脑卒中偏瘫患者家庭康复护理干预及效果评价

目的探讨家庭护理干预对脑卒中患者运动能力及日常生活活动能力的影响。方法选择经治疗好转出院80例脑卒中偏瘫患者，随机分成两组，干预组每月上门随访指导，对照组回家自行锻炼或休养，运动能力采用功能独立性评分（FIM）、日常生活活动能力（ADL），采用Barthel指数评分。结果6个月后干预组FIM及Barthel评分明显高于对照组（P〈0．01）结论家庭康复护理干预能明显改善脑卒中患者的运动能力和提高日常生活自理能力。     

延续护理在围绝经期脑卒中患者运动功能康复中的应用

目的探讨延续护理在围绝经期脑卒中患者运动功能康复中的应用效果。方法选取2016-01—2018-12康复出院的56例围绝经期脑卒中患者,依据随机数字表法分为观察组和对照组各28例。对照组采取常规出院后家庭照顾护理,观察组在对照组的基础上实施延续护理。结果实施延续护理后,观察组患者Barthel指数、Fugl-Meyer指数两项评定指标均高于对照组,差异具有显著统计学意义(P<0.01);出院时2组内对比差异无统计学意义(P>0.05);与出院时相比,出院3个月、6个月、12个月2组患者日常生活能力评定量表及康复评定量评分相关指标均有所上升,且观察组患者各项评分指标均要高于对照组(P<0.01)。结论实施延续护理,通过对社区围绝经期脑卒中患者进行规范康复、生活方式指导及心理护理,有助于促进患者肢体运动功能恢复及日常生活能力提高,使其逐步最大限度地恢复或重建功能,提高患者生存质量。     

脑心康复师主导的脑卒中照顾者培训计划表在脑卒中后运动康复中的应用及效果

目的 探讨脑心康复师主导的脑卒中照顾者培训计划表在脑卒中后运动康复中的应用及效果。方法 按入院先后顺序选2022年1月-2022年6月在某三甲医院神经内科收治的符合标准的患者及照顾者各80例，按随机数字表法分成观察组和对照组各40例；对照组按传统康复方案进行脑卒中后康复训练；观察组采用脑心康复师主导的照顾者培训计划表；对2组患者进行入院时、出院当天、入院后3个月这3个时间段的肢体运动功能及生活自理能力比较，同时对照顾者进行3次同时间段的焦虑评分。结果 2组组内比较出院时与入院时各指标均有明显差异(P<0.05),且观察组患者的3个时间段的简易Fugl-meyer运动量表(Fugl-Meyer assessment scale, FMAS)评分、Barthel指数及满意度评分明显高于对照组，但照顾者的焦虑评分低于对照组(P<0.05)。结论 脑心康复师主导的脑卒中照顾者培训计划表能帮助照顾者出院后对患者进行运动康复的管理，有助于激发照顾者及患者的潜能，促进患者的运动功能及生活自理能力的恢复，降低照顾者的焦虑情况，提高患者满意度。     

目标化康复指导路径表单在脑卒中病人早期康复中的应用

目的 探讨目标化康复指导路径表单在急性缺血性脑卒病人早期康复中的应用效果。方法 2018年1月1日~5月31日收治符合标准的缺血性脑卒中22例为对照组，2018年6月1日~12月31日收治符合标准的缺血性脑卒中23例为观察组。对照组采用常规健康教育和康复指导方法；观察组按照制订日具体目标及康复指导内容循序渐进进行康复指导。入院时、出院时采用自制问卷测评脑卒中知识，入院时、出院时、出院后3个月采用Fugl-Meyer运动功能量表（FMA）评分评定肢体功能。结果 入院时，两组病人脑卒中知识得分和FMA评分均无统计学差异（P>0.05）；出院时，两组脑卒中知识得分较入院时明显提高（P<0.05），而且观察组，明显高于于对照组（P<0.05）；出院时、出院后3个月，两组组FMA评分较入院时均明显提高，而且观察组明显高于对照组（P<0.05）。结论 目标化康复指导路径表单可有效提高病人脑卒中疾病知识、康复技能及遵医行为，提高康复效果。     

不同方式延续性护理对脊髓损伤病人的效果比较

目的 比较不同方式延续性护理对脊髓损伤病人的效果。方法 回顾性分析2017年3~9月收治的100例脊髓损伤的临床资料。50例采用骨科常规延续护理方式（对照组）,50例在对照组基础上加入居家骨科护理平台进行延续护理（观察组）。出院时、出院后6个月,采用功能独立性评定量表（FIM）、抑郁自评量表（SDS）评价干预效果。结果 出院时,两组FIM评分、SDS评分均无统计学差异（P>0.05）;出院后6个月,两组FIM评分和SDS评分均明显改善（P<0.05）,而且观察组明显优于对照组（P<0.05）。观察组泌尿系统感染、静脉血栓形成等并发症发生率显著低于对照组（P<0.05）。结论 居家骨科护理平台有利于保证脊髓损伤病人出院后护理的延续性,提高运动和认知水平,减少并发症     

