Quantifying intra-limb coordination in walking of healthy children aged three to six

The aim of this study was first to quantify intra-limb coordination and then to explore the gender differences of 180 healthy children aged 3–6. The children's joint Euler angles and angular velocities were measured and were used to calculate the phase angle (PA) and continuous relative phase (CRP). Firstly, a portrait of the mean and standard deviation (SD) of PA and CRP was applied to quantify coordination in the knees and ankles; then five key events in walking were selected and their inter-age differences were assessed by One-way ANOVA. Finally, gender differences were evaluated by GLM-Univariate. The significance level was 0.05 and confidence interval was 95%. Our results show that similar portraits of PA and CRP were found for knees and ankles from age 3–6; SD demonstrated that the PA and CRP in the knees and ankles were consistent with the increase in age. Moreover, θ_CRP(K-A) demonstrated that the direction reversal in heels off of those two joints in children aged 5 and 6 was earlier than those of age 3 and 4 and no inter-age significant differences were recorded for PA and CRP in either gait event. Finally, gender differences exist before the age of six, particularly in the transition period such as heel contact, toe off and during the mid swing. Overall, although further development such as gait control or balance is still improving, basic principle of intra-limb coordination has formed by the age of 3 and gender differences already existed before age of 6.     

Examination of stride-to-stride independence of selected lower extremity kinematic and temporal variables during treadmill walking

The purpose of this study was to examine the nature of the intra-subject independence among strides during treadmill walking. We investigated the strength of the relationships among strides sampled in different ways from a population of observed strides. Eighteen asymptomatic subjects walked on a treadmill at 1.4 ± 0.1 m/s. Maximum angles and ranges of motion from the ankle, knee and hip joints, as well as stride duration were obtained and autocorrelation coefficients (AC) for 3 lags were calculated among 12 strides sampled consecutively (CS), in order but non-adjacently (NA), and randomly (RA). Ninety-nine percent of AC values were within Bartlett's 95% confidence interval limits and thus the strides were not considered significantly autocorrelated. The results support the hypothesis that strides obtained from an individual walking on a treadmill can be statistically independent. This supports the theoretical assumption that in some circumstances humans can be modeled as random sample generators due to inherent movement variability. The ability to assess statistically clinical intervention provides objective rigor for evaluating rehabilitation outcomes.     

农民高血压防治干预效果分析

目的：探索农民高血压防治策略．提高农民生活质量。方法：通过基线调查、综合干预、现场评估等手段,评价农村社区高血压患者的随访干预效果。结果：干预后,10．41％的患者血压降至正常水平,1级、2级、3级高血压病人比例明显下降;规律药物治疗率由13．04％提高到36．35％,不规律服药和不服药患者比例下降明显;患者饮酒和饮食口味偏咸等生活习惯分别由42．81％、36．29％下降至32．08％、26．79％,适量运动比例由31．44％上升到40．10％;每年至少测量1次血压由57．36％上升至99．32％,认为缺少运动、精神紧张、大量饮酒和吃盐多是高血压危险因素的知晓率分别由21．74％、26．59％、41．81％和22．41％上升至28．67％、32．25％、49．32％和32．08％。干预前后各项指标比较有统计学意义。结论：随访干预对高血压患者的血压控制效果显著,对高血压综合防治具有积极意义,是值得全面推广的防治策略。     

多索茶碱联合吸入用复方异丙托溴铵溶液治疗60例支气管哮喘急性发作的疗效和安全性

目的:观察多索茶碱联合吸入用复方异丙托溴铵溶液治疗60例支气管哮喘急性发作的疗效和安全性。方法:将某院收治的60例支气管哮喘急性发作患者以抛币法均分为2组,对照组和治疗组均30例。对照组给予吸入用复方异丙托溴铵溶液等常规疗法治疗,治疗组给予多索茶碱联合吸入用复方异丙托溴铵溶液进行治疗。对2组患者治疗前后的PaO₂、PaCO₂两种常见临床主要血气指标的进行统计分析,并对患者治疗前后肺功能分析情况进行分析。统计2组患者整体疗效评价情况及治疗后不良反应情况。结果:治疗前,2组患者PaO₂、PaCO₂、FEV1、FEV1/FVC和PEF等指标比较无明显差异(P>0.05),治疗后2组血气指标和肺功能指标均得到显著改善(P<0.05)。治疗后,治疗组患者的PaO₂指标明显高于对照组,且治疗组患者的PaCO₂指标明显低于对照组,FEV1、FEV1/FVC和PEF三种主要肺功能指标明显高于对照组(P均<0.05)。治疗组总有效率为93.33%明显高于对照组的76.66%(P<0.05)。治疗组发生胃肠道反应、神经系统亢奋和过敏反应等不良反应情况的患者例数明显少于对照组,差异有统计学意义(P<0.05)。结论:多索茶碱联合吸入用复方异丙托溴铵溶液可有效治疗支气管哮喘急性发作患者,显效迅速,不良反应少,安全性高。     

马大正治疗月经病常用药对举隅

介绍马大正主任医师运用药对治疗月经病的临床经验。认为山药—鸡内金健脾通经治闭经,降香—旋覆花降气活血以通经,猪苓—茯苓利水渗湿以止血,花蕊石—阳起石化瘀止血治血证,醋—地榆清热凉血以收敛,川芎—白酒行气活血而祛瘀。并举医案以例证。     

