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ObjectiveTo explore the effects of different intensity of wearable lower limb rehabilitation robot-assisted training on walking function, lower limb motor function, balance function and functional independence of stroke patients. MethodsFrom November, 2021 to December, 2022, 60 stroke patients hospitalized in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), observation group 1 (n = 20) and observation group 2 (n = 20). All the groups received routine rehabilitation, while the control group received routine walking training 30 minutes a day, the observation group 1 received wearable lower limb rehabilitation robot-assisted training 30 minutes a day, and the observation group 2 received wearable lower limb rehabilitation robot-assisted training 60 minutes a day, for four weeks. They were assessed with Functional Ambulation Category scale (FAC), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Rivermead Mobility Index (RMI) before and after treatment. ResultsOne case in the observation group 1 and three cases in the observation group 2 dropped down. The FAC, FMA-LE, BBS and RMI scores improved in all the three groups after treatment (|Z| > 3.448, |t| > 8.102, P < 0.001), and there was no significant difference in all the indexes among the three groups (|H| < 4.643, F = 1.454, P > 0.05); however, the improvement of BBS score was more in the observation group 1 than in the control group (P < 0.05), and the improvement of all the indexes was more in the observation group 2 than in the control group (P < 0.05). ConclusionThe wearable lower limb rehabilitation robot-assisted training may promote the recovery of walking function, lower limb motor function, balance function and functional independence of stroke patients, and high-intensity training seems to be more effective.
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ObjectiveTo observe the effect of video-based mirror therapy on lower limb motor function, walking ability, and balance of stroke patients at recovery stage. MethodsFrom January to October, 2022, 43 stroke patients in Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and mirror therapy group (n = 21). Both groups received routine rehabilitation, and the mirror therapy group received video-based mirror therapy additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC) and Berg Balance Scale (BBS) before and after treatment. ResultsAfter treatment, the scores of FMA-LE, FAC and BBS improved significantly in both groups (|t| > 6.205, P < 0.001), and the scores of FMA-LE and BBS were better in the mirror therapy group than in the control group (|t| > 2.164, P < 0.05). ConclusionCombining with video-based mirror therapy could facilitate to improve the lower limb motor function and balance ability of stroke patients at recovery stage.
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The interaction between heart and brain has drawn more and more attention in recent years. The concept of heart-brain inte-gration has been gradually established, which means the interaction in physiology and pathology between the two organs. On the basis of nerve-fluid system, sympathetic nervous system and renin-angiotensin-aldosterone system (RAAs) are involved in the modulation of heart and brain. As review of the ancient literature of China, heart and brain were considered as the organs of cognition and behavior, which are the functions of only brain from modern science. Several recent researches supported the opinions of ancient Chinese scholars in some ways.
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Objective To evaluate the method of controlled cortical impact(CCI) on long term cognitive disorder after traumatic brain injury(TBI) and to investigate the possible pathological mechanism.Methods Sixty male SD rats were randomly assigned into 3 groups:sham surgery group(n =10),control group (n =10) and CCI group(n =40).CCI application was used to make the bilateral frontal lobe controlled cortical impact model (depth:1.5 mm,velocity =3.5 m/s,dwell time =400 ms).Morris water maze test and Nissl's staining was used to assess the cognitive function and pathological changes after 8 weeks of CCI.The expressions of brain derived neurotrophic factor (BDNF) and tyrosine protein kinase B (TrkB) mRNA in frontal lobe and hippocampus tissue was detected by reverse transcription polymerase chain reaction(RT-PCR).Results The mortality in CCI group was only 12.5％.Morris water maze test results showed the escape latency in CCI group was longer than that in sham surgery and control groups(F =51.784,P ＜ 0.05).Percent of time spend in goal quarter during probe trial in CCI group was significantly less than that in sham surgery and control groups(F =13.468,P ＜ 0.05).Nissl's staining showed frontal lobe had obviously defects; Nissl's bodies of frontal cortex and CA1 region in hippocampus reduced.The expressions of BDNF and TrkB mRNA in frontal lobe and hippocampus were significantly less than those in sham surgery and control groups(P ＜ 0.05).Conclusions The CCI model can be applied for study on long term cognitive disorder after TBI with good stability and repeatability.Using the experimental parameters of CCI can damage the long term cognitive function after TBI in rats,and lead the pathology changes of brain tissue clearly.This may have some relationship with the expressions of BDNF and TrkB mRNA.
