Sensory changes, C-and A-fiber function, and shoulder-hand syndrome in hemiplegic patients after stroke

BACKGROUND： Clinical diagnosis of various neurological disorders involving the sensory nerves depends primarily on subjective description, which cannot be quantitatively evaluated, and is also less reproducible and specific. Quantitative sensory testing methods can overcome these shortcomings and is currently used to identify the function of the C- and A-fibers. OBJECTIVE： To apply the quantitative sensory testing method for analyzing changes in temperature sensation, cryalgesia, thermalgesia, and vibration sense on the skin surface of hemiplegic patients with post-stroke shoulder-hand syndrome, and to analyze the relationship between these changes and shoulder-hand syndrome. DESIGN, TIME AND SETTING： A non-randomized, concurrent, control study was performed at the Clinic and Inpatient Department of the Third Xiangya Hospital, Central South University, between June 2000 and April 2001. PARTICIPANTS： Thirty post-stroke, hemiplegic patients were divided into shoulder-hand syndrome and control groups, according to whether patients exhibited shoulder-hand syndrome, with 15 patients in each group. METHODS： A TSA2001 quantitative sensory testing device （Medoc, Israel） was used for quantitative sensory testing. All sensory testing employed limits, testing temperature sense on the palm thenar eminence and vibration sense on the thumb metacarpal. Cold threshold was ≤ 28 ℃, warmth threshold was ≥ 36 ℃, cold-evoked pain threshold was ≤ 5 ℃, heat-evoked pain threshold was ≥ 51 ℃, vibration threshold was ≥ 5 μm/s; if a patient met one of these items, he/she was considered to be hypoanesthesia. MAIN OUTCOME MEASURES： Cold, warm, cold-evoked pain, heat-evoked pain and vibration threshold changes on skin from the paralyzed upper extremity was measured in the shoulder-hand syndrome and control groups. RESULTS： Incidence of sensory disability in the shoulder-hand syndrome group increased more significantly than in the control group （P 〈 0.05）, with the primary manifestations being decreased cold threshold （P 〈 0.05） and increased warmth threshold （P 〈 0.05）. The value differences between cold and cold-evoked pain thresholds, as well as between warmth and heat-evoked pain thresholds, decreased significantly in the shoulder-hand syndrome group （P 〈 0.05）. There were no significant differences between the two groups in cold-evoked pain, heat-evoked pain, or vibration thresholds. CONCLUSION： The primary manifestations of sensory impairment in hemiplegic patients with post-stroke shoulder-hand syndrome were displayed as thermohypesthesia and hyperalgesia. Functional impairments of nerve fibers that control pain and temperature sense may play an important role in the pathogenesis of post-stroke shoulder-hand syndrome.

Research progress on the effect of the combination of Jing acupoints bloodletting therapy and Sangzhi (Mori Ramulus) on shoulder-hand syndrome after stroke

Shoulder-hand syndrome(SHS)is one of the common complications of ischemic stroke.The pathogenesis is not completely clear and the therapeutic effects are not very satisfactory.As one of the Five-Shu acupoints(the general terms of acupoints that the twelve meridians are located below the elbow and knee of the body),Jing acupoints is distributed at the end of fingers and toes where the twelve meridians of the human body pass by,and has the functions of stimulating the meridians and dredging the channels and collaterals.For the effects of discharging neurons,promoting cerebral blood flow and improving the brain micro-circulation,Jing acupoints bloodletting therapy can effectively relieve the clinical symptoms of the patients with SHS after stroke.Sangzhi(Mori Ramulus),with the ability of dredging the meridian and relieving the pain,is also has certain treatment functions to the SHS.In clinical practice,the combination of Jing acupoints bloodletting and Sangzhi(Mori Ramulus)have been widely used in the treatment of various diseases,and in terms of their mechanism of action,the combined treatment has a positive effect on post-stroke SHS,but there are few reports on this.Therefore,it is worth affirming the efficacy of combined treatment of SHS after stroke.This article elaborates the theoretical basis of Jing acupoints bloodletting on SHS after stroke,and the research progress of Sangzhi(Mori Ramulus)in treating SHS after stroke,which provide the theoretical guidance for the combination.

