双重任务行走步态分析预测短暂性脑缺血发作患者认知功能障碍的发生

目的 寻找简便易行且敏感、有效地预测短暂性脑缺血发作(TIA)患者认知功能障碍发生的方法,以便及时干预TIA患者认知功能障碍的发生和进展。 方法 选取首次发病,且可独立自主行走的TIA患者36例［蒙特利尔认知评估量表（MoCA）评分不低于26分］,设为TIA患者组;另选取年龄、性别及受教育年限与TIA患者组相匹配的正常受试者36例设为作正常对照组。2组受试者均于入组后当天进行1次双重任务行走步态分析,并于入组12个月后对2组受试者进行MoCA量表评定。采用SPSS 22.0版统计学软件进行数据分析,通过诊断试验验证步态参数预测认知功能障碍的可靠性,并计算接受者操作特性曲线（ROC）下面积。 结果 入组后当天,异常步长的TIA患者的步长变异率分别与正常对照组和非异常步长的TIA患者比较,差异均有统计学意义（P<0.05）;异常平均步速的TIA患者的平均步速分别与正常对照组和非异常平均步速的TIA患者比较,差异均有统计学意义（P<0.05）。入组后当天,正常对照组行双重任务步行时的计算正确率为（90.72±8.72）%,而TIA患者组中异常步态患者和非异常步态组患者的计算正确率均显著低于正常对照组,差异均有统计学意义（P<0.05）,且异常步态患者的计算正确率显著低于非异常步态组患者,差异均有统计学意义（P<0.05）。入组12个月后,异常步态患者中MoCA评分<26分的患者例数与非异常步态患者中MoCA评分<26分的患者例数比较,差异有统计学意义（P<0.01）。计算参数ROC曲线下面积得出,步态参数中的步长变异率和平均步速均可预测12个月后TIA患者认知功能障碍的发生,差异有统计学意义(P<0.01)。 结论 双重任务行走步态分析可有效地预测TIA患者认知功能障碍的发生,较MoCA测试可更早发现异常。     

高频重复周围磁刺激对正常人身体特异性注意的影响初探

目的 观察高频重复周围磁刺激对正常人身体特异性注意的影响及其随时间的变化。 方法 采用Excel随机函数将正常受试者40例分为重复刺激组20例（其中1例脱落）和假性刺激组20例。重复刺激组采用Pathleader周围磁刺激仪刺激非优势侧上肢桡神经深支,强度设置为在受试者可耐受范围内能引起明显的腕背伸运动,频率50 Hz,刺激时间2 s,间歇时间1 s, 刺激序列36个;假性刺激组仪器及参数设置均同重复刺激组,将线圈旋转90°,无实质刺激。以身体条件下两侧反应时间差减去对照条件下两侧反应时间差的差值作为身体特异性注意,观察刺激前、刺激后和刺激10 min后身体特异性注意的变化。 结果 刺激前,2组受试者身体特异性注意的组间比较,差异无统计学意义（P＞0.05）。刺激后和刺激后10 min,2组受试者身体特异性注意组间同时间点比较,差异均无统计学意义（P＞0.05）,重复刺激组刺激后和刺激后10 min的身体特异性注意与组内刺激前的（2.77±16.54）ms比较,差异均有统计学意义（P＜0.05）,假性刺激组刺激后和刺激后10 min的身体特异性注意与组内刺激前比较,差异均无统计学意义（P＞0.05）。 结论 高频重复周围磁刺激可能以先抑制后增强的方式增强正常人的身体特异性注意。     

氯化锂对人眼Tenon囊成纤维细胞增殖的影响

目的：观察氯化锂（Lithium chloride）对人眼Tenon囊成纤维细胞（human Tenons capsule fibroblasts, HTFs）体外生长的抑制效应,并探讨其作用机制。 方法：磺基罗丹明（SRB）法和BrdU法检测细胞生长抑制率;采用流式细胞技术（FCM）检测细胞凋亡和细胞周期的变化;Hoechst 33258染色后荧光显微镜观察细胞形态学的改变。结果：在40-160mmol/L范围内,氯化锂能够抑制HTFs的增殖,且呈剂量与时间依赖性。氯化锂使HTFs阻滞于G2/M期,且能诱导细胞凋亡,高浓度组尤为明显。结论：氯化锂能抑制HTFs增殖,机制为诱导细胞凋亡,并将细胞阻滞于G2/M期。     

