棕榈酸帕利哌酮注射液治疗少年精神分裂症的疗效观察及社会功能的恢复

分析棕榈酸帕利哌酮注射液对社区精神分裂症患者疾病家庭负担及康复等效果的影响。

随机抽取上海市446名使用棕榈酸帕利哌酮注射液的精神分裂症患者,分别采用疾病家庭负担量表、药物治疗依从性简明评定量表、治疗满意度VAS100评分、生存质量测定量表简表、社会功能缺陷筛选量表进行治疗前后的评价,分析患者使用棕榈酸帕利哌酮注射液效果。采用SPSS 26.0软件进行数据统计分析。

使用棕榈酸帕利哌酮注射液后,患者的疾病家庭负担量表总分（13.94±12.17）、家庭日常活动得分（3.26±2.74）、家庭娱乐活动得分（2.21±2.30）、家庭关系得分（2.79±2.76）均明显优于治疗前（14.98±12.64、3.51±2.88、2.48±2.38、3.11±2.87）,差异有统计学意义（P<0.05）。使用棕榈酸帕利哌酮注射液后,世界卫生组织生存质量测定量表简表得分（62.89±11.94）、药物治疗依从性简明评定量表得分（28.11±5.64）均优于治疗前（60.67±12.62、27.37±6.96）,差异有统计学意义（P<0.05）。与使用棕榈酸帕利哌酮注射液前相比,使用后患者的住院人数显著降低（P<0.01）。

棕榈酸帕利哌酮注射液对精神分裂症作用显著,能有效减轻患者的疾病家庭负担,提高患者生存质量,提升患者药物依从性,降低患者住院率,保障长期治疗效果和促进疾病康复。

     

Long-term body-weight-supported treadmill training for incomplete cervical spinal cord injury: a case report

[Purpose] To investigate the effects of long-term body-weight-supported treadmill training on walking ability and physical function in an elderly individual with incomplete cervical spinal cord injury. [Participant and Methods] The patient was a 68 year-old male with an incomplete spinal cord injury at the C3/C4 level, incurred when he was 56 years old. He initiated home-based body-weight-supported treadmill training using a body-weight-supported treadmill installed at his home. His walking ability was measured as the percentage of body weight load reduction, and his physical function was evaluated using manual muscle testing and measuement of the range of motion of his lower limbs. [Results] The physical function of the lower limbs was improved, maintained, or showed delayed decline until 9.5 years post-injury. [Conclusion] Long-term body-weight-supported treadmill training may improve, maintain, or at least delay the decline of the physical function of participants for several years, without causing any remarkable complications.     

中山市社区康复精神病人社区-家庭一体化管理效果评估

目的研究社区康复精神病人社区-家庭一体化管理的效果。方法将家庭支持因素引入现有"市精防院-镇医院-村卫生站"三级管理模式中, 突出家庭支持的重要作用, 收集管理前后精神病人所获得的社会(家庭)支持、综合生存质量和社会危害性等方面所发生的数据变化。结果实施社区-家庭一体化管理后精神病人受到家庭的接纳和照顾(照顾比例由原先的42.24%提高到77.37%), 综合生存质量明显改善(生存质量问卷调查总分均值由开始时的111.21分下降到了管理后的107.96分), 肇事肇祸率降低(年肇事肇祸率由管理前9.91%下降到4.09%), 上述差异有统计学意义(P < 0.05)。结论社区-家庭一体化管理(重视家庭因素的参与)可以明显改善精神病人生存质量和降低肇事肇祸率。     

Psychotic Disorders in Adolescence and Later Long-term Exclusion From Education and Employment

Background and hypothesisPsychotic disorders have been associated with not being in education, employment, and training (NEET). There is a lack of knowledge on the importance of risk markers for NEET among people with psychotic disorders and what rehabilitation they receive.Study designWe based our research on the register-based 1987 Finnish Birth Cohort study, which included all live births in Finland during that year. The study cohort were 288 people who had been diagnosed with psychotic disorders during 2004–2007, when they were 16–20 year old, and 55 883 who had not. We looked at the national register data for those subjects in 2008–2015, when they were 20–28 year old, and compared any associations between sociodemographic factors and NEET status.Study resultsNEET for more than 5 year affected 2.2% of those without psychosis, 35.8% of those with any nonaffective psychotic disorder, and 57.0% of those with schizophrenia or schizoaffective disorders. Family-related risk factors were weaker predictors of long-term NEET in subjects with psychotic disorders than other cohort members. Having a psychotic disorder plus long-term NEET was associated with not applying for upper secondary education, not finishing upper secondary education, parents receiving welfare benefits, being diagnosed with schizophrenia or schizoaffective disorders and being hospitalized for psychosis. Only 24.3% with psychotic disorders had participated in vocational rehabilitation.ConclusionsA diagnosis of psychosis in adolescence is independently associated with serious long term functional disability. Among those with psychotic disorders, educational problems are markers for adverse labor market outcomes. Despite this, vocational rehabilitation is seldom provided.     

