Objective:To observe the effect of oral-facial muscle training applying virtual reality technology (VR) and of action observation therapy on the salivation of children with cerebral palsy (CP).Methods:Sixty CP children with uncontrolled salivation were randomly divided into a control group and an observation group, each of 30. In addition to conventional rehabilitation treatment, the control group received routine tongue muscle training, buccal lip muscle training, ice stimulation, and Masako swallowing training. The observation group received oral-facial muscle training based on action observation therapy in a virtual environment. Both groups were trained 30min per day, 5 times a week for 3 weeks. Before and after the treatment, drooling (DDSS) and swallowing function scores were evaluated. Integrated surface electromyography (iEMG) of the buccinator and orbicularis oris muscles was also performed.Results:After treatment, a significant decrease was observed in the average DDSS and the swallowing function scores of both the control and observation groups, along with a significant increase in the average root mean square values of the buccinator and orbicularis oris iEMGs of both groups. However, the average DDSS score of the observation group was significantly lower than that of the control group, while the average iEMG readings were significantly better.Conclusion:VR-based action observation oral-facial muscle training is a more effective supplement to conventional rehabilitation treatment than conventional oral-facial muscle training in improving the salivation of children with CP.

目的:对不同强度神经肌肉电刺激(neuromuscular electrical stimulation,NMES)治疗脑瘫吞咽障碍患儿临床效果进行分析.方法:将脑瘫吞咽障碍患儿60例随机分为NMES I组、NMESⅡ组、NMESⅢ组和对照组(每组各15例),其中对照组患儿给予常规康复训练,NMES组在常规康复训练基础上分别给予10mA、15mA、20mA不同强度NMES治疗共12周.分析4组患儿在治疗前后吞咽障碍严重程度、营养状况改善程度.运用表面肌电图测定颌下肌群sEMG中吞咽时程及平均振幅改变.结果:4组患儿治疗后较治疗前吞咽障碍评分改善,差异具有显著性(P＜0.05),NMES组吞咽障碍评分较对照组有显著改善(P＜0.05);NMES组总有效率较对照组有所提高,NMES组较对照组营养状况改善程度具有显著性意义,其中NMESⅢ组吞咽障碍及营养状况改善程度优于其他NMES组.sEMG平均振幅增高,吞咽时程缩短,差异具有显著性(均P＜0.05),其中NMESⅢ组优于其他强度NMES组.结论:对脑瘫吞咽障碍患儿实施NMES治疗效果显著,有效改善吞咽障碍、营养状况、咽部肌肉收缩功能.在可耐受范围内,增加刺激强度,可提高治疗效果.

Objective To investigate the effect and underlying mechanism of lipoxin A4 receptor agonist BML-111 on renal ischemia-reperfusion(I-R)injury in rats.Methods Twenty-five SD rats were equally randomized into five groups.The rats of group B were taken as the controls.Renal I-R injury models were established by renal ischemia for 45 min in groups of A,C,D and E,which were injected intraperitoneally normal saline,BML-111 3mg/kg,ZnPP 25mg/kg,and BML-1113mg/kg plus ZnPP 25mg/kg before ischemia.Serum creatinine(SCr),blood urea nitrogen(BUN),malondialdehyde(MDA)and glucosaminidase(NAG)were measured,and positive expression of heme oxygenase-1(HO-1)was determined by immunohistochemical staining.Moreover,the expressions of HO-1mRNA and protein were detected by RT-PCR and Western blot,respectively.Results The levels of SCr,BUN,MDA,NAG and HO-1expression in groups of A,C and E were higher than those in group B(P0.01 or P0.05).Compared with group A,the levels of SCr,BUN,MDA and NAG were decreased(P0.01),while HO-1expression was increased in group C(P0.05).Compared with group D,the levels of SCr,BUN,MDA and NAG were decreased(P0.05),while HO-1expression was increased in group E(P0.05).Conclusion BML-111 can reduce renal I-R injury in rats and protect renal function,which may be related to the regulation of HO-1overexpression and inhibition of oxygen radical injury.

目的:探讨脂氧素A4(lipoxin A4,LXA4)在人肾脏近曲小管上皮细胞(HK-2)缺氧/复氧损伤中的保护作用及可能机制.方法:LXA4预处理HK-2细胞后进行缺氧/复氧处理,CCK-8法检测细胞活性水平,ELISA法检测细胞上清液γ-谷氨酰转肽酶(γ-GT)、氨基葡萄糖苷酶(NAG)和亮氨酸氨基肽酶(LAP)水平,羟胺法检测细胞超氧化物歧化酶(SOD)活性,硫代巴比妥酸法检测细胞丙二醛(MDA)水平,实时定量PCR和Western blot法分别检测HK-2细胞的过氧化物酶体增殖子活化受体γ(PPARγ)和血红素加氧酶-1(HO-1)的mRNA和蛋白表达的变化,利用RNA干扰技术干扰PPARγ表达后检测HO-1和核因子E2相关因子2(Nrf2)的表达.结果:LXA4预处理的缺氧/复氧组细胞活性和SOD活性明显升高,细胞中γ-GT、NAG、LAP和MDA水平降低,而加入HO-1抑制剂锌原卟啉(ZnPP)和转染PPARγ的siRNA后,LXA4对HK-2细胞缺氧/复氧损伤的保护作用被阻断;此外,LXA4预处理的缺氧/复氧组HO-1、PPARγ和Nrf2表达均明显升高,并且LXA4预处理诱导的HO-1和Nrf2过表达能够被PPARγsiRNA所抑制.结论:LxA4预处理能够通过诱导HK-2细胞的HO-1高表达对抗HK-2细胞缺氧/复氧损伤,其机制与激活PPARγ/Nrf2有关.

