Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of ce...Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the exc...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons.However,there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction.We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function.This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction.These patients were randomly assigned to three groups.The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1).The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1.Finally,the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1.A total of 135 seconds of stimulation was applied in the sham group and high-frequency group.At 2 weeks after treatment,cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment.Moreover,motor function scores were significantly improved.The above indices for the low-and high-frequency groups were significantly different compared with the sham group.However,there was no significant difference between the low-and high-frequency groups.The results show that low-and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
Objective： To observe the difference in clinical efficacy between governor vessel-unblocking and mind- regulating acupuncture therapy combined with conventional rehabilitation therapy and simply conventional rehabili...Objective： To observe the difference in clinical efficacy between governor vessel-unblocking and mind- regulating acupuncture therapy combined with conventional rehabilitation therapy and simply conventional rehabilitation therapy for sensory and motor dysfunction of patients with spinal cord injury. Methods： Forty patients with spinal cord injury （SCI） were randomly assigned into rehabilitation combined with acupuncture group （group A） and rehabilitation group （group B）, with 20 patients in each group. In group A, governor vessel-unblocking and mind-regulating acupuncture therapy combined with conventional rehabilitation therapy was adopted, and Baihui（百会 GV 20）, Fengffu （风府GV 16）, Dazhui （大椎GV 14）, Zhiyang （至阳GV 9）, Mingmen （命门 GV 4） and Yfioyangguan （腰阳关 GV 3） were adopted as the main acupoints. Conventional rehabilitation therapy was also applied, including the rehabilitation training of joint, motion, respiration, urinary bladder and intestinal tract. In group B, conventional rehabilitation therapy was adopted as same as the group A. Treatment in the two groups was conducted for once a day, 6 times a week, and 12 weeks in total. ASIA motor score （MS）, ASIA sensory score （SS） and activity of daily living （ADL） score of patients in the two groups were observed before and after the treatment. Results： Before treatment, the differences in MS, SS and ADL score of patients in the two groups were not statistically significant （all P 〉 0.05）, and the results were comparable. After treatment, MS, SS and ADL score of patients in the two groups were all higher than that before the treatment （all P 〈 0.05）, and MS, SS and ADL score of the patients in group A were all higher than that in group B （all P 〈 0.05）. Conclusion： The curative effect of governor vessel-unblocking and mind-regulating acupuncture therapy combined with conventional rehabilitation therapy was superior to that of simply conventional rehabilitation therapy in the treatment of sensory and motor dysfunction of the patients with SCI.展开更多
BACKGROUND Carpal tunnel syndrome(CTS)has been associated with gout and type 2 diabetes mellitus(T2DM).However,due to insufficient clinical understanding of goutrelated CTS and reliance on the diagnostic importance of...BACKGROUND Carpal tunnel syndrome(CTS)has been associated with gout and type 2 diabetes mellitus(T2DM).However,due to insufficient clinical understanding of goutrelated CTS and reliance on the diagnostic importance of elevated serum uric acid levels,such cases are prone to missed diagnosis,misdiagnosis,and delayed treatment.In addition,the effect of T2DM on gout-induced carpal tunnel syndrome has not been reported.CASE SUMMARY Herein,we present an unusual case of CTS and motor dysfunction caused by miliary tophaceous gout and T2DM.The patient presented to the hand and foot clinic with paresthesia of the fingers of both hands,especially at night.The patient was diagnosed with type 2 diabetes a month ago.Ultrasonography revealed bilateral transverse carpal ligament thickening with median nerve compression during hospitalization.The patient was successfully treated with carpal tunnel decompression and tendon release.The postoperative pathological examination revealed typical gout nodules.This case suggests that the presence of T2DM could accelerate tophi formation and worsen CTS symptoms,although no definitive proof in this regard has been described previously.CONCLUSION Tophi formation may most likely cause the co-occurrence of CTS and flexor dysfunction in gout and incipient diabetes patients.展开更多
