Objective To systematically evaluate the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. Methods Databases including PubMed, EMbase, BIOSIS and CNKI were electronically searched from establishment dates of databases to June 2012 to retrieve animal experiments on the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. The relevant studies were identified according to the predefined inclusion and exclusion criteria, the data were extracted, and the quality was evaluated. Then meta-analysis was performed using RevMan 5.1 software. Results Eight studies were included. The results of meta-analysis showed that no significant difference was found between the alcohol intervention group and the control group (MD=?6.98%, 95%CI ?20.38% to 6.43%, P=0.31). However, compared with the control group, low dose of acute alcohol intervention (less than 2 g/kg) improved the prognosis of ischemic stroke with a significant difference (MD=?22.83%, 95%CI ?38.77% to ?6.89%, P=0.005), and highly-concentrated of chronic alcohol intervention worsened the cerebral ischemic damage of rats and mice with a significant difference (MD=24.06%, 95%CI 10.54% to 37.58%, P=0.000 5). Conclusion Low dose of acute alcohol intervention (less than 2 g/kg) could improve the prognosis of rats and mice with ischemic stroke which has the potential neuro-protective effects. However, highly-concentrated chronic alcohol intervention could worsen the cerebral ischemic damage. Due to the limitations of the included studies such as publication bias, the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke could be overestimated.
A realizaton project of electrical stimulator aimed at motor dysfunction of stroke is proposed in this paper. Based on neurophysiological biofeedback, this system, using an ARM9 S3C2440 as the core processor, integrates collection and display of surface electromyography (sEMG) signal, as well as neuromuscular electrical stimulation (NMES) into one system. By embedding Linux system, the project is able to use Qt/Embedded as a graphical interface design tool to accomplish the design of stroke rehabilitation apparatus. Experiments showed that this system worked well.
ObjectiveTo systematically review the efficacy and safety of lumbrokinase capsule for patients with acute ischemic stroke (AIS).MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on lumbrokinase capsule for patients with AIS from inception to 1st December, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 33 RCTs involving 4 751 patients were included. The results of meta-analysis indicated that compared with control group, lumbrokinase capsule could improve the treatment efficiency (RR=3.51, 95%CI 2.29 to 5.39, P<0.001), enhance neurological function (SMD=?0.55, 95%CI ?0.72 to ?0.38, P<0.001) and reduce fibrinogen after treatment (SMD=?0.93, 95%CI ?1.41 to ?0.44, P<0.001). Reported adverse reactions included dizziness, nausea and gastric discomfort, and no mortality was reported.ConclusionsCurrent evidence shows that lumbrokinase capsule can improve the neurological deficit in patients with AIS. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the outcomes reported in clinical trials of post-stroke dysarthria.MethodsPubMed, The Cochrane Library, EMbase, CNKI, Sinomed, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of post-stroke dysarthria from inception to December 6th, 2019. Two reviewers independently screened literature, extracted data and analyzed outcomes using qualitative method.ResultA total of 112 RCTs involving 39 outcomes (therapeutic effect assessment outcomes and safety outcomes) were included. The top 4 outcomes were the Frenchay dysarthria assessment scale, the dysarthria examination method developed by the Chinese rehabilitation center, the evaluation of the speech therapists or clinicians and GRBAS.ConclusionsCurrent evidence shows that there is no acceptable outcomes for post-stroke dysarthria. It is recommended to improve the suitable assessment scale for Chinese to improve quality of studies on post-strohe dysarthria.
ObjectiveTo systematically review the efficacy of antidepressants in the prevention of poststroke depression (PSD).
MethodsWe searched The Cochrane Library (Issue 2, 2015), PubMed, MEDLINE, EMbase, CNKI and VIP databases to collect randomized controlled trials (RCTs) about antidepressants in preventing PSD from inception to April 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.
ResultsA total of 26 RCTs involving 2 190 patients were included. The results of meta-analysis showed that:compared with the control group, the antidepressants group could significantly reduce the incidence of PSD (OR=0.24, 95%CI 0.17 to 0.36, P<0.000 01). Subgroup analysis based on types of drugs showed that:the selective serotonin reuptake Inhibitor (SSRI) could significantly reduce the incidence of PSD (OR=0.23, 95%CI 0.15 to 0.37, P<0.000 01). Subgroup analysis based on length of time showed that antidepressants could decrease the incidence of PSD in short term (OR=0.11, 95%CI 0.06 to 0.19, P<0.000 01), middle term (OR=0.31, 95%CI 0.21 to 0.46, P<0.000 01) and long term (OR=0.30, 95%CI 0.19 to 0.49, P<0.000 01). In addition, there was no statistical difference in the incidence of adverse effect between the antidepressants group and the control group (P>0.05).
