大鼠脊髓5－羟色胺1A受体和1C／2受体亚型参与高频电针镇痛

通过脊髓蛛网膜下腔慢性埋植导管分别注射５－ＨＴ受体的多种拮抗剂，分析了大鼠脊髓５－ＨＴ受体的三个主要类型５－ＨＴ１、５－ＨＴ２和５－ＨＴ３受体在高频电针镇痛中的作用。实验结果表明：ｉ．ｔ．注射５－ＨＴ１Ａ受体拮抗剂ｓｐｉｐｅｒｏｎｅ２５μｇ不影响１００Ｈｚ电针的平均针效（Ｐ＞０．０５），但可阻断电针后效应（Ｐ＜０．０１）；ｉ．ｔ．注射５－ＨＴ１ｃ／２受体拮抗剂ｍｉａｎｓｅｒｉｎ５０μｇ可阻断１００Ｈｚ电针的平均针效，也可阻断电针后效应（Ｐ＜０．０１）；ｉ．ｔ．注射５－ＨＴ２受体拮抗剂１－ＮＰ２０μｇ和５－ＨＴ３受体拮抗剂ＩＣＳ２０５－９３０１００μｇ对１００Ｈｚ电针镇痛没有显著影响（Ｐ＞０．０５）。提示大鼠脊髓５－ＨＴ１Ａ受体和５－ＨＴ１ｃ／２受体参与介导１００Ｈｚ电针镇痛，而５－ＨＴ３受体可能不起主要作用。     

椎-基动脉缺血发作与睡眠呼吸障碍

Therelationshipbetweencerebro－vasculardiseases（CVD）andSRBDhasattractedpeople’sattentionmoreandmoreinthepastyears．WepresentinthispapertherelationshipofVBIandSRBDwhichhasnoteverbeenreportedbefore．１Subjectandmethod１．１SubjectFortyfivepatients，male３２，female１３，withanageof２７～７４yearsandanaveragedurationofillnessof２．１years（５daysto１０years）．１．２Criteriaofdiagnosis犤１犦（１）Transientvertigoattacksaccom－paniedbyotherVBIsymptomssuchasdiplopia，scintillation，visua…     

He-Ne激光重复照射抑制培养增生性瘢痕成纤维细胞胶原合成的实验研究

Hypertrophicscar（HS），atypeoffibrosisdiseaseofskinwhichischaracterizedbyhyperproductionanddepositionofcolla－genmatrix．So，inhibitionofcollagensynthesisanddepositionofcollageninfibroblastsareimportantforpreventionofHS犤１犦．Inthecurrentstudy，He－NelaserofvariouspowerdensitywasusedtoirradiateculturedfibroblastsderivedfromHStostudythepre－ventingeffectsofHe－NelaseronHS．１Materialsandmethod１．１Cellcultureandgrouping５casesofHSwereincludedinthisstudyaged１２～３１yearsold（２males，…     

Repair of posterior skin of heel and postoperative rehabilitation

INTRODUCTIONInjuryofposteriorskinofheeloftencausesskinnecrosisandwhenareaofsofttissuedefectislargeorcomplicatedwithexposureofAchillestendonandbone，therepairisverytroublesome．MATERIALSANDMETHODS７patientswereinvestigatedincluding５malesand２femalesaged２４－４９（mean：３５）yearsoldamongwhichwere５casesofsofttissuedefectaftercrashing，２casesafterskinscald．５caseswerecomplicatedwithexposureoftendonorbone，１casewasduetofailureoffreeskingraft，３caseswerefailureafterlong－termdre…     

