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Objective To analyze the results of theoretical test and clinical skills examination of standardized resident training gradua-tion exam in Beijing in recent years, to improve the examination standards and assessment models. Methods The results of theoretical test and clinical skills examination from 2011 to 2016 were collected. The difficulty, degree of differentiation, and factors related with the result of clinical skills examination were analyzed. Results The test paper is difficult with good degree of differentiation from 2014 to 2016. Edu-cation degree and year were not related with the clinical skills (P>0.05), while the hospital level was (P<0.05). Conclusion The standardized training and assessment of residents in rehabilitation medicine need continuously attention. Combined with the results of the assessment and the problems exposed in the assessment, a feasible scheme should be put forward, in order to improve the quality of resident training.
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Objective To explore the clinical characteristics and rehabilitation of apraxia with unilateral neglect after corpus callosum in-farction. Methods A case of apraxia with unilateral neglect after corpus callosum infarction was discussed. Results After rehabilitation, the apraxia and unilateral neglect were improved. Conclusion For similar cases, rehabilitation can significantly improve the symptoms and ac-tivities of daily living.
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@#Objective To observe the effect of Tongqiaohuoxue decoction on cognitive impairment in rats with traumatic brain injury and explore the mechanisms. Methods 70 Sprague-Dawley rats were randomized into normal group (n=10), sham operated group (n=20), untreated group (n=20) and treatment group (n=20). Controlled cortical impact device was utilized to establish traumatic brain injury model. The treatment group received Tongqiaohuoxue decoction 5 ml/d, and other groups received distilled water. The cognitive function of rats was evaluated with Morris water maze 1, 2, 3, 4 weeks post operation. And the rats were sampled to test the expression of brain-derived neu-rotrophic factor (BDNF) and synaptophysin (Syn) I in hippocampus through immunohistochemistry. Results The escape latency was longer in the untreated group than in the normal group in all the time points (P<0.05), and was longer in the treatment group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). And it was shorter in the treat-ment group than in the untreated group 3 and 4 weeks after injury (P<0.05). The percentage of swimming time was lower in the untreated group than in the normal group in all the time points (P<0.05), and was lower in the treatment group than in the normal group 1, 2, and 3 weeks after injury (P<0.05), with no significant difference 4 weeks after injury (P>0.05). And it was higher in the treatment group than in the untreated group weeks after injury (P<0.05). The BDNF expression was lower in the untreated group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). It was higher in the treatment group than in the normal group 4 weeks after injury (P<0.01), and was higher in the treatment group than in the untreated group 2, 3 and 4 weeks after in-jury (P<0.05). The Syn I expression was lower in the untreated group than in the normal group in all the time points (P<0.001), and was low-er in the treatment group than in the normal group 1, 2 and 3 weeks after treatment (P<0.01). And it was higher in the treatment group than in the untreated group 3 and 4 weeks after injury (P<0.01). Conclusion Tongqiaohuoxue decoction could improve the cognitive function in rats with traumatic brain injury. The change in expression of BDNF and Syn I might be associated with the improvements.
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Objective To investigate any correlation between diffusion tensor imaging (DTI) results and Montreal cognitive assessment (MoCA) scores after severe traumatic brain injury (TBI).Methods Eight male pa-tients with chronic severe TBI were given the MoCA (including memory,attention,speech and executive function).DTI was used to quantify the fractional anisotropy (FA) of white matter fiber tracts in the radial and longitudinal fasciculus,under longitudinal fasciculus,internal capsule,corpus callosum genu and body,and the cingulate cortex.Pearson correlation coefficients were calculated to quantify the correlation between the FA values and MoCA scores.Results There was a positive correlation between FA in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus and MoCA total scores.Conclusion The MoCA scores of patients with chronic severe TBI are related to white matter damage in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus.
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@# Objective To investigate the influence of age, injury side and injury area on Mini- Mental State Examination (MMSE)scores. Methods General data of 67 patients with severe traumatic brain injury were recorded, and they were assessed with MMSE. Results The scores were low in recalling, orientation, calculation, writing and drawing, while they were high in naming, memorizing, reiteration and comprehension. The total MMSE scores and the scores of space orientation and reading were lower in 45~65 years old patients than in 18~44 years old patients (P<0.05). There was significantly difference in time orientation, space orientation, recalling and calculation between basal ganglia injury and front lobes injury (P<0.05), as well as in total MMSE scores, time orientation, space orientation, calculation and drawing between basal ganglia injury and front, temporal and parietal lobes injury (P<0.05). Conclusion MMSE scores do reflect cognitive impairment in patients with traumatic brain injury, the specific age and injury area of the brain can influence the cognitive impairment in patients.
