Objective:To explore any changes with age in the center of plantar pressure among normal people after walking.Methods:Fifty healthy subjects were divided into a young group and an elderly group, each of 25. Gait descriptors were collected for each subject using a model AL-600 gait and balance training and evaluation apparatus. The gait descriptors were the center of pressure displacement (COPD), and the COPD in the medial-lateral (COPD-X) and anterior-posterior (COPD-Y) directions before and after 10 and 15 minutes of walking.Results:The average COPD, COPD-X and COPD-Y of the elderly group increased after both 10 and 15 minutes of walking, but among the young group increases were observed only after 15 minutes. The average COPD, COPD-X and COPD-Y of the elderly group were always significantly larger than the young group′s averages.Conclusions:Gait stability among the elderly decreases after as little as 10 minutes of walking, but among the young decreases are observed only after 15 minutes.

Objective:To document the blood indexes of middle-aged and elderly intracerebral hemorrhage (ICH) patients complicated with deep vein thrombosis (DVT).Methods:A retrospective analysis was conducted of 77 hospitalized ICH patients using venous color Doppler ultrasonography within 3 days of admission. According to the results, they were divided into a DVT group (18 cases) and a non-DVT group (59 cases). The blood routine, biochemistry, coagulation, and D-dimer examinations were conducted on the 2nd day after admission. T-tests and rank sum tests tested the significance of any differences between the groups in average white blood cell counts, neutrophil percentages, platelets, albumin, globulin, fasting blood glucose, urea nitrogen, creatinine, uric acid, electrolytes, fibrinogen or D-dimer.Results:The average levels of albumin, uric acid and calcium in the DVT group were significantly lower than in the non-DVT group. The average levels of fasting blood glucose and D-dimer were significantly higher.Conclusions:Decreased serum uric acid, calcium and albumin levels, together with increased fasting blood glucose and D-dimer are related to the occurrence of DVT in ICH patients. To reduce the risk of DVT it is important to maintain normal levels of serum uric acid, calcium and albumin and to limit D-dimer and fasting blood glucose.

Objective:To observe factors influencing the risk of urinary tract infection (UTI) after cerebral hemorrhage (ICH).Methods:A total of 77 ICH patients undergoing rehabilitation between August 2015 and August 2017 were studied. Among them, 24 were diagnosed with a UTI according to clinical manifestations and urine routine tests and urine culture. They formed the UTI group. The other 53 were the non-UTI group. Complete clinical evaluations were available for all 77, and those data were used to identify risk factors for UTI using univariate and multivariate logistic regression analysis.Results:The univariate analysis showed that age, side of paralysis, consciousness dysfunction, Brunnstrom staging of the lower extremity, tracheotomy, indwelling catheter, lung infection, white blood cell count, neutrophil percentage, serum natrium, uric acid, D-dimer level and fibrinogen were all significant predictors of UTI. The multivariate analysis identified age, right side hemiplegia and D-dimer level as useful predictors.Conclusions:Advanced age and a high D-dimer level are independent risk factors for UTI after ICH, while hemiplegia on the right side is a protective factor.

Objective:To observe risk factors for lung infection (LI) after cerebral hemorrhage (ICH).Methods:A total of 118 patients with ICH were retrospectively analyzed. Among them, 63 were diagnosed with an LI according to clinical manifestations and X-ray or CT on admission. They were selected into an LI group, while the rest formed the non-LI group. Gender, age, duration of disease, side of paralysis, position and type of ICH, complications, cognitive disorders, consciousness, dysphagia, motor function, and serum levels of albumin, sodium, potassium, calcium and magnesium were recorded on the second day after admission. The risk factors for LI were analyzed using univariate and multivariate logistic regression analysis.Results:Age, duration of disease, side of paralysis, position and type of ICH, tracheotomy, urinary tract infection, cognitive impairment, dysphagia, motor function, and serum levels of albumin, sodium, calcium, and magnesium were all significant predictors of LI after an ICH. Multivariate logistic regression analysis showed that right side hemiplegia, bilateral paralysis, subarachnoid hemorrhage, urinary tract infection, and serum magnesium are all significant predictors.Conclusions:Right or bilateral paralysis, subarachnoid hemorrhage and urinary tract infection are independent risk factors for LI after an ICH. High serum magnesium within the normal range can reduce the incidence of LI.

