康复机器人结合康复训练对脑卒中患者步态功能的影响

目的：研究康复机器人结合常规康复训练对脑卒中患者步态功能的影响。方法将60例脑卒中患者按随机数法分为治疗组和对照组,每组30例,对照组给予常规康复训练,治疗组在常规康复训练基础上使用康复机器人训练,两组患者均于治疗前和治疗12周后采用简化Fugl-Meyer运动功能量表（ FMA）评定下肢运动功能、Berg平衡量表（ BBS）评定平衡功能。结果治疗前,治疗组与对照组的FMA、BBS评分组间差异无统计学意义（ P＞0．05）,经过12周的治疗后两组FMA、BBS评分均优于治疗前水平,差异有统计学意义（P＜0．05）,且治疗组FMA、BBS评分均明显优于对照组（P＜0．05）。结论康复机器人可显著改善脑卒中患者步态功能。     

躯干控制能力对脑卒中患者平衡功能的影响

目的：探讨躯干控制能力训练对脑卒中患者平衡功能的影响。方法：80例编瘫患者随机分成治疗组和对照组各40例。两组采用常规康复治疗方法。治疗组同时强调躯干控制能力训练,治疗后两组患者分别采用躯干控制能力（Sheikh）评分、FMA平衡功能评分进行比较,比较两组治疗效果。结果：两组治疗前后比较和组间比较差异均有显著性意义（P（0.05）;两组变化均数比较治疗组优于对照组（P（0.001）。结论：躯干控制能力训练对脑卒中患者平衡功能有良好的促进作用。     

优质护理服务在产科护理中的应用

目的：探讨在产科护理工作中优质护理服务的临床应用效果。方法将妇产科收治的200例孕妇随机分为观察组及对照组两组,依照分组采用不同的护理方案,采用常规护理服务对对照组孕妇进行干预,主要对产妇的焦虑、不安等负面情绪进行护理,指导产妇合理饮食及用药等。观察组孕妇在此基础上行优质护理服务,对两组孕妇的剖宫产率、产后出血率、新生儿窒息率、住院时间、护理满意度、基础护理合格率及孕妇焦虑和抑郁情况进行分析。结果两组患者剖宫产率无显著性差异（P＞0.05）,但观察组产后出血率及新生儿窒息率均显著低于对照组（P＜0.05）;观察组孕妇住院时间显著低于对照组（P＜0.05）,且观察组护理满意度明显高于对照组,且差异具有统计学意义（P＜0.05）,但两组孕妇基础护理合格率差异无统计学意义（P＜0.05）;入院前两组孕妇SAS评分及SDS评分无显著性差异（P＞0.05）,产后7天时观察组孕妇SAS评分及SDS评分均显著降低（P＜0.05）,产后7天时观察组孕妇SAS评分及SDS评分均显著低于对照组（P＜0.05）。结论在产科护理临床工作中,应用优质护理服务进行干预可显著提高临床有效率,并有效帮助孕妇克服不良心理,提高整体满意度。     

高龄晚期胃癌患者不同姑息性介入治疗前后生活质量及焦虑状态的临床观察

【摘要】　目的?观察高龄晚期胃癌患者两种不同姑息性介入治疗对生活质量及焦虑状态的影响,探索对其身心双重治疗的最佳策略。方法?入选62例≥75岁确诊晚期胃癌患者,根据患者及家属治疗意愿,分为动脉灌注化疗栓塞组（TACE组）37例和金属支架置入组（支架组）25例。记录基本临床资料,所有患者术前及术后3、7、28 d进行肿瘤患者生活质量评分（QOL）及汉密尔顿焦虑量表（HAMA）评分。结果?①与术前比较,化疗栓塞组术后3 d QOL评分无统计学差异（P=0.05）,术后7、28 d均升高（P＜0.05）;支架组,术后QOL评分均升高（P＜0.05）。组间比较,术后3 d QOL评分TACE组低于支架组（P＜0.05）;28 d则高于支架组（P＜0.05）。②与术前比较,TACE组术后3 d HAMA评分变化不显著,术后7、28 d显著下降（P＜0.05）;支架组,术后HAMA评分均下降（P＜0.05）。组间比较,术后3 d TACE组HAMA评分高于支架组（P＜0.05）;而28 d则低于支架组（P＜0.05）。结论?两种姑息性介入治疗对高龄晚期胃癌患者在躯体、心理两方面均可获益。支架组患者生活质量和焦虑状态在短期内可迅速改善,而TACE组患者更受益于远期疗效。     

