Low-intensity pulsed ultrasound reduces alveolar bone resorption during orthodontic treatment via Lamin A/C-Yes-associated protein axis in stem cells

BACKGROUND The bone remodeling during orthodontic treatment for malocclusion often requires a long duration of around two to three years,which also may lead to some complications such as alveolar bone resorption or tooth root resorption.Low-intensity pulsed ultrasound(LIPUS),a noninvasive physical therapy,has been shown to promote bone fracture healing.It is also reported that LIPUS could reduce the duration of orthodontic treatment;however,how LIPUS regulates the bone metabolism during the orthodontic treatment process is still unclear.AIM To investigate the effects of LIPUS on bone remodeling in an orthodontic tooth movement(OTM)model and explore the underlying mechanisms.METHODS A rat model of OTM was established,and alveolar bone remodeling and tooth movement rate were evaluated via micro-computed tomography and staining of tissue sections.In vitro,human bone marrow mesenchymal stem cells(hBMSCs)were isolated to detect their osteogenic differentiation potential under compression and LIPUS stimulation by quantitative reverse transcription-polymerase chain reaction,Western blot,alkaline phosphatase(ALP)staining,and Alizarin red staining.The expression of Yes-associated protein(YAP1),the actin cytoskeleton,and the Lamin A/C nucleoskeleton were detected with or without YAP1 small interfering RNA(siRNA)application via immunofluorescence.RESULTS The force treatment inhibited the osteogenic differentiation potential of hBMSCs;moreover,the expression of osteogenesis markers,such as type 1 collagen(COL1),runt-related transcription factor 2,ALP,and osteocalcin(OCN),decreased.LIPUS could rescue the osteogenic differentiation of hBMSCs with increased expression of osteogenic marker inhibited by force.Mechanically,the expression of LaminA/C,F-actin,and YAP1 was downregulated after force treatment,which could be rescued by LIPUS.Moreover,the osteogenic differentiation of hBMSCs increased by LIPUS could be attenuated by YAP siRNA treatment.Consistently,LIPUS increased alveolar bone density and decreased vertical bone absorption in vivo.The decreased expression of COL1,OCN,and YAP1 on the compression side of the alveolar bone was partially rescued by LIPUS.CONCLUSION LIPUS can accelerate tooth movement and reduce alveolar bone resorption by modulating the cytoskeleton-Lamin A/C-YAP axis,which may be a promising strategy to reduce the orthodontic treatment process.

Wideband frequency-dependent dielectric properties of rat tissues exposed to low-intensity focused ultrasound in the microwave frequency range

Tissue dielectric properties can vary upon the incident of an acoustic wave.The goal of this study is to quantify this change due to the acoustoelectric effect(AE),and to obtain the frequency-dependent dielectric properties of tissues exposed to low-intensity focused ultrasound(LIFU).The dielectric properties of the blood,brain,chest muscle,heart,kidney,leg muscle,liver,lung,pancreas,and spleen of rats were measured by an open-ended coaxial probe method.The acoustic intensity of LIFU focus was 2.97 MPa(67.6 W/cm^(2)),3.95 MPa(120 W/cm^(2)),and 5.17 MPa(204 W/cm^(2)),respectively,and the measurement frequency band was 0.1–7.08 GHz.The measurement results show that with the LIFU modulation,the conductivity and dielectric constant decreased in the high-frequency band,and on the contrary,they increased in the lowfrequency band,and the larger the acoustic intensity was,the more obvious the phenomenon was.This work contributes to a better understanding of the mechanisms by which ultrasound acts on the dielectric properties of biological tissues.It is expected that the findings from this study will provide a basis that the response of tissue to LIFU modulation can be monitored by noninvasive techniques such as microwave-induced thermoacoustic imaging(MTI)and microwave imaging,present a new idea for improving the endogenous contrast between different biological tissues in MTI and acoustoelectric imaging,and possibly lead to the development of a new imaging method based on the relaxation time of tissue after LIFU modulation.

