低强度聚焦超声神经调控作用研究进展

神经调控技术为脑神经科学基础研究和临床治疗中枢神经系统疾病提供了全新且有价值的工具。经颅聚焦超声是新型无创神经调控技术,其中的低强度聚焦超声（LIFU）能可逆、双向调节靶神经元活动,具有非侵入性、高空间分辨率、高穿透力等优点。本文对LIFU的神经调控作用研究进展进行综述。     

电刺激对废用状态下腓肠肌肌电及酶活性的影响

目的本研究旨在观察经皮电刺激对废用状态下肌肉的肌电及酶组织化学的影响。方法用大鼠尾部悬吊法使大鼠下肢去负荷,以建立废用性肌萎缩模型。大鼠随机分为三组:下肢去负荷14 d组(Hu)、电刺激组(Hu+St)及正常对照组(Control)。吊尾期间给予大鼠左侧下肢皮肤低频电刺激(2 Hz,20-25 V)。采用电生理和酶组织化学技术观察腓肠肌肌电图,肌重及肌肉Na+-K+-ATP酶及Ca2+-ATP酶活性。结果下肢去负荷14 d后大鼠腓肠肌肌重,Mmax,Hmax/Mmax,Na+-K+-ATP酶及Ca2+-ATP酶活性均明显降低(P<0.05)。而在下肢去负荷期间给予大鼠左侧下肢电刺激后,以上指标与正常对照组比较均没有统计学差异(P>0.05)。结论以上结果提示,经皮电刺激不仅可对抗废用肌肉的肌重下降,还对肌肉肌电、Na+-K+-ATP酶及Ca2+-ATP酶活性具有保护作用。     

胺碘酮对正常犬与心力衰竭犬心室电生理效应的比较

目的：比较胺碘酮对正常犬与充血性心力衰竭（ＣＨＦ）犬心室电生理特性的影响。方法：３２只犬随机分成正常对照组（ｎ＝７）、正常服胺碘酮组（ｎ＝７）及ＣＨＦ组（ｎ＝９）、ＣＨＦ服胺碘酮组（ｎ＝９）。服胺碘酮组给予胺碘酮３００ｍｇ／ｄ,共４～５周。用快速右心室起搏（２４０ｍｉｎ－１共４～５周）制作ＣＨＦ犬模型,用心脏电刺激及单相动作电位记录技术测定心电生理参数。结果：胺碘酮明显延长正常犬的窦性心动周长（ＳＣＬ）、室内传导时间（ＩＶＣＴ）、单相动作电位时程（ＭＡＰＤ９０）、心室有效不应期（ＶＥＲＰ）、心室激动时间（ＡＴ）及心室恢复时间（ＲＴ）,对ＶＥＲＰ与ＭＡＰＤ９０的比值（ＶＥＲＰ／ＭＡＰＤ９０）、室颤阈值（ＶＦＴ）、ＲＴ离散性（ＲＴＤ）和复极后期（ＶＬＲＤ）无明显影响。胺碘酮对犬ＣＨＦ时明显延长的ＳＣＬ、ＭＡＰＤ９０、ＶＥＲＰ、ＡＴ及ＲＴ无进一步延长作用,可进一步延长ＩＶＣＴ,使降低的ＶＥＲＰ／ＭＡＰＤ９０及ＶＦＴ明显提高,缩短延长的ＶＬＲＤ,减小增大的ＲＴＤ。结论：胺碘酮对ＣＨＦ犬心室电生理特性的影响不同于对正常犬的影响,胺碘酮使ＣＨＦ犬部分异常的心室电生理特性改变大致回复正常,呈抗心律失常作用     

高压交联电缆终端局部发热原因及对策分析

对高压交联电缆终的局部发热区域进行电场分析,并利用红外成像测试和超声波局放探测对套管的局部发热进行现场检测,证明终端套管的局部发热与发热区域的高场强有关,改善局部电场可以消除终端套管的局部发热。     

