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1.
Clinical Medicine of China ; (12): 237-242, 2021.
Article in Chinese | WPRIM | ID: wpr-884158

ABSTRACT

Objective:To explore the intervention effect of cognitive-walking dual-task training on executive and walking function in patients with cerebral apoplexy.Methods:A total of 70 stroke patients who were hospitalized in the Department of Rehabilitation Medicine of Baoding Taihe Rehabilitation Hospital from June 2020 to October 2020 were selected as the study subjects.All 70 hemiplegic patients with stroke were randomly divided into control group ( n=35) and test group ( n=35) by random number table method, and a prospective study was conducted.The control group was given routine walking training, and the test group was given cognitive-walking dual-task training at the same time and frequency as the control group.E-Prime software was used to evaluate the executive function of patients before and 4 weeks after intervention, including three sub-tests of Flanker, 1-back and More-odd shifting, and the reaction time of each test was recorded.The score changes of Mini-Mental Status Examination (MMSE) and Modified Rankin Scale (MRS) were recorded.The single-task walking time, dual-task walking time and dual-task walking time cost during 10 m Walk Test were calculated.Finally, 33 cases in the experimental group and 31 cases in the control group completed the study.Finally, 33 cases in the experimental group and 31 cases in the control group completed the study. Results:After 4 weeks of intervention, the MMSE scores of the experimental group and the control group were improved compared with those before intervention (the experimental group (26.39±1.90) and (24.42±2.69), t=10.824, P<0.001; the control group (25.45±1.77) and (24.61±2.16), t=7.325, P<0.001), and the experimental group was significantly better than the control group ( t=2.049, P=0.045)). The duration of three tests of executive function in the experimental group and the control group was significantly shorter than that before the intervention (Flanker task: the experimental group (752.38±178.28) ms and (939.42±260.11) ms, t=10.467, P<0.001; the control group (863.40±227.86) ms and (951.67±265.93) ms, t=8.140, P<0.001.1-back task: the experimental group (983.31±314.16) ms and (1 242.10±444.77) ms, t=10.386, P<0.001; the control group (1 186.89±293.80) ms and (1 238.27±305.95) ms, t=9.569, P<0.001.More odd shifting task: the experimental group (1 121.29±260.17) ms and (1 362.32±352.80) ms, t=13.084, P<0.001; the control group (1 255.81±269.41) ms and (1 351.37±287.46) ms, t=8.550, P<0.001), and the experimental group was significantly better than the control group (Flanker task: t=2.198, P=0.032; 1-back task: t=2.691, P=0.009; more odd shifting task: t=2.044, P=0.045). The results of 10 m walking test in the experimental group and the control group were improved compared with those before the intervention (single task walking time: the experimental group (20.71±9.61) s and (26.10±13.88) s, t=6.312, P<0.001; the control group (22.42±9.60) s and (25.62±10.97) s, t=13.009, P<0.001). The duration of dual task walking: the experimental group (22.73±10.28) s and (31.64±16.07) s, t=7.931, P<0.001; the control group (28.30±11.72) s and (31.89±13.65) s, t=9.348, P<0.001.The cost of dual task walking: the experimental group (10.32±6.87)% and (23.26±11.40)%, t=10.602, P<0.001; the control group (27.39±7.38)% and (24.94±7.48)%, t=2.719, P=0.011). The 10 m walking test time of the experimental group was shorter than that of the control group ( t=2.027, P=0.047), and the walking time cost of the experimental group was lower than that of the control group ( t=9.583, P<0.001). Conclusion:Cognitive walking dual task training can improve the walking function of patients, which is more conducive to the recovery of executive function than conventional walking training.

