Abnormal behavior of elderly people residing in institutions of medical and social welfare systems

Abstract We investigated factors correlated with abnormal behavior in the elderly residing in a special nursing home (group A) and a psychiatric hospital (group B) using the dementia behavior disturbance scale, the mini mental state examination, the Japanese version of the Philadelphia Geriatric Center morale scale, and the ADL assessment scale. The cognitive function of group B was decreased compared with that of group A, but most activities of daily living (ADL) in the latter group were disrupted compared with those in the former. Only a few categories of ADL correlated with abnormal behavior in group A, whereas cognitive function, quality of life, and most categories of ADL correlated with abnormal behavior in group B. These results suggest that factors correlated with abnormal behavior in the elderly differ within institutions of medical and social welfare systems.     

Inter-rater reliability of the original and modified Barthel Index,and a comparison with the Functional Independence Measure

The Barthel Index (BI), the Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) are all widely used by occupational therapists as assessment tools for clinical decision-making and outcome measurement. All of these tools have demonstrated validity and the BI and the FIM have demonstrated inter-rater reliability. The MBI has been modified to increase sensitivity; however, there have been no publications on the inter-rater reliability of this tool following the changes. The purpose of this research was to examine the inter-rater reliability of two versions of the Barthel Index, and draw some comparisons between this assessment tool and the FIM. Twenty-five patients with neurological and orthopaedic conditions were assessed by three occupational therapists using the three tools. The method of analysis selected was percentage agreement and intraclass correlation coefficient. The results indicated that both the original and modified versions of the Barthel Index possess good inter-rater reliability. As all three tools have demonstrated adequate reliability and validity, it is suggested that clinicians select the most sensitive tool that best meets their clinical needs, and use this assessment tool in its standardized format.     

刺络闪火法治疗腰棘间韧带损伤

作者自1986年5月以来应用刺络闪火法治疗腰棘间韧带损伤取得满意效果。该法融按摩、刺络、闪火及复位于一体。结果表明该法不仅能消除棘间韧带的水肿,而且较好地调整损伤节段腰椎珠应和结构,从根本上促进损伤韧带的修复。     

REHABILITATION OF LOWER LIMB AMPUTEES AND SOME IMPLICATIONS FOR SURGICAL MANAGEMENT

Aspects of peri-operative management, amputation level and rehabilitation of the lower limb amputee are reported in the context of a review of a rehabilitation service for amputees which includes an integrated prosthetic service. Two hundred admissions were reviewed and some complex cases described. It is concluded that: a very close liaison between the surgeon and the rehabilitation team (ideally with pre-operative consultation) is in the patient's best interests; any person previously walking (or a potential walker) should be considered for a trial of prosthetic walking; an integrated prosthetic service enhances the efficiency of the rehabilitation service; and that modification of the current Artificial Limb Scheme to allow manufacture of first definitive limbs in prosthetic rehabilitation units would further enhance service to patients.     

The quality of acute stroke units on a nation-wide level: the Austrian Stroke Registry for acute stroke units

