大鼠肌紧张带重复低频电刺激后的生物力学及病理学改变

目的研究大鼠肌紧张带（TB）重复低频电刺激疲劳试验后的生物力学及病理学改变。 方法符合实验标准的28只Wistar大鼠,按随机数字表法分为对照组、强度疲劳实验组和频率疲劳实验组,分别进行对照、强度疲劳实验和频率疲劳实验研究。记录和分析TB和非肌紧张带（non-TB）在每一刺激循环中的最大收缩力和最大收缩力低刺激强度和高刺激强度,以及频率疲劳实验中的最大收缩力、强直收缩力和频率。光镜下观察其病理变化。 结果①强度疲劳实验中,TB的最大收缩力在第15次循环（1.42±0.28）g和第20次循环（0.93±0.54）g中明显比其第1次循环（1.99±0.31）g和第5次循环（1.97±0.27）g降低;最大收缩力高刺激强度在第15次循环（3.76±0.71）V和第20次循环（3.44±0.97）V中明显比其第1次循环（4.04±0.64）V降低。在第10、15和20次强度刺激循环中,TB的最大收缩力和最大收缩力高刺激强度明显比non-TB低。②频率疲劳实验中,TB最大收缩力频率（9.60±2.12）Hz和强直频率（25.45±2.65）Hz明显小于non-TB,最大收缩力（1.67±0.16）g和强直收缩力（2.02±0.21）g明显大于non-TB。③病理切片显微镜观察显示强度和频率疲劳实验后,TB肌纤维染色明显不均,肌纤维排列紊乱,出现明显的水肿、细胞退变和断裂。 结论TB耐受不同电刺激强度和频率的能力降低,肌纤维易受损伤,肌肉抗疲劳能力下降;TB或许参与肌筋膜疼痛综合征患者的肌无力和易疲劳性。     

An overview of the endodontic curriculum in Fiji from 2009 to 2013

This paper seeks to provide the reader with an overview of the endodontic curriculum in Fiji from 2009 to 2013. It also intends to inform readers of the changes in endodontic teaching, the learning methods utilised, curriculum development, the transition from block teaching to partial block teaching combined with longitudinal teaching, and the future plans for the endodontic module.     

“基于案例”教学法在口腔种植学教学中的实践体会

目的:探讨"基于案例"教学法(CBL)在口腔种植学教学中的应用效果及体会。方法 :遴选临床真实病例资料,设计并编写CBL教学案例,通过课前导入、课中讨论、教师评价总结等课堂形式,激发学生学习的主动性,培养其独立分析、思考及解决问题的能力,帮助学生达到对理论知识的深刻理解和融会贯通。结果:超过90%的学生认为CBL教学模式能够调动学生的学习积极性,锻炼逻辑思维,提高综合运用能力。结论:高质量的教学案例是获得理想教学效果的重要保证,如何更好地运用该教学模式,仍需进行深入探讨。     

A randomised controlled trial of integrated electrical stimulation and physiotherapy to improve mobility for people less than 6 months post stroke

Purpose: To investigate the feasibility of combining physiotherapy and functional electrical stimulation to improve gait post stroke. Methods: A parallel group partially single-blinded randomised clinical trial. Adults living at home, less than 6 months post stroke, were randomised to Group A (physiotherapy, n?=?10) or Group B (physiotherapy and common peroneal nerve stimulation, n?=?10). Assessments were conducted before randomisation (Week 1), after intervention (Week 8) and after 12 weeks follow-up (Week 20). Results: No between group differences were observed. There were statistically significant within group differences after the intervention period in both groups for walking speed and distance walked (without stimulation), Rivermead Mobility Index and Canadian Occupational Performance Measure, maintained at Week 20. There was statistically significant improvement in 10-m walking speed (Group B) when the stimulator was used at Week 8 (p?=?0.03, median 0.04?m/s (8%)). Only Group B had statistically significant within group change in Rivermead Visual Gait Analysis (Week 8), maintained at Week 20. Conclusions: Integrating electrical stimulation and physiotherapy was feasible and improved walking speed. There was no evidence of a training effect compared with physiotherapy alone. One-hundred forty-four participants per group would produce an adequately powered study based on this protocol.

• Implications for Rehabilitation

• At the end of the intervention period participants using electrical stimulation to correct dropped foot walked faster.

• It was feasible for electrical stimulation to be combined with physiotherapy for people less than 6 months post stroke.

• A larger adequately powered study is required to establish whether there are training effects associated with use of stimulation in this population.

     

Wireless micro current stimulation – an innovative electrical stimulation method for the treatment of patients with leg and diabetic foot ulcers

Clinical experience with a new electrical stimulation (ES) technique, the wireless micro current stimulation (WMCS), for the treatment of chronic wounds is described. WMCS transfers the current to any surface wound from a distance, by using oxygen's and nitrogen's ability to exchange electrons. We studied 47 patients with hard‐to‐heal wounds. Patients with venous, arterial and mixed leg ulcers were predominant; other aetiologies such as diabetic foot lesions, pressure ulcers, vasculitis and pyoderma were also included. WMCS treatment protocol specified treatment twice or thrice per week, for 45–60 minutes per session, with 1·5 μA current intensity. Standard wound care was applied to all patients, including compression bandages, if necessary. Clear progress of wound healing, even after 2 weeks, was observed in all cases. The mean reduction of the wound surface after WMCS treatment was 95% in 8 weeks. Complete healing was achieved within 3 months for the majority of the cases. No clinical side effects were observed. WMCS technology significantly accelerated wound healing for patients with hard‐to‐heal wounds of different aetiologies. This new therapy offers multiple advantages compared with the previous methods of ES, as it is contactless, free of pain and very easy to use.