Feeding dysfunction is a frequent presenting symptom of eosinophilic esophagitis(EoE). Here we present 3 children of various ages whose manifestations of EoE associated feeding dysfunction led to significant and life ...Feeding dysfunction is a frequent presenting symptom of eosinophilic esophagitis(EoE). Here we present 3 children of various ages whose manifestations of EoE associated feeding dysfunction led to significant and life altering impact on their growth and development. Early identification of presenting symptoms of EoE will allow for prompt diagnosis and initiation of appropriate treatments. Recognition of salient features of dysfunction and treatment by feeding therapists and nutritionists led to symptom resolution and growth.展开更多
BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms...BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.CASE SUMMARY A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient's physical status was improved substantially during his stay at the rehabilitation department.CONCLUSION Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.展开更多
目的观察深部经颅磁刺激(deep transcranial magnetic stimulation,dTMS)对脑卒中患者下肢运动功能障碍的影响。方法前瞻性选取2024年2月至2025年5月北京小汤山医院住院的脑卒中后出现下肢运动功能障碍患者75例,采用随机数字表法分为dTM...目的观察深部经颅磁刺激(deep transcranial magnetic stimulation,dTMS)对脑卒中患者下肢运动功能障碍的影响。方法前瞻性选取2024年2月至2025年5月北京小汤山医院住院的脑卒中后出现下肢运动功能障碍患者75例,采用随机数字表法分为dTMS组25例,重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)组25例,对照组25例。采用Fugl-Meyer下肢评估量表(Fugl-Meyer assessment of lower extremity,FMA-LE)、Berg平衡量表(Berg balance scale,BBS)、起立-行走计时测试(time up and go test,TUGT)、全身三维步态与运动分析系统(包括步速、步频、步长和步态周期)、静息运动阈值评估三组治疗前后的效果,监测治疗过程中的不良反应。结果与对照组比较,dTMS组和rTMS组治疗后FMA-LE评分明显升高,差异有统计学意义(P<0.05,P<0.01);与rTMS组比较,dTMS组治疗后FMA-LE评分明显升高[(23.97±5.08)分vs(21.56±5.11)分,P<0.05]。与对照组比较,dTMS组和rTMS组治疗后BBS、步速和步长明显升高,dTMS组治疗后TUGT明显降低,差异有统计学意义(P<0.05,P<0.01);与rTMS组比较,dTMS组治疗后BBS、步速和步长明显升高,TUGT明显降低,差异有统计学意义(P<0.05,P<0.01)。与对照组比较,dTMS组和rTMS组治疗后静息运动阈值明显降低,差异有统计学意义(P<0.05,P<0.01);与rTMS组比较,dTMS组治疗后静息运动阈值明显降低,差异有统计学意义(P<0.05)。结论dTMS能改善脑卒中患者下肢运动功能,提高平衡和步行能力,增强大脑皮质兴奋性。展开更多
基金supported by the National Natural Science Foundation of China,No.30540058,30770714the Natural Science Foundation of Beijing of China,No.7052030+2 种基金the Talents Foundation of Organization Department of the Beijing Municipal Committee in Chinathe Beijing Science Plan Project Fund of China,No.Z0005187040191-1the Research Foundation of Capital Medical Development of China,No.2007-2068
文摘Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons.However,there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction.We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function.This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction.These patients were randomly assigned to three groups.The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1).The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1.Finally,the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1.A total of 135 seconds of stimulation was applied in the sham group and high-frequency group.At 2 weeks after treatment,cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment.Moreover,motor function scores were significantly improved.The above indices for the low-and high-frequency groups were significantly different compared with the sham group.However,there was no significant difference between the low-and high-frequency groups.The results show that low-and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
基金Supported by clinical TCM scientific research project of Health and Family Plan-ning Commission of Anhui Province:2016ZY82~~
文摘Objective： To observe the difference in clinical efficacy between governor vessel-unblocking and mind- regulating acupuncture therapy combined with conventional rehabilitation therapy and simply conventional rehabilitation therapy for sensory and motor dysfunction of patients with spinal cord injury. Methods： Forty patients with spinal cord injury （SCI） were randomly assigned into rehabilitation combined with acupuncture group （group A） and rehabilitation group （group B）, with 20 patients in each group. In group A, governor vessel-unblocking and mind-regulating acupuncture therapy combined with conventional rehabilitation therapy was adopted, and Baihui（百会 GV 20）, Fengffu （风府GV 16）, Dazhui （大椎GV 14）, Zhiyang （至阳GV 9）, Mingmen （命门 GV 4） and Yfioyangguan （腰阳关 GV 3） were adopted as the main acupoints. Conventional rehabilitation therapy was also applied, including the rehabilitation training of joint, motion, respiration, urinary bladder and intestinal tract. In group B, conventional rehabilitation therapy was adopted as same as the group A. Treatment in the two groups was conducted for once a day, 6 times a week, and 12 weeks in total. ASIA motor score （MS）, ASIA sensory score （SS） and activity of daily living （ADL） score of patients in the two groups were observed before and after the treatment. Results： Before treatment, the differences in MS, SS and ADL score of patients in the two groups were not statistically significant （all P 〉 0.05）, and the results were comparable. After treatment, MS, SS and ADL score of patients in the two groups were all higher than that before the treatment （all P 〈 0.05）, and MS, SS and ADL score of the patients in group A were all higher than that in group B （all P 〈 0.05）. Conclusion： The curative effect of governor vessel-unblocking and mind-regulating acupuncture therapy combined with conventional rehabilitation therapy was superior to that of simply conventional rehabilitation therapy in the treatment of sensory and motor dysfunction of the patients with SCI.
