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ObjectiveTo observe the effect of motor imagery therapy on hand function and motor imagery ability of stroke patients. MethodsFrom March, 2018 to March, 2020, 41 stroke patients in Beijing Bo'ai Hospital were selected and randomly divided into control group (n = 20) and observation group (n = 21). Both groups received conventional rehabilitation training, and the observation group received motor imagery therapy in addition, for four weeks. Before and after training, the scores of Fugl-Meyer Assessment-Hand (FMA-H) and Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), and the accuracy of mental rotation task were compared between two groups. ResultsOne patient in the observation group dropped down. Before training, there was no significant difference in the scores of FMA-H and KVIQ, and the accuracy of mental rotation task between two groups (P > 0.05). After training, all the indexes improved in both groups (t > 6.611, P < 0.001), and the scores of FMA-H (t = 3.742, P < 0.001) and KVIQ (t = 4.122, P < 0.001), and the accuracy of mental rotation task (t = 2.075, P < 0.05) were higher in the observation group than in the control group. ConclusionMotor imagery therapy could facilliate the recovery of hand dysfunction and improve the motor imagery ability of stroke patients.
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This article reviewed the concept of spirituality and spiritual needs of family caregivers of cancer patients, types of spiritual needs, assessment tools, priorities, and influencing factors, aiming to provide a reference for hospice teams to identify the spiritual needs of family caregivers of cancer patients and carry out spiritual care.
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Objective:To explore the intervention effect of acceptance and commitment therapy on the psychological flexibility, self-compassion, anxiety and depression of the primary caregivers of patients with primary liver cancer, so as to provide reference for the clinical care of the primary caregivers of cancer patients.Methods:This was a prospective study. A total of 80 primary caregivers of patients with primary liver cancer treated in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from July to December 2021 were selected as the observation objects, and they were randomly divided into the control group and the intervention group according to the random drawing method, with 40 cases in each group. The control group was given routine nursing measures, while the intervention group was given acceptance and commitment therapy on the basis of routine nursing. The intervention effect was evaluated by the Acceptance and Action Questionnaire-2nd Edition (AAQ-Ⅱ), Self-Compassion Scale Short-Form (SCS-SF) and Hospital Anxiety and Depression Scale (HADS) before the intervention, on the day of discharge, and one month after discharge.Results:Finally, 71 primary caregivers completed the intervention and follow-up, 36 in the control group and 35 in the intervention group. Before the intervention, there was no statistically significant difference in the scores of AAQ-Ⅱ, SCS-SF, Anxiety subscale of HADS(HADS-A) and Depression subscale of HADS(HADS-D) between the two groups ( P>0.05). The AAQ-Ⅱscores of the intervention group on the day of discharge and one month after discharge were (19.63±2.59), (19.12 ± 2.20) points, which were significantly lower than those of the control group (23.14 ± 2.49), (22.56 ± 2.40) points. The differences were statistically significant ( t=5.83, 6.25, both P<0.01). The SCS-SF scores of the intervention group on the day of discharge and one month after discharge were (39.34 ± 2.68), (39.89 ± 2.81) points, which were significantly higher than those of the control group (36.69 ± 3.08), (37.72 ± 2.41) points, the differences were statistically significant ( t=-3.86, -3.49, both P<0.01). The HADS-A/HADS-D scores of the intervention group on the day of discharge and one month after discharge were (9.31 ± 1.95), (9.09 ± 1.60) points and (8.80 ± 2.15), (8.54 ± 1.75) points,which were significantly lower than those of the control group(11.42 ± 1.50), (11.03 ± 1.70) points and (10.11 ± 1.92), (10.03 ± 1.84) points, the differences were statistically significant( t values were 2.71-5.10, all P<0.01). The scores of AAQ-Ⅱ, SCS-SF, HADS-A and HADS-D of the two groups were analyzed by repeated measures analysis of variance, and there were significant differences in time effect, inter-group effect and interaction effect ( F vaules were 3.42-37.90, all P<0.05). Conclusions:Acceptance and commitment therapy can improve the self-compassion and psychological flexibility, reduce anxiety and depression of the primary caregivers of patients with primary liver cancer.
