卒中后抑郁与神经功能缺损及日常生活能力的相关性探讨

目的探讨脑卒中后抑郁发病率与神经功能缺损程度和日常生活能力的关系。方法对198例住院诊断为脑卒中的患者,在发病1个月时用改良的爱丁堡斯堪的那维亚神经功能缺损评分表和日常生活能力量表进行评分,并根据汉密尔顿抑郁量表评定,分卒中后抑郁(post stroke depression,PSD)和非PSD两组。结果卒中后1月时,PSD的发病率在神经功能缺损组中明显高于神经功能正常组;在生活能力依赖组中PSD的发生率明显高于独立生活能力组。结论脑卒中后PSD的发病率在卒中后有神经功能缺损以及日常生活能力需依赖的患者中较高。     

氟康唑胶囊的人体生物等效性研究

目的评价广州光华药业股份有限公司研制的氟康唑胶囊(受试制剂)与大连辉瑞制药有限公司生产的氟康唑胶囊(参比制剂)的生物等效性。方法20名健康志愿者随机交叉、单剂量口服氟康唑胶囊被试制剂与参比制剂各150 mg,用高效液相色谱法测定血浆中氟康唑浓度。用3P97药动学软件进行参数计算及生物等效性评价。结果受试制剂和参比制剂的主要药动学参数如下:tmax分别为(1.0±0.7)h和(1.7±0.8)h,Cmax分别为(4.0±1.2)mg.L-1和(3.6±1.3)mg.L-1,AUC0-t分别为(132.4±26.5)mg.h.L-1和(138.4±30.8)mg.h.L-1,AUC0-∞分别为(143.7±26.1)mg.h.L-1和(150.2±33.1)mg.h.L-1。氟康唑胶囊受试制剂的相对生物利用度为(97.9±18.3)%。结论对tmax及经对数转换后的Cmax、AUC0-t进行统计分析、方差分析后进行双单侧t检验及90%可信限判断,两制剂具有生物等效性。     

Living donor small bowel transplantation: Literature review 2003–2006

The experience with living donors for intestinal transplantation is limited. However, Intestinal Registry data suggest that the outcomes of the procedure are comparable with those obtained with intestinal transplant from deceased donors. In selected cases, this strategy may have a role in the treatment of patients with irreversible intestinal failure suffering life-threatening complications from total parenteral nutrition. The present review covers most of the published data on this topic between 2003 and 2006, with special reference to living donor intestinal transplantation of pediatric recipients.     

探索中枢神经自身免疫病的精确诊断和治疗

中枢神经自身免疫病是自身免疫异常导致神经系统损害的疾病。这类疾病发病机制不明,临床表现多样,治疗手段单一,最终结局各异,目前诊治面临巨大挑战。随着大数据技术、基因、蛋白组学及影像学新技术的发展,对特定疾病寻找个体化生物标记,寻找治疗新靶点,最终实现精确诊断和个体化治疗逐渐成为可能。本文将结合课题组已开展的工作,探讨中枢神经自身免疫病的精确诊断和治疗。     

强化躯干核心肌群对脑卒中患者躯干控制平衡步行及日常生活能力的康复效果

目的探讨躯干核心肌群训练的强度对脑卒中患者躯干控制、平衡步行及日常生活能力的康复效果。方法选择2017年4月至2018年3月在华中科技大学同济医学院附属协和医院康复医学科住院治疗的90例脑卒中偏瘫患者为研究对象,按照随机数字表法将患者分为A、B、C组,每组各30例,3组患者均在常规治疗基础上联合不同强度的躯干核心肌群训练,其中A组每天训练1次,B组每天训练2次,C组每天训练3次,每次训练30 min,每周5天,共训练3个月。3组患者治疗1个月、2个月和3个月时采用躯干控制能力测试(TCT)、Berg平衡量表(BBS)评价躯干控制能力,采用步行功能评级(FAC)评定平衡步行功能、采用日常生活能力(MBI)评定日常生活能力。比较3组患者上述评分差异。结果治疗前3组患者躯干控制能力、平衡步行功能和生活能力评分比较差异无统计学意义(P> 0. 05),3组患者治疗1个月、2个月、3个月后躯干控制、平衡步行和日常生活能力评分均逐渐提高,差异均有统计学意义(P均<0. 05);且在1～3个月期间躯干控制和平衡能力评分C组高于B组,B组高于A组,差异均有统计学意义(P均<0. 05),但3个月时差异无统计学意义(P> 0. 05)。3组患者步行和日常生活能力在1个月期间组间差异无统计学意义(P> 0. 05),但1个月后C组较B组,B组较A组均有统计学意义(P均<0. 05)。结论强化躯干核心肌力量可以显著提高患者躯干控制、平衡步行和日常生活能力,缩短康复时间。     

