How does work work for people with bipolar affective disorder?

Despite modern treatments, bipolar disorder remains a chronic, relapsing disorder that leads to long-term psychosocial disability. A review of the literature suggests that while employment rates amongst individuals with bipolar disorder may improve over time, and are relatively better compared to some other chronic mental disorders, employment prospects do not match the high scholastic achievements seen amongst this group of people before the onset of their illness. For those with bipolar disorder, clinical recovery does not necessarily mean functional recovery, and the usual early age of onset may further reduce an individual's preparedness for employment. Two brief vignettes are used to discuss how occupational therapists can help their clients maintain their sense of hope in vocational recovery, gain better self-awareness and work with clients at various stages of recovery rather than waiting for full functional recovery. Further research is required to help identify specific factors that contribute to the success of employment integration amongst people with bipolar disorder.     

Differential regulation by exercise of BDNF and NT-3 in rat spinal cord and skeletal muscle

We have investigated the impact of neuromuscular activity on the expression of neurotrophins in the lumbar spinal cord region and innervating skeletal muscle of adult rats. Rats were exercised on a treadmill for 1 day or 5 consecutive days and euthanized at 0, 2 or 6 h after the last bout of exercise. By Day 1, there was no clear evidence of an increase in brain-derived neurotrophic factor (BDNF) mRNA in the spinal cord or the soleus muscle. By Day 5, there was a significant increase in BDNF mRNA in the spinal cord at 2 h post-training, and the soleus muscle showed a robust increase between 0 and 6 h post-training. Immunoassays showed significant increases in BDNF protein in the soleus muscle by training Day 5. Immunohistochemical analyses showed elevated BDNF levels in motoneuron cell bodies and axons in the ventral horn. Neurotrophin-3 (NT-3) mRNA was measured to determine whether selected neurotrophins respond with a selective pattern of induction to neuromuscular activity. In the spinal cord, there was a progressive post-training decrease in NT-3 mRNA following a single bout of training, while there was a significant increase in NT-3 mRNA at 2 h post-training by Day 5. The soleus muscle showed a progressive increase in NT-3 mRNA by Days 1 and 5 following training. These results show that neuromuscular activity has specific effects on the BDNF and NT-3 systems, and that repetitive exercise affects the magnitude and stability of these responses.     

Exercise Rehabilitation in Pediatric Cardiomyopathy

Children with cardiomyopathy carry significant risk of morbidity and mortality. New research and technology have brought about advancements to the diagnosis and clinical management of children with cardiomyopathy. However, currently heart transplantation remains the standard of care for children with symptomatic and progressive cardiomyopathy. Cardiovascular rehabilitation programs have yielded success in improving cardiac function, overall physical activity, and quality of life in adults with congestive heart failure from a variety of conditions. There is encouraging and emerging data on its effects in children with chronic illness and with its proven benefits in other pediatric disorders, the implementation of a program for children with cardiomyopathy should be considered. Exercise rehabilitation programs may improve specific endpoints such as quality of life, cardiovascular function and fitness, strength, flexibility, and metabolic risk. With the rapid rise in pediatric obesity, children with cardiomyopathy may be at similar risk for developing these modifiable risk factors. Furthermore, there are potentially more detrimental effects of inactivity in this population of children. Future research should focus on the physical and social effects of a medically supervised cardiac rehabilitation program with correct determination of the dosage and intensity of exercise for optimal benefits in this special population of children. It is imperative that more detailed recommendations for children with cardiomyopathy be made available with evidence-based research.     

人工耳蜗植入患者术后言语康复效果的问卷评估

目的评价两种问卷式分级标准对人工耳蜗植入效果的直观评估效能。方法应用问卷式听觉行为分级标准和言语识别率分级标准分别评估人工耳蜗植入患者术后的言语感知能力和言语产生能力，并对患者的病程、术前助听器使用情况、植入时间、康复模式4个因素与康复效果之间的相关性进行统计学分析。结果人工耳蜗植入效果与患者的病程、植入时间的长短以及康复模式有关，而与术前助听器使用情况无关。结论听觉性行为分级标准及言语识别率分级标准能较客观地反映人工耳蜗植入患者术后听觉言语能力的真实水平。     

提高聋儿语言康复质量不容忽视的几个问题

通过对目前影响聋儿语言康复质量原因的分析,阐述了提高聋儿语言康复质量必须充分认识和应当切实加强的五项基础工作的重要性,并对提高聋儿语言康复质量提出了积极的建议。     

试论听觉功能评估的标准及方法

本文旨在探讨听觉功能评估的标准及方法。阐述了听觉功能评估的一个基本理念：夯实基础，循序渐进，螺旋上升。即听觉评估和训练是一个动态的过程。训练以评估为起点。在训练中或一个阶段后，应再次进行评估，从而监控训练方案的有效性，调整听觉功能训练方案，或提出更高的训练目标。     

Ⅱ期人工晶状体植入术后102例患者视力的分析

目的:评价分析无晶状体眼Ⅱ期植入前房型和后房型人工晶状体的效果。进行Ⅱ期人工晶状体植入的最常见原因是无晶状体眼眼镜矫正不满意或不耐受及不愿意佩戴隐形眼镜。方法:前瞻性,非随机对照实验研究,伊朗亚兹德Sadoughi医院眼科,1995/2005年。根据之前进行的白内障手术的类型,后房型人工晶状体植入62眼(60.78%),前房型人工晶状体植入40眼(39.21%)。根据随访期间的病历记录分析患者基本资料和临床资料。结果:患者102例,其中女42例(41.18%),男60例(58.82%),在1995/2005年期间进行了II期人工晶状体植入术。年龄在48 ～72(平均62.6)岁,平均随访时间20.2mo(6 ～72mo)。术中及术后并发症少,手术及拆线后3mo视力状况如下:视力20/20的有48例(47.05%),视力20/40以上的有51例(50%),视力下降(snellens视力表中3行)的有3例(2.95%)。结论:Ⅱ期人工晶状体植入术的短期并发症并不比I期白内障摘除并人工晶状体植入多,视力结果与术前最佳矫正视力相同,因此II期人工晶状体植入术可以安全有效的治疗无晶状体眼。     

参附注射液对肝胆外科患者术后康复的影响

目的：观察参附注射液对肝胆外科患者术后康复的影响。方法：150例手术患者随机分为对照组和参附注射液组(SF组)各75例,观察两组患者肛门排气时间、切口愈合情况、血常规、凝血功能、肝功能、组织修复相关因子、免疫功能及血液流变指标的变化。结果：SF组患者平均肛门排气时间较对照组显著缩短(P<0.05)；手术前后SF组与对照组比较,血常规、凝血功能及肝功能指标无显著差异；术后SF组全血黏度(1·s^-1,22·s^-1,200·s^-1),血液还原黏度,纤维蛋白浓度较对照组降低。术后SF组IgG,IgA较对照组升高；对照组术后IgG,CD4⁺/CD8⁺较术前降低；术后所有病例SOD明显降低,SF组降幅小于对照组(P<0.05)；对照组术后MDA明显升高(P<0.05)。术后对照组血液还原黏度,纤维蛋白浓度,全血黏度较术前升高；SF组术前术后血液流变指标比较无显著差异。结论：参附注射液可提高手术患者术后免疫功能,减少组织的损伤,促进血液循环,有助于术后康复。