Objective:To explore vibration, position and motion proprioception of the ankle joints after a stroke.Methods:Twenty-eight stroke survivors with impaired ankle proprioception were divided into a right-side stroke group ( n=18) and a left-side stroke group ( n=8). Twenty-two healthy volunteers constituted a control group. Vibration perception thresholds, passive and active joint angle resetting, and motion minimum thresholds were quantified among the stroke survivors on both the healthy and the affected side. With the controls the dominant and non-dominant sides were used. The differences in proprioception between the healthy volunteers and the stroke patients, between the affected side and the healthy side of the stroke patients, and between left- and right-side stroke patients were analyzed and compared. Results:Among the stroke survivors the vibration perception threshold on the affected side averaged (28.91±22.53)μm. The absolute difference in the perception of passive positioning was (5.49±5.39)° for 15° of plantar flexion and (4.48±3.89)° for 5° of dorsal extension. In active positioning plantar flexion was (5.23±4.34)° and for 30° of plantar flexion it was (3.26±1.73)°. The 5° dorsal extension error was (4.97±3.48)°. The motion perception thresholds between 20° of plantar flexion, 10° of plantar flexion and the neutral position were significantly higher, on average, than among the control group. The stroke group also had significantly higher motion perception thresholds than the control group.Conclusion:The vibration, position, and motion sense of the ankle joint on a stroke survivor′s affected side tend to be impaired, with the impairment of vibration and motion sensing tend to be more substantial. After stroke, there is also mild impairment of vibration, position and motion sensing in the healthy ankle joint. The impairment of proprioception caused by right cerebral hemisphere injury may be more serious than that caused by injury on the left.

Objective:To test the utility of monofilament cutaneous threshold testing among patients with impaired touch sensation caused by central nervous system injury.Methods:Thirty stroke survivors and 30 patients with spinal cord injury were recruited. Monofilament threshold testing and cotton wool tests were performed on the bilateral forehead, face, palms and dorsum of feet among the stroke survivors. Among those with a spinal cord injury both tests were performed on each side of the L 4, L 5 and S 1 vertebrae. One week later, all were retested. Intra-class correlation coefficients (ICCs) were used to quantify the test-retest reliability of the tests. Kappa values were calculated to determine the degree of agreement between them. Stepwise multiple linear regressions were evaluated to examine the relationship between touch perception thresholds and age, height, gender, type of injury and injured site. Results:①The ICC for the monofilament test was between 0.74 and 0.95, higher than that of the cotton wool test (ICC: 0.60 to 0.83). ②The kappa value between the monofilament and cotton wool tests was 0.550, indicating good agreement. ③The types of injury and injured sites were independent correlates of the touch perception thresholds, but there was no significant correlation between the touch perception thresholds and age, height, gender or group.Conclusions:The monofilament cutaneous threshold test has good test-retest reliability, better than the cotton wool test. Therefore, it may be useful as a tool for assessing impaired touch sensation caused by central nervous system injury.

目的 探讨基于脑损伤患者遗忘特征的个性化记忆康复疗效.方法 2018年9月至2019年10月,本院60例脑损伤患者随机分为常规记忆训练组(对照组,n=30)和个性化记忆训练组(观察组,n=30),观察组训练前进行遗忘特征测验,训练4周.训练前后分别进行Rivermead行为记忆测验第二版(RBMT-II)、蒙特利尔认知评估量表(MoCA)评定.结果 组内比较,两组训练后RBMT-II和MoCA总分均明显高于训练前(|t|>3.885,P<0.01).组间比较,两组训练前后RBMT-II和MoCA总分比较均无显著性差异(P>0.05);观察组训练前后RBMT-II和MoCA总分之差均显著大于对照组(|Z|>3.757,P<0.001).结论 记忆康复训练能改善脑损伤患者的记忆能力和总体认知功能,根据遗忘特征进行个性化记忆训练更为有效.

目的 探讨Gaitboter与Noraxon步态分析系统时空参数的一致性.方法 2019年2月至4月,选取35例健康成年人,分别应用Gaitboter与Noraxon步态分析系统进行步态测试,记录其站立相及迈步相时间比例、跨步长、步频、步速、足偏角等时空参数,采用组内相关系数(ICC)和Bland-Altman散点图评定两种步态分析系统的一致性及差异.结果 两种步态分析系统测试所得时空参数的信度较好(ICC 0.691～0.835).Bland-Altman法一致性检验结果 显示,两种步态分析系统测试所得时空参数间的一致性较好.结论 Gaitboter与Noraxon步态分析系统测试所得时空参数一致性较好,可进一步在临床试用以观察测试效果.

