星形胶质细胞连接蛋白在阿尔茨海默病中的作用研究进展

胶质细胞活化是阿尔茨海默病（AD）的一个显著特征,主要表现为星形胶质细胞和小胶质细胞的形态 和功能变化。这种活化与在胶质细胞广泛表达的跨膜蛋白--连接蛋白（Cx）的表达和功能变化有关。在AD 患者的脑组织中,接触淀粉样斑块的星形胶质细胞Cx表达明显增加;在AD小鼠模型APPswe/PS1dE9中也 有同样发现。Cx可以形成半通道（HC）和全通道缝隙连接（GJ）,分别介导细胞内外和细胞之间的小分子物 质交流。在APPswe/PS1dE9小鼠模型中,星形胶质细胞中Cx作为GJ的功能并未改变,但其作为HC可被激活 开放,并介导胶质递质（如ATP和谷氨酸）释放和星形胶质细胞内Ca2+ 浓度升高,从而导致神经元损伤。靶 向星形胶质细胞Cx HC,包括特异性敲除APPswe/PS1dE9小鼠脑中星形胶质细胞的Cx43或使用不同种类 的抑制性药物阻断HC的开放,可减少胶质递质的释放、减轻神经元损伤。本文主要概述近年来星形胶质细 胞Cx在AD发病过程中作用的研究进展,并探讨阻断星形胶质细胞HC开放是否可作为治疗AD的新策略。     

抗抑郁药对海马星形胶质细胞缝隙连接蛋白表达和通道功能的影响

目的 探讨3种不同机制抗抑郁药对海马星形胶质细胞缝隙连接蛋白和通道功能的影响。方法 CCK-8实验检测不同机制抗抑郁药对海马星形胶质细胞的细胞毒性,采用蛋白免疫印迹法和细胞接种荧光示踪法测定3种不同机制抗抑郁药对由缝隙连接蛋白43（Cx43）组成的通道功能和Cx43蛋白表达的影响。结果 CCK-8实验显示,25.00 µmol/L氟西汀、0.10 µmol/L阿米替林和0.20 nmol/L文拉法辛对海马星形胶质细胞无细胞毒性（P均> 0.05）; 25.00 µmol/L氟西汀、0.10 µmol/L阿米替林和0.20 nmol/L文拉法辛能抑制海马星形胶质细胞缝隙连接的荧光传递功能（P均< 0.05）,但3种抗抑郁药均不影响海马星形胶质细胞Cx43蛋白的表达（P均> 0.05）。结论 抗抑郁药能够显著降低海马星形胶质细胞Cx43组成的通道功能。     

大麻素对星形胶质细胞谷氨酸释放的影响及机制研究

目的:观察人工合成大麻素HU210对体外培养中脑腹侧被盖(VTA)区星形胶质细胞谷氨酸释放的影响,并探讨抑制星形胶质细胞谷氨酸释放的药物治疗途径。方法:体外培养大鼠VTA脑区星形胶质细胞,RT-PCR及免疫荧光染色检测胶质纤维酸性蛋白(GFAP)及大麻素受体1(CB1R)的表达。将培养的星形胶质细胞分为4组:对照组(培养基中只加入0.2%DMSO),HU210组(培养基中加入3μM HU210),HU210+AM281组(培养基同时加入3μM HU210及3μM AM281)和HU210+Riluzole组(培养基同时加入3μM HU210及3μM Riluzole),各组4孔。干预30 min后,采用谷氨酸检测试剂盒观察各组星形胶质细胞培养基中谷氨酸浓度。再培养VTA脑区星形胶质细胞,分为对照组(培养基中只加入0.2%DMSO)和Riluzole组(培养基中加入3μM Riluzole),干预30 min后,利用Western Blot印迹分析Riluzole干预后谷氨酸转运体-1(GLT-1)表达水平的变化。结果:RT-PCR及免疫荧光染色显示,星形胶质细胞内有广泛CB1R的表达。与对照组比较,HU210组星形胶质细胞谷氨酸的释放显著增加(P<0.01),HU210+AM281组及HU210+Riluzol组星形胶质细胞谷氨酸的释放较HU210组均显著降低(P<0.01);且HU210+Riluzol组星形胶质细胞的GLT-1表达较对照组升高(P<0.05)。结论:HU210可能通过激活星形胶质细胞的CB1R促进星形胶质细胞释放谷氨酸。Riluzole可能通过升高星形胶质细胞的GLT-1的表达,逆转HU210所致的谷氨酸释放。     