Treatable focal region modulated by double excitation signal superimposition to realize platform temperature distribution during transcranial brain tumor therapy with high-intensity focused ultrasound

Recently, the phase compensation technique has allowed the ultrasound to propagate through the skull and focus into the brain. However, the temperature evolution during treatment is hard to control to achieve effective treatment and avoid over-high temperature. Proposed in this paper is a method to modulate the temperature distribution in the focal region. It superimposes two signals which focus on two preset different targets with a certain distance. Then the temperature distribution is modulated by changing triggering time delay and amplitudes of the two signals. The simulation model is established based on an 82-element transducer and computed tomography （CT） data of a volunteer＇s head. A finite- difference time-domain （FDTD） method is used to calculate the temperature distributions. The results show that when the distances between the two targets respectively are 7.5-12.5 mm on the acoustic axis and 2.0-3.0 mm in the direction perpendicular to the acoustic axis, a focal region with a uniform temperature distribution （64-65 ℃） can be created. Moreover, the volume of the focal region formed by one irradiation can be adjusted （26.8-266.7 mm3） along with the uniform temperature distribution. This method may ensure the safety and efficacy of HIFU brain tumor therapy.

Effect of low-intensity pulsed ultrasound on posterolateral lumbar fusion of rabbit

Objective:To observe the effect of low-intensity pulsed ultrasound in the posterolateral Lumbar fusion of rabbit.Methods:A total of 48 New Zealand white rabbits were randomly divided into the observation group and control group,including the autogenous iliac observation group.artificial bone observation group,artificial bone control group and autogenous iliac control group according to the different bone grafting.The posterolateral lumbar fusion of rabbits in each group was analyzed and compared.Results:After 4 weeks of treatment using the low-intensity pulsed ultrasound,the fusion in the bone grafting area of observation group was good.There was the relatively dense fusion area between the right transverse process and artificial bone.The left transverse process had been completely fused,with the clear bone trabecula through the fusion area.There was no significant fusion sign in the control group.According to the fusion comparison between two groups,the fusion rale of the observation group was 83.3%and it was significantly higher than the one of the control group(37.5%).Results of the comparison were statistically significant(P<0.05).The number of chondrocytes and the increase in the relative gray-scale in the fusion area of the iliac observation group were significantly higher than ones of the iliac control group(P<0.05).The number of chondrocytes and the increase in the relative gray-scale in the fusion area of the artificial bone observation group were significantly higher than ones of the artificial bone control group(P<0.05).The expression of IL-1.IL-6 and IL-17 4 weeks after the treatment of the observation group was significantly lower than the one of the control group,with the statistical significance(P<0.05).It indicated that the treatment of low-intensity pulsed ultrasound could reduce the expression level of inflammatory factors.Conclusions:The low-intensity pulsed ultrasound can significantly increase the bone grafting fusion rate of the rabbit's posterolateral lumbar fusion.The possible mechanism is that it promotes the lumbar posterolateral endochondral ossification and reduces the inflammatory reaction.

Transcranial focused ultrasound stimulation reduces vasogenic edema after middle cerebral artery occlusion in mice

Blood-brain barrier(BBB)disruption underlies the vasogenic edema and neuronal cell death induced by acute ischemic stroke.Reducing this disruption has therapeutic potential.Transcranial focused ultrasound stimulation has shown neuromodulatory and neuroprotective effects in various brain diseases including ischemic stroke.Ultrasound stimulation can reduce inflammation and promote angiogenesis and neural circuit remodeling.However,its effect on the BBB in the acute phase of ischemic stroke is unknown.In this study of mice subjected to middle cerebral artery occlusion for 90 minutes,low-intensity low-frequency(0.5 MHz)transcranial focused ultrasound stimulation was applied 2,4,and 8 hours after occlusion.Ultrasound stimulation reduced edema volume,improved neurobehavioral outcomes,improved BBB integrity(enhanced tight junction protein ZO-1 expression and reduced IgG leakage),and reduced secretion of the inflammatory factors tumor necrosis factor-αand activation of matrix metalloproteinase-9 in the ischemic brain.Our results show that low-intensity ultrasound stimulation attenuated BBB disruption and edema formation,which suggests it may have therapeutic use in ischemic brain disease as a protector of BBB integrity.

