下腰腿痛患者大脑存在触觉空间辨识力相关的脑功能网络小世界属性改变的MRI研究

目的 使用图论方法探讨下腰腿痛(LBLP)患者大脑功能网络的拓扑特性及其与临床功能评分的相关性。方法 使用Siemens 3.0 T MR扫描仪采集29例LBLP患者和39名健康对照者的静息状态MRI数据,采用脑功能数据成像处理及分析助手(DPARSFA)4.5和SPM12工具箱对MRI数据进行预处理,采用Gretna软件构建大脑功能网络并度量和分析小世界指标。对组间小世界属性进行两样本t检验,并对LBLP患者有差异的脑功能网络小世界指标与临床评估参数进行偏相关分析。结果 在典型频段(0.01～0.1 Hz),与健康对照组相比,LBLP患者归一化集群系数和小世界参数显著降低;节点效率(Ne)降低位于双侧楔前叶,左侧杏仁核和海马、右侧枕上回和枕下回的Ne增加。在亚频段下,LBLP患者全局效率、局部效率、集群系数等整体水平指标均下降;双侧中央前回、右侧海马旁回、双侧额下回、左侧苍白球等区域节点效率增加,而右侧额中回和额上回、右侧壳核等区域节点效率降低(P<0.05,Bonfferrni校正)。偏相关分析显示LBLP患者典型频段内归一化集群系数与左脚两点触觉评分呈负相关(r=-0.51...     

躯体形式障碍患者脑葡萄糖代谢功能网络研究

目的探讨躯体形式障碍(SFD)患者大脑葡萄糖代谢网络的拓扑变化。方法用2011年10月至2012年12月期间复旦大学附属华山医院的18例SFD患者[男10例、女8例,年龄(39.5±12.0)岁,病程(3.67±3.20)年;SFD组]、21名健康体格检查者[男13名、女8名,年龄(43.9±8.4)岁;对照组]的18F-脱氧葡萄糖(FDG)PET图像,建立静息状态下2组的大脑葡萄糖代谢网络。使用图论的方法计算脑网络的全局参数(标准化聚类系数、标准化最短路径长度、小世界属性和全局效率)和节点参数(聚类系数和介数中心度)。2组脑网络参数间的差异采用重复1000次的置换检验进行统计学分析。根据聚类系数和介数中心度定义前20%(18/90)的节点为脑网络的关键(Hub)节点,分析SFD患者Hub节点的改变。结果SFD组患者的脑网络和对照组一样具有小世界属性(σ>1),但标准化聚类系数、小世界属性和全局效率有降低趋势,标准化最短路径长度有增加趋势(P>0.05)。与对照组相比,SFD患者左侧苍白球、左侧杏仁核、左侧楔前叶和右侧角回的介数中心度明显升高(置换检验,P<0.05),左侧颞中回和右侧枕上回的介数中心度明显降低(置换检验,P<0.05);双侧苍白球、双侧丘脑和左侧杏仁核的聚类系数明显降低(置换检验,P<0.05)。SFD组发生改变的Hub节点多数(16/24)位于边缘系统。结论SFD患者的葡萄糖代谢脑网络拓扑性质发生改变,小世界属性和全局效率呈降低的趋势及Hub节点的改变,导致网络信息传递效率有所降低,功能整合和功能分离的平衡被打破,这为躯体化症状的脑功能异常提供了有效的影像学证据。     

视觉刺激状态下电针阳陵泉穴的fMRI研究

目的:观察视觉刺激状态下电针足少阳胆经阳陵泉穴(GB34)引起的人脑血液动力学响应变化,剖析电针作用与脑功能之间的关联性。方法:12例健康自愿者纳入BOLD-fMRI实验;视觉刺激任务应用闪烁棋盘方格,频率8Hz;检测受试者在静息状态、视觉刺激任务、视觉刺激状态下电针双侧阳陵泉穴时的大脑响应功能区的激活,并分别进行分析比较;最后以图像数据重组方法(reblocked方法)处理结果。结果:视觉刺激任务时见左脑干及左小脑枕叶激活及左脑、边缘叶、海马旁回(BA19)、右脑颞中回、颞下回(BA37)等部位激活;电针状态时见左脑额上回、右脑额叶(BA31)等部位激活;视觉刺激任务下电针双侧阳陵泉见左侧额叶中央前回(BA6)、左侧额下回(BA9)、左侧颞上回(BA22)、顶叶楔前叶(BA7)、左侧顶下小叶(BA40)、右脑额叶(BA31)等部位激活。结论:视觉刺激状态下电针阳陵泉穴引起与人体运动相关的多个区域激活(BA6,BA7),其原因在于,电针与视觉刺激相结合后,通过大脑整合多个皮质区域,引起与人体运动功能相应的脑功能网络的激活有关。     

基于图论分析法对难治性癫痫脑功能网络的研究

目的：利用静息态fMRI(rs-fMRI)结合图论分析方法研究儿童及青少年难治性癫痫(ITE)脑功能网络拓扑属性的变化,分析异常网络属性指标与病程、智商之间的相关性,探讨ITE患者脑功能网络改变。方法：收集ITE患者23例(ITE组),同期招募23例健康志愿者作为对照组。采用3.0TMRI扫描仪进行扫描,获得T₂-FLAIR、3D-T₁WI、rs-fMRI数据。利用GRETNA V2.0软件包进行数据预处理并计算网络属性指标,使用SPSS18.0软件分析组间差异。结果：ITE组与对照组年龄、性别及受教育年限差异均无统计学意义(均P>0.05)。ITE组与对照组均有小世界属性,ITE组局部效率及标准化聚类系数减低(P=0.014,0.027)。ITE组节点属性有差异的脑区主要位于默认网络及视觉皮质。ITE组左侧楔前叶节点中心度、左侧楔前叶节点效率均与病程呈负相关(r=-0.564,P=0.005;r=-0.539,P=0.008)。结论：ITE组脑功能网络全局及节点属性均存在异常,脑功能网络改变以局部分离功能降低为主,为ITE脑功能网络研...     

经皮穴位电刺激对大脑神经功能活动影响研究进展

传统中医经脉穴位针灸调节机体生理功能有着重要作用,通过定量物理刺激穴位手段来探索大脑高级神经活动的机制受到关注。从经皮穴位电刺激、基于脑电和功能磁共振成像构建脑功能网络、脑电功率谱密度、相位同步性、复杂度特征和默认模式网络及各种客观变量(如针刺方式)影响等方面回顾了该领域的研究现状、存在问题;归纳小结了有关研究进展及其在脑电θ波段同步性、子频带能量变化、默认模式网络以及针对多穴位协同研究较少且结果模糊等不足之处。     

20Hz经颅交流电刺激对运动序列学习能力的影响

目的基于行为学指标评估20Hz经颅交流电刺激对运动序列学习能力的影响,进一步探究20Hz经颅交流电刺激对脑电节律与认知功能的调控作用。方法60名志愿者随机均分为4组,采用20Hz经颅交流电刺激分别对4组受试者进行左侧初级运动皮层(C3导联附近)真/伪刺激和右侧初级运动皮层(C4导联附近)真/伪刺激,刺激前、后受试者需要完成4种类型的手指序列按键任务(分别为左或右手随机或规律按键),记录反应时间及正确率。用SPSS22.0软件对行为学数据进行配对样本t检验,分析其经颅交流电刺激对序列反应时任务的行为学指标的影响。结果对受试者施加C4真刺激后,分析刺激前后行为学指标变化,发现受试者左手运动学习能力得到增强,且与右手具有显著性差异(P0.01)。结论 20Hz经颅交流电刺激可明显提高受试者运动学习能力。     

基于弥散张量成像的脑结构网络增龄性变化研究

目的基于弥散张量成像及纤维束追踪技术构建大脑结构网络,研究大脑结构网络增龄性变化。方法分别构建30例青年人和30例老年人的脑结构网络。运用图论分析方法,计算脑结构网络的全局以及局部网络拓扑参数,定量分析年龄对大脑网络全局特性及局部特性变化的影响。结果研究显示人脑结构网络具有小世界属性,脑网络全局特征参数与年龄具有强相关性(P<0.05),平均节点度、局部效率以及全局效率随年龄增长呈明显下降趋势,而平均聚类系数和平均最短路径长度呈上升趋势。脑网络局部特性与大脑全局特性的变化具有一致性,其中右侧楔前叶、左侧颞中回、双侧前扣带和旁扣带脑回、双侧内侧和旁扣带脑回、左侧梭状回、左侧舌回、左侧距状裂等脑区存在显著老化现象。结论大脑网络信息传输效率随年龄的增长而降低,整体机能随年龄增长呈下降趋势,但在局部脑区有着不同的老化机制。     

基于fMRI研究经筋疗法对健康人脑网络拓扑结构的影响

目的：使用静息态BOLD-fMRI结合图论方法,分析健康志愿者经筋治疗前后功能脑网络的拓扑结构,以揭示经筋疗法对脑神经网络的调控机制。方法：招募41例健康志愿者,随机分为理筋伴针刺组21例和单纯理筋组20例,采集治疗前后简单反应时间测试、舒尔特方格测试、颅脑MRI3D-T₁WI及BOLD数据。使用GRETNA软件构建功能脑网络、计算拓扑参数,并行治疗前后组内及组间比较。结果：治疗后2组反应力和注意力均显著提高;理筋伴针刺组的全局效率(E_glob)和小世界属性(σ)提高,聚类系数(Cp)和特征路径长度(Lp)降低,而理筋组仅E_glob提高和Lp降低;理筋伴针刺组发现一神经回路连接强度减弱,包括86条连边和73个节点。相关性分析示E_glob、标准化聚类系数(γ)和σ分别与舒尔特方格时间呈负相关,而Lp与舒尔特方格时间呈正相关。结论：经筋治疗能重塑功能脑网络、优化其信息处理模式,进而增强志愿者的反应力和注意力,这种重塑作用可能是其治未病疗效的作用基础。而针刺松解筋结点作为经筋疗法的重要组成部分,对功能网络...     

基于三重网络模型的酒精依赖患者静息态动态功能连接分析

目的:探讨酒精依赖(AD)患者静息态三重网络(中央执行网络、突显网络、默认模式网络)动态功能网络连通性(dFNC)的变化。方法:于2020年2月-2021年3月采集15例酒精依赖患者和15例健康志愿者(正常对照组)的静息态fMRI数据。对预处理后的fMRI数据进行独立成分分析以获得大脑网络成分,并通过滑动窗口方法生成大脑网络的动态功能连接矩阵。并对所有dFNC矩阵应用k-means聚类算法确定大脑网络连接模式,获得受试者脑网络的时间属性。最后,使用斯皮尔曼相关分析评估异常时间属性(时间分数、平均停留时间、转换次数)与酒精依赖量表(ADS)评分之间的关系。结果:最终将15例志愿者和12例AD患者纳入本研究,并通过聚类分析得到四种重复出现的功能连接状态。与对照组相比,AD组在弱连接状态下花费时间较长,但在中央执行网络和突显网络之间的强连接状态下花费时间较少(P均<0.05)。双样本t检验结果显示,AD患者中央控制网络内的IC38与IC49之间的功能连接显著增强(P<0.05,FDR校正)。结论:AD患者中央执行网络的功能连接发生了变化,本研究为探索酒精依赖的复杂神经病理学机制提...     

耳甲电针治疗轻度认知障碍脑机制静息态fMRI研究的试验方案

目的:探讨经皮耳迷走神经刺激术(taVNS)治疗轻度认知障碍(MCI)的脑功能机制.方法及设计:采用随机平行对照双盲试验,拟纳入MCI患者40例,随机分为taVNS组和假taVNS组各20例,并同期招募20例性别、年龄、受教育程度与MCI患者相匹配的健康志愿者作为对照组.所有患者治疗周期为24周,且在入组和出组时均行一...     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.