Introduction:Curcumin, a natural active compound derived from plants, is widely used as a pigment across the globe. Research has demonstrated that curcumin possesses neuroprotective properties in spinal cord injuries (SCIs); however, its specific mechanisms of action remain unclear. This study aimed to elucidate the potential mechanisms underlying curcumin's therapeutic effects in SCI. Methods:We screened the targets of curcumin in the treatment of spinal cord injury using network pharmacology across a variety of public databases. The interaction between the compound and the target was analyzed through bioinformatics analysis, molecular docking, and molecular dynamics simulation. Finally, the prediction results were verified by simulating spinal cord injury through oxygen-glucose deprivation (OGD) injury in PC12 cells. Results:Initial screening indicated 13 core targets involved in mitigating SCI. Curcumin may regulate the HIF pathway, immune cells, inflammation, oxidative stress, and other processes. Matrix metalloproteinase-9 (MMP9), tumor necrosis factor (TNF), interleukin-1β (IL-1β), signal transducer and activator of transcription 3 (STAT3), and caspase 3 (CASP3) were identified as key targets of curcumin in SCI regulation. Molecular docking results demonstrated that curcumin exhibited favorable affinity with the core targets, with MMP9 showing the highest binding affinity (-8.76 kcal/mol). Further studies confirmed that curcumin stably binds with MMP9, and the binding site was located at residues 220-225. Cell counting kit-8 (CCK8) assay results showed that curcumin exerted a good therapeutic effect. Western blot results showed that curcumin inhibited the expression of MMP9 protein but had no significant effect on the expression of TNF-α. Conclusion:Curcumin exerts its effects on SCI through multiple targets and pathways. Its specific mechanisms involve the inhibition of inflammation, prevention of apoptosis and ferroptosis, and promotion of neuronal repair. MMP9 may be a key target mediating curcumin's protective effects against SCI. These findings provide scientific evidence for further research and development of drugs.

In recent years, the role of Akkermansia muciniphila (A. muciniphila) in neurological diseases has attracted increasing attention. As a probiotic, A. muciniphila is closely associated with host health, metabolism, and immunity, demonstrating therapeutic potential in various conditions such as obesity, atherosclerosis, inflammatory bowel disease, diabetes, and liver disorders. In the context of neurological diseases, A. muciniphila significantly influences the host brain through the microbiota–gut–brain axis (MGBA). This review summarizes the roles and mechanisms of A. muciniphila and its active components (e.g., the outer membrane protein Amuc_1100, extracellular vesicles AmEVs, and short-chain fatty acids SCFAs) in various neurological disorders, including Alzheimer’s disease (AD), Parkinson’s disease (PD), depression, cerebral palsy (CP), epilepsy (EP), autism spectrum disorder (ASD), and amyotrophic lateral sclerosis (ALS). It exerts protective effects by enhancing the intestinal barrier, regulating lipid metabolism, producing SCFAs, secreting neuroactive substances, and inhibiting neuroinflammation, thereby suggesting novel therapeutic avenues for neurological disorders. However, due to limited data from large-scale human clinical trials and the complexity of disease mechanisms and host–microbiota interactions, its clinical translation faces considerable challenges. Future efforts should focus on multicenter randomized controlled trials and in-depth mechanistic studies utilizing technologies such as metabolomics to facilitate evidence-based clinical application.

Attention plays a vital part in the cognitive process, where different kinds of attention are associated with separate brain mechanisms. The objective of this research was to investigate the patterns of brain activation and functional connectivity in middle-aged and elderly individuals, while they were engaged in various attentional tasks, with the intention of establishing a reference foundation for the clinical treatment of attention disorders. A total of 44 healthy middle-aged and elderly persons (47.1

[This corrects the article DOI: 10.3389/fchem.2025.1568551.].

This case report details a patient with persistent middle femoral nonunion unresponsive to multiple surgeries. PRP therapy, shockwave intervention, and structured rehabilitation were combined to achieve clinical fracture healing. This multifaceted treatment approach illustrates the coordinated use of PRP and physical modalities, offering practical insight for the clinical treatment of complex bone nonunion.

