腕踝针缓解赛前紧张综合征的随机对照研究

目的:评价腕踝针对赛前紧张综合征的缓解作用。方法:将60例赛前紧张综合征参赛者随机分为腕踝针组和假针刺组,脱落4例,每组均为28例。腕踝针组,针刺双侧上1区;假针刺组,选择相同的部位,而不刺入皮肤。赛前2 h开始干预治疗,留针30 min。治疗前后填竞赛状态焦虑量表、预期和治疗信任度问卷(Expectation and Treatment Credibility Scale,ETCS),观察评分变化,进行疗效评定。结果:1与治疗前相比,腕踝针组治疗30 min后CSAI-2各项组内比较,差异均有统计学意义(P0.05)。提示腕踝针能够缓解赛前紧张综合征,起效迅速。2腕踝针疗法缓解躯体状态焦虑优于假针刺组(P0.05)。3经治疗后,两组组间及腕踝针组各项组内ETCS评分比较差异均有统计学意义,提示参赛者经腕踝针治疗后对腕踝针疗法的信任度明显提高。结论:腕踝针治疗赛前紧张综合征起效快,疗效显著、安全可靠,无毒副作用,并且不影响运动员的药检。     

Variable flip angle schedules in bSSFP imaging of hyperpolarized noble gases

Balanced steady-state free precession imaging sequences provide signal-to-noise ratio benefits for MRI of hyperpolarized nuclei. Hyperpolarized magnetization decays during the imaging sequence to thermal equilibrium, effectively necessitating imaging in a transient state characterized by nonconstant transverse magnetization and k-space filtering when using constant flip angles. This work presents an analytical method for calculation of variable flip angle schedules which maintain constant transverse magnetization in balanced steady-state free precession imaging of hyperpolarized nuclei. The approach is based on direct inversion of the Bloch equations and does not require any numerical optimization. Input parameters are pulse sequence timings and effective relaxation times, which take diffusion of hyperpolarized gas in imaging gradients into account. Provision of constant transverse magnetization is demonstrated in phantom experiments and human lung imaging using hyperpolarized (3) He. The benefit of a flat k-space filter is demonstrated by reduced blurring in (3) He and digital phantom data, and high quality (3) He ventilation images from human lungs are obtained.     

Quantification of arterial cerebral blood volume using multiphase-balanced SSFP-based ASL

A new technique is introduced in this study for in vivo measurement of arterial cerebral blood volume by combining arterial spin labeling with a segmented multiphase balanced steady-state free precession (bSSFP) readout sequence. This technique takes advantage of the phenomenon that the longitudinal magnetization of flowing blood is not or only marginally disturbed (besides T(1) relaxation) by the bSSFP ± α pulse train. When the blood water exchanges into tissue, it becomes quickly saturated by the bSSFP pulse train due to 0 velocity and reduced T(1), T(2) relaxation times. Therefore, labeled blood water behaves like an intravascular contrast agent in multiphase bSSFP scans, and can be used to quantify arterial cerebral blood volume in a similar way as dynamic susceptibility contrast MRI. Both Bloch equation simulation and in vivo experiments were carried out to demonstrate the feasibility for quantifying cerebral blood volume in arteries, arterioles, and capillaries using two variants of the proposed method. Functional MRI of visual cortex stimulation was further performed using multiphase bSSFP-based arterial spin labeling and compared with vascular-space occupancy contrast. The proposed multiphase bSSFP-based arterial spin labeling technique may allow separation of cerebral blood volume of different vascular compartments for functional MRI studies and clinical evaluation of the cerebral vasculature.     

On the fluid-tissue contrast behavior of high-resolution steady-state sequences

In general, MR image contrast is expected to be resolution independent, but a pronounced loss of contrast is observed between fluids and tissues with contemporary musculoskeletal protocols (typical inplane resolution << 1 mm) using nonbalanced steady‐state free precession, such as double echo steady state. For nonbalanced steady‐state free precession, diffusion sensitivity increases with increasing spoiler moments which increase with decreasing voxel size, suggesting diffusion damping as the major cause for the observed contrast variation. This is confirmed by simulations and measurements indicating that for fluids, diffusion effects become apparent already for resolutions Δx < 1 mm, whereas tissues typically require Δx < 200 μm. Gradient spoiling, however, is generically not minimized but frequently applied along the readout direction. For anisotropic steady‐state free precession scans, the loss of contrast between fluids and tissues from diffusion can thus be minimized by simply moving the spoiler gradients to the lowest resolution direction. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.     

Fast diffusion‐weighted steady state free precession imaging of in vivo knee cartilage

Quantification of molecular diffusion with steady state free precession (SSFP) is complicated by the fact that diffusion effects accumulate over several repetition times (TR) leading to complex signal dependencies on transverse and longitudinal magnetization paths. This issue is commonly addressed by setting TR > T₂, yielding strong attenuation of all higher modes, except of the shortest ones. As a result, signal attenuation from diffusion becomes T₂ independent but signal‐to‐noise ratio (SNR) and sequence efficiency are remarkably poor. In this work, we present a new approach for fast in vivo steady state free precession diffusion‐weighted imaging of cartilage with TR << T₂ offering a considerable increase in signal‐to‐noise ratio and sequence efficiency. At a first glance, prominent coupling between magnetization paths seems to complicate quantification issues in this limit, however, it is observed that diffusion effects become rather T₂(ΔD ～ 1/10 ΔT₂) but not T₁ independent (ΔD ～ 1/2 ΔT₁) for low flip angles α ～ 10 ? 15°. As a result, fast high‐resolution (0.35 × 0.35 ? 0.50 × 0.50 mm² in‐plane resolution) quantitative diffusion‐weighted imaging of human articular cartilage is demonstrated at 3.0 T in a clinical setup using estimated T₁ and T₂ or a combination of measured T₁ and estimated T₂ values. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.     