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Objective:To investigate the effects of cognitive types on dual-task paradigm gait performance in patients with stroke.Method:Using a cross-sectional study design, patients with stroke were trained with single task walking and dual-task walking with four different cognitive tasks (spontaneous speech [SS], serial counting backward [SCB], word list generation (WLG), and auditory Stroop [AS]). A three-dimensional gait and motion analysis system were used to record and analyze gait data, and calculate dual-task effect (DTE) for different cognitive tasks, and compare the differences in spatiotemporal parameters and DTE of gait analysis under different states.Results:A total of 35 patients with stroke (aged 61.0±2.5 years) were included, among which 27 were males (77.1%). There were 25 patients with ischemic stroke (71.4%) and 10 patients with hemorrhagic stroke (28.6%). Compared with single task walking, patients had decreased gait speed, shorter step length on the affected side, and a larger support phase ratio of the unaffected to the affected side during SCB dual task and SS dual task (all P<0.05), and the difference was more obvious during SCB dual task ( P<0.05). Compared with single task walking, patients had a reduced swing phase ratio of the unaffected to the affected side during SCB dual task (all P<0.05). The DTEs of gait speed, step length of the affected side, and the support phase ratio of the unaffected to the affected side during SCB dual task and SS dual task were significantly greater than those during WLG dual task and AS dual task ( P<0.05). The DTEs of gait speed and step length of the affected side during SCB dual task were significantly greater than that during SS dual task (all P<0.05). The DTE of the swing phase ratio of the unaffected to the affected side during SCB dual task was significantly greater than that during other types of cognitive tasks (all P<0.05). Conclusion:Different cognitive tasks had different effects on gait performance during dual-task walking in patients with stroke, and the degree of dual-task interference was associated with specific task types.
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Objective To explore the effect of early administration of high-dose amino acids in parenteral nutrition for low birth weight infants of prematurity.Methods A total of 191 prematures admitted to the First Affiliated Hospital of Nanjing Medical University from June 2015 to December 2016 were selected,and they were randomly divided into the study group (n =110) and the control group (n =81).The starting amino acid dose was 1.8-2.5 g/(kg · d)and 1.0-1.5 g/(kg · d) in the study group and the control group,respectively.Lipids,glucose,and electrolytes in parenteral nutrition were applied according to standard protocol of the guideline.And the start of enteral feeding,the recovery of birth weight,the duration of parenteral nutrition,the time before total enteral nutrition,duration of hospital stay,incidence of respiratory distress syndrome,duration of mechanical ventilation and incidence of kaliopenia were compared between the 2 groups.Results The start of enteral feeding,the recovery of birth weight,the duration of parenteral nutrition,the time before total enteral nutrition in the study group were earlier than those in the control group [(3.83 ±3.15) d vs.(5.53 ±5.63) d,(15.47±10.54) d vs.(19.47 ± 14.57) d,(16.46 ± 10.33) d vs.(21.41 ±18.00) d,(6.36 ± 4.88) d vs.(8.48 ± 9.27) d],and the differences were all statistically significant (t =2.455,2.097,2.217,2.041,P =0.016,0.038,0.029,0.043).The duration of hospital stay was shorter and the hospitalization expenses were lower in the study group than those in the control group,but the differences were not significant (all P ＞ 0.05).The incidence of respiratory distress syndrome in the study group was significantly lower than that in the control group[20.91％ (23/110 cases) vs.35.80％ (29/81 cases)],and the difference was statistically significant (x2 =5.223,P =0.022).The duration of mechanical ventilation in study group was shorter than that in control [(1.12 ± 2.62) d vs.(3.31 ± 8.13) d],and the difference was statistically significant (t =2.231,P =0.028).The incidence of kaliopenia in the study group was higher than that in the control group [30.91％ (34/110 cases)vs.17.28％ (14/81 cases)],and the difference was statistically significant (x2 =4.603,P =0.032).There were not significant differences in terms of complications of necrotizing enterocolitis,sepsis,extrauterine growth retardation,hospital infection,metabolic acidosis,hyperglycemia,glucopenia,patent ductus arteriosus and respiratory distress syndrome between 2 groups (all P ＞ 0.05).Conclusions Early administration of high-dose amino acids in parenteral nutrition for preterm infants can result in earlier enteral nutrition,shorter parenteral nutrition duration without increasing incidence of complications and hospitalization expenses.
