Objective To investigate the feature of event-related potential N400 for Chinese aphasia patients.Methods 23 Chinese aphasia patients and 20 controls were evaluated with Western Aphasia Battery(WAB),and N400 was also measured.Results N400 latency was longer and N400 amplitude was higher in the aphasia group than in the control group.In aphasia group,the latency(r=-0.553,P=0.000) and amplitude of N400(r=-0.628,P=0.000) correlated to the score of Aphasia Quotient(AQ),and the amplitude of N400 correlated to the score of anomia in WAB(r=-0.372,P=0.001).Conclusion Event-related potential N400 could reflect the level of language function impairment and it is a valuable index for evaluating language function,especially anomia level in Chinese aphasia patients.
Bilirubin has anti-inflammatory, antioxidant, and neuroprotective properties, but the association between bilirubin and stroke remains contentious. A meta-analysis of extensive observational studies on the relationship was conducted.Studies published before August 2022 were searched in PubMed, EMBASE, and Cochrane Library. Cohort, cross-sectional and case-control studies that examined the association between circulating bilirubin and stroke were included. The primary outcome included the incidence of stroke and bilirubin quantitative expression level between stroke and control, and the secondary outcome was stroke severity. All pooled outcome measures were determined using random-effects models. The meta-analysis, subgroup analysis, and sensitivity analysis were performed using Stata 17.A total of 17 studies were included. Patients with stroke had a lower total bilirubin level (mean difference = -1.33 μmol/L, 95% CI: -2.12 to -0.53, P < 0.001). Compared with the lowest bilirubin level, total odds ratio (OR) of the highest bilirubin for the occurrence of stroke was 0.71 (95% CI: 0.61-0.82) and ischemic stroke was 0.72 (95% CI: 0.57-0.91), especially in cohort studies with accepted heterogeneity (I2 = 0). Serum total and direct bilirubin levels were significantly and positively associated with stroke severity. A stratified analysis based on gender showed that the total bilirubin level in males correlated with ischemic stroke or stroke, which was not noted in females.While our findings suggest associations between bilirubin levels and stroke risk, existing evidence is insufficient to establish a definitive association. Better-designed prospective cohort studies should further clarify pertinent questions (PROSPERO registration number: CRD42022374893).
Objective:To study the effect of early rehabilitation on balace function and activities of daily living(ADL) in patients with hemiplegia after stroke.Method:80 patients were randomly divided into two groups, the rehabilitation group(40 cases) and the control group(40 cases). Patients in the rehabilitation group were given clinical treatment and regularly physical therapy, while those in control group were given clinical treament and unguided self-training, and the evaluation was done in pre-treatment and 3 months and 6 months after stroke. Balance function was assessed with Fugl-Meyer and ADL was assessed with Modified Barthel Index(MBI).Result:The balace function scores and MBI scores in each groups and between two groups rised had a significant difference(P0.05), the process of scores in the rehabilitation group were obviously superior to that in the control group(P0.001).The balance function is positive correlation to ADL(r=0.791).Conclusion:Early rehabilitation training on the patients with hemiplegia after stroke may obviously improve balance function and ADL.
Progressive motor deficits are relatively common in acute pontine infarction and frequently associated with increased functional disability. However, the factors that affect the progression of clinical motor weakness are largely unknown. Previous studies have suggested that pontine infarctions are caused mainly by basilar artery stenosis and penetrating artery disease. Recently, lower pons lesions in patients with acute pontine infarctions have been reported to be related to progressive motor deficits, and ensuing that damage to the corticospinal tracts may be responsible for the worsening of neurological symptoms. Here, we review studies on motor weakness progression in pontine infarction and discuss the mechanisms that may underlie the neurologic worsening.
Background: Frozen shoulder is a common shoulder disorder characterized by pain and restriction. Various nonsurgical treatments have been reported, but there is no consensus about their comparative efficacy and the effects of moderators. Purpose: To compare the efficacy of different nonsurgical interventions and identify potential patient-specific moderating factors for frozen shoulder. Study Design: Systematic review and network meta-analysis. Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched from their inception to February 18, 2019. The search was supplemented by manual review of relevant reference lists. Randomized controlled trials of participants with frozen shoulder that compared nonsurgical interventions were selected. Measured outcomes included pain, shoulder function in daily activities, and range of motion. Results: Of 3136 records identified, 92 trials were eligible, evaluating 32 nonsurgical interventions in 5946 patients. Intra-articular injection improved pain (pooled standardized mean difference [95% CI]: steroid injection, 1.68 [1.03-2.34]; capsular distension, 2.68 [1.32-4.05]) and shoulder function (steroid injection, 2.16 [1.52-2.81]; distension, 2.89 [1.71-4.06]) to a greater extent than placebo. Capsular distension and extracorporeal shockwave therapy showed the highest ranking for pain relief and functional improvement, respectively. Laser therapy also showed benefits for pain relief (3.02 [1.84-4.20]) and functional improvement (3.66 [1.65-5.67]). Subgroup analyses by disease stages revealed that steroid injection combined with physical therapy provided more benefits during the freezing phase, whereas joint manipulation provided more benefits in the adhesive phase. Adjunctive therapies, female sex, and diabetes were also identified as moderators of effectiveness. Conclusion: Capsular distension is a highly recommended choice for treatment of frozen shoulder, contributing greatly to pain relief and functional improvement; steroid injection is also a prevailing effective intervention. Among new options, extracorporeal shockwave therapy and laser therapy show potential benefits for multiple outcomes. Individualized optimal intervention should be considered, given that treatment effect is moderated by factors including the disease stage, time of assessment, adjunctive therapies, female sex, and diabetes.
