旋转床模拟推拉动作对脑循环功能的影响

目的 探讨推拉动作对脑血管循环功能的影响及推拉效应的＋ＧＺ下降机制。方法１０名被试者在旋转床上经受“直立位－倒立位－直立位”Ｒ 模拟推拉动作,采用网谱勒（ＴＣＤ）技术监测分析旋转床模拟推拉脑血流速度及脉动参数的变化。结果 倒立位时出现收缩期流速增加、舒张期流速降低、脉动参数ＰＩ与ＲＩ升高的阻力增高型频谱,随后直立位时,这些变化更加明显且恢复较慢。在实验过程中平均血流速度没有显著变化。结论在推拉动作     

The effect of two low-dose propofol infusions on the relationship between six-pulse transcranial electrical stimulation and the evoked lower extremity muscle response

BACKGROUND: Transcranial stimulation of the motor cortex using high-voltage electrical stimuli given in train is a method of monitoring the integrity of the motor pathways during thoracoabdominal aortic aneurysm surgery. The purpose of this study was to assess the relationship between the stimulus intensity and the corresponding amplitude of the myogenic motor evoked potential (tcMEP) in response to six-pulse transcranial electrical stimulation during two levels of low-dose propofol infusion and stable fentanyl/nitrous oxide anaesthesia. METHODS: Nine patients (37-78 yr) scheduled to undergo surgery on the thoracoabdominal aorta were studied. After achieving a stable anaesthetic state the output voltage was decreased with 50 V intervals from 350 V to 200 V during a target propofol infusion aimed at a plasma steady-state concentration of 0.7 microg x ml(-1) and increased with 50 V intervals from 200 V to 450 V during a target propofol infusion aimed at a plasma steady-state concentration of 1.4 microg x ml(-1). TcMEPs were recorded from the right tibialis anterior muscle. RESULTS: Doubling the target propofol infusion to 1.4 microg x ml(-1) resulted in a 30-50% decrease in tcMEP amplitude. The largest tcMEP amplitude using the six-pulse paradigm was found during a propofol infusion aimed at a plasma concentration of 0.7 microg x ml(-1) and demanded a stimulus output of 350 V, corresponding to a charge density of 7.5 microC x cm(-2) per phase. CONCLUSION: Doubling the target propofol infusion to 1.4 microg x ml(-1) provides less robust, but still recordable tcMEPs in response to six-pulse electrical stimulation. Safety guidelines are discussed.     

The Relationship Between Cerebral Blood Flow Velocities and the Amount of Blood Clots in Computed Tomography After Subarachnoid Haemorrhage

127 patients with aneurysmal subarachnoid haemorrhage (SAH) were analyzed for the relationship between the amount of blood clots as detected by initial computed tomography (CT) up to 48 hours after SAH and changes of blood flow velocities as measured using transcranial Doppler ultrasonography (TCD). All patients were operated on within 72 hours after SAH. Patients who presented with remarkable brain oedema or with pathological intracranial pressure (ICP) due to mass effects of a haematoma, and who were in a poor neurological condition classified according to Hunt-Hess as grade V were excluded from this study. Serial TCD examination of the middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) started within 48 hours after SAH and were performed daily up to three weeks. A statistically significant correlation between blood load designated according to Fisher's grading as group CT I-CT IV and mean flow velocities (MFV) was found in groups CT I, II, and III. High values of MFV in MCA examinations were noted in patients with severe SAH (group CT III)--161 cm/s, and low values in patients without SAH (group CT I)--119 cm/s. Patients with haematocephalus and/or haematoma without a mass effect (group CT IV) had lower blood flow velocities than patients with severe SAH (group CT III) but values were higher than in patients without SAH (group CT I). The number of days for which MFV in the MCA was > 120 cm/s and was statistically (p < 0.05) correlated with the amount of blood clots as observed in the respective CT (in group CT I, II, and III). MFV values in the anterior cerebral artery (ACA) were lower than those obtained in the middle cerebral artery (MCA) in all groups. Statistically significant (p < 0.05) differences were noted between groups CT I and CT III (first and third week) and between groups CT I and CT IV (third week). If the SAH was extensive in the CT scan, pathological values of MFV > 90 cm/s were observed in ACA, and this was more pronounced in group CT III than in group CT IV. Blood flow velocities obtained via TCD were registered to compare side-to-side differences and particularly high differences were observed in patients with severe SAH. It is concluded that the amount of blood clots in the initial computed tomography after SAH is significantly correlated with cerebral blood flow velocity measurements by TCD.     

经颅多普勒探测深度与儿童头围的相关性研究

目的　研究经颅多普勒 (TCD)探测深度与儿童头围的相关性。方法　采用TCD对 5 88名健康儿童进行检测 ,同时测量头围 ,并观察两者间相关性。结果　各血管TCD探测深度均值与不同年龄组有显著差异 (P<0 .0 1) ,随头围增加而变。结论　各血管TCD探测深度均值与各年龄组儿童头围均值比较具有相关性和规律性 ,可供临床参考     

