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In order to improve the management efficiency of standardized residency training for rehabilitation medicine and ensure the quality of training for trainees, we have conducted a precise management exploration of standardized residency training for rehabilitation medicine residents based on mobile phone platforms. An highly efficient and precise rehabilitation medicine residents training system has been constructed by applying some widely used APPs and network functions in China, such as WeChat, Sojump, Teachermate, Ding Talk, etc. With the mobile phone WeChat as the medium, the management framework of the residency training base has been built. The student information input, assessment, evaluation and feedback system have been completed through the questionnaire star as the medium. The Internet extension of teaching and training activities has been realized by the teachermate. Through the Ding Talk, the individualized precise graduation examination arrangements for the trainees have been achieved, and the customized skill training arrangements and records have also been achieved. Through the use of these modern teaching techniques and training methods, the precise and efficient management of the rehabilitation medicine standardized residency training has been basically realized.
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Objective:To explore the different design of readiness assurance process (RAP) and application in TBL teaching of rehabilitation medicine, and to compare the teaching effects.Methods:A total of 40 students who had clinical rotation in our department were chose as research subjects, and they were taught with TBL teaching. Two chapters of "Stroke Rehabilitation" and "Spinal Cord Injury Rehabilitation" were chosen for the two lectures. During the course of "Stroke Rehabilitation", the RAP adopted open-ended questions, and the application part simulated Teamwork meetings. In the course of "Spinal Cord Injury Rehabilitation", the RAP used close-ended multiple-choice questions, and the application part simulated making rehabilitation plan. At the end of the two lectures, questionnaires were send to students.Results:For the RAP part, more students preferred open-ended questions. In the application part, students preferred to make rehabilitation plan.Conclusion:The process of clinical diagnosis and treatment and the formulation of rehabilitation plan in clinical practice of rehabilitation medicine has been applied to different parts of TBL teachings, and students are favor of this teaching method, which provides a reference for the future TBL teaching design of rehabilitation medicine.
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In recent years, the studies have found that the intestinal micro-ecology is closely related to the development and treatment of tumors. This article aims to summarize the advance of anti-tumor mechanism of metformin through regulation of gut microbiota, describe the problems and its prospect in the research process.
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Objective To explore the effect and teaching methods of double supervisor sandwich teaching in rehabilitation medicine teaching. Methods Totally 48 students from eight-year program class in our university were randomly divided into experimental group and control group. Experimental group (24 students) using double supervisor sandwich teaching method, which was jointly conducted by an associate professor and a lecturer while control group (24 students) used the traditional single supervisor sandwich teaching method. Tests including basic theoretical knowledge and clinical application knowledge were delivered immediately after class to evaluate teaching efficacy, during which SPSS 23.0 software was used for statistical analysis and t-test was used for score comparison. Results The total scores of the tests in the experimental group and the control group were respectively (91.42±5.76) and (86.02±10.24). There was significant difference between the two groups (t=2.249, P=0.031). The scores of basic theoretical knowledge of experimental group and control group were (62.23 ±3.43) and (58.07 ±5.57). The differences be-tween the two groups were statistically significant (t=3.120, P=0.003). The scores of clinical application knowledge of the experimental group and the control group were (29.19±4.75) and (27.96±8.01). There was no significant difference between the two groups (t=0.646, P=0.522). Conclusion The application of double supervisor sandwich teaching method in rehabilitation medicine can not only significantly enhance the quality of teaching, but also improve students' test scores.
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Objective To observe the effects of early rehabilitation on the motor function of post-stroke hemiplegic patients treated with intravenous thrombolysis.Methods Thirty-six post-stroke hemiplegic patients after intravenous thrombolysis with rtPA were recruited in this study.They were randomly divided into the early rehabilitation group (with the course less than three days) and the control group (with the course between three and seven days),18 cases in each group.Both group received a two-week rehabilitation programme.They were assessed using the Fugl-Meyer assessment (FMA) of up extremity,FMA of lower extremity and ADL score (modified Barthel index,MBI) before and after treatment,as well as at the 3rd month after treatment (during the following-up).Results After treatment and at the following-up,FMA scores of up extremity,FMA scores of lower extremity and MBI scores had improved significantly compared with before treatment in both groups.Furthermore,after treatment,in the early rehabilitation group the average FMA score of lower extremity and MBI score reached (23.33 ± 4.37) and (56.11 ± 22.27) respectively,significantly higher than those of the control group [(17.06 ± 4.70) and (40.00 ± 15.81) respectively].Conclusion Early rehabilitation contributes to short-term recovery of lower extremity motor function and ability in the activities of daily living in post-stroke hemiplegic patients after intravenous thrombolysis.
