Effects of Rehabilitation Training Combined with Acupuncture on Upper Limb Function of Stroke Patients Based on Kinect / 医用生物力学

Objective To investigate the effect of rehabilitation training combined with acupuncture ( RTA) on upper limb function of stroke patients by Kinect. Methods Stroke patients with upper limb dysfunction werrandomly divided into control group (rehabilitation training) and treatment group ( RTA), with 15 cases in each group. The modified Barthel Index ( MBI), Fugl Meyer assessment ( FMA), and Wolf motor function test (WMFT) were compared between two groups before and after treatment. The changes in motor time ( MT), motor unit number (MUN), index of curvature (IC), elbow flexion angle (EFA), shoulder flexion angle (SFA),and shoulder adduction angle ( SAA) during three actions, namely, placing forearm on the table, extending elbow and drinking water, were evaluated by Kinect and then compared between two groups before and after treatment. Results After 6 weeks of intervention, the scores of MBI, FMA, WMFT and elbow extension in treatment group were higher than those in control group (P<0. 05). The scores of MBI, FMA, WMFT and three actions after treatment were higher than those before treatment (P<0. 05). For three actions, the improvement of MT, MUN, IC, EFA, SFA, and SAA in treatment group were better than those in control group ( P< 0. 05). Compared with pre-treatment, for the action of forearm placement on the table and elbow extension, both treatment group and control group showed an increase in EFA (P<0. 05), and a decrease in MT, MUN, IC, SFA and SA (P<0. 05). For the action of drinking water, both treatment group and control group showed an increase in EFA and SAA (P< 0. 05), and a decrease in MT, MUN, IC and SAA ( P< 0. 05). Conclusions RTA can improve the upper limb function of stroke patients. Kinect can accurately reflect the changes in upper limb function of stroke patients, and it is suitable for clinical work.

Effects and significance of α-synuclein on β-arrestin 2 expression in Parkinson' disease in a mouse model / 中华老年医学杂志

Objective:To investigate the effects and significance of α-synuclein(α-syn)on the expression level of β-arrestin 2 in Parkinson's disease(PD)in a mouse model.Methods:Twenty-eight C57BL/6J mice with similar motor skills were randomly divided into a model group and a control group, with 14 mice in each group.A PD model was established by injecting preformed fibrils of α-syn into the striatum of the brain, and behavioral changes were monitored after 4 weeks.The expression levels of α-syn, the dopamine receptor(DR), tyrosine hydroxylase(TH), inflammatory factors, β-arrestin 2 and the nuclear transcription factor-κB(NF-κB)signaling pathway-related proteins were determined by Western blotting.The interaction between α-syn and β-arrestin 2 was detected by fluorescence resonance energy transfer(FRET), and the regulation of α-syn on β-arrestin 2 transcriptional activation was detected by the dual luciferase report assay.Results:After 4 weeks of modeling, compared with the control group, the average movement speed of mice in the model group was significantly reduced( t=9.415, P<0.001), the movement track was sparse and concentrated around the open field, and the time needed to climb the pole was significantly prolonged( t=16.412, P<0.001). Compared with the control group, the relative expression of α-synin in astrocytes in the model group increased significantly, the relative expressions of D1DR and TH decreased significantly[(1.14±0.18) vs.(0.53±0.16), (0.67±0.13) vs.(1.15±0.11), (0.46±0.05) vs.(0.81±0.06)]( t=9.810, 10.917 and 17.356, all P<0.001), the relative expression of tumor necrosis factor-α, interleukin-1β, interleukin-6 and NF-κB signaling pathway-related proteins increased significantly( t=3.583, 4.284, 5.396, 11.747, 16.375 and 18.294, all P<0.001), and the relative expression of β-arrestin 2 protein[(0.42±0.11) vs.(1.33±0.14)]in astrocytes decreased significantly( t=19.795, P<0.001). The FRET results suggested a possible direct interaction between α-syn and β-arrestin 2.The results of the dual luciferase report assay showed that the transcription activity of β-arrestin 2 was significantly increased after α-syn gene knockout. Conclusions:The α-syn may induce inflammation in astrocytes by activating the NF-κB signaling pathway and participate in the pathogenesis of PD by reducing dopamine biosynthesis and inhibiting its physiological function through negative regulation of β-arrestin 2.

