Transcranial direct current stimulation as early augmentation in adolescent obsessive compulsive disorder:A pilot proof-of-concept randomized control trial

BACKGROUND Transcranial direct current stimulation(tDCS)is proven to be safe in treating various neurological conditions in children and adolescents.It is also an effective method in the treatment of OCD in adults.AIM To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with OCD.METHODS We studied drug-naïve adolescents with OCD,using a Children’s Yale-Brown obsessive-compulsive scale(CY-BOCS)scale to assess their condition.Both active and sham groups were given fluoxetine,and we applied cathode and anode over the supplementary motor area and deltoid for 20 min in 10 sessions.Reassessment occurred at 2,6,and 12 wk using CY-BOCS.RESULTS Eighteen adolescents completed the study(10-active,8-sham group).CY-BOCS scores from baseline to 12 wk reduced significantly in both groups but change at baseline to 2 wk was significant in the active group only.The mean change at 2 wk was more in the active group(11.8±7.77 vs 5.25±2.22,P=0.056).Adverse effects between the groups were comparable.CONCLUSION tDCS is safe and well tolerated for the treatment of OCD in adolescents.However,there is a need for further studies with a larger sample population to confirm the effectiveness of tDCS as early augmentation in OCD in this population.

Study on the Effect of Repetitive Peripheral Magnetic Stimulation Combined with Conventional Rehabilitation Measures on Shoulder Dysfunction in Early Stroke

Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.

Partial improvement in performance of patients with severe Alzheimer's disease at an early stage of fornix deep brain stimulation

Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov（NCT03115814） on April 14, 2017.

Early application of percutaneous neuromuscular electric stimulation in interfering motor function of limbs and difference in temperature of axilla of patients with ischemic stroke

BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.

Efficacy and safety of transcutaneous auricular vagus nerve stimulation combined with conventional rehabilitation training in acute stroke patients: a randomized controlled trial conducted for 1 year involving 60 patients

Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.

孕早期孕妇促甲状腺激素、甲状腺过氧化物酶抗体及微小RNA-873-5p水平与妊娠期糖尿病相关性研究

目的:分析研究孕早期促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)及微小RNA-873-5p(miR-873-5p)水平与妊娠期糖尿病(GDM)的相关性。方法:选取定期产检的GDM孕妇命名为GDM组(n=109),另选同期在本院产检的糖耐量正常孕妇为对照组(n=60)。收集两组孕妇的一般资料及孕早期实验室检测指标(TSH、TPOAb、miR-873-5p),采用单因素、多因素分析TSH、TPOAb、miR-873-5p水平与GDM的关系;并绘制ROC曲线分析血清TSH、TPOAb、miR-873-5p水平对GDM的预测价值。结果:GDM组的血清TSH、TPOAb、miR-873-5p水平均高于对照组,差异具有统计学意义(均P<0.05);多因素Logistic回归分析显示,年龄>30岁(OR=1.982)、孕前BMI≥24 kg/m^(2)(OR=2.020)、TSH升高(OR=2.113)、TPOAb升高(OR=2.307)及miR-873-5p水平升高(OR=2.059)是发生GDM的独立危险因素(均P<0.05);ROC曲线分析显示,血清TSH、TPOAb、miR-873-5p及联合检测的曲线下面积(AUC)分别为0.830、0.829、0.762、0.936,联合检测优于单一检测(P<0.05)。结论:TSH、TPOAb及miR-873-5p在GDM孕妇体内呈高表达,可能成为GDM发生的辅助预测指标。

