BACKGROUND The aging of the population has become increasingly obvious in recent years,and the incidence of cerebral infarction has shown an increasing trend annually,with high death and disability rates.AIM To analyz...BACKGROUND The aging of the population has become increasingly obvious in recent years,and the incidence of cerebral infarction has shown an increasing trend annually,with high death and disability rates.AIM To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.METHODS Between January 2020 and December 2023,we treated 98 cases of elderly acute insula,patients with cerebral infarction in the cerebral infarction acute phase(3-4 weeks)and for the course of 6 months in Montreal Cognitive Assessment Scale(MoCA)for screening of cognition.Notably,58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group,respec-tively.In patients with cerebral infarction,magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions,the relationship between the parts of the infarction volume,and analysis of acute insula cognitive disorder in elderly patients with cerebral RESULTS The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment(P<0.05).The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group,and the difference was statistically significant(P<0.05).The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group(P<0.05).In the cognitive impairment group,the infarct volumes in the basal ganglia,thalamus,and mixed lesions were negatively correlated with the total MoCA score,with correlation coefficients of-0.67,-0.73,and-0.77,respectively.CONCLUSION In elderly patients with acute insular infarction,infarction in the basal ganglia,thalamus,and mixed lesions were more likely to lead to cognitive dysfunction than in other areas,and patients with large infarct volumes were more likely to develop cognitive dysfunction.The infarct volume in the basal ganglia,thalamus,and mixed lesions was significantly negatively correlated with the MoCA score.展开更多
BACKGROUND： The insular cortex and habenular nucleus may be a regulatory center for obstructive sleep apnea syndrome, and dyspnea may be caused by insular cortex activity. The insular cortex is a cortical representat...BACKGROUND： The insular cortex and habenular nucleus may be a regulatory center for obstructive sleep apnea syndrome, and dyspnea may be caused by insular cortex activity. The insular cortex is a cortical representation of obstructive sleep apnea syndrome. The habenular nucleus is a station for descending insular cortex activity. OBJECTIVE： Through actively stimulating the rat insular cortex, to observe rat respiratory movement, myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity, and to verify a hypothesis that the insular cortex is a superior-position regulation center, and the habenular nucleus is an inferior-position nervous nuclei of the insular cortex in patients with obstructive sleep apnea syndrome. DESIGN, TIME AND SETTING： The randomized, controlled animal study was performed at the Laboratory of Electrophysiology, Department of Physiology, Norman Bathune College of Medicine, Jilin University, China from September 2004 to June 2008. MATERIALS： We used L-glutamic acid （Dingguo Biological Product Research Center, Beijing, China）, lidocaine hydrochloride （Seventh Pharmacy Co., Ltd., Wuxi, China）, electric stimulator （Nihon Kohden, Japan）, and an AVL-OPTI blood gas analyzer （AVL Scientific Co., Roswell, GA, USA）. METHODS： The insular cortex of healthy adult Wistar rats underwent electrostimulation and L-glutamic acid stimulation to record changes in the myoelectric activity of genioglossus and respiratory movement. Some rats were injected with lidocaine to block the habenular nucleus before electrostimulation or L-glutamic acid stimulation. L-glutamic acid and lidocaine were injected by microelectrodes embedded in nuclear groups. MAIN OUTCOME MEASURES： Myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity were measured following apnea in rats undergoing electrostimulation in the insular cortex and following blockade of the habenular nucleus. RESULTS： Following electrostimulation and L-glutamic acid stimulation, rats developed apnea or respiratory rhythm disorders. Simultaneously, the amplitude of myoelectric activity of the genioglossus was reduced （P 〈 0.01 ）, and the electromyogram integral was decreased （P 〈 0.01）. Arterial blood gas analysis showed arterial blood acidosis, a decrease in pH （P 〈 0.05）, and an increase in the negative value of alkaline reserve （P 〈 0.01）. Lidocaine in the habenular nuclear blocked respiratory and other index changes after insular cortex stimulation. CONCLUSION： Dyspnea induced by stimulating the insular cortex may require the habenular nucleus. Paralysis of the habenular nucleus can completely eliminate insular cortex stimulation-induced dyspnea.展开更多
