目的观察低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脑卒中后失眠的临床疗效。方法收集2018年12月至2019年12月武汉大学中南医院康复医学科住院的脑卒中失眠患者58例,男35例,女23例,采用随机数字法将...目的观察低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脑卒中后失眠的临床疗效。方法收集2018年12月至2019年12月武汉大学中南医院康复医学科住院的脑卒中失眠患者58例,男35例,女23例,采用随机数字法将患者分为对照组(n=28)和rTMS治疗组(n=30),两组患者均接受常规基础性治疗和康复护理,对照组患者给予口服阿普唑仑片治疗失眠,rTMS治疗组患者接受低频rTMS治疗,疗程均为1个月。比较两组患者治疗前和治疗1个月后匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分、神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS)以及不良反应发生率的差异。结果两组患者治疗前PSQI和NIHSS评分比较无统计学差异(均P>0.05);治疗1个月后,两组患者PSQI和NIHSS评分均较治疗前改善(均P<0.05),且rTMS治疗组PSQI及NIHSS评分改善程度高于对照组(P<0.05)。对照组不良反应发生率高于治疗组(P<0.05)。结论低频rTMS能有效改善脑卒中后失眠患者的睡眠质量,促进患者神经功能的恢复,安全性高,值得临床推广应用。展开更多
Background Dyslipidaemia is a potential independent The aim of this study was to investigate dyslipidaemia, with ischemic stroke in a Chinese hospital. risk factor for cerebrovascular disease in patients with diabetes...Background Dyslipidaemia is a potential independent The aim of this study was to investigate dyslipidaemia, with ischemic stroke in a Chinese hospital. risk factor for cerebrovascular disease in patients with diabetes. treatment and control of dyslipidaemia among diabetic patients Methods A total of 1046 type 2 diabetic patients were assigned to diabetes with （n=-522） and diabetes without stroke groups. The two groups were matched by gender, age and diabetes duration. Lipid and lipoprotein profile were measured. Serum level and control of lipids were assessed and classified according to American Diabetes Association （ADA） guidelines and an intensified low density lipoprotein-cholesterol （LDL-C） target recommended in Chinese dyslipidaemia control criteria. Results Diabetic patients suffering stroke displayed not only poorly-controlled lipid and lipoprotein profiles, including the significantly lower proportion of patients achieving intensified LDL-C target of 〈2.07 mmol/L （80 mg/dl）, and high density lipoprotein-cholesterol （HDL-C） target （14.4% vs 21.0%, P=0.005; 45.8% vs 51.9%, P=0.048 respectively）, but also less adherence to therapy prescribed for dyslipidaemia （30.8% vs 41.0%, P=0.001）, when compared with diabetic patients without stroke. For the diabetic women with stroke, situation of dyslipidaemia was worse, with significantly lower serum level of HDL-C and apoA1, higher LDL-C level and higher ratio of apoB/apoA1 when compared with diabetic counterparts without stroke. Conclusions Many diabetic patients with ischemic stroke remain uncontrolled for dyslipidaemia. Intensified LDL-C and overall lipid lowering clinical goals are potential precautions taken against ischemic stroke among diabetic patients in China.展开更多
The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular a...The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.展开更多
Eosinophilia has been reported as a very rare cause of stroke in children.The thrombotic event may be either due to cardiac damage induced by eosinophils and their granular protein,that is,the major basic protein,or ... Eosinophilia has been reported as a very rare cause of stroke in children.The thrombotic event may be either due to cardiac damage induced by eosinophils and their granular protein,that is,the major basic protein,or the systemic hypercoagulable state induced by eosinophilia.We report here a case of eosinophilia whose initial presentation was recurrent strokes and cardiac and arterial thrombosis.展开更多
Objective:To explore the relationships among ambient temperature,ischemic stroke severity,and blood pressure.Methods:Meteorological data(2005–2015)were collected from the Guangzhou Meteorological Data Service.Ischemi...Objective:To explore the relationships among ambient temperature,ischemic stroke severity,and blood pressure.Methods:Meteorological data(2005–2015)were collected from the Guangzhou Meteorological Data Service.Ischemic stroke patients from the Department of Neurology of the First Affiliated Hospital,Sun Yat-sen University were retrospectively evaluated,each winter from 2005 to 2015.Patient demographics,baseline measurements,and National Institute of Health