MOTOmed智能运动训练系统对脑损伤偏瘫痉挛期患者下肢肌张力和运动功能的影响

目的观察MOTOmed智能运动训练系统对于脑损伤偏瘫痉挛期患者下肢肌张力和运动功能的影响。方法 40例脑损伤偏瘫痉挛期患者,随机分成治疗组和对照组,每组20例。两组患者均给予常规康复训练,包括良肢位摆放、关节活动度训练、下肢功能训练等。治疗组在常规康复训练的基础上增加MOTOmed智能运动训练。治疗前和治疗4周后分别采用Fugl-Meyer下肢运动功能量表(FMA)和改良Ashworth肌张力分级评定法(MAS)来评定两组患者下肢肌张力和运动功能。结果治疗前,两组患者在下肢肌张力和运动功能方面无统计学差异(P>0.05);治疗后,两组患者下肢肌张力和运动功能均得到改善(P<0.05),且治疗组较对照组改善更明显(P<0.05)。结论通过对脑损伤偏瘫痉挛期患者实施MOTOmed智能运动训练结合常规康复治疗,可以有效的缓解痉挛,降低肌张力,改善并提高下肢运动功能。     

头针互动MOTOmed智能运动训练对脑卒中偏瘫患者下肢痉挛和运动功能的影响

目的 观察头针互动MOTOmed智能运动训练对脑卒中偏瘫患者下肢痉挛和运动功能的影响。方法 选择2014年6月至2016年12月安徽中医药大学第一附属医院针灸康复科收治的60例脑卒中偏瘫伴下肢痉挛患者,采用随机数字表法将患者分为对照组与观察组,每组30例。两组患者在内科基础治疗及常规康复治疗的基础上,对照组给予MOTOmed智能运动训练治疗,观察组给予头针互动MOTOmed智能运动训练。分别于治疗前、治疗4周后对两组患者行膝关节改良Ashworth痉挛量表（MAS）、踝关节综合痉挛量表（CSS）及Fugl-Meyer运动量表下肢功能评分（FMA-L）进行评分,比较两组患者上述评分的差异。结果 治疗4周后,两组患者的MAS、CSS评分较治疗前降低,FMA-L评分较治疗前升高,差异有统计学意义（P<0.05）,且观察组优于对照组（P<0.05）。结论 头针互动MOTOmed智能运动训练可有效改善脑卒中后下肢痉挛状态,提高下肢运动功能,优于单纯采用MOTOmed智能运动训练。     

智能运动训练系统对脑卒中偏瘫患者下肢运动功能和步行能力的影响

目的：探讨智能运动训练系统对脑卒中偏瘫患者下肢运动功能及步行能力的影响;分析偏瘫患者下肢运动功能和步行能力的相关性。方法将48例病程为1～3个月的脑卒中患者随机分为治疗组和对照组,各24例。对照组患者采用常规康复训练方法,治疗组在此基础上,增加智能训练系统治疗,每天2次,每次20 min。治疗前和治疗4周后评定患者的下肢运动功能（采用FMA-L评分量表）和步行功能（采用功能性步行量表FAC）。结果两组患者的下肢运动功能和步行能力治疗后均有改善（P＜0．05）,但治疗组患者的效果优于对照组（P＜0．05）;对照组及治疗组治疗前后偏瘫患者下肢运动功能和步行能力均呈显著正相关（P＜0．01或P＜0．05）。结论智能训练系统结合常规康复治疗可改善恢复期脑卒中偏瘫患者的下肢运动功能和步行能力,且效果优于单纯应用常规康复治疗;偏瘫患者下肢运动功能和步行能力有着显著的正相关性。     

减重步行训练对脑卒中偏瘫患者下肢运动功能的影响

目的：观察减重步行训练（BWSTT）对脑卒中偏瘫患者下肢功能的恢复作用。方法：50例脑卒中患者随机分成实验组25例和对照组25例。实验组行减重步行训练加常规康复治疗,对照组仅行常规康复治疗,每周6次,共6周。治疗前后分别用FAC评分、FMA下肢评分、Banhel指数和Berg平衡量表进行评定。结果：治疗前两组患者各评测指标差异无显著性（P〉0．05）,治疗后两组患者下肢功能较治疗前均明显改善（P〈0．01）,实验组改善明显优于对照组（P〈0．05）。结论：减重步行训练可进一步改善偏瘫患者下肢功能的恢复。     

