从心血管疾病的美国模式看肿瘤的中国模式

近年来,心脑血管疾病和癌症的死亡率在世界范围内已上升至前三位。自从美国通过改变生活方式,以控制心血管疾病的方针以来,心血管疾病的患病率减少了５０％,死亡率降低了２５％,人们称之为心血管疾病的美国模式。与此相应的是上海市癌症俱乐部提出了“群体抗癌”的新模式,倡导了“第四医学”和“第三人生”的新理论,１０年努力的结果,使癌症患者的５年生存率延长了３倍,１０年生存率延长了２－３倍,创造了癌症康复的中国模     

Luria's Neuropsychological Evaluation in the Nordic Countries

The publication of Luria's Neuropsychological Investigation (LNI) by Christensen in 1975 introduced Luria's evaluation procedures to worldwide neuropsychology. The LNI demonstrated the benefit of a thorough qualitative analysis of an individual patient's functioning as well as the usefulness of a comprehensive theory of brain functioning. This article reviews the experiences that led to the development of the LNI, discusses its use and extension in Scandinavian countries, and presents clinical and research applications of the LNI in diagnosis and rehabilitation. A series of case examples provides justification and validity for the continued use of the LNI and related procedures. Discussion of the advantages and disadvantages of the LNI and consideration of possible modifications of the procedures and interpretative methods provide the rationale for continued development of Luria's approach.     

脑外伤患者记忆功能的双重特征：损伤与保存

该研究探讨了中─重型闭合性脑外伤患者及对照被试（各１７名）在对单个汉字不同水平的加工后,其外显记忆（自由回忆、再认）和内隐记忆（汉字补笔起动效应）的若干特点。发现：患者组外显记忆受损而内隐记忆正常;两组被试在深层意义加工中的外显记忆均强于在浅层表面加工中的外显记忆,这种语义易化现象以耗费更多的认知努力为代价,其中患者组耗费的尤多,而记忆效率却不及对照组。综上,脑外伤患者记忆功能呈损伤和保存双重性。     

Response system analysis: What the neuropsychologist can contribute to the rehabilitation of individuals emerging from coma

The process of coma emergence is defined and important issues are identified. Rehabilitative goals for persons emerging from coma are best served by a focus on their response capabilities, rather than sensory stimulation. A method called response system analysis is described to guide assessment and treatment of response capabilities.     

急性心肌梗死早期康复治疗的探讨

遵循生物-心理-社会医学模式,结合传统康复治疗从生物功能、心理功能、社会功能三方面去探讨急性心肌梗死的早期康复治疗是切实可行的,而且明显优于传统的康复治疗,实行早期康复治疗时应从生物功能、心理功能、社会功能三个方面综合考虑,不宜偏废任何一方.     

中国卒中单元的模式探讨

卒中单元是针对急性卒中病人综合性治疗和康复的医疗单元,循证医学证据表明卒中单元是目前脑卒中治疗的最有效措施,建立有中国特色的卒中单元是我国目前脑血管病临床实践的当务之急。我们应该因地制宜,建立符合中国国情的卒中单元模式,卒中的早期康复治疗中应包括针灸疗法。     

Enhanced arm swing alters interlimb coordination during overground walking in individuals with traumatic brain injury

The current study investigated interlimb coordination in individuals with traumatic brain injury (TBI) during overground walking. The study involved 10 participants with coordination, balance, and gait abnormalities post-TBI, as well as 10 sex- and age-matched healthy control individuals. Participants walked 12 m under two experimental conditions: 1) at self-selected comfortable walking speeds; and 2) with instructions to increase the amplitude and out-of-phase coordination of arm swinging. The gait was assessed with a set of spatiotemporal and kinematic parameters including the gait velocity, step length and width, double support time, lateral displacement of the center of mass, the amplitude of horizontal trunk rotation, and angular motions at shoulder and hip joints in sagittal plane. Interlimb coordination (coupling) was analyzed as the relative phase angles between the left and right shoulders, hips, and contralateral shoulders and hips, with an ideal out-of-phase coupling of 180° and ideal in-phase coupling of 0°. The TBI group showed much less interlimb coupling of the above pairs of joint motions than the control group. When participants were required to increase and synchronize arm swinging, coupling between shoulder and hip motions was significantly improved in both groups. Enhanced arm swinging was associated with greater hip and shoulder motion amplitudes, and greater step length. No other significant changes in spatiotemporal or kinematic gait characteristics were found in either group. The results suggest that arm swinging may be a gait parameter that, if controlled properly, can improve interlimb coordination during overground walking in patients with TBI.     

Avatar-based therapy within prison settings: pilot evaluation

The paper presents an introduction of a newly developed, avatar-based virtual reality therapy, as an addition to the therapeutic programme, within a therapeutic community prison in the UK. The participants had six group sessions facilitated by a counsellor. The aim of the project was to investigate whether this approach would improve mental health outcomes for the prisoners, interpersonal relationships within the prison and facilitate the achievement of personal goals for the prisoners. The sample size (n?=?4) was insufficient to make firm conclusions about the mental health outcomes. However, the qualitative analysis showed a strong engagement with the programme in addressing personal issues, the development of insight and empathy, and improvements in relationships within the participants and with the counsellor. Further research with a larger sample is needed to establish efficacy of this type of therapy with the prison population.     

冰毒使用者抑制控制的损伤、可逆性及干预策略

冰毒使用的危害日益凸显,受到社会的普遍关注。行为、认知和脑功能的研究结果一致表明:长期的冰毒使用会导致使用者的抑制控制受损,包含一般抑制控制损伤以及药物相关线索条件下的损伤。这些损伤与前额脑区的异常密切相关,对冰毒使用者的行为和认知能力产生不良影响。目前,这些损伤只能部分恢复,因此,改善冰毒使用者抑制控制的干预策略成为热点。未来研究可以从不同药物成瘾者的差异性、多药物使用模式以及有区别的运动干预等方面对冰毒使用者的抑制控制损伤进行深入研究。     

Improving left spatial neglect through music scale playing

The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right‐brain‐damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right‐brain‐damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age‐matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no‐sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder.