se realizó un estudio observacional, descriptivo, de tipo longitudinal de los todos los pacientes de 60 y más años, que acudieron al Centro de rehabilitación integral, quedando la muestra constituida por 920 pacientes tratados en el período comprendido entre enero y diciembre de 2007 con enfermedades del Soma. Resultados: predominó el sexo femenino (59 %) en el grupo de edades de 60 a 69 años (48%). Las afecciones ortopédicas fueron las más frecuentes con el 64 % y dentro de estas, la periartritis escapulo humeral. La electroterapia fue el tratamiento más utilizado (38,4%) de los casos. Dentro de los síntomas que presentaron estos pacientes el que más frecuente se encontró fue el de alteraciones en las funciones tanto al inicio y como posterior al tratamiento aplicado. El 93% de los pacientes resultaron rehabilitados, siendo el 86 % los evaluados de excelente al final de tratamiento aplicado. Conclusiones: los resultados en la atención al adulto mayor fueron excelentes en la gran mayoría de los casos con la aplicación del tratamiento rehabilitador (AU).

SUMMARY Introduction: the elder patient is exposed to multiple problems with ageing that will greatly condition their independence and that we will necessarily have to know and try to solve, using all the available resources within our reach. Objective: to assess the result of the treatment applied to older adults with entities of the osteomyoarticular system in the comprehensive rehabilitation room. Materials and methods: an observational, descriptive, longitudinal study of all the patients aged 60 years and over who attended the Comprehensive Rehabilitation Center was carried out, intentionally the sample stayed formed by 920 patients treated in the period between January and December 2007 with diseases of the OMAS. Results: female sex predominated (59%) in the age group of 60 to 69 years (48%). Orthopedic conditions were the most frequent with 64% and within these, scapular-humeral periarthritis. Electrotherapy was the most used treatment (38.4% of the cases). Among the symptoms that these patients presented, the most frequently found was alterations in functions both at the beginning and after the treatment applied. 93 % of the patients were rehabilitated, resulting outstanding 86 % of the assessed patients at the end pf the treatment. Conclusions: the results of elder people care was outstanding in most of the cases with the rehabilitative treatment application (AU).

Effect of Task-based Rehabilitation Training on Neural Circuit Plasticity and Forelimb Motor Function post Spinal Cord Injury in Mice / 中国康复理论与实践

Objective:To explore the effect of task-based rehabilitative training on neural circuit plasticity and forelimb motor function after C5 spinal cord injury in mice. Methods:A total of 21 healthy C57/BL mice were randomly and equally divided into sham group, model group and training group. The model was established by left C5 spinal cord crush injury. The lamina was removed without damaging the spinal cord in the sham group. Four weeks after injury, the training group received task-based rehabilitative training for four weeks. The horizontal ladder and rearing tests were used to assess motor function for forelimb before injury, and three days, two weeks, four weeks, six weeks and eight weeks after injury. The axons of the corticospinal tract in all mice were observed six weeks after injury by using biotinylated dextran amin (BDA) anterograde tracing. Eight weeks after injury, motor-evoked potential was applied to measure nerve conduction velocities in forelimb, while the axon sprouting and syntagmatic relation of neuron in the anterior horn of gray matter above lesion were observed by immunofluorescence double-labeling of BDA/neuron-specific nuclei protein (NeuN); the expression of Synapsin in the anterior horn of gray matter at lesion was observed by immunofluorescence double-labeling of NeuN/Synapsin I. Results:Eight weeks after injury, the latency of P1 and N1 was longer in the model group than in the sham group (P < 0.05), and was shorter in the training group than in the model group (P < 0.05). Compared with the sham group, the error rate of left forelimb increased, and the usage rate decreased (P < 0.05) in the model group and the training group; compared with the model group, the error rate of left forelimb decreased six weeks and eight weeks after injury (P < 0.05), and the usage rate increased eight weeks after injury (P < 0.05) in the treatment group. Compared with the model group, more axon sprouting co-localized with neurons in the anterior horn of gray matter above lesion (P < 0.05), and the expression of Synapsin I increased in the training group (P < 0.05). Conclusion:Task-based rehabilitative training could promote the neural circuit plasticity and improve the motor function of forelimb after spinal cord injury in mice.

Development and Clinical Effect of Self-made Lower Limbs Rehabilitative Apparatus for Cerebral Palsy / 中国康复理论与实践

Objective To develop a lower limbs rehabilitative apparatus and explore its effects. Methods From January to September, 2016, 28 children with spastic cerebral palsy were divided into control group (n=14) and observation group (n=14) randomly. The control group received routine rehabilitation, while the observation group received self-made lower limbs rehabilitative apparatus training addition-ally. They were assessed with Gross Motor Function Measure (GMFM)-88 and Berg Balance Scale (BBS) before and three months after treatment. Results There was no significant difference in the scores of GMFM-88 and BBS between two groups before treatment (P>0.05), while they increased after treatment (t>6.124, P2.329, P<0.05). Conclusion Self-made lower limbs rehabilitative apparatus could help to improve the gross motor function and balance function in children with spastic cerebral palsy.

An Arithmetic for Quantifying the 3D Motion Space of Ankle / 中国康复理论与实践

Objective To obtain the three-dimensional (3D) motion space of ankle by an integral for the 3D rotation angle with mutual relationships of rotation angles in different directions, which is used to evaluate the flexibility and recovery of ankle more accurately and ful-ly. Methods Twenty-five graduate students were recruited to participate in this study, one group consisted of 20 healthy individuals without ankle injury, and the other was composed of 5 patients with ankle injury. A motion capturing system was used to simultaneously capture the 3D coordinates of the marked points on the foot. Next, these 3D coordinates were converted into rotation angles through trigonometric func-tions processed. The maximum rotation angles of adduction, abduction, varus, and eversion change with the rotation angles of plantar flex-ion and dorsal flexure were measured by using polynomial fitting. At last, the size of the ankle's 3D motion space was obtained by integrat-ing the fitting functions. Results The ankle's 3D motion space of the healthy people was 41.256, and the variation among them was less than 10%. The ankle's 3D motion space of the patient side was 33.163, and the variation among them was less than 15%because of the different degrees of rehabilitation. There was significant difference between two groups (t=8.804, P<0.01). With the same rotation angles of plantar flexion or dorsal flexure, the maximum rotation angle of varus was larger than that of eversion, and the maximum rotation angle of adduc-tion was larger than that of abduction. Conclusion The algorithm can be used to quantify the 3D motion space of ankle more accurately, and to achieve a more comprehensive evaluation of ankle's flexibility and rehabilitation.

Influence of early involvement of rehabilitation treadmill on function recovery after total hip arthoroplasty / 医疗卫生装备

Objective To observe the influence of early involvement of rehabilitation treadmill on hip function and daily life after total hip arthroplasty (THA).Methods Totally 80 patients receiving THA in Foshan Hospital of Traditional Chinese Medicine from January 2013 to January 2016 were randomized into a trial group (40 cases) and a control group (40 cases).The control group underwent conventional rehabilitation treatment such as training of muscle strength,joint motion and daily life,and the trial group applied rehabilitation treadmill for early training besides above measures.The two groups were compared on Harris score,Barthel scaore and re-visiting rate at the time points of 1,3 and 6 months after THA.Results Follow-up was carried out for the two groups.Harris scores and Barthel scores of the two groups were significantly enhanced 3 and 6 months after THA (P＜0.05).Harris scores in the trial group were (83.08±2.38) and (88.05±2.54) respectively 3 and 6 months after THA,which were statistically higher than (69.03±2.39) and (74.85±3.39) of the control group.Barthel scores in the trial group were (79.25±3.31) and (90.25+2.25) respectively 3 and 6 months after THA,which were obviously higher than (75.13±3.10) and (84.88±3.84) in the control group.The trial group had the re-visiting rate (17.5％) significantly higher than that (37.5％) in the control group 6 months after THA (P＜0.05).Conclusion Early involvement of rehabilitation treadmill combined with conventional training promotes the recovery of hip function,lower limb muscle strength,walking ability and daily life,while decreases the re-visiting rate of the patient.

An Arithmetic for Quantifying the 3D Motion Space of Ankle / 中国康复理论与实践

Objective To obtain the three-dimensional (3D) motion space of ankle by an integral for the 3D rotation angle with mutual relationships of rotation angles in different directions, which is used to evaluate the flexibility and recovery of ankle more accurately and ful-ly. Methods Twenty-five graduate students were recruited to participate in this study, one group consisted of 20 healthy individuals without ankle injury, and the other was composed of 5 patients with ankle injury. A motion capturing system was used to simultaneously capture the 3D coordinates of the marked points on the foot. Next, these 3D coordinates were converted into rotation angles through trigonometric func-tions processed. The maximum rotation angles of adduction, abduction, varus, and eversion change with the rotation angles of plantar flex-ion and dorsal flexure were measured by using polynomial fitting. At last, the size of the ankle's 3D motion space was obtained by integrat-ing the fitting functions. Results The ankle's 3D motion space of the healthy people was 41.256, and the variation among them was less than 10%. The ankle's 3D motion space of the patient side was 33.163, and the variation among them was less than 15%because of the different degrees of rehabilitation. There was significant difference between two groups (t=8.804, P<0.01). With the same rotation angles of plantar flexion or dorsal flexure, the maximum rotation angle of varus was larger than that of eversion, and the maximum rotation angle of adduc-tion was larger than that of abduction. Conclusion The algorithm can be used to quantify the 3D motion space of ankle more accurately, and to achieve a more comprehensive evaluation of ankle's flexibility and rehabilitation.

Rehabilitative nursing of patients with recurrent patellar dislocation treated with retinaculum patellae mediale reconstruction under arthroscopy / 现代临床护理

Objective To explore rehabilitative nursing of patients with recurrent patellar dislocation treated with retinaculum patellae mediale reconstruction under arthroscopy. Method Systematic rehabilitative nursing was performed to 18 patients with recurrent patellar dislocation treated with retinaculum patellae mediale reconstruction under arthroscopy , including the perioperative psychological nursing, systematic and standard rehabilitative training plan, and discharge guidance. Results The symptoms of unstable retinaculum disappeared, their motor ability was improvement and there was no patellar dislocation. All patients were scheduled for follow-up three months, six months, nine months and one year after surgery, and annually thereafter. The preoperative and postoperative Kujala and Lysholm scores were with statistical difference between pre-and post-surgery (P<0.001). Conclusion Systematic and standard rehabilitative nursing can be important for the recovery of patients , including preoperative psychological nursing and postoperative functional exercise.

Approach to the patients with Graves'ophthalmopathy / 中华内分泌代谢杂志

[Summary] Graves'ophthalmopathy ( GO) is the most common extrathyroidal manifestation of Graves disease ( GD) . It is an organ-specific autoimmune disorder. The estimated incidence of GO in the general population is 16 women and 3 men per 100,000 population every year. Approximately 3%-5% of patients with GO are exposed to the potential of losing their sight and requiring optimized medical intervention. For the clinicians it is helpful to assess the degree of activity and severity of GO;both are important in deciding whether a patient requires intervention and which type of intervention is indicated. These interventions include management of hyperthyroidism, measures to relieve local symptoms, immunosuppressive therapies for active moderate and severe GO, and finally rehabilitative surgery for inactive patients.

Development of Comprehensive Rehabilitation Information System Based on Browser/Server Structure / 中国康复理论与实践

Objective To develop a comprehensive rehabilitation information system based on browser/server (B/S) structure, to imple-ment entry, retrieval, statistics, analysis, browsing and exhibition of electronic data in rehabilitation medicine. Methods Based on the system-atic analysis of the rehabilitation work flow and the data need to be disposed, a distributed database system was established, and some mod-ules of applications were developed, such as treatment planning, efficacy evaluation, outcome prediction and performance appraisal. Results The simplified version of Hydrotherapy Comprehensive Rehabilitation Information System was initially developed based on Ruby on Ralis framework and PostgreSQL database, and tested in the local area network of China Rehabilitation Research Center. Conclusion The compre-hensive rehabilitation information system based on B/S structure is feasible, and shows the potentialities to improve the team work in reha-bilitation based on internet.