小剂量多巴胺对肠系膜上动脉闭塞休克兔动脉血及门静脉血乳酸浓度影响的研究

目的：探讨肠系膜上动脉闭塞（ＳＭＡＯ）休克兔动脉血和门静脉血乳酸浓度的变化,以及小剂量多巴胺（５ μｇ·ｋｇ－ １·ｍ ｉｎ－ １）对其的影响。方法：２０只新西兰家兔随机分成２组,均制成ＳＭＡＯ 休克模型,２组均按３０ ｍ ｌ·ｋｇ－ １·ｈ－ １输入０．９％ ＮａＣｌ;Ａ组另给予多巴胺５ μｇ·ｋｇ－ １ ·ｍ ｉｎ－ １,Ｂ组作为对照组。分别观察血流动力学、动脉血和门静脉血乳酸浓度（ＡＬＴ、ＰＬＴ）,以及腹腔组织氧供（ＳＤＯ２）、氧耗（ＳＶＯ２）和氧摄取率（ＳＯ２ＥＲ）的变化。结果：Ａ组门静脉血流量指数（ＱｐｖⅠ）在休克模型复制后６０、９０ 和１２０ 分钟时明显高于Ｂ组（Ｐ＜ ０．０５或Ｐ＜ ０．０１）;２ 组ＡＬＴ、ＰＬＴ均明显升高,以休克后０ 时为最高〔Ａ 组分别为（６．５±１．１）ｍ ｍ ｏｌ／Ｌ和（６．９±１．４）ｍ ｍ ｏｌ／Ｌ;Ｂ组分别为（６．４±０．８）ｍ ｍ ｏｌ／Ｌ和（６．８±１．２）ｍ ｍ ｏｌ／Ｌ〕,但Ａ 组在此后呈逐渐下降趋势,在１２０分钟时最低〔分别为（３．２±０．３）ｍ ｍ ｏｌ／Ｌ和（３．５±０．３）ｍ ｍ ｏｌ／Ｌ〕,而Ｂ组则呈持续高水平〔分别为（５．５±０．５）ｍ ｍ ｏｌ／Ｌ和（５．７±０．９）ｍ ｍ     

舍曲林在强迫症、抑郁症治疗中的应用

舍曲林（Sertraline）是常用的选择性５－羟色胺（５－HT）再摄取抑制剂（SSRI）之一，通过对突触前膜５－羟色胺再摄取的阻滞作用广泛作用于５－羟色胺失调所致的疾病。１临床应用１．１强迫症随着神经生理学研究的进展，强迫症的发病机理也日渐明了。目前认为，强迫症与多种神经递质、特别是５－羟色胺失调有关犤１犦。而舍曲林系５－HT再摄取抑制剂，可通过对５－HT递质系统的调节作用达到治疗强迫症的目的犤２犦。陆林等（１９９７）以中国精神疾病分类和诊断标准（CCMD－２－R）和DSM－Ⅳ为诊断标准，用Yale－Brown．NIMH强…     

心理、行为疗法治疗慢性前列腺炎的效果分析

１Subjectandmethod１．１SubjectFromMay１９９９toJune２００１，４８６consecutivepatientssufferedfromchronicprostatitis（CP）andcomplicatedmooddisorderincluding２１９withnon－bacterialprostatitis，６３withsimpleprostatitispain，and２１９withchronicbacterialprostati－tis．Thesepatientsarerandomlydividedintostudygroupandcon－trolgroupeuqually．Theyare１９～４１yearsofage（meanage：３４years）．Diseasecourselastedfor０．５～４years，meanly２．５years．Mooddisorderischaracterizedbylackadaisicalne…     

654－2救治野芹中毒5例

６５４－２救治野芹中毒５例黑龙江省七台河市医院（１５４６００）沙中泉，王志国，莫文涛佳木斯市汤原县中心医院（１５４７００）南斗镇，王金凤用常规综合疗法抢救５例野毒芹中毒患儿．效果不佳，改用６５４－２治疗后，５例均获救。报道如下。１临床资料１．１发病情...     

高压氧对动物有机磷中毒后神经损害恢复的实验研究

１Subjectandmethod１．１Subject１６healthyNewZealandrabbitsaging６monthsandweightingfrom１．５kgto２．０kg，meanweight：（１．６７±２．０）kg，wereprovidedbyAnimalcenterDepartmentofGeneralHospitalofFuzhouMilitaryRegion．５０％oxidizingorgor（orgonicphospho－rus）wereperfusedintorabbit＇sstomach，５０mg／kg．Acutepoisoningmodelsofratswereestablished．Allratswererandomlydividedintohyperbaricoxygenandcontrolgroups．１．２MethodRabbitsinhyperbaricoxygengroupweretreatedwithHBO，２０minutesea…     

