ObjectiveTo observe the clinical efficacy of acupotomy in the treatment of anterolateral ankle impingement syndrome (ALAIS).MethodsA total of 60 patients diagnosed with ALAIS treated at the Outpatient Department of Orthopedics and Traumatology, Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from December 2024 to November 2025 were enrolled and divided into a control group and an observation group using a random number table method, with 30 cases in each group. The control group received oral meloxicam at 7.5 mg once daily for 20 days in addition to routine treatment, while the observation group received acupotomy treatment once every 10 days for a total of 2 sessions in addition to routine treatment. Before and after treatment, ankle range of motion was measured using a goniometer, dynamic balance was assessed using the Y-balance test (YBT), ankle function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, and foot and ankle-related quality of life was assessed using the Foot and Ankle Outcome Score (FAOS). Adverse events were also recorded.Results(1) Ankle range of motion: Compared with those before treatment, ankle dorsiflexion, inversion, and eversion range of motion in the control group increased significantly after treatment (P<0.05), and ankle dorsiflexion, plantarflexion, inversion, and eversion range of motion in the observation group increased significantly after treatment (P<0.05). Compared with the control group, ankle dorsiflexion, and inversion range of motion in the observation group were significantly greater after treatment (P<0.05). (2) YBT scores: Compared with those before treatment, the anterior reach, posteromedial reach, posterolateral reach, and composite YBT scores in both groups increased significantly after treatment (P<0.05). Compared with the control group, the anterior, posteromedial, posterolateral, and composite scores of YBT in the observation group were significantly higher after treatment (P<0.05). (3) AOFAS ankle-hindfoot scores: Compared with those before treatment, the pain, function, alignment, and total scores of AOFAS in both groups increased significantly after treatment (P<0.05). Compared with the control group, the pain, function, alignment, and total scores of AOFAS in the observation group were significantly higher after treatment (P<0.05). (4) FAOS scores: Compared with those before treatment, the subscores of FAOS pain, other symptoms, activities of daily living, sports and recreational function, and quality of life in both groups increased significantly after treatment (P<0.05). Compared with the control group, the subscores of FAOS pain, other symptoms, sports and recreational function, and quality of life in the observation group were significantly higher after treatment (P<0.05). (5) No adverse reactions occurred in either group during the study.ConclusionAcupotomy can effectively improve ankle range of motion, enhance dynamic balance ability, restore ankle-foot function, and improve quality of life for patients with ALAIS, with favorable short-term safety.
Transcranial direct current stimulation (tDCS) devices are medical instruments that deliver low-intensity direct current (1-2 mA) to specific cortical regions via electrodes for therapeutic or adjunctive purposes. To standardize the design, development, manufacturing, inspection, quality control, and preclinical evaluation of such devices, this technical specification clarifies the terminology and definitions, classification and composition, performance and functional requirements, test methods, inspection rules, marking and labeling, instruction manuals, packaging, and storage, based on relevant requirements for basic safety, environmental testing, biological evaluation, usability engineering, electrodes for nerve and muscle stimulators, electromagnetic compatibility, and software life cycle. This specification places particular emphasis on output current error, output voltage, output current, impedance measurement error, electrode and electric field design, electrode pad impedance, biocompatibility, electrical safety, electromagnetic compatibility, environmental adaptability, software data logging, user interface, and alarm prompts, and specifies the corresponding test methods for appearance, performance, function, safety, and environmental adaptability. This specification is applicable to the technical evaluation, registration testing, factory inspection, and pre-use quality control of tDCS devices, and may serve as a reference for relevant organizations in product design, manufacturing, and testing.
ObjectiveTo investigate the mechanism of electroacupuncture in treating diabetic neuropathic pain (DNP) through the lipoxin A4 (LXA4) and its receptor-mediated Nrf2 antioxidative stress pathway in the spinal dorsal horn.MethodsA total of 36 SPF-grade male SD rats were randomly divided into a normal control group (n=6) and a model induction group (n=30). The DNP model was established by single intraperitoneal injection of streptozotocin (65 mg/kg) in the model induction group. After successful modeling, the rats were further randomized into five groups (n=6 for each group): model group, aspirin-triggered lipoxin A4 (ATL) group, ATL+BOC-2 group, electroacupuncture (EA) group, and EA+BOC-2 group. The ATL group received intrathecal injection of ATL solution (25 μL) once weekly for 4 consecutive weeks. The ATL+BOC-2 group received intrathecal injection of a mixed solution of ATL (25 μL) and BOC-2 (50 μg) with the same treatment course. The EA group received electroacupuncture at bilateral "Shenshu" (BL23) and "Zusanli" (ST36) acupoints, 30 min per session, once every other day, three times per week, for 4 consecutive weeks. The EA+BOC-2 group received the same electroacupuncture intervention combined with intrathecal injection of BOC-2 solution. Paw withdrawal latency (PWL) to thermal stimulation was measured before modeling, 2 weeks after modeling, and 6 weeks after modeling. At 6 weeks after modeling, spinal dorsal horn and sciatic nerve tissue samples were collected. Sciatic nerve ultrastructure was observed by transmission electron microscopy; LXA4 content in the spinal dorsal horn was detected by ELISA; protein relative expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), NAD(P)H:quinone oxidoreductase 1 (NQO1), protein kinase B (Akt) and phosphorylated Akt (p-Akt) were detected by Western blot.ResultsCompared with the normal control group, LXA4 content in the spinal dorsal horn was lower in the model group after intervention (P<0.05); compared with the model group, LXA4 content was higher in the EA group (P<0.05). No significant difference in PWL was found among all groups before modeling (P>0.05). At 2 weeks after modeling, PWL in all modeled subgroups was lower than that in the normal control group (P<0.05), indicating successful DNP modeling. At 6 weeks after modeling (at completion of intervention), compared with the control group, PWL was lower in the model group (P<0.05); compared with the model group, PWL was higher in the ATL and EA groups (P<0.05); compared with the ATL group, PWL was lower in the ATL+BOC-2 group (P<0.05); compared with the EA group, PWL was lower in the EA+BOC-2 group (P<0.05). Transmission electron microscopy revealed moderate to severe pathological changes in the sciatic nerve of the model group; all treatment groups showed markedly attenuated lesions compared with the model group, with the EA group exhibiting the most prominent improvement. Compared with the normal control group, the model group showed lower protein expression levels of Nrf2, HO-1 and NQO1, and higher p-Akt level in the spinal dorsal horn (P<0.05); compared with the model group, the ATL and EA groups showed higher Nrf2, HO-1 and NQO1 expressions, and lower p-Akt level (P<0.05); compared with the ATL group, the ATL+BOC-2 group showed lower Nrf2, HO-1 and NQO1 expressions, and higher p-Akt level (P<0.05); compared with the EA group, the EA+BOC-2 group showed lower Nrf2, HO-1 and NQO1 expressions, and higher p-Akt level (P<0.05).ConclusionElectroacupuncture may exert its analgesic effect by promoting LXA4 expression and upregulating its receptor, thereby inhibiting Akt phosphorylation in the spinal dorsal horn, upregulating the Nrf2-mediated antioxidative stress pathway, and attenuating peripheral nerve injury in DNP rats.
