Effects of Transcranial Direct Current Stimulation and Neuromuscular Joint Facilitation on Upper Limb Motor Disorders for Stroke Patients.

Context: Approximately 1.5- to 2-million new patients suffer from stroke annually in China. 60% of patients suffering from stroke will sustain different degrees of upper limb dysfunction at six months after onset. Recovery of upper limb function after stroke is of great significance in improving patients' quality of life. Objective: The study intended to explore the rehabilitative the effects of transcranial direct current stimulation combined with neuromuscular joint therapy on the rehabilitation of patients with upper-limb motor disorders after strokes to provide new ideas for rehabilitative treatment. Design: The study was a paired control test. Setting: The study took place in the Department of Rehabilitation Medicine at Heping Hospital of Changzhi Medical College in Changzhi, Shanxi, China. Participants: Participants were 80 stroke patients with upper-limb motor disorders who were treated at the hospital between January 2020 and December 2020. Intervention: According to the natural grouping method, the research team divided participants into an intervention group (n = 42) and a control group (n = 38). The control group received transcranial direct-current stimulation, and the intervention group received transcranial direct-current stimulation combined with neuromuscular joint therapy. Outcome Measures: The measurements included the scores on the Fugl-Meyer Assessment (FMA) scale, the Action Research Arm Test (ARAT), activities of daily living (ADL), and National Institutes of Health Stroke Scale (NIHSS) as well as the serum levels of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and superoxide dismutase (SOD). The team also measured the maximum isometric torque of flexion and extension of the elbow joint. The research team compared the differences in the scores between the groups for all variables. Results: Postintervention, the FMA, ARAT, and ADL scores, the torques of elbow flexion and extension maximum isometric contraction, the amplitude, and the serum BDNF, NGF, and SOD levels were significantly higher in the intervention group than those in the control group, while the NIHSS score and the incubation period of evoked potential were significantly lower than those in the control group. Conclusions: Transcranial direct current stimulation combined with the neuromuscular joint method demonstrated good rehabilitative effects on upper-limb movement disorders for stroke patients and significantly improved their upper-limb function and promoted recovery of nerve functions.

SCFAs improve disease resistance via modulate gut microbiota, enhance immune response and increase antioxidative capacity in the host.

To evaluate the effects of dietary short chain fatty acids (SCFAs) on the intestinal health and innate immunity in crucian carp, a six-week feeding trial was carried out with following treatments: basal diet (BD), basal diet supplementation with 1% sodium acetate (BDSA), basal diet supplementation with 1% sodium propionate (BDSP) and basal diet supplementation with 1% sodium butyrate (BDSB). The results showed dietary BDSA, BDSP and BDSB could protect the host against oxidative stress by improving the activity of certain antioxidative enzymes (T-SOD, GSH-Px and CAT). Additionally, dietary SCFAs could enhance mucosal and humoral immune responses by improving certain innate immune parameters in serum and skin mucus productions (IgM, ACH50 and T-SOD). Furthermore, dietary BDSA and BDSP could up-regulate the expression of immune related genes (TNF-α, TGF-ß and IL-8) and tight junction protein genes (occludin and ZO-1). Dietary BDSB could also elevate the expression of IL-8, TGF-ß, ZO-1 and Occludin in the midgut. Although dietary differences of SCFAs didn't alter the α-diversity of the intestinal flora, they altered the core microbiota. Finally, the challenge trial showed that dietary basal diet supplementation with SCFAs could protect zebrafish against Aeromonas hydrophila. These results suggest that dietary SCFAs could improve innate immunity, modulate gut microbiota and increase disease resistance in the host, which indicated the potential of SCFAs as immunostimulants in aquaculture.

Rehabilitation of patients with COVID-19.

INTRODUCTION: In 2020, due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), coronavirus disease (COVID-19) has become a pandemic. As of 11 August 2020, the cumulative number of confirmed cases worldwide had reached 19 million, with 700,000 reported deaths, indicating this pandemic's significant global impact. AREAS COVERED: We reviewed the application of rehabilitation therapy in the clinical treatment of COVID-19 patients. A systematic search was performed using PubMed, Springer, CNKI, and Wanfang Data of database up to 1 August 2020. The search terms included the English terms and their Chinese equivalents: 'COVID-19,' 'ARDS,' 'rehabilitation,' 'critically ill patients,' 'physiotherapy,' 'respiratory rehabilitation,' 'traditional Chinese medicine,' and 'psychotherapy.' EXPERT OPINION: Rehabilitation research concerning patients with COVID-19 remains ongoing. Rehabilitation guidance for such patients with COVID-19 is based on previous experience. However, as different patients have differing degrees of dysfunction, personalized plans need to be designed according to the patients' age, sex, lifestyle, hobbies, occupation, and physical conditions. The rapid development of remote devices that can monitor patients' real-time physical conditions post-discharge may encourage better adherence to rehabilitation training.

