Study of symptom clusters and their influencing factors in elderly patients with acute phase stroke / 中国实用护理杂志

Objective:To investigate the symptoms and symptom clusters of elderly stroke patients in the acute phase, analyze the factors influencing the symptom clusters and to provide a basis for the implementation of targeted symptom management in elderly stroke patients.Methods:Convenience sampling method was used to select 257 acute-phase elderly stroke patients who attended Fenyang Hospital in Shanxi Province from October 2022 to January 2023, and a cross-sectional survey was conducted by the General Information Questionnaire, Memory Symptom Evaluation Inventory, Modified Barthel Index Scale (MBI), and the National Institutes of Health Stroke Scale (NIHSS), and the symptom clusters were extracted by means of exploratory factor analysis, and the factors influencing symptom clusters were explored by means of binary logistic regression analysis.Results:Of the 257 patients, 138 were male and 119 were female, aged 60 to 90 (70.34 ± 6.94) years old. Factor analysis yielded four symptom clusters, which were named oral-intestinal symptom cluster, negative emotional symptom cluster, fatigue symptom cluster, and perceptual symptom cluster according to the symptom characteristics; regression analysis showed that: stroke site and NIHSS scores were the influencing factors of the oral-intestinal symptom cluster (all P<0.05); per capita monthly family income, number of episodes and MBI scores were the influencing factors of the negative emotional symptom cluster (all P<0.05); number of chronic diseases, type of stroke, and gender were the influencing factors of the fatigue emotional symptom cluster (all P<0.05); and literacy and stroke site were influencing factors of the perception symptom cluster (all P<0.05). Conclusions:Elderly stroke patients in the acute phase of the existence of more symptoms, symptoms interact with each other to form symptom clusters, health care personnel should be symptom clusters as a unit, the implementation of interventions for their influencing factors, effective symptom management, in order to improve the quality of life of patients.

Effect of the staging comprehensive treatment with acupuncture-moxibustion on Bell's facial palsy in the acute stage / 中国针灸

OBJECTIVES@#To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication.@*METHODS@#Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups.@*RESULTS@#After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05).@*CONCLUSIONS@#The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.

Comparison of five risk assessment tools of deep venous thrombosis in patients with acute intracerebral hemorrhage / 中国现代医生

Objective To compare five public deep venous thrombosis(DVT)risk assessment models(RAM)in patients with acute cerebral hemorrhage,and to select one suitable assessment tool,with which medical staff are able to carry out effective individualized prevention accordingly in time.Methods In this retrospective study,256 in-patients with acute cerebral hemorrhage in the Neurology Department of the First Affliated Hospital of Wenzhou Medical University from January to December 2020 were randomly enrolled.The researchers applied five models and record the scores,including Padua RAM,Caprini RAM,Wells DVT RAM,Autar RAM and acute stroke DVT-RAM.The data were summarized and analyzed with SPSS 25.0 and R4.1.The predictive values of above RAMs are compared separately by TOPSIS(technique for order preference by similarity solution)to find out a suitable tool.Results Predictive value(Ci)ranking of five DVT-RAMs,Autar RAM,Padua RAM,Caprini RAM,acute stroke DVT-RAM and Wells DVT RAM,by TOPSIS were 0.681,0.636,0.385,0.363,0.315.Conclusion According to comprehensive comparison by TOPSIS,Autar RAM was the suitable assessment model to assess the DVT risk of patients with acute cerebral hemorrhage.It is suggested that medical staff apply the Autar risk assessment model to predict the risk of DVT in patients with acute cerebral hemorrhage.