智能反馈训练系统对偏瘫早期下肢运动功能及平衡能力的疗效观察

目的：观察智能反馈训练系统对脑卒中后偏瘫早期下肢运动功能及平衡能力的治疗效果。方法将40名脑卒中后偏瘫患者随机分为两组,对照组进行常规康复训练,试验组在此基础上增加智能反馈训练系统训练,每天治疗1次,每周治疗5次,4周后评估患者下肢表面肌电积分肌电值（ IEMG）、协同收缩率（ CR）,Berg平衡功能量表（ BBS）、简化Fugl?Meyer下肢运动功能评定（ FMA）。结果治疗4周后,两组患者膝屈曲和踝背伸时的协同收缩率、BBS评分较治疗前均有显著改善（P＜0．01）,FMA评分较治疗前有明显改善（P＜0．05）,试验组改善程度较对照组更优,差异有统计学意义（P＜0．05）。结论智能反馈训练系统在脑卒中后偏瘫早期治疗中可以有效改善患者下肢运动功能及平衡能力。     

运动想象结合运动再学习训练偏瘫患者的下肢运动功能

目的探讨运动想象结合运动再学习训练对偏瘫患者下肢运动功能恢复的影响。方法将88例脑卒中偏瘫患者随机分为治疗组和对照组,每组各44例,两组均采用常规神经内科药物治疗和运动再学习训练,其中治疗组在训练前进行15~20min运动想象训练。运动再学习训练1次/d,40min/次,疗程6周。采用下肢运动功能评分法(FMA)、改良指数法(MBI)对两组患者治疗前、治疗后下肢功能和日常生活活动能力进行评定。结果两组患者下肢功能和日常生活活动能力积分较治疗前均有明显提高(P<0.01),但治疗组治疗前后改善明显优对照组(P<0.01)。结论运动再学习训练结合运动想象疗法可提高偏瘫患者下肢运动功能,值得临床推广应用。     

脑卒中患者早期康复干预对下肢运动功能的影响

目的探讨早期康复干预对脑卒中患者下肢运动功能的影响。方法64例急性脑卒中偏瘫患者随机分为2组各32例．进行临床对照研究,两组均进行常规神经内科治疗,康复组加入以神经促通技术为主的综合康复治疗：结果治疗4周后．2组Fulg—Meyer（FMA）、改良巴氏指数（MBI）评分与治疗前比较均有一定程度的提高,但康复组优于对照组（P〈0．01）：结论早期介入康复治疗可明显改善患者的下肢运动功能和ADL能力。     

偏瘫康复操对脑卒中患者偏瘫肢体运动功能的影响

目的探讨偏瘫康复操对脑卒中患者偏瘫肢体运动功能及日常生活能力的影响。方法以康复科住院的脑卒中患者为研究对象,将符合入选条件的脑卒中患者随机分为干预组和对照组,每组各50例。两组患者均接受康复科常规康复治疗和护理,在此基础上干预组由康复护士给予实施个体化偏瘫康复操以提高偏瘫肢体运动功能和ADL能力。康复护士分别在患者入院时和治疗4周后测量运动功能,采用Fugl-Meyer(FMA)评分和ADL(采用Barthel指数)评分。结果治疗4周后两组患者评分均有提高,干预组FMA评分及ADL评分均高于对照组,差异有显著性(P<0.05)。结论实施偏瘫康复操可有效提高脑卒中患者偏瘫肢体的运动功能及日常生活能力,避免和减少脑卒中并发症的发生。     

蜡疗联合肌力训练对痉挛性偏瘫患者下肢运动功能的作用分析

目的:观察蜡疗联合肌力训练对痉挛性偏瘫患者下肢运动功能的影响。方法:依据入选标准,选取脑卒中后肩痛患者42例,分别纳入对照组和治疗组,每组患者21例;两组患者均给予8周常规康复治疗,治疗组再次基础上给予蜡疗联合肌力训练;在治疗前及治疗后,应用日常生活活动能力量表和Fugl-Meyer简式运动功能评定法(FMA)下肢运动评分量表对两组患者进行评估,收集评估结果,对比两组评分差异。结果:两组患者经8周康复治疗后,两组下肢FMA评分均明显升高,其中治疗组分数升高较对照组明显(P<0.05),差异具有统计学意义;两组ADL评分均明显升高,其中治疗组分数升高较对照组明显(P<0.05),差异具有统计学意义。结论:蜡疗联合肌力训练能够提高下肢运动功能及患者日常生活活动能力。     