[Warming Needle Moxibustion Relieves Symptoms of Lumbar Disc Herniation Patients and Upregulates Plasma ß-endorphin].

OBJECTIVE: To analyze the effect of warming needle moxibustion of Jiaji (EX-B 2), Huantiao (GB 30), etc. on lumbago and other symptoms of lumbar disc herniation (LDH) patients and changes of plasma ß-endorphin (ß-EP) content. METHODS: A total of 60 LDH patients were equally randomized into warming needle moxibustion group and conventional acupuncture group. Patients of the conventional acupuncture group were treated by puncturing lumbar Jiaji (EX-B 2), Huantiao (GB 30), Weizhong (BL 40), and Yanglingquan (GB 34) with filiform acupuncture needles. Patients of the warming needle moxibustion group were treated by puncturing the same 4 acupoints, and with the acupuncture needle in lumbar EX-B 2 attached an ignited moxa-stick segment. The treatment in both groups lasted for 30 min every time, once every other day for 15 times, with 5 times being a therapeutic course and two days' rest between every two courses. The therapeutic effect was evaluated according to the "Criteria for Evaluating the Therapeutic Effect of Disorders of Traditional Chinese Medicine". The lumbago severity was assessed using visual analogue scale (VAS), and the lumbar functional activity assessed using modified Oswestry dysfunction (in objects-lifting, sitting, standing, walking, sleeping, pain, activity of daily living, social activity, outing, etc.) index (ODI). The plasma ß-EP content was assayed using ELISA. RESULTS: After the treatment, of the two 30 cases in the conventional acupuncture and warming needle moxibustion groups, 8 (26.67%) and 12 (40.00%) were under control, 8 (26.67%) and 10 (33.33%) had a marked improvement, 3 (10.00%) and 4 (13.33%) were effective, and 11 (36.66%) and 4 (13.33%) ineffective, with the effective rates being 63.34% and 86.66%, respectively. The effective rate of the warming needle moxibustion was significantly higher than that of the conventional acupuncture (P<0.05). The VAS scores and ODI values of the two groups were gradually decreased along with the prolongation of treatment, and significantly lower in the warming needle moxibustion group than in the acupuncture group at the 1st, 2nd and 3rd course of treatment (P<0.01). The levels of plasma ß-EP were gradually increased in the two groups at the 1st, 2nd and 3rd course of treatment, and were obviously higher in the warming needle moxibustion group than in the conventional acupuncture group at each of the 3 courses (P<0.01). No obvious adverse reactions were observed in the two groups. CONCLUSION: Warming needle moxibustion has a better therapeutic effect in relieving lumbago and lumbar dysfunction, and can up-regulate blood ß-EP level.

The Arabidopsis lectin receptor kinase LecRK-I.9 enhances resistance to Phytophthora infestans in Solanaceous plants.

Late blight caused by the plant pathogenic oomycete Phytophthora infestans is known as one of the most destructive potato diseases. Plant breeders tend to employ NB-LRR-based resistance for introducing genetically controlled late blight resistance in their breeding lines. However, P. infestans is able to rapidly escape this type of resistance, and hence, NB-LRR-based resistance in potato cultivars is often not durable. Previously, we identified a novel type of Phytophthora resistance in Arabidopsis. This resistance is mediated by the cell surface receptor LecRK-I.9, which belongs to the family of L-type lectin receptor kinases. In this study, we report that expression of the Arabidopsis LecRK-I.9 gene in potato and Nicotiana benthamiana results in significantly enhanced late blight resistance. Transcriptional profiling showed strong reduction in salicylic acid (SA)-mediated defence gene expression in LecRK-I.9 transgenic potato lines (TPLs). In contrast, transcripts of two protease inhibitor genes accumulated to extreme high levels, suggesting that LecRK-I.9-mediated late blight resistance is relying on a defence response that includes activation of protease inhibitors. These results demonstrate that the functionality of LecRK-I.9 in Phytophthora resistance is maintained after interfamily transfer to potato and N. benthamiana and suggest that this novel type of LecRK-based resistance can be exploited in breeding strategies to improve durable late blight resistance in Solanaceous crops.

Phytophthora infestans field isolates from Gansu province, China are genetically highly diverse and show a high frequency of self fertility.