The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. Many studies suggest that maintaining normal serum vitamin D levels is associated with improvement of the cardiovascular system and a reduction in stroke risk. As a neurosteroid, vitamin D influences brain development and function and immunomodulation and affects brain neuroplasticity. It supports many processes that maintain homeostasis in the body. As stroke is the second most common cause of death worldwide, more studies are needed to confirm the positive effects of vitamin D supplementation, its dosage at different stages of the disease, method of determination, and effect on stroke onset and recovery. Many studies on stroke survivors indicate that serum vitamin D levels only offer insignificant benefits and are not beneficial to recovery. This review article aims to highlight recent publications that have examined the potential of vitamin D supplementation to improve rehabilitation outcomes in stroke survivors. Particular attention has been paid to stroke prevention.     

盆底康复治疗对不同分娩方式再生育妇女盆底功能的影响研究

目的 探究盆底康复治疗对不同分娩方式再生育妇女盆底功的影响,为促进产妇盆底康复提供相关临床依据.方法 选择2016年1月至2019年12月在潍坊市妇幼保健院分娩的654例二胎产妇进行盆底功能检查,根据分娩方式及初产后是否行盆底康复治疗,分为顺产未治疗组330例,顺产治疗组70例,选择性剖宫产未治疗组204例,选择性剖宫...     

NIHSS评分分组干预模式在脑梗死患者神经康复中的应用价值

目的:研究美国国立卫生研究院卒中量表(NIH stroke scale,NIHSS)评分分组干预模式在脑梗死患者神经康复中的应用价值。方法:收集脑梗死患者100例,采用NIHSS评估患者的神经功能损伤程度,其中58例患者评分数值≥10分,42例患者评分数值<10分,将100例患者分为实验组和对照组,每组50例患者,其中29例评分数值≥10分,21例评分数值<10分。实验组根据评分结果将评分数值≥10分患者和评分数值<10分患者分别进行不同的护理;对照组采用常规护理;比较护理后两组临床疗效、神经功能、生活质量。结果:实验组患者总有效率为94.00%高于对照组76.00%(P<0.05);护理后实验组神经功能、肢体功能、情绪、思维、活动能力评分均低于对照组(P<0.05)。结论:NIHSS评分分组干预模式能够合理分配和利用护理资源,改善患者的神经功能和生活质量。     

Marginal bone level change during sequential loading periods of partial edentulous rehabilitation using immediately loaded self-tapping implants: a 6.5-year retrospective study

PURPOSEA large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points.MATERIALS AND METHODSThe patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05).RESULTSOverall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05).CONCLUSIONSlight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.     

Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel

AimsOur study explored the perceived feasibility of using a home-based telerehabilitation service for older adults with chronic health conditions in Israel.MethodThis mixed-methods study included two focus groups of registered occupational therapists (n = 10) working in rehabilitation wards in Israel. Participants completed an open-ended questionnaire and Likert scale items so that data could be gathered on their perspectives regarding using an in-home telerehabilitation service for older adults after discharge from rehabilitation units. Thematic analysis with an a priori coding approach was applied to the data.ResultsPerceived advantages included transfer to the natural environment and the overcoming of geographical distance. Caregiver support and patient motivation were recognized as enabling factors. Perceived barriers included lack of hands-on contact and the concern that safety could be impeded by technological challenges and the patients’ cognitive status.ConclusionsFindings from this study can potentially contribute to facilitating the implementation of a home-based telerehabilitation service as a practical alternative for elderly patients after discharge from rehabilitation units in Israel.     

穴位气压疗法配合康复训练对帕金森病病人运动功能及自理能力的影响

目的:探讨穴位气压疗法配合康复训练对帕金森病病人运动能力及自理能力的影响。方法:选取2020年3月—2021年5月医院收治的64例帕金森病病人为研究对象,采用随机数字表法分为对照组和试验组各32例,两组病人均给予常规治疗和规律的康复训练,试验组在此基础上联合穴位气压治疗仪辅助治疗,比较两组病人运动功能(UPDRS-Ⅲ评分)和生活自理能力(Barthel评分)变化。结果:干预10周后,两组病人的运动功能和生活自理能力均提高,但试验组UPDRS-Ⅲ评分明显低于对照组,Barthel评分明显高于对照组(P<0.001)。结论:穴位气压疗法配合康复训练可以明显改善帕金森病病人的运动功能,提高病人的生活自理能力,从而改善其生活质量。