简介：Thepurposeofthisstudyistoinvestigatedifferentfactorsoftheartifactinsurfaceelectromyography(EMG)signalcausedbyfunctionalelectricalstimulation(FES).Thefactorsinvestigatedincludethesizeofstimulationelectrodepads,theamplitude,frequency,andpulsewidthofthestimulationwaveformandthedetectingelectrodepoints.Wecalculatetherootmeansquare(RMS)ofEMGsignaltoanalyzetheeffectofthesefactorsontheM-waveproperties.TheresultsindicatethattheM-wavemainlydependsonthestimulationamplitudeandthedistributionofdetectingelectrodes,butnotontheotherfactors.Thisstudycanassistthereductionofartifactandtheselectionofdetectingelectrodepoints.

简介：

简介：BackgroundThisarticlesummarizedtheexperienceofatrioventricularvalvereplacementoperationforfunctionalsingleventriclepatientswhoseatrioventricularvalvewasinsufficiency.Thefollow-uptimeofoperationwasarrangedfromearly-tomedium-term.MethodsFromJuly2009toJuly2015,therewere40patientsoffunctionalsingleventriclereceivingtheoperationofatrioventricularvalvereplacement,including23maleand17femalepatients.TheageatA-Vvalvereplacementwasrangedfrom6daysto32years(themediumageof9years),andthebodyweightrangedfrom2.7to57kg(themediumbodyweightof21.5kg).Moreover,theatrioventricularvalvereplacementwasperformedonallpatientsunderextracorporealcirculation.ResultsAtrioventricularvalvereplacementwasperformedon40patientswithfunctionsingleventricleinhospital,ofwhicheight(20.0%)diedinhospitalincludingtwoneonateandinfant(agerange:6days-2yearsold)accountingfor25%(2/8),Amongthem,sevenpatientsdiedoflowcardiacoutputsyndrometwopatientswithrepeatedhypoxemiaconcurrentinfectionafteroperation,andonewithbilateraldiaphragmaticparalysisandmalignantarrhythmia.Forthepatientssufferingthesevereperivalvularleakage,therewasareoperation,andthecardiacfunctionbeforethefirstoperationwasclassⅣ.OnepatientreceivedhearttransplantationfinallyforsevereheartfailureafterAVvalvereplacement.Fortherestofpatients,theircardiacfunctionrecoveredtoclassⅠ-Ⅱafteroperation.ConclusionsForfunctionsingleventriclepatientswithatrioventricularvalveregurgitation,themortalityrateofatrioventricularvalvereplacementcanbeacceptediftheoperationwasindicated.Forpatientswithsevereatrioventricularvalueregurgitation,theresultoftheoperationintheearlyandmediumtermwassatisfying.Thus,theatrioventricularvalvereplacementservedasausefultreatmentforpatientsdiagnosedofA-Vvalveregurgitationandfunctionalsingleventricle.

简介：目的将在更低的手足讨论ischemic挛缩的功能的重建的方法并且基于它的严厉和预后在更低的手足为ischemic挛缩建议一个分类协议。有在更低的手足的ischemic挛缩的42个病人全部的方法A在这研究被包括。根据骚乱的不同类型和严厉，由神经解压缩组成的外科的重建，腱变长或转移的度，内在的脚肌肉版本和小腿腹胫骨的神经吻合在每个病人被执行。手术后地结果，所有病人能走在扁平的地面上。落下脚在10个病人被改正，并且5个病人仍然在楼梯活动期间感到了一些困难。到屈肌hallucislongus腱的裂口跟腱转移在12个病人被执行，并且他们的走的稳定性被改进。七个病人接受了在5个病人在2个病人和S3到达到S2的ipsilateralsuraltibial神经吻合，和敏感恢复。在更低的手足的结论Ischemic挛缩是在更低的手足损伤以后的破坏复杂并发症。挛缩的预防比确定的挛缩的治疗更重要。到屈肌hallucislongus腱和小腿腹胫骨的神经吻合的裂口跟腱转移，被我们开始实现，能在更低的手足改进ischemic挛缩的功能的恢复，并且因此在更低的手足为ischemic挛缩的功能的重建提供一种新选择。

