运动想象疗法对缺血性脑卒中患者下肢平衡能力的影响

目的：评价运动想象疗法对缺血性脑卒中患者下肢平衡能力的康复效果。方法选取50例脑卒中偏瘫患者,随机分为治疗组、对照组各25例。两组均进行常规康复治疗,治疗组增加运动想象训练,持续治疗8周。于治疗前后用Berg平衡评价量表（Berg balance scale, BBS）和步长、步宽、步频、步速评定患者下肢平衡能力。结果治疗后,BBS评分和步长、步宽、步频、步速的评测较治疗前均有明显改善（P＜0.05）;与对照组相比,运动想象疗法治疗组改善效果更明显,两组比较有统计学意义（P＜0.05）。结论运动想象疗法明显提高缺血性脑卒中患者下肢平衡能力,值得在临床进行推广运用。     

镜像疗法对脑卒中偏瘫患者下肢运动功能障碍的康复效果研究

目的 探讨镜像疗法对脑卒中偏瘫患者下肢运动功能障碍的康复效果.方法 选取脑卒中偏瘫患者124例,随机分为观察组和对照组,各62例,对照组给予常规护理和康复治疗,观察组在对照组基础上,增加镜像疗法,连续治疗8周.运用徒手肌力量表(MMT)、简氏Fugl-Meyer运动量表(FMA)和简易平衡评定系统mini-BESTest,观察两组治疗前后下肢运动功能障碍变化.结果 两组治疗前MMT、FMA和mini-BESTest评分比较,差异无统计学意义(P>0.05),治疗后两组以上评分均明显高于治疗前(P<0.05);观察组下肢功能评定指标得分明显高于对照组(P<0.05).结论 镜像疗法能明显改善脑卒中偏瘫患者下肢功能障碍,提高下肢运动功能.     

运动想象疗法对脑卒中偏瘫患者下肢运动功能恢复的影响

目的探讨常规康复治疗联合运动想象疗法对脑卒中偏瘫患者下肢运动功能恢复的影响。方法选取在本院接受治疗的40例脑卒中偏瘫患者,病程均小于6个月且病情稳定,将患者随机分为治疗组20例,对照组20例。治疗组运用常规康复治疗联合运动想象训练,对照组只采用常规康复治疗。在治疗前和治疗后第6周评定偏瘫侧下肢最大负重百分比（％）、5m最快折返速度、Berg平衡功能表以及Fugl—Meyer运动功能评分法。结果经治疗后,治疗组与对照组相比,平衡功能、运动功能差异无统计学意义（P〉0．05）;5m最快折返速度和偏瘫侧下肢最大负重百分比治疗组优于对照组（P〈0．05）。结论运动想象疗法在脑卒中偏瘫患者下肢运动功能恢复方面效果显著,值得进行临床推广。     

BIODEX训练系统对脑卒中后偏瘫患者步行能力的影响

目的 探讨BIODEX平衡功能训练系统对脑卒中偏瘫患者步行能力的影响.方法 56例脑卒中偏瘫患者随机分为治疗组28例和对照组28例,两组患者均采用药物及常规康复治疗,治疗组采用BIODEX平衡功能训练;对照组进行传统的平衡功能训练.分别在治疗前、治疗后进行以下评定：①下肢运动功能评定（Fugl-Meyer量表）;②Berg平衡量表（Berg balance scale,BBS）;③功能性步行量表（Functional ambulation category scale.FAC）;④Biodex平衡功能评分进行评定,分析患者平衡能力、步行能力改善情况.两组患者入组后开始为期4周的康复治疗.结果 两组患者治疗后Fugl-Meyer、BBS、FAC、BIODEX的评分均较治疗前提高,平衡功能和步行能力得到改善,治疗前、后各量表的评分差异有统计学意义（P＜ 0.01）;与对照组相比,治疗组患者在各量表评分提高幅度更大（P＜0.05）结论 BIODEX训练能更好地提高脑卒中后偏瘫患者的平衡及步行能力.     

