Ultrashort wave alleviates oxygen -glucose deprivation/reoxygenation injury via up -regulation of SPCA1 expression in N2a cells / 中南大学学报(医学版)

OBJECTIVES@#Application of ultrashort wave (USW) to rats with cerebral ischemia and reperfusion injury could inhibit the decrease of expression of secretory pathway Ca2+-ATPase 1 (SPCA1), an important participant in Golgi stress, reduce the damage of Golgi apparatus and the apoptosis of neuronal cells, thereby alleviating cerebral ischemia-reperfusion injury. This study aims to investigate the effect of USW on oxygen-glucose deprivation/reperfusion (OGD/R) injury and the expression of SPCA1 at the cellular level.@*METHODS@#N2a cells were randomly divided into a control (Con) group, an OGD/R group, and an USW group. The cells in the Con group were cultured without exposure to OGD. The cells in the OGD/R group were treated with OGD/R. The cells in the USW group were treated with USW after OGD/R. Cell morphology was observed under the inverted phase-contrast optical microscope, cell activity was detected by cell counting kit-8 (CCK-8), apoptosis was detected by flow cytometry, and SPCA1 expression was detected by Western blotting.@*RESULTS@#Most of the cells in the Con group showed spindle shape with a clear outline and good adhesion. In the OGD/R group, cells were wrinkled, with blurred outline, poor adhesion, and lots of suspended dead cells appeared; compared with the OGD/R group, the cell morphology and adherence were improved, with clearer outlines and fewer dead cells in the USW group. Compared with the Con group, the OGD/R group showed decreased cell activity, increased apoptotic rate, and down-regulating SPCA1 expression with significant differences (all P<0.001); compared with the OGD/R group, the USW group showed increased cell activity, decreased apoptotic rate, and up-regulating SPCA1 expression with significant differences (P<0.01 or P<0.001).@*CONCLUSIONS@#USW alleviates the injury of cellular OGD/R, and its protective effect may be related to its up-regulation of SPCA1 expression.

The sensitivity and specificity of the Chinese eating assessment tool (EAT-10) for screening oropharyngeal dysphagia in acute stroke patients / 中华物理医学与康复杂志

Objective To study the sensitivity and specificity of the Chinese eating assessment tool (EAT-10) in screening acute stroke patients for oropharyngeal dysphagia (OD).Methods A total of 130 inpatients with acute stroke were screened using the Chinese EAT-10.On the same day they were also screened using the gold standard technique for diagnosing dysphasia-videofluoroscopy.A receiver operating characteristics (ROC) curve was developed to study EAT-10's sensitivity and specificity.A Youden index,positive predictive value (PPV),negative predictive value (NPV),and positive and negative likelihood ratios (LHR+ and LHR) were quantified.Results According to the ROC curve,a cut-off point of 1 (EAT-10 score≥ 1) gave the best sensitivity (77.9％),the highest NPV (73.2％),with 66.1％ specificity,71.6％ PPV,2.30 LHR+ and 0.33 LHR in screening for OD.The test-retest reliability was above 0.7.An investigator consistency reliability test showed good repeatability,and the consistency between each item and the mean total score was high.Conclusion The Chinese EAT-10 has good test-retest reliability and investigator consistency.The optimal cut-off point is 1,with good sensitivity and NPV at scores ≥ 1.The test can be recommended as a screening tool for OD in acute stroke patients.

Aerobic exercise for preventing knee osteoarthritis and its mechanism / 中华物理医学与康复杂志

Objective To observe the effect of aerobic exercise of different intensities on type Ⅱ collagen,glycosaminoglycan (GAG) and chondrocyte apoptosis in rabbits modeling knee osteoarthritis (OA),so as to explore the preventive effect and its possible mechanism.Methods Twenty healthy New Zealand white rabbits were randomly divided into Groups A,B,C and D,each of 5.Group A was allowed free activity in a cage for 9 weeks.Group B was allowed free activity for 4 weeks,then an OA model was established using papain and confirmed via MRI 1 week later,Another 4 weeks of free activity were then allowed.Groups C and group D were given running training for 20 minutes a day at 0.5 km/h,3 times a week,and then 20 minutes a day at 1.5 km/h,5 days a week on a treadmill for 4 weeks.Nine weeks later,all 4 groups of rabbits were killed and the articular cartilage damage of each group was compared using Mankin scoring,and expression of type Ⅱ collagen,GAG content and chondrocyte apoptosis in the cartilage.Results After the intervention,the average Mankin score,expression of type Ⅱ collagen and GAG content of groups B,C and D were significantly lower than those of group A,and all of those values in group B were significantly lower than those of group D.After 9 weeks the chondrocyte apoptosis rate of group A was significantly lower than that of the other groups,and that of groups C and D was significantly lower than that of group B.Conclusion Aerobic exercise may prevent knee articular cartilage degeneration through inhibiting reduction in the amount of type Ⅱ collagen and GAG in the cartilage matrix.It may be related to decreasing the chondrocyte apoptosis.

