Corticospinal tract integrity and the upper limb motor functioning of stroke survivors treated with repetitive transcranial magnetic stimulation / 中华物理医学与康复杂志

Objective:To observe any relationship between corticospinal tract integrity and the upper limb motor function of stroke survivors treated with repetitive transcranial magnetic stimulation (rTMS).Methods:Bilateral corticospinal tracts (CSTs) were reconstructed in ischemic or hemorrhagic stroke survivors with upper limb motor dysfunction using diffusion tensor imaging (DTI). Thirty patients with good CST integrity (rFA>0.5) and 30 with rFA≤0.5 were further divided into a high frequency rTMS group (HF, n=10), a low frequency group (LF, n=10), and a control group ( n=10). All groups were given routine rehabilitation, while the high and low frequency groups were additionally provided with 5Hz and 1Hz rTMS respectively applied over the M1 area of the contralesional hemisphere. Before and after 3 weeks of treatment, all of the subjects were evaluated using the Fugl-Meyer upper extremity scale (F-M UE), the Wolf Motor Function Test (WMFT) and the Modified Barthel Index (MBI). Results:For the high CST integrity group, significant improvement was observed in the average scores of all measurements, with the average FMA-UE, WMFT and MBI scores of the LF group [(38.10±5.71), (43.20±5.32) and (78.00±11.35)] significantly better than those of the other 2 groups. Among the low CST integrity group, the HF subgroup showed greater improvement than the other 2 on average.Conclusions:For patients with good CST integrity, LF-rTMS over the contralesional cortex is superior to HF-rTMS in promoting upper limb motor function, while for patients with low CST integrity HF-rTMS over the contralesional cortex has a better effect than LF-rTMS or sham stimulation in terms of improving upper limb motor function after a stroke.

The effect of neuromuscular electrical stimulation on swallowing function after stroke / 中华物理医学与康复杂志

Objective To observe the clinical therapeutic effects of neuromuscular electric stimulation (NMES) on patients with swallowing disorders after stroke and to assess the value of surface electromyography (sEMG).Methods Forty stroke survivors with swallowing disorders were divided into a treatment group (20 cases) and a control group (20 cases) using a random number table.All of the patients were given routine medication and conventional swallowing training lasting 2 weeks,on the basis of which the patients in the treatment group were also given electrical stimulation.The seriousness of their swallowing disorders was evaluated and surface electromyographs were recorded for both groups before and after the 2 weeks of treatment.Results After treatment,the average dysphagia rating in the treatment group was significantly higher than before treatment,and significantly higher than that of the control group.sEMG of the suprahyoid muscles showed that the swallowing duration of both groups had significantly improved,but the values of the treatment group were significantly better than those of the control group.Conclusions NMES plus conventional swallowing training can significantly improve swallowing function for patients with swallowing disorders after stroke.sEMG can be regarded as an effective method for assessing swallowing disorders.

Cognition is correlated with auditory event-related potential P300 after traumatic brain injury / 中华物理医学与康复杂志

Objective To investigate any correlation between cognition and auditory event-related potential (ERP) after traumatic brain injury (TBI),and to explore the diagnostic value of the P300 ERP for TBI patients.Methods Thirty TBI patients and 28 healthy subjects were recruited.Their P300 auditory event-related potentials were measured and the Montreal cognitive assessment (MoCA) was administered.Results The TBI patients' total MoCA scores and their scores on most of the sub-item components were significantly lower than those of the control subjects,though their naming and speech showed no significant difference.The TBI patients had abnormal P300 responses.Their N1,P2,N2 and P3 latencies were significantly longer and their P2 and P3 amplitudes were significantly lower than those of the control group.Stepwise regression and multivariate analysis showed that the P300 latency was significantly associated with delayed memory,impaired visual spatial executive functioning and total MoCA score.Conclusion P300 can be used as a quantitative electrophysiological index for detecting cognitive impairment in patients with TBI.

Detection of NPM1 gene mutation in acute myeloid leukemia / 中华检验医学杂志

Objective To analyze the frequency of NPM1 mutation in de novo acute myeloid leukemia (AML) patients and the relationship between NPM1 mutation and chromosome alterations,as well as FAB subgroups,and to analyze the mutation type.MethodsA total of 99 de novo AML patients from 2004 to 2010 in China-Japan Friendship Hospital were studied.Genomic DNA was amplified by polymerase chain reaction (PCR),denaturing polyacrylamide gel electrophoresis (PAGE) and capillary electrophoresis were used to detect the mutation of NPM1 gene in 99 AML patients,and karyotyping was performed in 72 AML patients by G banding techniques.DNA sequences analysis of NPM1 mutation was performed on 10 patients.Chi-square test was used to compare the frequencies of NPM1 mutation among the different subgroups,and McNemar's test was used to compare the different rates between denaturing PAGE and capillary electrophoresis.ResultsThe frequencies of NPM1 mutations were detected in 15％ (15/99) of AML patients with capillary electrophoresis and 11％ (11/99 ) with denaturing PAGE(x2 =2.25,P ＞0.05 ).The NPM1 was at different rates in M2(27％,8/30),M5(32％,6/19),M6( 13％,1/8),respectively (x2 =1.06,P ＞ 0.05 ),and not detected in the other subgroups.NPM1 mutation in patients with normal karyotype(26％ ) was more prevalent than patients with abnormal karyotype (4％) (x2 =5.61,P ＜ 0.05)All of the 10 patients were of A type ( c.860_863dupTCTG).The C-terminal portion of the NPM protein by replacing the last seven amino acids(WQWRKSL) with 11 residues (CLAVEEVSLRK).Two intronic deletions were novel,one case was IVS10-18_-15delCTTT,the other was IVS10-17_-15delTTT.Conclusions NPM1 mutations represents a common genetic abnormality in AML patients,and NPM1 mutation in patients with normal karyotype is higher than patients with abnormal karyotype.Two new intronic deletion mutations are identified.

Study on the relationship between the grouping criterion of SWOG/ECOG and the prognosis of acute myeloid leukemia / 白血病·淋巴瘤

Objective To investigate the incidence and distribution of aberrational karyotype in acute myeloid leukemia (AML), and study the significance of the grouping by Southwest Oncology Group/Eastern Cooperative Oncology Group (SWOG/ECOG) in the prognosis of AML Methods The chromosome was prepared with brief culture of bone marrow, and the karyotype was analysed by G banding technique. All the patients were grouped according to the criterion of SWOG/ECOG, and the survival function of different groups was observed by the Kaplan-Meier method.Results 56 (67.47 %) out of 83 patients had clonal chromosome aberrations. Among those 56 patients, AML with translocation (15;17) and with translocation (8;21) presented in 30 patients(53.57 %), and the other kinds of aberrational karyotypes shared the left proportion. Among the 74 followed-up patients, 42 patients were dead. Among three groups with favorable, intermediate and adverse prognosis respectively, there is a significant difference (P 0.05). Conclusion Cytogenetic aberration is one of the important factors affecting the effect on prognosis. The criterion of SWOG/ECOG can predict prognosis objectively.