简介：摘要Functional dyspepsia (FD) and gastroparesis are two common functional gastrointestinal diseases, affecting millions of people in both China and around the world. However, treatment options are limited and difficult due to multiple factors involved in their pathophysiologies. Therefore it is critically important to assess and understand pathophysiologies of these diseases before a treatment is given. In this minireview we provide updates on recent development in the pathophysiologies and treatments of FD and gastroparesis. In addition to common abnormalities in gastric accommodation, antral hypomotility and visceral hypersensitivity, FD has recently been reported to display a number of impairment in duodenal functions, such as low-grade inflammation and increased permeability. For gastroparesis, macrophages have recently been reported to play an important role in its pathophysiology. A brief overview on the assessment of pathophysiologies of FD and gastroparesis is also provided; pros and cons of clinically available methodologies as well as emerging methods are discussed. Finally, available treatment options for FD and gastroparesis are presented in this minireview, including authors′ opinions on the advantages and disadvantages of each therapy. Potential novel therapies for FD and gastroparesis, especially those associated with Traditional Chinese Medicine, are also introduced and discussed.

简介：

简介：Functionaltricuspidregurgitation(TR)primarilyarisesfromasymmetricdilationofthetricuspidannulusinthesettingofrightventriculardysfunctionandenlargementinresponsetoleft-sidedmyocardialandvalvularabnormalities.EveniftheTRisnotsevereatthetimeofmitralvalvesurgery,itcanworsenandevenappearlateaftersuccessfulmitralvalvesurgery,whichportendsapoorprognosis.DespitedatademonstratinginferioroutcomesinthepresenceofresidualTR,surgicalrepairforfunctionalTRremainsunderused.AcceptanceofTR,inthepresenceoftricuspidannulardilation,maybeunacceptable.Surgicalrepairshouldconsistofplacementofarigidorsemirigidannularring,whichhasbeenshowntoprovidesuperiordurabilityascomparedwithsutureandflexiblebandtechniques.Finally,percutaneousannuloplastyforcorrectionoffunctionalTRmayallowtreatmentofpatientswithrecurrentTRathighriskofreoperation.

简介：Purpose:Tostudythecorrelationbetweenfunctionalandstructurallossinchronicglaucoma,asdetectedbyFrequencyDoublingTechnology(FDT)andHeilderbergRetinaTomograph(HRT).MaterialandMethods:60eyesof60patientswitheitherocularhypertensionorchronicopen-angleglaucomaunderwentvisualfieldtestingwithbothstandardautomated

简介：AbstractBackground and objective:Functional endoscopic sinus surgery (FESS) increases the nasal volume, and thereby it can alter the nasal resonance. The objectives were to measure the percentage of nasal resonance following FESS and compare it with healthy individuals with normal nasal findings.Methods:The nasometric analysis of voice was done using n/p/m consonant sounds in 72 individuals with healthy post FESS cavities (group 1) and 72 healthy individuals with normal nasal findings without any nasal pathology (group 2). The scores of nasal resonances were expressed in percentages and were compared between the two groups. Both in group 1 and group 2, 32 (44.4%) were females, and 40(55.6%) were males. In group 1, 51 participants had bilateral FESS cavities, and 21 had unilateral FESS cavities. Kannada was the mother tongue in 30 (41.7%) participants in group 1 and 36 (50.0%) in group 2. Malayalam was the mother tongue in 42(58.3%) participants in group 1 and 36 (50.0%) in group 2.Results:In both cases and control groups, more than 80% of the participants were showing less than 20% of nasal resonance. In group 1, the mean values of/n/p/m sounds were 11.23%, 10.23% and 11.42% respectively, and in group 2 the mean values were 8.27%, 8.58% and 8.58% respectively. But the P value was not statistically significant. Individuals with unilateral FESS cavities had more nasal resonance values compared to bilateral FESS cavities. Similarly, Kannada speaking people had more values compared to Malayam speaking individua.Conclusion:Changes in nasal resonance after FESS is minimal, and it is unnoticed. But it may affect the speech quality in professional voice users, depending on their language. Though the nasometer is considered as the most validated instrument to record nasal resonance, we feel that further standardization is needed to evaluate the nasalance.

