Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept

Background and Purpose . Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. Method . A single‐subject experimental study design with ABAA phases was used, and two patients with relapsing–remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self‐report measures and interviews were used. Results . After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as ‘much improved’. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). Conclusion . The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS. Copyright © 2006 John Wiley & Sons, Ltd.     

COPD机械通气病人下呼吸道感染致病菌分布特点

①目的 探讨慢性阻塞性肺病(COPD)病人机械通气后下呼吸道感染致病菌的特点。②方法 取32例COPD并发呼吸衰竭行机械通气病人下呼吸道分泌物做痰细菌学培养，同时做药物敏感试验。③结果 32例病人共分离出菌株76株，阳性率71．7％，其中混合感染10例次。其中革兰阴性杆菌(GNB)58株，占76．3％；阳性球菌10株，占13．2％；真菌8株，占10．5％。常见致病菌以铜绿假单胞菌、鲍曼不动杆菌和肺炎杆菌为主，GNB中铜绿假单胞菌和不动杆菌的耐药率高。④结论 COPD应用机械通气病人下呼吸道感染以革兰阴性杆菌为主，耐药性高。     

老年人肺功能与年龄增长的关系

目的: 探讨60岁以上老人动态肺功能随年龄增长的变化规律及机制.方法: 用日本PM-81型胸描仪对60岁以上老人动态肺功能的各项指标进行测量和分析.结果: 60岁以上老人动态肺功能各项指标均随年龄增加而降低,差异有高度显著性(P<0.01).结论: 60岁以上老人动态肺功能随年龄的增加而降低.其机制主要是呼吸中枢的功能降低,肺和胸廓的弹性阻力、呼吸道的非弹性阻力增加所致.     

茶色素对冠心病及高血压病病人血小板功能的影响

目的：探索茶色素对冠心病、高血压病病人血小板功能的影响。方法：冠心病病人３６例（男性２１例，女性１５例；年龄６４±ｓ４ａ）；高血压病病人３０例（男性１８例，女性１２例；年龄５８±８ａ）。采用茶色素２５０ｍｇ，ｐｏ，ｔｉｄ，３０ｄ为一个疗程。结果：治疗后ＴＸＢ２下降，６－ｋｅｔｏ－ＰＧＰ１α上升，ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值下降（Ｐ＜０．０１或Ｐ＜０．０５），ＧＭＰ－１４０下降（Ｐ＜０．０５），ＰａｇＴ，ＰａｄＴ下降（Ｐ＜０．０５）。结论：茶色素具有降低血小板表面活性作用，抑制血小板聚集和粘附，抗血栓形成，改善微循环，对冠心病和高血压病病人起到积极的防治作用。     

绿茶对小鼠Lewis肺癌生长的抑制及免疫调节

为了研究茶叶防癌作用，以接种Ｌｅｗｉｓ肺癌细胞的Ｃ５７／ＢＬ６Ｊ小鼠为实验模型，研究绿茶对带瘤小鼠肿瘤生长的抑制及免疫调节作用。结果表明，接种Ｌｅｗｉｓ肺癌细胞后，Ｃ５７／ＢＬ６Ｊ小鼠胸腺重量及其指数减轻，Ｔ淋巴细胞ＣＤ４亚群阳性百分数及ＣＤ＋４／ＣＤ＋８比值下降，外周血白细胞本底化学发光降低，受酵母多糖刺激产生的化学发光增高以及脾ＩｇＭ抗体生成细胞数减少。绿茶对小鼠体内Ｌｅｗｉｓ肺癌的生长有明显抑制作用，并对上述各项指标的不良改变有不同程度的保护效果     

An alternative method for significance testing of waveform difference potentials

Guthrie and Buchwald (1991) proposed an ad hoc procedure for assessing the statistical significance of waveform difference potentials that may arise in a variety of psychophysiology research contexts. In our paper, an alternative method is presented and demonstrated that has fewer underlying assumptions than does the Guthrie-Buchwald test and may, therefore, produce better results in some situations. In particular, the test proposed here (a) is distribution free, (b) requires no assumption of an underlying correlation structure (e.g., first-order autoregressive), (c) requires no estimate of the population autocorrelation coefficient, (d) is exact, (e) produces p values for any number of subjects and time points, and (f) is highly intuitive as well as theoretically justifiable. This procedure may be used to carry out multiple comparisons with exact specification or experimentwise error, however, this test is based on permutation principles and may require large amounts of computer time for its implementation.     

