脑梗死偏瘫的早期康复治疗疗效探讨

目的 探讨脑梗死偏瘫的早期康复治疗疗效.方法 将122例脑梗死偏瘫患者随机分为两组,早期康复组60例,应用Clayton康复方案,疗程1个月;对照组62例,不进行康复锻炼.采用临床神经功能缺损程度评分,简式Fugl Meyer运动功能评分(FMA)以及改良Barthel指数(MBI)于初期、末期(1个月)对两组病人评定并进行t检验.结果 治疗后,早期康复组临床神经功能缺损程度评分明显减少,与对照组相比,P＜0.01,FMA、MBI明显提高,与对照组相比,P＜0.01.结论 早期康复治疗可明显促进患肢运动功能恢复,降低致残率,提高日常生活能力.     

528例脑卒中偏瘫早期康复治疗体会

目的 论证脑卒中偏瘫的早期康复的有效性、必要性，以及最佳时间。方法 将900例脑卒中病人随机分为2组，康复组528例，对照组372例。再将各组按发病时间先后分为超早期、早期、中期、后期4个小组。康复组除基本的神经科治疗外，每日应用Bobath技术康复锻炼lh，疗程1个月。对照组只给以基本的神经科治疗。分别在入院及治疗结束时，采用神经功能缺损程度评分、简式运动功能量表(FMA)、Barthal指数量表(MBI)，对各组病人进行评定，并进行t检验。结果早、中期康复组临床神经功能缺损评分明显减少，与对照组相比P＜0．00l;FMA及MBI明显提高，与对照组相比P＜0．00l.超早期的神经功能缺损减少及FMA、MBI提高与对照组相比有差异，P＜0．05。后期康复与对照组相比无差异，P＞0．05。康复组的早、中期与超早期、后期相比，有显著差异，P＜0．00l.结论 发病3-14d之间的康复均比未康复的FMA、MBI的提高与神经功能缺损降低有极显著差异，而发病3d之内或超过14d者其康复与未康复差异不显著。     

脑卒中偏瘫病人继发损伤的早期康复

目的观察早期康复治疗对脑卒中偏瘫病人继发损伤的作用。方法选择脑卒中偏瘫病人70例，随机分为康复组和对照组各35例，治疗组应用药物及正规的康复治疗，对照组仅用药物治疗。比较两组治疗效果。结果治疗后两组足下垂发生情况比较差异有显著性（Χ^2=8．93，P〈0．05）。两组病人治疗前后MBI评分比较差异有显著性（t=2．93、3．57，P〈0．05）。结论早期康复可有效提高病人生活自理能力，预防或改善脑卒中偏瘫病人继发损伤。     

急性脑卒中的早期康复疗效观察

目的：探讨急性脑卒中的早期康复疗效。方法：将70例急性脑卒中患者随机分为两组：早期康复组35例,应用易化技术进行康复训练,疗程3个月;对照组35例,不进行康复训练。采用临床神经功能缺损程度评分,简式Fugl-Meyer运动功能评分（FMA）,改良Barthel指数（MBI）于初期、末期（3个月后）对两组病人评定并进行t检验。结果：治疗后,早期康复组临床神经功能缺损程度评分明显减少,与对照组相比P＜0．01;FMA、MBI明显提高,与对照组相比P＜0．01。结论：早期康复治疗可明显促进患肢运动功能恢复,降低致残率,提高日常生活能力。     

脑卒中早期综合康复治疗的临床观察

目的:探讨早期综合康复治疗对急性脑卒中偏瘫患者运动功能和日常生活能力的影响。方法:80例急性脑卒中偏瘫患者随机分成康复组和对照组各40例。两组神经内科常规治疗相同,康复组同时由经过专业训练的治疗师给予系统的综合康复训练。结果:采用FMA评分进行运动功能评定,采用Barthel指数进行ADL评定,治疗前两组评分差异均无显著性(P>0.05);治疗4周后康复组评分均明显优于对照组(P<0.05)。结论:早期综合康复训练可以促进脑卒中偏瘫病人运动功能恢复,提高日常生活能力,降低残废率。     

