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Objective:To explore the effects of repetitive transcranial magnetic stimulation on balance function in stroke patients.Methods:A total of 238 patients randomized to a rTMS group and a control group by using the random number table at the ratio of 1∶1. Patients in the rTMS group were treated with low-frequency rTMS delivered to the contralateral M1 area, while those in the control group were treated with sham rTMS. The intervention was administered 5 times a week for 4 weeks. Both groups were also treated with conventional physical therapies in addition to rTMS. At one day before the intervention, two days and six weeks after the intervention, Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index were employed to evaluate the functional outcome of all the patients.Results:After intervention, the scores of Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index in both groups were significantly improved, and the rTMS group improved significantly more than control group ( P<0.05). When compare to the control group, the rTMS group improved to a significantly greater extent with regard to all the outcomes measures p after intervention and at follow-up ( P<0.05). Conclusion:rTMS is beneficial to the recovery of balance function in patients with stroke.
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Objective To study the effects of diterpene ginkgolides meglumine injection ( DGMI) on memory impairment, activation of microglia and astrocytes and inflammatory cytokines in aged mice. Methods Twenty aged mice (22 months old) were randomly divided into two groups:aged mouse group(n=10) and DGMI group(n=10). Another 10 mice (2 months old) were selected as young mouse control group. The mice in DGMI group were received 5 mg/kg DGMI per day by tail vain injection for 4 weeks. The mice in the other two groups were received the same amount normal saline for 4 weeks. The Morris water maze was used to evaluate the function of spacial learning and memory after administration of drugs. The ex-pression of CD11b,GFAP,IL-1β,IL-6,TNF-α and NFκB in mice brain hippocampus were detected by West-ern blot. Results (1) The escape latency time of aged mouse group was significantly longer than that of young mouse control group from the 2nd day to the 7th day(P<0. 01). The times of platform crossing,time and distance in target quadrant of aged mouse group were significantly shorter than those of young mouse group (all P<0. 01). Compared with aged mouse group,DGMI significantly reduced the escape latency time of DGMI group (P<0. 01). DGMI increased the times of platform crossing,time and distance in target quad-rant of aged mouse group (P<0. 01). (2) The expressions of CD11b,GFAP in young mouse control group, aged mouse group and DGMI group were as follows respectively:CD11b:(1. 036±0. 023),(1. 757±0. 046), (1. 214±0. 024);GFAP:(1. 022±0. 071),(1. 344±0. 021),(1. 086±0. 073). DGMI reduced the expres-sion of CD11b and GFAP in hippocampus compared with aged mouse group ( t=5. 556,P<0. 01;t=5. 484, P<0. 01). (3) The expressions of IL-1β,IL-6,TNF-α and NFκB in young mouse control group,aged mouse group and DGMI group were as follows respectively:IL-1β:( 1. 003 ± 0. 057),( 2. 062± 0. 105),( 1. 182± 0. 084);IL-6:(1. 018±0. 024),(1. 583± 0. 052),( 1. 152± 0. 031); TNF-α:( 1. 021± 0. 054),(1. 449± 0. 053),(1. 211±0. 036);p-NFκB:(1. 052±0. 034),(1. 782± 0. 113),( 1. 158± 0. 066). DGMI reduced the expression of p-NFκB(t=6. 547,P<0. 01) and pro-inflammatory cytokines including IL-1β(t=8. 513,P<0. 01),IL-6(t=3. 421,P<0. 01) and TNF-α( t=5. 562,P<0. 01) in hippocampus compared with aged mouse group. Conclusion DGMI can improve the ability of learning and memory in aged mice. The mecha-nism may be related with inhibiting activity of microgliosis,astrocytosis,NFκB and neuroinflammaton.
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Objective To study the clinical characteristics of Japanese encephalitis (JE) in 34 adult patients and to improve the level of diagnosis of this disease.Methods The clinical manifestations,laboratory results and radiological features of 34 adult patients with JE in our hospital from July 2017 to September 2017 were summarized and the progonsis was observed.The modified Rankin Scale (mRS) was used to evaluate the progonsis.Results Eighteen patients were males and 16 patients were females with the average age of (45.39 ± 16.34) years in 34 patients who were diagnosed as JE.The major clinical features of JE patients included fever (34,100％) with the average temperature of (39.4 ± 1.1) ℃ on admission,headache (26,76％),seizures (7,21％),decreased consciousness (25,74％) on day 2.6 ± 1.4 after the onset,respiratory failure (9,26％) on day 3.8 ± 1.6 after the onset.The major features of laboratory results included white blood cells increase (15,44％),blood hematocrit decrease (25,74％),eosinophil absolute value decrease (29,85％),cerebrospinal fluid pressure increase (12,35％),cerebrospinal fluid protein increase (27,79％),cerebrospinal fluid white blood cells increase (30,88％).Brain MRI scan of abnormal signal was found abnormal in up to 54％patients (14/26),involving the thalamus,basal ganglia,mesencephalon,temporal lobe,hippocampus and occipital lobe,especially in the area of bilateral thalamus and mesencephalon.The follow-up showed three cases were dead;mRS score was 0 in twenty-one cases,1 or 2 in five cases,3 or 4 in three cases,5 in two cases five-six months after onset;the sequelaes were cognitive impairment in nine patients and movement disorder in five patients.Conclusions The clinical symptoms of JE in adults are severe.The main clinical manifestations of JE are hyperthermia,disturbance of consciousness,seizures and respiratory failure,with characteristic imaging findings on brain MRI.JE is a disease with high mortality and severe long-term sequelae.