Insular lesions remain surgically challenging because of the need to balance aggressive resection and functional protection. Motor function deficits due to corticospinal tract injury are a common complication of surge...Insular lesions remain surgically challenging because of the need to balance aggressive resection and functional protection. Motor function deficits due to corticospinal tract injury are a common complication of surgery for lesions adjacent to the internal capsule and it is therefore essential to evaluate the corticospinal tract adjacent to the lesion. We used diffusion tensor imaging to evaluate the corticospinal tract in 89 patients with insular lobe lesions who underwent surgery in Chinese PLA General Hospital from February 2009 to May 2011. Postoperative motor function evaluation revealed that 57 patients had no changes in motor function, and 32 patients suffered motor dysfunction or aggravated motor dysfunction. Of the affected patients, 20 recovered motor function during the 6-12-month follow-up, and an additional 12 patients did not recover over more than 12 months of follow-up. Following reconstruction of the corticospinal tract, fractional anisotropy comparison demonstrated that preoperative, intraoperative and follow-up normalized fractional anisotropy in the stable group was higher than in the transient deficits group or the long-term deficits group. Compared with the transient deficits group, intraoperative normalized fractional anisotropy significantly decreased in the long-term deficits group. We conclude that intraoperative fractional anisotropy values of the corticospinal tracts can be used as a prognostic indicator of motor function outcome.展开更多
OBJECTIVE Exposure to stressful events can be differently perceived by individuals depending on the level of stress resilience or vulnerability.The neural processes that underlie such clinical y and social y important...OBJECTIVE Exposure to stressful events can be differently perceived by individuals depending on the level of stress resilience or vulnerability.The neural processes that underlie such clinical y and social y important differences are largely unknown.As insula cortex is important in emotional processing,we have examined whether the changes in synaptic plasticity in the insula cortex involved in stress resilience or vulnerability.METHODS Mice were divided into two groups:control and stress group.Stress group was treated by foot electric shock twice daily(0.8 mA,2 s,ten times in 1 min) in continuous two weeks.Then we used fear conditioning test to detect re-experiencing of traumatic experience,open field test to detect avoidance,pre-pulse inhibition experiment to detect hyper arousal.The changes of synaptic plasticity in the insular cortex were recorded by the multiple channels electrophysiology and whole cell patch.RESULTS According to the behavioral scores,it was divided into resilient and vulnerable group.In the fear conditioning test,the vulnerable group showed the significant freezing time decreased than that of the resilient group(P<0.01).In the open field test,the time that enter the center zone of vulnerable group is increased than that resilient group(P<0.01);In the pre-pulse inhibition experiment,there are not significant difference of PPI value in both groups(P=0.4239).And then electrophysiological experiments are performed to detect the synaptic plasticity of the insular cortex.Compared with the resilient group,the LTP level was decreased(P<0.05) and the mEPSC was increased(P<0.01) in vulnerable group.CONCLUSION The impairment of synaptic plasticity in the insular cortex may be one of the neural mechanisms for the vulnerability to chronic stress.展开更多