Important role of ELMO1 in invasion and migration of breast cancer cells induced by IL-8 / 中国药理学通报

Aim To explore the relationship between IL-8 and ELMO1 in breast carcinoma and the mecha-nisms of IL-8 induced invasion and metastasis. Meth-ods Under the IL-8 stimulation, chemotaxis assay was examined to detect the chemotaxis ability of breast cancer cell line MDA-MB-231 and MCF-7 . ELMO1 protein levels in breast cancer cell lines were detected using Western blot. MDA-MB-231 cells were transfect-ed with small RNA interference plasmids in order to downregulate ELMO1 expression, and overexpression plasmids were used to upregulate the expression of EL-MO1 in MCF-7 cells. Matrigel invasion assay and chemotaxis assay were used to detect the in vitro inva-sion and chemotaxis ability of breast cancer cells with IL-8 stimulation. Results IL-8 induced chemotaxis of the different breast cancer cell lines in a dose-depend-ent manner. After transient transfection, Western blot results showed that ELMO 1 protein levels observably decreased in SiELMO1/MDA-MB-231 cells compared with Scr/MDA-MB-231 cells, while the expression of ELMO1 protein levels significantly increased in MCF-7/ELMO1 cells compared with the MCF-7/Con cells;with IL-8 stimulation, SiELMO1/MDA-MB-231 cells showed significantly decreased chemotaxis ability com-pared with Scr/MDA-MB-231 cells. MCF-7/ELMO1 cells showed significantly increased chemotaxis ability compared with MCF-7/Con cells; the invasion assay showed under the stimulation of IL-8 , and the invasion ability was significantly reduced in SiELMO1/MDA-MB-231 cells compared with Scr/MDA-MB-231 cells ( P<0. 05 ) . The invasion ability was significantly en-hanced in MCF-7/ELMO1 cells compared with MCF-7 cells( P<0. 05 ) . Conclusion IL-8 promotes the in-vasion and migration of breast cancer cells MDA-MB-231 and MCF-7 , and ELMO1 plays an important role in IL-8 induced chemotaxis and invasion.

Reliability and validity of the Chinese Eating Assessment Tool (EAT-10) in evaluation of acute stroke patients with dysphagia / 中南大学学报(医学版)

OBJECTIVE@#To study the reliability and validity of the Chinese Eating Assessment Tool (EAT-10) in evaluation of acute stroke patients with dysphagia.
@*METHODS@#The inpatients of stroke were assessed with Chinese EAT-10. As a golden standard for evaluation of dysphagia, videofluoroscopic swallow study (VFSS) test was used to judge the reliability and validity of EAT-10.
@*RESULTS@#A total of 130 qualified questionnaires were collected. The Cronbach's alpha coefficient for Chinese EAT-10 scale was 0.845. The total score of each item was related. The lowest or highest correlation coefficient for the item 2 or 3 was 0.271 or 0.772. The retest reliability was greater than 0.7, which met the requirements. According to the investigator consistency reliability test, the value collected from the investigator in the item 2 kept constant. The consistent correlation coefficient of the remaining nine items was more than 0.7. The consistency between each item and the mean score was high. The EAT-10 with the cut-off point at 1 was an optimal cut-off point. With the cut-off value of 1 (EAT-10 score ≥ 1), the sensitivity and specificity for EAT-10 was 77.9% and 66.1%, respectively. The positive predictive value (PPV) and negative value (NPV) was 71.6% and 73.2%, respectively, with 2.30 LHR+ and 0.33 LHR- for dysphagia. 
@*CONCLUSION@#The Chinese EAT-10 has a good reliability and validity in evaluation of the acute stroke patients with dysphagia. The sensitivity and negative value are the best with the cut-off value of 1 (EAT-10 score ≥ 1). It offers a good way to discriminate dysphagia, impaired efficacy, penetrations, and aspirations in acute stroke patients.