Stroke Scale(NIHSS)score were evaluated.Results:Three hundred sixty-two patients were included.The median latency from symptom onset to admission was 2 d(IQR:1–3 d).During recruitment,the highest and lowest temperatures were 39℃and 1.3℃,respectively.Hypertension was the most common comorbidity(75.1%).NIHSS scores at admission and discharge were higher in the cold-exposed group than in the controls regardless of the average temperature at admission.In addition,systolic and diastolic blood pressure values at admission were higher in the cold-exposed group than in the controls.When stratified by hypertensive status,the average and minimum temperatures at admission were negatively associated with systolic and diastolic blood pressure values in hypertensive patients.Reductions in the average and minimum temperatures at symptom onset were associated with more severe stroke.Conclusion:Ischemic stroke patients with symptom onset in winter had higher systolic blood pressure values and more serious neurologic deficits upon admission.展开更多
BACKGROUND Few studies have investigated low-frequency electrical stimulation combined with tri-tongue acupuncture for the treatment of post-stroke dysarthria.This randomized clinical study assessed the correlation be...BACKGROUND Few studies have investigated low-frequency electrical stimulation combined with tri-tongue acupuncture for the treatment of post-stroke dysarthria.This randomized clinical study assessed the correlation between the clinical efficacy of low-frequency electrical stimulation combined with tri-tongue acupuncture in patients with post-stroke dysarthria.AIM To investigate the clinical effects of tri-tongue acupuncture combined with lowfrequency electrical stimulation for treating post-stroke dysarthria.METHODS Ninety patients with post-stroke dysarthria,who were admitted to our hospital from December 2019 to June 2021,were selected and equally divided into two groups(n=45/group)according to the random number table method.Tri-tongue acupuncture was administered in the control group.The treatment group received both tri-tongue acupuncture and low-frequency electrical stimulation.The clinical efficacy,Western Aphasia Battery(WAB)score,general quality of life inventory(GQOLI-74)score,Frenchay Dysarthria Assessment score,and speech function grades were compared and analyzed between both groups.RESULTS The overall efficacy in the treatment group was better than that in the control group(P<0.05).Before treatment,the WAB,Frenchay Dysarthria Assessment,or GQOLI-74 scores(P>0.05)did not differ between the groups.After therapy,the WAB,Frenchay Dysarthria Assessment,and GQOLI-74 scores in both groups increased significantly(P<0.05),and the treatment group exhibited a significantly greater increase than that of the controls(P<0.05).Moreover,the classification of speech function did not differ between the two groups before treatment(P>0.05),whereas significant improvements were observed in both groups after treatment(P<0.05).The degree of improvement in the treatment group was greater than that in the control group(P<0.05).CONCLUSION Low-frequency electrical stimulation,in conjunction with tri-tongue acupuncture,exhibits a good clinical effect on post-stroke dysarthria.展开更多
Rehabilitation is the most effective way to reduce motor impairments in post-stroke patients.This process demands several hours with a specialized therapist.Given resources and personnel shortages,the literature repor...Rehabilitation is the most effective way to reduce motor impairments in post-stroke patients.This process demands several hours with a specialized therapist.Given resources and personnel shortages,the literature reports a high interest in robotic assisted rehabilitation solutions.Recently,cable-driven robotic architectures are attracting significant research interest for post-stroke rehabilitation.However,the existing cable-driven robots are mostly unilateral devices allowing the rehabilitation only of the most affected limb.This leaves unaddressed the rehabilitation of bimanual activities,which are predominant within