不同强度低频重复经颅磁刺激对脑卒中后非流畅性失语的疗效

目的探讨不同强度低频(1 Hz)重复经颅磁刺激(r TMS)刺激右侧大脑半球Broca区镜像区对脑卒中后非流畅性失语患者语言功能恢复的影响。方法 40例脑卒中后非流畅性失语患者等分为低强度组和高强度组,低强度组r TMS治疗每天1次,高强度组每天2次,均每次10 min,共10 d。治疗前后及治疗结束2个月后应用西方失语症成套测验(WAB)进行评估。结果治疗后,高强度组自发言语、听理解、复述、命名、失语商(AQ)明显优于低强度组(P0.01);治疗结束2个月后,高强度组自发言语、复述、AQ优于低强度组(P0.05)。结论高强度低频r TMS刺激右侧大脑半球促进脑卒中后非流畅性失语患者语言功能恢复效果更明显,治疗效果可长期维持。     

低频重复经颅磁刺激治疗脑卒中后非流畅性失语的疗效观察

目的观察低频重复经颅磁刺激(rTMS)治疗脑卒中后非流畅性失语的临床疗效。 方法将40例脑卒中后非流畅性失语患者按随机数字表法随机分为rTMS组(n=20)和对照组(n=20)。两组患者均给予常规言语治疗,rTMS组在右侧大脑半球Broca镜像区给予0.5Hz的rTMS治疗,每日1次,每周5次,连续治疗3周。于治疗前和治疗3周后（治疗后）采用西方失语成套测验（WAB）和日常生活交流能力检查（CADL）评定2组患者的语言功能和交流能力。 结果治疗后,对照组患者WAB评分中,仅自发言语较组内治疗前有显著改善,差异有统计学意义（P<0.05）,rTMS组患者WAB各项评分较组内治疗前均显著改善,差异均有统计学意义（P<0.05）,且听理解、复述、命名以及AQ评分分别为（153.90±31.79）分、（82.65±15.14）分、（81.28±22.12）分和（63.66±13.64）分,均明显优于对照组治疗后,差异均有统计学意义（P<0.05）。 结论0.5Hz的rTMS作用于右侧大脑半球Broca镜像区可显著改善脑卒中后恢复早期非流畅性失语患者的语言功能。     

不同频率rTMS对脑卒中后中-重度运动性失语患者语言功能恢复的影响及机制

目的 探讨不同频率重复经颅磁刺激（rTMS）对恢复期脑卒中后中-重度运动性失语患者语言功能恢复的影响及机制。方法 纳入恢复期脑卒中后中-重度运动性失语患者30例,将其分为对照组、低频组（1 Hz rTMS）和高频组（10 Hz rTMS）各10例,3组均进行常规语言训练;低频、高频组予右侧额下回三角部相应频率rTMS治疗后再进行常规语言训练。采用中文版西方失语症成套检验（WAB）及任务态功能磁共振成像（fMRI）检测治疗前后语言水平差异以及脑区激活、激活体素指数（AVI）变化。结果 治疗后,3组患者的听理解、复述、失语商（AQ）值较治疗前改善（P均< 0.05）,且低频、高频组的自发言语、命名得分也较治疗前改善（P均< 0.05）;与对照组比较,低频组复述、命名、AQ值改善更明显（P均< 0.05）,高频组自发言语、听理解、命名、AQ值改善更明显（P均< 0.05）;与低频组比较,高频组自发言语、听理解改善更明显（P均< 0.05）。治疗后,3组患者AVI结果提示语言偏侧化半球均由治疗前的右侧转为左侧;fMRI结果显示双侧大脑半球均存在激活升高、降低的语言相关感兴趣区（ROI）、非感兴趣区,但以左侧大脑半球参与语言感知、语义理解和表达的ROI激活升高为主;低频组左侧大脑半球AVI增加（P < 0.05）,右侧额下回三角部受抑制后未出现左侧额下回三角部激活升高;高频组治疗后双侧大脑半球AVI均升高（P均< 0.05）,双侧额下回三角部等语言相关ROI激活升高。结论 低频、高频rTMS均有利于改善脑卒中后中-重度运动性失语患者语言功能,高频rTMS的效果优于低频rTMS。低频rTMS通过增加高效语言功能区的激活,优化失语患者语言功能重组模式;高频rTMS增强了右侧大脑半球的代偿作用,同时在促进左侧大脑半球激活重组中发挥了作用。     

