康复技术配合补阳化痰通络汤治疗脑卒中肢体运动功能障碍43例

目的:观察运用现代康复技术配合补阳化痰通络汤治疗脑卒中肢体运动功能障碍的临床疗效。方法:将85例患者随机分为治疗组和对照组,对照组42例采用常规神经生理学康复技术治疗,治疗组43例在对照组治疗的基础上加用补阳化痰通络汤,治疗21 d后观察肢体运动功能评分及肌力、肌张力评分的变化。结果:治疗组在改善肢体运动功能评分及肌力、肌张力评分方面的临床疗效均优于对照组。结论:现代康复技术配合补阳化痰通络汤治疗脑卒中能较好地改善患者的肢体运动功能。     

分娩计划的实施对母儿结局的影响

目的:研究和分析分娩计划实施对母儿结局的影响。方法:选取妊娠晚期在助产士门诊制定分娩计划的93例低危孕妇作为研究组,选择同期没有进行分娩计划的93例低危孕妇作为对照组。比较两组孕妇入院到分娩时间,剖宫产率,产后出血发生率,新生儿窒息,母乳喂养率。结果:研究组剖宫产率明显低于对照组(P0.01),母乳喂养率明显高于对照组(P0.05),孕妇从入院到分娩时间明显低于对照组(P0.05)。结论:分娩计划的实施可以促进自然分娩率和母乳喂养,母儿结局良好。     

舌针配合语言疗法治疗中风运动性失语的疗效观察

目的 :探讨舌针配合语言疗法治疗中风运动性失语的临床疗效。方法 :将符合纳入标准的60例患者随机分为对照组和治疗组各30例,对照组采用语言疗法治疗,治疗组在对照组基础上加舌针治疗,每次治疗时间40 min,每周治疗5次。4周后以《汉语失语症检查法》为标准判定疗效。结果:两种方法均能提高患者的语言功能,治疗组总有效率90.0%,对照组76.7%,两组疗效比较差异有统计学意义(P0.05)。结论:舌针配合语言疗法治疗中风运动性失语可有效提升患者的语言表达能力,优于单纯语言康复治疗。     

槲皮素促进小鼠脊髓损伤后轴突生长及功能恢复研究

目的 评价槲皮素对小鼠脊髓损伤后轴突生长及功能恢复的影响。方法 C57BL/6雌性小鼠24只,随机分为2组,各12只。将2组小鼠T10节段施以完全性脊髓钳夹伤,治疗组分别于损伤前30 min、损伤后即刻、损伤后1-10 d每天1次腹腔注射槲皮素(50 mg/kg),对照组则腹腔注射等量0.9%氯化钠溶液。于损伤后14 d将BDA神经示踪剂注入小鼠皮层感觉运动区,示踪皮质脊髓束,组织切片复染GFAP标记损伤边界。通过荧光显微镜观察损伤区近段皮质脊髓束轴突退缩及再生情况。在术后当日及1、3、7、14、28 d,采用BMS(Basso mouse scale)量表评价小鼠后肢及躯干运动功能。结果 损伤后第28天,与对照组相比,槲皮素治疗组轴突出芽量化比值上升;神经轴缩球量化比值下降;传导束到损伤边缘距离下降,差异均有统计学意义(P0.01)。行为学评估表明槲皮素显著提高小鼠BMS评分(P0.01),第28天治疗组BMS显著高于对照组(P0.01)。结论 槲皮素可明显促进脊髓损伤后轴突出芽,减少回缩,促进运动功能恢复。     

Food Insecurity and Eating Behavior Relationships Among Congregate Meal Participants in Georgia

