Functional Imaging of Stroke Recovery: An Ecological Review from a Neural Network Perspective with an Emphasis on Motor Systems

Functional imaging is beginning to outline the brain's functional architecture and mechanisms of recovery from injury. I will review primarily the motor‐function literature from normal populations, learning trials, stroke recovery, and rehabilitation with a neural network approach that may prove fruitful in further advancing our understanding of brain plasticity in response to focal lesions. A key consideration in this review will be how the development of distributed motor networks might constrain recovery as a function of the altered connectivity between damaged and nondamaged areas. It will be argued that this connectivity is central to both recovery from injury and response to treatment.     

倍他乐克联合胺碘酮治疗快速房颤疗效观察

目的探讨倍他乐克联合胺碘酮治疗快速心房颤动（房颤）的临床效果。方法将快速房颤患者56例随机分为观察组和对照组,各28例。对照组给予地高辛治疗,观察组给予倍他乐克联合胺碘酮治疗。观察2组卧位心率、血压及复律时间,并比较2组疗效。结果观察组总有效率为96.43%高于对照组的71.43%,差异有统计学意义（P〈0.05）。观察组患者卧位心率、收缩压、舒张压及复律时间明显优于对照组,差异有统计学意义（P〈0.05）。2组均未见明显的药物不良反应。结论倍他乐克联合胺碘酮治疗快速房颤,复律成功率高,时间短,优于地高辛等常规药物治疗。     

Breaking the habit: a retrospective analysis of desistance factors among formerly problematic heroin users

Introduction and Aims . The aim of this study was to examine heroin careers among former users to assess desistance factors and explanations for sustained abstinence. Design and Methods . The study surveyed 107 former problematic heroin users who have achieved long‐term abstinence about their experiences of achieving and sustaining abstinence. The cohort was recruited opportunistically from three sources, drawing heavily on former users working in the addictions field. Results . On average, the group had heroin careers lasting for just under 10 years, punctuated by an average of 2.6 treatment episodes and 3.1 periods of abstinence, and had been heroin abstinent for an average of 10 years at the time of completing the survey. The most commonly expressed reason for finally achieving abstinence was ‘tired of the lifestyle followed by reasons relating to psychological health. In contrast, when asked to explain how abstinence was sustained, clients quoted both social network factors (moving away from drug‐using friends and support from non‐using friends) and practical factors (accommodation and employment) as well as religious or spiritual factors. Treatment was not mentioned widely either in achieving or sustaining abstinence, in contrast to 12‐Step, which was endorsed widely. Discussion and Conclusions . The study supports a careers perspective for examining heroin careers and indicates that, while achieving abstinence is possible for chronic opiate users, the path to sustained abstinence is complex and often reliant upon external support systems.     

111In-tropolonate labelled platelets; studies in normals and in patients with thrombocytopenia

Human platelets were labelled with aqueous ¹¹¹In-tropolonate in comparison with ¹¹¹In-oxinate. In normals the labelling efficiency with ¹¹¹In-tropolonate was higher (93%±2%) than with ¹¹¹In-oxinate (67%±8%) (P<0.05). In cases of severe thrombocytopenia, lower labelling efficiencies were obtained. In six normals a mean platelet life of 9 days ±3 days and an initial recovery of 59%±15% were obtained. In twelve patients with trombocytopenia the mean platelet life was 4 days±4 days and the initial recovery was 58%±20%. The absolute uptake of radioactivity in spleen and in liver in both groups are reported.     

Confirmation of high blood flow rates through 150 μ filter/high-flow tubing

Many new products designed to assist in rapid blood infusion are appearing. Some highly touted and routinely used devices for intravenous (IV) infusion have recently been shown to be, at least in part, defective. A tubing with an in-line 150 μ filter (150 μ High-Flow Blood Filter; Saftifllter^® Blood Administration Sets; Cutter Biological, Berkeley, CA 94710) has recently been introduced to facilitate rapid blood transfusion. It is claimed that at least 8.5 units of blood can be rapidly run through each set before replacement is necessary. To test this under simulated clinical conditions, four sets of ten random units of outdated erythrocytes at 4 to 9°C were each admixed with 250 mL 70°C 0.9 NaCl and infused through the system under a constant 300 mmHg pressure. Two sets infused through unmodified tubing flowed at an average of 25 mL/sec (1500 mL/min) before there was an appreciable slowing of the flow rate. Two sets with 8 Fr catheters attached infused at an average of 22 mL/sec (1320 mL/min) before there was an appreciable slowing of the flow rate. Even after the flow slowed, the 9th and 10th units infused at an average greater than 10 mL/sec (600 ml/min). The tubing/filter exceeded the manufacturer's published claims. This tubing/filter appears to be one element that could be an effective component of a high-flow infusion system.     

