Post-stroke cognitive impairment (PSCI) severely affects patients' daily living activities and social participation, hindering the comprehensive rehabilitation process after stroke. Establishing a comprehensive, systematic, and accurate management standard and protocol for integrated rehabilitation assessment and treatment of PSCI will facilitate the widespread application and standardized implementation of integrated traditional Chinese and Western medicine in PSCI rehabilitation. This technical specification clarifies the terminology and definitions related to PSCI rehabilitation assessment and treatment. Based on the International Classification of Functioning, Disability and Health (ICF), it conducts a holistic rehabilitation assessment of PSCI patients across four dimensions: body functions and structures, activities, participation, and environmental factors. Furthermore, it formulates an integrated traditional Chinese and Western medicine rehabilitation treatment plan, addressing cognitive dysfunction, cognitive activity barriers, social participation barriers, and environmental adjustment barriers. This specification is applicable to guiding rehabilitation institutions at all levels, traditional Chinese medicine hospitals, and rehabilitation departments of general hospitals in China to provide systematic and standardized rehabilitation assessment and integrated traditional Chinese and Western medicine rehabilitation treatment for PSCI patients in the acute, recovery, and sequelae stages.

Children with developmental coordination disorder (DCD) exhibit significant deficits in both gross and fine motor functions. Baduanjin, a traditional Chinese mind-body exercise, has demonstrated potential in improving motor functions, including balance and neuromuscular coordination, in various rehabilitation settings. This study aims to investigate the effects of Baduanjin intervention on motor function in children with DCD, and further explore whether its potential benefits are mediated through improved cortical activation in motor-related brain regions, as reflected by cerebral hemodynamic responses. This single-blind randomized controlled trial enrolled 40 children aged 5–10 years who met the DSM-5 diagnostic criteria for DCD and had an MABC-2 standard score of ≤ 7. Participants were randomly assigned, using a SAS 9.4-generated randomization sequence with sealed opaque envelopes for allocation concealment, to either an experimental group receiving Baduanjin training plus health education or a control group receiving health education alone. The intervention lasted 8 weeks, with five sessions per week, including two instructor-led hospital sessions and three parent-supervised home sessions. After the intervention, motor coordination and balance were assessed using the Movement Assessment Battery for Children-2 (MABC-2) and the ProKin 254 balance test system, respectively. In addition, functional near-infrared spectroscopy (fNIRS) was used to measure hemodynamic responses in motor-related cortical regions during functional tasks, to evaluate cortical activation and examine its associations with changes in motor function. The per-protocol (PP) dataset included 36 participants, whereas the intention-to-treat (ITT) dataset included all 40 randomized children. Both PP and ITT analyses showed that the experimental group had significantly higher total MABC-2 scores than the control group (PP: P = 0.002; ITT: P = 0.001). Subscale analyses demonstrated significant improvements in aiming and catching (PP: P = 0.019; ITT: P = 0.005) and balance (PP: P = 0.008; ITT: P = 0.004). In addition, the experimental group showed significant improvements in key static balance parameters, including reduced sway area (PP and ITT: P < 0.001) and shorter sway path length (PP and ITT: P < 0.001). Dynamic postural stability also improved significantly (PP and ITT: P = 0.004). However, no statistically significant between-group differences were observed in manual dexterity (PP and ITT: P > 0.05). fNIRS results revealed that during the aiming and catching task, the experimental group exhibited significantly greater activation in the left premotor cortex and supplementary motor area (PMC + SMA) compared to the control group (CH31: FDR-adjusted P = 0.015; CH32: FDR-adjusted P = 0.041). In the one-leg balance task, the experimental group showed significantly enhanced activation in the left hemispheric regions, including the frontopolar area (FPA), dorsolateral prefrontal cortex (DLPFC), inferior frontal gyrus (IFG), primary motor cortex (M1), as well as the PMC + SMA (FDR-adjusted P = 0.018). No significant between-group differences in brain activation were observed during the manual dexterity task (FDR-adjusted P ≥ 0.05). Furthermore, correlation analysis indicated a significant positive association between improvements in motor performance and activation of motor-related brain regions in the experimental group. Baduanjin training improved motor coordination and balance in children with DCD. The observed changes in activation within motor-related cortical regions provide preliminary support for a possible neurophysiological basis of these functional improvements, although the underlying mechanisms require further investigation. ChiCTR, ChiCTR2300078980. Registered 22 December 2023, https//www.chictr.org.cn. The study protocol has been published (doi 10.1136/bmjopen2024084061).

