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Objective To systematically review reports dealing with the efficacy of pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The PubMed,EMbase,China National Knowledge Infrastructure,VIP and Wan Fang databases were searched to collect reports of randomized and controlled trials of pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease.The search covered from each database's inception to August 1,2016.Two reviewers screened the literature independently,extracted data and assessed the risk of bias for the studies eventually included.A meta-analysis was performed using version 5.3 of the RevMan software.Results After the initial selection,a total of 7 reports covering 486 patients were included in the meta-analysis.The results of the meta-analysis showed that the average mMRC score,the 6-minute walk distance and Borg score in the pulmonary rehabilitation group were all significantly higher than in the control group.There was,however,no significant difference between the two groups' average pulmonary function values.Conclusion Pulmonary rehabilitation is safe for patients experiencing an acute exacerbation of chronic obstructive pulmonary disease.It can effectively improve their exercise tolerance,expiratory dyspnea and daily living ability.
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Occupational Therapist Registered (OTR) Exam is established and managed under the national certification body for occupa-tional therapy professionals-National Board for Certification in Occupational Therapy (NBCOT). The OTR Exam is designed based on reg-ular practical analysis on the entry-level front-line occupational therapists in the United States, conducted by the Certification Examination Development Committee (CEDC). The panel will follow four steps, including drafting the exam blueprint, designing the questions, rounds of discussion and validation and finally putting the questions into confidential question bank for random selection by computer during exam. The OTR Exam is featured by its close relevance and update with clinical status of the States, high-standard professional requirement based on broadest public consensus within the profession as well as its evidence-based and scientific procedure throughout the designing process, which may benefit the development and standardization of Occupational Therapy Profession in China.
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Background and purpose:Adenosine triphosphate-binding cassette superfamily G member 2 (ABCG2), which has been found over-expressed in a variety of cancer cells, takes part in the drug resistance of cancer through effux of anticancer drugs. The purpose of this study was to investigate the mechanisms of human glioblastoma cells sensitivity to pyropheophorbide-a methyl ester (MPPa)-mediated photodynamic therapy (PDT) eradicating tumour cells and its relationship to ABCG2.Methods:U87 and A172 glioma cell lines in the logarithmic growth phase were selected and exposed to the treatment of MPPa-PDT and MPPa-PDT+fumitremorgin C (FTC) respectively. The cell viability was measured with the use of CCK-8 assay. The expression of ABCG2 was detected by Western blot. The intracellular contents of MPPa in each group without illumination were tested by lfow cytometry. Flow cytometry with AnnexinⅤ-FITC/PI double staining was used to detect the cell apoptotic rate. DCFH-DA staining was used to assess the generation of intracellular reactive oxygen species (ROS).Results:The MPPa-mediated PDT could eradicate A172 and U87 cancer cells in an energy-dependent manner. The light energy density in A172 was 8 times of that in U87 when the cell viability reached median lethal dose after MPPa-mediated PDT. The high expression of ABCG2 in A172 cells affected the accumulation of intracellular MPPa. Inhibition of ABCG2, not only could enhance the eradicating effect of MPPa-PDT on A172 cells, but also could increase the yield of ROS triggered by MPPa-PDT and the accumulation of intracellular MPPa.Conclusion:The human glioblastoma cell line A172 is insensitive to MPPa-mediated PDT. The mechanism may relate to ABCG2, which decreases the MPPa content in cancer cells through effux of MPPa, resulting in decline of cytotoxicity.