PNF技术在全膝关节置换术后患者功能恢复中的应用

目的观察神经肌肉本体感觉促进技术（PNF）对全膝关节置换术（TKA）后患者膝关节功能恢复及步行能力的影响。 方法纳入江苏省苏北人民医院择期TKA术后患者50例,随机分为治疗组和对照组,各25例,两组均进行4 w康复训练,主要内容包括康复教育、肌力、关节活动度、站立平衡训练、物理因子治疗,治疗组在此基础上应用PNF技术。于治疗前、治疗4 w后采用美国特种外科医院（HSS）膝功能评分量表、Berg平衡量表评分（BBS）和6 min步行试验（6 MWT）评定患者膝关节功能和步行能力。 结果治疗4 w后,治疗组和对照组患者HSS评分分别为（91.6±5.3）分和（86.8±4.4）分,高于治疗前的（52.7±4.8）分和（53.1±4.9）分,差异有统计学意义（t=4.126,t=2.722,P<0.01）;其中治疗组治疗后膝关节功能和稳定性评分为（19.4±1.3）分和（9.1±0.8）分,优于对照组的（16.2±1.4）分和（8.4±1.4）分,差异均有统计学意义（t=2.049,t=2.029,P<0.05）。治疗组与对照组患者治疗后BBS评分分别为（54.4±1.9）分和（50.5±2.1）分,均显著高于治疗前的（46.7±3.1）分和（46.5±2.2）分,差异有统计学意义（t=2.523,t=2.169,P<0.05）;且与对照组比较,治疗组治疗后BBS评分更高（t=2.498,P<0.05）。治疗组与对照组患者6MWT评分分别为（655±51）分和（580±56）分,均显著高于治疗前的（397±35）分和（402±42）分,差异有统计学意义（t=8.256,t=7.649,P<0.01）;与对照组比较,治疗组治疗后6MWT评分更高（t=2.579,P<0.05）。 结论TKA术后患者在康复训练中采用PNF技术可以促进膝关节的关节功能恢复,提高患者平衡功能和步行能力。     

关节腔内注射富血小板血浆或玻璃酸钠联合体外冲击波治疗膝骨关节炎的疗效

目的 比较关节腔内注射自体富血小板血浆(PRP)或玻璃酸钠联合体外冲击波(ESWT)治疗膝骨关节炎(KOA)的临床疗效。方法 37例KOA患者随机分为玻璃酸钠组(19例)和PRP组(18例)。两组患者均给予常规康复训练、行为干预和ESWT治疗。玻璃酸钠组予膝关节腔内注射玻璃酸钠20 mg,每周1次，连续4周；PRP组予膝关节腔内注射自体PRP 5 mL,每2周1次，连续4周。治疗前(T1)、治疗结束时(T2)、治疗后3个月(T3)和6个月(T4)时分别采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估两组膝关节功能，并记录不良事件发生情况。结果 两组患者均顺利完成治疗，无明显不良事件发生。两组T1时WOMAC各评分比较均无统计学差异(P>0.05)。与T1时比较，两组T2～T4时WOMAC各评分均下降(P<0.01)。与玻璃酸钠组比较，PRP组T3、T4时WOMAC关节疼痛评分和T4时关节功能评分均下降(P<0.05)。结论关节腔内注射自体PRP或玻璃酸钠联合ESWT均能有效缓解KOA患者膝关节疼痛，改善膝关节功能，自体PRP的疗效更好。     

Ab-externo precise localization of Schlemm’s canal in patients with primary open-angle glaucoma北大核心

Objective To investigate the ab-externo approach for the precise localization of the Schlemm’s canal (SC) in patients with primary open-angle glaucoma (POAG). Methods A total of 40 POAG patients (40 eyes) who underwent ab-externo SC-related surgeries in Weifang Eye Hospital from August 2020 to October 2021 were selected. According to the intraoperative measuring method, the patients were randomly divided into the high-definition (HD) image group and the sterile drawing group, with 20 patients (20 eyes) in each group. In the HD image group, HD images of the surgical area were captured by a microscope for measurement of the distance between loci. In the sterile drawing group, the loci were marked on the sterile drawing with a mapping compass under the microscope before measurement of their distance. The boundary line between the semitransparent and non-transparent tissues was marked by the sclerotic scatter and used as the base line (BL). A blood reflux band of SC was found on the scleral bed by the transillumination in the anterior chamber with the fiber optic endoscope. The outer wall of SC was removed completely during the operation for measuring related indexes, such as the width of SC (SW), the distance between the BL and the posterior edge of SC (d1), the distance between the conjunctival insertion line (CIL) and the anterior edge of SC (d2), and the distance between the BL and the CIL (d3). The white-to-white (WTW) distance and axial length (AL) were measured with IOL-Master before surgery. Differences and correlations among these indexes were analyzed. Results d2 [(1.85±0.28) mm] and d3 [(2.63±0.30) mm] in the HD image group were higher than those [d2: (1.61±0.37) mm and d3: (2.41±0.38) mm] in the sterile drawing group, and the differences were statistically significant (both P<0.05). WTW and d1 were positively correlated with AL (both P<0.05), d1 and d2 were positively correlated with d3 (both P<0.05) in both groups, while the rest indexes had no significant correlation (all P>0.05). The 40 eyes were divided into 3 groups according to AL: short AL group (AL<23 mm), medium AL group (23 mm≤AL<25 mm), and long AL group (AL≥25 mm). d1 in the short, medium, and long AL groups were (0.30±0.08) mm, (0.37±0.10) mm, and (0.57±0.09) mm, respectively, and the differences among the three groups were statistically significant (F=14.915, P<0.05). d1 in the long AL group was longer than that in the short and medium AL groups (both P<0.05). Conclusion The transillumination system can clearly display the SC blood reflux band on the deep scleral bed, facilitating the precise localization of SC. d1 is positively correlated with AL in POAG patients. © The Author(s) 2023.