简介：Rats(Rattusnorvegicus)havemanyadvantagesovermiceinscientificstudies,forexample,theyaremorerelevanttohumaninphysiologicalandpharmacologicalresponses.Therefore,ratsarebroadlyusedinexperimentalstudies.Therecentbreakthroughinthegenerationofratembryonicstemcells(rESCs)opensthedoortoapplicationofgenetargetingtocreatemodelsforthestudyofhumandiseases.Inaddition,theinvitrodifferentiationofrESCsintoderivativesofthreegermlineswillserveasapowerfultoolandresourcefortheinvestigationofmammaliandevelopment,cellfunction,tissuerepair,anddrugdiscovery.However,thedistinctcultureconditionandsignalinhibitor-dependedmaintenanceofrESCsstandasaconsiderablechallengeforitsinvitrodifferentiation.Toaddressit,weinvestigatedwhetherrESCsarecapableofformingterminaldifferentiatedcardiomyocytes.Wefoundthattheembryoidbodies(EBs)-basedmethodusedinmouseESC(mESC)differentiationfailedtoworkinthecultivationofrESCs.WethenmodifiedthedifferentiationprotocolandsuccessfullydevelopedaninvitrodifferentiationsystemtodifferentiaterESCsintothreeembryonicgermlayers.Byusingthismethod,therESCsformspontaneousbeatingcardiomyocyteswiththepropertiessimilartothosederivedfromfetalratheartsandmESCs.Thisuniquecellularsystemwillprovideanewapproachtostudytheearlydevelopmentandcardiacfunctionaswellastoperformpharmacologicaltestandcelltherapystudy(Grants:theStateMajorResearchProgramofChina(2009ZX09503-024,2010CB945603)andCAS(XDA01030000).

简介：

简介：

简介：摘要ObjectiveTo determine the mechanisms on cognitive improvement with repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex(L-DLPFC) in subacute stroke patients.MethodsTwenty-eight first-ever stroke patients with cognitive impairment were recruited. All subjects were randomly assigned to real or sham stimulation group and completed 10 sessions of rTMS for 2 weeks. 10 Hz of navigation rTMS were applied (5 s stimulation and 25 s resting, total 1500 pulses) on the L-DLPFC at 80% of resting motor threshold (rMT). At the time of baseline, 1 month and 3 months after stroke onset, all subjects received the Korean-mini mental state examination (K-MMSE), Korean-Montreal Cognitive Assessment (K-MOCA), Upper Fugl-Meyer Assessment (U-FMA), Korean-Modified Bathel Index (K-MBI), European Quality of life 5 Dimension (EQ-5D), Korean-Geriatric Depression Scale (K-GDS). In addition, the continuous performance test (CPT), vascular cognitive impairment harmonization standards (VCIHS), motor evoked potentials (MEP), event-related potentials (ERPs), resting state functional magnetic resonance imaging (RS fMRI) and diffusion tensor imaging (DTI) were completed at baseline and 3 months after stroke onset.ResultsAfter the intervention period, the real stimulation group improved significantly in the K-MMSE, K-MOCA, K-MBI and K-GDS compared with sham stimulation group. And these effects lasted after three months in MOCA. There was no significant time × group effect among the U-FMA, EQ-5D, and CPT. Among the VCIHS parameters, Z-scores of executive and memory function showed higher delta value between baseline and 3months timepoints in rTMS group. The MEP showed higher TIME × GROUP interaction in the intracortical inhibition value on right hand. It suggests that there is beneficial effect on premotor cortical excitability of rTMS. The change of P300 amplitude on F3 and C3 was more increased in real stimulation group significantly only in the auditry Oddball paradigm. The RS fMRI analysis results showed more increased functional connectivity of Cingulate Gyrus, Supramarginal Gyrus, Cerebelum Crus2, Precentral gyrus, Middle temporal gyrus and Inferial temporal gyrus after stimulation compared with the sham group. Brain activation in the cingulum showed a tendency that after 3 months, fractional anisotropy (FA) and fiber number (FN) in real group were larger than sham group, however there was no significant effect. The relationship between the change of K-MOCA and fractional anisotropy of the cingulum was found positive correlation in all subjects.ConclusionsThese results suggest that high frequency rTMS on the L-DLPFC improves cognitive function and functional network activity in subacute stroke. The rTMS seems to be a recommendable treatment in stroke patients with cognitive impairment.