Clinical efficacy of fire needling combined with cupping therapy on herpes zoster of acute stage and the effect on Th17/Treg cellular immune balance / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between the combined therapy of fire needling and cupping, and western medication on herpes zoster of acute stage, as well as the effects on Th17 and Treg cells and inflammatory factors, i.e. IL-10 and IL-17 in the peripheral blood.@*METHODS@#Eighty patients with herpes zoster of acute stage were randomly divided into a combined therapy (fire needling plus cupping) group and a western medication group, 40 cases in each one. In the combined therapy group, the pricking and scattering techniques with fire needle were used at ashi points and Jiaji (EX-B 2) corresponding to the affected spinal segments; afterwards, cupping therapy was delivered. The combined treatment was given once daily. In the western medication group, valaciclovir hydrochloride tablet and vitamin B1 tablet were administered orally. The duration of treatment in each group was 10 days. Before each treatment from day 1 to day 10 and on day 11 , the score of symptoms and physical signs was observed in the two groups separately. Before each treatment from day 1 to day 10 and on day 11, 30, 60, the score of visual analogue scale (VAS) and skin lesion indexes were observed in the two groups. On day 60, the incidence of postherpetic neuralgia was recorded in the two groups. The levels of Th17 and Treg cells, Th17/Treg ratio in the peripheral blood, as well as serum levels of IL-10 and IL-17 were detected before and after treatment in the two groups. The clinical efficacy was compared between the two groups.@*RESULTS@#From day 6 to day 10 during treatment and on day 11, the scores of symptoms and physical signs in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 3, day 6 to day 10 during treatment and day 11, day 30, VAS scores in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 60, the incidence of postherpetic neuralgia in the combined therapy group was lower compared with that in the western medication group (P<0.05). The blister arresting time and scabbing time in the combined therapy group were shorter than those of the western medication group (P<0.05). After treatment, the level of Th17, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 were all lower in comparison with those in the western medication group (P<0.05). The curative and remarkably effective rate was 82.5% (33/40) in the combined therapy group, higher than 62.5% (25/40) in the western medication group (P<0.05).@*CONCLUSION@#The early application of fire needling combined with cupping therapy can effectively treat herpes zoster of acute stage, relieve pain, and reduce the incidence of postherpetic neuralgia, which may be related to reducing the levels of Th17 and Treg cells, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 so that the cellular immune balance is modulated.

Risk factors and countermeasures of depression in acute stroke patients in Wuhan / 公共卫生与预防医学

Objective To explore the risk factors and countermeasures of depression in stroke patients in Wuhan. Methods A stratified cluster sampling method was used to randomly select 628 hospitalized patients at acute stage of stroke in Wuhan from June 2019 to June 2020. According to HAMD score, the patients were divided into normal group (n=381) and post-stroke depression group (n=247). The risk factors of depression in stroke patients were analyzed by Logistic regression using self-made questionnaire, including gender, age, education level, stroke type, residence, patient compliance to treatment, NIHSS score, ADL score and independent walking, and early intervention measures were proposed. Results Univariate analysis showed that education level, family burden, NIHSS score, ADL score and independent walking were related to the occurrence of depression in stroke patients (P<0.05). Logistic multivariate regression analysis showed that, NIHSS score, ADL score and independent walking were correlated with depression in patients at acute stage after stroke (P<0.05). Conclusion the risk of depression in patients with acute cerebral apoplexy is higher, the patients' adherence to treatment, NIHSS score, ADL scores, situation of independent walking is a cause of depression in patients with cerebral apoplexy risk factors, should improve patients' adherence to treatment as soon as possible and daily life ability, improve nerve function, should pay attention to its early intervention.

Hydroxymethylnitrofurazone (NFOH) decreases parasitaemia, parasitism and tissue lesion caused by infection with the Bolivia Trypanosoma cruzi type I strain in Swiss and C57BL/6 mice

Abstract The chemical hydroxymethylation of the antimicrobial nitrofurazone leads to the prodrug NFOH, also increases the anti-T. cruzi activities (in vitro and in vivo), as well as showed non-genotoxic (Ames and micronucleus assays). In the present study, we assessed the anti-T. cruzi effect of the NFOH In vivo - in acute Swiss and C57Bl/6 experimental Chagas models. The treatment started at 5 days post-infection during 20 consecutive days (orally, once day, 150mg/kg), and the parasitaemia as well as histopathology analysis were performed. In both experimental murine models, NFOH was able to reduce parasitemia blood avoiding parasitic reactivation, during immunosuppression period (dexamethasone 5mg/kg, 14 days), in 100% of the mice, and decrease tissue parasite nests, demonstrating absence of amastigote forms in all organs (100%) analyzed, data similar to benznidazole (BZN). Therefore, the results shown here pointing to the NFOH as promising compound for further preclinical studies, being a high potential drug to effective and safe chemotherapy to Chagas disease.

