Compacted layers of expansive soils are used in different engineering projects,such as subgrades,engineered clay barriers,and buffers for radioactive waste disposal.These layers are exposed to a variety of stresses an...Compacted layers of expansive soils are used in different engineering projects,such as subgrades,engineered clay barriers,and buffers for radioactive waste disposal.These layers are exposed to a variety of stresses and wetting conditions during field serviceability.Coupling between hydraulic and mechanical repeated loading provides insight understanding to the induced progressive deformation of expansive clay.This study was conducted to investigate the hydromechanical behavior of unsaturated compacted expansive clay under repeated loadingeunloading(RLU)conditions.Two series of onedimensional(1D)oedometer tests were conducted under controlled matric suction up to 1500 kPa using the axis translation technique(Fredlund soil-water characteristic curve device,SWC-150).The first test series was carried out at different levels of controlled matric suction for non-repeated loading eunloading(NRLU)cycles.RLU cycles were applied in the second test series at different repetitivestress levels and under different levels of matric suction.The results indicated increasing axial wetting strainε_(a)(s),axial swell pressure ss(s),compression index C_(c)(s),and swell index C_(s)(s)with suction reduction.The estimated loadecollapse(LC)curves obtained from NRLU series(LCN)and RLU series(LCR)indicated increasing yield stress sy(s)with increasing suction.This is attributed to the developed apparent cohesion between soil particles,which in turn rigidifies the material response.Applying repetitive loading induced a notable reduction of compression index C_(c)(s)at the same level of suction,whereas swell index C_(s)(s)seems to be independent of repetitive loading.Finally,repetitive loading exceeding initial yield stresses results in plastic hardening and,hence,enlargement of yield stress locus(i.e.LCR curve).展开更多
Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent pa...Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent patients were collected from Mudanjiang Medical University and Sun Yat-sen Memorial Hospital at Sun Yat-sen University between 2019 and 2021.The patients were divided into groups depending on alcohol abstinence and non-abstinence.There were 43 patients in the alcohol consumption(AC)group.The patients in the abstinence group were randomly assigned to treatment regimens with different combinations of rTMS and CBT using the Elton system.There were 49 patients in the TB+C0 group,36 in the TB+C1 group,44 in the TL+C0 group,36 in the TL+C1 group,37 in the TR+C0 group,and 40 in the TR+C1 group.Cognitive function was assessed by using the Montreal Cognitive Assessment Scale(MoCA).Results The proportion of patients with cognitive impairment in the AC group at 24 weeks was higher than that at baseline(P<0.05),whereas the proportion of cognitive impairment in the other groups did not differ significantly over time.The percentage of patients with cognitive impairment at 24 weeks was 52.3%in the TL+C0 group and 47.2%in the TL+C1 group,which was significantly lower than that in the AC group(P<0.05).MoCA scores at different time points in the AC group were significantly higher than those in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups,respectively.MoCA