RESUMO
OBJECTIVE: The aim of this study was to evaluate the additional effects of acupuncture treatment on motor function in patients with subacute hemorrhagic stroke. DESIGN: One hundred and thirty-four patients with subacute hemorrhagic stroke were randomized to receive acupuncture treatment plus conventional treatment (treatment group) or conventional treatment only (control group). Acupuncture treatments were given in 24 sessions over 4 weeks, with 3-month follow-up period. Blinded evaluation was based on Fugl-Meyer Assessment, Barthel Index with an intention-to-treat analysis. For those patients who were able to walk, a three-dimensional gait analysis system was employed to objectively record spatiotemporal and kinematic parameters. RESULTS: Compared with control group, the treatment group showed a significantly greater over-time improvement in total Fugl-Meyer, lower-limb Fugl-Meyer, but not in upper-limb Fugl-Meyer and Barthel Index. The spatiotemporal parameters of velocity, step length, cadence, step width all showed significant difference between the 2 groups. The velocity in treatment group decreased unexpectedly at day 14, then increased sharply and overcame control group at day 28. The treatment group also showed a significantly greater increase in peak circumduction, peak hip hiking, hip range of motion, knee range of motion and a tendency for the ankle range of motion. CONCLUSIONS: Acupuncture may promote the motor function recovery of hemorrhagic stroke patients in subacute phase mainly by enhancing the lower limb ability. It probably diminishes the compensation strategies earlier to correct the abnormal gait pattern. Although this adjustment may result in a compromise in the improvement of gait velocity temporarily, patients would benefit from it in a long run.
Assuntos
Terapia por Acupuntura , Hemorragias Intracranianas/terapia , Transtornos das Habilidades Motoras/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Extremidades/fisiopatologia , Feminino , Humanos , Hemorragias Intracranianas/fisiopatologia , Masculino , Pessoa de Meia-Idade , Transtornos das Habilidades Motoras/fisiopatologia , Acidente Vascular Cerebral/fisiopatologiaRESUMO
OBJECTIVE: To investigate the immediate effect of scalp acupuncture on walking pattern, using three-dimensional gait analysis (3D-GA), among patients in the subacute stage of intracerebral haemorrhage (ICH). METHODS: A subset of 30 patients with subacute ICH participating in a recently published randomised controlled trial who were able to walk independently were assessed by 3D-GA before and immediately after scalp acupuncture treatment (treatment group) or no intervention (control group) and the results presented here as a secondary analysis. The acupuncture manipulation was repeated three times with an interval of 5 min. Spatiotemporal and kinematic parameters during walking were collected and analysed using a 3D motion analysis system. RESULTS: After treatment, there were significant differences between the treatment and control groups in the spatiotemporal parameters of step length, velocity and cadence (p<0.05) and double-limb support. No significant difference was found in step width. When kinematic parameters were evaluated, the treatment group showed a significantly decreased peak pelvic anterior tilt angle and an increased hip extension angle after scalp acupuncture treatment, whereas the control group demonstrated no temporal changes. There were no significant changes in any other kinematic parameters in either group. CONCLUSIONS: As the first exploratory study to investigate the effect of the scalp acupuncture on gait performance in patients with subacute ICH, this secondary analysis of a recent randomised trial suggested an immediate effect of treatment on spatiotemporal parameters. Improvement in gait pattern may be associated with a decreased anterior tilt of the pelvis and augmented hip joint motion during walking. TRIAL REGISTRATION NUMBER: ChiCTR-TRC-08000225; Post-results.
