近5年经颅磁刺激相关研究的可视化分析

目的分析经颅磁刺激近5年的研究现状和热点。方法以Web of Science中的SCI-E为来源,检索2014年至2018年经颅磁刺激相关研究,应用CiteSpace软件分析研究者、国家(地区)/机构分布、学科领域分布和关键词。结果和结论共纳入4820篇文献。发文最多的研究者是Daskalakis Z J,发文最多的机构是多伦多大学,发文最多的国家是美国,研究方向以神经科学和神经学最多;基础研究多探讨经颅磁刺激与大脑运动皮质的联系,临床研究主要针对脑卒中和抑郁症。     

近五年神经病理性疼痛相关研究的可视化分析

目的:探索过去5年来神经病理性疼痛研究中的学科热点和合作网络，对这些研究进行定性和定量的分析，以明确未来的研究方向，促进进一步的研究。方法:有关神经病理性疼痛的研究文献来源于Web of Science数据库。通过CiteSpace 5.8.R3软件分别从年发文量、被引频次、国家、机构、基金、作者、关键词、参考文献等方面进行可视化分析。结果:共纳入3187篇文献，分析结果显示：该领域年均发文量在600篇以上，年发文量总体呈上升趋势，发文量最多的作者为元祥涛，作者Finnerup NB和Chaplan SR为主要影响人物，美国约翰斯·霍普金斯大学为领先机构，基于中枢敏化、氧化应激、神经炎症、小胶质细胞激活探讨的发病机制，以及重复经颅磁刺激、经皮神经电刺激、和非阿片类药物开发的治疗措施，是该领域的研究热点。预测以免疫机制为基础，探讨免疫系统和神经病理性疼痛之间的相互作用，评估免疫调节剂在疼痛中的疗效，探究有效的神经病理性疼痛的防治措施，可能成为前沿趋势。结论:本研究通过可视化分析总结了神经病理性疼痛领域的研究趋势和发展，并预测潜在的研究前沿和热点方向。     

基于CiteSpace的经颅直流电刺激研究热点及趋势分析

目的:分析经颅直流电刺激（tDCS）的研究热点及趋势。方法:采用CiteSpace软件对中国知网及Web of Science核心合集数据库中2011年1月—2020年12月发表的tDCS相关研究进行可视化分析，主要分析内容包括文献作者、机构、关键词等，同时绘制相应的知识图谱。结果:2011年1月—2020年12月tDCS相关中文文献年均发文量为57.5篇，高产作者以宋为群为代表，高产机构以首都医科大学宣武医院为代表，研究热点为脑卒中、康复、认知功能、帕金森病等。2011年1月—2020年12月tDCS相关外文文献年均发文量为533.4篇，高产作者以Felipe Fregni为代表，高产机构以哈佛大学为代表，研究热点为兴奋性、脑刺激、运动皮质等。结论:tDCS中文文献发文量不高，发文机构分布不平衡且缺乏影响力，今后应加强不同地区、不同机构间的合作，开展多中心、跨区域研究，应进行更深层次的作用机制研究。     

经颅磁刺激运动诱发电位有关指标及其在脑卒中运动功能评估中的应用研究进展

脑卒中是全球致残的最常见疾病,对患者功能障碍进行准确评定可更好的指导康复治疗并改善预后。大脑皮质兴奋性是脑卒中康复及预后的重要标志。然而目前临床评估多采用量表,精确性差,无法定量评定患者大脑兴奋性情况。由经颅磁刺激诱发的运动阈值及运动诱发电位是大脑皮质兴奋性的代表性评价指标,可定量评估大脑皮质兴奋性。近年来,经颅磁刺激成对脉冲刺激模式诱发的短间隔皮质内抑制及皮质内易化已成为皮质兴奋性相关研究的新方向。经颅磁刺激诱发的相关皮质兴奋性评价指标在脑卒中后运动功能评估及预后参考中有重要意义。本文就经颅磁刺激运动诱发电位有关指标的特性及其在脑卒中运动功能评估中的应用进行综述。     

