Repetitive transcranial magnetic stimulation promotes motor function recovery in mice after spinal cord injury via regulation of the Cx43-autophagy loop.

Spinal cord injury (SCI) is a severe condition with an extremely high disability rate. It is mainly manifested as the loss of motor, sensory and autonomic nerve functions below the injury site. High-frequency transcranial magnetic stimulation, a recently developed neuromodulation method, can increase motor function in mice with spinal cord injury. This study aimed to explore the possible mechanism by which transcranial magnetic stimulation (TMS) restores motor function after SCI. A complete T8 transection model of the spinal cord was established in mice, and the mice were treated daily with 15 Hz high-frequency transcranial magnetic stimulation. The BMS was used to evaluate the motor function of the mice after SCI. Western blotting and immunofluorescence were used to detect the expression of Connexin43 (CX43) and autophagy-related proteins in vivo and in vitro, and correlation analysis was performed to study the relationships among autophagy, CX43 and motor function recovery after SCI in mice. Western blotting was used to observe the effect of magnetic stimulation on the expression of mTOR pathway members. In the control group, the expression of CX43 was significantly decreased, and the expression of microtubule-associated protein 1 A/1b light chain 3 (LC3II) and P62 was significantly increased after 4 weeks of spinal cord transection. After high-frequency magnetic stimulation, the level of CX43 decreased, and the levels of LC3II and P62 increased in primary astrocytes. The BMS of the magnetic stimulation group was greater than that of the control group. High-frequency magnetic stimulation can inhibit the expression of CX43, which negatively regulates autophagic flux. HF-rTMS increased the expression levels of mTOR, p-mTOR and p-S6. Our experiments showed that rTMS can restore hindlimb motor function in mice after spinal cord injury via regulation of the Cx43-autophagy loop and activation of the mTOR signalling pathway.

Bionics investigation of blood 25-hydroxyvitamin D in the interpretable biomechanics diagnosis of childhood anemia.

Vitamin D deficiency (VDD) causes a wide range of health problems, including anemia in infants. If not treated promptly, it may create serious issues for infants with long-term impacts. Therefore, a satisfactory solution to this problem is required. This investigation was to explore the correlation between the blood 25-hydroxyvitamin D (25(OH)D) levels and childhood anemia. In this investigation, a cross-sectional examination was performed on 2,942 babies ranging in age from 2 to 36 months and classified into three cohorts: VDD (Vitamin D deficiency), VDI (Vitamin D insufficiency), and VDS (Vitamin D sufficiency). Multiple-variables and multinomially-related logistic regressions for examining the anemia status-vitamin D (Vit-D) relationship of the baseline as the interpretable visual quality models were examined. The median serum 25(OH)D level in 2,942 infants was 24.72±4.26 ng/l, with 661 cases (22.5%) of VDD and 1710 cases of deficiency (58.1%), and a noticeable seasonal variation (p<0.05). Anemia was present in 28.5% of the VDD group compared with 3.3% in vit-D sufficient infants (p<0.0001). Lower levels of 25(OH)D were found to be associated with an increased risk of anemia in a multiple-variable regression analysis. In healthy children, low 25(OH)D levels were associated with increased risk of anemia. Biologically inspired, primary care physicians should assess Vit-D levels and place a greater emphasis on adequate supplementation for deficiency prevention.

Key points of development of motor skills in childhood embodied in gait parameters.

OBJECTIVE: To observe changes of correlations of gait parameters of four sets of body in children aged 3-6. DESIGN: A cross-sectional observational study. SETTING: Dong Gang kindergarten in Suzhou, China. PARTICIPANTS: A total of 89 children between 3 and 6 years old. MAIN OUTCOME MEASURES: A total of 37 three-dimensional (3-D) gait parameters assessed with a wearable gait analysis system in 2-min walking test, for 3 times. RESULTS: There were significant differences in gait speed, stride length and sagittal range of motion (ROM) of trunk among children of 3-6 years old (P < 0.05). The left and right toe out angle, sagittal ROM of waist, coronal ROM of trunk and arm swing velocity of male were significantly greater than those of female children (P < 0.05). Most gait parameters were symmetrical (P < 0.01). Canonical correlations of Upper Limbs Set vs. Trunk and Waist Sets increased by ages (P < 0.05). Canonical correlation of Trunk Set vs. Waist Set decreased by ages. Canonical correlations of Lower Limbs Set to any other sets were not significant (P > 0.05). CONCLUSIONS: Values and symmetry of gait parameters cannot reflect the development of motor skill during ages of 3-6. Proper trunk movement coordinating with upper limbs and isolating from waist is the key point of development of motor skill in walking. It is built during preschool period and girls develop better. Before the preschool period, lower limbs' isolating movements from the other segments have already developed well. These key points of motor skills in walking should be considered when motor tasks for segment isolation and coordination are given to children with motor dysfunction.

