眼轮匝肌功能作用状态的实时识别

目的 基于用神经功能性电刺激的方法恢复面瘫患者闭眼功能的需要,研究健侧眼轮匝肌的功能作用状态的实时识别方法,以期能将其作为控制信号,调控对患侧眼轮匝肌的功能性电刺激.方法 通过植入式微电极提取狗眼轮匝肌的肌电信号,分析眼轮匝肌在不同功能状态下肌电号表现的差异性,以探索眼轮匝肌功能状态的实时识别方法.结果 眼轮匝肌在收缩时的肌电信号相对于舒张状态有幅值显著增加的特点,基于这种特征,我们采用了一种带延迟判断的幅度阂值方法,对信号进行实时分析.以接近于同步的方式识别出了眼轮匝肌收缩动作的发生.结论 可以通过对眼轮匝肌肌电信号实时分析的方法,监控眼轮匝肌的功能状态,从而监控闭眼动作的发生.     

眼轮匝肌反射及其在临床上的应用

本文对眼轮匝肌反射产生的原理、操作方法及其对临床的应用进行了综述。眼轮匝肌反射检查对三叉神经、面神经和脑干病变的早期诊断具有的临床价值,它可以帮助发现临床下的早期病变,对治疗的效果及预后判定也有重要的帮助。     

颞部眼轮匝肌穿支皮瓣修复下睑周皮肤缺损

目的探讨颞部眼轮匝肌修复下睑周皮肤缺损的方法和疗效。方法应用颞部眼轮匝肌穿支皮瓣,自2012年6月至2015年7月修复下睑皮肤缺损12例。结果本组患者共12例,随访1年,皮瓣无坏死及血运障碍,效果满意。结论眼轮匝肌穿支皮瓣修复下睑周皮肤缺损,具有血运丰富、转移灵活、供区隐蔽、瘢痕轻的优点,值得临床推广。     

长春西汀注射液静脉滴注治疗眼轮匝肌痉挛的临床疗效

目的 对长春西汀注射液静脉滴注治疗眼轮匝肌的临床疗效进行分析与探究.方法 选取接受治疗的眼轮匝肌痉挛的患者60例,按治疗方法的不同分为两组,即对照组和实验组.对照组的患者给予体针与耳穴治疗方法对眼轮匝肌痉挛治疗,实验组的患者在给予体针与耳穴的同时采用长春西汀注射液滴注治疗.比较两组患者经治疗所患得的临床疗效.结果 两组患者分别接受治疗后,实验组的总有效率(83.34%)明显高于对照组的总有效率(56.67%),统计学上有意义(P<0.05);两组患者经治疗后,实验组的不良发应的发生率与对照组的不良反应发生率没有明显差异,不具有统计学意义(P>0.05).结论 采用长春西汀注射液的眼轮匝肌痉挛治疗的效果更加显著,安全可靠,可以在临床中广泛应用.     

维生素C在眼化学性烧伤中的作用

眼烧伤约占烧伤的13%,且多为化学性烧伤[1]。但对眼轻微损伤也可造成严重视力障碍。因此,对眼化学性烧伤的处理至关重要。眼化学性烧伤后的处理,关键在于角膜基质的及时愈合,以避免发生角膜溃疡和角膜穿孔。大量研究已证实了维生素C在眼化学性烧伤治疗中的重要作用。为了提高对各种眼化学性烧伤治疗水平,减少并发症,现就维生素C在眼化学性烧伤中的应用综述如下。1　眼酸性烧伤后维生素C的应用眼被强酸性物质致伤后,因条件反射病人会立即紧闭双眼,故进入结膜囊的酸性物质的量较少,但可立即产生蛋白凝固作用,使表层角膜及结膜蛋白凝固,引起…     

影象学在脑和眼缺血诊治中的作用

本文阐述了影象学在脑和眼缺血的诊断、治疗和预后估计中的作用。 详细介绍了CT、MRI、DSA、PET、SPECT、Xe-CT、多普勒血流研究、多普勒超声及B型超声等各自优点和不足。强调了鉴别脑梗塞与脑出血、颈动脉狭窄与闭塞的重要性。     

头眼运动同步测量与分析

目的研究头眼运同步测量与分析,解决航空航天医学领域头眼运动数据测量分析问题。方法根据头眼运动生理物理特征,采用惯性测量和红外视频技术进行头眼运动数据同步检测和分析。结果头眼运动同步测量,实现了头眼运动一体化分析,提高了前庭功能评价准确性。结论头眼运动同步测量与分析为航空医学领域提供了一种方便、快速、准确的评价手段。     

频域光学相干断层扫描在眼挫伤黄斑损害中的应用

目的：观察眼挫伤所致黄斑损害的频域光学相干断层扫描（Frequency Domain Optical Coherence Tomo-graphy）图像特征。方法：对34眼眼外伤患者进行FD-OCT扫描检查。两组之间的比较采用t检验进行。结果：外伤眼急性期黄斑区OCT图像主要表现为：神经上皮浆液性脱离、色素上皮脱离、视网膜内出血及黄斑区神经上皮层变薄。回复期黄斑区OCT图像主要表现为黄斑区神经上皮层变薄、黄斑区增生膜形成、黄斑裂孔。结论：眼挫伤黄斑损害的OCT图像可以提供黄斑区解剖结构改变的重要信息,有助于对病变进行诊断及全面评估。     

眼创伤评分法在军人机械性眼外伤中的临床应用

目的 探讨眼创伤评分(OTS)在军人机械性眼外伤视力预后评估中的临床应用,并分析比较军事训练和非军事训练所致眼外伤预后评分的构成差别.方法 对633例(665眼,其中军事训练伤326眼,非军事训练伤339眼)军人机械性眼外伤进行OTS评分,比较本研究纳入病例的终视力比率与OTS表推算各级终视力概率的差别,分析评分与终视...     

Foot hyperpronation alters lumbopelvic muscle function during the stance phase of gait

BackgroundAlthough altered muscular control of the lumbopelvic region is one of the main risk factors for the development of low back pain and dysfunction, the influence of abnormal foot posture on lumbopelvic muscular function has not been investigated.Research questionTo determine possible functional changes due to hyperpronation in the main muscles that control the lumbopelvic segment.MethodsKinematic and kinetic data were collected from 15 persons with hyperpronated feet and compared to a control group of 15 persons with normally aligned feet during the stance phase of gait. A generic OpenSim musculoskeletal model was scaled for each participant. A computed muscle control approach was used to produce a forward dynamic simulation of walking to determine muscle function.ResultsIn the hyperpronation group significantly greater peak forces were observed in the erector spinae, iliopsoas and abdominals compared to controls. The former group showed peak latencies for abdominal muscles during early stance, and for erector spinae muscles during both early and late stance. No significant between-group differences were found in gluteus maximus muscle activation in the stance phase of gait.SignificanceAbnormal foot pronation can change the timing and intensity of lumbopelvic muscle activation. These changes may predispose people to develop secondary dysfunctions.     

防治失神经骨骼肌萎缩的研究进展

骨骼肌在失神经支配后不可避免地会发生萎缩变性,往往在肌肉获得神经再支配之前已丧失了肌细胞再生的物质基础,表现为骨骼肌的不可逆萎缩,严重影响其功能的恢复。本文就失神经骨骼肌萎缩的防治进展作一综述。     

单纯运动或感觉神经损伤在骨骼肌萎缩中的致凋亡作用

目的探讨单纯运动神经或感觉神经损伤在骨骼肌萎缩中的致凋亡作用。方法健康成年SD大鼠30只,随机分为前根切断组(切断左侧L4-L6脊神经前根)、后根切断组(切断左侧L4-L6脊神经后根)和坐骨神经切断组(切断左侧坐骨神经),每组10只。10周后取左右两侧腓肠肌,应用荧光标记、电镜技术以及免疫组化方法观察单纯运动或感觉神经损伤后骨骼肌细胞的凋亡表现及Fas/FasL的表达变化。结果失神经支配10周后,骨骼肌细胞出现各种凋亡变化,细胞核凋亡形态明显,其中后根切断组、前根切断组和坐骨神经切断组的细胞核排列密集程度依次增加,Fas/FasL表达依次增强。电镜观察可见失神经支配的骨骼肌细胞未见典型的凋亡小体,但出现凋亡前期的形态改变。结论运动神经损伤对骨骼肌萎缩的影响大于感觉神经损伤,临床治疗失神经支配的骨骼肌萎缩应优先考虑重建运动神经。     

Standardized echography of the eye and orbit

Summary Standardized echography (pioneered and developed by Dr. Karl Ossoinig) is a state-of-the-art method of diagnostic ophthalmic ultrasound. More than sixty (60) orbital and periorbital and eighty (80) intraocular conditions may be detected and differentiated with high reliability. Optimal results can be expected when specified instrumentation and techniques are used by a well trained examiner. Specific instrumentation to be used includes standardized A-scan (i.e. Kretztechnik 7200MA/Ophthascan S), contact B-scan and Doppler instrumentation. A systematic approach to intraocular and orbital examinations includes use of the specific basic examination and special examination techniques. Once a lesion is detected with the basic examination, a variety of acoustic criteria are determined with topographic, quantitative and kinetic examination techniques for lesion differentiation, localization and measurement. In the globe, standardized echography is useful in both opaque media, where fundus view is obscured or prevented, and in clear media as a supplement to the ophthalmoscopic examination. Standardized echography is also useful in the evaluation of orbital and periorbital disease. Mass-like lesions, extraocular muscle and optic nerve conditions may be detected, differentiated and accurately measured.This work has been supported in part by the Florida Lions Eye Bank     

颞骨内面神经的影像学研究：多层面CT和高场强MR

目的探讨多层面CT和高场强MR对颞骨内面神经及面神经管检查的应用价值.材料和方法选择5例头颅标本行多层面CT和1.5TMR扫描.多层面CT扫描参数如下螺旋方式,管电压120kV,管电流230mA,扫描时间28,视野220mm,扫描层厚5mm,重建厚度1.25mm,螺距13,矩阵512×512.在工作站上行多平面重建.MR检查采用三维稳态射频傅立叶采集(3DRF-FAST)序列(TR50ms,TE13ms,FOV250mm,层厚1.5mm).头颅标本进行大体解剖,结果与CT、MR影像相对照.结果颞骨内面神经管可以通过多平面重建在一个平面内显示,与MR图像相比,多层面CT对于面神经管的显示较好.MR图像可以清晰显示面神经鼓室段、乳突段和膝状神经节.对于5例标本的双侧颞骨内面神经及面神经管分别于MR和多层面CT进行测量,直径分别为1.15±0.25mm,1.26±0.14mm.所测量结果与解剖标本相比无显著性差异(p＞0.05).结论高场强MR和多层面CT是颞骨内面神经和面神经管检查的理想方法,两者结合使用更有利于颞骨内面神经病变的检出.     

兔面神经部分缺损两端不同幅度延长对修复效果的影响

目的 观察面神经缺损两端不同幅度延长对修复效果的影响。方法 对于中点切断兔面神经颊支，断点近，远段均以１０ｍｍ／１０ｍｉｎ的速度分开延长，延长幅度分别对神经全长的０％，１０％，２０％，３０％，４０％，按正交设计法配伍，延长结束后缝合神经端外膜，近，远端延长幅度均为０％组则切除１０ｍｍ神经再回植，作为对照；第１２周用肌电图。神经传导速度及组织病理改变评价修复效果。     

预构神经的趾短伸肌皮瓣移植重建第一背侧骨间肌功能

目的 探讨采用预构神经的趾短伸肌皮瓣移植重建第一背侧骨间肌功能的效果。方法 本组5例病人,男2例,女3例;年龄17－24岁,平均21岁。将正中神经的旋前方肌肌支用腓肠神经延长预构,待神经轴突长过预构神经后,再用带神经血管的趾短伸肌皮瓣移植,治疗尺神经损伤后第一背侧骨间肌纤维化。结果 移植后4－6周,所有病例临床显示其肌力均恢复到2级以上,肌电图均出现移植肌肉动作电位。7－9周后,所有病例第一背侧骨间肌功能均恢复到4－5级。结论 预构神经的趾短伸肌皮瓣移植是重建第一背侧骨间肌功能的有效方法。     

Strenuous resistance exercise effects on magnetic resonance diffusion parameters and muscle–tendon function in human skeletal muscle

Purpose:

To assess the effects of strenuous exercise on magnetic resonance diffusion parameters and muscle–tendon complex function in skeletal muscle.

Materials and Methods:

Six men performed ankle plantar flexion exercises with eccentric contraction. The fractional anisotropy (FA), λ₁, λ₂, λ₃, mean diffusivity (MD), and T₂ values in the triceps surae muscles were measured by magnetic resonance diffusion tensor and spin‐echo imaging. Passive torque of plantar flexors, maximal voluntary isometric plantar flexion torques (MVIP), and Achilles tendon stiffness during MVIP were measured by combined ultrasonography and dynamometry. Plasma creatine kinase and muscle soreness were also assessed. These parameters were measured before and 1–8 days postexercise.

Results:

The medial gastrocnemius exhibited significantly decreased FA 2–5 days after, increased λ₂ 3 days after, and increased λ₃ 2 and 3 days after exercise. This muscle also showed significantly increased MD and T₂ values 3 days postexercise. MVIP significantly decreased 2 and 3 days postexercise, while passive torque significantly increased 2 days postexercise. Creatine kinase and muscle soreness increased 3–5 days and 1–5 days postexercise, respectively.

Conclusion:

Exercise‐induced muscle damage manifested as significant changes in muscle diffusion parameters with muscle–tendon complex dysfunction and delayed‐onset muscle soreness. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Contrast enhancement of the facial nerve on MRI: normal or pathological?

We prospectively analysed the normal contrast-enhanced MRI features of the facial nerve and determined criteria for pathological contrast enhancement. We studied 31 patients with clinically normal facial nerves with T1-weighted images before and after contrast medium. The intensity, thickness and right-left symmetry of enhancement were assessed in each segment and correlated with MRI features observed in abnormal facial nerves. Enhancement along at least one segment of the facial nerve was seen in 98 % of cases, but only within the facial canal: labyrinthine segment: 78.2 %; geniculate ganglion: 96.9 %; tympanic: 88.4 %; mastoid: 66.6 %. Marked (++) to intense (+++) enhancement was seen in the labyrinthine segment in 17.4 %, the geniculate ganglion in 36.3 %, and the tympanic (25.6 %) and mastoid (7.1 %) segments, whereas intense enhancement was only seen in the geniculate ganglion (6 %) and the tympanic segment (11.6 %). A right-left asymmetry was noted in 69 % of cases. No correlation was found between enhancement and the thickness of the nerve. No enhancement of the eighth nerve was seen. We suggest three criteria for pathological enhancement: enhancement outside the facial canal; extension of enhancement to the eighth nerve; and intense enhancement in the labyrinthine and/or mastoid segments. Accepted: 7 May 1996     

Effects of passive stretching on post-activation potentiation and fibre conduction velocity of biceps brachii muscle

Stretching is usually part of warm-up routines in many sports, but it affects the subsequent muscle force; therefore, it could negatively influence post-activation potentiation (PAP), one of the warm-up’s main effects. The aim of this study was to evaluate the acute effects of passive stretching on PAP and fibre conduction velocity (CV). Seven subjects underwent 2 experimental sessions, control (C) and stretching (S), each consisting of 2 series (7 min resting) of 3 maximal voluntary contractions (MVC) of biceps brachii (5 s isometric contraction, 10 s recovery). During the resting phase of the S session, the biceps brachii was passively stretched (5×45 s stretches, 15 s recovery). Root mean square (RMS), mean frequency (MF) and CV were calculated from electromyography. Peak torque (pT) and half-contraction time (1/2CT) were measured and normalised by the arm muscular area (pTn). After C, pTn increased and 1/2CT decreased (p<0.05); moreover, MF and CV increased (p<0.05). After S, 1/2CT increased (p<0.05) and RMS decreased (p<0.05). Passive stretching could blunt the effects of PAP, presumably due to mechanical and neuromuscular changes. The observed changes in CV suggest a possible decrease in Ca²⁺ sensitivity in contractile proteins. Therefore, the use of passive stretching in warm-up routines remains questionable.