Observations on the efficacy of combined acupuncture and medicine in Treating 50 cases of pseudobulbar paralysis

目的：观察针药结合治疗假性延髓麻痹的疗效。方法：采用完全随机抽样法分为针刺组50例，对照组48例。针刺组在西医治疗的同时，应用针刺进行综合治疗；对照组单纯接受西医药物治疗。结果：针刺组有效率为92．0％，对照组为62．5％。两组疗效差异具有非常显著性意义（P〈0．01）。结论：针药结合治疗假性延髓麻痹效果明显优于单纯西药治疗。     

Paralysis of the axillary nerve with Complete compensation – a case report

Summary Two patients with complete paralysis of the axillary nerve are reported on. One case is well documented. In both cases there was very good functional adaptation, resulting from hypertrophy of the rotator cuff so that there was only a slight or no loss of movement. The rotator cuff should therefore be exercised at an early stage when there is isolated axillary nerve damage. The function of the supraspinous muscle is also discussed.      

Bilateral Todd''s Paralysis After Focal Seizures

Transient postictal hemiparesis or monoparesis is not uncommon after partial (focal) seizures. We report 2 patients who complained of severe bilateral limb weakness after generalized tonic-clonic seizures (GTCS) beginning focally. Bilateral Todd's paralysis was verified and documented in both patients. EEG and clinical evidence indicate the supplementary motor cortex as the most likely source of the seizures in both cases.     

截瘫患者医院感染的监测及预防措施

目的了解截瘫患者医院感染的病原菌对药物敏感情况. 方法回顾分析我院自1996年9月～2003年11月,316例截瘫患者的有关临床资料. 结果 98例患者发生医院感染,医院感染率为31.01%,感染部位主要以呼吸道、皮肤软组织、手术切口、泌尿道感染为多;医院感染的病原菌主要是条件致病菌,以G-菌为主.结论医护人员必须严格无菌操作,根据细菌药敏结果合理选用抗菌药物,加强营养,提高患者机体抵抗力.     

周围性面神经麻痹急性期不同针灸方法疗效观察

目的:探寻周围性面神经麻痹急性期的最佳治疗方法.方法:将197例患者随机分为观察组(125例)、对照组(72例).观察组采用穴位注射配合温针治疗,穴取翳风、完骨、下关、牵正、太阳为主;对照组采用电针疗法,穴取翳风、阳白、下关等,观察比较两组疗效.结果:治疗3个疗程后,观察组痊愈率76.0%、总有效率100.0%,优于对照组的48.6%、86.1%(均P＜0.01).结论:急性期面瘫采用穴位注射配合温针疗法有助于缩短疗程,提高疗效,减少后遗症.     

双侧声带麻痹及固定的治疗：附12例报告

文中总结了１２例双侧声带麻痹或固定的治疗。气道通畅型２例，行病因治疗。气道阻塞型１０例，８例作了气管切开术，声带外移术３例，２例呼吸发音功能恢复较好，１例失败者行一侧声带切除＋喉扩张术。另外２例行Ｔ型管扩张术，均顺利拔管。药物治疗共５例。并讨论各种手术治疗现状。     

The effect of ageing in spinal cord injured humans on the blood pressure and heart rate responses during fatiguing isometric exercise

Groups of 50 healthy male controls and 50 subjects suffering from paraplegia (aged 20–65 years) were examined as to the inter-relationships between age, paraplegia and the strength, endurance, blood pressure and heart rate responses to fatiguing isometric exercise. Contractions were maintained in both groups under voluntary effort and through a contraction induced by electrical stimulation in the paraplegic group. All contractions were maintained to fatigue at a tension of 40% of the maximal muscle strength in either the handgrip or quadriceps muscles. Muscle strength of the handgrip was higher in the paraplegic subjects than in the controls, averaging 589 N and 463 N, respectively for the two groups. In contrast, quadriceps leg extension strength averaged 696 N in the controls and 190 N in the paraplegic groups; for both groups, ageing was associated with a reduction in muscle strength. While leg endurance was less in the paraplegic group than the control group, handgrip endurance was similar in the two groups, endurance increasing with ageing in both the controls and paraplegics. Both systolic and diastolic blood pressures increased at rest in paraplegic and control subjects with age. The magnitude of the pressor response to exercise also increased with age. This was true during both voluntary exercise and exercise induced through electrical stimulation in the paraplegic groups. The heart rate response (change in heart rate during exercise) to a fatiguing isometric handgrip contraction decreased by about 50% between the ages of 20 and 60 years in both the controls and paraplegics for isometric handgrip exercise. In contrast, heart rate changed little with age during contractions of the quadriceps muscle in paraplegics which were induced by electrical stimulation. Electronic Publication     

Paralysis and unilateral arthritis: is the association established ?

Summary A patient with long-standing upper limb lower motor neurone paresis more recently developed homolateral upper motor neurone hemiplegia. Subsequent primary generalised osteoarthritis spared only the paralysed upper limb. Detailed review of reported cases suggest that the protective effect of paralysis against subsequent development of arthritis is not as clearly established as generally believed.     

Spinal schwannoma causes acute subarachnoid haemorrhage: A case report and literature review

BackgroundSpinal schwannomas that arise from spinal nerve root sheaths are the most common intradural extramedullary spinal tumours and are often accompanied by nerve roots or spinal cord irritation symptoms. The phenomenon of spinal schwannoma causing subarachnoid haemorrhage (SAH) is rare, with ependymoma of the conus medullaris accounting for most cases.Case reportA 45-year-old man was admitted to our hospital due to progressive lower limb weakness and sudden back pain after hard physical work. The patient had not been able to walk for 2 hours upon admission. An emergency magnetic resonance imaging (MRI) scan showed that the spinal cord at the C6-T4 level was severely compressed by a subdural mass. During the emergency operation, exploration of the dura and arachnoid mater revealed a fresh blood clot covering a tumour located on the ventral side of the spinal cord. The size of the tumour was approximately 3 × 2 × 1 cm without adhesion to the surrounding tissue, but the drainage vein was ruptured. Postoperative pathology showed that the tumour was a schwannoma with areas of fresh haemorrhage and focal necrosis.ConclusionsSpinal schwannomas presenting with SAH are rare events. In our opinion, spinal pathology with rapid progression of neurological symptoms requires early diagnosis and emergency management. Complete excision of haemorrhagic tumours is the goal of treatment to prevent recurrence, which can effectively avoid irreversible damage to the spinal cord resulting from spinal cord compression.     

李彦民治疗类风湿关节炎经验

类风湿关节炎(RA)在中医学中属于“痹病”范畴,是临床中常见的难治性疾病,且呈年轻化趋势,迁延难愈。目前现代医学对RA的发病病因及机制尚不完全清楚。《素问·痹论》提出风寒湿三邪致痹,还有学者提出痰瘀致痹、肝肾亏虚等观点。李彦民主任医师根据多年临床经验提出RA的病机关键是络脉痹阻,其病机特点是虚实夹杂,临床辨证分为寒湿阻络型、湿热蕴结型、痰瘀互结型、气血两虚型、肝肾亏虚型等五型。分别采用祛邪通络和补虚通络等不同治则,辨证施法。李老师善用川乌、鸡血藤以及乌梢蛇等药以通络止痛,并主张辨证用药,内外兼治,多取良效。临床采用经验方仙龙汤,配合外用舒筋活络洗剂,且取得理想疗效。