Ca^2＋ Entry Through TRPC1 Channels Contributes to Intracellular Ca^2＋ Dynamics and Consequent Glutamate Release from Rat Astrocytes

各种不同的刺激作用于星型胶质细胞,可以导致胞浆内Ca2+浓度增加,进而释放更多谷氨酸作用于周边的神经元。大部分Ca2+来源于细胞内,小部分来源于细胞外。Ca2+内流是通过钙池操纵Ca2+通道(SOC)实现的。因此,作者观察在星型胶质细胞内Ca2+激活与谷氨酸释放过程中钙池操纵Ca2+通道(SOC)发挥了什么样的作用。已有研究显示星型胶质细胞所表达的TRPC通道(Ca2+通过瞬时受体电位通道相关蛋白)介导了钙池操纵Ca2+的内流。本文发现培养的星形胶质细胞以及从视皮质中新分离的星形胶质细胞表达TRPC1,TRPC4,和TRPC5。间接免疫组化显示这些蛋白存在于整个细胞中,然而机能检测TRPC1主要表达在质膜上。在新分离的星形胶质细胞中做标记,显示了在细胞发育过程中TRPC表达的改变。应用抗TRPC1的抗体,可以阻断TRPC1通道并且可以测定它们在培养的星形细胞的机械性和激动剂触发的钙离子内流过程中的作用。阻断TRPC1可以减少机械诱导的钙离子依赖性的谷氨酸盐的释放。这些实验数据表明,钙离子通过TRPC1通道的内流有助于钙离子在星形细胞中的信号传导以及由此引起的谷氨酸盐的释放。     

氯胺酮体外对星形胶质细胞表面脑保护相关受体表达的影响

目的:观察消旋体氯胺酮体外对星形胶质细胞表面谷氨酸转运体1(glial glutamate transporter-1,GLT-1)、Na~+-K~+泵和生长相关蛋白43(growth associated protein-43,GAP-43)表达的影响,探讨氯胺酮作用于星形胶质细胞的可能作用机制。方法:建立离体培养的原代星形胶质细胞。选取MK-801及AP-5作为对照药物,采用蛋白质印迹法观察氯胺酮处理不同时间后,星形胶质细胞表面GLT-1、Na~+-K~+泵及GAP-43蛋白表达的变化。同时检测星形胶质细胞乳酸脱氢酶(lactate dehydrogenase,LDH)漏出率,观察氯胺酮处理30 min～24 h对细胞的毒性作用。结果:经氯胺酮处理30 min、2 h的星形胶质细胞表面GLT-1表达量较空白组明显增加(P0.05)。经氯胺酮处理15、30 min及MK-801处理6 h的星形胶质细胞表面Na~+-K~+泵的表达量较空白组明显增加(P0.05)。经氯胺酮及MK-801处理6、24 h的星形胶质细胞表面GAP-43表达量较空白组明显减少(P0.05)。终浓度分别为100、1、50μmol/L的氯胺酮、MK-801、AP-5持续作用24 h后,离体培养原代星形胶质细胞的LDH漏出率与空白组差异无统计学意义。结论:消旋体氯胺酮可通过非N-甲基-D-天冬氨酸(NMDA)途径体外上调星形胶质细胞表面GLT-1、Na~+-K~+泵表达;100μmol/L氯胺酮持续作用24 h对离体培养的原代星形胶质细胞无明显损伤。     