This study explored relationships of food insecurity with cognitive restraint, uncontrolled eating, and emotional eating behaviors among congregate meal participants in northeast Georgia [n = 118 years, age 60 years and older, mean (SD) age = 75 (8 Olson CM, Bove CF, Miller EO. Growing up poor: long-term implications for eating patterns and body weight. Appetite. 2007; 49(1):198–207.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) years, 75% female, 43% Black, 53% obese (Body Mass Index ≥ 30)]. Food insecurity was assessed with a 6-item questionnaire. Scores ranged from 0 to 6 and were defined as high or marginal food security, FS, 0–1 (70%); low food security, LFS, 2–4 (20%); very low food security, VLFS, 5–6 (10%); and low and very low food security, LVLFS, 2–6 (30%). Eating behavior was assessed with an 18-item Three-Factor Eating Questionnaire R-18. In bivariate analyses food insecurity was consistently associated with cognitive restraint scores above the median split and to a lesser extent with uncontrolled eating scores (p ≤ 0.05). No association was found between emotional eating and food insecurity. In multivariate linear and logistic regression analyses, food insecurity was consistently associated with cognitive restraint (p ≤ 0.05) even when controlled for potential confounders (demographics, Body Mass Index, and chronic diseases). Food insecurity was also associated with uncontrolled eating (p ≤ 0.05), but the relationship was attenuated when controlled for potential confounding variables. Although cognitive restraint is defined as the conscious restriction of food intake to control body weight or promote weight loss, these findings suggest there may be other dimensions of cognitive restraint to consider in nutritional assessment and interventions among food-insecure older adults.     

眼科八年制学生临床和科研培养的思考

针对眼科八年制学生的培养要求,结合自身从事眼科八年制学生的教学经验,就眼科基础理论学习、医患沟通能力培养、临床基本技能训练、显微手术技巧学习、眼科亚专业兴趣培养及基本实验技能培训等方面进行了思考,以期提高眼科八年制学生的综合能力。     

Diagnostic pitfall: Adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy,case report and literature review

IntroductionWe describe a patient with an unusual presentation of an isolated hypoglossal nerve palsy as a result of perineural invasion (PI) from adenoid cystic carcinoma (ACC). We will also discuss the diagnostic pitfalls as well as present a short literature review of adenoid cystic carcinomas and suggest improvement to the current diagnostic algorithm for isolated hypoglossal nerve palsies.Presentation of caseA 63 year old Malay female presented with progressive dysphagia and slurred speech for one year. Physical examination showed unilateral right tongue wasting, fasciculation and deviation to the right. An MRI showed atrophy of the tongue due to denervation and subsequently she was treated in a neurology clinic for 8 months.Due to lack of improvement, she was referred to our surgical unit and underwent examination under anaesthesia (EUA) and biopsy. Histology showed adenoid cystic carcinoma with perineural involvement, resulting in lower motor neuron signs.She underwent radiotherapy to the base of her tongue (70 Gy/35#). A PET-CT one month post treatment showed complete response.DiscussionAdenoid cystic carcinoma (ACC) is a salivary gland neoplasm. It is characterized by local invasiveness with frequent recurrence and indolent growth. It affects major salivary glands more than minor salivary glands.In malignancies that have a propensity for PI such as ACC, patients may present atypically with nerve palsies. In infiltrative lesions, the primary tumour may not be evident on magnetic resonance imaging. Therefore, to achieve a diagnosis, a high index of suspicion is required. When the diagnosis is in question, deep biopsy and positron emission tomography may be useful.     

五年制高职护生专业自我概念的纵向研究

目的了解五年制高职护生专业自我概念的变化趋势,分析影响因素。方法便利抽取某校2010级五年制高职护生104人进行为期5年的追踪调查,调查内容包括专业自我概念及其影响因素。结果 5年来,护生的专业自我概念总分均75分,领导力、满意度、沟通交流维度及总分变化有统计学差异(P0.05,P0.01)。发展前景、护士形象、劳动报酬、理论知识是影响护生专业自我概念的主要因素,共解释其变异的69.5%。结论五年制高职护生专业自我概念总体较积极,各维度的变化趋势不相同,需针对影响因素采取干预策略。