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Objective To explore the efficacy of neuromuscular electrical stimulation (NMES) in treating severe and chronic obstructive pulmonary disease (COPD).Methods Seventy-eight COPD patients were randomly divided into an NMES group of 38 and an exercise therapy group of 32.In addition to the routine drug therapy and basic rehabilitation training,the NMES group received 8 weeks of NMES of the lower limbs while the exercise group was provided with strength and endurance training of the lower limbs,also for 8 wceks.Before and after the 8 weeks of treatment,pulmonary function was tested along with isokinetic quadriceps strength,cardiopulnonary capacity,and lung capacity using Saint George's respiratory questionnaire (SGRQ).Results The two groups showed no significant difference in any of the measurements before the treatment.After the treatment,forced expiratory volume in 1 second of (FEV1),FEV1/forced vital capacity (FVC),FEVI in percentage of the predicted value,medical research council dyspnea scale (MRC) score and the 6-minute walk distance (6MWD) improved in both groups.However,the average body mass index and 6 minute walk distance differed significantly between the groups after the treatment.The quadriceps' peak torque increased after the treatment in both groups,but the average in the exercise group was significantly higher than that in the NMES group.VO2max and Wmax also increased significantly in both groups,and the average time to exhaustion increased significantly in the exercise group.Significant improvement was observed in the BODE assessment after the intervention for both groups.Conclusion Neuromuscular electrical stimulation is as effective as therapeutic exercise in promoting the rehabilitation of severe COPD patients.However,lower limbs exercise is still the first choice in managing such patients.
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This study descriptively illustrated the definition of certified hand therapist, eligibility requirement and accreditation system based on the official guidelines from American Society of Hand Therapists (ASHT), Hand Therapy Certification Commission (HTCC) and Handbook of Certified Hand Therapy Examination. Besides, this exam was compared with National Physical Therapy Examination (NPTE) and Occupational Therapist Registered Examination (OTR Exam). The testing domains and contents may help the domestic teaching faculty to standardize the course syllabi, promote divided development of physical therapy and occupational therapy in a specialized manner, and ex-erted positive impact for promoting establishment of the hand specialists and accreditation system of China itself.
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Objective There is a huge demand for rehabilitative services in Chongqing whereas detailed information regarding local clinical services and rehabilitative professionals are unknown. Therefore, a cross-sectional survey was conducted to generate a profile of current rehabilitative status in Chongqing for reference of relevant local parties and peers in other provinces of China to create a larger picture of rehabil-itation in China. Methods The survey began in early January of 2015 and ended on October 20th of 2015. With two categories of information, including background of rehabilitation professionals and rehabilitative clinical services, the self-made questionnaire was sent via email to rehabilitation therapists working in local clinical settings which fulfilled the inclusion criteria. The reminder was sent once a month to those who did not yet replied. The software SPSS 20.0 was used to analyze the data descriptively. Results 7 out of 13 in-volved clinical settings responded with an overall response rate of 53.8%. 98 out of 122 copies were adopted based on filling requirement. The result revealed 68.4%(n=67) of the participants were junior practitioners, 57.1%(n=56) of them had less than 5 years experience and 45.9%(n=45) were holding a diploma with little research experience. As for clinical services, assessment of ROM (94.9%, n=93) and manual muscle testing (94.9%, n=93) were mostly used. The physical therapy service was more prevalent than occupational therapy services. The clinical field mostly involved was adult rehabilitation (77.6%, n=76). Bedside training in the acute phase (81.6%, n=80) and one-to-one treatment (92.9%, n=91) was the most commonly seen mode of service in the departments. Conclusion The local rehabilitative professionals were featured by their young age with comparatively low educational level, qualification and weak research skills. The clinical services they provided were yet quite basic and simple. Thus, a set of policies regarding education and profession in rehabilitation therapy should be facilitated instantly and it also calls for the establishment of local academic society for rehabilitation therapists, thus promoting an all-round development of rehabilitative profession.
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Objective To obtain imaging information of the cervical arteries and vertebral structure of rhesus ma -caques and provide useful reference data for medical research works using macaques as animal models .Methods Six a-dult macaques (3 males and 3 females) in age of 3-5 years, body weight from 3.5 to 5 kg, were used to examine the neck by 320 row spiral CT imaging under general anesthesia , and three-dimensional reconstruction was performed to observe the vertebral artery morphology , and to measure the diameter of vertebral artery and the size of transverse foramen of the ma -caques .Color Doppler ultrasound was combined with 320-CT imaging to assess the blood flow velocity in carotid arteries . After CT scan to make sure that the vertebral artery and cervical vertebra of macaques had no deformity , the size of trans-verse foramen and diameter of vertebral artery were measured in the cross-sectional images .Color Doppler ultrasound was used to analyze the peak systolic velocity ( PSV) , diastolic peak flow velocity ( EDV) and the diameter ( D) of common ca-rotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) of the ma-caques .Results The 320-CT scan showed that in the monkeys , the vertebral artery enters the cervical spine through the intervertebral foramina at C6, and leaves the cervical spine at C 2 level, and the cervical spine has Luschka joint , which is similar to the anatomic structure in humans .The diameter of left and right vertebral arteries was 1.89 ±0.44 mm and 1.72 ±0.39 mm, respectively , with no significant difference between them in the same segment ( P>0.05 ) , and the size of transverse foramen also had no significant difference in the same segment ( P>0.05 ) .Color Doppler ultrasound showed that the left and right side systolic peak velocity (PSV) and diastolic peak velocity (EDV) of CCA and ICA, the left and right side systolic peak velocity (PSV) of ECA and VA had statistically significant difference (P<0.05), and the left ar-teries were predominant in the macaques .Conclusions In this study we obtained some imaging information of vertebral artery morphology and artery blood flow of macaques and these information may provide some useful basic data for further studies using rhesus macaques as animal models .
