经颅直流电刺激结合局部振动对脑卒中后偏瘫 53例肢体运动功能康复的影响

目的 探讨经颅直流电刺激（tDCS）结合局部振动对脑卒中后偏瘫（HAS）病人53例肢体运动功能康复的影响。方法选择2019年2月至2021年9月三亚市人民医院收治的106例HAS病人,将其按随机数字表法划分为tDCS组（n=53,tDCS治疗）和联合组（n=53,tDCS+局部振动治疗）。于治疗前、治疗8周后采用中国卒中量表（CSS）对两组神经功能进行评定,采用FuglMeyer评估表（FMA）、Wolf运动功能测试量表（WMFT）对两组肢体运动功能进行评定,采用改良Barthel指数量表（MBI）对两组日常生活能力进行评定,同时检测两组血清神经生长因子（NGF）、神经营养素-3(NT-3)、S100-β蛋白（S100-β）水平。结果 治疗后,两组CSS评分、血清S-100β水平均较治疗前明显降低（P<0.05）,且联合组CSS评分[（7.21±1.76）分比（9.47±2.13）分]、血清S-100β水平[（0.67±0.22）μg/L比（0.93±0.28）μg/L]均明显较tDCS组低（P<0.05）;两组FMA、WMFT、MBI评分及血清NGF、NT-3水平均较治疗...     

Sensorineural Hearing Loss after Vibration: an Animal Model for Evaluating Prevention and Treatment of Inner Ear Hearing Loss

Sensorineural hearing loss following a variety of acoustic trauma, including middle ear surgery, is well known. Current literature, which points to the deleterious influence of noise on the inner ear during surgery, has yet to assess the influence of vibration generated by the burr. The purpose of the study reported here was to establish an animal model that mimics drilling and can be used to explore methods of hearing loss prevention and treatment. A specially developed electromagnetic vibrator was calibrated and used in 59 guinea pigs to induce hearing loss. Both young and old guinea pigs were used. The bony external ear canal of guinea pigs were exposed to vibration or sound of varying duration and intensity. The vibration of the temporal bone and noise level in the middle ear were measured. Electrocochleography was recorded to evaluate the hearing loss. Among the young animals, 90% developed a significant threshold shift (TS &gt;20 dB), when vibrated with 250 Hz at an intensity of 6.2 m/s² for 15 min. An average of 42 dB TS was observed. With 10 min exposure 63% showed a TS. The older animals vibrated for 5 min developed the same TS (mean TS 34 dB) as the young animals when vibrated for 10 min. The vibration-induced TS showed no recovery within 3 days of observation. In the contralateral ear 4 out of 5 animals showed TS&gt;20 dB. When exposed to sound levels exceeding the vibration-generated sound in the middle ear (119 dB at 250 Hz) only 2 out of 11 animals (18%) showed TS. The frequency of TS and level of TS were significantly greater in the vibrated animals than in sound-only exposed animals (p&lt;0.01). The degree of vibration-induced TS in the present animal model could be controlled by vibration intensity and duration. The older animals were more susceptible to vibration-induced inner-ear damage than younger animals. This model will be used in further studies to find methods for prevention and treatment of hearing loss during ear surgery.