脑卒中偏瘫患者步行时足底压力中心的特点

目的探讨脑卒中偏瘫患者步行时足底压力中心（COP）相关参数的特点及其与步速、不对称性的相关性。 方法选取60例能够独立步行的脑卒中偏瘫患者（偏瘫组）及健康中老年人（对照组），每组30例，2组受试者均以自我选择的步速进行步态测试，提取并计算步速及两侧下肢的单支撑时间、双支撑时间、单支撑期COP在前后方向的位移（AP-COPDS）及其速度(AP-COPVS)、双支撑期COP在前后方向的位移（AP-COPDD）及其速度（AP-COPVD），以及单支撑时间对称性比等参数，并分析和比较COP相关参数及其与步速、不对称性的相关程度。 结果对照组和偏瘫组的步速分别为（73.60±9.66）和（37.88±16.01）cm/s，偏瘫组步速较对照组明显下降（P<0.01）。偏瘫侧单支撑时间［（0.39±0.07）s］较对照组［（0.44±0.04）s］明显缩短（P<0.01）；非偏瘫侧的单支撑时间［（0.53±0.12）s］及两侧双支撑时间［（0.36±0.15）s、（0.36±0.21）s］均较对照组［（0.44±0.04）s及（0.15±0.03）s］延长（P<0.01）；偏瘫组患者两侧下肢所有COP相关参数均较对照组减小，且差异均有统计学意义（P<0.01）。偏瘫组两侧下肢所有COP相关参数均与步速呈高度正相关（r=0.765～0.967，P<0.01）；所有COP相关参数与单支撑时间对称性比呈不同程度正相关（r=0.505～0.764，P<0.01）。 结论脑卒中偏瘫患者步行时，足底负重在前后方向转移的能力下降，且与步速、单支撑时间对称性比呈正相关。     

肿节风静脉注射液治疗肺癌5O例临床研究

目的 肿节风静脉注射液治疗肺癌的疗效。方法 肿节风静脉注射液4ml，im，2次／d，治疗前后自身对照。结果PR13例（26％），MR12例（24％），PD5例（10％）。结论肿节风静脉注射液对肺癌有较好疗效，值得进一步开发应用。     

Subvocal articulatory rehearsal during verbal working memory in multiple sclerosis

This study was designed to examine verbal working memory (VWM) components among multiple sclerosis (MS) patients and determine the influence of information processing speed. Of two frequently studied VWM sub-components, subvocal rehearsal was expected to be more affected by MS than short-term memory buffering. Furthermore, worse subvocal rehearsal was predicted to be specifically related to slower cognitive processing. Fifteen MS patients were administered a neuropsychological battery assessing VWM, processing speed, mood, fatigue, and disability. Participants performed a 2-Back VWM task with modified nested conditions designed to increase subvocal rehearsal (via inter-stimulus interval) and short-term memory buffering demands (via phonological similarity). Performance during these 2-Back conditions did not significantly differ and both exhibited strong positive correlations with disability. However, only scores on the subvocal rehearsal 2-Back were significantly related to performance on the remaining test battery, including processing speed and depressive symptoms. Findings suggest that performance during increased subvocal rehearsal demands is specifically influenced by cognitive processing speed and depressive symptoms.     

持续颅内压监测下观察甘露醇不同输注速度的降压效果

目的了解不同速度静脉滴注甘露醇降压效果及作用维持时间。方法将需要定时使用甘露醇的患者随机分为3组，观察1组：10min内输完，观察2组：11～20min输完，观察3组：21～30min输完，分别在输注甘露醇前和输完甘露醇时、输完甘露醇后30min、输完甘露醇后6h记录颅内压（ICP）值，观察不同速度输注甘露醇患者ICP的变化。结果3组输完甘露醇后30min内患者的ICP都有下降，以观察1组变化的幅度最大。6h后患者ICP恢复至使用甘露醇前的水平。结论使用甘露醇降压时，输注速度越快，其降压效果越好，建议甘露醇使用的间隔时间以6h为宜。     

