Cortical basis for skilled vocalization

Marmosets display remarkable vocal motor abilities. Macaques do not. What is it about the marmoset brain that enables its skill in the vocal domain? We examined the cortical control of a laryngeal muscle that is essential for vocalization in both species. We found that, in both monkeys, multiple premotor areas in the frontal lobe along with the primary motor cortex (M1) are major sources of disynaptic drive to laryngeal motoneurons. Two of the premotor areas, ventral area 6 (area 6V) and the supplementary motor area (SMA), are a substantially larger source of descending output in marmosets. We propose that the enhanced vocal motor skills of marmosets are due, in part, to the expansion of descending output from these premotor areas.

Speech is a uniquely human form of communication which uses vocalization to express thoughts and feelings. Vocalization is built on the exquisitely coordinated control over respiration, phonation, and articulation. Historically, the enhanced vocal motor skills of humans have been attributed to alterations in the peripheral mechanisms for sound production (1, 2). However, recent studies of laryngeal biomechanics have ruled out this explanation (3). Instead, modifications in central neural circuits are the likely basis of the enhanced vocal abilities of humans (1). Here, we used a comparative approach to identify the adaptations in the cerebral cortex that provide a substrate for the enhanced vocal motor abilities of some monkeys.Our experiments compared the areas of the cerebral cortex that are involved in the control of a laryngeal muscle in macaques and marmosets. We selected these two monkey species because of the striking differences in their vocal behavior. Macaque vocalization is generally limited to spontaneous utterances of acoustically simple calls which relate the animal’s emotional and motivational state (4). In the laboratory setting, it is difficult for researchers to elicit macaque vocalizations and for the monkeys to suppress spontaneous calls (5, 6). In contrast, marmosets readily vocalize in the laboratory setting. These monkeys naturally exhibit vocal turn taking with multiple back-and-forth exchanges that entrain to each other just as in human conversation (7–10). Marmosets can modulate the amplitude (11), timing (9, 11), and pitch (12) of their calls to compensate not only for physical noise but also for physical distance between conspecifics. Overall, marmosets demonstrate vocal skills and experience-dependent vocal production not observed in macaques (13–15).To identify areas of the cerebral cortex that are involved in vocalization, we used retrograde transneuronal transport of rabies virus from the cricothyroid muscle. We selected the cricothyroid because it is the laryngeal muscle that is most specifically related to vocal motor control. The cricothyroid is an intrinsic laryngeal muscle that when active increases tension on the vocal folds (4). This muscle is unique in controlling vocal pitch while contributing little to other laryngeal functions, such as swallowing and airway regulation (4).     

Arthroscopic Modified Double‐Row Biceps Tenodesis versus Labral Repair for the Treatment of Isolated Type II SLAP Lesions in Non‐Overhead Athletes

ObjectiveTo evaluate the postoperative efficacy and the clinical outcomes of arthroscopic modified double‐row biceps tenodesis versus labral repair.MethodsA retrospective study was conducted in 56 patients with isolated type II superior labrum anterior and posterior (SLAP) lesions from March 2015 to November 2018. Thirty patients (male:female = 17:13) were treated with labral repair, and 26 patients (male:female = 15:11) were treated with modified double‐row biceps tenodesis. The average age of the labral repair group and the modified double‐row biceps tenodesis group were 42.8 ± 10.6 and 40.9 ± 10.2 years, respectively. Pre‐ and postoperative assessments with the visual analog scale (VAS), University of California Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) scores were compared between the two treatment groups. Additional outcome measures included patient satisfaction, the time to return to previous activities, workers'' compensation status, and postoperative complications.ResultsAt a 2‐year follow‐up, the tenodesis group showed significant differences in postoperative VAS (1.5 to 1.8, respectively; p = 0.008), patient satisfaction (92.3% vs. 46.7%, p < 0.001), and recovery time to return to their previous activities (6.8 ± 1.8 vs. 8.1 ± 1.5, p = 0.007) compared to the labral repair group; however, there was no significant difference in postoperative ASES and UCLA scores between the two groups. Additionally, one patient in the tenodesis group developed persistent postoperative stiffness, which was resolved by conservative treatment. In the labral repair group, two patients presented with persistent postoperative night pain, three developed persistent postoperative stiffness, and two required a subsequent capsular release.ConclusionsCompared with the labral repair group, the arthroscopic modified double‐row biceps tenodesis showed more encouraging postoperative pain reduction, earlier recovery to previous activities, and higher patient satisfaction.     

