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Objective To analyze the clinical features of Parkinson's disease (PD) combined with chronic pain in the elderly.Methods A total of 366 idiopathic PD patients experiencing pain were enrolled and divided into two groups:the elderly group (n=289) and the young group (n=77).Rating scales including Visual Analogue Scale (VAS),Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn Yahr (H-Y) Scale,Self-rating Anxiety Scale (SAS),Self rating Depression Scale (SDS) and Brief Pain Inventory (BPI) were evaluated.Results Compared with the young group,the elderly group had evidently higher scores of UPDRSⅡ,Ⅱ,Ⅳ,H-Y Scale,VAS as well as five sub-items of BPI including daily living,working,sleeping,walking ability and social communication [(13.7±5.3) vs.(12.3±6.3),(27.3±12.9)vs.(23.3±9.6),(2.3±2.2)vs.(1.7±1.3),(2.4± 1.0)vs.(2.1±0.9),(63.3±25.6)vs.(56.6±25.0),(5.3±2.7)vs.(4.6±2.7),(5.9±3.2)vs.(5.1±2.8),(6.3±2.5)vs.(5.6±2.6),(4.7±3.1)vs.(3.8±2.0),(3.2±2.1)vs.(2.6±2.5),t=1.976,2.539,2.287,2.381,2.050,2.021,1.997,2.165,2.420,2.134,respectively,all P＜0.05].No significant differences were found in SAS,SDS or other sub-items of BPI such as life pleasure and mood scores between the two groups (all P＞0.05).Compared with the young group,patients in the elderly group had a higher ratio of two or more pain types associated with PD[41.2％ (119/299)vs.23.4％ (18/77),x2=8.190,P＜0.05],but a lower ratio of pain-related treatment [29.76％ (86/299)vs.51.95％ (40/77),x2=13.260,P＜0.05].Conclusions Pain in elderlyPD patients is more severe,shows more diverse types,and significantly aftects the quality of life.Enhanced intervention is needed.
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Objective To explore the effect of occupational therapy on the cognitive function and P300 event-related potentials (ERPs) of patients with acute cerebral infraction.Methods Ninety-eight acute cerebral infarction patients with cognitive impairment were selected using the mini-mental state examination (MMSE).They were randomly divided into an observation group (n =49) who received occupational therapy plus routine rehabilitation treatment and a control group (n =49) who received only the routine rehabilitation treatment.Before and after 8 weeks of treatment,the patients' cognitive function and their ability in the activities of daily living(ADL) were evaluated using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel index (MBI),respectively.P300 ERPs were also detected.Results There was no significant difference between the two groups with regard to various scores before the treatment (P ＞ 0.05).After 8 weeks of treatment,the LOTCA and MBI scores and the latency and amplitude of ERPs were significantly better than those before treatment in both groups (P ＜ 0.05).In the observation group,the scores of LOTCA (99.4 ± 8.4),MBI (80.7 ± 5.9) and the latency and amplitude of ERPs [(373.45 ± 52.13) ms and (5.87 ± 2.63) μV,respectively] were significantly better than those in the control group(P ＜ 0.05).Conclusion Occupational therapy program based on conventional rehabilitation training can promote the ADL ability and cognitive function of patients with acute cerebral infraction.It is worth applying in clinical practice.
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Objective To explore the effects of leukoaraiosis on cognitive function in elderly patients after acute cerebral infarction.Methods From May 2010 to August 2011,a total of 147 elderly patients with acute cerebral infarction were enrolled,including 96 patients with leukoaraiosis and 51 patients without leukoaraiosis.The Montreal Cognitive Assessment (MOCA) and the correlative factors of cognitive function were assessed in all patients.Results There was no statistical difference in general information between patients with and without leukoaraiosis.There were significant differences in the MoCA scores between patients with and without leukoaraiosis (x2 =19.15,P＜0.01),as well as between the vital and non-vital positions of cerebral infarction (x2=21.41,P＜0.01).The Logistic regression analysis showed that the vital position of infarction and leukoaraiosis were related to the cognitive impairment (OR=12.27,6.60,both P＜0.01),while the area of infarction and the type of cerebral infarction in Oxford County Community Stroke Project (OCSP) had no effects on cognitive impairment.Pearson correlation analysis showed that there was a positive relationship between the degree of white matter lesions and the decline in cognitive function (r=-0.87,P＜0.01).Conclusions The position of acute cerebral infarction and leukoaraiosis are independent risk factors for cognitive function after acute cerebral infarction,and the former plays a more important role than does the latter.
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Objective To explore whether ischemic tolerance exists in patients of cerebral infarction following transient ischemic attacks (TIA). Methods Thirty-eight patients with cerebral infarction following TIA(with TIA group) and 98 patients with cerebral infarction without TIA (without TIA group)were studied. The positive expression rate of CD62P in platelet and the size of cerebral infarction on admission was measured. The scores of activities of daily living were evaluated on admission and after a month. Results The positive expression rate of CD62P in platelet was lower in with TIA group than that in without TIA group [ (4.21 ± 0.43 )% vs (6.01 ± 0.03)%,P< 0.05 ]. The area of cerebral infarction and the scores of activities of daily living were lower in with TIA group than those in without TIA group(P< 0.05 ). Conclusion Cerebral infarction following TIA has ischemic tolerance.
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@#Objective To observe the effect combination of acupuncture and rehabilitation therapy early on motor function of patients with acute cerebral infarct.Methods 85 patients with acute cerebral infarct were randomly divided into treatment group (43 cases) and control group(42 cases).The all patients were treated by conventional medicine and rehabilition early. The cases of treatment group were treated by combination of acupuncture therapy simultaneously, All patients were evaluated before and after treatment respectively.Results The scores of Fugl-Meyer Assessment(FMA), Modified Barthel Index (MBI) and European Stroke Scale (ESS) of the patients in the treatment group and the control group were better than before treatment（P<0.05）, the effect of the patients in the treatment group were superior to the control group（P<0.05）. Conclusion Early rehabilitation combined with acupuncture therapy can improve motor function of patients with acute cerebral infarct.
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The aim of our study was to investigate the effectof mannitol on treatment of brain edema.Focal ischemic brain edema model was established by left middle cerebral artery occlusion(LMCAO) .The ratswere divided into 1 1 group.Each ratwasintravenously injected with2 0 % mannitol(0 .5 g/ kg within1 0 minutes) .The dose of mannitol was differ- ent.One dose of mannitol at1 2 h,1 6 h,2 0 h,2 4h after L MCAO,three doses,five doses,seven doses of mannitol at 2 4h after L MCAO.Again respective control animals were 1 2 h,1 6 h, 2 0 h,2 4h after L MCAO.Brain water content(BWC) ,morphological changes and ischemic size were used to evaluate the brain edema.The result showed that the BWC reduced in damaged brain atone dose,three doses,five doses of mannitol,(P