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ObjectiveTo clarify the feasibility of the 3D scanning volume method for distal upper limb volume measurement, and to analyze its scorer reliability and criterion-related validity. MethodsFrom January to March, 2022, a therapist (operator A) who had not been exposed to 3D scanning volume method and water displacement method was trained to use a handheld 3D laser scanner and a spilt cup to measure the volume of a PVC distal upper limb model. The operation time of 30 operations of each method was recorded. The learning curves of the two methods were plotted using cumulative sum (CUSUM) analysis. The curve was cut into the learning stage and the mastery stage by the vertex of peak. The times required to reach the mastery stage and the operation time of the mastery stage for the two methods were recorded. A total of 20 healthy subjects were recruited from Huashan Hospital of Fudan University. Two trained therapists (operator A and operator B) measured the bilateral distal upper limb volume using a handheld 3D laser scanner, and operator A measured the bilateral distal upper limb volume using a spilt cup. ResultsThe fitting learning curve of the 3D scanning volume method (R² = 0.984) reached its peak after eight times of operation; while that of the water displacement method (R² = 0.494) reached its peak after five times of operation. At mastery stage, the operator spent less time using 3D scanning volume method than using water displacement method (P < 0.05). The intraclass correlation coefficient between the two operators were both 0.979 for bilateral distal upper limb volume measure (P < 0.001). The Pearson coefficients was above 0.979 between 3D scanning volume method and water displacement method (P < 0.001). ConclusionA therapist can master the use of the 3D scanning volume method after eight times of operation, and the operation time of 3D scanning volume method is shorter than that of water displacement method at mastery stage. The 3D scanning volume method is well reliable and valid, that can be used as an alternative to the water displacement method for distal upper limb volumetric measurement.
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Objective:To study the correlation between the residual amounts of commonly used tissue decellularization reagents like sodium dodecyl sulfate (SDS), Triton X-100, sulfobetaine 10 (SB-10) and cytotoxicity, and to find the safety threshold for controlling the residual of the reagent.Methods:SDS, Triton X-100, SB-10 solutions of different concentrations were prepared, and the cytotoxicity of solutions of different concentrations was detected by L-929 cells and MC3T3-E1 cells according to the method of GB/T 16886.5. The mass concentration range of the above three decellularization reagents was refined, and the threshold for the residual non-cytotoxicity of a single reagent was determined. Mix the three reagents in pair or three blends, and determine the threshold of non-cytotoxicity after the reagents are mixed by cytotoxicity test.Results:SDS, Triton X-100 and SB-10 caused L-929 cells to produce cytotoxic concentration values of 4×10 -3, 2×10 -2 and 6×10 -1 mg/ml, and MC3T3-E1 cells 6×10 -3, 4×10 -2 and 2 mg/ml. The toxicity trend of the three reagents is SDS>Triton X-100>SB-10. When three reagents at critical concentrations are mixed in pairs or three, they have no cytotoxicity to L-929 cells and MC3T3-E1 cells. Conclusions:When using the above three decellularization reagents to prepare decellularized scaffolds, a variety of reagent cleaning procedures should be used to efficiently clean the tissues so that the residual amount of reagents is below the critical value to ensure the biological safety of the decellularized scaffolds.
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BACKGROUND: A proper virus inactivation procedure of medical bio-derived tissue repair material is very important to reduce the risk of virus infection and ensure the safety in the therapeutic process. OBJECTIVE: To elaborate different virus inactivation methods of allogeneic and xenogeneic tissue repair materials. METHODS: PubMed, Elsevier, CNKI, and WanFang databases were searched for relevant articles using the keywords of "allogeneic, xenogeneic, viral inactivation, disinfection, tissue repair biomaterial" in English and Chinese, respectively. RESULTS AND CONCLUSION: Virus inactivation methods can damage the performance of biological materials to different extents. For example, heat inactivation may produce permanent damage to the performance of heat-sensitive materials; γ-ray irradiation may result in the loss of mechanical properties and biologically active substances; acid/alkali method may also destroy the properties and structure of some materials intolerant to acid and alkali corrosion; and some reagent residues such as ethylene oxide, peracetic acid, and hydrogen peroxide may produce irritation to the body and even cause carcinogenic and teratogenic substances. Therefore, in enterprises and research institutions, the virus-killing effect and severity of damage to the material performance should be considered when the virus inactivation process is selected, and the use of existing production processes to verify the virus inactivation is recommended as much as possible.