Background:Ischemic stroke (IS) is a major cause of death and long-term disability worldwide. Multiple complex biological processes contribute to IS-related neuronal death, among which oxidative stress plays a central role in disease progression. Increasing evidence suggests that oxidative stress-induced neuronal injury is closely associated with ferroptosis and mitochondrial dysfunction, both of which contribute to excessive reactive oxygen species accumulation, lipid peroxidation, and impaired cellular energy metabolism during cerebral ischemia. However, their relative contributions and associated molecular signatures in IS have not been systematically compared. Therefore, this study aimed to identify ferroptosis- and mitochondria-associated genes involved in oxidative stress and neuronal injury in IS and to explore their potential as therapeutic targets for ischemic brain injury. Methods:Two public microarray datasets (GSE22255 and GSE58294) were integrated and analyzed using weighted gene co-expression network analysis (WGCNA) to identify IS-associated gene modules. Ferroptosis-related genes from FerrDb and mitochondria-associated genes from MitoCarta3.0 were intersected with key modules to screen candidate genes. Protein-protein interaction analysis and CytoHubba were applied to identify hub genes. Logistic regression models were constructed to compare the diagnostic performance of ferroptosis- and mitochondria-related gene signatures. Functional enrichment analyses were conducted using Gene Ontology and KEGG. Key genes were further validated in a rat middle cerebral artery occlusion/reperfusion (MCAO/R) model treated with the ferroptosis inhibitor Ferrostatin-1 (Fer-1). Results:Nine ferroptosis-related hub genes and nine mitochondria-related hub genes were identified. The ferroptosis-based diagnostic model showed significantly higher discriminatory power than the mitochondrial model (AUC = 0.949 vs. 0.829). Among these genes, GSK3B, IDH1, and PRDX1 exhibited the most prominent differential expression and were selected as core genes. In vivo experiments demonstrated that Fer-1 markedly reduced infarct volume, improved neurological function, attenuated oxidative stress, and restored the ACSL4/GPX4/TFR1 signaling axis. Fer-1 also reversed MCAO-induced dysregulation of GSK3B phosphorylation, IDH1, and PRDX1 expression, indicating effective suppression of ferroptosis. Conclusion:Ferroptosis-related gene signatures outperform mitochondria-associated genes in the diagnosis of ischemic stroke. GSK3B, IDH1, and PRDX1 represent key molecular regulators linking oxidative stress to ferroptotic neuronal injury and may serve as promising biomarkers and therapeutic targets for ischemic stroke.

ObjectiveTo identify protein targets and explore the potential mechanisms of contralateral acupuncture in improving motor dysfunction after cerebral ischemia-reperfusion injury, using Tandem Mass Tag (TMT)-based quantitative proteomics.MethodsEighty SPF-grade SD rats were randomly assigned to four groups (n=20 each): a sham-operated group, a model group, a contralateral acupuncture group, and a non-acupoint group. Middle cerebral artery occlusion/reperfusion (MCAO/R) models were established in the model, contralateral acupuncture, and non-acupoint groups, while the sham group underwent identical arterial dissection without occlusion. The contralateral acupuncture group received electroacupuncture (EA) at the healthy-side acupoints Zusanli (ST36) and Quchi (LI11). The non-acupoint group received EA at non-meridian points located 5 mm lateral to ST36 and LI11. Both groups received treatment for 7 days. The sham and model groups received no acupuncture intervention. Motor function (behavioral scores), cerebral infarct volume, and differential protein expression in the cerebral cortex were compared among the four groups.ResultsAfter 7 days of intervention: Zea-Longa scores were significantly lower in the contralateral acupuncture and non-acupoint groups compared to the model group (P<0.05). In the HomeCage behavioral test, rats in the contralateral acupuncture group retrieved food pellets more readily and spent less time doing so. TTC staining showed a significant reduction in infarct volume in the contralateral acupuncture group compared to the non-acupoint and model groups (P<0.05). Proteomic analysis revealed 18 upregulated and 14 downregulated proteins in the contralateral acupuncture vs. sham group comparison, and 26 upregulated and 7 downregulated proteins in the contralateral acupuncture vs. non-acupoint group comparison. Western blotting confirmed that, compared to the non-acupoint group, the contralateral acupuncture group showed significantly decreased expression of CaMKII-δ protein (P<0.05) and significantly increased expression of Gαolf protein (P<0.05) in the cerebral cortex. Compared to the sham group, the model group showed increased CaMKII-δ expression (P<0.05) and significantly decreased Gαolf expression (P<0.05).ConclusionContralateral acupuncture can significantly ameliorate motor dysfunction in a post-stroke rat model. The downregulation of the differential protein Gαolf, potentially affecting the dopaminergic synapse pathway or calcium signaling, may be part of the pathogenic mechanism of motor dysfunction after ischemia-reperfusion injury. The CaMKII family may be a potential key target for the specific mechanism of action of contralateral acupuncture. The differential proteins involved in contralateral acupuncture intervention were primarily enriched in the PPAR and Hippo signaling pathways. Myelin repair in the white matter and enhancement of synaptic function may be critical sites for its therapeutic effect.