Objective To observe the effect of cognition training on the motor and executive functioning of patients after a basal ganglia stroke.Methods Thirty patients with basal ganglia stroke were randomly divided into a treatment group and a control group.The control group received standard stroke rehabilitation training,while the treatment group received in addition 2 months of cognitive function training.The executive and motor functions of all of the subjects and their facility in the activities of daily living (ADL) were tested using the Tower of Hanoi,the Wisconsin card sorting test,a Stroop-3 test and the Fugl-Meyer assessment,the Berg balance scale and the modified Barthel index before and at the end of treatment.Results After two months of training,both within-group and between group comparisons showed that the treatment group had improved significantly more in executive function,cognition and motor function.Conclusion Cognition training can improve executive function,motor function and ADL performance after a basal ganglia stroke.
Key words:
Cognition training; Executive function; Motor function; Stroke
Osteoarthritis (OA) is a common degenerative disease in mammals. However, its pathogenesis remains unclear. Studies indicate that OA is not only an aging process that but also an inflammation-related disease. Synovitis is closely related to the progression of OA, and synovial macrophages are crucial participants in synovitis. Instead of being a homogeneous population, macrophages are polarized into M1 or M2 subtypes in OA synovial tissues. Polarization is highly associated with OA severity. However, the M1/M2 ratio cannot be the only factor in OA prognosis because intermediate stages of macrophages also exist. To better understand the mechanism of this heterogeneous disease, OA subtypes of synovial macrophages classified by gene expression were examined. Synovial macrophages do not act alone; they interact with surrounding cells such as synovial fibroblasts, osteoclasts, chondrocytes, lymphocytes and even adipose cells through a paracrine approach to exacerbate OA. Treatments targeting synovial macrophages and their polarization are effective in relieving pain and protecting cartilage during OA development. In this review, we describe how synovial macrophages and their different polarization states influence the progression of OA. We summarize the current knowledge of the interactions between macrophages and other joint cells and examine the current research on new medications targeting synovial macrophages.
Background Intravaginal electrical stimulation (IVES) has been explored as a potential treatment for pelvic floor disorders (PFDs), although its efficacy remains a subject of debate. We aim to conducted a comprehensive meta-analysis of relevant trials. Methods This meta-analysis was performed under the PRISMA 2020 guideline. We meticulously searched for randomized controlled trial (RCT) studies in various databases, including PubMed, Cochrane Library, EMBASE, and ClinicalTrials.gov , spanning from inception to March 6, 2023. All studies included one treatment group of intravaginal electrical stimulation and the diseases spectrum of the studies involved different kinds of PFDs, including urinary incontinence, overactive bladder, etc. Risk of bias charts were used to assess the risk of bias in the studies and forest plots were used the demonstrate the overall effects. Results Our analysis encompassed a total of 13 RCT studies. In most of the assessed PFD cure outcomes, the results demonstrated positive effects of IVES therapy, as indicated by the following findings: daily voiding frequency (MD = −1.57, 95% CI = −3.08 to −0.06, I 2 = 68%,), nocturia (MD = −1.07, 95% CI = −2.01 to −0.13, I 2 = 71%), Pad test, and Urinary incontinence. Nevertheless, the data concerning the impact of IVES therapy on the quality of life of individuals with PFDs did not confirm these positive results. Discussion In light of the insufficiency in both the quality and quantity of the included studies, it is premature to draw a definitive conclusion regarding the efficacy of IVES therapy for treating PFDs. Nonetheless, our study does provide several pieces of evidence in support of the potential therapeutic effects of electrical stimulation therapy in this context. We recommend that further research in this area be conducted to provide more conclusive insights into the efficacy of IVES therapy for PFDs. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier: CRD42023442171.
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