高体质量指数和使用促排卵药的交互作用与子宫内膜癌保留生育功能治疗后复发风险的关联分析

目的探讨高体质量指数和使用促排卵药的交互作用与子宫内膜癌(EC)保留生育功能治疗后复发风险的关联。方法选取2021年1月至2023年1月于长治医学院附属和平医院接受保留生育功能治疗的58例早期EC患者,所有患者经孕激素联合宫腔镜治疗均已达到完全缓解,收集并统计患者的临床资料。采用单因素、多因素Logistic回归以及相加模型分析影响早期EC保留生育功能治疗后复发的危险因素及其交互作用。结果58例早期EC患者经治疗后均已达到完全缓解,其中16例出现治疗后复发,42例未出现复发,复发率为27.59%(16/58)。2组患者体质量指数、病灶直径以及是否使用促排卵药物比较差异均有统计学意义(χ^(2)=13.110,P<0.001;χ^(2)=9.166,P=0.002;χ^(2)=8.133,P=0.004)。体质量指数≥25 kg/m^(2)(OR=13.316,95%CI:2.734~23.899)、病灶直径≥2 cm(OR=6.773,95%CI:1.225~12.322)、使用促排卵药物(OR=32.983,95%CI:1.354~64.613)是早期EC患者保留生育功能治疗后复发的危险因素。早期EC患者保留生育功能治疗后复发的危险因素之间存在相加交互作用,体质量指数≥25 kg/m^(2)与病灶直径≥2 cm、体质量指数≥25 kg/m^(2)与使用促排卵药物、病灶直径≥2 cm与使用促排卵药物的交互作用指数分别为2.836、3.609、2.626,超额相对危险度分别为6.936、12.384、5.653。结论体质量指数≥25 kg/m^(2)、病灶直径≥2 cm、使用促排卵药物是早期EC患者保留生育功能治疗后复发的危险因素,且危险因素间具有正向交互作用。

早期活动联合电刺激神经肌肉改善重症肺炎患者ICU获得性衰弱

目的 探究早期活动联合电刺激神经肌肉用于改善重症肺炎重症监护室获得性衰弱(ICU-AW)患者的效果。方法 选取150例上海市某三甲医院急诊重症监护室(EICU)入住的重症肺炎引发的ICU-AW患者作为研究对象,随机分为对照组(75例)和联合组(75例)。其中对照组给予早期活动,联合组给予早期活动联合电刺激神经肌肉。比较2组机械通气恢复情况(ICU住院时间、机械通气时间、脱机拔管率、ICU转出率)、肺功能[用力肺活量(FVC)、第1s用力呼气容积(FEV1)/FVC、最大吸气末压力(MIP)]、肌力[医学研究理事会(MRC)评分]、疾病严重程度[急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)]及并发症发生情况。结果 联合组ICU住院时间、机械通气时间明显低于对照组(P<0.05);与干预前比较,2组干预后FVC、FEV1/FVC、MIP及MRC评分均明显升高(P<0.05),且与对照组比较,联合组明显升高(P<0.05);2组APACHEⅡ评分均明显降低(P<0.05),且与对照组比较,联合组明显降低(P<0.05);联合组并发症发生率(9.33%)明显低于对照组(24.00%)(P<0.05)。结论 早期活动联合电刺激神经肌肉用于重症肺炎ICU-AW患者可有效促进机体恢复,提高肺功能,安全有效。

早期康复训练与经颅磁刺激联合应用于脑性瘫痪合并语言发育障碍患儿中的效果研究

目的分析早期康复训练与经颅磁刺激(Transcranial Magnetic Stimulation,TMS)联合应用于脑性瘫痪(Cerebral Palsy,CP)合并语言发育障碍患儿中的效果。方法选取2021年7月—2023年6月通辽市医院收治的90例CP合并语言发育障碍患儿为研究对象,参照随机数表法分为对照组和研究组,每组45例。对照组采取早期康复训练,研究组在对照组基础上联用TMS治疗。比较两组的临床疗效、Frenchay构音障碍评定法评分、Gesell发育诊断量表(Gesell Developmental Schedule,GDS)评分。结果研究组的总有效率为91.11%,高于对照组的71.11%,差异有统计学意义(χ^(2)=5.874,P<0.05)。研究组的Frenchay构音障碍评定法评分、GDS评分均高于对照组,差异有统计学意义(P均<0.05)。结论早期康复训练与TMS联合治疗CP合并语言发育障碍患儿效果确切,能够有效改善其语言功能与构音能力,促进智力发育。

