Acupuncture at pharyngeal acupoints for true bulbar paralysis after cerebral infarction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of acupuncture at the affected side and both sides of the pharyngeal acupoints for true bulbar paralysis after cerebral infarction.@*METHODS@#A total of 66 patients with true bulbar paralysis after cerebral infarction were randomly divided into an unilateral group and a bilateral group, 33 cases in each group, 1 case dropped off in each group at last. On the basis of conventional drugs and electro-nape-acupuncture treatment, the patients in the unilateral group were treated with acupuncture at the affected side's , and (Extra), while patients in the bilateral group were treated with acupuncture at the both sides' , and The treatment was performed once a day, 6 days a week, and the clinical effect was assessed after 21-day therapy. The swallowing and vocalization of the two groups were evaluated by dysphagia grading scale, Kubota water swallowing test and GRBAS grading scale before and after treatment.@*RESULTS@#After 21 days of treatment, the scores of the dysphagia grading scale in the two groups were both improved (<0.01), and the unilateral group was superior to the bilateral group (<0.01). The GRBAS grading scale and Kubota water swallowing test grading after treatment were improved in both groups (<0.01), and the unilateral group was superior to the bilateral group (<0.05, <0.01).@*CONCLUSION@#Acupuncture at the pharyngeal acupoints of the affected side achieves much better therapeutic effect on true bulbar paralysis as compared with the acupoints of the bilateral sides.

Needle electromyography of the genioglossus muscle in the detection of amyotrophic lateral sclerosis / 中华神经科杂志

Objective To investigate the diagnostic value of spontaneous activities in genioglossus of amyotrophic lateral sclerosis (ALS).Methods A retrospective analysis of 79 patients diagnosed with ALS from January 2014 to December 2015 in Beijing Tiantan Hospital Affiliated to Capital Medical University was made.The patients were divided into two groups according to the clinical examination:with (44 patients) or without bulbar symptoms (35 patients).The course of disease,spontaneous potentials and ALS-Functional Rating Scale (ALS-FRS) scores were discussed,together with the association between semi-quantitative evaluation of spontaneous potential of the genioglossus and ALS-FRS score.Results In ALS patients,the overall positive rate of glossal spontaneous potentials was 69.6％ (55/79),among which the positive rate was 82.9％ (29/35) in patients with bulbar symptoms and 59.1％ (26/44) in patients without bulbar symptoms,with statistically significant differences between the two groups (x2=5.206,P＜0.05).While the positive rate in sternocleidomastoid was only 13.9％ (11/79),and there was no statistically significant difference between patients with or without bulbar symptoms.Semi-quantitative evaluation of fibrillation potentials in genioglossus muscle was correlated with ALS-FRS score (r=-0.258,P＜0.05).Conclusion Compared with sternocleidomastoid muscle,genioglossus muscle has a higher positive rate of spontaneous potentials and a higher diagnostic value in patients with subclinical bulbar symptoms.

Electromyography guided point injection at Renying (ST 9) for post-stroke dysphagia / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect of electromyography (EMG) guided point injection at Renying (ST 9) for post-stroke dysphagia caused by bulbar paralysis, and explore effective treatments for improving swallowing function on the basis of conventional medicine and rehabilitation training.</p><p><b>METHODS</b>A total of 60 patients were randomly divided into an observation group and a control group, 30 cases in each one. The conventional drugs combined with rehabilitation training were given in the control group, the treatment was given once every day. Based on the treatment in the control group, the EMG guided point injection at Renying (ST 9) was added in the observation group, three times a week. All the treatment was given for 2 weeks. drinking test score and Toshima Ichiro swallow test score were observed before and after treatment in the two groups, and the effects were assessed.</p><p><b>RESULTS</b>Toshima Ichiro swallow test score increased after treatment in both groups compared with that before treatment, and drinking test score decreased compared with that before treatment (all <0.05), and the change rate in the observation group was significantly better than that in the control group (both <0.05). The total effective rate of swallowing efficacy in the observation group was 93.3% (28/30), and the cured rate was 46.7% (14/30), which were better than 26.7% (8/30) and 3.3% (1/30) in the control group (both <0.05).</p><p><b>CONCLUSION</b>On the basis of conventional drugs and rehabilitation training, the EMG guided point injection at Renying (ST 9) can effectively increase the swallowing function of patients with post-stroke dysphagia caused by bulbar paralysis .</p>

Clinicial analysis of 69 patients with acute hyperthyroid myopathy and its treatment / 中华内分泌代谢杂志

Sixty-nine cases of acute hyperthyroid myopathy admitted from 1990 to 2011 were retrospectively analyzed.Hoarseness was the most common symptom; 17.39％ of the patients had difficulty in breathing; respiratory muscle paralysis and aspiration pneumonia were the main causes of death.Efficient treatment lasting for two weeks was carried out in 81.16％ of the cases.Patients with severe bulbar palsy were often complicated with aspiration pneumonia and thus had high mortality rate.The main treatments in cluded anti-hyperthyroid drugs,corticosteroids,energy supports,and symptomatic management,which usually resulted in good clinical improvement.