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Objective:To explore the clinical effect of Bobath manipulation combined with traditional Chinese medicine fumigation and intradermal acupuncture on shoulder hand syndrome(SHS) after stroke.Methods:From April 2017 to August 2019, 80 patients with SHS after stroke admitted to the People's Hospital of Deqing County were selected, and they were divided into control group and observation group according to the random digital table method, with 40 cases in each group.The control group was treated by Bobath therapy, and the observation group was treated by Bobath therapy combined with acupuncture(intradermal acupuncture) and traditional Chinese medicine fumigation.After 8 weeks of treatment, the ROM scale, FMA scale, BI scale and VAS scores were used to evaluate the improvement in the mobility of the shoulder and wrist joints, motor function of the upper limbs, quality of life and pain, and the clinical efficacy of the two groups was compared.Results:Compared with before treatment, the ROM scale score of all dimensions of shoulder and wrist mobility, FMA scale score and BI scale score of all patients after treatment increased significantly, and the VAS score decreased significantly, the differences were statistically significant(all P<0.05). Compared with the control group after treatment, the improvement of the indicators mentioned above of the observation group were better[shoulder joint flexion ROM score: (154.83±25.63)points vs.(133.82±22.03)points; shoulder joint abduction ROM score: (152.36±25.68)points vs.(133.35±19.96 )points; shoulder joint external rotation ROM score: (75.87±14.69)points vs.(60.82±16.57 )points; wrist joint palm flexion ROM score: (73.94±14.37)points vs.(57.37±9.47)points; wrist joint back extension ROM score: (60.83±7.61)points vs.(42.27±6.37 )points; FMA scale score: (45.74±6.82)points vs.(34.19±4.07)points; BI scale score: (70.36±12.09)points vs.(58.70±12.53)points; VAS score: (1.05±0.49)points vs.(3.37±1.14)points, t=3.703, 3.715, 3.257, 5.576, 7.964, 3.037, 8.746, 3.153, all P<0.05]. The total effective rate of the observation group was significantly higher than that of the control group[97.5%(39/40) vs.62.5%(25/40), χ 2=15.313, P<0.05)]. Conclusion:The combination of Bobath therapy with traditional Chinese medicine fumigation and intradermal acupuncture can improve the pain degree, joint mobility disorder, upper limb motor function and quality of life of SHS patients, the efficacy is better than single Bobath therapy.The clinical effect is accurate, and it is worthy of further promotion and application.
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Objective To understand the loneliness of elderly people,and to analyze the correlation between frailty,family social support and loneliness.Methods The elderly people aged 75 and over from 10 community health service centers in Tangshan were selected and evaluated with the CFAI comprehensive e-valuation tool and the loneliness scale.Results The frailty rate was 100% in 3 448 elderly people.The score of the frailty of elderly was(47.27±0.77),and the degree of frailty was increased with the increase of age. The social support level of general and below accounted for 95.92%.The total average score of social support for the elderly was(32.72±6.21);and the medium or above loneliness accounted for 68.94%.The total aver-age score of loneliness in the elderly was(40.24± 10.23).The most needed caregiver was the children and their daughters. Multivariate analysis showed that the degree of education,the degree of frailty,family support (the relationship with children,with the children who do not support the elderly,communicating with chil-dren,taking the views of the elderly,importance of being at home and the visiting frequency of the children), community support(received the services provided by the neighborhood committee,often keep up with rela-tives and friends,the frequency of neighborhood interaction,have received community psychological counse-ling and have received volunteer service)and social support entered the regression equation.The regression coefficient were -0.084,1.167,1.016,1.212,0.914,1.029,1.025,1.264,1.400,0.889,1.053,1.307,1.466, 1.332,-0.405,respectively.Conclusion Frailty,family function and community social support are important factors of loneliness among the elderly.The support system construction should be strengthened to reduce the loneliness of the elderly,and improve the quality of life.
