疏经通督推拿联合智能运动训练对脑卒中偏瘫患者肢体功能恢复的影响

目的 探讨疏经通督推拿联合智能运动训练对脑卒中偏瘫患者肢体功能恢复的应用效果。方法 选取2021年1月-12月神经内科收治的104例脑卒中偏瘫患者为研究对象,采用随机数字表法将所有患者分为对照组及观察组,各52例。对照组行常规康复训练,观察组在对照组基础上行疏经通督推拿联合智能运动训练,比较2组偏瘫侧肢体功能评分、步行情况及生活质量。结果 干预后观察组偏瘫侧肢体功能评分明显高于对照组(t=11.632,P<0.001),最大步行速度及步频均快于对照组(t=10.513,P<0.001;t=16.065,P<0.001),观察组生活质量总分高于对照组(t=5.913,P<0.001)。结论 疏经通督推拿联合智能运动训练可有效改善脑卒中偏瘫患者肢体功能及步行能力,提升患者生活质量,值得临床推广应用。     

匹罗卡品致(癎)大鼠海马中表达生长抑素的中间神经元数目变化及其轴突出芽

Objective To investigate the roles of somatostatin(SS)positive intemeurons in the development and compensation of temporal lobe epilepsy.Methods Piloearpine-induced epilepsy rat model was established.Immunohistochemistry method was used to detect number changes and axonal sprouting of SS positive intemeurons in different domains of the hippocampus at difierent time points.Degeneration of SS positive interneurons and their neurophils were detected by the double immunofluorescence staining with SS and Fluoro-Jade B(FJB)at 7 and 60 days after status epilepticus (SE).Results In the exoerimental rat group,the number of SS positive neurons decreased in each hippocampal domain,and it reached the lowest at 7 days post-SE(There were 11.1±3.3 in hilus,2.8±0.9 in CA1region and 1.8±0.7 in CA1region,t=13.519,9.644 and 8.808,all P<0.01).In chronic phase,the number of SS neurons gradually recovered,and exceeded the control group in CA1 area at 60 days post-SE(12.8±1.5 vs 8.8±1.3,t=-4.506,P<0.01),however,the number of SS neurons in the hilus(25.5±4.6)and CA1 area(4.8±0.8)remained significantly less than normal levels(t value were 4.691 and 3.953.both P<0.01).Increased SS positive fibers were found in the lacunosum-molecular (1m)layer and outer molecular layer of dentate gyrus after 30 days post-SE,and numerous SS positive fibers were seen threnghout the layers of area CA1 at 60 days post-SE.Double immunofluuorescence revealed that a few SS positive interneurons and fibers were also labeled by FJB in area CA1 at 7 days post-SE and in CA domain/hilus at 60 days post-SE.Conclusions SS intemeurons loss plays an important role in the development of temporal lobe epilepsy.The loss is partially caIlsed by the degeneration and death of neurons;SS positive neurophils increase within area CA1 in chronic phase may play a significant role in the generation and compensation of temporal lobe epilepsy.     

游戏疗法对老年脑卒中认知功能及情绪障碍的影响

目的:探讨游戏疗法对老年护理医院脑卒中患者认知功能及情绪障碍的影响。方法:选取脑卒中患者认知功能及情绪障碍患者85例,分为对照组41例和研究组44例,对照组常规训练结合常规作业治疗,研究组在常规训练的基础上,加入治疗师设计的游戏疗法,于治疗前、治疗3及12个月后的随访进行蒙特利尔认知量表(MoCA)、贝克抑郁量表(BDI)评估。结果:治疗3个月后,2组MoCA评分均较入组时明显升高(P0.05),且研究组高于对照组(P0.05);12个月后随访,研究组MoCA评分较治疗3个月后显著降低(P0.05),但与入组时比较差异无统计学意义,对照组MoCA评分12个月后随访时较治疗3个月后及入组时显著降低(P0.05),研究组MoCA评分显著高于对照组(P0.05)。治疗3个月后,2组BDI评分均较入组时明显减低(P0.05),2组间比较差异无统计学意义;12个月后随访,研究组BDI评分较治疗3个月后明显升高(P0.05),但仍显著低于入组时(P0.05),对照组BDI评分较治疗3个月后及入组时明显升高(P0.05),研究组BDI评分明显低于对照组(P0.05)。结论:游戏疗法对改善老年脑卒中患者认知功能有积极效果,但对情绪障碍的改善还有待进一步的研究。     

