2.Effect of rehabilitation intervention on reconstruction of brain and limb function of patients with hemorrhagic cerebral arteriovenous malformation after embolization
Sheng LI ; Liping GUO ; Baomin LI ; Xiangyu CAO
Chinese Journal of Tissue Engineering Research 2005;9(37):126-128
BACKGROUND: Functional injury of brain and limb induced by hemorrhage of cerebral arteriovenous malformation could be restored by rehabilitative treatment OBJECTIVE: To investigate the curative effect of rehabilitation on restoration of the functional injury of the brain and limbs induced by bleeding of hemorrhage cerebral arteriovenous malformation (AVM) after embolization.DESIGN: Case analysis.SETTING: Department of Interventional Medicine of General Hospital of Chinese PLA.PARTICIPANTS: From January 1996 to December 2001, a total 56 patients who were diagaosed as cerebral hemorrhage or intraventricle hemorrhage by CT or MRI scanning was selected from General Hospital of Chinese PLA.METHODS: All 56 patients with cerebral arteriovenous malformation were diagnosed by DSA. Rehabilitative treatment was performed with α-butyl cyanoac-rylate or radian surgery. Rehabilitative therapy were as follow: [1] Electric stimulate: S J-Ⅱ type nerve-muscle therapy instrument was used to stimulate the muscles (flexor and extensor) of limbs in the involved side, intensity of which is from weak to strong and frequency of which was from 2 to 3 or 4 per day; [2] Acupuncture: The selected points are:Fengchi, Fengfu, Yintang, Shangxing, Baihui, Quchi, Waiguan, Hegu,Huantiao, Zusanli, Yanglingquan, Sanyinjiao, Taichong, et al. In those who suffered aphasia, lianquan, Jinjin, Yuye were selected. Once a day and a period of treatment was 2 weeks; [3] physical training: the passive movement on the joint in the involved limbs were performed in grade 0 to 1 of muscle strength, the balance training of sitting on bed or standing beside the bed in grade 1 to 2, walking training in grade 2 to 3. The training intensity should be from weak to strong gradually. The items of observation were the improvement in speaking, sense and activity in limbs in the involved side. Evaluation of myodynamia was referenced to 6 grading method of Lovett.MAIN OUTCOME MEASURES: [1] the degree of embolism; [2] the degree of speaking fluency, the sense of limbs and the strength of the muscles of the limbs.RESULTS: Totally 56 cases entered the final analysis without any loss. [1]Degree of embolism: Among 56 cases, 100% focus was eliminated for 77% in 43 cases, 90% was eliminated for 12% in 7 cases and 60%-80% was eliminated for 11% in 6 cases. [2] Fluency of language: Before the treatment of rehabilitation, they suffered different degree impediment of speaking in 14 cases, improvement in 14 cases and obvious improvement in 11 cases. [3] Sense of limb:The sense of limbs was improved in 23 cases and 18 of them improved obviously. [4] Strength of muscles: The strength of muscles in 0 to 1 grade in 3 cases, 1 to 2 grade in 11 cases, 2 to 3 grade in 15 cases. But after the treatment of rehabilitation, speaking ability was improved in 14 cases, and 11 of them improved obviously. The strength of muscles was. resumed to 2 or 3 grade from 0or 1 grade in 2 cases, and to 4 grade in 21 cases and 5 grade in 6 cases.CONCLUSION: Endovascular embolization is a minimal traumatic, the rehabilitative therapy which is secure and effective method for treatment of high risk cerebral AVM, can promote motion function, language function and ability of activity of daily living, and quality of life of patients with cerebral arteriovenous malformation after embolism.
3.Advances in research on intronic miRNAs feedback regulation of their host genes
Bao-Chun, HUANG ; Guo-Jun, CAO ; Ning-Sheng, SHAO
Bulletin of The Academy of Military Medical Sciences 2009;33(6):580-582,595
miRNAs were discovered less than a decade ago, and have emerged as important regulators of gene expression in mammals. A large number of miRNAs have been identified to be located within the intronic regions of protein-encoding genes(host genes) and called intronic miRNAs. The intronic miRNAs may play a key role in regulating the expression and function of their host genes due to the fact that most of them are co-expressed with the host genes. In this paper, the recent advances on the research on potential relationship between intronic miRNAs and their host genes are reviewed.
