Effects of whole body vibration combined with extracorporeal shock wave therapy on spasticity and balance gait parameters in hemiplegic patients with stroke. / ä½“å¤–å†²å‡»æ³¢æ²»ç–—è”åˆå ¨èº«æŒ¯åŠ¨å¯¹è„‘å’ä¸­åç˜«æ‚£è€ ä¸‹è‚¢ç—‰æŒ›åŠå¹³è¡¡æ­¥æ€çš„å½±å“.

OBJECTIVES: Stroke patients may have various sensory-motor disorders, such as spasticity, muscle weakness or sensory damage. Spasticity affects 20% to 40% of stroke patients. Patients with spasticity may have problems such as pain, motor function damage, and the decreased range of motion, which leads to decline of activity and quality of daily life. Extracorporeal shock wave therapy (ESWT) is a technique that can improve post-stroke spasticity. Whole body vibration (WBV), as a passive neuromuscular muscle stimulation technique, can improve the posture control, muscle strength, and muscle work of different people. At present, there are still few studies using WBV combined with ESWT for the treatment of hemiplegic patients with stroke. This study aims to explore the effects of WBV combined with ESWT on spasticity of the affected lower limb and gait function in stroke patients. METHODS: From March 2020 to March 2021, 50 hemiplegic patients with stroke were treated in the Department of Rehabilitation Medicine of the First Hospital of Changsha and they were assigned into a control group and a combined group, 25 cases per group. Both groups carried out conventional treatment, while the control group undertook the ESWT and fake WBV based on conventional treatment, and the combined group undertook ESWT after WBV and conventional treatment. Modified Ashworth Scale (MAS), Lower Extremity portion of the Fugl-Meyer Motor Assessment (FMA-LE), Berg Balance Scale (BBS), and parameters of three-dimensional gait analysis including kinematic parameters (peak value of hip flexion and knee flexion) and spatiotemporal parameters (velocity, cadence and stride length) were assessed before and after 4-week treatment between the 2 groups. RESULTS: After 4 weeks of treatment, MAS scores in 2 groups were lower than before (both P<0.05), and the combined group was lower than the control group (P<0.001); BBS and FMA-LE scores were higher than those before treatment (both P<0.05), and the combined group was higher than the control group (both P<0.001); in the control group, the walking speed, stride frequency, and stride length were higher than those before treatment (all P<0.05), and there was no significant difference between the peak value of flexion hip and peak value of flexion knee (both P<0.05); the peak value of hip flexion, peak value of knee flexion, step speed, step frequency, and stride length in the combined group were higher than those before treatment (all P<0.05), and were higher than those in control group (P<0.05 or P<0.001). CONCLUSIONS: WBV combined with ESWT can improve the spasticity and motor function of the affected lower extremity, balance, and gait in hemiplegic patients with stroke.

Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study.

Craniopharyngiomas (CPs) are benign tumors arising from the sellar region. However, little is known about their clinical features and long-term recurrence due to low morbidity and the lack of large cohort studies. Thus, we aimed to develop nomograms to accurately predict the extent of resection and tumor recurrence using clinical parameters. A total of 545 patients diagnosed with CP between 2009 and 2019 were examined: 381 in the development cohort and 164 in the validation cohort. Least absolute shrinkage and selection operator (LASSO) and Cox regression analyses were performed to establish two nomograms. Receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA) and Kaplan-Meier (KM) curves were used to evaluate their predictive performance and discriminative power, respectively, in the two cohorts. In addition, the EORTC QLQ-BN20 questionnaire was used to assess neuropsychological status in the follow-up. In the development cohort, the area under the curve (AUC) and C-index were 0.760 and 0.758, respectively, for predicting the extent of resection and 0.78 and 0.75, respectively, for predicting 3-year progression-free survival (PFS) and 5-year PFS. Additionally, the model had a predictive accuracy of 0.785. Both nomograms showed acceptable discrimination in the two cohorts. Moreover, DCA demonstrated excellent clinical benefits from the two nomograms. Finally, participants were classified into two distinct risk groups according to the risk score, and an online calculator was created for convenient clinical use. During long term follow-up, hypothyroidism (77.61%) and hypocortisolism (76.70%) were the most common endocrine dysfunction after surgery and significant deficits were observed concerning visual disorder, motor dysfunction and seizures in the recurrent groups. In particular, better quality of life was associated with gross total resection (GTR), postoperative radiation, anterior interhemispheric (AI) approach and transsphenoidal approach. To our knowledge, these are the first nomograms based on a very large cohort of patients with CP that show potential benefits for guiding treatment decisions and long-term surveillance. The current study demonstrated the online calculator serve as the practical tool for individual strategies based on the patient's baseline characteristics to achieve a better prognosis.

