康复机器人对痉挛型脑性瘫痪患儿的康复效果

目的分析康复机器人训练对痉挛型脑性瘫痪患儿康复治疗的效果。方法选择2014-10—2016-10我院收治的痉挛型脑性瘫痪患儿94例,按随机数字表法分为对照组和观察组各47例,对照组采用常规康复训练,观察组在对照组基础上增加康复机器人辅助的减重步行训练,治疗前和治疗后3个月分别采用粗大运动功能测量表(GMFM)和日常生活能力评分(ADL)评定2组患儿的运动功能和生活能力。结果治疗后3个月,对照组E区GMFM评分及ADL评分均高于治疗前(P0.05),D区GMFM评分与治疗前比较差异无统计学意义(P0.05),观察组D区、E区GMFM评分及ADL评分均高于治疗前(P0.05),且观察组D区、E区GMFM评分及ADL评分均显著高于对照组(P0.05)。结论康复机器人训练能够有效改善痉挛型脑性瘫痪患儿的下肢运动功能,显著提高患儿的日常行动能力。     

综合干预疗法治疗小儿脑损伤综合征的疗效观察

目的探讨综合干预疗法治疗脑损伤综合征患儿的效果。方法选取我院小儿康复门诊收治的脑损伤综合征患儿120例为研究对象,采用数字随机对照表分为对照组和观察组,对照组予以脑活素穴位注射,观察组在对照组基础上行综合干预疗法,治疗前和治疗3个月后行Gesell法测定发育商,行粗大神经运动功能(GMFM)评分评估各区水平,均于1a后复查。结果观察组治疗3个月、12个月后社会适应、精细运动、大运动、个人社交、语言发育商均高于对照组,差异有统计学意义(P0.05);观察组治疗3个月、12个月后A卧位和翻身、B坐位、C爬和跪水平均较对照组高,差异有统计学意义(P0.05)。结论综合干预疗法能够促使脑损伤综合征患儿神经运动发育,疗效确切。     

单唾液酸四己糖神经节苷脂联合Bobath疗法对痉挛型脑性瘫痪患儿的疗效

目的观察单唾液酸四己糖神经节苷脂(GM1)联合Bobath疗法治疗痉挛型脑性瘫痪患儿的疗效。方法选取2013-03—2015-03我院收治痉挛型脑性瘫痪患儿56例为研究对象,采用随机数字法随机分为研究组(29例)和对照组(27例);2组患儿均给予Bobath干预技术,研究组在此基础上给予GM1治疗,2组患儿治疗前后进行粗大运动功能评估(GM-FM)与格赛尔发育量表(GDS)评估。结果治疗后2组患儿卧位和翻身能区、坐位能区、爬和跪能区、站立能区和行走与跑、跳能区评分均出现显著升高(P0.05),研究组评分均显著高于对照组(P0.05);治疗后2组患儿适应性、粗大运动、精细运动、语言和个人社交评分出现显著升高(P0.05),且研究组患儿适应性、粗大运动、精细运动、语言和个人社交评分均显著高于对照组(P0.05)。结论 GM1联合Bobath疗法治疗痉挛型脑性瘫痪患儿具有明显的疗效,值得临床推广。     

急性脑卒中肢体瘫痪早期康复治疗探讨

目的 探讨急性脑卒中肢体瘫痪早期康复治疗的疗效.方法 96例急性脑卒中伴肢体瘫痪患者随机分为对照组(31例)和治疗A组(32例)、治疗B组(33例).3组患者均接受神经内科常规药物治疗,治疗组在病情稳定48h后即予开始康复治疗,其中治疗A组进行运动疗法,治疗B组在进行运动疗法基础上加用中药离子中频脉冲穴位导入治疗瘫痪肢体,1次/d,20次为1疗程.治疗期间注意观察患肢瘫痪改善情况.结果 治疗A组与治疗2组有效率均优于对照组(P＜0.05及P＜0.01).结论 急性脑卒中早期综合性肢体康复治疗能有效提高患肢的肌力,减轻致残程度.     

