摘要
OBJECTIVE:To systematically evaluate the efficacy of transcranial direct current stimulation on the motor function of patients with Parkinson's disease,and to compare the efficacy of transcranial direct current stimulation at different targets on the motor function of patients with Parkinson's disease,so as to provide a theoretical basis for the target selection of transcranial direct current stimulation in clinical practice. METHODS:Cochrane Library,PubMed,Web of Science,CNKI,VIP,WanFang Data were retrieved for randomized controlled trials on the improvement of motor function in patients with Parkinson's disease by transcranial direct current stimulation published from the database inception to January 2023.The keywords were"Parkinson,transcranial direct current stimulation"in English and Chinese.The quality of the included studies was evaluated using the Cochrane 5.1.0 risk of bias assessment tool and the PEDro scale.Meta-analysis of outcome indicators was performed using RevMan 5.4 and Stata 17.0 software. RESULTS:Fifteen randomized controlled trials were finally included,and the PEDro scale showed that all were high-quality or very high-quality studies.Meta-analysis showed that transcranial direct current stimulation significantly improved Unified-Parkinson Disease Rating Scale part III score[mean difference(MD)=-2.49,95%confidence interval(CI):-4.42 to-0.55,P<0.05),step frequency score(MD=0.07,95%CI:0.03-0.11,P<0.05)and step speed score(MD=0.02,95%CI:0.00-0.05,P<0.05),but not for Berg Balance Scale scores(MD=2.57,95%CI:-0.74 to 5.87,P>0.05).Network Meta-analysis probability ranking:In terms of Unified-Parkinson Disease Rating Scale part III scores,the probability ranking results of target stimulation efficacy were dorsal lateral prefrontal cortex(52.4%)>primary motor cortex(45.8%)>central point of the brain(1.8%)>conventional rehabilitation(0%);in terms of gait frequency scores,the probability probability ranking results of target stimulation efficacy were cerebellum(50.1%)>central point of the brain(45.8%)>dorsal lateral prefrontal cortex(3.9%)>primary motor cortex(0.2%)>conventional rehabilitation(0%);in terms of gait speed scores,the probability ranking results of target stimulation efficacy were cerebellum(64.8%)>dorsal lateral prefrontal cortex(23.8%)>central point of the brain(9.4%)>primary motor cortex(1.7%)>conventional rehabilitation(0.4%);in terms of Berg Balance Scale scores,the probability ranking results of target stimulation efficacy were cerebellum(77.4%)>dorsal lateral prefrontal cortex(20.7%)>central point of the brain(0.7%)>conventional rehabilitation(0.2%). CONCLUSION:Transcranial direct current stimulation significantly improves motor function of patients with Parkinson's disease,with better motor coordination in the dorsolateral prefrontal cortex and better walking and balance in the cerebellum.
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ObjectiveTo analyze the research hotspots and development trends of postpartum rehabilitation at home and abroad in the past ten years. MethodsCiteSpace 6.2.R2 was used to analyze the co-occurrence, cluster, and bursting of keywords of the relevant literature in the field of postpartum rehabilitation in CNKI and Web of Science (WOS) in the past ten years. ResultsTotally, 2 686 Chinese papaers were included in CNKI and 1 247 English papers were included in WOS. Both databases showed an increasing trend in the number of publications related to the field of postpartum rehabilitation, but the overall number of publications in CNKI grew faster and the total number of publications was more than that in WOS. For CNKI, there were 455 nodes, 1 102 links, with a density of 0.010 7; nine clusters were obtained; the bursting keywords showed that the diseases of concern shifted from breast distension and pain to pelvic floor diseases, and the hot spots of treatment methods shifted from Chinese medicine to electrical stimulation, biofeedback, and then pelvic floor training. For WOS, there were 463 nodes, 1 633 connected lines, with a density of 0.015 3; 14 clusters were obtained; the bursting keywords showed that the disease hotspots of concern shifted from anal prolapse and postpartum hemorrhage to organ prolapse, the hotspots of treatment methods shifted from analgesia to exercise, and the focus of research methods shifted from trial to qualitative research and meta-analysis. ConclusionDomestic postpartum rehabilitation started later than foreign countries. Although certain research results have been achieved, there is still a certain gap compared with the development of foreign postpartum rehabilitation.