Greece as a significant tourist destination showed a considerable increase （5.1%） in tourist arrivals in 2016, despite intense geopolitical upheaval, especially in the area of South-East Aegean. It is noteworthy tha...Greece as a significant tourist destination showed a considerable increase （5.1%） in tourist arrivals in 2016, despite intense geopolitical upheaval, especially in the area of South-East Aegean. It is noteworthy that the main volume of tourism proceeds in Greece was generated by its insular regions, despite the intense problems faced by insularity, and by the insular Region of Southern Aegean in particular, despite the heavy refugee flows due to its geopolitical position. However, how is insularity affected by the new hyper-taxation of the islands through the increase of value added tax in insular local development and tourism？ Is insular economy strong enough to withstand the increased and intensely varying international challenges？ In this paper, after realistically depicting the official and published national tourism results for 2016, it is presented the immediate policy, institutional and destination management actions required in the Region of Southem Aegean so that it might be able to respond adequately to the new European or global tourism challenges, and act as the steam engine of the Greek tourism, pulling the broader Greek tourism development forward.展开更多
Serotonin (5HT) in the central nervous system has been associated with pain processing and modulation. The insular cortex (IC) plays an important role in the development and perception of the inflammatory and chronic ...Serotonin (5HT) in the central nervous system has been associated with pain processing and modulation. The insular cortex (IC) plays an important role in the development and perception of the inflammatory and chronic pain. The role of the serotoninergic system in IC has not been completely studied. We used micro-dialysis in freely moving rats to determine the extracellular release of 5HT and its main metabolite (5HIAA) in the IC during an inflammatory process. Results showed an increase of extracellular levels of 5HT and 5HIAA in the IC during carrageenan-induced inflammation and this augmentation correlates with a decrease of behavioral mechanonociceptive response. Furthermore, the exogenous administration of 5HT and 5HIAA in the IC increases the nociceptive response. Our current data imply that the serotoninergic system in the IC participates in the long-term pain process.展开更多
The rostral agranular insular cortex(RAIC)has been associated with pain modulation.Although the endogenous cannabinoid system(eCB)has been shown to regulate chronic pain,the roles of eCBs in the RAIC remain elusive un...The rostral agranular insular cortex(RAIC)has been associated with pain modulation.Although the endogenous cannabinoid system(eCB)has been shown to regulate chronic pain,the roles of eCBs in the RAIC remain elusive under the neuropathic pain state.Neuropathic pain was induced in C57BL/6 mice by common peroneal nerve(CPN)ligation.The roles of the eCB were tested in the RAIC of ligated CPN C57BL/6J mice,glutamatergic,or GABAergic neuron cannabinoid receptor 1(CB1R)knockdown mice with the whole-cell patch-clamp and pain behavioral methods.The E/I ratio(amplitude ratio between mEPSCs and mIPSCs)was significantly increased in layer V pyramidal neurons of the RAIC in CPN-ligated mice.Depolarization-induced suppression of inhibition but not depolarization-induced suppression of excitation in RAIC layer V pyramidal neurons were significantly increased in CPN-ligated mice.The analgesic effect of ACEA(a CB1R agonist)was alleviated along with bilateral dorsolateral funiculus lesions,with the administration of AM251(a CB1R antagonist),and in CB1R knockdown mice in GABAergic neurons,but not glutamatergic neurons of the RAIC.Our results suggest that CB1R activation reinforces the function of the descending pain inhibitory pathway via reducing the inhibition of glutamatergic layer V neurons by GABAergic neurons in the RAIC to induce an analgesic effect in neuropathic pain.展开更多
An increasing body of neuroimaging and electrophysiological studies of the brain suggest that the insular cortex（IC） integrates multimodal salient information ranging from sensation to cognitive-affective events to ...An increasing body of neuroimaging and electrophysiological studies of the brain suggest that the insular cortex（IC） integrates multimodal salient information ranging from sensation to cognitive-affective events to create conscious interoception. Especially with regard to pain experience, the IC has been supposed to participate in both sensory-discriminative and affective-motivational aspects of pain. In this review, we discuss the latest data proposing that subregions of the IC are involved in isolated pain networks： the posterior sensory circuit and the anterior emotional network. Due to abundant connections with other brain areas, the IC is likely to serve as an interface where cross-modal shaping of pain occurs. In chronic pain,however, this mode of emotional awareness and the modulation of pain are disrupted. We highlight some of the molecular mechanisms underlying the changes of the pain modulation system that contribute to the transition from acute to chronic pain in the IC.展开更多