硬膜外植入式皮质刺激脑卒中患者提高神经网络功能

背景：硬膜外植入式皮质刺激兼顾了经颅磁刺激、经颅直流电刺激、硬膜下皮质刺激和深部脑刺激的优点,可显著改善脑卒中后的肢体运动与语言功能。 目的：综述近年来有关硬膜外植入式皮质刺激在脑卒中康复中的研究及其临床应用。 方法：由第一作者应用计算机检索1995年1月至2014年4月PubMed数据库及中国期刊全文数据库文献,检索关键词为“cortical stimulation,extradural motor cortex stimulation,extradural cortical implants,extraduralcorticalstimulation,stroke,rehabilitation;皮质刺激,硬膜外电刺激,硬膜外皮质植入,硬膜外皮质刺激,脑卒中,康复”。纳入有关硬膜外植入式皮质刺激在脑卒中后运动与言语障碍中应用的文章。结果与结论：硬膜外皮质刺激是植入式皮质刺激,其优势是侵入性小、高度精确性和经硬膜与大脑密切接触,对缺乏有效治疗的脑卒中慢性期运动和语言障碍患者来说,这有可能是一种新的治疗方法。硬膜外皮质刺激通过促进神经可塑性、促进病灶周围结构与功能改变、提高神经网络功能、促进大脑半球间功能平衡及增加感觉输入来改善脑卒中后的肢体运动功能与语言功能。     

低频重复经颅磁刺激治疗半侧空间忽略的临床研究

目的探讨低频重复经颅磁刺激治疗半侧空间忽略症的临床疗效。方法将40例脑卒中所致半侧空间忽略症患者分为治疗组及对照组各20例,并对治疗组进行为期2周的低频重复经颅磁刺激治疗。在治疗前后,采用半侧空间忽略评估量表分别对两组患者进行评定。结果治疗前,两组患者半侧空间忽略程度无显著性差异(P>0.05);治疗后,治疗组半侧空间忽略程度较对照组改善(P<0.05);治疗后,治疗组中重度异常率较治疗前明显降低(P<0.05),对照组无显著性差异(P>0.05)。结论通过低频重复经颅磁刺激治疗,脑卒中所致半侧空间忽略程度明显改善。     

近5年慢性意识障碍治疗的可视化分析

目的 了解近5年慢性意识障碍(pDOC)治疗的研究现状和研究热点，并预测未来的研究趋势。方法 检索2019年1月1日至2023年6月7日Web of Science核心合集数据库中pDOC治疗的相关文献，采用CiteSpace 5.8.R3软件进行可视化分析，分别绘制作者、国家、机构、关键词、共被引文献、共被引作者的知识图谱。结果 纳入411篇文献。年发文量呈上升趋势，影响力较大的作者为Aurore Thibaut，影响力突出的国家为比利时，发文量最多的机构为哈佛大学医学院。近5年的研究热点为pDOC患者的神经调控、预后评估以及护理和吞咽功能训练；主要使用的神经调控技术为经颅直流电刺激、重复经颅磁刺激、脑深部刺激和经皮耳迷走神经电刺激。未来的研究趋势为pDOC患者的神经调控和意识恢复机制的探索，主要使用的神经调控技术为脑深部刺激和经皮耳迷走神经电刺激。结论 pDOC治疗的研究呈上升趋势，主要关注pDOC患者的神经调控、预后评估以及护理和吞咽功能训练，未来研究仍将集中于探讨pDOC患者的神经调控和意识恢复机制。     

重复经颅磁刺激治疗脑卒中患者上肢运动功能障碍的研究进展

重复经颅磁刺激通过对大脑特定皮质部位重复刺激,可能以半球间抑制、代偿等机制,实现神经可塑性。刺激频率、强度、刺激时长的灵活组合对脑卒中患者上肢功能有不同的改善效果。     

脑卒中后单侧忽略的康复治疗

单侧忽略是脑卒中后常见的高级神经功能障碍之一,对脑卒中患者的神经功能有明显的消极影响.目前对脑卒中后单侧忽略有多种康复治疗手段,包括感觉输入、视扫描训练、作业训练、头和躯干旋转、暗示、环境适应和日常生活活动训练等传统的治疗方法,以及近年来开创的几种新治疗方法如棱镜适应、强制性使用疗法和单眼遮避、重复经颅磁刺激等.     

