ABSTRACT
Objective To compare if the Montreal cognitive assessment (MoCA) performed in the morning or afternoon would affect abnormal rate of cognitive function in the elderly with stroke.Methods A total of 378 senile patients (≥ 65 years) with acute ischemic stroke and low NIHSS score (≤ 3) were enrolled in the prospective study,which was held in the Department of Neurology at Cangzhou Hospital of Integrated Traditional Chinese Medicine.MoCA was assessed after one month of hospitalization.Based on the time of MoCA assessment,all patients were randomly divided into the group A (assessed in the morning,9 am-12 am) and the group B (assessed in the afternoon,12 am to 5 pm).Clinical data were collected,and RANKIN scale (mRS) examination was performed.Moreover,patients were further divided into severe cognitive impairment (SCI) subgroup (score ＜ 20),mild cognitive impairment (MCI) subgroup (score 20-25) and no cognitive impairment (NCI) subgroup (score ＞ 26) according to the MoCA score.Results There were 189 patients in the group A (50％),and 189 cases in the group B (50％).There was no significant difference in age,gender,education level,disability (mRS score ＜ 1),history of hypertension,diabetes,hyperlipidemia,smoking and atrial fibrillation between the two groups.Based on the MoCA score,211 cases had NCI,142 had MCI,and 25 had SCI.Compared with patients in group B,patients in group A was associated with significantly higher positive rate of SCI[12.2％ (23/189)vs.1.1％ (2/189),P=0.000],MCI[40.2％ (76/189)vs.34.9％ (66/189),P=0.013]and slightly higher positive rate of NCI[56.6％ (107/189)vs.55.0％ (104/189),P=0.214].Conclusions The test time of MoCA may have an effect on the cognitive function detection rate in elderly patients with stroke,and the time of MoCA examination should be considered in clinical examination.
ABSTRACT
Objective To investigate the clinical efficacy of sequential acupuncture in treating post-stroke dysphagia. Methods One hundred and ten patients with post-stroke dysphagia were randomly allocated to treatment and control groups, 55 cases each. The control group received routine medication and the treatment group, “cortex-pharynx-tongue root” sequential acupuncture in addition. The pre-/post-treatment difference in the Kubota’s water drinking test score was observed in the two groups and the clinical therapeutic effects were compared between the two groups after 14 days of treatment.Results There was a statistically significant pre-/post-treatment difference in the Kubota’s water drinking test score in the two groups (P<0.01,P<0.05). There was a statistically significant post-treatment differences in the Kubota’s water drinking test score between the treatment and control groups (P<0.05). The total efficacy rate was 89.1% in the treatment group and 67.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Sequential acupuncture is an effective way to treat post-stroke dysphagia.