脑卒中后手运动相关脑区正负网络连接的变化:一项静息态fMRI的研究

目的 探讨皮质下脑卒中后手运动相关脑区正负网络连接的变化及与运动功能障碍的关系.材料与方法 对18例单侧皮层下脑卒中患者和18名性别、年龄完全匹配的健康志愿者分别进行静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)检查.以左侧初级运动皮质(primary motor cortex,M1,对应病灶侧)内与手运动功能相关的区域为感兴趣区,基于体素水平的全脑功能连接方法 分析手运动相关的正网络和负网络;进一步基于感兴趣区水平的功能连接方法 分析正负网络内和网络间功能连接的变化;最后,将卒中患者异常的功能连接指标与上肢运动功能评分进行相关性分析.结果 卒中组与病灶侧M1功能连接显著大于对照组的脑区均在负网络内;而显著小于对照组的脑区均在正网络内;卒中组正负网络内和网络间的功能连接强度均显著降低;且病灶侧M1与负网络内同侧额中回的功能连接系数与上肢运动功能评分呈负相关(r=-0.735,P<0.01).结论 脑卒中后与手运动相关脑区的正负网络连接强度均下降.尤其是卒中组大于对照组的功能连接可能并非意味相关脑区的"功能代偿",而是反映了手运动相关脑区之间的负性功能连接降低,这将更有利于深入理解脑卒中神经作用机制并为康复干预提供参考价值.     

瞳孔直径和调节刺激对年轻人正视眼单色高阶波阵面像差的影响

目的 探讨不同瞳孔直径下,调节对年轻正视眼单色高阶波阵面像差的影响.方法 干预性试验研究设计.使用光线追踪原理的波阵面像差仪测量12只年轻正视眼自然生理状态,在4.0、3.0、2.0 mm瞳孔直径下,0.00、1.00、2.00、3.00和4.00 D调节刺激下的单色波阵面像差.采用单因素方差分析及最小显著差法多重比较,对获得的数据进行统计学分析.结果 调节松弛下正视眼的总高阶像差、总彗差、总高阶散光、总球差和总三叶草像差的均方根值均随瞳孔直径减小而减小.在4.0、3.0、2.0mm瞳孔直径下,总彗差是调节松弛状态总高阶像差的最主要成分;总高阶像差仅在调节刺激达4.00 D时升高(P<0.05).瞳孔直径4.0 mm时,随调节刺激增加,4阶球差出现从大到小、从正值向负值的变化,但在瞳孔直径为3.0和2.0 mm时,4阶球差始终为正值.3阶水平方向三叶草像差在4.0、3.0、2.0 mm瞳孔直径下均表现出从负值向正值变化的规律.结论 不同瞳孔直径不同调节刺激下,正视眼各项单色高阶波阵面像差发生了不同规律和方向的变化.高阶像差在调节过程变化的意义和对不同注视距离视觉处理过程的作用有待于进一步研究,波阵面像差的研究将从单纯的消除向优化方向发展.     

海德堡视网膜断层扫描仪测量黄斑厚度的 可重复性研究

目的对海德堡视网膜断层扫描仪（HRT）黄斑水肿分析软件（MEM）进行黄斑厚度测量的可重复性评价。方法对62名正常人（9～68岁）用HRT-Ⅱ黄斑程序进行检查，对黄斑部视网膜信号宽度、中心凹视网膜信号宽度和黄斑水肿指数进行均数分析、t 检验和相关分析，对个体内重复测量的变异性采用变异系数、95%耐受限（TC）、类内相关系数（ICC）进行研究。结果正常人的黄斑部视网膜信号宽度为（0.734±0.236） mm，中心凹视网膜信号宽度为（0.781±0.243）mm，平均水肿指数E=（1.169±0.619）。各参数的重复测量变异系数分别为：视网膜信号宽度（8.7±6.8）%，中心凹视网膜信号宽度（8.5±6.7）%, 平均水肿指数（15.6±13.9）%；个体内连续重复测量发生改变的95%TC分别为，视网膜信号宽度0.131（8.9%）；中心凹信号宽度0.137（10.5%）；平均水肿指数0.198（7.4%）。同一操作者对同一个体进行多次重复测量的ICC分别为：黄斑区视网膜信号宽度0.950；中心凹信号宽度0.949；平均水肿指数0.898。结论海德堡视网膜断层扫描仪MEM软件，具有无创、快速、可重复性较好等特点，为视网膜厚度相关的黄斑疾病的客观定量监测提供了一种新的手段。(中华眼底病杂志,2005,21:103-105)     

基于健康人皮质脊髓束模板分析脑卒中皮质脊髓束损伤

目的运用磁共振扩散张量成像(diffusion tensor imaging,DTI)探究脑卒中皮质脊髓束(corticospinal tract,CST)扩散定量指标与运动功能的关系.材料与方法采集37例单侧皮质下脑卒中患者和30例健康被试的DTI数据,运用概率性纤维束成像追踪出健康被试的CST,获得健康对照组CST...     

太极拳学习过程中的静息态脑功能活动局部一致性研究

目的 运用静息态功能磁共振成像(resting-state function magnetic resonance imaging,rs-fMRI)探究太极拳零基础者在太极拳不同学习阶段的脑功能活动的局部一致性(regional homogeneity,ReHo)变化.材料与方法 采用被试内设计,对18名太极拳零基础被...     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

阴道内镜技术在宫腔镜检查中的临床应用研究北大核心CSCD

目的评价阴道内镜技术应用于门诊宫腔镜检查中的可行性、优势和局限性。方法 2015年5月至10月对北京天坛医院行宫腔镜检查的患者,不使用任何麻醉和镇痛,采用阴道内镜技术进行宫腔镜检查,计算其成功率、患者的视觉模拟量表(VAS)疼痛评分、失败原因分析、失败人群构成分析(年龄、孕产次、分娩方式、绝经、痛经),以寻找阴道内镜的适合人群。结果 103例患者进行阴道内镜检查,成功率72.82%,VAS评分的中位数为2,失败的主要原因是宫腔镜不能通过宫颈内口,使用Logistic回归分析年龄、剖宫产史、绝经状态、痛经、阴道分娩史、阴道分娩次数与阴道内镜的成功率均无相关性。结论阴道内镜技术进行宫腔镜检查具有较高的成功率,减轻了患者的疼痛,适用人群广泛,可作为门诊宫腔镜检查的操作方式之一。