INTRODUCTION:Knee osteoarthritis (KOA) is a prevalent degenerative disease that causes pain and disability in older individuals. This study aimed to examine the effects of the traditional Chinese medicine (TCM) rehabilitation program for aging populations with KOA. METHODS:A total of 101 participants with KOA were randomly assigned to either a TCM rehabilitation group (n = 49) or a conventional physical therapy group (n = 52) with a 1:1 allocation ratio for this randomized controlled trial. Participants in the TCM group received acupuncture, massage, and South Shaolin exercise training for 4 weeks, with three sessions per week lasting 50 min per session. Participants in the control group received conventional physical therapies of equal duration and frequency. RESULTS:Outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), Knee Outcome Survey Activities of Daily Living Scale, the 6-min Walking test (6MWT), the Time Up and Go (TUG) Test, and the Stair-climbing Test. Significant improvements were observed in the WOMAC, VAS, 6MWT, TUG, and Stair-climbing test after a 4-week TCM rehabilitation intervention (p < 0.05). The WOMAC and VAS were found to be decreased at the 4-week follow-up assessments compared to baseline scores (p < 0.05). Only the TUG test showed significant changes in the control group compared with the TCM rehabilitation group (p = 0.043) after 4 weeks post-intervention. CONCLUSION:The TCM rehabilitation program improved knee function and reduced pain intensity in aging populations with knee osteoarthritis. Well-designed randomized controlled trials with long-term follow-up assessments are needed to draw more definitive conclusions. Trial registration Chinese Clinical Trial Register ChiCTR2000033351, date of registration: May 29, 2020.

Vascular dementia (VaD) significantly impairs patients' quality of life and imposes a major social and economic burden. Electroacupuncture (EA), a contemporary modification of traditional acupuncture, has demonstrated potential in improving cognitive function in VaD, particularly when applied at the Shenting and Baihui. However, the underlying mechanisms remain inadequately understood. Elucidating how EA ameliorates cognitive deficits is critical for validating its clinical application and advancing non-pharmacological interventions for neurodegenerative disorders. This study aimed to investigate the neuroprotective mechanisms of electroacupuncture at these acupoints on cognitive function in VaD rats. VaD was induced in male Sprague-Dawley rats through bilateral common carotid artery occlusion (BCAO), with sham rats serving as controls. Rats were subsequently divided into three groups: BCAO, BCAO + EA and BCAO + EA + YC-1 (a HIF-1α inhibitor). Electroacupuncture was applied to the Shenting and Baihui. Cerebral blood flow (CBF) was measured using dynamic susceptibility contrast functional MRI, and cognitive recovery was evaluated through the Morris water maze. Immunohistochemical analysis quantified myelin repair and angiogenesis, while expression of HIF-1α, VEGF and VEGFR2 in white matter was quantified using PCR and Western blot. The results indicated that electroacupuncture improved learning and memory, increased CBF, enhanced myelin recovery and promoted angiogenesis in VaD rats. The expression of HIF-1α, VEGF and VEGFR2 in the white matter was significantly elevated in VaD rats. Electroacupuncture at Shenting and Baihui activates the HIF-1α/VEGF/VEGFR2 pathway, enhances angiogenesis, white matter perfusion and myelin repair, thereby restoring cognitive function in VaD rats.

Objective:Major depressive disorder is a common psychiatric condition characterized by persistent sadness and a lack of interest in life. It is often associated with alterations in autonomic nervous system functioning. This study examined the impact of a 10-week Baduanjin exercise program on heart rate variability and depression severity in individuals with major depressive disorder. Methods:The present study was a two-arm, single-blind, pilot randomized controlled trial. Thirty-four participants were randomly assigned to either a Baduanjin group (n = 17) or a control group (standard care) (n = 17). The Baduanjin group participated in 60-minute sessions twice weekly while the control group were given the standard care appropriate for people with major depression disorder. Heart rate variability (HRV) and depression severity were assessed at baseline, Week 5, and Week 10. Results:Results showed no significant interaction effect between group and time. However, there was a group effect for ratio of low-frequency-to-high-frequency (LF/HF ratio) HRV (p=0.049) only. Between-group differences were observed with Baduanjin exercise (Mean±SD: 0.27±0.33) group having higher scores than the control group (0.01±0.40). Also, there were significant time effects for depression, high-frequency (HF) HRV, low-frequency (LF) HRV, LF norm HRV, and total power (ps<0.05). Depression severity significantly decreased in both groups by Week 5 and Week 10 (ps<0.05) while low-frequency HRV and total power HRV increased in both groups by Week 5 and Week 10 (ps<0.05). Conclusion:These findings suggested that Baduanjin exercise may positively influence aspects of autonomic function. Future research with larger sample sizes and longer follow-up periods is needed to investigate its long-term effects and potential benefits for depressive symptoms in individuals with major depressive disorder. This study was registered with the Chinese Clinical Trial Registry (ChiCTR1900027222).

