脑卒中后抗抑郁治疗对神经功能康复的影响

目的 评价抗抑郁治疗对脑卒中患者神经功能康复的影响.方法 将126例急性脑卒中后并发早发性抑郁症患者随机分为治疗组和对照组,每组各63例,治疗组在常规脑卒中治疗基础上给予抗抑郁治疗,对照组仅采用常规治疗,3个月后进行疗效评价.结果 中国卒中量表(CSS)评分、日常生活能力(ADL)评分、血压控制达标率、汉密尔顿抑郁量表(HAMD)评分、睡眠障碍发生率、1个月内脑卒中再发率、2个月后血管性认知障碍发生率组间比较差异均有统计学意义(P＜0.01).结论 脑卒中后常并发抑郁症,及时抗抑郁治疗对神经功能康复起着促进和协调作用,能明显提高脑卒中患者的生活质量.     

抗抑郁治疗对脑卒中后神经功能康复疗效对照研究

目的 比较氟派噻顿美利曲辛片和非抗抑郁药物治疗对脑卒中后抑郁症患者的神经功能康复的临床疗效差异.方法 将90例脑卒中后抑郁症患者分为抗抑郁治疗组（治疗组）和非抗抑郁药物治疗组（对照组）,利用HAMD抑郁量表及NIH-NINDS评分表分别在治疗前及治疗8周后评定抑郁严重程度及治疗疗效.结果 （1）治疗第8周后治疗组及对照组HAMD评分及NIH-NINDS评分显示治疗前后临床疗效差异有统计学意义（P〈0.01）.（2）治疗组与对照组在第8周末疗效差异有统计学意义（P〈0.01）.结论 抗抑郁治疗对脑卒中后神经功能康复的疗效确切,值得临床进一步推广.     

心理康复在预防脑卒中抑郁症中的效果观察

目的评价早期心理康复在预防脑卒中后抑郁症中的效果。方法将92例PSD患者随机分为对照组(基础治疗+心理疏导)及治疗组(基础治疗)各46例,治疗前、治疗后3个月、6个月、12个月、24个月后分别采用HAMD17项抑郁量表及SSS评分量表,对每位患者进行评分,评定效果。所有并发PSD患者采用百分比(发生率)进行统计,判断效果。结果治疗组HAMD及SSS评分明显优于对照组,有统计学意义(P<0.01),且PSD发生率治疗组亦明显低于对照组,有统计学意义(P<0.01)。结论早期心理康复不仅可有效预防PSD的发生,而且还可提高神经功能缺损的康复率。     

尼莫同治疗脑卒中后抑郁症的临床研究

目的探讨尼莫同对脑卒中后抑郁症的抑郁状态和神经功能缺损的改善作用。方法根据CCMD—Ⅱ—R的抑郁诊断标准，选取80例脑卒中后抑郁症患者，随机分为治疗组（尼莫同组）和对照组（赛乐特组），采用汉密顿抑郁量表（HAMD）评定抑郁程度，和采用神经功能缺损程度评分标准进行神经功能评分，并对两组病例0、2、4、6周的评分进行统计分析，评定疗效。结果脑卒中患者抑郁症状的发生率为43．0％；尼莫同与赛乐特治疗脑卒中后抑郁症均可取得较好疗效，抗抑郁治疗有效率尼莫同组为85％，赛乐特组为90．0％；促进神经功能恢复方面，尼莫同组有效率为87．5％，赛乐特组为67．5％，但尼莫同对于神经功能的恢复效果明显优于赛乐特，有显著性差异，且不良反应轻。结论对脑卒中后抑郁症尽早给予尼莫同治疗，可显著改善抑郁状态和促进神经功能的恢复。     

支持性心理干预对社区老年脑卒中后抑郁患者康复的影响

目的：探讨支持性心理干预对老年脑卒中后抑郁患者康复的影响。方法：将42例老年脑卒中后抑郁患者随机分2组,每组各21例,两组患者均进行常规脑卒中的药物、抗抑郁及康复治疗,支持性心理干预组同时进行支持性心理干预,两组治疗前、后分别进行Hamilton抑郁量表（HAMD）评分、神经功能缺损评分（NFA）、Barthel生活能力指数（BL）评定、运动功能评分（FMA）检测。结果：支持性心理干预组和对照组,治疗前各项评分比较,差异无统计学意义（P〉0.05）;经过8~12周治疗后,支持性心理干预组和对照组各项评分比较：抑郁量表评分（HAMD）和运动功能评分（FMA）差异有统计学意义（P〈0.05）,生活能力评分（NFA）和生活能力指数评分（BI）差异有统计学意义（P〈0.05）。结论：支持性心理干预在社区老年脑卒中后抑郁患者康复治疗中起重要作用,能显著提高康复效果。     