心理干预配合针灸治疗对小儿脑瘫康复治疗的疗效观察

目的探讨心理干预配合针灸治疗小儿脑瘫康复的临床疗效。方法选取2010-04—2013-09于我院诊治的116例小儿脑瘫患者,随机分为A组和B组,每组58例,A组采用针灸与运动功能训练相结合的方法治疗;B组在此基础上加用心理干预治疗。评定治疗效果以及患儿运动功能的改善情况。结果 B组总有效率为91.38%,相比于A组的67.24%明显提高(χ2=14.053,P0.05);2组治疗后6个月GMFM评分相比于治疗前均明显提高,但B组提高幅度更大(P0.05);6个月~3岁患儿的总有效率为89.70%,明显高于3~6岁的62.50%,差异有统计学意义(P0.05)。结论针灸联合心理干预能够有效改善患者的运动功能,提高治疗效果,改善预后。早期治疗可能治疗效果更佳。     

针刺疗法治疗不随意运动型脑性瘫痪的疗效观察

目的 探讨针刺疗法治疗不随意运动型脑性瘫痪的疗效.方法 将40例不随意运动型脑瘫患者随机分为观察组和对照组.对照组进行常规康复治疗,观察组在常规康复的基础上进行针刺治疗,治疗前后分别评定2组患儿的运动功能.结果 观察组与对照组的运动功能相比差异有统计学意义(P＜0.05).结论 针刺疗法能有效提高不随意运动型脑瘫患儿的运动功能.     

头穴透刺配合核心稳定训练治疗痉挛型脑性瘫痪

目的探讨头穴透刺配合核心稳定训练治疗痉挛型脑性瘫痪患儿粗大运动功能的影响。方法 100例脑性瘫痪患儿随机分为2组,每组50例。根据痉挛型脑性瘫痪的临床特点,对照组采用传统的神经发育运动疗法;观察组采用头穴透刺配合核心稳定性训练治疗。治疗前后采用粗大运动功能量表(GMFM 88)进行评估。结果通过3个疗程治疗后,2组患儿的粗大运动功能量表评分均较治疗前提高(P0.05),观察组疗效明显优于对照组(P0.05)。结论头穴透刺配合核心稳定性训练能有效提高痉挛型脑性瘫痪患儿粗大运动功能,具有良好的临床效果。     

康复锻炼联合神经节苷脂治疗小儿脑性瘫痪的疗效观察

目的：探讨康复锻炼联合神经节苷脂治疗小儿脑性瘫痪的临床疗效。方法选择我院2012—2013年小儿科收治的60例脑瘫患儿的资料，将患儿分为观察组及对照组各30例，2组患儿均采用康复锻炼治疗，观察组加用神经节苷脂注射液静滴，在治疗前及治疗后90 d采用智力量表发展指数（MDI）和运动量表发展指数（PDI）对2组患儿的智力及运动功能进行评定。结果观察组MDQ和PDQ均明显增加，与对照组比较差异有统计学意义（P＜0.05）。结论康复锻炼联合神经节苷脂治疗小儿脑性瘫痪可明显促进患儿智力发育，同时提高运动能力，效果满意，值得临床推广。     

早期认知语言康复干预对精神发育迟缓儿童的影响

目的探讨早期认知与语言康复干预在精神发育迟缓(MR)患儿中的应用价值。方法以信阳市中心医院收治的104例精神发育迟缓患儿为研究对象,随机分成A组与B组各52例。A组给予常规干预,B组在A组基础上给予早期认知与语言康复干预,比较2组DQ(发育商)评分与WISC(韦氏幼儿智力量表)评分。结果干预后,B组DQ评分高于A组,差异有统计学意义(P0.05);干预后,B组WISC评分高于A组,差异有统计学意义(P0.05);B组干预后临界率为48.08%,A组为9.62%,差异有统计学意义(P0.05)。结论早期对精神发育迟缓患儿进行认知、语言康复干预,能改善精神发育水平,提升DQ与WISC,值得临床推广。     

运动发育推拿法与神经发育疗法在小儿脑瘫治疗中的疗效比较

目的比较运动发育推拿法与神经发育疗法在小儿脑瘫治疗中的疗效。方法将80例脑瘫患儿随机分为2组,均根据伴随症状给予针对性治疗,A组(n=40)采用运动发育推拿法治疗,B组(n=40)采用神经发育疗法治疗;比较2组患儿治疗前后粗大运动功能测量(GMFM-66)评分。结果 A组和B组接受治疗时间分别为(4.1±0.4)个月、(4.4±0.3)个月,组间比较差异无统计学意义(P0.05);2组患儿治疗后GMFM-66评分均较治疗前显著提高(P0.05),但治疗后组间比较差异无统计学意义(P0.05)。结论运动发育推拿法与神经发育疗法均可在短期内能有效提高脑瘫患儿的整体粗大运动功能,并在短期内得到维持,且两者的近期疗效相似。     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。