低频经颅磁刺激对缺血缺氧脑损伤大鼠学习记忆及体外培养缺血缺氧神经元谷氨酸释放的影响

摘要 目的：观察低频经颅磁刺激（TMS）对缺血缺氧脑损伤（HIBI）大鼠学习记忆能力的影响,同时探讨低频TMS对体外培养的缺血缺氧（HI）大鼠神经元谷氨酸释放的影响。 方法：选用成年SD大鼠,制作缺血缺氧模型,将模型大鼠分为如下三组：HIBI组,TMS+HIBI组以及正常对照组。采用水迷宫来评估大鼠的学习记忆能力。与此同时,我们还体外培养大鼠海马区神经元,同样将其分为HI组、TMS+HI组以及正常对照组。采用氧气葡萄糖剥夺法制作细胞缺血缺氧模型,测定细胞外液谷氨酸及乳酸脱氢酶（LDH）浓度（与神经元损伤呈正相关）,同时观察细胞存活率。 结果：①HIBI后,WM结果显示大鼠的学习记忆能力受损,与正常对照组相比较,有显著差异（P＜0.05）。②经过TMS刺激14d后,TMS+HIBI组大鼠的学习记忆能力高于HIBI组（P＜0.05）。③HI刺激后,体外培养的神经元细胞外液谷氨酸及LDH浓度升高,显著高于正常对照组（P＜0.05）,而神经元存活率则显著下降,低于正常对照组（P＜0.05）。④TMS+HI组神经元细胞外液谷氨酸和LDH浓度低于HI组（P＜0.05）,神经元存活率也显著上升,高于HI组（P＜0.05）。 结论：①HIBI后,大鼠学习记忆能力显著下降,而低频TMS 可以显著改善HIBI大鼠的认知功能;②HI诱导体外培养的神经元损伤,谷氨酸释放增加,细胞存活率降低,而低频TMS可以抑制HI诱导的神经元损伤以及谷氨酸释放,减轻谷氨酸毒性作用,同时增加神经元存活率。这可能与低频TMS改善学习记忆能力有关,这为缺血缺氧脑损伤的治疗提供了新的思路。     

Cx43及GLT-1对三叉神经痛大鼠疼痛行为学变化的调控作用

目的:研究大鼠三叉神经痛模型中缝隙连接蛋白43(connexin-43,Cx43)和谷氨酸转运体-1(glutamate transporter-1,GLT-1)表达的变化,探讨Cx43和GLT-1与三叉神经痛大鼠疼痛行为的关系。方法:将42只SD大鼠随机分为正常组(N)、假手术组(S)、模型组(ION-CCI)、ION-CCI+生理盐水1组(NS1)、ION-CCI+Gap26组(Gap26)、ION-CCI+生理盐水2组(NS2)、ION-CCI+头孢曲松组(Cef),每组6只。用铬肠线疏松结扎大鼠眶下神经建立三叉神经痛动物模型;造模成功后,相应组于术后第8天分别腹腔注射Gap26、头孢曲松或生理盐水;假手术组仅暴露神经,不结扎。于术前1天,术后1、3、5、7、9、11、14天行机械痛阈值及视频行为学检测。术后第15天取三叉神经脊束核,应用蛋白质印迹检测Cx43和GLT-1蛋白表达水平。结果:腹腔注射Gap26或头孢曲松可提高三叉神经痛大鼠的机械痛阈值(P<0.001),减少其抓脸次数(P<0.001)。术后第15天,ION-CCI、NS1及NS2组大鼠较N组及S组大鼠相比,Cx43表达明显增加(P<0.01),GLT-1表达明显减少(P<0.001);Gap26组大鼠较ION-CCI、NS1组大鼠相比,Cx43表达减少(P<0.05),GLT-1表达增加(P<0.01);Cef组大鼠较ION-CCI、NS2组大鼠相比,GLT-1表达增加(P<0.001),Cx43表达无明显差异。结论:腹腔注射Gap26或头孢曲松可改变三叉神经痛大鼠疼痛行为并改变三叉神经脊束核中Cx43和GLT-1的表达,提示Cx43和GLT-1参与了三叉神经痛大鼠疼痛行为的变化。     

