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ObjectiveTo explore the correlation of index of standing balance tester to score of Berg Balance Scale (BBS) and Fugl-Meyer Assment-Lower Extremites (FMA-LE) in stroke patients with hemiplegia, and analyze the predictive effect to BBS. MethodsFrom March to October, 2022, 66 stroke hemiplegic patients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected. The elliptical area and length of motion were measured with a balance tester when they were standing with eyes open or closed, respectively. They were also evaluated with BBS and FMA-LE. The correlation between the test results and the scores of BBS and FMA-LE was analyzed with Pearson's correlation analysis, and the predictive effect of the test results to the score of BBS was also analyzed with receiver operating characteristic (ROC) curve. ResultsHypertension, diabetes, coronary heart disease, smoking and alcohol drinking were not significant for the scores of BBS and FMA-LE (|t| < 1.124, P > 0.05). In the balance test, the eye opening movement ellipse area, eye opening movement length, eye closing movement ellipse area and eye closing movement length were negatively correlated with the scores of BBS and FMA-LE (|r| > 0.250, P < 0.05). The area under the ROC curve of eye opening movement ellipse area to the score of BBS was 0.685 (P = 0.019), and the area under the ROC curve of the eye opening movement length to the score of BBS was 0.764 (P < 0.001). ConclusionThe open eye movement ellipse area, open eye movement length, closed eye movement ellipse area and closed eye movement length are significantly negatively correlated with the scores of BBS and FMA-UE. The indexes of the balance test with eyes open may predict the score of BBS.
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ObjectiveTo understand the current research status, research hotspots and development trends of constraint-induced movement therapy (CIMT) in the field of rehabilitation. MethodsThe relevant articles of CIMT in rehabilitation from January, 2000 to October, 2022 in CNKI and Web of Science were retrieved. The authors, institutions, countries, keywords and burst words were extracted with CiteSpace 6.1.R3 to draw knowledge mapping. ResultsA total of 1 165 articles were included, 359 articles in Chinese and 806 in English. The trend of annual publications was generally consistent, and after a period of rapid growth, the current annual publications showed a fluctuating trend. There was more cooperation among the institutions in English articles, with geographical limitation. The institutions in Chinese articles had the problem of insufficient cooperation. The researches mainly focused on the application of CIMT in different diseases, the improvement of motor function by CIMT, the application of CIMT in combination with other therapies, and the study of the related mechanisms of CIMT. In recent years, Chinese burst keywords included modified constraint-induced movement therapy, stroke hemiparesis, clinical efficacy and repetitive transcranial magnetic stimulation; English burst keywords included transcranial direct current stimulation, non-invasive brain stimulation, and unilateral cerebral palsy. ConclusionResearch on CIMT in the field of rehabilitation is in a period of steady development, and CIMT combined with non-invasive brain stimulation is likely to be a hotspot in future research.
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Objective:To explore the effect of combining inspiratory muscle training with diaphragm resistance training on the respiratory, motor and balance functioning of stroke survivors.Methods:Eighty-eight stroke survivors were randomly divided into a respiratory muscle training group and a control group, each of 44. Both groups received routine rehabilitation, but the respiratory muscle training group also received daily inspiratory muscle and diaphragm resistance training, five days a week for 4 weeks. The respiratory muscle strength, motor function and balance of the two groups were evaluated using the inspiratory muscle strength index, the Fugl-Meyer assessment scale and the Berg balance scale before and after the treatment.Results:After the treatment, the average inspiratory muscle strength index of the respiratory muscle training group was 61.80%, its average Fugl-Meyer score was 75 and its average Berg balance score was 38. All were significantly better than before the treatment and better than the control group′s averages at the same time point. Spearman correlation analysis found significant correlation among the three measurements.Conclusions:Combining inspiratory muscle training with diaphragm resistance training can significantly improve the inspiratory muscle strength of stroke survivors, and promote the recovery of their motor and balance functions.
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Objective:To explore the factors influencing the pulmonary function of persons with mild to moderate adolescent idiopathic scoliosis (AIS).Methods:Forty-four persons with AIS were tested for their pulmonary ventilation functioning. The indicators were the percentage of forced vital capacity (FVC%), the percentage of forced expiratory volume in the first second (FEV1%) and the percentage of maximum chase volume (MVV%). Data including age, gender, course of disease, dancing habits, exercise habits, body mass index (BMI), Cobb angle, rotation angle, diaphragm thickness, and diaphragm excursion (DE) were also collected. Linear regressions were evaluated to analyze the factors best predicting pulmonary functioning. Spearman correlation coefficients were computed to quantify the correlation between respiratory muscle functioning and pulmonary functioning.Results:The univariate analysis showed that dancing and DE independently influence FVC%, FEV1%, and MVV%. DE was the only independent factor significantly predicting pulmonary functioning for mild to moderate AIS patients. DE was also significantly positively correlated with average FVC%, FEV1% and MVV%.Conclusions:Respiratory training aimed at enhancing DE is necessary to improve the pulmonary ventilation of persons with AIS.
