Evaluation of stroke rehabilitation by randomized controlled studies: a review

In all, 22 reports of 20 randomized, controlled rehabilitation studies were evaluated. In 18 of these, the design of the trial was parallel, with a cross-over format being employed in the remaining 2 instances. Seven studies related to intensive rehabilitation during the early post-acute period. In six others, specific techniques--sometimes associated with traditional physiotherapy procedures--were compared: biofeedback, perceptual retraining, and amphetamine treatment. Eight experiments evaluated speech therapy in aphasia. Frequently, methodological considerations limited the interpretation of the results. The review showed that: 1) as regards activities of daily life and motor function, differences as between rehabilitation in stroke units on the one hand and non-rehabilitation or rehabilitation in medical wards on the other, were detected in relatively few quality studies and remained particularly inconclusive insofar as life in the home environment was concerned; 2) rehabilitation for aphasia and perceptual dysfunction proved effective for at least several months after acute stroke; 3) in general, examination of the reports cited revealed no differences in the effects of biofeedback and perceptual retraining vs conventional physiotherapy; 4) rehabilitation, whether administered by specialists or amateur caregivers purpose-trained by specialists, proved equally effective for aphasia. These conclusions constitute a valuable basis for the development and evaluation of modern rehabilitation programs for stroke patients.     

Additive effects of earthworm extract with HpD-laser on the enhancement of reactive oxygen production and the inhibition of[~3H]—thymidine.uptake in mouse ascitic tumor cells

The effects of combined use of earthworm extract(912)and HpD-laser on the produc-tion of reactive oxygen and the biosynthesis of DNA in S_(180) tumor cells were studied throughchemiluminescence measurement and[~3H]-TdR incorporation assay.The results showed that as com-pared with the control,the intensity of chemiluminescence emitted by tumor cells treatedsimultaneously with 912 and HpD-laser was enhanced more than ten-folds,while that treated with912 or HpD-laser alone was increased only 2～4 folds.The[~3H]-TdR incorporation into tumorcells of the former group was inhibited upto 74.1%,and that of the latter groups decreased onlyby 42.2% and 40.0%,respectively.In accordance with these biochemical changes,the ultrastructuraldamage of tumor cells of the former,combinedly treated group appeared to be the most serious.This suggests an additive effect of 912 with HpD-laser on tumor cells.In addition,if free radicalscavengers,such as catalase and superoxide dismutase,were added to the reaction systembefore chemiluminescence assay,the luminescent enhancement effect mentioned above was dramaticallyalleviated,implying the presence of O_2~ and H_2O_2 in the system.Therefore,as to the toxic effecton tumor cells,912 and HpD-laser are not only additive in efficiency,but also similar in theunderlying mechanism of action.     

鲁格氏棒横突固定法的实验研究和临床应用

取10具新鲜成年雄性家猪的脊柱标本,分两组观察鲁格氏棒经椎管行椎板固定和鲁格氏棒经横突椎板固定时,受破坏性屈曲力的数据,结果显示鲁格氏棒经椎管固定组在达1048.6（±20）N时,所固定的椎板发生骨折,部分钢丝断裂;鲁格氏棒经横突固定组达2058（±20）N时,仅发生棒弯曲,未发现任何部位骨折或钢丝断裂。临床治疗33例不稳定胸腰椎骨折脱位患者,术后X线片示骨折脱位复位满意,两周后患者可离床活动,随访2～2.5年未发现任何并发症。     

《中国矫形外科杂志》被引分析研究

目的：分析《中国矫形外科杂志》被引情况，从文献引证角度了解该刊学术水平和期刊质量。方法：利用清华大学同方光盘股份有限公司研制开发的中国医院知识仓库期刊全文数据库中的数据，用定量分析的方法，对《中国矫形外科杂志》被引情况进行统计、分析和研究。结果：总被引2039篇次，被引频次逐年上升。2002年自引率1839％，单篇平均被引1．2次，影响因子0．293。结论：《中国矫形外科杂志》已形成自己的学术风格和专业特点，具有较高的被引率，是我国骨科领域的精品期刊之一。     

反义核酸技术及应用

反义核酸技术是用人工合成的或生物合成的特定互补的DNA或RNA片段阻断从基因到蛋白的信息流 ,以达到抑制或阻断基因表达的生物新技术。利用核酸分子杂交原理将反义寡核苷酸 (antisenseoligonucleotide,ASON)作为外源性基因表达抑制物结合到靶mRNA序列上阻止其翻译成蛋白[1 ] 。具有杂交特异性和选择性调节基因的表达的特点[2 ] ,这一技术不仅已成为常用的实验室研究方法 ,还广泛的应用于研究病毒、肿瘤、寄生虫和遗传性疾病的预防和治疗 ,具有重要的应用前景。对于人类基因的研究 ,人们采用分子克隆、分子杂交、PCR技术等一系列研究…     