the common Activities of Daily Living(ADL).Thus,this paper presents a specific novel design to achieve bimanual rehabilitation tasks that has been named as BiCAR robot.Specifically,this paper provides a full insight on the BiCAR system as well as on its dedicated developed software BiEval.In particular,BiEval software has been developed as based on a serious game strategy and a virtual reality environment to track the patient exercising duration,motion ranges,speeds,and forces over time for achieving a quantitative assessment of the rehabilitation progress.Finally,the paper presents the BiCAR/BiEval capabilities by referring to a pilot Randomized Controlled Trial(RCT).The clinical trials have been used to validate the BiCAR/BiEval in terms of engineering feasibility and user acceptance to achieve an innovative cost-oriented integrated hardware/software device for the bimanual assistive rehabilitation of post-stroke patients.展开更多
文摘目的观察低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脑卒中后失眠的临床疗效。方法收集2018年12月至2019年12月武汉大学中南医院康复医学科住院的脑卒中失眠患者58例,男35例,女23例,采用随机数字法将患者分为对照组(n=28)和rTMS治疗组(n=30),两组患者均接受常规基础性治疗和康复护理,对照组患者给予口服阿普唑仑片治疗失眠,rTMS治疗组患者接受低频rTMS治疗,疗程均为1个月。比较两组患者治疗前和治疗1个月后匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分、神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS)以及不良反应发生率的差异。结果两组患者治疗前PSQI和NIHSS评分比较无统计学差异(均P>0.05);治疗1个月后,两组患者PSQI和NIHSS评分均较治疗前改善(均P<0.05),且rTMS治疗组PSQI及NIHSS评分改善程度高于对照组(P<0.05)。对照组不良反应发生率高于治疗组(P<0.05)。结论低频rTMS能有效改善脑卒中后失眠患者的睡眠质量,促进患者神经功能的恢复,安全性高,值得临床推广应用。
基金This work was partially supported by the National Natural Science Foundation of China （No. 30870870, WANG Shao-hua No. 30600206, GUO Yi-jing） and Natural Science Foundation of Jiangsu Province （No. BK2008302, WANG Shao-hua）.Acknowledgment： We would like to express our thanks to the nursing staff of the Division of Endocrinology, Zhongda Hospital of Southeast University, for their help.
文摘Background Dyslipidaemia is a potential independent The aim of this study was to investigate dyslipidaemia, with ischemic stroke in a Chinese hospital. risk factor for cerebrovascular disease in patients with diabetes. treatment and control of dyslipidaemia among diabetic patients Methods A total of 1046 type 2 diabetic patients were assigned to diabetes with （n=-522） and diabetes without stroke groups. The two groups were matched by gender, age and diabetes duration. Lipid and lipoprotein profile were measured. Serum level and control of lipids were assessed and classified according to American Diabetes Association （ADA） guidelines and an intensified low density lipoprotein-cholesterol （LDL-C） target recommended in Chinese dyslipidaemia control criteria. Results Diabetic patients suffering stroke displayed not only poorly-controlled lipid and lipoprotein profiles, including the significantly lower proportion of patients achieving intensified LDL-C target of 〈2.07 mmol/L （80 mg/dl）, and high density lipoprotein-cholesterol （HDL-C） target （14.4% vs 21.0%, P=0.005; 45.8% vs 51.9%, P=0.048 respectively）, but also less adherence to therapy prescribed for dyslipidaemia （30.8% vs 41.0%, P=0.001）, when compared with diabetic patients without stroke. For the diabetic women with stroke, situation of dyslipidaemia was worse, with significantly lower serum level of HDL-C and apoA1, higher LDL-C level and higher ratio of apoB/apoA1 when compared with diabetic counterparts without stroke. Conclusions Many diabetic patients with ischemic stroke remain uncontrolled for dyslipidaemia. Intensified LDL-C and overall lipid lowering clinical goals are potential precautions taken against ischemic stroke among diabetic patients in China.
文摘The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.
文摘 Eosinophilia has been reported as a very rare cause of stroke in children.The thrombotic event may be either due to cardiac damage induced by eosinophils and their granular protein,that is,the major basic protein,or the systemic hypercoagulable state induced by eosinophilia.We report here a case of eosinophilia whose initial presentation was recurrent strokes and cardiac and arterial thrombosis.
