脑卒中患者应用双侧上肢训练的临床效果观察

目的观察脑卒中患者应用双侧上肢训练的临床效果。方法 54例恢复期脑卒中患者,随机分成观察组与对照组,各27例。观察组应用双侧上肢训练,对照组应用常规上肢训练,均训练4周。观察两组简式Fugl-Meyer量表上肢部分(FMA-UE)、运动评定量表上肢部分(MAS-UE)评分。结果治疗后观察组FMA-UE、MAS-UE评分均高于对照组,差异有统计学意义(P<0.05)。结论上肢功能中度到重度残损的恢复期脑卒中患者经双侧上肢训练后能够明显改善上肢运动功能,值得临床应用。     

上肢康复机器人对脑卒中偏瘫患者上肢运动功能的影响

目的观察上肢康复机器人对脑卒中偏瘫患者上肢运动功能的影响。方法选取2018年1-12月在浙江省余姚市人民医院接受治疗的脑卒中偏瘫患者60例,采用随机数字表法分为观察组与对照组各30例。对照组采用上肢重复性运动训练,观察组采用上肢康复机器人辅助训练。比较2组日常生活能力和上肢运动功能。结果观察组患者的日常生活能力评分及上肢运动功能各项评分均高于对照组(P均<0.05)。结论上肢康复机器人有利于提升脑卒中偏瘫患者上肢运动功能,值得在今后临床中进一步推广实施。     

视觉反馈联合任务导向性训练对脑卒中患者上肢功能障碍及生活质量的影响

目的:探讨视觉反馈联合任务导向性训练对脑卒中患者上肢功能障碍及生活质量的影响。方法:选择某院2019年1月～2020年1月康复医学科收治的120例脑卒中患者,随机分为观察组和对照组各60例,对照组进行任务导向训练治疗,观察组在对照组基础上结合视觉反馈训练治疗,比较分析治疗后两组患者的FMA评分、(FTHUE-HK)分级、MBI指数及SF-36评分情况。结果:治疗后,观察组FMA评分、(FTHUE-HK)分级、BMI指数及SF-36评分改善明显优于治疗前(P0.05);与对照组比较,观察组FMA评分、(FTHUE-HK)分级、BMI指数及SF-36评分改善更显著,差异具有统计学意义(P0.05)。结论:视觉反馈联合任务导向性训练对脑卒中患者上肢功能恢复有显著效果,并能提高患者生活质量。     

对脑卒中恢复期患者采取双侧下肢同步同向训练的意义研究

目的探讨对脑卒中恢复期患者采取双侧下肢同步同向训练的意义。方法80例脑卒中恢复期患者,随机分为试验组和对照组,每组40例。两组患者均在康复护师的指导下接受1对1的常规康复训练,对照组增加徒手重复运动训练,试验组患者增加双侧下肢同步同向训练。比较两组患者功能性步行能力量表(FAC)评分、Berg平衡功能量表(BBS)评分、跌倒指数评分及满意度。结果治疗后,试验组患者的FAC评分(3.15±0.29)分、BBS评分(40.15±2.25)分均高于对照组的(2.99±0.32)、(38.92±2.99)分,跌倒指数评分(77.19±9.65)分低于对照组的(88.71±10.29)分,差异有统计学意义(P<0.05)。试验组患者满意度95.0%高于对照组的75.0%,差异有统计学意义(P<0.05)。结论脑卒中恢复期患者采取双侧下肢同步同向训练的临床效果较好,可以有效改善患者的临床状态,值得临床推广应用。     

基于任务导向性训练的家庭康复训练在脑卒中偏瘫患者中的应用研究

目的:探讨基于任务导向性训练的家庭康复训练在脑卒中偏瘫患者中的应用效果。方法:选择2018年7月-2020年6月收治的108例脑卒中偏瘫患者,按随机数字表法分为对照组和观察组,每组54例。对照组实施常规护理,观察组在此基础上应用基于任务导向性训练的家庭康复训练,对比两组肌力水平、肢体运动功能与日常生活能力。结果:观察组护理后肌力水平优于对照组,差异有统计学意义(P<0.05);观察组护理后肢体功能评估量表(FMA)、日常生活能力指数量表(ADL)评分均高于对照组,差异有统计学意义(P<0.05)。结论:基于任务导向性训练的家庭康复训练能够提高脑卒中偏瘫患者肌力,改善机体运动功能与日常生活能力。     