从经颅磁刺激谈起

经颅磁刺激是经颅电刺激的发展。经颅电刺激又是从周围神经电刺激而来。最开始的电刺激是从离体的神经肌肉刺激开始，已经有200多年的历史。经颅磁刺激的临床应用报道首见于1985年，报道采用经颅皮质单刺激的方法研究中枢神经的运动传导。以Medline的收录为据，1986以后有关磁刺激的报道就以1．1：1的比例逐年增加。迄今已有3600多篇，2003年收录论文最多，达382篇，2005年1至9月有关磁刺激的国外文献已经有367篇。     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Towards an acoustic model-based poroelastic imaging method: I. Theoretical foundation

The ultrasonic measurement and imaging of tissue elasticity is currently under wide investigation and development as a clinical tool for the assessment of a broad range of diseases, but little account in this field has yet been taken of the fact that soft tissue is porous and contains mobile fluid. The ability to squeeze fluid out of tissue may have implications for conventional elasticity imaging, and may present opportunities for new investigative tools. When a homogeneous, isotropic, fluid-saturated poroelastic material with a linearly elastic solid phase and incompressible solid and fluid constituents is subjected to stress, the behaviour of the induced internal strain field is influenced by three material constants: the Young's modulus (E(s)) and Poisson's ratio (nu(s)) of the solid matrix and the permeability (k) of the solid matrix to the pore fluid. New analytical expressions were derived and used to model the time-dependent behaviour of the strain field inside simulated homogeneous cylindrical samples of such a poroelastic material undergoing sustained unconfined compression. A model-based reconstruction technique was developed to produce images of parameters related to the poroelastic material constants (E(s), nu(s), k) from a comparison of the measured and predicted time-dependent spatially varying radial strain. Tests of the method using simulated noisy strain data showed that it is capable of producing three unique parametric images: an image of the Poisson's ratio of the solid matrix, an image of the axial strain (which was not time-dependent subsequent to the application of the compression) and an image representing the product of the aggregate modulus E(s)(1-nu(s))/(1+nu(s))(1-2nu(s)) of the solid matrix and the permeability of the solid matrix to the pore fluid. The analytical expressions were further used to numerically validate a finite element model and to clarify previous work on poroelastography.     

Quasi-quantum model of potentization

Analytical time-dependent functions describing the change of the concentration of the solvent S(t) and the homeopathic active substance A(t) during decimal and centesimal dilution are derived. The function S(t) is a special case of the West-Brown-Enquist curve describing ontogenic growth, the increase in concentration of the solvent during potentization resembles the growth of biological systems. It is demonstrated that the macroscopic S(t) function is the ground state solution of the microscopic non-local Horodecki-Feinberg equation for the time-dependent Hulthèn potential at the critical screening. In consequence potentization belongs to the class of quasi-quantum phenomena playing an important role both in biological systems and homeopathy. A comparison of the results predicted by the model proposed with the results of experiments on delayed luminescence of a homeopathic medicine is made.     

Intérêt du Télos dans l'évaluation de la laxité chronique antérieure du genou en pré- et en postopératoire

The objective of our work is to clarify the contribution of knee arthrometer in the diagnosis of the anterior laxity of the knee, to look for the factors of escalation of this pathology, to estimate the objective results and outcomes following of the anterior cruciate ligament surgery. It is about a retrospective study which concerned 78 patients presenting the anterior chronic laxity of the knee, investigated, treated and followed in the M.-T.-Kassab Institute of Orthopaedics over a period of 10 years. The average age of our patients was of 27.6 years with a male ascendancy. The anterior cruciate ligament surgery was realized according to the technique of Kenneth-Jones under arthroscopy. The arthrometer has been used to determine the outcome 6 months after the surgery. Before the surgery, the average anterior translation of the tibia was 15.3 mm, 95% of the patients had 8 mm previous absolute laxity, while the differential was about 4 mm in 87% of the cases in which comparative study could be made. There was a statistically significant correlation between the Lachman's test, the internal meniscus injuries and the delay accident — surgery with the anterior knee laxity in the arthrometer. The postoperative average laxity was bout 8.2 mm and earning was proportional to the importance of the initial tibial translation. The present study demonstrates that arthrometer tests may be an objective complement for the clinical exam, with a diagnostic, previous and therapeutic purpose.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Phase and amplitude fluctuations in the propagation of acoustic waves in lossless inhomogeneous continua with velocity, density and bulk modulus variations

Discussions of the phase and amplitude fluctuations of waves travelling through inhomogeneous media have previously considered only fluctuations caused by the variation of sound velocity in the medium, density variations being ignored since in water and air they can be shown to be small. In biological tissues this assumption cannot be made, and this paper derives the fluctuation dependence on velocity and density variations of characteristic dimension large compared to the wavelength.Previous discussions have shown a more appropriate formulation to be that of the fluctuation dependence on bulk modulus and density variations and this analysis is presented for the first time. The form of the solutions is shown to be simplified for extreme values of the wave parameter, but formulae for comparison with experiment require the specification of the analytical form of the correlation coefficients of the parameter variations.The fluctuations for correlation coefficients of the form exp (−r²/a²) are evaluated both for the general case, and for extreme values of the wave parameter.It is found that the density variations contribute to the fluctuations only insofar as they are cross-correlated with the velocity fluctuations (for velocity and density variations); while the amplitude fluctuations, for small values of the wave parameter and the specific form of correlation coefficients used, are independent of frequency.     

