Objective:To explore the rehabilitation effect of Tai Chi Yunshou combined with robot-assisted training on hand function of stroke pa-tients.Method:A total of 60 stroke patients were selected and randomly divided into a treatment group(n=30)and a control group(n=30).Both groups received conventional rehabilitation therapy.The treatment group received Tai Chi Yunshou training combined with robot-assisted training,the control group received robot-assisted training.The training frequency of the two groups was 60min/day,5 days/week,and the treatment continued for 8 weeks.Before treatment,after 4 weeks of treatment,and after 8 weeks of treatment,the Fugl-Meyer motor function scale(FMA)wrist-hand part,the Wolf motor function test(WMFT),Box and Block Test(BBT),grip strength and pinch strength to assess the hand function.Result:The dif-ference between the two groups of patients after treatment and before treatment was statistically significant(P<0.001).There was no statistically sig-nificant difference between the groups after 4 weeks of treatment(P>0.05).After 8 weeks of treatment,the difference in WMFT between the groups was statistically significant(P>0.05).FMA wrist-hand part,BBT,grip strength and pinch strength were not statistically different(P>0.05).Conclu-sion:Tai Chi Yunshou combined with robot-assisted training can improve hand function in stroke patients.
Objective:To analyze the rehabilitation needs and the associated factors of individuals with spinal cord injury(SCI)in Shanghai.Meth-ods:The participants were individuals with SCI from permanent Shanghai families who participated in rehabilitation training at Shanghai Sunshine Rehabilitation Center.The evaluation table of community-based rehabilitation demand of individuals with SCI developed by our research team,Com-munity Integration Questionnaire(CIQ),EQ-VAS,Zung self-rating anxiety/depression Scale(SAS/SDS)and a self-designed questionnaire were used.Descriptive statistics,reliability and validity analysis,and multiple logistic regression were employed in statistical analysis.Results:A total of 280 individuals with SCI were included in the study,of which 65 participated in the test-retest study.The evaluation table of community-based reha-bilitation demand showed good internal consistency,test-retest reliability,and content and structural validity.Exploratory Factor Analysis revealed that the 15 assessment items could be categorized into four need dimensions:education/employment,social,empowerment and health.The overall level of community rehabilitation needs was 64.6%,with education/employment needs(55.3%)and social needs(58.4%)scoring lower than 60%.The percentages of the seven need items were lower than 50%:cultural and artistic activities(34.7%),psychological counselling(35.0%),informal education(35.3%),formal school education(41.9%),sports activities(43.6%),employment and entrepreneurship(43.7%),and entertainment and lei-sure activities(48.6%).The multivariate analysis found that individuals with high school or lower education level(OR=2.20)and those from other provinces/cities(OR=2.06)had higher possibilities to demand psychological counselling compared to those with a higher education background and Shanghai Hukou residents.The participants who had been enrolled in 2018-2019(OR=3.21),had a college degree or above(OR=2.31),and acted as community rehabilitation instructors(OR=2.10)were associated with higher proportions of informal education needs compared to those who had been enrolled in 2020,had a high school education background or below,and were normal individuals with SCI.Unmarried/divorced/widowed partic-ipants(OR=2.24)and those who were employed/students(OR=2.12)were more inclined to pursue formal education compared to the married or un-employed participants.The participants who were from other provinces/cities(OR=2.72),those aged under 50 years(OR=2.84),and with a monthly income below 6000 yuan(OR=3.63)had a higher possibility to demand employment and entrepreneurship compared to participants with Shanghai Hukou,those aged over 50 years,and those with a monthly income above 6000 yuan.Community rehabilitation instructors(OR=4.73 and 2.99)and females(OR=1.83 and 2.49)had greater needs for cultural and artistic activities,and sports activities compared to normal individuals with SCI and the males,respectively.The participants with more than 10 years of injury history(OR=1.72)had a higher percentage of cultural and artistic activities needs,while the participants with complete injury had a high possibility of needing sports activities compared to those with incomplete injury(OR= 1.90).Conclusion:The community rehabilitation needs of individuals with SCI from permanent Shanghai families were at a medium level,with em-powerment and health needs being at a high level,and education/employment and social needs being at a relatively low level.
