ABSTRACT
Objective To compare the therapeutic effect of Pilates and conventional training after total hip arthroplasty (THA).Methods Fifty-eight patients who had undergone minimally invasive total hip replacement surgery were divided into an observation group (n =29) and a control group (n =29) using a random number table.The observation group was given Pilates rehabilitation training,including a series of exercises especially designed for this condition,for 6 months after the operation.The control group was provided with conventional postoperative rehabilitation training including passive range of motion exercise,balance training,etc.,lasting for 1 to 2 months in hospital,followed by self-training after discharge.At 1 month,3 months and 6 months after the operation hip joint function was evaluated in both groups using the Harris hip score and the modified Barthel index (MBI).The time for first out-of-bed activity after the operation,length of hospital stay and postoperative complications of the two groups were also recorded.Results At 1 month after the operation,the average Harris hip score and MBI score of the observation group were significantly better than those of the control group [(59.78 ± 6.22) vs (51.26 ± 3.42) and (52.56 ± 16.67) vs (45.63 ± 15.24),respectively].Two and 4 months later,in the observation group the average Harris hip score had improved significantly to (82.12 ± 3.32) and further to (91.42 ± 5.91),while the MBI score increased significantly to (58.39 ± 13.32) and (81.17 ± 13.87).The same tendency was observed in the control group and at those two time points no significant difference was observed between the observation group and the control group.The patients in the observation group had their first out-of-bed ambulation significantly earlier,a significantly shorter average hospital stay and significantly fewer postoperative complications.Conclusion Pilates training after minimally invasive THA can promote earlier and quicker functional recovery than conventional rehabilitation training.
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@#Objective To evaluate the application of cough reflex testing with various concentrations of citric acid for dysphagia post stroke. Methods 20 normal controls (NC), 20 stroke patients with dysphagia (SD) and 20 stroke patients without dysphagia (SND) were tested with cough reflex inhalated 4 kinds of dosage of citric acid: 0.2 mol/L, 0.4 mol/L, 0.6 mol/L and 0.8 mol/L. Results The incidence of pass (coughed twice or more) decreased in the SD compared with those in the NC as inhalated citric acid of 0.2 mol/L and 0.4 mol/L (P< 0.05), and decreased under 0.4 mol/L compared with the SND (P<0.05). There was no significant difference between the SND and the NC (P>0.05). 90% of the NC passed as inhalated citric acid of 0.4 mol/L; however, it was 45% in the SD, and increased when they inhalated more dosage of citric acid (P<0.05). The incidence of pass decreased under 0.2 mol/L citric acid in the SND compared with other concentration (P<0.05). The result of the test was reliable interrater (κ=0.97). The incidence of cough was consistent of 96.8% with the same concentration. No asthma and asphyxia was observed. Conclusion Cough reflex testing with citric acid inhalation can be used to assess the defensive function of airway in lower concentration for dysphagia after stroke.
ABSTRACT
Objective To evaluate the application of cough reflex testing with various concentrations of citric acid for dysphagia post stroke. Methods 20 normal controls (NC), 20 stroke patients with dysphagia (SD) and 20 stroke patients without dysphagia (SND) were test-ed with cough reflex inhalated 4 kinds of dosage of citric acid:0.2 mol/L, 0.4 mol/L, 0.6 mol/L and 0.8 mol/L. Results The incidence of pass (coughed twice or more) decreased in the SD compared with those in the NC as inhalated citric acid of 0.2 mol/L and 0.4 mol/L (P0.05). 90%of the NC passed as inhalated citric acid of 0.4 mol/L;however, it was 45%in the SD, and increased when they inhalated more dosage of citric acid (P<0.05). The incidence of pass decreased under 0.2 mol/L citric acid in the SND compared with other concentra-tion (P<0.05). The result of the test was reliable interrater (κ=0.97). The incidence of cough was consistent of 96.8%with the same concen-tration. No asthma and asphyxia was observed. Conclusion Cough reflex testing with citric acid inhalation can be used to assess the defen-sive function of airway in lower concentration for dysphagia after stroke.
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Firstly, We used error-prone PCR to induce mutations on Armillariella tabescens MAN47 beta-mannanase gene, Secondly, we cloned the mutated fragments into secreted expression vector pYCalpha, Then the recombinant plasmids were transformed into Saccharomyces cerevisiae BJ5465 after amplified and extracted in DH5alpha cells. Through three cycles of error-prone PCR we built a mutant database, Then we screened one optimum (named M262) from about 104 mutants. The evoluted MAN47 beta-mannanase displayed both higher thermal stability and activity than wide type. The evoluted enzyme M262 retained high activity after treatment at 80 degrees C for 30 min, whereas, the wild type nearly lost activity under this condition. Meanwhile, the activity of M262 can reach to 25 U/mL, which is 4.3 times as wide type under optimum temperature. In addition, pH stability and pH range of evoluted enzyme M262 were both improved compared with wild-type enzyme. The optimum pH was estimated to be similar to that of wild-type enzyme. The sequence comparison illustrated that there were three nucleotide substitutions (T343A/C827T/T1139C) which carried corresponding amino acid changes (Ser115Thr/Thr276Met/Val380Ala). According to homologous modeling by SWISS-MODEL Repository, three mutated amino acids located at the sixth amino acid of the fourth beta-sheet, the first amino acid of the sixth alpha-helix, the turn between the tenth and eleventh beta-sheet, respectively.