OBJECTIVETo observe the clinical efficacy on cognitive impairment after traumatic brain injury (TBD treated with acupuncture and cognitive training.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one, and 5 cases of them were dropped out due to the earlier discharge. Finally, there were 28 cases in the observation group and 27 cases in the control group. In the control group, the cognitive training and conventional treatment were applied. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Baihui (GV 20), Fengchi (GB 20), Geshu (BL 17) and Fenglong (ST 40), once a day, for 4 weeks totally. The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were adopted to evaluate the cognitive function in the patients of post-TBI cognitive impairment.

RESULTS(1) After treatment, the total score in MMSE and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<0. 05). Except for the score of immediate recall, the score in MMSE and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05). (2)After treatment, the total score in MoCA and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<. 05). Except for the score of nomenclature item, the total score in MoCA and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05).

CONCLUSIONBoth the simple cognitive training and the combined therapy of acupuncture and cognitive training improve MMSE and MoCA scores and relieve the cognitive impairment induced by TBI. But the combined therapy achieves the much better efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Brain Injuries ; psychology ; therapy ; Cognition ; Cognition Disorders ; psychology ; therapy ; Cognitive Therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.

Objective To investigate the clinical value of abnormal course of fetal superior mesenteric arteries (SMA) detected by ultrasound during the first trimester (11-13+6 weeks) in predicting congenital diaphragmatic hernia (CDH). Methods This study enrolled women who underwent fetal nuchal translucency (NT) screening during the first trimester in Central Hospital of Panyu District from March to December 2017. Low-speed high-definition flow imaging was used to observe the course of fetal SMA, and it was regarded as abnormal when the angle between SMA and abdominal aorta >90°. Once abnormal course of the SMA was suspected, the position of fetal thoracic cavity and abdominal organs would be scanned carefully. Furthermore, ultrasound examinations would be repeated at 16-18, 20-24, 28-32 and 37-40 weeks of gestation. Fetus diagnosed as CDH by ultrasound would be scheduled for MRI or autopsy to confirm the diagnosis. Pregnancy outcomes of all cases were followed up by telephone. Descriptive statistical analysis was used in this study. Results A total of 6 899 gravidas (6 964 fetuses) underwent NT scan during the first trimester were enrolled and the SMA of all fetuses were successfully displayed. Three cases with abnormal course of the SMA were identified. Two of them were diagnosed with left CDH at 17+ and 23+ weeks of gestation, which was confirmed by autopsy after termination of pregnancy, and the other one terminated pregnancy in first trimester due to a large omphalocele. Among the 6 961 fetuses with normal SMA, the pregnancy outcomes of 6 120 were successfully followed up, only one of which was found to have left CDH at 32 gestational weeks by ultrasound examination, and was later confirmed by neonatal MRI after delivery. No other fetal CDH was detected. Conclusions Abnormal course of the SMA identified in early pregnancy may be a simple and effective indicator for CDH that allow early intervention and treatment.

Objective:To investigate the morphological characteristics of skull base in children with hemifacial microsomia (HFM) by three-dimensional reconstruction and measurement of skull base.Methods:Three-dimensional spiral CT data of HFM children with unilateral involvement who had not received any treatment from the First Center of Maxillofacial Plastic Surgery, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from February 2010 to December 2020 were collected. The patients were divided into four groups according to the Pruzansky-Kaban classification standard: Ⅰ, Ⅱa, Ⅱb and Ⅲ. The three-dimensional reconstruction and measurement of the skull base were performed using Mimics 17.0 software. Linear measurements of the skull base included the distance from tuberculum sellae to optic canal (OT), foramen rotundum (FrT), foramen ovale (FT), internal acoustic meatus (IT), hypoglossal canal (HT), and the distance from anterior clinoid process to the lesser wing of the sphenoid bone (ClS) and the petrous ridge of the temporal bone (ClP). The measurement indexes of skull base angle included anterior cranial angle (ACA), middle cranial angle (MCA), posterior cranial angle (PCA), and petrous ridge angle (PRA). SPSS 26.0 software was used for statistical analysis of the measurement result. Paired t-test was used for comparison within each group, and one-way ANOVA was used for comparison between different types. P<0.05 was statistically significant. Results:A total of 40 children with HFM were collected, with 10 cases in each group. The result of skull base angle measurement showed that the MCA of the healthy side of typeⅠHFM was significantly larger than that of the affected side, and the MCA and PRA of the healthy side of type Ⅲ HFM were larger than those of the affected side ( P<0.05). There was no significant difference in the angle of skull base between the healthy side and the affected side of typeⅡa andⅡb HFM ( P>0.05). In terms of linear distance measurement of skull base, FrT and HT on the healthy side of typeⅠHFM were longer than those on the affected side; FrT, IT, HT and ClP on the healthy side of typeⅡa HFM were significantly longer than those on the affected side; IT, HT and ClP on the healthy side of typeⅡb HFM were longer than those on the affected side; and HT on the healthy side of type Ⅲ HFM was longer than those on the affected side ( P<0.05). The difference between FrT and ClP (affected / healthy) of four types of HFM was statistically significant ( P<0.05). Conclusions:The morphology of HFM is different between the affected side and the healthy side. As for the angle of skull base, MCA was obvious smaller in the affected side than that in the healthy side in the type Ⅰ and type Ⅲ HFM. As for the linear measurement, the distance from the hypoglossal canal to the tuberculum sellae on the affected side is shorter than that on the healthy side in each type HFM, indicating that the growth and development of the cranial base on the affected side is affected in a certain degree.

