Objective: To compare and evaluate the efficacy and adverse reactions of tizanidine, baclofen and eperisone for treatment of limb spasticity in patients after stroke. Method: One hundred and three patients with stroke were enrolled in this prospective, randomized, controlled study. They were randomly divided into 4 groups: Tizanidine (n = 30), baclofen (n = 25), eperisone (n = 22) and control (n = 26) groups. The muscular tone, motor function and daily live activities (ADL) were evaluated with the modified Ashworth scale (MAS), Fugl-Meyer ssessment (FMA) and modified Bathel index (BI) respectively 4 and 12 weeks before and after the medication. Results: Circled digit oneTwelve weeks after the medication, the MAS scores of the upper and lower limbs of the patients were decreased in the 3 treatment groups as compared to the control group (P < 0.05 all). The average decrease scores of the upper limbs in the tizanidine, baclofen, eperisone and control group were 0.8 ± 0.6, 0.7 ± 0.6, 0.7 ± 0.4, and 0.4 ± 0.4, respectively; and those of lower limbs were 0.8 ± 0.6, 0.7 ± 0.5, 0.7 ± 0.5, and 0.5 ± 0.5. However, there was no significant difference among the 3 treatment groups (P > 0.05). Circled digit twoThe FMA scores of the upper limbs in patients of the 4 groups showed that there were no significant differences before and after the treatment (P > 0.05 all); the FMA scores of the lower limbs in patients of the 4 groups after the 12-week treatment were significantly higher than those before treatment. The average increased scores were 5 ± 3, 6 ± 5, 5 ± 4, and 4 ± 4, respectively (P < 0.05 all), and there were no significant differences between the 4 groups (P > 0.05). Circled digit threeCompare to the scores before the treatment, the MBI showed that there were significant differences in the average scores in the 4 groups 12 weeks after the treatment (P < 0.05 all), and the average increased scores were 27 ± 12, 25 ± 14, 25 ± 12, and 21 ± 11. There were no significant differences between the 3 groups and the control group (P > 0.05). Circled digit fourBlood, urine, liver and renal function tests of all patients were in the normal range before and after treatment. 10% and 8% of patients in the tizanidine and baclofen groups experienced drowsiness; 6.7%, 8%, and 4.5%. of patients in the tizanidine, baclofen, and eperisone groups had gastrointestinal discomfort; 6.7% and 8% of patients in the tizanidine and baclofen groups had blood pressure drop; and 22.7% of patients in the eperisone group had generalized weakness. The symptoms were relieved in all patients after reduce or stop the medication. Conclusion: Tizanidine, baclofen and eperisone have obviously effects for reducing muscular tone and relieving spasticity. Their therapeutic effects has no differences, but the three medicines did not show significant effect on functional recovery.

Objective To economically investigate tertiary stroke rehabilitation treatment.Methods 3 tertiary rehabilitation networks were set up in Beijing.82 patients with acute cerebrovascular diseases were enrolled into the study according to standardized criteria in all centers and randomized into rehabilitation group and control group.Rehabilitation training was implemented according to standardized procedures.The patients in rehabilitation group were given rehabilitation training in acute stage for 28 days and then underwent long term rehabilitation'program for 6 months in rehabilitation centers or community rehabilitation settings.The patients in control group were only given rehabilitation training in acute stage for 28 days. Altogether 4 evaluations were conducted in one week after the onset and at the end of 1,3,6 months, respectively.Results Significant differences of motor function,ability of daily activities,quality of life evaluation and cost were found in the 1st,3rd and 6th month after the onset of diseases.The rehabilitation group surpassed the control group significantly.At the end of 6 months,the average of Barthel Index of rehabilitation group was 83.18?18.22 while that of control group was 63.69?12.73.At the end of 6 months,total cost of rehabilitation group was(56 420.0?17 831.8)Yuan and that of control group was (64 864.2?18 267.5)Yuan.The rehabilitation group had better cost/effectiveness and cost/utility.There was a significant difference of cost between two groups.The total rehabilitation cost of rehabilitation group was 4613 Yuan,accounting for 15.3%of all the cost.Conclusion The tertiary rehabilitation treatment for stroke patients has achieved better cost/effectiveness and cost/utility.In China pharmaceutical cost constitutes the major part of the stroke therapy while the rehabilitation cost only a small portion,which is significantly different from the situation in developed countries.