Rapid Action of Oestrogen in Luteinising Hormone-Releasing Hormone Neurones: The Role of GPR30

Previously, we have shown that 17β-oestradiol (E₂) induces an increase in firing activity and modifies the pattern of intracellular calcium ([Ca²⁺]_i) oscillations with a latency < 1 min in primate luteinising hormone-releasing hormone (LHRH) neurones. A recent study also indicates that E₂, the nuclear membrane impermeable oestrogen, oestrogen-dendrimer conjugate, and the plasma membrane impermeable oestrogen, E₂-BSA conjugate, all similarly stimulated LHRH release within 10 min of exposure in primate LHRH neurones, indicating that the rapid action of E₂ is caused by membrane signalling. The results from a series of studies further suggest that the rapid action of E₂ in primate LHRH neurones appears to be mediated by GPR30. Although the oestrogen receptor antagonist, ICI 182, 780, neither blocked the E₂-induced LHRH release nor the E₂-induced changes in [Ca²⁺]_i oscillations, E₂ application to cells treated with pertussis toxin failed to result in these changes in primate LHRH neurones. Moreover, knockdown of GPR30 in primate LHRH neurones by transfection with human small interference RNA for GPR30 completely abrogated the E₂-induced changes in [Ca²⁺]_i oscillations, whereas transfection with control siRNA did not. Finally, the GPR30 agonist, G1, resulted in changes in [Ca²⁺]_i oscillations similar to those observed with E₂. In this review, we discuss the possible role of G-protein coupled receptors in the rapid action of oestrogen in neuronal cells.     

精神分裂症病人及家属联合进行心理康复指导的研究

目的 探讨对住院精神分裂症病人及其家属进行早期心理康复指导的意义,寻求治疗精神分裂症的新途径.方法 将120例初发精神分裂症患者随机分为心理康复指导组(治疗组)和对照组(每组60例)进行对照研究.对治疗组患者及家属进行针对性的个别心理康复指导,每周1次,连续8w,病人出院后每月1次,连续6个月,并于出院第6、12个月时进行随访.分别于入院第1、8周末及出院第6、12个月时用N-BPRS评价病人病情严重程度;用SDSS评价病人出院1年后的各种社会功能缺陷情况并比较两组病人出院后第6、12个月时的复发情况.结果 心理康复指导组于出院第6个月时N-BPBS评分较第8周末明显降低(P<0.05).1年后两组间SDSS第1、5、6、9、10项及总分有显著或非常显著性差异;两组1年内复发率分别为27.08%和57.78%,心理康复指导组复发率明显低于对照组(P<0.01).结论 心理康复指导可以提高精神分裂症的治疗效果,有效地延缓精神分裂症复发,有利于病人保持和提高其社会功能,值得进一步深入研究.     

Fat suppression for 1H MRSI at 7T using spectrally selective adiabatic inversion recovery.

Proton magnetic resonance spectroscopic imaging ((1)H MRSI) at 7T offers many advantages, including increased SNR and spectral resolution. However, technical difficulties associated with operating at high fields, such as increased B(1) and B(0) inhomogeneity, severe chemical shift localization error, and converging T(1) values, make the suppression of the broad lipid peaks which can obscure targeted metabolite signals, particularly challenging. Conventional short tau inversion recovery can successfully suppress fat without restricting the selected volume, but only with significant metabolite signal loss. In this work, we have designed two new pulses for frequency-selective inversion recovery that achieve B(1)-insensitive fat suppression without degrading the signal from the major metabolites of interest. The first is a spectrally selective adiabatic pulse to be used in a volumetric (1)H MRSI sequence and the second is a spatial-spectral adiabatic pulse geared toward multi-slice (1)H MRSI. Partial interior volume selection may be used in addition to the pulses, to exclude areas with severe B(0) inhomogeneity. Some differences in the spectral profile as well as degree of suppression make each pulse valuable for different applications. 7T phantom and in vivo data show that both pulses significantly suppress fat, while leaving most of the metabolite signal intact.