早期强化膝关节控制训练对脑卒中偏瘫患者下肢运动功能的影响分析

目的：探讨早期强化膝关节控制训练对脑卒中偏瘫患者下肢运动功能的影响。方法将2012年12月~2014年6月本院康复医学科住院的90例偏瘫患者随机分为治疗组和对照组,每组45例。两组患者在内科治疗的基础上,对照组接受常规康复治疗,治疗组在对照组的基础上加强化膝关节控制训练。分别于治疗前后对两组患者的Berg平衡量表(BBS)、Fugl-Meyer动功能量表(FMA)、功能性独立量表(FIM)进行评定,比较两组的治疗效果。结果8周治疗后,两组的BBS、FMA及FIM评分与治疗前比较,差异有统计学意义(P<0.05),并且治疗组BBS、FMA及FIM评分改善明显优于对照组,差异有统计学意义(P<0.05)。结论早期强化膝关节控制训练对偏瘫患者下肢运动功能及日常生活能力的改善均有积极促进作用。     

药检室在医院药学中的职能及功能拓展

目的 拓展医院药检室的职能.方法 综合分析探讨医院药检室的主要职能和功能拓展.结果 药检室的职能正从对自制制剂的质量控制扩大到对全院药品质量监督,从与各临床科室交流制剂问题到临床药学,从单一化工作到开展新制剂、新剂型等方面的科研研究.结论 药检室应根据实际情况,制订发展计划,在医院药学服务中发挥作用.     

Structure and Function of Cobrotoxin

Abstract

In this review I describe the current status of the study of postsynaptic neurotoxins with special emphasis on the extensive studies of cobrotoxin which I started more than three decades ago. Cobrotoxin, is a neurotoxic protein isolated in crystalline state from the venom of Taiwan cobra Naja naja atra. It is a small basic protein consisting of a single peptide chain of 62 amino acid residues, crosslinked by four disulfide bonds. Cobrotoxin binds specifically to the nicotinic acetylcholine receptor on the postsynaptic membrane and thus blocks the neuromuscular transmission. The disulfide bonds and Tyr-25 which are buried in the molecule form a central core to maintain and stabilize the active conformation of the toxin. Selective and stepwise chemical modifications of cobrotoxin indicate that at least two cationic groups, an ? -amino group of Lys-47 and a guanidino group of Arg-33, both of which are common to all known postsynaptic snake neurotoxins, held at a certain critical distance in the molecule, are functionally important for its neuromuscular blocking activity.     

Pharmacologic Inhibition of Platelet Function

Atherothrombosis continues to be a leading cause of death and disability despite advances in pharmacologic and procedural therapies. Antiplatelet agents have been extensively studied and validated to improve outcomes in multiple settings of cardiovascular disease. The emergence of the phenomenon of resistance to antiplatelet therapy resulted in the availability of platelet function tests to assess the effectiveness of these agents. Subsequent evaluations have shown considerable inter-individual variability in platelet inhibition in patients receiving antiplatelet agents. Several small studies showed that patients who were deemed 'resistant' to antiplatelet therapy by platelet function testing had adverse clinical outcomes. It is essential that ongoing investigations help delineate a standard definition of 'resistance' to antiplatelet therapy, which test of platelet function should be the gold standard, and what therapy, once identified, can help overcome resistance to the currently available antiplatelet agents. Data are needed to determine if outcomes can be improved by changes to existing antiplatelet therapy based on the results of platelet function tests. Alternatively, newer antiplatelet agents may prove effective in overcoming resistance; however, these agents also await validation in large-scale clinical trials.     

中药的抗肿瘤作用

中药防治恶性肿瘤，在减轻临床症状，提高生存质量，防止复发转移，延长生存期等很好效果。本文从增强机体免疫功能，抑制肿瘤血管生成，诱导肿瘤细胞分化，促进凋亡，调节相关基因表达等方面阐述了中药的抗肿瘤作用机制。     