2.
Chinese Journal of Trauma ; (12): 197-201, 2020.
Article in Chinese | WPRIM | ID: wpr-867700

ABSTRACT

Corona virus disease 2019 (COVID-19) patients with trauma are at high risk of venous thromboembolism (VTE), which must be taken seriously in the therapeutic processes. Hypercoagulable state is induced by 2019 novel coronavirus (2019-nCoV) in many ways, such as increasing the level of inflammatory factors and fibrinogen, and inducing endothelial cell injury. The venous wall injuries from trauma and operation directly or indirectly trigger off the exogenous coagulation pathway and the microcirculation can be damaged at the same time, which may initiate the exogenous pathway of VTE. Immobilization of limbs and forced bed rest during the treatment of traumatic patients will slow venous blood flow. Chronic non-communicable diseases such as diabetes in the elderly were independent risk factors for VTE. Furthermore, the persistent fever, severe lung disease, respiratory failure, sepsis and invasive technology application add the risk of VTE and the difficulty of treatment. In order to help effective prevention VTE of for COVID-19 patients with trauma, the authors put forward relevant technical suggestions for prevention and nursing of VTE to provide basis for nursing work during pandemic of COVID-19.

3.
Article in Chinese | WPRIM | ID: wpr-746027

ABSTRACT

Objective To observe the effect of Tomatis converted auditory training on the executive functioning of breast cancer patients undergoing chemotherapy.Methods Eighty breast cancer patients with the executive dysfunction who were undergoing chemotherapy were divided into a control group and an experimental group,each of 40.The experimental group was given Tomatis high and low frequency auditory training,while the control group was given ordinary music training.The patients in both groups were treated in 4 stages,each of 5 consecutive days with intervals of 21 days.The Chinese Version of the Behavioral Assessment of Dysexecutive Syndrome (BADS) was used to evaluate both groups before and after the intervention,including rule transformation ability,problem solving ability,planning ability,supervising ability and organizing ability.Results After the intervention,the experimental group had a significantly higher average score than before the intervention in the rule-switching card test,the action planning test,the key-finding test,and the modified six-element test.Their average BADS score was also significantly improved.The control group showed a significantly better average score only in the key-finding test and in its average BADS total score.After the intervention,the experimental group had a significantly higher average score than the control group in the rule-switching card test and the action planning and six-element tests.Its average BADS rating was also significantly better.Conclusion Tomatis high and low frequency auditory training can improve the executive function of patients undergoing chemotherapy for breast cancer.Its effect is better than that of ordinary music training.

4.
Article in Chinese | WPRIM | ID: wpr-694102

ABSTRACT

Objective To analyze and validate the key molecular targets correlated with the overall survival of patients with HER2-positive breast cancer.Methods First,the survival time and transcriptome data of patients with HER2-positive breast cancer in stage Ⅰ / Ⅱ and Ⅲ/Ⅳ were downloaded from the TCGA database.The significantly differential genes between overall survival <2 years and >8.5 years in stage Ⅰ / Ⅱ were picked out by edgeR package,and the pathways were enriched by KEGG.Similarly,the differential genes between overall survival <2 years and >7 years in stage Ⅲ/Ⅳ were analyzed.Furthermore,KEGG pathway analysis was performed using the differential genes overlapped by stage Ⅰ /Ⅱ and Ⅲ/Ⅳ.Second,the relationships between the expression levels of key node genes and other genes in enriched pathway and the overall survival of patients with HER2-positive breast cancer were validated by KMplot database.Last,the correlation between the activity of pathway enriched in KEGG and the resistance to anti-HER2 treatment was validated in HER2-positive breast cancer cell line BT474.Results In patients with stage Ⅰ / Ⅱ HER2-positive breast cancer whose overall survival was <2 years,PI3K/AKT was the 9th signaling pathway enriched by up-regulated differential genes.In patients with stage Ⅲ/Ⅳ whose overall survival was <2 years,PI3K/AKT was the 2nd signaling pathway enriched by up-regulated differential genes.Furthermore,PI3K/AKT was the first signal pathway enriched by the overlapping upregulated genes of patients in stage Ⅰ / Ⅱ and Ⅲ / Ⅳ whose overall survival was <2 years.Patients with high expression of PI3K and AKT (key node genes) or CFAP221 and COL4A6 (other genes) of PI3K/AKT pathway had shorter overall survival than those with low expression.PI3K inhibitors could enhance the growth inhibitory effect of HER2 small molecule inhibitor on HER2-positive breast cancer cell line BT474.Conclusions The overexpression of PI3K/AKT pathway is associated with the shorter overall survival in HER2-positive breast cancer patients,and associated with anti-HER2 resistance in HER2-positive breast cancer cell line.