Aims Nestedness is a characteristic of insular metacommunity structure.Relatively few studies,however,have attempted to evaluate temporal changes in nestedness,or elucidate the mechanisms underlying nestedness.I evalu...Aims Nestedness is a characteristic of insular metacommunity structure.Relatively few studies,however,have attempted to evaluate temporal changes in nestedness,or elucidate the mechanisms underlying nestedness.I evaluated both spatial and temporal patterns of nestedness in the insular floras of four archipelagoes of small islands in the Bahamas and the potential underlying environmental gradients.Methods The NODF(a nestedness metric based on overlap and decreasing fill)and the matrix temperature measure,T,were used to quantify nestedness in insular floras on small islands near Abaco,Andros,Great Exuma and the Exuma Cays,Bahamas.Two different null models were employed for each nestedness measure.Six environmental variables were evaluated in relation to nestedness by ordering islands according to gradients and recalculating NODF scores.Important Findings All archipelagoes were significantly nested.Nestedness among sites contributed more to overall nestedness than did nestedness among species.NODF scores varied among archipelagoes,but were surprisingly constant over time.Ordering islands by vegetated area yielded the highest nestedness scores for three archipelagoes;ordering islands by protection from exposure yielded the highest nestedness score for one archipelago.Nestedness scores varied little over time even though species compositions changed,indicating that extinctions occurred in a deterministic manner.The relative importance of area suggests extinction is an important mechanism in producing nestedness.Attempting to determine the relative importance of immigrations or extinctions requires some assumptions,however,and both processes are likely cumulative in most cases.展开更多
Background:The insula is a hidden part in the cerebral cortex.Insular epilepsy is underrecognized and it bears a special risk for misdiagnosis with regard to nonepileptic seizures or wrong localization of epileptic se...Background:The insula is a hidden part in the cerebral cortex.Insular epilepsy is underrecognized and it bears a special risk for misdiagnosis with regard to nonepileptic seizures or wrong localization of epileptic seizures.Case presentations:The manuscript describes 2 cases with ictal semiology of paresthesia and pain followed by hyperkinetic movements,noninvasive findings of source localization and/or invasive SEEG exploration.Conclusion:Magnetic source imaging,ictal SPECT as noninvasive and invasive recordings with depth electrodes(SEEG)can provide important preoperative information for the involvement of insular and periinsular regions in focal pharmacoresistant epilepsies.The optimal use of these methods presupposes extensive knowledge of ictal semiology and other clinical characteristics.The clinical localization hypothesis can be optimally proofed by SEEG exploration.展开更多
目的探讨老年(年龄60~70岁)急性岛叶梗死患者的梗死部位、梗死体积与临床预后的关系。方法选取2021年2~12月张家口市第一医院老年病科及全科医学科收治的100例老年急性岛叶梗死患者作为研究对象,受试者的脑梗死部位均运用核磁共振成像(m...目的探讨老年(年龄60~70岁)急性岛叶梗死患者的梗死部位、梗死体积与临床预后的关系。方法选取2021年2~12月张家口市第一医院老年病科及全科医学科收治的100例老年急性岛叶梗死患者作为研究对象,受试者的脑梗死部位均运用核磁共振成像(magnetic resonance imaging,MRI)筛查并明确,按Pullicino公式计算其脑梗死体积。根据脑梗死体积大小分组,脑梗死体积<3 cm^(3)组(A组)61例,脑梗死体积≥3 cm^(3)组(B组)39例,利用美国国立卫生院卒中量表(national institutesof health stroke scale,NIHSS)、蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)、脑卒中改良Rankin量表(modifed rankin scale,mRS)、日常生活能力评估量表(activity of daily living scale,ADL)和简易精神状况量表(mini-mental state examination,MMSE)分别评估所有受试者入院时、出院时、出院后的神经功能缺损程度、认知、功能恢复、日常生活能力及精神状态进行综合评估。用秩和检验、Spearman等级相关性检验NIHSS、MoCA、mRS、ADL、MMSE评分与梗死部位、梗死体积的相关性。结果组内比较,A、B组入院时NIHSS、mRS评分依次高于出院时,出院后3、6个月时,MoCA、ADL、MMSE评分及TST剩余值依次低于出院时(P<0.05)。组间比较,A组入院时、出院期(出院时,出院后3、6个月)NIHSS、mRS评分显著低于B组,MoCA、ADL、MMSE评分及TST剩余值显著高于B组(P<0.05)。A组梗死部位(基底核、皮质、脑干、小脑、丘脑、混合病变)的TST剩余值均高于B组(P<0.05)。急性岛叶梗死患者的TST剩余值、NIHSS评分、mRA评分与脑梗死体积呈负相关(rs=-0.358、-0.425、-5.06,P=0.003、0.06、0.09),MoCA、ADL、MMSE评分与脑梗死体积呈正相关(rs=0.547、0.614、0.548,P均<0.001)。结论老年急性岛叶梗死患者的脑梗死部位与神经功能缺损程度、功能恢复呈负相关,与认知、日常生活能力及精神状态呈正相关,其中脑梗死体积与肢体运动功能呈负相关。展开更多
基金Zhangjiakou City Science and Technology Bureau Municipal Science and Technology Plan Project,No.2121136D.