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Objective:To analyze the respiratory muscle functioning of stroke survivors and explore factors influencing it so as to provide references for clinical rehabilitation intervention.Methods:A total of 139 stroke survivors were randomly divided into a respiratory muscle dysfunction group and a control group based on the actual strength of their inspiratory muscles divided by the predicted strength. Beyond typical clinical data, information was collected about the subjects′ exercise habits. Balance ability was evaluated using the Fugl-Meyer assessment scale (FMA) and the simplified Berg Balance Scale (BBS). Multivariate logistic regression was used to analyze the factors influencing respiratory muscle dysfunction.Results:Among the 139 patients, 81 (58.27%) had respiratory muscle dysfunction. Univariate analysis showed that patients with stroke in the brainstem and dysphagia and those with poor FMA and BBS scores were at significantly greater risk of respiratory muscle dysfunction. Logistic regression analysis showed that dysphagia, FMA and BBS scores were factors independently predicting respiratory muscle dysfunction among stroke survivors, with dysphagia as a risk factor, and high FMA and BBS scores as protective factors.Conclusion:Some stroke survivors may have respiratory muscle dysfunction, and dysphagia is a risk factor, while the high FMA and BBS scores are protective.
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OBJECTIVE：To study the protective effect of tadehaginoside（TA）on liver fibrosis model mice induced by carbon tetrachloride（CCl4），and to investigate its mechanism. METHODS ：Kunming mice were randomly divided into normal group ， model group ，colchicines group （positive control ，0.2 mg/kg），TA low-dose ，medium-dose and high-dose groups （3，6，12 mg/kg），with 10 mice in each group. Those groups were intraperitoneally injected with 10％ CCl4-olive oil solution （5 mL/kg）to induce liver fibrosis model twice a week ，for consecutive 8 weeks；except that ，the normal group was intraperitoneally injected with olive oil. From 3rd week ，the mice in each administration groups were given relevant medicine intragastrically ，normal group and model group were given constant volume 2％ sodium carboxymethylcellulose solution intragastrically ，once a day ，for consecutive 6 weeks. The contents of ALT ，AST，HA and IL- 6 in serum of mice were test ed by ELISA. The contents of Hyp ， SOD，MDA and GSH-Px in liver tissues were detected by spectrophotometry. mRNA expression of Col- Ⅰ，TIMP-1 and TIMP-2 in liver tissue was detected by RT-PCR. The protein expression of MMP- 2 and TGF-β1 in liver tissue was detected by Western blotting. RESULTS ： Compared with normal group，the contents of ALT，AST，HA，IL-6，MDA and Hyp，the mRNA expression of Col- Ⅰ，TIMP-1 and TIMP- 2，as well as the protein exp ression of MMP- 2 and TGF-β1 were increased significantly ，while the contents of SOD and GSH-Px were decreased significantly （P＜0.01）. Compared with model group，the contents of ALT ，AST，HA，IL-6，MDA and Hyp ，the mRNA expression of Col- Ⅰ，TIMP-1 and TIMP- 2，as well as the protein expression of MMP- 2 and TGF-β1were decreased significantly ，while the contents of SOD and GSH-Px were increased significantly（P＜0.05 or P＜0.01）. CONCLUSIONS ：TA has a significant protective effect on liver tissue and anti-fibrosis effects in liver fibrosis model mice ，the mechanism of which may be associated with inhibiting lipid peroxidation and collagen synthesis ， down-regulating the mRNA expression of Col- Ⅰ，TIMP-1 and TIMP- 2 as well as the protein expression of MMP- 2 and TGF-β1.