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Objective To study the protective mechanisms of lipoxin A 4 ( LXA4 ) for hyperoxia-induced lung injury through modulation of let-7c/TGF-β1 signal pathway in mice.Method MLE-12 cells was transfected with let-7c mimic, mimic negative control ( NC) , let-7c inhibitor and inhibitor NC.The cells were assigned into hyperoxia group , LXA4 group, let-7c over-expression group, let-7c silence group, let-7c silence+LXA4 group, and all exposed to 85% oxygen.The mRNA level of the extracellular matrixα-smooth muscle actin (α-SMA) and collagen Ⅰ( COL-Ⅰ) , and the expression of related genes in TGF-β1 signaling pathway (Smad 2, Smad 3, Smad 4, TGF-βR1, TGF-βR2) were examined using qPCR.The protein expressions in TGF-β1 signaling pathway was examined using Western blot .Result The mRNA expressions of α-SMA, COL-Ⅰ, Smad 3, Smad 4, TGF-βR1 and TGF-βR2 in LXA4 group [(24.3 ±2.1), (14.6 ±0.2), (17.0 ±0.0), (14.9 ±0.1), (20.8 ±0.1), (9.0 ±0.0) ] and let-7c over-expression group [ ( 12.2 ±0.5 ) , ( 3.0 ±0.0 ) , ( 3.1 ±0.0 ) , ( 9.6 ±0.4 ) , ( 28.5 ±0.2 ) , ( 7.6 ± 0.1)] were decreased comparing with the hyperoxia group [(51.4 ±0.5), (32.0 ±0.1), (40.6 ±0.2), (16.3 ±0.1), (89.1 ±1.1), (19.3 ±0.2)].These expressions were increased in both let-7c silence group [(87.3 ±7.0), (38.5 ±0.3), (48.0 ±0.2), (56.5 ±0.2), (126.0 ±0.9), (33.1 ±1.0)] and let-7c silence +LXA4 group [(144.5 ±12.9), (86.3 ±3.0), (91.5 ±4.7), (86.5 ±3.3), (109.0 ±4.5), (45.6 ±1.6)].The protein levels of Smad 2, Smad 3, Smad 4, p-Smad 2, p-Smad 3 and TGF-βR1 of LXA4 group and let-7c over-expression group were decreased comparing with the hyperoxia group, while p-Smad 2, p-Smad 3 of let-7c silence+LXA4 group were increased(P<0.05).Conclusion LXA4 may play a protective role through let-7c /TGF-β1 signal pathway of lung epithelial cells for hyperoxia-induced lung injury in mice .
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Objective To investigate the protective effects of lipoxin A4 (LXA4) on the lung epithelial cells (MLE-12) in mice with hyperoxia injury.Methods MLE-12 cells were cultured in vitro and divided into air group,air + LXA4 group,hyperoxia group and hyperoxia + LXA4 group.The receptor of LXA4 (ALX) was verified by using reverse transcription-polymerase chain reaction (RT-PCR).MLE-12 cells were exposed to hyperoxia (＞ 850 mL/L oxygen concentration) for 12 h followed by pretreatment of 1 nmol/L,10 nmol/L and 50 nmol/L LXA4 for 1 h,6 h,12 h and 24 h.Quantitative real-time PCR (qRT-PCR) was applied to analyze the heme oxygenase 1 (HO-1) expression to determine the optimal concentration and the optimal pretreatment time of LXA4.The cell morphology was observed by using inverted microscope.The survival rates and cell viability were determined by using Trypan Blue stain and cell counting kit-8 (CCK-8).The superoxide dismutase (SOD) level was determined by using hydroxylamine method.The expressions of mRNA and protein of HO-1 were measured by using qRT-PCR,western blot and immunofluorescence assay,respectively.The interleukin-6 (IL-6) and monocyte chemotactic protein 1 (MCP-1) were determined by using enzyme-linked immunosorbent assay.Results ALX was expressed in MLE-12 cells.The optimal intervention concentration and time of LXA4 was 10 nmol/L for 12 h.Compared with air group [(84 ± 5) ％,1.22 ± 0.27,(5.33 ± 1.16) kU/L],the cell survival rate,viability and SOD level of hyperoxia group [(66 ± 8) ％,0.67 ± 0.21,(2.38 ± 0.65) kU/L] decreased,and the differences were significant (t =3.98,2.55,4.86;P =0.01,0.03,0.00);compared with the hyperoxia group,the cell survival rate,viability and SOD level of hyperoxia + LXA4 group [(88 ± 5) ％,1.43 ± 0.05,(6.50 ± 0.19) kU/L] significantly increased,and the differences were significant (t =4.83,3.52,6.78;P =0.01,0.02,0.00).The HO-1 mRNA and protein expression of hyperoxia group (0.57 ± 0.03,1.31 ± 0.11) increased as compared to air group (0.13 ± 0.03,0.24 ± 0.10),and the differences were significant (t =8.00,10.10;all P =0.00);the HO-1 expression of hyperoxia + LXA4 group (0.78 ± 0.08,1.82 ± 0.09) significantly increased as compared to hyperoxia group,and the differences were significant (t =3.94,8.82,all P=0.00).The levels of MCP-1 and IL-6 of hypemxia group [(1 025.18 ±35.51) rig/L,(1 136.65 ±160.01) ng/L] significantly increased as compared to air group [(467.63 ± 13.69) ng/L,(470.03 ± 118.22) ng/L],and the differences were significant (t =16.51,7.48;all P =0.00);the MCP-1 and IL-6 of hyperoxia + LXA4 group [(640.25 ± 61.03) ng/L,(655.48 ± 88.57) ng/L] significantly decreased as compared to hyperoxia group,and thedifferences were significant (t =11.40,5.40,all P =0.00).Conclusions LXA4 can attenuate hyperoxia-induced injury in MLE-12 cells.The protective role of LXA4 in the hyperoxia-induced cell injury is related to the up-regulation of HO-1 expression and down-regulation of IL-6 and MCP-1 levels.
