慢性疼痛患者静息态脑功能磁共振的默认网络研究

运用静息态功能磁共振成像技术(resting-state fMRI)研究慢性疼痛患者脑默认网络结构.通过选择双侧膝骨性关节炎(knee osteoarthritis,KOA)患者20例和正常志愿者20名,以后扣带回(posterior cingulated cortex,PCC)为种子点,分别进行fMRI扫描,分析配对两组受试者的脑功能连接情况.结果显示相对正常受试者,KOA患者存在异常脑功能连接,主要表现为PCC呈负激活,边缘叶、脑岛呈正激活.     

研究报告: 大鼠感觉运动系统静息态脑网络研究

为了理解啮齿类动物的脑功能连接,本文利用9.4T fMRI获得轻度麻醉状态下大鼠静息状态及刺激激活的数据,通过互相关分析构建节点之间的相关系数矩阵并计算相应的网络参数．结果发现：给予前爪电刺激时,刺激对侧初级感觉皮层(S1)、丘脑(Tha)有较强的正激活,双侧尾状壳核(CPu)有较强的负激活．静息状态时大鼠感觉/运动皮层内部、丘脑内部的连接性较强,而感觉/运动皮层与丘脑之间的连接较弱,双侧感觉运动系统之间存在较强的同步低频振荡,感觉运动系统在静息态时的脑网络具有小世界属性．结果提示,啮齿类动物在大脑信息处理中的功能分离和整合可能与人类存在某些相似性,支持哺乳动物中枢神经系统的基本功能存在遗传保守性的观点．     

基于fMRI的屈光参差性弱视静息视觉网络的研究

利用静息功能磁共振成像技术,对屈光参差性弱视(anisometropic amblyopia)患者静息态视觉网络进行研究,分析此类患者大脑视觉皮层功能受到的影响。采用独立成分分析(independent component analysis, ICA)这一数据驱动方法对8名屈光参差性弱视患者和11名正常对照的静息数据进行分离,并采用拟合度值(goodness-of-fit scores)分析挑选出静息视觉网络,将结果进行组内分析和组间分析。结果表明,屈光参差性弱视的静息视觉网络中,多级视觉皮层均发生了明显的功能损害,其功能连接度的范围与强度显著低于正常组,而且,高级别纹外皮层比低级别纹状皮层损害更加明显。静息fMRI为深入研究弱视初、高级视觉皮层功能损害的发病机制提供了新的方法。     

P27kip1、EGFR在星形胶质瘤中的表达与其对增殖活性的影响

目的检测P27kip1与EGFR在星形胶质瘤中的表达,探讨其对增殖活性的影响,为治疗提供一定的依据.方法采用免疫组化S-P法检测星形胶质瘤EGFR、P27kip1的表达,每一例肿瘤用ki-67LI表示其增殖活性,应用SAS8.0统计软件进行结果分析.结果 1.P27kip1表达水平与星形胶质瘤病理分级负相关(rs=-0.487,P<0.0001).2.对EGFR、P27kip1及Ki-67LI联合分析显示:P27kip1( )EGFR(-)组的ki-67LI(5.0%)明显低于P27kip1( )EGFR( )、P27kip1(-)EGFR( )、P27kip1(-)EGFR(-)组(10.4%、10.4%、10.8%)(P<0.05).结论 1.P27kip1在星形胶质瘤的发生、发展过程中可能起抑制作用.2.P27kip1、EGFR对星形胶质瘤增殖活性起相互拮抗的作用.     

颞叶内侧胶质瘤的显微手术治疗体会

目的:探讨颞叶内侧胶质瘤的显微手术疗效并总结经验。方法:回顾性分析23例行显微手术治疗的颞叶内侧胶质瘤患者的临床资料及手术并发症的发生情况。结果:23例患者中,20例全切除,3例次全切除术,术后术区残血1例,无手术死亡病例。术前癫痫发作18例,术后缓解16例;术前有失语8例,后缓解3例;术前8例偏盲,术后改善2例;术前偏瘫2例,术后改善1例;术后新增失语2例,术后新增偏盲3例,术后新增偏瘫1例,1年随访复发3例。结论:经侧裂入路切除颞叶内侧胶质瘤的手术疗效良好,可以最大程度切除术肿瘤,并发症较少。     

氟比洛芬酯注射液对于骨科四肢手术术后的疗效研究

目的:探讨氟比洛芬酯对骨科手术术后的患者的镇痛效果、不良反应及对运动痛及功能恢复的疗效研究.方法:60例择期手术患者,按随机数字表法分为两组:氟比洛芬酯(试验组),阿片类药物+非甾体类抗炎药物(对照组).分别于术后1、6、12、24h记录VAS评分、不良反应(恶心、呕吐、嗜睡、胃肠道出血、呼吸抑制等)、夜间静息疼痛情况、术后第48h-72h运动痛的情况.结果:实验组术后24h内VAS评分明显低于对照组(P＜0.05)、实验组不良反应也较少(P＜0.05),第48h-72h之间实验组运动镇痛效果明显优于时照组(P＜0.05)、且夜间静息疼痛实验组比对照组要轻(P＜0.05 o结论:氟比洛芬酯镇痛效果好,尤其是对运动痛的镇痛效果明显优于普通阿片类,不良反应少,更有利于术后功能恢复.     

