Effectiveness of Neuromuscular Electrical Stimulation on Lower Limbs of Patients With Hemiplegia After Chronic Stroke: A Systematic Review

Objective

To investigate the effectiveness of neuromuscular electrical stimulation (NMES) with or without other interventions in improving lower limb activity after chronic stroke.

Stimulation of whole blood cultures in patients with ankylosing spondylitis by a mitogen derived fromMycoplasma arthritidis (MAS) and other mitogens

In this study we compared cytokine production and cell proliferation of immunocompetent cells derived from patients with ankylosing spondylitis (AS) to those from healthy blood donors using a whole blood assay. To this end, blood cell cultures were stimulated with the superantigens MAS (Mycoplasma arthritidis supernatant) and staphylococcal enterotoxin B (SEB) and the plant lectins phytohaemagglutinin (PHA) and concanavalin A (Con A). The number of white blood cells (WBC) and lymphocyte subsets were also determined. Cell proliferation and levels of interferon- (IFN-), interleukin-1 (IL-1) and interleukin-6 (IL-6) were measured after stimulation with the different mitogens. An ELISA test was used to analyse supernatant cytokine levels. Individuals with AS showed significantly lower IFN- concentrations and markedly lower cell proliferation rates with all tested mitogens than healthy controls, while there was no significant difference in IL-6 synthesis. IL-I levels were slightly impaired in the patient group, but only blood cell cultures stimulates with MAS showed a statistical significance. Furthermore, there was a significant elevation of leucocytes and lymphocytes in patients with AS resulting in higher numbers of CD4-positive cells, which implies a higher CD4:CD8 cell ratio. CD19- and CD8-positive cells were not significantly distinct compared to healthy controls. This deviation in cytokine levels and cell proliferation points to a suppression of T lymphocytes. A disturbed T-lymphocyte function may play a part in the pathogenesis of AS.     

婚姻态度量表在精神障碍患者中的信效度分析

目的：探讨婚姻态度量表在精神障碍患者中的信效度。方法对160例疾病稳定期精神障碍患者采用婚姻态度量表和自知力与治疗态度问卷进行测评分析。结果婚姻态度量表总分与各条目得分的相关系数为0．40-0．67,总量表Cronbach’s a系数为0．86,间隔7 d后重测信度为0．78（ P＜0．01）;探索性因子分析显示,特征值＞1的因素有6个,累积贡献率为64．68％。结论婚姻态度量表在精神障碍患者中使用有较好的信度和效度,但仍需更深入地验证并改进其结构效度。     

高频振荡通气联合珂立苏治疗新生儿重症胎粪吸入综合征临床分析

目的探讨高频振荡通气(HFOV)联合珂立苏治疗新生儿重症胎粪吸入综合征(MAS)的疗效及并发症。方法本院43例MAS患儿随机分成控制性机械通气(CMV)组23例和HFOV组20例。HFOV组应用高频振荡通气,CMV组常规机械通气,两组均联合应用肺表面活性物质珂立苏治疗。监测两组通气治疗0、2、12、24、48h后反映肺氧合功能的指标吸入氧浓度(FiO2)、氧合指数(OI)、动脉血氧分压/动脉肺泡氧分压(a/ApO2)的变化,比较两组患儿的呼吸机使用情况、住院时间、并发症及临床转归的差异。结果两组患儿联合珂立苏通气治疗后反映肺氧合功能的各参数在不同时间点具有统计学差异(P<0.05),但HFOV组在时限和程度上要比CMV组显著;HFOV组上机时间、氧疗时间及住院时间均比CMV组短,两组比较差异具有统计学意义(P<0.05);HFOV组肺气漏与呼吸机相关性肺炎并发症的发生率低于CMV组(P<0.05),而病死率与Ⅲ度以上颅内出血的发生率两组比较差异无统计学意义(P>0.05)。结论早期高频振荡通气联合珂立苏治疗重症MAS,肺氧合功能改善快,上机时间、氧疗时间和住院时间缩短,并发症减少,可作为一种更安全有效的抢救性措施。     

不同机械通气方式治疗胎粪吸入综合征的随机对照研究

目的　比较不同机械通气方式对胎粪吸入综合征（MAS）患儿的治疗作用及并发症的发生。方法　河北省儿童医院新生儿科重症监护室2006年7月至2008年7月收治的84例氧合指数（OI） ≥ 15的重症胎粪吸入综合征患儿随机分为3组：A组25例患儿采用高频振荡 （HFOV）模式治疗;B组29例患儿采用同步间歇正压联合容量保证 （SIPPV+VG）模式治疗;C组30例采用间歇指令通气（IMV）模式治疗。比较3组治疗前后各时间点OI、动脉/肺泡氧分压比值（a/APO2）的变化,并对3组患儿的氧暴露时间、机械通气时间,以及肺气漏、呼吸机相关性肺炎、Ⅲ度以上颅内出血等并发症的发生率进行比较。结果　A组与B组在机械通气24 h后OI和a/APO2值均与0 h差异有统计学意义（P < 0.05）,而C组直到72 h方与0 h时差异有统计学意义（P < 0.05）。A组与B组各时间点相比差异均无统计学意义。A组与B组相比,氧暴露时间和上呼吸机时间均无统计学差异（P > 0.05）,但是A组与C组、B组与C组相比在统计学上差异均有统计学意义（P < 0.05）。不仅如此,A组与C组、B组与C组相比,肺气漏与呼吸机相关性肺炎的发生率差异均有统计学意义（P < 0.05）。Ⅲ度以上颅内出血的发生率3组相比差异无统计学意义（P > 0.05）。结论 　HFOV、SIPPV+VG通气模式与IMV比较,可以较快改善MAS的氧合,缩短氧暴露时间和呼吸机使用时间,降低肺气漏和呼吸机相关性肺炎的发生,可作为更有效、更安全的抢救性治疗手段。