颅脑损伤后运动功能障碍的康复评定

文章主要总结了颅脑损伤后运动功能障碍的表现形式。介绍了颅脑损伤后运动功能的评定,异常肌张力的评定以及共济失调障碍和手足徐动障碍的评定。     

脑卒中后肢体运动功能障碍的康复评定与治疗

运动功能障碍是脑卒中患者的常见症状,严重地影响了患者的生活质量,因此对脑卒中后偏瘫患者进行积极、及时的康复治疗十分重要。采用康复评定TEAM会的形式,对具体的脑梗死后偏瘫患者进行讨论、分析,制定合理的康复治疗方案,对患者进行积极治疗。治疗1个月后,再次对患者进行疗效及功能评定,并制定出患者后期所需接受的社区康复治疗方案,以期最终达到功能恢复。发病3个月后进行第三次康复评定,发病6个月后进行第四次评定,以观测社区康复治疗的效果,并探索适合中国国情的脑血管意外后偏瘫患者的康复治疗模式。     

颈椎病治疗成绩评分表

关于颈椎病疗效评定,目前尚缺乏客观标准,为了量化评定治疗前后颈椎功能改善状况,我们制定了“颈椎病颈椎功能评定表”,于2000年开始在临床试用,在临床应用中进行了多次修改和完善,制定了新的评分表。该表包括三部分：第一部分由临床症状、临床检查、日常生活动作、自我满意程度四大项目组成,可根据治疗前后评分,计算改善指数和／或改善率;第二部分为VAPS评定;第三部分为影像学资料,包括X线片、CT、MRI。我们认为该表具有较好的临床实用价值,值得推广应用。     

不同原因导致精神损伤司法鉴定相关分析

目的探讨精神损伤的原因及司法鉴定程序、标准等相关问题。方法对94例涉及精神损伤被鉴定案例的鉴定资料进行回顾性分析，对器质性精神损伤及功能性精神损伤的相关问题进行讨论。结果重型及中型颅脑损伤所致精神损伤以智能障碍为主，轻型颅脑损伤以应激障碍及神经症样症状为主，二者比较有极显著性差异（x^2=51．658，P〈0．01）。功能性精神损伤以创伤后应激障碍、反应性精神病、癔症居多。损伤的因果关系评定：直接关系与间接关系有极显著性差异（X。。39．00，P〈O．01）。结论导致精神损伤的原因较多，鉴定内容广泛，制定全国统一的精神损伤评定标准刻不容缓。     

脑卒中后肢体运动功能障碍的康复评定与治疗

运动功能障碍是脑卒中患的常见症状，严重地影响了患的生活质量，因此对脑卒中后偏瘫患进行积极、及时的康复治疗十分重要。采用康复评定TEAM会的形式，对具体的脑梗死后偏瘫患进行讨论、分析，制定合理的康复治疗方案，对患进行积极治疗。治疗1个月后，再次对患进行疗效及功能评定，并制定出患后期所需接受的社区康复治疗方案，以期最终达到功能恢复。发病3个月后进行第三次康复评定，发病6个月后进行第四次评定，以观测社区康复治疗的效果，并探索适合中国国情的脑血管意外后偏瘫患的康复治疗模式。     

颅脑损伤后运动功能障碍的康复评定

章主要总结了颅脑损伤后运动功能障碍的表现形式。介绍了颅脑损伤后运动功能的评定，异常肌张的评定以及共济失调障碍和手足徐动障碍的评定。     

日常生活自理能力情景图示评定方法的设计

目的 设计符合国人文化和生活习惯,且能够准确、直观、便捷地评定功能障碍者日常生活自理能力的评定方法。 方法 在对1900名肢体残疾人调查的基础上,结合普通人的活动范围,将功能障碍者分为床上功能障碍者,家庭功能障碍者和社会功能障碍者。设计相应的指标来评定在同一个活动范围内的功能障碍者日常生活自理能力的差异,并设计日常生活自理能力的划分标准和评定的流程。 结果 设计并制作出龙氏日常生活自理能力评定量表。 结论 龙氏日常生活自理能力评定量表的评定内容通俗易懂,真实可信,且评定过程简单,有标准化的流程,易于操作。     

我国主要残疾评定标准分析

根据2 0 0 1年世界卫生组织出版的《国际功能、残疾和健康分类》(InternationalClassificationofFunc tioning ,DisabilityandHealth ,ICF)所述,残疾包括身体结构或功能损伤、身体活动受限或参与的局限性。我国各有关部门根据其工作要求和需要,各自制定了相关的残疾评定标准,据统计有十余种之多。现对部分仍在应用的评残标准,尤其是涉及肢体残疾的标准进行分析、探讨。1本文涉及的评残标准本文所涉及的评残标准有:①1986年国务院批准的《全国残疾人抽样调查五类残疾标准》[1] ;②1989年由民政部颁布的《革命伤残军人评定伤残等级的条件…     

