A simple method for localising single-photon emission computed tomographic images on an anatomical template

We introduce a simple method for localising brain images an anatomical templates. Our method does not need expensive software or hardware and may be useful for clinical investigation.     

醒脑开窍针刺法结合语言康复训练治疗脑梗死运动性失语临床研究

目的:探讨醒脑开窍针刺法结合语言康复训练治疗脑梗死所致运动性失语的临床研究。方法:将64例脑梗死所致运动性失语患者随机分成两组,每组32例,均给予常规神经内科脑血管常规基础治疗,对照组在此基础上结合语言康复训练,联合组在对照组治疗基础上再予脑开窍针刺法治疗,均连续治疗5周。记录治疗前后患者语言功能评分以及逆境商数(Adversity Quotient,AQ)、功能性语言沟通能力检查法(chincse functional communicarion profile,CFCP)、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分,观察比较失语程度以及临床疗效。结果:与治疗前比较,两组患者口语理解、自发言语、命名以及复述等语言功能评分均升高(P0.05),AQ、CFCP评分升高(P0.05),NIHSS评分降低(P0.05),运动性失语程度减轻(P0.05);与对照组比较,联合组口语理解、自发言语、命名以及复述等语言功能评分较高(P0.05),AQ、CFCP评分较高(P0.05),NIHSS评分较低(P0.05),运动性失语程度较轻(P0.01),治疗有效率较高(P0.05)。结论:醒脑开窍针刺法结合语言康复训练对脑梗死所致运动性失语临床疗效显著,促进患者语言功能恢复,利于预后。     

中医情志护理结合耳穴压豆对脑卒中后抑郁患者的疗效观察

目的 观察中医情志护理结合耳穴压豆治疗脑卒中后抑郁的疗效。方法 将80例脑卒中后抑郁患者随机分为治疗组和对照组,每组40例,对照组采用抗抑郁药物及康复治疗,治疗组在对照组治疗基础上给予中医情志护理结合耳穴压豆疗法,疗程8周。采用汉密尔顿抑郁量表(HAMD)和Zung抑郁自评量表(SDS)评分比较干预前后的效果。结果 2组患者治疗后HAMD评分及SDS评分较治疗前均有所下降,治疗组较对照组下降更加明显。结论 中医情志护理结合耳穴压豆疗法对脑卒中后抑郁的治疗效果显著。     

针药结合治疗脑卒中后肢体疼痛疗效观察

目的观察针刺结合益气活血补肾方对脑卒中后肢体疼痛的疗效。方法将60例脑卒中后肢体疼痛患者随机分为治疗组(n=30)与对照组(n=30),治疗组在康复训练基础上予以针刺结合益气活血补肾方治疗,对照组予以康复训练。治疗4周后观察疼痛视觉模拟评分(VAS)、肢体疼痛缓解时间等情况。结果两组治疗后疼痛视觉模拟评分均较治疗前降低,差异有统计学意义(P<0.01),且治疗组低于对照组,差异有统计学意义(P<0.01)。治疗组疼痛缓解时间较对照组短,差异有统计学意义(P<0.05)。结论针刺结合益气活血补肾方对脑卒中后肢体疼痛疗效较好。     

中西医结合治疗脑卒中后疲劳疗效观察

目的:探讨运用中西医结合综合治疗脑卒中后疲劳的疗效。方法:对照组60例采用常规西医及康复治疗,治疗组60例在对照组基础上结合中医中药,治疗4周后分别观察巴塞尔指数(BI)、疲劳评定量表(FAI)改善情况,治疗前、后各评定1次BI和FAI,并比较其分值。结果:治疗后两种评分值均有改善,BI的分值治疗组治疗前后比较、治疗组与对照组比较均有非常高度显著性差异(P0.001);FAI的分值治疗组治疗前后比较有高度显著性差异(P0.01)、治疗组与对照组比较有显著性差异(P0.05)。结论:中西医结合综合治疗脑卒中后疲劳是有效的,能显著提高患者的日常生活能力并改善疲劳状态,值得进一步研究。     