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@#Objective To investigate the effects of various intensity of 1 Hz repetitive transcranial magnetic stimulation (rTMS) on up-per limbs motor function after stroke. Methods From December, 2014 to December, 2015, sixty patients with ischemic stroke were random-ly divided into high density group (HD, n=20), low density group (LD, n=20) and control group (n=20). They all received routine rehabilita-tion and medication. The HD group received rTMS over contralesional motor cortex twice a day, while the LD group received rTMS once a day, and the control group received sham stimulation, 10 minutes a time for 10 days. They were tested with motor-evoked potentials (MEPs), Fugl-Meyer Assessment (FMA) of upper limbs and modified Barthel Index (MBI) before and after treatment. Results The ampli-tude of MEPs of the affected cortex, the scores of FMA and MBI were more in HD and LD groups than in the control group after treatment (P<0.01), and were more in HD group than in LD group (P<0.01). No serious side-effect was found. Conclusion rTMS was feasible for pa-tients with stroke to improve the upper limbs motor function. It is more effective as more times a day.
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Objective To analyze the clinical risk factors of hemorrhagic transformation (HT) of cardiogenic cerebral embolism and the influence of HT on outcome. Methods The clinical data of 115 inpatients were reviewed from May, 2012 to December, 2015. They were di-vided into HT group (n=58) and non-HT group (n=57). The age, anticoagulant therapy, thrombolytic therapy, infarction diameter, diabetes, coronary heart disease, hyperlipidemia, the National Institutes of Health Stroke Scale (NIHSS) score and HAS-BLED score were compared. The risk factors for HT was screened with the multivariate Logistic regression. NIHSS score and Modified Rankin Scale (mRS) score as hos-pitalization, and one month and three months after stroke were compared. Results There were significant difference in NIHSS score (t=-2.991, P=0.003) and HAS-BLED score (t=-2.499, P=0.014), as well as infarction diameter (χ2=8.355, P=0.004) between HT group and non-HT group. NIHSS score (OR=1.127, P=0.027), HAS-BLED score (OR=1.783, P=0.03) and infarction diameter (OR=4.390, P=0.035) were the risk factors for HT. The incidence of HT was less in low-risk group (HAS-BLED score=0-2) than in high-risk group (HAS-BLED score≥3) (χ2=4.643, P=0.031). The NIHSS score as hospitalization, and one month and three months after stroke were all more in HT group than in non-HT group (t>2.387, P0.05). Conclusion HT tends to happen in the patients of cerebral embolism patients after atrial fibril-lation with severe neural function defect, large infarction diameter and high HAS-BLED score. The neural function is poor in those with HT.
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Objective To evaluate the efficacy and safety of Sheng-qi-zhuang-yang formula combined with specific immunotherapy (SIT) with standardized house dust mite vaccine on allergic asthmatic children. Methods Participants were 100 children with mild to moderate allergic asthma , who were receiving SIT at Guangdong Provincial Hospital of Chinese Medicine from Jan 2011 to Dec 2013 , who were divided into treatment group and control group. Patients in the treatment group received Sheng-qi-zhuang-yang Decoction combined with SIT while patients in the control group received SIT alone. Asthma symptom scores, respiratory function and related adverse events were compared before and after treatment, between groups. Results The desensitization treatment functions was ahead of time than expected in both groups. There is no significant difference between groups in terms of respiratory function and adverse effects. Conclusion Sheng-qi-zhuang-yang decoction combined with SIT for allergic asthmatic children seems to advance clinical effect without increasing adverse events. Further large scale clinical trial is required to confirm this.
