持续被动运动条件下骨关节炎软骨细胞Erk活性及增殖

BACKGROUND: Whether continuous passive motion improves osteoarthritis by enhancing the proliferation ability of chondrocytes is rarely reported. OBJECTIVE: To analyze the therapeutic outcomes of continuous passive motion in rabbits with osteoarthritis and the underlying mechanism. METHODS: Thirty-six New Zealand white rabbits were randomly allotted into three groups (n=12 per group). Rabbits in control group only underwent capsulotomy with no harm to the cartilage; osteoarthritis models were established in the rabbits of model and treatment groups using Hulth method. At 1 day after modeling, the treatment group rabbits were treated with continuous passive motion, 8 hours daily for consecutive 8 weeks. Interleukin-1 and tumor necrosis factor α levels in the synovial fluid were detected by ELISA; collagen type II expression and the proliferation ability of chondrocytes were detected by MTT assay; Erk signaling pathway activation was determined using western blot assay. RESULTS AND CONCLUSION:In the model group, interleukin-1 and tumor necrosis factor α levels in the synovial fluid were significantly increased, and the expression level of collagen type II mRNA was remarkablely down-regulated. Continuous passive motion significantly downregulated interleukin-1 and tumor necrosis factor α levels and up-regulated the collagen type II mRNA level (P < 0.01). The model group showed significantly decreased proliferation ability of chondrocytes and down-regulated Erk signaling pathway activation, while after continuous passive motion, all above indicators were significantly improved (P < 0.01). These results indicate that the continuous passive motion can alleviate osteoarthritis probably by influencing interleukin-1 and tumor necrosis factor α levels, proliferation ability of chondrocytes, and collagen type II expression, as well as regulating Erk signaling pathway activation. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

优化运动技巧的练习与训练对脑卒中患者ADL及MAS评分的影响

目的：观察优化运动技巧的练习与训练对脑卒中患者日常生活活动能力（ADL）及运动评定量表（MAS）的影响.方法：将脑卒中患者40例随机,分为治疗组20例和对照组20例.两组患者均进行常规药物治疗的同时,治疗组给予优化运动技巧的练习和训练,对照组给予bobath、PNF、Rood等神经易化技术的综合训练.每日训练一次,每次40分钟,连续进行5天,休息2天,持续6周.在治疗前和治疗后分别对2组患者进行ADL评分和MAS评分.结果：治疗后2组患者的ADL评分及MAS评分均有改善,差异有统计学意义（P〈0.01）,治疗组均明显优于对照组,差异有统计学意义（P〈0.01）.结论：优化运动技巧的练习与训练能显著提高脑卒中患者的运动功能和日常生活活动能力.     

老年肺癌患者外周血白细胞升高与预后的关系

肺癌病人常引起外周血液WBC升高,总结我院6年来部分住院老年肺癌病人60例的白细胞变化,发现WBC持续升高与其疾病预后显著相关,现报告并讨论如下:     

不同强度低频重复经颅磁刺激治疗慢性非流利性失语的临床疗效

目的观察不同强度低频重复经颅磁刺激(rTMS)治疗慢性非流利性失语的疗效。方法选取脑梗死恢复期失语患者90例,随机分为对照组、治疗Ⅰ组和治疗Ⅱ组,每组各30例。三组患者均进行常规言语训练,治疗Ⅰ、Ⅱ组在言语训练前接受1个疗程的低频rTMS,刺激强度分别为健侧肢体运动诱发电位阈值的80%和100%,余参数相同。结果与对照组及治疗前相比,治疗结束时及治疗结束90 d治疗Ⅰ、Ⅱ组患者ABC评分差异有统计学意义(P0.05),但两组治疗组间比较无明显差异(P0.05);与治疗结束时相比,治疗结束90 d治疗Ⅰ、Ⅱ组患者ABC评分均有明显提高,且差异有统计学意义(P0.05),两治疗组间比较仍无明显差异(P0.05)。不同强度低频rTMS刺激结束90 d后,治疗Ⅰ、Ⅱ组的命名准确率均有明显提高。结论低频rTMS可改善脑梗死后非流利性失语患者的语言功能,并且治疗效果可持续到治疗后3个月;不同强度的低频rTMS可能对语言功能恢复的效果大致相同。     

坐站能力强化训练与比目鱼肌牵伸在偏瘫康复中的临床应用

大多数脑卒中患者在运动功能恢复的过程中都会出现不同程度的骨骼肌张力过高,主要是由于上运动神经元受损后引起的牵张反射亢进所致。许多患者出现踝阵挛、小腿三头肌挛缩、足下垂等,与肌肉纤维与肌腱的物理特性改变有     

任务导向性训练结合肌电生物反馈治疗对脑卒中患者上肢腕背伸功能的影响

目的探讨任务导向性训练结合肌电生物反馈治疗对脑卒中偏瘫患者上肢手背伸功能的影响。 方法将36例脑卒中偏瘫患者按随机数字表法分为对照组和实验组,每组18例。对照组进行常规康复治疗和肌电生物反馈疗法治疗,实验组在上述治疗的同时增加患侧上肢任务导向训练,即训练时结合日常实物并完成明确指令动作,如手背伸抓握及够物等训练。由不知分组的同一治疗师分别于治疗前和治疗8周后（治疗后）评定2组患者的患侧腕关节背伸主动活动度（AROM）、手腕Fugl-Meyers运动功能评定（FMA）和腕背伸表面肌电图（sEMG）值,并进行统计学分析比较。 结果治疗前,实验组和对照组患者腕关节AROM、手腕FMA评分和腕背伸sEMG值分别为（4.17±2.68）°和（3.11±2.85）°、（11.11±3.69）分和（13.72±4.46）分、（42.83±16.48）μV和（37.28±18.48）μV,组间差异无统计学意义(P&rt;0.05),具有可比性。治疗后,实验组和对照组患者上述指标分别为（6.39±4.22）°和（3.83±4.02）°、（27.72±8.84）分和（22.05±7.81）分、（102.5±53.11）μV和（72.17±32.65）μV,均较治疗前有所改善(P<0.05),且实验组明显优于对照组(P<0.05)。 结论任务导向性训练结合肌电生物反馈治疗能明显促进偏瘫患者上肢腕背伸功能改善。     

反流性食管炎的阶段性治疗

近年来,胃食管反流性疾病(GERD)发病日趋增多。经过24h食管PH监测发现,正常健康者均有胃食管反流(GER)现象,但无任何临床症状,称之为生理性GER。其特点为白天常发作,夜间罕见;餐时或餐后反流较多,其反流总时间每24h少于1h。由于反流物可即刻被清除到胃内,一般并不致病。但是当食管下段括约肌(LES)抵抗GER的屏障功能削弱时,会导致频繁GER,反流物量多且较持久,从而损伤食管下段粘膜,形成反流性食管炎,并能引起食管溃疡和狭窄,这些统称GERD。Sandmark在内镜下把食管炎分为5级:0级,正常食管粘膜;1级,食管粘膜充血,水肿;2级,粘膜点状糜烂;3级,糜烂融合或溃疡形成;4级,食管四周糜烂及形成深部溃疡,狭窄和/或Barret食管形成。目前临床上对GERD的治疗方法很多,但最佳方案是以内镜改变为基础,进行阶段性治疗。