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Objective:To explore the effectiveness of 1+N+N team model with family physician as the core for rehabilitation of community-dwelling stroke patients.Methods:Convalescent stroke patients in Fenglin Community of Shanghai Xuhui District, who were followed up and registered from January 2019 to October 2021, were continuously enrolled in this intervention study. The 1+N+N care team consisted of a family doctor as the core (“1”) with the professional and technical team of the community health service center (“N”) and specialists in second or third hospitals (“N”). Patients were randomly divided into 1+N+N intervention group and control group. The control group was treated with traditional stroke management scheme, while the intervention group was treated by the 1+N+N team model. The activities of daily living (ADL), motor function and psychological status scores were evaluated at baseline and 12 months after intervention. Multivariate linear regression model was used to analyze the association of intervention methods with the improvement of ADL score, motor function score and psychological status score of patients.Results:A total of 120 patients were enrolled (60 in each group), including 59 males and 61 females with a mean age of (71.5±6.8) years. Compared with the control group, the age of patients in the intervention group was younger ( P=0.013), and the proportion of patients with coronary heart disease was lower ( P=0.003). There was no significant differences in other variables between the two groups ( P>0.05). After 12 months of intervention, the scores of ADL, motor function and psychological status were significantly improved compared with those before intervention in both groups ( P<0.01). There was no significant difference in motor function scores between the intervention group and the control group before intervention ( P>0.05), but the scores of ADL and psychological status in the intervention group were higher than those in the control group ( P<0.001). After intervention, the above scores in the intervention group were higher than those in the control group ( P<0.01). After adjusting for confounding factors, multivariate linear regression showed that the 1+N+N team model had no significant correlation with ADL score ( t=0.27, P=0.799), but had a positive correlation with motor function score ( t=15.64, P<0.01) and psychological status score ( t=13.70, P<0.01). Conclusion:The 1+N+N team model can effectively improve the daily living ability, motor function and psychological status of stroke patients in the convalescent period, and the intervention effect on the latter two is better than that of the traditional rehabilitation mode.
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Objective To evaluate the therapeutic effect of acupuncture combined with rehabilitation training on children with cerebral palsy. Methods A total of 68 children with cerebral palsy who met the inclusion criteria were randomly divided into two groups, 34 in each group. The control group was treated with Bobath therapy combined with Vojta therapy for rehabilitation training, while the observation group was treated with acupuncture on the basis of the control group. Both groups were treated for 12 weeks. Modified Ashworth method was used to assess the muscular tension of lower limbs, the gross motor function scale was used to assess the gross motor function, and the Fugl-Meyer motor function evaluation method was used to evaluate the limb motor function of children. And the serum levels of vascular endothelial growth factor and creatine kinase brain isoenzyme (CK-BB) were detected by ELISA. Results After treatment, the muscle tension score (1.3 ± 0.3 vs. 1.7 ± 0.4, t=4.108) in the observation group was significantly lower than that in the control group, while the GMFM score (55.7 ± 13.7 vs. 37.8±11.4, t=5.881) significantly higher than that in the control group (P<0.01). The serum VEGF (145.67 ± 19.78 ng/L vs. 171.35 ± 22.54 ng/L, t=4.993) in the observation group were significantly lower than those of the control group (P<0.01). The levels of CK-BB (71.46 ± 17.62 U/L vs. 95.76 ± 19.65 U/L, t=5.368) in the observation group were significantly lower than those of the control group (P<0.01). The total effective rate was 94.1% (32/34) in the observation group and 73.5% (25/34) in the control group. There were significant differences between the two groups (χ2=5.314, P=0.021). Conclusions Acupuncture combined with rehabilitation training can improve the muscle tension and gross motor function of children with cerebral palsy, reduce the levels of VEGF and CK-BB in serum of children with cerebral palsy, and improve the clinical effect.
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Objective To explore clinical characteristics of patients with Klinefelter′s syndrome(KS; 47,XXY).Methods 227 male patients with 47,XXY treated by artificial insemination with donor(AID)were included.Age, education, height, weight, body mass index(BMI), testicular volume, FSH, LH, testosterone(T), prolactin(PRL), estradiol(E2)were analyzed retrospectively.Results Of these patients, their height were(176.4±5.5)cm, weight(74.5±12.7)kg, BMI(23.89±3.66)kg/m2[77 of overweight(33.92%)and 34 of obesity(14.98%)], FSH(38.35±14.33)IU/L, LH(19.40±9.00)IU/L, T(132.00±194.50)ng/dl, E2(23.90±15.00)ng/L, PRL(10.50±8.20)μg/L, E2/T 0.21±0.80.Testicular volume had the positive association with the level of T(r=0.197, P=0.003).BMI had the negative association with the serum concentration of T(r=-0.284, P=0.000), while positive association with the E2(r=0.174, P=0.009)and ratio of E2/T(r=0.323, P=0.000).Age had no association with T, E2, and E2/T(P>0.05), but had negative association with the serum concentration of LH(r=-0.154, P=0.02)nd FSH(r=-0.196,P=0.03).The higher education group were older(P<0.01), while the level of T were lower(P<0.01).Conclusion In patients with Klinefelter′s syndrome(KS; 47,XXY), level of T may associate with testicular volume.T, E2, and the ratio of E2/T seem to associate with their height, BMI, and education level.
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Objective To establish a new method to measure alkaline phosphatase (ALP) activity using disodium p-acetylphenylphosphate (PAP-PNa2) as substrate.Methods Experimental parameters were set up with continuous-monitoring procedures on a semiautomatic analyzer.Results The wavelength of maximum absorption of PAP was 325 nm,and the Km of ALP was 0.376 mmol/L.The molecular extinction coefficient of PAP at 340 nm was 23 390 L?mol-1?cm-1 and the concentration of citrate buffer was 0.438 mol/L.In the measurement,the optimum pH was 10.4,and the optimum concentration of substrate was 5.0 mmol/L.The delay time was 60 sec and the time keeping the linear reaction was 15 min,and the linear range was 0~1 110 U/L.The measurement was not interfered by the hemoglobin