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Objective To observe the intervention effect of Forbrain speech auditory feedback training on cognitive dysfunction in patients with stroke.methods 120 patients with cognitive dysfunction after stroke were divided into experimental group 1(n=40),experimental group 2 (n=40)and control group(n=40).The control group accepted conventional rehabilitation,while the experimental group 1 received Forbrain speech auditory feedback training additionally,and the experimental group 2 received the non-standard Forbrain speech auditory feedback training additionally.All the cases were assessed with Montreal cognitive assessment scale (MoCA)before and 10 weeks after intervention.Result sAfter 10-week intervention,the scores of structure skills(2.05±0.50),attention and concentration(2.15±0.36),memory(2.18±0.59) and the total score of MoCA(17.53±2.41) in experimental group 1 were higher than those in experimental group 2 (1.80±0.46,1.90±0.44,1.90±0.55,17.53±2.41) and control group(1.78±0.53),1.85±0.36,1.70±0.56,17.18±2.37) (all P<0.05).The Scores of language in experimental group 1(2.03±0.48)and experimental group 2(1.85±0.53) were higher than those in control group(1.70±0.46) (all P<0.05).Conclusion Forbrain speech auditory feedback training can improve cognitive function of patients with stroke.
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Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.
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Objective To investigate the efficacy of BrainHQ visual training in rehabilitating memory function among stroke survivors.Methods Sixty stroke patients with memory disorders were recruited from the rehabilitation center of Tangshan Workers' Hospital.They were randomly assigned to a control group or an intervention group,each of 30.Both groups accepted conventional rehabilitation,while the intervention group was additionally given BrainHQ visual training five times a week for 30 minutes,lasting four weeks.Before and after the treatment,both groups completed the Rivermead behavioral memory test.Results After the 4 weeks of treatment,the average scores in recalling full names,recalling hidden items,recalling appointments,recognizing pictures,recognizing faces,recalling a story immediately,delayed story recall,recalling a route promptly,delayed route recall and the average total score in both groups were all significantly higher than before the treatment.The treatment group scored significantly better than the control group except in recalling hidden items,and recognizing faces and pictures.Conclusion BrainHQ visual training can improve the memory of stroke survivors.
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Objective To observe the intervention effect of BrainHQ visual training on depressive symptom in patients with post stroke depression.Methods Eighty patients with post stroke depression were divided into control group(n=40)and intervention group(n=40).The control group accepted routine drug therapy and conventional rehabilitation, while intervention group received BrainHQ visual training additionally.They were assessed with Hamilton depression scale(HAMD) before and 4 weeks after intervention.Results Before intervention the HAMD score between control group and intervention group(respectively(19.80±3.96), (18.43±2.94)) had no statistical difference (P＞0.05).After 4-week intervention, the HAMD score of intervention group(9.58±5.42) was significantly lower than that of control group (13.85±5.73)(P＜0.01).Before the intervention, depression level of two groups had no difference(P＞0.05).After 4-week intervention,the difference of depression level was statistically significant in two groups(P＜0.05).Conclusion BrainHQ visual training can improve depressive symptom in patients with post stroke depression.
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@#Objective To develop the Chinese version of mini-Balance Evaluation Systems Test (mini-BESTest) and evaluate its reliability. Methods Chinese version of mini-BESTest was developed following the process of translation, reverse translation, cultural adaptation and pre-experiment. 61 Chinese patients with stroke were tested with it by 2 testers, and 30 patients in them were tested again in 48 h. The inter-class coefficient (ICC) of testers and test-retest, and the Cronbach's α among the total score and 4 factors scores were calculated. Results The ICC of testers of 4 factors were 0.856- 0.978 (P<0.01), ICC of test- retest were 0.795- 0.951 (P<0.01). The Cronbach's α were 0.794-0.905 (P<0.01). Conclusion The Chinese version of mini-BEStest is reliable for patients with stroke.
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@#Objective To explore the relationship between the cardiovascular health behavior and health factor and the executive function in newly acute cerebral infarction patients. Methods Wisconsin Card Sorting Test (WCST) and Clock Drawing Task (CDT) were used to evaluate the executive function of 1440 patients with newly acute cerebral infarction, with 240 cases in each subgroup respectively in 0-1,2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factor. The impact of ideal cardiovascular health behaviors and factors on the executive function was analyzed combined with the general clinical data. Results The incurrence rates of executive function impairment in cerebral infarction patient with 0-1, 2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factor were 90.8%,85%, 66.7%, 42.5%, 20.8%, 13.4% respectively; compared with the patients with 0-1 of cardiovascular health behavior and health factors,the scores of WCST significantly changed in the patients with 2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factor (P<0.05).There was no significant difference in gender and infarction location among 6 groups (P>0.05), but was in age, ducation degree,infarction size and complications (P<0.05). After adjusting the age, infarction size, infarction location and complications, multivariate logistic regression analysis showed that compared with the patients with 0-1 of cardiovascular health behavior and health factors, 2, 3, 4, 5, 6 component ideal cardiovascular health behavior and health factors were protective factors for the executive dysfunction of cerebral infarction patients, the OR were 0.686, 0.564, 0.369, 0.232, 0.116 respectively. Conclusion The cardiovascular health behavior and health factor protect the executive function in new acute cerebral infarction.