Assuntos
Terapia por Acupuntura , Hemorragia Cerebral/terapia , Couro Cabeludo , Adolescente , Adulto , Idoso , Hemorragia Cerebral/fisiopatologia , Feminino , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Couro Cabeludo/fisiopatologia , Resultado do Tratamento , Caminhada , Adulto JovemRESUMO
BACKGROUND: Acupuncture, especially acupuncture treatment on head for acute intracerebral hemorrhage (ICH), has long been disputable. The aim of this study was to evaluate the efficacy and safety of penetration acupuncture on head in patients with acute ICH. METHODS: Eighty-two patients with acute ICH were randomized to receive penetration acupuncture treatment on head combined with conventional treatment (treatment group [TG]) or conventional treatment only (control group [CG]). Acupuncture treatments were given in 24 sessions over 4 weeks, with 3-month follow-up period. Measures included Clinical Neurological Function Deficit Scale (CNFDS), Barthel Index (BI), vital signs (respiration, heart rate, blood pressure, and oxygen saturation), and hematoma absorption ratio. RESULTS: Both groups showed a progressively improvement in CNFDS and BI scores from day 7 to 90. The TG showed a significantly greater improvement in CNFDS than CG over time (Pâ<â0.05). However, BI failed to show significant difference between the 2 groups (Pâ>â0.05). The vital signs were stable and no expansion of hematoma occurred over the course of acupuncture treatment. CONCLUSION: Penetration acupuncture treatment on head appeared to be safe over the course of treatment on acute ICH and may result in additional functional improvements detected in the CNFDS but not reflected in the BI. A larger-scale clinical trial with longer follow-up assessments is required to confirm these findings.
Assuntos
Terapia por Acupuntura , Hemorragia Cerebral/terapia , Adolescente , Adulto , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Método Simples-Cego , Resultado do TratamentoRESUMO
With the rising awareness of a healthy lifestyle, natural functional foods have gained much interest as promising alternatives to synthetic functional drugs. Recently, wild Agaricus bisporus (Lange) Sing. Chaidam has been found and artificially cultivated for its thick fresh body and excellent taste, with its antioxidant and anti-hypoxic abilities unknown. In this work, the antioxidant potential of its methanolic, 55% ethanolic, aqueous extracts and crude polysaccharide was evaluated in different systems. The results showed that polysaccharide was the most effective in scavenging ability on 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydroxyl radicals, metal chelating activity and reducing power, with EC50 values of 0.02, 2.79, 1.29, and 1.82 mg/mL, respectively. Therefore, we further studied the anti-hypoxic activity of crude polysaccharide. The results turned out that polysaccharide (300 mg/kg) prolonged the survival time, decreased the blood urea nitrogen and lactic acid content as well as increased the liver glycogen significantly, compared with the blank control and the commercialized product Hongjingtian (p < 0.05). With such excellent activities, we purified the polysaccharide and analyzed its molecular weight (120 kDa) as well as monosaccharide components (glucose, fructose and mannose). This study indicated that wild Agaricus bisporus (Lange) Sing. Chaidam had strong potential to be exploited as an effective natural functional food to relieve oxidative and hypoxia stresses.
Assuntos
Agaricus/química , Antioxidantes/química , Antioxidantes/farmacologia , Animais , Relação Dose-Resposta a Droga , Sequestradores de Radicais Livres/química , Sequestradores de Radicais Livres/farmacologia , Radical Hidroxila/antagonistas & inibidores , Hipóxia , Quelantes de Ferro/química , Quelantes de Ferro/farmacologia , Masculino , Camundongos , Oxirredução/efeitos dos fármacosRESUMO
The effect of culture medium compositions on gellan gum production produced by fermentation with a halobacterium Sphingomonas paucimobilis QHZJUJW CGMCC2428 was studied. In this work, a fractional factorial design was applied to investigate the main factors that affected gellan gum production by S. paucimobilis QHZJUJW CGMCC2428. Sucrose was the best carbon source for gellan gum and peptone displayed better inducing effect. Central composite design and response surface methodology were adopted to derive a statistical model for optimizing submerged culture medium composition. These experimental results showed that the optimum culture medium for producing gellan gum was composed of 40.00 (w/v) sucrose, 3.00% peptone (w/v), MgSO4 (w/v), 9.20% KH2PO4 (w/v), 7.50% Na2HPO4 (w/v), 4.30% K2SO4 (w/v), pH 6.8-7.0. The maximal gellan gum was 19.89±0.68 g/L, which was agreed closely with the predicated value (20.12 g/L). After incubated for 72 h under the optimized culture medium in 5-L bioreactor, the gellan gum fermentation reached about 19.90±0.68 g/L, which was higher than that in the initial cultivation medium.