探戈舞蹈锻炼对有近期跌倒史老年患者平衡能力的影响

目的:观察探戈舞蹈锻炼对有近期跌倒史老年患者平衡能力的影响。方法:舞蹈组为35例有近期跌倒史老年患者,志愿参加探戈舞蹈锻炼,每天活动时间大约80～100min,每周至少坚持5天,4个月为1个学期(疗程)。对照组为37例同龄、同性别参与散步活动者,活动形式为匀速平路步行,活动时间相同,速度在50～70m/min,每周活动频度和疗程与实验组相同。两组对象实验前后分别接受Berg平衡量表(BBS)、单腿支撑时间(OLS)、步速、步长、起立-行走测试(TUGT)和平衡功能测试仪评估。结果:(1)两组对象实验前BBS、OLS、步速、步长和TUGT等指标分布接近(P均>0.05),两组实验后BBS、OLS、步速和步长等指标明显上升,而TUGT则明显下降;与实验后对照组比较,舞蹈组BBS、OLS、步长均显著增加,TUGT显著减少(P均<0.01～0.05)。(2)两组实验后睁眼和闭眼左右摆幅指数和单位面积轨迹长等指标明显上升,而外周面积、矩形面积、总轨迹长、单位轨迹长则明显下降;与实验后对照组比较,舞蹈组睁眼和闭眼左右摆幅指数和闭眼单位面积轨迹长显著增加,而睁眼和闭眼总轨迹长、外周面积以及闭眼单位轨迹长则显著减少(P均<0.01～0.05)。结论:与散步活动比较,探戈舞蹈锻炼改善有近期跌倒史老年患者各项平衡能力指标更为明显。     

耳穴贴压对肝癌射频消融患者超前镇痛干预的应用效果研究

【摘要】 目的 观察耳穴贴压对肝癌射频消融（radiofrequency ablation, RFA）患者超前镇痛干预的应用效果。方法 使用试验病例随机编码表,对符合纳入标准的患者随机分成A组、B组、C组,每组50例。A组RFA术前30 min皮下注射吗啡注射液10 mg。B组RFA术前24 h使用耳穴贴压,C组采用吗啡注射联合耳穴贴压。记录术中疼痛程度和术后4、8、12、16、20、24、48和72 h静息性疼痛（NRS评分）、活动性疼痛强度（FAS评级）和CD3+细胞、CD4+细胞、CD4+／CD8+比值变化。 结果 三组患者RFA术后各时间点NRS评分、FAS评级差异均有统计学意义（均P＜0.05）,与A组相比,B组各个时间点NRS评分、FAS评级无差异（均P＞0.05）,C组各个时间点NRS评分、FAS评级明显降低,差异有统计有意义（均P＜0.05）;与B组相比,C组各个时间点NRS评分、FAS评级明显降低,差异有统计有意义（均P＜0.05）。与治疗前比较,治疗后A组、B组CD4+下降（P＜0.05）,C组CD3+、CD4+、CD4+/CD8+比例下降（P＜0.05）;治疗后与C组比较,A、B组CD3+、CD4+降低。 结论 耳穴贴压超前镇痛可有效缓解肝癌RFA术中、术后患者疼痛,对促进机体免疫力提升有待进一步研究。     

本体感觉训练在髌骨骨折术后康复中的应用效果分析

目的 探讨本体感觉训练在髌骨骨折术后康复中的应用效果。方法 选取2019年7月至2021年7月河南大学第一附属医院收治的114例髌骨骨折患者作为研究对象,采用交替分组法将其分为观察组(57例)和对照组(57例),观察组患者张力带内固定术后在常规康复训练基础上行本体感觉训练,对照组患者张力带内固定术后单纯行常规康复训练,对比观察两组患者膝关节功能、平衡能力以及日常生活能力。结果 干预2个月后,观察组患者膝关节主动活动度(AROM)为(118.82±17.46)。,明显大于对照组患者的AROM (99.56±17.80)。(t=5.832,P<0.001);Lysholm评分为(90.13±4.01)分、Berg平衡量表(BBS)评分为(42.58±4.10)分、Barthel指数评分为(84.60±3.27)分,明显高于对照组患者的Lysholm评分(79.53±3.97)分、BBS评分(36.70±3.46)分、Barthel指数评分(80.70±3.09)分(t=14.182、8.275、6.545,P均<0.001)。结论本体感觉训练可明显提高髌骨骨折患者术后膝关节活动...     

足底振动噪声对老年人平衡能力的影响

目的 通过足底振动噪声刺激,提高老年人足底感觉敏感度,改善其平衡控制能力.方法 采用可调频振子作用于足底,利用三维运动跟踪系统对6名老年人及8名年轻人进行了平衡能力测试和评估,提取4个主要评估参量:移动轨迹总距离、最大前后动摇径、最大左右动摇径和身体移动包络面积.分析了在5种测试条件下老年人立位姿势的变化. 结果加振后4个参量均有减弱趋势,其中3个参量(移动轨迹总距离、最大左右动摇径、身体移动包络面积)有明显差异(P＜0.05),而最大前后动摇径未有明显差异(P＞0.05).不同振动频率对老年人平衡控制能力有着不同的影响.结论 微弱的振动噪声刺激,能够改善老年人平衡控制能力,可以利用在足底增加振动刺激的方法对老年人立位平衡能力进行训练.     