16Hz,90dB和16Hz,130dB次声小鼠海马区IL-6及星型胶质细胞GEAP的表达

目的观察16 Hz,90 dB和16 Hz,130 dB次声对小鼠海马区白介素-6（IL-6）表达及星形胶质细胞胶质纤维酸性蛋白含量（GFAP）的影响,从而探讨次声作用对中枢神经系统自我保护功能的影响。 方法共选取BALB/C小鼠60只,将其随机分为90 dB次声作用组（20只）、130 dB次声作用组（20只）及对照组（20只）。将90 dB次声作用组、130 dB次声作用组小鼠分别置于次声压力舱内2 h,期间分别给予90 dB或130 dB的次声刺激,对照组小鼠也于同期置入次声压力舱内,但期间不给予次声刺激。于次声作用1,7,14,21及28 d时观察各组小鼠海马区IL-6及星形胶质细胞GFAP的表达情况。 结果对照组小鼠海马区有一定强度IL-6表达;各次声作用组小鼠海马区IL-6在次声作用7,14及21 d时均较对照组明显增高（P<0.05）,并于次声作用14 d时达到峰值;进一步分析后发现,90 dB次声作用组IL-6表达水平明显高于130 dB次声作用组（P<0.05）。各次声作用组小鼠海马区GFAP表达水平在次声作用7,14及21 d时均较对照组明显增高（P<0.05）,并于次声作用14 d时达到峰值;90 dB次声作用组小鼠海马区GFAP表达水平明显低于130 dB次声作用组（P<0.05）。 结论次声刺激能显著促进小鼠海马区神经元IL-6表达,提高海马区星形胶质细胞GFAP含量。     

磁刺激通过星形胶质细胞磷酸化蛋白影响星形胶质细胞迁移

目的 研究1.0Hz 60%最大刺激强度的磁刺激通过调控星形胶质细胞磷酸化蛋白（PEA-15）对星形胶质细胞迁移的影响。 方法 取第3～4代体外分离培养的大鼠星形胶质细胞,分为对照组、转染组、磁刺激组和转染+磁刺激组。对照组进行阴性siRNA转染,转染组应用化学合成的siRNA进行脂质体瞬时转染,干扰PEA-15的蛋白表达;磁刺激组的星形胶质细胞在铺板24h后接受60%最大强度磁刺激;转染+磁刺激组进行PEA-15的siRNA转染,并给予60%最大强度磁刺激。用细胞划痕试验检测星形胶质细胞的迁移程度,用免疫印迹试验检测PEA-15的蛋白表达和磷酸化水平变化。 结果 ①PEA-15 siRNA的转染效果明显,Western Blot检测与对照组比较,PEA-15的蛋白表达明显降低。②体外划痕实验中,转染组、磁刺激组、转染+磁刺激组的细胞迁移面积分别与对照组比较,其星形胶质细胞迁移程度增加,差异均有统计学意义（P<0.05）。③与对照组相比,磁刺激组的PEA-15磷酸化明显增加。 结论 干扰PEA-15表达后的星形胶质细胞迁移增加明显;磁刺激可通过增强PEA-15磷酸化促进星形胶质细胞的迁移。     

星形胶质细胞中连接蛋白43在肌萎缩侧索硬化中促发运动神经元毒性

肌萎缩侧索硬化(ALS)是一种神经退行性疾病,其特征是中枢神经系统中运动神经元的进行性丧失。星形胶质细胞在ALS的疾病进程中起重要作用。星形胶质细胞通过缝隙连接蛋白家族,如连接蛋白(Connexin,Cx)互相连接。Cx43是中枢神经系统中保持稳态的主要星形胶质细胞连接蛋白。在病理状态下,连接蛋白的表达和功能发生改变。本文发现,在ALS中Cx43异常增高是星形胶质细胞介导的毒性作用机制之一。笔者观察到,在ALS SOD1~(G93A)小鼠模型的疾病进程中,Cx43表达进行性增高。尤其是,在ALS患者的运动皮质和脊髓也能检测到Cx43增高。从SOD1~(G93A)小鼠中分离的星形胶质细胞,与人诱导多能干细胞衍生的星形胶质细胞一样,都检测到Cx43蛋白增高,且为独立于神经元共培养的内源性现象。与对照的星形胶质细胞过表达的野生型SOD1(SOD1~(WT))相比,SOD1~(G93A)星形胶质细胞中增高的Cx43表达可产生重要的功能性影响。本文发现,SOD1~(G93A)星形胶质细胞表现出缝隙连接偶联增强,半通道介导活动升高,细胞内钙离子水平上升。最后,本文检测Cx43蛋白表达升高对MN生存的影响,发现应用pan-Cx43阻滞剂和Cx43半通道阻滞剂均对与SOD1~(G93A)星形胶质细胞共培养的MNs有神经保护作用。这些新发现展示出未被认知的Cx43在ALS相关的运动神经元丢失中所起作用。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

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.