Assuntos
Polissacarídeos Bacterianos/biossíntese , Sphingomonas/metabolismo , Reatores Biológicos , Meios de Cultura , Fermentação , Sulfato de Magnésio/metabolismo , Compostos de Nitrogênio/metabolismo , Peptonas/metabolismo , Fosfatos/metabolismo , Compostos de Potássio/metabolismo , Sacarose/metabolismo , Sulfatos/metabolismoRESUMO
Angiogenic proliferation of vascular endothelial cells is believed to play an important role in pulmonary vascular remodeling in pulmonary arterial hypertension. In the present study, we found that c-GMP (cyclic guanosine monophosphate) inhibited the proliferation and tube formation of pulmonary vascular endothelial cells induced by TGF-ß1, and that this process was reversed by PKG (protein kinase G) inhibitor and PKC (protein kinase C) inhibitor. In addition, small interfering RNA (siRNA) targeting ERK also reduced cellular proliferation. Furthermore, western blotting showed that cGMP down-regulated the phosphorylation level of ERK1/2, which was reversed not only by PKG inhibitor but also by PKC inhibitor. Silencing different PKC isoforms showed that PKCΔ, PKCγ and PKCα were involved in ERK phosphorylation, suggesting that PKC kinases have a permissive action. Three subtypes, PKCΔ, PKCγ and PKCα are likely to be involved the phosphorylation suppression of ERK included cGMP. Taken together, these data suggest that ERK phosphorylation mediates the proliferation of pulmonary vascular endothelial cells, and PKC kinases have a permissive action in this process.
Assuntos
GMP Cíclico/metabolismo , Células Endoteliais/citologia , Pulmão/irrigação sanguínea , Neovascularização Fisiológica , Proteína Quinase C/metabolismo , Transdução de Sinais , Animais , Proliferação de Células , Células Cultivadas , Células Endoteliais/metabolismo , Sistema de Sinalização das MAP Quinases , Fosforilação , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Proteína Quinase C/genética , RNA Interferente Pequeno/genética , Ratos , Fator de Crescimento Transformador beta1/metabolismoRESUMO
OBJECTIVE: To compare analgesic and mobility effects of different ropivacaine concentrations in femoral-sciatic nerve block, for postoperative analgesia in knee arthroscopy. METHODS: Outpatients (American Society of Anesthesiologists physical classification status of I or II), scheduled for elective knee arthroscopy, were randomly allocated to one of seven groups, prospectively investigating different concentrations of ropivacaine (0.12%; 0.14%; 0.16%; 0.18%; 0.20%; 0.22% or 0.50%), for ultrasound-guided femoral-sciatic nerve block procedures for postoperative analgesia. Visual analogue scale (VAS) pain scores and motor block evaluation scales were observed at 4, 8, 16 and 24 h postsurgery. RESULTS: In total, 105 patients were enrolled; results were analysed for 103. VAS scores for the 0.12%, 0.14% and 0.16% groups were significantly different from the 0.50% group. There were no significant differences between the 0.18%, 0.20%, 0.22% and 0.50% groups: half maximal effective concentrations and 95% maximal effective concentrations of ropivacaine were 0.158 (95% confidence intervals [CI] 0.149, 0.167) and 0.198 (95% CI 0.186, 0.221), respectively. Rates of motor blockade (Bromage score or hip motor function scale > 0) were significantly different between the 0.50% group and all other ropivacaine doses. CONCLUSION: The 0.20% ropivacaine dose for femoral-sciatic nerve block in knee arthroscopy provided satisfactory postoperative analgesia, while preserving ability of motion.