5.
Clinical Medicine of China ; (12): 125-130, 2018.
Article in Chinese | WPRIM | ID: wpr-706632

ABSTRACT

Objective To investigate the occurrence of common symptoms in breast cancer patients in different chemotherapy periods and to analyze the relationship with the chemotherapy periods. Methods A total of four hundred and fifty?six breast cancer patients receiving chemotherapy in Tangshan Cancer Hospital from August 2016 to August 2017 were investigated via common symptom questionnaire among breast cancer patients. The results of the investigation were statistically analyzed, and the relationship between chemotherapy related symptoms and chemotherapy periods was analyzed by multiple Logistic regression analysis. Results In terms of the 20 kinds of chemotherapy symptoms, among the patients whose incidence rate was >50% had 9 kinds of symptoms. Multivariate Logistic regression analysis showed that alopecia (95% CI=5. 820~562. 784,P=0. 001) ,skin allergy ( 95% CI=0. 002~0. 157,P<0. 001) ,cancer caused insomnia( 95% CI=1. 179~25. 638, P=0. 030) ,dry mouth ( 95% CI=0. 008~0. 470,P=0. 007) ,vaginal dryness or burning heat ( 95% CI=13. 368~647. 615 P<0. 001) ,oral ulcer ( 95%CI=0. 026~0. 654,P=0. 013) ,abnormal defecation ( 95% CI=0. 025~0. 749,P=0. 022),memory loss (95%CI=1. 065~19. 415,P=0. 041),distal phalanges numbness (95% CI=0. 004~0. 421,P=0. 007),poor appetite (95% CI=1. 189~65. 964,P=0. 033),local skin irritation /ulceration ( 95% CI=0. 003~0. 143, P<0. 001 ) were associated with the chemotherapy, the difference was statistically significant. The above symptoms can be divided into 3 symptom groups by factor analysis,and they were respectively medicine side effect symptom cluster, neuropsychiatric symptom cluster and mucocutaneous symptom cluster. Conclusion There are many symptom clusters that affect the life and rehabilitation level in patients with breast cancer during chemotherapy, and are closely related with the chemotherap cycle. Doctors should adopt a scientific model of symptom management and take measures to improve the survival state of the patients.

6.
Article in Chinese | WPRIM | ID: wpr-704202

ABSTRACT

Objective To investigate the influencing factors of mental fatigue in patients with cere-bral apoplexy. Methods Using a hospital-based case-control method,total 358 patients with cerebral apo-plexy from Tangshan Gong Ren Hospital were recruited from October 2016 to May 2017. A total of 175 sub-jects were fatigue group(MFS≥10. 5),the remaining 183 individuals were non-fatigue group (MFS<10. 5). All the patients with stroke were investigated with MFS,MMSE,SAS,SDS and homemade general scale. Re-sults The total MFS score(17. 68±5. 06)vs(5. 70±2. 15) and dimensions score of fatigue perception(6. 86 ±2. 17)vs(2. 12±1. 15),cognition fatigue(3. 58±1. 54)vs(1. 12±0. 93),increased sensitivity(5. 90±2. 05) vs(1. 95±1. 20),changes of sleep(1. 35±0. 82)vs(0. 51±0. 62) in the fatigue group were higher than those of the non-fatigue group,total score. Multivariate Logistic regression showed that income below expenditure (β=0. 608,OR=1. 836,95%CI=1. 037-3. 252),cognitive dysfunction (β=1. 886,OR=6. 594,95%CI=3. 276-13. 275),mild anxiety(β=0. 770,OR=2. 160,95%CI=1. 069-4. 364),moderate anxiety(β=1. 157, OR=3. 181,95%CI=1. 230-8. 228),severe anxiety (β=1. 295,OR=3. 651,95%CI=1. 096-12. 160),mod-erate and severe depression (β=1. 318,OR=3. 738,95%CI=1. 318-10. 602) were the influencing factors of mental fatigue in stroke patients. Conclusion Income below expenditure,cognitive dysfunction,mild anxie-ty,moderate anxiety,severe anxiety,moderate and severe depression are the potential risk factors of mental fatigue in stroke patients.

