国家级继续医学教育项目[项目编号:2012010302050(国)]神经训导康复治疗系列技术专项第六届培训班招生通知

中枢神经(CN)细胞坏死和运动程序破坏是运动功能障碍的根源,恢复的方法需符合CN可塑性变化的"技巧性使用-依赖"机制并能重建运动程序方可。民政部国家康复辅具研究中心附属康复医院(国康)赵文汝根据上述机制将以调神、调息和调形为基本技术、完全主动运动的我国古老中医导引术改良成六步法以更好开发CN潜能,采用信号接收设备实时检测并以曲线形式显示导引出的运动程序信号的强度和比例,然后通过冲着箭靶圆心反复练习射箭才能提高射箭准确度的生物反馈机制,反复调控该信号的强度和比例使之重建,并在此基础上通过专有设备进行运动模式重塑训练恢复丧失的运动功能。经临床应用证明效果良好,适用于CN损伤和骨关节肌肉病变导致的运动功能障碍的恢复、或经传统康复不能进一步改善功能患者的治疗。     

第七届全国神经训导康复治疗技术培训班通知

(国家级中医药继续教育项目编号:【国】2013010302007)神经训导康复技术系赵文汝教授和团队经18年研究、11年临床验证,以按经络实施的六步法中医导引术为基本技术,通经活络、开发脑腑潜能,结合生物反馈技术,接收并实时显示导引出的运动程序信号,使之能够有的放矢地进行运动程序重建的训练,并在此基础上通过有效限制肢体运动中不需要的关节活动训练,重塑运动模式等一系列技术,实现方法的规范化应用。     

国家级继续医学教育项目神经训导康复治疗系列技术专项第六届培训班招生通知

中枢神经(CN)细胞坏死和运动程序破坏是运动功能障碍的根源,恢复的方法需符合CN可塑性变化的"技巧性使用-依赖"机制并能重建运动程序方可。民政部国家康复辅具研究中心附属康复医院(国康)赵文汝根据上述机制将以调神、调息和调形为基本技术、完全主动运动的我国古老中医导引术改良成六步法以更好开发CN潜能,采用信号接收设备实时检测并以曲线形式显示导引出     

国家级继续医学教育项目神经训导康复治疗系列技术专项第六届培训班招生通知

中枢神经（CN）细胞坏死和运动程序破坏是运动功能障碍的根源,恢复的方法需符合CN可塑性变化的“技巧性使用．依赖”机制并能重建运动程序方可。民政部国家康复辅具研究中心附属康复医院（国康）赵文汝根据上述机制将以调神、调息和调形为基本技术、完全主动运动的我国古老中医导引术改良成六步法以更好开发CN能,采用信号接收设备实时检测并以曲线形式显示导引出的运动程序信号的强度和比例,然后通过冲着箭靶圆心反复练习射箭才能提高射箭准确度的生物反馈机制,反复调控该信号的强度和比例使之重建,并在此基础上通过专有设备进行运动模式重塑训练恢复丧失的运动功能。经临床应用证明效果良好,适用于CN损伤和骨关节肌肉病变导致的运动功能障碍的恢复、或经传统康复不能进一步改善功能患者的治疗。培训班采用课堂和实践相结合方式,由本项目发明人赵文汝教授及赵海红副教授和著名康复专家授课。培训对象为康复医师、体疗师、神经内外科、骨科、护理人员及中医师等。内容：神经训导康复技术理论和方法,中医导引术现代化发展和在康复医学中的应用,人体潜能开发、运动程序重建、运动模式重塑、预防和校正异常运动模式的三阶段治疗方法,神经训导虚摸实际训练技术,以及运动中枢、吞咽、面瘫、括约肌失禁、言语和认知训导等治疗技术。     

神经训导康复治疗系列技术专项第六届培训班招生通知

中枢神经(CN)细胞坏死和运动程序破坏是运动功能障碍的根源,恢复的方法需符合CN可塑性变化的"技巧性使用-依赖"机制并能重建运动程序方可。民政部国家康复辅具研究中心附属康复医院(国康)赵文汝根据上述机理将以调神、调息和调形为基本技术、完全主动运动的我国古老中医导引术改良成六步法以更好开发CN潜能,采用信号接收设备实时检测并以曲线形式显示导引出的运动程序信号的强度和比例,然后通过冲着箭靶圆心反复练习射箭才能提高射箭准确度的生物反馈机制,反复调控该信号的强度和比例使之重建,并在此基础上通过专有设备进行运动模式重塑训练恢复丧失的运动功能。     

