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1.
Article in Chinese | WPRIM | ID: wpr-971864

ABSTRACT

ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.

2.
Journal of Clinical Surgery ; (12): 1133-1136, 2023.
Article in Chinese | WPRIM | ID: wpr-1019272

ABSTRACT

Objective The combined detection of serum angiopoietin-like protein 8(ANGPTL8)and Vascular cell adhesion molecule-1(VCAM-1)levels was analyzed for the predictive value of cerebral vasospasm(CVS)after intracranial aneurysm embolization.Methods A total of 196 patients who underwent intracranial aneurysm embolization in our hospital from March 2019-March 2022 were selected as the study subjects,99 patients with CVS were in the CVS group,and 97 patients without CVS were in the non CVS group.Serum ANGPTL8 and VCAM-1 levels were detected by ELISA;the correlation between serum ANGPTL8 and VCAM-1 levels was analyzed by Pearson method,Logistic regression was used to analyze the influencing factors of CVS in patients undergoing intracranial aneurysm embolization;ROC curve was used to analyze the serum levels of ANGPTL8 and VCAM-1 to predict the cutoff value of CVS in patients undergoing intracranial aneurysm embolization;four grid table method was used to analyze the predictive value of ANGPTL8,VCAM-1 and their combination on the occurrence of CVS in patients undergoing intracranial aneurysm embolization.Results The differences between CVS and non-CVS groups were statistically significant in hypertension,Hunt-Hess grade,and Glasgow coma(GCS)scores(P<0.05).The serum ANGPTL8 and VCAM-1 levels in the CVS group were significantly higher than those in the non-CVS group(P<0.05).There was a positive correlation between serum ANGPTL8 and VCAM-1(r=0.468,P<0.05).Multivariate analysis showed that high level of ANGPTL8(OR=3.652,95%CI:1.434-9.302),high level of VCAM-1(OR=2.619,95%CI:1.212-5.658),Hunt Hess grade Ⅲ-Ⅳ(OR=1.927,95%CI:1.104-3.362),GCS score of 3-8(OR=2.813,95%CI:1.257-6.295)were independent risk factors for CVS in patients undergoing intracranial aneurysm embolization.The AUC of serum ANGPTL8 level in predicting CVS in patients undergoing intracranial aneurysm embolization was 0.844,and the cut-off value was 189.233 U/L;the AUC of serum VCAM-1 level in predicting CVS in patients undergoing intracranial aneurysm embolization was 0.795,and the cutoff value was 17.984 mg/L.The accuracy,sensitivity and specificity of the combined prediction for CVS were 89.81%,93.94%and 85.57%,respectively,which were obviously higher than those of the single prediction.Conclusion The serum levels of ANGPTL8 and VCAM-1 in CVS group are obviously higher than those in non CVS group.The combination of the two has a high predictive value for CVS after intracranial aneurysm embolization.

3.
Article in Chinese | WPRIM | ID: wpr-923467

ABSTRACT

@#Objective To explore the risk of venous thromboembolism (VTE), especially lower-extremity deep vein thrombosis (DVT) and pulmonary embolism (PE), for stroke patients in rehabilitating, and the functional outcome. Methods A total of 3 557 stroke patients in the neurological rehabilitation center of Beijing Bo'ai Hospital for stroke rehabilitation from January, 2015 to October, 2020 were reviewed through the electronic medical record system. Demographic characteristics, stroke characteristics (type and location), laboratory data (D-dimer polymer and arterial partial pressure of oxygen), motor function (Brunnstrom stage, Fugl-Meyer Assessment of motor and balance, modified Ashworth Scale score of triceps crus, and Holden Walking Ability Classification), activities of daily living (Barthel Index), and anticoagulant/antiplatelet treatment data were collected and analyzed. Results The incidence of DVT and PE was 28.5% and 1.29%, respectively. Most were found 30 days later after onset. The incidence of PE was higher after ischemic stroke (χ2 = 12.49, P < 0.001) rather than hemorrhagic stroke. The patients with hemispheric stroke, severe lower-extremity paralysis, and poor activities of daily living were more prone to complications associated with VTE. After rehabilitation, the function of stroke patients with PE could be improved (|t| > 4.302, P < 0.001). Conclusion The risk of DVT and PE in patients during stroke convalescence may not be negligible, and those with older age, previous history of thrombosis, severe stroke, and severe limb paralysis may be stratified in high-risk. Following anticoagulation treatment, early individualized comprehensive rehabilitation can be done for patients with PE to improve their function and activities of daily living.