Development of Rehabilitation Therapy and Requirment of Rehabilitation Therapist in Hunan, China / 中国康复理论与实践

@#Objective To investigate the development of rehabilitation medicine, the knowledge, ability and quality requirements of stu-dents in different professional positions, and the demand for rehabilitation industry personnel in Hunan, China, and to discuss the strategies for improving the quality of vocational education. Methods 87 directors of personnel management or rehabilitation department in all levels of hospitals and 100 rehabilitation therapists were included from May to Semptember 2014. The rehabilitation medical service, education background of employees, professional positions, and the demand for rehabilitation knowledge, ability, and industry personnel were sur-veyed. Results and Conclusion Rehabilitation medical service was not sufficiently carried out for insufficient number of employees, unbal-ance structure and other deficiencies. Rehabilitation personnel training schools and enterprises need to strengthen the depth of integration, and improve the professional quality and clinical ability.

Ultrashortwave irradiation for the repair of sciatic nerve injury and its mechanism / 中华物理医学与康复杂志

Objective To observe the effect of low doses of ultrashortwave therapy (USW) on sciatic nerve injury and to deduce its possible mechanism.Methods Fifty-four Sprague-Dawley rats were randomly divided into a USW group,a control group and a normal group with 18 rats in each.Each group was then sub-divided into 1 week,2 week and 3 week subgroups with 6 rats in each.A model of peripheral nerve injury was established by forceps clipping of the sciatic nerve in the USW and control groups.The USW group was then treated with USW exposure.Rats from the appropriate subgroups were sacrificed after 1,2 and 3 weeks of treatment.Sciatic nerve samples were stained using hematoxylin-eosin and toluidin blue.Expression of basic fibroblast growth factor (bFGF) was detected by immunohistochemical methods.Results Degeneration of axons was observed in both the therapy and control groups after 1 week,and regeneration at the end of the 2nd and 3rd weeks.The number of axons with myelin sheaths was significantly higher in the therapy group than in the control group at the end of the 2nd and 3rd weeks.The expression of bFGF was significantly higher in the USW group compared with the control group at all observation time points.Conclusion USW can obviously accelerate the regeneration of the sciatic nerve,probably through increased expression of bFGF.

Application of Evoked Potentials in Spinal Orthopedics and Reasons for Changes (review) / 中国康复理论与实践

@#Evoked potentials which can monitor spinal cord function in operation continuously and timely has been widely used in spinal orthopedics. However, intraoperative evoked potentials are affected by the technique in a variety of factors, how to improve the accuracy of intraoperative monitoring is still a problem to explore. In this paper, intraoperative nerve monitoring application and intraoperative potential reasons for the changes in the spine surgery orthopedic surgery were reviewed.

The effect of pulsed electromagnetic fields on the expression of transforming growth factor beta-1 after sciatic nerve injury / 中华物理医学与康复杂志

Objective To observe any effects of pulsed electromagnetic fields (PEMFs) on the expression of transforming growth factor beta-1 (TGF-β1) after sciatic nerve injury and to investigate the possible mechanism of any regeneration of the injured sciatic nerve.MethodsForty-eight SD rats were randomly divided into a PEMF treatment group,a model group and a normal control group with 16 rats in each group.The three groups were then sub-divided into 1 day,3 day,7 day and 14 day subgroups.The rats of the model and treatment groups were clamped to produce a sciatic nerve injury model.The treatment sub groups were exposed to a 9 mT PEMF at 14 Hz for 2 hours once daily for 1,3,7 and 14 days,respectively.The model group was given sham exposure and the normal control group was reared conventionally and not given any special treatment.The histological changes in the rats' sciatic nerves were observed under a light microscope after hematoxylin-eosin staining.Expression of TGF-β1 was detected by immunohistochemical methods.ResultsAfter 7 and 14 days of treatment,Wallerian degeneration of the sciatic nerve in the treatment group was more obvious than in the model group.The expression of TGF-β1 increased during the treatment process and reached a maximum at the 14th day after nerve injury.The expression of TGF-β1 had increased significantly in the model and treatment groups compared with the control group at all observation time points.At the 3rd,7th and 14th day after the operation,the expression of TGF-β1 in the treatment group was significantly higher than that in the model group. Conclusion PEMFs can accelerate Wallerian degeneration of peripheral nerves and can up-regulate the expression of TGF-β1 after sciatic nerve injury,at least in rats.