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Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)injection in the treatment of spasmodic torticollis.Methods Sixty-four patients with spasmodic torticollis underwent the treatment of intramuscular injection of BTX-A in neck muscles.As a result,the efficiency of BTX-A therapy could be evaluated successfully.Results Considerable improvement of symptoms for the spasmodic torticollis patients was observed with BTX-A treatment.The average dose of BTX-A was(120.37 ±25.26) U.Injection points were 30.00 ± 4.85.The Tsui scores before treatment were (13.08 ±4.16) scores,and 2 weeks after treatment were (4.21 ± 2.63) scores.The Tsui scores showed a significant reduction after BTX-A injections (P <0.01).After treatment complete remission rate was 25.0% (16/64),significant improvement rate was 60.9% (39/64),partial improvement rate was 12.5% (8/64),invalid rate was 1.6%(1/64) and efficient rate was 85.9% (55/64).Duration of effect was (16.86-4.57) weeks.Patients who received repeated injections also had good response,with symptoms improved and dosage of BTX-A reduced.No serious adverse events happened in treatments.Conclusion BTX-A therapy is simple and effective in the treatment of spasmodic torticollis and should be considered as the first-choice treatment for the condition.
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Objective To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis based on individual condition. Methods Twelve patients with intracranial venous sinus thrombosis were treated with endovascular management according to the severity and course of disease after they failed to respond to anticoagulant therapy. The clinical signs and symptoms,cerebrospinal fluid pressure and arteriovenous circulation time were observed and followed up (including MRV). Intravenous thrombolysis and mechanical thrombus maceration were carried out in all 12 patients,while intravenous thrombolysis, mechanical thrombus maceration in combination with intra-arterial thrombolysis were employed in 3. After the treatment, anticoagulant therapy was carried out for 6 months.The patients were followed up for 12 to 24 months. Results Of the twelve patients, clinical signs and symptoms included slight headache (2 cases), mild hemiplegia (1 case), ambiopia or blurred vision (3 cases). The cerebrospinal fluid pressure returned to under 26 cm H2O (1 cm H2O =0.098 kPa)following treatment from 28 to 38 cm H2O [ mean (32. 4 ±3.0) cm H2O] in preoperative measurement and the arteriovenous circulation time returned to below 10 s in all patients following treatment. Neither recurrence of thrombosis nor new symptoms of neurologic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation with the exception of a subcutaneous bleeding at the venopuncture site. Conclusion Endovascular treatment is effective and safe for patients with intracranial venous sinus thrombosis.
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@#Objective To investigate the protective effects of Naoxintong capsule on cerebral ischemia-reperfusion injury in rats.Methods 45 SD rats were randomly divided into 5 groups: sham operation group (n=5), ischemia-reperfusion group (n=10), small dose of Naoxintong capsule group (n=10), large dose of Naoxintong capsule group (n=10), CoQ-10 group (n=10). The the cerebral ischemia-reperfusion model was established by occluding bilateral carotid arteries of animal. The moisture content and activity of ATPase in brain tissue of model rat were observed respectively at ischemia 30 min plus reperfusion 30 min and ischemia 30 min plus reperfusion 60 min.Results The activities of Na+-K+-ATPase, Ca2+-ATPase and Mg2+-ATPase decreased (P<0.01), contents of water in brain tissues increased (P<0.01) in the ischemia-reperfusion group, compared with the sham operation group. The activities of Na+-K+-ATPase, Ca2+-ATPase and Mg2+-ATPase increased (P<0.01), contents of water in brain tissues decreased (P<0.01) in the Naoxintong capsule group, compared with the ischemia-reperfusion group.Conclusion Naoxintong capsule can protect the brain tissue from ischemia-reperfusion injury.