BackgroundValeriana jatamansi Jones, a globally utilized medicinal plant, exhibits favorable pharmacological effects against depression and tumors. Iridoids derived from V. jatamansi (IRFV) promote recovery following spinal cord injury (SCI). Inflammation and disruption of the blood-spinal cord barrier (BSCB) represent key pathological processes in SCI. However, the specific effects of IRFV on neuroinflammation and BSCB integrity remain unexplored.Methods and ResultsThis study aims to elucidate the functional significance and molecular mechanisms by which IRFV modulates neuroinflammation and preserves BSCB function following SCI. Experimental results demonstrated that IRFV treatment significantly enhanced locomotor recovery in SCI models. Moreover, IRFV reduced macrophage infiltration and inhibited inflammatory mediator secretion, effectively attenuating the neuroinflammatory response. IRFV also mitigated BSCB permeability alterations by suppressing tight junction disruption and structural damage. In vitro experiments revealed that IRFV attenuated oxygen-glucose deprivation/reperfusion (OGD/R)-induced endothelial cell damage and tight junction protein degradation, suggesting a potential mechanism for its BSCB protection. Critically, the protective effects of IRFV were abolished upon suppression of the Nrf2/HO-1 pathway, demonstrating its essential role in this process.ConclusionIn conclusion, our study demonstrates that IRFV treatment activates the Nrf2/HO-1 signaling pathway, thereby suppressing neuroinflammation, mitigating blood-spinal cord barrier damage, and promoting recovery from SCI, thus highlighting its therapeutic potential.

ObjectiveIn this study, we retrospectively evaluated the efficacy of platelet-rich plasma (PRP) for the treatment of training-induced knee traumatic osteoarthritis (KTOA) by means of a functional scale and MRI cartilage score, and analysed its effects on the improvement of knee function, pain relief and cartilage repair.MethodsIn this study, 120 patients with training-induced KTOA (screened from 519 cases) were retrospectively analysed from May 2019 to December 2023, and knee function, pain and cartilage repair were evaluated by LKSS, VAS and MRI cartilage scores before and 3 months after treatment, and the statistical methods used were paired t-tests or Wilcoxon tests (P < 0.05).ResultsAmong 120 patients with training-induced KTOA treated with PRP, the Lysholm Knee Score (LKSS) significantly improved from (62.34 ± 18.69) to (81.2 ± 18.20) at 3 months after treatment, and the effective rate was 55.0%; the visual analogue score (VAS) of pain decreased from (5.24 ± 1.57) to (2.66 ± 1.43), and the effective rate of 81.7%; MRI cartilage damage score decreased from (3.24 ± 0.72) to (3.02 ± 0.86), and the effective rate was 36.7%; the differences were statistically significant (P < 0.05).ConclusionKTOA due to PRP therapeutic training improves joint pain and promotes the recovery of knee joint function. Meanwhile, it has a repairing effect on articular cartilage damage.

Evidence has demonstrated that exoskeleton robots can improve intestinal function in patients with spinal cord injury (SCI). However, the underlying mechanisms remain unelucidated. This study investigated the effects of exoskeleton-assisted walking (EAW) on intestinal function and intestinal flora structure in T2-L1 motor complete paraplegia patients. The results showed that five participants in the EAW group and three in the conventional group reported improvements in at least one bowel management index, including an increased frequency of bowel evacuations, less time spent on bowel management per day, and less external assistance (manual digital stimulation, medication, and enema usage). After 8 weeks of training, the amount of glycerol used in the EAW group decreased significantly (p <0.05). The EAW group showed an increasing trend in the neurogenic bowel dysfunction (NBD) score after 8 weeks of training, while the conventional group showed a worsening trend. Patients who received the EAW intervention exhibited a decreased abundance of Bacteroidetes and Verrucomicrobia, while Firmicutes, Proteobacteria, and Actinobacteria were upregulated. In addition, there were decreases in the abundances of Bacteroides, Prevotella, Parabacteroides, Akkermansia, Blautia, Ruminococcus 2, and Megamonas. In contrast, Ruminococcus 1, Ruminococcaceae UCG002, Faecalibacterium, Dialister, Ralstonia, Escherichia-Shigella, and Bifidobacterium showed upregulation among the top 15 genera. The abundance of Ralstonia was significantly higher in the EAW group than in the conventional group, and Dialister increased significantly in EAW individuals at 8 weeks. This study suggests that EAW can improve intestinal function of SCI patients in a limited way, and may be associated with changes in the abundance of intestinal flora, especially an increase in beneficial bacteria. In the future, we need to further understand the changes in microbial groups caused by EAW training and all related impact mechanisms, especially intestinal flora metabolites.Clinical trial registration: https://www.chictr.org.cn/.