Delphi and Analytic hierarchy process for the construction of a risk assessment index system for post-stroke shoulder-hand syndrome

Background:Shoulder-hand syndrome(SHS)is one of the common complications after stroke,which is difficult to cure once it occurs.Early risk identification is an effective measure to prevent and treat SHS,but there is no effective tool to assess the risk assessment of SHS.Objective:To develop a validated tool to assess the risk of SHS occurrence after stroke.Methods:This was an observational study with a 3-step process:(1)Literature review to establish initial indicators;(2)Application of a modified Delphi method for two rounds of correspondence,with final indicators obtained by modifying each round based on expert opinion;(3)Application of hierarchical analysis to determine the weights of each indicator.Results:The initial literature review constructed4 primary indicators and 24 secondary indicators;after the first round of Delphi,a total of 10 secondary indicators were deleted and 6 secondary indicators were added,and the final indicators included 3 primary indicators and 15 secondary indicators,and in the second round,consensus was reached;by AHP analysis,the highest weight was given to existing risk factors(0.5584),followed by relevant medical history(0.3196);lastly,demographic factors(0.1220),and the scores of other secondary indicators met the requirements.Conclusion:This study establishes and constructs a post-stroke SHS risk assessment tool,which provides a basis for early identification of SHS and early intervention.Meanwhile,this study provides a methodological reference for the development of other indicatorssets.

Clinical Research of Traditional Chinese Medicine Fumigation and Washing Combined with Rehabilitation Training in the Treatment of Post-Apoplexy Shoulder-Hand Syndrome

Objective:To observe the clinical effect of traditional Chinese medicine fumigation and washing combined with routine rehabilitation training on post-stroke shoulder and hand syndrome(SHS).Comparing and analysing the effects of this treatment on the living ability of patients with post-stroke shoulder and hand syndrome.Methods:Fifty patients with post-stroke SHS who met the inclusion criteria were divided into observation group and control group by random number table method with 25 cases in each group.Both groups were given post-stroke secondary prophylactic drugs,while the control group was given routine rehabilitation training,20-30 minutes at a time,once a day,5 days a week,4 weeks as a course of treatment.On the basis of treatment in the control group,the observation group was combined with traditional Chinese medicine fumigation and washing,decocted with water to extract 3,000-4,000 ml juice,and added into the medicine bath bucket to soak the affected limb for 30-40 minutes,once a day,5 days a week,4 weeks as a course of treatment.The changes of upper limb edema degree,Numeric Rating Scale(NRS)score,Barthel index(MBI)and Fugl-Meyer Rating(FMA)scores before and after treatment were observed between the two groups,and the differences of clinical efficacy between the two groups were compared.Results:After treatment,the total effective rate in observation group was significantly better than that in control group(P<0.05).After treatment,the degree in upper limb edema in the two groups was significantly reduced(P<0.05),NRS score was decreased(P<0.05).Barthel index and FMA score were significantly increased(P<0.05),and the degree of upper limb edema and NRS score in the observation group were significantly lower than those in the control group(P<0.05).Barthel index and FMA score were significantly higher than those in the control group(P<0.05).Conclusion:The combination of traditional Chinese medicine fuming and washing with rehabilitation training has a better therapeutic effect on SHS,and the clinical efficacy of the former is more significant than that of single rehabilitation training.In clinical application,the former shows low cost,simple and easy operation,high acceptance by patients,and is conducive to promotion and use.

Restless head syndrome:A retrospective study

BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as the arms,abdomen,face,neck,head,and genital area.There are only a few reports of the RLS variant affecting the head.AIM To assess the epidemiological,clinical,and other aspects of the RLS variant affecting the head.METHODS We conducted a retrospective study of 17 adult patients(>18 years)who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.RESULTS The median age at which symptoms appeared was 41.6 years.Males and females were equally affected(1.1:1).All 17 patients had uncomfortable sensations in the lower legs.Insomnia or disturbed sleep was the most common comorbidity(n=16,88.2%).However,headache was the most common presenting or primary symptom(n=10,70.5%).Dizziness or an abnormal sensation in the head was the second most common presenting symptom(5 patients,29.4%).Other presenting features were leg pain,backache,and generalized body pain.All patients responded favorably to dopaminergic medications.CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head,they may be misinterpreted as headache,dizziness,or psychosomatic symptoms.RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.

