气滞胃痛颗粒联合莫沙必利治疗动力障碍型功能性消化不良60例

目的:观察气滞胃痛颗粒联合莫沙必利治疗动力障碍型功能性消化不良的临床疗效。方法:选取2014年6月—2015年6月在本院就诊的功能性消化不良患者60例,随机分为对照组和治疗组,每组30例。对照组给予莫沙必利口服治疗,治疗组在对照组治疗的基础上给予气滞胃痛颗粒治疗。结果:治疗组有效率为93.33%,对照组有效率为70.00%,治疗组优于对照组(P0.05);治疗组治疗后临床症状积分、胃肠动力指数均优于对照组(P0.05)。结论:气滞胃痛颗粒联合莫沙必利治疗动力障碍型功能性消化不良疗效显著。     

须根自然腐解对滇重楼生长及其活性成分含量的影响

目的 研究添加外源性须根在自然腐解条件下对滇重楼生长发育和入药品质的影响。方法 通过室温盆栽试验,研究不同须根施用量自然腐解对滇重楼根系菌根侵染率、生理生化指标以及重楼皂苷含量的影响。结果 施加不同须根量自然腐解处理对滇重楼根系丛枝菌根（AM）真菌的侵染率无显著性影响,与侵染强度存在部分显著性差异;滇重楼叶片光合色素含量随须根施用量的增加显著降低,叶绿素总量最大降幅达78.7%;滇重楼叶片中可溶性蛋白、可溶性糖和丙二醛含量总体呈上升趋势,3种保护酶活性反应程度不同,过氧化物酶和丙二醛最大增幅达181.6%和200.0%;在滇重楼根系中上述6种成分含量有不同程度减少,过氧化物酶和丙二醛最大降幅达44.6%和69.7%;不同须根处理会降低滇重楼活性成分的含量,4种皂苷总含量降幅最大达58.9%,总皂苷含量最大降幅达46.9%。结论 须根自然腐解会影响滇重楼的根系土壤微生物环境、减少滇重楼叶片光合色素含量和破坏滇重楼细胞稳定性等,干扰滇重楼的生长发育,降低其药用成分含量,导致滇重楼发生连作障碍。     

Kinematic patterns for hindlimb obstacle avoidance during sheep locomotion

ABSTRACT

Functional recovery following general nerve reconstruction is often associated with poor results. Comparing to rat and mice experimental studies, there are much fewer investigations on nerve regeneration and repair in the sheep, and there are no studies on this subject using gait analysis in the sheep model as an assessment tool. Additionally, this is the first study evaluating obstacle negotiation and the compensatory strategies that take place at each joint in response to the obstacle during locomotion in the sheep model. This study aims to get kinematic data to serve as a template for an objective assessment of the ankle joint motion in future studies of common peroneal nerve (CP) injury and repair in the ovine model. Our results show that a moderately high obstacle set to 10% of the sheep’s hindlimb length was associated to several spatial and temporal strategies in order to increase hoof height during obstacle negotiating. Sheep efficiently cleared an obstacle by increasing knee, ankle and metatarsophalangeal flexion during swing, whereas the hip joint is not affected. This study establishes the bounds of normal motion in the neurologically intact hindlimb when approached and cleared an obstacle and provides baseline data for further studies of peripheral nerve research in the ovine model.     

Changes in center of pressure velocities during obstacle crossing one year after bariatric surgery

Adults with obesity have atypical gait with poor balance leading to an increase in fall risk. After massive weight loss, their gait improves. However, we know little about changes in postural stability after massive weight loss. The present study aimed to examine how massive weight loss after Roux-en-Y bariatric surgery affected adjustments in center of pressure (COP) velocities during flat ground walking and obstacle crossing. Before and one-year post-bariatric surgery, nineteen female adults walked under four conditions: baseline walking on flat ground and obstacle crossing with three different obstacle heights for a total of 20 trials. COP data were obtained from raw pressure time series data extracted from a gait carpet. Massive weight loss increased anteroposterior COP velocities under the midfoot of both trailing and leading legs (ps<.01) and decreased mediolateral COP velocities under the forefoot of trailing leg (p < .05). Decreased BMI from pre- to post-surgery was correlated with an increase in anterior-posterior and decrease in medial-lateral COP velocities and with increased velocity (ps<.05). Massive weight loss not only improved gait but also facilitated effective balance control strategies. Examining how massive weight loss affects adjustments in COP velocity may help create ways to better understand why individuals with obesity have atypical gait with poor balance and how we can facilitate participation in physical activities.     

Reference data for performances on the standardized walking obstacle course in children developing typically

PurposeTo establish reference performance groups on the Standardized Walking Obstacle Course (SWOC) a pathway to screen ambulation for children developing typically.MethodsSWOC tests ambulation under three conditions: walk (W), walk with tray (WT) and walk wearing sunglasses (WG). One trial consisted of standing up, walking the course in one direction and sitting down. Children (n = 355) completed two trials per condition. Trial measures included time to complete (seconds) and numbers of steps, stumbles, and steps off path.ResultsTrial 1 and trial 2 for time and number of steps are significantly different (p = 0.0005), but highly correlated (r = 0.93 and r = 0.96) therefore their average was used to establish reference data. Gender was not a significant factor. Age and height predict performances in all conditions, but measures between age groups were not always significantly different. Significant different measures by height groups could be established across all conditions, therefore reference data was established using three height groups.ConclusionReference values will assist clinicians to compare a child’s performance on the SWOC based on an individual height because this can vary within and between ages thus screening for possible ambulation limitations.     