Lead and Immune Function

The heavy metal lead is a widely deposited environmental toxicant known to impact numerous physiological systems, including the reproductive, neurological, hepatic, renal, and immune systems. Studies illustrating the capacity of lead to impair immune function and/or host resistance to disease date back to at least the 1960s. However, it has only been in recent years that lead has been recognized among a new category of immunotoxicants—those that dramatically shift immune functional capacity while producing only modest changes to immune cell populations and lymphoid organs. These relatively noncytotoxic immunomodulating chemicals and drugs represent the immunotoxic hazards most difficult to identify and problematic for risk assessment using historic approaches. As a result, such environmental factors are also among the most likely to contribute to chronic immune-related disease at relevant exposure levels. This review considers the animal and human evidence that lead exposure can produce a stark shift in immune functional capacity with a skewing predicted to elevate the risk of atopic and certain autoimmune diseases. At the same time, host defenses against infectious agents and cancer may be reduced. Age-based exposure studies also suggest that levels of blood lead previously thought to be safe, that is, below 10 μg/dl, may be associated with later life immune alterations.     

术前呼吸功能锻炼对瓣膜置换患者肺功能影响

目的 评估术前呼吸功能锻炼对改善肺功能的效果。方法 随机选取2001年6月～2004年9月瓣膜置换术者48例,术前1～3周进行呼吸功能锻炼,观察锻炼前后患者肺功能改善情况。结果 锻炼后患者的呼吸频率显著减慢,用力呼吸（FVC）、第1秒用力呼吸量（FEV1）、血氧饱和度（SaO2）、指脉氧饱和度（SpO2）较锻炼前均有不同程度提高（P〈0．01）。结论 呼吸功能锻炼可改善患者的肺功能,提高患者对手术的耐受性。     

间充质干细胞的免疫调节功能

间充质干细胞(MSC)在支持造血细胞的成熟、分化和生存方面具有重要作用.最近研究发现,MSC具有免疫调节作用,能抑制树突状细胞(DC)成熟,并通过细胞-细胞接触的机制,抑制T淋巴细胞、B淋巴细胞及自然杀伤细胞(NK细胞)的功能,在自身免疫性疾病及肿瘤细胞免疫逃逸中至关重要.现正尝试将MSC用于抗急性移植物抗宿主病(aGVHD)及自身免疫性疾病的治疗.     

Function of cardiac M3 receptors

1. Since the initial identification of the M3 subtype of muscarinic acetylcholine receptors (M3-mAChR) in the heart, there have been increasing interest and advances in studies on the pathophysiological roles of M3-mAChR in the heart. Recent studies from several laboratories have provided compelling and solid evidence in support of the important roles of M3-mAChR in regulation and maintenance of cardiac function and in generation and progression of heart disease as well. 2. The functions of the cardiac M3-mAChR revealed thus far include (i) M3-mAChR regulation of heart rate and cardiac repolarization, (ii) modulation of inotropic effects, (iii) cytoprotection against ischaemic injuries of myocardium, (iv) regulation of cell-to-cell communication, and (v) participation in generation and maintenance of atrial fibrillation. 3. Signal transduction mechanisms underlying these pathophysiological functions have also been studied, which have allowed us to get insight into the following mechanistic aspects. (i) M3-mAChR activates a delayed rectifying K+ current I(KM3) to participate in cardiac repolarization, negative chronotropic actions, and anti-dysrhythmic (suppresses ischaemic dysrhythmias) as well as pro-dysrhythmic (facilitates atrial fibrillation) actions. (ii) M3-mAChR interacts with gap-junctional channel connexin 43 to maintain cell-cell communication and excitation propagation. (iii) M3-mAChR regulates intracellular phosphoinositide hydrolysis to improve cardiac contraction and haemodynamic function. (iv) M3-mAChR activate anti-apoptotic signalling molecules, enhances endogenous antioxidant capacity, and diminishes intracellular Ca2+ overload, all of which contribute to protecting the heart against ischaemic injuries. 4. This article provides an overview of the potential roles of the M3-mAChR in parasympathetic control of heart function under normal physiological conditions and in the setting of a variety of pathological processes including heart failure, myocardial ischaemia and dysrhythmias.     

褪黑激素在人视网膜中的作用机制

褪黑激素（melatonin，MLT）是一种具有众多生理功能的吲哚胺类激素，而视网膜是它在人体内天然的分泌部位之一。MLT在视网膜中发挥了重要作用，包括参与调节视网膜功能昼夜节律性变化、抗氧化抗凋亡和调节视网膜神经网络系统等。对于这些作用机制的深入研究，有助于指导MLT在眼科的临床应用。本文仅就其在视网膜中的合成、代谢、受体分布及主要功能作一综述。