不同方法治疗产后早期膀胱膨出的临床效果分析

目的探讨不同方法治疗产后早期膀胱膨出的临床效果。方法选取160例产后早期膀胱膨出患者为研究对象,随机分为4组,各40例,分别采用电刺激生物反馈疗法(ESBF)、ESBF联合电针、ESBF联合康复手法、电针治疗,比较4组治疗前后膀胱颈移动度、膀胱后角相关数据及盆底肌肌力值。结果治疗后,各组膀胱颈移动度、静息期膀胱后角、压力期膀胱后角小于治疗前,差异有统计学意义(P<0.05);治疗后,各组1类肌纤维持续60s阴道收缩时的平均肌电位、2类肌纤维快速阴道收缩5次的最大肌电位大于治疗前,差异有统计学意义(P<0.05)。结论ESBF联合电针治疗产后早期膀胱膨出效果最佳,可作为首选方法。

巴氯芬联合早期神经肌肉电刺激对脑卒中患者高肌张力的临床疗效研究

目的探讨巴氯芬联合早期神经肌肉电刺激对脑卒中患者高肌张力的临床疗效。方法选取上海市嘉定区安亭医院2021年1月~2023年1月收治的106例脑卒中后高肌张力患者,随机数表法分为联合组和电刺激组,各53例。电刺激组给予常规治疗并实施早期神经肌肉电刺激,联合组加用巴氯芬片,连续治疗4周。评估两组患者治疗前后肢体痉挛状况、肌张力情况、运动功能以及患者日常生活能力;观察两组患者血清炎症指标变化;统计两组患者治疗效果和不良反应。结果联合组患者总有效率为96.23%,高于电刺激组83.02%,差异有统计学意义(χ^(2)=4.970,P<0.05)。治疗后,两组患者临床痉挛指数(CSI)、Ashworth评分明显降低,Fugl-Meyer评分(FMA)、改良Barthel指数(mBI)升高,且联合组治疗后CSI、Ashworth评分低于电刺激组,FMA、mBI则高于电刺激组[(4.65±1.12)分vs.(7.73±1.63)分、(1.38±0.53)分vs.(1.81±0.46)分、(71.47±7.65)分vs.(68.08±6.44)分、(68.92±7.46)分vs.(64.89±7.09)分],差异有统计学意义(t=11.376、2.070、2.634、2.860,P<0.05)。治疗后,两组患者血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)水平显著降低,且联合组治疗后血清IL-1β、TNF-α、HMGB1水平显著低于电刺激组[(4.63±0.85)pg ml vs.(5.29±0.91)pg ml、(9.58±2.58)pg ml vs.(12.35±3.13)pg ml、(4.51±1.24)μg L vs.(5.68±1.51)μg L],差异有统计学意义(t=3.927、4.921、4.288,P<0.05)。两组患者不良反应发生率相当(16.98%vs.7.55%),差异无统计学意义(χ2=2.192,P>0.05)。结论巴氯芬联合早期神经肌肉电刺激治疗脑卒中患者高肌张力的疗效良好,可有效降低肢体高肌张力状况,提高患肢运动功能,抑制体内炎症反应水平。