The genetic diversity of 85 isolates of Phytophthora infestans collected in 2007 from Gansu province in China was determined and compared with 21 isolates collected before 2004. Among them, 70 belonged to the A1 mating type and 15 were self-fertile (SF). The mitochondrial DNA haplotypes revealed both Ia (25%) and IIa (75%) haplotypes. Metalaxyl resistance occurred with high frequency (54%) in Gansu. Simple sequence repeat (SSR) genotyping revealed 26 genotypes (13 from the Tianshui region) among the 85 isolates, and 18 genotypes among the 21 isolates collected before 2004, without overlap in genotypes detected in the two groups. Cluster analysis showed clear subdivisions within the different mating type isolates. Among Gansu's isolates, Nei's and Shannon's diversity indices were highest in isolates collected in Tianshui where both A1 and SF isolates were found. Analysis of molecular variance of isolates from Gansu indicated that 51% and 49% of the variance was explained by within-area and among-area variance, respectively. The results suggest that the occurrence of SF isolates increases the risk of sexual reproduction, the formation of oospore as initial inocula in the field, and affects the genotypic diversity in the population.

Effects of single-variable biofeedback on wheelchair handrim biomechanics.

OBJECTIVE: To determine the effects of single-variable biofeedback on select wheelchair propulsion variables. DESIGN: Within-subject comparisons. SETTING: Biomechanics laboratory. PARTICIPANTS: Manual wheelchair users (N=31). INTERVENTIONS: Biofeedback on braking moment, cadence, contact angle, peak force, push distance, and smoothness were presented on a large monitor during propulsion on a motor-driven treadmill. For each variable, subjects were asked to make a maximum improvement, as well as a targeted 10% improvement for cadence, contact angle, peak force, and push distance. MAIN OUTCOME MEASURES: Relative differences (%) in each variable between the normal propulsion trial and the biofeedback trials. RESULTS: Subjects were able to interpret and respond to the biofeedback successfully. For the maximum change conditions, significant improvements were made to all variables except smoothness, with individual improvements of 11% in peak force, 31% in contact angle, 44% in braking moment, 64% in cadence, and 255% in push distance. For the 10% target conditions, improvements were achieved to within 1% for all variables except peak force, which was a difficult variable for most subjects to control. Cross-variable interactions were found for most variables, particularly during the maximum change conditions. Minimizing cadence led to a 154% increase in peak force, suggesting the need for multi-variable feedback if multiple training objectives, such as reducing cadence and peak force simultaneously, are desired. While subjects were unable to significantly change smoothness, efforts to push more smoothly led to improvements across most outcome variables. CONCLUSIONS: Biofeedback can be used to improve specific aspects of wheelchair propulsion. Cadence, contact angle, and push distance are well controlled by wheelchair users, and may be useful for clinical propulsion training. Clinicians should be aware of and comfortable with any cross-variable effects resulting from single-variable biofeedback training.

Genetic structure of Phytophthora infestans populations in China indicates multiple migration events.

One hundred isolates of Phytophthora infestans collected from 10 provinces in China between 1998 and 2004 were analyzed for mating type, metalaxyl resistance, mitochondrial DNA (mtDNA) haplotype, allozyme genotype, and restriction fragment length polymorphism (RFLP) with the RG-57 probe. In addition, herbarium samples collected in China, Russia, Australia, and other Asian countries were also typed for mtDNA haplotype. The Ia haplotype was found during the first outbreaks of the disease in China (1938 and 1940), Japan (1901, 1930, and 1931), India (1913), Peninsular Malaysia (1950), Nepal (1954), The Philippines (1910), Australia (1917), Russia (1917), and Latvia (1935). In contrast, the Ib haplotype was found after 1950 in China on both potato and tomato (1952, 1954, 1956, and 1982) and in India (1968 and 1974). Another migration of a genotype found in Siberia called SIB-1 (Glucose-6-phosphate isomerase [Gpi] 100/100, Peptidase [Pep] 100/100, IIa mtDNA haplotype) was identified using RFLP fingerprints among 72% of the isolates and was widely distributed in the north and south of China and has also been reported in Japan. A new genotype named CN-11 (Gpi 100/111, Pep 100/100, IIb mtDNA haplotype), found only in the south of China, and two additional genotypes (Gpi 100/100, Pep 100/100, Ia mtDNA haplotype) named CN-9 and CN-10 were identified. There were more diverse genotypes among isolates from Yunnan province than elsewhere. The SIB-1 (IIa) genotype is identical to those from Siberia, suggesting later migration of this genotype from either Russia or Japan into China. The widespread predominance of SIB-1 suggests that this genotype has enhanced fitness compared with other genotypes found. Movement of the pathogen into China via infected seed from several sources most likely accounts for the distribution of pathogen genotypes observed. MtDNA haplotype evidence and RFLP data suggest multiple migrations of the pathogen into China after the initial introduction of the Ia haplotype in the 1930s.