推拿结合A型肉毒毒素对脑卒中患者上肢运动功能及大脑皮质兴奋性的影响

目的：观察推拿结合A型肉毒毒素对脑卒中患者上肢运动功能及大脑皮质兴奋性的影响。方法：将60例脑卒中后上肢痉挛患者随机分为治疗组和对照组，每组各30例。2组均进行常规康复、内科治疗，对照组采用A型肉毒毒素治疗，治疗组在对照组治疗的基础上采用推拿治疗。治疗4周后评估上肢运动功能（上肢Fugl-Meyer评分）以及大脑皮质兴奋性［运动诱发电位（MEP）皮质潜伏期与中枢运动传导时间（CMCT）］。结果：2组上肢Fugl-Meyer评分、MEP皮质潜伏期、CMCT治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）。结论：推拿结合A型肉毒毒素能有效改善脑卒中后患者的上肢运动功能，提高大脑皮质兴奋性，促进脑功能重塑，二者具有协同增效的作用。     

火龙罐联合康复机器人手套治疗卒中后上肢及手功能障碍30例

目的:观察火龙罐联合康复机器人手套治疗卒中后上肢及手功能障碍的临床疗效,并探讨其作用机制。方法:选取符合诊断标准的60例患者,将其随机分为2组,每组各30例。对照组采用针刺联合康复机器人手套治疗,治疗组在对照组基础上联合火龙罐治疗,比较2组治疗前后上肢Fugl-Meyer运动功能量表（FMA）、Barthel指数（BI）、改良Ashworth分级（MAS）、血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）的变化。结果:2组治疗后的上肢FMA评分、BI评分、MAS等级、TNF-α、IL-6均较治疗前明显改善,且治疗组改善幅度均大于对照组(均P<0.05)。结论：火龙罐联合康复机器人手套治疗卒中后上肢及手功能障碍的临床疗效较单纯康复训练更佳,可明显改善上肢及手功能状态,值得临床推广。     

醒脑开窍针刺法联合刺络拔罐治疗脑梗死后偏瘫50 例疗效观察

目的：观察醒脑开窍针刺法联合刺络拔罐治疗脑梗死后偏瘫的疗效。方法：选取脑梗死后偏瘫患者100 例,按照随机数字表法分为治疗组和对照组,每组各50 例。对照组给予西医常规治疗联合中医刺络拔罐疗法,治疗组在对照组治疗的基础上实施醒脑开窍针刺法。治疗结束后对比2组患者综合疗效及美国国立卫生研究院卒中量表（NIHSS）、Barthel、Fugal-Meyer运动功能评分（FMA）结果。结果：总有效率治疗组为98.00%（49/50）,明显高于对照组的80.00%（40/50）,差异有统计学意义（P<0.05）;治疗组患者NIHSS评分低于对照组,FMA、Barthe评分均高于对照组,差异有统计学意义（P<0.05）。结论：醒脑开窍针刺法联合刺络拔罐可提高脑梗死后偏瘫患者肢体运动感觉能力及生活能力,减轻神经缺损程度,疗效颇佳。     

针刺六阳经首尾穴治疗急性脑梗死后运动功能障碍30例

目的：观察针刺六阳经首尾穴治疗急性脑梗死后运动功能障碍的临床疗效。方法：将60 例急性脑梗死后运动功能障碍患者随机分为治疗组和对照组,每组各30 例。2组均予以西医常规治疗,治疗组加用针刺六阳经首尾穴治疗,对照组加用常规针刺疗法治疗。观察2组治疗前及治疗后2、4周的美国国立卫生研究院卒中量表（NIHSS）评分、改良Barthel指数（BI）评分、Fugl-Meyer Assessment量表（FMA）评分和牛津残障量表（OHS）评分,以及治疗前、治疗4周后的脑血流灌注参数（平均血流速度、收缩期高峰血流速度、阻力指数）的变化。结果：治疗组治疗2、4周后NIHSS、BI、FMA、OHS评分治疗前后组内比较及与对照组治疗后同时间节点比较,差异均有统计学意义（P<0.05）。2组平均血流速度、收缩期高峰血流速度、阻力指数治疗前和治疗4周后组内比较以及治疗4周后组间比较,差异均有统计学意义（P<0.05）。结论：急性脑梗死后运动功能障碍患者选择针刺六阳经首尾穴治疗,能明显改善患者的运动功能和生活质量,减轻残障程度,值得临床推广应用。     