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@# Objective To observe the effectiveness of Dabugantang decoction on post-stroke fatigue. Methods 83 stroke patients were included and divided into control group (n=45) and treatment group (n=38). Both groups accepted routine rehabilitation, while the treatment group was administrated with Dabugantang decoction twice daily for 4 weeks in addition. All the patients were evaluated with Fatigue Severity Scale (FSS), Hamilton Depression Scale (HAMD), and Modified Barthel Index (MBI) before and after treatment. Results The scores of HAMD and MBI increased significantly in both groups after treatment (P<0.05). The score of FSS significantly decreased in the treatment group after treatment (P<0.05), but no significant difference was found in the control group (P>0.05). There were statistical differences in the scores of FSS, HAMD and MBI between two groups after treatment (P<0.05). Conclusion Dabugantang decoction can alleviate the fatigue and depression in stroke patients and improve activities of daily living.
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Objective To observe the effectiveness of Dabugantang decoction on post-stroke fatigue. Methods 83 stroke patients were included and divided into control group (n=45) and treatment group (n=38). Both groups accepted routine rehabilitation, while the treatment group was administrated with Dabugantang decoction twice daily for 4 weeks in addition. All the patients were evaluated with Fatigue Sever-ity Scale (FSS), Hamilton Depression Scale (HAMD), and Modified Barthel Index (MBI) before and after treatment. Results The scores of HAMD and MBI increased significantly in both groups after treatment (P0.05). There were statistical differences in the scores of FSS, HAMD and MBI between two groups after treatment (P<0.05). Conclusion Dabugantang decoction can alleviate the fa-tigue and depression in stroke patients and improve activities of daily living.
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@#ObjectiveTo observe the changes of thyroid hormone and reproductive hormone in post-acute traumatic brain injury(TBI).Methods70 post-acute TBI patients were selected from Beijing Charity Hospital from September 2009 to March 2010. The levels of thyroid stimulating hormone(TSH), triiodothyronine(T3), thyroxine(T4), free triiodothyronine(FT3), free thyroxine (FT4), follicie stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), and testosterone (T) were measured at 7 a.m. to 8 a.m. on the second day of admisson. According to the reference ranges, the total abnormal rate and the single hormone abnormal rate were calculated. According to the level of hormone, the subjects were divided into the normal group and the abnormal group. The two groups were compared in gender, age, course of disease, duration of coma, basal fracture and scores of Disability Rating Scale (DRS).ResultsThe total abnormal incidence of anterior pituitary hormone was 77.1% in post-acute TBI. The abnormality of reproductive hormones was higher. The duration of coma was related to the reproductive hormone.ConclusionThe abnormal incidence of anterior pituitary hormone occurs frequently in post-acute TBI. The duration of coma is related to the reproductive hormone.
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@#ObjectiveTo study the effect of a course of regular rehabilitation treatment on patients with different traumatic brain injury(TBI) course, explore the costs of one rehabilitation course in patients with different TBI course, and study the timing and focus of rehabilitation on patiens with different stages.Methods250 TBI patients were distributed to five groups by different TBI courses: <3 months, 3～6 months, 6 months～1 year, 1～2 years and >2 years. The clinical data and initial function evaluation were done at the admission. All of them received at least one regular rehabilitation treatment, then another function evaluation was done. Effects and costs of one rehabilitation course in patients with different TBI course were investigated.ResultsThe longer the duration of illness, the higher the cost-effectiveness ratio. The cost-effectiveness ratio of the second treatment course was higher than the first one. The patients within 12 months should receive a comprehensive rehabilitation treatment, and should be prevented and treated hydrocephalus and other complications; for patients within 1～2 years, there would be no significant improvement in balance and lower limb function, should enhance the training of activity of daily living (ADL) and upper extremity function; for the patients more than two years just improved ADL using of residual function.ConclusionTBI patients should accept rehabilitation as soon as possible, and should be conducted corresponding trainings according to different disease course.
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@#The change of pitutary hormones can occur in any time after traumatic brain injury, the main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury. It is important to further research when to test hormone and to carry on the hormone replacement therapy.