At the end of 2019, coronavirus disease 2019 (COVID-19) caused by a new coronavirus SARS-CoV-2 spread rapidly. There is still no specific medicine for it. It is important to consider the functional improvement and rehabilitation. This article discussed on respiratory rehabilitation in management of patients with COVID-19.

Objective To explore the association between the susceptibility,severity and generalization of myasthenia gravis (MG) and polymorphisms of rs2488457 and rs3811021. Methods We compare the allele frequencies between 480 MG patients and 487 healthy controls,between each pair of MG subgroups and between each MG subgroup and the control group.Subgroups were specified by susceptibility (gender,onset age,thymoma,AChRAb and onset muscle involvement,and each subgroup within a comprehensive classification of MG),maximal severity and generalization of MG.We compare genotype frequencies under log-additive and codominant mode of inheritance. Results No significant differences were found in allele frequencies of the two SNPs between MG group/each MG subgroup and the control group,and between each pair of MG subgroups,as well as no significant differences in genotype frequencies under additive and codominant mode of inheritance.In the comprehensive classification of MG established with combination of clinical features,there were no significant differences in allele and genotype frequencies of the two SNPs in each subgroup. Conclusion PTPN22 gene polymorphisms are not associated with the susceptibility,severity or generalization of MG.

[Abstract] Objective To observe the effects of the adipocyte hormone leptin on GABA content and receptor expression in hypothalamus of mice with sleep deprivation, and explore the possible mechanisms. Methods Male C57BL/6 mice were randomly divided into three groups (8 each): control group, sleep deprivation (SD) group and leptin supplement (L-SD) group. Mice in control group were set up in a water environment without sleep deprivation, mice in SD group were set up in a "modified multi-platform water environment" to establish a sleep deprivation model, and mice in L-SD group were given leptin 1.3 mg/kg intraperitoneally twice daily in conjunction with sleep deprivation. Seven days after sleep deprivation, the general conditions of mice were observed, body weight was measured and hypothalamic tissues and plasma specimens were collected. ELISA was used to detect the plasma leptin levels, hypothalamic γ-aminobutyric acid (GABA) and glutamate (Glu) contents. Western blotting was performed to detect the expression levels of GABA key glutamate decarboxylase 67 (GAD67) and GABAA receptor α1 subtype protein (GABAARα1). Results Compared with control group, the weight of mice in SD group significantly reduced [(22.03±0.42) g vs. (17.75±0.75) g, P<0.01], while the weight of mice in L-SD group [(15.10±0.38) g] significantly reduced compared with that in control group and SD group (P<0.01). The mice in SD group lost their smooth hair, were particularly sensitive to light and sound, and were slightly manic and aggressive; Compared with control group, the plasma leptin level in mice of SD group significantly reduced [(483.81±21.72) ng/ml vs. (359.14±16.69) ng/ml, P<0.01], and the hypothalamic GABA level significantly reduced [(152.37±8.14) ng/g vs. (111.31±2.96) ng/g, P<0.05]. GABA levels of mice hypothalamus in L-SD group [(132.19±3.38) ng/g] were significantly higher than that in SD group [(111.31±2.96) ng/g, P<0.05], but no statistical difference was when compared with that in control group (P>0.05). The hypothalamic Glu levels were obviously higher in SD group [(686.56±10.01) ng/g] and L-SD group [(668.64+9.93) ng/g] than that in control group [(577.11±16.36) ng/g] (P<0.05), but no statistical significance was found when compared between SD group and L-SD group (P>0.05). The expressive levels of GAD67 and GABAARα1 protein in the hypothalamus of mice in SD group [0.68±0.06, 0.69±0.07] were significantly lower than that in control group (1.09±0.13, 0.99±0.07) (P<0.05); While the expressive levels of GAD67 and GABAARα1 proteins in the hypothalamus of mice in L-SD group (1.39±0.19 and 1.33±0.14, respectively) were significantly higher than those in SD group and control group (P<0.05). Conclusion Leptin can up-regulate the expression of the key GABA synthase GAD67, increase the content of GABA and the expression of GABAARα1 protein in hypothalamus of sleep-deprived mice, which may be an important mechanism of leptin affecting sleep.

