ABSTRACT
ObjectiveTo investigate the effect of intermittent theta burst stimulation (iTBS) of the multi-target cerebral cortex after stroke on functional recovery of the upper limb of the hemiplegic side. MethodsFrom November, 2019 to August, 2020, 40 stroke patients in Gansu Provine Hospital Rehabilitation Center were included and randomly divided into single-target stimulation group (n = 20) and multiple-target stimulation group (n = 20). Both groups underwent basic neurorehabilitation drug therapy and conventional rehabilitation exercises. The single-target stimulation group received repetitive transcranial magnetic stimulation (rTMS) (iTBS mode) only in the primary motor cortex (M1) of the affected side. The multi-target stimulation group received rTMS (iTBS mode) in the cerebellar cortex of the healthy brain and M1 of the affected side, once a day, six days a week, for four weeks. Before and after treatment, the scores of Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI), and the latency and amplitude of somatosensory-evoked potentials N20 were compared. ResultsNo serious adverse reaction occurred during treatment. After treatment, the scores of FMA-UE, MBI and ARAT, and the amplitude and latency of N20 improved in both groups (|t| > 3.478, |Z| > 2.243, P < 0.05); and the scores of FMA-UE and ARAT, and the amplitude of N20 were better in the multiple-target stimulation group than in the single-target stimulation group (t > 2.939, Z = -2.697, P < 0.01). ConclusionMulti-target stimulation is superior to single-target stimulation for improving upper limb motor function and N20 amplitude in the hemiplegics after stroke.
ABSTRACT
Objective:To investigate the effect of compound glycyrrhizin on inflammatory factors and immune function in children with Henoch-Schonlein purpura (HSP).Methods:From March 2017 to December 2018, 75 children with clinically confirmed HSP in Shanxi Grand Hospital were divided into two groups by random number table method.The control group (38 cases) was given routine basic treatment, while the observation group (37 cases) was given intravenous drip of compound glycyrrhizin injection once a day.Both two groups were treated for 14 days.The curative effect and the differences of inflammatory factors[interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), procalcitonin (PCT), C-reactive protein (CRP)], immune function[CD 4+ , CD 4+ /CD 8+ , immunoglobulin G (IgG), immunoglobulin A (IgA)] before and after treatment were observed. Results:The effective rate of the observation group was higher than that of the control group (94.59% vs.76.32%, χ 2=5.005, P<0.05). The levels of IL-6, TNF-α, PCT, CRP in the observation group after treatment were lower than those in the control group[(3.52±1.46)ng/L vs.(5.12±1.39)ng/L, (2.31±0.12)μg/L vs.(4.21±0.29)μg/L, (1.25±0.46)μg/L vs.(3.12±0.82)μg/L, (5.98±1.19)mg/L vs.(9.55±3.82)mg/L, t=4.861, 6.891, 12.135, 5.433, all P<0.05]. The levels of IgG, IgA, CD 4+ , CD 4+ /CD 8+ in the observation group were higher than those in the control group[(14.65±2.57)g/L vs.(12.92±2.82)g/L, (5.26±2.57)g/L vs.(4.16±1.64)g/L, (43.94±10.71)% vs.(38.02±10.63)%, (2.90±0.61)% vs.(2.02±0.53)%, t=2.775, 2.216, 2.402, 6.675, all P<0.05]. Conclusion:Compound glycyrrhizin can effectively reduce inflammation in children with HSP, improve immune function and improve clinical efficacy.