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Objective To observe the therapeutic efficacy of focal vibration on shoulder-hand syndrome (SHS) in stroke patients.Methods Two stroke patients with SHS were observed.Both patients were treated with routine interventions including exercises,manipulation,intermittent sequential pneumatic compression,medications etc at the beginning,but got no significant improvement after 4 weeks of treatment.Focal vibration was then added on by applying it on the affected side for 10-12 minutes,once daily for 2 weeks.The SHS scoring system developed by Braus and colleagues was used to evaluate the outcome.Results It was found that after 2 weeks of treatment with focal vibration,both patients were improved significantly,in terms of pain,edema and shoulder range of movement,as reflected by the changes of SHS scores.The SHS scores of both patients were 12 before treatment with focal vibration and reduced to 5 after the treatment.Conclusions Focal vibration could be an effective option for the management of SHS in stroke patients.
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Objective To investigate the effects of hyperbaric oxygen (HBO) combined with neural stem cell (NSC) transplantation on functional recovery after spinal cord injury (SCI).Methods Forty healthy adult Sprague-Dawley rats were randomly divided into a sham group,an SCI group,an NSC group and an HBO+NSC group.In the latter three groups,complete spinal cord transection was performed at T10.The rats of the HBO+NSC group were treated with HBO therapy after NSC transplantation.Hindlimb motor function was assessed with the BassoBeattie-Bresnahan (BBB) scale and tilt table testing.Motor evoked potentials (MEPs) were measured to evaluate the rats'nerve conduction function.The amount of surviving transplanted NSCs at the injured site was counted using Hoechst dyeing.Results The average BBB scores and tilt table test results in the HBO+NSCs group were significantly better than in the SCI and NSC groups from the 2nd week post-SCI.By the 4th week the average latency period and MEP amplitude in the HBO+NSC group were significantly better than in the NSC group,while MEPs in the SCI group still had not re-appeared.The surviving amount of transplanted NSCs in the HBO+NSC group was also significantly greater than in the NSC group.Conclusion HBO combined with NSC transplantation has synergistic effects and can improve functional recovery after SCI.This may be explained by the important role of HBO in promoting the survival of transplanted NSCs.
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Objective To investigate the effects of epidural spinal cord electrical stimulation (ESCES) on spinal cord reflexes in normal adult rats, and to find out where and how the spinal cord reflexes are generated. Methods Ten adult female Sprague Dawley rats were anaesthetized and an electrode was placed at the S, spinal cord segment. Single electric pulses with 200 μs pulse width and voltages of 400 mV, 600 mV and 1200 mV were used in the ESCES. 1200 mV voltages with 50 Hz, 60 Hz, 80 Hz, 100 Hz frequency were also tested. EMG signals were re-corded with concentric needle electrodes in the rats' semitendinosus muscles to observe the characteristics of spinal cord reflexes. Results The voltage threshold for generating semitendinosus muscle response was 300 mV. The three ESCES voltages induced 2 kinds of spinal cord reflexes. The 400 mV and 600 mV stimulation induced spinal cord reflexes with short latency (5.27±0.36 ms and 5.19±0.67 ms respectively). The 1200 mV stimulation volt-age induced spinal cord reflexes with long latency (2.57±0.23 ms). Spinal cord reflexes could be generated by 50 Hz, 60 Hz, 80 Hz, and 100 Hz ESCES. At the higher frequencies, spinal cord reflexes declined late in the ex-periments and then appeared irregular. In some of the rats, spinal cord reflexes vanished entirely late in the stimula-tion experiments. The latency and duration of the spinal cord reflexes induced by 50 Hz ESCES were (4.46 ± 1.07) ms and (7.33±1.00)ms respectively. These were significantly different from the latency and duration initia-ted by 60 Hz, 80 Hz or 100 Hz ESCES. Conclusions Different ESCES voltages induce different spinal cord refle-xes generated differently. The long latency reflexes might be monosynaptic responses mediated by dorsal root excite-ment, while the short latency reflexes might be sarcous exciting electric activity mediated by direct excitement of mo-tor neurons or motor fibers. The irregular spinal cord reflexes induced by higher frequency ESCES might be one kind of monosynaptic response. Irregularly appearing spinal cord reflexes induced by higher frequency stimulation might due to the inhibitory effect of higher frequency stimulation.
