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Objective:To observe any effect of endoscopic evaluation of swallowing (FEES) on the functional outcomes of post-stroke patients in the subacute phase.Methods:A retrospective case-control study was conducted of 52 patients who had received an FEES assessment (the FEES group) and 51 who had not (the control group). Both groups received swallowing rehabilitation and intake training based on the results of the FEES assessment and those of a modified volume-viscosity swallowing test. The primary outcome indicator was the incidence of pneumonia. Secondary outcome indicators were the rate of removal of the nasal feeding tube, the length of indwelling of the nasal feeding tube, functional oral intake assessment scale (FOIS) scores, eating technique at discharge, and the length of hospital stay.Results:Compared with the control group, the incidence of pneumonia in the FEES group was significantly lower (7.7% vs. 39.2%). The removal rate of the nasal feeding tube was significantly greater (75.0% vs. 41.0%). The FEES group showed a significant improvement in its average FOIS score. And the proportion of patients who could try partial oral eating or complete oral eating at discharge was significantly higher in the FEES group. Regression analysis indicated that the risk of pneumonia in the FEES group was positively related to the time from onset to the first FEES examination.Conclusion:Early FEES examination after a stroke could reduce the incidence of pneumonia, increase chances of removing the nasal feeding tube and improve the swallowing function and outcome of stroke survivors.
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<p><b>OBJECTIVE</b>To evaluate the differences in the clinical therapeutic effects on spasmodic hemiplegia after stroke among the alliance therapy of scalp acupuncture, music therapy combined with rehabilitation, the simple rehabilitation therapy and the combination of music therapy and rehabilitation.</p><p><b>METHODS</b>A total of 76 patients of post-stroke spasmodic hemiplegia were randomized into a rehabilitation group (25 cases), a combination group with music therapy and rehabilitation (25 cases) and an alliance therapy group with scalp acupuncture, music therapy and rehabilitation (26 cases). In the rehabilitation group, the routine rehabilitation therapy was applied, including the removal of various incentives that cause spasm, the correction of body position and the physical therapy. In the combination group, the music therapy was added on the basis of the treatment as the rehabilitation group. The music physician used the rhythmic auditory stimulation, the patterned sensory enhancement and the therapeutic instrumental music playing to set up the task in the treatment. In the alliance therapy group, scalp acupuncture was added on the basis of the treatment as the combination group. The anterior oblique line of vertex-tempora (MS 6) and the posterior oblique line of vertex-tempora (MS 7) on the contralateral side were selected and stimulated with penetrating needling technique. The needles were retained. During the needling retaining, the needles were rotated once every 10 min, for 2 min each time. The treatment was given one session a day, totally for 5 sessions a week, continuously for 4 weeks. The Fugl-Meyer assessment (FMA), Barthel index (BI) and the modified Ashworth scale (MAS) of the affected elbow and the passive knee movement at static condition were observed in the patients before and after treatment.</p><p><b>RESULTS</b>The results of FMA, BI and MAS were not different before treatment in the patients among the three groups (all>0.05), indicating the comparability among groups. After treatment, FMA and BI scores were all increased apparently in the three groups as compared with those before treatment (all<0.05). MAS grade was reduced remarkably as compared with that before treatment (all<0.05). After treatment, FMA and BI scores in the alliance therapy group were higher than those in the combination group and the rehabilitation group (all<0.05). FMA and BI scores in the combination group were higher than those in the rehabilitation group (both<0.05). MAS grade in the alliance therapy group was lower than those in the combination group and the rehabilitation group (both<0.05). MAS grade in the combination group was lower than that in the rehabilitation group (<0.05).</p><p><b>CONCLUSION</b>The alliance therapy with scalp acupuncture, music therapy and rehabilitation achieve the remarkable clinical therapeutic effects on post-stroke spasmodic hemiplegia as compared with the routine rehabilitation and the combination of music therapy and rehabilitation.</p>
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Objective To explore the clinical effects of treating osteonecrosis of femoral head(ONFH) by stages with self designed Chinese medicine formula. Methods 106 ONFH patients in Shantou municipal TCM hospital from July 2010 to July 2013 were recruited and divided randomly into a control group and a treatment group, 53 patients in each. The treatment group was treated with self-designed Chinese medicine formula with the functions of strengthening spleen and promoting blood circulation in the early stage, and self-designed Chinese medicine formula with the functions of supplementing kidney and promoting blood circulation in the middle stage of disease, one dosage daily. The control group was treated with Xianliang Gubao capsule (3 granules per time, twice daily) and lovastatin capsule (10-20 mg per time). Both groups were treated for two therapeutic courses of 8-12 weeks. X-ray and hemorheology indexes were observed after the treatment. Results The total effects was 90.6%(48/53) and 73.6%(39/53) in the treatment group and the control group respectively, with significant difference(χ2=6.731,P<0.05);Whole blood viscosity, PV, HCT, Arbe, ESR, FIB were obviously improved in the treatment group after the treatment, [after the treatment: whole blood viscosity high cut(3.42±0.72)mPa?S, middle cut(4.21±0.30)mPa?S, low cut(8.36±0.12)mPa?S, PV(1.39±0.16)mPa?S, HCT(38.34±2.37)%, Arbe(5.47±0.33), ESR(27.35±2.16)mm/h, FIB(3.83±0.47)g/L], [before the treatment:whole blood viscosity high cut(3.97±0.21)mPa?S, middle cut (4.71±0.24)mPa?S, low cut (9.58±0.31)mPa?S, PV(2.01±0.13)mPa?S, HCT(41.29±1.01)%, Arbe(6.51±0.21),ESR(14.62±0.92)mm/h, FIB(4.94±0.26)g/L, P<0.05]. After the treatment, the treatment group was obviously improved in such indexes as whole blood viscosity high cut(3.76±0.08)mPa?S, middle cut(4.47±0.16)mPa?S, low cut (8.99±0.07)mPa?S, PV(1.72±0.14)mPa?S, HCT(40.46±1.06)%, Arbe(6.11±0.38), ESR(24.98±1.42)mm/h and FIB(4.33±0.57)g/L than the control group(P<0.01 or 0.05). Conclusion Self-designed Chinese medicine formula stage-therapy had better results in treating ONFH than Xianling Gubao capsule and lovastatin.
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Objective To explore the related factors of local reccurrence to rectal cancer after Dixon operation. Methods 100 patients with rectal cancer were used Dixon treatment. Then the tumor cells in the intestine and peritoneal fluid were qualitatively and quantitatively analyzed by flow cytometry during operation. The patients were followed up 2 years to understand the local recurrence. Results In 100 patients,8 cases were found in local recurrence after 2 years. 6 cases of recurrence were in the anastomotic site. Conclusion The local recurrence was related to Dukes stage,tumor distance from the anus,much margin of tumor length,tumor differentiation,intestine and abdominal shed close tumor cells,and it was worthy of attention.