团体心理辅导对血液透析患者述情障碍及焦虑抑郁的影响

目的观察团体心理辅导对行血液透析患者述情障碍、焦虑抑郁状态的干预结果。方法抽取74例终末期肾病行血液透析的患者为研究对象,按初次行透析治疗时间先后顺序分为观察组39例和对照组35例。观察组患者接受每周1次共8次的团体心理辅导,对照组给予常规的心理护理及健康指导。在干预前、干预结束时以及干预后第8周使用多伦多述情障碍量表、汉密尔顿焦虑评价量表及汉密尔顿抑郁评价量表对两组患者进行测评。结果干预后两组患者的述情障碍及焦虑、抑郁状态随着时间推移均逐渐降低,但观察组患者的述情障碍得分、焦虑得分、抑郁得分均低于对照组,组间同期比较差异有统计学意义(P0.05)。结论行血液透析治疗的患者述情障碍及焦虑、抑郁水平均较高,团体心理辅导可改善患者的述情障碍、焦虑和抑郁状态。     

氦氖激光结合康复训练治疗II期压疮的疗效观察

目的：观察氦氖激光结合康复训练治疗II期压疮的疗效。方法：老年II期压疮患者48例,分成观察组和对照组各24例,对照组采用常规护理和康复训练,观察组在此基础上结合氦氖激光治疗。结果：治疗8周后,观察组总有效率明显高于对照组（95．8％、62．5％,P＜0．05）。观察组在治疗4周时血红蛋白值及白蛋白值均较治疗前及对照组明显提高（P＜0．05）,治疗8周时及随访3个月时均较治疗4周时及对照组明显提高（P＜0．05）;对照组治疗前后差异无统计学意义。结论：结合常规护理,氦氖激光联合康复训练能更有效地改善老年患者II期压疮。     

炎症性肌病247例临床与病理研究

目的探讨多发性肌炎（PM）、间质性肌炎（IM）与神经肌炎（NM）的临床特点及神经肌肉活检的诊断价值。方法回顾分析247例炎症性肌病的临床表现及神经肌肉活检结果。结果3组临床表现相似,为近端肌无力、肌痛等;均有不同程度的肌酶增高,但PM组增高明显;IM和NM具有PM的病理改变,但炎性程度不及PM,又各有其特异性,IM组为炎性细胞浸润间质,NM组神经活检多有髓鞘脱失、炎性细胞浸润。结论PM、IM、NM炎性肌病的临床表现相似,诊断困难,需结合神经肌肉活检等辅助检查才能作出正确的诊断。     

匹罗卡品致(癎)大鼠海马中表达生长抑素的中间神经元数目变化及其轴突出芽

Objective To investigate the roles of somatostatin(SS)positive intemeurons in the development and compensation of temporal lobe epilepsy.Methods Piloearpine-induced epilepsy rat model was established.Immunohistochemistry method was used to detect number changes and axonal sprouting of SS positive intemeurons in different domains of the hippocampus at difierent time points.Degeneration of SS positive interneurons and their neurophils were detected by the double immunofluorescence staining with SS and Fluoro-Jade B(FJB)at 7 and 60 days after status epilepticus (SE).Results In the exoerimental rat group,the number of SS positive neurons decreased in each hippocampal domain,and it reached the lowest at 7 days post-SE(There were 11.1±3.3 in hilus,2.8±0.9 in CA1region and 1.8±0.7 in CA1region,t=13.519,9.644 and 8.808,all P<0.01).In chronic phase,the number of SS neurons gradually recovered,and exceeded the control group in CA1 area at 60 days post-SE(12.8±1.5 vs 8.8±1.3,t=-4.506,P<0.01),however,the number of SS neurons in the hilus(25.5±4.6)and CA1 area(4.8±0.8)remained significantly less than normal levels(t value were 4.691 and 3.953.both P<0.01).Increased SS positive fibers were found in the lacunosum-molecular (1m)layer and outer molecular layer of dentate gyrus after 30 days post-SE,and numerous SS positive fibers were seen threnghout the layers of area CA1 at 60 days post-SE.Double immunofluuorescence revealed that a few SS positive interneurons and fibers were also labeled by FJB in area CA1 at 7 days post-SE and in CA domain/hilus at 60 days post-SE.Conclusions SS intemeurons loss plays an important role in the development of temporal lobe epilepsy.The loss is partially caIlsed by the degeneration and death of neurons;SS positive neurophils increase within area CA1 in chronic phase may play a significant role in the generation and compensation of temporal lobe epilepsy.     