Objective:To investigate the morphological characteristics of skull base in children with hemifacial microsomia (HFM) by three-dimensional reconstruction and measurement of skull base.Methods:Three-dimensional spiral CT data of HFM children with unilateral involvement who had not received any treatment from the First Center of Maxillofacial Plastic Surgery, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from February 2010 to December 2020 were collected. The patients were divided into four groups according to the Pruzansky-Kaban classification standard: Ⅰ, Ⅱa, Ⅱb and Ⅲ. The three-dimensional reconstruction and measurement of the skull base were performed using Mimics 17.0 software. Linear measurements of the skull base included the distance from tuberculum sellae to optic canal (OT), foramen rotundum (FrT), foramen ovale (FT), internal acoustic meatus (IT), hypoglossal canal (HT), and the distance from anterior clinoid process to the lesser wing of the sphenoid bone (ClS) and the petrous ridge of the temporal bone (ClP). The measurement indexes of skull base angle included anterior cranial angle (ACA), middle cranial angle (MCA), posterior cranial angle (PCA), and petrous ridge angle (PRA). SPSS 26.0 software was used for statistical analysis of the measurement result. Paired t-test was used for comparison within each group, and one-way ANOVA was used for comparison between different types. P<0.05 was statistically significant. Results:A total of 40 children with HFM were collected, with 10 cases in each group. The result of skull base angle measurement showed that the MCA of the healthy side of typeⅠHFM was significantly larger than that of the affected side, and the MCA and PRA of the healthy side of type Ⅲ HFM were larger than those of the affected side ( P<0.05). There was no significant difference in the angle of skull base between the healthy side and the affected side of typeⅡa andⅡb HFM ( P>0.05). In terms of linear distance measurement of skull base, FrT and HT on the healthy side of typeⅠHFM were longer than those on the affected side; FrT, IT, HT and ClP on the healthy side of typeⅡa HFM were significantly longer than those on the affected side; IT, HT and ClP on the healthy side of typeⅡb HFM were longer than those on the affected side; and HT on the healthy side of type Ⅲ HFM was longer than those on the affected side ( P<0.05). The difference between FrT and ClP (affected / healthy) of four types of HFM was statistically significant ( P<0.05). Conclusions:The morphology of HFM is different between the affected side and the healthy side. As for the angle of skull base, MCA was obvious smaller in the affected side than that in the healthy side in the type Ⅰ and type Ⅲ HFM. As for the linear measurement, the distance from the hypoglossal canal to the tuberculum sellae on the affected side is shorter than that on the healthy side in each type HFM, indicating that the growth and development of the cranial base on the affected side is affected in a certain degree.

BACKGROUNDChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and has been the leading cause of death in China. Patients with COPD have significant decrements in their health-related quality of life (HRQL). It is necessary to identify the factors involved in worsening HRQL in order to improve the HRQL of COPD patients. However, evidence from longitudinal studies is limited. The aim of the study was to evaluate the determinants of the deterioration of HRQL in patients with COPD.

METHODSAt baseline, a total of 491 patients with stable COPD received comprehensive assessments, including psychosocial and clinical variables, six minutes walk distance (6MWD), dyspnea grade measured by the 5-grade Medical Research Council (MRC) dyspnea scale, anxiety and depression measured by the hospital anxiety and depression scale and HRQL measured by St. George's Respiratory Questionnaire (SGRQ). Patients were then monitored monthly for 12 months to document COPD exacerbations. At the end of the study period, the SGRQ values were reassessed. A 1-year change in SGRQ total score ≥ 4 was defined as a deterioration of the HRQL and as the outcome. A total of 450 patients completed the 12-month follow-up and were analyzed in the present study.

RESULTSThe age (mean ± SD) was (65.0 ± 10.6) years and 68.7% of subjects were men. The deterioration of the HRQL was 26.4%. In multivariate Logistic regression, independent and graded associations were found between the baseline MRC dyspnoea grade and the deterioration of HRQL (P = 0.012), OR 3.03 (95% CI 1.11-8.24) for patients with MRC dyspnoea grade ≥ 4 versus patients with MRC dyspnoea grade = 1. Similarly, the number of exacerbations during the follow-up was independently and gradually increased with the deterioration of HRQL (P < 0.001), OR 3.03 (95% CI 1.9-5.6) for the participants with exacerbations ≥ 3 versus participants with no exacerbation. The 6MWD evaluated by quartiles was negatively associated with the deterioration of HRQL with borderline statistical significance.

CONCLUSIONMRC dyspnea grade and the number of exacerbations impair the HRQL of patients with COPD.

Aged ; Dyspnea ; physiopathology ; psychology ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; psychology ; Quality of Life ; Risk Factors ; Surveys and Questionnaires