宫腔灌注粒细胞集落刺激因子对薄型子宫内膜患者冻融胚胎移植妊娠结局的影响

目的探讨粒细胞集落刺激因子(G-CSF)宫腔灌注治疗对薄型子宫内膜患者冻融胚胎移植妊娠结局的影响。方法回顾性选取2017年1月至2023年10月在湖州市妇幼保健院生殖医学中心接受冻融胚胎移植助孕,既往控制性卵巢刺激周期中因子宫内膜厚度未达标取消新鲜胚胎移植,予大剂量雌激素治疗后子宫内膜厚度<7 mm的薄型子宫内膜患者132例。其中76例患者接受宫腔灌注G-CSF治疗(G-CSF组),另56例患者未接受宫腔灌注G-CSF治疗(对照组)。比较GCSF组患者宫腔灌注治疗前后子宫内膜厚度;比较两组患者妊娠结局,并采用多因素修正泊松回归分析患者临床妊娠的影响因素。结果G-CSF组患者宫腔灌注治疗后子宫内膜厚度大于治疗前[(7.6±0.9)mm比(5.4±0.9)mm,P<0.05]。G-CSF组胚胎种植率、临床妊娠率均高于对照组(40.0%比30.3%、52.6%比33.9%,均P<0.05),早期流产率呈下降趋势,两组患者早期流产率比较差异无统计学意义(25.0%比31.6%,P>0.05)。多因素修正泊松回归分析显示,调整混杂因素后,G-CSF宫腔灌注不是薄型子宫内膜患者临床妊娠的影响因素(RR=1.217,95%CI:0.615~2.410,P>0.05)。结论薄型子宫内膜患者冻融胚胎移植内膜准备时可考虑行G-CSF宫腔灌注治疗,增加子宫内膜厚度,以提升临床妊娠率、胚胎种植率。

早期视嗅觉刺激对垂体瘤患者术后嗅觉功能、鼻腔功能及睡眠质量的影响

目的:探讨早期视嗅觉刺激在垂体瘤患者中的应用效果。方法:选取2019年3月—2023年3月许昌市中心医院神经外科二病区收治的100例垂体瘤患者作为研究对象。采用随机数表法分组,对照组(n=50)采取常规护理措施,观察组(n=50)在常规护理基础上实施早期视嗅觉刺激,两组患者均持续护理至患者出院。比较两组患者嗅觉功能、鼻腔功能、睡眠质量以及生活质量。结果:干预后,观察组患者嗅觉心理物理检测评分、嗅觉-12项(SS-12)试验评分均高于对照组;嗅觉察觉阈值、嗅觉识别阈值均低于对照组,差异有统计学意义(t=5.691、22.379、3.616、14.652,P<0.05);干预后,观察组患者鼻腔功能测量表(ASK)评分低于对照组,差异有统计学意义(t=12.958,P<0.05);干预后,观察组患者匹兹堡睡眠质量指数量表(PSQI)评分低于对照组,差异有统计学意义(t=28.461、25.495、19.325、11.875、29.699、30.673、23.985,P<0.05);干预后,观察组患者健康调查简表(SF-36)评分高于对照组,差异有统计学意义(t=17.732、15.274、13.202、6.426、14.451、13.901、13.906,P<0.05)结论:早期视嗅觉刺激可帮助垂体瘤患者嗅觉功能快速恢复,有效减轻其鼻腔症状,提供其睡眠质量和生活质量。

神经肌肉电刺激在颅脑损伤吞咽障碍患者中的应用效果

目的探讨神经肌肉电刺激结合早期吞咽功能训练在颅脑损伤吞咽障碍患者中的应用效果。方法选取2021年4月至2023年4月该院收治的颅脑损伤吞咽障碍患者184例,采用随机数字表法分为对照组和观察组,每组92例。对照组患者采取常规康复干预,观察组患者在常规康复干预基础上行神经肌肉电刺激结合早期吞咽功能训练,2组干预时间均为2个月。比较2组患者康复效果。结果观察组患者标准吞咽功能量表、美国国立卫生研究院卒中量表、吞咽生活质量量表各项评分差值均高于对照组,差异均有统计学意义(P<0.05);观察组患者吸入性肺炎、误吸、营养不良等并发症发生率均低于对照组,差异均有统计学意义(P<0.05)。结论将神经肌肉电刺激结合早期吞咽功能训练干预应用于颅脑损伤吞咽障碍患者中,可改善患者吞咽功能和神经功能,降低并发症发生风险,患者生活质量得到进一步提升。

