微波双极射频治疗过敏性鼻炎临床疗效观察

目的 探讨微波双极射频下鼻甲和鼻丘黏膜消融，对治疗过敏性鼻炎的临床效果。方法 和微波双极射频，对78例过敏性鼻炎患者，进行下鼻甲和鼻丘黏膜下消融治疗。手术当天和术后5个月，用VAS评分法对过敏性鼻炎的四个主要症状：鼻塞、鼻痒、喷嚏、流涕进行评分，比较手术前后的分值变化，确定其疗效。分值降低5以上为显效，降低3以上为有效。结果 术后5个月，鼻塞、鼻痒、喷嚏、流涕的VAS分值均降低3以上，近期疗效100％，显效为83％；鼻腔无粘连，下鼻甲滑、红润、体积缩小、无萎缩。27例随访3年，5例（18％）未复发，为临床痊愈。结论 下鼻甲、鼻丘黏膜下微波双极射频消融术，是治疗过敏性鼻炎安全、有效、简便的方法之一。     

CD33单克隆抗体GO在白血病治疗中的应用

CD33抗原大量表达于急性髓细胞白血病（AML）细胞表面，但在其它类型的急性白血病中也有表达，可成为靶向免疫治疗的目标。GO（Gemtuzumab ozogamicin）是人源化抗CD33单克隆抗体与强效抗肿瘤抗生素-乙酰刺胞霉素偶联物，与白血病细胞表面CD33抗原结合，进入细胞后释放刺胞霉素，对白血病细胞有明显的杀灭作用，从而单独或联合其它化疗药物治疗白血病。GO的耐受性一般较好，但肝脏毒性及肝静脉阻塞综合症等毒副作用值得关注。     

Amphetamine disrupts successive but not simultaneous visual discrimination in the monkey

Three adolescent marmosets were trained on simultaneous and successive versions of a red-white visual discrimination task. The effects of doses of 0.2–1.2 mg/kg d-amphetamine on the performance of these tasks were assessed using a balanced design. It was found that while there was no drug effect on performance of the simultaneous task, amphetamine exerted a dose dependent disruptive effect on the successive version of the task. It is argued that amphetamine disrupts response control rather than discriminative ability and, in this respect, resembles the effect of orbitofrontal and limbic lesions in contrast to other neocortical lesions.     

Cognitive deficits and rehabilitation mechanisms in mild traumatic brain injury patients revealed by EEG connectivity markers

ObjectiveTo explore the multiple specific biomarkers and cognitive compensatory mechanisms of mild traumatic brain injury (mTBI) patients at recovery stage.MethodsThe experiment was performed in two sections. In Section I, using event-related potential, event-related oscillation and spatial phase-synchronization, we explored neural dynamics in 24 volunteered healthy controls (HC) and 38 patients at least 6 months post-mTBI (19 with epidural hematoma, EDH; 19 with subdural hematoma, SDH) during a Go/NoGo task. In Section II, according to the neuropsychological scales, patients were divided into sub-groups to assess these electroencephalography (EEG) indicators in identifying different rehabilitation outcomes of mTBI.ResultsIn Section I, mean amplitudes of NoGo-P3 and P3d were decreased in mTBI patients relative to HC, and NoGo-theta power in the non-injured hemisphere was decreased in SDH patients only. In Section II, patients with chronic neuropsychological defects exhibited more serious impairments of intra-hemispheric connectivity, whereas inter-hemispheric centro-parietal and frontal connectivity were enhanced in response to lesions.ConclusionsEEG distinguished mTBI patients from healthy controls, and estimated different rehabilitation outcomes of mTBI. The centro-parietal and frontal connectivity are the main compensatory mechanism for the recovery of mTBI patients.SignificanceEEG measurements and network connectivity can track recovery process and mechanism of mTBI.     

