目的:探讨多通道功能性电刺激对脑卒中患者上肢运动功能及表面肌电信号的影响。方法:选取2019年1月至2019年6月在无锡市同仁康复医院康复医学科住院的脑卒中患者44例,随机分为观察组(21例)和对照组(23例),两组患者均给予常规临床、护理...目的:探讨多通道功能性电刺激对脑卒中患者上肢运动功能及表面肌电信号的影响。方法:选取2019年1月至2019年6月在无锡市同仁康复医院康复医学科住院的脑卒中患者44例,随机分为观察组(21例)和对照组(23例),两组患者均给予常规临床、护理及康复治疗,在此基础上,对照组患者接受手摇车训练,而观察组患者在进行手摇车训练的同时辅以多通道功能性电刺激治疗,均每日治疗1次,每周5次,共治疗4周。分别在治疗前和治疗4周后对患者患侧上肢肱二头肌、肱三头肌进行表面肌电图测试,并采用Fugl-Meyer评定量表上肢部分(FMA-UE)和改良的Barthel指数(modified Barthelindex,MBI)对所有患者进行上肢运动功能及日常生活活动能力评定。结果:治疗前两组患者上肢肱二、三头肌表面肌电均方根值(root mean square,RMS)、协同收缩率(co-contractionratio,CR)以及FMA-UE、MBI评分均无显著性差异(P>0.05)。治疗4周后,两组患者上肢肱二、三头肌RMS值、CR值较治疗前均有所降低(P<0.05),FMA-UE和MBI评分较治疗前均有所提高(P<0.05),差异具有显著性意义。4周后观察组各评分值改善程度优于对照组(P<0.05)。结论:多通道FES可以有效提高脑卒中患者上肢运动功能和日常生活自理能力,同时能有效降低脑卒中患者上肢的肌张力,值得临床推广应用。展开更多
Objective: The increased perinatal morbidity in diabetes may be partly related to vascular dysfunction. Because potassium channels play an important role in the regulation of vascular tone, this study explores the imp...Objective: The increased perinatal morbidity in diabetes may be partly related to vascular dysfunction. Because potassium channels play an important role in the regulation of vascular tone, this study explores the impact of diabetes on potassium channel function in the fetoplacental vascular bed. Study design: Vascular potassium channel function was investigated by ex vivo dual perfusion of isolated placental cotyledons (n = 47). Appropriate control experiments were carried out to exclude nonspecific effects. Results: Glibenclamide (KATP channel blocker) increased perfusion pressure to a maximum fetoplacental arterial pressure of 37 ± .6 mm Hg in controls versus 15 ± 6 mm Hg in diabetes (P <. 05). 4- Aminopyridine (KV channel blocker) equally increased fetoplacental arterial pressure in controls, and in diabetes (21 ± 4 mm Hg vs 22 ± 2 mm Hg). Apamin and charybdotoxin (KCa channel blockers) caused a negligible rise in fetoplacental arterial pressure. Conclusion: In the fetoplacental circulation, KATP channels and KV channels significantly contribute to baseline vascular tone. In diabetes, vascular KATP channel function is impaired.展开更多
Background &Aims: Cystic fibrosis (CF) is caused by over 1000 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and presents with a widely variable phenotype. Genotype phenotype stud...Background &Aims: Cystic fibrosis (CF) is caused by over 1000 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and presents with a widely variable phenotype. Genotype phenotype studies identified CFTR mutations that were associated with pancreatic sufficiency (PS). Residual Cl-channel function was shown for selected PS mutations in heterologous cells. However, the functional consequences of most CFTR mutations in native epithelia are not well established. Methods: To elucidate the relationships between epithelial CFTR function, CFTR genotype, and patient phenotype, we measured cyclic adenosine monophosphate (cAMP)mediated Cl-secretion in rectal biopsy specimens from 45 CF patients who had at least 1 non F508 mutation carrying a wide spectrum of CFTR mutations. We compared CFTR genotypes and clinical manifestations of CF patients who expressed residual CFTR mediated Cl-secretion with patients in whom Cl-secretion was absent. Results: Residual anion secretion was detected in 40%of CF patients, and was associated with later disease onset (P <0.0001), higher frequency of PS (P <0.0001), and less severe lung disease (P <0.05). Clinical outcomes correlated with the magnitude of residual CFTR activity, which was in the range of 12%-54%of controls. Conclusions: Specific CFTR mutations confer residual CFTR function to rectal epithelia, which is related closely to a mild disease phenotype. Quantification of rectal CFTR mediated Cl-secretion may be a sensitive test to predict the prognosis of CF disease and identify CF patients who would benefit from therapeutic strategies that would increase residual CFTR activity.展开更多