文摘BACKGROUND The aging of the population has become increasingly obvious in recent years,and the incidence of cerebral infarction has shown an increasing trend annually,with high death and disability rates.AIM To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.METHODS Between January 2020 and December 2023,we treated 98 cases of elderly acute insula,patients with cerebral infarction in the cerebral infarction acute phase(3-4 weeks)and for the course of 6 months in Montreal Cognitive Assessment Scale(MoCA)for screening of cognition.Notably,58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group,respec-tively.In patients with cerebral infarction,magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions,the relationship between the parts of the infarction volume,and analysis of acute insula cognitive disorder in elderly patients with cerebral RESULTS The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment(P<0.05).The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group,and the difference was statistically significant(P<0.05).The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group(P<0.05).In the cognitive impairment group,the infarct volumes in the basal ganglia,thalamus,and mixed lesions were negatively correlated with the total MoCA score,with correlation coefficients of-0.67,-0.73,and-0.77,respectively.CONCLUSION In elderly patients with acute insular infarction,infarction in the basal ganglia,thalamus,and mixed lesions were more likely to lead to cognitive dysfunction than in other areas,and patients with large infarct volumes were more likely to develop cognitive dysfunction.The infarct volume in the basal ganglia,thalamus,and mixed lesions was significantly negatively correlated with the MoCA score.
基金the National Natural Science Foundation of China,No.V30270502,C010703
文摘BACKGROUND： The insular cortex and habenular nucleus may be a regulatory center for obstructive sleep apnea syndrome, and dyspnea may be caused by insular cortex activity. The insular cortex is a cortical representation of obstructive sleep apnea syndrome. The habenular nucleus is a station for descending insular cortex activity. OBJECTIVE： Through actively stimulating the rat insular cortex, to observe rat respiratory movement, myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity, and to verify a hypothesis that the insular cortex is a superior-position regulation center, and the habenular nucleus is an inferior-position nervous nuclei of the insular cortex in patients with obstructive sleep apnea syndrome. DESIGN, TIME AND SETTING： The randomized, controlled animal study was performed at the Laboratory of Electrophysiology, Department of Physiology, Norman Bathune College of Medicine, Jilin University, China from September 2004 to June 2008. MATERIALS： We used L-glutamic acid （Dingguo Biological Product Research Center, Beijing, China）, lidocaine hydrochloride （Seventh Pharmacy Co., Ltd., Wuxi, China）, electric stimulator （Nihon Kohden, Japan）, and an AVL-OPTI blood gas analyzer （AVL Scientific Co., Roswell, GA, USA）. METHODS： The insular cortex of healthy adult Wistar rats underwent electrostimulation and L-glutamic acid stimulation to record changes in the myoelectric activity of genioglossus and respiratory movement. Some rats were injected with lidocaine to block the habenular nucleus before electrostimulation or L-glutamic acid stimulation. L-glutamic acid and lidocaine were injected by microelectrodes embedded in nuclear groups. MAIN OUTCOME MEASURES： Myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity were measured following apnea in rats undergoing electrostimulation in the insular cortex and following blockade of the habenular nucleus. RESULTS： Following electrostimulation and L-glutamic acid stimulation, rats developed apnea or respiratory rhythm disorders. Simultaneously, the amplitude of myoelectric activity of the genioglossus was reduced （P 〈 0.01 ）, and the electromyogram integral was decreased （P 〈 0.01）. Arterial blood gas analysis showed arterial blood acidosis, a decrease in pH （P 〈 0.05）, and an increase in the negative value of alkaline reserve （P 〈 0.01）. Lidocaine in the habenular nuclear blocked respiratory and other index changes after insular cortex stimulation. CONCLUSION： Dyspnea induced by stimulating the insular cortex may require the habenular nucleus. Paralysis of the habenular nucleus can completely eliminate insular cortex stimulation-induced dyspnea.
