目的:探讨中频电疗联合康复训练治疗脑卒中偏瘫肩关节半脱位的效果.方法:选取2021年1月—2022年12月西岗社区卫生服务中心收治的脑卒中偏瘫肩关节半脱位患者50例作为研究对象,根据随机数字表法分为两组,各25例.对照组实施康复训练,观察组在对照组基础上实施中频电疗.比较两组运动功能、日常生活能力、疼痛程度、肩关节脱位程度、复位情况.结果:治疗前,两组运动功能、日常生活能力、疼痛评分比较,差异无统计学意义(P>0.05);治疗后,观察组运动功能、日常生活能力评分高于对照组,疼痛评分低于对照组,差异有统计学

The aim of the present study was to investigate the function of long non-coding RNA taurine-upregulated gene 1 (lncRNA TUG1) in chronic obstructive pulmonary disease and further assess the underlying molecular mechanisms. Flow cytometry analysis was performed to detect cell apoptosis of human pulmonary microvascular endothelial cells (HPMECs) treated with 1% cigarette smoke extract (CSE). The activity of caspase-3 was measured using a Caspase-3 Activity assay kit and the protein expression of cleaved caspase-3, caspase-3 and Bcl-2 like 11 (BCL2L11) were measured using western blotting. Reverse transcription-quantitative PCR (RT-qPCR) was performed to measure the expression of TUG1 mRNA levels in the treated cells. The association between TUG1, the miR-9a-5p/BCL2L11 axis and with miR-9a-5p were predicted and verified using a dual luciferase reporter assay system. The mRNA expression of miR-9a-5p and BCL2L11, and the transfection efficiency were measured by RT-qPCR. The results showed that CSE induced cell apoptosis and increased lncRNA TUG1 expression in HPMECs. CSE significantly reduced the expression of miR-9a-5p in HPMECs compared with the control group. TUG1-short hairpin RNA relieved cell apoptosis induced by CSE by upregulating miR-9a-5p in HPMECs. The present study predicted and verified that BCL2L11 is a direct target of miR-9a-5p. The mRNA expression of BCL2L11 was increased in HPMECs following CSE treatment compared with the control group. miR-9a-5p mimic and BCL2L11-plasmid markedly increased the expression of miR-9a-5p and BCL2L11, respectively. miR-9a-5p mimic reversed the increase in cell apoptosis induced by CSE by inhibiting BCL2L11 expression in HPMECs. To conclude, the present study demonstrated that lncRNA TUG1 exerted roles in cell apoptosis induced by CSE through modulating the miR-9a-5p/BCL2L11 axis.

目的:探讨一种距下关节运动控制训练方案对髌骨外侧高压综合征患者膝关节功能的影响.方法:髌骨外侧高压综合征患者43例,随机分入对照组21例,实验组22例.所有患者接受每周3次,每次40min,持续3个月的常规股四头肌训练.实验组患者增加距下关节运动控制训练,每次40min,3次/周,持续3个月;对照组增加同等频次和强度的居家股四头肌练习.分别于入组时、治疗1个月、治疗2个月、治疗3个月使用Lysholm功能评分对患者功能进行评价,并同时测量髌骨向内和向外被动活动度以及患侧下肢Q角.结果:①Lysholm评分:实验组和对照组在治疗3个月后的Lysholm总分均较治疗前显著提高,并且实验组的改善程度较对照组更为明显.其中疼痛、不稳定、爬楼梯和下蹲四项,实验组明显优于对照组.②髌股向外被动活动度:实验组和对照组在3个月治疗前后及组间比较,均无显著差异.③髌股向内被动活动度:实验组和对照组在治疗3个月后的髌股向内被动活动度均较治疗前显著提高,但两组间比较差异无统计学意义.④Q角:实验组和对照组在3个月治疗前后及组间比较,均无显著差异.结论:距下关节运动控制训练能有效的改善髌骨外侧高压综合征患者的膝关节功能状态.