Quality of clinical practice guidelines relevant to rehabilitation of knee osteoarthritis: A systematic review.

OBJECTIVE: This systematic review summarized the rehabilitation recommendations for treating and managing knee osteoarthritis (OA) in practice guidelines and evaluated their applicability and quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. DATA SOURCES: PubMed, the Cochrane Library, EMBASE, CINAHL, PEDro, Guideline central, Guideline International Network and Agency for Healthcare Research and Quality (AHRQ) were used to search for relevant studies published between 1 January 2008 and 31 May 2022. METHODS: AGREE II was used to evaluate the included guidelines quality, SPSS 25.0 statistical software was used for data analysis, and the intra-group correlation coefficient value was calculated to verify the consistency between the raters. The two-way random effects model was used to calculate concordance scores, and each domain's total scores were calculated. Additionally, the median and interquartile range for domain and total scores were calculated. RESULTS: Twenty-four guidelines recommending knee OA rehabilitation were included. Inter-rater consistency evaluation ranged from 0.62 to 0.90. The domains where the guideline's overall and rehabilitation parts scored highest and lowest were scope and purpose (domain 1) and applicability (domain 5), respectively. The highly recommended rehabilitation opinions included aerobic exercise programs (21/24), weight control (16/24), self-education and management (16/24), gait/walking aids (7/24), and tai chi (6/24). However, the orthopedic insole and hot/cold therapy roles remain controversial. CONCLUSION: The clinical practice guidelines' overall quality for knee OA rehabilitation is good; however, the applicability is slightly poor. Therefore, we should improve the promoting factors and hindering factors, guideline application recommendations, tools, and resources when developing relevant guidelines.

Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking.

This study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.

Identification of Differentially Expressed Genes and Key Pathways in the Dorsal Root Ganglion After Chronic Compression.

Neuropathic pain (NP) is caused by primary or secondary impairment of the peripheral or central nervous systems. Its etiology is complex and involves abnormal patterns of gene expression and pathway activation. Using bioinformatics analysis, we aimed to identify NP-associated changes in genes and pathways in L4 and L5 dorsal root ganglia (DRG) in a rat model of NP induced by chronic compression of the DRG (CCD). Genome-wide transcriptional analyses were used to elucidate the molecular mechanisms underlying NP. We screened differentially expressed genes (DEGs) 7 days after CCD in comparison with sham-operated controls. Quantitative real-time polymerase chain reaction (RT-qPCR) and western blotting were used to confirm the presence of key DEGs. Kyoto Encyclopedia of Genes and Genomes (KEGG)-pathway analysis of DEGs and global signal transduction network analysis of DEGs were also conducted. The CCD group developed clear mechanical and thermal allodynia in the ipsilateral hind paw compared with the sham group. This comparison identified 1,887 DEGs, with 1156 upregulated and 731 downregulated DEGs, and 123 DEG-enriched pathways. We identified the key candidate genes that might play a role in the development of NP, namely syndecan 1 (Sdc1), phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit gamma (Pi3k), Janus kinase 2 (Jak2), jun proto-oncogene, AP-1 transcription factor subunit (Jun), and interleukin 6 (IL-6) by analyzing the global signal transduction network. RT-qPCR and western blot analysis confirmed the microarray results. The DEGs Sdc1, Pi3k, Jak2, Jun, and IL-6, and the cytokine signaling pathway, the neuroactive ligand-receptor interaction, the toll-like receptor signaling pathway, and the PI3K-Akt signaling pathway may have decisive modulatory roles in both nerve regeneration and NP. These results provide deeper insight into the mechanism underlying NP and promising therapeutic targets for its treatment.