综合康复对脑性瘫痪儿运动功能恢复的观察

目的：观察综合性康复方法对脑性瘫痪儿运动功能恢复效果。方法：选择脑瘫病例158例，随机分为3组，其中综合康复组108例，单纯康复组30例，单纯针刺组20例，3组均接受相同时间总计3个疗程的治疗。结果：显示综合康复组明显优于单纯康复组和单纯针刺组(X^2=7.952,P<0.05)。结论：综合性康复对脑瘫儿有最佳康复效果。     

物理疗法治疗小儿脑性瘫痪疗效探讨

目的：探讨以物理疗法（ Ｐ Ｔ） 治疗小儿脑瘫的疗效。方法：将２７４ 例脑瘫患儿分组治疗。第１ 组单纯药物组,第２ 组药物、头针、穴位注射组,第３ 组综合康复组。疗效评价分４ 等：正常化、显效、有效、无效。结果：总有效率,第１ 组６２ ．９ ％ ,第２ 组９１ ．１ ％ ,第３ 组９２．６％ 。第１ 组与第２ 组总有效率之比有非常显著差异（ Ｐ＜ ０．０１） 。第２ 组与第３ 组总有效率之比无显著差异（ Ｐ＞ ０ ．０１） ,但第２ 组与第３ 组的正常化与显效率之比有非常显著差异（ Ｐ＜ ０ ．０１） ,即第３ 组的治疗质量明显优于第２ 组。结论：以 Ｐ Ｔ为主的综合性康复治疗方法是目前治疗小儿脑瘫较为有效的方法,尤其对轻、中型痉挛型脑瘫效果更佳。     

综合疗法治疗小儿脑瘫疗效观察

目的观察综合疗法治疗小儿脑瘫的临床疗效。方法 15 0例脑瘫患儿随机分为针刺组 5 0例 (采用针刺疗法 )、康复组 5 0例 (用现代康复疗法 )、综合组 5 0例 (采用针刺结合康复疗法 ) ,3个月后比较各组的疗效。结果综合组治疗前后日常生活活动能力 (ADL)差值明显高于针刺组和康复组 (P <0 .0 1) ;综合组和康复组治疗后的爬行能力均较治疗前有显著性差异 (P <0 .0 5 ) ,针刺组无显著性差异 (P >0 .0 5 ) ,综合组和康复组治疗后的爬行能力与针刺组有显著性差异 (P <0 .0 1) ,但综合组和康复组之间无显著性差异。结论综合疗法是治疗脑瘫的有效方法 ,可提高患儿的ADL和爬行能力     

物理疗法治疗小儿脑性瘫痪疗效探讨

目的：探讨以物理疗法(PT)治疗小儿脑瘫的疗效。方法：将274例脑瘫患儿分组治疗。第1组单纯药物组．第2组药物、头针、穴位注射组．第3组综合康复组。疗效评价分4等：正常化、显效、有效、无效。结果：总有效率．第1组62．9％,第2组91.1％．第3组92.6％。第1组与第2组总有效率之比有非常显差异(P<0．01)。第2组与第3组总有效率之比无显整异（P>0.01),但第2组与第3组的正常化与显效率之比有非常显差异(P<0．01),即第3组的治疗质量明显优于第2组。结论：以PT为生的综合性康复治疗方法是目前治疗小儿脑瘫较为有效的方法．尤其对轻、中型痉挛型脑瘫效果更佳。     

针刺结合综合康复疗法治疗脑卒中后吞咽障碍的疗效观察

目的：观察针刺结合综合康复疗法对脑卒中后吞咽障碍患者的临床疗效。方法：脑卒中后吞咽障碍患者125例,随机分为康复组（65例）与对照组（60例）,2组均给予脑卒中常规治疗,康复组还给予针刺、生物电反馈、功能恢复训练和心理治疗。结果：临床疗效评定显示康复组的吞咽障碍及VFSS评分改善明显优于对照组（P〈0．05）。结论：针刺结合综合康复疗法治疗脑卒中后吞咽障碍有显著疗效。     

