Post-stroke constipation treated with acupoint embedding therapy: a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To verify the clinical effect of acupoint embedding therapy on post-stroke constipation.@*METHODS@#The multi-central randomized controlled trial was adopted. 210 patients of post-stroke constipation were divided into an acupoint embedding group (105 cases, 4 cases dropped off) and a sham-embedding group (105 cases, 6 cases dropped off). In the acupoint embedding group, the acupoint embedding therapy was used at Tianshu (ST 25), Daheng (SP 15), Xiawan (CV 10), Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4) and Daju (ST 27). In the sham-embedding group, the sham-embedding therapy was given, in which, the acupoint selection, needle devices and manipulation were the same as the acupoint embedding group. But, no absorbable surgical suture was used in the needle tube. The treatment was given once every two weeks and 4 treatments were required in either group. It was to compare the weekly average complete spontaneous bowel movements (CSBMs) during treatment (from the 3rd to the 8th week) between the two groups, the weekly average spontaneous bowel movements (SBMs), Bristol stool form score (BSFS), the score of the patient assessment of constipation quality of life questionnaire (PAC-QOL) and the score of defecation difficulty before and after treatment.@*RESULTS@#The percentage of the cases with weekly average CSBMs ≥ 3 times in the patients of the acupoint embedding group was higher markedly than the sham-embedding group [91.1% (92/101) vs 43.4% (43/99), <0.01]. Compared with the values before treatment, the weekly average SBMs and BSFS scores after treatment were all increased obviously in the two groups (<0.01), and PAC-QOL score and the score of defecation difficulty were reduced remarkably (<0.01). After treatment, the increase range of SBMs and BSFS scores, as well as the decrease range of PAC-QOL score and the defecation difficulty score in the acupoint embedding group were all higher than the sham-embedding group respectively (<0.05).@*CONCLUSION@#The acupoint embedding therapy remarkably increases the spontaneous bowel movements, improves in feces form and defecation difficulty and strengthens the quality of life in the patients of post-stroke constipation.

Neurodevelopmental outcome of preterm infants discharged from NICU at 1 year of age and the effects of intervention compliance on neurodevelopmental outcome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the neurodevelopmental outcome of preterm infants who were discharged from neonatal intensive care unit (NICU) at 1 year of age and the impact factors contributing to the neurodevelopmental outcome and to study whether early intervention can improve the neurodevelopmental outcome in preterm infants.</p><p><b>METHODS</b>Early intervention guidance and follow-up visits were performed after the preterm infants discharged from NICU. The infants received the infant development test of Child Development Centre of China (CDCC) for neurological development at 1 year of age. The neurodevelopmental outcome was evaluated based on mental development index (MDI) and physical development index (PDI). MDI and PDI > 85 was defined as normal, MDI or PDI between 70 and 85 as critical and MDI or PDI < 70 as abnormal. Social-domestic and clinical factors related to neurological development were analyzed by ANOVA or chi-square test. Potential high risk factors were analyzed with logistic regression. To investigate the effects of intervention compliance on neurological development, the infants were classified into two groups according to different intervention compliances. The good compliance group included infants who received a through familial intervention for more than 4 days weekly (30 minutes daily) and consulted with physicians more than 5 times in 1 year. The infants who did not receive the interventions as the good compliance group served as the bad compliance group.</p><p><b>RESULTS</b>This study consisted of 210 infants, with a mean gestational age of 33.2 +/- 2.6 weeks and a mean birth weight of 1923.3 +/- 558.8 g. Normal, critical and abnormal neurological development occurred in 123 cases (58.6%), 61 cases (29.0%) and 26 cases (12.4%) respectively. Eighteen infants (8.6%) had mental lag and 9 (4.3%) had cerebral palsy (CP). The MDI and PDI scores of the good compliance group (111 cases) were 97.15 +/- 17.38 and 94.23 +/- 18.55 respectively, which were markedly higher than those of the bad compliance group (89.87 +/-18.92 and 87.20 +/-19.12; P < 0.05). The incidence of CP (3/111, 2.7%) in the good compliance group was lower than that of the bad compliance group (5/99, 6.1%) although there were no statistical differences. Parents' education level, multiple birth, serious intracranial hemorrhage and apnea were risk factors for adverse neurodevelopmental outcome.</p><p><b>CONCLUSIONS</b>Preterm infants discharged from NICU are a high risk group of neurodevelopmental disablement. Early intervention can improve the neurodevelopmental outcome of perterm infants at high risk.</p>