Evaluation of Prognosis of Brain Function with Early Transcranial Color Doppler Ultrasound in Patients after Cardiopulmonary Resuscitation

Objective: To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). Methods: A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed. According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. Results: The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h;the difference between the two groups was statistically significant (p < 0.05);the Vd, Vs, Vm increased in the good prognosis group;the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. Conclusion: The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.

Low-intensity ultrasound for regeneration of injured peripheral nerve

BACKGROUND: Ultrasound is a kind of mechanical wave and characterized by mechanical effect, heat effect and physical and chemical effect. Ultrasound can promote regeneration of peripheral nerves after a slight injury based on its mechanical effect. However, whether it can promote regeneration of peripheral nerves after a severe injury or not is still unclear. OBJECTIVE: To study the effect of low-intensity ultrasound (LIU) on regeneration of injured peripheral nerve, through examining sciatic nerve function index, the sensory nerve conduction velocity and the thickness of myelin sheath. DESIGN: Single factor design of contrast observation. SETTING: Institute of Ultrasound Engineering, Chongqing Medical University. MATERIALS: A total of 64 female Wistar rats, of clean grade, aged 3 months, weighing 200-250 g, were provided by Experimental Animal Center of Chongqing Medical University. All rats were randomly divided into treatment group and control group with 32 in each group. In addition, rats were observed at 4 time points, including 2, 4, 6 and 8 weeks, with 8 at each time point. The main equipments were detailed as follows: forceps (Medical Treatment Apparatus Company, Chongqing), low-intensity ultrasound treatment instrument (Institute of Ultrasound Engineering in Medicine), the analysis instrument of diagram resembles and arithmetic figure (the United States Bio-RAD Company), ultrasound coupling agent (Xunde Image material factory, Hangzhou), Osmium Tetraoxide (Next Chimica, South Africa). METHODS: The experiment was carried out in Institute of Ultrasound Engineering of Chongqing Medical University from December 2003 to May 2004. The right sciatic nerves of 64 rats were crushed with forceps for 30 s to form the experimental animal models. Then they were treated at 3 days after operation. Rats in the treatment group received the LIU exposure. LIU was applied every other day to the crush site of rats, which had a spatial peak, time-averaged intensity of 0.25 W/cm2 operated at 1 MHz for 1 minute per application for total 8 weeks. At various stages after operation, the sciatic nerve function index(SFI), the sensory nerve conduction velocity and its histology were detected. Rats in the control received a sham exposure. MAIN OUTCOME MEASURES: SFI; sensory nerve conduction velocity; density of myelinated nerve fiber; velocity of nerve regeneration; histological examination. RESULTS: Among 64 Wistar rats, 2 were lost during the experiment and another 2 were supplied. ① Histological examination: Two weeks after treatment, degeneration of axis-cylinder and myelin sheath was obvious in treatment group as compared with that in control group. Within 4-8 weeks after treatment, regeneration of axis-cylinder and myelin sheath of nerve fiber was superior in treatment group to that in control group. At 8 weeks after treatment, axis-cylinder and myelin sheath in treatment group were closed to normal value. Quantity of nerve fiber was less in control group than that in treatment group and the arrangement was disorder. At 2, 4 and 6 weeks after treatment, proliferation of Schwann cells was superior in treatment group to that in control group. At 6 and 8 weeks after treatment, proliferation of fiber tissue in nerve was severer in control group than that in treatment group. ② SFI: At 4, 6 and 8 weeks after treatment, SFI was higher in treatment group than that in control group (t =8.00, 12.41, 15.13, P < 0.01). ③ Sensory nerve conduction velocity: At 2, 4, 6 and 8 weeks after treatment, sensory nerve conduction velocity was faster in treatment group than that in control group (t =11.74, 10.81, 3.51, P < 0.01). ④ Density of myelinated nerve fiber: At 2, 4, 6 and 8 weeks after treatment, density of myelinated nerve fiber was higher in treatment group than that in control group (t =2.16, P < 0.05; t =3.29, 3.52, 3.23, P < 0.01). ⑤ Velocity of nerve regeneration: Velocity of nerve regeneration was (1.50±0.08) mm/d and (1.22±0.10) mm/d of treatment group and control group, respectively. This suggested that velocity of nerve regeneration was faster in treatment group than that in control group (t =2.708, P < 0.05). CONCLUSION: LIU can promote the regeneration of injured peripheral nerve from the appearance, construction, function aspect and functional recovery. Its mechanism may be through the modulation and effect of many links of nerve regeneration process.

