胎儿头面部异常的临床咨询

胎儿头面部异常，是较为常见的结构异常。文章就常见的胎儿头面异常，包括唇腭裂、小颌畸形、耳郭畸形、巨舌症、眼畸形、颈项透明层增厚和颈部淋巴水囊瘤的分型与发生率、影像学诊断、病因、临床处理及预后分别进行论述，为临床决策和咨询提供参考。       

How the human brain exchanges information across sensory modalities to recognize other people

Recognizing the identity of other individuals across different sensory modalities is critical for successful social interaction. In the human brain, face‐ and voice‐sensitive areas are separate, but structurally connected. What kind of information is exchanged between these specialized areas during cross‐modal recognition of other individuals is currently unclear. For faces, specific areas are sensitive to identity and to physical properties. It is an open question whether voices activate representations of face identity or physical facial properties in these areas. To address this question, we used functional magnetic resonance imaging in humans and a voice‐face priming design. In this design, familiar voices were followed by morphed faces that matched or mismatched with respect to identity or physical properties. The results showed that responses in face‐sensitive regions were modulated when face identity or physical properties did not match to the preceding voice. The strength of this mismatch signal depended on the level of certainty the participant had about the voice identity. This suggests that both identity and physical property information was provided by the voice to face areas. The activity and connectivity profiles differed between face‐sensitive areas: (i) the occipital face area seemed to receive information about both physical properties and identity, (ii) the fusiform face area seemed to receive identity, and (iii) the anterior temporal lobe seemed to receive predominantly identity information from the voice. We interpret these results within a prediction coding scheme in which both identity and physical property information is used across sensory modalities to recognize individuals. Hum Brain Mapp, 36:324–339, 2015. © 2014 Wiley Periodicals, Inc .     

Object recognition in acquired and developmental prosopagnosia

Whether face and object recognition are dissociated in prosopagnosia continues to be debated: a recent review highlighted deficiencies in prior studies regarding the evidence for such a dissociation. Our goal was to study cohorts with acquired and developmental prosopagnosia with a complementary battery of tests of object recognition that address prior limitations, as well as evaluating for residual effects of object expertise. We studied 15 subjects with acquired and 12 subjects with developmental prosopagnosia on three tests: the Old/New Tests, the Cambridge Bicycle Memory Test, and the Expertise-adjusted Test of Car Recognition. Most subjects with developmental prosopagnosia were normal on the Old/New Tests: for acquired prosopagnosia, subjects with occipitotemporal lesions often showed impairments while those with anterior temporal lesions did not. Ten subjects showed a putative classical dissociation between the Cambridge Face and Bicycle Memory Tests, seven of whom had normal reaction times. Both developmental and acquired groups showed reduced car recognition on the expertise-adjusted test, though residual effects of expertise were still evident. Two subjects with developmental prosopagnosia met criteria for normal object recognition across all tests. We conclude that strong evidence for intact object recognition can be found in a few subjects but the majority show deficits, particularly those with the acquired form. Both acquired and developmental forms show residual but reduced object expertise effects.     

People with chronic facial pain perform worse than controls at a facial emotion recognition task,but it is not all about the emotion

Alexithymia, or a lack of emotional awareness, is prevalent in some chronic pain conditions and has been linked to poor recognition of others' emotions. Recognising others' emotions from their facial expression involves both emotional and motor processing, but the possible contribution of motor disruption has not been considered. It is possible that poor performance on emotional recognition tasks could reflect problems with emotional processing, motor processing or both. We hypothesised that people with chronic facial pain would be less accurate in recognising others' emotions from facial expressions, would be less accurate in a motor imagery task involving the face, and that performance on both tasks would be positively related. A convenience sample of 19 people (15 females) with chronic facial pain and 19 gender‐matched controls participated. They undertook two tasks; in the first task, they identified the facial emotion presented in a photograph. In the second, they identified whether the person in the image had a facial feature pointed towards their left or right side, a well‐recognised paradigm to induce implicit motor imagery. People with chronic facial pain performed worse than controls at both tasks (Facially Expressed Emotion Labelling (FEEL) task P < 0·001; left/right judgment task P < 0·001). Participants who were more accurate at one task were also more accurate at the other, regardless of group (P < 0·001, r² = 0·523). Participants with chronic facial pain were worse than controls at both the FEEL emotion recognition task and the left/right facial expression task and performance covaried within participants. We propose that disrupted motor processing may underpin or at least contribute to the difficulty that facial pain patients have in emotion recognition and that further research that tests this proposal is warranted.     

Congenital infiltrating lipomatosis of the face with lingual mucosal neuromas associated with a PIK3CA mutation

We report the case of a 5-year-old girl with congenital right-sided facial hemihypertrophy and right hemi-macroglossia with lingual mucosal neuromas. The segmental presentation of findings suggested the diagnosis of congenital infiltrating lipomatosis of the face (CILF), which belongs within the PIK3CA-related overgrowth spectrum (PROS). This was confirmed by genetic analysis showing a mosaic mutation in PIK3CA H1047R. CILF/PROS should be considered in the differential diagnosis of mucosal neuromas.     

新型冠状病毒肺炎疫情期间发热门诊的护理管理

新型冠状病毒肺炎疫情防控期间,发热门诊作为疾病诊治的重点部门,其防护工作是保障医护人员安全工作的重中之重,防护用品的使用、诊治流程以及呼吸机操作等环节的护理管理均要严格规范化、科学化。     

头面部血管肉瘤1例

患者男,80岁。头面部出现簇集血疱样皮疹40d。皮损组织病理:可见不规则的血管腔,管腔由内皮细胞排列而成,内皮细胞异型性。免疫组化检查:CD31,CD34,Vimetin(+)。诊断:头面部血管肉瘤。