Esophageal voice training and quality of life in laryngectomees / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the extensive and degree of physical rehabilitation improvement of the quality of life in laryngectomees.</p><p><b>METHODS</b>Forty nine patients who underwent total laryngectomies were trained by esophageal voice rehabilitation successfully. The questionnaires of performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of head and neck cancer therapy (FACT-H&N) were answered by them before esophageal voice training and 3 months after successful vocal rehabilitation.</p><p><b>RESULTS</b>Total laryngectomy deteriorated the quality of life in laryngectomees. The mean scores of PSS-HN scale and FACT-H&N questionnaire were lower than the criteria scores after patients underwent total laryngectomy, the mean score were 131. 4,90.6 respectively, the difference was significant statistically (t =53. 673, P <0.001) , (t = 67.44, P <0.001). After successful esophageal speech training, the mean scores of the laryngectomees were improved both in PSS-HN scale and FACT-H&N which were 240.4 and 103.7 respectively, the difference was significant statistically (t = 18.209, P < 0.001) , (t = 21.389, P<0.001).</p><p><b>CONCLUSIONS</b>The quality of life in laryngectomees can be improved by physical rehabilitation and the esophageal voice training.</p>

Cancer and surgical treatment impact the quality of life in patients with head and neck cancer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate head and neck cancer and surgical treatment impact the quality of life (QOL).</p><p><b>METHODS</b>In this study, 49 cases of head and neck cancer patients were recruited. Among them, 27 cases were laryngeal cancer, 14 cases were tongue cancer and 8 patients were recurrence of nasal pharyngeal cancer after radical radiotherapy. To demonstrate the cancer in different sites of the head and neck impact QOL of the patients in a different way and cancer impact QOL on the physical well-being, social family well-being, emotional well-being, functional well-being of the patients and quality of life (QOL) changed in different time-point before and after operation, QOL was assessed before surgical treatment and at 1,6 months after operation by means of a performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of cancer therapy head and neck (FACT-H&N) questionnaire.</p><p><b>RESULTS</b>QOL deteriorated significantly in head and neck cancer patients. Cancer in different sites impact on QOL differently especially in patients with tongue cancer (PSS-HN P = 0.0361, FACT-H&N P = 0.0487). Head and neck cancer impact QOL on the physical well-being, social family well-being, emotional well-being, functional well-being of the patients in FACT-H&N questionnaire especially for emotional well-being domains (F = 2.78, P = 0.0311). The QOL in patients deteriorated by surgical treatment and it could be improved following the time. At the 6 months after operation it nearly reached the same scores that assessed before the operation (PSS-HN t = 2.03, P = 0.1120 FACT-H&N t = 1.03, P = 0.1180). Different surgical approaches and different reconstruction methods have different impact on QOL for patients. Laryngeal cancer patients with partial laryngectomy were 107.20 in FACT-H&N while total laryngectomees were 97. 71 at the 6 months after operation, with statistically difference (t = 3.02, P = 0.0430). Tongue cancer patients without reconstruction were 119. 24 in FACT-H&N while the others with reconstruction were 111.39 at the 6 months after operation (t = 3.00, P = 0.0472).</p><p><b>CONCLUSIONS</b>The QOL in head and neck cancer patients can be assessed by the questionnaire and it can be improved by selecting treatment regimen, surgical approaches and reconstructive methods.</p>