单侧特发性声带麻痹神经电刺激治疗后即刻疗效初步观察

目的 探讨单侧特发性声带麻痹喉返神经/喉上神经电刺激治疗后即刻对主观声音改变、声学参数以及动态喉镜观察结果的影响.方法 选取诊断为单侧特发性声带麻痹的患者,回顾性收集其行喉肌电图检查并同期行神经电刺激治疗前后的动态喉镜及嗓音分析检查结果,分析检查及治疗前后主观声音改变,声学参数(jitter、shimmer、DSI、M...     

高速三角破片致猪坐骨神经损伤的特点

目的 探讨高速三角破片致猪坐骨神经损伤的伤情特点. 方法 长白猪14只,体重(34.3±5.2)kg.采用随机数字表法分为A、B两组各7只,用初速为(773.1±12.4)m/s的0.37 g三角破片致伤,分别瞄准猪右后肢外侧坐骨神经体表投影线中点和旁开2 cm射击.观察伤道入口和出口大小、长度,神经与伤道位置关系,伤后48 h观察神经大体及光电镜改变. 结果 破片在伤道内存在不同程度的偏离原射入方向.A、B组分别有5只和1只坐骨神经位于原发伤道内,其中4例出现不间程度断裂;光镜下见神经严重出血水肿、炎细胞浸润,大量神经纤维、轴索断裂,髓鞘着色浅;电镜下见髓鞘严重溃变、轴索变形.A、B组分别有1只和5只位于震荡区内,距原发伤道(2.07±0.45)cm,光镜见神经轻度出血、充血,部分神经纤维、轴索断裂;电镜下可见髓鞘部分分层.A、B组各有1只位于挫伤区内,神经受损程度介于二者之间. 结论 高速三角破片在组织内走行不稳定;其原发伤道内的猪坐骨神经断裂发牛率高,损伤严重,范围广,华勒变性早;位于原发伤道旁的神经亦发生形态学改变,其损害程度与神经和原发伤道距离有关.     

化疗解救上腔静脉压迫综合症的近期疗效观察

目的回顾性分析化疗治疗上腔静脉压迫综合症的近期疗效.方法32例上腔静脉压迫综合症在吸氧、抗炎、利尿、激素治疗的基础上,采用化疗解救,以CHOP方案治疗18例,紫杉醇 卡铂方案治疗11例,足叶乙甙 卡铂治疗3例.结果32例中淋巴瘤18例,占56.2%,肺癌14例,占43.8%,化疗后1周评价疗效有效率达93.8%(30/32),仅2例(6.2%)无效.结论对于上腔静脉压迫综合症无论是肺癌还是淋巴瘤,在基础治疗上首选化疗进行解救值得临床推广.     

肺癌致上腔静脉综合征病理学基础及CT表现

目的 探讨肺癌致上腔静脉综合征(superior vena cava syndrome,SVCS)病理学改变及相应CT表现类型.方法 回顾性分析川北医学院附属医院和四川大学华西医院2003年2月～2004年3月收治的经病理学确诊为肺癌致上腔静脉综合征51例患者的CT影像学资料.采用Sensation4螺旋CT. Sensation 16螺旋CT分别扫描13例、38例,均行胸部CT平扫及增强扫描,扫描层厚7～10 mm.结果 51例上腔静脉综合征患者中,上腔静脉(superior vena cava,SVC)梗阻性质属肺癌直接蔓延7例,SVC周围淋巴结转移17例,直接蔓延和淋巴结转移二者并存27例.梗阻形态CT表现为环状包埋11例,半环状包埋5例,夹心状包埋5例,推移10例,向左推压15例,完全闭塞5例.SVC梗阻性质不同,梗阻形态CT表现有差异;梗阻形态不同,梗阻程度有差异.结论 肺癌致SVCS的CT表现与SVC梗阻性质、梗阻程度有关.     

