Movement-related potential measures of different modes of movement selection in Parkinson's disease

Movement-related potentials were recorded preceding self-paced voluntary movements in patients with Parkinson's disease and in healthy subjects of the same age group. We compared the Readiness Potential preceding joystick movements in a fixed direction and preceding joystick movements in freely selected directions. In normal subjects the Readiness Potential amplitude was higher preceding freely selected movements than preceding movements in a fixed direction. The Readiness Potential in Parkinson patients failed to be modified by the different modes of movement selection. The modulation of the Readiness Potential by different ways of preparing for movement might be due to the supplementary motor area (SMA) being more strongly engaged by tasks requiring internal control of movements than by tasks that are externally structured. The results suggest that this task-dependent variation of SMA activity is reduced in Parkinson's disease. A failing capacity to adapt SMA activity to different task demands has previously been suggested by evidence from positron emission tomography studies using similar tasks.     

The Use of Performance Improvement Methods to Enhance Emergency Department Patient Satisfaction in the United States: A Critical Review of the Literature and Suggestions for Future Research

Objectives: The authors reviewed the evidence on performance improvement methods for increasing emergency department (ED) patient satisfaction to provide evidence-based suggestions for clinical practice.
Methods: Data sources consisted of searches through MEDLINE, CINAHL, PSYCHINFO, Cochrane Library, and Emergency Medicine Abstracts and a manual search of references. Articles were included if they reported a performance improvement intervention targeting patient satisfaction in the ED setting. Articles on studies not conducted in the United States or that failed to provide enough details to allow critical evaluation of the study were excluded. Two authors used structured evaluation criteria to independently review each retained study.
Results: Nineteen articles met all selection criteria. Three studies found varying levels of support for multicomponent interventions, predominantly focused on implementation of clinical practice guidelines for specific presenting complaints and process redesign. Sixteen studies evaluated single-component interventions, with the following having at least one supportive study: using alternating patient assignment to provider teams rather than "zone"-based assignment, enhancing provider communication and customer service skills, incorporating information delivery interventions (e.g., pamphlets, video) that target patient expectations, using preformatted charts, and establishing ED-based observation units for specific conditions such as asthma and chest pain.
Conclusions: There is modest evidence supporting a range of performance improvement interventions for improving ED patient satisfaction. Further work is needed before specific, evidence-based recommendations can be made regarding which process changes are most effective. Recommendations are made for improving the quality of performance improvement efforts in the ED setting.     

手术治疗Ⅱ型锁骨外侧端骨折

目的 介绍一种治疗Ⅱ型锁骨外侧端骨折的手术方法。方法 取用锁骨与喙突间螺丝钉加压固定，喙锁韧带修复。结果 24例患术后骨折端全部愈合，关节功能恢复良好，内固定物无松脱，肩锁关节无创伤性关节炎。结论 本术式治疗成人Ⅱ型锁骨外侧端骨折，操作方便，固定可靠，效果确切，并发症少，是理想的手术方法。     

骶骨上关节突关节面5点7点进钉方法的放射解剖学研究

目的 :对骶骨螺钉上关节突关节面 5点 7点进钉方法进行相关的放射解剖学研究。方法 :在 5 0块骶骨标本上 ,用 为 1mm的软钢丝在骶骨翼、骶骨上关节突处紧紧缠绕 2个钢丝圈 ,将 为 3mm的钢珠用胶布固定在 5点 7点处 ,拍骶骨正位片 ,观测钢珠与 2个钢丝圈的位置关系及其至骶管外侧壁、骶骨上面的距离。作经 5点 7点水平平行于S1椎体上面的CT扫描 ,观察骶骨横断面的形态特点 ,测量与矢状面夹角为 0°和向内 10°时的进钉深度。结果 :5点 7点处钢珠均位于上关节突与S1后孔缠绕的钢丝圈显影内 ,位于骶管侧壁钢丝圈显影的外侧 ,钢珠与骶管外侧壁的距离为左侧〔 ( 6 7± 2 3 ) ( 5 0～ 12 0 )〕mm ,右侧〔 ( 6 6± 1 9) ( 5 0～ 11 0 )〕mm ;此点至骶骨上面的距离为左侧〔 ( 11 5± 5 3 ) ( 5 0～ 2 8 0 )〕mm ,右侧〔 ( 11 6± 5 4) ( 5 0～ 2 9 0 )〕mm。CT片显示钉道与矢状面平行( 0°)时 ,进钉深度左侧为〔 ( 3 2 6± 3 5 ) ( 2 4 0～ 40 0 )〕mm ,右侧为〔 ( 3 2 6± 3 5 ) ( 2 4 0～ 42 0 )〕mm ;螺钉向内与矢状面的夹角为 10°时 ,进钉深度左侧为〔 ( 3 8 1± 3 8) ( 3 0 0～ 46 0 )〕mm ,右侧为〔 ( 3 8 0± 3 9) ( 3 0 0～ 46 0 )〕mm。结论 :骶骨上关节突恒定存在 ,将每侧上关节     