Bobath结合调神止痉法针刺、体感音波治疗缺血性脑卒中肢体痉挛27例

目的：观察Bobath疗法结合调神止痉法针刺和体感音波疗法治疗缺血性脑卒中后肢体痉挛的临床疗效。方法：将缺血性脑卒中后肢体痉挛患者90例随机分为3组各30例，对照1组采用Bobath加调神止痉法针刺治疗，对照2组采用Bobath加体感音波治疗，治疗组采用Bobath加调神止痉针刺及体感音波治疗。对3组患肢治疗前后的痉挛程度、运动功能采用改良Ashworth痉挛量表（MAS）、简化Fugl-Meyer评定法（FMA）进行评定，统计3组的疗效。结果：总有效率治疗组为88.89%，对照1组为82.14%，对照2组为74.07%，3组比较，差异均有统计学意义（P<0.05)。3组FMA评分治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P<0.05，P＜0.01）。结论：调神止痉法针刺联合体感音波疗法、Bobath的综合疗法可明显改善缺血性脑卒中后痉挛性偏瘫患者的痉挛状态，提高患肢运动功能。     

激痛点齐刺为主对急性期肩周炎患者镇痛效应及功能活动度的影响

目的：观察激痛点齐刺为主对急性期肩周炎患者镇痛效应及功能活动度的影响。方法：将87例急性期肩周炎患者随机分为治疗组43例和对照组44例。2组均采用自主功能训练及常规针刺治疗。治疗组加用激痛点齐刺治疗，对照组加用激痛点常规针刺治疗。观察2组治疗前后疼痛视觉模拟（VAS）评分、现时疼痛程度（PPI）评分、肩关节功能活动度（ROM）评分及综合疗效。结果：总有效率治疗组为95.35%，对照组为88.64%，组间比较，差异有统计学意义（P＜0.05）；2组VAS、PPI、ROM评分治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）。结论：激痛点齐刺治疗为主对急性期肩周炎患者的镇痛效果明显，能改善肩关节功能活动度，具有良好的临床疗效。     

头针联合MOTOmed康复训练改善中风患者上肢运动功能26 例总结

目的：观察头针与MOTOmed康复训练联合治疗对中风患者上肢运动功能改善的临床疗效。方法：纳入52 例中风后上肢功能障碍的患者,将其随机均分为治疗组和对照组,每组各26 例。对照组予单纯MOTOmed康复训练治疗,治疗组采用头针（取穴瘫痪对侧顶颞前斜线、顶颞后斜线、百会、四神聪）联合MOTOmed康复训练治疗。观察2组治疗前后上肢Fugl-Meyer量表中上肢部分(FMA-UE)评分、改良Barthel指数（MBI）评分的变化及上肢、手Brunnstrom分期的改变。结果：对照组脱落1 例。治疗后,2组Fugl-Meyer、MBI评分均较治疗前增高,且治疗组评分高于对照组(均P<0.05);治疗组上肢、手Brunnstrom分期均优于对照组(均P<0.05)。结论：头针联合MOTOmed训练的康复治疗对中风后患者上肢运动功能的改善疗效颇佳,并可提高患者日常生活能力。     

醒脑开窍针刺法合玉郎通络方治疗脑梗死后偏瘫54例总结

目的：探讨醒脑开窍针刺法合玉郎通络方在脑梗死后偏瘫中的应用价值。方法：选取我院54 例脑梗死后偏瘫患者，采用随机数字表法分为治疗组和对照组，每组各54 例。2组均采用常规治疗，对照组在常规治疗基础上加用玉郎通络方治疗，治疗组在对照组基础上再加用醒脑开窍针刺法治疗，均治疗4 周。统计2组中医证候疗效、治疗前后美国国立卫生院卒中量表（NIHSS）评分及生活质量指数量表（QLI）评分。结果：中医证候疗效总有效率治疗组为83.33%（45/54），高于对照组的66.67%（36/54），2组比较，差异有统计学意义（P＜0.05）；治疗后2组NIHSS评分、QLI评分均较治疗前改善，且治疗组NIHSS评分低于对照组，QLI评分高于对照组，差异均有统计学意义（P＜0.01）。结论：醒脑开窍针刺法联合玉郎通络方治疗脑梗死后偏瘫效果显著，可改善患者神经功能、提高生活质量。     