Development of Comprehensive Rehabilitation Information System Based on Browser/Server Structure / 中国康复理论与实践

@#Objective To develop a comprehensive rehabilitation information system based on browser/server (B/S) structure, to implement entry, retrieval, statistics, analysis, browsing and exhibition of electronic data in rehabilitation medicine. Methods Based on the systematic analysis of the rehabilitation work flow and the data need to be disposed, a distributed database system was established, and some modules of applications were developed, such as treatment planning, efficacy evaluation, outcome prediction and performance appraisal. Results The simplified version of Hydrotherapy Comprehensive Rehabilitation Information System was initially developed based on Ruby on Ralis framework and PostgreSQL database, and tested in the local area network of China Rehabilitation Research Center. Conclusion The comprehensive rehabilitation information system based on B/S structure is feasible, and shows the potentialities to improve the team work in rehabilitation based on internet.

Effect of recombinant bovine basic fibroblast growth factors combined with new rehabilitative liquid on neonatal diaper dermatitis / 现代临床护理

Objective To investigate the effects of recombinant bovine basic fibroblast growth factors combined with new rehabilitative liquid on neonatal diaper dermatitis. Methods One hundred and twenty neotates with neonatal diaper dermatitis from August 2013 to July 2014 were randomly divided into the control group and experiment group, 60 cases in each group. The control group was treated with conventional care, while the observation group with recombinant bovine basic fibroblast growth factors combined with new rehabilitative liquid. The total effective rate and the treatment time were compared between the two groups. Result The total effective rate of the observation group was significantly higher than that of the control group (P<0.05) and the treatment time of the observation group was statistically significantly shorter than that of the control group (P<0.05). Conclusion Recombinant bovine basic fibroblast growth factors combined with new rehabilitative liquid is effective in the treatment of neonatal diaper dermatitis and it is worth promoting and using clinically.

Survey of Family Function in Rehabilitative Breast Cancer Patients / 中国康复理论与实践

Objective To investigate the conditions of family function of rehabilitative breast cancer patients and its related factors. Methods Self-administrated questionnaire and the family APGAR (adaptation, partnership, growth, affection, resolve) index questionnaire were used in 245 breast cancer patients to investigate their general and illness information, and their family APGAR index. The factors relat-ed with the family function of breast cancer patients were analyzed. Results The APGAR score of the participants was (7.51±1.17), and the condition of family was graded from good (73.5%), moderate impairment (21.2%) to severs impairment (5.3%). The multiple regression analysis found that the stage of the disease (β=-9.671), the condition of marriage (β=8.29) and their social activities (β=7.402) related with the APGAR index in rehabilitative breast cancer patients. Conclusion The family function needs attention, especially the metastasis ones in breast cancer patients. A healthy marriage and beneficial socialization contribute to keep good family function.

Tratamiento rehabilitador integral en pacientes con fracturas de Colles consolidadas / Comprehensive rehabilitative treatment in patients with consolidated Colles fractures

Se realizó una intervención terapéutica en 50 pacientes con fracturas de Colles consolidadas, atendidos en el Hospital Clinicoquirúrgico Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba, en el período 2007-2008, a fin de evaluar el resultado del tratamiento rehabilitador integral. Se conformaron 2 grupos (control y de estudio) de 25 integrantes cada uno -- seleccionados de forma alterna --, quienes recibieron tratamiento convencional e integrador, respectivamente. Luego de aplicadas las escalas funcionales se evidenció mejor resultado terapéutico en los pacientes del segundo grupo, dado por menores complicaciones, mejor estado funcional de la muñeca y mano afectada y menor tiempo de recuperación.

