目的探讨高、低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)大脑初级运动皮层(M1区)治疗卒中后上肢痉挛的临床疗效及差异。方法纳入我院神经内科和中医理疗科卒中后痉挛性偏瘫患者60例,随机分为高频rT MS组...目的探讨高、低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)大脑初级运动皮层(M1区)治疗卒中后上肢痉挛的临床疗效及差异。方法纳入我院神经内科和中医理疗科卒中后痉挛性偏瘫患者60例,随机分为高频rT MS组、低频rTMS组和假刺激组各20例。高频rTMS组刺激患侧M1区,刺激频率为10 Hz,刺激强度为80%运动阈值;低频rTMS组刺激健侧M1区,刺激频率为1 Hz,刺激强度为90%运动阈值;假刺激组接受相同噪声与时间的假刺激治疗。所有患者均接受常规康复治疗。各组患者分别在治疗前及治疗8周后采用改良Ashworth痉挛评定量表(modified Ashworth scale,MAS)、Fugl-Meyer运动功能评定量表中上肢运动功能测试部分(upper extremities motor function test of Fugl-Meyer movement assessment,U-FMA)和改良Barthel指数(modified Barthel index,MBI)进行评定。以上治疗均1次/日,5次/周,连续治疗8周。结果与治疗前相比,治疗后三组患者上肢MAS、U-FMA和MBI评分均有显著改善,差异均有统计学意义(P<0.01);治疗后,高频rTMS组和低频rTMS组比假刺激组的上肢MAS、U-FMA和MBI评分改善更明显,比较差异有统计学意义(P<0.05);但低频rTMS组和高频rTMS组上肢MAS、U-FMA和MBI评分比较,差异无统计学意义。结论健侧低频与患侧高频rTMS刺激大脑M1区均可有效改善患者的临床症状和运动功能障碍。两种经颅磁刺激方案临床疗效相当。展开更多
Magnesium hydride(MgH2)was doped into PTFE/Al to improve the energy release characteristics of the material system and strive for better application in military engineering.Five types of PTFE/Al/MgH2 reactive material...Magnesium hydride(MgH2)was doped into PTFE/Al to improve the energy release characteristics of the material system and strive for better application in military engineering.Five types of PTFE/Al/MgH2 reactive materials with different MgH2 content were prepared by molding sintering method.The dynamic mechanical properties of the materials were studied by performing split-Hopkinson pressure bar(SHPB)tests and scanning electron microscope characterizations.The thermal behavior,reaction energy,reaction process and reaction mechanism were systematically investigated by conducting thermogravimetry-differential scanning calorimetry tests,oxygen bomb calorimeter measurements,Xray diffraction and SHPB tests.The results show that MgH2 particles less than 10%content contribute to heightening the dynamic mechanical properties of PTFE/Al system.The product Mg generated by decomposition of MgH2 can not only react with gas phase C2F4þbut also undergo a Grignard-type reaction with condensed PTFE.The reaction energy and ignition threshold of PTFE/Al/MgH2 reactive materials enhance monotonously as MgH2 content rose.With the increase of MgH2 content from 0%to 20%,the reaction time is prolonged as well as the reaction intensity is enhanced dramatically arising from the massive water vapour produced by the reaction between O2 and H2.The gaseous products generated can form a high pressure shortly after the reaction,which helps to elevate the damage effect of the PTFE/Al system.展开更多
文摘目的探讨高、低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)大脑初级运动皮层(M1区)治疗卒中后上肢痉挛的临床疗效及差异。方法纳入我院神经内科和中医理疗科卒中后痉挛性偏瘫患者60例,随机分为高频rT MS组、低频rTMS组和假刺激组各20例。高频rTMS组刺激患侧M1区,刺激频率为10 Hz,刺激强度为80%运动阈值;低频rTMS组刺激健侧M1区,刺激频率为1 Hz,刺激强度为90%运动阈值;假刺激组接受相同噪声与时间的假刺激治疗。所有患者均接受常规康复治疗。各组患者分别在治疗前及治疗8周后采用改良Ashworth痉挛评定量表(modified Ashworth scale,MAS)、Fugl-Meyer运动功能评定量表中上肢运动功能测试部分(upper extremities motor function test of Fugl-Meyer movement assessment,U-FMA)和改良Barthel指数(modified Barthel index,MBI)进行评定。以上治疗均1次/日,5次/周,连续治疗8周。结果与治疗前相比,治疗后三组患者上肢MAS、U-FMA和MBI评分均有显著改善,差异均有统计学意义(P<0.01);治疗后,高频rTMS组和低频rTMS组比假刺激组的上肢MAS、U-FMA和MBI评分改善更明显,比较差异有统计学意义(P<0.05);但低频rTMS组和高频rTMS组上肢MAS、U-FMA和MBI评分比较,差异无统计学意义。结论健侧低频与患侧高频rTMS刺激大脑M1区均可有效改善患者的临床症状和运动功能障碍。两种经颅磁刺激方案临床疗效相当。
基金support from the National Natural Science Foun-dation of China(General Program.Grant No.51673213)Na-tional Natural Science Foundation of China(Grant No.51803235)are gratefully acknowledged.
文摘Magnesium hydride(MgH2)was doped into PTFE/Al to improve the energy release characteristics of the material system and strive for better application in military engineering.Five types of PTFE/Al/MgH2 reactive materials with different MgH2 content were prepared by molding sintering method.The dynamic mechanical properties of the materials were studied by performing split-Hopkinson pressure bar(SHPB)tests and scanning electron microscope characterizations.The thermal behavior,reaction energy,reaction process and reaction mechanism were systematically investigated by conducting thermogravimetry-differential scanning calorimetry tests,oxygen bomb calorimeter measurements,Xray diffraction and SHPB tests.The results show that MgH2 particles less than 10%content contribute to heightening the dynamic mechanical properties of PTFE/Al system.The product Mg generated by decomposition of MgH2 can not only react with gas phase C2F4þbut also undergo a Grignard-type reaction with condensed PTFE.The reaction energy and ignition threshold of PTFE/Al/MgH2 reactive materials enhance monotonously as MgH2 content rose.With the increase of MgH2 content from 0%to 20%,the reaction time is prolonged as well as the reaction intensity is enhanced dramatically arising from the massive water vapour produced by the reaction between O2 and H2.The gaseous products generated can form a high pressure shortly after the reaction,which helps to elevate the damage effect of the PTFE/Al system.