Objective:To explore the factors related to cognitive dysfunction after traumatic brain injury.Methods:A total of 55 patients with traumatic brain injury were analyzed retrospectively. The clinical information about the patients, including age, gender, paralyzed side, course of the disease, type of injury, degree of injury, treatment, speech function (grades of Boston aphasia severity), swallowing function (7-level evaluation method), limb motor function (Brunnstrom stages of the upper limb, hand and lower limb), complications (tracheotomy, lung infection, urinary tract infection, pressure sores, electrolyte imbalance and hypoproteinemia), whether the patient received rehabilitation therapy, and D-dimer and coagulation examination results were recorded. Univariate analysis and ordered multi-class logistic regression analysis were conducted to screen the related factors using Rancho Los Amigos cognitive function grades as the dependent variable.Results:The results of the univariate analysis showed that consciousness, aphasia severity, swallowing ability, Brunnstrom stages, having received a tracheotomy, urinary tract infection, hypoproteinemia, fibrinogen and D-dimer all significantly predicted Rancho Los Amigos cognitive function grades. The logistic regression analysis showed that disordered consciousness, aphasia severity, Brunnstrom stage of the upper limbs, and urinary tract infection were significant predictors.Conclusions:Disordered consciousness, aphasia severity, Brunnstrom stage of the upper limbs, and urinary tract infection are factors related to cognitive dysfunction after traumatic brain injury.

A 27-year-old male patient mistakenly took an anti-obesity agent containing sibutramine. Two months later, the patient developed fever and myalgia. Two days later, his above symptoms were aggravated, and unconsciousness, rashes, and oliguria appeared. Laboratory tests showed serum creatinine 748 μmol/L, aspartate aminotransferase 299 U/L, alanine aminotransferase 102 U/L, total bilirubin 101.6 μmol/L, direct bilirubin 85.5 μmol/L, lactate dehydrogenase 3 070 U/L, myoglobin 12 081 μg/L, and creatine kinase 18 517 U/L. Rhabdomyolysis with multisystem injury caused by sibutramine was diagnosed. The anti-obesity agent was discontinued, and continuous renal replacement therapy and symptomatic and supportive treatments such as magnesium isoglycyrrhizinate, acetylcysteine, and terlipressin were given. After 2 weeks, the patient′s symptoms disappeared, the rashes subsided, and the liver and kidney functions and laboratory tests such as creatine kinase and myoglobin returned to normal.

A 27-year-old male patient mistakenly took an anti-obesity agent containing sibutramine. Two months later, the patient developed fever and myalgia. Two days later, his above symptoms were aggravated, and unconsciousness, rashes, and oliguria appeared. Laboratory tests showed serum creatinine 748 μmol/L, aspartate aminotransferase 299 U/L, alanine aminotransferase 102 U/L, total bilirubin 101.6 μmol/L, direct bilirubin 85.5 μmol/L, lactate dehydrogenase 3 070 U/L, myoglobin 12 081 μg/L, and creatine kinase 18 517 U/L. Rhabdomyolysis with multisystem injury caused by sibutramine was diagnosed. The anti-obesity agent was discontinued, and continuous renal replacement therapy and symptomatic and supportive treatments such as magnesium isoglycyrrhizinate, acetylcysteine, and terlipressin were given. After 2 weeks, the patient′s symptoms disappeared, the rashes subsided, and the liver and kidney functions and laboratory tests such as creatine kinase and myoglobin returned to normal.

Objective To explore the risk factors for deep vein thrombosis (DVT) of the lower extremity among patients hospitalized after a cerebral hemorrhage. Methods A total of 230 patients with cerebral hemorrhage admitted between August 2015 to August 2017 were retrospectively analyzed. At admission, each was were given a coagulogram, D-dimer and color Doppler ultrasound of the lower extremity. The patients were divided into a DVT group (31 cases) and a non-DVT group (199 cases) according to the color Doppler ultrasound results. The following clinical information was recorded: sex, age, disease course, paralysis side, consciousness, tracheotomy, complications (pulmonary infection, urinary tract infections and pressure sores), foreign matter implanting, history of venous catheterization, heart rate over 100 beats/ min or not, rehabilitation intervention after the onset, muscle tension in the lower extremity, activity and swelling on the paralysis side, and the serum levels of D-dimer and fibrinogen. Univariate and multivariate logistic regression was applied in search of useful risk factors. Results The univariate analysis showed that age, gender, disease course, tracheotomy, urinary tract infections, pressure sores, foreign matter implanting, and swelling and muscle tension in the lower extremity were all associated with the occurrence of DVT among these cerebral hemorrhage patients. According to the results of the multivariate logistic regression analysis, swelling and muscle tension in the lower extremity were related with the occurrence of DVT for those patients. Conclusion Swelling and muscle tension in a lower extremity are independent risk factors for the occurrence of DVT after a cerebral hemorrhage.__

OBJECTIVETo evaluate the clinical and radiological efficacy of paraspinal muscle approach with winglike working channel in the treatment of thoracic and lumbar spine fracture.