低频rTMS对急性脑梗死后运动性失语的疗效观察

目的:观察低频重复经颅磁刺激(rTMS)对急性脑梗死后运动性失语的临床治疗效果。方法:将116例急性脑梗死后运动性失语患者随机分为对照组和rTMS组各58例,对照组实施常规药物治疗及语言训练,rTMS组在此基础上采用低频rTMS和语言训练同步交叉的方法来进行康复。采用西方失语症成套测验(WAB)评价失语指数(AQ)及理解、复述、命名、自发言语等成分的得分情况。采用北京医科大学第一医院的汉语失语成套测验语言功能评分百分率提高程度和语言交流障碍好转程度进行疗效评定。结果:治疗30d后,2组AQ评分及理解、复述、命名、自发言语4项评分均高于治疗前(P0.05),且rTMS组提高幅度更高于对照组(P0.05);rTMS组的总有效率明显高于对照组(P0.05)。结论:早期低频rTMS治疗对急性脑梗死后运动性失语患者具有较好的疗效。     

反应扩充疗法联合低频重复经颅磁刺激对脑卒中非流畅性失语的临床疗效

目的:探讨反应扩充疗法(response elaboration training,RET)联合低频重复经颅磁刺激(rTMS)对脑卒中后非流畅性失语症患者的语言疗效。方法:纳入2018年9月至2019年11月本院收治的60例脑卒中非流畅性失语症患者,按随机数字表法分为常规组(仅采用传统语言训练),r TMS组(传统语言训练+低频rTMS治疗),RET+rTMS组(传统语言训练+RET+低频r TMS治疗),每组各20例。所有患者治疗前和治疗4周后均进行西方失语症成套测验(WAB)与汉语标准失语症检查法(CRRCAE)动作说明、画面说明2个亚项,以及实用性语言交流能力检查(CADL)评估,并进行组间比较。结果:治疗后,RET+rTMS组患者WAB自发言语、听理解、命名、复述、AQ得分均明显高于常规组(P0.05),RET+rTMS组自发言语、命名及AQ得分高于rTMS组(P0.05);治疗后,RET+rTMS组患者CRRCAE动作说明和画面说明得分均明显高于常规组和rTMS组(P0.05),rTMS组患者动作说明得分高于治疗前(P0.05),常规组以上两项得分与治疗前差异无显著性意义(P0.05);治疗后,rTMS组与RET+rTMS组患者CADL得分均高于常规组(P0.05),RET+rTMS组CADL得分高于rTMS组(P0.05)。结论:反应扩充疗法联合低频重复经颅磁刺激能显著改善非流畅性失语症患者的语言表达能力。     

抑制性rTMS刺激联合镜像神经元训练系统对脑卒中后完全性失语的作用研究

目的：探讨抑制性重复经颅磁刺激(rTMS)联合镜像神经元训练系统(MNS)对脑卒中后完全性失语的临床疗效及其作用机制。方法：50例脑卒中后完全性失语患者按随机数字表法随机分为对照组16例、MNS组16例和联合组18例。对照组仅给予常规的言语康复训练,MNS组在对照组的基础上给予镜像神经元系统训练,联合组在MNS组的基础上给予右侧Broca同源区1Hz的rTMS刺激,于治疗前和治疗3周后评定3组患者西方失语成套测验(WAB)以及波士顿失语症程度分级（BDAE）评分。结果：治疗3周后,3组WAB各项评分和BDAE评分均较治疗前明显提高（P<0.05）;且联合组WAB各项评分及BDAE评分显著高于MNS组和对照组（P<0.05）,MNS组WAB评分中自发语评分及AQ评分亦高于对照组（P<0.05）,BDAE评分MNS组和对照组治疗后比较差异无统计学意义。结论：抑制性rTMS刺激右侧Broca同源区联合MNS训练系统对改善脑卒中后完全性失语患者的语言功能有一定作用。     

