Application of the Buccal Fat Pad in Oral Reconstruction: Covered With Collagen Membrane or Not?

OBJECTIVE: To evaluate the clinical effectiveness of collagen membrane as biological dressing in protecting the covered buccal fat pad (BFP) from physical damage during postoperative healing phase in the reconstruction of oral soft tissue defect. METHODS: A retrospective cohort study was performed in patients undergoing oral defects reconstruction using BFP. The predictor variable was the application of collagen membrane or not. The primary outcome variable was the wound healing. Other variables considered included age, gender, pain score, time taken for epithe-lialization, defect size and site. Postoperative follow-up was done at 1 week, 3 weeks, 6 months, and 1 year. RESULTS: Thirty patients in Zhuhai People's Hospital were selected and randomly divided in 2 groups. Group i patients were reconstructed using BFP alone, whereas collagen membrane was used as a covering over BFP in group II patients. In group I, 4 patients developed dehiscence 1-week postoperative, and underwent infection with food lodgment along with another 1 patient at 3-week follow-up, whereas none of the group II patients developed dehiscence or infection. Pain score was lesser in group II patients as compared to group I. Time taken for epithelialization was about 3 weeks in both groups. CONCLUSIONS: Combined application of collagen membrane protects the covered BFP from masticatory physical damage and food lodgment, which reduces infection and graft loss. It is worthy of consideration as an effective method for the reconstruction of selected moderate-sized oral defects, especially in larger size or at distant location.

The effect of intermittent hypoxia training on migraine: a randomized controlled trial.

OBJECTIVE: To study the effect of intermittent hypoxia training (IHT) for migraine. DESIGN: A single-blind, randomized controlled trial. All participants were recruited from a rehabilitation department in an acute university-affiliated hospital. METHODS: Participants with migraines were randomly assigned to two groups (IHT group and control group). The Migraine Disability Assessment (MIDAS), Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Vascular endothelial growth factor (VEGF), calcitonin gene related peptide (CGRP) and cerebrovascular hemodynamic parameters were collected at baseline and end of the 8th week. The attack frequencies of migraines were evaluated at 3 months. RESULTS: Among the 48 subjects, five males and forty-three females, the ages ranged from 19 to 53 years old (mean ± SD = 31.3±7.78). MIDAS, SF-36, VAS, BAI, BDI, VEGF, CGRP and cerebrovascular hemodynamic parameters were improved after IHT intervention. There were significant differences between IHT group and the control group in MIDAS, SF-36, VAS, BAI, BDI, VEGF, CGRP and cerebrovascular hemodynamic parameters at the end of the 8th weeks (P<0.05). Attack frequencies were improved within 3 months after IH training intervention (P<0.01), but not in the control group (P>0.05). No adverse events occurred during the study. CONCLUSION: IHT could improve migraines after intervention up to three months. IHT could be an effective method for relieving a migraine.

Effect of functional electrical stimulation plus body weight-supported treadmill training for gait rehabilitation in patients with poststroke: a retrospective case-matched study.