METHODSFrom October 2010 to August 2012, a total of 51 patients with thoracic and lumbar spine fractures without neurological symptoms were enrolled in the study, including 32 males and 19 females. All patients were divided into two groups: 26 patients were treated through posterior paraspinal muscle approach with winglike working channel, and 25 patients were treated through traditional posterior approach. In all patients, the interval between injury and operation was less than two weeks; the vertebral canal blocked area was less than 1/3 in sagittal diameter; the compression of the fractured vertebra height was less than 2/3. And the patients with pathological fracture and severe osteoporosis were excluded. The perioperative index including operative blood loss, draining loss, operative time, postoperative bed time were recorded. The clinical results were evaluated by visual analogue scale (VAS) for back pain preoperatively, at 3 days, 3 months, the last follow-up postoperatively and modified Macnab criteria at the last follow-up. The radiological results were evaluated by sagittal Cobb angle and the anterior height of the fractured vertebra. The data of two groups were compared statistically with paired and independent t test, χ² test, Mann-Whitney U test and Wilcoxon test.

RESULTSAll patients were followed up with average of 16.6 months. In the two groups, the operative blood loss was respectively (91.5 ± 36.6) ml and (209.2 ± 38.3) ml (t=-11.216, P=0.000), draining loss was (13.7±4.4) ml and (162.3 ± 56.6) ml (t=-13.352, P=0.000), postoperative bed time was (87.3 ± 11.5) hours and (118.4 ± 20.4) hours (t=-6.727, P=0.000), VAS for back pain at 3 days postoperatively was 5.5 ± 1.0 and 6.4 ± 0.8 (t=-3.304, P=0.002), also VAS at the last follow-up was 1.0 (1.0) and 2.0 (1.0) (U=191.0, P=0.008). Data above showed significant differences between the two groups.No significant differences were found in operative time, (109.0 ± 29.7) min vs. (119.2 ± 26.8) min (t=-1.283, P=0.206), and modified Macnab criteria (χ²=0.513, P=0.774) between the two groups. The anterior height of the fractured vertebra preoperatively, at 1 week and the last follow-up postoperatively of the two groups were respectively (57.2 ± 11.8)% and (55.2 ± 10.9)% (t=0.685, P=0.496), (95.2 ± 8.3)% and (95.3 ± 5.8%) (t=-0.068, P=0.946), (92.9 ± 6.7)% and (92.1 ± 5.6)% (t=0.505, P=0.615). The sagittal Cobb angles preoperatively, at 1 week and the last follow-up postoperatively of the two groups were respectively 21.0° (12.5°) and 23.0° (12.0°) (U=316.0, P=0.544), 3.0° (5.5°) and 4.0° (4.5°) (U=342.5, P=0.893), 4.0° (5.5°) and 6.0° (6.0°) (U=328.5, P=0.701). There were no significant differences of these radiological results between the two groups in the same time point.

CONCLUSIONThe paraspinal muscle approach with winglike working channel in the treatment of thoracic and lumbar spine fracture is an efficient surgical option which can acquire satisfactory clinical and radiological results.

Blood Loss, Surgical ; Drainage ; Female ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Operative Time ; Orthopedic Procedures ; methods ; Pain Measurement ; Paraspinal Muscles ; surgery ; Postoperative Period ; Pressure ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Visual Analog Scale

Objective To explore the interaction of foot placement, trunk control and weight-bearing (WB) during sit-to-stand (STS) movement. Methods 32 hemiplegic stroke patients (experimental group) and 32 healthy people (control group) were recruited and completed STS movement with 3 different foot positions: ankle dorsiflexed 10° of both feet (BF), with the paretic foot posterior (PFP) or the undominant foot posterior (UDFP), with the non-paretic foot posterior (NPFP) or the dominant foot posterior (DFP). Balance function assessment system (model AL-080) was used for collecting the WB, WB asymmetry (WBasym), and the center of pressure of the buttocks in medial-lateral (CoPx) and anterior-posterior (CoPy) sway during STS movement. Results The control group had the mostly WB symmetry, and little trunk side movement in BF, and there was significant difference in all indicators compared with in DFP or UDFP. For the experiment group, the WB, WBasym and CoPx were different as BF from as NPFP (P<0.05); while all the indicators except CoPx were different from PFP. When PFP, the trunk moved to the non-paretic side, and then to paretic side, all the indicators were different from NPFP. When BF and NPFP of the experiment group compared with BF and DFP of the control group, all the indicators were different (P<0.05). CoPx and CoPy increased in the experiment group compared with the control group. CoPx negatively correlate with WBasym in the experiment group (r=-0.626, P<0.001) and in the control group (r=-0.776, P<0.001). Conclusion The trunk side movement affects weight-bearing symmetry, and foot placement can modify weight-bearing distribution during the STS movement in hemiplegic stroke patients.