影响周围性面神经麻痹预后的相关指标

目的探讨影响周围性面神经麻痹预后的相关指标。方法对109例周围性面神经麻痹患者行面神经病变定位、House-Brackmann(H-B)分级及神经电生理检查。随访半年,以H-B分级法评估预后,分为预后好组(1~2级)及预后差组(3~6级),两组的临床及电生理指标行统计学处理。结果根据H-B分级法,将患者分为预后好组89例,预后差组20例。与预后好组比较,预后差组年龄及入院时H-B分级4级的比率显著升高,入院时H-B分级3级的比率显著降低(均P0.001)。预后好组及预后差组膝状神经节、面神经管镫骨神经以上、面神经管镫骨神经以下、茎乳孔以外病变比率依次增高和降低,且预后差组膝状神经节病变比率显著高于,茎乳孔以外病变显著低于预后好组(均P0.001)。预后差组患侧面神经复合动作电位(CMAP)潜伏期、波幅下降比及F波消失率显著高于,波幅显著低于预后好组(均P0.001)。年龄(OR=2.545,95%CI:1.155~5.608,P0.05)、面神经病变部位(OR=0.178,95%CI:0.075~0.426,P0.01)、患侧面神经CMAP潜伏期(OR=1.843,95%CI:1.574~9.271,P0.05)及波幅下降比(OR=2.447,95%CI:0.577~5.631,P0.05)是预后差的独立影响因素。结论年龄、面神经病变部位、患侧面神经CMAP潜伏期及波幅下降比是周围性面神经麻痹患者预后差的独立影响因素。     

表面肌电生物反馈对急性脑梗死偏瘫患者下肢功能恢复作用观察

目的分析表面肌电生物反馈疗法对急性脑梗死(ACI)偏瘫患者下肢功能恢复的作用。方法选取ACI偏瘫患者60例,随机分为对照组及治疗组,其中对照组30例,治疗组30例。对照组患者给予神经内科常规药物治疗及常规康复治疗,治疗组在对照组治疗基础上加用表面肌电生物反馈治疗,于治疗前及治疗后4w分别进行简化Fugl-Meyer下肢运动功能评分、Fugl-Meyer平衡量表评分及日常生活能力的Barthel评分。结果两组患者于治疗前各项评分差异无统计学意义,经治疗4w后两组患者的各项评分均有所改善(P<0.05),且治疗组优于对照组(P<0.05)。结论应用表面肌电生物反馈治疗能有效改善ACI偏瘫患者的下肢运动功能,促进偏瘫患者肢体功能恢复,提高患者的生活自理能力。     

操作性肌电生物反馈对脑血管病后上肢远端肌力恢复分析

目的探讨操作性肌电生物反馈对脑血管病后偏瘫肢体肌力恢复疗效。方法将60例脑血管病后偏瘫病人分治疗组(30例)和对照组(30例)。治疗组在普通内科药物治疗基础上加用操作性肌电生物反馈治疗;对照组仅拥普通内科药物治疗。2组均与治疗前及治疗后28d行Carroll上肢功能评分并进行疗效评定。结果治疗组总有效率86.67%,对照组为56.67%,治疗组疗效优于对照组(P<0.05)。结论操作性肌电生物反馈治疗能有效改善偏瘫病人肢体肌力,疗效较好。     

表面肌电生物反馈治疗早期脑卒中后吞咽障碍的疗效观察

目的 探讨表面肌电生物反馈治疗早期脑卒中后吞咽障碍患者的疗效。方法 选取2021年9月至2023年3月就诊于河北医科大学第二医院康复医学二科的早期脑卒中后吞咽障碍患者(PSD)88例,并随机分为对照组(44例)、观察组(44例)。其中出血性脑卒中患者9例,年龄范围54～75岁,平均年龄65岁,病变部位为基底核2例,皮质2例,多发性5例;缺血性脑卒中患者79例,年龄范围38～75岁,平均年龄59.01岁,病变部位为基底核7例,皮质14例,脑干21例,小脑2例,多发性32例。给予对照组传统的吞咽康复治疗(包括直接治疗以及间接治疗)和vitalstim神经肌肉电刺激疗法;观察组在对照组的基础上给予表面肌电生物反馈(sEMG-BF)治疗。治疗前后两组患者均采用洼田饮水试验、功能性经口摄食量表(FOIS)、表面肌电图(sEMG)、舌压计进行评估。结果 两组患者的洼田饮水试验分级、FOIS评级、sEMG峰值、舌压均较治疗前有所增高(P <0.05),颏下肌群吞咽时程均有所减少(P <0.05),且观察组优于对照组(P<0.05)。结论 表面肌电生物反馈治疗能很大程度的改善早期脑卒...     

