目的 探讨脑卒中偏瘫患者采用康复机器人联合常规康复治疗后的偏瘫侧肘屈曲运动时主动肌与协同肌各自的肌力变化.方法 选取2020年10月—2021年3月在南方医科大学顺德医院住院的30例脑卒中偏瘫患者.将15例接受上肢智能反馈康复机器人结合常规康复治疗的患者作为观察组,15例接受常规康复治疗的患者作为对照组.采集患者屈肘时主动肌肱二头肌与协同肌尺侧腕屈肌的积分肌电值(iEMG),并计算协同收缩率(CSR),采用Fugl-Meyer运动功能评定量表上肢部分(FMA-UE)评估两组患侧上肢的肢体功能.结果 治疗前,两组患者偏瘫侧FMA-UE评分比较,差异无统计学意义(P>0.05);治疗后,观察组患者偏瘫侧FMA-UE评分为(33.20±3.73)分,高于对照组的(25.27±2.71)分,差异有统计学意义(P<0.05).治疗前,两组屈肘时肱二头肌及尺侧腕屈肌的iEMG比较,组间差异无统计学意义(P>0.05);治疗后,观察组屈肘时肱二头肌的iEMG为(274.59±31.68)(mV·s),高于对照组的(213.03±13.94)(mV·s),差异有统计学意义(P<0.05),但两组尺侧腕屈肌的iEMG比较,差异无统计学意义(P>0.05).治疗前,两组CSR比较,差异无统计学意义(P>0.05);治疗后,观察组CSR为(7.75±0.85)％,显著低于治疗前的(11.50±1.45)％,且低于对照组的(11.03±1.53)％,差异有统计学意义(P<0.05).结论 在常规康复治疗基础上联合上肢智能反馈康复机器人训练能够更好地促进脑卒中偏瘫患者的偏瘫侧屈肘运动功能恢复,有助分离运动形成.

目的 分析上肢机器人训练对脑卒中恢复期患者上肢运动功能的影响.方法 选取我院2017年11月～2019年2月收治的60例脑卒中恢复期患者,按照随机数字表法分为对照组和研究组各30例.对照组予以常规康复训练,研究组予以常规康复训练结合上肢机器人训练,两组均连续训练4周,比较两组FIM评分、改良Barthel指数评分、FMA-UE评分.结果 两组训练前FIM评分相比,差异无统计学意义(P>0.05),研究组训练后FIM评分高于对照组,差异有统计学意义(P<0.05),两组训练后均高于训练前,差异有统计学意义(P<0.05);两组训练前改良Barthel指数评分相比,差异无统计学意义(P>0.05),训练后研究组高于对照组,差异有统计学意义(P<0.05),两组训练后均高于训练前,差异有统计学意义(P<0.05);两组训练前FMA-UE评分相比,差异无统计学意义(P>0.05),训练后研究组高于对照组,差异有统计学意义(P<0.05),两组训练后均高于训练前,差异有统计学意义(P<0.05).结论 上肢机器人训练可显著提高脑卒中恢复期患者生活自理能力以及上肢运动功能,值得借鉴.

Objective:To investigate the plasticity of pedunculopontine tegrnental nucleus according to the changes of standardized uptake value(SUV) and vessicular glutamate transporters 2(VGLUT2) expression after body weight support treadmill training (BWSTT) in incompletely spinal cord injury rats.Method:Twenty-four Sprague-Dawley rats were randomly divided into the sham operated group (n=8),the untrained control group (n=8),and BWSTT treatment group (n=8).Spinal cord moderate contusion model was made at T10 segment with NYU impactor.Behavioral ability was evaluated by Basso-Beattie-Bresnahan (BBB) scale of hind limb movement.The 18F-FDG SUV of PPTg was collected by PET/CT.Furthermore,the VGLUT2 expression in PPTg were processed by immunofluorescence for quantitative analysis.Result:Comparing with the control group,BBB scores increased significantly more in the BWSTT treatment group (P＜0.05) at 7 weeks post-injury,whereas scores in BWSTT treatment group and control group are still much lower than those in sham group (P ＜ 0.05).The expression of VGLUT2 in BWSTT treatment group is much higher than that in untrained control group,and sham operated group is the highest among three groups.Conclusion:BWSTT can partially improve recovery of hind limbs locomotion.One of the mechanism is that it markedly promote neurohumoralplasticity of PPTg in rat after iSCI

