1.Measuring balance in stroke patients with tetra-ataxiametry and clinical balance scales
Huai HE ; Guiying DAI ; Chuandao LIU
Chinese Journal of Physical Medicine and Rehabilitation 2011;33(2):134-136
Objective To compare balance assessment with static balance measuring equipment and clinical balance measuring scales. Methods Seventy hemiplegic stroke patients ( the patient group) and 36 healthy volunteers (the controls) were recruited. Each subject's equilibrium was measured using the Berg Balance Scale (BBS) ,the Fugl-Meyer Balance Scale (FM-B) and tetra-ataxiametry, all by the same therapist. Results The BBS and FM-B results both showed significant differences between the patient group and the control group. The data obtained through tetra-ataxiametric assessment showed that the average weight distribution index ( WDI ) and stability index (SI) were significantly lower in the patient group than among the controls. There was a strong correlation between the tetra-ataxiametric assessment results and the clinical balance test outcomes. The WDI and SI from tetra-ataxiametry were strongly correlated with Berg total static scores. Conclusions Tetra-ataxiametry and the BBS and FM-B tests can all effectively reflect the equilibrium of stroke patients. Tetra-ataxiametry can measure balance ability quantitatively, while the clinical balance tests ( BBS, FM-B) are easier to conduct.
2.Venous Thromboembolism in Rehabilitation: 7 Cases Report
Chuandao LIU ; Huai HE ; Weixin YANG
Chinese Journal of Rehabilitation Theory and Practice 2013;19(4):387-389
Objective To strengthen physiatrist's knowledge of diagnosis and treatment of venous thromboembolism by analysing 7 venous thromboembolic events in rehabilitation. Methods 7 cases with venous thromboembolism (VTE) in our department were involved in this study. Related data of these patients were collected, investigated and analyzed. Results 6 cases were deep venous thrombosis (DVT), 1 case was pulmonary embolism (PE). The patients with DVT were treated successfully by thrombolytic and/or anticoagulant therapy as well as later rehabilitation treatment, and the patient with PE was cured after intra-arterial mechanical thrombolysis therapy and later anticoagulant therapy. Conclusion Prevention and treatment of VTE is becoming a very important issue in development in our country. Active prevention, early recognition and treatment are very important for the prognosis of patients with VTE.
3.Rehabilitating the non-motor symptoms of Parkinson's disease using repetitive transcranial magnetic stimulation
Min SU ; Liying HAN ; Chuandao LIU ; Yunqiang ZAN ; Weixin YANG
Chinese Journal of Physical Medicine and Rehabilitation 2012;(12):911-915
Objective To research the clinical rehabilitative effect of repeated transcranial magnetic stimulation (rTMS) for the non-motor symptoms of Parkinson's disease.Methods Fifty-five PD patients were randomly divided into an rTMS treatment group (n =29) and a sham stimulation group (n =26).The treatment group received a course of 0.5 Hz rTMS treatment,while the sham stimulation group had the same treatment but with no energy output.Both groups were evaluated using a non-motor symptoms questionnaire (NMSQuest),the Hamilton depression scale (HAMD),the Pediatric Daytime Sleepiness Scale (PDSS),the mini-mental state examination (MMSE) and the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT) before treatment,immediately after,and a month after treatment.Results Compared with before treatment,the average NMSQuest score of the treatment group declined significantly,though 1 month after treatment the improvement was no longer significant.After treatment and 1 month later the average NMSQuest score of the sham stimulation group increased gradually.The effect in the treatment group was therefore significantly better than in the sham stimulation group.After treatment and 1 month later the average HAMD score of the treatment group was significantly lower than before treatment while the average HAMD score of the sham stimulation group had increased gradually.The improvement in depression in the treatment group was therefore significantly better than in the sham stimulation group.After treatment,sleep disorders in the treatment group had been significantly alleviated,but one month later the improvement was no longer significant compared with before treatment.PDSS scores in the sham stimulation group declined gradually,but the improvement in sleep disorders among the treatment group was significantly better than among the sham stimulation group.Cognition improved significantly among the treatment group right after treatment,but 1 month later it had worsened while the MMSE scores of the sham stimulation group decreased gradually.The difference between the two groups was statistically significant.The average SCOPA-AUT scores of the two groups were not significantly different from each other or from the scores before treatment.Conclusion Repeated TMS can improve most non-motor symptoms of PD.The improvement in depression is the most significant.A short course of rTMS has no obvious rehabilitative effect on the autonomic function disorders of PD patients.