Saccharomyces boulardii as a single trigger of food protein-induced enterocolitis syndrome: Seven case reports

BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.

Health anxiety and work loss in patients diagnosed with serrated polyposis syndrome:A cross sectional study

BACKGROUND Serrated polyposis syndrome(SPS)is a polyposis condition with neoplastic potential,but its psychological impact is not well understood.AIM To assess health anxiety prevalence in a regional Australian cohort of SPS patients and explore factors influencing it,including workforce impacts of regular surveillance.METHODS This cross-sectional study screened patients aged 18-65 undergoing colonoscopy in a regional gastroenterology practice between January 2015 and June 2022.Eligible SPS patients were invited to participate.Data included the Short Health Anxiety Inventory,employment status,and previous demographic and medical findings.RESULTS Health anxiety was found in 21.57%of SPS patients,with anxious patients being significantly more concerned about surveillance(OR=7.70).Patients lost an average of 11.04 work hours per colonoscopy.CONCLUSION Health anxiety in SPS patients aligns with rates in other gastroenterology populations.Identifying it may improve management,though further research is needed to better understand prevalence and care improvements.

Unusual ovarian hyperstimulation syndrome presentation:Pleural effusion without ascites.A case report

BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique manifestation of OHSS involving pleural effusion(PE)in a patient without identifiable risk factors.CASE SUMMARY A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization(IVF)cycle experienced dyspnea on the eleventh day of post oocyte retrieval.The diagnosis was severe OHSS with a unique manifestation of PE without ascites.Clinical management involved fluid balance and treatment with albumin,furosemide,thromboembolic prophylaxis,and thoracentesis.A continued drainage of the pleural cavity was performed.The patient had a favo-rable outcome,and a dichorionic diamniotic gestation passed without incident.CONCLUSION OHSS and its potential complications can include respiratory distress and PE,as well as thromboembolic disorders.

Anlotinib-induced sick sinus syndrome:Two case reports

BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.

Timeliness of the analgesic effect of superficial needling on shoulder-hand syndrome after stroke

Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.

Magnetic resonance imaging evaluation and nuclear receptor binding SET domain protein 1 mutation in the Sotos syndrome with attention-deficit/hyperactivity disorder

Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.

Cauda equina syndrome with urinary retention as a postoperative complication of lumbar spine surgery:A case report

BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.

Effect of kinetic needling combined with blood-letting puncturing and cupping on functions of upper limbs of patients with shoulder-hand syndrome after apoplexy

Objective To observe influence of kinetic needling on functional restoration of upper limbs of patients with apoplexy-induced shoulder-hand syndrome. Methods Ninety patients were randomly divided into an observation group （45 cases） and a control group （45 cases）. Basic treatments selected according to corresponding stroke units were applied to both groups. Besides, scalp acupuncture at Dingnie Qianxiexian （MS 6, 顶颞前斜线）, Dingnie Houxiexian （MS 6, 顶颞前斜线） and Dingzhongxian （NS 5, 顶中线）, was applied in the treatment group. In the observation group, active and passive movement was carried out during the process of scalp acupuncture, and then needling plus bloodletting puncturing and cupping was applied. In the control group, only needling plus blood-letting puncturing and cupping was given. Therapeutic effects, pain scoring obtained by visual analogue scales （VAS）, FugI-Meyer and FugI-Meyer＇s scoring reflecting moving functions of upper limbs were made after 4 courses of treatments in both groups. Results The total effective rate was 95.5% and 91.1% in the observation group and control group, respectively, showing superiority of the former to the latter （P〈0.05）. After treatment, VAS scores were all obviously reduced in both groups （P〈0.01）, and the reduction in the former was significantly more than that in the latter （P〈0.01）. Moving functions of upper limbs shown by Fugl-Meyer＇s scoring were improved after 2 courses of treatment in both groups （P〈0.01）. The improvement was more obvious after 4 courses of treatment than that after 2 courses of treatment in both groups （P〈0.05）. After 4 courses of treatment, moving functions shown by FugI-Meyer＇s scoring were more remarkably improved in the observation group than those in the control group（t=3.9, P〈0.01）. Conclusion Both kinetic needling combined with needling plus blood-letting puncturing and cupping and simple needling plus blood-letting puncturing and cupping are effective in treating shoulder-hand syndrome after apoplexy, and the former is better than the latter.