高压氧联合双重任务训练在亚急性期脑卒中患者康复治疗中的疗效

目的 观察高压氧与双重任务训练联合改善亚急性期脑卒中患者运动功能、认知功能及生活质量的效果。方法 选取我院收治的88例亚急性期脑卒中患者为观察对象，采用随机数字法分为对照组(单行双重任务训练)和治疗组(在对照组基础上联合实施高压氧治疗)各44例，干预4周后，观察两组下肢运动功能评定量表(FMA-L)、上肢运动功能评定量表(UL-FMA)、蒙特利尔认知评估量表(MoCA)以及脑卒中专用生活质量量表(SS-QOL)评分差异。结果 干预后，两组UL-FMA、FMA-L、MoCA以及SS-QOL评分均较干预前上升(P<0.05),且治疗组各项评分均高于对照组(P<0.05)。结论 高压氧与双重任务训练联合干预对亚急性期脑卒中患者的运动功能、认知功能均有显著的改善作用，可以提升患者的生活质量，值得推广。     

康复机器人训练对脑卒中偏瘫上肢功能及神经电生理的影响

目的观察康复机器人对脑卒中偏瘫患者上肢功能恢复疗效及上肢神经传导速度的影响。方法将60例患者随机分为试验组和对照组,每组各30例。对照组给予常规肢体功能训练,包括运动疗法（PT）和作业治疗（OT）治疗等;试验组除给予常规肢体功能训练外,还进行上肢康复机器人治疗。入选患者分别于训练前、训练2W、训练4w后接受以下评定：（1）肩、肘、腕活动度（ROM）及手握力;（2）Lindmark评分;（3）上肢神经传导速度检测。结果治疗前,两组患者肩、肘、腕活动度（ROM）及手握力、Lindmark评分、上肢神经传导速度评分结果比较差异无统计学意义（P〉0．05）。训练4W后,两组患者的肩、肘、腕活动度（ROM）、Lindmark评分、上肢神经传导速度评分结果：试验组和对照组均较训练前有改善（P〈0．05）,部分有显著改善（P〈0．01）;试验组与对照组比较：在肩外展、肩前屈、肘屈、前臂旋前、前臂旋后、Lindmark评分和上肢神经传导速度上,试验组均优于对照组（P〈0．05）,在手握力、肩内收上,试验组明显优于对照组（P〈0．01）。结论上肢康复机器人结合常规肢体功能训练能更有效地促进脑卒中偏瘫患者上肢功能的恢复,并更有效地改善偏瘫侧上肢神经的传导功能。     

醒脑开窍针刺法结合任务导向性训练治疗脑卒中的临床效果观察

目的醒脑开窍针刺法结合任务导向性训练治疗脑卒中的临床效果观察。方法选取我院收治的64例脑卒中患者,采用随机数字表法将其分成对照组和观察组,每组各32例。对照组采用醒脑开窍针刺法,观察组在醒脑开窍法的基础上,采用任务导向性训练治疗。观察两组患者的临床疗效,以及对比治疗前后的运动功能(FugI-Meyer)评分、日常生活活动能力(ADL)评分。结果经治疗,观察组患者的治疗总有效率、治疗前后的FugI-Meyer评分、ADL评分均优于对照组,且差异具有统计学意义(P0.05)。结论醒脑开窍针刺法结合任务导向性训练治疗脑卒中具有显著临床效果,值得推广。     

基于认知泛化的任务导向训练对脑卒中患者认知功能及手功能的影响

目的 探讨基于认知泛化的任务导向训练对脑卒中患者认知功能及手功能的影响。方法 120例脑卒中患者根据不同康复方法均分为两组，对照组行基础康复，试验组在对照组的基础上实行基于认知泛化的任务导向训练。分别于干预前(T0)、干预2周后(T1)、干预4周后(T2)和治疗结束后4周(T3)对两组患者进行简明精神状态检查量表(MMSE)、改良Ashworth评定(MAS)、上肢运动功能评定(FMA-UE)、改良Barthel指数(MBI)评价。结果 T1～T3时，试验组患者MMSE评分、FMA-UE评分和MBI评分高于对照组(P<0.05),而MAS评分低于对照组(P<0.05)。与T0时相比，T1～T3时两组患者MMSE评分、FMA-UE评分和MBI评分均增加(P<0.05),而MAS评分降低(P<0.05)。结论 基于认知泛化的任务导向训练可以改善脑卒中患者的认知功能，提高患者的手功能，对于优化患者的日常生活活动功能具有一定帮助。     

康复护理路径在脑卒中偏瘫患者肢体功能训练中的应用效果观察

目的观察并分析康复护理路径运用于脑卒中偏瘫患者肢体功能训练中的应用价值。方法对本院2015年2月至2017年2月期间内收治的脑卒中偏瘫患者进行筛选,选择出82例为研究对象,并根据不同护理方式分为对照组、试验组,分别41例。给予对照组常规肢体功能训练方式,试验组在对照组基础上采取康复护理路径干预方式。比较两组患者护理干预后运动功能、神经功能缺损评分。结果护理干预后,观察组运动功能显著优于对照组(P <0.05),神经功能情况显著优于对照组(P <0.05)。结论在脑卒中偏瘫患者肢体功能训练中给予康复护理路径干预,能够有效改善患者运动功能、降低神经功能缺损程度,促进患者康复,值得在临床治疗中进一步运用。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.