7.
Article in Chinese | WPRIM | ID: wpr-704178

ABSTRACT

Objective To observe the effect of TOMATIS auditory training on improving cognitive and post-traumatic stress disorder in patients after breast cancer chemotherapy. Methods Eighty invasive ductal carcinoma of breast cancer patients with cognition and psychological disorders were selected in the breast department of Tangshan People's Hospital from October 2016 to September 2017. All patients were randomly divided into control group ( n=40) and experimental group ( n=40) . The experimental group was given the TOMATIS high and low audio frequency auditory training,and the control group was given ordinary music training. Before and after the intervention, the Chinese version of the Montreal cognitive assessment scale ( MoCA) and the post-traumatic stress disorder scale ( PTSD-SS) were evaluated for both groups of pa-tients. Results After the intervention,the experimental group had significantly higher scores in visual struc-ture skills((3. 83±0. 71)vs(2. 68±0. 57)),executive function ((2. 23±0. 53)vs(1. 55±0. 50)),attention and concentration((1. 55±0. 78)vs(1. 23±0. 53)),language((1. 50±0. 75)vs(1. 08±0. 47)),calculation ((2. 00±0. 60)vs(1. 45±0. 75)),abstract thinking((1. 63±0. 54)vs(1. 00±0. 51)),memory((4. 68± 0. 47)vs(2. 70±0. 72)),directive force((5. 25±0. 54)vs(3. 90±0. 81)) and total score((22. 65±2. 89)vs (15. 58±2. 10))than the control group(all P<0. 05). After intervention,the scores of subjective assessment of traumatic events((2. 60±0. 63)vs(3. 98±0. 62)),repeated recurring experiences((24.05±2.72)vs (26. 70±2. 28)),avoidance symptoms((24. 35±1. 64)vs(26. 40±1. 19)),increased alertness((24. 23± 1. 80)vs(25. 45±1. 20)),impaired social function((7. 28±1. 01)vs(8. 68±0. 66)),and total scores((85. 85±5. 13)vs(94. 63±2. 92)) in the experimental group were significantly lower than those in the control group,and the differences were statistically significant ( all P<0. 01) . Conclusion TOMATIS auditory train-ing can effectively improve the cognitive function and psychological state in breast cancer chemotherapy pa-tients,which is worthy of popularization and application.

8.
Article in Chinese | WPRIM | ID: wpr-704122

ABSTRACT

Objective To investigate the effect of ischemic postconditioning on autophagy and learning and memory impairment in rats with ischemia-reperfusion injury by P38MAPK.Methods Ninty-six rats were randomly divided into sham group ( Sham group), cerebral ischemia reperfusion group ( CIR group),cerebral ischemic postconditioning group ( CIP group) and cerebral ischemic postconditioning com-bined with SB203580 group (CIP + SB203580 group),and 24 rats in each group. The rat model of cerebral ischemia was established by Pulsinelli four-vessel occlusion. The learning and memory abilities of rats were measured by Morris water maze. HE staining were used to detect the morphological changes of hippocampal neurons. The phosphorylation of P38MAPK and Beclin-1,LC3-Ⅱexpression were observed by immunohisto-chemistry. Results Compared with the Sham group,the number of crossing the platform decreased(24 h: (3.04±0.20)times),and the escape latency was longer in CIR group(24 h:(58.38±1.52) s) (all P<0.05). The number of survival neurons reduced (24 h:70.93±1.86),and the expression of P38MAPK,LC3-Ⅱ,Bec-lin-1 in immunohistochemistry were increased in CIR group(all P<0.05). Compared with CIR group,the number of crossing the platform at each time point increased (24 h:(5.46±0.50)times),the escape latency was shorter (24 h:(52.42±1.53)s),the number of survival neurons increased at each time point(24 h:(83.07±5.30)) and the expression level of P38MAPK decreased in the CIP group,while the expression lev-el of LC3-II,Beclin-1 increased (all P<0.05).Compared with the CIP group,the number of crossing the plat-form((24 h:(7.13±0.33)times),the escape latency was shorter (24 h:(48.04±1.39)s),the number of survival neurons increased at each time point(24 h:(91.40±1.74)),and the expression of P38MAPK was down-regulated,while the expression of LC3-II,Beclin-1 were up-regulated in CIP +SB203580 group(all P<0.05). Conclusion Ischemic postconditioning can improve learning and memory impairment in rats with is-chemia-reperfusion injury by P38MAPK regulating autophagy.