Objective:To explore the repair effect of tuina on overuse-induced skeletal muscle injury in rats and the effects of Hippo signaling path-way and myogenic regulatory factors.Methods:Twenty-four male SD rats were randomly divided into control group(C group),model group(M group),model + tuina group(T group)and model + sham tuina group(G group),with 6 rats in each group.EIMD model was established by 4-week heavy load exercise in group M,T,G;Group T was treated with tuian by pressing 6 hours after exercise,and Group G was treated with brush at the same time.Ultrastructural changes of muscle fibers were observed by transmission electron microscope,cross-sectional area of muscle fibers was evaluated by HE staining,mRNA expression of MST1,YAP,TAZ,TEAD2 was detected by real-time quantitative RT-PCR,and expression of PAX7,MYOD,MYOG protein was detected by Western Blot.Results:(1)Behavioral results showed that the ratio of grasping force/body mass of limbs in-creased and CSA decreased in model group and sham push group(P<0.05).Tuina could further increase the ratio of grasping force/body mass of limbs and increase CSA(P<0.05);Transmission electron microscope showed that muscle fiber sarcomere swelling,Z-line rupture and cell arrange-ment disorder in model group and sham tuina group.Tuina promoted muscle fiber repair to a certain extent;The expression of YAP,TAZ,TEAD2 mRNA decreased and the expression of MST1 mRNA increased in model group and sham tuina group,but the expression of YAP,TAZ,TEAD2 mRNA increased and the expression of MST1 mRNA decreased(P<0.05);The expression of PAX7,MYOD protein decreased and the expression of MYOG protein increased in model group and sham tuina group.Tuina increased the expression of PAX7,MYOD protein and decreased the expres-sion of MYOG protein.Conclusion:tuina can effectively promote the benign repair of overused muscle injury,and the mechanism may be related to the regulation of hippo signaling pathway and myogenic regulatory factors.
Massage is a commonly used therapeutic technique in clinical massage,which has the effects of relaxing tendons and unblocking collater-als,activating blood circulation and removing blood stasis,relieving swelling and pain,eliminating accumulation and guiding stagnation,and calm-ing the heart and mind.Finger kneading and palm kneading are widely used in clinical practice.Based on the relevant clinical literature in recent ten years,this paper briefly describes the current application of kneading in pain,internal medicine,gynecology,pediatrics,providing reference for ex-panding the clinical application of kneading.
Objective:By pre-column derivatization to establish a gas chromatography-mass spectrography method for determination of protential metabolic biomarkers,and was used to study the metabolic changes in the plasma of experimental hyperlipidemia rats.Methods:SD rats were ran-domly divided into normal control group and experimental hyperlipidemia model group.The experimental hyperlipidemia rat model was reproduced by feeding with high-fat diet.Orbital blood was taken and pre column derivatization was performed.The analytical method was established by GC-MS and investigated for methodology,including precision,reproducibility and stability.The plasma samples of normal control group and experimen-tal hyperlipidemia group were detected,and the potential metabolic markers were identified.Results:A metabonomic method based on GC-MS was established for the analysis of experimental hyperlipidemia plasma.The RSD of the relative peak areas in the precision,repeatability and stability tests of the method were less than 10%.Conclusion:The method is rapid,accurate,reproducible,and can be used for the determination of endog-enous metabolites in plasma of rats with hyperlipidemia.The method can provide some reference for the application of metabonomics in hyperlipid-emia.
Neurogenic bladder is one of the most common complications in patients with spinal cord injury,and the urinary system caused by it causes varying degrees of dysfunction,which brings great pain to patients and their families.Electroacupuncture can improve neurogenic bladder symptoms after spinal cord injury by regulating multiple signaling pathways in vivo,and the pituitary adenylate cyclase activates peptide/cyclic ad-enosine monophosphate/protein kinase A(PACAP/cAMP/PKA)signaling pathway,Wnt/β-catenin signaling pathway,phosphatidylinositol-3-kinase/protein kinase B/mammalian rapamycin target(PI3K/AKT/mTOR)signaling pathway has become a research hotspot,but the following aspects still need to be paid attention to:Experimental studies mostly focus on a single signal pathway,and the interaction between each signal pathway needs to be further verified.Electroacupuncture can activate signaling pathways in vivo,but the expression detection of signaling molecules and other related transcriptional proteins in the downstream and downstream of related pathways is still lacking.The effects of different acupuncture points on various signaling pathways and signaling molecules need to be further studied.The specific mechanism of electroacupuncture in improving neurogenic blad-der function after spinal cord injury by activating the JAK-STAT signaling pathway needs to be further explored.