Prevalence of venous anatomic variants and occlusion among patients undergoing implantation of transvenous leads

BACKGROUND: The implantation of transvenous leads may be prohibited by venous occlusion or anatomical variants. The prevalence of these conditions among patients undergoing transvenous pacing or implantable cardioverter defibrillator (ICD) leads implantation has not been systematically studied. This study examined the prevalence of venous anatomic variants and/or venous occlusion, and related risk factors, prior to lead implantation. METHOD: The study included 273 consecutive patients scheduled for implantation of transvenous pacing or ICD leads. Before the procedure, the venous network of arms, neck, and thorax was evaluated by bilateral intravenous digital subtraction angiography (DSA). RESULTS: Complete venous occlusion associated with developed collateral circulation was observed in 12 patients (4.4%); at the site of the left innominate vein in 9, left subclavian vein in 2, and right subclavian vein in 1 patient. Of 12 patients with venous occlusion, 7 patients had a history of prior surgical procedure. A persistent left superior vena cava was observed in 1 patient (0.4%). The presence of abnormal findings on DSA was significantly higher on the left than the right side (P < 0.001). The cardio-thoracic ratio (CTR) was significantly greater in patients with venous occlusions than patients with normal circulation (P = 0.012). CONCLUSIONS: Asymptomatic venous abnormalities are not rare among patients requiring transvenous pacing lead implantation. Careful attention should be paid when implanting pacing or ICD leads from the left side, especially in patients with an increased CTR or history of prior insertion for central venous catheter.     

应用咽部冷刺激法于老年吞咽障碍康复训练的观察及护理

吞咽障碍是老年患者的临床常见症状,吞咽障碍可造成水和其它营养成分摄入不足,进食易出现误吸致吸入性肺炎及各种并发症甚至死亡。胃管鼻饲虽然能解决进食问题,但患者往往难以接受,另外,如长期留置鼻饲管不仅可造成鼻、咽、食管黏膜溃疡及出血等多种并发症[1],不利于吞咽功能的     

Footlift asymmetry during obstacle avoidance in high-risk elderly

OBJECTIVES: To test the hypothesis that vertical footlift asymmetries and low obstacle clearing distance during obstacle avoidance are characteristics of elderly people classified as high risk for falls. DESIGN: Controlled cross-sectional design with two conditions to cue selection of the foot-for-step initiation: sound cue and visual cue. SETTING: Senior independent living facilities. PARTICIPANTS: Eighteen community-dwelling elderly with a history of falling or prolonged Timed Up and Go score greater than 13.5 seconds, 16 elderly with no fall history and Timed Up & Go score of 13.5 seconds or less, and 15 younger subjects. MEASUREMENTS: Video kinematic analysis of bilateral footlift displacement and velocity using reflective markers as subjects stepped over foam obstacles scaled to a maximum tolerated height. RESULTS: High-risk elders contacted the obstacle more frequently and had significantly greater vertical footlift asymmetries adjusted for obstacle/subject height (mean+/-standard error asymmetry index for sound cue 3.25+/-0.42 cm, for visual cue 2.51+/-0.45 cm) than low-risk and younger subjects (P<.001). In low-risk elderly and younger subjects, the asymmetry index approached 0, which indicated symmetrical lower limb movements when stepping over the obstacles. CONCLUSION: High-risk elderly show a marked asymmetry in foot clearance while stepping over an obstacle, with the lag foot clearing the obstacle at a much lower distance than the lead foot. Possible mechanisms responsible for these findings (limited hip extension and deficits in executive cognitive function) are discussed.     

The relationship between lower body strength and obstructed gait in community-dwelling older adults

OBJECTIVES: To determine the relationship between lower body strength of community-dwelling older adults and the time to negotiate obstructed gait tasks. DESIGN: A correlational study. SETTING: The Biomechanics Laboratory, Deakin University, Australia. PARTICIPANTS: Twenty-nine women and 16 men aged 62 to 88 were recruited using advertisements placed in local newspapers. The participants were independent community dwellers, healthy and functionally mobile. MEASUREMENTS: Maximal isometric strength of the knee extensors and dynamic strength of the hip extensors, hip flexors, hip adductors, hip abductors, knee extensors, knee flexors, and ankle plantar flexors were assessed. The times to negotiate four obstructed gait tasks at three progressively challenging levels on an obstacle course and to complete the course were recorded. The relationship between strength and the crossing times was explored using linear regression models. RESULTS: Significant associations between the seven strength measures and the times to negotiate each gait task and to walk the entire course at each level were obtained (r = -0.38 to -0.55; P < .05). In addition, the percentage of the variance explained by strength (R(2)), consistently increased as a function of the progressively challenging level. This increase was particularly marked for the stepping over task (R(2) = 19.3%, 25.0%, and 27.2%, for levels 1, 2, and 3, respectively) and the raised surface condition (R2 = 17.1%, 21.1%, and 30.8%, for levels 1, 2, and 3, respectively). CONCLUSION: The findings of the study showed that strength is a critical requirement for obstructed locomotion. That the magnitude of the association increased as a function of the challenging levels suggests that intervention programs aimed at improving strength would potentially be effective in helping community-dwelling older adults negotiate environmental gait challenges.