Clinical observation on horizontal penetration needling combined with rizatriptan monobenzoate tablets for migraine without aura in acute stage / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of horizontal penetration needling combined with rizatriptan monobenzoate tablets, simple horizontal penetration needling and simple rizatriptan monobenzoate tablets for migraine without aura in acute stage.@*METHODS@#A total of 99 patients with migraine without aura in acute stage were randomized into an acupuncture plus medication group, an acupuncture group and a western medication group, 33 cases in each one. In the acupuncture group, horizontal penetration needling was applied once at Hanyan (GB 4) to Xuanli(GB 6), Shenting (GV 24) to Yintang (GV 29), Baihui (GV 20) to Qianding (GV 21), etc. for 2 h. In the western medication group, oral rizatriptan monobenzoate tablets for 10 mg were given once. In the acupuncture plus medication group, treatment of acupuncture combined with rizatriptan monobenzoate tablets were given, the application was the same as the acupuncture group and the western medication group. Before treatment and 0.5, 2, 24 h after treatment, the visual analogue scale (VAS) score was observed, the remission rate and the disappearance rate of migraine of 2, 24 h after treatment were compared in the 3 groups.@*RESULTS@#Compared before treatment, the VAS scores of each time point after treatment were decreased in the 3 groups (@*CONCLUSION@#Horizontal penetration needling combined with rizatriptan monobenzoate tablets have significant therapeutic effect on rapid analgesia and continuous analgesia for migraine without aura in acute stage, its effect is superior to simple horizontal penetration needling and simple rizatriptan monobenzoate tablets.

Neuroendoscopic treatment for non-acute traumatic intracranial hematoma: an efficacy and safety analysis / 中华神经医学杂志

Objective:To investigate the efficacy and safety of neuroendoscopy in the treatment of non-acute traumatic intracranial hematoma.Methods:Thirty-six patients with non-acute traumatic intracranial hematoma, admitted to our hospital from June 2018 to December 2019, were chosen in our study. These patients accepted small-bone window craniotomy and straight incision, or removal of intracranial hematoma by neuroendoscopy. The clinical data of these patients were retrospectively analyzed. Pain numerical rating scale (NRS) was used to assess degrees of pain in 22 patients with headache one d before surgery and three d after surgery. The neurological functions after treatment were evaluated by activity of daily living (ADL) evaluation criteria one d before surgery and 7 d after surgery.Results:All 36 patients were cured and discharged from hospital, and no death was noted; length of hospital stays was (6.7±1.1) d. No secondary hemorrhage re-craniotomy was needed, no postoperative complications such as cerebrospinal fluid leakage were noted, and no re-injection of urokinase was needed to melt the hematoma. As compared with the preoperative NSR scores (7.82±1.097), the postoperative NSR scores of 22 headache patients were significantly decreased (1.05±0.653, P<0.05). In these 36 patients, preoperative ADL level I was noted in 8 patients, level II in 14 patients, level III in 12 patients, and level IV in 2 patients. Postoperative nerve function in 30 patients were fully recovered, with ADL level I; and 6 patients had mild symptom of dizziness, with ADL level II. Conclusion:Non-acute traumatic intracranial hematoma treated by neuroendoscopy enjoys good curative effect, less surgical trauma, short hospital stays and high safety.