Objective:To compare the effect of moxibustion on perennial allergic rhinitis(PAR)with different moxibustion sensations(heat sensitive moxibustion vs resting moxibustion)at the same acupuncture point(Shangyitang)by using tendency score regression adjustment(PSRA)balanced baseline data.Methods:A prospective cohort study was designed and 106 qualified subjects were included.Moxibustion sensation was stimulated by moxibustion with moxibustion stick.According to the sensation of heat moxibustion,they were naturally divided into heat moxibustion group(n=69)and traditional moxibustion(n=37).Both groups were treated with moxibustion in Shangyin Tang for 30min each time,once a day for two weeks,a total of 12 times.The outcome measures were Variable rhinitis Symptom Scale(TNSS),concomitant Symptom Scale(TNNSS)and Quality of Life questionnaire(RQLQ).Result:PSM was used for 1:1 matching with a matching tolerance of 0.02,and 25 pairs were successfully matched with a to-tal of 50 patients.There was no significant difference in baseline data between the two groups(P>0.05).After matching,the TNSS score of the ther-mosensitive group after treatment was 4.01±1.52,which was lower than that of the static group(5.42±1.10),with statistical significance(P<0.01).TNNSS score of the thermosensitive group was 1.26±0.43,which was lower than that of the static group(1.52±0.50),with statistical significance(P<0.01).The RQLQ score of the thermal group was 37.62±6.01,which was lower than that of the static group(47.22±7.76),with statistical significance(P<0.01).This suggests that the static group has therapeutic advantages in improving symptoms,signs and quality of life in PAR patients.The results of univariate analysis with differences before propensity score matching were included in multivariate logistic regression analysis.The results showed that drug use and disease course were independent risk factors for the efficacy of moxibustion(P<0.05).Conclusion:The clinical effect of moxibustion heat sensitive acupoint therapy on PAR is better than that of rest state group.
Objective:To systematically evaluate the efficacy of motor imagery therapy(MI)on upper limb motor dysfunction and activities of daily living(ADL)after stroke.Methods:PubMed,EMBASE,Web of Science,the Cochrane Library,CNKI,Wanfang Data,CBM and VIP were searched.Randomized controlled trials(RCT)of MI intervention on upper limb motor function and ADL in stroke patients were collected.The search deadline was March 2022.The literature was screened according to the inclusion and exclusion criteria and the data of the required evaluation indicators were extracted.RevMan 5.3 software was used for Meta analysis.Results:A total of 16 RCTs involving 932 patients were included.The results of Meta-analysis showed that compared with the control group,the FMA-UE score[MD=6.93,95%CI(4.99,8.87),P<0.00001],ARAT score[MD=6.32,95%CI(1.86,10.78),P=0.005]and MBI score[MD=8.44,95%CI(5.94,10.94),P<0.00001]in the experimental group showed that MI had better effect on upper limb motor function and ADL disorder in stroke patients.Subgroup analysis showed that the efficacy of MI in patients with stroke within 6 months was better than that in the control group,but there was no significant difference between the two groups in patients with stroke over 6 months.Conclusion:MI can improve upper limb motor function and ADL in patients with stroke,and the effect of intervention on upper limb mo-tor dysfunction is better within 6 months after stroke.
