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Objective To discuss the influence of motor imagery therapy on the recovery of the stroke patients with aphasia.Methods Sixty cases of stroke patients with aphasia were divided into the treatment group and the control group according to the odd and even of last number.The single number was set into the control group.The double number was given to the treatment group.There were thirty patients in each group.Both groups received the conventional drug treatment and routine care of the Department of Neurology.On this basis,from the second day in hospital,the treatment group received the speech rehabili tation training with motor imagery therapy.Aphasia assessment was done for the two groups on the first day in hospital with CRRCAE.On the first day and after receiving ten-day treatment with motor imagery therapy,the grade of the severity for aphasia of Boston Diagnostic Aphasia Examination (BDAE) was done to assess the severity of aphasia in two groups.The scores of the two groups were compared.Results Before the treatment,there was no significant difference between the two groups.After receiving ten times treatment,both the two groups were improved.Compared with the control group,the treatment group became better.There was statistically significant difference between the two groups.Conclusions For the stroke patients with aphasia,motor imagery therapy has significant effect on their recovery.
ABSTRACT
Objective To assess the significance of elevated serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in predicting 30-day mortality rate for patients in intensive care unit (ICU).Methods A retrospective study was conducted.The clinical data of 480 patients admitted to ICU in Tianjin First Center Hospital from June 2012 to October 2013 were studied.The characteristics of patients were recorded,the acute physiology and chronic health evaluation Ⅱ (APACHE I) score was calculated,and the routine blood tests,blood biochemistry,and serum NT-proBNP level within 24 hours after admission were determined.Patients were divided into non-survival and survival groups according to 30-day outcome,and the characteristics and clinical parameters were compared between two groups,and single factor analysis affecting prognosis was analyzed.All patients were divided into four groups according to four percentile method as NT-proBNP＜280 ng/L (group Q1),280 ng/L≤NT-proBNP＜ 1 200 ng/L (group Q2),1 200 ng/L≤NT-proBNP＜1 990 ng/L (group Q3),1 990 ng/L≤NT-proBNP＜4 700 ng/L (group Q4).A Cox regression analysis was used to test the independence of the predictors.A receiver operator characteristic curve (ROC curve) was plotted to compare the power of APACHE Ⅱ score and NT-proBNP in predicting the outcome.Kaplan-Meier analysis was used to assess survival rate among different NT-proBNP patients.Results By single factor analysis it was shown that age,APACHE Ⅱ score,creatinine,NT-proBNP and severe infection were those influencing the outcome.NT-proBNP 1 200-4 700 ng/L (groups Q3 and Q4) and APACHE Ⅱ score ＞20 were independent risk factors for predicting outcome [relative risk (RR) for group Q3 was 3.624,95％ credibility interval (95％CI) was 1.258-10.138; RR for group Q4 was 5.059,95％ CI was 3.202-9.993; RR for APACHE Ⅱ score ＞20 was 2.987,95％ CI was 1.345-5.823].The area under the ROC curve (AUC) for APACHE Ⅱ score and serum NT-proBNP was similar,and it was 0.831 (95％CI 0.778-0.884) and 0.876 (95％CI 0.827-0.925),respectively.The cut-off value of NT-proBNP for predicting mortality was 1 250 ng/L.Kaplan-Meier analysis showed that groups of Q2,Q3 and Q4 had lower cumulative survival rate compared with group Q1 (26.5％,25.4％,16.2％ vs.29.6％),and group Q4 showed most significant extent of lowering of survival rate (x2=122.920,P＜ 0.05).Conclusion Elevated NT-proBNP level in ICU patients signify severity of the disease,and it is an independent predictor of death of ICU patients.