scores were significantly higher at 12 weeks compared with the baseline in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups(P<0.05),and similar changes were observed at 24 weeks.The MoCA scores in the TL+C1 and TL+C0 groups were higher than those in the TR+C0 group at 12 weeks after the intervention(P<0.05).Furthermore,MoCA scores in each of the TB+C1,TL+C1,TL+C0,TR+C1,and TR+C0 groups were higher than those in the AC group at 24 weeks(P<0.05).Conclusion Alcohol consumption impairs cognitive function,as evidenced by a significantly higher proportion of cognitive impairment after 24 weeks of non-abstinence.Most of the tested treatment regimens improved cognitive function.High frequency rTMS of the left dorsolateral prefrontal cortex(DLPFC)was associated with a greater improvement in cognitive function than that of the right DLPFC in alcohol-dependent patients at 12 weeks of abstinence.There does not appear to be a therapeutic advantage of CBT for cognitive impairment in alcohol-dependent patients.Screening for impaired cognitive function should be seriously considered for patients who engage in heavy drinking,and measures should be taken to reduce the risk of dementia induced by alcohol dependence.展开更多
目的:采用动态功能连接分析技术探讨孤独症谱系障碍(ASD)患者右侧梭状回与全脑动态功能连接特点,并分析异常脑区的动态功能连接时间变异性与ASD主要症状的相关性。方法:将孤独症脑影像公开数据库ABIDE I和Ⅱ中美国纽约大学朗格尼医学中...目的:采用动态功能连接分析技术探讨孤独症谱系障碍(ASD)患者右侧梭状回与全脑动态功能连接特点,并分析异常脑区的动态功能连接时间变异性与ASD主要症状的相关性。方法:将孤独症脑影像公开数据库ABIDE I和Ⅱ中美国纽约大学朗格尼医学中心收集的120例ASD患者和131名与之年龄相匹配的正常对照作为研究对象,利用滑动窗法,计算右侧梭状回与全脑动态功能连接的时间变异性,采用双样本t检验,以年龄、性别、利手及智商作为协变量,比较两组被试右侧梭状回与全脑动态功能连接时间变异性的差异,并将差异脑区动态功能连接时间变异值与ASD主要症状评分进行Spearman相关分析。结果:与正常对照相比,ASD组的右侧梭状回与右侧额中回、双侧内侧额中回、左侧背外侧额上回的动态功能连接时间变异性显著升高(Gaussian Random Field,GRF校正,体素水平P<0.005且团块水平P<0.05),差异脑区的动态功能连接时间变异值与ASD诊断观察量表(ADOS)重复刻板行为分数呈正相关(P<0.05)。结论:ASD患者右侧梭状回与全脑动态功能连接变异值增高的脑区均属于社会脑组成部分,该发现为社会脑功能异常在ASD形成机制的研究中提供了新的依据。展开更多
目的通过随机双盲对照研究,探索左前额叶高频重复经颅磁刺激(repetitivetranscranial magnetic stimulation,rTMS)对阿尔茨海默病(Alzheimer s disease,AD)的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)的...目的通过随机双盲对照研究,探索左前额叶高频重复经颅磁刺激(repetitivetranscranial magnetic stimulation,rTMS)对阿尔茨海默病(Alzheimer s disease,AD)的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)的疗效及安全性。方法筛选2020年4月至2022年1月在上海市精神卫生中心老年科住院的AD患者45例,年龄6085岁,符合简明精神状况量表(MMSE):224分;临床痴呆评定量表(CDR):13分;Hachinski缺血指数量表(HIS)≤4分;痴呆病理行为评定量表(BEHAVE-AD)≥8分。采用随机、双盲、伪刺激对照的临床实验设计,将患者分为rTMS干预真刺激组和伪刺激组,每天治疗1次,持续约22 min左右,每周5次,4周,共20次,最终完成实验的患者28例(真刺激组13例,伪刺激组15例)。2组均给予常规药物治疗,在基线期和4周干预结束后,分别进行疗效和安全性评估。结果干预后,真刺激组的神经精神症状量表(NPI)、AD病理行为评分表(BEHAVE-AD)及柯恩-曼斯菲尔德激越情绪行为量表(CMAI)的减分高于伪刺激组,分别为(28.85±8.23)vs(8.20±6.79)、(12.85±7.76)vs(7.07±4.57)、(16.31±6.68)vs(9.47±6.86),差异均存在统计学意义(p<0.05);真刺激组的NPI量表妄想、激越、情绪不稳和异常行为4个因子减分高于伪刺激组,差异存在统计学意义(p<0.05);真刺激组抗精神病药物日剂量增量低于伪刺激组(9 vs 50),差异存在统计学意义(p<0.05);真刺激组不良反应为短暂的头皮发紧2例和轻度头痛1例,伪刺激组为短暂的头皮发紧1例和面部肌肉收缩感1例,2组患者均能耐受,发生率无统计学差异,均无严重不良事件。结论左前额叶高频rTMS可能可以改善阿尔茨海默病患者精神行为症状,是一种安全有效的治疗方法。展开更多
Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless,few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamin...Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless,few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamine（METH） dependence, which is detrimental to human health. Thus, we investigated the behavioral adjustment performance following error commission in long-term METH addicts and how it varied with the application of repetitive transcranial magnetic stimulation（r TMS） of the left dorsolateral prefrontal cortex（DLPFC）. Twenty-nine male long-term METH addicts（for [ 3 years） were randomly assigned to high-frequency（10 Hz, n = 15） or sham（n = 14） r TMS of the left DLPFC during a two-choice oddball task. Twenty-six age-matched, healthy male adults participated in the two-choice oddball task pretest to establish normal performance for comparison. The results showed that 10 Hz r TMS over the left DLPFC significantly decreased the post-error slowing effect in response times of METH addicts. In addition, the 10 Hz r TMS intervention remarkably reduced the reaction times during post-error trials but not post-correct trials. While the 10 Hz r TMS group showed a more pronounced post-error slowing effect than the healthy participants during the pretest, the posterror slowing effect in the posttest of this sample was similar to that in the healthy participants. These results suggest that high-frequency r TMS over the left DLPFC is a useful protocol for the improvement of behavioral adjustment after error commission in long-term METH addicts.展开更多
阿尔茨海默病(Alzheimer′s disease,AD)是老年期最为常见的一种痴呆类型,是一种病因不明的慢性、进行性、原发性大脑神经系统退行性病变,以记忆力减退、行为能力下降、认知能力损失、日常自理能力下降等为主要特征。AD发病率高,疾病负...阿尔茨海默病(Alzheimer′s disease,AD)是老年期最为常见的一种痴呆类型,是一种病因不明的慢性、进行性、原发性大脑神经系统退行性病变,以记忆力减退、行为能力下降、认知能力损失、日常自理能力下降等为主要特征。AD发病率高,疾病负担重,患者在认知功能减退的同时,常会出现一系列精神行为症状(Behavioral and psychological symptoms of dementia,BPSD)。传统的药物治疗存在疗效不理想、副作用明显等局限,重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)作为一种重要的非侵入性脑刺激治疗技术,可经脉冲磁场对中枢神经产生作用,影响脑神经电活动及脑内代谢,与AD常用药物联合应用,可获得理想效果。本文就rTMS治疗AD患者的认知障碍和精神行为症状进行综述。展开更多
文摘Compacted layers of expansive soils are used in different engineering projects,such as subgrades,engineered clay barriers,and buffers for radioactive waste disposal.These layers are exposed to a variety of stresses and wetting conditions during field serviceability.Coupling between hydraulic and mechanical repeated loading provides insight understanding to the induced progressive deformation of expansive clay.This study was conducted to investigate the hydromechanical behavior of unsaturated compacted expansive clay under repeated loadingeunloading(RLU)conditions.Two series of onedimensional(1D)oedometer tests were conducted under controlled matric suction up to 1500 kPa using the axis translation technique(Fredlund soil-water characteristic curve device,SWC-150).The first test series was carried out at different levels of controlled matric suction for non-repeated loading eunloading(NRLU)cycles.RLU cycles were applied in the second test series at different repetitivestress levels and under different levels of matric suction.The results indicated increasing axial wetting strainε_(a)(s),axial swell pressure ss(s),compression index C_(c)(s),and swell index C_(s)(s)with suction reduction.The estimated loadecollapse(LC)curves obtained from NRLU series(LCN)and RLU series(LCR)indicated increasing yield stress sy(s)with increasing suction.This is attributed to the developed apparent cohesion between soil particles,which in turn rigidifies the material response.Applying repetitive loading induced a notable reduction of compression index C_(c)(s)at the same level of suction,whereas swell index C_(s)(s)seems to be independent of repetitive loading.Finally,repetitive loading exceeding initial yield stresses results in plastic hardening and,hence,enlargement of yield stress locus(i.e.LCR curve).