本文综述常见下肢关节损伤后其踝关节肌力的变化特点和能较好反映该特点的等速肌力测试方式.踝关节单次内翻跖屈损伤后外翻肌力明显下降;踝关节功能性不稳人群内翻肌力明显下降;前交叉韧带断裂术后及跟腱损伤后踝关节背屈肌力在长时间内未达到健侧水平.等速肌力测试方式主要包括测试方向、肌肉收缩形式和测试速度等内容.踝关节扭伤及踝关节功能性不稳人群的等速肌力测试内翻/外翻和跖屈/背屈方向测试意义明显,肌肉收缩方式和测试速度对结果的影响还有待进一步研究.

Gait analysis (GA) has been widely used in physical activity monitoring and clinical contexts, and the estimation of the spatial-temporal gait parameters is of primary importance for GA. With the quick development of smart tiny sensors, GA methods based on wearable devices have become more popular recently. However, most existing wearable GA methods focus on data analysis from inertial sensors. In this paper, we firstly present a two-foot-worn in-shoe system (Gaitboter) based on low-cost, wearable and multimodal sensors' fusion for GA, comprising an inertial sensor and eight film-pressure sensors with each foot for gait raw data collection while walking. Secondly, a GA algorithm for estimating the spatial-temporal parameters of gait is proposed. The algorithm fully uses the fusion of two kinds of sensors' signals: inertial sensor and film-pressure sensor, in order to estimate the spatial- temporal gait parameters, such as stance phase, swing phase, double stance phase, cadence, step time, stride time, stride length, velocity. Finally, to verify the effectiveness of this system and algorithm of the paper, an experiment is performed with 27 stroke patients from local hospital that the spatial-temporal gait parameters obtained with the system and the algorithm are compared with a GA tool used in medical laboratories. And the experimental results show that it achieves very good consistency and correlation between the proposed system and the compared GA tool.

目的：探讨闭合性脑外伤患者恢复期的图画遗忘特征。方法2012年10月~2013年8月，采用视觉彩色有意义图片，目标图片和干扰图片各60张，对38例闭合性脑外伤恢复期患者及31名正常人进行再认测验，观察学习后10 min、30 min及24 h的辨别力(d′)。结果14例闭合性脑外伤恢复期患者10 min时d′<2，未行长时记忆研究。另24例患者d′学习后30 min和24 h与正常组相比有显著性差异(t>2.044, P<0.05)；患者组内比较，d′学习后10 min、30 min与24 h均有显著性差异(P<0.05)。结论闭合性脑外伤恢复期患者图画遗忘部分表现为图画信息获得受损；图画信息获得能力相对正常的患者，遗忘速度明显加快。

Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Respons-es Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with trau-matic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Catego-ries Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention.

Objective To analyze the muscle utilization ratio (MUR) of the trunk muscles when walking after spinal cord injury (SCI).Methods Ten patients with T11 SCI formed the SCI group,and 10 healthy subjects were chosen as controls.The MUR of their pectoralis major,rectus abdominus,obliquus externus abdominis,trapezius,latissimus dorsi and erector spinae muscles were recorded while walking.Two independent sample t-tests were used to compare the MURs of the two groups.The MURs of the trunk muscles in the same group were compared using single-factor analysis of variance.Results The SCI group displayed significantly higher utilization of the pectoralis major,obliquus externus abdominis and erector spinae muscles compared to the control group during the stance phase,and significantly higher utilization of the obliquus externus abdominis and erector spinae during the swing phase.In the SCI group,the MUR of the obliquus externus abdominis was significantly higher than that of other muscles (except the pectoralis major) and the MUR of the pectoralis major was significantly greater than that of the trapezius during the stance phase.However,there were no significant differences in MUR among the different trunk muscles in the healthy group.The SCI patients generated significantly greater activity in the obliquus externus abdominis than in the trapezius during the swing phase.The control group developed significantly greater MUR in the trapezius than in the pectoralis major and more in the latissimus dorsi than in the rectus abdominus during the swing phase.Conclusion T11 complete SCI patients needed to generate higher MUR in the pectoralis major,obliquus externus abdominis and erector spinae during walking.This finding can serve as a reference for improving ambulation training.