滇西不同海拔地区健康人体液免疫和T淋巴细胞亚群水平研究

目的 探讨滇西不同海拔地区健康人群体液免疫和T淋巴细胞亚群水平变化.方法 对在我院健康体检人员按地区海拔高度分为4组：大理组（海拔1970 m）、维西组（海拔2300 m）、香格里拉组（海拔3280 rn）和德钦组（海拔4000m）,采用免疫比浊法检测血清免疫球蛋白IgG、IgM、IgA和补体C3、C4含量,采用流式细胞技术检测静脉血T淋巴细胞亚群CD3＋、CD4＋、CD8＋含量及CD4＋/CD8＋比值.结果 大理组与维西组比较,IgG、IgM、IgA、C3、C4水平相无显著差异（P＞0.05）,大理组和维西组的IgG、IgM、IgA、C3、C4水平明显低于香格里拉组（P＜0.05）,香格里拉组的IgG、IgM、IgA、C3、C4水平明显低于德钦组（P＜0.05）;大理组CD3＋、CD8＋水平明显低于其他3组（P＜0.05）,维西组CD3＋、CD8＋水平明显低于香格里拉组和德钦组（P＜0.05）,香格里拉组CD3＋、CD8＋水平明显低于德钦组（P＜0.05）.大理组与维西组和香格里拉组比较,CD4＋水平无显著差异（P＞0.05）,但明显低于德钦组（P＜0.05）;维西组与香格里拉组比较,CD4＋水平无显著差异（P＞0.05）,但明显低于德钦组（P＜0.05）;香格里拉组CD4＋水平明显低于德钦组（P＜0.05）;结论 滇西不同海拔高度地区健康人群体液免疫和细胞免疫功能变化不同.     

综合训练对偏瘫患者平衡功能及日常生活能力的影响

目的：观察躯干强化结合肋木训练对恢复期偏瘫患者平衡功能及日常生活能力（ADL）的影响。方法：将偏瘫60例随机分为观察组和对照组各30例。对照组采用常规康复治疗,观察组在常规康复治疗的基础上另给予躯干肌强化训练及肋木训练。分别于治疗前后对2组患者躯干控制能力、平衡功能及ADL进行评定。结果：2组患者经6周康复治疗后其躯干控制能力、平衡功能及ADL评分均较治疗前明显著改善（P〈0.01）,且观察组各项指标的改善均显著优于对照组（P〈0.05）。结论：躯干强化结合肋木训练对恢复期偏瘫患者平衡功能及ADL均有促进作用。     

Carotid artery dissection after treadmill running

The case is presented of carotid artery dissection causing Horner's syndrome in a 25 year old woman after treadmill running. She presented with characteristic eye signs and mild pain. Early diagnosis and treatment was associated with no long term, serious complications. It is now recognised that carotid artery dissection is more common than previously thought. Better imaging of the carotid artery has facilitated the diagnosis, and it is now essential to rule out this potentially fatal condition in patients presenting with postganglionic Horner's syndrome. It is accepted that relatively trivial trauma can cause a carotid artery dissection, and many sporting activities may place young, fit, healthy people at risk.     

Ultrasound and Doppler findings in a rare case of Castleman's disease of the parotid

Castleman''s disease of the parotid gland is an extremely rare entity, with fewer than 20 cases reported in world literature so far and only 1 previous case report describing the ultrasound findings. The Doppler findings of parotid Castleman''s disease have never been described before to the best of the authors'' knowledge. This report describes the ultrasonographic and Doppler findings in a histopathologically proven case of Castleman''s disease of the left parotid gland in a young man.     

Intracranial dural metastasis of Ewing's sarcoma: a case report.

Although intracranial dural metastasis of Ewing's sarcoma is a very rare finding, its imaging characteristics are similar to those of its primary form in the central nervous system. Thus, this tumor must be considered in the differential diagnosis of extra-axial dural masses.     

Granulomatosis with polyangiitis: A case report and brief review of literature

Granulomatosis with polyangiitis formerly known as Wegener''s granulomatosis was first described by German pathologist Friedrich Wegener in 1936. It is a multi-system necrotizing noncaseating granulomatous vasculitis which affects small to medium-sized vessels. It can involve any organ system, most commonly the lungs and kidneys. American College of Rheumatology requires 2 of 4 criteria for diagnosis: Positive biopsy for granulomatous vasculitis, urinary sediment with red blood cells, abnormal chest radiograph and oral/nasal inflammation. Here we present a case of Granulomatosis with polyangiitis with brief review of literature.     