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@#Objective To observe the effect of Tongqiaohuoxue decoction on cognitive impairment in rats with traumatic brain injury and explore the mechanisms. Methods 70 Sprague-Dawley rats were randomized into normal group (n=10), sham operated group (n=20), untreated group (n=20) and treatment group (n=20). Controlled cortical impact device was utilized to establish traumatic brain injury model. The treatment group received Tongqiaohuoxue decoction 5 ml/d, and other groups received distilled water. The cognitive function of rats was evaluated with Morris water maze 1, 2, 3, 4 weeks post operation. And the rats were sampled to test the expression of brain-derived neu-rotrophic factor (BDNF) and synaptophysin (Syn) I in hippocampus through immunohistochemistry. Results The escape latency was longer in the untreated group than in the normal group in all the time points (P<0.05), and was longer in the treatment group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). And it was shorter in the treat-ment group than in the untreated group 3 and 4 weeks after injury (P<0.05). The percentage of swimming time was lower in the untreated group than in the normal group in all the time points (P<0.05), and was lower in the treatment group than in the normal group 1, 2, and 3 weeks after injury (P<0.05), with no significant difference 4 weeks after injury (P>0.05). And it was higher in the treatment group than in the untreated group weeks after injury (P<0.05). The BDNF expression was lower in the untreated group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). It was higher in the treatment group than in the normal group 4 weeks after injury (P<0.01), and was higher in the treatment group than in the untreated group 2, 3 and 4 weeks after in-jury (P<0.05). The Syn I expression was lower in the untreated group than in the normal group in all the time points (P<0.001), and was low-er in the treatment group than in the normal group 1, 2 and 3 weeks after treatment (P<0.01). And it was higher in the treatment group than in the untreated group 3 and 4 weeks after injury (P<0.01). Conclusion Tongqiaohuoxue decoction could improve the cognitive function in rats with traumatic brain injury. The change in expression of BDNF and Syn I might be associated with the improvements.
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Objective To investigate any correlation between diffusion tensor imaging (DTI) results and Montreal cognitive assessment (MoCA) scores after severe traumatic brain injury (TBI).Methods Eight male pa-tients with chronic severe TBI were given the MoCA (including memory,attention,speech and executive function).DTI was used to quantify the fractional anisotropy (FA) of white matter fiber tracts in the radial and longitudinal fasciculus,under longitudinal fasciculus,internal capsule,corpus callosum genu and body,and the cingulate cortex.Pearson correlation coefficients were calculated to quantify the correlation between the FA values and MoCA scores.Results There was a positive correlation between FA in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus and MoCA total scores.Conclusion The MoCA scores of patients with chronic severe TBI are related to white matter damage in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus.
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@# Objective To observe the effectiveness of Dabugantang decoction on post-stroke fatigue. Methods 83 stroke patients were included and divided into control group (n=45) and treatment group (n=38). Both groups accepted routine rehabilitation, while the treatment group was administrated with Dabugantang decoction twice daily for 4 weeks in addition. All the patients were evaluated with Fatigue Severity Scale (FSS), Hamilton Depression Scale (HAMD), and Modified Barthel Index (MBI) before and after treatment. Results The scores of HAMD and MBI increased significantly in both groups after treatment (P<0.05). The score of FSS significantly decreased in the treatment group after treatment (P<0.05), but no significant difference was found in the control group (P>0.05). There were statistical differences in the scores of FSS, HAMD and MBI between two groups after treatment (P<0.05). Conclusion Dabugantang decoction can alleviate the fatigue and depression in stroke patients and improve activities of daily living.
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Objective To observe the effectiveness of Dabugantang decoction on post-stroke fatigue. Methods 83 stroke patients were included and divided into control group (n=45) and treatment group (n=38). Both groups accepted routine rehabilitation, while the treatment group was administrated with Dabugantang decoction twice daily for 4 weeks in addition. All the patients were evaluated with Fatigue Sever-ity Scale (FSS), Hamilton Depression Scale (HAMD), and Modified Barthel Index (MBI) before and after treatment. Results The scores of HAMD and MBI increased significantly in both groups after treatment (P0.05). There were statistical differences in the scores of FSS, HAMD and MBI between two groups after treatment (P<0.05). Conclusion Dabugantang decoction can alleviate the fa-tigue and depression in stroke patients and improve activities of daily living.
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@#ObjectiveTo observe the changes of thyroid hormone and reproductive hormone in post-acute traumatic brain injury(TBI).Methods70 post-acute TBI patients were selected from Beijing Charity Hospital from September 2009 to March 2010. The levels of thyroid stimulating hormone(TSH), triiodothyronine(T3), thyroxine(T4), free triiodothyronine(FT3), free thyroxine (FT4), follicie stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), and testosterone (T) were measured at 7 a.m. to 8 a.m. on the second day of admisson. According to the reference ranges, the total abnormal rate and the single hormone abnormal rate were calculated. According to the level of hormone, the subjects were divided into the normal group and the abnormal group. The two groups were compared in gender, age, course of disease, duration of coma, basal fracture and scores of Disability Rating Scale (DRS).ResultsThe total abnormal incidence of anterior pituitary hormone was 77.1% in post-acute TBI. The abnormality of reproductive hormones was higher. The duration of coma was related to the reproductive hormone.ConclusionThe abnormal incidence of anterior pituitary hormone occurs frequently in post-acute TBI. The duration of coma is related to the reproductive hormone.
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@# A 33-year-old male patient with tick-borne encephalitis (TBE) was reviewed, who presented with severe neurological deficits following TBEV infection, and improved in his motor and quality of life after an individualized rehabilitation.