Effects of pulsed electromagnetic fields on mechanical allodynia after acute skeletal muscle contusion in rats / 中华物理医学与康复杂志

Objective To observe the effects of pulsed electromagnetic fields (PEMFs) on behavior and mechanical paw withdrawal thresholds (MPWTs) after acute skeletal muscle contusion (ASMC) in rats, and to in-vestigate the application of PEMFs in rats with ASMC during the early stage. Methods Forty-two Sprague-Dawley rats were randomly divided into a PEMF group (P group) , control group (C group) and blank control group ( BC group). ASMC models were set up in groups P and C, and no intervention was applied in the BC group. A PEMF was administered to animals in the P group immediately after the ASMC was inflicted. The behavior of the rats in each group was then observed. The MPWT of each rat was tested 2 days before and 0, 12, and 18 hours after the ASMC was inflicted). Results In the P and C groups, MPWT of the left hind paw at the 12th and 18th hour after ASMC was significantly lower than the baseline pain threshold 2 days before the ASMC. At 18 hours, the MPWT was signifi-cantly higher than at 12 hours in the P group. MPWT at 12 hours in the P group and at both 12 and 18 hours in the C group were significantly lower than in the BC group. MPWT in the P group at 18 hours was significantly higher than in the C group. Conclusions The behavior of rats treated with PEMF immediately after ASMC was improved, and their pain threshold was still elevated 18 hours later.

The effect of pulsed ultrasound on medial collateral ligament repair / 中华物理医学与康复杂志

Objective To investigate the effect of pulsed ultrasound therapy (US) on medial collateral liga-ment healing in rats and it's mechanism.MethodsEighteen 3-month-old male Sprague-Dawley rats with transected medial collateral ligaments (MCLs) were studied. They were randomly divided into a control group, a 0.5 W/cm~2 group and a 1. 0 W/cm~2 group.The control group was not given any treatment.The 0. 5 W/cm~2 group and 1.0 W/cm~2 group were given 10 minutes of pulsed US (duty cycle: on/off = 3 ms/1 ms) daily for 8 days at either 0.5 or 1.0 W/cm~2 intensity. All the rats were sacrificed on the 9th day. After macroscopic examination, their MCLs were harvested and studied using haematoxylin-eosin staining, Van Gieson's staining and immunohistochemical tech-niques in order to detect transforming growth factor beta-1(TGF-β1) and any histological or histochemical changes.ResultsMacroscopically, the lacerated MCLs had healed with scar tissue formation. Scarring appeared to be greater in the 0.5 W/cm~2 and 1.0 W/cm~2 groups than in the control group. Inflamed cells appeared to be more numerous in the treated groups than in the controls. There were significant differences in collagen fiber extent among all three groups. In the 1.0 W/cm~2 group, the average level of TGF-β1 was significantly up-regulated, and TGF-β1 expres-sion was higher than in the other two groups.ConclusionsPulsed US can improve ligament healing in the short term, however whether long-term treatment with US can yield further improvement is unknown. Pulsed US can in-crease the level of TGF-β1, which will be higher with higher US dosage. Pulsed US may enhance injored ligament re-pair by up-regulating TGF-β1.Objective To investigate the effect of pulsed ultrasound therapy (US) on medial collateral liga-ment healing in rats and it's mechanism.MethodsEighteen 3-month-old male Sprague-Dawley rats with transected medial collateral ligaments (MCLs) were studied. They were randomly divided into a control group, a 0.5 W/cm~2 group and a 1. 0 W/cm~2 group.The control group was not given any treatment.The 0. 5 W/cm~2 group and 1.0 W/cm~2 group were given 10 minutes of pulsed US (duty cycle: on/off = 3 ms/1 ms) daily for 8 days at either 0.5 or 1.0 W/cm~2 intensity. All the rats were sacrificed on the 9th day. After macroscopic examination, their MCLs were harvested and studied using haematoxylin-eosin staining, Van Gieson's staining and immunohistochemical tech-niques in order to detect transforming growth factor beta-1(TGF-β1) and any histological or histochemical changes.ResultsMacroscopically, the lacerated MCLs had healed with scar tissue formation. Scarring appeared to be greater in the 0.5 W/cm~2 and 1.0 W/cm~2 groups than in the control group. Inflamed cells appeared to be more numerous in the treated groups than in the controls. There were significant differences in collagen fiber extent among all three groups. In the 1.0 W/cm~2 group, the average level of TGF-β1 was significantly up-regulated, and TGF-β1 expres-sion was higher than in the other two groups.ConclusionsPulsed US can improve ligament healing in the short term, however whether long-term treatment with US can yield further improvement is unknown. Pulsed US can in-crease the level of TGF-β1, which will be higher with higher US dosage. Pulsed US may enhance injored ligament re-pair by up-regulating TGF-β1.