基金National Key Research and Development Program(2018YFC1314400)Key R&D plan of Heilongjiang Province(GA21C010)。
文摘Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent patients were collected from Mudanjiang Medical University and Sun Yat-sen Memorial Hospital at Sun Yat-sen University between 2019 and 2021.The patients were divided into groups depending on alcohol abstinence and non-abstinence.There were 43 patients in the alcohol consumption(AC)group.The patients in the abstinence group were randomly assigned to treatment regimens with different combinations of rTMS and CBT using the Elton system.There were 49 patients in the TB+C0 group,36 in the TB+C1 group,44 in the TL+C0 group,36 in the TL+C1 group,37 in the TR+C0 group,and 40 in the TR+C1 group.Cognitive function was assessed by using the Montreal Cognitive Assessment Scale(MoCA).Results The proportion of patients with cognitive impairment in the AC group at 24 weeks was higher than that at baseline(P<0.05),whereas the proportion of cognitive impairment in the other groups did not differ significantly over time.The percentage of patients with cognitive impairment at 24 weeks was 52.3%in the TL+C0 group and 47.2%in the TL+C1 group,which was significantly lower than that in the AC group(P<0.05).MoCA scores at different time points in the AC group were significantly higher than those in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups,respectively.MoCA scores were significantly higher at 12 weeks compared with the baseline in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups(P<0.05),and similar changes were observed at 24 weeks.The MoCA scores in the TL+C1 and TL+C0 groups were higher than those in the TR+C0 group at 12 weeks after the intervention(P<0.05).Furthermore,MoCA scores in each of the TB+C1,TL+C1,TL+C0,TR+C1,and TR+C0 groups were higher than those in the AC group at 24 weeks(P<0.05).Conclusion Alcohol consumption impairs cognitive function,as evidenced by a significantly higher proportion of cognitive impairment after 24 weeks of non-abstinence.Most of the tested treatment regimens improved cognitive function.High frequency rTMS of the left dorsolateral prefrontal cortex(DLPFC)was associated with a greater improvement in cognitive function than that of the right DLPFC in alcohol-dependent patients at 12 weeks of abstinence.There does not appear to be a therapeutic advantage of CBT for cognitive impairment in alcohol-dependent patients.Screening for impaired cognitive function should be seriously considered for patients who engage in heavy drinking,and measures should be taken to reduce the risk of dementia induced by alcohol dependence.
文摘目的:采用动态功能连接分析技术探讨孤独症谱系障碍(ASD)患者右侧梭状回与全脑动态功能连接特点,并分析异常脑区的动态功能连接时间变异性与ASD主要症状的相关性。方法:将孤独症脑影像公开数据库ABIDE I和Ⅱ中美国纽约大学朗格尼医学中心收集的120例ASD患者和131名与之年龄相匹配的正常对照作为研究对象,利用滑动窗法,计算右侧梭状回与全脑动态功能连接的时间变异性,采用双样本t检验,以年龄、性别、利手及智商作为协变量,比较两组被试右侧梭状回与全脑动态功能连接时间变异性的差异,并将差异脑区动态功能连接时间变异值与ASD主要症状评分进行Spearman相关分析。结果:与正常对照相比,ASD组的右侧梭状回与右侧额中回、双侧内侧额中回、左侧背外侧额上回的动态功能连接时间变异性显著升高(Gaussian Random Field,GRF校正,体素水平P<0.005且团块水平P<0.05),差异脑区的动态功能连接时间变异值与ASD诊断观察量表(ADOS)重复刻板行为分数呈正相关(P<0.05)。结论:ASD患者右侧梭状回与全脑动态功能连接变异值增高的脑区均属于社会脑组成部分,该发现为社会脑功能异常在ASD形成机制的研究中提供了新的依据。