Background Knee joint injury is a common military training injury,which seriously affects the combat effectiveness of soldiers.In recent years,the prevention and treatment of military training injury becomes more and more important.Ultrasound therapy and Qingpeng ointment are commonly used to treat sports training injuries.However,the protective effectiveness of ultrasound combined with the external use of Qingpeng ointment for knee injury in sports training injury patients is less reported.Objective To comprehensively assess the clinical efficacy of Qingpeng ointment combined with ultrasound therapy in the treatment of knee injuries caused by military training.Methods Fifty-six patients with knee injury who were treated in the Fifth Pentry Outpatient Clinic,the General Hospital of the Western Theater Command PLA from May to July 2022 were selected and randomly grouped into control group(4 cases fell off during the study,n=24)and treatment group(n=28)using IBM-SPSS 25.0 statistical software to generate random numbers.The control group was given ordinary coupling agent ultrasonic therapy,and the treatment group was given Qingpeng ointment ultrasonic therapy,once a day,10 times a course,a total of 2 courses.The Lysholm knee joint score,VAS score,Hamilton Depression Scale-17(HAMD-17),and knee range of motion were compared between the two groups after a twenty-minute intervention.Results Before treatment,there was no significant difference in Lysholm knee joint score,VAS score,HAMD-17 score and knee joint motion between the two groups(P＞0.05).After 2 courses of treatment,the passive joint motion of the knee in the treatment group was better than that in the control group(P＜0.05).After 2 courses of treatment,Lysholm knee joint score in 2 groups was higher than before treatment,and VAS score was lower than before treatment(P＜0.05).Compared with before treatment,the active and passive joint motion in the treatment group increased after 2 courses of treatment(P＜0.05).Compared with before treatment,HAMD-17 score in the treatment group was decreased after 2 courses of treatment(P＜0.05).Conclusion Qingpeng ointment combined with ultrasound therapy and ultrasound therapy with ordinary coupling agents can significantly improve knee joint function,reduce pain in patients with knee injuries.As a special coupling agent for ultrasound therapy,Qingpeng ointment has certain advantages over ordinary coupling agents.

Every-other-day fasting (EODF) is a form of caloric restriction that alternates between periods of normal eating and fasting, aimed at preventing and treating diseases. This approach has gained widespread usage in basic research on neurological conditions, including spinal cord injury, and has demonstrated significant neuroprotective effects. Additionally, EODF is noted for its safety and feasibility, suggesting broad potential for application. This study aims to evaluate the therapeutic effects of EODF on spinal cord injury and to investigate and enhance its underlying mechanisms. Initially, the SCI rat model was utilized to evaluate the effects of EODF on pathological injury and motor function. Subsequently, considering the enhancement of metabolism through EODF, bile acid metabolism in SCI rats was analyzed using liquid chromatography-mass spectrometry (LC–MS), and the expression of the bile acid receptor TGR5 was further assessed. Ultimately, it was confirmed that EODF influences the activation of microglia and NLRP3 inflammasomes associated with the TGR5 signaling, along with the expression of downstream pyroptosis pathway related proteins and inflammatory cytokines, as evidenced by the activation of the NLRP3/Caspase-1/GSDMD pyroptosis pathway in SCI rats. The results demonstrated that EODF significantly enhanced the recovery of motor function and reduced pathological damage in SCI rats while controlling weight gain. Notably, EODF promoted the secretion of bile acid metabolites, activated TGR5, and inhibited the NLRP3/Caspase-1/GSDMD pyroptosis pathway and inflammation in these rats. In summary, EODF could mitigate secondary injury after SCI and foster functional recovery by improving metabolism, activating the TGR5 signaling and inhibiting the NLRP3 pyroptosis pathway.