Influence of mode conversions in the skull on transcranial focused ultrasound and temperature fields utilizing the wave field separation method： A numerical study

Transcranial focused ultrasound is a booming noninvasive therapy for brain stimuli. The Kelvin–Voigt equations are employed to calculate the sound field created by focusing a 256-element planar phased array through a monkey skull with the time-reversal method. Mode conversions between compressional and shear waves exist in the skull. Therefore, the wave field separation method is introduced to calculate the contributions of the two waves to the acoustic intensity and the heat source, respectively. The Pennes equation is used to depict the temperature field induced by ultrasound. Five computational models with the same incident angle of 0？and different distances from the focus for the skull and three computational models at different incident angles and the same distance from the focus for the skull are studied. Numerical results indicate that for all computational models, the acoustic intensity at the focus with mode conversions is 12.05%less than that without mode conversions on average. For the temperature rise, this percentage is 12.02%. Besides, an underestimation of both the acoustic intensity and the temperature rise in the skull tends to occur if mode conversions are ignored. However, if the incident angle exceeds 30？, the rules of the over-and under-estimation may be reversed. Moreover,shear waves contribute 20.54% of the acoustic intensity and 20.74% of the temperature rise in the skull on average for all computational models. The percentage of the temperature rise in the skull from shear waves declines with the increase of the duration of the ultrasound.

Effect of Low-Intensity Pulsed Ultrasound on Ischaemic Heart Disease Patients (Novel Technique)

Ischaemic Heart Disease (IHD) or Coronary heart disease means that the heart is not getting enough blood and oxygen supply through the coronary arteries. The most common cause of this disease is the process of atherosclerosis in the coronary arteries. Although significant progress has been made in the management of ischaemic heart disease (IHD) The number of severe IHD patients is increasing. The treatment options for IHD have not changed much over the last three decades, which is divided between medications, coronary Angioplasty and Coronary artery bypass surgery. Thus it was crucial to develop new, non-invasive therapeutic strategies in case of Failure of medical or interventional therapy or in case patient is not fit for surgery or angioplasty. In this study, we are pleased to reveal a novel technique that was carried out on a human model. We aimed to develop low-intensity pulsed ultrasound (LIPUS) therapy for the treatment of patients with Ischaemic Heart Disease. We have set up the inclusion and exclusion criteria, the treatment protocol of LIPUS on IHD patients. In this limited group of IHD patients, We found promising clinical results and improvement on myocardial functions.

The Effect of Material Surface Microstructure on the Enhancement of Bone-Bonding Ability of a Hydroxyapatite-Implant by Low-Intensity Pulsed Ultrasound (LIPUS)

Excellent firm bonding between the biomaterials and bone tissue (osseointegration and osteo-conductivity) has been desired for the stability in vivo of dental implants and artificial joints. Much has been learned about this concept, which has led to significant improvements in the design and surface modification of implants in the field of implant dentistry, orthopedic surgery. We have already reported that low-intensity pulsed ultrasound (LIPUS) irradiation can accelerate the bone bonding ability of the bio-conductive materials such as bioactive titanium and hydroxyapatite implant. However, it is still unclear whether the LIPUS could have same effect to different types of the bioactive-materials. Therefore, in this study, the differences of bone-like hydroxyapatite formation on some kind of hydroxyapatite surface in simulated body fluid (SBF) under the LIPUS irradiation were investigated. Two kinds of hydroxyapatite samples immersed in SBF was exposed to ultrasound waves, the bone-like apatite on the surface was analyzed by Scanning electron microscopy and X-ray diffraction. As a result, the enhancement of hydroxyapatite formation on the surface by LIPUS was confirmed, the initial epitaxial nucleation and crystal growth of apatite depended on crystal structure of the surface of matrix materials.