海洛因依赖者戒毒中应用护理程序的研究

目的:探讨护理程序对戒毒病人的护理模式,以促进病人积极参与戒毒,减轻戒断症状及改善吸毒导致生理、心理、社会的危害。方法:对应用护理程序工作方法的护理效果进行SPSS11.5统计分析。结果:开展后住院病人意外事件及暴力行为的发生率比开展前显著性降低,实施心理卫生教育后病人对毒品危害性及相关知识认识水平显著提高。结论:通过应用护理程序的工作方法能帮助病人进步且朝向预定目标,为病人走上康复之道打下基础。     

肾上腺皮质腺癌的诊断与治疗

目的 探讨肾上腺皮质腺癌的早期诊断、手术及围手术期处理。方法 回顾分析了1990年至2001年间31例肾上腺皮质腺癌临床资料．并与1978年至1989年同种病例作比较。结果 近10年患者病理分期更趋向早期，更易行根治性切除，5年的存活率明显提高。结论 影像学的发展，使患者易早期诊断；围手术期的充分准备是减少手术并发症及死亡率的关键。     

护理程序在临床教学中的应用

把护理程序运用于临床教学中 ,提高护生的综合素质 ,培养实用型高素质护理人才。通过对护生社会心理状态及学习情况的评估 ,确定知识目标、技能目标、素质目标 ,然后分别组织实施 ,最后作出综合评价。结果显示 ,运用护理程序进行带教后 ,护生的专科知识、技能、服务意识都有了全面的提高 ,同时也培养了护理人员运用护理程序实施带教的能力。揭示 :护理程序在临床教学中的应用具有科学性和实用性 ,值得进一步推广。     

2种磨牙根管预备方法的成本-效果分析

目的:比较不锈钢K锉常规根管预备(SSPT)法与镍钛机用根管器械逐步深入预备(NRPT)法在磨牙根管治疗中的近期临床效果和成本/效果(C/E)值。方法:入选患者随机分为SSPT法(49例)和NRPT法(45例)2组,记录治疗后不良反应、补救治疗措施和所花费用,评价近期疗效并进行成本-效果分析,用SPSS11.5统计分析软件进行数据统计。结果:NRPT组治疗满意率优于SSPT组(P=0.034),但前者人均治疗成本显著高于后者(P=0.001)。对重度弯曲根管,NRPT组治疗满意率优于SSPT组(P=0.007);前者的C/E值较后者低394.52元;轻中度弯曲根管前者的C/E值较后者高192.04元。根尖正常患者,NRPT组治疗满意率高于SSPT(P=0.012),但前者C/E值比后者高32.32元;而根尖阴影患者NRPT组的C/E值较SSPT组高376.47元。结论:NRPT法的疗效优于SSPT法,但治疗成本较高;对重度弯曲根管患牙,NRPT法可使患者受益;对中轻度弯曲根管患牙,应选用SSPT法。对根尖正常的患者,NRPT法近期疗效更高,而治疗前有根尖病变的患者,SSPT法可节约治疗成本。     

余甘子功能食品的开发及其类SOD活力测定

余甘子是一种具有较高的食用和药用价值的野生植物资源，风味独特，含有丰富的类SOD活性物质和其他多种具有生物活性的物质，具有清除自由基、抗肿瘤、抗衰老等保健作用。作者提出了余甘予保健口服液的生产工艺流程及配方，并采用改良的Marklund方法测定了类SOD的活力，结果较为满意。     

微波干燥法对腊叶标本压制的实验研究

目的：寻求一种不受气候条件影响而能成功制作腊叶标本的新技术。方法：采用微波干燥法，即用微波炉，由创制的直径31cm瓦楞纸板、吸水纸与玻璃皿组成的压制程序进行微波干燥。结果：微波干燥法可用于腊叶标本压制，且优于传统的常规腊叶标本压制方法。结论：本研究为腊叶标本的制作提供了一个新方法，收到了便捷、高效、且保色的理想效果。