强制运动疗法对脑卒中偏瘫患者上肢功能恢复的影响

目的探讨强制运动疗法对脑卒中偏瘫患者上肢功能恢复的影响。方法将42例脑卒中偏瘫患者分为强制运动治疗组（22例）和对照组（20例）。两组患者均给予作业疗法治疗。强制运动治疗组同时采用强制运动疗法训练。治疗前、后采用Fugl-Meyer量表评定患者的上肢综合运动功能,并进行日常生活活动（ADL）能力评定及简易上肢功能检查（STEF）评定。结果治疗后,两组患者的Fugl-Meyer量表评分、ADL及简易上肢功能检查（STEF）均较治疗前改善（P〈0.05）,且强制运动治疗组的疗效优于对照组（P〈0.05）。结论采用强制运动疗法结合作业疗法治疗,有利于提高脑卒中偏瘫患者上肢能力。     

悬吊疗法Neurac技术在脑卒中偏瘫患者康复中的应用

目的 尝试采用悬吊疗法神经肌肉激活（Neurac）技术对脑卒中偏瘫患者进行康复治疗并作为新型康复方 案。方法 选择初次诊断脑卒中偏瘫（Brunnstrom分期Ⅳ~Ⅴ期）患者共81例,根据随机数字表法分为对照组（40例） 和观察组（41例）。对照组采用常规药物治疗和康复训练,观察组同时应用Neurac技术,2组康复训练时间均为每次 50 min,每周 5 次,疗程 4 周。采用 Fugl-Meyer 上肢运动功能评定量表（FMA-UE）、偏瘫上肢功能测试-香港版 （FTHUE-HK）和Barthel指数（BI）评价患者上肢功能恢复情况;Fugl-Meyer下肢运动功能评定量表（FMA-LE）、Berg 平衡量表（BBS）、躯干控制能力评定量表（TCT）以及三维步态训练系统进行步态时空和时相参数分析,评价下肢功 能。结果 治疗后2组FMA-UE、FTHUE-HK和BI评分均较治疗前提高,治疗后观察组各量表评分均明显高于对照 组（P＜0.01）。下肢功能比较发现,治疗后2组FMA-LE、BBS和TCT评分均较治疗前提高,观察组各量表评分均明显 高于对照组（P＜0.05）。治疗后2组步态时空参数中步速、步频和步长均增加,步宽降低,时相参数中双支撑相、健侧 支撑相、患侧支撑相百分比以及健患侧支撑相比值均降低,且观察组改善情况优于对照组（P＜0.05）。结论 Neurac 技术能够进一步改善脑卒中偏瘫患者的上下肢功能,提高肢体平衡和控制能力,改善步态,增强康复质量和生活能 力,有较好的应用推广价值。     

丹红注射液联合镜像疗法对脑卒中偏瘫患者下肢运动功能障碍的康复效果研究

目的探讨丹红注射液联合镜像疗法对脑卒中偏瘫患者下肢运动功能障碍的康复效果。方法选取我院康复医学科住院收治的82例脑卒中伴一侧肢体功能障碍患者,随机分成对照组与观察组,每组41例。均予常规康复疗法,对照组在此基础上予丹红注射液肌肉注射(2~4mL/次,2次/d),观察组在上述基础上再予镜像疗法。治疗4周后,专人采用盲法评定运动功能、平衡功能以及步行功能。结果与治疗前比较,2组简式Fugl-Meyer评分法(FMA)、Berg平衡量表(BBS)、改良Barthel指数量表(MBI)评分显著升高(P<0.01),股四头肌、腘绳肌手法测试(MMT)分级标准Kendall百分比法评分显著升高(P<0.01),步长、步频、步速显著升高(P<0.01),Holden功能性步行分级法(FAC)步行能力分级显著升高(P<0.01);与治疗后比较,观察组FMA、BBS、MBI评分显著较高(P<0.01),股四头肌、腘绳肌MMT分级标准Kendall百分比法评分显著较高(P<0.01),步长、步频、步速显著较高(P<0.01),FAC步行能力分级显著较高(P<0.01)。结论丹红注射液联合镜像疗有助于脑卒中偏瘫伴下肢功能运动障碍患者的下肢功能恢复,提高步行能力。     