4.
Article in Chinese | WPRIM | ID: wpr-923468

ABSTRACT

@#Objective To investigate the incidence of Holmes tremor (HT) after stroke and its outcome after medication and rehabilitation. Methods Patients diagnosed as HT after stroke in the ward of neurorehabilitation department from October, 2019 to September, 2021 were reviewed the clinical features, imaging manifestations, drug treatment plan, rehabilitation evaluation scales scores, rehabilitation plan and outcome. Results There were five inpatients with HT (0.7%, 5/715), and all were hemorrhagic stroke, accounting for 1.7% of hemorrhagic stroke. The lesions were located in the midbrain and pons in three cases, cerebellum in one case and thalamus in one case. The tremor appeared 1.5 to seven months after stroke, limited on head and limbs, with other neurological dysfunction. After the comprehensive treatment of drugs and rehabilitation, tremor improved in four cases, and ineffective in one case. The motor and balance function improved less, and the activities of daily living improved somehow. Conclusion The incidence of Holmes tremor is low in stroke patients. The tremor might respond to the treatment, but motor function would not.

5.
Acta Pharmaceutica Sinica B ; (6): 294-303, 2019.
Article in English | WPRIM | ID: wpr-774974

ABSTRACT

Members of the proto-oncogene superfamily are indispensable molecular switches that play critical roles in cell proliferation, differentiation, and cell survival. Recent studies have attempted to prevent the interaction of RAS/GTP with RAS guanine nucleotide exchange factors (GEFs), impair RAS-effector interactions, and suppress RAS localization to prevent oncogenic signalling. The present study aimed to investigate the effect of the natural triterpenoic acid inhibitor glycyrrhetinic acid, which is isolated from the roots of plant species, on RAS stability. We found that glycyrrhetinic acid may bind to the P-loop of RAS and alter its stability. Based on our biochemical tests and structural analysis results, glycyrrhetinic acid induced a conformational change in RAS. Meanwhile, glycyrrhetinic acid abolishes the function of RAS by interfering with the effector protein RAF kinase activation and RAS/MAPK signalling.

6.
Article in Chinese | WPRIM | ID: wpr-923672

ABSTRACT

@#Objective To explore the effect of action observation therapy on unilateral spatial neglect after stroke.Methods From March, 2017 to April, 2018, 44 patients with left-sided neglect due to unilateral right-sided vascular brain lesions were randomly divided into control group (n=22) and experimental group (n=22). The control group received the dynamic landscape video observation training, and the experimental group received the action observation training, based on routine rehabilitation, for three weeks. Before treatment, one week and three weeks after treatment, they were evaluated with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (short line cancellation test, letter cancellation test, star cancellation test and line segment bisect), and the scores of Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA) and Activities of Daily Living (ADL) were compared.Results One week after treatment, four scores of CBIT routine tests almost improved (t>2.712, P<0.05), and the score of line segment bisect was significantly better in the experiment group than in the control group (t=4.822, P<0.001). Three weeks after treatment, four scores of CBIT routine tests and the scores of MMSE, FMA and ADL improved in both groups (t>1.596, P<0.05), and the scores of short line cancellation test, letter cancellation test and line segment bisect were significantly lower in the experiment group than in the control group (t>3.577, P<0.01).Conclusion The action observation therapy could faciliate to improve the lateral neglect of patients after stroke.

7.
Article in Chinese | WPRIM | ID: wpr-923845

ABSTRACT

@#Objective To investigate the effect of comprehensive rehabilitation on ischemic-hypoxic encephalopathy at recovery stage. Methods From January, 2014 to December, 2016, the general data, rehabilitation evaluation, main problems, rehabilitation methods and the functional scores from 28 patients with ischemic-hypoxic encephalopathy were retrospectively analyzed.Results The patients improved in the scores of Mini-Mental State Examination, motor function and balance of Fugl-Meyer Assessment, Holden Gait Classification and modified Barthel Index after rehabilitation (Z>2.588, P<0.05).Conclusion The patients with ischemic-hypoxic encephalopathy may be benefited from comprehensive rehabilitation in cognition, motor function, walking and activities of daily living, etc.

8.
Article in Chinese | WPRIM | ID: wpr-496338

ABSTRACT

Positive outcomes have been reported about the transcranial magnetic stimulation for aphasia. This paper reviewed the relat-ed literatures about repetitive transcranial magnetic stimulation used in clinical and research, and discussed the possible mechanisms in the recovery of aphasia, and the roles of hemispheres in brain.

9.
Article in Chinese | WPRIM | ID: wpr-496357

ABSTRACT

Objective To observe the effect of comprehensive rehabilitation on POEMS syndrome during sequel period. Methods Two cases of POEMS syndrome with multiple peripheral nerve injury as the main manifestation received physical therapy, occupational therapy, acupuncture, surface electromyography biofeedback and other comprehensive rehabilitation treatment. Results After treatment, the muscle strength, trunk balance, standing balance ability, activities of daily living (ADL) improved. The score of Berg Balance Scale increased from 18 to 28 in the first case, the modified Bathel Index increased from 55 to 70 in the second case. Conclusion Comprehensive rehabilitation can improve the function of patients with POEMS syndrome during sequel period, and surface electromyography biofeedback plays an im-portant role.