Repetitive transcranial magnetic stimulation has been extensively used in clinical practice to promote the recovery of upper limb motor function in stroke patients.There are currently three theoretical models to guide the application of repetitive transcranial magnetic stimulation:The vi-cariation model is based on brain plasticity.The interhemispheric competition model emphasizes the balance of excitability in the bilateral hemi-spheres after stroke.In clinical practice,most studies were mainly conducted according to the interhemispheric competition model and adopted the in-tervention method of low-frequency inhibition in the unaffected hemisphere or high-frequency excitation in the affected hemisphere,but the inter-hemispheric competition model may not be applicable for severe stroke patients.Based on the vicariation model and the interhemispheric competi-tion model,a more comprehensive bimodal balance-recovery model is proposed.It introduces the concept of structural reserve and brings the vicaria-tion model into the research perspective,emphasizing the importance of the unaffected hemisphere for severe stroke patients,but there is currently no standardized method for measuring structural reserve,which can still be problematic in practical applications.Therefore,a better standardized method of differentiating stroke severity may be beneficial for the clinical application of repetitive transcranial magnetic stimulation.Most studies also focused stimulation target on the primary motor cortex,but stimulation of the primary motor cortex did not always obtain a significant therapeu-tic effect.For this reason,Some studies have proposed new targets and multi-target stimulation.This paper briefly discusses the application of theo-retical models and relevant stimulation targets in repetitive transcranial magnetic stimulation to promote the recovery of upper limb motor function in stroke patients,in order to better promote the recovery of upper limb motor function after stroke.
Objective:To establish quality standard and optimize the preparation technology of Huoxue Xiaotong liquor.Methods:Thin layer chromatography(TLC)was used to identify sovereign drug including Zanthoxylum nitidum(Roxb.)DC and Panax notoginseng and identify minister drug:Resina Draconis;High Performance Liquid Chromatography(HPLC)was used to determine the content of notoginsenoside R1,ginsenoside Rg1 and ginsenoside Rb1.Chromatographic column is Waters X Bridge Shield RPC18(4.6×250 mm,5 μm)colum.Mobile phase consisting of water(A)-acetonitrile(B)and gradient elution(0～15 min,20%～23%B;15～25 min,23%B;25～35 min,23%～40%B;35～36 min,40%～90%B).The flow rate was 1 mL/min,column temperature was 30℃,detection wavelength was 203 nm,the injection volume was 10 μL;Central composite design(CCD)-response surface method was used to optimize the preparation technology of Huoxue Xiaotong liquor.Results:The characteristic spots of Zanthoxylum nitidum(Roxb.)DC、Resina Draconis and Panax notoginseng were clear and well separated,and there was no interference from the negative control.The notoginsenoside R1,ginsenoside Rg1 and ginsenoside Rb1 had a good linear relationship within their respective concentration ranges(r2>0.999).There was no interference from the negative control,and the results of precision,stability,repeatability and recovery rate were good.The total content of three saponins in 10 batches of samples ranged from 0.4225～0.5982 mg/mL;The CCD method was used along with actual situation to obtain the optimal process as follows:alcohol content was 42%,material ratio was 16.7 mg/mL,soaking time was 7 days.Conclusion:The method established in this study is simple,accurate and reliable,and can be used for the study of quality standard of Huoxue Xiaotong liquor.At the same time,the optimal technology of Huoxue Xiaotong liquor was found scientifically,comprehensively and accurately by the method of central composite design.
Objective:To explore the role and mechanism of miR-122-5p on the osteogenic differentiation of hBMSCs.Methods:we investigated the role of miR-122-5p in osteogenic differentiation by alkaline phosphatase staining and Alizarin red staining,Dual luciferase reporter gene assay was used to verify the targeting relationship between miR-122-5p and BRCC3,Expression of Runx2、Osterix、wnt3a、β-catenin、GSK3-β、miR-122-5 and BRCC3 mRNA in hBMSCs were detected by quantitative reverse transcription polymerase chain reaction(RT-qPCR).Western blot was used to de-tect the expression of β-catenin protein.Results:The over expression of MiR-122-5p significantly promoted the activation of alkaline phosphatase(ALP)and formation of calcified nodules in osteoblasts,The mRNA expressions of β-catenin、Runx2、Osterix、wnt3a、GSK3-β and the protein expres-sion of β-catenin were significantly higher than those in control group.The dual-luciferase reporter gene experiment confirmed that BRCC3 was the downstream target gene of miR-122-5p.At the same time,inhibited osteogenic differentiation was also observed after BACC3 overexpression,the ex-pression levels ofβ-catenin、Runx2、Osterix、wnt3a、GSK3-β were inhibited.Conclusion:miR-122-5p can promote osteogenic differentiation of hBM-SCs,and targeting BACC3affects the activation of the wnt/β-catenin signaling pathway and regulates the process of osteoporosis treatment.