Self-selection of enrollers at the creation of a managed care organization

Factors affecting choice between a managed care organization(MCO) and a fee-for-service insurance plan were examined whenthe University of Geneva health insurance plan was transformedinto an MCO, in October 1992. A case-control study using a mailedquestionnaire (response rate 84%) was conducted to compare formermembers who joined the MCO (joiners, n=421) to former memberswho opted out in order to keep fee-for-service coverage (non-joiners,n=222). Non-joiners were more likely to be women (odds ratio(OR) from multivariate model was 1.15, p=0.50), to be born inSwitzerland (OR=2.04, p<0.01), to have an annual income >75,000Swiss francs (OR=2.00, p<0.01), to have a personal physician(OR=1.96, p<0.01) and to have consulted a specialist (OR=1.69,p=0.02) or used unconventional medicine (OR=4.59, p<0.01)in the past year. During the previous year, non-joiners hadmore health care visits than joiners (14.6 versus 9.1, p=0.01).Non-joiners reported better mental health and fewer complainedof persistent fatigue (OR=2.18, p=0.03). The choice of healthplan was strongly influenced by socio-demographic characteristics,past patterns of health services utilization and health status.The self-selection process was paradoxical: MCO joiners hadused fewer health care visits than non-joiners, but their self-reportedhealth status was worse. The differences we have observed betweenself-selected populations have important implications for thefinancial performance of competing health care delivery systems.     

食管贲门癌术后早期肠内营养支持的应用研究

目的研究食管贵门癌切除术中放置鼻肠营养管进行早期肠内营养，在维持机体营养、促进恢复履在防治术后并发症的作用。方法将90例管责门癌病人随机分为A、B两组，A组术后常规静脉输液，B组术中放置鼻肠营养管，术后第1天给予肠内营养。两组病人监测术前、术后第10天的体重、肠功能恢复排气时间、疲劳评分，吻合口瘘反感染并发症的发生率。结果两组病人在体重、肠功能恢复方面存在明显差异（P〈0．05），在术后并发症方面差异明显（P〈0．01）。结论鼻肠营养管进行早期肠内营养具有易于维持机体营养，促进机体康复，尽快恢复正氮平衡，减少术后并发症的优点。     

糖骨康胶囊治疗糖尿病骨质疏松临床研究

目的:观察糖骨康胶囊对糖尿病骨质疏松的治疗作用。方法:将216例患者,遵照随机、盲法、对照原则分为治疗组144例、对照组72例,其中治疗组给予糖骨康胶囊,对照组给予甘露消渴丸,治疗8w后观察疗效。结果:治疗组显效率为40.0%;总有效率为88.6%。对照组显效率为28.9%,总有效率为82.6%。结论:糖骨康胶囊对2型糖尿病骨质疏松有显著的防治作用。     

扶正调平汤减轻化疗毒副反应的临床观察

目的研究在化疗过程中运用扶正调平汤对减轻肿瘤患者的骨髓抑制，消化道症状等化疗副反应的作用。方法通过临床对60例手术及非手术胃癌患者随机分成两组，即治疗组和对照组，观察化疗前后两组的血象变化、消化道反应情况，及其生活质量进行评定，比较、分析。结果实验证明化疗同时配合扶正调平汤对改善化疗副反应的作用显著化于对照组（P〈0．05）。结论说明扶正调平汤对减轻化疗毒副反应方面具有较好的临床疗效。提高了患者生活质量，使惠者顺利完成化疗疗程。     

中西医结合治疗慢性肾炎疗效观察及其与血液流变学和微循环的相关意义分析

本文对比观察了中西医结合治疗与单纯西药治疗慢性肾炎的临床疗效,结果表明,前者缓解率及总有效率分别为79.8%和92.1%,显著高于对照组(均P<0.01)。治疗组各临床类型及各中医证型的疗效亦均明显高于对照组相对应的各型肾炎(P<0.05～0.01)。治疗组各型肾炎之血液流变学及甲皱微循环改善均较对照组为显著。两组中完全缓解加基本缓解者,该两类检查指标改善极为显著(P<0.05～0.01),而好转及无效者则无明显改善(P>0.05)。提示临床疗效与之密切相关。