下肢康复机器人训练对早期脑卒中偏瘫患者下肢功能的影响

目的:观察下肢康复机器人对早期脑卒中偏瘫患者下肢功能的影响.方法:将80例早期脑卒中患者随机分为观察组和对照组.2组均给予常规康复训练,观察组在此基础上增加下肢康复机器人训练.治疗时间为12周,比较2组治疗前后髋关节和膝关节活动度、FMA下肢评分、FAC步行功能评分、ADL评分情况.结果:2组患者在治疗前各临床评价指标均无显著性差异(P>0.05).治疗12周后,2组的髋关节和膝关节活动度、FMA下肢评分、FAC步行功能评分、ADL评分均高于治疗前(P<0.05),且观察组髋关节和膝关节活动度、FMA下肢评分、FAC步行功能评分、ADL评分均高于对照组(P<0.05).结论:下肢康复机器人可改善早期脑卒中偏瘫患者下肢功能,提高步行能力.     

减重步行训练对脑梗死后偏瘫患者步行功能的影响

目的：探讨减重步行训练对脑梗死后偏瘫患者下肢运动功能、步行功能和日常生活能力的影响.方法：选择2003年10月～2005年1月在本院神经内科住院的98例初发脑梗死患者,随机分为常规康复治疗组（47例）和减重步行训练组（51例）.常规康复治疗组仅接受常规步态康复训练,减重步行训练组除接受常规康复训练外,尽早开始接受减重步行训练.两组患者康复治疗前后分别采用FAC量表、Fugl-Meyer量表及Barthel指数评分评定患者步行能力,下肢运动功能及日常生活能力,比较两组治疗效果.结果：两组患者经不同康复治疗后,上述各项指标均有改善,但减重步行训练组FAC、FMA积分及Barthel指数评分的改善情况明显优于常规康复治疗组（FAC、FMA积分比较P＜0.01,Barthel指数评分比较P＜0.05）.结论：减重步行训练较常规康复治疗能更大程度地提高脑梗死后偏瘫患者步行能力,下肢运动功能及日常生活能力,从而提高患者的生活质量.     

强制性运动疗法结合减重步行训练对卒中后偏瘫康复的效果

目的：研究强制性运动疗法结合减重步行训练对卒中后偏瘫康复的效果。方法：选择稳定脑卒中偏瘫患者122例,随机分为强化组（58例）和对照组（64例）。强化组给予强制性运动疗法结合减重步行（偏瘫肢体Brunstrom分级2级以上时）训练,每周5次;对照组给予常规康复治疗。治疗三个月（减重步行训练6周）,用简式的Fugl—Meyer评价法（FMA）来评价肢体活动,采用功能性步行量表（FCA）评价行走能力,采用独立功能量表（FIM）评价日常生活能力。结果：经治疗对照组及强化组FAC、FMA、FIM评分有显著差异。治疗后强化组独立步行达到70．7％,对照组独立步行达到51．6％,两组显著差异。结论：采取强制性运动疗法结合减重步行训练能够更大程度改善偏瘫后肢体功能的恢复。     

下肢康复机器人训练对脑卒中偏瘫患者平衡及步行功能的影响

目的 探讨下肢康复机器人训练对脑卒中偏瘫患者平衡及步行功能的影响。方法 选取2016 年1 月～2019 年1 月在我科住院治疗的50 例早期脑卒中偏瘫患者为研究对象,随机将其分为观察组和对照组,每组各25 例;其中对照组予以常规基础康复训练,观察组予以下肢康复机器人训练;对比两组治疗前后的平衡及步行功能。结果 两组治疗前BBS、FAC 评分比较,差异无统计学意义（P＞0.05）,两组治疗后的BBS、FAC 评分均较治疗前明显改善,且观察组的BBS、FAC 评分改善程度明显优于对照组（P＜0.05）。结论 对脑卒中偏瘫患者予以下肢康复机器人训练疗效显著,可有效提高患者的平衡及步行能力,可在临床上推广。     

下肢康复机器人配合康复训练在脑卒中偏瘫患者中应用观察

目的探究下肢康复机器人配合康复训练在脑卒中偏瘫患者中应用效果。方法将2016年1月‐2016年10月该院收治的90例脑卒中偏瘫患者纳入研究,将所有患者按随机数字表法分为两组,对照组45例采用常规康复训练,观察组45例采用下肢康复机器人配合康复训练,比较两组下肢运动功能、平衡功能、日常生活能力及步行能力。结果干预后,与对照组相比,观察组下肢Fugl-Meyer运动评分、下肢Berg平衡评分较高,差异具有统计学意义(P 0.05);干预后,两组日常生活能力量表(ADL)各维度评分均明显提高,与对照组相比,观察组ADL各维度评分较高,差异具有统计学意义(P 0.05);干预后,两组功能性步行分级法(FAC)评分、6 min步行距离均明显提高,与对照组相比,观察组FAC评分、6 min步行距离较高,差异具有统计学意义(P 0.05)。结论脑卒中偏瘫患者采用下肢康复机器人配合康复训练可有效促进其下肢运动功能恢复,改善患者步行及平衡能力,提高其日常生活能力。     