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Objective To investigate the effect of melody intonation therapy on the language function of Chinese-speaking stroke survivors with Broca's aphasia. Methods Forty patients with Broca's aphasia after stroke were randomly divided into a treatment group and a control group, each of 20. The treatment group received melodic intonation training, while the control group received routine speech rehabilitation training including training of the vocal organs, oral expression, literal expression and listening comprehension 30 minutes a day, five days a week for 12 weeks. Before and after the treatment, the spontaneous speech, listening comprehension, retelling and naming of both groups were tested using the western aphasia battery. Results After the intervention, a significant increase was observed in the average aphasia quotient, speech, listening comprehension, retelling and naming scores of both groups. The average spontaneous speech, listening comprehension and naming scores and the aphasia quotient of the treatment group were then significantly better than those of the control group. Conclusion Melody intonation training and rhythm training can improve the speech and daily communication ability of stroke survivors effectively.
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@#Corticospinal tract (CST) is the major neuronal pathway that mediates voluntary movements, and the severity of injury may influence the recovery of motor function, especially that of the upper limbs, and involve to the long-term outcome. Axonal remodeling may happen in the CST after stroke, at the levels of spine and brain, which promotes the recovery of motor function. The mechanism of remodeling is complicated, and need more researched.
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@#Objective In the recovery process of stroke patients, the ability of maintaining standing and sitting position might have a great effect on the improvement of activity of daily living. There are few the methods which evaluate quantitatively and effectively the ability of position control ability in clinical practice. The aim of the study is to quantitatively evaluate the reliability of posturographic parameters based on the center of pelvis in different standing positions and walking activity.Methods From May to June, 2018, Seventy-nine healthy participants were enrolled. They were evaluated with iReGo, a walking assisstant robot, in three conditions: normal standing position, left/right standing position and walking 10 meters at an appropriate speed. The computer calculated the posturographic parameters automatically. The participants completed their second test one day after the first one.Results During normal standing position, the intra-class correlation coefficients (ICC) of average sway in coronal plane, average sway in sagittal plane, path length, and covered area were more than 0.70. During left standing position, ICC of all the above parameters were more than 0.70. During right standing position, ICC of all the above parameters were more than 0.49. When walking 10 meters at an appropriate speed, ICC of path length and covered area were more than 0.75. Comparing different standing positions, the normal standing position was more stable than the left/right standing position, and there was no difference between the left and the right standing positions.Conclusion Posturographic parameters based on the center of pelvis might be a reliable way to assess the position control ability in different standing positions and walking process.
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Micro positron emission computed tomography (PET) is a sort of tomography technique specifically for small animal stud-ies. It can be used to observe radionuclide labeling molecules in vivo, especially for neuronal activities noninvasively, dynamically and quan-titatively at the molecular level. MicroPET can be used for early detection of atherosclerotic plaques, measurement of cerebral blood flow, judgment of the survival status in cerebral ischemia area in animal model. It is important for the control of risk factors, disease diagnosis, dis-ease staging and evaluation of curative effect.
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Diffusion tensor imaging (DTI) is a noninvasive MRI technique, which can identify changes in microstructure of the brain, especially in the variations of the nerve fiber bundles. For stroke rehabilitation, DTI is applied in the functional evaluation and prognosis, ba-sic experimental research and efficacy evaluation of rehabilitation therapy.
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Objective To investigate the effect of electromyographic biofeedback motion sensing game on upper limb function in chil-dren with obstetric brachial plexus palsy (OBPP). Methods From March, 2013 to February, 2014, 41 children with OBPP were randomly as-signed into conventional rehabilitation group (n=21) and motion sensing game group (n=20). Both groups underwent a comprehensive course of rehabilitation, and the motion sensing game group received upper limb occupational therapy in the motion sensing game, for four weeks. They were assessed with Mallet shoulder function scale and the surface electromyogram (EMG) of the deltoid muscle when abduct-ing the shoulder before and after treatment. Results Before treatment, there was no significant difference in the Mallet scores between two groups (t=0.730, P>0.05), the scores improved after treatment in both groups (t>5.085, P3.195, P4.420, P2.282, P2.155, P<0.05). Conclusion Electromyographic biofeedback motion sensing game therapy plays a role in the rehabilitation of upper limb function and muscle strength in children with OBPP.
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@#Constraint induced movement therapy (CIMT) is considered to be effective in restoring the impaired limb motor function in patients after stroke. CIMT enhanced neurogenesis in sub-ventricular zone and promoted the proliferation and long-term survival of the newborn neurons in the ischemic penumbra region. CIMT also enhanced the midline-crossing phenomenon, which means the midline crossing of the contralesional corticospinal tract originated nerve fibers to the denervated side in the cervical spinal cord. CIMT down-regulated the expression of Neurite outgrowth inhibitor-A (Nogo-A) as well as regulated other molecules to promote the growth of nerve fibers. In addition, CIMT ajusted the expression of brain- derived neurotrophic factor and Rho kinsase. Nevertheless, whether the structural plasticity caused by CIMT really participated in limb function remains unknown. And many studies on molecular mechanisms lack the evidence of necessary promotion and inhibition of the related molecule.
