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Objective To observe the clinical therapeutic effect of hyperbaric oxygen (HBO) therapy and swallowing training combined with Fengchi acupoint acupuncture on dysphagia caused by pseudobulbar paralysis after stroke. Methods Seventy-five patients were randomly divided into control group, HBO therapy group, swallow training group, acupuncture group and combined treatment group (n = 15). Patients in all groups were given cerebro-vascular disease routine treatment. In addition, the patients in HBO therapy group, swallowing training group and ac-upuncture group were given HBO therapy, swallowing training and Fengehi (GB20) acupoint acupuncture simultane-ously, respectively. The patients in combined treatment group were given HBO therapy combined with swallowing training and Fengchi acupoint acupuncture. Modified Kubota-Chiari's swallowing functional classification was used to assess swallowing function before and on the 3rd d,6th d,9th d, 12th d, 15th d, 18th d and 21st d after treatment. Results It was shown that the patients in all groups but the control group got significant improvement in swallowing after treatment, as demonstrated by the swallowing function scores (P < 0.05). Moreover, the priority order in im-provement of swallowing function and recovering rate were: combined treatment group > acupuncture group > swal-low training group > HBO therapy group > control group(P < 0.05). Conclusion The combination of HBO ther-apy, swallowing training and Fengchi acupoint acupuncture could act synergically to ameliorate dysphagia caused by pseudobulbar paralysis after stroke.
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Objective To investigate the risk factors related to cerebral vsospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH).Metrods The risk factors related to cerebral vasospasm in 88 patients with aSAH were identified through the multivariate logistic regression analysis and Cox analysis, including demographic factors, healthy habits, past mescal history, acute stress factors, acute complications, acute evaluation indexes, treatment time, therapeutic measures, and hemorrhage involving brain regions. Results Drinking history (OR=1.077,95%CI 1.015-1.142;P=0.014)was an independent risk factor for cerebral vasospasm before admission. Histories of smoking(RR=1.031,95%CI 1.001-1.063:P=0.042),diabetes mellitus(RR=1.333,95%CI 1.100-1.614;P=0.003)and hypertension (RR=1.066,95%CI 1.008-1.127;P=-0.024)were the independent risk factors for cerebral vasospasm during hospitalization. The increased leukocyte count(RR=1.117,95%CI 1.039-1.200;P=0.003)was a predictive factor for cerebral vasospasm; the administration of Nimotop(RR=0.990,95%CI 0.979-1.001;P=0.088)significantly decreased the risk of cerebral vasospasm;the blood glucose lexels in acute stage were not associated with the occurrence of cerebral vasospasm(RR=1.076,95%CI 0.968-1.196;P=0.175);there was no significant difference between endovascular embolization group and surgical clipping group in the risk of cerebral vasospasm(RR=0.792,95%CI 0.322-1.950;P=0.612).Conclusions The risk of cerebral vasospasm increased significantly in patients with aSAH who have the histories of long-term drinking, smoking, diabetes mellitus, hypertension as well as increased leukocyte count. The administration of Nimotop may significantly decrease the risk of cerebral vasospasm
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Objective To describe survival of patients with aneurysm subarachnoid hemorrhage (aSAH) and its related factors. Methods Data of 88 patients with aSAH were analyzed retrospectively, including their age, gender, past medical history, therapeutic measures, complications and prognosis, and so on. Their survival and its related factors were identified by Kaplan-Meier method and COX proportional hazard regression model. Results Eighty-eight patients were followed-up for a total of 141. 9 person-year,with an average of (1.6 ?.0) years, and the longest of 5. 6 years. Survival was 78 percent, 73 percentand 68 percent in the first month, first year and 2. 5 - 5. 6 years after onset, respectively. Administration ofnimodipine (RR = 0. 981, 95 % CI = 0. 965 - 0. 997, P = 0. 023) was potential protective factor for deaths caused by aSAH. Compared with conservative medical treatment, both surgical occlusion (RR =0. 147, 95% CI = 0. 041 - 0. 532, P = 0. 003) and intervention embolotherapy (RR = 0. 221, 95% CI = 0. 060-0. 823, P= 0.024) were also protective factors. However, complications such as hyponatremia, pulmonary infection, alimentary tract hemorrhage (RR = 1. 965, 95% CI - 1. 404 - 2. 748, P ＜ 0. 05) and cerebral vasospasm (RR = 2. 951, 95% CI = 1. 473 - 5. 911, P = 0. 002) were independent risk factors for aSAH.Conclusions Prognosis in patients with hyponatremia, pulmonary infection, alimentary tract hemorrhage and cerebral vasospasm is unfavorable, and aneurysm occlusion by surgical operation, embolotherapy andadministration of nimodipine all can decrease fatality caused by aSAH.