Effect of Adjuvant Therapy of Huayu Pills on Neurological Recovery of Patients with Acute Cerebral Infarction / 中国实验方剂学杂志

Objective:To observe the effects of adjuvant therapy of Huayu pills on neurological recovery of patients with acute cerebral infarction (ACI) and syndrome of Qi deficiency and blood stasis, and to investigate its mechanism of action for antioxidation, anti-inflammation and improvement of microcirculation. Method:One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. During the study period, there were 3 drop-out cases, 2 excluded cases, and 65 completed cases in the control group. There were 1 drop-out cases, 4 excluded case, and 65 completed cases in the observation group. Western medicine was given in both groups. Patients in control group additionally got oral administration of Xiaoshuang Tongluo tablets, 6 tablets/time, 3 times/day. The patients in observation group got oral administration of Huayu pills, 5 g/time, 2 times/days. The treatment course was 4 weeks in both groups. Before the treatment, and at the second and fourth week after treatment, scores of national institute of health stroke scale (NIHSS) were graded. Before and after treatment, scores of functional independent measures (FIM) scale, fugl-meyer assessment of motor function (FMA), Qi deficiency and blood stasis syndrome were graded. Disability/mortality and safety were discussed after treatment. Levels of the whole blood viscosity (BV), plasma viscosity (PV), platelet aggregation rate (PAG), fibrinogen (FIB), P-selectin (CD62p), D-dimer (D-D), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), lipid peroxide (PLO), homocysteine (Hcy), tumor necrosis factor -α (TNF-α), serum cystatin C (Cys-C) and hypersensitive C-reactive protein (hs-CRP) were detected both before and after treatment. Result:In the analysis of rank sum test, clinical efficacy in observation group was better than that in control group (Z=2.131, P<0.05). At the second and fourth week after treatment, scores of NIHSS, Qi deficiency and blood stasis, as well as levels of NO, PLO, MDA, Hcy, Cys-C, hs-CRP, TNF-α, BV, PV, PAG, FIB, CD62 p and D-D in observation group were lower than those in control group (P<0.01), while levels of FIM, FMA and SOD were all higher than those in control group (P<0.01). Conclusion:Based on the comprehensive treatment of Western medicine, adjuvant therapy of Huayu pills can improve the degree of nerve function defect, improve the ability of exercise and daily life, reduce the degree of disability, improve the microcirculation and hemorheology, reduce the inflammatory reaction, eliminate oxygen free radicals, and relieve the oxidative stress injury in patients with ACI and Qi deficiency and blood stasis syndrome, and the clinical efficacy is better than that of Western medicine alone.

Early treatment of suspension moxibustion for Bell's palsy in acute stage / 中国针灸

OBJECTIVE@#To observe the efficacy of early treatment of suspension moxibustion for Bell's palsy and its influence on the prognosis, and to explore whether the early treatment of suspension moxibustion has non-inferiority effect to hormone treatment and whether suspension moxibustion combined with hormone treatment has the synergistic effect.@*METHODS@#A total of 132 patients with acute-stage Bell's palsy were divided into a hormone group (94 cases) and a moxibustion group (38 cases) by non-random method, and the hormone group was further randomly divided into a hormone with moxibustion group (48 cases) and a hormone without moxibustion group (46 cases). The acupuncture and oral administration of mecobalamin capsule were used as basic treatment. Acupuncture was applied at Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Dicang (ST 4), Jiache (ST 6), Yifeng (TE 17), etc., with the needles retained for 30 min, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The oral administration of mecobalamin capsule was given 0.5 mg each time, 3 times a day for 4 weeks. The patients in the moxibustion group, on the basis of basic treatment, were treated with the suspension moxibustion at Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Wangu (GB 12), Yifeng (TE 17) of affected side, 5 min per acupoint, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The patients in the hormone without moxibustion group, on the basis of basic treatment, were treated with prednisone acetate tablets. The patients in the hormone with moxibustion group, on the basis of basic treatment, were treated with suspension moxibustion and prednisone acetate tablets. All the treatment was given for 4 weeks. The House-Brcackmann facial nerve grading (H-B) global score and facial disability index (FDI) scale were used to evaluate the curative effect in the three groups before treatment, 2 weeks and 4 weeks into treatment and 4 weeks after treatment; the efficacy was compared among the three groups.@*RESULTS@#Compared before treatment, the H-B grading and FDI scores were significantly improved 2 weeks and 4 weeks into treatment and 4 weeks after treatment (0.05); the H-B grading and FDI scores in the hormone with moxibustion group were superior to those in the moxibustion group and the hormone without moxibustion group 4 weeks into treatment and 4 weeks after treatment (0.05). At the end of follow-up, the cured rate in the hormone with moxibustion group was 81.3% (39/48), which was superior to 68.4% (26/38) in the moxibustion group and 60.9% (28/46) in the hormone without moxibustion group (0.05).@*CONCLUSION@#The three treatment methods are all safe and effective for acute-stage Bell's palsy. The suspension moxibustion combined with hormone therapy are superior to suspension moxibustion or hormone therapy alone. Early treatment of suspension moxibustion is safe and effective for Bell's palsy, and has obvious synergistic effect with hormone. For the patients who cannot use hormone, suspension moxibustion could replace hormone, which is non-inferior to hormone.