基金supported by the National Natural Science Foundation of China, No. 30800349the Natural Science Foundation of Beijing, No. 7102145
文摘Insular lesions remain surgically challenging because of the need to balance aggressive resection and functional protection. Motor function deficits due to corticospinal tract injury are a common complication of surgery for lesions adjacent to the internal capsule and it is therefore essential to evaluate the corticospinal tract adjacent to the lesion. We used diffusion tensor imaging to evaluate the corticospinal tract in 89 patients with insular lobe lesions who underwent surgery in Chinese PLA General Hospital from February 2009 to May 2011. Postoperative motor function evaluation revealed that 57 patients had no changes in motor function, and 32 patients suffered motor dysfunction or aggravated motor dysfunction. Of the affected patients, 20 recovered motor function during the 6-12-month follow-up, and an additional 12 patients did not recover over more than 12 months of follow-up. Following reconstruction of the corticospinal tract, fractional anisotropy comparison demonstrated that preoperative, intraoperative and follow-up normalized fractional anisotropy in the stable group was higher than in the transient deficits group or the long-term deficits group. Compared with the transient deficits group, intraoperative normalized fractional anisotropy significantly decreased in the long-term deficits group. We conclude that intraoperative fractional anisotropy values of the corticospinal tracts can be used as a prognostic indicator of motor function outcome.
基金National Natural Science Foundation of China(81402912).
文摘OBJECTIVE Exposure to stressful events can be differently perceived by individuals depending on the level of stress resilience or vulnerability.The neural processes that underlie such clinical y and social y important differences are largely unknown.As insula cortex is important in emotional processing,we have examined whether the changes in synaptic plasticity in the insula cortex involved in stress resilience or vulnerability.METHODS Mice were divided into two groups:control and stress group.Stress group was treated by foot electric shock twice daily(0.8 mA,2 s,ten times in 1 min) in continuous two weeks.Then we used fear conditioning test to detect re-experiencing of traumatic experience,open field test to detect avoidance,pre-pulse inhibition experiment to detect hyper arousal.The changes of synaptic plasticity in the insular cortex were recorded by the multiple channels electrophysiology and whole cell patch.RESULTS According to the behavioral scores,it was divided into resilient and vulnerable group.In the fear conditioning test,the vulnerable group showed the significant freezing time decreased than that of the resilient group(P<0.01).In the open field test,the time that enter the center zone of vulnerable group is increased than that resilient group(P<0.01);In the pre-pulse inhibition experiment,there are not significant difference of PPI value in both groups(P=0.4239).And then electrophysiological experiments are performed to detect the synaptic plasticity of the insular cortex.Compared with the resilient group,the LTP level was decreased(P<0.05) and the mEPSC was increased(P<0.01) in vulnerable group.CONCLUSION The impairment of synaptic plasticity in the insular cortex may be one of the neural mechanisms for the vulnerability to chronic stress.
文摘Greece as a significant tourist destination showed a considerable increase （5.1%） in tourist arrivals in 2016, despite intense geopolitical upheaval, especially in the area of South-East Aegean. It is noteworthy that the main volume of tourism proceeds in Greece was generated by its insular regions, despite the intense problems faced by insularity, and by the insular Region of Southern Aegean in particular, despite the heavy refugee flows due to its geopolitical position. However, how is insularity affected by the new hyper-taxation of the islands through the increase of value added tax in insular local development and tourism？ Is insular economy strong enough to withstand the increased and intensely varying international challenges？ In this paper, after realistically depicting the official and published national tourism results for 2016, it is presented the immediate policy, institutional and destination management actions required in the Region of Southem Aegean so that it might be able to respond adequately to the new European or global tourism challenges, and act as the steam engine of the Greek tourism, pulling the broader Greek tourism development forward.