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Objective To develop the Chinese version of mini-Balance Evaluation Systems Test (mini-BESTest) and evaluate its reliabil-ity. Methods Chinese version of mini-BESTest was developed following the process of translation, reverse translation, cultural adaptation and pre-experiment. 61 Chinese patients with stroke were tested with it by 2 testers, and 30 patients in them were tested again in 48 h. The inter-class coefficient (ICC) of testers and test-retest, and the Cronbach'sαamong the total score and 4 factors scores were calculated. Re-sults The ICC of testers of 4 factors were 0.856-0.978 (P<0.01), ICC of test-retest were 0.795-0.951 (P<0.01). The Cronbach's α were 0.794-0.905 (P<0.01). Conclusion The Chinese version of mini-BEStest is reliable for patients with stroke.
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(DBI) in rats by observation on the changes of Homer 1a expression and apoptotic nerve cells . Methods Spraque-Dawlley(SD) rats were randomly ( random number ) divided into control group and severe DBI group .DBI rat model was established according to the de-scription of Marmarou′s diffused brain injury .No injury was done on control group .The changes of neuron pathology were observed by light microscopy and electron microscope .The expression of Homer1a was observed by immunohistochemistry and western blot .The quan-tity of apoptotic cells was measured by terminal deoxynucleotidyl transfernase medicated nick end labeling ( TUNEL) method. Results The death rate of rats in severe DBI group was 49.3%.Compared with the control group , the ultrastructures in hippocampal neurons in-cluding organelle , axonal and capillary were damaged seriously after injury , the survival rate of nerve cells decreased significantly at 1 h after injury ([99.4 ±0.6]%vs [94.4 ±5.6]%, P<0.05), and peaked at 72 h ([99.2 ±0.8]%vs [54.7 ±33.8]%, P<0 .05) in DBI group.The expression of Homer1a protein increased significantly at 1 h after injury(0 .136 ±0.024 )and peaked at6 h(0.178 ± 0.028) and maintained to 24 h (0.176 ±0.027), while decreased at 48 h (0.145 ±0.02)and 72 h (0.117 ±0.012) in DBI group;the expression of Homer 1a was obviously higher at each time point in DBI group than that in control group (P <0.05).The apoptoticindex of TUNEL positive cells increased at 6 h and demonstrated significant difference at 72h in comparison to control group ([41.78 ±3 .96]%vs [1.92 ±0.22]%, P<0.05).The correlation analysis indicated that Homer1a expression from 1~24 h and 24 h~72 h was related to the survival rate of nerve cells ( r=-0.726, P<0.05; r=0.842, P<0.05) and the quantity of TUNE positive cells(r=0.738, P<0.0;5 r=-0.898, P<0.05). Conclusion The dynamic expression of Homer1a in hippocampus after severe DBI can reflect nerve cell loss.
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Objective To explore the effects of SB203580(a MAPK inhibitor) on the expression of Homer1a in hippocampus and learning-memory after diffuse brain injury in rats.Method Male Sprague-Dawlley rats were divided randomly into three groups:control group,diffuse brain injury(DBI) group and DBI+ SB203580 group (peritoneal injection,0.01 μg/kg).Morphological changes of neuronal cells were observed by electron microscope and the expression of Homer1a and phosphorylated p38MAPK was detected by immunohistochemistry and learning and memory functions were performed with Morris water maze (MWM).Results Compared with control group,ultrastructure of neuronal cells and synapses were significantly.The levels of phosphorylated p38MAPK(76.98±16.64,2.28±0.40,P＜0.05) and Homer1a (62.96± 12.74,1.28±0.10,P＜0.05)respectively were increased after injury impaired.MWM test showed that the escaping latency was prolonged((74.64± 8.96)s,(24.96±4.98)s,P＜0.05) and the frequency of crossing the platform was decreased(4.48± 1.12,12.65±2.36,P＜0.05).Compared with the model group,SB203580 decreased ultrastructure impariment in neuronal cells and synapses and decreased phosphorylated p38MAPK expression(54.82± 12.48,76.98± 16.64,P＜0.05) and increased Homer1a expression(54.82 ±12.48,76.98± 16.64,P＜0.05).MWM test showed that the escaping latency was shorten ((46.72±6.58) s,(74.64± 8.96) s,P＜0.05),and the frequency of crossing the platform was increased (7.56± 1.20,4.48± 1.12,P＜0.05).Conclusion SB203580 improves the learning-memory recovery after DBI,which is related to inhibition of p38MAPK activation and increasing Homer1a expression.