中空加压螺钉及带旋髂深血管髂骨移位对青壮年股骨颈骨折髋关节功能恢复的影响

３４patientswithfemoralneckfracturehadbeentreatedbycanulatecompressionbonescrewsinternalfixationwithtransplantingpedicleboneflapwithdeepiliaccircumflexvesselfromJuly１９９７，andtheeffectsweresatisfactory．１Subjectandmethod１．１SubjectInthegroup，therewere３４cases（aged１９～４８averaged３５．５，２８maleand６female）．Theinjurycausesinclud－ed：roadaccidentfor３２cases，andfallinginjuryfor２cases．Hospitalizationtimewerefrom２hoursto５months．Thetypeoffracture：２１patientswithinfra－head…     

物理疗法对解除妇科腹腔镜术后并发非切口疼痛的研究

目的 探讨物理疗法解除妇科腹腔镜术后与气腹相关的并发非切口疼痛的方法.方法 随机选取行腹腔镜妇科手术207例,随机分为按摩、仪器、常规3组,每组69例,按摩组予妇科腹腔镜术后并发非切口疼痛病人用穴位按摩,仪器组用微波仪器治疗,常规组进行常规术后护理等各种方法对解除非切口疼痛的效果进行比较.结果 穴位按摩及电磁波比常规护理治疗解除妇科腹腔镜术后并发非切口疼痛效果显著.结论 对妇科腹腔镜术后产生的非切口疼痛并发症可以由穴位按摩、电磁波治疗等物理方法解决,且是较理想的方法 .     

Transurethral microwave thermotherapy for prostatism: early Mayo Foundation experience.

As part of a multicenter investigative trial, transurethral microwave thermotherapy of the prostate was used in 60 men with symptomatic benign prostatic hypertrophy. A single office treatment on the Prostatron, a device that provides concurrent microwave heating of the prostate and conductive cooling of the urethra, was well tolerated and caused no major adverse events. Symptomatic improvement, especially the decrease in nocturia and urgency, was dramatic, and urinary flow was improved at 6 weeks. Continued follow-up suggests that further improvement will be achieved and that transurethral microwave thermotherapy has a role in the treatment of benign prostatic hypertrophy.     

微波聚束热疗法治疗晚期肝癌的疗效及护理

目的 探讨微波聚束热疗法治疗晚期肝癌患者的疗效及护理要点.方法 方便性抽样法选择我科于2009年4月至2013年3月行微波聚束热疗法治疗肝癌患者560例.采用UHR-2000型微波热疗机在电子监控系统调控下对其进行治疗.结果 560例患者全部顺利完成治疗,治疗结束1个月后进行评价,Karnofsky功能状态评分（KPS）提高10分以上者（即一般情况好转）占72.8%（408/560）,且患者疼痛、腹水及发热等不良反应均有较大改善.结论 热疗法对晚期肝癌的姑息性治疗有较好的效果.规范热疗患者的护理,减少患者在热疗过程中的不良反应,是提高患者热疗效果的重要保证.     

Spasticity After Stroke: An Overview of Prevalence, Test Instruments, and Treatments

ABSTRACT: The objective of this study was to present an overview of the prevalence of spasticity after stroke as well as of test instruments and treatments. Recent studies show that spasticity occurs in 20%-30% of all stroke victims and in less than half of those with pareses. Although spasticity may occur in paretic patients after stroke, muscle weakness is more likely to be the reason for the pareses. Spasticity after stroke is more common in the upper than the lower limbs, and it seems to be more common among younger than older people. To determine the nature of passive stretch, electromyographic equipment is needed. However, the Modified Ashworth Scale, which measures the sum of the biomechanical and neural components in passive stretch, is the most common instrument used to grade spasticity after stroke. Treatment of spasticity with physiotherapy is recommended, although its beneficial effect is uncertain. The treatment of spasticity with botulinum toxin in combination with physiotherapy is suggested to improve functioning in patients with severe spasticity. A task-specific approach rather than a neurodevelopmental approach in assessing and treating a patient with spasticity after stroke seems to be preferred.     