低频电刺激预防宫颈癌术后尿潴留32例临床分析

目的通过对两组患者的对照研究,评价低频电刺激在预防宫颈癌术后尿潴留及术后盆底肌力恢复方面的价值。方法对我科2009年1月至2009年12月宫颈癌Ia2-Ⅱb1期,行广泛全子宫切除＋盆腔淋巴结清扫术后的部分患者共32例,随机分成研究组（n=18）和对照组（n=14）。研究组采用膀胱操＋低频电刺激治疗,对照组仅采用传统的膀胱操治疗,观察两组术后排尿及盆底肌力情况。结果研究组术后尿潴留发生率11.11%,低于对照组50.00%,P〈0.05;研究组术后盆底肌力优于对照组,P〈0.05。结论低频电刺激预防宫颈癌术后尿潴留的效果优于传统方法;且对宫颈癌术后盆底肌力恢复有明显效果。     

金属钛夹在结肠息肉高频电凝切除术中的作用

目的探讨内镜下应用金属钛夹联合高频电凝切除治疗结肠息肉的临床疗效与安全性。方法对本院2012年4月至2014年4月金属钛夹联合结肠镜下高频电凝切除结肠息肉患者45例临床资料分析。观察患者术后出血、穿孔等并发症情况,同时随访患者2月后创面愈合、病变残留、复发情况。结果 45例患者成功切除息肉60枚,术后发生迟发性出血2例,无穿孔。随访1例有残蒂存留,予以内镜下切除。结论金属钛夹联合高频电凝切除结肠息肉是安全有效的。     

Effects of capacitive and resistive electric transfer therapy on pain and lumbar muscle stiffness and activity in patients with chronic low back pain

[Purpose] In this study, we investigated the therapeutic effects of capacitive and resistive electric transfer therapy in patients with chronic low back pain. [Participants and Methods] The study included 24 patients with chronic low back pain (12 patients each in the intervention and sham groups). Pain intensity, superficial and deep lumbar multifidus stiffness and maximum forward trunk flexion and associated activation level of the iliocostalis (thoracic and lumbar component) and lumbar multifidus muscles were measured. [Results] Post-intervention pain intensity and muscle stiffness were significantly lower than pre-intervention measurements in the intervention group. However, no between-group difference was observed in the muscle activation level at the end-point of standing trunk flexion. [Conclusion] Our findings highlight a significant therapeutic benefit of capacitive and resistive electric transfer therapy in patients with chronic low back pain and muscle stiffness.     

Low Electrical Resistance Properties of Acupoints: Roles of NOergic Signaling Molecules and Neuropeptides in Skin Electrical Conductance

Early studies from several independent laboratories demonstrated that acupoints possess the characteristics of low electrical resistance. New devices are developing to increase the reliability of electrical skin impedance measurements for counteracting the factors including skin dryness, skin thickness, size of the sensing electrode, pressure applied on the electrode, interelectrode distance, room temperature, and humidity. Morphological studies have identified that blood vessels, hair follicles, and nervous components are enhanced in the meridians/acupoints, which represent areas of potentially high neuronal activity. Recent evidence shows that nitric oxide (NO) concentrations are enhanced in skin acupoints/meridians. L-arginine-derived NO synthesis modifies skin norepinephrine (NE) synthesis/release in acupoints/meridians, and NO-NE activations play an important role in mediating the skin conductance responses to electrical stimulation. NOergic signaling molecules interact with gap junction and transient receptor potential vanilloid type-1. Other studies reported that the high conductance at acupoints is a result of the release of the neuropeptides substance P and calcitonin gene-related peptide during neurogenic inflammation in the referred pain area. Pathological body conditions caused considerable changes in skin conductance or impedance at acupoints. Although systematic research with an improved equipment and research design to avoid the influencing factors are requested for a definite answer in this field, the results from anatomical and biochemical studies consistently show that acupoints exist higher levels of nervous components, and NOergic signaling molecules and neuropeptides involved in the skin low resistance at acupoints. The increased interest in the acupoints/meridians has led to an open-minded attitude towards understanding this system, which is fundamental important to establish the valid aspects of scientific basis of Chinese medicine mechanisms and therapies.     

喉罩辅助通气气管镜介入治疗高位气管息肉一例

气管息肉是由于气管黏膜受到机械刺激、炎症感染等引发。目前随着各级医院人工气道技术普遍开展,其发生率越来越高。气管息肉缺乏特异性临床表现,易引起误诊。本文报道兰州大学第二医院呼吸内科收治的1例高位气管息肉患者,并分析其发病及诊治过程,以提高临床医师对该病的认识和处理水平。