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Objective To study the effect of comprehensive treatment in stroke unit on the cognition and life quality of patients with vascular cognitive impairment ( VCI) and also its effects on the mental state of their caregiv-ers. Methods Ninety-three persons with VCI were randomly divided into a control group ( n=44) and a compre-hensive treatment group ( n=49) after being admitted into the stroke unit. Both groups took routine basic drugs ( such as anti-platelet drugs, lipid lowering drugs, anti-hypertension drugs, huperzine-A tablets and Nicergoline tablets). The treatment group was additionally provided with limb movement rehabilitation training, social practice, cognitive training and health education. During the treatment, the treatment group's caregivers were also given health education about VCI and stroke, systematic rehabilitation knowledge and skills training and appropriate anti-depressant and anx-iety medication if need. Before the treatment, as well as 3 and 6 months after the treatment, the patients of both groups were evaluated using the mini-mental state examination ( MMSE ) , the Montreal cognitive assessment ( MoCA) , their ability in the activities of daily living ( ADL) was rated and Spitzer quality of life ( QLI) values were assigned. The caregivers were evaluated using the Hamilton depression scale (HAMD) and the Hamilton anxiety scale ( HAMA) . Results After 3 and 6 months of treatment, the average MMSE, MoCA, ADL and QLI scores of the treatment group had improved significantly and were then significantly better than those of the control group at the same time points. The average HAMD score of the treatment group was also significantly better. Conclusion Com-prehensive stroke unit therapy can improve the cognition and life quality of patients with vascular cognitive impair-ment. It can also improve the mental state of their caregivers.
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Objective@#To study the effect of comprehensive treatment in stroke unit on the cognition and life quality of patients with vascular cognitive impairment (VCI) and also its effects on the mental state of their caregivers.@*Methods@#Ninety-three persons with VCI were randomly divided into a control group (n=44) and a comprehensive treatment group (n=49) after being admitted into the stroke unit. Both groups took routine basic drugs (such as anti-platelet drugs, lipid lowering drugs, anti-hypertension drugs, huperzine-A tablets and Nicergoline tablets). The treatment group was additionally provided with limb movement rehabilitation training, social practice, cognitive training and health education. During the treatment, the treatment group′s caregivers were also given health education about VCI and stroke, systematic rehabilitation knowledge and skills training and appropriate anti-depressant and anxiety medication if need. Before the treatment, as well as 3 and 6 months after the treatment, the patients of both groups were evaluated using the mini-mental state examination (MMSE), the Montreal cognitive assessment (MoCA), their ability in the activities of daily living (ADL) was rated and Spitzer quality of life (QLI) values were assigned. The caregivers were evaluated using the Hamilton depression scale (HAMD) and the Hamilton anxiety scale (HAMA).@*Results@#After 3 and 6 months of treatment, the average MMSE, MoCA, ADL and QLI scores of the treatment group had improved significantly and were then significantly better than those of the control group at the same time points. The average HAMD score of the treatment group was also significantly better.@*Conclusion@#Comprehensive stroke unit therapy can improve the cognition and life quality of patients with vascular cognitive impairment. It can also improve the mental state of their caregivers.
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Objective To summarize and analyze the clinical features and diagnosis and treatment methods of patients with restless leg syndrome (RLS) mainly characterized by abdominal symptoms, and provide the basis for improving the correct diagnosis and treatment rate of RLS. MethodsThree patients, admitted to and completed routine laboratory examination (blood analysis, blood biochemistry, serum iron, serum ferritin, etc.), imaging, electroencephalogram, and electromyography in our hospital from August 2018 to April 2019, were chosen in our study. Polysomnography monitor was used to record the patient's sleep process for 12 h. Sleep and psychological status were evaluated by Pittsburgh Sleep Quality Index (PSQI), RLS Self-rating Depression Scale (IRLS), Epworth Sleeping Scale (ESS), RLS-quality of life (RLS-QoL), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD).Results General examination, physical examination of nervous system, imaging, electroencephalogram, electromyography and routine biochemical examination showed no obvious abnormalities in the three patients. Serum iron decreased in two patients. Polysomnography results indicated that the sleep efficiency of the three patients was obviously decreased, the sleep latency was prolonged, the time of awakening during sleep and the times of awakenings were increased; and the sleep structure was disordered; rapid eye movement sleep was significantly reduced. Meanwhile, all three patients had moderate and severe PLM events. Excessive sleepiness in the daytime was noted; the quality of life was affected about one month, and the severity was severe; all three patients had severe anxiety without evident depression. The condition of three patients with pramipexole hydrochloric acid after treatment were significantly improved.Conclusion s RLS subtype with abdominal symptoms as chief complaint is relatively rare in clinical practice. If patients have abdominal pain and discomfort during sleep at night and can exclude organic diseases of the digestive system, the possibility of RLS should be considered. A good therapeutic effect can be obtained by using dopa receptor agonist such as pramipexole.
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@#Objective To investigate the relationship between white matter hyperintensity and blood pressure variability and blood pressure rhythm in patients with acute lacunar stroke. Methods A total of 156 patients with acute lacuna stroke admitted to the Department of Neurology, Wuhan Hospital of Traditional Chinese and Western Medicine from January2017 to January 2019 were retrospectively enrolled, according to the results of cranial MRI examination, the enrolled patients were divided into mild white matter lesions group (n = 76) and moderate and severe white matter lesions group (n = 80) by Fazekas score. General information about vascular risk factors laboratory indicators and other findings were collected for both groups, the blood pressure variability and circadian rhythm were measured by 24 h ABPM, compare and analyze the related factors affecting WMI in patients with acute lacunar stroke. Results The history of prior stroke (P=0.005), the number of acute lacunar infarction (P=0.021), and the grade score of carotid plaque (P=0.041 ) in moderate and severe WMH group were higher than those in mild WMH group; The total day SBP-SD (P=0.01) daytime SBP-SD (P=0.004) daytime SBP-CV (P=0.018) daytime DBP-SD (P=0.028) were significantly increased in the moderate and severe WMH group; In the comparison of circadian rhythm of blood pressure between the two groups ,the riser pattern circadian rhythm in moderate and severe WMH group was significantly higher (P=0.03) ,and the arytenoid circadian rhythm in mild WMH group was higher (P=0.045). The multivariate Logistic regression analysis showed that the number of acute infarct lesions (OR=2.114, 95%CI 1.143-3.910, P=0.017) and riser pattern circadian rhythm (OR=0. 389, 95% CI 0.166-0.912, P=0.030) were independent risk factors for white matter hyperintensity in patients with acute lacunar stroke after adjusting for age, sex, and gender vascular risk factors (P<0.05). Conclusion WMH in patients with acute lacunar stroke is closely related to blood pressure variability (especially systolic blood pressure variability), and riser pattern circadian rhythm is an independent risk factor for WMH.
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Objective To observe the effect of health education on the mental health and life quality of people at high risk of stroke.Methods Totally 3092 residents of Wuhan aged over 40 were screened for stroke risk.Of those,392 cases were assessed as at high risk of stroke and were chosen as the study's subjects.They were given a 1-year course of standard health education.Before and after the intervention,their diet,exercise,compliance with medication and smoking habits were recorded.They were also assessed using the self-rating depression scale (SDS),the self-rating anxiety scale (SAS) and the Spitzer quality of life index (QLI).Results Significant improvement in healthy behavior was observed after the intervention.The average SDS score and SAS score had decreased significantly,and the average QLI score was significantly higher than before the intervention.Conclusion Health education can improve the healthy behavior,mental state and life quality of people at high risk of stroke.