With the aging of the population, the incidence of stroke is increasing year by year. More than 50% of stroke patients have post-stroke dysphagia, which not only increases the risk of complications such as aspiration pneumonia, malnutrition and dehydration, but also is associated with poor prognosis and increasing mortality. Due to its high morbidity and high risk of complications, the European Stroke Organization and the European Society for Dysphagia have launched the guideline for the diagnosis and treatment of post-stroke dysphagia (2021 Edition). This guideline mainly raises questions about the screening, assessment, and treatment of post-stroke dysphagia, and answers them based on evidence-based medical evidences. This article mainly interprets this in order to better guide clinical practice.
ObjectiveTo explore the clinical effect of the end-traction upper limb rehabilitation training system on patients with upper limb motor dysfunction after stroke.MethodsPatients with upper limb motor dysfunction who were admitted to the Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanchang University from September to November 2019 were selected. According to the software, the patients were randomly divided into the experimental group and the control group. Both groups received conventional medical treatment, basic rehabilitation, and activities of daily living training. In addition, the control group received traditional occupational therapy, while the experimental group received end-traction upper limb rehabilitation training. The training time of both groups was 30 min/ (times ·d) and 5 days per week. Rehabilitation evaluation and recording were performed before and after the four-week treatment in both groups using the simplified upper extremity Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI).ResultsA total of 36 patients were enrolled, with 18 in each group. All patients completed the experiment, and no special discomfort was observed. Before the treatment, there was no statistically significant difference in FMA and MBI between the experimental group [(13.22±3.13) and (49.66±6.81) points] and the control group [(14.78±1.70) and (51.67±6.65) points] (t=1.858, 0.896; P=0.072, 0.377). After four-week treatment, FMA and MBI in both groups improved significantly (P<0.05); the difference between the experimental group [(27.56±15.68) and (73.55±8.72) points] and the control group [(17.67±6.73) and (65.33±9.20) points] was statistically significant (t=2.459, 2.751; P=0.019, 0.009).ConclusionsThe end-traction upper limb rehabilitation training system can significantly improve the upper limb motor function of patients with upper limb motor dysfunction after stroke and improve the patients’ daily life ability. It is worthy of clinical promotion and application.
Median nerve electrical stimulation is a common peripheral nerve electrical stimulation treatment technology in clinic. With simple operation, it has been widely used in clinical to promote coma after craniocerebral trauma, relieve pain, improve cognition, Parkinson’s disease and so on. However, its mechanism has always been a hot topic and difficult part. At present, there are a large number of clinical efficacy studies and animal experiments of median nerve electrical stimulation at home and abroad. This article reviews the clinical application and animal experiments of median nerve electrical stimulation in recent years, and summarizes its mechanism, hoping to contribute to relevant clinical applications and research.
In recent years, with the great breakthroughs in the treatment of brain injury, neurological dysfunction and other serious diseases, more and more patients have been referred to disorders of consciousness (DOC). In clinical work, accurate assessment of DOC is critical to its treatment, and how to assess the level of consciousness and prognosis of patients after treatment has become a hot research topic in recent years. The model of consciousness loss and recovery is an ideal tool to understand the neural mechanism of consciousness, but clinical trials are easily restricted by many factors such as ethics, so animal models are often used as preclinical basic experiments, while non-human primates (NHP) are closely related to humans and are ideal models for studying human diseases. Currently, there are many tests to assess the level of consciousness of NHP, and there are different methods, all of which have certain advantages and limitations. This article reviews the current literature on the current status of the NHP consciousness scale assessment tool, and find that the assessment of NHP consciousness is mainly divided into stimulus response-based assessment after anesthesia experiments, behavioral task completion-based assessment after stimulus-reward experiments, and comprehensive multi-indicator assessment of NHP consciousness level. Therefore, this article provides an overview of the current status of each NHP consciousness scale assessment tool and its advantages and disadvantages in order to provide new thoughts on assessing consciousness from the perspective of animal models in the hope of finding a more appropriate assessment tool.