肌电生物反馈对急性期脑卒中偏瘫患者上肢功能的影响

目的:评价肌电生物反馈联合常规康复训练对急性期脑卒中偏瘫患者上肢功能的影响,为脑卒中后急性期上肢运动功能障碍的康复治疗探寻更有效的方法.方法:将35例生命体征平稳、无意识障碍的急性期脑卒中偏瘫患者分为观察组18例和对照组17例.两组患者均给予神经内科药物治疗和常规康复训练,观察组患者偏瘫侧上肢加以肌电生物反馈治疗.两组均于治疗前和治疗2个月后对偏瘫侧上肢进行Bmnnstrom运动功能分级、简式Fugl-Meyer(FMA)上肢运动功能评定和腕背伸时肌肉最大收缩时肌电(EMG)幅值的测定.结果:经2个月治疗后,两组患者偏瘫侧上肢的Bnnnstrom分级、FMA及EMG幅值较治疗前均有提高(P＜0.05),且观察组各项评分均优于对照组(P＜0.05).结论:本文中观察组和对照组的患者经康复治疗后,偏瘫侧上肢的运动功能均较治疗前提高.但在脑卒中患者的急性期应用肌电生物反馈治疗联合常规康复训练,较单独使用常规运动疗法和作业疗法治疗,能更好地改善急性期脑卒中偏瘫患者上肢的功能,更显著地促进偏瘫上肢的运动功能恢复及分离运动的产生,同时对促进腕关节背伸肌力的恢复方面提供了电生理学依据.总之,在常规康复训练的基础上加用肌电生物反馈治疗,可更显著地促进急性期脑卒中偏瘫患者的上肢功能,为脑卒中急性期肢体运动障碍的康复治疗提供了更有效的方法.     

颞叶癫痫脑“默认模式”的fMRI研究

功能磁共振成像(functional magnetic resonance imaging,fMRI)被用于检测静息时脑功能神经网络.作者运用静息fMRI检测海马硬化颞叶癫痫(temporal lobe epilepsy,TLE)脑"默认模式",采用感兴趣区域功能连接分析检测16例TLE患者和16名正常对照静息时脑的"默认模式",并进行组内和组间分析.研究发现,与正常对照相比,TLE静息时海马、颞极、额叶、颞叶、壳核及楔前叶等脑区与后扣带回的功能连接增强.研究结果表明TLE患者的固有脑功能组织模式有可能出现紊乱.这一研究将有助于从脑功能的角度了解癫痫患者某些临床症状的发病机理,为今后癫痫诊治的发展提供一定的帮助.     

反馈式功能性电刺激对脑梗死患者上肢运动功能影响的fMRI研究

目的:利用功能核磁共振成像(f MRI)技术探究反馈式功能性电刺激对脑梗死患者上肢运动功能的影响,为脑梗死患者的康复提供最佳治疗方案。方法:选取2010年1月至2014年12月我院收治的脑梗死患者42例,随机分为I、II、III组,各14例,3组患者均接受常规康复治疗和药物治疗,在此基础上,I组行反馈式功能电刺激治疗,II组行单纯功能性电刺激治疗,疗程均为28天。治疗前后对所有患者进行上肢功能Fugl-Meyer运动量表评估和腕背屈关节活动度测量,并于治疗后3 d内对患者大脑M1区的激活强度进行f MRI检查。结果:3组患者的运动功能均较治疗前有所改善,其中Fugl-Meyer运动量表评分和腕背屈关节活动度的测量结果显示,I、II组测量结果明显好于III组,I组测量结果明显好于II组,差异具有统计学意义(P0.05)。患者大脑M1区激活强度对比,I、II组明显强于III组(P0.05),I组测量明显强于II组,差异均有统计学意义(P0.05)。结论:脑梗死康复期患者采用功能性电刺激治疗有助于受损脑功能重组,其中反馈式功能性电刺激强调人的主观性运动,较单纯性电刺激效果更好。     

运动想象结合常规康复训练对脑卒中偏瘫患者上肢肌力恢复的影响

目的:探讨运动想象结合常规康复训练对脑卒中偏瘫患者上肢肌力恢复的影响.方法:选择31例病情稳定的脑卒中偏瘫患者,随机分为治疗组(n=16)和对照组(n=15)两组,两组患者均进行常规康复训练,其中治疗组采用常规康复训练联合运动想象治疗,对照组只进行常规康复训练.两组常规康复训练时间相同.分别在治疗前、治疗后4周、8周进行患侧上肢肌力评定,观察患侧上肢肌力恢复情况.结果:治疗前两组各项评分差异无统计学意义.治疗8周后,两组患者肌力评级与各组治疗前比较差异均有统计学意义(P＜0.05),且两组肌力比较差异也有统计学意义(P＜0.05).结论:运动想象结合常规康复训练有利于脑卒中偏瘫患者上肢肌力的恢复,与以往的研究结果一致.     