Literature study on traditional Chinese medicine syndromes after renal transplantation

BACKGROUND Kidney transplantation is the most effective means to treat patients with renal failure,but its postoperative problems such as rejection reactions,immunosuppressant poisoning,chronic transplant kidney nephropathy,etc.still have not been effectively solved.This study searched for literature on traditional Chinese medicine(TCM)syndromes after kidney transplantation in China,conducted statistical analysis of the results,and sought to identify the underlying patterns.AIM To understand the TCM syndromes after renal transplantation and associated rules and provide a theoretical basis for further clinical research.METHODS The literature pertaining to TCM syndromes in renal transplantation,published in the China National Knowledge Infrastructure,Wanfang database,and WIP database from 1970 to 2021,was meticulously searched and comprehensively and statistically analyzed.RESULTS Following the established inclusion and exclusion criteria,13 studies were selected for analysis.Post-renal transplantation,no significant discrepancy was noted among the groups based on the location of TCM viscera.However,when categorized according to TCM pathogenic factors,the groups with spleen and kidney yang deficiency,as well as liver and kidney yin deficiency,exhibited a statistically significant difference in the frequency.CONCLUSION Currently,the research on TCM syndromes pertaining to renal transplantation is in its nascent phase.It is imperative to conduct a multicentric,large-scale survey of TCM syndromes subsequent to renal transplantation in the ensuing years.

Pembrolizumab-induced Guillain-Barrésyndrome in triple-negative breast cancer:A case report

BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast cancer.However,it is associated with immune-related adverse events,including rare but serious neurological complications such as Guillain-Barrésyndrome(GBS).GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and paralysis.We present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint inhibitors.CASE SUMMARY A 69-year-old woman with a medical history of hypertension,anxiety,depression,and stage IIIB triple-negative breast cancer treated with pembrolizumab,carboplatin,and paclitaxel,presented to the emergency department with a 1-month history of tingling,lower extremity weakness,and shooting pain.Symptoms progressed to global weakness,ascending paralysis,and double vision.Neurological examination revealed significant lower extremity weakness and sensory deficits.Magnetic resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed GBS.Initial treatment with intravenous immunoglobulin led to relapse,requiring additional intravenous immunoglobulin and high-dose glucocorticoids.The patient’s condition improved,pembrolizumab therapy was permanently discontinued,and she was discharged to a rehabilitation facility.CONCLUSION Pembrolizumab can induce GBS,necessitating early recognition,prompt diagnosis,and multidisciplinary management to prevent serious complications.

Cardiovascular involvement in multisystem inflammatory syndrome in children and midterm follow-up from a pediatric tertiary center in India