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Objective To investigate the effects of inhibitors U0126 on expression of ERK1/2 and Ku70 in the hippocampus in diabetic rat after global cerebral ischemia and reperfusion.Methods The global cerebral ischemia model of diabetic rat was made by streptozotocin-induction with four-vessel occlusion of modified Pulsinelli' s method.Adult male SD rats (n =80) were randomly (random number) divided into 4 groups (n =20 rats per group),namely sham operation (SO) group,normoglycemia ischemia/reperfusion (NI/R) group,diabetes cerebral ischemia (DCI) group and DCI + U0126 (0.01 mg/kg Ⅳ)group.The morphological changes of neuronal cells were observed by using HE staining 1 h,6 h,24 h and 48 h after I/R; and immunohistochemistry method was used to detect the levels of phosphorylated ERK1/2 and Ku70 protein.Statistical analysis of experimental data was carried out by using SPSS 17.0 software.Comparisons between groups were done by using factorial variance analysis,and difference was statistically significant at P ＜ 0.05.Results Compared with SO group,some neurons showed histopathologic changes of neuronal necrosis and apoptosis in NI/R group as well as the phosphorylated ERK1/2 levels increased at 1,6,24,48 h (P ＜ 0.05) ; The Ku70 levels increased at 1,6 h (P ＜ 0.05) and were lower at 24 h,48 h (P ＜ 0.05) ; Compared with the NI/R group,the histopathological changes of brain tissue was more severe in DCI group,and the phosphorylated ERK1/2 levels were lower at 1,6,24,48 h (P ＜ 0.05) ;The Ku70 protein levels were lower at 1,6,24,48 h in DCI group (P ＜ 0.05) ; Compared with DCI group,the histopathological changes of neuronal necrosis and apoptosis was more severe in DCI + U0126 group; and the phosphorylated ERK1/2 expressions respectively decreased at 1,6,24,48 h (P ＜0.05) ;and the Ku70 protein levels were lower at 1,6,24,48 h (P ＜ 0.05).Conclusions U0126 enhanced the damage of nerve cells by inhibiting the activation of ERK1/2,thereby reducing the level of Ku70 protein in brain hippocampus of diabetic rats after global cerebral ischemia.
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<p><b>OBJECTIVE</b>To observe the changes in the expression of glucose-regulated protein 78 (GRP78) in the hippocampus of normal rats and spontaneously hypertensive rats with cerebral ischemia/reperfusion (IR) and explore the possible role of GRP78 in global cerebral IR injury aggravated by hypertension.</p><p><b>METHODS</b>Sixty male Wistar-Kyoto (WKY) rats were randomly divided into sham operation group and global cerebral ischemia-reperfusion group(I/R) and a Another 30 male rats with spontaneous hypertension served as hypertensive cerebral ischemia and reperfusion (SHR+I/R) group. Global cerebral ischemia model was established in rats using a modified four-vessel occlusion method. The morphological changes of the neurons in the hippocampal region were observed using HE staining, and GRP78 expression was detected using immunohistochemistry and Western blotting. The behavioral changes of the rats were examined using the Eight-arm Maze.</p><p><b>RESULTS</b>Compared with the rats with sham operation, the rats in I/R group showed a decreased density of surviving neurons in the hippocampus and an increased expression of GRP78, which reached the peak level at 24 h. Compared with that in I/R group, the density of surviving neurons decreased obviously at each time point in SHR+IR group, and GRP78 expression significantly increased at 6 h, followed then by progressive reduction at 24 and 48 h. The rats in SHR+IR group and I/R group showed no significant difference in behavior changes.</p><p><b>CONCLUSION</b>Hypertension can aggravate global cerebral IR injury by decreasing GRP78 expression and increasing the loss of nerve cells.</p>
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Animals , Male , Rats , Brain Ischemia , Metabolism , Heat-Shock Proteins , Metabolism , Hypertension , Metabolism , Neurons , Metabolism , Rats, Inbred SHR , Rats, Inbred WKY , Reperfusion Injury , MetabolismABSTRACT
