Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients’ activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity after stroke through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.
睡眠過程中反復出現呼吸暫停造成的間歇低氧是阻塞性睡眠呼吸暫停低通氣綜合征( OSAHS) 的主要病理生理學特點, 它能夠導致自主神經, 特別是交感神經興奮性異常增高[1] , 后者可能是OSAHS合并心血管疾病包括高血壓、充血性心力衰竭、心肌梗死以及心律失常的主要危險因素之一[2,3] 。現將慢性間歇低氧( chronic intermittent hypoxia,CIH) 所致交感神經異常興奮的相關研究作一綜述。
Objective To investigate the changes of steps walks daily in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) before and after the initiation of nasal continuous positive airway pressure ( nCPAP) ventilation. Methods 62 patients diagnosed by polysomnogaphy ( PSG) in the sleep respiratory disease center of Nanjing FirstHospital Affiliated to Nanjing Medical University were recruited as the OSAHS group, and divided into mild,moderate, and severe subgroups according to apnea-hypopnea index ( AHI) .28 subjects without OSAHS were recruited as the control group. All the subjects were evaluated by Epworth Sleepiness Scale ( ESS) and Functional Outcomes of Sleep Questionnaire ( FOSQ) . Steps walked daily were measured by electronic pedometer.10 patients with moderate and severe OSAHS were treated with nCPAP. Results Compared with the control group and the mild OSAHS patients, ESS scores were significantly higher while FOSQ scores and steps walked daily were significantly lower in the moderate and severe OSAHS patients ( P lt; 0. 05) . In the OSAHS patients, steps walked daily were correlated positively with FOSQ scores but negatively with BMI, ESS scores, AHI, oxygen desaturation index ( ODI) and saturation impair time below 90% ( SIT90) ( P lt; 0.05) . After one month of nCPAP therapy, ESS scores were significantly decreased, FOSQ scores and steps walked daily were significantly increased (Plt;0.05) . Conclusions Increased OSAHS severity is associated with decreased steps walked daily which is an objective index of routine physical activity. Untreated OSAHS may negatively impact the patients’ability to have an active lifestyle. nCPAP therapy can significantly improve steps walks daily of patients with OSAHS.
ObjectiveTo investigate the research progress of residual nodules after thermal ablation for benign thyroid nodules.MethodsThe domestic and foreign guidelines and consensus on the treatment of benign thyroid nodules were collected, and the indications for thermal ablation were summarized. The causes of residual nodules after ablation were analyzed, the characteristics of residual nodules were evaluated through multiple approaches, and the follow-up treatment measures were summarized.ResultsThe indications of thermal ablation of benign thyroid nodules were different at home and abroad. The causes of residual nodules included slow absorption after ablation and incomplete ablation. Among the evaluation methods of residual nodules, the nodules volume reduction rate was the evaluation standard of short-term efficacy, contrast-enhanced ultrasound was the best method, color Doppler blood color distributionwas the most commonly used method, elastic imaging was a valuable method, and puncture pathology biopsy was an important standard. Reablation and surgical resection were the follow-up treatments for residual nodules.ConclusionsAs a new technique, thermal ablation of benign thyroid nodules has some advantages, but it is flooding at present. In the future, it is necessary to standardize indications, improve the efficiency of first ablation, attach importance to pathological complete ablation, and reasonably evaluate the treatment of residual nodules, so that thermal ablation of benign thyroid nodules could reflect rationality, safety, and efficiency, and give full play to its advantages, so as to serve patients better and have better application prospects.