ABSTRACT
Objective To observe the effect of transcranial direct current stimulation (tDCS) with mirror neuronal rehabilitation training system (MNST-V1.0) in post-traumatic unconscious patients after severe craniocerebral injury. Methods A prospective, self controlled and open-label method was used. Thirty-six post-traumatic unconscious patients with severe craniocerebral injury from January 2016 to July 2017 were selected. Four cases of the patients did not complete the treatment and the last 32 cases completed the study. All patients were given routine wake-up therapy, and tDCS combined with MNST-V1.0 (20 min/time, 1 time/d, 6 times/week, a total of 8 weeks) was given at the same time. The Glasgow coma scale (GCS), JFK coma recovery scale and Four coma rating scale before treatment and 2, 4, 8 weeks after treatment were recorded. Results The scores of open reaction, language and motor response score of GCS 2, 4, 8 weeks after treatment were significantly higher than those before treatment:(1.56 ± 0.82), (2.06 ± 1.01) and (3.11 ± 1.45) scores vs. (1.00 ± 0.45) scores, (2.23 ± 1.06), (2.56 ± 1.08) and (3.02 ± 1.04) scores vs. (1.00 ± 0.61) scores, (2.79 ± 1.12), (3.22 ± 1.33) and (4.44 ± 1.07) scores vs. (1.00 ± 0.54) scores, and there were statistical differences (P ＜ 0.01 or ＜0.05). The scores of hearing, vision, movement, speech response, communication and arousal of JFK coma recovery scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.01). The scores of open reaction, sport reaction, brainstem response of Four coma rating scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.05); there was no statistical difference in respiratory score of Four coma rating scale before and after treatment (P＞0.05). Conclusions The tDCS combined with MNST-V1.0 can improve the consciousness level in post-traumatic unconscious patients with severe craniocerebral injury, and have the effect of promoting awakening.
ABSTRACT
Objective To investigate the effect of bone flap reduction on unilateral acute subdural hematoma (ASDH) under intracranial pressure monitoring.Methods A retrospective case control study was conducted to analyze the clinical data of 139 patients with unilateral ASDH admitted to the First Affiliated Hospital of Xinjiang Medical University from July 2014 to December 2017.There were 84 males and 55 females,aged 19-87 years (mean,53 years).At the time of admission,the Glasgow Coma Score (GCS) was 3-5 points in 63 patients and 6-8 points in 76.There were 40 patients with unilateral cavity dilation and 16 cases with bilateral pupil dilation.According to the different surgical methods,the patients were divided into study group (n =61) and control group (n =78).The study group removed the cranial hematoma under cranial pressure monitoring and determined whether to perform bone flap reduction according to the actual intracranial pressure.The control group was treated with craniotomy hematoma removal and standard large bone decompressed craniectomy (DC).The success rate of bone flap reduction in the study group was recorded.The complications at postoperative 3 months and the Glasgow Outcome Score (GOS) at postoperative 6 months were compared.Results All patients were followed up for 1-6 months,average 5.5 months.In the study group,23 patients underwent bone flap reduction,and the bone flap reduction rate was 38％.At postoperative 3 months,the study group showed better efficacy in subdural effusion (9:25),hydrocephalus (7 ∶19),and brain swelling in the skull defect area(5 ∶ 18) than the control group (P ＜0.05).Based on the GOS at 6 months after operation,in the study group,25 patients were with good results,nine with moderate disability,10 with heavy disability,seven with plant survival,and 10 died;in the control group,six patients were with good results,21 with moderate disability,15 with heavy disability,10 with plant survival,and 26 died.The number of patients with good prognosis (good and moderate disability) and the number of deaths in the study group were statistically different from those in the control group (P ＜ 0.05).Conclsion In the treatment of unilateral ASDH,bone flap reduction under intracranial pressure monitoring can reduce the incidence of complications and improve the life quality of patients.