Analysis on rule of first group of Chinese medicine masters in treating acute apoplexy / 中草药

Objective: To explore the prescription medication rule of the first batch of Chinese medicine masters in treating acute stage of stroke by using the data mining method. Methods: The experience books and published journal articles of Chinese medicine masters and the shared medical records of national famous TCM studios in the cloud platform V1.5 of ancient and modern medical records were searched; The first batch of national physician master data for the treatment of acute phase of stroke was selected; A standardized basis database, standardization of medicines were established after using statistical analysis of system integration, association rules analysis, methods of complex networks; The formula frequency, medicinal, and core prescription drugs were analyzed. Results: A total of 142 medical cases were eventually included. The frequency results of traditional Chinese medicine showed that 14 kinds of high-frequency traditional Chinese medicine were obtained, including Pheretima, Chuanxiong Rhizoma, Persicae Semen, etc., and most of the drugs were warm, smooth, bitter, sweet, and return to liver and lung meristem. The results showed that the frequency of chordal pulse and tongue red was the most. A total of 24 association rules and 18 TCM association rules were obtained by association rule analysis. Conclusion: In the treatment of acute apoplexy, the Chinese medicine master usually adopted the methods of clearing heat and relieving wind, promoting blood circulation and removing blood stasis, eliminating phlegm and resuscitative medicinal, moving qi, and dredging collaterals, and stopping convulsions.

Nutritional Care for the Elderly / 대한소화기학회지

Malnutrition among older people is a common health problem. It is well known that malnutrition is associated with a poor clinical outcome. Especially older individuals in catabolic crisis require comprehensive nutritional management to improve clinical outcome not only recovery of disease itself but also maintain physical and cognitive function. Intensive nutritional therapy in acute care is important since nutritional status is closely related to long-term clinical outcome and quality of life in the older people.

Systematic Review of Therapeutic Effect of Electroacupuncture for Idiopathic Facial Palsy at Acute Stage / 广州中医药大学学报

Objective To make a systematic review of therapeutic effect of electroacupuncture(EA) for idiopathic facial palsy at acute stage. Methods With reference to the included criteria and excluded criteria, clinical controlled trials of EA for idiopathic facial palsy at acute stage were screened from the databases of CBM, CNKI, Wanfang, VIP by computer retrieval and from the primary domestic academic journals of acupuncture by manual retrieval. Systematic review was performed following the Cochrane Reviewers' Handbook, and RevMan 5.3 was used for Meta-analysis. Results Sixteen clinical trials were included. The Meta-analysis results showed that the cure rate evaluated with 3 kinds of therapeutic effect criteria in the observation group was superior to that of the control group, the difference being significant (P<0.05 or P<0.01); the effects on improving days for cure, cure case number within one month, blink reflex, and case number with complications in the observation group were also superior to that of the control group, the difference being significant (P < 0.01). Conclusion EA exerts certain therapeutic effect for idiopathic facial palsy at acute stage. But for the quantity and quality of the included trials are not satisfactory, the conclusion still needs more high-quality, large-size and long-term follow-up trials to verify.