产后出血相关因素临床分析

目的:探讨产后出血的高危因素及防治的有效措施。方法:选择海南医学院附属医院2004年1月～2011年1月产科分娩产妇4 405例,其中产后出血135例,存在合并症及并发症85例,分析产妇产后出血的高危因素。结果:①多次妊娠、多产史与初孕初产产后出血发生率比较,具有统计学意义(P<0.05);②剖宫产与阴道分娩产后出血发生率比较,有统计学差异(P<0.05);③出血>2 000 ml和<1 000 ml病例发现,其合并症及并发症发生比例存在统计学差异(P<0.05);④剖宫产合并症及并发症对产后出血均有显著影响。结论:产后出血是产科最常见、最危急的并发症之一,强化孕产妇系统管理,降低剖宫产率,对降低产后出血及孕产妇死亡率起着重要作用。     

颞叶癫痫大鼠突触后致密物中差异性表达蛋白的筛选和鉴定

目的 筛选和鉴定颞叶癫痫(temporal lobe epilepsy,TLE)大鼠模型突触后致密物(postsynaptic density,PSD)中差异性表达的蛋白质.方法 建立氯化锂-毛果芸香碱TLE大鼠模型,收集TLE组和健康对照组大鼠新鲜全脑组织,联合应用蔗糖密度梯度离心和膜顺序提取技术提取PSD蛋白质,进行双向凝胶电泳,通过PDQuest图像分析软件筛选TLE组差异性表达的蛋白质点,并应用基质辅助激光解析电离飞行时间质谱(MALDI-TOF-MS)对其进行鉴定.结果 与健康对照组比较,TLE组存在70个差异性表达PSD蛋白质点,其中表达上调的蛋白质主要包括果糖二磷酸醛缩酶、肌酸激酶和热休克蛋白27,表达下调的蛋白质主要包括微管蛋白、肌动蛋白、中间丝蛋白α和脯氨酰顺反异构酶.结论 TLE大鼠PSD中存在差异性表达蛋白质,其异常表达可能与TLE的形成、发作或神经元保护有关.     

心电图QRS波群离散度与老年高血压患者左心室构型及功能的关系

目的 探讨心电图QRS波群离散度（QRSd）与老年高血压患者左心室构型及功能的关系。方法 选择2019年1月至2021年12月金华市第二医院收治的110例原发性高血压患者作为高血压组，同期50例健康体检者作为对照组。采用心电图测定两组受试者QRSd，超声心动图检测舒张末期室间隔厚度（IVS）、左心室后壁厚度（LVPW）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室质量指数（LVMI）等左心室构型指标及左心室短轴缩短率（FS）、左心室射血分数（LVEF）、舒张早期二尖瓣口最大血流速度/舒张晚期二尖瓣最大血流速度（E/A）、舒张早期二尖瓣口血流峰值速度/瓣环运动峰值速度比值（E/e’）等左心室功能指标，采用Pearson相关性检验分析QRSd与左心室构型指标、功能指标的相关性；评估高血压患者左心室肥厚及左心室舒张功能不全情况，采用受试者特征工作曲线（ROC）分析心电图QRSd评估左心室肥厚、左心室舒张功能不全的价值。结果 高血压组QRSd、IVS、LVPW、LVEDD、LVMI、E/e’高于对照组，FS、E/A等指标低于对照组（t=19.249、10.979、...