超声乳化白内障手术对角膜知觉的影响

目的 观察颞侧透明角膜切口的超声乳化白内障手术对角膜知觉的影响。方法 随机抽取行颞侧透明角膜切口超声乳化白内障吸出术的老年性白内障患者30例(30只眼)，分别于术前、术后1天、术后1、3、6月、术后1年行角膜知觉检查，用Cohet—Bonnet角膜知觉计分别测量角膜中央、上方、下方、鼻侧、颞侧的角膜知觉阈值(以测定器的尼龙丝长度表示)。结果 术后1天全部病人角膜知觉显著减退，中央减少40．4％、颞侧减少39．9％，上方、下方和鼻侧分别减少33％、28．5％、28．7％。上方、下方、鼻侧角膜知觉术后6个月恢复，中央及颞侧角膜切口知觉术后1年恢复。结论 小切口超声乳化白内障手术可影响角膜知觉，但术后角膜知觉恢复较快。     

Thalamic deep brain stimulation for Tourette Syndrome: A naturalistic trial with brief randomized,double-blinded sham-controlled periods

BackgroundThere is still a lack of controlled studies to prove efficacy of thalamic deep brain stimulation for Tourette's Syndrome.ObjectivesIn this controlled trial, we investigated the course of tic severity, comorbidities and quality of life during thalamic stimulation and whether changes in tic severity can be assigned to ongoing compared to sham stimulation.MethodsWe included eight adult patients with medically refractory Tourette's syndrome. Bilateral electrodes were implanted in the centromedian-parafascicular-complex and the nucleus ventro-oralis internus. Tic severity, quality of life and comorbidities were assessed before surgery as well as six and twelve months after. Short randomized, double-blinded sham-controlled crossover sequences with either active or sham stimulation were implemented at both six- and twelve-months’ assessments. The primary outcome measurement was the difference in the Yale Global Tic Severity Scale tic score between active and sham stimulation. Adverse events were systematically surveyed for all patients to evaluate safety.ResultsActive stimulation resulted in significantly higher tic reductions than sham stimulation (F = 79.5; p = 0.001). Overall quality of life and comorbidities improved significantly in the open-label-phase. Over the course of the trial two severe adverse events occurred that were resolved without sequelae.ConclusionOur results provide evidence that thalamic stimulation is effective in improving tic severity and overall quality of life. Crucially, the reduction of tic severity was primarily driven by active stimulation. Further research may focus on improving stimulation protocols and refining patient selection to improve efficacy and safety of deep brain stimulation for Tourette's Syndrome.     

The existence of propagated sensation along the meridian proved by neuroelectrophysiology

Propagated sensation along the meridian can occur when acupoints are stimulated by acupuncture or electrical impulses. In this study, participants with notable propagated sensation along the me-ridian ...     

乳腺癌患者不同乳房重建术后乳房感觉恢复情况研究进展

随着外科手术技术的进步、患者对生存质量要求的不断提高,乳腺癌外科治疗的目标从最初的根除肿瘤、解除病痛发展为修复局部缺损、还原乳房外形,并进一步发展至目前美学与功能学并重的乳房重建。作为功能学的重要组成部分,乳房感觉对乳腺癌患者术后生活质量的影响不容忽视。乳房重建术后乳房感觉的恢复已成为乳腺癌外科治疗的重要目标之一。本文就乳腺癌患者不同乳房重建术后乳房感觉恢复情况的研究进展作一综述。     

The latest evidence on target selection in deep brain stimulation for Parkinson’s disease

Deep brain stimulation (DBS) is one of the most promising neuromodulatory techniques to gain momentum over the last 20 years, with significant evidence showing the benefit of DBS for Parkinson’s disease (PD). However, many questions still exist pertaining to the optimal placement of stimulation contacts. This paper aims to review the latest and most relevant studies evaluating subthalamic nucleus (STN) and globus pallidus interna (GPi) stimulation. Additionally, it aims to shine a light on several of the lesser-known targets with mounting evidence of efficacy. Referenced literature for the main body of the article was gathered from Medline and PubMed databases. Results were limited to “full text”, “English language” and publications from 1999 onwards. Case reports were excluded. The current evidence irrefutably demonstrates the benefits of both STN and GPi DBS on Unified Parkinson’s Disease Rating Scale (UPDRS) III motor scores, with very similar outcomes seen after 1–2 years. Currently, it appears the greatest differences lie in the associated adverse effects. STN DBS was associated with a greater reduction in dopamine replacement therapy, but also appeared to have more negative effects on speech and mood. Meanwhile, in regards to alternative targets, the pedunculopontine nucleus has shown promising improvement in axial symptoms, while the ventral intermediate nucleus has demonstrated significant efficacy at suppressing tremor, and the caudal zona incerta may be superior to the STN and GPi in improving UPDRS-III scores. Due to the complexity of Parkinson’s disease, an individual disease profile must be determined in a patient-by-patient fashion such that appropriate targets can be selected accordingly.     

卵泡抑素样蛋白1在神经系统中的研究进展

卵泡抑素样蛋白1 (follistatin-like protein 1,FSTL1)是一种分泌型细胞外基质糖蛋白,在心血管疾病、自身免疫性疾病、肿瘤、炎症等疾病模型的发生、发展和转归过程中发挥重要作用,参与多种生物学过程,包括细胞增殖、凋亡、组织分化等.FSTL1在脊椎动物神经系统中调节神经胚形成和神经元分化诱导;参与大脑皮质进化机制和功能区域的划分;调节突触传递和维持躯体感觉正常阈值;减少脑卒中后神经元凋亡并改善神经缺陷功能.     

影响灸法治疗效果的因素浅析

灸法的作用因素包括以艾叶或艾叶为主的复方组成的灸材姜、蒜、附子等隔衬物的药力作用;灸材燃烧的热力,灸法操作的补泻作用;所选腧穴治疗部位的特殊治疗作用;因人、因时、因地三因影响因素;灸法感传发生与热力是否持久、均衡有关,这也是影响灸法效果的因素之一。