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ObjectiveTo investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on walking function of stroke patients at recovery stage. MethodsFrom January, 2021 to January, 2022, 60 stroke inpatients at recovery stage from Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the groups accepted conventional rehabilitation therapy and lower limb robot-assisted training, while group B accepted pseudo-rTMS, and group C accepted high-frequency rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT) and gait analysis before and after treatment. ResultsThe score of FMA-LE, TUGT, pace, stride width, stride, double support phase time, affected side support phase time, affected side swing phase time, healthy side support phase time and healthy side swing phase time improved after treatment in all the groups (|t| > 5.990, P < 0.001), and all the indexes improved the most in group C (F > 3.210, P < 0.05), except double support phase time. ConclusionHigh-frequency rTMS could facilitate the recovery of lower limb function and walking of stroke patients at recovery stage.
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The brain-gut axis is an important pathway for the interaction between the central nervous system and the gastrointestinal tract. Ischemic stroke can promote the imbalance and displacement of intestinal flora, and the intestinal flora and its metabolites in turn can affect the occurrence, development and outcome of ischemic stroke. This article reviews the related literature on ischemic stroke and intestinal flora, in order to review the relationship between the two and related mechanisms, and to prospect the stroke treatment of targeting intestinal flora.
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Objective To investigate the effect of capsule endoscopy on the small intestinal mucosa in the state of air insufflation. Methods Patients undergoing capsule endoscopy from November 2011 to April 2012 were divided into the air insufflation intervention group ( n＝14) and routine examination group (n＝13) by random number table method. The detection rate of small bowel disease, the transit time of capsule endoscope in small intestine, the degree of intestinal cleaning and the degree of intestinal lumen expansion were compared between two groups. Results There was no significant difference in total intestinal examination rate [ 85. 71%( 12/14) VS 61. 54%( 8/13),P＝0. 209] or disease detection rate [ 71. 43%(10/14) VS 84. 62%( 11/13), P＞0. 05] between air insufflation intervention group and conventional examination group. The mean procedure time of the air insufflation intervention group was 270. 86 ± 144. 85 min, which was shorter than that of the conventional examination group (325. 15±161. 76 min, P＝0. 369). The overall cleanliness of the air insufflation intervention group was higher than that of the conventional examination group (2. 05±0. 40 VS 1. 75±0. 40,P＝0. 060). The overall degrees of expansion of small intestine lumen were 1. 79 ± 0. 40 and 1. 38 ± 0. 29 scores, respectively ( P ＝ 0. 004 ). Conclusion Capsule endoscopy can significantly improve the degree of intestinal lumen expansion with trend of improving the overall cleanliness of the small intestine, and shortening the working time of the small intestine.
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Public hospital reform pilots have been initiated recently and it is necessary to clarify some key issues. To this end, thispaper touches upon six fundamental issues, discussing the generality and value for the existence of public hospitals, differences between reforms of public hospital and those of state-owned enterprise, the public financing for and regulation on public hospitals, relationship with the private sector, as well as service and function positioning of public hospitals.