Concepts for stroke units that cover the acute phase vary. Therefore, the network of acute stroke units that is being set up in Austria in a uniform way is of general interest. This nationwide network has been established in accordance to evidence-based recommendations and prespecified criteria for available resources. The location for such a unit follows a maximum of 90-min isochrones (transport time) to the hospital. The quality of the network is currently documented and the results are reported. A nationwide stroke registry was prospectively performed on 15 stroke units that were already functional in this network. The aim was to document the quality performance of Austrian stroke units, focusing on rapid admissions, ready availability of investigations and therapies performed. Outcome measures were Barthel scale, Rankin score and percentages of complications. Between August 1998 and December 2000, 2,313 patients with ischemic stroke or with primary intracerebral hemorrhage admitted to an Austrian stroke unit within 24 h after onset of symptoms were prospectively included. Forty-three percent of the patients had a moderate or severe stroke. Fifty-seven percent of all patients were admitted to the stroke unit within 3 h after the onset of symptoms. Twenty-seven percent of these patients were brought in by ambulance accompanied by an emergency physician. Two percent of patients were admitted by helicopter. Fifty-four percent of patients had their first brain imaging within 30 min after admission, another 26% within 3 h. Intravenous thrombolysis was performed in 4.1% of patients. The overall stroke-unit mortality was about 6.8% and mortality at 3 months was 12.9%. The outcome at 3 months showed a modified Rankin Scale score of 0 or 1 in 47% of patients, denoting none or mild impairment. This network of acute stroke units is highly efficient in terms of rapid admissions, short intrahospital delays, as well as rapid use of readily available investigations. Stroke units seem to be well accepted by the general public and the medical community because our data show that all types of strokes are treated in Austrian stroke units, including severe strokes. The total number of concurrently treated acute strokes in other institutions across Austria is not known and no formal comparison with other systems of hospitalized care was undertaken, therefore further research is necessary.     

中药治疗Mondor’s病34例临床分析

Mondor's病又名胸腹壁浅静脉血栓性静脉炎,是一种少见病,目前尚无特效治疗方法。1982年～1990年我院门诊采用中药“静脉炎”片治疗22例,20 d内治愈者占95.5％;对照组12例,20 d内无1例痊愈。     

End-to-side anastomosis of rat carotid artery: comparison of different types of section and shape of the terminal end

Summary In 50 rats, different types of end-to-side carotid artery anastomoses were compared. In one technique, a longitudinal split in the long axis of the vessel was performed to enhance the diameter of the anastomosis. This theoretical advantage was not confirmed in this series. The clamping time, anastomoses time, and tamponade time were increased significantly when compared with a simple, slightly oblique end-to-side anastomosis. This study highlighted that the most simple type of end-to-side anastomosis gave less bleeding, achieved a quicker water-tight anastomosis and decreased the risk of late problems.     

精子尾部低渗肿胀试验、DNA荧光染色有效精子计数在精液分析中的意义

本文对１６０名有正常生育力的男性精液标本同时进行了精子尾部低渗肿胀率（ＨＯＳ）、精子头部ＤＮＡ荧光染色的有效精子计数（ＥＳＣ）、前向运动精子百分率（ＰＭＳ）、活动精子百分率（ＭＳ）的检测，分析它们之间的一致性。结果发现：ＨＯＳ与ＰＭＳ或ＭＳ间的符合率分别为７４％与８８％；ＥＳＣ与ＰＭＳ或ＭＳ间的符合率分别为６３％与６６％；ＥＳＣ与ＨＯＳ间的符合率为６７％。提示ＨＯＳ或ＥＳＣ可从不同角度去反映被测精子的生育力。     

金地鼠颊囊癌模型PCNA,BrdU及光镜观察结果的相关分析

癌变的早期诊断对提高疗效具有特殊意义，为了寻求简捷，高效，超前，可靠的诊断方法，实验以ＤＭＢＡ（二甲基苯并蒽）诱导的金地鼠颊囊致癌模型为对象，以ＰＣＮＡ（增殖细胞核抗原）ＢｒｄＶ（溴脱氧尿嘧啶）等免疫组化技术为手段；以光镜观察诊断为对照，对三种观察结果进行相关分析，发现三者间有高度显著的相关性，证实了免疫组化方法在癌变诊断中有一定的参考价值，实验还发现ＰＣＮＡ和ＢｒｄＵ检测结果比较每天敏感，简捷，     

原发性贲门失弛缓症的外科治疗(附10例报告)

作者对10例原发性贲门失弛级症进行手术治疗．采用Heller术8例，食管下段贲门切除术3例，其中再手术3例，附加幽门成形术4例。本组资料表明，Olsen分期Ⅰ～Ⅲ期行Heller术效果满意，不需附加手术，Ⅲ期需行食管下段贲门切除术。作者对手术方法、手术径路、附加手术与手术效果的关系等进行探讨。