Temperature-triggered formation of a cellulose II nanocrystal network through regioselective derivatization.

The two ends of rodlike cellulose II nanocrystals (CNC-II) were regioselectively functionalized either with gold nanoparticles or thermosensitive polymer chains. In the first case, after the introduction of sulfur atoms at both ends of the rods, CNC-II were labelled using a method based on the in situ nucleation and growth of gold nanoparticles (AuNPs) from soluble derivatives. Transmission electron microscopy (TEM) images showed that such a method resulted in the grafting of one monodisperse AuNP at each extremity of the CNC-II, i.e. to the formation of hybrid dumbbell-shaped objects. No AuNP was detected on the lateral surfaces of the CNC-II and almost all observed CNC-II exhibited this dual labeling. This result confirmed with a good statistics when compared to previous works the possibility to derivatize only the two ends of the CNC-II, thanks to the antiparallel arrangement of cellulose chains in these nanoparticles. In the second case, the localized grafting of temperature-sensitive macromolecules onto the ends of the CNC-II was performed using an oxidation reaction followed by a peptide coupling. This end-specific grafting of thermosensitive chains onto CNC-II enhanced their colloidal stability when the temperature was below the lower critical solution temperature (LCST) of the polymer. Above the LCST, the TEM images revealed the formation of a network extending to tens of microns resulting from end-to-end associations of the derivatized rods through attractive interactions between collapsed polymer chains. Rheology experiments further evidenced a temperature-induced sol-gel transition from a liquid-like (sol) behavior below the LCST to solid-like (gel) behavior above the LCST, in agreement with a change from purely repulsive interactions to interconnections via the hydrophobic collapsed chains. Importantly, all results concurred with a full reversibility of the phenomena upon cooling and reproducibility when samples were subjected to temperature cycles around the LCST. This work reveals that the dual site-specific derivatization of CNC-II can provide symmetric hybrid particles with innovative assembling and macroscopic properties that cannot be obtained through homogeneous chemical modifications.

Optimized reducing-end labeling of cellulose nanocrystals: Implication for the structure of microfibril bundles in plant cell walls.

A strategy to optimize the labeling of the reducing end of native cellulose nanocrystals (CNCs) with gold nanoparticles (AuNPs) was developed and used to investigate the arrangement of the elementary crystallites constituting these biosourced particles. First, CNCs pre-functionalized with thiosemicarbazide molecules were reacted with presynthesized AuNPs. A second method consisted in synthesizing AuNPs in situ from soluble gold derivatives in the presence of CNCs regioselectively functionalized with thiosemicarbazide molecules. Transmission electron microscopy images revealed that the direct reaction resulted in a low labeling yield and the undesired formation of AuNP aggregates. Oppositely, unprecedent high labeling yields were achieved through the in situ growth approach, with a vast majority of CNCs bearing one or several AuNPs on one end. These results evidence that cotton-derived CNCs are composed of the unidirectional assembly of chemically polar elementary crystallites, implying that the acid hydrolysis isolates fragments of microfibril bundles present in the cell walls.

Temperature-Controlled Star-Shaped Cellulose Nanocrystal Assemblies Resulting from Asymmetric Polymer Grafting.

We present here the grafting of thermoresponsive polyetheramines at the reducing ends of cellulose nanocrystals (CNCs) using a two-step protocol involving an end carboxylation followed by a peptide coupling with the primary amine moiety of the polyetheramine. In aqueous suspensions these end-modified CNCs became associated by their derivatized tips when the temperature was raised past a lower critical solution temperature (LCST), above which these polyetheramines are known to collapse and become hydrophobic. The CNC association was reversible when the temperature was lowered and the phenomenon of association/disassociation was totally reproducible in repeated temperature cycles as followed by dynamic light scattering (DLS). Small-angle neutron scattering (SANS) data revealed the presence of grafted chains with an extended conformation and showed the assembly of modified CNCs into swollen aggregates in suspension at T > LCST. Transmission electron microscopy (TEM) images confirmed that the once dispersed derivatized CNCs at low temperature became associated through their reducing ends above the LCST. At such temperatures, these modified CNCs attached themselves in a remarkable fashion, forming the arms of regular four-, five-, or six-branched stars.

LncRNA SNHG5 Promotes Proliferation of Glioma by Regulating miR-205-5p/ZEB2 Axis.

