Objective To observe the effect of comprehensive rehabilitation in patients with peripheral nerve injuries after the Wenchuan earthquake. Methods A total of 24 cases of peripheral nerve injuries who were admitted to the Rehabilitation Center for Earthquake Victims of West China Hospital of Sichuan University were treated with comprehensive rehabilitation, including exercise therapy, acupuncture therapy, functional electrical stimulation, and occupational therapy (mainly sensory training and wearing orthosis). After 30 treatment sessions, patient motor and sensory function, upper limb functional activity, and electrodiagnostic parameters were evaluated. Meanwhile, concomitant injuries were also recorded. Results As for the recovery of motor and sensory functions, the effective rate was 41.66%. The difference in the scores of upper limb functional activities was statistically significant before and after treatment (Plt;0.01). As assessed by electromyogram and nerve conduction velocity, the response rate was 87.50%. Patients with more concomitant injuries were likely to have slower recovery. Conclusion Comprehensive rehabilitation is appropriate and effective for patients with peripheral nerve injuries after the Wenchuan earthquake.
Stroke can lead to dysfunction of movement, sensation, cognition and other functions, eventually affect the quality of life of patients. Many patients suffer from severe and persistent upper limb dysfunction. Upper limb rehabilitation has always been a focus in clinical practice and scientific research of rehabilitation field. As an emerging technology, virtual reality (VR) provides simulated environments for patients to enhance their participation and experience, and has been more and more widely used in stroke rehabilitation. This paper reviews the application and research progress of VR in upper limb rehabilitation after stroke, discusses the current evidences based on both the independent application of VR and the application of VR combined with other rehabilitation interventions, and indicates that VR can play a positive role in promoting the upper limb strength and coordination of stroke patients and enhancing their motivation to participant in rehabilitation. In the future, more high-quality studies are needed to further confirm the efficacy and optimal parameter settings.
ObjectiveTo construct the occupational therapy core items oriented by life return for stroke patients, and provide a reliable tool to promote the comprehensive rehabilitation and successful return for stroke patients.MethodsFrom January to February 2020, the primary items were summarized through literature analysis and research group discussion, and then Delphi method was used to determine which items should be included by two rounds of experts consultation.ResultsA total of 22 experts were selected. After two rounds of experts consultation, 60 items in 6 domains were included. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.87±0.54. In the two rounds of experts consultation, the importance scores of consulted items were 7.60±0.97 and 8.06±0.35, respectively; the variation coefficients were 0.14±0.05 and 0.11±0.03, respectively; the Kendall coefficients of concordance were 0.522 (P<0.001) and 0.578 (P<0.001), respectively.ConclusionThrough the Delphi method, the core items oriented by life return are identified with high recognition and consistency from experts, which can be used as a guideline tool for stroke patients in in-hospital occupational therapy, discharge guidance, and community/home rehabilitation.
ObjectiveTo systematically review the efficacy of virtual reality technology on cognitive dysfunction in patients with cerebral vascular accident (CVA).MethodsEMbase, Web of Science, PubMed, The Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect the randomized controlled trials (RCTs) on virtual reality technology on cognitive dysfunction in patients with CVA from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 25 RCTs involving 1 113 patients were included. The results of the meta-analysis showed that the scores of MBI (MD=9.24, 95%CI 1.91 to 16.56, P=0.01), MMSE (MD=3.02, 95%CI 1.11 to 4.93, P=0.002) and RBMT-2 (MD=2.74, 95%CI 1.97 to 3.51, P<0.000 01) in VR group were superior to the control group. However, there were no significant differences between the two groups in scores of BI, MOCA, and VCPT.ConclusionsCurrent evidence shows that virtual reality technology may have positively influence on cognitive function and participation in the daily life activities of patients with CVA. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Objective To systematically review the effect of percutaneous acupoint electrical stimulation (TEAS) on heart rate variability (HRV). Methods The PubMed, Embase, Ovid MEDLINE, Cochrane Library, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on the effects of percutaneous acupoint electrical stimulation on heart rate variability from inception to February 28, 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 14 RCTs involving 719 patients were included. The results of meta-analysis showed that SDNN (MD=12.95, 95%CI 9.18 to 16.72, P<0.01), RMSSD (MD=1.81, 95%CI 0.10 to 3.53, P=0.04), pNN50 (MD=1.75, 95%CI 1.02 to 2.48, P<0.01), HF (SMD=0.27, 95%CI 0.01 to 0.52, P=0.04), LF/HF (MD=−0.07, 95%CI −0.12 to −0.03, P<0.01), ln-LF (MD=0.63, 95%CI 0.25 to 1.01, P<0.01), ln-HF (MD=1.05, 95%CI 0.60 to 1.49, P<0.01), mean RR (MD=−11.86, 95%CI −21.77 to −1.96, P=0.02), and HR (SMD=−0.43, 95%CI −0.66 to −0.20, P<0.01) all showed improvement compared with the control group. However, there were no significant differences between the two groups in LF (SMD=0.15, 95%CI −0.10 to 0.40, P=0.23), LF norm (SMD=0.24, 95%CI −0.10 to 0.58, P=0.16) or HF norm (SMD=0.25, 95%CI −0.47 to 0.97, P=0.5). TEAS on PC6: SDNN, pNN50, HF, LF/HF, LF norm, HF norm, ln-LF, ln-HF, and HR all showed improvement compared with the control group. However, there were no significant differences between the two groups in RMSSD, LF, or RR interval. Conclusion This study supports the improvement of heart rate variability by transcutaneous acupoint electrical stimulation and PC6 acupoint selection. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of ICU diaries on psychological outcomes, cognition and health-related quality of life in both patients and their relatives. MethodsThe PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, CNKI, WanFang Data and VIP database were electronically searched to collect trails related to the objective from inception to August 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 17 studies involving 2 093 patients and 786 relatives were included. The results of meta-analysis showed that compared with the control group, ICU diaries could improve patients’ post-traumatic stress disorder (PTSD) (RR=0.64, 95%CI 0.50 to 0.83, P<0.01), depression (RR=0.65, 95%CI 0.48 to 0.89, P<0.01) and quality of life (MD=7.78, 95%CI 4.37 to 11.18, P<0.01) significantly. However, there were no significant differences in patients’ anxiety, memory and relatives’ psychological outcomes. ConclusionCurrent evidence shows that the use of ICU diaries can reduce the incidence rate of patients’ PTSD, depression and improve their quality of life, but other effects are unclear. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To construct the expert consensus on comprehensive rehabilitation assessment system for the elderly in the hospital and community. MethodsMedline, Embase, Cochrane Library, China National Knowledge Infrastructure and VIP databases were searched for geriatric rehabilitation assessment materials from June 2016 to June 2021. The primary items were summarized through literature review and research group discussion, and then Delphi method was used among 20 experts in geriatric rehabilitation medicine to develop consensus-based core items for the elderly comprehensive rehabilitation assessment system. Results A total of 158 references were included. Through integration, sorting and screening, the research team initially formulated 41 items and four major sections including cardiopulmonary exercise, sensory perception, cognition and psychology (speech contained), and swallowing, urination and defecation. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.92±0.05, the variation coefficients were 0.174±0.043 and 0.172±0.063, respectively; the Kendall coefficients of concordance were 0.587 and 0.601, with P values<0.05 for both, respectively. Finally, The comprehensive rehabilitation assessment system for the elderly including 16 items would be formed. Conclusion The expert consensus on comprehensive rehabilitation assessment system for the elderly constructed by Delphi method includes motor, sensory perception, cognition, swallowing, speech, cardiopulmonary, defecation, mental and psychological elements, which are identified with high recognition and consistency from experts.
Objective To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice. Methods A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables. Results The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS. Conclusions The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.
ObjectivesTo systematically review the efficacy of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation of unilateral neglect in stroke patients.MethodsPubMed, The Cochrane Library, PEDro, EMbase, CNKI, WanFang Data and VIP databases were searched online for randomized controlled trials (RCTs) of rTMS on rehabilitation of unilateral neglect in stroke patients from inception to March 2017. Two reviewers independently screened literature, extracted data and assessed the quality of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 12 RCTs involving 303 patients were included. The results of meta-analysis showed that: the stimulate group was superior to the control group in line bisection test (MD=–5.54, 95%CI –6.79 to –4.29, P<0.000 01), line cancellation test (MD=–3.75, 95%CI –4.60 to –2.90,P<0.000 1) and star cancellation test (MD=–22.94, 95%CI –26.52 to –19.35,P<0.000 01). However, there was no significant difference in the score of the modified Barthel index between two groups (MD=3.91, 95%CI–9.52 to 17.34,P=0.57).ConclusionsrTMS appears to improve the symptoms of unilateral neglect in stroke patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
【摘要】 目的 探讨葡萄糖转运蛋白Ⅰ型（glucose transporter 1，GLUT1）和肿瘤增殖细胞核抗原Ki-67在卵巢上皮性肿瘤组织中的表达及其临床意义。 方法 收集2000年1月-2008年6月不同卵巢上皮性肿瘤病变患者119例的组织标本，采用免疫组织化学SP二步法检测肿瘤组织中GLUT1和Ki-67的表达情况。 结果 卵巢交界性、恶性上皮性肿瘤灶性或广泛高表达GLUT1和Ki-67，其表达强度有差异。卵巢良性上皮性肿瘤不表达GLUT1和Ki-67。在卵巢癌中GLUT1及Ki-67的表达强度与病理分级、临床分期、预后有关。GLUT1表达强度与病理分型无关，Ki-67表达强度与病理分型有关。 结论 卵巢上皮性肿瘤组织中GLUT1和Ki-67的表达具有相关性，其表达强度与肿瘤的良恶性质和增殖状态有关，二者同时检测可以全面了解卵巢上皮性肿瘤的性质、卵巢癌恶性程度和生物学行为，对于判断肿瘤的性质和预后有一定价值。【Abstract】 Objective To investigate the expression and clinical significance of glucose transporter-1 (GLUT1) and tumor proliferating karyon antigen Ki-67 in epithelial ovarian tumor tissue. Methods Immunohistochemistry SP method was used to detect the expression of GLUT1 and Ki-67 protein in epithelial ovarian tumor tissues from 119 patients diagnosed in our hospital from January 2000 to June 2008. Results The expressions of GLUT1 and Ki-67 had local or abroad higher expressions in the borderline and malignant epithelial ovarian tumor, and the expressive intensity was different. In benign tumors, the expression was negative. The expressive intensity of GLUT1 and Ki-67 had correlation with the grade, stage, and prognosis in malignant tumors. The expressive intensity of GLUT1 had no correlation with the type of malignant tumors, while Ki-67 related to the pathological types. Conclusion The expressions of GLUT1 and Ki-67 have relativity. The expressive intensity of GLUT1 and Ki-67 relates to the character and proliferation of epithelial ovarian tumors. The combined detection GLUT1 and Ki-67 is helpful to know the character of epithelial ovarian tumors, the malignant degree and biologic behavior of ovarian carcinoma, which is useful in estimating the character and prognosis of epithelial ovarian tumors.