加味身痛逐瘀汤联合关节围刺法治疗中风后肩手综合征30例总结

目的：观察加味身痛逐瘀汤联合关节围刺法治疗中风后肩手综合征的临床效果。方法：将60 例中风后肩手综合征患者随机分为治疗组和对照组,每组各30 例。对照组予以关节围刺法治疗,治疗组在对照组基础上加用加味身痛逐瘀汤治疗。观察2组综合疗效及治疗前后肩关节疼痛情况［视觉模拟评分法（VAS）评分］、上肢水肿评分、上肢运动功能评分［简化Fugl-Meyer功能量表上肢部分（U-FMA）评分］及血液流变学指标。结果：总有效率治疗组为93.33%（28/30）,对照组为70.00%（21/30）,2组比较,差异有统计学意义（P<0.05）;治疗后2组VAS评分、上肢水肿评分、U-FMA评分、血液流变学各指标治疗前后组内比较及治疗后组间比较,差异均有统计学意义（P<0.01）。结论：加味身痛逐瘀汤联合关节围刺法治疗中风后肩手综合征可有效改善患者症状、缓解疼痛、恢复关节活动度,并能改善患者血液流变学指标,具有较好的临床效果。     

基于MTrPs回路理论观察干针治疗脑卒中后肩手综合征患者的临床疗效

目的：观察干针治疗脑卒中后肩手综合征(SHS)Ⅰ期的临床疗效,并探讨其有效的作用机制。方法：将60 例脑卒中后SHS Ⅰ期患者分为治疗组和对照组,每组各30 例,在常规康复治疗的基础上,治疗组采用普通针刺加干针治疗,对照组采用普通针刺治疗,疗程均为4周。观察治疗前后2组患者的疼痛视觉模拟量表（VAS）评分、日常生活能力量表（ADL）评分、Fugl-Meyer 上肢运动功能评分表（FMA）评分,检测肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）的水平。结果：2组治疗后VAS评分降低,ADL、FMA评分升高,血清TNF-α、IL-6水平下降（P<0.05或P<0.01）,且治疗组各项指标改善程度均优于对照组（P<0.05或P<0.01）。结论：普通针刺及干针疗法对Ⅰ期脑卒中后SHS均有一定的治疗作用,可缓解患者疼痛,提高生活能力及运动功能,而干针的疗效明显优于普通针刺,其作用机制可能与降低患者血清TNF-α、IL-6水平有关。     

Suction caisson installation in sand with isotropic permeability varying with depth

Suction-induced seepage is pivotal to the installation of caisson foundations in sand. Indeed, the upward pore water flow on the inner side of the caisson wall causes a release of a fraction of soil resistance due to the reduction of the lateral effective stress. A safe caisson installation requires a reliable prediction of soil conditions, especially soil resistance and critical suction for piping. These soil conditions must be predicted for the whole installation process.In this paper, we examine the effect on such prediction of the assumed permeability profile, which is described as a function of depth below the mudline. This study is motivated by the fact that marine sediments generally exhibit a permeability that decreases with depth because of consolidation under gravity. Hence, the question is whether conventional theories based on a constant permeability lead to a conservative prediction of soil conditions or not. Our conclusion is affirmative only regarding piping condition. As for soil resistance, a prediction based on the assumption of a constant permeability is non-conservative. This is due to an overestimated reduction in effective stresses under suction-induced seepage.     

A theory for waves interacting with porous structures with multiple regions

This study presents an analytical solution for the problem of waves passing a submerged porous structure, using a multi-region method in the solution scheme considering the characteristics of geometry and composing materials of the porous structure. Using the flux and pressure conditions on horizontal boundaries and interfaces, the orthogonal property of wave motion within the porous layers through water depth is derived, and applied in the solution process. The flux and pressure conditions on vertical boundaries and interfaces are integrated to give a set of linear matrix equations, through which the unknown coefficients are solved. Comparisons of the present method with previous studies are preceded in verification, which suggests the validity and practicability of the present study, with a further expectation of extending our work to build a mild-slope equation over multiple-layer porous medium in the future.     

海洋藻类--对付全球变暖的武器?