BACKGROUND: Glioma is a common primary brain tumor with extremely poor prognosis outcomes. Increasing evidences have proved the relation between lncRNAs and glioma onset and progression. LncRNA SNHG5 involves in the biological activities of tumor cells, such as proliferation, migration and metastasis. Nevertheless, it is still necessary to explain the molecular mechanism and biofunction of SNHG5 in glioma. MATERIALS AND METHODS: Quantitative real-time PCR (qRT-PCR) was performed to analyze expressions of SNHG5, miR-205-5p and ZEB2 in tumor tissues and cell lines. The cell counting kit-8 (CCK-8) assay, plate and soft agar colony formation assays were performed to evaluate cell proliferation ability. RNA immunoprecipitation assay and dual-luciferase reporter assay were used to confirm the interaction among SNHG5, miR-205-5p and ZEB2. The protein level of ZEB2 was measured by Western blot. RESULTS: Based on our findings, compared with normal tissues, the elevated expression of SNHG5 and decreased expression of miR-205-5p were observed in glioma tissues. The downregulation of SNHG5 exerted an obvious inhibitory effect on glioma cells in terms of their proliferation. With regard to the underlying mechanism, SNHG5 presented a direct inhibitory influence on miR-205-5p which targeted to the 3'-UTR region of zinc finger E-box binding homeobox 2 (ZEB2) mRNA. As a competing endogenous RNA (ceRNA), SNHG5 sponged miR-205-5p, regulating the expression of ZEB2 thereby. CONCLUSION: These discoveries indicate that SNHG5 promotes proliferation of glioma by regulating miR-205-5p/ZEB2 axis.

The role of neurovascular unit damage in the occurrence and development of Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disease with progressive cognitive impairment. It is the most common type of senile dementia, accounting for 65%-70% of senile dementia [Alzheimer's Association (2016). 2016 Alzheimer's disease facts and figures. Alzheimers Dement. 12, 459-509]. At present, the pathogenesis of AD is still unclear. It is considered that ß-amyloid deposition, abnormal phosphorylation of tau protein, and neurofibrillary tangles are the basic pathological changes of AD. However, the role of neurovascular unit damage in the pathogenesis of AD has been attracting more and more attention in recent years. The composition of neurovascular unit and the role of neurovascular unit damage in the occurrence and development of AD were reviewed in this paper.

[Verification of a sporadic Alzheimer disease model in SORL1 gene knockout mice].

OBJECTIVE: To compare the behavioral and pathological features of SORL1 gene knockout mice with those of normal mice and APP/PSE1 mice to verify the feasibility of using SORL1 knockout mice as a model of sporadic Alzheimer disease. METHODS: SORL1 gene of fertilized mouse eggs were edited using Crispr/Case9 technique. SORL1-/- mice were screened and identified by detecting the DNA sequence, and Western blotting was used to detect the expression of SORL1. SORL1-/- mice, control mice and APP/PSE1 mice all underwent Morris water maze test to assess their learning and memory abilities with positioning navigation and space exploration experiments. The expression of APP and Aß in the brain of the mice was detected using immunohistochemistry and Western blotting, respectively. RESULTS: DNA sequencing showed CAAT deletion in SORL1 gene in two chromosomes of SORL1-/- mice, and the control mice had intact SORL1 gene without the deletion; Western blotting did not detect the expression of the SORL1 in the brain of SORL1-/- mice. Morris water maze test showed that in positioning navigation experiment, the average avoidance latency was similar between SORL1-/- mice and APP/PSE1 mice (P>0.05) but increased significantly in both mice as compared with the control group (P<0.05); similar results were obtained in the space exploration experiment. Immunohistochemistry and Western blotting revealed significantly increased APP and Aß expression in the brain tissue of both SORL1-/- mice and APP/PSE1 mice compared with the control mice without significant differences between the two transgenic mice. CONCLUSION: SORL1-/- mice exhibit similar behavioral and pathological changes with APP/PSE1 mice and can be used as a model of sporadic Alzheimer's disease.

[Establishment of a new cell model mimicking Alzheimer's disease by knocking down SORL1 expression].