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@#ObjectiveTo study the effect of a course of regular rehabilitation treatment on patients with different traumatic brain injury(TBI) course, explore the costs of one rehabilitation course in patients with different TBI course, and study the timing and focus of rehabilitation on patiens with different stages.Methods250 TBI patients were distributed to five groups by different TBI courses: <3 months, 3～6 months, 6 months～1 year, 1～2 years and >2 years. The clinical data and initial function evaluation were done at the admission. All of them received at least one regular rehabilitation treatment, then another function evaluation was done. Effects and costs of one rehabilitation course in patients with different TBI course were investigated.ResultsThe longer the duration of illness, the higher the cost-effectiveness ratio. The cost-effectiveness ratio of the second treatment course was higher than the first one. The patients within 12 months should receive a comprehensive rehabilitation treatment, and should be prevented and treated hydrocephalus and other complications; for patients within 1～2 years, there would be no significant improvement in balance and lower limb function, should enhance the training of activity of daily living (ADL) and upper extremity function; for the patients more than two years just improved ADL using of residual function.ConclusionTBI patients should accept rehabilitation as soon as possible, and should be conducted corresponding trainings according to different disease course.
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@#The change of pitutary hormones can occur in any time after traumatic brain injury, the main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury. It is important to further research when to test hormone and to carry on the hormone replacement therapy.
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@# Objective To study the relationship between needle retaining anddeqi. Methods Manual acupuncture was performed at the left ST36 of 26 naive healthy adult volunteers. Half of them retained the needles for 6 min and others were put the needle out immediately afterdeqi. Hemodynamic parameters of the anterior tibial artery were observed with color Doppler ultrasonography before and at 0, 1, 2, 3, 4, 5 min after acupuncture. Results There was significant difference in Vmax、Vm、Pi and Dist in anterior tibial artery before and 3 min after acupuncture, but wasn't between needle remaining and not. Conclusion Needle retaining cannot change the regional haemodynamics during acupuncture, which suggest it cannot strengthendeqi.
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@#Objective To explore the effect of acupuncture on stroke patients in hemiplagic spasm period.Methods63 stroke patients in hemiplagic spasm period were randomly divided into the electro-acupuncture group(n=31) and control group(n=32).All patients of two groups received routine rehabilitation training,but those of the electro-acupuncture group were added with electro-acupuncture at "Zusanli"(ST36).The composite spasticity scale(CSS) score,H/Mmax and muscular compliance of two groups before and after treatment were observed and compared.ResultsThe CSS scores and H/Mmax and grading gastrocnemius muscular compliance of the electro-acupuncture group were superior to that of the control group(P<0.05～0.01).ConclusionAcupuncture can decrease muscular tension and increase motor function of stroke patients in hemiplagic spasm period.
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@#Stroke is common clinically and spasticity is one of the main symptoms.There is some advance in recognition of the spasticity after stroke in the basic and clinic,but it remains obscure.
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@#Objective To explore the effect of acupuncture on stroke patients in hemiplagic spasm period.Methods63 stroke patients in hemiplagic spasm period were randomly divided into the electro-acupuncture group(n=31) and control group(n=32).All patients of two groups received routine rehabilitation training,but those of the electro-acupuncture group were added with electro-acupuncture at "Zusanli"(ST36).The composite spasticity scale(CSS) score,H/Mmax and muscular compliance of two groups before and after treatment were observed and compared.ResultsThe CSS scores and H/Mmax and grading gastrocnemius muscular compliance of the electro-acupuncture group were superior to that of the control group(P<0.05～0.01).ConclusionAcupuncture can decrease muscular tension and increase motor function of stroke patients in hemiplagic spasm period.
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@#Objective To observe the effects of electroacupuncture at Zusanli (ST36) on lower limbs motor function in patients with stroke. Methods 63 patients were evenly randomized into electroacupuncture group and control group. All the patients received routine rehabilitation training and at the same time,patients in electroacupuncture group, received electroacupuncture at zusanli (ST36). They were assessed with Fugl-Meyer Assessment (lower limb, hip, knee and ankle), gait analysis (gait frequency, gait speed and step length of both sides) and lower limb Composite Spasm Scale (CSS) before and after treatment. Results The scores of Fugl-Meyer Measure, gait analysis, and CSS improved in both groups, and more significantly in electroacupuncture group. Conclusion Electroacupuncture at zusanli (ST36) can significantly improved lower limb motor function without worsening the spasm.
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OBJECTIVE To obtain the primary differential items between bacillary dysentery and other infectious diarrhea through risk factor analysis.METHODS The epidemiology and clinical manifestation of 138 bacillary dysentery patients and 205 other infectious diarrhea patients were investigated.The Logistic regression was used to screen the correlation factors to differentiate bacillary dysentery from other infectious diarrhea.RESULTS The mean temperature of bacillary dysentery patients was(38.4?0.7)℃,while that of other infectious diarrhea was(38.1?0.6)℃(P=0.023).Bacillary dysentery patients with tenesmus and mucous stool were 34.1% and 55.8%,respectively but of 11.7% and 1.5% of other infectious diarrhea patients(P