Feasibility of low-intensity ultrasound treatment with hydroxylamine to accelerate the initiation of partial nitrification and allow operation under intermittent aeration

Partial nitrification is a key aspect of efficient nitrogen removal,although practically it suf-fers from long start-up cycles and unstable long-term operational performance.To address these drawbacks,this study investigated the effect of low intensity ultrasound treatment combined with hydroxylamine(NH2OH)on the performance of partial nitrification.Results showthat compared with the control group,low-intensity ultrasound treatment(0.10W/mL,15 min)combined with NH2OH(5 mg/L)reduced the time required for partial nitrification initiation by 6 days,increasing the nitrite accumulation rate(NAR)and ammonia nitro-gen removal rate(NRR)by 20.4% and 6.7%,respectively,achieving 96.48% NRR.Mechanis-tic analysis showed that NH2OH enhanced ammonia oxidation,inhibited nitrite-oxidizing bacteria(NOB)activity and shortened the time required for partial nitrification initiation.Furthermore,ultrasonication combined with NH2OH dosing stimulated EPS(extracellular polymeric substances)secretion,increased carbonyl,hydroxyl and amine functional group abundances and enhanced mass transfer.In addition,16S rRNA gene sequencing results showed that ultrasonication-sensitive Nitrospira disappeared from the ultrasound+NH_(2)OH system,while Nitrosomonas gradually became the dominant group.Collectively,the results of this study provide valuable insight into the enhancement of partial nitrification start-up during the process of wastewater nitrogen removal.

a Transcranial Doppler Study of Locally Using Dexamethasone after Brain Injury in Rabbits

Objective To explore the effect of locally using dexamethasone on the blood flow velocity in the middle cerebral artery(FVmca) and cerebral edema after brain injury. Methods 20 rabbits were classified to 2 groups, group A( the control group) and B (the treated group). An experimental rabbit model was conducted to contusion by bone window plasty with extradural hitting. Group B was treated by locally infiltrating of dexamethasone at equidistance to lesions. Group A was given normal saline the same way as Group B. The changes of FVmca using trans－cranial Doppler and moisture in brain tissues were observed. Results The normal value of FVmca was (31.8± 4.5)cm/s, while the value of FVmca in group A and B were (15.4± 3.9)cm/s and (22.1± 3.5)cm/s separately.Water content in damaged hemisphere in Group A and B were (81.54± 0.55)％ and (79.35± 0.50)％ respectively. There was a significant difference between the 2 groups (P<0.05). The levels of FVmca in group A and B were lower than that of control and there was also a significant difference between group A and B (P<0.05).Conclusions FVmca decreased and the brain moisture increased after brain injury while FVmca increased and the brain moisture reduced after treatment with dexamethasone. It demonstreated that local treatment of dexamethasone had an obvious therapeutical effect on brain injury.