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@#A varus dropped foot, one of the most common deformities of hemiplegic lower limb in stroke patients, significantly affected the ability of ambulation. Electric stimulation therapy was one of mostly used techniques for this problem. This paper focused on the application of low frequency electric stimulation in the treatment of the varus dropped foot in stroke patients, analyzed the clinical efficacy and advantage of neuromuscular electrical stimulation and functional electrical stimulation, and the discussion of their mechanism.
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Objective:To investigate the prognostic value of plasma C-reactive protein (CRP) level in patients with paraquat poisoning. Methods: This study included 162 patients with paraquat poisoning. The data of plasma paraquat,CRP level and arterial blood gas were analyzed. Cox regression analysis was applied to evaluate the risk factors of prognosis. Receiver operating characteristics curve analysis and area under curve were used to calculate the predictive power of significant variable. Differences in patient survival were determined using the Kaplan-Meier method and a log-rank test. Results:PlasmaCRP level was significantly increased in non-survival patients compared with survival patients (P Conclusions: These results suggest that plasmaCRP level is distinct increased in patients with paraquat poisoning, and the plasmaCRP level may be useful for the prediction of prognosis in paraquat poisoning.
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Constraint induced movement therapy (CIMT) is considered to be effective in restoring the impaired limb motor function in patients after stroke. CIMT enhanced neurogenesis in sub-ventricular zone and promoted the proliferation and long-term survival of the new-born neurons in the ischemic penumbra region. CIMT also enhanced the midline-crossing phenomenon, which means the midline crossing of the contralesional corticospinal tract originated nerve fibers to the denervated side in the cervical spinal cord. CIMT down-regulated the expression of Neurite outgrowth inhibitor-A (Nogo-A) as well as regulated other molecules to promote the growth of nerve fibers. In addi-tion, CIMT ajusted the expression of brain-derived neurotrophic factor and Rho kinsase. Nevertheless, whether the structural plasticity caused by CIMT really participated in limb function remains unknown. And many studies on molecular mechanisms lack the evidence of necessary promotion and inhibition of the related molecule.
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A varus dropped foot, one of the most common deformities of hemiplegic lower limb in stroke patients, significantly affected the ability of ambulation. Electric stimulation therapy was one of mostly used techniques for this problem. This paper focused on the applica-tion of low frequency electric stimulation in the treatment of the varus dropped foot in stroke patients, analyzed the clinical efficacy and ad-vantage of neuromuscular electrical stimulation and functional electrical stimulation, and the discussion of their mechanism.
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@#Objective To investigate the effectiveness of facial motor therapy combined with acupressure on Bell's palsy. Methods 58 patients with Bell's palsy were randomly divided into control group (n=29) and experimental group (n=29). The control group was treated with routine treatment. The experimental group was treated with motor therapy and acupressure routine treatment in addition. All patients were assessed with Facial Nerve Function Defect Assessment before, 2 weeks and 4 weeks after treatment. Results The average time for treatment was (29.62±12.15) days in the control group and (25.63±11.56) days in the experimental group (P>0.05). The rate of effectiveness was 100% in two groups. The rate of complete recovery was not significantly different between the two groups (58.6% vs. 72.4%, respectively,P>0.05). Significantly difference of score of Facial Nerve Function Defect Assessment was only found between two groups 2 weeks after treatment (P<0.05), but tended to be lower in the experimental group than in the control group. Conclusion Facial motor therapy plus acupressure is helpful in promoting the recovery of Bell's palsy.
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Objective To evaluate the effectiveness of standardized three-stage rehabilitation program on spasticity and motor function in the upper extremities after cerebral hemorrhage.Methods A total of 364 patients were included and randomly assigned to a control group (n =181) and a rehabilitation group (n =183).The standardized three-stage rehabilitation program,which included early-stage bedside rehabilitation,specialized treatment in rehabilitation ward during recovery and rehabilitation follow-up at regular intervals was applied in the rehabilitation group,but only rehabilitation guidance and follow-up after discharge were provided for the control group.The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were performed at the time of recruitment,1 month (M1),3 months(M3) and 6 months(M6) later.Results There was no statistical difference between the groups at recruitment.The occurrence rate of spasticity was 22.7％ in the control and 23.5％ in the rehabilitation group.At M6 the occurrence rate of spasticity was about 59.7％ and 43.2％ in control group and rehabilitation group respectively,and the number of patients grade 1 + and grade 2 on the MAS was 50/181 in the control group,significantly more than in the rehabilitation group (25/183).At all time points,MAS grade 0 accounted for a large proportion of both groups.At M6,both MAS distributions and scores of the two groups were different statistically (P ＜ 0.01).FMA scores in both groups increased significantly (P ＜ 0.01) with time,with the score being (17.13 ± 16.46),(24.87±18.36),(30.68±19.41) at M1,M3 and M6 in the control group and (24.71 ±19.80),(39.83 ± 19.50),(48.87 ± 18.25) in the rehabilitation group,but the average scores of the latter were consistently significantly higher than the former (P ＜ 0.01).Conclusions Standardized three-stage rehabilitation can alleviate spasticity and improve motor function of the upper extremities in cerebral hemorrhage patients.
