ABSTRACT
Most post-stroke patients experience upper limb functionality challenges. Emergent therapies using upper limb-based robot machines present opportunities to resolve the limitations inherent in Occupational therapy such as increased therapist-patient exhaustion, monotonous methods, and so forth. The aim of this parallel trial was to compare the effects of the upper limb robotic training with matched Occupational therapy training on upper limb function and independence-related quality of life in post-stroke patients within the Brunnstrom arm motor recovery stages 1 to 4. During one-year (2018-2019), 50 post-stroke patients were enrolled and randomly assigned to 2 groups; robot and Occupational therapy (n = 25) and Occupational therapy (n = 25). Both groups were trained for 50-70 minutes per day, 5 days a week for 6 weeks. The Chinese-adapted Fugl-Meyer Assessment-Upper Extremity (FMA-UE) was the primary outcome measure. The secondary outcome measures were the Brunnstrom Recovery Stages Scale (BRS) and the Chinese-adapted Barthel Index (BI). The treatment effect sizes of both groups were large in the following variables; transfers (1), BI total score (2.2), FMA-UE upper limb (1.1), wrist (1.8), elbow (1), fingers (0.9), and FMA-UE total scores (1.4). The treatment group in comparison to the control group had larger BRS changes, significant improvements in upper limb function, and partial independence in activities of daily living during the baseline to post-treatment period. Robotic-assisted training with occupational therapy may improve the upper limb movement foundation blocks; however, it does not translate into complete functional independence and improved quality of life. This study has been registered at the ISRCTN registry, https://doi.org/10.1186/ISRCTN84804731.
Subject(s)
Occupational Therapy/instrumentation , Quality of Life , Recovery of Function , Robotics/instrumentation , Stroke Rehabilitation/methods , Stroke/therapy , Upper Extremity/physiopathology , Activities of Daily Living , Aged , Case-Control Studies , Female , Humans , Male , Middle Aged , Physical Therapy Modalities , Robotics/methods , Stroke/physiopathologyABSTRACT
<p><b>OBJECTIVE</b>To assess the feasibility of gray-scale contrast-enhanced ultrasound for characterizing thyroid nodules.</p><p><b>METHODS</b>Forty thyroid nodules from 35 patients were studied both by conventional techniques and gray-scale contrast-enhanced ultrasound. Of the nodules examined, 15 were benign and 25 malignant. The enhancement of echogenicity was evaluated. The diagnosis was confirmed by surgical biopsy and histopathological examination.</p><p><b>RESULTS</b>The study using gray-scale contrast-enhanced ultrasound showed absent contrast-enhancement in 9 of 25 malignant nodules and 1 of 11 benign solitary nodules; intense enhancement in 6 of 25 malignant nodules, with perfusion defect in the center; diffuse faint enhancement in 10 of 25 malignant nodules and 10 of 11 benign solitary nodules. Benign cystic nodules all showed absent enhancement in the cystic components and 2 of 4 intense enhancement in the solitary components.</p><p><b>CONCLUSIONS</b>Gray-scale contrast-enhanced ultrasonography imaging may be a useful tool for evaluating the perfusion of thyroid nodules. Solitary nodules showing absent enhancement or intense enhancement with absent enhancement in the nodular center may suggest malignant.</p>
Subject(s)
Female , Humans , Male , Contrast Media , Diagnosis, Differential , Image Enhancement , Methods , Thyroid Neoplasms , Diagnostic Imaging , Pathology , Thyroid Nodule , Diagnostic Imaging , Pathology , Ultrasonography , MethodsABSTRACT
with chitosan in situ using a chemical method and a porous structure obtained was then lyophilized. Preosteoblast MC 3T3-E1 the scaffolds was examined after staining it with Wright's stain. Their proliferation was assessed using MTZ assay. After being Abstract Nanohydroxyapatite/chitosan composite scaffolds were fabricated and the proliferation and differentiation of preosteoblast MC 3T3-E1 on them were examined for the assessment of their biocompatibility. Nanohydroxyapatite was combined with chitosan in situ using a chemical method and a porous structure obtained was then lyophilized. Preosteoblast MC 333-E1 cells were inoculated into the porous composite scaffolds and chitosan scaffolds, respectively. The morphology