BACKGROUND: Functional electrical stimulation (FES) plus body weight-supported treadmill training (BWSTT) provide effective gait training for poststroke patients with abnormal gait. These features promote a successful active motor relearning of ambulation in stroke survivors. AIM: This is a retrospective study to assess the effect of FES plus BWSTT for gait rehabilitation in patients poststroke. DESIGN: A retrospective case-matched study. SETTING: Participants were recruited from a rehabilitation department in an acute university-affiliated hospital POPULATION: Ninety patients poststroke from Yue Bei People's Hospital underwent BWSTT (A: control group) were compared to an equal number of cross-matched patients who received FES plus BWSTT (B: FES plus BWSTT group). METHODS: While B group received FES for 45 minutes plus BSWTT for 30 minutes in the program, group A received time-matched BWSTT alone. The walking speed, step length, step cadence, Fugl-Meyer Lower-Limb Scale (LL-FMA), composite spasticity scale (CSS), 10-Meter Walk Test (10MWT), Tinetti Balance Test (TBT) and nerve physiology testing were collected before and after intervention. RESULTS: One hundred and eighty patients with poststroke abnormal gait were chosen. There were significant differences in walking speed, step length, step cadence, LL-FMA, CSS, TBT, and 10MWT between baseline and postintervention (P<0.05). There were significant differences in walking speed, step length, step cadence, LL-FMA, CSS, TBT, and 10MWT between two groups at the end of the eighth week (P<0.05), but not at baseline (P>0.05). In comparison with group A, the peak of somatosensory evoked potential (SEP) and motor evoked potential (MEP) amplitude increased, the latency was shortened, and the conduction velocity of sensory nerve (SCV) and motor nerve (MCV) was significantly increased in the group B (P<0.05). No adverse events occurred during the study. CONCLUSIONS: This study suggests that FES plus BWSTT could be more effective than BWSTT alone in the improvement of gait, balance, spasticity, and function of the lower limb in patients poststroke. CLINICAL REHABILITATION IMPACT: Introduce effective rehabilitation strategies for poststroke patients with abnormal gait.

Effect of Intermittent Hypoxia Training for Dizziness: A Randomized Controlled Trial.

OBJECTIVE: To study the effect of intermittent hypoxia training (IHT) for dizziness. DESIGN: A single-blind, randomized controlled trial. All participants were recruited from a rehabilitation department in an acute university-affiliated hospital. INTERVENTION: Participants with dizziness were randomly assigned to 2 groups (IHT group and control group). The Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, and Vertigo Visual Analog Scale were conducted at baseline, end of the fourth week. RESULTS: Among 52 subjects, there were18 males and 34 females, ages 35 to 62 years old (mean [SD] = 46.9 [7.93]). Time length since onset ranged from 12 to 34 months (20.2 [7.15] mo). Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, Vertigo Visual Analog Scale scores, and attack frequencies of dizziness were improved after IHT intervention in the end of the fourth week. There were significant differences between the IHT group and the control group in the Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, Vertigo Visual Analog Scale scores, and attack frequencies of dizziness at the end of the fourth week (P < .05). No adverse events occurred during the study. CONCLUSION: IHT could improve dizziness after intervention at the end of the fourth week. IHT could be the effective method for treating dizziness.

Effect of therapeutic exercise on knee osteoarthritis after intra-articular injection of botulinum toxin type A, hyaluronate or saline: A randomized controlled trial.

OBJECTIVE: To study the effect of therapeutic exercise on knee osteoarthritis after injection of botulinum toxin type A, hyaluronate or saline. METHODS: Sixty participants with knee osteoarthritis were randomly assigned to 3 groups: injection of saline (control) (group A), botulinum toxin type A (group B), or hyaluronate (group C). All participants received therapeutic exercise. Western Ontario and McMaster Universities Osteoarthritis Index questionnaire score, visual analogue scale pain scale, and Medical Outcomes Study 36-item Health Survey were conducted at baseline, and at the end of the 4th and 8th weeks. RESULTS: At end of the 4th and 8th weeks, the scores on the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and visual analogue scale were higher in the control group. There were significant differences in Physical Component Summary-36 and Mental Component Summary-36 scores between the 3 groups (p <0.05) at the end of the 4th and 8th weeks, but not between groups A (control) and C (hyaluronate) at the end of the 4th week. No changes were seen on magnetic resonance imaging and X-ray images of the affected knees after the intervention. CONCLUSION: Therapeutic exercise plus botulinum toxin type A or hyaluronate injection can significantly reduce pain and improve knee functioning. Botulinum toxin type A plus therapeutic exercise appears to be more effective.

Hyperbaric oxygen ameliorated the lesion scope and nerve function in acute spinal cord injury patients: A retrospective study.