肌电生物反馈治疗手足口病合并急性弛缓性麻痹患儿的疗效

目的研究肌电生物反馈治疗手足口病合并急性弛缓性麻痹患儿的疗效。方法将48例手足口病合并急性弛缓性麻痹患儿随机分为肌电生物反馈治疗组(常规康复治疗基础上联合肌电生物反馈治疗)及对照组(常规康复治疗),分别在康复治疗前、治疗1个月后采用表面肌电分析系统评估患侧肢体肌力。结果常规康复结合肌电生物反馈治疗对手足口病合并急性弛缓性麻痹患儿患侧三角肌、股四头肌的表面肌电信号相比仅给予常规康复治疗者有明显差异。结论肌电生物反馈结合常规康复治疗可提高手足口病合并急性弛缓性麻痹患儿患侧肌力,改善患侧肢体运动功能。     

肌电生物反馈联合电针治疗急性脑梗死后运动障碍疗效评价

目的观察肌电生物反馈联合电针治疗急性脑梗死后运动障碍的临床疗效。方法选取2010-05—2013-06收治的急性脑梗死患者146例,随机分为观察组与对照组,对照组实施常规药物治疗及康复训练,观察组在此基础上实施肌电生物反馈联合电针治疗,观察2组临床疗效。结果 2组患者治疗后运动功能、神经功能缺损以及生活质量等评分均有明显改善,且观察组患者改善程度明显优于对照组,差异有统计学意义(P<0.05)。结论对急性脑梗死患者实施肌电生物反馈联合电针治疗,能够有效改善神经功能情况,减少运动障碍,提高生活质量,具有较高的临床价值。     

脑梗死后足下垂肌电生物反馈疗效观察

目的观察肌电生物反馈联合按摩对脑梗死后足下垂患者下肢运动功能临床疗效方法选取脑梗死后足下垂患者60例,采用随机数字表法分为按摩组和肌电生物反馈联合按摩组,每组30例。按摩组给予按摩和其他常规康复治疗;肌电生物反馈联合按摩组增加肌电生物反馈治疗,余治疗同按摩组。2组均于治疗前、后分别进行胫前肌表面肌电(sEMG)信号采集、踝关节主动活动度(AROM)、肌力测定。结果治疗前,2组各项指标组间比较,差异均无统计学意义(P0.05);治疗后,肌电生物反馈组各项指标与组内治疗前及常规康复组治疗后比较,差异均有统计学意义(P0.01)。结论肌电生物反馈联合按摩对脑梗死后足下垂患者疗效明显,值得临床推广。     

肌电生物反馈治疗脑卒中患者运动功能障碍的疗效观察

目的观察在进行常规药物治疗的同时,早期使用肌电生物反馈疗法辅助治疗脑卒中患者运动功能障碍的疗效。方法对我科2008年5月至2010年1月收治的105例脑梗死及脑出血住院患者进行回顾性分析。其中治疗组55例住院期间使用肌电生物反馈疗法辅助治疗14d。对照组50例未做辅助治疗。两组患者于治疗前后进行简式Fugl—Meyer运动功能评定（FMA）并进行统计分析。结果两组运动功能恢复比较显示治疗组改善较对照组明显,统计学分析差异有显著性（P〈0．01）。结论本研究结果表明在进行常规药物治疗的同时,早期使用肌电生物反馈疗法辅助治疗脑卒中偏瘫患者有明显疗效,有利于患者运动功能的康复。     

肌电生物反馈联合康复训练对脑卒中偏瘫患者下肢运动功能的影响

目的探讨肌电生物反馈治疗联合康复训练对脑卒中偏瘫患者下肢运动功能的影响。方法将60例脑卒中偏瘫患者分为对照组(30例)和治疗组(30例)。两组均给予神经内科药物及康复训练,治疗组同时增加患侧下肢肌电生物反馈训练。同一治疗师分别于治疗前和治疗4 w后评定两组患者Fugl-Meyer下肢运动功能评分(FMA-L)、改良Barthel指数(MBI)、Fugl-Meyer平衡功能评分、胫前肌最大收缩时肌电积分(i EMG)值,并进行统计学分析比较。结果治疗前,两组患者各项指标组间比较,差异无统计学意义(P>0.05);治疗后,两组治疗前后比较均有显著性差异(P<0.01);治疗组4 w后Fugl-Meyer下肢运动功能评分、MBI、Fugl-Meyer平衡功能评分和i EMG值恢复优于对照组(P<0.05、P<0.01)。结论肌电生物反馈治疗能明显改善偏瘫患者下肢运动功能。     

肌电生物反馈对脑卒中后吞咽神经损伤患者吞咽功能恢复的作用

目的分析肌电生物反馈疗法对脑卒中后吞咽神经损伤患者吞咽功能恢复中的促进作用。方法选取2010-01—2014-08我院收治的86例脑卒中后吞咽障碍患者为研究对象,随机分为观察组与对照组各43例,对照组进行常规吞咽训练,观察组在此基础上加用肌电生物反馈治疗,2个疗程后进行疗效评价。结果 2组患者治疗前FIOS分级与洼田饮水试验吞咽功能评级情况大致相同(P0.05),治疗后观察组FIOS分级和洼田饮水试验功能评级改善情况远好于对照组(P0.05)。结论肌电生物反馈通过反复训练,帮助患者掌握吞咽动作与技术,为患者提供快速准确的行为疗法,对脑卒中后吞咽神经损伤患者的吞咽功能恢复具有显著疗效,值得临床推广。     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

Bibliography of officers of department of mental hygiene

Psychiatric Quarterly -     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.