4.Improvement of diastolic function in patients with congestive heart failure after cardiac resynchronization therapy by echocardiography
Jinling CHEN ; Ruiqiang GUO ; Fengxia JIANG ; Sheng CAO
Chinese Journal of Ultrasonography 2013;(1):17-20
Objective To evaluate the diastolic function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by conventional echocardiography or Doppler tissue imaging (TDI).Methods 31 patients with CHF were divided into responders to CRT (group R) and nonresponders to CRT (group N) according the standard of a decline in left ventricular(LV) end-systolic volume ≥10%.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Color M-mode echocardiography indices included Vp,E/Vp.TDI indices included the peak velocity in early diastole (e) at 4 sites of mitral annulus,E/e,time to peak velocity in systole (Ts),Ts-SD and maximum difference of Ts (Ts-Dif) among 12 segments.Results Compared with before CRT,Ts-SD and Ts-Dif significantly shortened in group R;Vp increased significantly,E/e at each 4 site and mean value at 4 sites of mitral annulus,E/Vp decreased significantly; but there were no significant difference in group N.There were significant positive correlation between mean value at 4 sites of E/e,E/Vp and Ts-SD in group R.Conclusions The diastolic function in responders to CRT improved after CRT,which was associated with the decreased LV filling pressure and improved LV relaxation.
5.Evaluation of flow structure within left ventricle in patients with chronic heart failure by vector flow mapping
Yi LIU ; Jinling CHEN ; Yintao CHENG ; Sheng CAO ; Ruiqiang GUO
Chinese Journal of Ultrasonography 2013;(5):383-387
Objective To evaluate blood flow structure and quantify the variation of the flow within left ventricle,assess the impact of chronic heart failure(CHF) by vector flow mapping(VFM).Methods Twenty-seven patients with chronic heart failure and thirty controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by VFM.Time-flow(T-F) curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile,flow profile were analyzed by DSA-RS1 program.Results Ventricular ejection peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower at basal and middle segments in CHF group than normal control group.Normal velocity profile,velocity profile,flow profile at peak S and E were lower at basal and middle segments in CHF group than normal control group.Conclusions VFM technology could provide quantitative and intuitive information to demonstrate the flow structure of the ventricle and evaluate the cardiac function in patients with CHF.
6.Evaluation of the function and synchronization of left atrial in chronic heart failure patients by real-time three-dimensional echocardiography
Sheng CAO ; Ruiqiang GUO ; Jinling CHEN ; Lidan HAO ; Juan HE
Chinese Journal of Ultrasonography 2012;21(2):116-120
Objective To evaluate the function and synchronization of left atrial in patients with chronic heart failure(CHF) by real-time three dimensional echocardiography (RT-3DE).MethodsThirty healthy controls and thirty-two patients with CHF were studied.The CHF were divided into group CHF1 with the normal of left ventricular filling pressure and group CHF2 with the elevated of that.From the volume-time curve of RT-3DE workstation,the maximum volume (LAVmax),the minimum volume (LAVmin),the volume before contraction (LAVp) of left atrial were acquired.Accordingly,the total,passive and active ejection fraction could be calculated.The synchronization parameters derived from RT3DE were the dispersion and maximum difference of time to minimum volume for left atrial segments (Tmsv- 16-SD,Tmsv 12-SD,Tmsv-6-SD,Tmsv- 16-Dif,Tmsv 12-Dif,Tmsv-6 Dif).The index of volume and time were corrected by the body surface area and interval of R-R,respectively.The correlation were analysed in them.Results ① All the index of volume before and after correction were gradually increasing from control to CHF2 group,but the LATEF,LAPEF and LAAEF were just the reverse,with all parameters had significant difference among total groups( P <0.01 ).②The synchronization parameters were significantly higher from control to CHF2 group( P <0.01 ).Comparing between two groups,no significant difference of the synchronization parameters were found between CHF1 group and CHF2 group ( P > 0.05),except Tmsv-16-SD% and Tmsv-16-Dif% ( P <0.01 ).③The Tmsv-16-SD% and Tmsv-16-Dif% had a positive correlation with the index of volume and a negative correlation with the ejection fraction.The most significantly correlation parameters was LAVmaxI,with r =0.75 and P <0.01.ConclusionsThe function of left atrium are reduced in patients of CHF,there are dyssynchronization.The higher of the filling pressure of left ventricle,the lager of the dyssynchronization of left atrium.RT-3DE may paly important roles in the evaluation of function and synchronization of left atrium.
7.Evaluation of left atrial systolic function and synchronization in healthy subjects by two dimensional speckle tracking imaging
Sheng CAO ; Ruiqiang GUO ; Jinling CHEN ; Li LI
Chinese Journal of Ultrasonography 2011;20(11):935-939
Objective To evaluate left atrial systolic function and synchronization by two dimensional speckle tracking imaging(2D-STI) measuring the strain in healthy subjects.Methods Thirty-two healthy subjects were studied.The peak velocity(Vmax),the peak amplitude of longitudinal and radial strain (Am-LS and Am-RS),the peak time of both longitudinal and radial strain(T-LS and T-RS) were acquired in each left atrial wall(anterior,inferior,posterior,lateral and septal) at three levels (basal,middle and apical)during left atrial active contraction by 2D-STI.Results ① No significant differences were found at theVmax,Am-LS,Am-RS,T-LS and T-RS among all left atrial walls in the same level ( P > 0.05).②The Vmax,Am-LS and Am-RS were decreased progressively from basal to apical,and there were significant differences( P <0.05) except the Am-RS at anterior,posterior and septal( P =0.218,0.258 and 0.238,separately).③Compared all levels in each left atrial wall,the T-LS and T-RS showed no significant differences( P >0.05),except the T-LS at posterior( P =0.002) and the T-RS at lateral( P =0.026).④The standard deviation of the T-LS,T-RS and T-globe were 37.38 ms,48.25 ms and 43.85 ms,respectively.There were no significant correlation between T-LS and T-RS in the same segment with r =0.014 and P =0.885.Conclusions There were some regularity during left atrial active contraction.On the whole,the peak velocity and the peak amplitude were decreased progressively from basal to apical in each atrial wall,and the peak time of strain showed no significant difference in the same level of each left atrial wall.The 2D-STI may paly important roles in the evaluation of left atrial systolic function and synchronization.
8.Effects of cardiac resynchronization therapy on right ventricular function in patients with congestive heart failure by 2-dimensional speckle tracking imaging
Jinling CHEN ; Fengxia JIANG ; Sheng CAO ; Hongning SONG ; Ruiqiang GUO
Chinese Journal of Ultrasonography 2013;22(11):927-931
Objective To evaluate the right ventricular function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by 2-dimensional speckle imaging (2D-STI).Methods 46 patients with CHF were divided into responders to CRT and non-responders to CRT according the standard of a decline in LV end-systolic volume ≥ 10%.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Tissue Doppler imaging (TDI) indices included SD of time to peak velocity in systole (Ts-SD) among 12 segments.Right ventricular diameters included RV basal transverse diameter (D1),RV middle transverse diameter (D2) and RV longitudinal diameter (D3) in apical four views.2D-STI indices included systolic strain (S) and stain rate (SR) of basal or middle segment of RV free wall.Results Compared with before CRT,LVEDd,LVEDV,LVESV and Ts-SD significantly decreased,LVEF significantly increased in responders 6 months after CRT.Before CRT,compared with nonresponders,there was no significant difference of D1,D2 and D3 in responders,while S and SR in basal or middle segment of RV free wall were higher than non-responders.Compared with before CRT,D1,D2 and D3 in responders decreased significantly,S and SR in basal or middle segment of RV free wall increased significantly,while there was no difference in non-responders.There were significant negative correlation between S and SR in basal or middle segment of RV free wall and Ts-SD in responders.Conclusions The remodeling and systolic function of RV are improved after CRT.It may help for improving the efficacy of CRT when takes RV function data into account before CRT.
9.Case-control study on modified Weaver-Dunn surgery combined with clavical hook-plate internal fixation for the treatment of Tossy type III acromioclavicular dislocation.