Objective To measure the temperature sensation threshold of trunk skin in healthy adults. Methods The threshold of cold sensation, warm sensation, cold pain sensation and heat pain sensation of trunk skin key points (T3, T7 and T11) were measured with Thermal Sensory Analyzer in 123 healthy adults. Results The thresholds of cold, warm, cold pain and heat pain sensations were obtained. The stan-dard deviation of cold and warm threshold was less than that of heat pain. The range of cold sensation threshold was the largest. The heat pain sensation threshold increased with segmental declining and the sensation threshold increased with age. Conclusion Normal reference value should be established variously with the segment and age. The threshold of cold, warm varies less, while the threshold of cold pain and heat pain varies too much.

Objective To investigate the correlation between Semmes-Weinstein monofilament test and light touch exam of international standard for spinal cord injury (SCI). Methods 84 inpatients with SCI were assessed with Semmes-Weinstein monofilament test and light touch exam of international standard to determine the SCI level. The results were recorded as right-side and left-side of the body respective-ly. Results The normal tactual level of monofilament test and the normal light touch level of International Standard of Spinal Cord Injury (ISSCI) was consistent in 36%result to the unilateral level of SCI. For the 45 cases with ASIA A injury, 71%of the key points below the SCI level lost the tactual sensation in monofilament test, and 84%lost in light touch exam of ISSCI. Conclusion The result of monofilament test is poorly consistent with light touch exam of SCI, which may result from tactile sensitization after SCI. It is recommended to combine these exam in practices.

Objective To compare the efficacy of different models of attention rehabilitation on attention deficits after acquired brain in-jury.Methods According to the training models,47 patients with attention deficits were randomly assigned to 3 groups: computer-assisted training group(n=16),face-to-face training group(n=21) and control group(n=10).The training groups were given attention training once a day which sustained 30 minutes for 6 weeks.All patients were tested with the Montreal Cognitive Assessment(MoCA) and the Loewenstein Occupational Therapy Cognitive Assessment Battery(LOTCA) before and 6 weeks after the rehabilitation.Results The performance of both the computer-assisted training group and the face-to-face training group significantly improved(P0.05).The various of the scores was the most in the computer-assisted training group among them(P0.05).Conclusion The computer-assisted training is a high-effective meth-od for attention deficits.

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury.Methods 113 cases were randomly assigned to 3 groups: control group(n=37),computer-assisted training group(n=38) and face-to-face training group(n= 38).The control group just received cognitive dysfunction evaluation.The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks.And 33 patients were selected to prolong for 12 weeks.They were evaluated with Revised EC301 Calculation and Number Processing Battery in Chinese version(EC301-CR) at the beginning,the 6th week point and the 12th week point respectively.Results 6-week after treatment,The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001);It showed that computer-assisted group>face-to-face group>control group(P< 0.001) both 6 weeks and 12 weeks latter.Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training;The first 6 weeks of training is the best period for rehabilitation;The younger the patient is,the better results are.

OBJECTIVE To evaluate the efficacy and tolerability of the fixed combination of amlodipine 5 mg/benazepril 10 mg once-daily therapy, compared with benazepril, 10 mg, monotherapy in patients with mild and moderate hypertension, and to evaluate the 24 h antihypertensive efficacy and the duration of action by ambulatory blood pressure monitoring. METHODS In a multicenter, randomized, double-blind, parallel controlled trial, 356 cases of hypertensive patients after 2 weeks wash-out, and then given 4 weeks of benazepril 10 mg monotherapy, 220 patients with mean seated diastolic blood pressure (SeDBP) remained ≥ 90 mm Hg (1 mm Hg = 0.133 kPa) were randomly divided into benazepril 10 mg/amlodipine 5 mg (BZ10/AML5) fixed-dose combination therapy group (once a day, n = 113), and benazepril monotherapy group (daily 20 mg, n = 107). In the two groups the patients with SeDBP ≥ 90 mm Hg were doubled the dosage of the initial regimen at the end of 4-week treatment for additional 4 weeks, and the patients with SeDBP < 90 mm Hg remained the initial regimen for additional 4 weeks. The primary endpoint was to evaluate the improvement of SeDBP at the end of 8-week treatment. There were 74 patients (the combination therapy group n = 38, monotherapy therapy group n = 36) completed the 24 h ambulatory blood pressure monitoring which was included in the final efficacy analysis. RESULTS The randomized, double-blind treatment for 8 weeks, the mean value of SeDBP reduction, the reaching target blood pressure rate and total successful response rate to the treatment (a SeDBP < 90 mm Hg or a decrease of 10 mm Hg or more from baseline) were (11.7 ± 6.8) mm Hg, 65.7% and 88.5% in the combination therapy group, respectively, and were (7.7 ± 6.9) mm Hg, 35.5% and 65.5% in the monotherapy group, respectively. There were statistically significant difference between the combination therapy and the monotherapy groups in all the 3 indexs (P < 0.001). The fixed combination significantly reduced systolic blood pressure (SBP) and diastolic blood pressure (DBP) values throughout the 24 h. The trough to peak ratios of DBP/SBP in the fixed compound of benazepril/amlodipine (10 mg/5 mg) and benazepril (20 mg) alone were 83.1%/76.0% and 85.8%/79.5%, respectively. Adverse events rates were 16.8% in the combination therapy group and 35.5% in the monotherapy group (P < 0.001). CONCLUSIONS The combination therapy with benazepril/amlodipine was superior to benazepril monotherapy and was well tolerated in patients with essential hypertension and allowing a satisfactory BP control for 24 hours.