of cells cultured on the scaffolds was examined after staining it with Wright's stain. Their proliferation was assessed using MTT assay. After being cultured in conditioned medium for 30 days, the cells' alkaline phosphatase activities on the scaffolds were studied in situ to compare their differentiation levelabout. Moreover, the alkaline phosphatase activities were assessed with a kit. The expression level of characteristic osteogenic gene was evaluated using Reverse Transcription-Polymerase Chain Reaction (RT-PCR). The results indicated that MC 3T3-E1 cells grown on the composite scaffolds showed a higher proliferation rate and spread better than that on chitosan scaffolds. The alkaline phosphatase stain results showed that the alkaline phosphatase activity of cells on composite scaffolds was significantly higher than that on the chitosan scaffolds. In addition, the quantitative examination of alkaline phosphatase activity indicated that the cells cultured on the composite scaffolds expressed an activity level about 8 times higher than that on chitosan scaffolds. Simultaneously, the osteogenic gene osteopontin (OPN) of cells cultured on composite scaffolds showed a higher expression level than that on chitosan scaffolds. Another osteogenic gene osteocalcin (OC) was expressed in cells cultured on composite scaffolds, whereas it was not detected in cells on chitosan scaffolds. The addition of nanohydroxyapatite in the scaffolds improved not only the proliferation but also the differentiation of preosteoblast cultured on them. The composite scaffolds showed good biocompatibility and bioactivity. These scaffolds would be promising in bone tissue engineering.
Subject(s)
Animals , Mice , Alkaline Phosphatase , Metabolism , Biocompatible Materials , Chemistry , Cell Culture Techniques , Methods , Cell Differentiation , Cell Line , Cell Proliferation , Chitosan , Chemistry , Durapatite , Chemistry , Gene Expression , Nanostructures , Osteoblasts , Cell Biology , Metabolism , Osteocalcin , Genetics , Osteopontin , Genetics , Porosity , Reverse Transcriptase Polymerase Chain Reaction , Tissue Engineering , Methods , Tissue Scaffolds , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical value of real-time tissue elastography (RTE) in the diagnosis of breast cancer.</p><p><b>METHODS</b>One hundred and twenty patients with breast lumps (135 lesions) were examined with B-mode imaging, color Doppler flowing imaging (CDFI) and RTE. The elastogram was graded using 5-score evaluating method. The postoperative pathological diagnosis was used as gold standard, and the sensitivity, specificity and accuracy of RTE and two-dimensional ultrasonography combined with RTE in diagnosis of breast cancer were calculated.</p><p><b>RESULT</b>When the score >4 was set for cut-off criteria of malignancy, the sensitivity, specificity and accuracy of RTE was 85.45%, 83.75% and 84.4%, respectively. While two-dimensional ultrasonography combined with RTE was used, the sensitivity, specificity and accuracy increased up to 100%, 95% and 97%, respectively.</p><p><b>CONCLUSION</b>RTE combined with two-dimensional ultrasonography can improve the validity in the diagnosis of malignant breast lesions.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Middle Aged , Breast Neoplasms , Diagnostic Imaging , Pathology , Computer Systems , Diagnosis, Differential , Elasticity , Image Enhancement , Sensitivity and Specificity , Ultrasonography, MammaryABSTRACT
Objective To explore the diagnostic value of neuron-specific enolase(NSE) in cerebrospinal fluid(CSF) in children with meningitis.Methods NSE levels in CSF of 18 children with purulent meningitis,13 children with tuberculous meningitis and 25 children with viral meningitis were determined by enzyme-linked immunosorbent assay(ELISA).Results CSF-NSE levels increased significantly in children with purulent meningitis and tuberculous meningitis compared with that of control group(P0.05);CSF-NSE levels increased significantly in children with purulent meningitis and tuberculous meningitis,compared with that of viral meningitis group(P0.05).Conclusions The determination of the neuron-specific enolase in cerebrospinal fluid can be used as an important parameter for identifying bacterial meningitis from viral meningitis.It also can be used to estimate the severity and prognosis of meningitis in children.