心肺运动试验在慢性心力衰竭患者运动康复中的应用价值

〔摘 要〕 目的：探讨心肺运动试验（CPET）在慢性心力衰竭（CHF）患者运动康复中的应用价值。方法：选择河南 大学第一附属医院 2018 年 4 月至 2020 年 4 月收治的 74 例 CHF 患者，按随机数表法分为对照组和观察组，各 37 例。 对照组给予常规治疗，观察组在对照组基础上进行 CPET 指导的运动康复治疗。比较两组患者治疗前后的心肺功能指标 〔无氧阈氧耗量（VO2AT）、峰值氧耗量（peak VO2）〕及生活质量水平。结果：治疗前两组患者 VO2AT、peak VO2、明 尼苏达心力衰竭生活质量问卷表（MLHFQ）评分比较，差异无统计学意义（P ＞ 0.05）。治疗后观察组患者 VO2AT、peak VO2 水平均较对照组高，MLHFQ 评分较对照组低，差异均具有统计学意义（P ＜ 0.05）。结论：CPET 在 CHF 患者运动康 复中有积极应用价值，其指导的运动康复治疗可改善患者心肺功能，利于提高生活质量。     

Efficacy of comprehensive rehabilitation therapy for checkrein deformity: A case report

BACKGROUND In clinical practice, checkrein deformity is usually found in patients with calf injuries after ankle fracture or distal tibial fracture. The patients with checkrein deformity mainly report distending pain in toe tips, pain when walking or wearing shoes, and gait instability. Previous studies have mainly reported surgical treatments for checkrein deformity, while few studies have reported using comprehensive rehabilitation alone to improve the checkrein deformity.CASE SUMMARY A 28-year-old woman was admitted to the hospital due to unstable gait caused by pain in the right hallux, for which she was unable to stretch for over three months. The patient had undergone "resection of ameloblastoma at the right mandible, mandibulectomy, and autogenous right fibula grafting". The patient’s hallux toe, as well as the second and third toes of the right foot could not be stretched, with pain in all the toes during walking. Based on the medical records of the patient, as well as the results of physical and auxiliary examinations, the main diagnosis was checkrein deformity in the right foot. Since the patient refused surgical treatment, rehabilitation was the only treatment option. At discharge, the patient reported evident improvement in the pain in the toes, gait stability, as well as increased ability to climb up and downstairs.CONCLUSION Comprehensive rehabilitation therapy could effectively alleviate the manifestations of checkrein deformity and improve the walking ability of the patients.     

情境模拟教学在康复专科护士临床实践教学中的应用探讨

目的分析和探讨康复专科护士学员在临床实践教学中应用情境模拟教学的效果。方法随机将2019年1—12月我院康复医学中心招收的80名康复专科护士学员随机分为观察组和实验组,观察组(40名)采用常规临床带教,实验组(40名)采用情境模拟教学方法。结果实验组学员理论知识平均得分、实践操作平均得分及康复专科护士学员对带教老师满意度均高于观察组(P<0.05)。结论在临床实践教学过程中应用情境模拟教学,能有效提升康复专科护士的理论知识水平及临床实践操作能力,提高教学质量和教学水平,提升教学效果。     

精神障碍社区康复服务规范（DB 51/T 2697-2020）

本规范为四川省精神障碍社区康复服务地方标准,规定了精神障碍社区康复服务相关术语和定义,包括机构设置、管理制度、服务内容、服务流程、服务要求、基本管理服务、专业康复服务、质量控制和工作指标等内容。适用于四川省行政区域内为精神障碍患者开展精神康复训练、辅助就业培训、日间照料、过渡期宿舍、庇护就业、康复会所和长期康养的各类机构和社会组织。     

Paul Cololian (1869–1956) : membre de la Société Médico-Psychologique (1902) et fondateur de l’Union des Médecins Arméniens de Paris (1920) et de la Croix-Rouge Arménienne de Paris (1922) (Partie I)

Maksoud Boghos Cololian was born December 12, 1869 in Ortakeuy. It was a suburb of Constantinople. The young Maksoud Boghos was sent to the Armenian school of Berberian when he is expected to learn to read and write in. It was here he developed a taste for litterature and the knowledge of the French language thanks to a thorough instruction. When he completed his secondary schooling, he left Armenia for France. In September 1889, he registered at the faculty of medicine of Paris. Extern in 1891 then intern from the asylums of the Seine (1894), he was appointed doctor of medicine in 1898. Cololian acquired a deep knowledge of psychiatry under the direction of great specialists (Taguet, Briand, Magnan, Garnier). Member of the Société Médico-Psychologique in 1902, his happy memories of his non-residential internship in the department of Nicolas Augustin Gilbert (1858–1927) led him to practice general medicine. That is the speciality he dedicated to as a liberal, in Paris rue de Ponthieu, without forgetting his training in psychiatry. In the Rosenwald Book, his speciality was neuropsychiatry. Considering he was a former Ottoman subject and volunteer since the beginning of hostilities in 1914, Cololian became immediately naturalized French with the title of assistant major physician medical. He was appointed head physician of the physiotherapy centers of Versailles (VR 69 and 74), Grignon and the Officers’ Hospital at Versailles. Also, he named himself Paul. He took care of war-wounded and became a precursor in the field of mechano-therapeutic on one hand, and for the measurement of impotence and infirmities one the other hand. In 1918, Cololian was decorated with the Legion of Honor by Raymond Poincaré (1860–1934) himself. Several times laureate of the Academy of Medicine and the Institute, Cololian wrote articles or memories on semiology and psychiatric treatment. He was with P. Garnier the author of a treatise on therapeutics of mental and nervous diseases (1901). Author of chronic hunting in the newspaper “Le Figaro”, medical and scientific popularization in the review “Guérir” and “La Femme et l’Enfant” and too informal written in “Les Annales politiques et littéraires”, Cololian published various articles or analyzes on studies based on morbid psychological constitutions from characters in literature, plays, movies or politics (Emma Bovary, Marie Lafarge, Hitler…). In his psychiatric and psychoanalytic reading of Flaubert's Madame Bovary, Cololian asserted that the creator of Freudianism was Flaubert. Regarding psychoanalysis, he felt Freud's theory had been taken too far by the founder and mostly by his students.     

Exploration of the cognitive and behavioural consequences of paediatric cochlear implantation

Abstract

This study followed the progress of young deaf children undergoing cochlear implantation, in terms of their non-verbal cognitive abilities and their emotional/behavioural development. A consecutive series of 20 children, between the ages of 2 and 5 years, were assessed using the Leiter International Performance Scale – Revised (LIPSR) and the Child Behaviour Checklist (CBCL), prior to receiving a Nucleus 24 cochlear implant. They were assessed again one year after the device was switched on. Scores on seven of the 13 subtests and composite scales of the LIPS-R increased significantly during the first year of cochlear implant use. Cognitive functions post-implant (Sequential Order, Fluid Reasoning, Full IQ and Attention Sustained) were positively related to behavioural outcomes. These results may be explained by an increased capacity of the implanted children to use verbal concepts to encode visual material. There was also evidence for a reduction in internalizing behaviour problems. The results are discussed in the context of previous research, clinical and theoretical perspectives. Copyright© 2006 John Wiley & Sons, Ltd.