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Objective:To explore the research and teaching ability of rehabilitation in medical institutions at different levels in Zhejiang province, for better guiding and promoting of rehabilitation medicine.Methods:90 public hospitals in Zhejiang province were surveyed by Zhejiang Rehabilitation Center from May to August during 2019, to collect information of the research papers, research project applications, patents and monographs of each rehabilitation medicine department in the past five years, as well as the teaching and training activities in 2018.Results:Among the 90 hospitals surveyed, 86 hospitals had rehabilitation medicine departments. In the past five years, 86 hospitals published 636 papers in core journals, 120 SCI/EI papers, and applied for 19 national projects, 40 provincial projects, and 204 bureau level projects, and applied for 25 invention patents and 40 utility model patents, and edited 19 monographs. The average research capacity of rehabilitation including research paper, research project application, patent invention and monograph preparation in tertiary hospitals was significantly better than that of secondary general hospitals in recent 5 years. No SCI/EI papers have been published in the secondary hospital in the past 5 years, and no national project has been awarded. The proportion of SCI/EI papers published by tertiary hospitals was 92.5% (111/120). More teaching work was conducted by tertiary hospitals.Conclusions:The research and teaching ability of rehabilitation in public hospitals of Zhejiang province has reached a certain scale, but there is still a long way to go with other subjects. It is suggested that we should take the opportunity of development of great health and great rehabilitation, different levels of rehabilitation institutions should take their advantages to carry out scientific research and teaching training at different levels. Combined with the three-level rehabilitation network, a number of rehabilitation development measures such as linkage between the upper and the lower levels, mutual assistance in scientific research and integration in teaching should be implemented.
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Objective:To observe the effects of applying ultrasound-guided balloon dilatation in the treatment of post-stroke cyclopthyroid achalasia.Methods:Thirty-eight stroke survivors with cyclopneaful achalasia were divided into a control group ( n=19) and an experimental group ( n=19). All had been diagnosed with cycloparyngeal achalasia using videofluoroscopic swallowing study (VFSS). The controls were treated with conventional oral balloon dilatation, while the experimental group underwent ultrasound-guided oral balloon dilatation. The treatment was performed once every 2 days. During the treatment period, the durations and the number of expansions were recorded, and the patient′s comfort and throat pain were evaluated. The Kubota drinking water test (KDWT), standardized swallowing assessment (SSA) scoring and VFSS scoring were compared before and after the 2 weeks of treatment. Results:The average daily duration of expansions in the experimental group was significantly less than in the control group and their number was significantly greater. Comfort and larynx pain were also significantly better in the experimental group. The effective rate in the KDWT was 78.95% in the treatment group, significantly higher than the control group′s 31.58%. Significant differences were also found in the average SSA scores, VFSS pharyngeal phase scores and in the incidence of achalasia between the experimental and control groups.Conclusions:Using ultrasound to guide balloon dilatation can shorten the operation, reduce the throat pain involved and allow for more expansions, greater comfort and thus more effective treatment.
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Objective To elucidate the mechanism underlying eletroacupuncture's (EA's) amply-documented analgesic effect.To observe its effect on the pain threshold and on the expression of P2X4 receptor and microglia activation in the spinal cords of rats with neuropathic pain.To demonstrate whether or not interfering with A1 receptors and P2X4 receptors at the same time could enhance the analgesic effect.Methods A total of 40 SpragueDawley rats weighing 150 to 180 g were randomly divided into a sham group,a CCI group,an EA group,a 2-chloroN(6)-cyclopentyladenosine (CCPA) group and a CCPA+EA group,each of 8.Chronic constriction injury (CCI)was induced successfully in the rats of all groups except the sham group.Five days later,EA and 20 μL injections of 0.1 mm/L CCPA were applied to the rat analogues of the Zusanli (ST36) and Yanglingquan (GB34) acupoints once a day for 15 days for the rats in the appropriate groups.The mechanical withdrawal threshold (MWT) and the thermal withdrawal latency (TWL) were measured before the CCI operation and 20 days afterward.L4-L6 spinal cord tissue was then resected and the fluorescence intensity of P2X4 and OX42 receptors was detected using double label immunohistochemical staining.The correlation between the mean fluorescence intensity and the pain threshold gap was analyzed.Results The average MWT and TWL of the CCI group were significantly lower than in the other four groups.The expression of P2X4 receptor and OX42 in the spinal cord increased significantly in the CCI group compared to the other four groups.There was significant correlation between the mean fluorescence intensity of P2X4 and OX42 receptors and the gap in pain threshold,with correlation coefficients of 0.907 and 0.717 respectively.Conclusion P2X4 receptor and microglia activation might be involved in the development of neuropathic pain.CCPA and EA can inhibit the activation of microglia and reduce the activity of P2X4 receptors.The interaction between A1 receptors and P2X4 receptors can strengthen the analgesic effect of EA.
