A flowchart for the diagnosis and differential diagnosis of post-stroke aphasia types in the Chinese language and treatment of post-stroke aphasia / 中华老年医学杂志

This article aims to comprehensively review the concept, etiology, classification, classical cortical mapping, assessment, a proposed flowchart for the diagnosis and differential diagnosis, treatment, rehabilitation, mechanisms of development and recovery, prognosis, and influencing factors for post-stroke aphasia(PSA)types in the Chinese language.We emphasize the necessity and significance of neuroimaging assessment of the brain and blood vessels and neuropsychological assessment in the diagnosis and differential diagnosis of PSA in Chinese.We also recommend and encourage the use of the dichotomies of internal vs.external and anterior vs.posterior as a starting point, based on the association of anatomical locations of the brain and blood vessels with brain language areas and language disorders.A classification system of PSA in Chinese developed from this approach in the form of a flowchart is well-suited for guiding the clinical treatment of cerebral stroke.Incorporating the "four elements" , the flowchart enables convenient diagnosis, classification and differential diagnosis of PSA in Chinese and facilitates targeted and personalized rehabilitation planning to benefit the patient.This article introduces the use of memantine, piracetam, donepezil and other drugs for PSA treatment, evaluates clinical trials on memantine conducted in China and abroad and its mechanisms of action for the treatment of PSA, and discusses how rehabilitation therapy achieves therapeutic effects.For the treatment of PSA, clinical research and practice using drugs such as memantine, piracetam and donepezil in combination with non-pharmacotherapy and rehabilitation training should be promoted.

Effects on the labor four elements of continuous epidural analgesia in labor / 中国实用护理杂志

Objective To explore the influence of continuous epidural analgesia in labor (hereinafter referred to as labor analgesia) to the labor four elements. Methods The study included 210 parturients with analgesia during labor, form cervix opens 2 cm, based on the parturients′choose. Observe the differences in the labor analgesia parturients, through the force of labor and birth canal, fetal and psychology. Results The uterine-work after analgesia showed a trend of rising first, then dropping, reduce abdominal pressure (t=46.78, P<0.01), and the contractive ability of musculus levator ani (t=20.99, P<0.01); Soften uterus cervix (t=3.59, P<0.01) and reduced the pelvic floor muscle convergent force (t=66.90, P<0.01); Decreased the fetal heart rate range (t=6.00, P<0.01), increased fetal heat deceleration times (t=6.85, P<0.01). The differences in the position of fetus was not statistically significant (χ2=6.00, P<0.01);Lower the pain score in the labor stage (t=60.25, P<0.01), increased the self-control score during the labor (t=24.30, P<0.01) and the satisfaction score during the labor, after analgesia (t=36.61, P<0.01). Conclusions The labor analgesia influenced labor elements, include the force of labor and birth canal, fetal and psychology, or promote or restrict or maintain.