应用烧伤整形外科技术治疗大面积皮肤撕脱伤

探讨大面积皮肤撕脱伤的治疗方法。分析总结大面积皮肤撕脱伤及合并损伤17例,根据伤情综合应用清创撕脱皮肤缝合、带蒂真皮下血管网皮瓣回植、撕脱皮肤反取皮回植、组织瓣转移修复、游离皮片移植、头皮取皮术、异体／异种皮移植、创面持续负压吸引VSD等治疗方法,观察创面修复、肢体外观及功能恢复情况。结果17例患者经综合治疗后创面均愈合。功能部位均予全层皮片或皮瓣修复;19处创面有深部组织外露,予皮瓣或肌瓣修复;随访6个月～3年,所有肢体功能良好。根据皮肤软组织损伤情况而综合运用多种烧伤整形外科技术修复大面积撕脱伤可缩短疗程,并最大可能保留受伤区域的功能与外观,改善患者生活质量。     

Differential acetylcholine release in the prefrontal cortex and hippocampus during pavlovian trace and delay conditioning

Pavlovian trace conditioning critically depends on the medial prefrontal cortex (mPFC) and hippocampus (HPC), whereas delay conditioning does not depend on these brain structures. Given that the cholinergic basal forebrain system modulates activity in both the mPFC and HPC, it was reasoned that the level of acetylcholine (ACh) release in these regions would show distinct profiles during testing in trace and delay conditioning paradigms. To test this assumption, microdialysis probes were implanted unilaterally into the mPFC and HPC of rats that were pre-trained in appetitive trace and delay conditioning paradigms using different conditional stimuli in the two tasks. On the day of microdialysis testing, dialysate samples were collected during a quiet baseline interval before trials were initiated, and again during performance in separate blocks of trace and delay conditioning trials in each animal. ACh levels were quantified using high-performance liquid chromatography and electrochemical detection techniques. Consistent with our hypothesis, results showed that ACh release in the mPFC was greater during trace conditioning than during delay conditioning. The level of ACh released during trace conditioning in the HPC was also greater than the levels observed during delay conditioning. While ACh efflux in both the mPFC and HPC selectively increased during trace conditioning, ACh levels in the mPFC during trace conditioning testing showed the greatest increases observed. These results demonstrate a dissociation in cholinergic activation of the mPFC and HPC during performance in trace but not delay appetitive conditioning, where this cholinergic activity may contribute to attentional mechanisms, adaptive response timing, or memory consolidation necessary for successful trace conditioning.     

The role of Broca's area in speech perception: evidence from aphasia revisited

Motor theories of speech perception have been re-vitalized as a consequence of the discovery of mirror neurons. Some authors have even promoted a strong version of the motor theory, arguing that the motor speech system is critical for perception. Part of the evidence that is cited in favor of this claim is the observation from the early 1980s that individuals with Broca’s aphasia, and therefore inferred damage to Broca’s area, can have deficits in speech sound discrimination. Here we re-examine this issue in 24 patients with radiologically confirmed lesions to Broca’s area and various degrees of associated non-fluent speech production. Patients performed two same-different discrimination tasks involving pairs of CV syllables, one in which both CVs were presented auditorily, and the other in which one syllable was auditorily presented and the other visually presented as an orthographic form; word comprehension was also assessed using word-to-picture matching tasks in both auditory and visual forms. Discrimination performance on the all-auditory task was four standard deviations above chance, as measured using d′, and was unrelated to the degree of non-fluency in the patients’ speech production. Performance on the auditory–visual task, however, was worse than, and not correlated with, the all-auditory task. The auditory–visual task was related to the degree of speech non-fluency. Word comprehension was at ceiling for the auditory version (97% accuracy) and near ceiling for the orthographic version (90% accuracy). We conclude that the motor speech system is not necessary for speech perception as measured both by discrimination and comprehension paradigms, but may play a role in orthographic decoding or in auditory–visual matching of phonological forms.     

Distinct modes of executing movement sequences: reacting, associating, and chunking

Responding to individual key-specific stimuli in entirely unfamiliar keying sequences is said to involve a reaction mode. With practice, short keying sequences can be executed in the chunking mode. This is indicated by the first stimulus sufficing for rapid execution of the entire sequence. The present study explored whether an associative mode develops also in participants who practice short keying sequences. This associative mode would involve priming by earlier events of responses to external stimuli, and is believed to be responsible for skill in the Serial Reaction Time task. In the present study participants practiced two discrete 6-key sequences. In the ensuing test phase, participants were prevented from using the chunking mode by including two deviant stimuli in most sequences. The results from the remaining - unchanged - familiar sequences confirmed that participants no longer used the chunking mode, but as predicted by associative learning these sequences were executed faster than unfamiliar sequences.     