Objective:To observe the difference in postural stability and lower limb joint angle between patients with different severity of Knee Osteo-arthritis(KOA,low KOA kinesiophobia and high KOA kinesiophobia)and age-matched non-KOA symptomatic patients during stairs negotiation by using three-dimensional motion analysis system.Methods:Three-dimensional motion analysis system was used to detect the differences of biome-chanical factors such as postural stability(MoS)and joint angle among 78 patients with low KOA kinesiophobia,high KOA kinesiophobia and non-KOA symptoms during stairs negotiation.Results:The sagittal and coronal MoS of patients with low and high KOA kinesiophobia were worse than those of asymptomatic people.Compared with asymptomatic people,the maximum angle of hip flexion,maximum angle of hip adduction and range of knee flexion and extension in patients with low and high KOA kinesiophobia increased.Maximum angle of ankle dorsiflexion and maximum angle of knee flexion in patients with low KOA kinesiophobia decreased;the maximum angle of knee flexion decreased in patients with low KOA ki-nesiophobia.Compared with asymptomatic people,the maximum angle of hip flexion increased in low and high KOA kinesiophobia patients,the range of motion of ankle varus increased in low KOA kinesiophobia patients,and the maximum angle of hip adduction increased in high KOA kine-siophobia patients.Conclusion:The sagittal and coronal stability of KOA patients with low and high KOA is poor,but no significant effect of KOA patients is found.
背部肌筋膜炎属于中医经筋病的范畴,临床以局部疼痛、筋结点形成为主要表现.傅立新教授认为,本病多为本虚标实之证,在治疗时既要注重松解局部筋结,又要顾护脾胃、调补气血.临床上常先以芒针针刺调气要穴中脘、气海,再用筋骨针松解筋结点,效果显著.本文通过介绍傅立新教授治疗背部肌筋膜炎的诊治思路,以期为临床提供新思路与新方法.
目的:系统评价颅脑损伤患者发生低钠血症的危险因素.方法:计算机检索Cochrane图书馆、Pubmed、Embase、Web of Science、CNKI、VIP、CBM、万方数据库等数据库平台自建库起至2022年12月20日有关颅脑损伤患者发生低钠血症危险因素的研究,采用RevMan5.3软件进行Meta分析.结果:共纳入13项原始研究,均为病例对照研究,涉及患者3237例,Meta分析结果表明,年龄[OR=1.03,95%CI(1.01,1.05)]、GCS评分≤8分[OR=3.90,95%CI(2.67,5.70)]、颅骨骨折[OR=3.63,95%CI(2.88,4.58)]、脑水肿[OR=2.88,95%CI(1.81,4.60)]、脑出血[OR=1.80,95%CI(1.44,2.24)]、脑挫裂伤[OR=2.33,95%CI(1.58,3.43)]、穿透性损伤[OR=3.53,95%CI(1.72,7.24)]是颅脑损伤患者发生低钠血症的危险因素.结论:现有证据显示,颅脑损伤后患者发生低钠血症受到各种因素的影响,临床应针对现有的可能危险因素作尽早的干预.
月经病是常见的妇科疾病,中医认为妇人以血为先天,如今女性随着生活节奏的增快,在生活与社会中压力倍增,饮食、情志、生活规律的改变使得女性正常生理机制得到破坏,月经病也随之接踵而来,而中医治疗月经病有着自己独特的优势.本文阐述袁师运用运气思维治疗月经病的相关验案的思路和经验,并附验案3则.