The expression level of β-arrestin 1/2 in mice with Parkinson's disease and its relationship with pathogenesis of Parkinson's disease / 中华老年医学杂志

Objective:To observe the expression level of β-arrestin 1/2 in mice with Parkinson's disease(PD)and its relationship with pathogenesis of PD.Methods:PD model was prepared by using 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine hydrochloride(MPTP). The mice were killed at 3 days after the last administration and the brain tissue was taken for observing brain histopathological changes.The colocalization of β-arrestin1/2 with microglia was detected by using immunofluorescence double-labeling of β-arrestin1/2 and microglia.Tyrosine hydroxylase(TH)and Iba-1 were used to label cells, and then the loss of dopaminergic neurons and the activation of microglia were observed by immunohistochemistry.Results:As compared with the blank control group, the relative expression level of β-arrestin1 protein in brain tissue of PD mice was increased significantly, while the relative expression level of β-arrestin2 protein was decreased significantly( t=11.535, 9.948, both P=0.000), and β-arrestin1/2 shared cell localization with microglia.After MPTP induced PD, the number of Th + neurons in SNc area of midbrain was decreased significantly in β-arrestin1 + /+ group and β-arrestin1 -/- group( t=4.098, 3.571, P=0.000, 0.001), while the number of Iba-1 + cells in SNc area of midbrain was increased significantly( t=10.097、6.448, both P=0.000). After MPTP induced PD, the number of Th + neurons in SNc area of midbrain was decreased significantly in β-arrestin2 + /+ group and β-arrestin2 -/- group( t=3.512, 5.237, P=0.001, 0.000), while the number of Iba-1 + cells in SNc area of midbrain was increased significantly( t=5.816、8.402, P=0.000). Compared with β-arrestin1 + /+ group, the expressions of TRAF6, NF-κB and COX-2 in mouse microglia were significantly increased in β-arrestin1 -/- group( t=5.324, 5.837, 9.350, all P=0.0000). Compared with β-arrestin2 + /+ group, the expressions of TRAF6, NF-κB and COX-2 in mouse microglia were significantly down-regulated in β-arrestin2 -/- group( t=5.094, 6.318, 9.466, all P=0.000). Conclusions:The expression of β-arrestin1 is up-regulated and β-arrestin2 is down-regulated in brain tissue of PD mice.β-arrestin1/2 may affect the proliferation and activation of microglia and the loss of dopaminergic neurons through TRAF6/NF-κB/COX-2 pathway, and participate in the pathological process of PD.

Genetic characterization of bovine ephemeral fever virus in southern China, 2013-2017.

Bovine ephemeral fever virus (BEFV) can cause bovine ephemeral fever and is an economically important arbovirus of cattle. To expand the knowledge of the molecular epidemiology of BEFV in southern China, the complete surface glycoprotein G gene of BEFV was sequenced from samples collected in five restricted outbreaks from 2013 to 2017, namely 2013ZH, 2014HM, 2015GX, 11082-2016, and qy2017. It was noted that both 2014HM and 11082-2016 were detected in cattle regularly vaccinated with inactivated vaccine. Phylogenetic analysis demonstrated that all five strains grouped into cluster I. However, qy2017 was closer to the BEFV strains identified in Thailand, Japan, and Taiwan after 2000, while 2013ZH, 2014HM, 2015GX, and 11082-2016 were closer to the Chinese strains in 2011 and the Turkey strains in 2012. The analysis of antigenic sites indicated that several amino acid changes occurred between the five strains and the vaccine strain. Importantly, one novel amino acid mutation site was observed in the putative N-linked glycosylation sites of 2013ZH, 2014HM, 2015GX, and 11082-2016. Our study indicated novel genetic characteristics of the newly emerging BEFV strains in southern China and the necessity of updating the component of commercially available inactivated BEFV vaccines in China.

Effects of Electro-Acupuncture on Vertical Ground Reaction Force and Impulse Symmetry of Patients with Knee Osteoarthritis during Stair Climbing / 医用生物力学

Objective To observe the effects of electro-acupuncture on loading of lower limb joints in patients with knee osteoarthritis (KOA) during stair climbing and explore the related biomechanical mechanism. Methods Forty patients with KOA were randomly assigned, with 20 patients in observation group (electro-acupuncture group, EA group) and 20 patients in control group (superficial acupuncture group, SA group). Finally 18 patients in each group completed the study. In observation group, seven knee acupuncture points were chosen and patients were connected with electro-acupuncture instrument; while in control group, the electro-acupuncture instrument was connected but not electrified after superficial acupuncture at non-acupoint points. The three-dimensional gait analysis system was used to assess the biomechanical characteristics during stair climbing before and after treatment, including peak vertical force (PFz), vertical impulse (IFz) and symmetry index (SI%). Results After 3 weeks of treatment in EA group, PFz of the right foot during stair ascent and PFz of the left foot during stair descent increased (P＜0.05); IFz of both feet during stair ascent and IFz of the right foot during stairs descent significantly decreased (P＜0.05); no significant differences were found in SI% of peak and impulse (P＞0.05). In SA group, only SI of impulse during stairs ascent increased (P＜0.05). There was no significant difference between two groups before and after treatment (P＞0.05). Conclusions Electro-acupuncture can effectively improve the joint load capacity and reduce the dynamic cumulative load of patients w