镜像神经元视觉反馈疗法结合语音矫治对脑卒中构音障碍的治疗效果

目的 观察镜像神经元视觉反馈疗法结合语音矫治对脑卒中后构音障碍的康复作用.方法 80例脑卒中后伴构音障碍患者随机均分为观察组和对照组.对照组仅给予语音矫治,观察组在语音矫治的基础上再给予镜像神经元视觉反馈疗法.比较两组治疗前和治疗3周后最长发声时间(MPT)、改良Frenchay构音障碍评估量表(FDA)评分、嗓音障碍指数量表(VHI)评分以及临床疗效.结果 与治疗前相比,两组治疗后MPT增加(P＜0.05),改良FDA评分和VHI评分降低(P＜0.05),其中观察组治疗后MPT、改良FDA评分和VHI评分改善更加明显(P＜0.05).观察组治疗显效率和总有效率均高于对照组(42.5％ vs.5.0％和92.5％ vs.52.5％)(P＜0.05).结论 镜像神经元视觉反馈疗法结合语音矫治可以改善脑卒中后构音障碍患者的口舌运动,提高其沟通交流能力和生活质量.     

强制性运动疗法对脑卒中患者运动功能的影响

目的观察强制性运动疗法对脑卒中偏瘫患者肢体运动功能的影响,探讨其对肢体使用能力和运动功能康复的效果。方法选择脑卒中偏瘫患者64例(男性38例,女性26例),采用强制性运动疗法等综合康复治疗,Berg平衡量表(BBS)、Fugl-meyer(FMA)、最大步行速度评定(MWS)及ADL等综合评价患者的运动功能,比较治疗前后肢体的运动功能的改变。结果采用Berg平衡量表(BBS)、Fugl-meyer(FMA)、最大步行速度评定(MWS)及ADL等综合评价患者的运动功能,总有效率为92%。结论 CIMT能够显著改善脑卒中患者的运动功能,是有效的康复治疗方法。     

功能性电刺激技术对运动发育迟缓患儿康复的效果观察

目的探讨功能性电刺激技术对运动发育迟缓患儿的康复效果。方法选取2011年1月至2013年6月海南省人民医院儿童康复科收治的60例运动发育迟缓患儿,按照随机数字表法分为观察组和对照组各30例。对照组给予常规的康复治疗,观察组在对照组的基础上加用功能性电刺激技术康复治疗。于治疗前和治疗后6个月分别采用Berg平衡量表、Barthel指数评分量表对两组患儿进行评定并比较。结果治疗前,两组在Berg平衡量表评分、Barthel指数评分等方面比较无显著性差异(P>0.05);治疗后,观察组在Berg平衡量表评分和Barthel指数评分方面明显优于对照组,差异具有统计学意义(P<0.05)。结论常规康复治疗联合功能性电刺激技术可显著提高运动发育迟缓患儿的平衡能力和日常生活活动能力,值得临床推广应用。     

Cancer therapy by gene therapy with angiostatin

Angiostatin, an internal fragment of plasminogen, has been shown to inhibit angiogenesis. A new area of cancer research that has generated excitement is the use of angiostatin to treat cancer. Angiostatin protein therapy has not been pursued because current technology is inadequate to manufacture the needed biologically active proteins in sufficient quantities. It is sufficient for effective therapy with angiostatin to establish angiostatin production in the vicinity of tumors by gene transfer of angiostatin cDNA. There are various methods by which to transfer angiostatin cDNA. One way is to use a viral vector to incorporate the gene into cells. Another way is to use nonviral vectors. In this review, evidence accumulated from many laboratories suggests that angiostatin gene therapy may be an important new cancer therapy as an adjuvant therapy to prevent recurrence. (c) 2001 Prous Science. All rights reserved.     