Background: In the fields of environmental monitoring and nuclear emergency, in order to obtain the relevant information of uranyl-induced environmental pollution and nuclear accident, it is necessary to establish a rapid quantitative analytical technique for uranyl ions. As a new promising technique, surface-enhanced Raman scattering (SERS) is hopeful to achieve this goal. However, uranyl ions are easily desorbed from SERS substrates under acidic conditions, and the structures of SERS substrates will be destroyed in the strong acidic aqueous solutions. Besides, the quantitative detection ability of SERS for uranyl ions needs to be promoted. Hence, it is necessary to develop new SERS substrates for accurate quantitative detection of trace uranyl in environmental water samples, especially in acidic solutions. Results: In this work, we prepared silver ions/sodium alginate supramolecular hydrogel membrane (Ag+/SA SMH membrane), and the Ag+ ions from the membrane were transformed into Ag/Ag2O complex nanoparticles under laser irradiation. The Raman signal of uranyl was strongly enhanced under the synergistic interaction of elec- tromagnetic enhancement derived from the Ag nanoparticles , charge transfer enhancement between uranyl and Ag 2 O. Utilizing the peak of SA (550 cm -1 ) as an internal standard, a quantitative detection with a LOD of 6.7 x 10 -9 mol L -1 was achieved due to a good linear relation of uranyl concentrations from 1.0 x 10 -8 mol L -1 to 2 x 10 -6 mol L -1 . Furthermore, foreign metal ions hardly affected the SERS detection of uranyl , the sub- strate could determine trace uranyl in natural water samples. Particularly, the acidity had no obvious effect on SERS signals of uranyl ions. Therefore, in addition to the detection of uranyl ions in natural water samples, the proposed strategy could also detect uranyl ions in strong acidic solutions. Significance and novelty: A simple one-step method was used to prepare an Ag + /SA SMH membrane for rapid quantitative detection of uranyl ions for the first time. The proposed substrate successfully detected uranyl ions under acidic conditions by immobilizing uranyl ion in hydrogel structure. In comparison with the previous studies, a more accurate quantitative analysis for uranyl ions was achieved by using an internal standard, and the proposed strategy could determine trace uranyl in either natural water samples or strong acidic solutions.

BackgroundBoth inflammatory cytokines and the gut microbiome are susceptibility factors for vascular dementia (VaD). The trends in the overall changes in the dynamics of inflammatory cytokines and in the composition of the gut microbiome are influenced by a variety of factors, making it difficult to fully explain the different effects of both on the different subtypes of VaD. Therefore, this Mendelian randomization (MR) study identified the inflammatory cytokines and gut microbiome members that influence the risk of developing VaD and their causal effects, and investigated whether inflammatory cytokines are gut microbiome mediators affecting VaD.MethodsWe obtained pooled genome-wide association study (GWAS) data for 196 gut microbiota and 41 inflammatory cytokines and used GWAS data for six VaD subtypes, namely, VaD (mixed), VaD (multiple infarctions), VaD (other), VaD (subcortical), VaD (sudden onset), and VaD (undefined). We used the inverse-variance weighted (IVW) method as the primary MR analysis method. We conducted sensitivity analyses and reverse MR analyses to examine reverse causal associations, enhancing the reliability and stability of the conclusions. Finally, we used multivariable MR (MVMR) analysis to assess the direct causal effects of inflammatory cytokines and the gut microbiome on the risk of VaD, and performed mediation MR analysis to explore whether inflammatory factors were potential mediators.ResultsOur two-sample MR study revealed relationships between the risk of six VaD subtypes and inflammatory cytokines and the gut microbiota: 7 inflammatory cytokines and 14 gut microbiota constituents were positively correlated with increased VaD subtype risk, while 2 inflammatory cytokines and 11 gut microbiota constituents were negatively correlated with decreased VaD subtype risk. After Bonferroni correction, interleukin-18 was correlated with an increased risk of VaD (multiple infarctions); macrophage migration inhibitory factor was correlated with an increased risk of VaD (sudden onset); interleukin-4 was correlated with a decreased risk of VaD (other); Ruminiclostridium 6 and Bacillales were positively and negatively correlated with the risk of VaD (undefined), respectively; Negativicutes and Selenomonadales were correlated with a decreased risk of VaD (mixed); and Melainabacteria was correlated with an increased risk of VaD (multiple infarctions). Sensitivity analyses revealed no multilevel effects or heterogeneity and no inverse causality between VaD and inflammatory cytokines or the gut microbiota. The MVMR results further confirmed that the causal effects of Negativicutes, Selenomonadales, and Melainabacteria on VaD remain significant. Mediation MR analysis showed that inflammatory cytokines were not potential mediators.ConclusionThis study helps us to better understand the pathological mechanisms of VaD and suggests the potential value of targeting increases or decreases in inflammatory cytokines and gut microbiome members for VaD prevention and intervention.