BACKGROUND:Recently, high-frequency repetitive transcranial magnetic stimulation (rTMS) is reported to evaluating the corticospinal pathway and improving both cortical excitability and motor function significantly in subjects. According to some previous reports, the maximum voluntary muscle contraction (MVC) of target muscle can reinforce the influence by rTMS. The aim of this study was to confirm 5 Hz rTMS with MVC in healthy individuals is an effective method to facilitate motor neuron excitability and the efficiency can last at least 30 min post stimulation.OBJECTIVE:To compare the motor evoked potentials (MEPs) elicited by 5Hz rTMS and 5Hz rTMS combined with MVC.METHODS:In this randomized, controlled, assessor-blinded, crossover trial, 40 healthy right-handed subjects were divided into group A (n=20) and group B (n=20). All subjects received rTMS over the primary motor cortex area (M1) in the left hemisphere. The parameters of rTMS were 5 Hz, 90.of the resting motor threshold (RMT), for a total of 500 pulses in 100 trains (1-sec inter-stimulus and 8- sec inter-interval). Method 1: All subjects received rTMS over the hand area of left M1. Method 2: All subjects received rTMS at the same stimulated point, combined with maximum voluntary hand griping in each 10 trains. Test 1: group A underwent method 1, while group B underwent method 2. Test 2: A week later, group B underwent method 1, while group A underwent method 2. In each test, the MEP amplitude and latency was measured before (P-rTMS), 5 min after (Post 1) and 30 min after (Post 2) the rTMS intervention.RESULTS:MEP amplitude increased significantly from baseline at 5 minutes post intervention under both treatment regimes. However for both sequences, it decreased towards baseline under the rTMS intervention at 30 minutes post intervention but remained relatively high when rTMS was combined with MVC. MEP latency decreased significantly from baseline at 5 minutes post intervention under both treatment regimes. For both sequences, it then increased again towards baseline under both treatment regimes at 30 minutes post intervention. Although there was a trend for a less pronounced increase under the combined treatment, this effect was not significant.CONCLUSION:Both 5 Hz rTMS and 5 Hz rTMS combined with MVC facilitate motor cortical excitability, but the enhancement in rTMS with MVC is more pronounced and maintained longer than simple rTMS.

Objective To compare the accuracy of weight-bearing training using biofeedback with conventional training for partial weight-bearing patients,and the factors influencing the accuracy.Methods Seven healthy volunteers were recruited to practice on a treadmill with their body weight partially supported on paired elbow crutches.The weight reduction was controlled by the subjects by means of verbal prompting from an experienced therapist,or by using a bathroom scale or a sound-vibrating biofeedback from the PierenStep gait quantization system.The PierenStep gait quantization system was also used to collect the data.All the subjects were instructed to reduce 20％ of their body weight on their appointed leg.The accuracy of weight reduction on the appointed leg after training under the three methods was compared and the factors influencing the accuracy were analyzed.Results Significant differences were found among the three methods in terms of the average deviations observed,the maximum and minimum values.Sex,height and exercise time per day all were significantly correlated with the accuracy.Conclusions Biofeedback can help healthy young persons control the weight borne by their lower limbs accurately with obvious short-time subsequent effects.This should be helpful in the rehabilitation of fracture patients.

>脑卒中是常见病、多发病,约55% 7 5%的患者会遗留不同程度的上肢运动功能障碍,患肢活动能力以及日常生活能力的下降。尽管康复治疗技术和方法众多,但其上肢运动功能恢复仍是康复的难题。近年来,经颅磁刺激（transcranial magnetic stimulation,TMS）作为脑卒中后促进运动功能恢复的新技术与手段,已得到广泛的关注和研究。英国Barker等于

>腰椎间盘突出症是临床上的常见病之一。腰椎牵引是目前国内使用较广泛的保守治疗手段之一,其能减轻椎间盘内压、牵伸粘连组织、纠正关节错位 [1] 。临床上常用的牵引方式为持续牵引和间歇牵引,目前有关牵引疗法的研究较多,但多数均是采用综合疗法治疗腰椎间盘突出症,单纯采用持续牵引或间歇牵引治疗腰椎间盘突出症的研究尚较为少见。本研究