核心稳定性训练对脑卒中偏瘫患者平衡功能和步行能力的影响

目的:观察核心稳定性训练对脑卒中偏瘫患者步行能力和平衡功能的影响。方法:选取脑卒中偏瘫患者112例作为观察对象,采用随机数字表法将其分为观察组和对照组各56例。对照组行常规康复训练,观察组行核心稳定性训练,对比两组训练前后的步行能力(FAC量表)和平衡功能(Berg量表)。结果:训练后,观察组FAC分级和Berg量表评分均明显优于对照组,差异有统计学意义(P<0.05)。结论:核心稳定性训练改善脑卒中偏瘫患者的平衡功能和步行能力的效果优于常规康复训练。     

减重平板步行训练对脑卒中偏瘫患者下肢运动功能的影响

目的 探讨减重平板步行训练对脑卒中偏瘫患者下肢运动功能的影响.方法 48例脑卒中偏瘫患者被随机分为减重平板步行组和一般康复组,各24例.一般康复组患者采用常规康复治疗,减重平板步行组在此基础上进行减重平板步行训练,在此间分三阶段强化患者负重、膝踝控制、屈髋和踝背伸能力.两组患者在治疗前和治疗12周后分别给予Motricity index中下肢肌力积分(MI-L)、Berg平衡量表(BBS)、Fugl-Meyer运动功能量表(FMA)、Barthel指数(MBI)来分别评定患者的下肢肌力,平衡功能,下肢运动功能及ADL能力.同时12周后还测定患者的功能性步行分级(FAC)、通过10米最大步行速度测定出患者的步速、步长和步频参数,Tinetti步态评测表评测步态.结果 治疗后MI-L、BBS、FMA、MBI减重平板步行组较治疗前比较(P＜0.01)两组间比较P ＜0.01.减重平板步行组FAC步行功能分级4级及以上者22例(92％),一般康复组共12例,(50％),两组间具有显著性差异(P＜0.01),在10米最大步行速度、步长、步频以及步态评分方面观察组较对照组有显著性差异(P＜0.01).结论 减重平板步行训练对脑卒中偏瘫患者下肢运功动能的恢复有一定的效果.     

针刺联合康复疗法治疗卒中后偏瘫患者的效果

目的:观察针刺联合康复疗法治疗卒中后偏瘫患者的效果。方法:选取88例卒中后偏瘫患者为研究对象,按照随机数字表法分为观察组与对照组各44例。对照组行常规康复治疗,观察组在对照组基础上给予针刺治疗,比较两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)、Fugl-Meyer运动功能评定量表(FMA)和功能性步行量表(FAC)评分。结果:观察组治疗总有效率为95.5%,明显高于对照组的79.5%,差异有统计学意义(P<0.05);治疗后,观察组NIHSS评分低于对照组,BI、FMA、FAC评分均高于对照组,差异有统计学意义(P<0.05)。结论:针刺联合康复疗法治疗卒中后偏瘫患者可提高治疗总有效率、BI、FMA和FAC评分,以及降低NIHSS评分,优于单纯康复疗法治疗效果。     

下肢康复机器人辅助康复训练对脑卒中后偏瘫患者下肢功能的影响

目的 探讨下肢康复机器人辅助康复训练对脑卒中后偏瘫患者下肢功能的影响。方法 选取2019年1—6月我院康复治疗部就诊的脑卒中后偏瘫患者74例,随机分为干预组与对照组,每组各37例。两组均酌情予以控制颅内压、营养神经细胞、基础疾病治疗及预防并发症等基础治疗。对照组予常规康复训练,干预组在对照组基础上加用下肢康复机器人辅助康复训练,两组均干预8周。观察并比较两组患者干预前与干预8周后下肢肌力、运动、平衡及步行能力的变化。结果 干预8周后,两组患者腘绳肌和股四头肌肌力较干预前明显上升(P0.05或P0.01),且干预组上升幅度高于对照组(P0.05);同时两组FMA评分、BBS评分和FAC评分较干预前明显上升(P0.05或P0.01),且干预组上升幅度高于对照组(P0.05)。结论 下肢康复机器人辅助康复训练用于脑卒中后偏瘫患者不仅可提高下肢肌力,还可促进下肢运动功能恢复,改善平衡能力和步行能力。     

电话随访联合家属参与式康复训练在脑梗死后偏瘫患者中的应用价值

目的分析电话随访联合家属参与式康复训练在脑梗死后偏瘫患者中的应用价值。方法选取南阳市第二人民医院2017年3月至2018年3月脑梗死后偏瘫患者86例,根据建档顺序分为对照组(43例)和观察组(43例)。对照组患者接受常规护理,观察组患者在对照组基础上接受电话随访联合家属参与式康复训练。比较两组康复训练依从性、运动功能(FMA)评分、日常生活能力量表(ADL)评分、生活质量(SF-36)评分。结果观察组患者康复训练依从率高于对照组(P<0.05);干预后观察组FMA、ADL、SF-36评分高于对照组(均P<0.05)。结论电话随访联合家属参与式康复训练可增强脑梗死后偏瘫患者康复训练依从性,提高运动功能与日常生活能力,改善生活质量。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.