Objective To investigate the effect of telerehabilitation on memory disorders. Methods From August, 2010 to April, 2015, 81 patients with memory disorders were randomized into control group (n=26), computer-assisted training group (n=33) and telerehabilita-tion training group (n=22). All the patients accepted medicine to facilitate the recovery of memory. Besides, the computer-assisted training group and the telerehabilitation training group accepted memory-based training programs with cognitive rehabilitation system locally or on network respectively, for six weeks. They were evaluated with Wechsler Memory Scale, Rivermead Behavioural Memory Test-2nd Edition and Rey Auditory Verbal Learning Test before and after training. Results Both computer-assisted and telerehabilitation training groups im-proved in all the assessment after training (t>4.059, P<0.001). There was no significant difference between them (P>0.05). There was no sig-nificant improvement in the control group after training (t<0.771, P>0.05). Conclusion Memory rehabilitation training can significantly im-prove memory abilities, similar with locally or telerehabilitation system.

OBJECTIVE:To study the differential microRNAs expression between patients with essential hypertension and healthy controls.METHODS:Whole blood from 15 hypertensive patients and 5 controls healthies were separated into plasma at 3000 rpm for 10 minutes. MicroRNAs were harvested using kit, and stored at -80°C. MicroRNAs profiling were performed using Exiqon microRCURY(TM) LNA microRNAs array, and were quantitative RT-PCR for the differential microRNAs expression. In addition, we used a set of plasma samples from 24 hypertensive patients and 22 healthy donors to independently validate the expression of these signature microRNAs.RESULTS:MicroRNAs expression profile was found to be differentially in the essential hypertensive patients compared with the healthy donors. Of 1700 microRNAs detected on the microarray, 46 microRNAs were found to be differentially expressed in the essential hypertensive patient, 27 microRNAs were collected in Sanger microRNAs data-bank, the function of remaining 19 microRNAs were unknown. In the 27 microRNAs, 9 microRNAs were up-regulated in the hypertension patient samples, while 18 known microRNAs were down-regulated. MiR-296-5p (Fold change 0.47, P = 0.013) and miR-133b (Fold change 0.57, P = 0.033) were consistently down-regulated in the patient plasma, whereas let-7e (Fold change 1.62, P = 0.009) and hcmv-miR-UL112 (Fold change 2.72, P = 0.004), one human cytomegalovirus encoded microRNAs, were up-regulated in the patient samples. The microRNAs expression was independently validated using another sample. We showed that MHC class I polypeptide-related chain B (MHC class I polypeptide-related chain B, MICB) and Interferon regulatory factor 1 (Interferon regulatory factor 1, IRF1) were functional targets of hcmv-miR-UL112 by fluorescent reporter assays.CONCLUSIONS:The hypertensive patients have distinct microRNAs expression Profile. Hcmv-miR-UL112 may have important implications toward pathogenesis of essential hypertension.