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Objective To explore the potential of creating a cat model of spinal cord infarction initiated by a photochemical reaction in terms of the neuroethology, motor evoked potential, and morphological outcomes. Meth-ods Fifteen cats were divided into three groups at random. T_13 in the spinal cord was photochemically irradiated for 40 min, 60 min or 80 min in different groups. A photochemically-induced infarction was produced by intravenous in-jection of rose Bengal (35 mg/kg) combined with immediate cold light irradiation (3000 klx) of the spinal cord.Neuroethology changes were observed every day after the surgery far 21 days, and morphological changes were exam-ined at day 21, before which the motor evoked potential was examined and compared with measurements taken before injury. Results The spinal cord infarctions induced by intravenous injection of rose Bengal plus cold light irradia-tion for 40 min were stable by day 8, while the other two groups were stable by day 12. The size of the infarction area in the spinal cord was stable, while the neuroethology, electrophysiological and histopathological changes in the cats were significant. Conclusions All of the cats demonstrated decreased functional mobility after photochemically in-duced thrombosis of the spinal cord, with corresponding pathomorphological and electrophysiologic changes. The model of infarction was stable and reliable.
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Objective To investigate the effect of electroacupuncture (EA) combined with repetitive transcranial magnetic stimulation ( rTMS) on postsynaptic density 95 ( PSD- 95) in the hippocampus of rats after cerebral ischemia. Methods Sixty healthy male Wistar rats were divided into normal, model, EA, rTMS and EA + rTMS groups randomly, and the rats in each group were further divided into 7 d, 14 d and 28 d subgroups. A model of middle cerebral artery occlusion ( MCAO) was established, followed by EA, rTMS or EA + rTMS treat-ment. The expression of PSD-95 in the dentate gyros and area CA3 of the hippocampus of the ischemic cerebral hemisphere were investigated. Results The expression of PSD-95 in the dentate gyrus and area CA3 of the ische-mic cerebral hemisphere had decreased 7 d after cerebral ischemia. The expression of PSD-95 in the three treat-ment groups increased after 14 d of treatment and was significantly greater compared with the model group after 28 d of treatment. The EA + rTMS group was especially superior to the EA and rTMS groups in terms of the expression of PSD-95 in area CA3 by the 28th day. Conclusions EA + rTMS can significantly increase the expression of PSD-95 in the hippocampus after cerebral ischemia. This may help explain how EA + rTMS improves learning and mem-ory after cerebral ischemia.
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Objective:To investigate the effects of epidural spinal cord stimulation (ESCS) and treadmill training on the locomotion function and ultrastructure of spinal cord anterior horn after moderate spinal cord injury in rats. (IT, n=3). All rats received a moderate spinal cord injury surgery. Four weeks after surgery, rats in SE group received an electrode implantation procedure, with the electrode field covering spinal cord segments L2-S1. Four weeks after electrode implantation, rats received subthreshold ESCS for 30 min/d. Rats in TY group received 4cm/s treadmill training for 30min/d. Rats in SI group received no intervention, as a control group. All procedures in these three groups lasted four weeks.The open field Basso,Beattie and Bresnahan (BBB) scale was used before and after intervention to evaluate rats' hindlimb motor function. Result:After four weeks intervention, rats in TT group improved their open field locomotion scores to 20. In contrast, no significant improvement was observed in groups SI and SE. The morphology of synapses and neurons were similar regardless of whether rats had undergone ESCS, treadmill training or not. Conclusion:ESCS alone was not sufficient to improve the walking ability of spinal cord injured rats. ESCS or treadmill training alone might not contribute to the changes of ultrastructure in anterior horn of spinal cord that underlie the recovery of walking ability. Further research is needed to understand the contributions of combination of ESCS and treadmill training to the rehabilitation of spinal cord injured rats.