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目的:探讨脊柱微创经皮椎间孔镜日间手术全程化管理模式的构建与效果。方法:选取2017年3月1日~2018年3月31日行经皮椎间孔镜下髓核摘除术的94例腰椎间盘突出症患者作为对照组,采取常规住院管理模式。选取2018年4月1日~2019年4月30日行经皮椎间孔镜下髓核摘除术日间手术的88例腰椎间盘突出症患者作为日间组,实施涵盖门诊、病房、出院后随访的全程化日间手术管理模式。比较两组临床效果。结果:两组患者术后各期视觉模拟评分法(VAS)、JOA、ODI评分较术前改善(P<0.05),两组术后各期VAS、JOA、ODI评分及并发症发生率比较差异无统计学意义(P>0.05)。日间组术前等待时间、住院时间、直接医疗费用低于对照组(P<0.01),患者满意度高于对照组(P<0.05)。结论:经皮椎间孔镜日间手术全程化管理模式应用于腰椎间盘突出症患者临床疗效较好,具有可行性、安全性、有效性,同时在提高医疗资源的利用率、降低住院费用方面具有明显优势。  相似文献   
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输尿管上段结石为临床中常见泌尿系结石类型之一,如不能及时诊治,可引起重度积水、泌尿系感染,甚至脓毒血症,对患者肾功能、健康造成严重影响。随着微创治疗技术在泌尿系结石中应用,微创治疗方法能降低对患者造成治疗性创伤,降低相关并发症发生率,促进患者康复,了解临床中微创治疗输尿管上段结石方法,对临床中合理治疗输尿管上段结石有重要价值。  相似文献   
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Subjective tinnitus is the most common type of tinnitus, which is the manifestation of pathological activities in the brain. It happens in a substantial portion of the general population and brings significant burden to the society. Severe subjective tinnitus can lead to depression and insomnia and severely affects patients’ quality of life. However, due to poor understanding of its etiology and pathogenesis, treatment of subjective tinnitus remains challenging. In recent decades, a growing number of studies have shown that subjective tinnitus is related to lesion-induced neural plasticity of auditory and non-auditory central systems. This article reviews cellular mechanisms of neural plasticity in subjective tinnitus to provide further understanding of its pathogenesis.  相似文献   
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Prediction of periodic event timing is an important function for everyday activities, while the exact neural mechanism remains unclear. Previous studies in nonhuman primates have demonstrated that neurons in the cerebellar dentate nucleus and those in the caudate nucleus exhibit periodic firing modulation when the animals attempt to detect a single omission of isochronous repetitive audiovisual stimuli. To understand how these subcortical signals are sent and processed through the thalamocortical pathways, we examined single-neuron activities in the central thalamus of two macaque monkeys (one female and one male). We found that three types of neurons responded to each stimulus in the sequence in the absence of movements. Reactive-type neurons showed sensory adaptation and gradually waned the transient response to each stimulus. Predictive-type neurons steadily increased the magnitude of the suppressive response, similar to neurons previously reported in the cerebellum. Switch-type neurons initially showed a transient response, but after several cycles, the direction of firing modulation reversed and the activity decreased for each repetitive stimulus. The time course of Switch-type activity was well explained by the weighted sum of activities of the other types of neurons. Furthermore, for only Switch-type neurons the activity just before stimulus omission significantly correlated with behavioral latency, indicating that this type of neuron may carry a more advanced signal in the system detecting stimulus omission. These results suggest that the central thalamus may transmit integrated signals to the cerebral cortex for temporal information processing, which are necessary to accurately predict rhythmic event timing.SIGNIFICANCE STATEMENT Several cortical and subcortical regions are involved in temporal information processing, and the thalamus will play a role in functionally linking them. The present study aimed to clarify how the paralaminar part of the thalamus transmits and modifies signals for temporal prediction of rhythmic events. Three types of thalamic neurons exhibited periodic activity when monkeys attempted to detect a single omission of isochronous repetitive stimuli. The activity of one type of neuron correlated with the behavioral latency and appeared to be generated by integrating the signals carried by the other types of neurons. Our results revealed the neuronal signals in the thalamus for temporal prediction of sensory events, providing a clue to elucidate information processing in the thalamocortical pathways.  相似文献   
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为了保证电子设备在复杂的电磁环境中正常运行,需要对其进行电磁防护。传统的电磁防护方法尽管已取得较好的防护效果,但是还存在一定的不足。为了弥补传统电磁防护的不足,本研究提出基于神经抗扰机制的电磁仿生方法,并具体提出基于神经元抗扰机制的新型方波发生器。采用最接近生物神经元电生理活动的数学模型Hodgkin-Huxley模型对新型方波发生器进行设计。利用Matlab的Simulink工具箱搭建方波发生器的仿真程序,分析方波信号占空比的特性,得到模型参数对占空比的影响程度。基于田口方法的望小特性优化方波发生器的模型参数,从而得到特定占空比。该方波发生器可为智能电子设备提供稳定可靠的方波信号。  相似文献   
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Background and purposeThe use of dry needling (DN) with other treatments may be more beneficial in managing post-stroke spasticity. We report the effects of DN plus exercise therapy (ET) on wrist flexor spasticity.Patient presentationThe patient was a 45-year-old man with an 8-year history of stroke. The outcome measures included the Modified Modified Ashworth Scale (MMAS), Hmax/Mmax ratio, H-reflex latency, Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), and range of motion (ROM) which were assessed before (T1), after (T2), and after 3-week follow-up (T3).ConclusionThe MMAS was improved at T2 from “3” to “2”. The Hmax/Mmax decreased from 0.77 to 0.53 at T3. The H-reflex latency increased from 15.4 ms to 18.5 ms at T3. The wrist active and passive ROM increased ∼30° and ∼20° at T2, respectively.A 4-session DN plus ET may improve spasticity and ROM. No meaningful improvement was observed in function.  相似文献   
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