Prediction of the response to citalopram and reboxetine in post-stroke depressed patients

Rationale and objective Depression is a significant complication of stroke. The effectiveness of antidepressant drugs in the management of post-stroke depression (PSD) has been widely investigated. However, the choice of antidepressant drug is critically influenced by its safety and tolerability and by its effect on concurrent pathologies. Here we investigate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI), citalopram, and a noradrenaline reuptake inhibitor (NARI), reboxetine, in post-stroke patients affected by anxious depression or retarded depression.Methods This was a randomized double-blind study. Seventy-four post-stroke depressed patients were diagnosed as affected by anxious or retarded depression by using a synoptic table. Randomisation was planned so that 50% of the patients in each subgroup were assigned for 16 weeks to treatment with citalopram and the remaining 50% were assigned to treatment with reboxetine. The Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS) and a synoptic table were used to score depressive symptoms.Results Both citalopram and reboxetine showed good safety and tolerability. Citalopram exhibited greater efficacy in anxious depressed patients, while reboxetine was more effective in retarded depressed patients.Conclusions Citalopram or other SSRIs and reboxetine may be of first choice treatment in PSD because of their good efficacy and lack of severe side effects. In addition, PSD patients should be classified according to their clinical profile (similarly to patients affected by primary depression) for the selection of SSRIs or reboxetine as drugs of choice in particular subgroups of patients.     

大脑前动脉皮质支分布区域梗死所致的偏瘫、缄默或淡漠

目的：提高对大脑前动脉皮质支分布区域梗死的临床认识。方法：本文结合3例患者的临床表现及CT影像学特点进行了回顾性调查分析。结果：3例大脑前动脉皮质支分布区域的额叶矢状窦旁皮质、额叶内侧面包括扣带回前部、中央前回内侧面、运动前区和辅助运动区梗死的病人，出现了以对侧偏身严重瘫痪、精神缄默或淡漠为突出的临床症状。结论：大脑前动脉皮质支闭塞，可以造成对侧偏瘫、精神缄默或淡漠症候群。     

米氮平治疗脑卒中后抑郁的疗效观察

目的探讨米氮平治疗脑卒中后抑郁(PSD)的疗效及安全性。方法米氮平开放治疗PSD 32例,疗程6周。以Hamilton抑郁量表(HAMD)、临床疗效总评量表的病情严重程度(CGI-SI)和副反应量表(TESS)评定疗效和不良反应。结果米氮平治疗1周即起效,6周治疗结束时有效率93.75%,显效率81.25%,未见明显不良反应。结论米氮平治疗PSD安全有效。     

ANALYSIS OF EFFECT OF APOPLECTIC HEMIPLEGIA TREATED BY NEEDLING AROUND THE PROJECTIVE AREA ON THE SCALP OF FOCUS LOCATED WITH NUCLEAR MAGNETIC RESONANCE(NMR)

Apoplexyisafrequentlyencountereddis-easeinthepeopleofmiddleandoldage.ItisanimPOrtantproblemhowtoincreasetheclinicaltherapeuticeffectofaPOplectichemiplegiaandimprovethepatient'slifequalityintheaPoplec-ticconvalescentstudiesatpresent-InordertoexplorethemoreeffectiveacupuncturetherapyforaPoplectichemiplegia,anothersadoptedthemethodofneedlingaroundtheipsilateralprojec-tiveareaonthescalpofthefocus1ocatedwithNMRtotreataPoplectichemiplegiaandcom-paredwiththecommonscalpacupuncture.Theresultsarepre…     

Eales'' disease with hemiplegia

A case of Eales' disease with hemiplegia is reported. The patient had a right hemiparesis and a left hemiplegia occurring after a sudden loss of vision in the left eye two years earlier. The diagnosis was based on fluorescein angiography showing neovascularisation, fluorescein leakage, perivascular sheating and hemorrhages and on CT scan showing multiple hypodense lesions in right and left hemispheres and on IDSA showing bilateral occlusion of anterior cerebral arteries. The patient did not have further relapses.     

A Comparative Study on the Immediate Effects of Hand Orthoses on Reducation of Hypertonus

This paper compares the immediate effects of dorsal, volar and no splints in reducing hypertonicity in the wrist flexors of spastic hemiplegic subjects. The measures include: (i) passive range of motion; (ii) angle of point of stretch reflex; (iii) resistance to passive wrist extension; and (iv) force of spontaneous wrist flexion. Results of this study indicate a significant reduction in hypertonicity following both dorsal and volar splint application on the passive range of motion and resistance to passive extension measures (P < .05), and a significant reduction in hypertonicity as measured by spontaneous flexion following two hours of dorsal splint wearing (P < .05). No significant reductions in hypertonicity were noted on the angle of point of stretch reflex measure, and on the force of spontaneous flexion measure. Possible explanations for results and suggestions for further resarch are discussed.     

Acupoint electrogymnastics therapy in stroke hemiplegia

BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these impulses. During this process, functional reorganization of connecting network between segment and intersegment takes place. OBJECTIVE： To observe the therapeutic efficacy of acupoint electrogymnastics and traditional electroacupuncture on stroke hemiplegia. DESIGN, TIME AND SETTING： A multicenter, randomized, controlled, blinded, clinical study was performed at the College of Acu-moxibustion and Massage in Shanghai University of Traditional Chinese Medicine from May 2004 to September 2006. PARTICIPANTS： A total of 153 patients suffering from stroke hemiplegia, comprising 83 males and 70 females, aged 63-70 years, were admitted to outpatient and inpatient at LongHua Hospital Affiliated Shanghai University of Traditional Chinese medicine, Putuo District Traditional Chinese Medicine Hospital and Changqiao Street Community Health Service Center of Shanghai. METHODS： The patients were randomly divided into treatment （n = 77） and control （n = 76） groups. They were treated with acupoint electrogymnastics and traditional electroacupuncture, respectively. In the treatment group, two pairs of positive and negative JD-2008 type electrodes from a hemiplegia treatment apparatus were directly pasted on the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan （GB34） acupoints of the lower limb, respectively. In the control group, needles were consecutively inserted into the above acupoints. Using the method of lifting-inserting and twisting-rotating, the needle was manipulated with small amplitude of 5-7 mm and a fast frequency of 80-120 times/min when the needle was inserted to a suitable depth. When the sensation of needling was attained, the two pairs of positive and negative electrodes of type G6805-Ⅱelectro-acupunctur     

电针阳明经穴位对偏瘫患者运动功能康复的影响

目的探讨电针阳明经穴位对偏瘫患者运动功能康复的影响。方法54例早期脑卒中后偏瘫患者,分为A、B、C三组,A组行运动疗法,B组行运动疗法加电针阳明经穴,C组行运动疗法加平衡肌张力针法,2周和4周后,根据Ashworth痉挛评级和Fugl-Meyer评定(FMA)评定两组疗效。结果3组治疗后运动功能明显改善、肌张力提高,但B、C组评分高于A组(P<0.05)。治疗4周后B组较C组、A组下肢Ashworth分级评分均有显著性差异(P<0.05)。结论电针偏瘫患者阳明经穴位主要提高患者肌张力,对软瘫期运动功能康复可能有效,而不适用于痉挛期。