喹硫平对精神分裂症阴阳性症状和社会功能康复的影响

目的探讨喹硫平对精神分裂症患者阴、阳性症状和社会功能康复的影响。方法将100例精神分裂症患者随机分为两组,每组50例,研究组口服喹硫平治疗,对照组口服舒必利治疗,观察8周。于治疗前及治疗第1周、4周、8周末、出院1月末采用简明精神病量表、阴性症状量表、阳性症状量表评定精神症状,于治疗前和出院1月末采用社会功能缺陷筛选量表评定社会功能缺陷状况。结果治疗后两组简明精神病量表、阴性症状量表、阳性症状量表评分均较治疗前有显著下降（P〈0．01）;治疗第1周末,研究组各量表评分均较对照组下降显著（P〈0．05或0．01）,其他时段评分两组均无显著性差异（P均〉0．05）。两组出院1月末社会功能缺陷筛选量表总分及各因子分均较治疗前有显著下降;研究组总分及职业功能、社会活动、家庭活动、生活能力因子分均较对照组下降更显著（P〈0．05或0．01）。结论喹硫平治疗精神分裂症疗效显著且与舒必利相当,但喹硫平起效更快,对社会功能缺陷的改善显著优于舒必利。     

Transversus Abdominis Block: Clinical Uses,Side Effects,and Future Perspectives

Poorly controlled acute pain during the postoperative setting after abdominal surgery can be detrimental to the patient. Current pain management practices for the postoperative abdominal surgery patient rely heavily on opioids, which are associated with many unwanted side effects. Recently, interest surrounding regional anesthesia has been growing owing to its demonstrated efficacy and safety outcomes. More specifically, the transversus abdominis plane (TAP) block procedure has attracted attention owing to its ability to successfully block peripheral pain signaling in the abdomen, its ease of use, few complications, and its greater acceptability. A majority of the studies published has demonstrated the successful reduction in pain in many abdominal surgical procedures using local anesthetics during the TAP block. However, the short duration of the pain block causes the patient to still rely on other analgesics throughout the additional postoperative days. Preliminary studies using continuous infusion catheters placed in the TAP has been one of the ways to prolong the nerve block in the abdomen; however, technical and operational issues currently limit the widespread adoption of this method. In this review, current studies will be presented and summarized to update the field on the potential benefits of the TAP block procedure, in addition to providing insight into the future direction of the drugs that could be used for TAP block.     

L’apport du muscle pectoralis minor dans le traitement de l’instabilité antérieure de l’épaule

The surgical stabilization of the shoulder knew many technical improvements energy. We propose a preliminary study about an engineering change by the addition of a fourth muscular bolt for the treatment of former instabilities of the shoulder. Our study is prospective gathering 16 patients having a stabilization of the shoulder by a quadruple locking using an osseous thrust by the coaracoid process, a tendineux bolt by a hammock applied thanks to the coaraco-biceps tendon to the lower bank of the sub-scapularis, a capsular bolt by joining the acromio-coracoid ligament to the glenohumeral capsule and a fourth bolt by the joining of the pectoral small tendon to the coraco-biceps. Our results evaluated by the score of Dupaly after 18 months show that the average retreat are satisfactory with an early resumption of the activity (2 months on average). The techniques of former stabilization of the shoulder are currently allowing that triple locking is indicated among all patients whose score ISIS exceeds five points. The addition of small pectoral as fourth bolt seems to us as well interesting because of the good preliminary results.     

孕产妇分娩前后心身健康状况调查

目的 探讨孕产妇分娩前后心身健康状况,为临床干预提供依据.方法 对100名孕产妇产前、产后1周、4周、12周末采用焦虑自评量表、抑郁自评量表和爱丁堡产后抑郁量表评定焦虑抑郁状况,于产前、产后1周末检测血清雌二醇和孕酮水平.结果 入组被试产后焦虑自评量表、抑郁自评量表和爱丁堡产后抑郁量表评分随着时间的延续均呈持续性下降(...