躯干与肢体动作组合训练对脑梗死患者的康复效果分析

目的:探讨躯干与肢体动作组合训练在脑梗死患者中的康复效果。方法:选择脑梗死患者80例,随机分为观察组和对照组,对照组患者给予常规脑梗死治疗,根据患者具体病情给予对症处理,对照组患者实施常规肢体训练康复治疗,观察组在实施常规康复训练同时给予躯干和肢体动作组合训练,采用简式Fugl-Meyer运动功能评分标准两组患者均在治疗前和治疗后运动功能改变情况进行评定;采用Barthel指数评分法对两组患者日常生活活动能力进行评定。结果:观察组治疗前Fugl-Meyer运动功能评分和日常生活活动能力评分和对照组治疗比较,差异无统计学意义(P>0.05);观察组治疗后Fugl-Meyer运动功能评分和日常生活活动能力评分与对照组治疗后比较,差异有统计学意义(P<0.05)。结论:躯干与肢体动作组合训练在脑梗死患者中的康复效果显著,能够显著改善患者运动功能和提高日常生活能力。     

脑卒中患者呼吸功能水平与肢体功能康复相关性研究

目的 探讨脑卒中患者呼吸功能改善与肢体功能障碍康复相关性分析研究。方法 选取106例脑卒中偏瘫患者,随机分为对照组53例;干预组53例。对照组53例患者进行包括运动治疗、作业治疗、传统康复等多种治疗方法在内的常规康复治疗;干预组53例患者在此基础上另外进行呼吸肌反馈训练。每周5次,共训练4周。于治疗前后,对两组患者进行呼吸功能评定、上下肢功能评定及日常生活活动能力评定,对治疗后的患者呼吸功能与肢体功能评分及日常生活活动能力评分进行相关性分析。结果 干预组患者的呼吸功能评定评分、上下肢运动功能简式Fugl-Meyer 量表(FMA)评分、日常生活活动能力改良Barthel 指数(MBI)评分均高于对照组,差异具有统计学意义(P＜0.05),干预组患者治疗后呼吸功能水平与肢体功能FMA、MBI评分呈正相关(r=0.425、0.478,P＜0.05)。结论 呼吸肌反馈训练可以有效改善脑卒中偏瘫患者的上下肢运动功能,并提高患者的日常生活活动能力,脑卒中患者的呼吸功能改善与患者的肢体功能障碍恢复呈正相关,可以在临床上通过改善提高患者的呼吸功能水平以恢复患者的肢体功能。     

早期康复护理训练对急性脑梗死患者肢体运动功能的影响

目的探讨早期康复护理训练对急性脑梗死患者肢体运动功能恢复的影响。方法将80例急性脑梗死患者,随机分为治疗组和对照组,每组40例。两组均采用电刺激小脑顶核、常规神经内科药物治疗及护理,治疗组在发病48h内进行早期康复护理训练。所有病例在治疗前和治疗后30d应用简化Fugl-M eyer运动功能积分法(FMA)和欧洲卒中评分(ESS)进行功能评定。结果两组在治疗前FMA评分、ESS评分差异均无统计学意义(P>0.05),治疗组在治疗后30d ESS评分明显好于治疗前及对照组,差异有高度统计学意义(P<0.01),FMA评分与治疗前比较明显好转,差异有高度统计学意义(P<0.01),与对照组比较,上肢差异有高度统计学意义(P<0.01),下肢差异无统计学意义(P>0.05)。结论早期康复护理训练对脑梗死患者肢体的恢复有明显促进作用。     

急性脑梗死早期康复治疗90例临床观察

目的:探讨早期康复治疗对急性脑梗死患者偏瘫肢体功能及日常生活能力的影响.方法:180例急性脑梗死患者随机分为康复组和对照组各90例,积组患者均给予常规药物治疗,康复组给予系统的早期康复治疗,对照组自行锻炼.结果:采用修订的Barthel指数(MBI)和简式Fugl-Meyer运动功能积分法对两组进行治疗前后神经功能评定:治疗前两组评分差异无显著性(P>0.05),治疗后康复组评分明硅优于对照组(P<0.05).结论:早期康复治疗对急性脑梗死患者偏瘫肢体运动功能及日常生活能力恢复具有促进作用.     

NJF技术对脑梗死患者偏瘫肢体功能及ADL的影响

目的:探讨神经肌肉关节促进法对脑梗死后偏瘫患者的偏瘫肢体功能及日常生活活动能力的康复疗效.方法:将67例急性期的脑梗死患者随机分为观察组与对照组.在常规治疗基础上,观察组患者给予神经肌肉关节促进法训练,对照组给予神经肌肉本体感觉促进技术训练.所有入选患者均分别在治疗前、治疗30 d后采用简式Fugl-Meyer运动功能量表评定患者偏瘫肢体的运动功能,改良Barthel指数评定患者的日常生活活动能力(ADL).结果:与治疗前比较,两组患者治疗30 d后的FMA和MBI的评分均有所提高,比较差异具有统计学意义(P<0.05);治疗30 d后两组患者的FMA和MBI评分的组间比较,观察组的FMA和MBI评分均高于对照组(P<0.05).结论:NJF能有效提高急性期脑梗死患者偏瘫肢体运动功能及ADL能力,疗效确切,值得临床推广应用.     

早期康复治疗对脑梗死患者运动及认知功能的影响

目的：探讨早期康复对脑梗死患者肢体运动功能，日常生活能力及认知功能恢复的影响。方法：选择首次发病的脑梗死患者50例，随机分为康复组和对照组（每组25例），康复组在给予常规治疗的同时分别给予正规的康复治疗，对照组仅给予神经科常规治疗，分别于康复治疗前当天和治疗后6周采用简式Fugl-Meyer评估（FMA）及Barthel指数分别评定肢体运动功能及日常生活能力（ADL），采用简明精神状态检查量表（MMSE）评估认知功能。结果：经6周康复治疗后，两组患者的肢体运动功能评分，ADL及认知功能评分均有明显改善，与对照组比较，康复组日常生活能力评分增高显著（P＜0．01），且下肢运动功能恢复明显，康复组认知功能评分与对照组比较无统计学差异，但康复组定向力及和改善明显优于对照组（P＜0．01），结论：早期康复能明显改善脑梗死患者的肢体运动功能及日常生活能力。     

肢体康复训练与高压氧治疗急性脑梗死的疗效观察

目的：探讨肢体康复训练与高压氧综合治疗急性脑梗死患者的疗效。方法：将我院2005年8月至2006年10月收治的78例急性脑梗死患者根据所接受治疗的不同分为2组。对照组48例,观察组30例,对照组进行常规药物治疗,观察组在此基础上进行肢体康复训练加高压氧治疗。采用患肢运动功能评定（FMA）,日常生活能力评分（ADL）和焦虑自评量表（SAS）、分别于治疗前和治疗20天后对两组患者进行评定。两组患者在治疗前的各项评分无显著差异。结果：治疗20天后观察组FMA和ADL评分明显高于对照组,有显著性意义（P〈0.01）。SAS评分明显低于对照组,有显著性意义（P〈0.01）。结论：肢体康复训练与高压氧治疗急性脑梗死,可显著提高患肢运动功能,改善患者焦虑心理,增强患者日常生活能力和治疗的信心,提高生存质量。     

强化屈髋训练对脑卒中偏瘫患者下肢运动功能的影响

目的探讨强化屈髋训练对偏瘫患者下肢运动功能恢复的影响。方法将72例脑卒中偏瘫患者随机分为强化曲髋训练组（强训组）和常规康复训练组（对照组）各36例。对照组进行常规康复治疗,强训组在常规康复治疗的基础上进行强化屈髋训练。治疗前后两组进行下肢简式运动评分（Fugl—Meyer assessment,FMA）评定,比较各组治疗前后及两组治疗后FMA评分。结果两组治疗前下肢运动功能评分比较无显著性差异（P〉0．05）,两组康复训练后下肢功能运动评分均较训练前升高,差异有显著性（P〈0．05）;并且强训组评分高于对照组,差异亦有显著性（P〈0．05）。结论强化屈髋训练对脑卒中偏瘫患者下肢运动功能恢复有良好的促进作用,值得临床推广应用。     

早期康复护理对脑梗死患者肢体功能的影响

目的探讨早期康复护理对脑梗死后患者运动功能恢复的影响。方法将106例脑梗死患者随机分组,分为浅试验组53例和对照组53例。两组患者均接受内科常规药物治疗和护理。试验组加用康复护理,肢体运动功能采用简式Fugl-Meyer(FmA)积分评定,分别于治疗前和治疗后一个月评定。结果治疗后,两组FmA评分均较治疗前有一定程度的改善,而且治疗组改善程度均优于对照组(上肢P0.05,下肢P0.01)。结论早期康复护理可提高脑梗死患者的肢体运动功能。     

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.     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.