脑卒中后并发抑郁症的临床分析

对脑卒中后并发抑郁症的临床资料进行分析。对128患者脑卒中患者，根据汉密尔顿抑郁量表（HAMD）评分，分为伴抑郁脑梗死组（A组）49例，无抑郁对照组（B组）79例，分析脑梗塞发生部位与抑郁症、脑卒中抑郁与神经功能缺损程度的关系。脑卒中后抑郁的发生率为38．28％（49／128）；左侧半球脑卒中与右侧组比较，差异有统计学意义（P〈0．05）；A组在左侧半球基底结、额颞叶及其他部位上的脑卒中分部，差异有统计学意义（P〈0．05）。神经功能正常与不同程度的神经功能缺损组其抑郁情绪正常、轻度、中度、重度间存在明显的相关性（P〈0．01）。结论脑卒中后抑郁症（Post stroke depression。PSD）与脑卒的部位有关，神经功能缺损程度与抑郁也有相关性。     

急性脑卒中偏瘫的早期综合康复治疗疗效观察

目的研究早期综合康复治疗对急性脑卒中偏瘫的疗效。方法240例急性脑卒中偏瘫患者随机分为治疗组（120例）和对照组（120例）,均进行神经内科常规药物治疗,治疗组加以早期综合康复治疗,包括针灸、功能锻炼、神经功能重建治疗仪及心理治疗。两组患者分别在治疗前及治疗结束后三个月测试神经功能缺损评分对比治疗结果。结果治疗结束后治疗组神经功能缺损评分较治疗前明显降低,对照组神经功能缺损评分也较治疗前降低,但两组治愈率及治愈加显效率比较有显着性差异（P〈0．05）。结论早期综合康复治疗能明显改善患者的运动功能,提高生活质量。     

探讨康复护理在脑卒中患者中的应用效果

目的:探讨康复护理在脑卒中患者中的应用效果。方法:选取2013年1月~2015年1月收治的90例脑卒中患者平均分组,对照组采用常规护理方法,观察组在常规护理的基础上,采用康复护理措施进行干预,观察和比较两组患者的神经功能缺损评分、QOL评分、并发症的发生情况。结果:观察组治疗后神经缺损评分对照组,差异显著,P0.05;治疗前治疗后,差异显著,P0.05。治疗后1个月、2个月、3个月QOL评分治疗前,差异显著,P0.05;观察组治疗后1个月、2个月、3个月QOL评分对照组,差异显著,P0.05。观察组并发症发生率对照组,差异显著,P0.05。结论:康复护理在脑卒中患者中的应用效果显著,能够有效地改善患者的神经功能和肢体运动功能,减少并发症的发生,改善患者的预后情况,值得临床广泛应用以及推广。     

盐酸帕罗西汀对脑卒中后抑郁及神经功能恢复的影响

目的探讨盐酸帕罗西汀对脑卒中后抑郁及神经功能恢复的影响。方法将合并抑郁障碍的脑卒中患者82例随机分为观察组（盐酸帕罗西汀治疗组）和对照组（常规治疗组）。于治疗前及治疗后2、4、8周对两组患者分别采用汉密顿焦虑量表（HAMA）、神经功能缺损量表及修订的Barthel指数量表（MBI）进行评定。结果观察组治疗后4周末和8周末较治疗前明显降低（P〈0.05）,对照组治疗后8周末较治疗前明显降低（P〈0.05）;治疗4周末和治疗8周末两组差异有统计学意义（P〈0.05）。治疗8周后,两组患者神经功能缺损评分和MBI均较治疗前明显改善,观察组的改善优于对照组,差异有统计学意义（P〈0.05）。结论盐酸帕罗西汀对脑卒中后合并抑郁障碍者的抗抑郁效果肯定,且能促进患者神经功能的恢复,提高日常生活活动能力,用药安全。     

综合康复疗法对脑卒中偏瘫患者神经功能恢复的研究

目的探索康复治疗时于脑卒中偏瘫患者神经功能的影响。方法脑卒中患者180例随机分成康复组和对照组，康复组106例，对照组74例，康复组给予康复治疗，对照组康复治疗不规范，两组神经内科治疗两组相同。分别于发病时及发病后第1、2、3个月末进行临床神经功能缺损程度评分。结果康复组在入选后各阶段的评分均低于对照组（P〈0．01）。结论康复治疗对于脑卒中偏瘫患者各阶段神经功能的恢复有明显促进作用。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.