BACKGROUND:In recent years, lower limb walking exoskeletons have been widely used in the study of spinal cord injury (SCI). OBJECTIVE:To explore the effect of a lower limb walking exoskeleton on quality of life and functional independence in patients with motor complete SCI. METHODS:This was a multi-center, single blind, randomized controlled trial. A total of 16 SCI patients were randomly assigned to either the exoskeleton-assisted walking (EAW) group (n= 8) or the conventional group (n= 8). Both groups received conventional rehabilitation training, including aerobic exercise and strength training. The EAW group additionally conducted the exoskeleton-assisted walking training using an AIDER powered robotic exoskeleton for 40-50 minutes, 5 times/week for 8 weeks. World Health Organization quality of life-BREF (WHOQOL-BREF) and the Spinal Cord Independence Measure III (SCIM-III) were used for assessment before and after training. RESULTS:There was an increasing tendency of scores in the psychological health, physical health, and social relationships domain of WHOQOL-BREF in the EAW group after the intervention compared with the pre-intervention period, but there was no significant difference (P> 0.05). SCIM-III scores increased in both groups compared to pre-training, with only the conventional group showing a significant difference after 8 weeks of training (P< 0.05). CONCLUSION:A lower limb walking exoskeleton may have potential benefits for quality of life and activities of daily living in patients with motor complete SCI.

Background:The efficacy of high-flow nasal cannula (HFNC) in patients extubated after lung resection surgery remains inconclusive. Our objective was to execute a meticulous systematic meta-analysis to accurately assess the advantages of HFNC compared to conventional oxygen therapy (COT) for patients extubated after lung resection surgery, by examining postoperative hypoxemia and other patient-focused outcomes.Methods:We searched PubMed, Embase, the Cochrane Library, Web of Science and Scopus to identify randomized controlled trials (RCTs) from inception to July 2023. We employed the revised Cochrane risk of bias (RoB) tool (2.0) to evaluate the RoB of the included studies, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method to ascertain the certainty of the pooled effect estimates. The primary outcome was the incidence of postoperative hypoxemia.Results:Five RCTs (n=564) were included in the ultimate analysis. Utilizing HFNC rather than COT did not reduce the risk of postoperative hypoxemia [relative risk (RR), 0.67; 95% confidence interval (CI): 0.30-1.49; low certainty]. Compared to COT, HFNC may significantly enhance oxygenation index within first 12 hours after extubation in patients with lung resection. There were no significant differences in reintubation rate (RR, 0.25; 95% CI: 0.04-1.54; high certainty), escalation of respiratory support (RR, 0.35; 95% CI: 0.11-1.08; high certainty), change in partial pressure of carbon dioxide (PaCO2) within first 24 hours after extubation, hospital length of stay [mean difference (MD), -0.19; 95% CI: -0.44 to 0.06; moderate certainty], and intensive care unit (ICU) length of stay (MD, 0.02; 95% CI: -0.16 to 0.19; high certainty).Conclusions:Our meta-analysis suggests that preemptive use of HFNC, instead of COT, in extubated patients following lung resection surgery may not significantly impact postoperative hypoxemia incidence, reintubation rate, escalation of respiratory support, postoperative PaCO2 difference, hospital and ICU length of stay. However, HFNC may significantly enhance the oxygenation index within the first 12 hours post-extubation following lung resection surgery. To verify the effect of HFNC on this population, additional large-scale, multicenter studies are essential.

Valeriana jatamansi Jones (VJJ), renowned for its extensive history in traditional Chinese medicine and ethnomedicine within China, is prevalently utilized to alleviate ailments such as epigastric distension and pain, gastrointestinal disturbances including food accumulation, diarrhea, and dysentery, as well as insomnia and other diseases. Moreover, the Iridoid-rich fraction derived from Valeriana jatamansi Jones (IRFV) has demonstrated efficacy in facilitating the recuperation of motor functions after spinal cord injury (SCI). This study is aimed to investigate the therapeutic effect of IRFV on SCI and its underlying mechanism. Initially, a rat model of SCI was developed to assess the impact of IRFV on axonal regeneration. Subsequently, employing the PC12 cell model of oxidative damage, the role and mechanism of IRFV in enhancing axonal regeneration were explored using the phosphoinositide-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway inhibitor LY294002. Ultimately, the same inhibitor was administered to SCI rats to confirm the molecular mechanism through which IRFV promotes axonal regeneration by activating the PI3K/Akt signaling pathway. The results showed that IRFV significantly enhanced motor function recovery, reduced pathological injury, and facilitated axonal regeneration in SCI rats. In vitro experiments revealed that IRFV improved PC12 cell viability, augmented axonal regeneration, and activated the PI3K/Akt signaling pathway. Notably, the inhibition of this pathway negated the therapeutic benefits of IRFV in SCI rats. In conclusion, IRFV promote promotes axonal regeneration and recovery of motor function after SCI through activation of the PI3K/Akt signaling pathway.