Effect of Sensory Deprivation on Maximal Force Abilities from Local to Non-local Digits

Abstract

The present study investigates the effect of sensory deprivation of the index and middle finger on motor function of all digits during maximal voluntary force production tasks. A total of 27 subjects performed maximal isometric pressing tasks by using different instructed finger combinations. Subjects completed the same tasks in two visits: a control visit when they had normal sensory feedback in all fingers, and an anesthesia visit when digital nerve blocks were performed on their right index and middle fingers. We evaluated three aspects of motor adaptation on both local (anesthetized) and non-local (non-anesthetized) digits during maximal force production: (1) task-relevant and overall force magnitude, (2) force directional application, and (3) digital individuation and force sharing. Our results indicate that selective digital anesthesia resulted in decreased maximal force magnitude, changed direction of force production, and significant changes extended to non-local digits. The motor weakness and inefficiency revealed in the non-local digits implies that sensory information from each digit can be shared across the digits to assist motor execution within the same hand.     

A brief review on the use of functional near-infrared spectroscopy (fNIRS) for language imaging studies in human newborns and adults

Upon stimulation, real time maps of cortical hemodynamic responses can be obtained by non-invasive functional near-infrared spectroscopy (fNIRS) which measures changes in oxygenated and deoxygenated hemoglobin after positioning multiple sources and detectors over the human scalp. The current commercially available transportable fNIRS systems have a time resolution of 1-10 Hz, a depth sensitivity of about 1.5 cm, and a spatial resolution of about 1 cm. The goal of this brief review is to report infants, children and adults fNIRS language studies. Since 1998, 60 studies have been published on cortical activation in the brain’s classic language areas in children/adults as well as newborns using fNIRS instrumentations of different complexity. In addition, the basic principles of fNIRS including features, strengths, advantages, and limitations are summarized in terms that can be understood even by non specialists. Future prospects of fNIRS in the field of language processing imaging are highlighted.     

Neural correlates of feigned memory impairment are distinguishable from answering randomly and answering incorrectly: an fMRI and behavioral study

Previous functional magnetic resonance imaging (fMRI) studies have identified activation in the prefrontal-parietal-sub-cortical circuit during feigned memory impairment when comparing with truthful telling. Here, we used fMRI to determine whether neural activity can differentiate between answering correctly, answering randomly, answering incorrectly, and feigned memory impairment. In this study, 12 healthy subjects underwent block-design fMRI while they performed digit task of forced-choice format under four conditions: answering correctly, answering randomly, answering incorrectly, and simulated feigned memory impairment. There were three main results. First, six areas, including the left prefrontal cortex, the left superior temporal lobe, the right postcentral gyrus, the right superior parietal cortex, the right superior occipital cortex, and the right putamen, were significantly modulated by condition type. Second, for some areas, including the right superior parietal cortex, the right postcentral gyrus, the right superior occipital cortex, and the right putamen, brain activity was significantly greater in feigned memory impairment than answering randomly. Third, for the areas including the left prefrontal cortex and the right putamen, brain activity was significantly greater in feigned memory impairment than answering incorrectly. In contrast, for the left superior temporal lobe, brain activity was significantly greater in answering incorrectly than feigned memory impairment. The results suggest that neural correlates of feigned memory impairment are distinguishable from answering randomly and answering incorrectly in healthy subjects.     

Sequential dependencies in driving

The effect of recent experience on current behavior has been studied extensively in simple laboratory tasks. We explore the nature of sequential effects in the more naturalistic setting of automobile driving. Driving is a safety-critical task in which delayed response times may have severe consequences. Using a realistic driving simulator, we find significant sequential effects in pedal-press response times that depend on the history of recent stimuli and responses. Response times are slowed up to 100 ms in particular cases, a delay that has dangerous practical consequences. Further, we observe a significant number of history-related pedal misapplications, which have recently been noted as a cause for concern in the automotive safety community. By anticipating these consequences of sequential context, driver assistance systems could mitigate the effects of performance degradations and thus critically improve driver safety.     

动画呈现速度对多媒体学习效果影响的眼动研究

多媒体学习过程中,动画学习材料的呈现速度是影响学习效果的一个重要因素。基于认知负荷理论,已有研究对动画速度是否影响多媒体学习中的注意转换和学习效果存在不一致的结论。研究采用闪电形成原理动画作为实验材料,操纵慢速、正常速度和快速三个速度水平,利用Eyelink 1000眼动仪记录学习过程中的眼睛注视,探讨多媒体学习中动画呈现速度对学习效果和注意转换的影响。结果发现,在记忆测验的成绩上,慢速水平的迁移测验成绩要好于正常速度和快速;慢速在注视次数、眼跳次数、任务相关区停留时间和进出兴趣区次数这些总体眼动指标上比其他两组显著要高,但是对相关指标按时间进行加权后发现,只在兴趣区停留时间上慢速和快速长于正常速度。结论认为多媒体学习过程中,动画呈现速度会影响学习的理解效果,但是对识记不产生影响;材料呈现速度影响知识深层次加工,它独立于学习者的注意转换。并且材料呈现速度对学习者眼动的影响是微弱的。