1.A Retrospective Analysis of 105 Drowning Victims with Psychiatric Disorders
Hai ZHAO ; Limin DONG ; Lianjie SUN ; Deyuan DENG ; Meng HE
Journal of Forensic Medicine 2014;(6):456-459
Objective To analyze the features of drowning victim s with psychiatric disorders to support further investigation on such cases. Methods O ne hundred and five archives of drowning victim s with psychiatric disorders from January 2010 to June 2014 in H arbor Public Security Subbureau, Shanghai Public Security B ureau were reviewed. The decedents’ general inform ation, autopsy findings, case inves-tigation data and disease histories were statistically analyzed. Results O f the 105 cases, 104 were sui-cides. Most decedents were poorly educated. Most suicides occurred in warm clim ate, and the corpses were usually found within 2 days. Most decedents had no suicide history and notes, but had abnorm al m ental or behavior changes before suicide. D epression, depression status and schizophrenia were the m ain types of psychiatric disorders, and only 9 decedents had received regular therapies before their deaths. Conclusion Mental disorder is a high risk factor in the drowning victim s. G uardians should be aware of psychotic abnorm al behaviors, especially during warm clim ate seasons.
2.The effects of dynamic instability training on the postural control, balance and walking of stroke survivors
Lianjie MA ; Xudong GU ; Yan LI ; Jianming FU ; Yunhai YAO ; Linhua TAO ; Liang LI ; Ya SUN ; Hua WU
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(3):210-215
Objective:To observe any effect of dynamic motor instability training on the balance and postural control of stroke survivors.Methods:Forty stroke survivors with poor balance were randomly divided into a control group and an observation group, each of 20. In addition to routine rehabilitation, the observation group was given 20 minutes of dynamic motor instability training, 5 days a week for 8 weeks, while the control group underwent routine rehabilitation for the same length of time. Before and after the intervention, surface electromyogram of the rectus femoris, biceps femoris, and erector spinae were recorded during perturbation. Activation time and the intensity of the anticipatory and complementary postural adjustments (APAs and CPAs) were also observed. Balance and lower limb motor functioning were assessed using the Berg balance scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), and GaitWatch analysis.Results:After the treatment the average activation time of the rectus femoris, biceps femoris in the affected side and those of the biceps femoris [(-84.31±5.74)s] and erector spinae in the intact side in APAs were all significantly shorter in the observation group than in the control group, while the average activation intensity of the rectus femoris and erector spinae was significantly greater. There was no significant difference in the activation intensity of each muscle group in CPAs after the treatment. After the intervention the average BBS score, FMA-LE score, stride length and walking speed of the observation group all were significantly better than the control group′s averages.Conclusions:Supplementing traditional rehabilitation training with dynamic motor instability training can further improve the posture control of stroke survivors and promote recovery of their balance and walking ability.
3.Predictors and prediction scores of shunt-dependent hydrocephalus in patients with aneurismal subarachnoid hemorrhage
Lianjie SUN ; Guanjun FENG ; Rixat PARHAT ; Xiaopeng YANG ; Hongxing WU
International Journal of Cerebrovascular Diseases 2023;31(2):151-156
Shunt-dependent hydrocephalus (SDHC) is a common and serious complication of aneurismal subarachnoid hemorrhage (aSAH). The incidence of SDHC after aSAH was 9%-36%, and it is associated with the poor outcome of patients. This article reviews the predictors and prediction scores of SDHC after aSAH.
4.Effects of transcranial magnetic stimulation on the swallowing and brain-stem auditory evoked potentials of dysphagic stroke survivors
Zhongli WANG ; Ming ZENG ; Minmin JIN ; Danni XU ; Yunhai YAO ; Jianming FU ; Fang LIU ; Fang SHEN ; Lianjie MA ; Xuting CHEN ; Xiaolin SUN ; Xudong GU
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(7):620-627
Objective:To observe any effects of contralateral repeated transcranial magnetic stimulation (rTMS) of the swallowing motor cortex on the swallowing and brainstem auditory evoked potentials (BAEPs) of stroke survivors with dysphagia.Methods:A total of 83 stroke survivors with dysphagia were randomly divided into an ipsilesional stimulation group ( n=22), a contralesional stimulation group ( n=21), a bilateral stimulation group ( n=20), and a control group ( n=20). In addition to their conventional dysphagia training, those in the three stimulation groups received 3Hz rTMS while the control group was given fake stimulation. The treatment was administered daily for 20 minutes, 6 days a week, for 5 consecutive weeks. Before and after the treatment, swallowing function was assessed videofluoroscopically and using the Dysphagia Outcome and Severity Scale (DOSS). The oral and pharyngeal stages of swallowing were evaluated using the videofluoroscopic dysphagia scale (VDS). Brain stem conduction was assessed using BAEPs. Results:After treatment the average DOSS scores of all 4 groups were significantly better than before the treatment. The average DOSS scores of the contralesional and bilateral sti-mulation groups were then significantly better than those of the other two groups. The sub-item and total VDS scores of all 4 groups had decreased significantly, but the average score of the bilateral stimulation group was significantly lower than the control group′s average. Ipsilesional stimulation significantly improved the VDS sub-item scores for the triggering of pharyngeal swallowing, laryngeal elevation, and pharyngeal transit time compared with the control group. In the contralesional stimulation group the average total score and the VDS sub-item scores for apraxia, premature bolus loss, oral transit times, the triggering of pharyngeal swallowing, vallecular residue, laryngeal elevation, coating on the pharyngeal wall, and pharyngeal transit time were significantly lower than those of the control group, on average. After the treatment the latencies of BAEP waves I, III and V and the I-III, III-V and I-V interpeak intervals had decreased significantly in all four groups, but the average latencies and intervals of the bilateral and contralesional groups were significantly shorter than those of the control group. The latencies and intervals of the bilateral stimulation group were then significantly shorter than those in the ipsilesional stimulation group on average. The average latency of wave V in the bilateral stimulation group (6.53±0.73ms) was significantly shorter than that in the contralesional stimulation group after the treatment.Conclusion:Bilateral rTMS over the swallowing motor cortex combined with conventional dysphagia training can significantly improve the swallowing of dysphagic stroke survivors.