MRI-based brain volumetry in chronic whiplash patients: no evidence for traumatic brain injury

Introduction –  Cognitive complaints, such as poor concentration and memory deficits, are frequent after whiplash injury and play an important role in disability. The origin of these complaints is discussed controversially. Some authors postulate brain lesions as a consequence of whiplash injuries. Potential diffuse axonal injury (DAI) with subsequent atrophy of the brain and ventricular expansion is of particular interest as focal brain lesions have not been documented so far in whiplash injury.
Objective –  To investigate whether traumatic brain injury can be identified using a magnetic resonance (MR)-based quantitative analysis of normalized ventricle–brain ratios (VBR) in chronic whiplash patients with subjective cognitive impairment that cannot be objectively confirmed by neuropsychological testing.
Materials and methods –  MR examination was performed in 21 patients with whiplash injury and symptom persistence for 9 months on average and in 18 matched healthy controls. Conventional MR imaging (MRI) was used to assess the volumes of grey and white matter and of ventricles. The normalized VBR was calculated.
Results –  The values of normalized VBR did not differ in whiplash patients when compared with that in healthy controls ( F  = 0.216, P  = 0.645).
Conclusions –  This study does not support loss of brain tissue following whiplash injury as measured by VBR. On this basis, traumatic brain injury with subsequent DAI does not seem to be the underlying mechanism for persistent concentration and memory deficits that are subjectively reported but not objectively verifiable as neuropsychological deficits.     

Ultrasound as visual feedback in speech habilitation: exploring consultative use in rural British Columbia, Canada

Ultrasound has shown promise as a visual feedback tool in speech therapy. Rural clients, however, often have minimal access to new technologies. The purpose of the current study was to evaluate consultative treatment using ultrasound in rural communities. Two speech-language pathologists (SLPs) trained in ultrasound use provided consultation with ultrasound in rural British Columbia to 13 school-aged children with residual speech impairments. Local SLPs provided treatment without ultrasound before and after the consultation. Speech samples were transcribed phonetically by independent trained listeners. Eleven children showed greater gains in production of the principal target /[image omitted]/ after the ultrasound consultation. Four of the seven participants who received more consultation time with ultrasound showed greatest improvement. Individual client factors also affected outcomes. The current study was a quasi-experimental clinic-based study. Larger, controlled experimental studies are needed to provide ultimate evaluation of the consultative use of ultrasound in speech therapy.     

Bupivacaine-induced cellular entry of QX-314 and its contribution to differential nerve block

Background and Purpose: Selective nociceptor fibre block is achieved by introducing the cell membrane impermeant sodium channel blocker lidocaine N-ethyl bromide (QX-314) through transient receptor potential V1 (TRPV1) channels into nociceptors. We screened local anaesthetics for their capacity to activate TRP channels, and characterized the nerve block obtained by combination with QX-314.Experimental Approach: We investigated TRP channel activation in dorsal root ganglion (DRG) neurons by calcium imaging and patch-clamp recordings, and cellular QX-314 uptake by MS. To characterize nerve block, compound action potential (CAP) recordings from isolated nerves and behavioural responses were analysed.Key Results: Of the 12 compounds tested, bupivacaine was the most potent activator of ruthenium red-sensitive calcium entry in DRG neurons and activated heterologously expressed TRPA1 channels. QX-314 permeated through TRPA1 channels and accumulated intracellularly after activation of these channels. Upon sciatic injections, QX-314 markedly prolonged bupivacaine''s nociceptive block and also extended (to a lesser degree) its motor block. Bupivacaine''s blockade of C-, but not A-fibre, CAPs in sciatic nerves was extended by co-application of QX-314. Surprisingly, however, this action was the same in wild-type, TRPA1-knockout and TRPV1/TRPA1-double knockout mice, suggesting a TRP-channel independent entry pathway. Consistent with this, high doses of bupivacaine promoted a non-selective, cellular uptake of QX-314.Conclusions and Implications: Bupivacaine, combined with QX-314, produced a long-lasting sensory nerve block. This did not require QX-314 permeation through TRPA1, although bupivacaine activated these channels. Regardless of entry pathway, the greatly extended duration of block produced by QX-314 and bupivacaine may be clinically useful.     