透明质酸钠配合物理疗法治疗膝关节骨性关节炎的临床效果

目的:观察透明质酸钠关节腔内注射结合物理治疗膝关节骨性关节炎的疗效。方法:84例膝关节骨性关节炎患者分为2组,A组43例采用关节腔内注射透明质酸钠2 ml,每周1次,再交替配合超声波、微波治疗;B组41例采用超声波、微波交替治疗。2组治疗前后均行Lysholm膝关节综合评分。结果:治疗5周后,2组Lysholm膝关节综合评分与治疗前比较均有明显提高(P<0.05),2组间比较A组优于B组(P<0.05)。结论:透明质酸钠关节腔内注射结合物理治疗膝关节骨性关节炎能明显缓解临床症状,提高关节功能,疗效优于一般的常规治疗。     

微波热疗联合中心静脉导管置入治疗结核性胸膜炎的疗效

目的探讨微波热疗联合中心静脉导管治疗结核性胸膜炎的疗效。方法 120例结核性胸膜炎且胸腔积液为中等量至大量的患者,按简单随机方法分为分为试验组和对照组,每组60例。对照组采用全身抗结核、反复胸腔穿刺引流治疗;试验组采用全身抗结核、中心静脉导管胸腔置入并联合微波热疗。比较2组疗效及胸水吸收时间、住院时间及并发症发生率。结果治疗2周后,试验组总有效率明显高于对照组(91.7%比78.3%,P<0.05);试验组胸水吸收时间和住院时间明显少于对照组(P<0.05);试验组并发症发生率明显低于对照组(5.00%比41.67%,P<0.05)。结论微波热疗联合中心静脉导管置入可促进结核性胸腔积液的吸收,缩短胸水吸收时间,减少胸膜包裹的发生率。     

Asociación entre diagnósticos e intervenciones de enfermeras en pacientes sometidos a cirugía torácica o abdominal superior

ObjectiveTo determine associations between respiratory nursing diagnoses and nursing interventions in patients submitted to thoracic or upper abdominal surgery.MethodCross sectional quantitative study. Participants were 312 adult patients within the first 48 hours after thoracic or upper abdominal surgery. Patients were examined by the research team using an instrument with variables related to the respiratory function. The research team established the presence/absence of three nursing diagnoses and proposed interventions using the NANDA-I classification and the Nursing Interventions Classification. Correlations were tested using the chi-square or Fisher's test.ResultsFrom the total 312 examinations, ineffective airway clearance was present in 185 (59.3%) assessments, ineffective breathing pattern in 123 (39.4%), and impaired gas exchange in 141 (45.4%). Significant correlations showed that patients with ineffective airway clearance were more likely to require pain management (or: 2.27), chest physiotherapy (or: 2.96), and positioning (or:1.8), while patients with impaired gas exchange were less likely to require airway management (or: 0.13) and chest physiotherapy (or: 0.28).ConclusionsPatients with ineffective airway clearance had more chances of requiring pain management, chest physiotherapy, and positioning, while the nursing diagnosis impaired gas exchange was related with airway management and chest physiotherapy. The findings provide basis for nurses to develop effective care plans and to minimize postoperative respiratory complications.     

The effect of a physiotherapy intervention on intestinal motility

[Purpose] It is important to facilitate intestinal motility in patients with reduced bowel movement through physiotherapy. The purpose of the present study was to compare the effects of passive exercise of the lower limbs and trunk (PELT) and combination therapies (COM) with those of conventional thermotherapy (TT) on bowel sounds (BSs) in healthy adult subjects. Since autonomic activity (AA) significantly influences intestinal motility, we also investigated the relation between intestinal motility and AA by measurement of BSs. [Subjects] The subjects were 16 healthy adult males. [Methods] The subjects were randomly assigned to 3 different physiotherapies, and BSs and sympathetic nerve activity were measured before and after the physiotherapies. [Results] While BSs significantly increased following all physiotherapies, the temporal changes in BSs were different among the physiotherapies. AA measurement showed that PELT and TT significantly decreased the heart rate. While the high-frequency (HF) component was increased in all physiotherapy groups, the increases in HF did not reach statistical significance. There were no significant correlations between BSs and AA. [Conclusion] We found that all of the tested physiotherapies increased BSs, suggesting that they are clinically useful for treatment of patients with reduced intestinal motility due to limited spontaneous movement or inability to rise up from bed.Key words: Intestinal motility, Passive exercise, Thermotherapy     