目的:探讨温针灸结合关节松动术对椎动脉型颈椎病患者椎-基底动脉血流状况的影响.方法:选取2020年1月至2022年1月收治的80例椎动脉型颈椎病患者,按照随机数字表法将其分对照组和观察组各40例,对照组接受温针灸治疗,观察组接受温针灸结合关节松动术治疗,比较两组患者治疗疗效、椎-基底动脉血流状况、改良颈性眩晕症状与功能评估量表(ES-CV)、X线检测结果等.结果:观察组总有效率高于对照组(P<0.05);治疗后,两组患者的RVA、LVA、BA的RI较治疗前降低,Vm较治疗前增高(P<0.05),且观察组治疗后的RVA、LVA、BA的RI均低于对照组(P<0.05),Vm均高于对照组(P<0.05).治疗后,两组患者的ES-CV评分较治疗前增高(P<0.05),且观察组治疗后的ES-CV评分高于对照组(P<0.05).治疗后,两组患者的椎体角度位移、椎体水平位移较治疗前增高(P<0.05),颈椎弧度、椎体屈伸活动范围较治疗前降低(P<0.05),且观察组治疗后的椎体角度位移、椎体水平位移高于对照组(P<0.05),颈椎弧度、椎体屈伸活动范围低于对照组(P<0.05).结论:温针灸结合关节松动术治疗椎动脉型颈椎病,患者椎-基底动脉血流状况和患者颈椎功能改善效果更理想,疗效高.
《黄帝内经》中关于针刺取穴原则与应用的论述内容颇丰,古人在其指导下取穴运用疗效极为显著,反复应用与考究使其原则逐渐系统化,无论理论研究与临床运用始终不曾脱离《黄帝内经》基本的取穴宗旨,在坚持原有理论的基础上进一步发挥,也取得了新的突破,由此可见原有取穴原则的重要意义.本文拟进一步探析与挖掘《黄帝内经》中针刺治病取穴原则与应用价值,以期为临床取穴防治疾病提供实用参考价值.
随着世界老龄化日趋严重,衰弱综合征开始成为一个热点话题.COPD与衰弱密切相关,常发生于老年人,影响老年人的健康,降低其生活质量,加重机体损害.目前,尚无针对老年COPD相关性衰弱发病机理及运动干预机制的综述类文献,因此,本文概述了老年COPD相关性衰弱的现况,分析了其发病机理,包括炎症反应、自噬异常、氧化应激反应、内分泌功能紊乱等方面,综述了运动干预对老年COPD患者相关性衰弱的作用机制,旨在为老年COPD合并衰弱患者进行运动干预提供理论依据.
目的:探讨神经肌肉本体感觉促进疗法(Proprioceptive Neuromuscular Facilitation,PNF)对胸椎骨折致脊髓损伤(Spinal cord injury,SCI)患者术后康复的干预效果.方法:选取我院2020年6月～2022年1月收治的104例胸椎骨折致SCI患者为研究对象,掷硬币法随机分为观察组和对照组各52例,对照组术后采取常规治疗,观察组另加用PNF治疗,对比两组治疗效果.结果:治疗后,两组患者的脊髓损伤Frankel分级均较治疗前改善(P<0.05),且观察组治疗后的脊髓损伤Frankel分级显著优于对照组(P<0.05).治疗后,两组患者的FIM、感觉、NIHSS、MBI、SCIMⅢ评分均较治疗前改善(P<0.05),且观察组治疗后的FIM、感觉、MBI、SCIMⅢ评分均高于对照组(P<0.05),NIHSS评分低于对照组(P<0.05).治疗后,两组患者的椎体后缘、前缘高度均较治疗前增高(P<0.05),且观察组治疗后的椎体后缘、前缘高度显著高于对照组(P<0.05).结论:对胸椎骨折致SCI患者采取PNF疗法效果较好,可有效改善神经功能,提高患者日常生活能力和运动功能.
慢性萎缩性胃炎伴肠化生是一种常见的消化系统疾病,被世界卫生组织称作胃癌前病变.西医治疗本病难以逆转肠化,临床疗效不佳.陆敏教授临证二十余年,治疗慢性萎缩性胃炎伴肠化生经验颇丰,疗效显著.他认为脾胃虚弱是本病的发病基础,痰湿瘀结是发病关键,治疗时以健脾补中为主,理气散结为辅,标本兼顾,扶正与祛邪同用,同时需注意三因制宜,随证加减,调养后天.