床旁经骨窗超声检查评估颅脑外伤去骨瓣减压术患者的预后

目的探讨床旁经骨窗超声检查对颅脑外伤去骨瓣减压术(DC)患者预后的评估价值。方法纳入2021年7月至2023年7月在上海健康医学院附属周浦医院重症医学科接受DC治疗的42例颅脑外伤患者为研究对象。分别于术后第1、2、3、5、7天经骨窗测量中线移位(MLS)以及大脑中动脉的收缩期血流速度(FVs)和舒张期血流速度(FVd),计算平均血流速度(FVm)和脉动指数(PI)。随访患者30 d,根据格拉斯哥预后评分分为预后不良组(≤3分)和预后良好组(>3分),比较两组患者的临床资料。采用Logistic回归分析影响患者预后的因素,绘制受试者工作特征曲线(ROC曲线)分析超声参数对患者预后的评估价值。结果42例患者中,预后不良23例,预后良好19例。预后不良组入院时格拉斯哥昏迷评分低于预后良好组(P<0.01),严重颅脑外伤比例和死亡率高于预后良好组(P<0.01)。预后不良组患者MLS大于预后良好组[6(2,9)mm比2(1,8)mm](P<0.01),FVs、FVd和FVm低于预后良好组[115(66,135)cm/s比132(112,144)cm/s、30(6,48)cm/s比48(42,57)cm/s、60(24,79)cm/s比77(65,86)cm/s](P<0.01),PI高于预后良好组[1.6(1.2,2.3)比1.0(0.9,1.1)](P<0.01)。ROC曲线分析显示,PI预测不良预后的曲线下面积最大,为0.861(95%CI 0.803~0.907),灵敏度为67.78%,特异度为95.79%。多因素回归分析显示,PI升高是颅脑外伤DC患者术后30 d预后不良的独立危险因素(OR=1.076,95%CI 1.048~1.105,P<0.01)。12例患者在DC术后第1~12天内死亡,死亡前均出现FVd消失。结论床旁经骨窗超声检查可用于预测颅脑外伤DC患者的预后。PI升高是预后不良的独立危险因素,而FVd消失预示着死亡。

经颅多普勒超声动态监测应用于蛛网膜下腔出血患者发生脑血管痉挛中的价值

目的探讨经颅多普勒超声动态监测应用于蛛网膜下腔出血(SAH)患者发生脑血管痉挛中的价值。方法选取2018年6月至2021年6月白银市第一人民医院收治的85例SAH患者作为观察组,另选取同期76名健康志愿者作为常规组。比较两组收缩期峰值流速(Peak)、搏动指数(PI)及平均血流速度(Mean),比较观察组发生与未发生脑血管痉挛患者的PI、Peak及Mean,分析PI、Peak、Mean单独及三者联合对SAH患者发生脑血管痉挛的诊断价值。结果观察组PI高于常规组,Peak、Mean慢于常规组,差异有统计学意义(P<0.05)。观察组发生脑血管痉挛10例,未发生脑血管痉挛75例,发生脑血管痉挛患者PI高于未发生脑血管痉挛患者,发生脑血管痉挛患者Peak、Mean慢于未发生脑血管痉挛患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PI、Peak、Mean是脑血管痉挛发生的危险因素(P<0.05)。PI、Peak、Mean联合诊断脑血管痉挛的灵敏度高于单独诊断(P<0.05)。结论经颅多普勒超声动态监测在SAH患者发生脑血管痉挛中的应用价值较高,PI、Peak、Mean是脑血管痉挛发生的危险因素,三者联合对脑血管痉挛的诊断灵敏度较高。

重复经颅磁刺激联合核心稳定训练对脑卒中患者平衡功能的影响研究

目的:探讨重复经颅磁刺激(rTMS)联合核心稳定训练对脑卒中患者的治疗效果。方法:将符合标准的45例脑卒中偏瘫患者随机分为对照组、磁刺激组和联合组各15例。3组常规治疗相同,对照组进行假rTMS+核心稳定性训练;磁刺激组在常规康复治疗基础上增加健侧1Hz rTMS;联合组在常规康复治疗基础上增加健侧1Hz rTMS联合核心稳定训练。3组均持续干预3周。比较3组治疗前后的腹横肌(TrA)、腹内斜肌(IO)和腹外斜肌(EO)的厚度,同时进行Fugl-Myer运动功能(FMA)、Berg平衡量表(BBS)及改良Barthel指数(MBI)评定。结果:治疗3周后,3组FMA、BBS和MBI评分均较治疗前明显提高(均P<0.001);联合组和磁刺激组患侧TrA、IO及EO的厚度与治疗前相比均明显增加(均P<0.05),而对照组上述指标较治疗前增加差异无统计学意义。组间比较,联合组的FMA、患侧TrA厚度分别与磁刺激组比较,联合组的FMA、BBS、MBI、患侧TrA和患侧EO厚度分别与对照组比较,磁刺激组MBI与对照组比较,差异均有统计学意义(均P<0.05)。3组健侧TrA、IO和EO厚度组内及组间比较,差异均无统计学意义。结论:低频rTMS联合核心稳定性训练能明显提高患者运动功能和平衡功能,改善日常生活活动,值得在临床推广应用。