Pain Threshold Measuring and Its Influencing Factors (review) / 中国康复理论与实践

@#With increasing attention to pains, the measurement of pain threshold has become an important part among researches to pains. Therefore, measuring Methods and their validity as well as reliability have direct influenced the Conclusion of the researchs. The approaches of pain threshold measurements, and the factors influenced the result were discussed in this paper.

Effects of pulsed electromagnetic fields on the expression of MyoD after acute skeletal muscle contusion / 中华物理医学与康复杂志

Objective To observe the effects of pulsed electromagnetic fields (PEMFs) on histological changes and myogenic differentiation factor D (MyoD) expression in rats with acute skeletal muscle contusion ( ASMC), and to explore the effects of PEMF therapy on rats with ASMC in its very early stages. Methods Forty-two rats were randomly divided into three groups : a treatment group, a control group and a blank control group. ASMC models were established with all the animals in the treatment and control groups. PEMF treatment was admin-istered to the treatment group immediately after the establishment of the ASMC model. Seven rats in each group were sacrificed at the 12th and 18th h after the models were set up. Their triceps surae muscles were sampled and treated with haematoxylin-eosin staining for study using immunofluorescence techniques and a fluorescence microscope. Re-suits In the control group at the 12th h and 18th h, HE staining showed pale cytoplasm and polymorphism in the cell nuclei ; in the treatment group these effects were significantly lighter, but in both groups it was more serious than in the blank control group. In the treatment and control groups, the fluorescence intensity of MyoD at the 18th h was higher than at the 12th h, and at each time point in both groups it was higher than in the blank control group. At the 18th h, fluorescence in the treatment group was stronger than in the control group. Conclusion MyoD expression in rats with ASMC is upregulated by thel8th h after early PEMF treatment. This might be one of the mechanisms ac-celerating the regeneration of skeletal muscles after trauma.

Advance in Rehabilitation of Diabetic Peripheral Neuropathy (review) / 中国康复理论与实践

@#Diabetic peripheral neuropathy (DPN) is the most common complaint of diabetic patients, affecting the quality of life of patients seriously. The effect of DPN treated with traditional medicine therapy is poor. The rehabilitation of DPN develops fast recently. The authors overview the current trend of the rehabilitation treatments of DPN in the article including medicine therapy, physical therapy, exercise therapy, traditional Chinese medicine, hyperbaric oxygen therapy, orthopaedic devices and so on.

Verbal Arts of Rehabilitation Therapists in Medical Services / 中国康复理论与实践

@#The words and deeds of rehabilitation therapists are associated with the health and life of patients,the stability and harmony of the families.The language is the bridge of communication.Therapists should employ the speech correctly.More attention should be paid to artistic speech.The therapist could use the speech,which could promote patients.So that,patients can renew their work,and lofty morality could be showed.Meanwhile,therapists should use speech rationally and grasp the skills of speech to avoid the doctor-patient quarrel.