4.Effects of motor imagery therapy combined with electromyographic biofeedback on upper limb function in hemiplegic stroke patients
Hongjun ZHU ; Huai HE ; Chuandao LIU ; Weixin YANG
Chinese Journal of Physical Medicine and Rehabilitation 2011;33(6):443-446
Objective To study the effects of motor imagery therapy combined with electromyographic (EMG) biofeedback on upper limb function in hemiplegic patients.Methods Sixty hemiplegic stroke patients were recruited and divided into a control group (n=20),an electrical stimulation group (n=20) and a combination group (n=20).All groups received basic medication and routine rehabilitation training once daily for 4 weeks.The electrical stimulation group was also treated with EMG biofeedback,and the combination group with motor imagery therapy plus EMG biofeedback.The Fugl-Meyer assessment (FMA),the modified Barthel index (MBI) and EMG parameters were assessed before and after 2 courses of treatment.Results After 8 weeks of treatment all groups had significantly higher FMA scores and MBI scores,and better integrated EMG values,but the effects in the combination group were significantly better than those in the other two groups.Conclusions Motor imagery therapy combined with EMG biofeedback can more effectively promote recovery of upper limb function in hemiplegic stroke patients.
5.The effect of botulinum toxin injection to the external urethral sphincter on detrusor wall thickness in patients with detrusor-sphincter dyssynergia
Hongjun ZHU ; Weixin YANG ; Nan SU ; Chuandao LIU ; Yunqiang ZAN
Chinese Journal of Physical Medicine and Rehabilitation 2016;38(6):421-424
Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17%,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.
6.Detrusor wall thickness and lower urinary tract function after spinal cord injury
Hongjun ZHU ; Dawei ZHANG ; Yunqiang ZAN ; Chuandao LIU ; Jinfa FENG ; Weidong SHEN ; Weixin YANG
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(3):185-189
Objective To determine any relationship among detrusor wall thickness (DWT),bladder capacity (BC) and neurogenic lower urinary tract dysfunction (NLUTD),and to study the clinical implications of using DWT to predict the risk of renal injury after spinal cord injury (SCI).Methods Forty-eight adults with NLUTD due to SCI were recruited for the SCI group,and another 41 healthy adults formed a control group.Both groups underwent urodynamic evaluation and maximum bladder capacity (MBC) detection.The DWT of all subjects was measured by ultrasound imaging of the anterior bladder wall.Thereafter,the SCI group was divided into low and high risk subgroups based on the results of the urodynamic tests.Patients with detrusor leak point pressure <40 cmH2O were classified as low risk.Results At MBC,the average DWT in the SCI group was (0.97 ± 0.31)mm and (0.59 ± 0.08)mm in the control group,demonstrating a significant difference in DWT between patients with NLUTD and normal adults.The average DWT among the patients with type A detrusor sphincter dyssynergia was (1.10 ± 0.34)mm,which was significantly higher than among the patients with external urethral sphincter contraction without detrusor contraction (type C).DWT was significantly correlated with detrusor leak point pressure.A DWT of 0.87 mm (sensitivity 89.5%,specificity 58.6%) could be used as a critical point for predicting risk of renal injury in patients with NLUTD.Conclusions DWT is significantly greater among SCI patients with NLUTD and it correlates positively with detrusor leak point pressure.DWT could be used as a risk predictor for renal injury in patients with NLUTD due to SCI.
7.Current situation and discussion on curriculum construction of "Fundamentals of Toxicology" in preventive medicine major of TCM universities in China
Zhigang ZHANG ; Longzhu LIU ; Yang YANG ; Chuandao SHI ; Minmin TIAN ; Qiong ZHANG
Chinese Journal of Medical Education Research 2023;22(11):1745-1750
Objective:To know the current situation of curriculum construction of "Fundamentals of Toxicology" of preventive medicine major in traditional Chinese medicine (TCM) universities.Methods:The undergraduates of preventive medicine major from TCM universities in whole China were selected as the research objects using the cluster sampling method, who took "Fundamentals of Toxicology" course in the 2019-2020 academic year. Questionnaires were compiled and analyzed using descriptive method and radar chart.Results:Six TCM universities were investigated in this study. According to the results, 83.09% (344/414) thought it was necessary to set up the "Fundamentals of Toxicology" course, and the main motivation was to deal with the examination. The agreement rate between the opening semester and the students' wishes was 59.90% (248/414), and the percentages of better satisfaction of theoretical course teaching content, selection of teaching materials and class time were 64.73% (268/414), 55.07% (228/414) and 59.90% (248/414) respectively. The satisfaction rate of experimental course setting, teaching effect and class time was 59.66% (247/414), 62.08% (257/414) and 58.21% (241/414) respectively. It was better to set five times [27.29% (113/414)] or four times [26.81% (111/414)], and four students in each group was the best [53.86% (223/414)]. The most interesting experiment project was bone marrow micronucleus test [29.21% (59/202)], and comprehensive design experiments and highly operable experimental projects should be added. The radar chart of the core knowledge was normal operation type, and there were some differences among students in different schools.Conclusion:There are some differences in the course setting and core knowledge mastery level of the "Fundamentals of Toxicology" course of preventive medicine major in TCM universities. It is necessary to optimize the curriculum construction from opening semester, textbook selection, teaching content, experimental project, etc.