Effects of butylphthalide injection on cerebral blood flow perfusion and cognitive function in patients with acute cerebral infarction accompanied by cognitive disorder / 中华神经医学杂志

Objective To investigate the effects of butylphthalide injection on cerebral blood flow (CBF) perfusion and cognitive function in patients with acute cerebral infarction accompanied by cognitive disorder.Methods From September 2016 to September 2017,80 patients with acute cerebral infarction and cognitive impairment were admitted to the Department of Neurology,Yan'an Hospital of Kunming Medical University.They were assigned to an observation group (n=40) and a control group (n=40).The control group received conventional treatment while the observation group received butylphthalide injection in addition to conventional treatment.The treatment lasted for 14 days for both groups.Before and after treatment,dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) was used to measure the CBF parameters in the cerebral ischemic region,and Montreal Cognitive Assessment (MoCA) was used to evaluate the changes in cognitive function.Results After treatment,rCBF and rCBV increased significantly and rMTT and rTTP decreased significantly in the observation group (P＜0.05).After treatment,there were significant improvements in MoCA subscores and total score in the observation group (P＜0.05).In the observation group,the post-treatment increases in rCBV and rCBF were positively correlated with increased MoCA total score (r=0.474,P=0.013;r=0.282,P=0.027),and the post-treatment decreases in rMTT and rTTP were negatively correlated with increased MoCA total score (r=-0.294,P=0.021;r=0.382,P=0.019).Conclusion Butylphthalide injection can safely improve CBF perfusion in the focal region and cognitive function in patients with acute cerebral infarction,with no obvious adverse reactions.

Meta-analysis of the Clinical Efficacy of Contralateral Needling in Treating Acute-stage Peripheral Facial Paralysis / 上海针灸杂志

Objective To compare the clinical efficacy between contralateral needling and homolateral (the affected side) needling in treating acute-stage peripheral facial paralysis by using systematic evaluation. Method By computer and manual retrieval, literatures about clinical trials on contralateral needling in treating acute-stage peripheral facial paralysis published before March of 2017 were collected from China National Knowledge Infrastructure (CNKI), WanFang database, Vip database, China Biology Medicine disc (CBMdisc), Pubmed, Web of Science, EMbase and The Cochrane Library. By adopting the Cochrane systematic evaluation, the collected data underwent meta-analysis by using RevMen 5.3 software. Result A total of 276 articles were retrieved and 11 articles were finally recruited, including 761 patients with acute-stage facial paralysis, 394 cases treated by contralateral needling and 367 by homolateral needling. The meta-analysis showed that contralateral needling produced more significant effective rate and recovery rate than homolateral needling [effective rate: RR=1.06, 95％CI(1.01,1.11), Z=2.32, P=0.02; recovery rate:RR=1.53, 95％CI(1.31,1.78), Z=5.42, P<0.01]. Moreover, contralateral needling produced a better effect in improving facial nerve function, showing an advantage in ameliorating facial movement [HB: WMD=0.26, 95％CI(0.04,0.48), Z=2.34, P=0.02; FDIP: WMD=3.77, 95％CI(1.53,6.01), Z=3.30, P<0.01]. Conclusion Contralateral needling is worth applying in treating acute-stage peripheral facial paralysis. However, due to the small amount and unsatisfactoryquality of the recruited literatures in this systematic evaluation, multiple-centered randomized trials with high quality and large sample size are expected for further verification.

Protective role of Gingko Biloba extract in intestinal mucosal barrier of intestinal inflammation mouse / 重庆医学

Objective To investigate the protective role of Gingko Biloba extract (EGB 761) in intestinal mucosal barrier of intestinal inflammation model mouse.Methods Thirty mice were randomly divided into the control group,model group and EGB 761 group;the animal model was established;the general condition,body mass change,fecal occult blood and colon histopatho1ogical changes were observed,the expressions of occludin-1 proteins in colon tissue were detected by immunofluorescence.Results The body mass in the model group appeared to decrease,drinking water and eating food were significantly decreased compared with that in the control group.However after the EGB 761 intervention,the body mass of the model mice was significantly risen again;little inflammatory cells infiltration could be seen in the EGB 761 group,the inflammatory degree was significantly alleviated compared with the model group.The fluorescence distribution of the claudin-1,occludin and zo-1 in colonic tissues of the model group was more disperse compared with the normal group,the fluorescence intensity was weakened with rough edge;after EGB 761 intervention,the fluorescence in the EGB7 61 group was distributed along with the cellular membrane,the intensity was slightly weakened compared with the normal control group,but was still stronger than that in the model group.Conclusion EGB 761 can improve the inflammatory reaction in mouse colonic tissue,its mechanism may be related with its strengthening the protective effect of intestinal mucosal barrier.