椎基底动脉缺血性脑梗死所致精神障碍的经颅多普勒和磁共振血管成像的对照研究

目的：探讨椎基底动脉缺血性脑梗死所致精神障碍的经颅多普勒和磁共振血管成像的特点，为椎基底动脉缺血性脑梗死所致精神障碍的诊断提供量化指标。方法：对20例经磁共振血管成像确诊为椎基底动脉缺血性脑梗死同时伴有精神障碍的患者做经颅多普勒检测，测量椎基底动脉的脑血流量。同时对20例正常人做经颅多普勒和磁共振血管成像的检测，同患者组进行对照。结果：对照组双侧椎动脉脑血流量为110．4～275．8mL／min（均值193．5），较患者组47．5～260．2mL／min（均值147．8）高（P〈0.01）。患者组双侧椎动脉广泛迂曲。椎动脉重、中、轻度狭窄或发育不良患者的脑血流量均值分别为117．0、137．8、152．3（mL／min）。三者健侧脑血流量占双侧脑血流量的百分比分别是90．2％、81．5％、67．2％。结论：通过经颅多普勒和磁共振血管成像可以测量脑血流量及椎动脉的狭窄和迂曲程度，是有助于诊断的一种量化指标。对提高诊断和研究病理形态学改变提供线索。     

椎动脉收缩期切迹对早期锁骨下动脉盗血综合征的诊断意义

目的：应用经颅多普勒超声（TCD）及束臂试验证实椎动脉收缩期切迹可提示早期锁骨下动脉盗血综合征（SSS）.方法：通过对椎动脉收缩期切迹组与无切迹组做束臂试验,比较束臂前后收缩期血流速度下降幅度及流速自下降至恢复的时间.结果：两组束臂前后椎动脉收缩期流速下降幅度及持续时间有显著差异（P＜0.01）.结论：椎动脉收缩期切迹是诊断早期SSS的敏感且可靠方法,能使更多的临床患者得到诊断.     

低频重复经颅磁刺激对尿毒症失眠患者的临床研究

【摘要】目的 研究重复经颅磁刺激（rTMS）对尿毒症失眠患者的疗效及静息态功能磁共振成像（rs fMRI）下大脑自发神经活动低频振幅（ALFF）的变化。方法 选取2015年3月~2016年6月在南充市中心医院血液净化中心进行维持性血液透析的尿毒症失眠患者31例,分为rTMS治疗组（n=21）与空白对照组（n=10）。rTMS治疗组接受rTMS治疗,在治疗前后采用匹兹堡睡眠质量指数量表（PSQI）、阿森斯失眠量表（AIS）进行评分及rs fMRI图像采集。空白对照组不接受rTMS治疗,不采集rs fMRI图像,其余与rTMS治疗组相同。对比分析rTMS治疗组治疗前后睡眠量表评分及低频振幅（ALFF）的差异。结果 rTMS组治疗15d后,与治疗前及空白对照组入组15d后相比,尿毒症失眠患者睡眠情况明显改善。rTMS组治疗前后ALFF值比较,差异有统计学意义（P＜005）,其中双侧眶额叶、双侧杏仁核、左侧海马、左侧前扣带回的ALFF值增高,双侧脑岛的ALFF值降低。结论 低频可rTMS通过影响大脑相关脑区神经活动强弱来治疗尿毒症患者的失眠,改善睡眠结构。     

无创神经脑刺激在儿童心理障碍治疗中的应用

无创神经脑刺激治疗儿童心理障碍是当下较为先进的物理治疗手段.本文着重介绍了无创神经脑刺激的两种代表技术-经颅磁刺激与经颅直流电刺激的工作原理,两者分别在儿童抑郁症、注意缺陷多动障碍与孤独症谱系障碍中的治疗应用,以及对无创神经脑刺激在儿童心理障碍治疗中存在的问题与未来的发展,其中人工智能的引用是其发展很具潜力的方向.     

经颅多普勒超声检查对蛛网膜下腔出血后脑血管痉挛的诊断价值

目的探讨经颅多普勒超声(TCD)检查对蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的诊断价值。方法应用TCD对30例SAH患者脑血流状况进行动态监测,并结合临床表现、头颅影像学资料进行分析。结果经TCD证实,本组17例(56.7%)发生CVS,其中10例无症状,7例出现CVS症状。头颅CTFisher分级中,Ⅲ、Ⅳ级SAH患者中CVS的发生率明显高于Ⅰ、Ⅱ级(均P<0.05)。结论TCD监测是早期发现SAH后CVS的一种敏感的检查手段。     

Causal role of the right temporoparietal junction in selfishness depends on the social partner

The right temporoparietal junction (rTPJ) is a hub of the mentalizing network, but its causal role in social decisions remains an area of active investigation. While prior studies using causal neurostimulation methods have confirmed the role of the rTPJ in mentalizing and strategic social interactions, most of the evidence for its role in resource-sharing decisions comes from correlational neuroimaging studies. Further, it remains unclear if the influence of the rTPJ on decisions about sharing resources depends on whether the other person is salient and identifiable. To clarify the causal role of the rTPJ in social decision making, we examined the effects of putatively inhibitory rTPJ transcranial magnetic stimulation (TMS) on Dictator Game behavior with one partner that was physically present and one that was only minimally identified. Under control conditions, participants tended to create more advantageous inequity toward the partner that was only minimally identified, selfishly keeping more resources themselves. rTPJ TMS reduced this differential treatment of the two partners. Clarifying prior mixed findings, results suggest that the rTPJ may play a role in differentiating between others when deciding how equitably to divide resources, but may not play a general role in reducing selfishness by promoting aversion to advantageous inequity.