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ObjectiveTo investigate the effect of transcutaneous auricular vagus nerve stimulation (taVNS) combined with robot-assisted therapy on upper limb function of subacute stroke patients. MethodsFrom March, 2022 to March, 2023, 60 subacute stroke patients from Dushu Lake Hospital and the First People's Hospital of Kunshan were randomly divided into control group (n = 20), robot group (n = 20) and combined group (n = 20). All the groups received conventional treatments including medication, physical therapy and occupational therapy; the robot group received sham taVNS combined with hand robot-assisted therapy; while the combined group received taVNS combined with hand robot-assisted therapy, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and hand part, the root mean square (RMS) electromyography of the extensor carpi radialis and extensor digitorum muscles during contraction, and the latency and amplitude of transcranial magnetic stimulation motor-evoked potential (TMS-MEP) before and after treatment. ResultsAfter treatment, the scores of FMA-UE and hand part, RMS of the extensor carpi radialis and extensor digitorum muscles, and latency and amplitude of TMS-MEP improved in all the groups (t > 2.099, P < 0.05); and they were the best in all indicators in the combined group (F > 9.106, P < 0.001). ConclusiontaVNS combined with robot-assisted therapy can promote central nervous system remodeling and further improve upper limb function in stroke patients.
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ObjectiveTo investigate clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage (sICHr) after intravenous thrombolysis.MethodsThe acute ischemic stroke patients with sICHr after intravenous thrombolysis therapy were enrolled retrospectively.The clinical data were collected and the related literature was analyzed and summarized.ResultsA total of 6 acute ischemic stroke patients with sICHr were enrolled, including 4 males.Three patients had a history of using antiplatelet agents, 2 with atrial fibrillation, 4 with hypertension, 3 with previous stroke history, 4 with smoking history, and 4 had sICHr at 2 h after intravenous thrombolysis.Of the 14 hemorrhagic foci (except in the infarct areas), 10 were in the cerebral cortex.Three patients died within 1 week, and 1 was in a persistent vegetative state.Conclusions SICHr after intravenous thrombolysis in patients with acute ischemic stroke is mainly located in the cerebral cortex.The outcomes in acute ischemic stroke patients with SICHr after intravenous thrombolysis are poor, and the mortality is high.
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Objective To research the running status of dual-referral in a township of Dongguan city.Methods Hospitals and community health service centers in C town were selected as the research sites.The dual-referral system implementation situatidn in local area was understood by the questionnaire survey on the patients and medical personnel.Results About 44.4％ of patients understood the dual-referral system in local region.However,82.1％ of patients had no the dual-referral experience.The majority of doctors had the experience of upward referral patients and downward referral patients,but their number only accounted for below 10.0 ％ of diagnosis and treatment patients.When the proportion of community reimbursement increased by 20.0％,for the question of whether or not to go to the community first,57.6 ％ of patients expressed willingness,32.7 ％ of patients expressed unwillingness,and 9.7 ％ of patients expressed no influence on own willingness.Conclusion The understand degree of the patients in C township on dual-referral is in the low side.The links of upward transfer and downward transfer of dual referral are insufficient smooth.
ABSTRACT
Objective To research the running status of dual-referral in a township of Dongguan city.Methods Hospitals and community health service centers in C town were selected as the research sites.The dual-referral system implementation situatidn in local area was understood by the questionnaire survey on the patients and medical personnel.Results About 44.4％ of patients understood the dual-referral system in local region.However,82.1％ of patients had no the dual-referral experience.The majority of doctors had the experience of upward referral patients and downward referral patients,but their number only accounted for below 10.0 ％ of diagnosis and treatment patients.When the proportion of community reimbursement increased by 20.0％,for the question of whether or not to go to the community first,57.6 ％ of patients expressed willingness,32.7 ％ of patients expressed unwillingness,and 9.7 ％ of patients expressed no influence on own willingness.Conclusion The understand degree of the patients in C township on dual-referral is in the low side.The links of upward transfer and downward transfer of dual referral are insufficient smooth.