文摘Serotonin (5HT) in the central nervous system has been associated with pain processing and modulation. The insular cortex (IC) plays an important role in the development and perception of the inflammatory and chronic pain. The role of the serotoninergic system in IC has not been completely studied. We used micro-dialysis in freely moving rats to determine the extracellular release of 5HT and its main metabolite (5HIAA) in the IC during an inflammatory process. Results showed an increase of extracellular levels of 5HT and 5HIAA in the IC during carrageenan-induced inflammation and this augmentation correlates with a decrease of behavioral mechanonociceptive response. Furthermore, the exogenous administration of 5HT and 5HIAA in the IC increases the nociceptive response. Our current data imply that the serotoninergic system in the IC participates in the long-term pain process.
基金This work was supported by the National Natural Science Foundation of China(32271056,81671081,and 81701095)University Science and Technology Fund Planning Projects(2022XC002 and 2019XB006).
文摘The rostral agranular insular cortex(RAIC)has been associated with pain modulation.Although the endogenous cannabinoid system(eCB)has been shown to regulate chronic pain,the roles of eCBs in the RAIC remain elusive under the neuropathic pain state.Neuropathic pain was induced in C57BL/6 mice by common peroneal nerve(CPN)ligation.The roles of the eCB were tested in the RAIC of ligated CPN C57BL/6J mice,glutamatergic,or GABAergic neuron cannabinoid receptor 1(CB1R)knockdown mice with the whole-cell patch-clamp and pain behavioral methods.The E/I ratio(amplitude ratio between mEPSCs and mIPSCs)was significantly increased in layer V pyramidal neurons of the RAIC in CPN-ligated mice.Depolarization-induced suppression of inhibition but not depolarization-induced suppression of excitation in RAIC layer V pyramidal neurons were significantly increased in CPN-ligated mice.The analgesic effect of ACEA(a CB1R agonist)was alleviated along with bilateral dorsolateral funiculus lesions,with the administration of AM251(a CB1R antagonist),and in CB1R knockdown mice in GABAergic neurons,but not glutamatergic neurons of the RAIC.Our results suggest that CB1R activation reinforces the function of the descending pain inhibitory pathway via reducing the inhibition of glutamatergic layer V neurons by GABAergic neurons in the RAIC to induce an analgesic effect in neuropathic pain.
基金supported by the National Natural Science Foundation of China(31371120)the Foundation for Returned Overseas Students of Ministry of Education,China(HG3503)
文摘An increasing body of neuroimaging and electrophysiological studies of the brain suggest that the insular cortex（IC） integrates multimodal salient information ranging from sensation to cognitive-affective events to create conscious interoception. Especially with regard to pain experience, the IC has been supposed to participate in both sensory-discriminative and affective-motivational aspects of pain. In this review, we discuss the latest data proposing that subregions of the IC are involved in isolated pain networks： the posterior sensory circuit and the anterior emotional network. Due to abundant connections with other brain areas, the IC is likely to serve as an interface where cross-modal shaping of pain occurs. In chronic pain,however, this mode of emotional awareness and the modulation of pain are disrupted. We highlight some of the molecular mechanisms underlying the changes of the pain modulation system that contribute to the transition from acute to chronic pain in the IC.
基金This work was supported by National Geographic Society grants(7447-03 and 8137-06)to the author.
