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Objective To evaluate the clinical effect of dextromethorphan and its effect on daily living of patients with poststroke pseudobulbar affect. Methods Sixty patients with poststroke pseudobulbar affect admitted in our hospital from May 2013 to October 2016 were enrolled. Then they were randomly divided into the control group and the treatment group,with 30 patients in each group.Patients in the control group were treated with fluox-etine therapy and patients in the treatment group were treated with dextromethorphan therapy.The center for neuro-logic study lability scale(CNS-LS)and activity of daily living(Barthel index,BI)before and 30 days after the treat-ments in the two groups had been accessed. Results Thirty days after the treatment,CNS-LS of the treatment group had obvious improvement compared with that before treatment(P < 0.01),but CNS-LS of the control group had no obvious improvement compared with that before treatment(P > 0.05). And significant improvement has been found 30 days after the treatment between the two groups(P<0.01).Furthermore,significant difference was found on BI between these two groups(P<0.05).Conclusions Dextromethorphan is effective in treatment of pa-tients with poststroke pseudobulbar affect and it can improve the activity of daily living of these patients.
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Objective To observe the clinical effects of breaking blood expelling stasis method of traditional Chinese medicine (TCM) combined with edaravone on patients with acute hypertensive intra-cerebral hemorrhage and preliminarily discuss its protection mechanism on this disease. Methods Ninety-two patients with hypertensive intra-cerebral hemorrhage within 72 hours after occurrence admitted to Zengcheng District People's Hosipital of Guangzhou from May 2013 to December 2017 were enrolled, they were divided into conventional therapy group and combined treatment of TCM and western medicine group by random numbers produced by a computer, 46 cases in each group. The conventional therapy group was treated with conventional therapy, and the combined treatment of TCM and western medicine group was treated with conventional therapy, additionally the treatment of Poxue Zhuyu decoction (the ingredients of the decoction: leech 10 g, gradfly 10 g, rhubarb 15 g, cattail pollen 5 g, trichosanthes fruit 10 g, radix notoginseng 5 g, colla plastri testudinis 10 g, grassleaf sweetflag rhizome 10 g, ground beetle 3 g, dried lacquer 3 g, peach seed 10 g) and edaravone for 10 days. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were tested by enzyme-linked immunosorbent assay (ELISA) before and 7 days after treatment in the two groups; and the differences in National Institutes of Health stroke scale score (NIHSS) before and 14 days, 90 days after treatment as well as the changes of brain edema around the hematoma 14 days after treatment were compared between the two groups, and the incidence of adverse reaction was observed. Results After treatment, the levels of TNF-α, IL-6 and intra-cerebral hemorrhage quantities in the two groups were all decreased compared with those before treatment, and the degrees of decrease of TNF-α and cerebral hemorrhage volume in combined treatment of TCM and western medicine group were more significant than those in the conventional treatment group [TNF-α (ng/L): 21.00±6.10 vs. 29.40±11.33, cerebral hemorrhage volume (mL): 5.23±0.60 vs. 8.50±0.64, both P <0.05]. The IL-6 in the two groups were recovered to approximately normal levels after the treatment (ng/L: 13.60±5.36 vs. 15.40±6.13, P > 0.05). With the prolongation of therapeutic time, the scores of NIHSS of the two groups were significantly lowered than those before treatment, and the degree of reduction in the combined TCM and western medicine group on 90 days after treatment was more obvious than that of the conventional treatment group (4.34±0.67 vs. 7.73±0.61, P < 0.05). The volumes of edema around hematomas were increased after treatment in the two groups, but the degree of increase in combined treatment of TCM and western medicine group was slower than that of the conventional group (cm3: 7.57±0.64 vs. 10.16±0.60, P < 0.05). There was no statistical significant difference in the incidence of adverse reactions in comparison between the combined treatment of TCM and western medicine group and conventional therapy group [18.2% (8/44) vs. 20.5% (9/44), P > 0.05]. Conclusions Using breaking blood expelling stasis and edaravone for treatment of acute hypertensive intra-cerebral hemorrhage can accelerate the absorption of brain hematoma and improve the neurological function, and its mechanism may be relevant to the inhibition of some inflammatory factors.
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Objective:To explore the effect of nerve physicians ' empathy on depressive mood of hospitalized stroke patients .Methods:Choosing hospitalized stroke patients in a hospital in Guangdong province from January 2017 to May 2017 ,we used the Hospital Anxiety and Depression Scale ( HADS) to measure their depressive mood;the Jefferson Scale of Empathy -Health Professionals ( JSE-HP) to measure their charge doctors ' empathy ability and analyzed the effect of doctors ' empathy on patients ' depressive mood .Results:The score of patients ' depres-sive mood was (7.48 ±4.75).Doctors' empathy ability and patients' family relationship were the influencing fac-tors of depressive mood of hospitalized stroke patients .After equilibrating other factors , when a one -point in-creased on the doctor ' s empathy score , the patient ' s depressive mood score decreased by 0 .135 points ( P <0 .001 ) .Conclusion:Hospitalized stroke patients managed by neurological physicians with high empathy ability are less likely to be depressive .Narrative medicine and empathy should be applied and deepened in the clinical prac -tice.
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Objective:To explore the effect of nerve physicians ' empathy on depressive mood of hospitalized stroke patients .Methods:Choosing hospitalized stroke patients in a hospital in Guangdong province from January 2017 to May 2017 ,we used the Hospital Anxiety and Depression Scale ( HADS) to measure their depressive mood;the Jefferson Scale of Empathy -Health Professionals ( JSE-HP) to measure their charge doctors ' empathy ability and analyzed the effect of doctors ' empathy on patients ' depressive mood .Results:The score of patients ' depres-sive mood was (7.48 ±4.75).Doctors' empathy ability and patients' family relationship were the influencing fac-tors of depressive mood of hospitalized stroke patients .After equilibrating other factors , when a one -point in-creased on the doctor ' s empathy score , the patient ' s depressive mood score decreased by 0 .135 points ( P <0 .001 ) .Conclusion:Hospitalized stroke patients managed by neurological physicians with high empathy ability are less likely to be depressive .Narrative medicine and empathy should be applied and deepened in the clinical prac -tice.