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Music and speech may share the same neural pathway, and the role of music therapy in speech rehabilitation gradually at-tracts the attention from the rehabilitation medical profession in recent years. This article reviewed the effect, mechanism, and strategy of music therapy in speech rehabilitation.
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Objective To analyze the effects of rehabilitation training,acupuncture and the combination of these two therapies on the motor function of stroke survivors,and to evaluate their health economics.Methods Two hundred and five stroke survivors were randomly divided into a rehabilitation group (64 cases),an acupuncture group (69 cases) and a combined group (72 cases).The rehabilitation group received conventional rehabilitation training for 28 days,while the acupuncture group received scalp needling combined with body acupuncture.The combined group received both the training and the acupuncture.The clinical neural functional deficiency scale (NDS) and functional comprehensive assessments (FCA) were evaluated at baseline and on the 28th day after treatment and 28th day after the treatment had ended.The total cost including the direct medical costs,direct non-medical costs and indirect costs were calculated and analyzed.Results The NDS and FCA scores showed no significant difference between the three groups at baseline.At the 28th day after treatment and and 28th day after the treatment had ended,both the NDS and FCA scores had improved significantly in all groups compared with the baseline.However,there was no significant difference between the groups.At the 28th day there was a significant difference in the NDS results of the combined group compared to the other two groups.Significant differences in NDS results among all three groups had appeared by the 56th day,but there was still no significant difference in average FCA scores.At the 28th day no significant difference in cost was observed among the three groups,but the combined group spent significantly less in total cost,direct medical costs,direct non-medical costs and indirect costs for a one point NDS decrement.However,there was no significant difference in the cost of producing a one point increment in FCA among the three groups.Conclusion Combining rehabilitation training with acupuncture is more economical and effective than either treatment alone.
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Objective To explore the factors influencing the recovery of ability in the activities of daily living (ADL) after intracerebral hemorrhage. Methods A total of 108 patients with intracerebral hemorrhage admitted for rehabilitation to the rehabilitation medicine department of Huashan Hospital between January 2007 and June 2011 were studied.Twelve items of clinical data were collected with regard to the patients' medical history,physical status,modified Barthel index (MBI) score and Brunnstrom stage at admission.Functional status was classified according to the MBI scores and Brunnstrom stages assessed at admission and before discharge.Linear regression analysis was used to relate the variables. Results After rehabilitation,the MBI scores and Brunnstrom stages had improved relative to the scores at admission.Factors influencing the MBI improvements included the intervention timing of rehabilitation and the course of therapy employed. Conclusions It is very important to comprehend the factors influencing the recovery of ADL ability after cerebral hemorrhage in order to design effective rehabilitation strategies,better predict functional outcomes and improve patients' ADL ability effectively.
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Objective In order to explore the effects of rehabilitation training and acupuncture on the neural function deficit and motor function in patients with ischemic streke.Methods Eighty patients with ischemic stroke were randomly divided into rehabilitation and acupuncture groups.According to different recovery stages,the rehabilitation group received purposeful rehabilitation training for 28 days while the acupuncture group received scalp needling combined with body acuptmcture.The neural deficit scores(NDS)and motor fimction comprehensive assessment(FCA) were evaluated at the recruitment(M_0),the 28~(th)(M_1)and 56~(th)(M_2)days after treatment.Results No significant difierences were found in the NDS and motor FCA between the rehabilitation and the acurluncture groups at the recruitment.The significant differences appeared at the 28~(th) and the 56~(th) days comparing with baseline assessments in each group.There was no significant difference in the changes of NDS and motor FCA between the two groups at 28~(th) day,however,the NDS and motor FCA in rehabilitation group revealed better outcome than the acupuncture group at the 56~(th) day.Conclusion The study indicated that both rehabilitation training and acupuncture could improve the neural function and enhance the motor function in patients with ischemic stroke.