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Objective To study the effects of binary cardiac rehabilitation (CR) composed of hospital-based and home-based CR in patients after acute myocardial infarction (AMI) evaluated by six-minute walking distance (6MWD). Methods A total of 38 post-MI patients were divided into two groups, namely conventional CR group (n=20) and binary CR group (n=18). In the first seven days, CR training was carried out in all 38 patients in our hospital, and then 20 patients were kept at CR training in the hospital (hospital-based CR group), whereas the remaining 18 patients (binary CR group) got tele-monitored walking training at home for eight weeks (binary model). Before discharge from hospital based CR or after 8 weeks CR at home, all patients received Cardiopulmonary Exercise Testing and Six-minute Walk Test, and the data of patients' body mass index (BMI),thyroid function, serum lipid metabolism and echocardiography were collected before and after CR. Results After CR, BMI and low density lipoprotein (LDL) decrease in both groups compared with those before CR[hospital-based group: BMI, (25.99±3.36)kg/m2 vs. (23.04±3.72) kg/m2,P＜0.05; LDL, (3.40±1.38) mg/dl vs. (2.04±0.73)mg/ dl,P＜0.01; binary group: BMI, (24.84±2.70) kg/m2 vs. (22.88±2.56) kg/m2,P＜0.05; LDL, (3.40±1.01) mg/dl vs. (92.11±0.37) mg/dl,P＜0.01]. After 8 weeks CR at home or hospital based CR until discharge, the anaerobic threshold (AT), maximum rate of oxygen consumption (VO2max),metabolic equivalent (MET) and 6MWD improved significantly in both groups compared with those at 7 days after CR in hospital [Hospital-based group: AT, (12.37±1.53) mL/(kg. min) vs. (14.77±1.57) mL/(kg. min); VO2max (17.87± 1.66 mL/(kg. min) vs. (20.73±2.14) mL/(kg. min); MET (5.02±0.36) vs. (6.09±0.53); 6MWD (500±53.36) m vs. (582.5±57.6) m,P＜0.01; Binary group: AT, (12.56±1.11) mL/(kg·min) vs. (14.30±1.23) mL/(kg. min); V02max, (17.28±1.38) mL/(kg. min) vs. (20.02±1.37) mL/(kg. min); MET, (5.07±0.47)vs (5.94±0.46); 6MWD,(511.4±50.96) m vs. (590.3±56.1)m,P＜0.01]. There was no significant difference in CR effects observed between two groups (P＞0.05). Conclusions In post-MI patients,a binary model of CR training improved physical capacity and was a similarly effective form of CR as a entirely hospital-based approach. A home-based tele-monitored program facilitated patients' adherence to CR. The 6 minute walk experiment is economical and good evaluation on the CR effect of binary cardiac rehabilitation.
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@#Objective To observe the effects of Pilates on balance, walking and lower limbs motor function in older patients after stroke. Methods From November, 2016 to December, 2017, 60 older patients after stroke were divided into control group (n=30) and Pilates group (n=30). The control group received routine medicine and rehabilitation, the Pilates group accepted Pilates training in addition, for ten weeks. They were evaluated with Berg Balance Scale (BBS), 10-metre Maximum Walking Speed (MWS), Timed 'Up and Go' Test (TUGT) and Fugl-Meyer Assessment-Lower Extremity (FMA-LE) before, and five weeks and ten weeks after training.Results The BBS score, MWS, TUGT and FMA-LE score all improved ten weeks after training in both groups (t>2.122, P<0.05), and improved more in the Pilates group than in the control group (t>2.264, P<0.05).Conclusion Pilates can improve the balance, walking and lower limbs motor function in older patients after stroke.
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Objective To investigate the therapeutic effects of acupuncture on pelvic floor muscles and urinary function in patients with spinal cord injury. Methods From March, 2012 to March, 2015, 23 patients with spinal cord injury were divided into control group (n=8), early intervention group (n=8) and later intervention group (n=7). The control group received routine rehabilitation, the intervention groups received acupuncture at Baliao (BL-31, BL-32, BL-33 BL-34), Yanglingquan (GB-34), Sanyinjiao (SP-6) and Taichong (LR-3) acupoints in addition. The early intervention group was acupunctured one week before removal of catheter, and the later intervention group adopted inter-mittent catheterization after removal of catheter, and then received acupuncture. The pelvic floor muscles strength, the urine function and quality of life were recorded before and six weeks after intervention. Results There was no significant difference in all the indices before in-tervention (P>0.05). After intervention, the pelvic floor muscles strength improved in the intervention groups compared with the control group (P0.05). The quality of life improved in all the groups after inter-vention (F>0.864, P<0.05), however, no significant difference was found among three groups (F=1.558, P<0.05). Conclusion Acupuncture, especially early acupuncture, could improve the pelvic floor muscle strength and bladder function in spinal cord injury patients.