Introduction Poststroke shoulder pain is a common complication that severely affects the recovery of upper limb motor function. Acupuncture has positive analgesic effects in treating poststroke shoulder pain, and studies have demonstrated the efficacy of transcranial direct current stimulation (tDCS) in treating patients with this pain. However, whether acupuncture combined with tDCS has a superior rehabilitation effect on poststroke shoulder pain is currently unknown. We aimed to observe the effect of the combined intervention on poststroke shoulder pain and explore its possible central analgesic mechanism.Methods and analysis This study describes a randomised controlled trial using assessor blinding. A total of 135 poststroke patients with shoulder pain will be randomly assigned in a 1:1:1 ratio to the tDCS group, acupuncture group and combined group (acupuncture plus tDCS). All three groups will undergo conventional rehabilitation treatment. Participants in the tDCS group will receive tDCS stimulation on the M1 area for 20 min, while the acupuncture group will receive 20 min of acupuncture. The combined treatment group will receive both. All treatments will be performed five times per week for 4 weeks. The primary outcome indicator in this study is the Visual Analogue Scale pain score. Secondary outcome indicators include shoulder mobility, Shoulder Pain and Disability Index, Fugl–Meyer Motor Function Scale, Modified Barthel Index Scale, Self-Rating Anxiety and Depression Scale and functional MRI. All scale results will be assessed at baseline and at 2 weeks and 4 weeks, and during follow-up at 1 month, 3 months and 6 months postdischarge. A repeated analysis of variance will be conducted to observe the group×time interaction effects of the combined intervention. Moreover, functional MRI will be applied to explore the central analgesic mechanism.Ethics and dissemination Ethics approval was obtained from the Ethics Committee of the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine (2023KY-039–001). The results of the study will be published in a peer-reviewed journal and presented at scientific conferences.Trial registration number ChiCTR2300078270.

ObjectiveTo systematically evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) on language function in patients with non-fluent aphasia post-stroke.MethodsWe selected randomized clinical trials (RCT) that involved stroke patients with non-fluent aphasia, whose intervention was rTMS vs. no therapy or other therapy. Two researchers autonomously reviewed the literature based on the specified criteria for inclusion and exclusion and completed the process of data extraction, data verification, and quality evaluation. Meta-analysis was performed using RevMan 5.41 and Stata MP 172, while the assessment of risk of bias was carried out utilizing the Risk of Bias version 2 tool (RoB2)3.ResultsThe meta-analysis involved 47 RCTs, encompassing 2,190 patients overall. The indexes indicated that rTMS has the potential to decrease the severity of non-fluent aphasia in stroke patients, including improvement of the capability of repetition, naming, and spontaneous language. The determination of BDNF in the serum of patients was also increased. In addition, rTMS reduced the likelihood of depression in stroke patients.ConclusionTo summarize the relevant studies, rTMS has significant effects on improving the language abilities of stroke patients suffering from non-fluent aphasia, including the abilities of repetition, naming, and spontaneous language.

