在高质量证据支持下,运动疗法目前被认为是膝骨关节炎(OA)的主要干预措施。这项研究评估了几种辅助治疗方法治疗膝骨关节炎的疗效。这项前瞻性、双盲、随机对照试验纳入了100名年龄在40至80岁之间的膝骨关节炎患者。受试者分为五组:运...在高质量证据支持下,运动疗法目前被认为是膝骨关节炎(OA)的主要干预措施。这项研究评估了几种辅助治疗方法治疗膝骨关节炎的疗效。这项前瞻性、双盲、随机对照试验纳入了100名年龄在40至80岁之间的膝骨关节炎患者。受试者分为五组:运动训练组、运动训练联合安慰剂组、运动训练联合干扰电疗法(interferential current therapy,ICT)组、运动训练联合短波透热疗法(shortwave diathermy therapy,SDT)组和运动训练联合光生物调节疗法(photobiomodulation,PHOTO)组。以最大无痛强度的70%进行重复训练,每次90min,每周3次,共8周。展开更多
目的通过多中心临床研究,探讨新型神经电生理监测协议指导下微创入路选择性神经后根离断术(single-level laminectomy selective dorsal rhizotomy,SL-SDR)联合康复治疗对于痉挛型脑瘫儿童的近期疗效。方法回顾性分析上海市儿童医院、...目的通过多中心临床研究,探讨新型神经电生理监测协议指导下微创入路选择性神经后根离断术(single-level laminectomy selective dorsal rhizotomy,SL-SDR)联合康复治疗对于痉挛型脑瘫儿童的近期疗效。方法回顾性分析上海市儿童医院、重庆医科大学附属儿童医院及湖南省儿童医院等于2015年11月至2021年8月期间收治的所有在新型神经电生理监测协议指导下行SL-SDR联合康复治疗,并获得至少6个月随访的痉挛型脑瘫患儿临床资料。收集患儿手术前及手术后末次随访时目标肌群肌张力、肌力、关节活动度、粗大运动功能分级系统(gross motor function classification system,GMFCS)分级及粗大运动功能66项(gross motor function measure-66 items,GMFM-66)评分情况,并评估患儿手术后运动功能变化。结果共有435例符合入组标准的痉挛型脑瘫患儿纳入研究,其中男249例,女186例;手术年龄(8.2±2.3)岁(3.2~15.5岁)。术前标记目标肌群2523组,受累关节2133个。术中离断神经后根(小根)数为(9.3±3.8)枚/例,其中3849枚(3849/4059,94.8%)符合离断50%神经截面积的标准。术后83例(83/435,19.1%)出现短期下肢浅感觉异常,经对症治疗1周后症状缓解,无一例出现长期并发症。患儿均获随访,随访时间(13.1±8.3)个月,目标肌群肌张力、肌力、关节活动度、GFMCS分级及GMFM-66评分均显著改善;术前GMFCS分级为Ⅱ、Ⅲ级者术后粗大运动功能改善情况优于Ⅳ、Ⅴ级者(134/309比8/105,P<0.01);术前GMFM-66评分≥50分者术后GMFM-66评分提升值高于术前CMFM-66评分<50分者[(7.65±3.39)分比(5.01±2.18)分,P<0.01];手术时年龄小于6岁者术后GMFCS分级改善情况好于年龄大于6岁者(106/249比36/165,P<0.01);术后GMFCS分级获改善患儿的平均年龄小于术后GMFCS分级无改善患儿的平均年龄[(6.1±1.0)岁比(11.6±1.7)岁,P<0.01]。结论新型神经电生理监测协议指导下SL-SDR联合康复治疗肢体痉挛瘫痪型脑瘫安全、有效,术后近期预后良好。展开更多
目的研制局部给药跨室壁氯化钾单相动作电位(MAP)记录电极(KC lMAP电极),探讨模拟在体犬交感神经不均一的致心律失常机制。方法由5F动脉鞘管和0.2 mm的绝缘银丝,组构成3对MAP记录电极,鞘芯腔内注入含30%氯化钾琼脂糖凝胶即制成KC lMAP...目的研制局部给药跨室壁氯化钾单相动作电位(MAP)记录电极(KC lMAP电极),探讨模拟在体犬交感神经不均一的致心律失常机制。方法由5F动脉鞘管和0.2 mm的绝缘银丝,组构成3对MAP记录电极,鞘芯腔内注入含30%氯化钾琼脂糖凝胶即制成KC lMAP电极。用自制的电极记录犬左室前壁跨室壁MAP,观察局部异丙肾上腺素对三层心肌细胞动作电位时程(APD)及跨室壁复极离散度(TDR)的影响和心律失常的诱发情况。结果KC lMAP电极能稳定记录三层心肌MAP 120 m in以上,随时间的延长动作电位振幅逐渐降低但不影响复极特性的分析;局部给予异丙肾上腺素(10-5mg/m l)能显著降低中层心肌细胞的APD90(236.9±3.8 m s vs 226.3±3.0 m s)和TDR(35.7±4.8 m s vs 24.9±3.9 m s),中层心肌细胞易于诱发早期后除极及触发活动并引起室性心律失常。结论KC lMAP电极可理想地用于跨室壁心肌复极特性的研究;异丙肾上腺素降低正常犬的TDR,其诱发室性心律失常的机制与后除极和触发活动有关。展开更多
Purpose: To evaluate (with three different electrophysiological methods) the r esidual retinal function in a selected group of patients with retinitis pigmento sa and remaining small central visual fields. Methods: Fo...Purpose: To evaluate (with three different electrophysiological methods) the r esidual retinal function in a selected group of patients with retinitis pigmento sa and remaining small central visual fields. Methods: Fourteen patients from se veral different genetic subgroups, who had been followed with visual acuity and visual field testing for periods up to 32 years, were examined. Ophthalmological examination included full-field electroretinography (ERG), multifocal electror etinography (mfERG) and multifocal visual evoked potential (mfVEP). Results: The ERGs were severely reduced in all patients. The mfERGs demonstrated the residua l central retinal function in five of the patients. The mfVEPs showed measurable amplitudes centrally in most of the patients. The follow-up examinations demon strated the slowly progressive course of the disease with preservation or only s light further loss of visual fields over a period of 7-32 years. Conclusion: Pa tients with retinitis pigmentosa may not always follow the typical natural cours e with progressive loss of visual fields, which may in some patients remain unaf fected over several decades. Multifocal ERG and mfVEP may be clinically useful f or evaluating remaining visual function in these patients.展开更多