目的探讨高危脑损伤儿早期干预治疗的效果。方法对120例高危脑损伤儿,详细回顾母孕产期情况?新生儿期病史,并进行肌张力?异常姿势?神经系统检查,采用综合康复治疗方法按疗程进行治疗,疗程结束随访至1岁半并进行评估。结果年龄在0～6个月时接受治疗的患儿正常化率为88.2%,年龄在6～12个月时治疗者正常化率38.6%。结论对高危脑损伤儿进行早期干预治疗,可以有效地降低脑瘫的发生率及减轻残疾程度。

表面肌电图(surface electromyogram, sEMG)又称动态肌电图(dynamic electromyogram,dEMG)~([1]),是通过表面电极从肌肉表面引导和记录肌肉活动时神经肌肉系统生物电变化的一维时间序列电信号,并经计算机处理为对肌肉功能状态具有特异性、敏感性和依赖性的时、频变化值,其振幅约为0～5000 μV,频率30～350 Hz.近年来,sEMG在康复医学、神经科学、骨科学、运动医学、生物医学和工程学等方面的应用日益受到重视~([2]),与传统的针式肌电图相比,sEMG具有操作方便、无创伤性、探测空间较大、可动态进行较长时间探测和重复性好的优点,因此能被脑瘫患儿所接受.我科自2007年起应用表面肌电分析系统评估治疗前、后痉挛型脑瘫息儿的坐位平衡功能,现总结如下.

目的观察Vojta疗法对脑瘫患儿早期康复中所起的作用。方法96例患儿随机分为治疗组及对照组,2组均以Bobath疗法为基础,治疗组加用Vojta法,1个月为1个疗程,3个疗程后进行评估。结果治疗组各级GMFM评分显示其疗效明显优于对照组(P均<0.05)。结论Vojta疗法在脑瘫患儿康复中通过早期对脑瘫患儿进行协调的复合的前进运动的整合,可以有效地抑制其异常反射及异常姿势,建立正常的运动模式,达到治疗的目的,对脑瘫患儿早期康复有重要作用。

<正>脑性瘫痪(简称脑瘫),是指在妊娠至新生儿期各种原因所致的脑的非进行性病变为基础,形成永久的但可以变化的运动和姿势异常,同时伴有程度不同的智力低下、语言落后、癫痫、视听觉障碍和行为异常等多种功能障碍,是儿童致残的主要疾病之一。临床上针对性地制定护理计划,落实护理措施,实施康复护理,可以有效地提高患儿运动功能,减轻

目的观察针灸、经络导平仪并手法训练治疗肌张力低下脑瘫患儿的疗效。方法对39例3月~4岁的肌张力低下的脑瘫患儿进行针灸、理疗及手法叩击等方法治疗。结果其中30例肌张力提高明显,能保持一定的姿势,运动发育有一定的进步;6例肌张力较前有提高,运动发育略有进步;无效果者3例。结论针灸刺激手足三阳经的穴位,则肌力易于恢复;经络导平仪导通受阻经络,使经脉通,肢体功能恢复,肌张力提高;手法叩击深部及表浅感受器,提高肌张力。3种方法合用,作用相加,疗效较单一方法好。

目的观察单唾液酸四乙糖神经节苷脂钠(申捷)治疗小儿脑性瘫痪(CP)的疗效。方法将64例CP患儿随机分为观察组(44例)和对照组(20例),给予理学疗法、头针、经络导平仪、脑循环仪等常规综合治疗为对照组,观察组同时静脉滴注申捷,比较两组间疗效差异。结果观察组疗效优于对照组(P<0.05)。结论申捷可提高CP的康复疗效。

目的:穴位注射疗法配合功能训练治疗痉挛型脑瘫患儿效果好。方法:2001年3月~2005年12月间36例痉挛型脑瘫患儿均按疗程进行乙酰谷酰胺注射液穴位注射;同时根据患儿的实际运动能力,综合运用Bobath法、Vojita法及上田法进行功能训练。结果:36例患儿中有28例显效,占77%,6例好转,占17%,无效2例,占6%,总有效率为94%。结论:穴位注射疗法配合功能训练,二种方法合用作用相加,更有利于提高患儿的治疗效果。