文摘目的通过随机双盲对照研究,探索左前额叶高频重复经颅磁刺激(repetitivetranscranial magnetic stimulation,rTMS)对阿尔茨海默病(Alzheimer s disease,AD)的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)的疗效及安全性。方法筛选2020年4月至2022年1月在上海市精神卫生中心老年科住院的AD患者45例,年龄6085岁,符合简明精神状况量表(MMSE):224分;临床痴呆评定量表(CDR):13分;Hachinski缺血指数量表(HIS)≤4分;痴呆病理行为评定量表(BEHAVE-AD)≥8分。采用随机、双盲、伪刺激对照的临床实验设计,将患者分为rTMS干预真刺激组和伪刺激组,每天治疗1次,持续约22 min左右,每周5次,4周,共20次,最终完成实验的患者28例(真刺激组13例,伪刺激组15例)。2组均给予常规药物治疗,在基线期和4周干预结束后,分别进行疗效和安全性评估。结果干预后,真刺激组的神经精神症状量表(NPI)、AD病理行为评分表(BEHAVE-AD)及柯恩-曼斯菲尔德激越情绪行为量表(CMAI)的减分高于伪刺激组,分别为(28.85±8.23)vs(8.20±6.79)、(12.85±7.76)vs(7.07±4.57)、(16.31±6.68)vs(9.47±6.86),差异均存在统计学意义(p<0.05);真刺激组的NPI量表妄想、激越、情绪不稳和异常行为4个因子减分高于伪刺激组,差异存在统计学意义(p<0.05);真刺激组抗精神病药物日剂量增量低于伪刺激组(9 vs 50),差异存在统计学意义(p<0.05);真刺激组不良反应为短暂的头皮发紧2例和轻度头痛1例,伪刺激组为短暂的头皮发紧1例和面部肌肉收缩感1例,2组患者均能耐受,发生率无统计学差异,均无严重不良事件。结论左前额叶高频rTMS可能可以改善阿尔茨海默病患者精神行为症状,是一种安全有效的治疗方法。
基金supported by the National Natural Science Foundation of China (31371042, 31400906 and 31600886)the Key Program of the Higher Education Institutions of Henan Province, China (17AJ90002)
文摘Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless,few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamine（METH） dependence, which is detrimental to human health. Thus, we investigated the behavioral adjustment performance following error commission in long-term METH addicts and how it varied with the application of repetitive transcranial magnetic stimulation（r TMS） of the left dorsolateral prefrontal cortex（DLPFC）. Twenty-nine male long-term METH addicts（for [ 3 years） were randomly assigned to high-frequency（10 Hz, n = 15） or sham（n = 14） r TMS of the left DLPFC during a two-choice oddball task. Twenty-six age-matched, healthy male adults participated in the two-choice oddball task pretest to establish normal performance for comparison. The results showed that 10 Hz r TMS over the left DLPFC significantly decreased the post-error slowing effect in response times of METH addicts. In addition, the 10 Hz r TMS intervention remarkably reduced the reaction times during post-error trials but not post-correct trials. While the 10 Hz r TMS group showed a more pronounced post-error slowing effect than the healthy participants during the pretest, the posterror slowing effect in the posttest of this sample was similar to that in the healthy participants. These results suggest that high-frequency r TMS over the left DLPFC is a useful protocol for the improvement of behavioral adjustment after error commission in long-term METH addicts.
文摘阿尔茨海默病(Alzheimer′s disease,AD)是老年期最为常见的一种痴呆类型,是一种病因不明的慢性、进行性、原发性大脑神经系统退行性病变,以记忆力减退、行为能力下降、认知能力损失、日常自理能力下降等为主要特征。AD发病率高,疾病负担重,患者在认知功能减退的同时,常会出现一系列精神行为症状(Behavioral and psychological symptoms of dementia,BPSD)。传统的药物治疗存在疗效不理想、副作用明显等局限,重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)作为一种重要的非侵入性脑刺激治疗技术,可经脉冲磁场对中枢神经产生作用,影响脑神经电活动及脑内代谢,与AD常用药物联合应用,可获得理想效果。本文就rTMS治疗AD患者的认知障碍和精神行为症状进行综述。