Diagnosis and treatment of thoracic outlet syndrome

Patients who develop symptoms of thoracic outlet syndrome (TOS) have a predisposing anatomic abnormality. In most patients with TOS, the symptoms are caused by entrapment of the brachial plexus and they do not arise from compression of the subclavian artery, as was previously thought. The tests advocated for diagnosing this common syndrome (i.e., evaluating the positional compression of the artery when the arms are raised, the neck is turned, or the shoulders are braced) cannot accurately diagnose this syndrome. There are two reasons for this. The symptoms of TOS are not related to the compression of the artery in the outlet in 98% of patients, and 75% of normal individuals without symptoms show diminished radial pulse on various provocation tests. We employed four timed provocation tests (minute tests) to diagnose TOS: the timed Morley test, timed Wright test, timed Eden test, and elevated arm stress exercise, all of which are very sensitive. In normal individuals without symptoms, 20% experience transitional symptoms such as slight pain and tiredness, on these tests indicating a subclinical state. TOS is treated by keeping the thoracic outlet wide, this being done either conservatively or surgically. In 1993 and 1994, we conservatively treated 418 of 422 patients with TOS by means of active exercise, a brace, and by block therapy. These measures did not reduce the symptoms in 23 of these patients, so surgical treatment was indicated. In the remaining 4 of the 422 patients, conservative treatment was not indicated and surgery was performed directly. All the patients showed significant clinical improvement of varying degree. Presented at the 69th Annual Meeting of the Japanese Orthopaedic Association, Tokyo, April 12, 1996     

测定血清及尿β2微球蛋白评估健康老年人肾功能的价值

测定72例健康老年人（60-84岁）和65例健康青中年人（20-50岁）血清和尿β2微球蛋白（β2m)，发现前血清β2m浓度比后明显增高（p<0.001)；老年组≥70岁尿液β2m浓度也明显增高（p<0.05)。结果表明肾小球滤过率下降随年龄增长而降低，以后再出现肾小管功能减退。本试验较血清尿素氮、肌酐和内生肌酐清除率测定更为敏感。     

XD—1型微电脑程序刺激器在心血管病中的临床应用

本文应用XD—Ⅰ型微电脑程序刺激器检查26例患者,在窦房结功能检查中测定了窦房结恢复时间、窦房传导时间及固有心率;在房室传导功能的估计中测定了文氏点,2∶1阻滞点及房室结的有效不应期;在室上性心动过速中测定了旁路不应期,房室结双通道,折返区及折返性心动过速区;还进行了心脏负荷试验及右束支不应期等方面的测定。并就其方法,判断标准及临床意义等分别作了讨论。     

咳嗽变异型哮喘多项检测指标的Bayes判别分析

目的探讨咳嗽变异型哮喘（CVA）肺功能、气道弹性阻力、支气管激发试验、最大呼气峰流量（PEF）日内波动率[△PEFR（％）]、支气管肺泡灌洗液（BALF）细胞学以及血清IgE的变化特点及诊断意义。方法对22例CVA、20例慢性阻塞性肺病（COPD）稳定期患者以及20名健康成年人进行最大呼气流量-容积曲线（MEFV曲线）、气道弹性阻力、支气管激发试验、[△PEFR（％）]、BALF细胞学分析以及血清IgE测定。结果（1）CVA患者呼气流量指标[PEF、一秒用力呼气容积（FEV1）、FEV，／FVC、最大呼气中段流量（MMEF）]与健康对照组比较差异无统计学意义（P〉0．05）。CVA组气道弹性阻力增高，与健康对照组比较差异有统计学意义（P〈0．01），但与COPD组比较差异无统计学意义（P〉0．05）；（2）CVA组患者气道反应性明显增高，支气管激发试验阳性，Mch—PC20-FEV1明显降低、[APEFR（％）]增大（〉20％）、BALF中嗜酸性粒细胞明显增高、血清IgE明显增高与健康对照组及COPD组比较差异有统计学意义（均P〈0．01）。结论气道弹性阻力、支气管激发试验、[APEFR（％）]、BALF细胞学以及血清IgE的测定有助于CVA的诊断且与COPD等的鉴别。根据Bayes判别结果，鉴别CVA与COPD的上述病因学指标作用大小依次为Mch—PC20-FEV1、JgE、[△PEFR（％）]、BALF嗜酸性粒细胞计数、FEV1／FVC、FEV1、PEF、MMEF和气道弹性阻力，其中主要为Mch—PC20-FEV1、IgE、[APEFR（％）]、BALF嗜酸性粒细胞计数。