Caloric Vestibular Stimulation Modulates Affective Control and Mood

BackgroundClinical evidence suggests a link between vestibular dysfunctions and mood disorders. No study has yet investigated mood and affective control during vestibular stimulation in healthy participants.ObjectiveWe predicted a modulating effect of caloric vestibular stimulation (CVS) on affective control measured in an affective Go/NoGo task (AGN).MethodsThirty-two participants performed an AGN task while they were exposed to cold left or right ear CVS (20 °C) and sham stimulation (37 °C). In each block, either positive or negative pictures (taken from the International Affective Picture System) were defined as targets. Participants had to respond to targets (Go), and withhold responses to distractors (NoGo).ResultsThe sensitivity index d′ (hits – false alarms) was used to measure affective control. Affective control improved during right ear CVS when viewing positive stimuli (P = .005), but decreased during left ear CVS when compared to sham stimulation (P = .009). CVS had a similar effect on positive mood ratings (Positive and Negative Affect Schedule). Positive mood ratings decreased during left ear CVS when compared to sham stimulation, but there was no effect after right ear CVS.DiscussionThe results suggest that CVS, depending on side of stimulation, has a modulating effect on mood and affective control. The results complement previous findings in manic patients and provide new evidence for the clinical potential of CVS.     

Type 1 diabetes,cognition and the neurologist: Exploring Go/No-Go and Maze tasks in the search for a practical screening tool

AimsThe objectives were to use inexpensive and easy-to-apply tasks in order to investigate the differences between type 1 diabetes mellitus (T1DM) patients and controls regarding attention and impulsivity, which are the basis for key-executive function components that are traditionally assessed using subjective, long and difficult to reproduce questionnaires. Additionally, we sought to correlate these differences with clinical characteristics, and to explore correlations between the tasks.MethodsWe compared the scores of 20 T1DM patients with 20 controls. The sample population included both males and females, aged 12–15 years. They were tested using a Go/No-Go paradigm and a Maze task, and correlations were verified between the groups.ResultsThe T1DM group had more anticipatory answers (AA) in the Go/No-Go task (p <0.05), and made more direction changes in Mazes (p<0.01). There was a correlation between non-severe hypoglycemia and AA (p=0.01), as well as between severe hypoglycemia and the number of touches in Mazes’ walls (p<0.05). Glycated hemoglobin (HbA1c)>9% correlated with a greater number of alleys in Mazes (p<0.05). The tasks’ parameters were coherent among each test, and also between them.ConclusionsWe found indicators of inattention and impulsivity to be associated with T1DM, with inattention being closely related with hyperglycemia, and impulsivity being associated with hypoglycemia. Further research is needed to study diabetes-associated cognitive decline with more objective parameters, and to analyse the reliability and psychometric properties of the tasks proposed in this study.     

Cognition and resting-state functional connectivity in schizophrenia

Individuals with schizophrenia consistently display deficits in a multitude of cognitive domains, but the neurobiological source of these cognitive impairments remains unclear. By analyzing the functional connectivity of resting-state functional magnetic resonance imaging (rs-fcMRI) data in clinical populations like schizophrenia, research groups have begun elucidating abnormalities in the intrinsic communication between specific brain regions, and assessing relationships between these abnormalities and cognitive performance in schizophrenia. Here we review studies that have reported analysis of these brain–behavior relationships. Through this systematic review we found that patients with schizophrenia display abnormalities within and between regions comprising (1) the cortico-cerebellar-striatal-thalamic loop and (2) task-positive and task-negative cortical networks. Importantly, we did not observe unique relationships between specific functional connectivity abnormalities and distinct cognitive domains, suggesting that the observed functional systems may underlie mechanisms that are shared across cognitive abilities, the disturbance of which could contribute to the “generalized” cognitive deficit found in schizophrenia. We also note several areas of methodological change that we believe will strengthen this literature.     

Activity-Based Therapy for Recovery of Walking in Chronic Spinal Cord Injury: Results From a Secondary Analysis to Determine Responsiveness to Therapy

