ABSTRACT
Objective To observe the c linical effect of scalp acupuncture combined with swallowing and speech therapeutic instrument for the treatment of post-stroke dysphagia. Methods Sixty-eight patients with post-stroke dysphagia were randomly divided into treatment group (N = 34)and control group (N = 34). Both groups were given the internal medicine treatment for lowering blood lipids,stabilizing plaque,and nourishing nerves,and took rehabilitation training. And additionally,the treatment group was given scalp acupuncture therapy and the treatment with swallowing and speech therapeutic instrument,and the control group was given the treatment with s wallowing speech therapeutic instrument alone. Two weeks constituted one treatment course, and the two groups were treated for 4 weeks. The scores of Standardized Swallowing Assessment(SSA) and Swallowing Quality of Life Instrument (SWAL-QOL) of the two groups were observed before and after treatment, and then the curative effects were evaluated by Saito 7-grade dysphagia assessment method. Results (1)Till the end of the trial,7 cases of the 68 patients were excluded for transferring to other departments or loss to follow-up. Of the 7 excluded cases, 3 cases were from the treatment group and 4 were from the control group. (2) The total effective rate of the treatment group was 90.32%and that of the control group was 66.67%,the difference being significant(P < 0.05).(3)After treatment,SSA scores of the 2 groups were decreased(P < 0.01)and SWAL-QOL scores were increased (P < 0.01),and the effect on improving SSA scores and SWAL-QOL scores in the treatment group was superior to that in the control group (P < 0.01). Conclusion Both groups can relieve dysphagia and improve the quality of life of post-stroke dysphagia patients,and the scalp acupuncture combined with swallowing and speech therapeutic instrument is more effective for the treatment of post-stroke dysphagia.
ABSTRACT
BACKGROUND: Ulnar osteotomy is firstly recommended for the therapy of Monteggia fracture in children. But,there is still a lack of biomechanical evidence to confirm its efficacy and safety. OBJECTIVE: To analyze the stress distribution on the humeroradial joint after ulnar osteotomy and to provide evidence for confirming the angular size and mechanism for ulnar osteotomy. METHODS: Nine elbow joints were subjected to different positions of physiological, posterior 15° and posterior 30° osteotomy, followed by loaded at different flexion angles in the neutral, pronation and supination positions, respectively, and then the detailed stress distribution and area in the humeroradial joint were obtained using I-Scan Stress Distribution Test system. One elbow joint was scanned by three-dimensional reconstruction CT and the three-dimensional finite element model was established by ANSYS software. The model was loaded with the same conditions based on the I-Scan Test RESULTS AND CONCLUSION: (1) I-Scan Test system showed that the stress concentration area was in the medial side of humeroradial joint when elbow joint extended after the posterior osteotomy. Following the buckling angle of elbows increased, the area of stress concentration was changed to posterior and stress and contact area of humeroradial joint decreased correspondingly. An increase of stress and decrease of contact area appeared after posterior osteotomy compared with physiological osteotomy. (2) According to the finite element analysis, after posterior 15° and 30° osteotomy, pressure of humeroradial joint concentrated in medial-posterior region and the stress was increased. (3) To conclude, ulnar posterior 30° osteotomy is superior to 15° in reducing the incidence of radial head redislocation of Monteggia fracture, but may induce osteoarthritis of humeroradial joint.
ABSTRACT
BACKGROUND: Unicompartment knee replacement is more popular for small trauma, rapid recovery, low less complications and almost normal knee mechanics, and has been used to repair unicompartmental knee diseases. At abroad, unicompartmental knee arthroplasty for advanced spontaneous osteonecrosis of knee (SONK) has obtained satisfactory outcomes, but its long-term efficacy and safety are not known in China. OBJECTIVE: To explore the short-term effectiveness of unicompartmental knee arthroplasty for advanced SONK. METHODS: Clinical data of 12 SONK patients (12 knees) admitted between January and August 2015 were analyzed retrospectively. Unicompartmental knee arthroplasty was operated by the same surgical team using the 3rdgeneration of Oxford?Unicompartmental Knee. The Visual Analogue Scale, femorotibial angle, range of motion of the knee and Hospital for Special Surgery scores were used to evaluate the curative efficacy at 3, 6, 12, and 18 months postoperatively. RESULTS AND CONCLUSION: (1) All patients were followed up for 12-18 months. The incision in all patients achieved primary union, and no infection, lower limb venous thrombosis or fracture occurred. (2) At the end of follow-up, the Visual Analogue Scale scores were significantly reduced from preoperative (6.67±0.78) to (1.75±0.97); the Hospital for Special Surgery scores were significantly increased from preoperative (63.92±7.27) to (91.67±2.87); the femorotibial angle changed from preoperative (178.28±3.38)° to (176.82±2.37)°(All P < 0.05). But the range of motion of the knee joint did not differ significantly before and after surgery. (3) That is to say, unicompartmental knee arthroplasty obtains satisfactory short-term efficacy in the treatment of advanced SONK.