OBJECTIVE:To observe the effects of electroacupuncture (EA) at "Baihui" (GV 20) and "Sishencong" (EX-HN 1) on the expression of brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) pathway, synaptophysin (SYN), and the levels of interleukin-1β (IL-1β) and interleukin-18 (IL-18) in the hippocampus of the ischemic side in rats with cerebral ischemia-reperfusion injury (CIRI), and to explore the effects and action mechanism of EA on post-CIRI learning-memory function. METHODS:Forty-eight SPF-grade male SD rats were randomly divided into a sham operation group, a model group, an EA group, and a non-acupoint group, with 12 rats in each group. The CIRI model was established in the model group, the EA group, and the non-acupoint group using the modified ZeaLonga suture method. The rats in the EA group were treated with EA at "Sishencong" (EX-HN 1) and "Baihui" (GV 20), with disperse-dense wave at frequency of 2 Hz/10 Hz and intensity of 1 mA. The rats in the non-acupoint group were treated with EA at non-meridian and non-acupoint points under the ribs bilaterally with the same parameters as the EA group. EA were conducted for 30 min each session, once daily, for 7 days. During the intervention, body weight was measured daily at a fixed time, and neurological deficits were assessed on the 1st, 3rd, and 7th days into intervention. Brain infarct volume was measured using small animal magnetic resonance imaging before and after the intervention. After the intervention, learning-memory function were evaluated using the Morris water maze. Hippocampal morphology was observed with HE staining. The positive expression of SYN in the hippocampus of the ischemic side was detected by immunohistochemistry. BDNF, TrkB, and SYN protein expressions in the hippocampus of the ischemic side were detected by Western blot. IL-1β and IL-18 levels in the hippocampus of the ischemic side were measured by ELISA. RESULTS:From the 2nd to the 7th day into intervention, compared with the sham operation group, the body weight of rats in the model group was decreased (P<0.01); compared with the model group and the non-acupoint group, the body weight of rats in the EA group was increased (P<0.01). On the 1st day into intervention, compared with the sham operation group, neurological function scores of rats in the model group, the EA group, and the non-acupoint group were increased (P<0.01); on the 3rd and 7th days into intervention, neurological function scores of rats in the model group were higher than those in the sham operation group (P<0.01); on the 7th day, neurological function scores of rats in the EA group were lower than those in the model group and the non-acupoint group (P<0.05). Compared with the sham operation group, escape latency was prolonged (P<0.05), and the number of platform crossings was decreased (P<0.01) in the model group; compared with the model group and the non-acupoint group, escape latency was shortened (P<0.05), and the number of platform crossings was increased (P<0.01) in the EA group. Before intervention, the high signal infarcts were observed in the left ventricles of rats in the model group, the EA group, and the non-acupoint group; after intervention compared with the model group and the non-acupoint group, infarct volume in the EA group was decreased (P<0.01). Neuronal cells in the model group and the non-acupoint group were sparsely and disorderedly arranged, with deep-stained cytoplasm and shrunken nuclei; the number and arrangement of neuronal cells in the EA group were similar to the sham operation group, with less deep-stained cytoplasm and shrunken nuclei compared to the model group. Compared with the sham operation group, the positive expression of SYN, and BDNF TrkB, and SYN protein expressions in the hippocampus of the ischemic side were decreased (P<0.01, P<0.05), while levels of IL-1β and IL-18 were increased (P<0.01) in the model group; compared with the model group and the non-acupoint group, the positive expression of SYN, and BDNF, TrkB and SYN protein expressions in the hippocampus of the ischemic side were increased (P<0.01, P<0.05), while levels of IL-1β and IL-18 were decreased (P<0.01) in the EA group. CONCLUSION:EA at "Baihui" (GV 20) and "Sishencong" (EX-HN 1) may improve learning-memory function in rats with CIRI by activating the BDNF/TrkB signaling pathway, reducing neuroinflammatory response, and promoting the recovery of synaptic plasticity.

目的:基于突触可塑性观察电针曲池、足三里对大脑中动脉闭塞(MCAO)大鼠运动障碍的改善.方法:将60只雄性SD大鼠随机分为假手术组、模型组、穴位组、非穴组,每组15只.采用Zea Longa线拴法制备MCAO大鼠模型,电针曲池、足三里,干预14 d.通过神经功能评分判断大鼠的神经功能缺损情况;CatWalk步态分析比较各组大鼠运动功能,TTC染色观察脑梗死体积,透射电镜观察突触超微结构和数量,免疫荧光检测缺血侧运动皮层突触相关因子突触后致密物-95(PSD-95)、突触蛋白的表达情况.结果:干预14 d后,与模型组比较,穴位组大鼠神经功能评分降低(P<0.05);步行速度提高、双足支撑时间缩短(P<0.05);脑梗死体积减少(P<0.05);突触超微结构改善明显,突触数量增加(P<0.05),突触相关因子突触蛋白、PSD-95表达上调(P<0.05).Catwalk步态参数、脑梗死体积与突触超微结构改善有一致性.结论:电针曲池、足三里穴可改善MCAO大鼠运动障碍,其机制可能与上调突触相关因子的表达,改善突触可塑性有关.