基金Supported by Science and Technology Bureau of Jining,No.2021YXNS115.
文摘BACKGROUND Carpal tunnel syndrome(CTS)has been associated with gout and type 2 diabetes mellitus(T2DM).However,due to insufficient clinical understanding of goutrelated CTS and reliance on the diagnostic importance of elevated serum uric acid levels,such cases are prone to missed diagnosis,misdiagnosis,and delayed treatment.In addition,the effect of T2DM on gout-induced carpal tunnel syndrome has not been reported.CASE SUMMARY Herein,we present an unusual case of CTS and motor dysfunction caused by miliary tophaceous gout and T2DM.The patient presented to the hand and foot clinic with paresthesia of the fingers of both hands,especially at night.The patient was diagnosed with type 2 diabetes a month ago.Ultrasonography revealed bilateral transverse carpal ligament thickening with median nerve compression during hospitalization.The patient was successfully treated with carpal tunnel decompression and tendon release.The postoperative pathological examination revealed typical gout nodules.This case suggests that the presence of T2DM could accelerate tophi formation and worsen CTS symptoms,although no definitive proof in this regard has been described previously.CONCLUSION Tophi formation may most likely cause the co-occurrence of CTS and flexor dysfunction in gout and incipient diabetes patients.
文摘Feeding dysfunction is a frequent presenting symptom of eosinophilic esophagitis(EoE). Here we present 3 children of various ages whose manifestations of EoE associated feeding dysfunction led to significant and life altering impact on their growth and development. Early identification of presenting symptoms of EoE will allow for prompt diagnosis and initiation of appropriate treatments. Recognition of salient features of dysfunction and treatment by feeding therapists and nutritionists led to symptom resolution and growth.
文摘BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.CASE SUMMARY A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient's physical status was improved substantially during his stay at the rehabilitation department.CONCLUSION Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.
文摘目的观察深部经颅磁刺激(deep transcranial magnetic stimulation,dTMS)对脑卒中患者下肢运动功能障碍的影响。方法前瞻性选取2024年2月至2025年5月北京小汤山医院住院的脑卒中后出现下肢运动功能障碍患者75例,采用随机数字表法分为dTMS组25例,重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)组25例,对照组25例。采用Fugl-Meyer下肢评估量表(Fugl-Meyer assessment of lower extremity,FMA-LE)、Berg平衡量表(Berg balance scale,BBS)、起立-行走计时测试(time up and go test,TUGT)、全身三维步态与运动分析系统(包括步速、步频、步长和步态周期)、静息运动阈值评估三组治疗前后的效果,监测治疗过程中的不良反应。结果与对照组比较,dTMS组和rTMS组治疗后FMA-LE评分明显升高,差异有统计学意义(P<0.05,P<0.01);与rTMS组比较,dTMS组治疗后FMA-LE评分明显升高[(23.97±5.08)分vs(21.56±5.11)分,P<0.05]。与对照组比较,dTMS组和rTMS组治疗后BBS、步速和步长明显升高,dTMS组治疗后TUGT明显降低,差异有统计学意义(P<0.05,P<0.01);与rTMS组比较,dTMS组治疗后BBS、步速和步长明显升高,TUGT明显降低,差异有统计学意义(P<0.05,P<0.01)。与对照组比较,dTMS组和rTMS组治疗后静息运动阈值明显降低,差异有统计学意义(P<0.05,P<0.01);与rTMS组比较,dTMS组治疗后静息运动阈值明显降低,差异有统计学意义(P<0.05)。结论dTMS能改善脑卒中患者下肢运动功能,提高平衡和步行能力,增强大脑皮质兴奋性。