Neuronal correlates of the motor function of the cerebral motor cortex

Modern ideas about the motor cortex neuronal mechanisms ensuring the initiation and correction of the instrumental manipulational movements in mammals have been analysed. A close correlation has been established to exist between the neuronal activity and various characteristics of movement including those that are not induced by muscle force. The role of somatic afferentation in the formation and realization of the movement programme is analysed as well as in motor output modulation by means of fast feedback.     

Regulation of motor behaviour

The review is devoted to analysis of the basic links of motor behavior control systems: sensorimotor cortex, cerebellum, a red nucleus and striatum. The organization and communications of these structures and their participation in learning and memory processes are described. The synaptic neurotransmitter and nonsynaptic neuromodulatory systems innervating these structures are also described. Hierarchical synaptic networks are formed by GABA and glutamatergic systems. The nonsynaptic dopaminergic system innervates both of these structures, but carries out a modulatory function. The mesocorticolimbic dopaminergic system induces an emotional and motivational state - processes of reinforcement, and participates in realization of purposeful behavior. The nigrostriatal dopaminergic system, through triggering an endocellular signal and the processes ofphosphorylation and dephosphorylation modulates activity ofGABA and glutamatergic receptors ofdorsal striatum spiny neurons and adapted thalamocortical networks.     

The motor of leukocytes

The movements of leukocytes involve extension, flow, and contraction of a margin of organelle-excluding cytoplasm. Actin is the principal structural component of this region. This paper reviews evidence that the expansion of cortical cytoplasm can result from the growth of actin polymers into an orthogonal network in which actin fibers branch perpendicularly under the influence of actin-binding protein. Flow occurs when actin filaments are disassembled and severed. The assembly and fragmentation of actin are regulated by actin-modulating proteins such as profilin, which sequesters actin monomers, acumentin, which binds to the slow-growing end of actin fibers, and gelsolin, a calcium-regulated protein that binds to the fast-growing end of actin polymers and severs actin filaments. Contraction of the actin network is caused by myosin, the assembly and activity of which are regulated by its state of phosphorylation, which is in turn controlled by phosphorylating and dephosphorylating enzymes and by calmodulin and calcium. Present information leads to the prediction that intracellular calcium gradients guide cytoplasmic movement and that the direction of actin assembly and therefore of cytoplasmic extension is toward regions of low cytoplasmic free calcium.     

Development of motor behaviour

The development of motor behaviour depends on the differentiation of underlying circuitry. Recent work with the zebrafish brings the simple swimming behaviour of lower vertebrates and their embryos into focus as a suitable model to study the development of motor circuitry and its genetic control. Changes in connectivity and excitability contribute to the development of swimming in this simple system. In the chick embryo, limb motor circuitry is spontaneously active before motor axons reach their muscle targets, and it has properties in common with the spontaneously active networks in the retina. The early rhythmic activity responsible for embryonic movement is probably a generalised property of developing spinal networks that precedes, and may be required for, the completion of functional locomotor circuitry.     

Analysis of motor unit firing characteristics in patients with motor neuron diseases

This study was designed to evaluate firing rate variability in patients with upper/lower motor neuron disorders. Twenty healthy subjects and 19 patients with motor neuron disorders participated in the study. Consecutive motor unit action potential pairs from extensor digitorum communis (EDC) muscle were recorded from each subject with trigger-delay line mode. Patients with motor neuron disorders (17.7?±?10.8?ms) showed significantly higher mean time variability of interpotential interval value than healthy volunteers (10.3?±?0.1?ms) (p?相似文献   

The assessment of preschool children's motor skills after familiarization with motor tests

This research study was conducted to establish the influence of familiarization on the information component of movement in a motor task for the assessment of preschool children's motor skills. The sample included 50 children whose mean age was 5.9 years (71.5 months). The experimental group consisted of 27 children who were 5.9 years (71.5 months) old, and the control group consisted of 23 children who were 5.9 years (71.5 months) old. The examinees performed 2 motor tasks, standing long jump (SJ, explosive strength) and standing on 1 leg on a beam "flamingo test" (FT, balance). The experimental group underwent a period of familiarization with the motor task in 3 sessions with 5 trials every 3 days. The results indicate statistically significant differences in the final testing between both groups of examinees; the experimental group mean was 112.73 cm, and the control group mean was 100.62 in the SJ test (p = 0.00), and the experimental group mean was 27.10 seconds and the control group mean was 15.01 seconds in the FT (for balance) (p = 0.00). The results obtained in this research indicate that children significantly improved the results in the motor test of strength and balance, being influenced by familiarization. It was confirmed that it was necessary for preschool children to be familiar with the test and it is not justified to use testing and assessment protocols and standards for adults. Physical educators and coaches, when testing preschool children, should introduce children to tests to obtain the best result.