Objective To evaluate the relationship between N-terminal brain natriuretic peptide (NT-proBNP) and prognosis of acute ST-segment elevation myocardial infarction (STEMI), the predictive value of NT-proBNP in coronary artery multi-vessel disease, and whether the level of plasma NT-proBNP can be used as an independent predictor of 6-month MACE. Methods 207 patients diagnosed as acute STEMI in Chao-yang Hospital in Beijing from September 2009 to October 2010 and had reveived emergency percutaneous coronary intervention (PCI) within 24 h since the symptoms occurred were included. We detected the plasma NT-proBNP level immediately after emergency PCI with immunofluorescence technic, collected clinical data during hospitalisation, including admission age, Killip classification of cardiac function, left ventricular ejection fraction (LVEF) in cardiac ultrasonography, the number of diseased vessels found by coronary angiography, duration from onset to patency of diseased vessels, and then divided the patients into several subgroups according these data and analysed the difference of NT-proBNP among the subgroups. The major adverse cardiac events (Major Adverse Cardiac Event, MACE) occurred in the next 6 months were also collected. Logistic multivariate regression analysis was used to evaluate whether elevated plasma NT-proBNP levels are related to short-term prognosis of acute STEMI patients. Results (1) Plasma NT-proBNP level increases with the patients9 age increasing (r=0.39, p=0.000); (2) As left ventricular ejection fraction (LVEF) decreases, plasma NT-proBNP level increases (r=−0.29, p=0.000); (3) Plasma NT-proBNP level in subgroup cardiac function Killip III–IV and II are higher than Killip I subgroup (p=0.000, p=0.002), and plasma NT-proBNP levels in subgroup cardiac function Killip III–IV and Killip II have no significant difference; (4) The patent time of infarct related artery in STEMI patients are 0 – <6 h (subgroup A), 6 – <12 h (subgroup B) and 12 – 24 h (subgroup C) respectively, and plasma NT-proBNP level increases as the patency time prolongs (p=0.001, p=0.000 and p=0.000); (5) Logistic multivariate regression analysis shows that NT-proBNP is not an independent risk factor for short-term prognosis in STEMI patients. Conclusion Plasma NT-proBNP levels in acute STEMI patients who received emergency PCI are related to patients9 age, LVEF, Killip classfication of cardiac function, the number of diseased vessels, the patent time of criminal vessels, and 6-month MACE. However, the level of plasma NT-proBNP can not be used as an independent predictor of MACE.

There has been more and more results from both in vitro and clinical researches indicating the relativity between vascular injury and human cytomegalovirus infection. This mini review elaborated primarily several possible molecular mechanisms of vascular injury by human cytomegalovirus, such as oxidative stress, signal transduction, and immune inflammation. Virus interacts with its host through these mechanisms, involving many factors and cells, leading to pathological changes of vascular structure and function by influencing the survival, proliferation and apoptosis of vascular endothelial and smooth muscle cells, which finally causes the development of various cardiovascular diseases.

Objective: To evaluate the effects of high-dose glucose-insulin-potassium (GIK) solution on hemodynamics and cardiac remodeling in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). Patients and Methods: We observed the changes in the hemodynamic parameters in 26 patients with AMI. All patients received primary PCI before entering the study. All patients in the study were randomized into the GIK group (n = 14) or the control group (n = 12). Patients in the GIK group received high-dose GIK solution (25% glucose, 80mmol/L KCl and 50IU/L insulin; 1.5ml/kg/h) over 24h. Patients in the control group received standard therapy. We monitored the hemodynamic parameters at baseline and after 6h, 12h, 18h and 24h, respectively. Then, we followed-up the cardiac function with echocardiography after 7 days, 1 month and 6 months. Results: The basic clinical data was similar between the groups. Primary PCI was performed successfully in 25 patients. The two groups were indistinguishable in all factors measured. GIK solution did not have a deleterious effect on the hemodynamic parameters. The pulmonary capillary wedge pressure increased during the first 12-h period and then decreased smoothly (F = 3.75, P = 0.02). The trends were similar between the two groups. The system vascular resistance index (SVRI) and pulmonary vascular resistance index (PVRI) decreased during the first 12h in the GIK group but increased in the control group. The GIK solution significantly influenced SVRI (F = 4.71, P = 0.02). GIK solution improved the cardiac function measured by stroke volume (F = 4.11, P = 0.03) and cardiac index (F = 4.40, P = 0.02). In the 6-month follow-up, GIK improved cardiac remodeling (left ventricular diastolic diameter: 49.2 ± 2.89 vs. 53.9 ± 2.48, P < 0.001; left ventricular systolic diameter: 32.9 ± 2.24 vs. 35.9 ± 2.78, P < 0.01). Conclusion: High-dose GIK solution had no adverse effects on the hemodynamics in AMI patients treated with primary PCI. It can improve cardiac function by lowering SVRI. In the 6-month follow-up, it improved cardiac remodeling.

Memory disorders is the commonest cognitive impairment of people with traumatic brain injury,cerebral vascular disease,senile dementia and so on. Recently researchers at home and abroad used different rehabilitation training methods to treat the memory disorders in patients with brain injury,and has made some progress. This study reviewed the methods and efficacy of recent rehabilitation about memory disorders,and discussed the optimum rehabilitation programs.