Objective: To investigate the origin, whether ocular or extraocular, of the short latency frontal potential (N15) reported by Todd et al. (2003) following vestibular stimulation. Methods: Fourteen subjects with low VE...Objective: To investigate the origin, whether ocular or extraocular, of the short latency frontal potential (N15) reported by Todd et al. (2003) following vestibular stimulation. Methods: Fourteen subjects with low VEMP thresholds (VT) and 9 patients with vestibular or ocular disorders were stimulated at the mastoid with bone-conducted tone bursts (500 Hz, 8 ms) above vestibular threshold, using a B71 bone vibrator. Surface potentials were recorded from Fpz and around the eyes and referred to linked earlobes. Results: The N15 was present at Fpz,but was largest around the eyes (mean amplitude 2.6 μV, peak latency 13.4 ms, with stimulation at +18 dB above threshold) and was generally in phase above and below the eyes. The response was vestibular-dependent and modulated by alteration of gaze direction. The potentials were delayed in a patient with Miller Fisher syndrome and were larger in patients with superior canal dehiscence than in controls. Conclusions: We report a new vestibular-evoked extraocular potential. Its properties are not consistent with an eye movement. It is likely to be produced, mainly or exclusively, by synchronous activity in extraocular muscles (i.e. a myogenic potential). Significance: Vestibularevoked extraocular potentials extend the range of vestibular pathways that can be assessed electrophysiologically, and may be a useful additional test of vestibular function.展开更多
文摘在高质量证据支持下,运动疗法目前被认为是膝骨关节炎(OA)的主要干预措施。这项研究评估了几种辅助治疗方法治疗膝骨关节炎的疗效。这项前瞻性、双盲、随机对照试验纳入了100名年龄在40至80岁之间的膝骨关节炎患者。受试者分为五组:运动训练组、运动训练联合安慰剂组、运动训练联合干扰电疗法(interferential current therapy,ICT)组、运动训练联合短波透热疗法(shortwave diathermy therapy,SDT)组和运动训练联合光生物调节疗法(photobiomodulation,PHOTO)组。以最大无痛强度的70%进行重复训练,每次90min,每周3次,共8周。
文摘目的通过多中心临床研究,探讨新型神经电生理监测协议指导下微创入路选择性神经后根离断术(single-level laminectomy selective dorsal rhizotomy,SL-SDR)联合康复治疗对于痉挛型脑瘫儿童的近期疗效。方法回顾性分析上海市儿童医院、重庆医科大学附属儿童医院及湖南省儿童医院等于2015年11月至2021年8月期间收治的所有在新型神经电生理监测协议指导下行SL-SDR联合康复治疗,并获得至少6个月随访的痉挛型脑瘫患儿临床资料。收集患儿手术前及手术后末次随访时目标肌群肌张力、肌力、关节活动度、粗大运动功能分级系统(gross motor function classification system,GMFCS)分级及粗大运动功能66项(gross motor function measure-66 items,GMFM-66)评分情况,并评估患儿手术后运动功能变化。结果共有435例符合入组标准的痉挛型脑瘫患儿纳入研究,其中男249例,女186例;手术年龄(8.2±2.3)岁(3.2~15.5岁)。术前标记目标肌群2523组,受累关节2133个。术中离断神经后根(小根)数为(9.3±3.8)枚/例,其中3849枚(3849/4059,94.8%)符合离断50%神经截面积的标准。术后83例(83/435,19.1%)出现短期下肢浅感觉异常,经对症治疗1周后症状缓解,无一例出现长期并发症。患儿均获随访,随访时间(13.1±8.3)个月,目标肌群肌张力、肌力、关节活动度、GFMCS分级及GMFM-66评分均显著改善;术前GMFCS分级为Ⅱ、Ⅲ级者术后粗大运动功能改善情况优于Ⅳ、Ⅴ级者(134/309比8/105,P<0.01);术前GMFM-66评分≥50分者术后GMFM-66评分提升值高于术前CMFM-66评分<50分者[(7.65±3.39)分比(5.01±2.18)分,P<0.01];手术时年龄小于6岁者术后GMFCS分级改善情况好于年龄大于6岁者(106/249比36/165,P<0.01);术后GMFCS分级获改善患儿的平均年龄小于术后GMFCS分级无改善患儿的平均年龄[(6.1±1.0)岁比(11.6±1.7)岁,P<0.01]。结论新型神经电生理监测协议指导下SL-SDR联合康复治疗肢体痉挛瘫痪型脑瘫安全、有效,术后近期预后良好。