文摘Aims Nestedness is a characteristic of insular metacommunity structure.Relatively few studies,however,have attempted to evaluate temporal changes in nestedness,or elucidate the mechanisms underlying nestedness.I evaluated both spatial and temporal patterns of nestedness in the insular floras of four archipelagoes of small islands in the Bahamas and the potential underlying environmental gradients.Methods The NODF(a nestedness metric based on overlap and decreasing fill)and the matrix temperature measure,T,were used to quantify nestedness in insular floras on small islands near Abaco,Andros,Great Exuma and the Exuma Cays,Bahamas.Two different null models were employed for each nestedness measure.Six environmental variables were evaluated in relation to nestedness by ordering islands according to gradients and recalculating NODF scores.Important Findings All archipelagoes were significantly nested.Nestedness among sites contributed more to overall nestedness than did nestedness among species.NODF scores varied among archipelagoes,but were surprisingly constant over time.Ordering islands by vegetated area yielded the highest nestedness scores for three archipelagoes;ordering islands by protection from exposure yielded the highest nestedness score for one archipelago.Nestedness scores varied little over time even though species compositions changed,indicating that extinctions occurred in a deterministic manner.The relative importance of area suggests extinction is an important mechanism in producing nestedness.Attempting to determine the relative importance of immigrations or extinctions requires some assumptions,however,and both processes are likely cumulative in most cases.
文摘Background:The insula is a hidden part in the cerebral cortex.Insular epilepsy is underrecognized and it bears a special risk for misdiagnosis with regard to nonepileptic seizures or wrong localization of epileptic seizures.Case presentations:The manuscript describes 2 cases with ictal semiology of paresthesia and pain followed by hyperkinetic movements,noninvasive findings of source localization and/or invasive SEEG exploration.Conclusion:Magnetic source imaging,ictal SPECT as noninvasive and invasive recordings with depth electrodes(SEEG)can provide important preoperative information for the involvement of insular and periinsular regions in focal pharmacoresistant epilepsies.The optimal use of these methods presupposes extensive knowledge of ictal semiology and other clinical characteristics.The clinical localization hypothesis can be optimally proofed by SEEG exploration.
文摘目的探讨老年(年龄60~70岁)急性岛叶梗死患者的梗死部位、梗死体积与临床预后的关系。方法选取2021年2~12月张家口市第一医院老年病科及全科医学科收治的100例老年急性岛叶梗死患者作为研究对象,受试者的脑梗死部位均运用核磁共振成像(magnetic resonance imaging,MRI)筛查并明确,按Pullicino公式计算其脑梗死体积。根据脑梗死体积大小分组,脑梗死体积<3 cm^(3)组(A组)61例,脑梗死体积≥3 cm^(3)组(B组)39例,利用美国国立卫生院卒中量表(national institutesof health stroke scale,NIHSS)、蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)、脑卒中改良Rankin量表(modifed rankin scale,mRS)、日常生活能力评估量表(activity of daily living scale,ADL)和简易精神状况量表(mini-mental state examination,MMSE)分别评估所有受试者入院时、出院时、出院后的神经功能缺损程度、认知、功能恢复、日常生活能力及精神状态进行综合评估。用秩和检验、Spearman等级相关性检验NIHSS、MoCA、mRS、ADL、MMSE评分与梗死部位、梗死体积的相关性。结果组内比较,A、B组入院时NIHSS、mRS评分依次高于出院时,出院后3、6个月时,MoCA、ADL、MMSE评分及TST剩余值依次低于出院时(P<0.05)。组间比较,A组入院时、出院期(出院时,出院后3、6个月)NIHSS、mRS评分显著低于B组,MoCA、ADL、MMSE评分及TST剩余值显著高于B组(P<0.05)。A组梗死部位(基底核、皮质、脑干、小脑、丘脑、混合病变)的TST剩余值均高于B组(P<0.05)。急性岛叶梗死患者的TST剩余值、NIHSS评分、mRA评分与脑梗死体积呈负相关(rs=-0.358、-0.425、-5.06,P=0.003、0.06、0.09),MoCA、ADL、MMSE评分与脑梗死体积呈正相关(rs=0.547、0.614、0.548,P均<0.001)。结论老年急性岛叶梗死患者的脑梗死部位与神经功能缺损程度、功能恢复呈负相关,与认知、日常生活能力及精神状态呈正相关,其中脑梗死体积与肢体运动功能呈负相关。