人工耳蜗植入术后NRT与EABR动态变化研究

目的观察人工耳蜗植入后短期神经反应遥测（neural response telemetry,NRT）、电诱发听性脑干反应（electrically auditory brainstem response EABR）的动态变化,探讨人工耳蜗植入术后神经传导通路的动态变化。方法：对12例极重度感音神经性聋患者分别于人工耳蜗植入术后1月（开机）及术后2月（开机1月）行NRT、EABR检测,观察NRT、EABR阈值及EABR波v潜伏期变化。结果：术后1月及术后2月NRT阈值无显著性差异（P〉0．05）;术后2月与术后1月相比,20号电极EABR阈值显著降低（P〈0．05）、EABR波V潜伏期显著缩短（P〈0．05）。10号、3号电极在两个不同时间点EABR阈值、EABR波V潜伏期均无显著性差异（P〈0．05）.结论：人工耳蜗植入术后短期内,NRT阈值变化不明显,而EABR阈值、波V潜伏期在发生变化,提示人工耳蜗术后患者的听觉神经传导通路具有动态变化趋势。     

1例万古霉素导致儿童药物热的药学监护

目的:探讨万古霉素导致药物热的药学监护要点。方法:临床药师参与1例儿童使用万古霉素所致药物热的会诊及用药干预,并对万古霉素所致药物热文献进行检索分析。结果:万古霉素致药物热可能与免疫球蛋白E(IgE)介导的变态反应相关,其发热出现时间为用药开始后1~15 d,停药后体温3 d内恢复正常。结论:万古霉素所致药物热时有发生,临床医师和临床药师在临床工作中对此要有警觉性,尤其应及时区分药物热和感染热,正确诊断并采取相应的干预措施。     

永嘉县农村高血压流行病学调查分析

目的：了解永嘉县农村高血压病流行现状。方法：采用整群抽样方法，抽取永嘉县6个行政村35岁以上常住村民进行高血压流行病学调查，应用SPSS13．0统计软件分析。结果：高血压患病率为38．26名；高血压患病率与性别、年龄、文化程度、农业劳动、高血压家族史、精神因素等有关；良好饮食和慢性病相关知识知晓率足高血压的保护因素。结论：永嘉县农民高血压患病率非常高，需要通过提高农民健康知识水平等干预手段降低高血压患病率。     

剪切应力对椎体终板的影响

目的:通过建立剪切应力加载椎间盘的在体动物模型,探索剪切应力与椎体终板退变间的关系。方法:设计剪切应力加载装置(夹持于L4、L5椎体),用于研究剪切应力加载下LA/5椎体终板的变化。选用38只成年雌性日本大耳白兔,随机分成4组。A组(n=10)加载50N的剪切力4周;B组(n=10)加载50N的剪切力8周;C组(n=10)为对照组,只置入加载装置但不加载剪切力,置入加载装置时间为8周;D组(n=8)为非手术空白组。在4周或8周时将各组兔子全麻后进行X线及MRI检查,对透视下椎体终板变化和MRIT2加权像上椎间盘信号强度的改变情况进行观察分析。检查完毕后处死动物取材(兔L4/5椎间盘及椎体终板),固定后HE染色观察椎体终板组织学变化情况,分析剪切应力对椎体终板和椎间盘退变的影响,并行micro-CT检测,通过计算孔隙率(1-相对骨体积)分析剪切应力对椎间盘渗透率的影响。结果:X线观察发现造模后4周(A组)椎间隙开始出现狭窄,椎体终板尚平整,钙化不明显。第8周时(B组)椎间隙狭窄明显,椎体终板出现不同程度钙化,表面不平且发生轻微移位;相对于对照组(C、D组),A、B组椎间隙明显狭窄,两组MRI(T2加权像)椎间盘信号明显降低。HE染色检查发现A、B组椎体终板组织排列紊乱,病理性增生。micro-CT检测计算孔隙率发现A组实验节段范围为28.4%~37.0%,较B组(范围为26.2%~40.0%)无明显统计学差异,但与C、D两组比较可见统计学差异。结论:一定的剪切应力可导致动物椎体终板退变及孔隙率下降,这可能与椎间盘退变有密切的关系。     

SB203580对大鼠再灌注损伤肺细胞凋亡的干预

目的：探讨P38丝裂原活化蛋白激酶（p38MAPK）特异性抑制剂SB203580对再灌注损伤肺细胞凋亡的影响。方法：30只SD大鼠随机分为3组：假手术对照（control,C）组,肺缺血／再灌注（I／R）组,肺缺血／再灌注＋SB203580（S组）;TUNEL法检测肺组织细胞凋亡的改变：免疫组化法检测Bcl-2、Bax蛋白的表达;电镜观察肺组织形态学改变。结果：I／R组与C组比较,Bcl-2蛋白和Bax蛋白表达均明显上调（均P〈0．01）,Bcl-2／Bax比值显著下降（P〈0．01）,凋亡指数（AI）显著增高（P〈0．01）,肺组织超微结构明显异常;使用SB203580后,Bcl-2蛋白表达上调（P〈0．01）,Bax蛋白表达下调（P〈0．01）,Bel-2／Bax比值上升（P〈0．01）,AI显著下降（P〈0．01）,肺组织超微结构异常改变不同程度减轻。结论：SB203580可通过上调Bcl-2蛋白的表达、下调Bax蛋白的表达、调控Bcl-2／Bax蛋白之间的平衡而减轻细胞凋亡,对肺缺血／再灌注损伤发挥积极的防治作用。