Kinetic mechanism of electroacupuncture for stair climbing in knee osteoarthritis patients / 中国针灸

<p><b>OBJECTIVE</b>To observe the kinetic change that reflects joint loading in different planes during stair climbing in knee osteoarthritis (KOA) after electroacupuncture (EA) by three-dimensional motion analysis, so as to provide reference for its biomechanical mechanism treated with acupuncture.</p><p><b>METHODS</b>Forty KOA patients, in accordance with the random number table, were assigned into an observation group and a control group, 20 cases in each one and finally 18 cases completed. Acupoints in the observation group were Neixiyan (EX-LE 4), Dubi (ST 35), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Liangqiu (ST 34) and Zusanli (ST 36); points in the control groups were located about 2 cm next to the above acupoints with shallow acupuncture. EA was connected at Neixiyan (EX-LE 4) and Yinlingquan (SP 9), Liangqiu (ST 34) and Yanglingquan (GB 34). The frequency was 2 Hz with continuous wave in the observation group and there was no current in the control group for the corresponding points. All the treatment was given for 3 weeks, totally 11 times. Climbing stairs gait was measured before and after treatment. Velocities and kinetic parameters during ascending and descending stairs were analyzed, including flexion and extension peak torques of hip, knee, ankle on the vertical plane, external knee adduction moment on the coronal plane.</p><p><b>RESULTS</b>After treatment in the observation group, velocities during ascending and descending stairs significantly increased (<0.05,<0.01); maximal ankle plantar flexor moments during ascending and descending stairs and the second peak external knee adduction moment (PEKAM2) during ascending stairs significantly increased (<0.05,<0.01). After treatment in the control group, the first peak external knee adduction moment (PEKAM1) and PEKAM2 during descending stairs were less than those before treatment (<0.05,<0.01). In the observation group, the difference value (DV) of velocity before and after treatment was positively correlated to DV in the torque of ankle plantar flexors during ascending stairs in the observation group (=0.598，<0.01). Excluding the impact of velocity, the DV of the maximal torque of ankle plantar flexors during ascending stairs didn't show difference in the observation group (>0.05).</p><p><b>CONCLUSION</b>EA can increase the velocities of ascending and descending stairs of KOA patients. It improves the loading capacity of knee joint on both sagittal and coronary planes. But its effect during ascending may be correlated with the increase of velocity. The mechanism of different effects between EA and minimal acupuncture on joint moments is still unclear and warrants further study.</p>

Warm-needling moxibustion for knee osteoarthritis:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of warm-needling moxibustion for knee osteoarthritis (KOA), and to explore its effects on isokinetic strength of lower limb muscle.</p><p><b>METHODS</b>Fifty cases of KOA were randomly divided into an observation group (25 cases) and a control group (21 cases), but 4 cases lost contact. The observation group was treated with warm-needling moxibustion at Dubi (ST 35), Neixiyan (EX-LE 4), Xuehai (SP 10), Liangqiu (ST 34), Yinlingquan (SP 9), Yanglingquan (GB 34), Weizhong (BL 40), Heyang (BL 55) and Fengshi (GB 31) for 40 min per treatment. The first 6 treatments were given once a day, and the last 6 treatments were given once every other day. 12 treatments were taken as one course, and totally 3-week treatment was given. No treatment was given in the control group for 3 weeks. The isokinetic strength of extensor muscle and flexor muscle, including the total work, absolute peak torque (aPT) and relative peak torque (rPT), and Western Ontario and McMaster Universities Arthritis Index (WOMAC), and comprehensive efficacy were observed and compared in the two groups.</p><p><b>RESULTS</b>Compared before treatment, the total work, aPT and rPT of the extensor and flexor muscle increased significantly after treatment in the observation group (<0.01,<0.05), but the flextion/extention ratio was lowered (<0.05). In the control group, aPT and rPT of flexor muscle were reduced after treatment (<0.05,<0.01). The total work, aPT and rPT of the extensor muscle in the observation group were higher than those in the control group after treatment (<0.05,<0.01), but the flextion/extention ratio was lowered (<0.05). The item score and total score of WOMAC were reduced in the observation group after treatment (all<0.01), but no significant change was observed in the control group (all>0.05). The pain score, stiffness scores and total score of WOMAC in the observation group were lower than those in the control group (<0.01,<0.05); the score of daily function activities was declined in the observation group, but not significantly different from that in the control group (>0.05). The total effective rate was 88.0% (22/25) in the observation group.</p><p><b>CONCLUSIONS</b>Warm-needling moxibustion could relieve pain, improve function and muscle balance, strengthen extensor and flexor muscle power, especially extensor, which has superior clinical efficacy.</p>