文摘目的研制局部给药跨室壁氯化钾单相动作电位(MAP)记录电极(KC lMAP电极),探讨模拟在体犬交感神经不均一的致心律失常机制。方法由5F动脉鞘管和0.2 mm的绝缘银丝,组构成3对MAP记录电极,鞘芯腔内注入含30%氯化钾琼脂糖凝胶即制成KC lMAP电极。用自制的电极记录犬左室前壁跨室壁MAP,观察局部异丙肾上腺素对三层心肌细胞动作电位时程(APD)及跨室壁复极离散度(TDR)的影响和心律失常的诱发情况。结果KC lMAP电极能稳定记录三层心肌MAP 120 m in以上,随时间的延长动作电位振幅逐渐降低但不影响复极特性的分析;局部给予异丙肾上腺素(10-5mg/m l)能显著降低中层心肌细胞的APD90(236.9±3.8 m s vs 226.3±3.0 m s)和TDR(35.7±4.8 m s vs 24.9±3.9 m s),中层心肌细胞易于诱发早期后除极及触发活动并引起室性心律失常。结论KC lMAP电极可理想地用于跨室壁心肌复极特性的研究;异丙肾上腺素降低正常犬的TDR,其诱发室性心律失常的机制与后除极和触发活动有关。
文摘Purpose: To evaluate (with three different electrophysiological methods) the r esidual retinal function in a selected group of patients with retinitis pigmento sa and remaining small central visual fields. Methods: Fourteen patients from se veral different genetic subgroups, who had been followed with visual acuity and visual field testing for periods up to 32 years, were examined. Ophthalmological examination included full-field electroretinography (ERG), multifocal electror etinography (mfERG) and multifocal visual evoked potential (mfVEP). Results: The ERGs were severely reduced in all patients. The mfERGs demonstrated the residua l central retinal function in five of the patients. The mfVEPs showed measurable amplitudes centrally in most of the patients. The follow-up examinations demon strated the slowly progressive course of the disease with preservation or only s light further loss of visual fields over a period of 7-32 years. Conclusion: Pa tients with retinitis pigmentosa may not always follow the typical natural cours e with progressive loss of visual fields, which may in some patients remain unaf fected over several decades. Multifocal ERG and mfVEP may be clinically useful f or evaluating remaining visual function in these patients.
文摘Objective: To investigate the origin, whether ocular or extraocular, of the short latency frontal potential (N15) reported by Todd et al. (2003) following vestibular stimulation. Methods: Fourteen subjects with low VEMP thresholds (VT) and 9 patients with vestibular or ocular disorders were stimulated at the mastoid with bone-conducted tone bursts (500 Hz, 8 ms) above vestibular threshold, using a B71 bone vibrator. Surface potentials were recorded from Fpz and around the eyes and referred to linked earlobes. Results: The N15 was present at Fpz,but was largest around the eyes (mean amplitude 2.6 μV, peak latency 13.4 ms, with stimulation at +18 dB above threshold) and was generally in phase above and below the eyes. The response was vestibular-dependent and modulated by alteration of gaze direction. The potentials were delayed in a patient with Miller Fisher syndrome and were larger in patients with superior canal dehiscence than in controls. Conclusions: We report a new vestibular-evoked extraocular potential. Its properties are not consistent with an eye movement. It is likely to be produced, mainly or exclusively, by synchronous activity in extraocular muscles (i.e. a myogenic potential). Significance: Vestibularevoked extraocular potentials extend the range of vestibular pathways that can be assessed electrophysiologically, and may be a useful additional test of vestibular function.