基于微信平台的延续性护理对重型颅脑损伤病人术后康复效果的影响

目的 探讨基于微信平台的延续性护理对重型颅脑损伤病人术后康复效果的影响。方法 回顾性分析2017年1月~2018年1月手术治疗的100例重型颅脑损伤的临床资料,术后实施常规出院指导50例（对照组）,术后实施基于微信平台的延续性护理50例（观察组）。采用美国国立卫生研究院卒中量表（NIHSS）评分评估神经功能,采用Barthel指数评估生活自理能力。结果 入院时,两组NIHSS评分、Brathel指数均无统计学差异（P>0.05）;干预6个月,两组NIHSS评分、Brathel指数均明显改善（P<0.05）,而且,观察组明显优于对照组（P<0.05）。结论 重型颅脑损伤术后病人,采用基于微信平台的延续性护理可促进病人神经功能恢复,改善病人生活自理能力     

多发性硬化康复体操在神经内科病房中的应用价值

目的探讨多发性硬化康复体操在神经内科病房中的应用价值。方法将100例多发性硬化患者随机分为实验组50例和对照组50例。对照组采用常规的治疗和非系统锻炼,实验组在此基础上由专科护士指导,进行康复体操锻炼,随访观察2个月,采用Barthel指数评分对患者生活自理能力进行评估,并对2组患者的评分进行比较。结果实验组应用康复体操后生活自理能力评分高于对照组,差异有统计学意义(P0.05)。结论多发性硬化患者进行康复体操锻炼能有效促进其肢体功能的康复。     

Orem理论在40例脑卒中患者家庭康复中的应用效果观察

目的探讨Orem自理理论在脑卒中患者家庭康复中的作用,为患者家庭康复提供更好的护理干预措施,以期提高脑卒中患者的生活质量。方法将80例脑卒中出院患者随机分为观察组40例和对照组40例,观察组采用Orem自理理论对患者进行康复指导,并帮助制订个体康复训练计划。对照组给予护理常规出院指导。2组均于出院时、出院后3和6个月行日常生活活动能力评估。结果观察组日常生活Barthel指数与对照组比较,出院3、6个月差异均有统计学意义(P<0.01)。结论Orem护理在脑卒中患者家庭康复中具有重要作用。     

居家护理干预对精神分裂症患者长期预后的影响

目的探讨居家护理在精神分裂症患者康复中的干预作用。方法选择痊愈精神分裂症120例,随机分为干预组60例和对照组60例,出院后两组均给予精神药物治疗。干预组实施出院后居家护理康复指导,包括定期电话和上门随访。对照组实施常规出院宣教,每个月门诊复查和电话咨询。在出院时及第6、12个月末两组分别采用日常生活能力（ADL）评定量表、简明精神病评定量表（BPRS）及康复状态量表（MRSS）、进行评定,并统计1年内复发情况。结果观察1年后,干预组的ADL总分、BPRS总分、MRSS总分低于对照组,差异有显著性意义（P〈0.01）;干预组服药依从性高于对照组,差异有显著性意义（P〈0.01）,干预组的复发率（21.67%）低于对照组（33.39%）,差异有显著性意义（P〈0.05）。结论实施居家护理干预可巩固治疗效果,减少疾病复发,改善日常生活能力。     

基于PEO模式的家庭作业治疗对卒中偏瘫患者功能预后的影响

目的 研究基于人-环境-作业（person-environment-occupation,PEO）模式的家庭作业治疗对卒中偏瘫患者上肢功能、日常生活活动能力及生活质量的影响。方法 前瞻性、连续纳入2020年1月—2020年12月南京市浦口人民医院（原南京市浦口区中心医院）康复医学科出院的卒中偏瘫患者,随机分为试验组和对照组,并分别建立微信群聊,对照组定期更新康复小视频,有任何问题随时咨询。试验组基于PEO模式,个性化更新每位患者的小视频,两组分别于出院时、出院3个月、6个月和12个月分别进行Fugl-Meyer运动功能量表上肢部分（Fugl-Meyer assessment upper extremity scale,FMA-UE）、日常生活活动能力Barthel指数（Barthel index,BI）及卒中专用生活质量量表（stroke-specific quality of life scale,SS-QOL）的评定。结果 最终纳入卒中偏瘫患者60例,平均年龄（63.10±6.83）岁,其中男性30例。将入组患者随机分为对照组和试验组各30例。组内比较显示,试验组出院3个月BI评分...     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.