Effects of Multidisciplinary Rehabilitation on Early Heterotopic Ossification of Patients with Traumatic Elbow Joint Iinjury / 中国康复理论与实践

@#Objective To observe the effects of multidisciplinary rehabilitation on early heterotopic ossification of patients with traumatic elbow joint injury.Methods 80 work injury patients of early heterotopic ossification after traumatic elbow joint injury were randomly divided into the experiment group(42 cases) and control group(38 cases).The experiment group received multidisciplinary rehabilitation,including physical therapy,occupational therapy,physical factor therapy,traditional Chinese medicine,ward rehabilitation and vocational training.The control group was treated with pain killer and diminish inflammation medicine and median frequency electrical therapy.Range of motion(ROM) of joint and visual analogue scale(VAS) were separately assessed before and after 3 months treatment.Results After 3 months treatment,ROM and VAS of the experiment group were significantly changed compared with admission(P<0.01).The effectiveness of the experiment group was superior to that of the control group(P<0.05).After discharge,39 cases returned to primary work,3 cases changed work in the experiment group,and after 1 year follow-up,no case needed to receive operation.Conclusion In the early stage of heterotopic ossification after traumatic elbow joint injury,multidisciplinary rehabilitation can significantly relax clinical signs,improve functions and make the work injury patients return to work.

The effects of ultrashortwave therapy and passive motion on osteoarthritis of the knee joint in the rabbits / 中华物理医学与康复杂志

Objective To investigate the effects of uhrashortwave therapy and passive motion on experimen-tal osteoarthritis caused by immobilization of the joint. Methods Twenty healthy male rabbits had their left knee joints fixed in extension for 4 weeks. They were randomly divided into 4 groups : a control group which did not receive any treatment, an uhrashortwave therapy group, a passive motion group, and an ultrashortwave therapy plus passive motion group, and treated accordingly for 4 weeks. The range of motion of the joint before and after treatment was compared in every group. At the end of the 4th week, all the rabbits were sacrificed, and the cartilage at the condylus medialis femoris was sampled and observed with toluidine blue staining, haematoxylin-eosin staining. Its gross appearance was noted and it was also analyzed using immunohistochemical techniques. Results ①Passive range of motion (PROM): there were no significant differences among the 4 groups before the treatment. Uhrashortwave therapy per se did not yield significant therapeutic effects in terms of PROM as compared to the controls, However, passive motion alone and in conjunction with ultrashortwave therapy brought about significant improvement of PROM when compared against the control group. The most significant change was seen in the integrated group, followed by the passive motion group. ②The histological scoring system : Mankin's scoring system showed significant differences a-mong all 4 groups. The highest value was the control group, which was followed by the ultrashortwave therapy group, the passive motion group and the integrated group. ③The positive expression rate of inducible nitric oxide synthase: there were significant differences among all 4 groups. The control group had the highest values, followed by the ultra-shortwave treated group, the passive motion treated group and the integrated group. Conclusions Ultrashortwave therapy, passive motion therapy and integrated therapy combining ultrashortwave therapy with passive motion can all can reduce and prevent the cataplasia of articular cartilage. Integrated therapy is the best treatment method, followed by passive motion therapy, and then uhrashortwave therapy.

The expression of IL-1β and MMP-1 in the knee cartilage on experimental osteoarthritis rabbit / 中华物理医学与康复杂志

Objective To establish an animal model of knee osteoarthritis (OA) , and to explore the relationship between cartilage degeneration and the expression of IL-1β and MMP-1. Methods A total of 16 healthy male rabbits (32 hind knee joints) were used. The experimental OA model was established in their left knees by intraarticular injection of0.2 ml of 4% papain solution and 0.1 ml of 0.03 mol/L L-cysteine solution. The right knees were used as the controls and were treated with intraarticular injection of 0.3 ml of normal saline solution. General and histological scoring, and IL-1β and MMP-1 expression intensity were compared between the 2 groups. Results The degree of cartilage degeneration in the left knees was higher than in the right knees as observed by naked eye and using an electron microscope. The left knees scored significantly higher than the right ones with Mankin's scoring system. There was significantly greater expression of IL-1β and MMP-1 in the chondrocytes of the left knees. Conclusions lntraarticular injection of papain and L-cysteine can induce experimental knee osteoarthritis in rabbits. The expression of IL-1β and MMP-I is significantly related with carti-lage degeneration.

互动式教育在康复专业运动疗法实习带教中的应用 / 中国康复理论与实践

@#目的探讨互动式教育对康复治疗系实习生在运动疗法实习期间的学习效果。方法两组学生分别采用传统教学法和互动式教学法带教实习,实习结束,比较两组学生出科测试成绩。结果接受互动式教学法的学生成绩明显优于传统教学法(P<0.01)。结论互动式教学法可提高康复治疗系实习生的教学效果。