分期针刺法治疗周围性面瘫31例疗效观察

目的：寻找治疗周围性面瘫的最佳治疗方法。方法：运用“分期针刺法”治疗周围性面神经麻痹31例，并与对照组30例进行比较。结果：治疗组的愈显率为90．3％，对照组为70．0％，治疗组疗效明显优于对照组（P＜0．01）。     

颈动脉加压灌注+动脉给氧技术治疗脑梗死后遗症的临床观察

目的：观察颈动脉加压灌注疗法配合动脉给氧技术对脑梗死后遗症治疗后的观察瘫痪肢体肌力、言语、智力的改善情况，及对人体的不良反应。方法：利用颈动脉加压灌注疗法配合动脉给氧技术进行治疗观察，与静脉给药进行对照，随机分组，采用单盲方法，结合脑CT观察影像学的变化。结果：总有效率，治疗组83．54％；对照组45．03％，两组比较P＜0．05。结论：颈动脉加压灌注疗法配合动脉给氧技术对脑梗死后遗症的治疗可明显提高疗效，安全。     

Antitoxin's effect on tetanus toxin induced sphincter pupillae paralysis in the rabbit

Summary The effectiveness of antitoxin in preventing tetanus toxin's blockage of acetylcholine release from the cholinergic nerves of the rabbit iris was tested by injecting purified tetanus toxin into the anterior chamber, and by injecting horse antitoxin at various time intervals either into the anterior chamber, intravenously, or into the anterior chamber and intramuscularly.The results indicate that antitoxin is ineffective in preventing the development of sphincter pupillae paralysis once it is induced by tetanus toxin, prior to appearance of the symptoms.The efficacy of antitoxin treatment depends on the administration of an optimal therapeutic dose.Neither the rate of development, nor the rate of recovery from the maximal pupillary paralysis are altered by antitoxin treatment.The severity, the duration, and the time of complete recovery from the paralysis are directly related to the time antitoxin treatment begins.     

Magnetic resonance signal alterations in the acute onset of heterotopic ossification in patients with spinal cord injury

The purpose of our study was to evaluate magnetic resonance (MR) signal characteristics of acutely forming heterotopic ossification (HO) in paralyzed patients. Fourteen patients with spinal cord injury (female n=2, male n=12, mean age 38.3 years) and acute onset of radiographically proven HO had contrast-enhanced 1.5-T MRI within 13.4±18.3 days of clinical onset of symptoms. MR signal alterations of affected muscles, fascia, subcutaneous tissue, skin and adjacent bone were evaluated. A diffuse T2-hyperintense signal of multiple muscle groups was seen in all patients (bilateral in 12) involving quadriceps (n=13, 93%), adductors (n=13, 93%) and iliopsoas (n=12, 86%) with contrast enhancement in n=11 (79%), n=8 (57%) and n=8 (57%) patients. All patients had nonenhancing areas (mean size 2×3.5×5.8 cm) within diffusely enhancing muscles. HO formation occurred around these nonenhancing areas in four patients with computed tomography follow-up. Other MR findings included fascial edema (n=14, 100%), fascial enhancement (n=13, 93%), subcutaneous edema (n=13, 93%), subcutaneous enhancement (n=12, 86%), bone marrow edema (n=5, 36%), and joint effusion (n=12, 86%). MRI reveals mostly bilateral edema and enhancement of muscles, fascia and subcutaneous tissue during acute onset of HO. HO develops in the periphery of well-defined areas of no enhancement.     

Clostridium infection resulting in paralysis in a child

Case report We report an 11-year-old boy who fell from an All Terrain Vehicle and sustained multiple minor soft tissue contusions and a small midthoracic laceration. Irrigation and closure of the small wound was performed at another hospital. There was no history of a penetrating wound. Within 48 h of injury, the patient developed profound dysesthesia and paralysis of the lower extremities and was transferred to our hospital. MRI disclosed a paraspinal abnormality without bony involvement. At exploration a portion of a tree branch was removed. Wound cultures were positive for Clostridium botulinum, tetani, and perfringens.Conclusions To our knowledge, this is the first case of direct Clostridium intoxication of the spinal cord in man. Moreover, this report demonstrates the invasive manner in which Clostridium toxins may breach both the intact ligamentum flavum and the dura mater to deliver their toxicity to the intradural contents. Although the patients dysesthesia resolved and paraplegia improved to ambulation he is still left with a significant motor deficit.     