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Objective To apply the virtual reality training in clinical education of rehabilitation therapy. Methods 26 undergraduate stu-dents majored in rehabilitation therapy were randomly divided into 2 groups during clinical education of physiotherapy. The experimental group (n=14) received virtual reality training first, and then with routine teaching, while the control group (n=12) learnt with routine teach-ing only. Self-assessment and physiotherapy test were conducted after training. Results The experimental group reported more interested, initiative and positive in training than those of the control group. The experimental group achieved higher scores in practical tests than the control group (P<0.05), while no significant difference in the theoretical examination between the groups. Conclusion Application of virtual reality training may improve the teaching of physiotherapy.
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@#ObjectiveTo investigate the influence of dysphagia on nutritional status of stroke patients. MethodsSwallowing function of stroke patients were studied with videofluoroscopy. They were divided into study group and control group according to the results of videofluoroscopy (60 cases in each group). Their nutritional status were compared. ResultsThe triceps skin fold, mid-upper arm muscle circumference and serum albumin in the study group were lower significantly than those in the control group (P<0.05). ConclusionDysphagia is associated with poor nutrition in stroke patients.
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@#ObjectiveTo investigate the effect of constraint-induced movement therapy(CIMT) on improving the flexibilty of upper extremities and the ability of daily living(ADL) of patients with hemiplegia.Methods36 patients with hemiparesis were randomized to two groups: CIMT and traditional rehabilitation(TR).In CIMT group,18 patients received intensive shaping training of 5 h/d,lasting 3 weeks, with the constraint of unaffected arms.In TR group,patients received traditional rehabilitation in the same times,without the constraint of unaffected arms. They were evaluated with Action Research Arm(ARA) Test and Barthel Index(BI) before intervention,immediate after intervention,4 and 12 weeks after intervention respectively.Patients in CIMT group were also evaluated with ARA tests 2 and 3 weeks after training.ResultsSignificant difference was found between CIMT and TR group on the improvement of ARA test(P<0.05).There was no significant difference between 2 and 3 weeks after training in CIMT group.Significant difference in BI was also found in CIMT group(P<0.01),but has not been found between CIMT and TR group.ConclusionCIMT significantly improved the flexibilty of upper extremities and ADL of patients with hemiplegia,which is superior to the traditional rehabilitation.
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Objective To investigate the therapeutic effects and relative mechanisms when constraint-induced movement therapy (CIMT) is used in patients with upper extremity disorders after head injury, and to compare the effects of CIMT with those of traditional rehabilitation (TR). Methods Thirty-six hemiparesis patients were randomly divided into a CIMT group and a TR group. Patients in the CIMT group were treated with intensive shaping training for 5 h a day for 3 weeks, as well as having their unaffected arms constrained. Meanwhile, the patients in the TR group were treated with traditional rehabilitation with no constraint of their unaffected arms. Motor activity logs (MALs) were compiled, and the Wolf Motor Function Test ( WMFT) and Barthel Index ( BI) were used to evaluate the therapeutic effects before treatment and at 0 d, 1 month and 3 month after treatment. Results Compared with the scores before treatment, the therapeutic effects were significant in the CIMT group, and the effect lasted to the follow-up period. Significant differences were also found between the CIMT group and the TR group in the improvement of dexterity by means of WMFT, and the usage of unaffected upper extremity as recorded in the MAL. There were no significant differences in therapeutic effects between the 2 week and 3 week treatments in the CIMT group. Conclusion CIMT significantly improved upper extremity function and ability in the activities of daily living ( ADL) of hemiplegia patients in the subacute period. The effectiveness of CIMT is superior to that of traditional rehabilitation methods.
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Objective To explore the effects of videofluoroscopic swallowing study (VFSS) in the assessment of dysphagia in post-stroke patients. To study the representation and rehabilitative outcome of dysphagia following stroke. Methods Seventy post-stroke patients and 80 normal adults were assigned to study group and control group and underwent VFSS. Abnormal signs on VFSS were compared between 2 groups. Aspiration patients received swallowing therapy for 4 weeks followed by VFSS again. Abnormal signs on VFSS were compared with those of pre-treatment. Results Penetration/aspiration, oral retention and pharyngeal retention occurred respectively at a frequency of 5.0%, 13.4% and 25.3% in control group in mild status, 45.0%,46.5%, 48.9% in study group in moderate to severer status. 10 times of silent aspiration were seen, accounting for 24.4% of all aspiration. The frequency of severe penetration/ aspiration decreased after the treatment (P