8.Construction and preliminary application of a Perioperative Exercise Program for Frail Elderly Patients with Colorectal Cancer based on the goal-directed therapy
Meng WANG ; Xiaoqing SHI ; Jing LU ; Yue ZHANG ; Runda WU ; Jianhua YIN ; Chuandao LIU
Chinese Journal of Nursing 2024;59(18):2189-2196
Objective To construct a perioperative exercise program for older frail patients with colorectal cancer,and to verify its effect.Methods Based on Goal-directed Theory and literature review,expert consultation was carried out to establish the perioperative exercise program for older frail patients with colorectal cancer.Then,from July to December 2022,the perioperative exercise program was established for older frail patients with colorectal cancer hospitalized in the General Surgery Department of a tertiary A hospital in Suzhou by convenience sampling method for preliminary application.It was divided in to the intervention group and the control group by the ward.The intervention group was applied with the constructed perioperative exercise program on the basis of routine perioperative nursing.The safety,feasibility and intervention effect of the program were evaluated.Results 15 experts were included for 2 rounds of expert consultations.The authority coefficient was 0.880;the coefficient of variation was<0.250;the Kendall concordance coefficient was 0.167 and 0.224,respectively.The final program contained 4 stages:preoperative exercise,postoperative bed rest,sitting and standing exercise.In the end,54 specific interventions were constructed.During the preliminary application,all the patients completed the program.Generalized estimation equation showed that,on the interaction effect,there was no statistical difference(P=0.752);there were significant differences on the intervention effect and the time effect(P<0.05).At discharge,there were significant differences in timed up and go test and Barthel Index between the 2 groups(P<0.05).Only 2 patients experienced mild pain in the intervention group,and no other adverse events occurred.Conclusion The perioperative exercise program for older frail patients with colorectal cancer,based on Goal-directed Theory,is scientific,reliable and safe.It has been preliminarily verified in improving postoperative physical function,activities of daily living and early postoperative recovery of elderly frail patients with colorectal cancer.
9.The expression of GSTM5 in prostate cancer and its potential mechanism for the progress of prostate cancer
Ying ZHANG ; Na SUN ; Yashou GUO ; Chuandao SHI ; Yixiao LIU
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):100-106
【Objective】 To explore the differentially expressed genes in normal prostate and prostate cancer (PCa) tissues based on bioinformatics and screen out potential biomarkers for PCa, so as to provide scientific basis for later clinical medicine. 【Methods】 Three gene chip datasets of GSE55945, GSE46602 and GSE69223 were downloaded from GEO database, and differentially expressed genes (DEGs) were screened by the OmicStudio tools, and protein-protein interaction network (PPI) of DEGs was constructed by STRING. After Cytoscape was imported, CytoHubba plug-in was used to screen the top 30 genes in MCC score as key genes (Hub gene). DAVID was used for GO and KEGG enrichment analysis of Hub gene, and GraphPad Prism software was used to draw ROC curve. GEPIA database was used to verify the key genes, and survival analysis was further carried out. UALCAN was used to verify the correlation between the expression of key genes and Gleason grade of PCa. 【Results】 Three data sets (GSE55945, GSE46602 and GSE69223) obtained 428, 727 and 1285 differentially expressed genes, respectively. The Venn diagram shows that the three datasets contain 105 DEGs. Among 105 PPI networks corresponding to DEGs, the top 30 genes with MCC score were selected as Hub genes. The biological processes involved mainly include the positive regulation of protein kinase B signal, cell differentiation, positive regulation of transcription, negative regulation of transforming growth factor β receptor signaling pathway, positive regulation of cell migration, etc. The pathways involved are adhesion plaque, estrogen signaling pathway, etc. ROC curve results showed that the diagnostic ability of 9 genes in 3 data sets was statistically significant, and 9 Hub genes were CAV1, KDR, CAV2, TGFBR1, SLC7A11, GSTM2, GSTM3, GSTM5 and MYO6. Nine Hub genes were verified by GEPIA website, among which CAV1, KDR, CAV2, TGFBR1, GSTM2, GSTM3 and GSTM5 showed low expression in PCa, while SLC7A11 and MYO6 showed high expression in PCa. Survival analysis suggested that high GSTM5 expression prolonged OS in PCa patients. UALCAN results showed that the expression of GSTM5 gene was significantly correlated with Gleason grade, and the expression of GSTM5 gene decreased with the increase of Gleason score. 【Conclusion】 Hub genes CAV1, KDR, CAV2, TGFBR1, GSTM2, GSTM3 and GSTM5 are low expression in PCa, while SLC7A11 and MYO6 are high expression in PCa. GSTM5 gene is related to the survival rate of PCa. The expression of GSTM5 decreased with the increase of Gleason score, which indicated that GSTM5 may be a potential biomarker for PCa.