Paralysis of the femoral nerve following totally extraperitoneal laparascopic inguinal hernia repair

Totally extraperitoneal preparation (TEP) of an inguinal hernia is an established method of treating inguinal hernias associated with an acceptable complication rate (2–12%) and low rate of recurrence (0–3%). This is the first reported case of sensorimotor paralysis of the femoral nerve following the complete endoscopic mesh treatment of a primary inguinal hernia to the left side. Following a discussion of the necessary diagnostic and therapeutic steps, traumatic postsurgical paralysis of the nerve as well as spontaneous paralysis of the femoral nerve are discussed. The prognosis is positive given the lack of macroscopic evidence of any direct damage to the nerve.     

Trumpets of attack: collaborative efforts between nursing and philanthropies to care for the child crippled with polio 1930 to 1959

The purpose of this historical inquiry research was to explore (a) the relationship of nursing and foundations focusing on polio from 1930 to 1959; (b) the employment and educational opportunities arising from the polio epidemics for white and black nurses, as well as the obstacles encountered; (c) the role of nursing leaders in the care of the crippled child; and (d) the effects of the resolution of the polio epidemics resulting from the polio vaccine on public attitude and on the philanthropic organizations. Relevant journals, primary and secondary sources, and personal interviews were the methods used for data collection. Because of the extraordinary community support for work related to polio, nurses were able to obtain support from foundations. This support resulted in employment and educational opportunities for bedside nursing, primarily for white nurses. Middle and upper class fear of polio enabled the development of powerful and successful private organizations to supplement the available governmental services. This research illustrates the advances that nursing has made and reminds nurses to develop and maintain strong praxis relationships, alliances with philanthropies, referrals for clients with local organizations, and a strong voice in the planning arena.     

针刺治疗周围性面瘫文献中的若干问题及其建议

目的:分析针刺治疗周围性面瘫文献中存在的若干问题,并提出相应的改进建议。方法:利用计算机网络通过中国医院知识仓库系统(CHKD),检索了817篇针刺治疗周围性面瘫文献,并进行整理、归纳。结果:发现在针刺治疗周围性面瘫文献中,对临床资料相关信息、顽固性面瘫的称谓命名、后遗症与并发症的区分使用及治愈标准的把握等诸方面认识不够。结论:在针刺治疗周围性面瘫的文献中存在着具有一定普遍性和代表性的问题,它可能会对针刺治疗周围性面瘫的理论及临床研究产生错误的思维定势。充分认识并解决好上述问题,不仅可以提高针刺治疗周围性面瘫文献的整体质量,还可对临床诊治周围性面瘫的整体水平产生积极的影响。     

本院近5年截瘫患者的医院感染分析

目的探讨截瘫患者医院感染的病原菌对药物敏感情况。方法回顾分析我院自2001年12月～2006年12月246例截瘫患者的有关临床资料。结果78例患者发生医院感染,医院感染率为31.71%,感染部位主要以呼吸道、皮肤软组织、手术切口、泌尿道为多;医院感染的病原菌主要是条件致病菌,以G-菌为主。结论医护人员必须严格无菌操作,根据细菌药敏结果合理选用抗菌药物;加强营养,提高患者机体抵抗力。     

Substance Misuse in Individuals with Spinal Cord Injury

The literature addressing substance misuse in spinal cord injury (SCI) is reviewed with special attention paid to differences in substance misuse in the spinal cord injury and general populations. Studies examining epidemiology indicate that while substance misuse often is present when spinal cord injuries occur, the exact prevalence of it in the SCI population has yet to be determined. The literature also suggests that risk factors unique to SCI predispose substance misuse in this population in addition to risk factors commonly present in the general population. Articles examining issues relevant to substance misuse in SCI identify some concerns specific to this population. Although treatment outcome literature for substance misuse in SCI is scarce, it is clear that treatment facilities must be adapted to suit the needs of the spinal cord injured. However, it has yet to be determined how treatment content should differ.