脑卒中智能康复评定编辑系统的设计与实现

介绍脑卒中的智能康复评定编辑系统的开发和使用情况，全面纪录病人的各种功能障碍，用来规范康复评定纪录和治疗计划，使其成为电子病例的一部分。     

脑性瘫痪功能量雷达图的设计和80分评定方法

功能康复是脑瘫治疗的最终目的,由于不少脑瘫病人除了有较严重的肢体功能障碍外,还合并有不同程度的弱智、语言障碍、视听觉障碍、生长发育迟缓、癫痫和行为情绪异常等等。因此,目前国内外对脑瘫功能评定逐渐趋向于综合性评估,象日本Ｓ-Ｍ社会生活能力检查、儿童适应行为量表（Ｃｈｉｌｄｒｅｎ＇ｓＡｄａｐｔｉｖｅＢｅｈａｖｉｏｒＳｃａｌｅ，ＣＡＢＳ）等等,均能较全面地评估病人的社会生活能力。但它们内容繁多、操作复杂、重复性差,检测认识能力的内容较多,检测肢体功能的内容较少,因此它较适合于脑瘫物理康复和智力开发的功能评估,尤…     

Interprofessional education for the quality use of medicines: Designing authentic multimedia learning resources

It is claimed that health care students who learn together will be better prepared for contemporary practice and more able to work collaboratively and communicate effectively. In Australia, although recognised as important for preparing nursing, pharmacy and medical students for their roles in the medication team, interprofessional education is seldom used for teaching medication safety. This is despite evidence indicating that inadequate communication between health care professionals is the primary issue in the majority of medication errors. It is suggested that the pragmatic constraints inherent in university timetables, curricula and contexts limit opportunities for health professional students to learn collaboratively. Thus, there is a need for innovative approaches that will allow nursing, medical and pharmacy students to learn about and from other disciplines even when they do not have the opportunity to learn with them. This paper describes the development of authentic multimedia resources that allow for participative, interactive and engaging learning experiences based upon sound pedagogical principles. These resources provide opportunities for students to critically examine clinical scenarios where medication safety is, or has the potential to be compromised and to develop skills in interprofessional communication that will prepare them to manage these types of situations in clinical practice.     

醋酸氯己定体外抗菌作用的实验观察

目的观察醋酸氯己定体外抗菌作用。方法采用肉汤稀释法,测定了醋酸氯己定对4种条件致病菌和一种厌氧菌的抗菌效果。结果醋酸氯己定对脆弱拟杆菌MIC为4μg/ml,MBC为8μg/ml;对产气荚膜梭菌的MIC为1μg/ml,MBC为2μg/ml。醋酸氯己定对金黄色葡萄球菌MIC为0.0625μg/ml,MBC为0.125μg/ml;对大肠埃希菌MIC为2μg/ml,MBC为4μg/ml;对铜绿假单胞菌MIC为4μg/ml,MBC为4μg/ml;奇异变形杆菌MIC为8μg/ml,MBC为8μg/ml。结论醋酸氯己定对常见条件致病菌和厌氧菌都有良好的体外抗菌作用。     

Policy analysis: a framework for nurse managers

The lack of involvement of nurses in the policy process is an issue of concern which has resulted in calls for nurses to become more active in this area of activity. However, what is often less clear is precisely how this can be done. This paper presents a template for policy analysis which can be used by nurse managers. The nature of policy and policy analysis is explored to provide a broad context for the discussion and the need for managers and nurse managers in particular to be 'policy competent' is established, as a prerequisite for effective management. There is also an examination of policy analysis in nursing which demonstrates why a range of approaches to the analysis of policy is needed. Based on this, a particular framework for policy analysis which can be used by nurse managers is presented. The overall purpose of the paper is to encourage debate in this area and contribute to the development of a specific tool for policy analysis that may help ensure a nursing management perspective informs policy formation and implementation.     

Preparedness for Influenza Pandemic in Hong Kong Nursing Units

BACKGROUND: To present preparedness planning for an influenza pandemic for two nursing subunits: nursing services in hospitals and schools of nursing in universities. DISCUSSION: The preparedness plan is modeled on a modified Haddon matrix, a logical approach to identify measures appropriate for the pre-event, event, and postevent phases of an influenza pandemic. For the pre-event phase, the objective is to ensure preparedness for the potential pandemic outbreak through training, communication, surveillance, infection control, and vaccination. Once the pandemic outbreak is declared, the aim is to implement effective measures to ensure a rapid and appropriate response. For the postevent phase, the plan is focused on the restoration of core functions, vigilance for a second or possibly more waves of the pandemic, and psychosocial support to staff and students. CONCLUSION: Measures required to prepare for, respond to, and manage the consequences of influenza pandemic are identified. This planning indicates the need to balance a logical approach with contextual perspectives and the importance for nursing leaders to develop plans for subunits of larger entities.     

