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Objective:To explore the synchronization effect of whole-body vibration therapy combined with squat-up train-ing on ambulation of patients with stroke. Method:40 stroke survivors who could walk independently with supervision or assistive devices,were recruit-ed from the Department of Rehabilitation Medicine,Huashan Hospital Affiliated to Fudan University(Pudong Cam-pus)and were randomly divided into the WBVT group and the control group.Both groups received conven-tional rehabilitation treatment for 40 minutes per day.The WBVT group was given additional whole-body vibra-tion therapy while squat-up training for another 20 minutes a day.The control group added sham stimulation of standing on the vibration platform with no vibration for the same amount of time per day.At the begin-ning of enrollment and after 4 weeks intervention,participants received two times evaluation by the wearable three-dimensional gait assessment instrument for the function of walking,and the electromyographic signals of the rectus femoris and long head of the biceps femoris were collected by surface electromyography instrument and statistical analysis on the data before and after the intervention. Result:After 4 weeks intervention,the stride speed and stride length of both groups improved siginificanlty(P＜0.05),while the WBVT group was better than the control group(P＜0.05).The swing angle of knee(flex-ion or extention)in the WBVT group improved significantly after intervention compared with the control group.At the single leg support phase(SS)of affected side,the differences were found in the synergistic contraction rate of the rectus femoris and biceps femoris in the bilateral lower extremity of the WBVT group after the in-tervention(P＜0.05).At the swing phase(SW)of affected side,the differences were found in the synergistic contraction rate of the rectus femoris and biceps femoris in the bilateral lower extremity between the two groups before and after the intervention(P＜0.05),but the affected side of the WBVT group was better than that the control group after intervention(P＜0.05). Conclusion:Whole-body vibration therapy combined with rhythmic squat-up synchronous training can improve the stride speed,stride length and synergistic contraction rate of lower limb muscles for better ambulation of patients with stroke.
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ObjectiveTo explore the effect of multi-sensory artificial intelligence feedback gait training on the recovery of walking function in stroke patients based on enriched environment theory. MethodsFrom July, 2021 to June, 2023, a total of 80 stroke patients in Huashan Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation in the lying and seated positions, for 40 minutes. The control group received ground walking training, for 20 minutes, while the experimental group received multi-sensory feedback gait training in enriched environment, for 20 minutes. Before and after four weeks intervention, the digital motion monitoring treadmill was used to mearsure step speed, step length, hip and knee swing angle and weight symmetry. They were assessed with Berg Balance scale (BBS), Fugl-Meyer Assessment-Lower Extremities (FMA-LE) and Barthel Index (BI). ResultsAfter intervention, the hip swing angle, step length of both sides and step speed significantly improved in both groups (|t| > 3.162, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.568, P < 0.05); the average knee joint swing angle and bilateral weight-bearing symmetry significantly improved in the experimental group (|t| > 3.249, P < 0.01); the scores of BBS, FMA-LE and BI improved in both groups (|t| > 3.569, P < 0.01), and they were better in the experimental group than in the control group (|t| > 2.922, P < 0.05). ConclusionMulti-sensory feedback gait training based on enriched environment theory could effectively improve the walking and balance of stroke patients, and increase the ability of independence.
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OBJECTIVE To analyze the situation and causes of the shortage of drugs in centralized volume-based procurement， and to put forward countermeasures and suggestions for optimizing centralized procurement rules and improving the drug shortage supply guarantee system. METHODS The shortage data of the first five batches of centralized purchasing drugs during January 2019 and December 2021 were collected from the Shortage Database of Chinese medicine economic information； descriptive statistical analysis was performed for shortage frequency， varieties and reasons. RESULTS & CONCLUSIONS After the first five batches of centralized volumetric procurement policy landed， the frequency of drug shortage reported for selected specifications and selected enterprises increased significantly， mainly drug shortage of selected enterprises. The shortage of some varieties from selected enterprises in the short term was obvious， and most of them were commonly used clinical drugs. The occurrence of drug shortages was affected by various links such as the production， circulation and use， and the main reasons were shortage or monopoly of raw materials. In order to ensure the drugs supply， the government should scientifically assess the risk of production interruption of enterprises， further optimize centralized procurement rules， improve the reporting system for drug shortages， and attach importance to the supply of key drugs； in addition， hospitals should take a variety of measures within the scopes of policies to flexibly respond to drug shortages so as to avoid delaying the treatment of patients.
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Objective: To analyze the chemical constituents of Polygonum multiflorum extract which may cause human liver cell damage and to explore the mechanism. Methods: Raw and processed Polygonum multiflorum were extracted by 70% ethanol, then raw and processed Polygonum multiflorum water-eluted material (RW and PW), 50% ethanol-eluted material (R50 and P50) and 95% ethanol-eluted material (R95 and P95) were obtained by absorbing through AB-8 macroporous resin, followed by water, 50% ethanol and 95% ethanol elution in order. The water extracts of raw and processed Polygonum multiflorum (RWE or PWE) were obtained by boiling them in water as usual. Normal human liver L02 cells were treated by different concentrations of eluted Polygonum multiflorum materials for different time, and the cell growth inhibition of each group was determined by methylthiazolyldiphenyl-tetrazolium bromide method. The chemical constituents which had a significant cytotoxicity to L02 cells were analyzed by high-performance liquid chromatography (HPLC). Morphological changes of L02 cells were observed by Giemsa staining and cell cycle distribution was observed by flow cytometry. Results: It was found that 95% ethanol-eluted extracts of raw and processed Polygonum multiflorum showed significant growth inhibition on normal human liver L02 cells, while the other components showed no significant inhibition on cell growth. HPLC analysis showed that the main component in 95% ethanol-eluted extract of raw and processed Polygonum multiflorum was emodin at content of (18.53+/-2.96)% and (10.28+/-1.34)% respectively. Cell cycle analysis showed that 95% ethanol-eluted material of Polygonum multiflorum and emodin had a similar significant effect of S phase arrest and all could induce L02 cell apoptosis. Conclusion: The main part of Polygonum multiflorum causing liver cell damage is the 95% ethanol-eluted extract, and emodin is one of the important chemical constituents leading to liver cell damage.
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24 cases of hypoparathyroidism, 24 cases of normal control were included. The levels of enzymes, concentration of Ca were measured in all cases. The electrocardiogram was carried out in the hypoparathyroidism group carries. The levels of CK, CK-MB, BHDH, LDH and AST were significantly higher in patients with hypoparathyroidism than in normal control cases(P＜0.05), especially the levels of CK and CK-MB (P＜0.01). After the treatment, the electrocardiogram and enzymes basically returned to normal. The changes of enzymes in patients with hypoparathyroidism may play a benchmark about the severity and treatment.