9.
Article in Chinese | WPRIM | ID: wpr-620483

ABSTRACT

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.

10.
Article in Chinese | WPRIM | ID: wpr-502526

ABSTRACT

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.

11.
Article in Chinese | WPRIM | ID: wpr-469199

ABSTRACT

Objective To evaluate the validity and responsiveness of the Chinese version of the miniBalance Evaluation Systems Test(mini-BESTest).Methods A total of 208 stroke patients were evaluated by 2 professionals using both mini-BESTest and Berg balance scale (BBS).All data were analyzed using Pearson correlation,t-test and descriptive statistical analysis.Results Significant correlation was observed between each entry of the mini-BESTest and its domain,with correlation coefficients ranging from 0.78 to 0.93 (P < 0.05).The scores of whole assessment and the three related domains were significantly correlated between mini-BESTest and BBS results,the correlation coefficients ranging from 0.68 to 0.87 (P < 0.05).After 2 weeks of treatment,there was significant improvement in each domain and in the total assessment score (P < 0.05).No floor or ceiling effects were observed in the total mini-BESTest scores,but there was a slight ceiling effect in the anticipatory and sensory orientation domains,and a slight floor effect in the reactive postural control domain.Conclusion The mini-BESTest has good validity and responsiveness,and can be applied to evaluate patients after stroke.

12.
Journal of Medical Postgraduates ; (12): 797-801, 2014.
Article in Chinese | WPRIM | ID: wpr-456398

ABSTRACT

(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.

13.
Article in Chinese | WPRIM | ID: wpr-453844

ABSTRACT

Objective To study the effects of integrative body-mind training with cognitive rehabilitation based on the sensory integration training theory on executive function and anxiety and depression mood in patients with traumatic brain injury.Methods 85 cases were randomly divided into the control group (42 cases) and the treatment group (43 cases).The control group took targeted cognitive rehabilitation with sensory integration training theory and the treatment group was given targeted integrative bodymind training based on this training.Before training and after 3 months,the cognitive function and executive function were detected by the Behavioral Assessment of Dysexecutive Syndrome (BADS); the cognitive dysfunction were evaluated by Loewenstein Occupation Therapy Cognitive Assessment (LOTCA); Anxiety and Depression were evaluated by Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).Results There was no marked differences in BADS,LOTCA,SDS and SAS scores before treatment; Compared with the control group,they were much improved after training; Moreover,they were much more improved in the treatment group than those of the control group.Conclusions Integrative bodymind training with cognitive rehabilitation based on the sensory integration training theory can improve the executive function and regulate the mood on cognitive dysfunction in patients with traumatic brain injury.

14.
Article in Chinese | WPRIM | ID: wpr-924334

ABSTRACT

@#Objective To research the effects of somatic sense interactive game Kinect on balance and walking function in stroke patients.Methods 40 patients with stroke were divided into control group (n=20) and experimental group (n=20), who accepted conventional rehabilitation and additional somatic sense interactive game Kinect. They were evaluated with gait analysis, Berg Balance Scale, Holden Walking Function Rating Scale and Barthel Index before and after treatment. Results Both groups improved in all the indices after 4 weeks of treatment (P<0.001), and improved more in the experimental group than in the control group (P<0.05). Conclusion The somatic sense interactive game Kinect could further improve the balance and walking function of stroke patients.

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