253专科护士如何帮助患者进行深部脑刺激治疗

如果帕金森综合征患者有可通过药物控制的震颤、运动过缓、强直和肌张力异常症状以及由于长期左旋多巴治疗出现的不可预料的波动症状 ,可考虑用功能性立体定向深部脑刺激治疗。它是一种能抑制这些症状的微创性的、可逆的和可调节的神经外科技术。Ninewlls医院的 Dundee神经科的运动疾病组认为患者进行这种治疗需要有指定的临床护理专家 ( CNS)的支持。 CNS的 3个目标是 :1了解患者和亲属的心理 ,2确定他们在整个过程中的需求 ,3神经科护士和多学科组的合作。患者来诊时 ,CNS了解每个患者的病程和诊治过程 ,收集患者和亲属的意见 ,目的…     

脑梗死后偏瘫患者康复治疗前后sEMG信号变化的研究

目的：观察和分析脑梗死偏瘫患者下肢在康复治疗前后sEMG信号MF和MPF值的变化特征．为康复治疗疗效评定提供电生理依据。方法：20例脑梗死偏瘫患者在治疗前后进行运动功能评定，并在康复治疗前采集健侧及患侧下肢被动运动、主动助力运动时股直肌和半腱肌的肌电信号,采用快速傅立叶变换方法收集MF和MPF值．经过30d至45d的综合康复治疗后，再次采集相同条件下股直肌和半腱肌的MF和MPF值。结果：股直肌和半腱肌在治疗前后被动运动时MF值差异有显著性（P〈0．05），主动运动时MF值差异无显著性意义（P〉0．05）；在治疗前后被动运动和主动运动的MPF值差异有显著性（P〈0．05）。结论：表面肌电图信号可反映脑梗死偏瘫患者患侧下肢在康复治疗前后的运动功能改善情况，MPF值优于MF值，sEMG可作为偏瘫患者的运动功能恢复的评价指标。     

上肢人体潜能开发训练装置的研制及临床适应证

制作具有承重保护及减重功能的上肢潜能训练装置,应用六步法中医导引术指导患者进行上肢撑起和撑落训练,并用导引言语营造没有危险的危急气氛,鼓励患者尽量自主完成要求的动作,训练时间30min/次,30次为1个疗程.上肢潜能开发训练装置能对患者起到确实的减重和安全保护作用,使训练在安全的情况下循序渐进地进行.结合中医导引技术的应用,充分调动患者毅力、鼓励患者尽最大努力去完成指定动作,促进上肢自主运动功能恢复,具有较好的卜肢人体潜能开发作用.结果提示,上肢人体潜能开发训练装置是一种能够提供减重和安全保护作用的上肢人体潜能开发、改善上肢运动功能的有效训练装置.     

肌电生物反馈联合康复训练对脊髓损伤患者运动功能及功能独立性的影响

目的:观察肌电生物反馈疗法联合康复训练对脊髓损伤(SCI)患者运动功能障碍的康复疗效。方法:60例胸腰段不完全性脊髓损伤患者随机分为观察组和对照组,每组30例。2组均进行常规康复治疗,观察组加用双下肢肌电生物反馈治疗。治疗前及治疗后8周、12周进行下肢肌肉最大收缩时表面肌电(sEMG)信号采集、运动功能评定及功能独立性(FIM)评定,比较临床疗效。结果:治疗8周后,2组患者股四头肌、胫前肌最大收缩时的sEMG信号均较治疗前明显提高(P0.05),治疗后12周继续提高(P0.01);观察组sEMG信号增幅高于对照组(P0.05)。治疗8周后,2组患者ASIA运动功能评分及FIM评分亦较治疗前提高(P0.05),组间比较差异无统计学意义;治疗12周后,2组ASIA运动功能及FIM评分较治疗8周后提高更明显(P0.01),观察组更高于对照组(P0.05)。结论:肌电生物反馈疗法联合康复训练对胸腰段不完全性脊髓损伤患者运动功能有促进作用,能明显提高患者的股四头肌、胫前肌表面肌电信号及肌力,并能提高功能独立水平,减少并发症。     

下肢潜能开发训练装置的研制和临床适应证

目的研制一种能够提供减重和安全保护功能、营造有利于下肢潜能开发的专用训练设备。方法制作承重保护、减重及刻度脚踏板装置,在保护和减重状态下应用中医导引术进行下肢人体潜能开发、神经传导速度和肢体运动协调性训练。结果潜能开发训练装置能起到安全保护和减重作用,使训练循序渐进,在中医导引术的配合下,具有较好的下肢潜能开发作用。结论下肢潜能开发训练装置是一种能够提供减重和安全保护的下肢潜能开发和改善肢体运动协调性的有效训练装置。     

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.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

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.