ObjectiveTo observe the efficacy of Liuzijue Qigong exercise combined with repetitive transcranial magnetic stimulation (rTMS) on spastic post-stroke dysarthria (PSD).MethodsA total of 80 patients diagnosed with spastic PSD admitted to the Department of Rehabilitation Medicine, the First People's Hospital of Yibin, from September 2024 to September 2025 were recruited and randomly divided into a control group and an observation group using a random number table method, with 40 cases in each group. During the study, 3 cases dropped out, resulting in 39 cases in the control group and 38 cases in the observation group. Both groups received conventional treatment. The control group additionally received high-frequency rTMS over the left Broca's area and low-frequency rTMS over the right Broca's mirror area, while the observation group received the identical rTMS protocol combined with Liuzijue Qigong exercise. Both groups were treated continuously for 8 weeks. Before and after treatment, the modified Frenchay Dysarthria Assessment Scale (m-FDA) was used to assess the severity of dysarthria; the speech intelligibility (SI) assessment was used to assess speech clarity; the Voice Handicap Index-10 (VHI-10) was used to assess voice function; the Communication Effectiveness Index (CETI) was used to assess communication ability; phonetic analysis software and a decibel meter were used to assess acoustic parameters and speech loudness; the Chinese version of Stroke and Aphasia Quality of Life Scale (SAQOL) was used to evaluate quality of life; and the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess mental health status.Results(1) m-FDA scores: compared with those before treatment, all m-FDA dimension scores and total scores in both groups decreased significantly after treatment (P<0.05). Compared with the control group, subscores of reflex function, respiratory function, jaw position, tongue function and speech function, and total m-FDA scores in the observation group were lower after treatment (P<0.05). (2) SI, VHI-10, and CETI scores: compared with those before treatment, SI and CETI scores in both groups increased significantly after treatment (P<0.05), while VHI-10 scores decreased significantly (P<0.05). Compared with the control group, SI and CETI scores in the observation group were higher after treatment (P<0.05), and VHI-10 scores was lower (P<0.05). (3) Acoustic parameters: compared with those before treatment, second formant (F2), vowel articulation index (VAI), maximum phonation time (MPT), maximum counting ability (MCA), and speech loudness in both groups increased significantly after treatment (P<0.05), while first formant (F1) and formant centralization ratio (FCR) decreased significantly (P<0.05). Compared with the control group, F2, VAI, MPT, MCA, and speech loudness in the observation group were higher after treatment (P<0.05), while F1 and FCR were lower (P<0.05). (4) SAQOL, SAS and SDS scores: compared with those before treatment, SAQOL scores in both groups increased significantly after treatment (P<0.05), while SAS and SDS scores decreased significantly (P<0.05). Compared with the control group, SAQOL scores in the observation group was higher after treatment (P<0.05), while SAS and SDS scores were lower (P<0.05).ConclusionLiuzijue Qigong exercise combined with high-frequency and low-frequency rTMS can effectively reduce the severity of dysarthria, enhance speech clarity, and improve quality of life and mental health status in patients with spastic PSD.
Stroke is the leading cause of disability among adults in China, and patients often suffer from permanent neurological deficits, including limb motor dysfunction and cognitive impairment, which severely affect their quality of life. The integration of brain-computer interface and virtual reality (BCI-VR) technology has demonstrated significant therapeutic efficacy and great potential in functional rehabilitation after stroke. This review summarizes the research progress of BCI-VR technology in stroke rehabilitation and elucidates its core mechanisms: it induces neuroplasticity and brain network reorganization, and modulates motor-related neural networks through multimodal neurofeedback, thereby promoting brain functional reconstruction and functional recovery. This review also summarizes clinical applications of BCI-VR in the rehabilitation of upper-limb and lower-limb motor dysfunction as well as cognitive impairment, while objectively analyzing current limitations of this technology in neuromodulation mechanisms, intervention strategies, and clinical application models. Future efforts should be made to enhance signal acquisition and processing capabilities, develop individualized decoding algorithms, establish optimal configurations for multimodal feedback, and conduct large-sample, multicenter randomized controlled trials, in order to build a more comprehensive BCI-VR integrated rehabilitation system and provide theoretical foundations and practical guidance for precise and personalized stroke rehabilitation.
