- balance penetrating acupuncture combined with rehabilitation training on upper limb spasticity in stroke hemiplegia / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of - balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia.@*METHODS@#A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, - balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups.@*RESULTS@#①After treatment, the MAS classification reduced in both groups (<0.05), the cases of grade 0 to Ⅰ in the observation group were more than those in the control group (<0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups (<0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group (<0.05). ②After treatment, the scores of NIHSS were decreased (<0.05), the scores of FMA, MBI were increased in both groups (<0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group (<0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group (<0.05).@*CONCLUSION@#- balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.

Intervention and prognostic study in patients with severe stroke complicated with plasma hyperosmolality / 中国脑血管病杂志

Objective: To explore the clinical value in the intervention of patients with severe stroke complicated with plasma hyperosmolality. Methods: Th irty-four patients with severe stroke (Glasgow coma score [GCS] ≤12 on admission), who complicated with plasma hyperosmolality were selected. The changes of plasma osmotic pressure before and after the intervention and its related factors, as well as the effect of interventional therapy on prognosis were observed dynamically by controlling fluid replacement, diuretic, and blood sugar. Results: The most common interventional measures for plasma hyperosmolality were to control the fluid replacement (85.3%), the secondly to control the dosage of osmotic diuretic (41.2%) and blood glucose level (41.2%. Before the intervention, plasma osmotic pressure, natrium intaking and blood glucose level were (321 ± 10), (146 ± 5), and (9.5 ± 2.8) mmol/L, respectively; after the intervention, they were reduced to (308 ± 18), (142 ± 7), and (7.5 ± 3.1) mmol/L, respectively. The in-hospital mortality in patients who were intervened successfully (plasma osmotic pressure reduced to normal levels) in hyperosmolality group was 15.8%, and it was significantly lower (P < 0.01) than that in patients (100%) who were intervened unsuccessfully (plasma osmotic pressure did not reduced to normal levels). Multifactor logistic regression analysis showed that the major risk factors that influenced the in-hospital mortality were the increase of plasma osmotic pressure, and the increase of acute physiology and chronic health evaluation II (APACHE II) scores. Conclusion: Reducing the plasma osmot ic pressure may improve the prognosis in patients with severe stroke complicated with plasma hyperosmolality, and reduce the in-hospital mortality.

Establishing the System of Academic Assessment and Evaluation on Introduced Talented Personnel / 上海第二医科大学学报

Objective To evaluate the system of academic assessment and evaluation on introduced talented personnel so as to establish a consummate talented personnel introduction mechanism and to further standardize the introduction work. Methods On the basis of referring to document papers and soliciting management as well as human resource experts iteratively,the research method of expert consultation was adopted.(Results)The index system of academic assessment and evaluation on introduced talented personnel in school of medicine was preliminary established,and the objective index and subjective evaluation were scientifically combined to form the method of academic assessment and evaluation on introduced talented personnel. Conclusion Through simulative assessment and evaluation as well as probational demonstration,there exits definite scientificality and applicability on this academic assessment and evaluation index system,and it can provide a properly objective evaluation and essential reference foundation in the aspect of introducing more advanced talented personnel in the near future.