帕金森静止性震颤脑局部一致性的功能磁共振研究

目的探讨静息状态下,帕金森静止性震颤患者的脑局部一致性。资料与方法在静息状态下,对9例左侧静止性震颤的帕金森病患者进行功能磁共振成像(functional magnetic resonance imaging,fMRI),分析其脑部局部一致性,并与健康对照组比较。结果与健康对照组相比,单侧静止性震颤的帕金森病患者表现为对侧的楔前叶、额下回、额中回、顶上小叶及同侧前扣带回等区域的局部一致性增强;小脑蚓部的局部一致性减弱。结论静息状态下,帕金森病静止性震颤患者的脑部局部一致性异常,为该病的研究提供了新依据。     

健脾清化方对CKD2～3期患者慢性微炎症状态的随机对照多中心研究

目的:研究健脾清化方对慢性肾脏疾病(CKD)2～3期脾虚湿热患者慢性微炎症状态的作用。方法:3个中心的随机对照临床研究,随机分成中药组和对照组,并设20例健康体检患者为正常组。对照组予西医常规治疗,中药组在对照组基础上加用健脾清化方。共随访8周,观察治疗前后血肌酐(Scr)、超敏C反应蛋白(hs-CRP)、白细胞介素-17(IL-17)、干扰素-γ(IFN-γ)的变化。结果:最终中药组有74例、对照组有73例完成研究。治疗前两组的hs-CRP、IL-17、IFN-γ比正常组显著升高(P<0.05)。8周的治疗后,中药组的Scr有显著下降(P<0.05)。中药组hs-CRP平均下降了26.4%(P<0.05),而对照组有上升的趋势。中药组IL-17平均下降了73.5%(P<0.05),对照组平均下降了25.6%。中药组IFN-γ平均下降了48.3%(P<0.05),而对照组平均下降了23.3%。结论:CKD2～3期的脾虚湿热患者存在慢性微炎症状态,健脾清化方能明显改善微炎症状态。     

意识与脑功能连接性:麻醉药物作用机制的研究进展

背景 功能连接性(整合),相对于解剖结构连接性,是指在耦联的神经系统中信号之间存在统计学上的依赖关系,近年来发现大脑不同区域之间的功能连接性与意识关系密切,而麻醉药物诱导意识丧失的机制很可能与功能连接性有关.目的 现从意识与大脑功能连接性角度对麻醉药物作用机制的研究进展作一综述.内容 静息态功能磁共振(resting state functional magnetic resonance imaging,rs-fMRI)在分析大脑功能连接性方面具有优势,多项研究应用rs-fMRI技术分析全身麻醉药物对脑区功能连接性的影响,提示麻醉药物的可能作用靶点为脑区功能连接性. 趋向 rs-fMRI技术的不断发展,为研究麻醉药物作用机制开辟了新的方向.     

2011年广州市越秀区部分公务员亚健康状况调查

[目的]了解广州市越秀区公务员亚健康罹患状况,为公务员亚健康的干预措施提供科学依据。[方法]2011年3～6月,在越秀区党校2011年上半学年各级培训班的干部学员中,抽取部分没有疾病的学员,采用亚健康自评表进行调查。[结果]调查1147人,处于总体亚健康者占71．57％,躯体亚健康罹患率为52．49％,心理型亚健康罹患率为34．00％,社会型亚健康罹患率为3．40％。总体亚健康罹患率在不同年龄、不同体重指数（BMI）、不同行政级别组的差异有统计学意义（P〈O．01）;躯体亚健康罹患率,男性高于女性,不同年龄、不同BMI组、不同婚姻状况、不同行政级别的差异均有统计学意义（P〈0．01）。调查对象亚健康自评总得分为216．88±29．47分,躯体亚健康得分为127．11±18．78分,心理亚健康得分为42．36±7．40分,社会亚健康得分为36．45±5．35分。亚健康自评总得分,女性低于男性（P〈O．01）;躯体亚健康得分,女性低于男性,不同年龄、不同婚姻状况、不同行政级别的差异均有统计学意义（P〈0．01或〈0．05）。[结论]越秀区公务员总体亚健康罹患率处于一般水平。亚健康表现以躯体亚健康为主,应重视对公务员群体开展健康教育,增强对亚健康危害的认识及知晓率。     

持续性植物状态患者脑深部电刺激疗法及护理

目的:评价脑深部及脊髓电刺激疗法治疗持续性植物状态患者的术前和术后护理的临床效果评估.方法:通过规范的术前术后护理提高手术的临床疗效.结果:规范的护理方法对提高脑深部及脊髓电刺激疗法治疗持续性植物状态具有重要的作用.结论:进行脑深部及脊髓电刺激疗法治疗持续性植物状态时,在术前、术后必须采取规范的护理辅助措施.