ABSTRACT
Objective To analyze the clinical feature of the patients with anti -N -methyl -D -aspartate receptor (NMDAR)encephalitis and feature of brain MRI and electroencephalogram (EEG)in children.Methods We reviewed the clinical manifestations,brain MRI and EEG features of 10 patients who were diagnosed anti -NMDAR encephalitis.Results Of the 10 patients,3 cases were male and 7 cases were female.The age was ranged from 13 months to 14 years (6 years and 11 months on average).No tumor was found in those patients.Main symp-toms included seizure in 9 cases,psychiatric symptoms in 10 cases,consciousness disturbance in 4 cases,involuntary movements in 8 cases,autonomic nerve instability in 5 cases,and sleep disorders in 10 cases.7 patients of MRI exami-nation were normal,2 patients revealed abnormal signal of temporal lobe,frontal,and parietal cortex.One patient revealed brain atrophy.All patients had abnormal EEG with diffusive slow waves,and some with focal spikes or sharp waves,left side abnormal more than right side.Conclusion Anti -NMDAR encephalitis can be found in children, even young boys may be affected.They have a lower incidence of tumors.Its predominant clinical features are psychi-atrics symptoms,seizures,involuntary movements and consciousness alteration.EEG was considered more significant than brain MRI.
ABSTRACT
@#Objective To investigate the awareness of knowledge about stroke rehabilitation in medical professionals in Gansu. Methods 520 professionals of neurology, neurosurgery, and others from 10 hospitals of different level were investigated with questionnaire. Results The awareness of the knowledge about stroke rehabilitation was different with the gender (χ2=17.50), education levels (χ2=66.35), professional levels (χ2=16.81), specialities (χ2=124.39) and duties (χ2=29.99) of the professionals (P<0.05). Conclusion It is necessary to improve the education of rehabilitation in hospitals.
ABSTRACT
@# Objective To understand the awareness of early symptoms of stroke patients in Gansu. Methods 1100 stroke patients in neurology and neurosurgery departments in 10 hospitals of different levels in Gansu in 2010 were surveyed by questionnaire. Results The awareness rate of early symptoms of stroke was generally low in all age groups. Conclusion Stroke patients were lack of awareness of early symptoms in Gansu, we should step up publicity efforts to enable more patients to receive early treatment and reduce morbidity and mortality.
ABSTRACT
@#Objective To investigate the knowledge of stroke risk factors, early symptoms, and rehabilitation in stroke patients. Methods 1043 cases with stroke were stratified randomly sampled from 10 hospitals at different levels in Gansu, and were surveyed with self-designed questionnaire. Results For risk factors for stroke, hypertension was the most aware (61.55%), 6.42% knew all the factors. For the prevention and treatment, reasonable diet was the most aware (56.18%), followed with giving up smoking and drinking (52.92%). For the early symptoms, dysaesthesia of one side body was the most aware (53.88%), and then the headache and dizzy (50.14%). It was less than 30% to know the blurring, nausea and vomiting, and stiff tongue, etc. as the early symptoms. 60% of the patients did not know any about the rehabilitation, 22% did not know if rehabilitation be needed. 80% of the patients with stroke chose medication regardless of family income, and rehabilitation was chosen less than 30%. Conclusion It is important to popularize the knowledge of risk factors, early symptoms, and rehabilitation of stroke.
ABSTRACT
@#ObjectiveTo investigate the effect of integrated psychotherapy on activities of daily living (ADL) in patients with post-stroke depression. Methods60 stroke patients were divided into 2 groups: the treatment group and the control group, each including 30 cases. Both groups were treated with routine medicine and rehabilitation, while the treatment group was also treated with psychological approaches in addition. Before and 4 and 12 weeks after treatment, all the patients were assessed with the Zung Self-rating Depression Scale (SDS) and the modified Barthel Index (MBI). ResultsThere was no significant difference between these 2 groups in all the assessment parameters before treatment. The scores of SDS and MBI improved more in treatment group than in control group (P<0.05) 4 and 12 weeks after treatment. ConclusionThe integrate psychotherapy is effective on ADL in patients with post-stroke depression.