ConclusionAntidepressants is effective in the prevention of PSD, and may not affect patient's life quality. Due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective
To carry out the systematic clinical management to reduce the incidence of femoral pseudoaneurysm after interventional treatment.
Methods
A historical controlled study was used to compare the management effect before (from October 2012 to October 2013) and after (from March 2014 to March 2015) the application of doctor-nurse integrated systematic clinical management mode. This work mode enhanced cooperation between doctors and nurses, formed the clinical path for nursing workflows and contingency plans, and strengthened specialized education and training for nurses.
Results
After the implementation of systematic clinical management, the incidence of femoral pseudoaneurysm was significantly lower than before (1.0% vs. 2.7%), and the difference was statistically significant (P<0.05).
Conclusions
The systematic clinical management, carrying out in the doctor-nurse integration mode, can improve the quality of nursing and reduce the incidence of femoral pseudoaneurysm. And the management model has achieved remarkable results. So it is worth to be applied in the clinical practices.
ObjectiveTo systematically review the efficacy of three transcranial direct current stimulation protocols (anodal stimulation, cathodal stimulation, and bipolar stimulation) on upper extremity function interventions in stroke patients. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of three transcranial direct current stimulation protocols on upper extremity function interventions in stroke patients from inception to April 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, the network meta-analysis was performed by using R software and ADDIS software. ResultsA total of 64 RCTs involving 3 968 patients were included. The results of network meta-analysis showed that, the probability order of the three stimulation methods on FMA-U, MBI, NIHSS score was: anode>bipolar>cathode>control. In addition, the probability order on ARAT and BBT score was: anode>cathode>bipolar>control. ConclusionCurrent evidence shows that the intervention effect of anodic stimulation on upper limb function of stroke patients may be better. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
Objective To study the application effect of Snyder hope theory combined with Satir model in the rehabilitation therapy of young and middle-aged patients with stroke. Methods A total of 224 young and middle-aged patients with stroke admitted to Zhongshan Hospital of Fudan University between August 2018 and August 2020 were divided into four groups (control group, Satir group, Snyder group, and combined group) according to the random number table method by taking admission time as sequence. All patients were given rehabilitation training on the basis of conventional treatment, and the Satir group was given group guidance of Satir model, the Snyder group was given hope therapy based on Snyder hope theory, and the combined group was given intervention combined Snyder hope theory with Satir model. All patients were continuously treated for six weeks. The scores of Herth Hope Index (HHI), Self-perceived Burden Scale (SPBS), exercise rehabilitation willingness questionnaire, Health Promoting Lifestyle Profile Ⅱ (HPLP Ⅱ), and Simplified Coping Style Questionnaire (SCSQ) were compared among the four groups before and after intervention. Results There were 53, 52, 54, and 52 patients enrolled in the control group, the Satir group, the Snyder group, and the combined group, respectively. The differences among the four groups in basic information such as sex, age, and type of stroke and the scores of the above scales before intervention were not statistically significant (P>0.05). After intervention, the total scores of HHI scale (27.65±6.34, 30.54±6.85, 32.79±7.12, 35.08±7.63), scores of exercise rehabilitation willingness (39.85±8.16, 40.52±7.93, 40.17±8.25, 43.81±7.46), total scores of HPLP Ⅱ scale (149.87±26.08, 159.32±26.73, 165.89±28.01, 173.18±28.54), and scores of positive coping style of SCSQ scale (19.65±5.08, 22.46±5.29, 25.04±4.91, 28.45±5.12) of the four groups significantly increased compared with those before intervention (P<0.05), while the total scores of SPBS scale (27.35±4.92, 23.74±5.02, 25.16±4.98, 21.49±5.27) and scores of negative coping style of SCSQ scale (4.83±1.25, 3.71±1.02, 3.94±1.08, 4.13±0.96) significantly decreased compared with those before intervention (P<0.05); the scores of HHI scale, exercise rehabilitation willingness, HPLP Ⅱ scale, and positive coping style of SCSQ scale of the combined group were higher than those of the other three groups (P<0.05), while the score of SPBS scale was lower than that of the other three groups (P<0.05). Conclusions Snyder hope theory combined with Satir model for rehabilitation therapy of young and middle-aged patients with stroke can help to improve the hope level, reduce the self-perceived burden, and improve the exercise rehabilitation willingness, health behaviors and coping styles. In addition, it is of great significance for promoting the rehabilitation of patients.
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