OBJECTIVE: This is a retrospective study to assess the therapeutic effect of hyperbaric oxygen (HBO) in early treatment of acute spinal cord injury (SCI) using magnetic resonance imaging (MRI) and electrophysiology in diagnosing. METHODS: Forty acute SCI patients from Sun Yat-Sen Memorial Hospital who were assigned into HBO treatment were included during August 2013 to October 2014.The patients with adverse reactions or contraindications for HBO were assigned as controls. Both of two groups (HBO and Control) received medicine treatment with Urbason, GM-1 and mecobalamine after surgery. ASIA and the Frankel scores were used to evaluate the therapeutic effect of HBO at the 15th and 30th day after HBO treatment by using MRI and electrophysiology features. RESULTS: Significant therapeutic effect of HBO treatment on acute SCI patients was observed compared with the control group (P<0.05). Comparison for ASIA and Frankel scores showed that motor and neurological functions were significantly improved in HBO group at day 15 and day 30 post treatment. MRI images showed that the grade III injury in HBO group was significant lower than the control group. In comparison with the control, the peak of somatosensory evoked potential (SEP) and motor evoked potential (MEP) amplitude increased, the latency was shortened, and the conduction velocity of sensory nerve (SCV) and motor nerve (MCV) was significantly increased in the HBO group (P<0.05). CONCLUSIONS: HBO treatment has a great efficacy in acute SCI patients. HBO therapy at early stage of acute SCI is beneficiary to the recovery.

Electrical stimulation therapy improves sleep respiratory parameters in obstructive sleep apnea syndrome: a meta-analysis.

Recent clinical trials have shown that electrical stimulation has beneficial effects in obstructive sleep apnea syndrome (OSAS). The purpose of this study was to evaluate the efficacy of electrical stimulation therapy for OSAS with a meta-analysis. The meta-analysis of all relative studies was performed through searching international literature, including PUBMED, CNKI, and EMBASE databases. This literature analysis compared all patients undergoing electrical stimulation therapy with respect to the respiratory disturbance index (RDI) and changes in sleep structure. Six studies were selected involving a total of 91 patients. The meta-analysis indicated that electrical stimulation therapy reduced RDI, longest apnea time, and improved the minimum SaO2. Based on the evidence found, electrical stimulation may be a potential therapy for OSAS, warranting further clinical trials.

[The correlation between early lymphocyte count post-allogeneic hematopoietic stem cell transplantation and prognosis in leukemia patients].

OBJECTIVE: To analyze the correlation between early lymphocyte count (lymphocyte count on day 30, LC30) post-allogeneic hematopoietic stem cell transplantation (allo-HSCT) and transplant prognosis in leukemia patients. METHODS: The data from 124 consecutive patients undergoing allo-HSCT for leukemia from January 2003 to April 2011 was analyzed retrospectively. LC30 post-allo-HSCT correlated with 5-year overall survival (OS), 5-year relapse rate (RR), 5-year nonrelapse mortality (NRM), accumulative rate of acute graft versus host disease (aGVHD) and chronic graft versus host disease (cGVHD) was studied. RESULTS: Univariate analysis indicated that patients with LC30 ≥ 0.40×10(9)/L had higher 5-year OS than those with LC30 < 0.40×10(9)/L \[(62.2 ± 5.8)% vs (37.0 ± 8.6)%, P = 0.003\], lower 5-year RR\[(13.9 ± 4.7)% vs (32.0 ± 8.4)%, P = 0.027\], lower 5-year NRM \[(31.3 ± 5.8)% vs (45.0 ± 9.3)%, P = 0.048)\], and higher cGVHD cumulative incidence \[(82.9 ± 4.6)% vs (62.7 ± 11.1)%, P = 0.042)\]. Multivariate analysis also suggested that LC30 was associated with 5-year OS, 5-year RR, 5-year NRM, and cGVHD cumulative incidence. At the same time disease risk stratification was associated with prognosis. CONCLUSIONS: Early lymphocyte count (LC30) post-allogeneic hematopoietic stem cell transplantation in leukemia is highly associated with prognosis, which can be the independent prognosis index after allo-HSCT in leukemia and can identify a group of patients who might be suitable candidates for early interventions treatment.