反应扩充疗法联合rTMS对脑卒中后非流畅性失语症患者的语言疗效分析

目的:探讨反应扩充疗法(RET)联合重复经颅磁刺激(rTMS)治疗脑卒中后非流畅性失语的临床疗效。方法:选取脑卒中后非流畅性失语患者90例随机分为2组各45例,对照组予以常规语言训练和低频rTMS治疗;联合组在对照组治疗基础上予以反应扩充疗法训练,疗程均为4周。比较2组治疗前后西方失语症成套测验(WAB)评分、汉语标准失语症检查工具(CRRCAE)中动作说明评分、画面说明评分和日常生活交流能力量表(CADL)评分及波士顿失语诊断测验(BDAE)分级。结果:治疗后,2组自发言语、听理解、复述、命名及AQ评分较治疗前增加(P<0.01),CRRCAE动作说明评分、画面说明评分和CADL评分均较治疗前增加(均P<0.01),BDAE分级显著改善(P<0.01)。治疗后联合组自发言语、听理解、复述、命名及AQ评分均高于对照组(P<0.01);CRRCAE动作说明评分、画面说明评分和CADL评分均高于对照组(P<0.01),BDAE分级优于对照组(P<0.05),结论:rTMS是非流畅性失语有效的康复治疗方法,RET联合rTMS有利于增加WAB评分、RRCAE动作说明、画面说明评分和CADL评分,改善BDAE分级,治疗脑卒中后非流畅性失语效果显著。     

低频重复经颅磁刺激联合动作观察疗法治疗卒中后非流利性失语的疗效观察

目的:观察低频重复经颅磁刺激(rTMS)联合动作观察疗法(AOT)治疗卒中后非流利性失语的疗效。方法:随机将32例脑卒中后非流利性失语患者分为低频rTMS刺激组(简称rTMS组)和联合组。2组患者均给予常规康复干预(包括药物治疗、言语训练),rTMS组在此基础上辅以低频rTMS治疗,联合组在rTMS组的基础上辅以AOT治疗。经颅磁刺激部位为右侧大脑半球Broca镜像区,磁刺激频率为1Hz。AOT为患者佩戴VR眼镜,观察180个词汇的口型以及动作视频,同时进行复述。于治疗前及治疗4周后分别使用中国康复研究中心汉语标准失语症检查量表(CRRCAE)评估患者的语言功能及改善情况,采用实用语言交流能力检查表(CADL)评价治疗前后失语症的严重程度分级,并计算显效率和有效率。结果:经过4周治疗,2组CRRCAE各项评分均明显提高(均P<0.01),联合组各项分值均更高于rTMS组(均P<0.01),联合组有效率显著高于rTMS组(P<0.05)。结论:低频重复经颅磁刺激联合动作观察疗法可显著改善卒中后非流利性失语患者的语言功能。     

不同频率重复经颅磁刺激对脑卒中后非流畅性失语的影响及其血氧水平依赖-功能性磁共振成像的表现

目的 探讨不同频率(10 Hz、1 Hz)重复经颅磁刺激(rTMS)刺激右侧大脑半球Broca区镜像区对脑卒中后非流畅性失语患者语言功能恢复的影响及其作用机制.方法 对2例脑卒中后非流畅性失语患者分别进行低频rTMS治疗(1 Hz)和高频rTMS治疗(10 Hz),2例患者均于治疗前和治疗2周后(治疗后)行西方失语症成套检查量表(WAB)测试及fMRI检查.结果 治疗后,2例患者的语言功能均治疗前均明显改善,病例1的AQ评分由治疗前37.2分提升至66.6分,病例2的AQ评分由36.2分提升至60.8分.治疗前,病例1词汇朗读任务主要激活脑区有左侧中央前回,左侧额中回,此外左侧的枕叶下部也有少量激活;治疗后,词汇朗读任务主要激活脑区有左侧额叶内侧面,左侧额下回,左侧额前区,左侧岛叶前部,左侧顶下小叶,左侧颞叶中下回前中部.治疗前,病例2词汇朗读任务主要激活脑区有双侧颞叶内侧面,双侧中央前回;治疗后,词汇朗读任务主要激活脑区有双侧额中回和额叶内侧面,右侧额下回,左侧额前区,双侧顶上小叶,右侧颞上、中回.结论 rTMS治疗可显著改善脑卒中后非流畅性失语患者的语言功能,左侧半球语言区病灶较小的患者可能发生同侧半球功能重组,左侧半球病灶语言区较大的患者则可能发生双侧半球功能重组.     

基于镜像神经元理论的动作观察疗法对脑卒中后非流畅性失语的影响

目的:观察基于镜像神经元理论的动作观察疗法(action observation therapy,AOT)对脑卒中后非流畅性失语的疗效。方法:将30例脑卒中后非流畅性失语患者按随机数字表法分为对照组(n=15例)和AOT试验组(n=15例)。对照组给予每日2次语言康复训练,每次30min,每周5天,疗程4周。试验组在对照组基础上,在第一次语言功能训练前进行动作观察治疗,每次20min,每天1次,每周5天,疗程4周。于治疗前、治疗4周后,采用西方失语成套测验(WAB)评定2组患者的语言功能。结果:经过4周治疗后,对照组患者WAB评分中的自发言语、复述、命名、AQ值较治疗前有明显提高(P0.05);试验组患者WAB各项评分和AQ值较治疗前均有显著改善(P0.05);试验组患者WAB各项评分及AQ均显著优于对照组(P0.05)。结论:基于镜像神经元理论的动作观察疗法联合常规语言康复训练可显著改善脑卒中后非流畅性失语患者的语言功能。     

Ventricular fibrillation frequency

BACKGROUND: Ventricular-fibrillation (VF) wave frequency is known to decrease with prolonged, untreated VF. VF wave frequency is used as an algorithm to identify VF in AEDs and ICDs; yet the nature of the frequency change is not appreciated. METHODS: In this study, anesthetized pigs were used and VF was induced electrically. VF wave frequency was measured each second during VF for periods up to 200 sec. Defibrillation was achieved with transchest electrodes. VF wave frequency was plotted for each second during VF. In 2 animals, CPR was applied and VF wave frequency was measured. RESULTS: In all cases VF wave frequency decreased with increasing duration of VF. At the onset of VF, the VF wave frequency ranged from 5 to 12/sec. A plot of the normalized ratio of VF wave frequency during fibrillation to the VF frequency at induction decreased to between 0.1 and 0.8 of the initial frequency. In one of the animals, VF was initiated, CPR was provided and the VF wave frequency was measured over a 200-second period. Then, the procedure was repeated without CPR. Beyond 130 seconds, the VF frequency with CPR was higher than that without CPR, indicating myocardial oxygenation. CONCLUSION: Those who use VF wave frequency to identify the presence of VF should be aware of the nature of the VF wave frequency decrease with the passage of time.     

高频与低频超声联合诊断急性阑尾炎价值

目的比较高频超声及高频与低频超声联合应用诊断急性阑尾炎的价值。方法回顾性分析经手术组织病理证实的183例急性阑尾炎患者的超声声像资料,其中急性单纯性阑尾炎48例,急性化脓性阑尾炎75例,急性坏疽性阑尾炎39例,阑尾周围脓肿21例,比较高频超声、高频与低频超声联合术前诊断急性阑尾炎的准确性。结果急性单纯性阑尾炎、急性化脓性阑尾炎、急性坏疽性阑尾炎、阑尾周围脓肿高频超声诊断符合率分别为52．1％、80．0％、71．8％、81．0％,高频与低频超声联合诊断符合率分别为91．7％、96．0％、94．9％、100．0％,2种方法比较差异均有统计学意义（P〈0．05）。结论高频与低频超声联合应用可提高急性阑尾炎的诊断准确率。     

Wavelength and frequency optimization in spatial frequency domain imaging for two-layer tissue

Spatial frequency domain imaging is a non-contact, wide-field, fast-diffusion optical imaging technique, which in principle uses steady-state spatially modulated light to irradiate biological tissue, reconstruct two-dimensional or three-dimensional tissue optical characteristic map through optical transmission model, and further quantify the spatial distribution of tissue physiological parameters by multispectral imaging technique. The selection of light source wavelength and light field spatial modulation frequency is directly related to the accuracy of tissue optical properties and tissue physiological parameters extraction. For improvement of the measurement accuracy of optical properties and physiological parameters in the two-layer tissue, a multispectral spatial frequency domain imaging system is built based on liquid crystal tunable filter, and a data mapping table of spatially resolved diffuse reflectance and optical properties of two-layer tissue is established based on scaling Monte Carlo method. Combined with the dispersion effect and window effect of light-tissue interaction, the study applies numerical simulation to optimize the wavelength in the 650-850 nm range with spectral resolution of 10 nm. In order to minimize the uncertainty of the optical properties, Cramér-Rao bound is used to optimize the optical field spatial modulation frequency by transmitting the uncertainty of optical properties. The results showed that in order to realize the detection of melanin, oxyhemoglobin, deoxyhemoglobin, water and other physiological parameters in two-layer tissue, the best wavelength combination was determined as 720, 730, 760 and 810 nm according to the condition number. The findings of the Cramér-Rao bound analysis reveal that the uncertainty of optical characteristics for the frequency combinations [0, 0.3] mm^-1, [0, 0.2] mm^-1, and [0, 0.1] mm^-1 increases successively. Under the optimal combination of wavelength and frequency, the diffuse reflectance of the gradient gray-scale plate measured by the multi-spectral spatial frequency domain imaging system is linearly correlated with the calibration value. The error between the measured liquid phantom absorption coefficient and the collimation projection system based on colorimetric dish is less than 2%. The experimental results of human brachial artery occlusion indicate that under the optimal wavelength combination, the change of the second layer absorption coefficient captured by the three frequency combinations decreases in turn, so as the change of oxygen saturation.     

High frequency ventilator therapy for newborns

High-frequency ventilation is a general term that refers to a family of ventilator techniques that utilize respirator rates greater than 60 breaths/minute and tidal volumes that are usually less than or equal to the anatomical dead space of the airways. These techniques include high frequency positive-pressure ventilation, high frequency jet ventilation, high frequency flow interruption, high frequency oscillatory ventilation, and high frequency chest wall oscillation. I review the proposed mechanisms of gas transport during high-frequency ventilation and the different ventilators capable of delivering this mode of ventilation. In addition, clinical studies involving infants treated with this new technology are reviewed, along with long-term patient follow-up and reported complications.     

The relationship between EMG median frequency and low frequency band amplitude changes at different levels of muscle capacity

OBJECTIVE: To test the validity of high and low frequency band amplitudes of the surface electromyography (EMG) profile as representation of muscle fatigue. DESIGN: A within subjects (n=10) repeated measures design was used to collect surface EMG signals from the biceps during an isometric contraction under two levels of fatigue status. BACKGROUND: The use of the shift in the median frequency of the surface EMG power spectrum is a well known method of assessing muscle fatigue. Fatigue also results in amplitude changes of the specific frequency bands. The use of frequency band analysis may be an alternative option for the assessment of muscle fatigue in specific experimental settings. METHODS: Surface EMG profiles of the biceps were recorded at 1024 Hz during a sustained isometric hold at 60% of the individuals fresh and fatigued maximal voluntary isometric torque. The median frequency of the power spectrum was compared with changes in the low frequency (15-45 Hz) and high frequency (>95 Hz) bands.Results. There was a close association between median frequency shift and the amplitude of the 15-45 Hz bandwidth and the high-low frequency amplitude ratio. The association was similar for performance under different muscle capacity states. CONCLUSIONS: Frequency band amplitude analysis provides similar information to median frequency shift under isometric conditions and may be suited to specific experimental protocols in workplace fatigue studies. RELEVANCE: The use of amplitude band analysis that closely approximates the standard median frequency changes allows greater possibility of assessing muscle fatigue in different experimental settings and the use of lower sampling rates.     

Elliptical frequency diverse array radars: uniform and non-uniform frequency offsets

In this paper a new configuration of Frequency Diverse Array (FDA) i.e. Elliptical Frequency Diverse Array (EFDA) has been proposed. The foresaid geometry has been analyzed with a uniform and non-uniform frequency offset. Analysis reveals highly range selective beampatterns with decreasing average side lobe levels (SLL). The paper further investigates tangent hyperbolic function for non-uniform frequency offset scheme in EFDA. Investigation reveals a 3D single maximum beampattern. Furthermore by utilizing the properties of tangent hyperbolic function, a highly configurable type array system is achieved, where beampatterns of three different configurations of FDA can be generated, by just adjusting a single function parameter.     

一种高场磁共振频率源的设计方法

目的 针对目前高场磁共振成像系统中用来产生射频脉冲信号的频率源存在的问题,提出一种设计频率源的新方法。 方法 采用直接数字频率合成器件AD9910,可满足系统高频输出的需要,采用CPLD作为控制芯片,通过SPI方式控制,使所设计的电路具有简单高效的特点。 结果 实验结果表明,采用本设计方法可以产生频率、相位、幅度快速切换的高频信号。 结论 本设计方法为高场磁共振频率源设计提供了一个较好的解决方案。     

Life event stress and headache frequency revisited

Life stress is found to be related to headache frequency in some studies, but not others. Research designs that find a relationship between the two tend to evaluate young subjects and employ large sample sizes. The purpose of this study was to evaluate the relationship between headache frequency and life stress, while considering gender and age differences that may be present in the relationship. In addition, as depression or presence of headache at the time of assessment may influence the report of headache frequency, an attempt to control for these factors was employed. Several self-report measures of headache symptomatology, headache presence, depression, and life stress were completed by 1289 subjects. Negative life event stress was found to be modestly but significantly related to headache frequency. The relationship between the 2 variables was stronger for women than for men and, after the influence of depression and headache state was removed, the relationship between life stress and headache frequency remained significant only for women. In the oldest 10% of the sample, there was no evidence of a relationship between negative life event stress and headache frequency.     

Very high frequency pulsed Doppler apparatus

A study of a method for exploration of microvessels is presented. Theoretical considerations taking into account the backscattering of ultrasound wave from a red cell and the attenuation versus frequency (up to 180 MHz) show that a frequency in the range of 80 to 120 MHz is most favorable for small depths of exploration (300 microns). The characteristics of the 113 MHz Doppler system which was built are described. The minimum detectable signal is 3 microV, the lateral resolution around 20 microns and the minimum length of the Doppler sample volume about 80 microns. The Doppler data are displayed in the form of a frequency spectrum. The first encouraging tests carried out using 20 microns rectangular glass capillary tubes and 50 to 150 microns microvessels of the mesentery of rat have demonstrated the resolution and the sensitivity of the system. A discussion illustrates the difficult problem of motion artefacts and the improvements which have to be made. From a technical point of view the authors think that it is possible to work with such a high frequency but there are two main difficulties: the processing of a very low frequency Doppler spectrum and the optimization of the probe (dimensions and shape).     

High frequency oscillations and mucociliary transport

Mucociliary transport is influenced by high frequency oscillation of air within the lungs. While some studies suggest that high frequency ventilation may be detrimental, with appropriate techniques, there is no doubt that this has potential as a means of improving the clearance of secretions from the lung.