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@#Objective To observe the effect of hyperbaric oxygen,rehabilitation training or acupuncture at Fengchi acupoint on pseudobulbar paralysis after stroke.Methods 90 patients were divided into group Ⅰ(A,B,C) or Ⅱ(A,B,C) randomly.Patients in all groups were given conventional therapy,while those in groups ⅠB and ⅡB were given hyperbaric oxygen,ⅠC and ⅡC were given swallowing training and group Ⅱ was given acupuncture at Fengchi acupoint additionally.They were assessed with Modified Kubota-Chiari's swallowing functional classification before and after treatment.Results In all groups except ⅠA,swallowing function scores improved after treatment significantly(P<0.05).The scores were different significantly between group Ⅰ and group Ⅱ after treatment(P<0.05).Except 3 d after treatment,the scores were different significantly between sub-group of group Ⅰ or group Ⅱon other time points(P<0.05).Conclusion The hyperbaric oxygen is more effective than conventional therapy on pseudobulbar paralysis,but less than swallowing training.Acupuncture at Fengchi acupoint can improve their efficacy.
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@#Objective To investigate the psychologic characteristics of the hypertensive with transient ischemic attack(TIA). Methods 56 hypertensive patients with TIA were surveyed with Symptom Checklist 90 (SCL-90), Eysenck Personality Questionnaire (EPQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS). Results and Conclusion The score in interpersonal sensitivity and paranoid factors of SCL-90 were below the norm obviously(P<0.05), the score of other factors were higher than the norm(P<0.01). Somatization, obsessive-compulsive, anxiety correlated negatively with E scale, while hostility, phobia anxiety, anxiety correlated positively with N scale. 71.4% patients appeared depression while 78.6% patients appeared anxiety in differently degree. Depression and anxiety correlated positively with the times of TIA, especially the anxiety.
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@#ObjectiveTo observe the effect of equilibrium therapy of decontamination living creature of blood dilution (ETBD) on acute cerebral infarction.Methods124 inpatients were divided randomly into the treatment group and control group with 62 cases in each group. The patients of the treatment group were treated with routine medicine and ETBD. The patients of the control group were treated only with routine medicine. The blood-lipid and blood viscosity were tested and nerve function evaluation was performed before and on the 15th day after the treatment in two groups.ResultsAfter treatment, the levels of blood-lipid, blood viscosity and nerve functions of all patients in two groups were better than that before the treatment, but the effect of the treatment group was better than that of the control group ( P<0.05), and no obvious adverse reaction was found.ConclusionETBD is a safe, effect, simply and convenient therapeutic method for acute cerebral infarction and it is suitable for primarily medical units.
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Objective To investigate the effectiveness,safety of the percutaneous transluminal angioplasty and stenting(PTAS) in the management of the vertebrobasilar stenosis.Methods From April 2003 to June 2004,the PTAS was performed in 28 patients with the vertebrobasilar stenosis.Results Among the 28 patients,the unilateral significant stenosis of the dominant vertebral artery was found in 18 patients,the bilateral stenosis of the vertebral artery in 4 patients,the tandem stenosis of the vertebral artery in 1 patient,the stenosis of the basilar artery in 2 patients.According to Mori's division,the type A occurred in 24 patients,the type B in 3 patients,the type C in 1 patient.The successful rate of stent implantation was 100% without any serious complication.Twenty-eight patients underwent PTAS with a mean pre-procedural vertebrobasilar stenosis of 81.3% and the residual stenosis was less than 10%.Over a mean 6-month follow-up in 17 patients,according to Malek's scale,the scale 1 was in 15 patients,the scale 2 in 2 patients.No restenosis was in 3 patients by the cerebral angiography.Conclusion PTAS in the management of the vertebrobasilar stenosis is a safe and effective method.Meanwhile,PTAS may alleviate the vertebrobasilar ischemia and prevent stroke of the vertebrobasilar system.
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Objective To study the effects of dendritic cells (DC) modified with transforming growth factor ?1 (TGF-?1) gene on experimental autoimmune myasthenia gravis (EAMG) in Lewis rats. Methods 30 female Lewis rats were divided randomly into 6 groups: normal group, EAMG group, DCs treatment group, pcDNA_3-TGF-?1-DCs treatment group, pcDNA_3-DCs treatment group and normal saline group. The rats were immunized with the acetylcholine receptor (AChR) protein extracted from electric organ of Narcine timilei and completed Freund’s adjuvant (CFA) in the experiment groups except normal group. 2?106 pcDNA_3-TGF-?1-DCs/rat were injected subcutaneously into the backs of the rats that had been immunized 5 days earlier with AChR+CFA. The rats in DCs treatment group, pcDNA_3-DCs treatment group and normal saline group were injected in parallel with untreated DCs, pcDNA_3-DCs and normal saline respectively. Then the clinical manifestations were observed everyday. And 7 weeks after the first immunization, repetitive nerve stimulation, detection of acetylcholine receptor antibody (AChRab) and ultrastructural study of neuromuscular junction (NMJ) were performed. Results (1) The mild symptoms were observed on 1 or 2 rats in the experiment groups except normal group after a week, which lasted for 2 to 5 days. After about 5 weeks, the rats in EAMG group, DCs treatment group, pcDNA_3-DCs treatment group and normal saline group presented some symptoms at different degree like myasthenia gravis, and only one of the rats in pcDNA_3-TGF-?1-DCs treatment group presented mildly decreased activity. (2) The significant decrement of repetitive nerve stimulation were found in EAMG group, DCs treatment group, pcDNA_3-DCs treatment group and normal saline group(16.75?6.13, 17.75?7.81, 18.25?8.22 and 16.50?7.14, respectively), but there was no attenuation in pcDNA_3-TGF-?1-DCs treatment group and normal group(3.20?3.70 and 5.60?2.70, respectively). The percentage of decrement in pcDNA_3-TGF-?1-DCs treatment group was lower than that in EAMG group(5.60?2.70 and 16.75?6.13, respectively,P0.05). (4) The combined AChRs in NMJ of the rats in pcDNA_3-TGF-?1-DCs group were higher than that in EAMG group, and the structure changes of the synapse were relieved.Conclusion It suggests that DCs, transfected with pcDNA_3-TGF-?1, when injected subcutaneously into Lewis rats with incipient EAMG, could inhibit the production of AChR-Ab, relieve the pathologic changes in NMJ and ameliorate the development of EAMG.
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12 point indicating poor outcome;The release of S 100 in patients were associated with the volume of brain lesions ( P
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Objective To study the pathway of IFN-?-iNOS-NO on T lymphocytic cells in the rats with experimental autoimmune myasthenia gravis (EAMG).Methods Lewis rats were divided randomly into groups EAMG , normal control(NC) and completed Freund's adjuvant control(CFA-C) . The rats were immunized in foot pad, abdomen and back subcutaneouly with the AChR protein extracted from electric organ of Narcine timilei and CFA in the EAMG group, or only with CFA in the CFA-C group. The above-mentioned emulsions were injected again after 4 weeks . At the 7th week after first immunization, T lymphocytic cells in every rat were separated from the spleen. After cultured in vitro for 48 h, the content of IFN-? in the supernatant of cultured T lymphocytic cells was detected by enzyme-linked immunoadsordent assay (ELISA), and the level of NO was examined with Griess reagent method. Results The contents of IFN-? were (81.68?10.23 ) pg/ml in EAMG group,(29.20?5.41) pg/ml in NC group,(31.54?6.12) pg/ml in CFA-Cgroup.The levels of NO were (23.68?7.13 )?mol/L in EAMG group ,(9.05?2.11) ?mol/L in NC group,(10.21?2.67 )?mol/L in CFA-C group.The contents of IFN-? and NO in EAMG group were increased markedly than groups NC and CFA-C(allP
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Objective To observe the feasibility and safety of carotid artery stenting(CAS) for treating the patients with symptomatic carotid artery stenosis.Methods 60 patients who were diagnosed with symptomatic carotid artery stenosis by DSA were performed CAS.Among them, 52 cases were onset stenosis of carotid artery,8 cases were extracanical stenosis.The degree of stenosis was 50%～70% in 14 patients,70%～90% in 28 patients and≥90% in 18 patients.64 stents were placed,and 15 filter protection devices were used.Results The drgree of stenosis was decreased from (73.4?9.5)% to (12.5?8.2)%. The plaques were disappear in 53 cases, many debris were found in 5 filter protection divices. The clinical symptoms of all patients were disappear within one week, the mild paralyse was recover in all patients. There were 53 cases with heart rate slowdown during or after operation,the blood pressure declined in 48 cases,and there were 5 patients with vasospasm, as well as one case with cerebral embolization,one case with sydrome of high perfusion and one case with sydrome of low perfusion or swoon. During flowing up for 3 months to 2 years,no one case was found TIA or cerebral infarction,however,only one case was found mild restenosis by DSA.Conclusions CAS is a safety and efficient method for treatment symptomatic carotid artery stenosis. Lowering the risk of operation is done by handling indication seriously and operation skillfully.