文摘Objective:To explore the relationships among ambient temperature,ischemic stroke severity,and blood pressure.Methods:Meteorological data(2005–2015)were collected from the Guangzhou Meteorological Data Service.Ischemic stroke patients from the Department of Neurology of the First Affiliated Hospital,Sun Yat-sen University were retrospectively evaluated,each winter from 2005 to 2015.Patient demographics,baseline measurements,and National Institute of Health Stroke Scale(NIHSS)score were evaluated.Results:Three hundred sixty-two patients were included.The median latency from symptom onset to admission was 2 d(IQR:1–3 d).During recruitment,the highest and lowest temperatures were 39℃and 1.3℃,respectively.Hypertension was the most common comorbidity(75.1%).NIHSS scores at admission and discharge were higher in the cold-exposed group than in the controls regardless of the average temperature at admission.In addition,systolic and diastolic blood pressure values at admission were higher in the cold-exposed group than in the controls.When stratified by hypertensive status,the average and minimum temperatures at admission were negatively associated with systolic and diastolic blood pressure values in hypertensive patients.Reductions in the average and minimum temperatures at symptom onset were associated with more severe stroke.Conclusion:Ischemic stroke patients with symptom onset in winter had higher systolic blood pressure values and more serious neurologic deficits upon admission.
文摘BACKGROUND Few studies have investigated low-frequency electrical stimulation combined with tri-tongue acupuncture for the treatment of post-stroke dysarthria.This randomized clinical study assessed the correlation between the clinical efficacy of low-frequency electrical stimulation combined with tri-tongue acupuncture in patients with post-stroke dysarthria.AIM To investigate the clinical effects of tri-tongue acupuncture combined with lowfrequency electrical stimulation for treating post-stroke dysarthria.METHODS Ninety patients with post-stroke dysarthria,who were admitted to our hospital from December 2019 to June 2021,were selected and equally divided into two groups(n=45/group)according to the random number table method.Tri-tongue acupuncture was administered in the control group.The treatment group received both tri-tongue acupuncture and low-frequency electrical stimulation.The clinical efficacy,Western Aphasia Battery(WAB)score,general quality of life inventory(GQOLI-74)score,Frenchay Dysarthria Assessment score,and speech function grades were compared and analyzed between both groups.RESULTS The overall efficacy in the treatment group was better than that in the control group(P<0.05).Before treatment,the WAB,Frenchay Dysarthria Assessment,or GQOLI-74 scores(P>0.05)did not differ between the groups.After therapy,the WAB,Frenchay Dysarthria Assessment,and GQOLI-74 scores in both groups increased significantly(P<0.05),and the treatment group exhibited a significantly greater increase than that of the controls(P<0.05).Moreover,the classification of speech function did not differ between the two groups before treatment(P>0.05),whereas significant improvements were observed in both groups after treatment(P<0.05).The degree of improvement in the treatment group was greater than that in the control group(P<0.05).CONCLUSION Low-frequency electrical stimulation,in conjunction with tri-tongue acupuncture,exhibits a good clinical effect on post-stroke dysarthria.
基金partially funded by UFU,FAPEMIG,CNPQ,and CAPES(Finance Code 001).
文摘Rehabilitation is the most effective way to reduce motor impairments in post-stroke patients.This process demands several hours with a specialized therapist.Given resources and personnel shortages,the literature reports a high interest in robotic assisted rehabilitation solutions.Recently,cable-driven robotic architectures are attracting significant research interest for post-stroke rehabilitation.However,the existing cable-driven robots are mostly unilateral devices allowing the rehabilitation only of the most affected limb.This leaves unaddressed the rehabilitation of bimanual activities,which are predominant within the common Activities of Daily Living(ADL).Thus,this paper presents a specific novel design to achieve bimanual rehabilitation tasks that has been named as BiCAR robot.Specifically,this paper provides a full insight on the BiCAR system as well as on its dedicated developed software BiEval.In particular,BiEval software has been developed as based on a serious game strategy and a virtual reality environment to track the patient exercising duration,motion ranges,speeds,and forces over time for achieving a quantitative assessment of the rehabilitation progress.Finally,the paper presents the BiCAR/BiEval capabilities by referring to a pilot Randomized Controlled Trial(RCT).The clinical trials have been used to validate the BiCAR/BiEval in terms of engineering feasibility and user acceptance to achieve an innovative cost-oriented integrated hardware/software device for the bimanual assistive rehabilitation of post-stroke patients.