床旁经颅多普勒超声在神经重症脑血管疾病患者中的监测价值

目的分析神经重症脑血管疾病患者监测中床旁经颅多普勒超声应用效果。方法筛选郑州人民医院2021年5月至2023年5月86例重症脑血管疾病患者作为研究对象(高血压脑出血,术后35例,未手术者7例,脑动脉瘤破裂出血,术后32例,未手术者5例,其他脑血管疾病术后4例,未手术者3例),均采用经颅多普勒超声(TCD)监测,包含经枕窗探测基底动脉(BA)、经颞窗探测双侧大脑中动脉(MCA),另监测收缩期峰值血流动力学改变、舒张末期峰值血流速度、平均峰值血流速度、血管阻力指数、血管搏动指数、血流频谱形态等了解血流动力学改变,了解血流动力学改变,依照监测结果分三组,脑血管痉挛组(n=26)、供血不足组(n=37)、血流增快组(n=29),对各组监测结果予以分析。结果患者均完成TCD监测,在不同病因中,脑动脉瘤破裂出血与高血压脑出血患者供血不足发生率最高,其次是血流增快、血管痉挛,三组发生率对比差异有统计学意义(P<0.05)。结论在神经重症脑血管疾病患者中,床旁TCD监测能为临床治疗及预后评价提供有效支持。

异氟烷麻醉对小鼠自发肌电及TUS/TMAS诱发肌电的影响

经颅超声刺激(TUS)和经颅磁声耦合刺激(TMAS)调控运动皮层效果明显,但受限于清醒状态动物难以束缚,已有研究大多在麻醉状态下进行,对麻醉减弱调控效果的分析集中于中枢神经系统。本研究记录了异氟烷麻醉下24只小鼠的肢体自发肌电和TUS/TMAS诱发肌电,定量分析了麻醉对自发肌电和诱发肌电发放率、潜伏期、时长和幅值的影响。结果显示,随着异氟烷输出浓度从0.40%增加至0.75%,每周期内小鼠自发肌电频次减少约50%,肌电发放时长变短,呈抑制状态;TUS/TMAS诱发肌电的成功率分别降低约50%和70%、潜伏期均延长约0.1 s、时长分别缩短约0.3和0.5 s,表明TUS/TMAS对运动皮层的调控效果随麻醉程度的加深而减弱。肢体自发和诱发肌电在发放率和时长上存在关联性特征,提示麻醉状态下小鼠自发肌电抑制状态可能是刺激效果减弱的影响因素之一。

经颅多普勒超声监测指导颈动脉内膜剥脱术中选择性应用转流管的单中心研究

目的探讨经颅多普勒超声(transcranial Doppler ultrasound,TCD)监测在指导颈动脉内膜剥脱术(carotid endarterectomy,CEA)术中选择性使用转流管的价值。方法回顾性分析2018年7月至2023年12月在首都医科大学宣武医院血管外科行CEA治疗的321例颈动脉狭窄患者(330例次手术)的临床数据,根据术前TCD评估将患者分为无需转流组(157例次)、可能需要转流组(92例次)和必需转流组(81例次)。评估TCD术前评估及术中监测在CEA的应用价值。结果共75例次(22.73%)使用转流管。症状性脑梗发生率为1.52%,其中转流患者为5.33%,未转流患者为0.39%。无需转流组、可能需要转流组和必需转流组分别有3.2%、15.2%和69.1%的患者进行转流操作,症状性脑梗死的发生率分别为0.64%、2.06%和2.47%,差异无统计学意义(P=0.455)。结论TCD术中监测能安全、有效地指导CEA选择性使用转流管;术前评估对于术中精准转流有较高的指导价值,但术中实时监测仍是必要的。