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Objective To compare the effects of nonsurgical spinal decompression system (SDS) cervical traction and common cervical traction using surface electromyography (sEMG).Methods Twenty-two volunteers' sEMG signals were recorded before,during and after two modes of cervical traction:the conventional traction in sitting and SDS traction in supine.The interval between the two modes of traction was no shorter than 24 hours.The mean and peak amplitudes of their sEMG signals were observed before,during and after traction.The sEMG signals of the posterior cervical muscle while sitting or lying were compared at different stages of the traction.Results There was no statistically significant difference in sEMG signals between the subjects' right and left posterior cervical muscles.The sEMG signals decreased significantly during both traction trials.With common cervical traction the mean and peak amplitudes of the left posterior cervical muscle pre-and post-traction were higher than during traction,and the same as that of the right posterior cervical muscle.In the SDS trials the sEMG signals during traction and post-traction were significantly lower than those pre-traction.After traction the sEMG signals while sitting (common cervical traction) were significantly higher than those post-traction while lying (SDS cervical traction),and the sEMG signals post-traction while either lying or sitting were stronger than during traction while lying.The post-traction signals in sitting were stronger than those in lying.Conclusions Both nonsurgical SDS and common cervical traction can relax the posterior cervical muscles.The effect of nonsurgical SDS was better than that of common cervical traction.
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Objective To test using musculoskeletal ultrasound (MSUS) to observe uncovertebral joints (UJs) and to explain the ultrasound images of UJs and their adjacent tissues,especially the vertebral artery (VA).Methods MSUS was used first with human skeletons and cadavers to localize the UJs and VA on the MSUS images with the aid of implanted needles.MSUS was then used with a patient clinically diagnosed with cervical spondylosis of the vertebral artery type (CSA) to detail the image of a normal UJ and its relationship with the adjacent tissues,especially the VA.Whether there was a lateral spur from the uncinate process (UP) was assessed to try to establish a method for measuring osteophytes.Results During the examination the patient was in supine,the neck was elevated 15cm with a pillow and was at 45 degrees of rotation to the contralateral side.The probe was placed at the medial border of the sternocleidomastoid muscle.When the longitudinal section of the common carotid artery was shown,the probe was slowly moved laterally until the VA first appeared,and then was moved up along the VA.Once the VA entered the transverse foramen,moving the probe slightly allowed the UJ behind the VA to be seen between two transverse processes.The UJ thus lies between two transverse processes,that is,between the lateral margins of two vertebral bodies and outside the intervertebral disc.The echo of the lateral border of the UP is on a straight line with the echo of the lateral margin of the vertebral body,with the VA in front of the line.It was noticed that the image of a UP with lateral osteophyte formation crossed the line and reached closer to the VA.The transverse diameter of the UJ was measured as the distance from a line cutting the lateral cortical margin of the cervical vertebra to the outer cortical margin of the lateral UP.Conclusion MSUS can clearly show the UJ and its adjacent tissues,especially the VA.It can be used to assess and measure UJs with lateral osteophyte formation.