Radiographic enlargement of mandibular canal as first feature of non-Hodgkin's lymphoma

Non-Hodgkin''s lymphoma has the propensity to affect non-lymphoid tissue including oral tissue. Primary non-Hodgkin''s lymphoma of the mandible mistreated as chronic periodontitis with diffuse enlargement of the mandibular canal and ice-cold numbness is very rarely described in English medical literature. A 57-year-old patient presented with a painful swelling on the left side of the mandible with a clinically chronic periodontitis associated with ice-cold numbness. A panoramic radiograph showed a diffuse uniform enlargement of the mandibular canal. Histological examination showed that the lesion was a primary intraosseous non-Hodgkin''s lymphoma of the mandible. Immunohistochemical examination showed a positive reaction for CD20+, Ki-67+. Seven months after chemotherapy the patient was observed for possible life-threatening propagation of the disease. In conclusion, primary (extra-nodal) non-Hodgkin''s lymphoma of the mandible usually clinically presents with bone swelling, teeth mobility and neurological disturbance. Radiographic features presenting as diffuse enlargement of the mandibular canal could be considered as non-Hodgkin''s lymphoma.     

Survival estimates for elite male and female Olympic athletes and tennis championship competitors

In this paper, we report survival estimates for male and female Olympic medal winners and for male and female finalists at the British and U S national tennis championships. We find a consistent longevity advantage of Olympic medal‐winning female athletes over Olympic medal‐winning male athletes competing separately in the same events since 1900 and for female finalists over male finalists competing separately in the finals of the national tennis championships of Britain and of the United States since the 1880s. This is the case for sample mean comparisons, for Kaplan–Meier survival function estimates, including life expectancy, and for Cox proportional hazard estimates, which show statistically significant lower hazard rates for women with birth year and other variables constant. The female longevity advantage over males is similar in the early period samples (birth years before1920) and in the full period samples, and is 5–7 years.     

Munchmeyer's disease—a rare case report and review of literature

Munchmeyer''s disease is a rare variety of myositis ossificans. It is a significant clinical entity, diagnosing and understanding its pathophysiology can save a patient from spurious medical workups and anxiety of a suspected neoplasm. The number of authentic cases of this disease in the literature is small. The purpose of this article is to present a case of Munchmeyer''s disease and review the literature for the same to date. The rare incidence, obscure aetiology, unknown definitive treatment plan and poor prognosis make this condition an enigma.     

Gorham's disease: a report of a case with mandibular involvement in a 10-year follow-up study

Gorham's disease, or vanishing bone disease, is a rare condition of unknown aetiology. Any bone of the body can be affected, although there is a predilection for the pelvis, humerus, axial skeleton and the mandible. The mandible is the most commonly involved bone in the maxillofacial region. 41 cases have been reported so far in the literature showing involvement of the mandible in Gorham's disease. This paper presents a rare case of Gorham's disease involving the mandible in a 38-year-old male with a 10-year follow-up.     

Epidemiology of injuries and illnesses in America's Cup yacht racing

Objectives

To determine the incidence and severity of injuries and illnesses incurred by a professional America''s Cup yacht racing crew during the preparation for and participation in the challenge for the 2003 America''s Cup.

Methods

A prospective study design was used over 74 weeks of sailing and training. All injuries and illnesses sustained by the 35 professional male crew members requiring medical treatment were recorded, including the diagnosis, nature, location, and mechanism of injury. The volume of sailing and training were recorded, and the severity of incidents were determined by the number of days absent from both sailing and training.

Results

In total, 220 injuries and 119 illnesses were recorded, with an overall incidence of 8.8 incidents/1000 sailing and training hours (injuries, 5.7; illnesses, 3.1). The upper limb was the most commonly injured body segment (40%), followed by the spine and neck (30%). The most common injuries were joint/ligament sprains (27%) and tendinopathies (20%). The incidence of injury was significantly higher in training (8.6) than sailing (2.2). The most common activity or mechanism of injury was non‐specific overuse (24%), followed by impact with boat hardware (15%) and weight training (13%). “Grinders” had the highest overall injury incidence (7.7), and “bowmen” had the highest incidence of sailing injuries (3.2). Most of the illnesses were upper respiratory tract infections (40%).

Conclusions

The data from this study suggest that America''s Cup crew members are at a similar risk of injury to athletes in other non‐collision team sports. Prudent allocation of preventive and therapeutic resources, such as comprehensive health and medical care, well designed conditioning and nutritional programmes, and appropriate management of recovery should be adopted by America''s Cup teams in order to reduce the risk of injury and illness.