注射用己酮可可碱联合奥扎格雷钠治疗急性脑梗死的临床研究

目的 分析注射用己酮可可碱联合奥扎格雷钠治疗急性脑梗死的临床疗效。方法 选取2015年3月—2020年10月北京市丰台中西医结合医院收治的112例急性脑梗死患者,按随机数字表法将患者分为对照组和治疗组,每组各56例。对照组静脉滴注注射用奥扎格雷钠,80 mg/次,溶于500 mL生理盐水中,2次/d。治疗组在对照组治疗基础上静脉滴注注射用己酮可可碱,0.2 g/次,溶于250 mL生理盐水中,1次/d,输注过程中患者平卧,2～3 h内滴注完成。两组疗程均为14 d。观察两组的临床疗效,比较两组治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、简式Fugl-Meyer评定量表（FMA）评分、脑卒中专门化生存质量量表（SS-QOL）评分及血小板压积（PCT）、血小板聚集率（PAgT）、纤维蛋白原（FIB）和炎症相关指标[中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）]的变化。结果 治疗后,治疗组总有效率是94.64%,显著高于对照组的82.14%（P＜0.05）。治疗3、7、14 d后,两组NIHSS评分均较同组治疗前显著降低（P＜0.05）;治疗后,治疗组患者NIHSS评分显著低于对照组（P＜0.05）。治疗后,两组FMA、SS-QOL评分均较治疗前显著增加（P＜0.05）;治疗后,治疗组FMA、SS-QOL评分高于对照组（P＜0.05）。治疗后,两组PCT、PAgT、FIB、NLR、PLR均显著下降（P＜0.05）;治疗后,治疗组凝血及炎症相关指标显著低于对照组（P＜0.05）。结论 注射用己酮可可碱联合奥扎格雷钠治疗急性脑梗死的效果确切,能在较佳的安全性基础上,有效促进患者神经功能、运动功能恢复,改善凝血功能紊乱和机体炎症损害,利于患者生存状态提升。     

The Efficacy of Lower Extremity Mirror Therapy for Improving Balance,Gait, and Motor Function Poststroke: A Systematic Review and Meta-Analysis

Background

Mirror therapy is less commonly used to target the lower extremity after stroke to improve outcomes but is simple to perform. This review and meta-analysis aimed to evaluate the efficacy of lower extremity mirror therapy in improving balance, gait, and motor function for individuals with stroke.

早期康复介入对急性脑卒中重度偏瘫患者运动功能恢复的影响

Hemiplegiaafterstrokecaninfluencelivingqualityofpatientsdirectly，wetookearlyrehabilitationinterventiononacutestrokepatientswithseverehemiplegia．Patients＇motorfunctionswereim－provedapparently．Reportasfollow：１Subjectandmethod１．１Subject７７strokecaseswerefromApril１９９９～January２００２，allthepatientsaccordedwiththecriteriainstitutedonthefourthnationalcerebrovasculardiseasemeetingin１９９５．AllthecaseswereconfirmedbyCTthatinternalcarotidarterialsystemsupplementareaandinternalcapsu…     

Differences between flexion and extension synergy-driven coupling at the elbow,wrist, and fingers of individuals with chronic hemiparetic stroke

ObjectiveThe flexion and extension synergies were quantified at the paretic elbow, forearm, wrist, and finger joints within the same group of participants for the first time. Differences in synergy expression at each of the four joints were examined, as were the ways these differences varied across the joints.MethodsTwelve post-stroke individuals with chronic moderate-to-severe hemiparesis and six age-matched controls participated. Participants generated isometric shoulder abduction (SABD) and shoulder adduction (SADD) at four submaximal levels to progressively elicit the flexion and extension synergies, respectively. Isometric joint torques and EMG were recorded from shoulder, elbow, forearm (radio-ulnar), wrist, and finger joints and muscles.ResultsSABD elicited strong wrist and finger flexion torque that increased with shoulder torque level. SADD produced primarily wrist and finger flexion torque, but magnitudes at the wrist were less than during SABD. Findings contrasted with those at the elbow and forearm, where torques and EMG generated due to SABD and SADD were opposite in direction.ConclusionsFlexion and extension synergy expression are more similar at the hand than at the shoulder and elbow. Specific bulbospinal pathways that may underlie flexion and extension synergy expression are discussed.SignificanceWhole-limb behavior must be considered when examining paretic hand function in moderately-to-severely impaired individuals.     