Although there are many assessment tools for upper extremity (UE) function, it is still difficult to select an appropriate outcome measurement for the rehabilitation process of individuals with stroke. This review aims to classify each tool within the International Classification of Functioning, Disability and Health (ICF) framework and provide an overview of UE assessments. Through a comprehensive understanding of assessments based on ICF, health care professionals will be able to choose suitable measurement tools for individuals, facilitating their rehabilitation.

Post-stroke spastic movement disorder (PS-SMD) develops in up to 40% of stroke survivors after a first ever stroke within the first year. Chronic PS-SMD is often associated with severe disabilities and complications, emphasizing the importance of its early recognition and early adequate management. Extensive research has aimed to accurately predict and sensitively detect a PS-SMD. Symptomatic therapies include conventional rehabilitation and local intramuscular injections of botulinum toxin A (BoNT-A). The latter is widely used, but primarily in the chronic phase of stroke. However, recent studies have shown the safety and efficacy of BoNT-A therapy even in the acute phase and early sub-acute phase after stroke, i.e., within three months post-stroke, leading to an improved long-term outcome in stroke rehabilitation. Local BoNT-A injections evolve as the primary approach in focal, multifocal, and segmental chronic or acute/subacute PS-SMD. Patients at high risk for or manifest PS-SMD should be identified by an early spasticity risk assessment. By doing so, PS-SMD can be integral part of the patient-centered goal-setting process of a multiprofessional spasticity-experienced team. The benefit of an early PS-SMD treatment by BoNT-A should predominate putative degenerative muscle changes due to long-term BoNT-A therapy by far. This, as early treatment effectively avoids complications typically associated with a PS-SMD, i.e., contractures, pain, skin lesions. The management of PS-SMD requires a comprehensive and multidisciplinary approach. Early assessment, patient-centered goal setting, early intervention, and early use of BoNT-A therapy prevents from PS-SMD complications and may improve rehabilitation outcome after stroke.

ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.

Objective:To explore the effects of respiratory training on pulmonary and motor function for patients with Parkinson's disease. Methods:From January, 2018 to November, 2019, 60 inpatients with idiopathic Parkinson's disease from the Second Rehabilitation Hospital of Shanghai were randomly divided into control group (n = 30) and experimental group (n = 30). All the patients accepted routine rehabilitation, while the experimental group accepted respiratory training with Power Breathe in addition. They were measured the pulmonary function, and assessed with Unified Parkinson's Disease Rating Scale (UPDRS) part II and III, and modified Barthel Index (MBI) before and four weeks after treatment. Results:The scores of UPDRS II and III, and MBI improved in both groups after treatment (|t| > 2.550, P < 0.05), while the forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁) and maximum expiratory flow rate at 50% vital capacity (MEF₅₀) increased in the experimental group (|t| > 2.838, P < 0.01), but did not in the control group (|t| < 1.058, P > 0.05). FVC, FEV₁, MEF₅₀, MBI score and UPDRS II score improved more in the experimental group than in the control group (|t| > 2.191, P < 0.05). Conclusion:Respiratory training can improve pulmonary function for patients with Parkinson's disease, to further improve their activities of daily living. No synergistic effect is found on motor function.