Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke （59.6%） was the primary stroke type found in the young group, while ischemic stroke （60.0%） was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction （such as friendship） improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

Macular pigment and serum zeaxanthin levels with Goji berry supplement in early age-related macular degeneration

AIM： To evaluate the efficacy of Goji berry supplementation on improving macular pigment, serum zeaxanthin levels and visual acuity in patients with early age-related macular degeneration （AMD）. METHODS： A total of 114 patients （aged from 51 to 92y, mean age 69.53±8.41y） with early AMD were enrolled in our prospective, randomized controlled study. The included patients were assigned randomly to the Goji group （n=57） with 25 g of Goji berries supplementation per day for 90d and the control group （n=57） with their normal diet for 90d. Macular pigment optical density （MPOD） was measured using heterochromatic flicker photometry （HFP）. The levels of serum lutein （L）/zeaxanthin （Z） were analyzed using high-performance liquid chromatography （HPLC）. MPOD, serum L/Z levels and best corrected visual acuity （BCVA） were recorded at baseline and 90d. RESULTS： In the Goji group, there were no statistically significant differences in the serum L levels between the baseline （0.199±0.149 μmol/mL） and 90d （0.203±0.181 μmol/mL） （t=-0.186, P=0.850）; however the serum Z levels were increased at 90d （0.101±0.087 μmol/mL） compared with those at the baseline （0.029±0.032 μmol/mL） （t=6.412, P〈0.001）. Patients treated with Goji berry for 90d showed an elevated MPOD （0.877±0.202 DU） from the baseline （0.731±0.205 DU） （t=-4.741, P=0.000）. In contrast to the control group, the serum Z levels and MPOD were higher in the Goji group at 90d （both P〈0.05）. At 90d, patients with Goji berry supplementation had a relative decrease in BCVA （0.21±0.18 logMAR） compared with the baseline （0.27±0.20） （t=2.397, P=0.020）. CONCLUSION： Overall, daily supplementation with Goji berry for 90d improves MPOD by increasing serum Z levels rather than serum L levels in early AMD patients. Goji berry may be an effective therapeutic intervention for preventing the progression of early AMD.