影响输液速度的常见原因分析及对策

影响输液速度的原因很多,既有滴速、输液器本身滴系数的影响,又有滴速对滴系数的影响、液体间的差别,还有病人及其他因素的不同,因此,在实践过程中需要仔细观察和探索,掌握不同滴速、不同液体间滴系数的差别,及时发现影响输液速度的问题,以便精确地控制输液速度,防止输液意外发生,达到安全输液和治疗疾病的目的。     

Heat Losses Caused by the Temporary Influence of Wind in Timber Frame Walls Insulated with Fibrous Materials

The paper presents the results of research concerning three fiber materials—mineral wool, hemp fiber and wood wool—as loose-fill thermal insulation materials. The analysis used the material parameters determined in previous works conducted by the authors, such as thermal conductivity and air permeability in relation to bulk density. These materials exhibit open porosity; thus, convection is an essential phenomenon in the heat transfer process. The paper aimed at conducting thermal simulations of various frame wall variants which were filled with the above-mentioned insulation materials. The simulations were performed with the Control Volume Method using the Delphin 5.8 software. The studies accounted for the effect of wind pressure and the time of its influence on a wall insulated by means of fiber material with a thickness of 150 as well as 250 mm. The simulation enabled us to obtain such data as maximal R-value reduction and time to return to equilibrium after filtration for the analyzed materials. The study proved that heat transfer in these insulations strongly depends on the bulk density, thickness of the insulation and wind pressure. The decrease in R is reduced as the density increases. This results from the decreased air permeability characterizing the material. Wind washing causes lower R reduction than air filtration in all models. The greater the thickness, the longer it takes for the models to return to the equilibrium state following air filtration (and wind washing). This period is comparable for air filtration and wind washing. Hemp fibers were characterized with the strongest susceptibility to air filtration; in the case of wood wool, it was also high, but lower than for hemp fibers, while mineral wool was characterized with the lowest.     

汪悦教授运用风药治疗痹证经验探析

[目的]总结探讨汪悦教授运用风药治疗痹证的临床经验。[方法]从痹证病因病机、风药功效、选药思路、配伍原则等方面介绍汪师经验,并附验案一则佐证。[结果]针对风邪、湿邪在痹证产生过程中的重要作用,汪师临证常根据邪气偏盛、病位证候等不同,并结合现代药理研究选用不同的风药进行治疗,以达到散风邪、燥湿邪、行气血、止痹痛的效果。遣方用药时常将风药与祛湿药、化瘀药、补血药、养阴药、温阳药等配伍使用,每获良效。所举验案患者患有脊柱关节炎,属于中医"骨痹"范畴,辨证属正虚邪实、肾阳不足、风湿痹阻,治拟温阳益肾、祛风胜湿、通络止痛,以阳和汤加减治疗,其中包括麻黄、独活等多味风药,收效甚佳。[结论]汪师灵活运用风药配伍组方以治疗痹证,疗效显著,值得进一步研究和探讨。     

张锡纯从脑论治痿证特色探析

[目的]探讨张锡纯从脑论治痿证的思路与特色。[方法]从中医文献整理、研究的角度,对张锡纯所著《医学衷中参西录》中从脑病角度论治痿证的相关论述、医案、具体药方进行系统分析,归纳和总结其痿证论治思路和特色。[结果]张锡纯汇通中西,以“肢体痿废”一症立论,结合现代医学对脑病的认识,创造性地提出脑贫血、脑充血两种病因均可导致肢体痿废,在此基础上以传统医学宗气不足、精髓不充、脏腑气血大热的观点诠释二者病机,立益气引血、镇肝熄风大法,创干颓汤、镇肝熄风汤、建瓴汤等,大大扩展了痿证的治疗思路。[结论]张锡纯衷中参西,从脑病角度论治痿证,对痿证理论的继承和发展作出重要贡献,于今日临床启发尤多。