基于BDNF/TrkB/p-CREB信号通路探讨血府逐瘀胶囊促进神经再生防治卒中后抑郁的作用及机制

目的 探讨血府逐瘀胶囊对卒中后抑郁（post-stroke depression,PSD）大鼠抑郁症状的改善作用,并基于神经再生关键通路脑源性神经营养因子（brain derived neurotrophic factor,BDNF）/酪氨酸激酶受体B(tyrosine kinase receptor,TrkB)/磷酸化环腺苷酸应答元件结合蛋白（phosphorylated cAMP response element-binding protein,p-CREB）探讨其机制。方法 采用短暂大脑中动脉梗塞（transient middle cerebral artery occlusion,tMCAO）复合慢性不可预知应激（chronic unpredictable mild stimulation,CUMS）方法复制PSD大鼠模型。大鼠随机分为假手术组、模型组及血府逐瘀低、高剂量（0.43、0.86 g/kg）组和氟西汀（1.8 mg/kg）组,每组18只。连续给予药物干预28 d,利用神经功能评分、糖水偏好实验、旷场实验、强迫游泳实验考察血府逐瘀胶囊对PSD大鼠神经功能损伤以及抑郁症...     

How clerks understand the requests of people living with aphasia in service encounters

ABSTRACT

Aphasia often restricts participation. People living with aphasia (PLWA) engage in fewer activities, which leads to fewer interactions than before aphasia. Analyses of interactions with non-familiar people in activities of daily life could provide knowledge about how to integrate these situations in rehabilitation and facilitate ongoing PLWA participation post-rehabilitation. This qualitative study is the first to examine how PLWA make their requests understood in service encounters despite aphasia. Six people living with moderate or severe aphasia were video-recorded in situations of service encounters, e.g., pharmacies, specialised shops, restaurants, and others. We identified fifty-nine occurrences with one or several difficulties in the formulation of the request. They were examined, including the clerks’ responses and ensuing interaction using multimodal conversation analysis. Results showed that PLWA used nonverbal communication within the physical environment and the context of the interaction to support verbal production. In the majority of situations, the clerks understood the request promptly. In other situations, they both collaborated to achieve a clear understanding of the request. Moreover, the findings attest to the competence of people living with moderate or severe aphasia in engaging in service encounters and add to the knowledge base about interaction and social participation in aphasia.     

“I’ve got somebody there,someone cares”: what support is most valued following a stroke?

Purpose: There is often a need for increased support following a stroke. This study explored what types of support are provided by different network members and what support functions are most valued.

Methods: Adults with first stroke were recruited from a stroke unit and participated in in-depth interviews 8–15 months poststroke. Framework Analysis was used to build thematic and explanatory accounts of the data.

Results: Twenty-nine participants took part. Main themes to emerge were as follows: the spouse was the most important provider of support; children were a relatively stable source of support, although many participants expressed reservations about worrying a child; relatives and friends typically provided social companionship and emotional support rather than on-going practical support. The only universally valued support function was the sense that someone was concerned and cared. Other valued functions were as follows: social companionship including everyday social “chit chat”; practical support provided sensitively; and, for many, sharing worries and sensitive encouragement. The manner and context in which support was provided was important: support was easiest to receive when it communicated concern, and was part of a reciprocal, caring relationship.

Conclusions: As well as measuring supportive acts, researchers and clinicians should consider the manner and context of support.

• Implications for rehabilitation

• The manner in which support was provided mattered: support was easier to receive when it communicated concern.

• The spouse was the most important source of all support functions; children, relatives and friends were important providers of emotional and social companionship support.

• Researchers and clinicians should not only focus on what support is received, but also the context (e.g., contribution, reciprocity, quality of relationship) and manner (e.g., responsiveness, sensitivity) of the support.

     

The differential dependence of abstract and concrete words upon associative and similarity-based information: Complementary semantic interference and facilitation effects

We report mirror-image effects of interference and facilitation in the semantic processing of identical sets of abstract and concrete words in a patient F.B.I. with global aphasia following a large left middle cerebral artery stroke. Interference was elicited when the tasks involved comprehending the spoken form of each word, but facilitation was found when the patient read aloud the written forms of the same words. More importantly, irrespective of whether the dynamic effect was one of facilitation or interference, effects of semantic association were observed for abstract words, whilst effects primarily of semantic similarity were observed for concrete words. These results offer further neuropsychological evidence that the more abstract a word, the greater its dependence upon associative information and the smaller its dependence upon similarity-based information. The investigations also contribute to a converging body of evidence that suggests that this theory generalizes across different experimental paradigms, stimuli, and participants and also across different cognitive processes within individual patients. The data support a graded rather than binary or ungraded model of the relationships between concreteness, association, and similarity, and the basis for concrete words’ greater dependence upon similarity-based information is discussed in terms of the development of taxonomic structures and categorical thought in young children.