右正中神经电刺激联合早期持续功能锻炼对高血压脑出血患者术后康复的治疗效果

目的分析右正中神经电刺激联合早期持续功能锻炼对高血压脑出血患者术后康复的治疗效果。方法以2020年1月—2022年12月收治的60例高血压脑出血手术患者为研究对象,并根据康复治疗措施分为对照组(30例,早期持续功能锻炼)和治疗组(30例,右正中神经电刺激联合早期持续功能锻炼),统计对比两组的治疗效果相关指标。结果对照组患者美国国立卫生研究院卒中量表(NIHSS)评分、大脑前/中/后动脉阻力指数(RI)均显著高于治疗组(P<0.05),而Fugl-Meyer肢体运动功能评定量表(FMA)评分、Barthel指数评分及大脑前/中/后动脉平均血流速度(Vm),正中神经、腓总神经的运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)均显著低于治疗组(P<0.05)。结论在高血压脑出血患者术后康复中采取右正中神经电刺激联合早期持续功能锻炼的综合治疗,能快速恢复患者神经功能与日常生活能力,促进其病情转归。

rTMS联合早期吞咽功能分级康复训练对老年脑卒中合并吞咽障碍患者吞咽功能的影响

目的研究老年脑卒中合并吞咽障碍患者经高频重复经颅磁刺激(Repetitive Transcranial Magnetic Stimulation,rTMS)联合早期吞咽功能分级康复训练对神经及吞咽功能的临床应用价值。方法便利选取2021年1月-2023年1月泰州市第三人民医院收治的70例老年脑卒中合并吞咽障碍患者为研究对象,按随机数表法分为对照组(n=35,常规治疗)和观察组(n=35,rTMS联合早期吞咽功能分级康复训练)。比较两组治疗前后舌体移动度(舌骨上移距离、舌骨前移距离),神经功能[美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)]、吞咽功能[标准吞咽功能评分量表(Standard Swallowing Function Assessment Scale,SSA)]及生存质量[吞咽生存质量问卷(Swallowing Quality of Life,SWAL-QOL)]评分,观察两组不良反应发生情况。结果较治疗前,两组治疗后舌骨上移距离、舌骨前移距离及SWAL-QOL评分均升高,NIHSS评分、SSA评分均降低,且观察组较对照组更优,差异有统计学意义(P均<0.05)。观察组治疗总有效率(97.14%)高于对照组(82.86%),差异有统计学意义(χ^(2)=3.968,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。结论在rTMS治疗基础上,老年脑卒中合并吞咽障碍患者联合早期吞咽功能分级康复训练,对自身神经功能及吞咽功能均有显著改善作用,且安全性高。

生物反馈电刺激联合早期康复训练治疗产后压力性尿失禁患者的效果

目的:观察生物反馈电刺激联合早期康复训练治疗产后压力性尿失禁患者的效果。方法:回顾性分析2021年2月至2022年4月该院收治的116例产后压力性尿失禁患者的临床资料,按照治疗方法不同将其分为观察组和对照组各58例。对照组采用早期康复训练治疗,观察组在对照组基础上联合生物反馈电刺激治疗,两组均连续治疗3个月。比较两组临床疗效,治疗前后盆底肌肌力水平、尿动力学参数[最大尿流率、膀胱顺应性(BC)、功能尿道长度(FUL)、腹部漏尿点压(ALPP)]水平、氧化应激指标[丙二醛(MDA)、谷胱甘肽(GSH)、超氧化物歧化酶(SOD)]水平,以及不良反应发生率。结果:观察组治疗总有效率为93.10%(54/58),高于对照组的75.86%(44/58),差异有统计学意义(P<0.05);治疗后,观察组Ⅰ、Ⅱ类肌纤维肌力水平均高于对照组,差异有统计学意义(P<0.05);治疗后,观察组最大尿流率、BC、ALPP水平均高于对照组,FUL长于对照组,差异有统计学意义(P<0.05);治疗后,观察组MDA水平低于对照组,GSH、SOD水平均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:生物反馈电刺激联合早期康复训练治疗产后压力性尿失禁患者可提高治疗总有效率、盆底肌肌力水平,改善尿动力学参数和氧化应激指标水平,效果优于单纯早期康复训练治疗。