文摘目的:探讨多通道功能性电刺激对脑卒中患者上肢运动功能及表面肌电信号的影响。方法:选取2019年1月至2019年6月在无锡市同仁康复医院康复医学科住院的脑卒中患者44例,随机分为观察组(21例)和对照组(23例),两组患者均给予常规临床、护理及康复治疗,在此基础上,对照组患者接受手摇车训练,而观察组患者在进行手摇车训练的同时辅以多通道功能性电刺激治疗,均每日治疗1次,每周5次,共治疗4周。分别在治疗前和治疗4周后对患者患侧上肢肱二头肌、肱三头肌进行表面肌电图测试,并采用Fugl-Meyer评定量表上肢部分(FMA-UE)和改良的Barthel指数(modified Barthelindex,MBI)对所有患者进行上肢运动功能及日常生活活动能力评定。结果:治疗前两组患者上肢肱二、三头肌表面肌电均方根值(root mean square,RMS)、协同收缩率(co-contractionratio,CR)以及FMA-UE、MBI评分均无显著性差异(P>0.05)。治疗4周后,两组患者上肢肱二、三头肌RMS值、CR值较治疗前均有所降低(P<0.05),FMA-UE和MBI评分较治疗前均有所提高(P<0.05),差异具有显著性意义。4周后观察组各评分值改善程度优于对照组(P<0.05)。结论:多通道FES可以有效提高脑卒中患者上肢运动功能和日常生活自理能力,同时能有效降低脑卒中患者上肢的肌张力,值得临床推广应用。
文摘Objective: The increased perinatal morbidity in diabetes may be partly related to vascular dysfunction. Because potassium channels play an important role in the regulation of vascular tone, this study explores the impact of diabetes on potassium channel function in the fetoplacental vascular bed. Study design: Vascular potassium channel function was investigated by ex vivo dual perfusion of isolated placental cotyledons (n = 47). Appropriate control experiments were carried out to exclude nonspecific effects. Results: Glibenclamide (KATP channel blocker) increased perfusion pressure to a maximum fetoplacental arterial pressure of 37 ± .6 mm Hg in controls versus 15 ± 6 mm Hg in diabetes (P <. 05). 4- Aminopyridine (KV channel blocker) equally increased fetoplacental arterial pressure in controls, and in diabetes (21 ± 4 mm Hg vs 22 ± 2 mm Hg). Apamin and charybdotoxin (KCa channel blockers) caused a negligible rise in fetoplacental arterial pressure. Conclusion: In the fetoplacental circulation, KATP channels and KV channels significantly contribute to baseline vascular tone. In diabetes, vascular KATP channel function is impaired.
文摘Background &Aims: Cystic fibrosis (CF) is caused by over 1000 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and presents with a widely variable phenotype. Genotype phenotype studies identified CFTR mutations that were associated with pancreatic sufficiency (PS). Residual Cl-channel function was shown for selected PS mutations in heterologous cells. However, the functional consequences of most CFTR mutations in native epithelia are not well established. Methods: To elucidate the relationships between epithelial CFTR function, CFTR genotype, and patient phenotype, we measured cyclic adenosine monophosphate (cAMP)mediated Cl-secretion in rectal biopsy specimens from 45 CF patients who had at least 1 non F508 mutation carrying a wide spectrum of CFTR mutations. We compared CFTR genotypes and clinical manifestations of CF patients who expressed residual CFTR mediated Cl-secretion with patients in whom Cl-secretion was absent. Results: Residual anion secretion was detected in 40%of CF patients, and was associated with later disease onset (P <0.0001), higher frequency of PS (P <0.0001), and less severe lung disease (P <0.05). Clinical outcomes correlated with the magnitude of residual CFTR activity, which was in the range of 12%-54%of controls. Conclusions: Specific CFTR mutations confer residual CFTR function to rectal epithelia, which is related closely to a mild disease phenotype. Quantification of rectal CFTR mediated Cl-secretion may be a sensitive test to predict the prognosis of CF disease and identify CF patients who would benefit from therapeutic strategies that would increase residual CFTR activity.