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Objective: To study the anti-gout effect of active ingredients in Poecilobdella manillensis. Methods: Hypoxanthine was used to replicate mouse model of hyperuricemia, and xylene was used to induce mouse auricle swelling model. The hot plate method and writhing method were used to screen the active site of Poecilobdella manillensis, and then the active ingredients were screened. The material basis of anti-gout effect of Poecilobdella manillensis was observed. Results: The water-soluble fraction of Poecilobdella manillensis was the active site against gout, which could reduce the level of serum uric acid in hypoxanthine-induced hyperuricemic mice and inhibit xylene-induced auricular swelling in mice, deduce acetic acid-induced writhing reaction in mice and increase the hot plate pain threshold in mice; Hirudin was the main active ingredient in water-soluble parts. Poecilobdella manillensis active ingredient 0.8 g/kg and 0.4 g/kg and Poecilobdella manillensis residue 2.0 g/kg could significantly reduce serum uric acid levels. The serum uric acid levels decreased from232.73 ± 50.93 umol/L in model group to 140.70 ± 25.97 umol/L, 149.07 ± 39.28 umol/L, 176.45 ± 44.33 umol/L, respectively (P ＜ 0.01) . Poecilobdella manillensis active ingredients 0.8 g/kg, 0.4 g/kg and 0.2 g/kg and Poecilobdella manillensis residue 2.0 g/kg could significantly inhibit xylene-induced ear auricle swelling in mice. The swelling degree was inhibited from 22.80 ± 2.86 mg to 20.10 ± 2.18 mg, 19.80 ± 2.57 mg, 20.10 ± 1.66 mg and 20.85 ± 1.60 mg respectively (P ＜ 0.05) . Poecilobdella manillensis 0.8 g/kg active ingredient could significantly reduce the number of writhing mice caused by acetic acid. The number of times was reduced from 22.80 ± 2.86 times to 20.10 ± 2.18 times (P ＜0.05) . Conclusion: Poecilobdella manillensis anti-gout activity is in water-soluble parts, and Hirudin is the main active ingredient.
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Objective To observe the clinical efficacy of three-dimensional rapid traction combined with sacral hiatus epidural blocking for the treatment of lumbar disc herniation(LDH). Methods A totsl of 450 patients with LDH were divided into three groups.Group A received conventional slow traction,group B received three-dimensional rapid traction,and group C received sacral hiatus injections for epidural blocking combined with three-dimensional rapid traction.The Japanese Orthopadedic Association(JOA)scale for lumbar disease and a visual analogue scale(VAS)were used to evaluate the treatment effect and the patients'subsequent quality of life.All of the patients were followed up for 1 year and evaluated using standard clinical evaluations. Results The average VAS scores and JOA scores of the three groups were not significantly different before treatment,and all had significantly improved after treatment.The overall effectiveness rates were 63.33% for group A,90.67%for group B and 94% for group C,and these differences were all statistically significant.After one year the recurrence rates in the A,B and C groups were 20.7%,14.0%and 8.7% respectively,and these differences were again statistically significant.Conclusion Sacral hiatus epidural blocking combined with three-dimensional rapid traction showed good therapeutic effect and safety for LDH patients and was superior to simple rapid traction or slow traction.
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Our objective is to prevent doctors and nurses who worked on SARS ward from contracting this highly communicable disease through observing strict isolation strategies. The following measures have been taken in our hospitals. The wards for SARS patients were remodeled according to the isolation requirements for infectious diseases. They were separated into three quarters, namely clean area, semi-contamination area and contamination area. Two buffer zones were set up to separate the three quarters. Four specific passages were separately allotted to health care staffs, patients, soiled materials disposal and handling and dispatch of specimens, to avoid cross infection by contact. According to the criteria for isolation of serial A respiratory infectious diseases, every health care worker was strictly requested to wear and take off isolation garments properly when they entered and left the ward. Most importantly, specific garbs for different areas were essential for efficient isolation. Respiratory tract, skin and mucous surfaces should be effectively protected on the ward. In addition, doctors and nurses should wear special masks or helmets and waterproof suit during the performance of intubation, CPR or operation. Direction of air flow in SARS ward was diverted away from the clean area by using ventilator in order to prevent air-borne contamination. The air outlet of SARS ward was efficiently filtered to cut down pollution of the environment. Living quarters of medical staff working on SARS ward were isolated with a safe distance from the ward. Their health condition was closely monitored daily. After working in SARS ward for four weeks, they should enjoy a special vacation to assure their good health condition. In the past spring, 882 SARS patients were admitted to both the 309 hospital and Xiao Tanghan hospital. 1 632 health care workers worked for those SARS paitents by turns. To our satisfaction, none of our staffs was infected by SARS. Our experiences indicated that health care workers on the SARS ward could be effectively protected from contracting SARS infection by taking efficient and strictly observed protective measures.
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With the gradual deepening of the reform in the medical and health system, reform and innovation inside hospitals have come to carry increasingly great weight. In light of their hospital's practical experience and proceeding from factors that affect innovation, the process of innovation and the links of innovation, the authors put forward ways for hospital innovation and the principles that ought to be adhered to. They argue that in striving for innovation, hospitals should first of all give priority to the building of the contingents of department heads and young and middle aged key professional and technological members, set forth an advanced operating strategy and goal, highlight innovation through science and technology, and create a sound environment for innovation. On the basis of establishing an effective mechanism for innovation, hospitals ought to stick to the principles of humanistic management, close attention to the actual conditions and objective evaluation.