Background: Motor dysfunction is the main functional disability after spinal cord injury (SCI), seriously affecting the life and work of patients. In addition to spinal cord damage, the brain undergoes structural and functional plastic changes. This study explored brain function remodeling in patients with SCI and the effect of right ankle dorsiflexion motor imagery task on brain function. Methods: This prospective study enrolled 11 patients with SCI and dyskinesia of the right lower limb and 12 healthy subjects at the General Hospital of Western Theater Command PLA (January 2015 to December 2016). They underwent functional magnetic resonance imaging (fMRI) in the resting state and the "right ankle dorsiflexion" motor imagery task state. Four-dimensional (spatiotemporal) concordance (FOCA) of local neuronal activity was used for fMRI image analysis. The differences between SCI patients and healthy subjects were compared using the two-sample t-test. Results: In the resting state, compared with healthy subjects, patients with SCI showed decreased FOCA in the left putamen, right caudate nucleus, and right superior occipital gyrus and increased FOCA in the left precentral gyrus. In the right ankle dorsiflexion motor imagery task state, FOCAs in the right inferior temporal gyrus and left inferior parietal lobule were decreased in patients with SCI. Conclusions: After SCI, a series of changes in the structure and function of the brain occur. Research on brain plasticity after SCI might help explore the central mechanisms underlying functional recovery after treatments, providing more therapeutic strategies for SCI.

Background: Grade I and II knee meniscus injuries in young people account for a relatively large proportion of sports injuries. If not cured in time, it may seriously affect the quality of life and even cause disability.Studies have shown that platelet-rich plasma (PRP) is effective in the treatment of knee meniscus injury, but the optimal therapeutic dose of PRP has not been regulated and clarified in current relevant guidelines or expert consensus.This study intends to use a randomized controlled trial to compare and analyze the efficacy and safety of 2ml, 5ml and 8ml PRP in the treatment of meniscus injury of knee joint, so as to provide evidence-based medical evidence for improving the clinical guidelines for the treatment of meniscus injury with PRP. Methods/design: This study is a one-year prospective single-center triple-blind randomized controlled trial. Patients who meet the inclusion criteria are randomly divided into the experimental group and the control group. The experimental group is set as the PRP treatment group, and the control group is set as the placebo group. The treatment of all patients will last for 5 weeks and follow-up for 6 months.The experimental group and the control group plan to evaluate Lysholm knee score, MRI (including T2mapping technology) and other main observation indicators.And visual analog scale (Visual analogue scale, VAS), quality of life score(36-item Short Form Health Survey, SF-36), muscle Bone ultrasound, infrared thermal imaging,incidence of adverse reactions and other secondary observation indicators are used to compare the curative effects.All these results will be analyzed at the end of the trial Analysis. Discussion: There is no uniform standard for the dose of PRP in the treatment of meniscus injury, and there is no literature report on whether there are differences in efficacy and safety among several commonly used doses in clinical practice. This study explores the clinical appropriate dose of PRP in the treatment of meniscus injury of knee joint of young people in degree I and II,which provides a scientific basis for the optimization of the treatment of meniscus injury, and provides evidence-based medical evidence for the revision and improvement of PRP treatment guidelines for meniscus injury. Trial Registration: China Clinical Trial Registration: ChiCTR2200057591, November 14,2022 Experimental Ethics: 2022EC1-008