Ya-nan TUO ; Zhi-min SHEN ; Guo-sheng WANG ; Ming-yu CAO ; Qiang MA
China Journal of Orthopaedics and Traumatology 2015;28(12):1141-1146
OBJECTIVETo compare therapeutic effects of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation in treating Tossy type III acromioclavicular joint dislocation.
METHODSForty-one patients with Tossy type III acromioclavicular dislocation treated by operation were retrospectively analysis from January 2012 to January 2014. The patients were divided into clavicular hook-plate fixation group (group A) and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation (group B) according to surgical procedures. In group A, there were 15 males and 6 females aged from 17 to 51 years old with an average of (31.60 ± 12.58) years old, preoperative Constant-Murley score was 40.25 ± 9.80, and treated with clavicular hook-plate fixation. In group B, there were 13 males and 7 females aged from 18 to 48 years old with an average of (29.40 ± 11.27) years old, preoperative Constant-Murley score was 41.45 ± 8.81, and treated with modified Weaver-Dunn surgery combined with clavicular hook-plate fixation. Operative time, blood loss, imaging changes before and after operation, postoperative complications were compared; Constant-Murley score at 3, 6 and 12 months after operation were evaluated.
RESULTSIn group A, operative time was 40.50 ± 24.36) min, blood loss was (75.30 ± 30.36) ml; In group B, operative time was (60.10 ± 23.55) min, blood loss was (100.70 ± 40.12) ml. Twenty-one patients in group A were followed-up from 12 to 18 months with an average of (14.8 ± 3.1) months; 20 patients in group B were followed-up from 12 to 14 months with an average of (13.6 ± 1.5) months. There were no significant differences in operative time, blood loss and follow-up time between two groups. Complications were in six patients of group A and 3 patients of group B, and there were no significant meaning between two groups. At 6 months after operation, Constant-Murley score in group A was 88.85 ± 4.23, 92.15 ± 3.82 in group B; and had significant meaning between two groups (t = -2.56, P = 0.022 < 0.05). While there were no differences in Constant-Murley score in other times.
CONCLUSIONBoth of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation are effective operative methods for the treatment of Tossy type III acromioclavicular dislocation. Clavicular hook-plate fixation has advantage of less trauma, while modified Weaver-Dunn surgery combined with clavicular hook-plate fixation could reconstruct coracoclavicular ligament more stronger, clavicular hook plate could take out earlier, also improve shoulder joint function earlier.
Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Shoulder Dislocation ; surgery
10.Nursing and study on correlation among cognitive dysfunction and post-stroke constipation
Li WANG ; Jingxin WANG ; Xiaomei ZHANG ; Li GUO ; Xiaoyan SHENG ; Wenjing CAO ; Wenzhi CAI
Chinese Journal of Practical Nursing 2013;(5):20-23
Objective To understand the status of cognitive dysfunction among new onset constipation after stroke and to explore the relationship between them.Methods With a self-designed questionnaire,the general information of 723 inpatients from 10 hospitals in Guangzhou were collected,including general demographic information,stroke situation,defecation situation and Mini-mental State Examination (MMSE)etc.Results The incidence of new-onset constipation,cognitive dysfunction(PSCD)after stroke was respectively 34.6% and 62.4%.Among whom 31.0% in ischemic stroke,44.8% in hemorrhagic stroke,47.4% in cerebral hemorrhage and infarction.There was statistical significance between stroke type and constipation,and ischemic stroke had statistical significance compared to other two types.During the acute phase reached 41.6%,the recovery phase 31.5% and the sequelae phase 22.6%.The rates of constipation patients with cognitive dysfunction were higher than patients without cognitive dysfunction,and the difference in directional force,memory,attention and calculation force,reading and expression was statistically significant respectively,among which expression was the most relevant.The difference in the incidence of constipation among different cognitive dysfunction groups was statistically significant,and they were positively correlated,compared with normal cognitive function,the light,medium and severe cognitive dysfunction was 1.519,2.879,3.064 times respectively.Conclusions Medical staff need to be alerted to the possibility that patients with impared cognitive function may be at greater risk of constipation.The preventive and treatment measures should be emphasized in order to improve patients' cognitive function.