An analysis of FMA using structural self-bisimilarity

As ontologies are mostly manually created, they tend to contain errors and inconsistencies. In this paper, we present an automated computational method to audit symmetric concepts in ontologies by leveraging self-bisimilarity and linguistic structure in the concept names. Two concepts A and B are symmetric if concept B can be obtained from concept A by replacing a single modifier such as “left” with its symmetric modifier such as “right.” All possible local structural types for symmetric concept pairs are enumerated according to their local subsumption hierarchy, and the pairs are further classified into Non-Matches and Matches. To test the feasibility and validate the benefits of this method, we computed all the symmetric modifier pairs in the Foundational Model of Anatomy (FMA) and selected six of them for experimentation. 9893 Non-Matches and 221 abnormal Matches with potential errors were discovered by our algorithm. Manual evaluation by FMA domain experts on 176 selected Non-Matches and all the 221 abnormal Matches found 102 missing concepts and 40 misaligned concepts. Corrections for them have currently been implemented in the latest version of FMA. Our result demonstrates that self-bisimilarity can be a valuable method for ontology quality assurance, particularly in uncovering missing concepts and misaligned concepts. Our approach is computationally scalable and can be applied to other ontologies that are rich in symmetric concepts.     

Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke

Objective

To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke.

早期神经探查松解修复术治疗闭合腓总神经损伤临床分析

目的探讨早期神经探查松解修复术治疗闭合腓总神经损伤患者的临床效果。方法 80例闭合腓总神经损伤患者按照随机数字表法分为实验组和对照组各40例。对照组给予常规治疗,实验组在对照组治疗基础之上采用早期神经探查松解修复术。比较2组治疗前后胫骨前肌及腓骨长短肌MMT分级、FMA评分变化及临床疗效。结果 2组胫骨前肌及腓骨长短肌MMT分级差异有统计学意义(P0.05);实验组的FMA评分(26.03±5.90)较对照组高(16.03±4.02),差异有统计学意义(P0.05);实验组临床总有效率为95.0%,较对照组高(70.0%),差异有统计学意义(P0.05)。结论早期神经探查松解修复术治疗方法较常规治疗方案具有明显的优势,能够提高临床治疗效果,值得临床推广。     

手术室护理质量综合评价指标在手术室持续质量改进中的应用研究

目的：探讨实施手术室护理质量综合评价指标在手术室持续质量改进中的应用效果。方法：2011年6-12月采用《持续质量改进登记本》的传统常规质量控制方法对手术室护理质量进行监管,2012年1-6月制定并应用手术室护理质量综合评价指标,应用失效模式分析法和根本原因分析法对手术室护理质量进行持续改进管理。结果：实施干预后,实验组的总体不良事件发生率从0．851％下降到0．276％（P〈0．001）。手术室护理质量综合评价15项指标中;实验组有10项指标的不良事件发生率较对照组低,说明干预措施有效（P〈0．05）。结论：运用手术室护理质量综合评价指标进行质量控制管理能降低手术室差错发生率,提高手术室护理质量。     

电针联合经筋刺法对中风后肢体痉挛运动功能与日常生活能力影响随机平行对照研究

[目的]观察电针联合经筋刺法对中风后肢体痉挛运动功能与日常生活能力影响。[方法]随机平行对照方法,将80例住院患者按就诊顺序编号方法随机分为两组。对照组40例经筋刺法,取穴:上肢取手阳明、手少阳经筋循行所过的位于肩、肘、腕、手的经筋结点,即肩后伸旋外结点,伸肘结点,伸腕伸指结点,拇指展结点,指外展结点;下肢取足太阴,足厥阴,足少阳,足太阳经筋循行所过的位于髓、膝、踝、足的经筋结点,即屈髋结点,屈膝结点,足外翻结点,屈踝结点,留针30min。治疗组40例电针,上肢:内关,极泉,尺泽,肩骼,手三里,合谷,外关;下肢:委中,足三里,阳陵泉,环跳,阴陵泉,风市;连接电针正极在上,负极在下,选取疏波,30min/次,强度以患者能够耐受并且可以看到肌肉抽动为度;经筋刺法治疗同对照组。连续治疗10d为1疗程。观测临床症状、运动功能评分、日常生活能力评分、不良反应。连续治疗2疗程,判定疗效。[结果]ADL、四肢FMA评分两组均有明显升高(P0.05),治疗组升高优于对照组(P0.05)。[结论]电针联合经筋刺法可有效改善中风后肢体痉挛运动功能与日常生活能力,无副作用,值得推广。