创伤截肢后的假肢康复

5·12汶川地震使当地许多伤员肢体残缺,对伤者的生理和心理产生了重大的影响。帮助这些伤员尽快走出阴影,使他们在灾后能够最大程度的身心康复,重新回归社会,假肢的装配和使用是目前最有效的方法。为了使假肢能够更好地替代残缺肢体的功能,应当从截肢前着手,包括患者截肢平面的选择、残端的正确处理。术后早期对患者进行功能锻炼指导,防止畸形发生,尽可能早地根据患者自身情况选配合适的假肢,并指导患者正确使用和维护假肢,使其能够成功地回归社会,增强截肢者生活的信心。     

儿童创伤截肢

儿童意外伤害在国内外一直是受到普遍重视的问题,我国在这这方面的研究不多。严重肢体创伤的处理无论从专业理论还是在手术技巧上均要求很高,尤其对儿童肢体的毁损性创伤的治疗往往使临床医师常需在截肢与肢体挽救二者之间作出困难的选择。如何确定急诊截肢和保留肢体,国内外目前尚未有一个客观合理权威的标准。本文主要综述儿童截肢的标准和方法,以供参考。     

肢体严重毁损伤保留与否的循证思考

肢体严重毁损伤的修复是当今医学领域的一个研究热点。从循证医学角度对肢体严重毁损伤的保肢与截肢提出思考并加以阐述,同时结合当前我国医疗环境提出一些这方面的倡议。     

肢体严重毁损伤保留与否的循证思考

肢体严重毁损伤的修复是当今医学领域的一个研究热点.从循证医学角度对肢体严重毁损伤的保肢与截肢提出思考并加以阐述,同时结合当前我国医疗环境提出一些这方面的倡议.     

我观故我在？— 从橡胶手错觉对自我身体所有权的探讨

橡胶手错觉是一种能将非自我的肢体感知为自我的肢体的反应。继发现橡胶手错觉现象后,研究者通过操纵自变量以及观测不同的因变量,得到了大量新的研究结果。橡胶手错觉的出现与强度受到时间、空间和手姿势的影响。橡胶手错觉的产生机制为单纯的多感觉整合或多感觉整合与身体表征共同作用的结果。未来研究侧重于被试取样、研究策略以及医学领域中瘫痪患者的认知神经康复和截肢病人的假肢控制方面。     

骨巨细胞瘤外科治疗几个问题的思考

骨巨细胞瘤是临床上常见的骨肿瘤,其治疗方式由以前的截肢术发展到保肢术,一直到现在的多种局部切除与功能重建方式,透过其治疗理念的更新,以及手术技术的转变,不难看出临床医生应重视循证医学实践,不断更新观念,坚持个体化治疗,明确切除范围、切除方式与重建方法及肢体功能之间的关系,不断改善患者的生活质量。     

骨巨细胞瘤外科治疗几个问题的思考

骨巨细胞瘤是临床上常见的骨肿瘤,其治疗方式由以前的截肢术发展到保肢术,一直到现在的多种局部切除与功能重建方式,透过其治疗理念的更新,以及手术技术的转变,不难看出临床医生应重视循证医学实践,不断更新观念,坚持个体化治疗,明确切除范围、切除方式与重建方法及肢体功能之间的关系,不断改善患者的生活质量.     

脱下裙子,才知道她的美

正有时候,她抚着长腿,微笑地看着你,那时她身高一米七七。有时候,她在TED演讲台上风姿绰约,那时她身高一米八六……她凭借这个"善变"的身高,在不同场合总能给人一个"满意"的表现。"随心所欲地创造,发掘全部潜质,把身上最美丽的东西展现出来!",这就是她的人生追求。她是一个天生没有小腿腓骨的孩子,1岁多的时候,就做了膝盖以下全部截肢的手术。为了不让她的一生在轮椅中度过,将来能够像正常人一样生活,父母就尝试着给她换上了假肢。2岁的     

小腿严重创伤修复适应证的选择和启示

随着医疗技术的不断发展,我院对治疗小腿严重创伤修复的适应证认识在不断地深入和提高,本文指出要提高小腿严重创伤治疗的满意度,首先要规范手术修复适应证的选择,根据伤情不断改进和优化手术术式和治疗方案,必须综合性治疗,对于无法保留和修复的伤肢,则果断采取截肢术.     

