Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely un...Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.展开更多
目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病...目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。展开更多
目的:为减小胸椎间孔穿刺时发生气胸、脊髓损伤等并发症的风险,基于CT(computed tomography)影像测量数据,分析不同性别、年龄和体重指数(body mass index,BMI)病人的差异,探究不同节段的变化规律。方法:选取中日友好医院影像数据库中18...目的:为减小胸椎间孔穿刺时发生气胸、脊髓损伤等并发症的风险,基于CT(computed tomography)影像测量数据,分析不同性别、年龄和体重指数(body mass index,BMI)病人的差异,探究不同节段的变化规律。方法:选取中日友好医院影像数据库中180例成年住院病人胸部CT影像,以T_(2)~T_(12)左侧椎间孔(intervertebral foramen,IF)为穿刺靶点,选取可清楚显示胸椎间孔的CT横断面,模拟椎间孔穿刺操作,测量旁开距离、穿刺角度、穿刺深度和椎间孔至后正中线距离,计算出可行的安全穿刺范围,分析不同性别(男性、女性)、年龄(青年、中年、老年)、BMI(非超重、超重)的测量结果。结果:不同性别的病人相比,男性在各节段的旁开距离和穿刺深度均明显高于女性,在上胸段的穿刺角度低于女性,椎间孔至正中线距离明显大于女性;不同年龄的病人相比,老年病人在T_(2~3)至T_(4~5)节段的最小旁开距离大于青年、中年病人,在T_(3~4)和T_(4~5)节段的穿刺角度小于青年、中年病人;不同BMI病人相比较,超重病人在各节段的旁开距离、穿刺深度均高于非超重病人,在T_(9~10)以上节段的穿刺角度小于非超重病人。从总体规律来看,椎间孔至后正中线距离在T_(5~6)和T_(6~7)最短,旁开距离、穿刺角度、穿刺深度和椎间孔至正中线距离均在中胸段出现极值,向两侧逐渐减小或增大。结论:胸椎穿刺的旁开距离、穿刺角度、穿刺深度由T_(2~3)至T_(11~12)有一定变化规律,各参数在不同性别、年龄、BMI病人之间存在差异,对于临床进行不同节段和人群的椎间孔穿刺操作有一定参考意义。展开更多
Totheeditor:Major depressive disorder(MDD)is a principal cause of disability worldwide and is often associated with high morbidity and mortality rates.Although there are several therapies available for the treatment o...Totheeditor:Major depressive disorder(MDD)is a principal cause of disability worldwide and is often associated with high morbidity and mortality rates.Although there are several therapies available for the treatment of depression,about one-third of patients with MMD will not respond to two or more antidepressant drugs with different mechanisms;the patients are then referred to as having treatment-resistant depression(TRD).Patients with TRD have a poorer quality of life,greater economic burden and increased suicidal behaviours.Therefore,new antidepressant treatments that are effective,safe,long-lasting and tolerable are needed.Ketamine infusion,intranasal esketamine and transcranial magnetic stimulation(TMS)have been used to treat early stage TRD.’A recent review suggests that electroconvulsive therapy(ECT)may be superior to ketamine for reducing depression severity in the acute treatment of TRD.展开更多
目的:观察细银质针导热松解术治疗肱二头肌长头腱炎(myotenositis of the long head of biceps brachii, MLHB)的有效性和安全性。方法:纳入MLHB病人102例,采用随机数字表法平均分为细银质针导热组(A组)和局部注射组(B组),比较两组治疗...目的:观察细银质针导热松解术治疗肱二头肌长头腱炎(myotenositis of the long head of biceps brachii, MLHB)的有效性和安全性。方法:纳入MLHB病人102例,采用随机数字表法平均分为细银质针导热组(A组)和局部注射组(B组),比较两组治疗前后的肩关节功能评分(american shoulder and elbow surgeons’form score, ASES)、腱鞘积液厚度和长头腱周长。结果:A组治疗后1周的ASES显著提高、腱鞘积液厚度明显降低,治疗后4周长头腱周长显著减小;B组治疗后5 min的ASES明显升高,治疗后4周较2周的ASES明显降低;治疗后1周长头腱周长明显减小、2周腱鞘积液厚度明显减少。治疗后4周A组ASES评分以及腱鞘积液厚度均优于B组。两组无明显不良反应。结论:细银质针导热松解术及局部药物注射均能改善MLHB的临床症状,细银质针导热松解术远期疗效优于局部药物注射。展开更多
基金The study was partly funded by the National Natural Science Foundation of China(82371490)the National Key R&D Program of China(2022YFC2503900,2022YFC2503901)+1 种基金Beijing Hundred,Thousand and Ten Thousand Talents Project(2017-CXYF-09)Beijing Health System Leading Talent Grant(2022-02-10).