生长相关性癌基因-1在喉癌中的表达及其与CD34的相关性研究

目的探讨生长相关性癌基因-1（GRO-1）在喉癌组织中的表达及其与喉癌部分临床生物学特性的相关性。方法采用免疫组织化学染色方法检测48例喉癌组织中GRO-1和CD34的表达。结果免疫组织化学染色结果显示,GRO-1表达和CD34的表达与喉癌分期（早期与进展期）及淋巴结转移相关,染色度随喉鳞状细胞癌分期增高而增高并且有淋巴结转移的癌组织GRO-1染色度和CD34的表达,明显高于无淋巴结转移的喉癌组织（P〈0.01）;GRO-1表达和CD34的表达与喉癌分化程度无关（P〉0.05）;GRO-1与CD34在不同年龄和性别的表达均无统计学意义（均P〉0.05）。GRO-1和CD34的表达存在显著的正相关关系（r=0.722,P〈0.01）。结论GRO-1能够通过多种作用影响喉癌的发生、发展和转移,其中在微血管形成方面GRO-1的高表达可能在喉癌的发生发展中起重要作用。     

lncRNA DNM3OS在喉鳞状细胞癌组织和细胞中的表达及其临床和生物学意义

目的:检测lncRNA DNM3OS在喉鳞状细胞癌(laryngeal squamous cell carcinoma,LSCC)组织和LSCC细胞株中的表达及其临床意义,探讨其对LSCC TU177细胞体外增殖、迁移及侵袭的影响,并分析DNM3OS与EMT的关系.方法:从河北医科大学第四医院生物标本库选取2014年3...     

各向同性的3D T2 SPAIR SPACE序列在正常人肘部神经显像的应用

目的:观察磁共振3D T2 SPAIR (spectral adiabatic inversion recovery) SPACE序列在正常人肘部神经的显示情况,并观察其在不同人群中的显示差异?方法:在3.0 T MR下对64例正常人的2D FS-T2WI序列及3D T2 SPAIR SPACE序列平扫?对每个志愿者的3D T2 SPAIR SPACE序列的原始数据进行尺神经?正中神经及桡神经的曲面重建及最大密度投影重建,分别重建出矢状位及冠状位图像?分别统计3根神经的两种重建方法在上臂?肘关节及前臂的显示率?统计3根神经在2D FS-T2WI序列及3D T2 SPAIR SPACE序列上相对周围肌肉信号增高的比率? 结果:64例志愿者的尺神经?正中神经及桡神经在曲面重建上可以全部清晰显示?尺神经在上臂?肘关节及前臂的最大密度投影图像上的显示率分别为92%?83%?98%,正中神经在上臂?肘关节及前臂的最大密度投影图像上的显示率分别为81%?89%?80%,桡神经在上臂?肘关节的最大密度投影图像上的显示率分别为94%?95%?尺神经信号增高在2D FS-T2WI序列上为55%,而在3D T2 SPAIR SPACE序列上仅仅为30%?结论:3D T2 SPAIR SPACE序列对正常人的肘部神经显示效果好,对正常人尺神经信号增高显示更可靠?     

Endovascular stenting for nutcracker syndrome

Nutcracker syndrome (NCS) is a rare pathology manifested by pain or hematuria in males and females alike. It can be easily overlooked, and should be considered in young men or women with symptoms of extended duration. We present a case of a 54-year-old female with chronic lower abdominal pain radiating to the left thigh of 4 years in duration. Computed tomography (CT) eventually revealed engorged left renal, gonadal, and uterine veins due to compression between the superior mesenteric artery (SMA) and the abdominal aorta, consistent with NCS. After a successful endovascular stenting and a 6-month period of antiplatelet and anticoagulant therapy, the patient returned to stable health. NCS, while rare, should be suspected in patients of both sexes with persistent pain or hematuria.