A therapeutic intervention in 50 patients with consolidated Colles fractures; assisted in "Dr. Joaquín Castillo Duany" Teaching Clinical Surgical Hospital in Santiago de Cuba was carried out in the period 2007-2008, in order to evaluate the result of the comprehensive rehabilitative treatment. Two groups were formed (control and study groups) of 25 members each -- selected in an alternating way -- who received conventional and integrative treatment, respectively. After having applied the functional scales, a better therapeutic result was evidenced in the patients of the second group, given by smaller complications, better functional state of the wrist and affected hand and shorter time of recovery.

cAMP/PKA-pCREB signal transduction pathway may mediate a promoting effect of rehabilitation training on motor function after ischemic stroke in rats / 中国实验动物学报

Objective To explore whether the cAMP-PKA-pCREB signal pathway plays a role in promoting the recovery of motor function after rehabilitation training in cerebral ischemia-reperfusion rats .Methods The middle cerebral artery occlusion model ( MCAO) was established by modified Longa nylon occlusion method in adult male Sprague -Dawley rats.The 84 MCAO rats were selected and randomly assigned to four groups:the natural recovery group without any special training (group B, n=24),natural recovery group with Rp-cAMP (group C, n=24), rehabilitation training group (group D, n=18) and rehabilitation training with Rp-cAMP (group E, n=18), and in addition a control group (group A, n =12).To establish rat MCAO models immediately after injection of Rp-cAMP into the lateral ventricle of the brain .The rats in the groups D and E were trained by balance beam , bar rotating and rolling exercises started at 48 h after MCAO.The ex-pression of PKA was determined by enzyme-linked immunosorbent assay ( ELISA) and the pCREB protein expression was detected by Western blot assay .Motor function was assessed by balance beam test .Results (1) The motor function score in the group C was significantly higher than that of group B , suggesting that Rp-cAMP inhibited the recovery of motor func-tion in the cerebral ischemia-reperfusion rats .The score of group D was significantly lower than that of groups B and E , in-dicating that Rp-cAMP inhibited the promoting effect of rehabilitation training on motor function in the cerebral ischemia -reperfusion rats.(2) The expressions of PKA and pCREB proteins detected at 2nd, 7th, 14th, and 21th days after surgery showed that their expressions in the group D were significantly higher than those of the groups B and E , indicating that re-habilitation training promoted the expression of PKA and pCREB , and Rp-cAMP significantly inhibited the promoting effect of rehabilitation training on the expressions of PKA and pCREB proteins .Conclusion cAMP/PKA-pCREB signal trans-duction pathway may mediate a promoting effect of rehabilitation training on the recovery of motor function after ischemic stroke in rats.

Self-efficacy on rehabilitative exercise and the influential factors in patients having undergone total hip or knee arthroplasty / 现代临床护理

Objective To explore the exercise self-efficacy and its influential factors in patients having undergone total hip or knee arthroplasty.Method The Self-Efficacy Rehabilitation Outcome Scale(SER)and demographic questionnaire were used in the investigation among sixty-five patients recruited by convenient sampling.Results The average score on exercise self-efficacy was(67.94±17.22)and the influential factors included age,family income,types of surgery,whether there were monitors for their exercise and whether there were other patients communicating on exercise methods(all P<0.05).Conclusions The self-efficacy in patients after total hip or knee arthroplasty is at lower level.It is necessary to enhance rehabilitative education to improve their self-efficacy in rehabilitative exercise.

Effect of early rehabilitative intervention on prognosis of patients with hypertensive cerebral hemorrhage / 中国基层医药

Objective To explore the effect of early rehabilitative intervention on prognosis of patients with hypertensive cerebral hemorrhage.Methods 60 patients with hypertensive cerebral hemorrhage were randomly divided into the observation group and the control group,each group 30 cases.Both two groups received common therapy,while the observation group was given early rehabilitative intervention.Results After treatment for one month,the total effective rate of the observation group was obviously higher than that of the control group (90.00％ vs 73.33％,x2 =2.81,P ＜ 0.05).After treatment for three months,the living ability of experiment group was obviously better than control group (66.67 ％ vs 50.00％,x2 =2.69,P ＜ 0.05).Conclusion Early rehabilitative intervention in patients with hypertensive cerebral hemorrhage can increase clinical effect and improve prognosis.