社区康复与“人人享有康复服务”目标的实现

康复是广大残疾人有别于其他弱势群体的最迫切、最急需解决的现实问题。做好残疾人康复工作是改善残疾人基本生活状况、增强社会参与能力的基础,而社区康复是实现残疾人人人享有康复服务目标的关键。只有实现康复在社区,服务在家庭,才能实现人人享有康复服务的目标。     

Defining ‘competency’ in nursing (part II): an analytical review

? The reason for the present uncertainty in defining nursing competency is analysed. ? The prevailing educational philosophy underpinning nursing preparation for competence is subjected to a critique. ? The effect and outcome of this philosophy on clinical supervision, PREP and the law are considered in relation to nursing competence. ? It is concluded that because nursing competency is only vaguely and broadly defined, preparation and assessment of competency is haphazard and unstructured; and hence a potential safety hazard for both patient and nurse. ? It is suggested that the UKCC needs to assume responsibility for ascertaining nursing competence; and a four-point framework is proposed for setting and testing national standards of nursing competency.     

Review article: Hypertonic saline use in the emergency department

Hypertonic saline (HS) is being increasingly used for the management of a variety of conditions, most notably raised intracranial pressure. This article reviews the available evidence on HS solutions as they relate to emergency medicine, and develops a set of recommendations for its use. To conclude, HS is recommended as an alternative to mannitol for treating raised intracranial pressure in traumatic brain injury. HS is also recommended for treating severe and symptomatic hyponatremia, and is worth considering for both recalcitrant tricyclic antidepressant toxicity and for cerebral oedema complicating paediatric diabetic ketoacidosis. HS is not recommended for hypovolaemic resuscitation.     

Applications of gene therapy for familial amyloidotic polyneuropathy

Familial amyloidotic polyneuropathy (FAP), caused by mutated transthyretin (TTR), is the common form of hereditary generalised amyloidosis. As TTR is predominantly synthesised in the liver, liver transplantation is now considered an effective treatment for FAP to halt the production of variant TTR. However, this invasive therapy has several problems, leading to a requirement for a non-invasive treatment to be developed. At present, gene therapy for FAP has focused on two therapeutic strategies for suppressing variant TTR gene expression. The first is inhibition of variant TTR mRNA expression by antisense or ribozymes, and the other is the repair of mutated TTR gene by chimaeraplasts or single-stranded oligonucleotides. In particular, targeted gene repair is considered to be a promising tool for gene therapy because the effect can last permanently and the method is more suitable for proteins with a short plasma half-life. This article summarises the general concept of gene therapy and reviews the recent data on gene therapy for FAP.     

Clinical biochemistry education, training and continuing professional development in the United Kingdom

Education and training to become a senior professional in UK clinical biochemistry is coordinated at national level and is largely dependent upon completion of the MRCPath examination. The number of training commissions is regulated to accord with workforce planning requirements. Both medical and science graduates are eligible to undertake this training and the core curriculum is similar for both groups. Medical trainees have the option of including additional clinical training in metabolic medicine. Increasingly, with the introduction of new methods of assessment, the MRCPath examination is becoming a measure of competence rather than knowledge. Structured CPD is mandatory for career grade doctors and scientists as part of the requirements for them to maintain their individual licence to practice and in order that the laboratory in which they work may be accredited. The education, training and assessment of trainees in clinical biochemistry enable the production of a flexible workforce that is competent and designed to be fit for purpose. The requirement for structured CPD is one part of maintaining competence.     

多发性骨髓瘤的实验室诊断指标对临床治疗和预后的意义

目的探讨多发性骨髓瘤（MM）的常见实验室诊断指标对分型、治疗和预后的意义。方法观察40例MM患者骨髓细胞形态及细胞化学染色情况,并进行血清蛋白电泳、免疫固定电泳及血清β2-微球蛋白（β2-MG）、乳酸脱氢酶（LDH）检测。结果 MM患者的骨髓瘤细胞具有较高的异质性,酸性磷酸酶染色（ACP）,酸性α-醋酸萘酚酯酶染色（ANAE）,过典酸-雪夫染色（PAS）对骨髓瘤细胞分型具有鉴别诊断意义;血清蛋白电泳M蛋白检出率为84.0%,59.0%出现在γ区,25.0%出现于β与γ区间,16.0%出现于β区;免疫固定电泳对M蛋白检出率为95.0%,其中IgG型55.0%I、gA型25.0%、轻链型15.0%;LDH检测显示ISS分期Ⅰ期、Ⅱ期、Ⅲ期对应MM患者的LDH平均值分别为198.70 U/L2、32.34 U/L3、61.67 U/L,与血清β2-MG有较好的平行性。结论骨髓细胞形态与细胞化学染色对MM有鉴别诊断意义;免疫固定电泳对M蛋白检出率高于血清蛋白电泳,且前者对MM的临床分期及预后更具有临床意义;血清β2-MG与LDH的含量与MM患者病情呈正相关,可作为临床疗效及预后判断指标。