简介：

简介：ObjectiveTostudytheinfluenceofunilateralairflowratechangeontheresultofcalorictest.MaterialsandMethodsTheunilateralweakness(UW)indexwascalculatedwhentheairflowratewassetat6L/mininbothears(calledsymmetricstimulation)andagainwhenitwassetat6L/mininleftearand3L/minintherightear(calledasymmetricstimulation).Eachindividualsubjectwastestedwithbothsymmetricalandasymmetricalstimulations.Pairedttestwasusedtoexaminethedifferencesbetweenresultsfromsymmetricalandasymmetricalstimulations.ResultUWindexdecreasedinresponsetoasymmetricalstimulation.ConclusionUnilaterallydecreasedairflowratecanproduceindicessuggestingipsilateralUW,whichcanbemisleading.

简介：无

简介：目的：观察不同针刺法对脑卒中患者腕手功能重建的影响。方法：选择符合纳入标准的脑卒中患者40例，随机分为4组，每组10例。A组给予伸肌运动点针刺，B组给予仲-屈肌交替运动点针刺，C组针刺肩髑、臂膈、手三里、外关，D组针刺肩髑、臂膈、手三里、外关、尺泽、内关。以上肢表面肌电信号（SurfaceElectromyography，SEMG）特征值、Fugl—Meyer功能评定表及Barthel日常生活活动能力（ActivitiesofDailyLiving，ADL）指数评价各组治疗前后的患侧上肢运动功能。结果：伸-屈肌交替运动点针刺可以使上肢SEMG的峰值（MAX）、积分肌电值（IntegratedElectromyogram，IEMG）、Fugl—Meyer运动功能分值、BarthelADL指数明显提高。结论：不同针刺部位治疗脑卒中后腕手运动功能疗效的影响不同。仲．屈肌交替运动点针刺在临床治疗中疗效确切。

简介：ObjectivesItisnotfullyclarifiedhowdiabetesmellitusinducedcardiacdysfunctionandmyocardialultrastructuralchangesintheearlystate.Inthepresentstudy,weprovidedanintegratedapproachtoinvestigateearlychangesinmyocardialfunctionofdiabeticrabbitsandassessedthestructuralalteration.MethodsandResultsDiabeteswasinducedbyalloxaninjection.After30days,echocardio-graphyandleftventricularcannulationwereperformedindia-betic(D,n=8)andcontrolrabbits(C,n=10).Aftercatheterization,animalswerekilledforhistologicalstudies.Hema-toxylin-eosinandMasson’sTrichromestainingoftheheartwereanalyzed.Theultrastructureofleftventriclewasalsoexaminedwithelectronmicroscopy.EchocardiographyrevealedthatearlydiabeticcardiomyopathyhadimpairedLVdiastolicfunctionexpressedbydiminishedE-waves,increasedAwaves,E/AratioreversionandincreasedE-wavedecelerationtime(EDT).Concurrently,LVend-diastolicpressure(LVEDP)anddiastolictimeconstant(T)wereincreased,minimumdP/dt(LV-dp/dt)wasreduced,obtainedthroughcardiaccatheterization.TherewerenosignificantdifferencesinLVejectionfraction(EF),LVpeaksystolicpressure(LVSP),ormaximumdP/dt(LV+dp/dt).Qualitativelightmicroscopyrevealednohistologicchangesinmyocardiumfromdiabeticrabbits.Themostevidentultrastructuralchangewasspottedmyofibrillardamage,whileinterstitialfibrosiswasslight.ConclusionsTheseresultssuggestthatearlydiabeticcardiomyopathyinanimalmodelischaracterizedbyleftventriculardiastolicdysfunction,bothimpairedactiverelaxationandincreasedpassivechamberstiffness.Whereas,leftventricularsystolicfunctioncanremainnormal.Itmightpartlycontributetomyofibrillardamage,butnotmyocardialfibrosis.