Fatigue and pain limit independent mobility and physiotherapy after hip fracture surgery

Purpose: The patient’s ability to complete their planned physiotherapy session after hip fracture surgery has been proposed as an independent predictor for achieving basic mobility independency upon hospital discharge. However, knowledge of factors limiting mobility is sparse. We therefore examined patient reported factors limiting ability to complete planned physiotherapy sessions as well as limitations for not achieving independency in basic mobility early after hip fracture surgery.

Methods: A total of 204 consecutive patients with a hip fracture (mean (SD) age of 80 (9.9) years, 47 patients were admitted from a nursing home) were treated in accordance with a multimodal program. The Cumulated Ambulation Score was used to evaluate the patient’s independency in three basic mobility activities: getting in and out of bed, sit-to-stand-to-sit from a chair and indoor walking. Pre-defined limitations; pain, motor blockade, dizziness, fatigue, nausea, acute cognitive dysfunction and “other limitations”, for not achieving a full Cumulated Ambulation Score or inability to complete planned physiotherapy sessions were noted by the physiotherapist on each of the three first postoperative days. This period was chosen, because of its importance on how well the patients had regained their pre-fracture functional level.

Results: Fatigue and hip fracture-related pain were the most frequent reasons for patients not achieving an independent basic mobility level (>?85%) or not fully completing their planned physiotherapy (>?42%) on all three days. At hospital discharge (median day 10), only 54% of the patients had regained their pre-fracture basic mobility level.

Conclusion: Based on the patient’s perception, fatigue and pain are the most frequent limitations in not achieving independent basic mobility and not completing physiotherapy after hip fracture surgery. This raises questions whether multimodal peri-operative programs can be further optimized to enhance the early recovery of these frail patients.

• Implications for rehabilitation

• Early postoperative mobilization is essential for patients undergoing hip fracture surgery to regain the pre-fracture functional level, in not only the short but also in the long term.

• The most frequent reasons for not achieving an independent Cumulated Ambulation Score or completing physiotherapy, early after hip fracture surgery, are fatigue, pain, and the habitual cognitive status of patients.

• Knowledge concerning postoperative fatigue is important for rehabilitation professionals and should contribute as an essential factor when planning physiotherapy.

     

Failure of electrical myofeedback to augment the effects of physiotherapy in stroke

Electromyographic biofeedback has been used with some success to treat patients with disturbances of muscle tone resulting from neurological disease. The aim of this study was to incorporate electrical myofeedback as an integral part of a physiotherapeutic regime designed to improve quality of movement and function in limbs weakened or paralysed by stroke. A portable, inexpensive E. M. G. biofeedback machine was used. Stainless steel skin electrodes were applied which needed minimal skin preparation. Twelve adults, (five male, seven female, mean age 44.2 years and 51.3 years respectively) who were referred for treatment due to weakness of limb muscles due to disease of the brain or spinal cord, were treated. The mean time from onset of incidence to treatment was 75.5 days. Each patient received six weeks of treatment. This was divided into two phases. Phase 1, (weeks 1, 2, 3) and phase 2 (weeks 4, 5, 6). Physiotherapy, and physiotherapy with biofeedback was randomly allocated to either phase. Each patient acted as his/her own control. A validated assessment was carried out by an independent therapist at the start of treatment, after three weeks and after six weeks of treatment. General function, knee function, range of movement of the affected side and timed tests were measured. Results show an overall improvement in general function. The second phase of treatment was slightly more favourable to improvement, but there was no indication that biofeedback significantly improved the outcome. In three tests it was equally significant to the physiotherapy applied; in one test it improved the effectiveness of physiotherapy and in one test it reduced the effectiveness of physiotherapy. This suggests that a six week course of physiotherapy improved muscular function and range of movements in patients with weakness due to upper motor neurone disease, but that these effects are not enhanced by myofeedback.