慢性失眠的诊治及思考

慢性失眠是神经科门诊常见疾病之一.在慢性失眠的诊断中应分清病因,明确类型及严重程度,避免诊断扩大化.治疗时须按照最优化的医疗原则,提倡重视非药物治疗,避免长期大剂量应用镇静安眠剂.在治疗过程中要注意结合人文思想来提高失眠的治疗效果.     

Preliminary evidence for a fronto‐parietal dysfunction in able‐bodied participants with a desire for limb amputation

Background. Reports of able‐bodied participants with the persisting desire for limb amputation raise legal and ethical questions that are partly due to insufficient empirical knowledge about the condition. Here, we searched for potential neurological mechanisms in participants with desire for limb amputation in order to help develop adequate nosological classifications, diagnosis, and treatment. Methods. Semi‐structured interviews were carried out with 20 participants who self‐identified themselves as able‐bodied individuals desiring amputation of a limb. Results. The results suggest that amputation desire is not unspecific, but in most cases specific for a circumscribed part of the body. Most frequently affected was the leg, mostly on the left, non‐dominant side. Left‐sidedness and limb specificity was associated with elementary and complex somatosensory disturbances of the affected limb akin to those reported by neurological patients. The most frequent neurological co‐morbidity was migraine headache. Conclusions. These results document the existence of an unusual condition in able‐bodied participants characterized by a person's desire for the amputation of one or more particular limbs. Left‐sidedness, limb specificity and somatosensory disturbances of the affected limb are suggestive of abnormal brain mechanisms in right fronto‐parietal cortex. Based on this association we suggest that desire for limb amputation may be conceptualized as asomatognosia due to disturbed integration of multi‐sensory information of the affected body parts into a coherent cerebral representation of the own body. This suggestion has to be regarded with caution as we did not perform any neurological examination.     

The prevalence of symptoms of Post-Traumatic Stress Disorder among soldiers with amputation of a limb or spinal injury: a report from a rehabilitation centre in Sri Lanka

Post-Traumatic Stress Disorder has been identified as one of the most commonly occurring mental illnesses in combatants. This study was conducted to determine the prevalence of Post-Traumatic Stress Disorder among soldiers who had undergone amputation of a lower or an upper limb or sustained a spinal cord injury in the battlefield, and to compare the prevalence among these categories. The research presented seeks to increase the awareness of this condition among those treating war casualties so that appropriate treatment choices could be made to address them. The study was carried out in 2009 at a rehabilitation centre for combatants of war. Data were collected from 96 male army veterans between the ages of 18-49 years using a pre-tested self-administered questionnaire based on the Diagnostic and Statistical Manual of Mental Disorders, the Impact of Event Scale and the PTSD symptom scale. Soldiers with injuries sustained at least four weeks prior to the study were selected by a convenience sampling technique. Soldiers with multiple injuries, head injuries or those diagnosed with psychiatric disorders were excluded. The results revealed that 41.7% of the study population was compatible with the diagnosis of Post-Traumatic Stress Disorder. Within the three groups, 42.5% of the lower limb amputees, 33.3% of the upper limb amputees and 45.7% of the participants with spinal cord injury had symptoms compatible with Post-Traumatic Stress Disorder. There was no difference between the prevalence among the different injury categories considered. This study highlights the need to pay more attention in providing psychological care as a part of the overall health management of injured combatants. Early preparation of soldiers for stressors of war and screening for and proper management of Post-Traumatic Stress Disorder will improve the overall outcome of rehabilitation.     