Application of reverse engineering techniques to measure the distance and volume of medial and lateral compartments of human knee joint / 中国组织工程研究

BACKGROUND:Knee joint is the most complicated structure of human body, and X-ray is often used to reflect the stenosis of knee compartment. However, radiographs are two-dimensional projection of three-dimensional joint structure. Thus, different joint shooting locations can impact the outcomes of measurement, and it is difficult to ensure the accuracy of repeated measurements. OBJECTIVE:To build three-dimensional model of knee compartment, measure the distance and volume, and provide the basis for subsequent models, biomechanics and relevant clinical studies. METHODS:Based on the principle of reverse engineering, using CT images of the knee joint and the software of Mimics, three-dimensional model of medial compartment knee structure was reconstructed. After the model was imported and smoothed, the medial and lateral compartment volumes were finaly calculated by the software of Geomagic Studio. RESULTS AND CONCLUSION: Three-dimensional model of the knee compartment, including femur, tibia and fibula, was successfuly structured by CT images. The models of knee and knee compartment could be observed at any angle or observed individualy, and could be measured. It was discovered that the volume of medial and lateral compartments of knee is close, although the joint space width of them is different, which ilustrates that the procedure can accurately reflect the degree of knee joint space width in the round by calculating the volume of medial and lateral compartments of knee joint through computer.

Charecteristics of the activity in brain resting regions of patients with asymptomatic reflux esophagitis / 中华消化杂志

Objective To observe characteristics of the activity in resting brain of asymptomatic reflux esophagitis (RE) patients,and explore the role of default network in the pathogenesis of asymptomatic RE.Methods Functional magnetic resonance imaging (fMRI) was performed to scan the brains of 15 asymptomatic RE patients,15 symptomatic RE patients and 15 healthy volunteers under no-mission-stimulation state.With fractional amplitude of low frequency fluctuation (fALFF),characteristics of the strengthened and weakened regions of asymptomatic RE patients,symptomatic RE patients and healthy individuals were compared and analyzed.SPM 5 was applied for data preprocessing.Single-sample t test was performed to observe the noticeable active regions of each group under resting state,and then double-sample t test was used to compare the characteristics of active regions of the entire brain between asymptomatic RE patients and symptomatic RE patients or healthy individuals.Results Under resting state,the active brain regions of asymptomatic RE patients,symptomatic RE patients and healthy individuals were similar.The activity of only small part of brain regions in visceral sensory processing relevant networks changed.There was no significant difference in the active regions of default network under resting state between asymptomatic RE patients and healthy individuals.Compared with symptomatic RE patients,fALEF decreased at right central sulcus cover,right superior temporal gyrus,right insula,right transverse temporal gyrus,right postcentral gyrus,superior temporal gyrus and temporal pole (X=50,Y=-6,Z=12,t=2.7874,P＜0.01).Conclusion The difference in characteristics of activity in default network under resting state may play an important role in the pathogenesis of asymptomatic RE.

Clinical Observation of Acupuncture, Tuina and Acupoint Injection on Cervicogenic Headache / 针灸推拿医学（英文版）

Objective: To investigate the clinical effect of acupuncture therapy and Tuina therapy in treating cervicogenic headache. Method: Forty inpatients, were divided into acupuncture and Tuina group(experiment group, n= 20), and Tuina and acupoint injection group(controlled group, n = 20) with random number table. Patients in the experimental group were firstly needled Fengchi (GB 20, major acupoint), Taiyang (Ex-HN 5), Baihui (GV 20), Shuaigu (GB 8),and Jiaji (Ex-B 2) around the affected cervical vertebrae, and applied Tuina treatment.Patients in the controlled group were treated with Tuina treatment, and then injection in Fengchi (GB 20) with 500 μg of Methycobal. Before and after treatment, all patients in both groups were evaluated with Evaluation Scale for Cervicogenic Headache. Result: After treatment, score of each item of patients in both two groups were enhanced (P＜0.01), and compared with patients in the controlled group, patients in the experimental group had higher scores of headache(13.1±3.02 vs 10.8±2.36, P＜ 0.01), daily life and working (3.3±0.66 vs 2.6±0.79, P ＜ 0.01), mental state and social adjustment (3.1±0.85 vs 2.1±0.85, P＜ 0.05), and total points (24.6±4.36 vs 20.3± 2.53, P＜ 0.01). Conclusion: Acupuncture combining with Tuina had better effects than acupoint with Tuina, and could effectively relieve pain, and enhance quality of life and ability of social adjustment in patients with cervicogenic headache.