多学科合作康复治疗对脑卒中偏瘫的疗效观察

目的:探讨在社区卫生服务中心开展多学科合作康复治疗对脑卒中偏瘫患者运动功能和日常生活活动(ADL)能力的影响.方法:采用随机病例对照方法.56例脑卒中偏瘫患者随机分两组,治疗组27例和对照组29例.两组常规康复治疗相同,治疗组采用多学科合作康复治疗进行干预.两组对象在治疗前分别接受Fugl-Meyer运动功能评定量表(FMA),改良Barthel指数量表(MBI)评定,治疗12周后再次评定.结果:两组治疗前后FMA和MBI评定比较差异有显著性(P＜0.05),治疗后治疗组与对照组之间的FMA和MBI评定比较差异有显著性(P＜0.05).结论:在社区卫生服务中心开展多学科合作康复治疗可明显地促进脑卒中偏瘫患者运动功能和ADL能力,疗效优于常规康复治疗.     

肌电生物反馈技术治疗脑卒中偏瘫病人的效果

目的观察肌电生物反馈技术治疗脑卒中偏瘫病人的效果。方法脑卒中偏瘫病人100例,随机分为两组。两组药物治疗相同,治疗组在传统康复疗法基础上加肌电生物反馈技术进行治疗,对照组只进行传统康复治疗。观察两组治疗前后临床神经功能缺损程度评分、肢体运动功能Fugl—Meyer评分（FMA）,日常生活活动能力（ADL）按Barthel指数积分（MBI）评定。结果治疗组治疗后临床神经功能缺损程度评分、MBI、FMA与对照组相比,差异有显著性（t=13．42-17．16,P〈0．01）。结论肌电生物反馈技术治疗对提高脑卒中病人的肢体运动功能及ADL能力有重要作用。     

早期康复对脑卒中患者生活质量的影响

目的　探讨早期康复对急性脑卒中偏瘫患者生活质量的影响。方法　对 6 0例脑卒中偏瘫患者随机分为康复组 32例、对照组 2 8例进行对照研究 ,两组均经过相同的神经内科治疗 ,康复组早期予以Bobath(神经生理学疗法 )和运动再学习方法康复治疗 ,治疗开始及 1个月后分别进行神经功能缺损 ,运动功能 (FMA)、日常生活活动能力Bartherlndex(BI)、生活质量指数QLI评分。结果　康复组与对照组末次 4项积分均有非常显著性差异 (P <0 .0 0 1 )。结论　早期康复可使脑卒中患者生活质量明显提高。     

早期综合康复对脑卒中患者运动功能ADL能力的影响

目的:探讨早期综合康复治疗对脑卒中患者偏瘫肢体运动功能和ADL能力的影响。方法:56例急性脑卒中患者随机分成康复组与对照组,两组患者均给以常规药物治疗,康复组加予规范化的综合康复训练;入组时与治疗1个月后分别采用简化Fugl-Meyer量表(FMA)和Barthel指数(BI)来评定患者运动功能及ADL能力。结果:在入组时。康复组与对照组FMA评分、BI评分比较(P>0.05)差异无显著性,而治疗1个月后康复组与对照组FMA评分与BI评分差异有显著性,康复组患者明显提高,FMA值与BI值明显高予对照组。结论:早期综合康复治疗明显可以改善患者运动功能,提高日常生活自理能力。     

早期康复介入对脑卒中后偏瘫患者的影响

目的 探讨早期康复介入治疗对脑卒中偏瘫患者预后的影响.方法 将90例脑卒中患者分为康复组和传统治疗组,分别采用Fugl-Meyer运动量表(FMA)、Barthel指数(BI)和肩手综合征(SHS)发生率于治疗前及治疗30、60d后评定两组患者的肢体运动功能、日常生活活动能力(ADL)和肩手综合征发生率.结果 康复组和传统治疗组治疗前各项评分比较差异无显著性(P＞0.05),治疗30、60d后两组比较,康复组FMA及BI评分明显高于传统治疗组(P＜0.01),肩手综合征发生率明显低于传统治疗组.卡方检验发现肢体运动功能的改善与ADI的提高呈正相关.结论 早期综合康复介入对脑卒中患者肢体运动功能有明显的改善,能提高ADI能力、减少肩手综合征发生率、改善患者的预后.     

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.