Spinal cord injury (SCI) is characterized by high rates of disability and death. Valeriana jatamansi Jones (VJJ), a Chinese herbal medicine, has been identified to improve motor function recovery in rats with SCI. The study aimed to analyze the potential molecular mechanisms of action of VJJ in the treatment of SCI. The main ingredients of VJJ were obtained from the literature and the SwissADME platform was used to screen the active ingredients. The Swiss TargetPrediction platform was used to predict the targets of VJJ, and the targets of SCI were obtained from the GeneCards and OMIM databases. The intersecting genes were considered potential targets of VJJ in SCI. The protein-protein interaction network was constructed using the STRING database and the hub genes of VJJ for SCI treatment were screened according to their degree values. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed using the Metascape database. Cytoscape software was used to construct the "herb-ingredient-target-pathway" network. Preliminary validation was performed using molecular docking via Auto Dock Vina software. A total of 56 active ingredients of VJJ, mainly iridoids, were identified. There were 1493 GO items (P < .01) and 173 signaling pathways (P < .01) obtained from GO and Kyoto Encyclopedia of Genes and Genomes enrichment, including the phosphoinositide-3-kinase (PI3K)-protein kinase B (Akt) signaling pathway, hypoxia-inducible factor 1 signaling pathway, and tumor necrosis factor signaling pathway. Molecular docking revealed that 12 hub genes enriched in the PI3K/Akt signaling pathway had a high binding affinity for the active ingredient of VJJ. VJJ may exert its therapeutic effects on SCI through the iridoid fraction, acting on signal transducer and activator of transcription 3, CASP3, AKT1, tumor necrosis factor, mammalian target of rapamycin, interleukin 6, and other hub genes, which may be related to the PI3K/Akt signaling pathway.

Neurodegenerative diseases are a group of conditions caused by the progressive loss of the function or structure of neurons in the central nervous system. Although the physical or mental symptoms of neurodegenerative diseases can be alleviated by combined therapy, there is no strategy to directly slow down or prevent neurodegenerative diseases. Recent studies on the microbiota-gut-brain axis have found that gut microbiota and their metabolites play an important role in the occurrence and development of nervous system diseases. As the main metabolites of gut microbiota, short-chain fatty acids (SCFAs) , are the key transmitter involved in gut-brain communication and have neuroprotective effect on neurodegenerative diseases, but the specific mechanism is not clear. This article mainly reviews the mechanism of SCFAs in neurodegenerative diseases. It is concluded that improving the level of SCFAs in vivo by changing dietary habits via increasing dietary fiber intake and supplementing probiotics and exogenous SCFAs, may become a new safe and effective target for the prevention and treatment of neurodegenerative diseases, which may provide guidance for the treatment of neurodegenerative diseases.

综述电阻抗断层成像技术在重度急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)俯卧位通气病人肺部护理中的应用情况,以期为电阻抗断层成像技术在俯卧位通气病人肺部护理中的应用提供思路.

Objectives Spinal cord injury (SCI) is a disastrous central nervous system (CNS) disorder, which was intimately associated with oxidative stress. Studies have confirmed that Iridoids Effective Fraction of Valeriana jatamansi Jones (IEFV) can scavenge reactive oxygen species. This study aimed to confirm the efficacy of IEFV in ameliorating SCI. Methods For establish the SCI model, the Sprague-Dawley rats underwent a T10 laminectomy with transient violent oppression by aneurysm clip. Then, the rats received IEFV intragastrically for 8 consecutive weeks to evaluate the protective effect of IEFV on motor function, oxidative stress, inflammation and neurotrophic factors in SCI rats. Results Basso, Beattie and Bresnahan scores, hematoxylin and eosin (H&E) staining and transmission electron microscopy experiments found IEFV protected motor function and alleviated neuron damage. Meanwhile, IEFV treatment decreased the release of malondialdehyde, interleukin-6 (IL-6), cyclooxygenase-2 and tumor necrosis factor-α. Moreover, IEFV treatment elevated the expression levels of brain-derived neurotrophic factor and nerve growth factor of SCI rats. Finally, administration of IEFV significantly inhibited the expression of p-p65 and toll-like receptor 4 (TLR4). Conclusions This study suggests that IEFV could attenuate the oxidative stress and inflammatory response of the spinal cord after SCI, which was associated with inhibition of the TLR4/nuclear factor-kappaB signaling pathway.