10.
Article in Chinese | WPRIM | ID: wpr-487961

ABSTRACT

@#Objective To explore the rehabilitation for chorea after bilateral thalamus hemorrhage. Methods A case was reviewed. Re-sults The score of Fugl-Meyer Assessment of balance increased from 0 to 7, the modified Barthel Index increased from 25 to 50, and the co-ordination of movement improved significantly after rehabilitation treatment. Conclusion Early comprehensive rehabilitation may reduce the chorea movement, improve the activities of daily living and balance for chorea after bilateral thalamus hemorrhage.

11.
Article in Chinese | WPRIM | ID: wpr-480556

ABSTRACT

@#Objective To explore the effect of intensity of 1 Hz repetitive transcranial magnetic stimulation (rTMS) to right Broca's ho-mologue on nonfluent aphasia after stroke. Methods 40 inpatients were equally divided into low-intensity group and high-intensity group, who received rTMS (1 Hz for 10 minutes) once a day and twice a day respectively for 10 days. They were assessed with Western Aphasia Battery (WAB) before and after intervention, and 2 months after intervention. Results The scores of content and fluency, auditory compre-hension, naming, repetition and AQ improved more in the high-intensity group than in the low-intensity group (P<0.01). It maintained more for 2 months in the scores of content and fluency, repetition and AQ (P<0.05). Conclusion High-intensity rTMS can promote the improve-ment of speech in patients with nonfluent aphasia after stroke that remains for a long term.

12.
Article in Chinese | WPRIM | ID: wpr-936894

ABSTRACT

@#Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.

13.
Article in Chinese | WPRIM | ID: wpr-937023

ABSTRACT

@# Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with congenital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospective analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dissection mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilitation training need attention.

14.
Article in Chinese | WPRIM | ID: wpr-473491

ABSTRACT

Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.

15.
Article in Chinese | WPRIM | ID: wpr-460508

ABSTRACT

Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with con-genital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospec-tive analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dis-section mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilita-tion training need attention.

16.
Article in Chinese | WPRIM | ID: wpr-455855

ABSTRACT

Objective To explore the effects and mechanism of repetitive transcranial magnetic stimulation (rTMS) applied to the right Broca's homologue of stroke patients with non-fluent aphasia.Methods One stroke patient with non-fluent aphasia received rTMS at 1 Hz and another received the same treatment at 10 Hz.The western aphasia battery (WAB) and functional magnetic resonance imaging (fMRI) were used to evaluate their language function before and after the intervention.Results After treatment,language function in both patients had improved significantly.The aphasia quotient (AQ) score of patient 1 had improved from 37.2 to 66.6,and the AQ score of patient 2 had improved from 36.2 to 60.8.Before treatment,patient 1's activated brain areas during a vocabulary reading task were the left anterior central gyrus and the left gyrus frontalis medius.After the 1 Hz rTMS treatment the activated brain areas were the left medial surface of the lobus frontalis,the left gyrus frontalis inferior,the left prefrontal area,the left preinsula,the left lobulus parietalis inferior,and the left middle/inferior temporal gyrus.Before the 10 Hz rTMS treatment,patient 2's activated brain areas with the same vocabulary reading task were the bilateral medial surface of the temporal lobe,and the bilateral anterior central gyrus.After treatment the bilateral medial surface gyrus,the frontalis medius and lobus frontalis,the right gyrus frontalis inferior,the left prefrontal area,the bilateral lobulus parietalis superior,and the right superior/middle temporal gyrus were activated.Conclusion rTMS can significantly improve language function in stroke patients with non-fluent aphasia.Patients with smaller lesions in the left hemisphere language area can achieve hemisphere function restructuring.Larger lesions in the left hemisphere language area will probably yield bilateral restructuring in both hemispheres.

17.
Article in Chinese | WPRIM | ID: wpr-936846

ABSTRACT

@#Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.

18.
Article in Chinese | WPRIM | ID: wpr-440480

ABSTRACT

Objective To study the regularity of cerebral edema in middle cerebral artery occlusion rats and the influence of rehabilita-tion training on edema. Methods 120 male Sprague-Dawley rats were randomly assigned to normal control group (n=24), no-intervention group (n=24), resting plus natural feeding group (n=24), resting plus natural feeding and special nutrition group (n=24), and training group (n=24). Bederson score was used to evaluate the neurological function, and the dry-wet weight way was used to measure brain water content on the 1st day, 3rd day, 5th day, and 7th day. Results There was no significant difference in the other 4 groups except the normal group on the 1st day, 3rd day, and 5th day (P>0.05). However, neurological function in the training group was better than that in the other 3 groups ex-cept the normal control group on the 7th day (P<0.01). Except the normal control group, the brain water content decreased most rapidly in the training group and slowest in the resting groups after the 3rd day. Conclusion Rehabilitation training could accelerate the recovery of neurological function and release cerebral edema in rats with focal cerebral ischemia.

19.
Article in Chinese | WPRIM | ID: wpr-961413

ABSTRACT

@# Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (rTMS) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency rTMS for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P<0.05). The USN degree of patients in the treatment group decreased significantly after the treatment (P<0.05), while patients in the controlled group had no difference (P>0.05). Conclusion USN induced by stroke could be improved obviously through low frequency rTMS.

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