Protective role of Gingko Biloba extract in intestinal mucosal barrier of intestinal inflammation mouse / 重庆医学

Objective To investigate the protective role of Gingko Biloba extract (EGB 761) in intestinal mucosal barrier of intestinal inflammation model mouse.Methods Thirty mice were randomly divided into the control group,model group and EGB 761 group;the animal model was established;the general condition,body mass change,fecal occult blood and colon histopatho1ogical changes were observed,the expressions of occludin-1 proteins in colon tissue were detected by immunofluorescence.Results The body mass in the model group appeared to decrease,drinking water and eating food were significantly decreased compared with that in the control group.However after the EGB 761 intervention,the body mass of the model mice was significantly risen again;little inflammatory cells infiltration could be seen in the EGB 761 group,the inflammatory degree was significantly alleviated compared with the model group.The fluorescence distribution of the claudin-1,occludin and zo-1 in colonic tissues of the model group was more disperse compared with the normal group,the fluorescence intensity was weakened with rough edge;after EGB 761 intervention,the fluorescence in the EGB7 61 group was distributed along with the cellular membrane,the intensity was slightly weakened compared with the normal control group,but was still stronger than that in the model group.Conclusion EGB 761 can improve the inflammatory reaction in mouse colonic tissue,its mechanism may be related with its strengthening the protective effect of intestinal mucosal barrier.

Retrospective Analysis of Stroke at Acute Stage Treated by Traditional Chinese Medicine Clinical Pathway / 广州中医药大学学报

Objective To evaluate the effect for stroke(cerebral infarction)at acute stage intervened by traditional Chinese medicine(TCM) clinical pathway. Methods A retrospective analysis was carried out in the patients before and after intervention by TCM clinical pathway during the year of 2013-2016. The outcomes included the entrance rate,completion percentage,aberration rate,severity,hospitalization time,and hospitalization fee as well as functional prognosis 30 d after discharge. Results A total of 792 cases was included,241 cases admitted in the year of 2013, 191 in the year of 2014, 135 in the year of 2015, and 225 in the year of 2016. In the year of 2014-2016,the entrance rate,completion percentage,hospitalization time,hospitalization fee,critical case percentage,and gender constituent ratio were steadily(P > 0.05). Modified Rankin Scale(mRS)for short-term functional prognosis mRS 0 ~ 2 percentage and aberration rate in the year of 2016 were superior to those in the year of 2014 and 2015(P < 0.05). Functional improvement on discharge day 30 in the year of 2014-2016 was superior to that in the year of 2013(P < 0.05). The hospitalization time and hospitalization fee in the year of 2014-2016 were a liffle higher than those in the year of 2013(P < 0.05), showing no obvious increase. Conclusion The application of TCM clinical pathway can make the diagnosis and treatment procedure of stroke at acute stage standardized,enhance the therapeutic effect,achieve or even exceed the goal of manage scheme.

Clinical observation the effect of Tongue Manipulation of Pulling and massage on stroke in acute stage with allolalia / 中国实用护理杂志

Objective To analyze the clinical effect of tongue traction massage in the improvement of speech deficit in acute stage of ischemic stroke. Methods A total of 60 cases of acute ischemic stroke aphasia patients from June 2015 to June 2016 were selected and divided into experimental group (30 cases)and control group(30 cases)by random digits table method,the control group was treated with drug therapy, experimental group was treated with drug plus tongue traction massage therapy. The curative effect of tongue body massage and traction safety was compared between two groups. Results After 2 courses of treatment, there was no significant change in vital signs in the experimental group, the total effective rate was 90.00%(27/30), and the total effective rate of the control group was 70.00% (21/30), there was significant difference between two groups(Z=-2.05,P<0.05). Conclusions In the treatment of acute ischemic stroke aphasia,the tongue traction massage,good clinical effect,can effectively improve the patient′s speech function,simple operation,safety,compliance is good,worthy of promotion.