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@#Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD decreased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P<0.05), and there was no significant difference between the two groups 4 and 8 weeks after treatment (P>0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.
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Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD de-creased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.
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Objective To observe the effect of cognition training on the motor and executive functioning of patients after a basal ganglia stroke.Methods Thirty patients with basal ganglia stroke were randomly divided into a treatment group and a control group.The control group received standard stroke rehabilitation training,while the treatment group received in addition 2 months of cognitive function training.The executive and motor functions of all of the subjects and their facility in the activities of daily living (ADL) were tested using the Tower of Hanoi,the Wisconsin card sorting test,a Stroop-3 test and the Fugl-Meyer assessment,the Berg balance scale and the modified Barthel index before and at the end of treatment.Results After two months of training,both within-group and between group comparisons showed that the treatment group had improved significantly more in executive function,cognition and motor function.Conclusion Cognition training can improve executive function,motor function and ADL performance after a basal ganglia stroke.
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Objective To investigate the feature of event-related potential N400 before and after speech therapy in Chinese aphasia pa-tients. Methods 20 Chinese aphasia patients received speech therapy for 12 weeks. Language function was evaluated with Western Aphasia Battery (WAB), and the latency and amplitude of N400 were monitored before and after treatment. Results Spontaneous speech, retelling, and nomination in WAB and aphasia quotient (AQ) of WAB significantly increased after treatment (P<0.05). N400 latency was shorter and N400 amplitude was lower after treatment (P<0.05). The latency and amplitude of N400 were negatively correlated to the score of AQ in the difference before and after treatment (P<0.001). Conclusion Event-related potential N400 could reflect the improvement of speech function before and after treatment, and it is a valuable index for evaluating the recovery of language function in Chinese aphasia patients.
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Objective To explore the effects of post-stroke depression on working memory,aiming to find a new method for alleviating the dysfunction in post-stroke depression patients.Methods Eighteen patients with poststroke depression and 20 stroke survivors with no depression were recruited as the experimental and control groups respectively.Both groups' working memory was tested early every morning.The two groups' performance was compared in terms of each working memory test item and their results were correlated with their scores on the Hamilton depression scale (HAMD).Results The average HAMD score was 21.78 ± 3.21 for the experimental group and 5.06 ±2.35 for the control group.Compared with the control group,the experimental group was significantly different in its performance counting backward,in its word memory span and its calculation task span,as well as in successive subtraction.At the same time,compared with the control,the experimental group was significantly better in total reaction number and the percentage of number of right reaction of the number of total reaction of Digit Subtraction Test.The HAMD scores of the experimental group were negatively correlated with their performance in counting backward,their word memory span,their successive subtraction performance and their calculation task span.Conclusion Poststroke depression has an obvious negative effect on working memory.
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@#ObjectiveTo explore the effect of bladder curer in the treatment of patients with neurogenic bladder after spinal cord injury.Methods60 spinal cord injury patients with neurogenic bladder were randomly divided into intervention group (n=30) and control group (n=30). Comprehensive rehabilitation therapy was used in the two groups, but bladder curer was used only in intervention group. Residual urine in the bladder, incidence of urinary tract infection and course of achieving bladder balance were observed in the two groups.ResultsAfter 8 weeks, residual urine in the bladder decreased significantly in intervention group compared with control group, and the course of achieving bladder balance shortened significantly in intervention group compared with control group, but incidence of urinary tract infection had no difference between intervention group and control group. ConclusionBladder curer could decrease residual urine in the bladder early, and shorten the course of achieving bladder balance in the treatment of patients with neurogenic bladder after spinal cord injury.
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@#ObjectiveTo explore the effect of early rehabilitation therapy in the treatment of patients with trihemiparalysis sign following acute stroke.Methods86 patients following acute stroke were divided into two groups, trihemiparalysis sign group(n=37) and non-trihemiparalysis sign group(with hemiplegia only, n=49). Standard rehabilitation therapy was used in both groups early. At admission and 3 months after treatment，both groups were assessed by using the National Institutes of Health Stroke Scale(NHISS), Fugl-Meyer Assessment of motor (FMA) and Balance (FMB), Modified Barthel Index(MBI), and World Health Organization quality of life questionnaire (WHOQOL-BREF).ResultsAfter 3 months, patients in both groups scored significantly better in NHISS, FMA, FMB, MBI and PHYS, PSYCH, ENVIR of WHOQOL-BREF compared with that at admission. But the trihemiparalysis sign group improved less significantly in NHISS, FMA, FMB, MBI and PHYS, PSYCH of WHOQOL-BREF compared with non-trihemiparalysis sign group after treatment.ConclusionEarly rehabilitation therapy improved functional status and quality of life of acute stroke patients with trihemiparalysis sign, but showed not better than the patients with non-trihemiparalysis sign.