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ObjectiveTo establish a managing mode for illegal and irregular acts of occupational medical examination (OME) institutions to the requirements of the new situation. Methods The OME institutions from the “Guangdong Province Key Occupational Disease Monitoring and Management Platform” were selected as the study subjects using the judgment sampling method. The clues of suspected illegal and irregular acts of OME institutions were found and submitted to the local health commission for investigation and managed according to the case information monitoring and on-site quality assessment. The OME institutions found to have illegal and irregular acts were filed and investigated according to the national law after investigation and verification. A “follow-up inspection” was conducted on five OME institutions for closed loop management. Results A total of 12 OME institutions were found to have suspected illegal and irregular acts, including seven institutions that did not meet the filing requirements for effective personnel, five institutions that conducted projects beyond the scope without filing to the provincial health authorities within 15 work days from the start of the project, and two institutions that failed to fulfill the obligation of informing and reporting to the health authorities, employers, and workers as required. After submitting relevant clues and evidence to the local health commission for investigation and management, seven institutions were not given penalty, and five institutions were given administrative penalties including two institutions were fined and warned, and three institutions were warned. No illegal or irregular acts were found in the five institutions inspected during the “follow-up inspection”. Conclusion It is beneficial to explore the managing mode of “clue discovery, clue submission, investigation and disposal, follow-up inspection” for OME institutions suspected of illegal and irregular acts, which helps urge OME institutions to work in accordance with laws and regulations and effectively protect the legitimate rights and interests of workers' occupational health.
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Objective:To compare the curative effect of hematoma removal and minimally invasive puncture drainage in hypertensive intracerebral hemorrhage (HICH) under neuroendoscope.Methods:The clinical data of 118 patients with HICH admitted to our hospital from February 2017 to November 2019 were retrospectively analyzed. According to the different surgical methods, the patients were divided into group A ( n=59, minimally invasive puncture and drainage) and group B ( n=59, neuroendoscopic hematoma removal). The perioperative indexes, complications and neurological function indexes [neuron specific enolase (NSE), neurotrophic factor (NGF), substance P (SP)], inflammatory factor index [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] and related scale scores [National Institutes of Health Stroke Scale (NIHSS), modified Barthel Index (mBI)] were compared between the two groups. Results:The operation time, cerebrospinal fluid recovery time, hematoma removal time and hospitalization time of group B were shorter than those of group A ( P<0.05). On the 7th day after operation, the NSE, SP, IL-6, TNF-α in the two groups were decreased, and the levels of NSE, SP, IL-6 and TNF-α in group B were lower than those in group A ( P<0.05); on the 7th day after operation, the levels of NGF in two groups were increased, and those in group B were higher than those in group A ( P<0.05). 6 months after operation, the NIHSS decreased and mBI increased in both groups ( P<0.05), and NIHSS in group B was lower than that in group A, but mBI was higher than that in group A ( P<0.05). There was no difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Compared with minimally invasive puncture and drainage, neuroendoscope hematoma removal for HICH patients can effectively improve perioperative indicators, reduce neurological damage and body inflammatory stimulation, and improve the self-care ability of patients, which is safe and reliable.
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Objective:To observe the effect of mirror visual feedback (MVF) on the motor functioning and balance of stroke survivors, and to observe any morphological and structural changes in the tibialis anterior (TA) after MVF training.Methods:Thirty-six stroke survivors were divided into a mirror group ( n=18) and a control group ( n=18). Both groups received conventional drugs and routine rehabilitation treatment, while the mirror group was additionally provided with MVF training 5 days a week for 4 weeks. Before and after the treatment, both groups were evaluated using the Fugl-Meyer assessment for the lower extremities (FMA-LE) and the Berg balance scale (BBS). Moreover, the pennation angle (PA), the muscle thickness (MT) and the fascicle length (FL) of the tibialis anterior were measured at rest and in maximum isometric voluntary contraction (MVC) using ultrasonic imaging. Results:After the treatment the average PA of the affected side at rest and the MVC of the TA increased significantly in both groups compared with before the treatment, with the average improvement in the mirror group significantly greater than in the control group. The average TA thickness at rest and the MVC were both significantly greater in the mirror group than among the control group after the treatment. The average FMA-LE and BBS scores of both groups had improved significantly, but the mirror group′s average scores were significantly better than those of the control group.Conclusion:MVF can improve the motor function and balance ability of stroke survivors. Moreover, ultrasound can be used to evaluate the changes of TA morphology in such patients quantitatively, providing an objective foundation for tracking clinical efficacy.
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Objective To investigate the effect of the mirror therapy (MT) combined with motor imagery therapy (MIT) on the lower limb motor performance,balance and ability in the activities of daily living of ischemic stroke patients soon after a stroke.Methods Forty hospitalized ischemic stroke patients were randomly allocated to an MT+MIT group (n=20) or an MIT only group (n=20).In addition to routine rehabilitation,the MIT group exercised practicing knee extension and ankle dorsiflexion 30 minutes a day,five days a week for 8 weeks following motor imagery therapy protocols,while the MT+MIT group accepted MIT combined with mirror therapy.The Fugl-Meyer lower extremity assessment (FMALE),Berg Balance scores (BBSs) and the Modified Barthel index (MBI) were used to evaluate the effects of the treatment before the treatment and after 4 and 8 weeks of therapy.Results Before the intervention there was no significant difference between the two groups in terms of their average FMA,BBS and MBI ratings.After 4 weeks of treatment a significant improvement was observed in the MT+MIT group's average FMA-LE and BBS scores and in the flat walking component of the MBI.In the MIT group only the average bed/wheelchair transfer and flat walking scores in the MBI were significantly improved.After 8 weeks the MT+MIT group's average FMA-LE and BBS scores had improved significantly,along with its average scores in the feeding,dressing,grooming,bathing,urination,bed/wheelchair transfer,walking up and down stairs and flat walking components of the MBI.In the MIT group the average FMA-LE and BBS scores had improved significantly,along with those for bed/wheelchair transfer,walking up and down stairs and flat walking in the MBI.After both 4 and 8 weeks,the MT+MIT group's average scores were consistently significantly better than those of the MT group.Conclusion Mirror therapy can significantly enhance the effectiveness of motor imagery therapy when they are combined in the rehabilitation of ischemic stroke patients in the early post-stroke stage.
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@#Objective To observe the effects of mirror therapy (MT) combined with functional electrical stimulation (FES) on motor of lower extremities, walking ability and activities of daily living for subacute stroke patients. Methods From July, 2016 to December, 2017, 38 subacute stroke patients were randomly divided into treatment group (n=20) and control group (n=18). All the patients received routine rehabilitation. The control group accepted FES, and the treatment group accepted FES and MT, for eight weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Categories (FAC) and modified Barthel Index (MBI) before and after treatment. Results Both groups improved in the scores of FMA-LE and MBI, and grade of FAC after treatment (Z>3.002, t>7.985, P<0.01), and the scores of FMA-LE improved more in the treatment group than in the control group (Z=-2.037, P<0.05). There was no difference between two groups in the scores of MBI and grade of FAC (t=-1.044, Z=-1.287, P>0.05). Conclusion The addition of MT on FES may further improve the lower extremities motor function, but not enough to improve their walking and activities of daily living in subacute stroke patients.