Attention Demands in Balance Recovery following Lower Limb Amputation

The attention demands in balance control after damage to the peripheral sensorimotor system were studied in 12 persons with a recent lower limb amputation. The interference of an arithmetic task with two postural tasks of different complexity (quiet standing and active weight shifting) was examined several times during their rehabilitation while the subjects stood on a force platform. Control data were obtained from healthy subjects. For both postural tasks, persons with amputation performed worse than controls. Quiet standing, a relatively simple task, revealed clear dual-task interference only in the amputation group. Evidence was found for a reduction in dual-task interference as rehabilitation progressed. In contrast, voluntary (feedback-controlled) weight shifting, a more complex task, revealed an equal amount of dual-task interference in persons with amputation and in controls, without changes in interference over the period of rehabilitation. The results indicate that attentional mechanisms may be involved in postural control, depending on both the novelty and complexity of the task. Moreover, a reduction in attention demands of quiet standing may reflect a central adaptation of the postural organization to the peripheral sensorimotor impairments caused by lower limb amputation.     

Attention demands in balance recovery following lower limb amputation

The attention demands in balance control after damage to the peripheral sensorimotor system were studied in 12 persons with a recent lower limb amputation. The interference of an arithmetic task with two postural tasks of different complexity (quiet standing and active weight shifting) was examined several times during their rehabilitation while the subjects stood on a force platform. Control data were obtained from healthy subjects. For both postural tasks, persons with amputation performed worse than controls. Quiet standing, a relatively simple task, revealed clear dual-task interference only in the amputation group. Evidence was found for a reduction in dual-task interference as rehabilitation progressed. In contrast, voluntary (feedback-controlled) weight shifting, a more complex task, revealed an equal amount of dual-task interference in persons with amputation and in controls, without changes in interference over the period of rehabilitation. The results indicate that attentional mechanisms may be involved in postural control, depending on both the novelty and complexity of the task. Moreover a reduction in attention demands of quiet standing may reflect a central adaptation of the postural organization to the peripheral sensorimotor impairments caused by lower limb amputation.     

Body Integrity Identity Disorder: From A Psychological to A Neurological Syndrome

Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.     

On the syndrome of the "spare limb": one case

We describe a case of a brain-damaged patient who had a peculiar bodily illusion which could not be labelled an hallucination but seemed somatognosically and phenomenologically similar to the phantom limb without amputation. The patient, who showed left hemiplegia, felt a third upper limb (without seeing it) which he himself defined as "spare." The spare limb was not deformed; it could be moved and controlled by the patient, and there was no sensation of pain. The patient did not show psychopathological or cognitive disorders. A possible interpretation of the phenomenon is as a "phantom movement" of the paralysed limb: the mental representation of the movement of the limb was dissociated from the bodily representation of his own limb and so was still present in his consciousness despite the paralysis.     

The translation and introduction of Mo Yan's works based on neurolinguistics

As an advanced function of the cognitive neural mechanism of human brain, inductive reasoning is an important skill in language communication. Under the background of the development of information intelligence, it is a new research field to effectively display the cognitive neural function of inductive reasoning with the advantage of the logic operation of artificial intelligence algorithm. Therefore, in this paper, based on the neurolinguistics, the translation and introduction of Mo Yan's works were studied. And on the basis of the analysis of the characteristics of the cognitive neural mechanism of sentence inductive reasoning, by using fMR and ERP techniques, the narrowing characteristics of the semantic integrated components in the induction were investigated, and the dual processing model of inductive reasoning was discussed. After that, artificial intelligence particle swarm optimization (PSO) algorithm was introduced, and the problem of alignment in the translation of English and Chinese sentences in Mo Yan's works was transformed into the problem of finding the optimal solution for the corresponding fitness function in Chinese and English sentences in bilingual space. Thus, a scientific mathematical model was used to improve the accuracy of translation. The simulation experiments show that this study can effectively improve the accuracy of the translation and introduction of Mo Yan's works.