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<p><b>OBJECTIVE</b>To explore the current status on traditional Chinese medicine (TCM) use for hospitalized acute coronary syndrome patients in China's level 2 hospitals, and to explore associated factors of TCM use for these patients.</p><p><b>METHODS</b>This survey was performed in 102 level 2 hospitals from 15 provinces or autonomous region in China. Patients admitted to these hospitals with acute coronary syndrome during September 2011 to May 2012 were eligible for this study. Information on TCM use was obtained from their medical records. Chi-square test and logistic regression analysis were used to explore the related factors of TCM use in these patients.</p><p><b>RESULTS</b>We recruited 5 432 acute coronary syndrome patients in this study, TCM was applied to 3 503 patients (64.5%). Multivariable logistic regression showed that pre-hospital TCM use was positively related with in-hospital TCM use (OR = 2.08, P < 0.01) , while pre-hospital use of 4 medicines recommended by the guidelines(including aspirin/clopidogrel, β acceptor blocker, stain and angiotensin converting enzyme inhibitor/angiotensin converting enzyme receptor blocker ), being a smoker and diagnosis of myocardial infarction rather than unstable angina at hospital discharge were negatively related with in-hospital TCM use (the ORs were 0.58, 0.78 and 0.71, respectively, all P < 0.01). The TCM use varied significantly between regions. Taking southwest region as a reference, the ORs varied between 2.98-13.37 (all P < 0.01) in eastern China, south China, central China, north China, northwest and northeast regions.</p><p><b>CONCLUSIONS</b>TCM is widely used in hospitalized acute coronary syndrome patients in China's resource-constrained level 2 hospitals. Pre-hospital TCM use is positively correlated with in-hospital TCM use for these patients.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Acute Coronary Syndrome , Drug Therapy , China , Cross-Sectional Studies , Drugs, Chinese Herbal , Therapeutic Uses , Inpatients , Logistic Models , Prospective Studies摘要
Objective To observe the changes of expressions of brain-derived neurotrophic factor (BDNF)and its receptor tyrosine kinase B(TrkB)and in rats with hemitransectional spinal cord injury(SCI)after electroacupuncture on Du Meridian and rehabilitation training.Methods The animal model of acute hemitransectional lesion at the right half of T11 spinal cord was established in 96 adult female rats,which were then divided randomly into an electroacupuncture group,a rehabilitation training group,an electroacupuncture combined with rehabilitation training group and a control group.All the groups received treatment on the 3rd d after operation.The electroacupuncture group and rehabilitation training group were given electroacupuncture on points of Du Meridian and rehabilitation training,respectively,and the combined group was given Du Meridian electroacupuncture in addition to rehabilitation training.Basso-Beattie-Bresnahan(BBB)scale was used to evaluate motor function every week.Twelve rats of each group were sacrificed 4 and 8 weeks after operation,respectively,and their spinal cord tissues were extracted.The polymerase chain reaction(PCR),reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemical techniques were used to detect the expressions of BDNF and TrkB.Results BBB grade increased gradually as time went on.There were significant differences between control group and other groups at the same time point(P ＜ 0.05).The scores increased obviously in electroacupuncture combined with rehabilitation training group compared with electroacupuncture group and rehabilitation training group(P ＜ 0.05).The result of immunohistochemical observation and RT-PCR also showed that there were significant differences of expressions of BDNF and TrkB among control group and other groups at the same time(P ＜ 0.05).The effects in electroacupuncture combined with rehabilitation training group were much more obvious than those in electroacupuncture group and rehabilitation training group(P ＜ 0.05),but there was no significant difference between electroacupuncture group and rehabilitation training group (P ＞ 0.05).Conclusions Electroacupuncture on Du Meridian combined with rehabilitation training had synergic effect on rat's SCI,and could obviously improve the restoration of rat's motor function; the mechanism maybe related to the upregulation of expressions of BDNF and TrkB.
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A semantic modeling approach for medical image semantic retrieval based on hierarchical Bayesian networks was proposed, in allusion to characters of medical images. It used GMM (Gaussian mixture models) to map low-level image features into object semantics with probabilities, then it captured high-level semantics through fusing these object semantics using a Bayesian network, so that it built a multi-layer medical image semantic model, aiming to enable automatic image annotation and semantic retrieval by using various keywords at different semantic levels. As for the validity of this method, we have built a multi-level semantic model from a small set of astrocytoma MRI (magnetic resonance imaging) samples, in order to extract semantics of astrocytoma in malignant degree. Experiment results show that this is a superior approach.
Subject(s)
Humans , Artificial Intelligence , Astrocytoma , Diagnosis , Bayes Theorem , Brain Neoplasms , Diagnosis , Diagnostic Imaging , Methods , Image Interpretation, Computer-Assisted , Methods , Image Processing, Computer-Assisted , Methods , Magnetic Resonance Imaging , Models, Theoretical , Semantics摘要
Objective:To study the relationship of circulating endothelial cell(CEC)with syndrome differentiation of TCM(Traditional Chinese Medicine)in patients with cardiovascular diseases(CD)and to observe the effect and clinical significance of CEC in the pathogenesis of CD.Methods:150 patients with CD were divided into four groups by syndrome differentiation of TCM.Besides,a control group consisted of 30 healthy persons.CEC was determined for all cases and healthy contral by Hladovec method.30 patients with coronary heart disease(CHD)accepted oral Tongxinluo capsule,3 capsules each time,Tid.The treatment course lasted one month.CEC was determined before and after treatment.Results:Compared with healthy group,the content of CEC in CD group increased obviously(P
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Objective To study the protective effect of Xinfuli Granula(XG) on acute and chronic cardiac failure in cats and rats. Methods The cat models of acute cardiac failure were established by injecting pentobarbital. Then the cat models were given XG through duodenum. After medication,hemodynamics parameters such as heart rate(HR),mean arterial pressure(MAP),left ventricular systolic pressure(LVSP),left ventricular end-diastolic pressure(LVEDP),+ dp/dtmax and cardiac output(CO) in cats were determined. The rats were divided randomly into 5 groups:the control group,the model group,the positive control group,and high-dose and Low-dose XG groups. The rat models of myocardial injury were induced by isoproterenol(20 mg/kg). The normal group and the model group were treated with normal saline(10 mL/kg) orally,the positive contral group were treated with cedilanid(0.2 mg/kg) by intravenous,the high-and low-dose XG groups were orally treated with XG(10 g/kg and 5 g/kg respectively),and the propranolol group was orally treated with propranolol(4 mg/kg),once a day for successive 8 days. Animals were sacrificed on the 9th day,then the heart was taken out and the cardiac index was calculated. The pathological changes in myocardial cells of the rats were observed under electron microscope. Results XG had no effect on hemodynamics of cats with acute cardiac failure,but had obvious protective and therapeutic effect on isoproterenol-inducedmyocardial injury and myocardial ischemia of rats. Conclusion Xinfuli Granula has good preventive effect on isoproterenol-induced myocardial injury and sub-acute cardiac failure of rats,but has no effect on acute cardiac failure of cats.