Secondary Prevention of Cardiovascular Disease in Older Adults

Atherosclerotic cardiovascular disease is extremely common in older adults and the potential benefits of secondary prevention are perhaps greater in this population than in younger patients. While there is good evidence that secondary prevention efforts are justified in patients up to 80 years of age, limited data are available on secondary prevention in octogenarians and there is no evidence to guide treatment in patients ≥ 90 years of age. Further, the value of secondary prevention may be confounded by prevalent comorbidities, polypharmacy, and limited life expectancy. It is therefore essential that all management decisions be made in relation to individual preferences and goals of care, with understanding by patients that benefits as well as risks may increase with age. Furthermore, research is needed to refine markers to better delineate which older adults are most likely to benefit from preventive therapies.     

Effectiveness of training on the community skills of children with intellectual disabilities

Background: Children with intellectual disabilities often have difficulties in daily tasks, requiring training to increase functional independence. This study measured the effectiveness of community skills training in a telephone task and a shopping task, and examined if community-based training was more effective than classroom-based training. Material and methods: A randomized control trial with 40 children aged 9–11years was completed. Intervention groups attended an eight-week training programme; the control group received no treatment. One intervention group practised skills in local shops. All participants were assessed before and after treatment in a shopping task and telephone task, using task analysis methodology. Results: Data showed a highly statistically significant difference between intervention and control groups in the shopping task (p=0.007); however, there was no significant difference between classroom and classroom supplemented by community-based learning in the shopping task. There was no significant difference between the intervention and control groups in the telephone task. Conclusion: Results suggested that skills training was effective in one of the skill areas with this client group. Further research is required to determine if community-based training is more effective than classroom-based learning.     

Disability in Older Adults 1: Prevalence,Causes, and Consequences

The effects of disability on an aging population's health and welfare are an important issue in gerontological research. The rapid growth of the elderly population and increases in longevity have led to an ongoing debate about whether longer lives can be matched by longer active lives that are free from disability. After a detailed review of current disability literature, the authors discuss the impact of disability in the elderly, defining disability and reviewing three classes of disability—physical, mental, and social. Both subjective and objective disability measures are described, and disability trends and prevalence rates are reviewed and compared cross culturally, by gender, by age, and over time. The path from chronic disease to disability is described and the consequences of living with disability are discussed in terms of family burdens and the increased need for medical care.     

Differences in awareness between persons with left and right hemispheric stroke

Abstract

Aim: The aim of this study was to investigate whether there are any differences in awareness of ability between persons with left and right hemispheric stroke. Methods: The sample consisted of data from the Assessment of Awareness of Ability (A³) database, primarily consisting of clients admitted to occupational therapy services. In total the study included 183 data records from clients, 78 with left and 105 with right hemispheric stroke. Awareness of ability was assessed using the Assessment of Awareness of Ability (A³). Differences in awareness were investigated using t-tests, CI, effect size, and differential item functioning. Results: No significant overall mean difference (t-test = 1.31, p = 0.19) in awareness between left and right hemispheric stroke was identified. However, significant differences (p < 0.05) were identified on three specific items included in the A³. In these cases, persons with right hemispheric stroke showed a more limited awareness. Conclusion: Persons with right hemispheric stroke have more pronounced problems with being aware of limitations in specific ADL performance skills compared with persons with left hemispheric stroke.