近年来,笔者运用电针结合康复手法治疗中风后肩痛30例,并与单纯采用康复手法治疗的30例作对照,取得较好疗效,现报告如下。1临床资料1.1一般资料2006年12月～2010年5月南京中医药大学第三附属医院脑病中心和江苏省人民医院康复科门诊、住院患者64例,随机分为治疗组、对照组。临床观察中脱落4例,最终有完整资料者60例。治疗组30例:男25例,女5例;年龄38～75岁,平均年龄（61.63±11.13）岁;平均病程（1.57±0.88）月;脑出

Objective To observe the therapeutic effects of muscle energy technique combined with joint mobilization on frozen shoulder.Methods Thirty-six patients with frozen shoulder were randomly assigned to:group A (treated with muscle energy technique plus joint mobilization),group B (treated with passive stretching with joint mobilization),and group C (treated with joint mobilization merely),and each had 12 patients.All the patients were treated accordingly for 3 times a week,totally for 4 weeks.The American Shoulder and Elbow Surgeons evaluation system (ASES) was adopted to evaluate clinical effects before and at the end of treatment.Results After 4 weeks of treatment,all patients' ASES scores were improved significantly (P ＜ 0.05).The improvement in the shoulder score index and shoulder range of motion were to a significantly better extent in group A than in the other two groups.Conclusion Muscle energy technique plus joint mobilization could effectively relieve pain increase the shoulder ROM and improve performance in activities of daily living in patients suffering from frozen shoulder.

Objective: To explore the effectiveness of nerve mobilization combined with traditional massage for lumbar intervertebral disc herniation.Methods: 54 patients with lumbar intervertebral disc herniation were randomly divided into two groups.Both groups received massage,and observation group received treatment of nerve mobilization additionally.Visual analogue scale(VAS),straight leg raise test(SLR) and Japanese orthopaedic association score(JOA) were used to evaluate the clinical outcome.Results: After treatment for 4 weeks,the scores of VAS in both groups were reduced,and those in observation group were reduced more significantly(P0.01).SLR and JOA scores in the two groups were significantly increased,and those in observation group were significantly higher than in control group(P0.05).Conclusion: Both therapies were effective in alleviating pain and improving function,and the combined use of nerve mobilization and massage exerts the synergic effectiveness.

<正>慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是常见的呼吸道疾病,肺生理功能发生进行性损害,尚无治愈方法,目前肺康复治疗已得到广泛开展,渐成为治疗稳定期COPD的重要方案之一[1]。临床上常见COPD

OBJECTIVE:To compare the therapeutic effect difference between electroacupuncture combined with rehabilitation techniques and simple rehabilitation techniques for treatment of the shoulder subluxation after stroke.METHODS:Sixty cases of shoulder subluxation patients were divided into an acupuncture combined with rehabilitation group (30 cases) and a rehabilitation group (30 cases). The acupuncture combined with rehabilitation group was treated with electroacupuncture at Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) etc. combined with rehabilitation treatment, the rehabilitation group was treated with rehabilitation only. The therapeutic effects were evaluated and the pain score of the shoulder joint, passive range of motion of shoulder joint, the muscle strength of middle group of the deltoid and the function grade of the upper limbs motion of the two groups were evaluated before and after treatment.RESULTS:The acupuncture combined with rehabilitation group was superior to that of the rehabilitation group in pain score of the shoulder joint, passive range of motion of shoulder joint, the muscle strength of middle group of the deltoid and the function grade of the upper limbs motion with significant differences between the two groups (all P<0.05); the total effective rate of 93. 3% in the acupuncture combined with rehabilitation group was superior to that of 73.3% in the rehabilitation group (P<0.05).CONCLUSION:The therapy of electroacupuncture combined with rehabilitation techniques can act a good regulating role on muscle strength and the muscular tension of shoulder joint and the muscles around the scapula through many steps, and can effectively improve the shoulder subluxation.