ABSTRACT
@#ObjectiveTo review the efficacy and safety in secondary prevention of ischemic stroke with cilostazol or aspirin.Methodswe searched Cochrane Library(the 4th issue, 2009 ), PubMed(1980.1～2009.11), EMBASE(1980.1～2009.11), CBM(1978.1～2009.11), CNKI(1979.1～2009.11) and some other databases, then collected all of the studies describing the outcomes in curing the ischemic stroke after taking cilostazol or aspirin. According to the strict inclusion and exclusion criteria, two reviewers independently selected trials, extracted datas, made cross-checking and methodological quality assessment of the homogeneity studies by using the Cochrane systematic review methods, then made Meta analysis using RevMan 5.0 software.ResultsThis systematic review study included two randomized controlled trials and a cross-over trial, which contained a total of 838 participants. The evidence quality of one of the randomized controlled trials was high, however, the evidence quality of another randomized controlled trial and the cross-over trial was poor. Meta analysis results suggested that the effectiveness of cilostazol and aspirin in the secondary prevention of ischemic stroke performed no significantly statistical difference: primary endpoint(30 d［RR=3.00, 95%CI(0.31,28.70)］; 90 d［RR=1.67, 95%CI(0.40,6.92)］; 180 d［RR=1.25, 95%CI(0.50, 3.13)］; 360 d［RR=0.65, 95%CI(0.33, 1.29)］; 540 d［RR=0.80,95%CI(0.54, 1.18)］); combined endpoint(30 d［RR=4.00, 95%CI(0.45,35.61)］; 90 d ［RR=1.75,95%CI(0.52,5.93)］; 180 d［RR=1.00, 95%CI(0.48, 2.07)］; 360 d ［RR=0.77, 95%CI(0.45, 1.29)］; 540 d［RR=0.66,95%CI(0.40,1.09)］); the recurrence of ischemic stroke: cilostazol group: RR=0.64, 95%CI(0.31,1.30)，aspirin group: RR=0.21, 95%CI(0.04,1.06); PDMP［RR=1.00, 95%CI(0.39, 2.58)］. But in terms of the probability of intracranial hemorrhage (［RR=7.14, 95%CI(0.7,58.33)］) and other safety standards, taking cilostazol performed lower than taking aspirin.ConclusionThe side effects of cilostazol and aspirin in the treatment for ischemic stroke were similar to each other, but in terms of the probability of dizziness, headache, tachycardia and palpitation, taking cilostazol performed higher than taking aspirin, however, taking cilostazol performed lower in the probability of intracranial hemorrhage and other organ hemorrhage than taking aspirin. Since this study included a small amount of studies, in which the evidence quality of one of the randomized controlled trials and the cross-over study was poor, therefore, it would be necessary to make a further validation with lots of high-quality clinical trials.
ABSTRACT
Objective Determining the respective incidence, risk factors and prognosis of hyperuricemia post normothermic cardiac surgery with cardiopulmonary bypass. Methods Clinical data was collected from April 2002 to October 2004. 232 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Patients were classified into three groups: nonhyperuricemia group, hyperuricemia group, and acute goutynephropathy group. Uricemia levels 24 hours post cardiac surgery, the respective incidence, risk factors, and prognosis among three groups were analyzed. Results Seventy patients (30.1%) had hyperuricemia, and twenty-two patients (9.5%) had acute goutynephropathy during their ICU stay. The mortality was 0.7% for no hyperuricemia group, 1.4% for hyperuricemia group, and 13.6% for acute goutynephropathy group (P
ABSTRACT
OBJECTIVE To quantify the HBV DNA in saliva of chronic hepatitis B(CHB) patients and to study its relation to the periodontal status of the patients. METHODS HBV DNA were isolated from 60 patients with CHB by Trizol-chloroform method.HBV DNA levels were tested by real-time PCR technique and their relationship with plaque index,gingival index and probing depth was analyzed. RESULTS The positive rate of HBV DNA was (56.7%,) and the level of HBV DNA was 4.16+0.57(LogE,copies/ml) in saliva.The detectability of HBV DNA in saliva had no significant correlation with the values of oral clinical parameters. CONCLUSIONS The detectability and level of HBV DNA in saliva have no correlation with the oral hygienic parameters.Other sources of the HBV DNA may exist besides the serum in saliva.