BACKGROUND:The elderly hip fracture patients with chronic obstructive pulmonary disease (COPD) have a higher postoperative mortality than those only with hip fractures. In recent years, it has become an issue of concerns. Because the mechanism is unknown, however, there are no effective clinical interventions for these patients. OBJECTIVE:To observe the effect of bone marrow stromal stem cel s (BMSCs) on the level of pulmonary inflammation in aged rats with chronic obstructive pulmonary disease (COPD) after hip fractures. METHODS:Thirty male Sprague-Dawley rats, 12 months old, were exposed to smoking for 4 months and randomized into three groups, smoking, smoking+hip fracture+normal saline, smoking+hip fracture+BMSCs groups. Animal models of hip fracture were made in the latter two groups. Twenty-four hours after hip fracture, the lower lobe and peripheral blood samples were taken from al rats in the three groups, to evaluate the pathological changes of lung tissue and detect levels of inflammatory factors in the lung tissue and peripheral blood. RESULTS AND CONCLUSION:After closed hip fracture, aged COPD rats exhibited inflammatory cel infiltration, mucus secretion, airway stenosis or occlusion;the levels of interleukin-6, tumor necrosis factor-αand interleukin-10 in the lung tissue and peripheral blood were increased. After intravenous injection of BMSCs, the pathological changes of the lung tissue were reduced, and the levels of pro-inflammatory factors, tumor necrosis factor-αand interleukin-6, decreased, but the level of anti-inflammatory factor interleukin-10 further increased, which were significantly different from those in the normal saline group (P<0.05). These findings indicate that BMSCs can relieve acute lung injury in aged COPD rats with hip fractures.

目的 探讨β淀粉样蛋白(amyloid β,Aβ)在大鼠脊髓损伤(spinal cord injury,SCI)后的表达变化及γ分泌酶抑制剂DAPT对其作用机制的影响.方法 选用雌性SD大鼠117只,随机分成3组:假手术组(Sham组,31只)、脊髓损伤组(SCI组,43只)、干预组(DAPT组,43只),采用Allen's打击法制作大鼠脊髓损伤模型,DAPT组于造模前及术后给予DAPT药物溶液胃管灌注,并于术后6h、ld、3d、7d、14 d、21 d、28 d取血液、脑脊液及损伤段脊髓组织,分别行酶联免疫吸附试验(ELISA)检测血清和脑脊液Aβ水平,免疫印迹法(Western blot)检测脊髓组织淀粉样前体蛋白(amyloid precursor protein,APP)、β淀粉样蛋白、轴突生长抑制因子受体(neurite growth inhibitor receptor 1,NgRl)、Rho相关激酶2(Rho related kinase 2,Rock2)蛋白水平,免疫组化分析观察Aβ表达并计数阳性细胞,采用BBB评分评估大鼠后肢运动功能恢复情况.结果 SCI组大鼠Aβ水平明显高于Sham组(P＜0.05),血清和脑脊液中Aβ水平在SCI后6h开始升高,3d时达到高峰,7d时降至正常水平,应用DAPT能够明显降低SCI后Aβ水平(P＜0.05);脊髓损伤后3 d SCI组Aβ、NgR1、Rock2蛋白水平较Sham组明显升高(P＜0.05),DAPT组Aβ、NgR1、Rock2蛋白水平较SCI组明显降低(P＜0.05);免疫组化分析可见损伤区脊髓Aβ阳性细胞明显增多,DAPT组Aβ阳性细胞数明显少于SCI组(P＜0.05);DAPT组大鼠BBB评分明显高于SCI组(P＜0.05);SCI大鼠血清和脑脊液Aβ水平与运动功能BBB评分呈负相关(P＜0.05).结论 大鼠SCI后Aβ表达上调,通过应用γ分泌酶抑制剂DAPT减少Aβ表达能够促进运动功能恢复,其机制可能是通过下调NgR1蛋白表达、抑制Rho/Rock通路激活,从而减少白质区髓鞘结构损伤.