Objective To investigate the effects of Edaravone (Ed) on p38mitogen-activated protein kinases/Caspase-3 (p38MAPK/Caspase-3) pathway following the diffuse injury of brain (DIB) in rats, as well as the protective effects of Edaravone on traumatic injury of brain (TIB). Method The TIB models were established by using Marmarou's method in adult male Spraque-Dawlley rats. A total of 250 rats were divided (random number)9nto control group, model group, low-dose Edaravone treatment group and high-dose Edaravone treatment group.The rats were sacrificed separately 1, 6, 24, 48 and 72 hours after DIB and the brain tissues of rats were taken.The morphological changes of neuron in hippocampus region were observed by using Nissl staining. The levels of phosphorylated p38MAPK and Caspase-3 were detected by using immunohistochemistry and Western blot. The learning and memory functions were determined with Morris water maze test from the 3rd to 7th day after injury.Results Compared with control group, some neurons displayed histopathological changes of necrosis and apoptosis in rats of model group. The levels of phosphorylated p38MAPK significantly increased in 1, 6, 24, and 48 hours after injury in rats of model group ( P ＜ 0.05), but there was no statistic significance in increase 72 hours later ( P＞ 0.05). The levels of Caspase-3 significantly increased in 6, 24, 48 and 72 hours after injury in rats of model group ( P ＜ 0.05), but there was no significant difference in increase in one hour after injury (0.59±0.29 vs.0.40±0.17, P ＞0.05).In the Morris water maze test from the 3rd to 6th day, the latency to find the platform significantly prolonged in rats of model group ( P ＜ 0.05), and the numbers of passing the platform by rats decreased on the 7th day (2.28 ± 1.18 vs. 8.20 ± 1.52, P ＜ 0.05). Compared with model group, the levels of phosphorylated p38MAPK in 6, 24 and 48 hours after injury in low-dose Edaravone group were lower (P ＜0.05), but there was no statistical difference in one hour after injury ( P ＞ 0.05). The levels of Caspase-3 in 6,24, 48 and 72 hours after injury in rats of low-dose Edaravone group were lower than those of model group ( P ＜0.05). The latency to find the platform significantly shortened ( P ＜ 0.05) and the numbers of passing the platform by rats increased (4.17 ± 1.15 vs. 2.28 ± 1.18, P ＜ 0.05) in low-dose Edaravone group. The above variables changed more prominently in high-dose Edaravone group. Conclusions Edaravone attenuates p38MAPK pathway activation, lowers the level of Caspase-3 following DIB and protects the rats against the traumatic injury of brain.
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Objective To study the utility of sleep intervention combined with memory training for alleviating dysmnesia in the elderly and provide a basis for improving memory function. Methods A total of 647 community-dwelling elderly people were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Rivermead behavioral memory test ( RBMT). One hundred and fifty elderly persons with sleep disorders and dysmnesia were divided into three groups; the control group, the memory intervention group, and the sleep plus memory training group. Sleep quality and dysmnesia were evaluated again after 3 months of intervention. Results Among the 647 elderly people, the incidence of sleep disorders was 38. 8% , and of dysmnesia was 78. 4%. Dysmnesia was significantly more prevalent among subjects who also had sleep disorders. After three months of intervention, instant recall scores had declined in the control group while scores on 7 kinds of memory function had improved significantly in the memory intervention group. Scores on 10 measures of memory and sleep quality improved in the sleep plus memory intervention group. Compared to the control group, scores on 9 kinds of memory improved significantly in the memory intervention group and scores on 11 kinds of memory improved in the sleep plus memory intervention group. Compared to the memory intervention group, scores on 5 kinds of memory had improved significantly in the sleep plus memory intervention group. Conclusions The occurrence of dysmnesia in elderly people is influenced by sleep quality. Memory training can improve their memory function, but sleep intervention combined with memory training is even more effective.