ABSTRACT
Objective:To explore the problems of accessibility in the construction of hospital. Methods:From March to October, 2018, according to the limits and classifications of environmental factors proposed by International Classification of Functioning, Disability and Health (ICF), ten accessible facilities (entrance, routes and doors, handrails, stairs and steps, elevators, tactile indicator, parking lots, toilets, low-height service facilities and sign indentification system) were evaluated in 30 hospitals in Guangzhou, China. The limit value was judged by "obstacle". Each environmental factor was assessed according to five levels, the score ranged from 0 as barrier-free to four as complete obstacle. Results:The average barrier score of tertiary hospitals was 1.48, which was between mild and moderate obstacles; the average barrier score of secondary hospitals was 2.32, which was between moderate and severe obstacles, tending to moderate obstacles; the average barrier score of primary hospitals was 2.66, which was between moderate and severe obstacles, tending to severe obstacle. Conclusion:The accessibility of hospitals at all levels should be improved.
ABSTRACT
Objective:To observe the effect of melodic intonation therapy combined with speech training on nonfluent aphasia after stroke, and the changes of brain function. Methods:From March, 2017 to August, 2019, 40 patients with nonfluent aphasia after stroke were randomly divided into control group (n = 20) and intensive group (n = 20). Both groups accepted routine speech training, and the intensive group accepted melodic intonation therapy in addition. They were assessed with China Rehabilitation Research Center Chinese Standard Aphasia Examination before and four weeks after treatment. Three patients from each group were examined with resting-state functional magnetic resonance imaging to observe the changes of regional homogeneity (ReHo) of cerebral hemisphere. Results:The scores of comprehension (noun, verb and sentence), repetition (noun and verb), read (noun) and naming (verb) increased in the control group (t > 2.221, P < 0.05), while it increased in comprehension (noun, verb and sentence), repetition (noun, verb and sentence), reading (noun and verb) and naming (noun and verb) in the intensive group (t > 2.179, P < 0.05). The scores of repetition (noun and verb) increased more in the intensive group than in the control group (t > 2.299, P < 0.05)， and the scores of reading (sentence) increased somehow. The ReHo in left cerebellum and temporal occipital area increased and the ReHo in bilateral frontal and temporal cortex decreased after treatment. Conclusion:Melodic intonation therapy based on speech therapy can promote the recovery of speech function for patients with nonfluent aphasia after stroke, especially in sentence reading and words repetition. The changes of the ReHo in resting state may associate with the neurological repairment after brain injury.
ABSTRACT
Objective: To investigate the relationship between the prevalence of anemia and New York Heart Association (NYHA) class in patients with chronic heart failure (CHF), and to assess the influence of hemoglobin (Hb) on patients' mortality. Methods: Totally 1 415 patients with CHF were retrospectively analyzed and the patients with secondary anemia or other serious conditions were excluded. Multivariable logistic analysis was used to assess the effect of Hb level on hospital mortality. Results: Among 1 415 patients, 413 (29.2%) were found to have anemia (Hb<120 g/L). The prevalence of anemia was positively correlated with the NYHA-class of patients (NYHA-class I 17.9% [5/28], class II 24.7% [125/507], class III 26.3% [151/574], and class IV 43.1% [132/306]. Patients with severe heart failure (NYHA-class III and IV [32.2%]) had a significantly higher prevalence of anemia than patients with slight heart failure (class I and II [24.3%], P<0.01). Patients with a Hb level of (140-159) g/L had the lowest hospital mortality, and those with Hb levels <80 g/L, (80-99) g/L, (100-119) g/L, (120-139) g/L, and ≥160 g/L had higher hospital mortalities. The relationship between mortality and Hb level was in a U-shaped manner. For patients with Hb level <160 g/L, multivariable logistic analysis showed that Hb remained as an independent predictor of the hospital mortality when the influences of the age, gender, basic cause of the disease, diabetes, cardiac function classification, serum creatinine, etc. were adjusted. Conclusion: Anemia is a common condition in hospitalized CHF patients and the degree of anemia is closely correlated with the severity of CHF. Hb level significantly influences the patients' hospital mortality. Hb level (<160 g/L) is an independent predictor of hospital mortality in the patients with CHF.