全髋关节置换术中钴-铬股骨头不同磨损部位的摩擦学特性

 通过使用原子力显微镜检查(atomic force microscopy,AFM)计算表面粗糙度和摩擦系数的方法,对工程和生物材料的摩擦学特性进行研究。尽管之前的大量研究对全髋关节置换术中不同承重材料的摩擦系数进行了报告,但却没有关于全髋关节置换术术中轴承材料的表面粗糙度和摩擦系数的关系的报道。此外,钴-铬股骨头不同磨损部位的摩擦学特性尚不明确。因此,本研究对全髋关节置换术后 10年钴-铬股骨头发生严重磨损及轻微磨损部位的表面粗糙度、摩擦系数和硬度之间的关系进行研究。钴-铬股骨头的平均维氏硬度为(380.7±11.3) HV。在 AFM扫描的 25滋m伊25滋m面积内,严重磨损和轻微磨损部位的摩擦系数分别为 0.229±0.054和 0.243±0.059,两者差异无统计学意义(P=0.449)。严重磨损部位的表面粗糙度[Rq=(96.5±26.2) nm]与轻微磨损部位[Rq=(17.7±4.2) nm]的差异有统计学意义(P <0.0001)。本研究结果显示院钴-铬股骨头的摩擦特性与其表面粗糙度没有明显关系,为金属植入材料表面特性的改善提供了依据。     

身高是影响血管功能的主要因素

目的:探讨性别及其它生理因素对大动脉血管功能的影响.我们使用非创伤性血压压力波分析方法研究和探讨性别和身高对年长者中心和外周血流动力学变化的影响.方法:研究对年龄、身高、体重指数、心率和血压等等生理因素与系统动脉顺应性(SAC)和动脉压力增加指数(AI)等血流动力学参数之间的相关性和影响进行评估,共选择280个正常志愿者,其中男性98例,女性182例,年龄49～75岁.结果:结果经年龄校正后,脉搏波速度、系统动脉顺应性和动脉压力增加指数有显著的性别差异.系统动脉顺应性,动脉压力增加指数与高度相关,而且此相关在性别上有明显差异.经年龄和性别校正后身体体重指数与SAC正相关与AI负相关.经年龄、性别和身高校正后,脉搏波速度、中心动脉压增加指数与心率、中心脉压差呈显著地直线相关.结论:研究表明在正常老年人群中,性别影响动脉功能指数的测定,身高是影响系统动脉顺应性和动脉脉压增加指数的关键因素.     

知母中呋甾皂甙的研究

自知母 Anemarrhena asphodeloides Bge.根茎的乙醇提取物中,经硅胶柱层析和制备型HPLC分得四种呋甾皂甙。用化学反应和波谱(IR,FAB-MS,EI-MS,¹HNMR,¹³CNMR,DEPT,一维多重接力CoSY,二维接力HOHAHA,¹H-¹H COSY,¹H-¹³C COSY和NOE差谱)解析,确定其结构为知母皂贰B(anemarsaponinB,I),(25S)-26-O-β-D-吡喃葡萄糖基-5β-呋甾-20(22)-烯-3β,26-二醇-3-O-β-D-吡喃葡萄糖基(1→2)-β-D-吡喃哺葡萄糖甙(Ⅱ),(25S)-26-O-β-D-吡喃葡萄糖基-22-羟基-5β-呋甾-3β,26-二醉-3-O-β-D-吡喃葡萄糖基(1→2)-β-D-吡喃半乳糖甙(Ⅲ),(25S)-26-O-β-D-吡喃葡萄糖基-22-甲氧基-5β-呋甾-3β,26-二醇-3-O-β-D-吡喃葡萄糖基(1→2)-β-D-吡喃半乳糖甙(Ⅳ)。Ⅱ为一新的呋甾皂甙,命名为知母皂甙C;化合物Ⅳ为首次从知母中分离得到,命名为知母皂甙E。初步的药理实验显示,化合物1～Ⅳ均有一定的清除羟自由基的作用。     

COMPARING THE EFFICACY OF CISAPRIDE AND RANITIDINE IN OESOPHAGITIS: A DOUBLE-BLIND,PARALLEL GROUP STUDY IN GENERAL PRACTICE

SUMMARY Patients with endoscopically confirmed oesophagitis (n=49) were treated for 8 weeks with either cisapride (10 mg four times a day) or ranitidine (150 mg twice a day) in a double-blind study in general practice. Mean overall symptom scores fell from 10.8 to 4.5 in the cisapride group and from 9.9 to 4.4 in the ranitidine group over the course of the study. The proportion of patients reporting improvements in individual symptoms in the two treatment groups (cisapride and ranitidine respectively) were: heartburn, 66% and 55%; acid regurgitation, 53% and 47%; epigastric pain, 60% and 52%; satiety, 57% and 47%; bloating, 69% and 71%; belching, 65% and 72%; nausea, 62% and 85%; vomiting, 77% and 66%; poor appetite, 50% and 75%. Improvement in the endoscopic grade of oesophagitis was observed in 66% of patients receiving cisapride and 63% of those receiving ranitidine. It was concluded that cisapride is as effective as ranitidine in relieving the symptoms of oesophagitis and in healing oesophageal erosions.