ObjectiveTo gain insight into who is likely to benefit from activity-based therapy (ABT), as assessed by secondary analysis of data obtained from a clinical trial.DesignSecondary analysis of results from a randomized controlled trial with delayed treatment design.SettingOutpatient program in a private, nonprofit rehabilitation hospital.ParticipantsVolunteer sample of adults (N=38; 27 men; 11 women; age, 22–63y) with chronic (≥12mo postinjury), motor-incomplete (American Spinal Injury Association [ASIA] Impairment Scale [AIS] grade C or D) spinal cord injury (SCI).InterventionsA total of 9h/wk of ABT for 24 weeks including developmental sequencing; resistance training; repetitive, patterned motor activity; and task-specific locomotor training. Algorithms were used to guide group allocation, functional electrical stimulation utilization, and locomotor training progression.Main Outcome MeasuresWalking speed and endurance (10-meter walk test and 6-minute walk test) and functional ambulation (timed Up and Go test).ResultsThis secondary analysis identified likely responders to ABT on the basis of injury characteristics: AIS classification, time since injury, and initial walking ability. Training effects were the most clinically significant in AIS grade D participants with injuries <3 years in duration. This information, along with information about preliminary responsiveness to therapy (gains after 12wk), can help predict the degree of recovery likely from participation in an ABT program.ConclusionsABT has the potential to promote neurologic recovery and enhance walking ability in individuals with chronic, motor-incomplete SCI. However, not everyone with goals of walking recovery will benefit. Individuals with SCI should be advised of the time, effort, and resources required to undertake ABT. Practitioners are encouraged to use the findings from this trial to assist prospective participants in establishing realistic expectations for recovery.     

Neurophysiological correlates of alcohol-specific inhibition in alcohol use disorder and its association with craving and relapse

ObjectiveThis study investigates neurophysiological correlates of general and alcohol-specific inhibitory control in patients with Alcohol Use Disorder (AUD), focusing on its association with individual craving levels and with relapse at three-month follow-up.Methods59 abstinent AUD patients and 20 healthy controls performed a Go/NoGo task incorporating alcohol-related and neutral stimuli during 64-channel electroencephalography (EEG) recording, yielding four event-related potentials (ERP) per participant (NoGo-Alcohol, Go-Alcohol, NoGo-Neutral, Go-Neutral). Whole-scalp randomization-based statistics assessed effects of the factors group (patients/controls or relapsers/abstainers), craving level, response type (NoGo/Go) and picture type (alcohol/neutral) on topography and signal strength of the ERP components N2 and P3.ResultsNo differences on group level were observed between patients and controls. However, analyses incorporating individual craving indicated that the topographic difference between alcohol-related and neutral NoGo-N2 components increased with craving. Moreover, topographic differences in the alcohol-related and neutral NoGo-P3 component allowed for differentiation between relapsers and abstainers.ConclusionsIn alcohol-related contexts, the response inhibition conflict reflected in the NoGo-N2 seems enhanced in patients with high craving. The inhibition-sensitive NoGo-P3 varies in relapsers but not in abstainers between neutral and alcohol-related contexts.SignificanceIn AUD patients, neurophysiological correlates of inhibition vary with alcohol-related contexts and craving, and might be indicative of relapse risk.     

The effects of inhibitory control training on alcohol consumption,implicit alcohol-related cognitions and brain electrical activity

This study aimed to replicate findings that alcohol consumption and positive implicit beer-related cognitions can be reduced using inhibitory control (IC) training, with the addition of an active training control. Frontal EEG asymmetry, an objective psychophysiological index of approach motivation, was used as a dependent measure to examine training outcomes. Participants were randomly assigned to one of two IC training conditions (Beer NoGo or Beer Go) or a Brief Alcohol Intervention (BAI) (i.e. the active training control). The IC training tasks consistently paired a stimulus that required a response with images of water (Beer NoGo) or images of beer (Beer Go). Alcohol consumption and implicit beer-related cognitions were measured at pre-training, post-training and at one week follow-up. Frontal EEG asymmetry was recorded during a passive image viewing task that presented neutral, healthy, and beer stimuli — at pre-training, post-training and follow-up. Participants in the Beer NoGo and BAI conditions consumed less beer in a taste test immediately after training than Beer Go participants, suggesting that IC training may be as effective as the already established BAI. The taste test findings were in line with the frontal EEG asymmetry data, which indicated that approach motivation for beer stimuli was altered in the expected directions. However, the positive correlation between post-training frontal EEG asymmetry data and taste test consumption was not significant. While there were no significant changes in implicit beer-related cognitions following training, a trending positive relationship between implicit beer-related cognitions at post-training and taste test consumption was reported. Further exploration addressing the limitations of the current study is required in order to clarify the implications of these findings.