针刺治疗小儿痉挛性脑瘫的临床疗效观察

目的:探索针刺在痉挛性脑瘫患儿康复治疗的临床效果。方法:痉挛性脑瘫患儿80例,随机为2组各40例,观察组采用针刺结合康复训练,对照组仅采用单纯康复训练,治疗前后采用Ashworth量表、粗大运动功能积分量表及Peabody量表评价临床效果。结果:治疗3个月后,2组Ashworth评分均较治疗前有明显下降(P0.05),且观察组更低于对照组(P0.05);2组粗大运动功能百分比及Peabody握力区评分均较治疗前有明显提高(P0.05),且观察组更高于对照组(P0.05)。结论:针刺结合康复综合训练治疗小儿痉挛性脑瘫临床效果优于单纯康复综合训练,能显著缓解患儿的痉挛程度、改善患儿的粗大运动功能和精细运动功能。     

针刺疗法在脑卒中早期康复中的应用研究

目的:探讨针刺对中风患者的运动功能、ADL、QOL的影响,以及早期针刺介入是否可行。方法:57例急性脑卒中患者,随机分为针刺康复组(29例)和单纯康复组(28例)。针刺康复组在Bobath疗法基础上加针刺治疗。比较两组功能改善的情况,观察两组继发并发症的发生率,以对比两组的QOL。结果:治疗后,针刺康复组的运动功能评分高于单纯康复组(P<0.05),ADL能力改善也略优于单纯康复组。两组间痉挛级别分布和肌痉挛发生率差异无显著性。针刺康复组的痛肩发生率低于单纯康复组(P<0.05),但两组间肩手综合征和足下垂或足内翻的发生率差异无显著性意义。结论:针刺与早期康复的叠加疗效优于单纯康复治疗。     

早期康复结合针刺冶疗对急性动脉血栓性脑梗死的临床疗效观察

目的观察早期康复配合针刺治疗对动脉血栓性脑梗死急性期临床疗效。方法将91例首次发病的动脉血栓性脑梗死形成患者随机分成早期康复组和对照组，早期康复组采用Bobath疗法和针刺疗法，对照组仅采用针刺疗法，采用神经功能缺损评分、FMA和MBI指标评价2组疗效，并进行统计学分析。结果治疗后2组各项指标较治疗前均明显改善（P〈0．01），组间疗效比较早期康复组优于针刺组（P〈0．01）。结论动脉血栓性脑梗死急性期实施早期康复配合针刺疗法，临床疗效肯定，且效果优于单纯针刺法。     

针刺结合语言训练治疗脑瘫儿童语言障碍的临床观察

目的探讨脑瘫儿童合并语言障碍的最佳治疗方法,提高患儿的语言能力。方法将93例脑瘫合并语言障碍患儿随机分为针刺组和对照组进行临床观察,2组患儿都进行了语言训练以及系统的康复治疗,针刺组加针刺四神针、智三针、舌三针、脑三针、语言二区、风池、哑门为主;2组均治疗4个月。结果针刺组总有效率95．8％,对照组总有效率78．3％,差异有统计学意义（p〈0．01）。结论脑瘫合并语言障碍的康复治疗,针刺结合语言训练的治疗效果明显优于单纯语言训练对照组。     

脑瘫儿童的康复与教育初探-附60例分析

目的 探讨脑瘫儿童康复治疗和教育的基本方法及其关系.方法 将60例脑瘫患儿分为康复组、教育组和康复＋教育组各20例，观察康复训练和教育效果.结果 2年后，WeeFIM量表评定康复组和教育组为有效，而康复＋教育组为基本恢复，且疗效优于康复组和教育组（ P＜0.05）.结论 对脑瘫患儿分阶段、有针对性地采取医疗康复与教育相结合的方法，可获得良好效果。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.