简介：BackgroundManypatientshavesymptomssuggestiveofcoronaryarterydisease(CAD)andareoftenevaluatedwiththeuseofdiagnostictesting,althoughtherearelimiteddatafromrandomizedtrialstoguidecare.MethodsWerandomlyassigned10,003symptomaticpatientstoastrategyofinitialanatomicaltestingwiththeuseofcoronarycomputedtomographicangiography(CTA)ortofunctionaltesting(exerciseelectrocardiography,nuclearstresstesting,orstressechocardiography).Thecompositeprimaryendpointwasdeath,myocardialinfarction,hospitalizationforunstableangina,ormajorproceduralcomplication.SecondaryendpointsincludedinvasivecardiaccatheterizationthatdidnotshowobstructiveCADandradiationexposure.ResultsThemeanageofthepatientswas60.8±8.3years,52.7%werewomen,and87.7%hadchestpainordyspneaonexertion.ThemeanpretestlikelihoodofobstructiveCADwas53.3±21.4%.Overamedianfollow-upperiodof25months,aprimaryend-pointeventoccurredin164of4996patientsintheCTAgroup(3.3%)andin151of5007(3.0%)inthefunctional-testinggroup(adjustedhazardratio,1.04;95%confidenceinterval,0.83to1.29;P=0.75).CTAwasassociatedwithfewercatheterizationsshowingnoobstructiveCADthanwasfunctionaltesting(3.4%vs.4.3%,P=0.02),althoughmorepatientsintheCTAgroupunderwentcatheterizationwithin90daysafterrandomization(12.2%vs.8.1%).ThemediancumulativeradiationexposureperpatientwaslowerintheCTAgroupthaninthefunctional-testinggroup(10.0mSvvs.11.3mSv),but32.6%ofthepatientsinthefunctional-testinggrouphadnoexposure,sotheoverallexposurewashigherintheCTAgroup(mean,12.0mSvvs.10.1mSv;P<0.001).ConclusionsInsymptomaticpatientswithsuspectedCADwhorequirednoninvasivetesting,astrategyofinitialCTA,ascomparedwithfunctionaltesting,didnotimproveclinicaloutcomesoveramedianfollow-upof2years.

简介：AbstractPurpose:Fingertip injuries are common in industrial production activities as well as in domestic work. Loss of pulp hampers daily life activities. Functional and aesthetic aspects are important in fingertip reconstruction. The bone is usually exposed along with soft tissue loss. Therefore to reconstruct the pulp flap with adequate bulk is required.Methods:We reported a case series of 12 patients with the injury over the volar aspect of distal phalanx of the index or middle finger. In all cases, laterally based thenar flap was chosen. The flap donor site was closed primarily in most of cases, while 4 patients required skin graft. The flap was detached between 2-3 weeks. Functional assessment was done using static and dynamic 2-point discrimination and range of motion at each joint. The aesthetic outcome was assessed through questionnaire. The results were analyzed using the unpaired t-test (SPSS version 21).Results:Partial necrosis occurred in 2 cases while rest of flaps survived successfully. Static 2-point discrimination ranged from 6-10 mm, mean 8.6 mm; and dynamic 2-point discrimination ranged from 8-10 mm, mean 8.9 mm. The mean satisfaction score was (4.0 ± 0.55).Conclusion:Thenar flap is a good choice for reconstruction of the finger pulp as it provides the bulk with good functional and aesthetic outcome.