电针联合低频经颅超声刺激对创伤性脑损伤大鼠脑电信号的影响

背景:创伤性脑损伤是由头部受到撞击、打击而导致大脑正常功能被破坏的疾病,目前需要寻找有效治疗方式和客观指标,帮助医生判别损伤状况及恢复患者脑功能。目的:探究电针联合低频经颅超声刺激对创伤性脑损伤大鼠脑电信号的影响。方法:将40只6周龄SPF级雄性SD大鼠随机分为假手术组、模型组、电针组、低频经颅超声刺激组和联合组(n=8),后4组采用Feeney自由落体法造模,假手术组只开骨窗而不打击。各干预组均于造模后1 d开始实施干预,电针组进行电针干预,低频经颅超声刺激组进行低频经颅超声刺激干预,联合组进行两者联合干预,共干预7 d。造模后8 h,用改良神经功能缺损评分评定大鼠神经功能缺损情况;干预7 d后观察大鼠Y迷宫自发轮流行为百分比,而后采集脑电信号,利用快速傅里叶变换分解出α、β、θ和δ波段,计算各频段振荡幅值、能量占比百分比以及Lempel-Ziv复杂度、样本熵。结果与结论:①造模后8 h,模型组、电针组、低频经颅超声刺激组和联合组的改良神经功能缺损评分显著高于假手术组(P<0.05);②造模后第7天,模型组的α波、δ波频带振荡幅值、δ波能量占比百分比显著高于假手术组(P<0.05),自发轮流行为百分比、α波、β波能量占比百分比、Lempel-Ziv复杂度、样本熵显著低于假手术组(P<0.05);③与模型组比较,联合组的α波、δ波频带振荡幅值显著下降(P<0.05),电针组、低频经颅超声刺激组、联合组的α波、β波频带能量占比百分比显著升高(P<0.05),δ波能量占比百分比显著下降(P<0.05);④与电针组和低频经颅超声刺激组相比,联合组的δ波能量占比百分比显著降低(P<0.05),自发轮流行为百分比、α波、β波能量占比百分比、Lempel-Zi复杂度、样本熵显著升高(P<0.05);⑤结果显示,创伤性脑损伤大鼠出现脑电信号异常,而电针联合低频经颅超声刺激干预后可以改善大鼠脑电信号的异常情况,提示脑电频域特征和非线性特征可用来评估创伤性脑损伤情况。

经颅超声检查对卒中后抑郁的诊断价值

目的观察卒中后抑郁(PSD)的发生与中缝核(BR)回声的关系,探讨BR回声异常对PSD的诊断价值。方法选取2023年1月至8月洛阳市中心医院神经内科收治的240例脑卒中患者作为研究对象,依据汉密尔顿抑郁量表评分分为PSD组及无抑郁(NPSD)组,分别进行经颅超声(TCS)检查,比较两组间的一般资料和超声资料。结果两组的性别、年龄、疾病病程、高血压病史、冠心病史、糖尿病史、吸烟饮酒史、黑质(SN)阳性率与第三脑室(V3)增宽率比较,差异无统计学意义(P>0.05)。两组的文化程度、脑卒中次数、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力Barthel指数(BI)评分、BR阳性率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,BI指数(OR=1.847,95%CI:1.01~2.79,P<0.001)和BR阳性(OR=4.432,95%CI:1.15~8.96,P<0.001)是PSD的独立危险因素。ROC曲线分析显示,两者联合诊断PSD的AUC为0.881(95%CI:0.83~0.94)。结论BR阳性可以作为PSD的辅助诊断指标,联合BI指数可提高诊断效能。