Therapeutic effects of acupuncture combined with rehabilitation training on dysphagia in post-stroke pseudobulbar palsy / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic effects on dysphagia in post-stroke pseudobulbar palsy between the combined treatment with acupuncture and rehabilitation training and the combined treatment with low-frequency electrical therapy and rehabilitation training and to explore its more effective therapy, using the ultrasonographic examination.</p><p><b>METHODS</b>A total of 60 patients of dysphagia in post-stroke pseudobulbar palsy were randomly assigned into an observation group and a control group, 30 cases in each one. The rehabilitation treatment was provided in the two groups. Additionally, in the observation group, acupuncture was used at the three-tongue points [Shanglianquan (Extra), located in the depression between the lingual bone and the border of lower jaw, 1 inferior to the midline of the jaw; and the other two points, located at 0.8 bilateral to Shanglianquan (Extra)], bilateral Fengchi (GB 20) and Fengfu (GV 16). After arrival of , the last two tongue-points were stimulated with electricity, with disperse-dense wave, periodically at 2 Hz, 10 Hz and 100 Hz, at the interval of 3 s, lasting for 30 min. Bilateral Fengchi (GB 20) was stimulated with electricity, with disperse-dense wave and the same frequency as above, lasting for 30 min. In the control group, the low-frequency electrical stimulation was adopted. The electrodes were placed on the bilateral sides of the midline of the throat, 30 min each time. The treatment was for 1 month in the two groups, once a day. The scores of the standardized swallowing assessment (SSA) and the videofluoroscopy swallowing study (VFSS) were observed and the reducing rate of the hyoid-thyroid cartilage distance was determined with ultrasound quantitative measure.</p><p><b>RESULTS</b>After treatment, SSA scores of the two groups were all lower than those before treatment and VFSS scores were higher than those before treatment (all <0.05). The above scores in the observation group were better than those in the control group (both <0.05). The reducing rates of the hyoid-thyroid cartilage distance were higher than those before treatment in the two groups (both <0.05). The result in the observation group was higher than that in the control group (<0.05).</p><p><b>CONCLUSION</b>The treatments with acupuncture and rehabilitation training or with the low-frequency electrical therapy and rehabilitation obtain the effects on dysphagia in post-stroke pseudobulbar palsy in the patients. The effects of the combined treatment with acupuncture and rehabilitation training are better. The ultrasonographic technology effectively and quantitatively analyzes the changes in the glossopharyngeal complex in the patients of dysphagia.</p>

Avaliação ultrassonográfica ao duplex Doppler colorido da varicocele / Doppler sonographic evaluation of varicoceles

INTRODUÇÃO: A varicocele é a dilatação das veias do plexo pampiniforme do testículo. A associação entre a varicocele e a infertilidade é diagnosticada em 20 a 40% dos homens inférteis. Atualmente, o estudo ultrassonográfico da varicocele é realizado com o paciente na posição supina antes e durante a realização de Valsalva, levando-se em consideração o diâmetro das veias (> 0,20cm), e a presença de refluxo maior que 1, segundo ao estudo Doppler espectral. OBJETIVO: A) Propor uma nova metodologia na avaliação ultrassonográfica da varicocele. B) Avaliar a concordância dos achados no exame ultrassonográfico com Doppler colorido dos vasos dos plexos pampiniformes e as alterações no espermograma na infertilidade masculina. C) Avaliar a correlação entre o diâmetro de um dos vasos dos plexos pampiniformes e as alterações no espermograma na infertilidade masculina. MÉTODOS: Foram examinados 266 pacientes, provenientes do setor de reprodução humana do Hospital das Clínicas da Universidade de São Paulo (HCUSP), por meio de duplex Doppler colorido, inicialmente com o paciente em decúbito dorsal e posteriormente, após 5 minutos de espera, na posição ortostática, realizando as medidas dos diâmetros transversais dos plexos pampiniforme nas duas posições, tanto em repouso como em Valsalva. Ao estudo pulsado foi considerado refluxo patológico apenas quando persistia por mais de 1 segundo, com uma velocidade superior que 2 cm/s. Estes pacientes também foram submetidos a analise seminal. RESULTADOS: Em relação à metodologia de realização do exame, observou-se aumento no diâmetro do plexo pampiniforme apenas com a variação da posição de cerca de 18% à direita e 5,9% à esquerda, bem como aumento na detecção do refluxo venoso na posição ortostática, de 23% à direita e 6,8% à esquerda. Observou-se também correlação direta entre as alterações no espermograma com o refluxo venoso, 65% à direita e 86% à esquerda, o mesmo não ocorrendo com o diâmetro do plexo...

INTRODUCTION: Varicocele is the dilatation of the veins of the pampiniform plexus of the testicle. The association between varicocele and infertility is diagnosed in 20 to 40% of the infertile men. Currently, in the ultrasound study of varicocele, the diameter of the veins is carried through with the patient in the supine position, before and during the Valsalva maneuver, taking the diameter of the veins consideration (> 0,20cm), and a more than 1 second bigger presence of reflux according to spectral Doppler study. OBJECTIVE: A) To consider a new methodology in the ultrasonographic evaluation of varicocele. B) To evaluate the agreement of the findings in the colorful Doppler ultrasonographic examination of the pampiniform plexus vases with the alterations in the spermogram in masculine infertility. C) To evaluate the correlation between the diameter of one the pampiniform plexus vases and the alterations in the spermogram in the masculine infertility. METHODS: 266 patients from the reproduction sector human being of the Hospital of the Clinics of the University of São Paulo (HCUSP) had been examined, by means of colorful duplex-Doppler, initially with the patient in dorsal decubitus and later, after 5 minutes, in the orthostatic position, carrying through the transversal measures of the diameter of the pampiniform plexus in the two positions, in rest and in Valsalva. To the pulse study reflux was considered pathological only when persisted for more than 1 second, with speed superior to 2 cm/s. These patients were also submitted to seminal analysis. RESULTS: Regarding the methodology of accomplishment of the examination, an increase in the diameter of pampiniform plexus was noted only with the variation of the examination position, about 18% to the right and 5,9% to the left, as well as an increase in the detection of venous reflux in the orthostatic position, 23% to right and 6,8% to the left. It was also detected a correct correlation between variations...

Value of intravenous urography before shockwave lithotripsy in the treatment of the middle and lower ureteral calculi / 中国基层医药

Objective To study the impact of preprocedure intravenous urography(IVU)on the outcome of shock wave Iithotripsy(SWL)for the middle and lower ureteral stones.Methods 112 patients with solitary radiopaque the middle and lower ureterat stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were divided randomly to two treatment groups.IVU group(n=56)had IVU before the start of SwL,whereas patients in the control group(n=56)underwent SWL without IVU.Postoperative success,stone-free rates and complications were evaluated in both groups.Results Eleven patients in the IVU group were excluded from the study.The SUCCESS rate[91.1%(41/45)in IVP group VS 94.6%(53/56)in control group],stone-free rate[88.9%(40/45)vs 89.3%(50/56)],and complication rate[22.2%(10/45)vs 21.4%(12/56)]were similar in two groups(P＞0.05).ConclusionIt is not necessary to obtain an IVU for patients who have solitary radiopaque the middle and lower calculi on plain radiographs with no severe hydronephrosis on ultrasonographic examination before scheduling them for SWL,thus minimizing the cost,avoiding exposure to contrast medium,and reducing radiation exposure.