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Objective To assess the use of the Chinese version of Montreal Cognitive Assessment (MoCA) in differentiating Alzheimer's disease (AD) and vascular dementia (VD).Methods A total of 62 patients with AD and 54 patients with VD were recruited for this study.All subjects were subject to examination using MoCA to collect information in terms of their visuospatial/executive function,attention,language,abstraction delayed recall and orientation.The demographic data of the subjects was also were collected and analyzed.Results It was shown that there were statistically significant differences between the AD and VD patients with regard to their scores of visuospatial / executive,attention,delayed recall (P ＜ 0.05).The rate of diagnostic coincidence was 100％ in AD patients using MoCA Chinese version,and 98.15％ in VD patients,with a statistically significant difference between the two groups.There was high correlation in all items of MoCA between the two evaluators (ICC:0.911 ～1.000).Conclusion Montreal Cognitive Assessment Chinese version can be used for the diagnosis of AD and VD,and the scale can help differentiate AD and VD.
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Objective To investigate the effects of exercise therapy and health education on the hospitalization and exercise endurance of patients with moderate or severe chronic obstructive pulmonary disease (COPD).Methods A total of 86 patients with moderate or severe but stable COPD were divided randomly into an observation group (n=46) and a control group (n=40).The patients in both groups accepted general respiratory medical therapy.The patients in the observation group also accepted additional pulmonary rehabilitation therapy which consisted of exercise and health education while the patients in the control group only accepted health education and rehabilitation training guidance by telephone instead of standardized pulmonary rehabilitation therapy.The average recurrence of hospitalization,length of stay,and total bed time of all of the patients was tracked for a year before and after enrolment.Their 6 minute walking distance (6MWD) and quality of life (QOL) as reflected by using a scale recommended by the Chinese Society of Respiratory Disease before and after entering the study were evaluated.Results There was no significant difference between the groups in the year before entering the study in terms of their average frequency of hospitalization,length of stay or total bed time.In the year after enrollment average frequency of recurrence requiring hospitalization,length of stay and total bed time in the observation group all decreased significantly compared with the previous year,and all were significantly lower than in the control group.There were no significant differences between the groups in average 6MWD or average QOL score at entry,but in the subsequent year both groups' results improved significantly.Conclusion Long term pulmonary rehabilitation can not only enhance exercise endurance,it also improves QOL and relieves the economic burden of COPD patients on society.
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Objective To observe the effects of 860 MHz microwave radiation on an established dual task model of trace and delay eyeblink conditioning in guinea pigs.Methods Twenty-four guinea pigs with an established dual task model of trace and delay eyeblink conditioning were assigned randomly into four groups : a microwave-exposed 1 h group, a microwave-exposed 20 min group, a sham-exposed group and a normal control group.The guinea pigs in the 1 h and 20 min groups were irradiated on the head daily for 3 days using 860 MHz electromagnetic radiation at a power density of 1 mW/cm2 for 1 h and for 20 min, respectively. After radiation the guinea pigs were trained with classical dual task eyeblink conditioning.Results Compared with the normal control group, the behavioral parameters (acquisition rate and peak amplitude of trace and delay eyeblink) of guinea pigs in the microwave-exposed 1 h group had decreased significantly with no obvious change in latency. The behavioral parameters of guinea pigs in the microwave-exposed 20 min group, the sham-exposed group and the normal control group showed no obvious change.Conclusions Microwave radiation at 860 MHz and 1.0 mW/cm2 for 1 h can cause changes in dual trace and delay eyeblink conditioning in guinea pigs and decrease learning and memory capacity.
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Objective To evaluate the therapeutic effect of rapid angulation rotation traction for lumbar intervertebral disc protrusion. Methods A total of 88 patients (66 male and 22 female;age: 18-65), with a history of 2 days to 10 years were analyzed. Among them 20 cases were central protrusion 68 cases were lateral protrusion. Traction range: 60-65 mm, angle: 20°-25°, rotation degree: 20°-25°, traction time: 3 s-1 min. The process of treatment was computer designed. The traction was then 1 to 3 times, with a interval of 4-7 days between two treatments. Results The effective rate was 96% for the case with history <1 month 96% and 85% for cases with history >1 month (P<0.01). The effective rate was 62% for central protrusion, and 87% for lateral protrusion respectively. χ2 test showed the difference was not significant. Conclusion The rapid angulation rotation is an effective treatment for lumbar inter-vertebral disc protrusion and this non operative method should be used as early as possible.