基于无机-有机激发体系的硅锰渣基早高强喷射混凝土的研制与应用

本文根据早高强喷射混凝土的性能要求、施工环境及硅锰渣的性能特点,采用单因素试验及正交试验方法,研究了早高强喷射混凝土掺合料各组分对喷射混凝土性能的影响,制备出一种硅锰渣基早高强喷射混凝土并在实际工程中施工应用。结果表明:激发剂按亚硝酸钠∶硫酸锂∶二乙醇单异丙醇胺质量比1∶1∶1进行混合,早高强喷射混凝土各组分的最佳配合比为激发剂掺量0.6%、铝酸盐水泥掺量7%、硅锰渣粉掺量40%、六水合氟硅酸镁掺量0.5%、粉剂聚羧酸减水剂掺量1%、粘度改性剂掺量1%、普通硅酸盐水泥49.9%。该配合比制备的早高强喷射混凝土在实际工程施工中,和易性良好,能保持2 h工作性能不变,8 h抗压强度大于10 MPa,1 d抗压强度大于20 MPa,7 d抗压强度大于30 MPa,28 d抗压强度大于45 MPa,回弹率8%。

神经肌肉电刺激联合进阶式早期肺功能锻炼在急性呼吸窘迫综合征患者中的应用效果

目的:观察神经肌肉电刺激联合进阶式早期肺功能锻炼在急性呼吸窘迫综合征(ARDS)患者中的应用效果。方法:选取2021年1月至2023年1月该院收治的88例ARDS患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各44例。两组均接受常规治疗,在此基础上,对照组实施进阶式早期肺功能锻炼治疗,观察组在对照组基础上联合神经肌肉电刺激治疗,比较两组康复时间[机械通气时间、带管时间、住重症监护室(ICU)时间],治疗前后氧合指数和膈肌增厚率、肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气流量峰值(PEF)]水平、ICU获得性肌无力发生率和撤机成功率。结果:观察组机械通气时间、带管时间、住ICU时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组氧合指数、膈肌增厚率均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组FEV_(1)、FVC、PEF水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组ICU获得性肌无力发生率为9.09%(4/44),低于对照组的27.27%(12/44),撤机成功率为95.45%(42/44),高于对照组的81.82%(36/44),差异均有统计学意义(P<0.05)。结论:神经肌肉电刺激联合进阶式早期肺功能锻炼治疗ARDS患者,可缩短其康复时间,改善氧合指数和肺功能,提高膈肌增厚率和撤机成功率,降低ICU获得性肌无力发生率,效果优于单纯进阶式早期肺功能锻炼。

格林模式联合早期足底应力刺激在跟骨骨折患者中的应用

目的探讨跟骨骨折患者应用格林模式联合早期足底应力刺激的效果。方法选取2020年7月—2023年6月聊城市人民医院收治的86例跟骨骨折患者作为研究对象,按照随机数表法将其分为干预组和对照组,每组43例。对照组给予常规护理,干预组给予格林模式联合早期足底应力刺激干预,比较两组锻炼依从性、疼痛程度、患足功能及日常生活能力。结果干预组锻炼依从性高于对照组,差异有统计学意义(P<0.05)。干预后,两组视觉模拟评分法(VAS)评分均低于干预前,且干预组低于对照组,差异有统计学意义(P<0.05)。干预后,两组美国足踝外科协会(AOFAS)踝-后足评分量表评分均高于干预前,且干预组高于对照组,差异有统计学意义(P<0.05)。干预后,两组Barthel指数(BI)评分均高于干预前,且干预组高于对照组,差异有统计学意义(P<0.05)。结论格林模式联合早期足底应力刺激应用于跟骨骨折患者干预中,能够提高锻炼依从性,减轻疼痛程度,促进患足功能、日常生活能力改善。