In light of the tremendous number of patients with vascular dementia in China, it is of great significance for the treatment of this disease to summarize related research focuses. In this study, articles on the treatment of vascular dementia, which were included in CNKI and Web of Science from January 1, 2012 to December 31, 2021, were analyzed. Specifically, CiteSpace 5.7.R2 was employed to visualize nationalities of authors, author affiliations, authors, keywords, and journals, and dissect the status quo and trend of research on the treatment of this disease. On this basis, the research focuses and evolution were elucidated. The findings are expected to serve as reference for the future research. Finally, 2 579 Chinese articles and 453 English articles were included. The annual number of published articles showed an upward trend. Authors from China published most papers and England had the highest centrality value. HU Yue-qiang and LIU Cun-zhi respectively published the most Chinese and English articles. Guangxi University of Chinese Medicine and Capital Medical University respectively topped the author affiliations in the number of published Chinese and English articles. Among the English journals, Anal Biochem and Stroke separately boasted the highest centrality value and the highest cited frequency. The analysis of keywords in the Chinese articles suggested that most studies on the treatment of vascular dementia focused on the observation of patients' mobility after treatment. Moreover, as for the therapeutic method, western medicine, as well as the Chinese medicine and acupuncture frequently attracted the attention of scholars. Basic research highlighted the oxidative stress, angiogenesis, and apoptosis. According to the analysis result of keywords in English articles on treatment of vascular dementia, the focus was the improvement of the memory function of patients with vascular dementia. As to the therapeutic method, drug therapy was frequently studied compared with other methods. The basic research focused on autophagy, nerve regeneration, and oxidative stress. This study concludes that the future research trend might be the combination of Chinese and western medicine in the treatment of vascular dementia.

The direct detection method possesses the ability of both content detection of uranyl ions and structural analysis of uranyl compounds in nmol level, while the indirect detection method can detect the uranyl ions as low as fmol level.

This work presents a rapid and highly sensitive colorimetric assay using bifunctional DNA probe decorated agarose microbeads (MBs) coupled with a cascade signal amplification system, including rolling circle amplification (RCA) and the hemin/G-quadruplex-catalyzed colorimetric reaction, for visualized detection of uranyl ions. The DNA probe integrates the UO22+-specific DNAzyme/substrate as the target recognition unit and a DNA primer as the signal conversion unit. The presence of uranyl ions induces the efficient cleavage of the DNA substrates with the catalysis of DNAzyme. Then the conjugated primers are released from MBs, initiating the RCA reaction (the first amplification). The RCA product consists of repetitive G-quadruplexes that can lead to a second amplification by catalyzing the oxidation of ABTS2- with hemin binding, resulting in a coloration that is visible to the naked eye. The whole assay procedure could be finished within 40 min, including recognition of uranyl and DNA cleavage (5 min), the RCA reaction (30 min) and data readout either by eye or using a UV-vis spectrometer (5 min for each sample). In the optimal conditions, concentrations as low as 5 nM uranyl ions could be distinguished by the naked eye. With UV-vis spectrometric measurement, the visible absorbance had a linear relationship with the concentration of uranyl ions with a dynamic range from 1 nM to 50 nM, and a low detection limit of 0.48 nM (i.e. ∼0.12 ppb) was obtained. Excellent selectivity and anti-interference capability in water samples were also certified. This facile visualized assay could be applied in detecting trace-level uranium for on-site environmental analysis.

目的:基于神经血管单元稳态探讨巨刺法改善大脑中动脉闭塞模型(MCAO)大鼠运动功能的机制.方法:将48只雄性SD大鼠随机分为假手术组(IS组)、模型组(IC组)、巨刺组(ON组)、非穴组(FON组)(各12只).其中IC组、ON组及FON组大鼠制备MCAO模型,成模后ON组接受电针健侧"曲池"和"足三里",FON组取穴位置的旁开5mm处电针干预7天,IS组和IC组不进行电针干预,仅进行模拟抓取.使用改良神经功能缺损评分(mNSS)评测各组大鼠神经功能;应用CatWalk步态分析对比各组大鼠运动功能;应用小动物磁共振成像系统行弥散张量成像(diffusion tensor imaging,DTI)扫描,使用DTI衍生参数测量运动皮质、纹状体神经传导束各向异性分数比值(ratio fractional anisotropy,rFA);应用TTC染色观察脑梗死体积,应用免疫荧光法检测脑缺血侧运动皮质神经元核蛋白(neuronal nuclei,NeuN)的表达变化;应用免疫组织化学法检测血小板-内皮细胞黏附分子(platelet endothe-lial cell adhesion molecule-1,PECAM-1/CD31)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、钙结合蛋白(ionized calcium binding adapter molecule 1,Ibal)表达变化;应用Western Blot法检测闭锁连接蛋白-1(zonu-la occludens 1,ZO-1)及闭合蛋白(Occludin)的表达变化.结果:干预7天后,与IC组相比,ON组大鼠神经功能评分、mNSS评分降低(P＜0.05);与IC组、FON组相比,ON组的平均运动速度加快、足印最大接触面积增加(P＜0.05);与IC组、FON组相比,ON组的梗死体积减少、rFA值相对增加(P＜0.05);与IC组、FON相比,ON组的NeuN阳性细胞表达明显升高(P＜0.05);与IC组、FON组相比,ON组的CD31表达显著升高、GFAP和Iba1的表达显著降低(P＜0.05);与IC组、FON组相比,ON组的ZO-1、Occludin蛋白表达均显著升高(P＜0.05).CatWalk步态参数、免疫荧光、免疫组化与Western Blot检测结果改善有一致性.结论:巨刺法改善MCAO大鼠运动功能,其机制可能与修复神经血管单元稳态有关.