文摘Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.
文摘目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。
文摘目的:为减小胸椎间孔穿刺时发生气胸、脊髓损伤等并发症的风险,基于CT(computed tomography)影像测量数据,分析不同性别、年龄和体重指数(body mass index,BMI)病人的差异,探究不同节段的变化规律。方法:选取中日友好医院影像数据库中180例成年住院病人胸部CT影像,以T_(2)~T_(12)左侧椎间孔(intervertebral foramen,IF)为穿刺靶点,选取可清楚显示胸椎间孔的CT横断面,模拟椎间孔穿刺操作,测量旁开距离、穿刺角度、穿刺深度和椎间孔至后正中线距离,计算出可行的安全穿刺范围,分析不同性别(男性、女性)、年龄(青年、中年、老年)、BMI(非超重、超重)的测量结果。结果:不同性别的病人相比,男性在各节段的旁开距离和穿刺深度均明显高于女性,在上胸段的穿刺角度低于女性,椎间孔至正中线距离明显大于女性;不同年龄的病人相比,老年病人在T_(2~3)至T_(4~5)节段的最小旁开距离大于青年、中年病人,在T_(3~4)和T_(4~5)节段的穿刺角度小于青年、中年病人;不同BMI病人相比较,超重病人在各节段的旁开距离、穿刺深度均高于非超重病人,在T_(9~10)以上节段的穿刺角度小于非超重病人。从总体规律来看,椎间孔至后正中线距离在T_(5~6)和T_(6~7)最短,旁开距离、穿刺角度、穿刺深度和椎间孔至正中线距离均在中胸段出现极值,向两侧逐渐减小或增大。结论:胸椎穿刺的旁开距离、穿刺角度、穿刺深度由T_(2~3)至T_(11~12)有一定变化规律,各参数在不同性别、年龄、BMI病人之间存在差异,对于临床进行不同节段和人群的椎间孔穿刺操作有一定参考意义。
基金supported by the National Natural Science Foundation of China(82371490)the National Key R&D Program of China(2022YFC2503901,2022YFC2503900)+1 种基金the Beijing Hundred,Thousand,and Ten Thousand Talents Project(2017-CXYF-09)Beijing Health System Leading Talent Grant(2022-02-10).
文摘Totheeditor:Major depressive disorder(MDD)is a principal cause of disability worldwide and is often associated with high morbidity and mortality rates.Although there are several therapies available for the treatment of depression,about one-third of patients with MMD will not respond to two or more antidepressant drugs with different mechanisms;the patients are then referred to as having treatment-resistant depression(TRD).Patients with TRD have a poorer quality of life,greater economic burden and increased suicidal behaviours.Therefore,new antidepressant treatments that are effective,safe,long-lasting and tolerable are needed.Ketamine infusion,intranasal esketamine and transcranial magnetic stimulation(TMS)have been used to treat early stage TRD.’A recent review suggests that electroconvulsive therapy(ECT)may be superior to ketamine for reducing depression severity in the acute treatment of TRD.
文摘目的:观察细银质针导热松解术治疗肱二头肌长头腱炎(myotenositis of the long head of biceps brachii, MLHB)的有效性和安全性。方法:纳入MLHB病人102例,采用随机数字表法平均分为细银质针导热组(A组)和局部注射组(B组),比较两组治疗前后的肩关节功能评分(american shoulder and elbow surgeons’form score, ASES)、腱鞘积液厚度和长头腱周长。结果:A组治疗后1周的ASES显著提高、腱鞘积液厚度明显降低,治疗后4周长头腱周长显著减小;B组治疗后5 min的ASES明显升高,治疗后4周较2周的ASES明显降低;治疗后1周长头腱周长明显减小、2周腱鞘积液厚度明显减少。治疗后4周A组ASES评分以及腱鞘积液厚度均优于B组。两组无明显不良反应。结论:细银质针导热松解术及局部药物注射均能改善MLHB的临床症状,细银质针导热松解术远期疗效优于局部药物注射。