Combination therapy with statins

Statins effectively inhibit cholesterol synthesis and are currently the most commonly used drugs for the treatment of hypercholesterolemia. However, patients with familial hypercholesterolemia and those unwilling to take, or who cannot tolerate statins, and patients with combined hyperlipidemia require a combination treatment. Statins combined with cholesterol malabsorption, caused, e.g., by plant stanol esters or ezetimibe (Schering-Plough Corp/Merck & Co Inc), or with bile acid malabsorption, caused by bile acid binding resins or guar gum, inhibit compensatory increases in cholesterol synthesis and effectively lower LDL cholesterol levels. Combination therapy of statins with fibrates should be controlled by lipidology experts. Recent information on indications and advantages of combining statins with n-3 fatty acids, hormone replacement therapy, or niacin, will also be discussed.     

Cancer therapy with beta-lapachone

Beta-lapachone is an ortho naphthoquinone, originally isolated from a tree whose extract has been used medicinally for centuries. Recent investigations suggest its potential application against numerous diseases. Its lethality at micromolar ( m) concentrations against a variety of cancer cells in culture indicates its potential against tumor growth. A few experiments with positive results have been performed that apply the compound to tumors growing in animals. Particularly promising is the remarkably powerful synergistic lethality between beta-lapachone and taxol against several tumor cell lines implanted into mice; the mice did not appear to be adversely affected. Enhanced lethality of X-rays and alkylating agents to tumor cells in culture was reported when beta-lapachone was applied during the recovery period, because of inhibition of DNA lesion repair. Clinical trials are still to be initiated. The detailed mechanism of cell death induced by beta-lapachone remains for investigation. DNA topoisomerase I was the first biochemical target of beta-lapachone to be discovered, although its role in cell death is not clear. A proposed mechanism of cell death is via activation of a futile cycling of the drug by the cytoplasmic two-electron reductase NAD(P) H: quinone oxidoreductase, also known as NQO1, DT-diaphorase and Xip3. Death of NQO1 expressing cells is prevented by the NQO1 inhibitor dicoumarol, and cells with low NQO1 are resistant. At higher drug concentrations the production of reactive oxygen species (ROS) appears to be responsible. Furthermore, this process is p53- and caspase- independent. Either apoptotic or necrotic cell death can result, as reported in various studies performed under differing conditions. Beta-lapachone is one of a few novel anticancer drugs currently under active investigation, and it shows promise for chemotherapy alone and especially in combinations.     

The risks and benefits of therapy with aldosterone receptor antagonist therapy

Spironolacotone and eplerenone are mineralocorticoid-blocking agents. These compounds block both the epithelial and non-epithelial actions of aldosterone with the latter assuming increasing clinical importance. Spironolactone and eplerenone both effectively reduce blood pressure either as mono- or add-on therapy; moreover, they each offer survival benefits in diverse circumstances of heart failure and the potential for renal protection in proteinuric chronic kidney disease. However, as the use of mineralocorticoid-blocking agents has increased the hazards inherent to use of such drugs has become more apparent. Whereas; the endocrine side-effects of spironolactone are in most cases little more than a cosmetic annoyance the potassium-sparing effects of both spironolactone and eplerenone can prove fatal if sufficient degrees of hyperkalemia develop. However, for most patients the risk of developing hyperkalemia in and of itself should not discourage the sensible clinician from bringing these compounds into play. Hyperkalemia should always be considered as a possibility in any patient receiving one or the other of these medications. As such, steps should be taken to lessen the likelihood of its occurring if therapy is being contemplated with agents in this class.     

高血压患者抗动脉粥样硬化治疗策略:降压联合降脂

高血压患者伴有高胆固醇血症时,其心血管疾病的发生危险将显著升高。同时治疗其高血压和高胆固醇血症可有更多获益,达到真正的抗动脉粥样硬化事件的作用,减少心脑血管疾病的发生。降胆固醇方案相同时,以氦氯地平为基础的降压方案的临床获益显著高于以阿替洛尔为基础的降压方案。并且,联合应用降雎及降胆固醇方案时,阿托伐他汀降胆固醇方案尽甲使用获益更多。     

Compliance with drug therapy.

Although no single method is ideal for measuring compliance the methods now available allow accurate assessment of compliance in most settings. Studies using new and more accurate methods of measuring compliance have shown poor compliance to be an even greater problem than was previously thought. Using these methods, efforts in the future should be directed at relating compliance to treatment outcome, and investigating whether manoeuvres aimed at improving compliance actually improve patient outcome.