ATP depletion is one of the pathological bases in cerebral ischemia. Electro-acupuncture (EA) is widely used in clinical practice for ischemia. However, the mechanism of EA remains unclear. The purpose of this study was to investigate whether EA could activate the AMPK/PGC-1α/TFAM signaling pathway and, consequently, increase the preservation of ATP in rats with ischemia. In this study, 48 rats were randomly divided into four groups as a sham-operation control group (sham group), a middle cerebral artery occlusion group (MCAO group), an EA group, and an EA group blocked by the AMPK inhibitor compound C (EA + CC group) (N = 12/group). The rats of the EA group and EA + CC group received the EA treatment for 7 days. The rats that belonged in the two remaining groups were only grasped in the same condition. Then, their brain tissues were collected for further detection. When compared with other groups, EA significantly reduced neurological deficits score and increased motor function. The cerebral infarction volume was significantly reduced in the EA group according to TTC staining. With western blot, we found that EA improved the ratio of p-AMPKα/AMPKα (P < 0.05), however, there is no difference between the MCAO group and sham group (P > 0.05). In addition, EA also increased the expression of PGC-1α and TFAM (all P < 0.05). By Elisa, we observed that EA increased the preservation of ATP (P < 0.05) and mitochondrial respiratory enzymes, including Complex I (P < 0.05), Complex IV (P < 0.05), but not Complex III (P > 0.05). In summary, we conclude that EA may protect against ischemic damage in MCAO rats, improve the preservation of ATP and mitochondrial respiratory enzymes. This effect may be positively regulated by the activation of the PGC-1α/TFAM signaling pathway.

Effective methods of detection and removal of iodide ions (I−) from radioactive wastewater are urgently needed and developing them remains a great challenge. In this work, an Ag+ decorated stable nano-MOF UiO-66-(COOH)2 was developed for the I− to simultaneously capture and sense in aqueous solution. Due to the uncoordinated carboxylate groups on the UiO-66-(COOH)2 framework, Ag+ was successfully incorporated into the MOF and enhanced the intrinsic fluorescence of MOF. After adding iodide ions, Ag+ would be produced, following the formation of AgI. As a result, Ag+@UiO-66-(COOH)2 can be utilized for the removal of I− in aqueous solution, even in the presence of other common ionic ions (NO2−, NO3−, F−, SO42−). The removal capacity as high as 235.5 mg/g was calculated by Langmuir model; moreover, the fluorescence of Ag+@UiO-66-(COOH)2 gradually decreases with the deposition of AgI, which can be quantitatively depicted by a linear equation. The limit of detection toward I− is calculated to be 0.58 ppm.

Objective. The purpose of this study was to review the effects of robot-assisted therapy (RT) for improving poststroke upper extremity motor impairment.Methods. The PubMed, Embase, Medline, and Web of Science databases were searched from inception to April 8, 2020. Randomized controlled trials that were conducted to evaluate the effects of RT on upper extremity motor impairment poststroke and that used Fugl-Meyer assessment for upper extremity scores as an outcome were included. Two authors independently screened articles, extracted data, and assessed the methodological quality of the included studies using the Physiotherapy Evidence Database (PEDro) scale. A random-effects meta-analysis was performed to pool the effect sizes across the studies.Results. Forty-one randomized controlled trials with 1916 stroke patients were included. Compared with dose-matched conventional rehabilitation, RT significantly improved the Fugl-Meyer assessment for upper extremity scores of the patients with stroke, with a small effect size (Hedges g = 0.25; 95% CI, 0.11-0.38; I-2 = 45.9%). The subgroup analysis revealed that the effects of unilateral RT, but not that of bilateral RT, were superior to conventional rehabilitation (Hedges g = 0.32; 95% CI, 0.15-0.50; I-2 = 55.9%). Regarding the type of robot devices, the effects of the end effector device (Hedges g = 0.22; 95% CI, 0.09-0.36; I-2 = 35.4%), but not the exoskeleton device, were superior to conventional rehabilitation. Regarding the stroke stage, the between-group difference (ie, RT vs convention rehabilitation) was significant only for people with late subacute or chronic stroke (Hedges g = 0.33; 95% CI, 0.16-0.50; I-2 = 34.2%).Conclusion. RT might be superior to conventional rehabilitation in improving upper extremity motor impairment in people after stroke with notable upper extremity hemiplegia and limited potential for spontaneous recovery.