BACKGROUND In multisystem inflammatory syndrome in children(MIS-C)with coronavirus disease 2019,there was paucity of data from low-income and middle-income countries on cardiovascular involvement and its longitudinal outcomes.We planned to estimate the pattern of cardiovascular involvement among children with MIS-C and its mid-term outcomes.AIM To determine association between cardiovascular abnormalities and clinical and laboratory parameters.To study the time-line for resolution of various abnormalities.METHODS In this prospective study done in a tertiary care hospital,270 were recruited from June 2020 to January 2022.Baseline demographic data and clinical presentation were recorded.Laboratory parameters and echocardiography were done at admission.Follow-up was done at 2 weeks,3 months,6 months and 1 year after diagnosis.Descriptive statistics were used for parametric and non-parametric data.Risk factors were identified by multivariate regression analysis.RESULTS The 211(78.2%)had cardiac involvement and 102 needed intensive care unit(ICU)admission.Cardiovascular abnormalities observed were shock 123(45.6%),coronary dilatation 28(10.4%),coronary aneurysm 77(28.5%),left ventricular(LV)dysfunction 78(29.3%),mitral regurgitation(MR)77(28.5%)and pericardial effusion 98(36.3%).Coronary artery aneurysm/dilatation during follow-up at 2 weeks and 1 year were 25.7%and 0.9%respectively.Multivariate regression analysis revealed breathlessness[odds ratio(OR)=3.91,95%CI:1.25-12.21,P=0.019]and hi-flow nasal cannula(HFNC)support(OR=8.5,95%CI:1.06-68.38,P=0.044)as predictors of cardiovascular involvement.Higher mean age(OR=1.16,95%CI:1.02-1.32,P=0.026),breathlessness(OR=4.99,95%CI:2.05-12.20,P<0.001),gallop(OR=4.45,95%CI:0.41-2.52,P=0.016),MR(OR=3.61,95%CI:1.53-8.53,P=0.004)and invasive ventilation(OR=4.01,95%CI:1.28-12.58,P=0.017)were predictive of LV dysfunction.Altered sensorium(OR=4.96,95%CI:2.23-11.02,P<0.001),headache(OR=6.61,95%CI:1.46-29.92,P=0.014),HFNC(OR=7.03,95%CI:2.04-24.29,P=0.002),non-rebreathing mask usage(OR=21.13,95%CI:9.00-49.61,P<0.001)and invasive ventilation(OR=5.64,95%CI:1.42-22.45,P=0.014)were risk factors for shock.Anemia was a risk factor for coronary involvement(OR=3.09,95%CI:1.79-5.34,P<0.001).CONCLUSION Significant number of children with MIS-C had cardiovascular involvement contributing to higher ICU management.Although shock resolved quickly,resolution of ventricular function and coronary abnormalities were slower,and hence warrants a structured long-term follow-up protocol.

Large-for-size syndrome prophylaxis in infant liver recipients with low body mass

Transplantation of the left lateral section(LLS)of the liver is now an established practice for treating advanced diffuse and unresectable focal liver diseases in children,with variants of the LLS primarily used in infants.However,the surgical challenge of matching the size of an adult donor's graft to the volume of a child's abdomen remains significant.This review explores historical developments,various approaches to measuring the required functional liver mass,and techniques to prevent complications associated with large-for-size grafts in infants.

Therapeutic effect of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients:a clinical two-center randomized controlled trial

OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 weeks.The primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after treatment.The secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).On Fugl-Meyer evaluation,functional movement of the upper limb was also improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).CONCLUSION:Standardized acupuncture-massage therapy may have curative effects on shoulder-hand syndrome in hemiplegia patients.

Clinical Observation on Electroacupuncture Treatment of Shoulder-Hand Syndrome in Apoplectic Hemiplegia

Objective： To investigate the therapeutic effect of electroacupuncture on shoulder-hand syndrome in apoplectic hemiplegia. Methods： One hundred and sixty patients were randomly divided into two groups. 80 cases in the control group was treated by conventional acupuncture by filiform needles and 80 cases in the treatment group were treated by electroacupuncture. The therapeutic effects were evaluated after two courses of treatment. Results： After two courses of treatment, the therapeutic effect for edema on back of the hand and hand pain in digital flexion and the total effective rate were better in the treatment group than in the control group （P〈0.05）. Conclusion： Electroacupuncture is of significant importance for relieving pain on back of hand, preventing the muscular atrophy of hand and promoting recovery from apoplexy.

Treatment of 40 Cases of Poststroke Shoulder-Hand Syndrome by Acupuncture

Acupuncture and rehabilitation therapies were used to treat 40 cases of shoulder-hand syndrome, the results show that integration of acupuncture and rehabilitation can increase therapeutic effects and shorten treatment courses to accelerate recovery.