最近,由欧盟(则资助的研究项目(Parforce)研究人员发现了海洋藻类与气候变化之间的联系。项目研究人员发现,从海洋藻类及浮游生物释放的碘蒸汽,在海面上浓缩,形成对抗地球变暖的悬浮微粒。此悬浮微粒对地球气候变化及降     

肺复方联合顺铂对气阴两虚Lewis肺癌荷瘤小鼠的影响

目的：研究气阴两虚Lewis肺癌荷瘤模型小鼠的行为学特征、饮水量、摄食量、体质量及肺复方对上述指标及脏器指数的影响。方法：取C57BL/6J小鼠40只,将其随机分为空白组8只、造模组32只。造模组灌服热性中药水煎液合并烟熏制备气阴两虚模型（造模第一阶段,共14 d）,于第15天移植Lewis肺癌细胞（造模第二阶段,共14 d）,按性别、体质量分层随机分为模型组、顺铂组、肺复方组及顺铂+肺复方组（联用组）,连续进行药物干预14 d。以造模每阶段及药物干预第1天的体质量、饮水量和摄食量分别作为基础体质量、基础饮水量和基础摄食量。并于固定时间,每2 d记录动物饮水量和摄食量,每3 d记录动物体质量,药物干预结束后处理动物,测量、计算其去瘤体质量和肝、脾及胸腺的脏器指数。结果：造模第一阶段小鼠饮水量和摄食量减少,造模第二阶段小鼠体质量增加,气阴两虚Lewis肺癌荷瘤模型小鼠脾脏和肝脏指数升高,胸腺指数降低（P<0.05或P<0.01）。药物干预后各组小鼠活动量增加,肺复方组饮水量、体质量增加,顺铂组小鼠摄食量、体质量减少,脾脏指数、去瘤体质量降低,联用组小鼠饮水量增加、摄食量减少,脾脏、胸腺指数升高（P<0.05或P<0.01）。结论：气阴两虚Lewis肺癌荷瘤模型小鼠的饮水量和摄食量减少,体质量增加;肺复方可缓解模型动物口干少饮、形体羸瘦等症状,改善顺铂引起的不良反应,增加模型小鼠脾脏和胸腺指数;肺复方干预肺癌的作用机制可能与其增强机体免疫功能有关。     

善待海洋就是善待人类自己

本文介绍了浙江近海生态环境恶化情况，并提出了强化浙江省生态环境保护与建设的对策措施建议。     

Swath bathymetry with GLORIA

For many years, GLORIA has been producing sonar images of the deep ocean floor. In the mid-1980's, the SeaMARC II system came to prominence producing depth values as well as sonar images. The basic method compares the phases of the signals returning from the seafloor to two rows of transducers. The phase differences are converted into angles of arrival and together with the arrival times converted into range and depth values. This capability has now been added to the GLORIA system. The fact that GLORIA uses a 2s FM pulse means the backscattered reverberation can come from a strip of seafloor up to 1.5 km wide. To accommodate this, overlapping complex FFT's are used to produce a time-frequency matrix for the returning signals. In this matrix, a constant range feature appears as a diagonal. Phases are then calculated using a least-mean-squares estimate along diagonals. The main source of error and bias is due to surface reflection, and this is taken into account. The GLORIA swath bathymetry system was tested on two cruises and it was possible to produce depth contours with a good level of confidence. The total swath width was over eight water depths and would have been greater with a more favorable velocity profile. Comparison with other bathymetry data (such as multibeam systems) showed excellent correlation, having a standard deviation of only 4% of total water depth     

太阳能海水淡化技术

文章论述应用太阳能集热和太阳能光伏发电系统进行蒸馏淡化和膜法淡化的海水淡化方法。与传统动力源和热源相比 ,太阳能具有安全、环保等优点 ,将太阳能采集与脱盐工艺两个系统结合是一种可持续发展的海水淡化技术     

Norway's experience with ITQs

This paper discusses the development of ITQs in Norway. Even if some would deny that anything such exists, fisheries management in Norway has some unmistakable characteristics of an ITQ system. Both boatowners and policy makers have discovered the attractions of transferable quotas, the former as a means to increase their private profits, the latter as a vehicle to reduce fleet overcapacity. The slow evolution of transferability is mainly the result of ideological opposition and opposition to structural changes, the latter involving falling number of fishermen, changes in location of the fishing industry, and changed composition of the fishing fleet. The development of this system in the purse seine fleet and the fleet fishing for cod and similar species is traced. Then the concept of resource rent is discussed, as well as how it has become capitalized in quota values, which show up as a rise in value of long term assets of the fishing industry.     

Position measurements with radiosondes

The use of Omega sondes, designed for the determination of upper air wind vectors, for relative position measurements on the ground is described. The technique shows promise in measuring the deformation of sea ice, the motion of oceanic surface water, and the trajectories of constant-level balloons. The sondes need not be recollected, are inexpensive, and can be built up to large arrays. The accuracy can be as high as ±30 m within a radius of about 30 km from the observing point. The computation is based on noise suppression of the signal retransmitted from the sondes