OBJECTIVE: To establish a cell model mimicking Alzheimer's disease (AD) by knocking down SORL1 gene and compare the viability, apoptosis, and expressions of tumor necrosis factor-α (TNF-α) and interleukin-1ß (IL-1ß) in this model with a traditional Alzheimer's disease cell model. METHODS: A traditional cell model of AD was established by inducing N2a cells with Aß25-35, and the optimal Aß25-35 concentration was determined by assessing the cell viability changes. Another cell model of AD was established by transfecting N2a cells with SORL1-shRNA lentiviral vector, and SORL1 expression in the transfected cells were detected using Western blotting and qRT-PCR. With wild-type N2a cells without any treatment and cells transfected with a scramble shRNA as the control groups, the two cell models were examined for cell viability with MTT assay, cell apoptosis with flow cytometry, and TNF-α and IL -1ß levels in the culture supernatant with ELISA. RESULTS: The two cell models of AD showed obviously decreased viability and increased cell apoptosis compared with the untreated control cells or cells transfected with a scramble shRNA (P < 0.05); no significant difference was found in the cell viability and apoptosis rate between the two AD cell models or between the two control groups (P>0.05). Significantly increased expressions of TNF-α and IL-1ß were observed in both of the two cell models compared with their respective control groups (P < 0.05) without significant differences between the two cell models or between the two control groups (P>0.05). CONCLUSIONS: A new AD cell model similar to Aß25-35-induced AD model can be established by SORL1 knockdown in N2a cells.

[Protective effect of butylphthalide in a cell model of Alzheimer's disease induced by Aß25-35 in Neuro 2a cells].

OBJECTIVE: To study the protective effect of butylphthalide in a cell model of Alzheimer's disease(AD) induced by Aß25-35 in Neuro 2a (N2a) cells. METHODS: N2a cells were divided into AD group, butylphthalide (NBP) group and control group. AD cell model was established by adding 20 µmol/L Aß25-35 to cultured N2a cells. The cells in NBP group were treated with 0.1, 1, 10, or 100 µmol/L NBP 4 h prior to treatment with 20 µmol/L Aß25-35. The cell viability were determined by MTT assay, the cell apoptotic rate were detected by AnnexinV-FITC flow cytometry, and the cell morphological changes were observed under inverted phase contrast microscope. The expression of TNF-α and IL-1ß mRNA were determined by qRT-PCR. RESULTS: Compared with those in the control group, the number of adherent cells was significantly decreased, neurite structures were reduced, and the cell viability was decreased, while the apoptotic rate and expressions of TNF-α and IL-1ß mRNA were increased in AD group (P<0.05). Compared with that in AD group, the number of adherent cells was increased in NBP group and the cell morphology was similar to the normal control cells. The cell viability of N2a cells was increased in NBP group with decreased apoptotic rate and expression of TNF-αand IL-1ß mRNA (P<0.05). CONCLUSION: Butylphthalide can protect against AD in the cell model induced by Aß25-35 possibly by inhibiting the expression of inflammatory cytokines.

Role of ABC transporters in the pathology of Alzheimer's disease.

The ATP-binding cassette (ABC) transporter superfamily is a large family of proteins that transport specific molecules across membranes. These proteins are associated with both cholesterol metabolism and Alzheimer's disease (AD). Cholesterol homeostasis has a key role in AD, and ABC transporters are important mediators of lipid transportation. Emerging evidence suggests that decreased expression and hypofunction of ABC transporters are crucial to the occurrence and development of AD. In the present article, we review the current knowledge regarding ABC transporters and speculate on their role in the pathogenesis of AD.

[Research progress of depression and the application of esketamine].

OBJECTIVE: The pathogenesis and etiology of still remain unknown. Current evidence suggests that the occurrence of depression may be related to a reduced secretion of neurotransmitters, neuronal apoptosis, inflammation, intestinal flora and other factors. Although the commonly used antidepressants such as SSRIs, SNRIs, NaSSA, and SARIs produce some therapeutic effects, they fail to relieve the full spectrum of the symptoms of depression. In recent years, esketamine was found to produce a potent and a long-lasting antidepressant effect by acting on the NMDA receptors. Herein the authors review the progress in the study of the pathogenesis and drug therapies of depression, the efficacy of esketamine treatment and the underlying mechanism, and the prospect of esketamine treatment. Currently the mechanism of the antidepressant effect of esketamine remains indeterminate and its clinical application is limited, but its effect in rapidly alleviating the symptoms of depression suggests its bright prospect for clinical applications.

Use of the anterolateral thigh and vertical rectus abdominis musculocutaneous flaps as utility flaps in reconstructing large groin defects.

BACKGROUND: Groin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds. METHODS: Groin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum) defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM) flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded. RESULTS: Twenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10) and the vertical rectus abdominis (n=13) pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap) was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series. CONCLUSIONS: The anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover.