Biomechanics of the lower limb in patients with mild knee osteoarthritis during the sit-to-stand task.

BACKGROUND: Knee osteoarthritis (KOA) is a prevalent and debilitating condition that markedly affects the sit-to-stand (STS) activity of patients, a prerequisite for daily activities. Biomechanical recognition of movements in patients with mild KOA is currently attracting attention. However, limited studies have been conducted solely on the observed differences in sagittal plane movement and muscle activation. AIM: This study aimed to identify three-dimensional biomechanical and muscle activation characteristics of the STS activity in patients with mild KOA. METHODS: A cross-sectional study was conducted to observe the differences between patients with mild KOA and a control group (CG). It was conducted to observe the differences in muscle activation, including root mean square (RMS%) and integrated electromyography (items), kinematic parameters like range of motion (ROM) and maximum angular velocity, as well as dynamic parameters such as joint moment and vertical ground reaction force (vGRF). RESULTS: Patients with mild KOA had a higher body mass index and longer task duration. In the sagittal plane, patients with KOA showed an increased ROM of the pelvic region, reduced ROM of the hip-knee-ankle joint, and diminished maximum angular velocity of the knee-ankle joint. Furthermore, patients with KOA displayed increased knee-ankle joint ROM in the coronal plane and decreased ankle joint ROM in the horizontal plane. Integrated vGRF was higher in both lower limbs, whereas the vGRF of the affected side was lower. Furthermore, patients showed a decreased peak adduction moment (PADM) and increased peak external rotation moment in the knee joint and smaller PADM and peak internal rotation moment in the ankle joint. The affected side exhibited decreased RMS% and iEMG values of the gluteus medius, vastus medialis, and vastus lateralis muscles, as well as a decreased RMS% of the rectus femoris muscle. Conversely, RMS% and iEMG values of the biceps femoris, lateral gastrocnemius, and medial gastrocnemius muscles were higher. CONCLUSION: The unbalanced activation characteristics of the anterior and posterior muscle groups, combined with changes in joint moment in the three-dimensional plane of the affected joint, may pose a potential risk of injury to the irritated articular cartilage.

Non-invasive brain stimulation effectively improves post-stroke sensory impairment: a systematic review and meta-analysis.

More than half of stroke patients experience sensory dysfunction that affects their quality of life. Previous training modalities are ineffective in improving sensory function. In contrast, non-invasive brain stimulation (NIBS) is a new promising intervention for stroke rehabilitation. The aim of this meta-analysis was to summarize the current effectiveness of NIBS in the treatment of post-stroke sensory dysfunction. Articles published in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese scientific journals full-text database (VIP), and Wanfang database from the inception to March 8, 2023 were searched. There were no restrictions on language. A total of 14 RCTs were included (combined n = 804). Moderate-quality evidence suggested that NIBS significantly improved sensory function after stroke, and significant effects were observed up to 1 year after the intervention. In subgroup analysis, treatment with transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) was significantly more effective than controls for recovery of sensory function in stroke patients. Stimulation of the primary motor cortex (M1), primary somatosensory cortex (S1) or M1 + S1 stimulation sites significantly improved sensory function. NIBS for sensory dysfunction showed significant therapeutic potential in patients with different stages of stroke. No significant effects were observed in subjects with less than 10 NIBS stimulations. Significant therapeutic effects were observed with either high-frequency or low-frequency rTMS.

Silver doped-silica nanoparticles reinforced poly (ethylene glycol) diacrylate/hyaluronic acid hydrogel dressings for synergistically accelerating bacterial-infected wound healing.

Various cutaneous wounds are easily infected with external bacteria, which might result in a chronic wound and ongoing consequences. However, the appropriate development of biomaterials for the controllable delivery of antibacterial silver (Ag) and the simultaneous enhancement of mechanical adhesiveness remains an urgent challenge. Herein, we proposed a double network (DN) hydrogel dressings based on a covalent network of polyethylene glycol diacrylate (PEGDA) and a coordination network between catechol-modified hyaluronic acid (C-HA) and Ag-doped mesoporous silica nanoparticle (AMSN) for promoting the bacterial-infected full-thickness skin wound regeneration. This distinctive dual cross-linked structure of PEGDA/C-HA-AMSN significantly improved physicochemical properties, including gelation time, mechanical performance, and tissue adhesion strength. Importantly, PEGDA/C-HA-AMSN served as a hydrogel dressing that can respond to the acidic environment of bacterial-infected wounds leading to the controllable and optimized delivery of Ag, enabling the durable antibacterial activity accompanied by favorable cytocompatibility and angiogenesis capability. Further in vivo studies validated the higher efficacy of hydrogel dressings in treating wound healing by the synergistic antibacterial, anti-inflammatory, and pro-vascular strategies, meaning the prominent potential of the prepared dressings for overcoming the concerns of wound theranostics.

Biomechanical analysis of lower limbs during stand-to-sit tasks in patients with early-stage knee osteoarthritis.

Background: Knee osteoarthritis (KOA) is a common degenerative disease among the older people that severely affects their daily life. Previous studies have confirmed that movement biomechanics are altered in patients with KOA during task performance. However, changes that occur in lower limb joints and muscles in the three planes during stand-to-sit (STS) tasks in patients with early-stage KOA are unclear. Method: Of the 36 participants recruited in this study, 24 (8 males and 16 females) and 12 (4 males and 8 females) were added to the KOA and control groups, respectively. The Nexus Vicon motion capture system along with Delsys wireless surface electromyography devices and plantar pressure measurement mat was used to record test data. A Visual 3D software was used to process the data and calculate the biomechanical and electromyographic parameters during STS tasks. Results: There was no significant difference in task duration between the two groups. Patients with KOA could perform a greater range of pelvic motion and smaller range of hip and knee joint motion with a lower maximum hip joint angular acceleration in the sagittal plane and greater knee and ankle joint motion in the coronal plane. There was no significant difference in the motion range in the horizontal plane. During the STS task, patients in the KOA group had a lower vertical ground reaction force (GRF) amplitude on the injured side but a higher integrated GRF on both sides than those in the control group. Moreover, patients with KOA demonstrated higher PERM and PABM of the lower limb joints and smaller knee PADM and ankle PEM. Additionally, maximum activation levels of GMed muscle, affected-side gluteus medius (GM), ST, rectus femoris (RF), and tibialis anterior (TA) muscles were lower in patients with KOA than in controls. Conversely, the activation level of biceps femoris (BF) was higher. Furthermore, the integral EMG values of GMed, GM, ST, VL, RF, vastus medialis VM, and TA muscles on the affected side were lower, except for the BF muscle, in patients with KOA. Conclusion: Compared with the participants in the control group, patients with early-stage KOA exhibited consistent changes in sEMG parameters and biomechanical alterations in the sagittal plane, as observed in previous studies. However, differences in parameters were observed in the coronal and transverse planes of these patients. The noninvasive analysis of the 3D parameters of the involved motion patterns may lead to the early detection of KOA.

Correlational analysis of three-dimensional spinopelvic parameters with standing balance and gait characteristics in adolescent idiopathic scoliosis: A preliminary research on Lenke V.

Background: Adolescent idiopathic scoliosis (AIS), the most common spinal deformity, possibly develops due to imbalanced spinal loading following asymmetric development. Since altered loading patterns may affect standing balance and gait, we investigated whether a correlation exists between balance ability, gait pattern, and the three-dimensional radiographic spinopelvic parameters in AIS patients. Methods: A cross-sectional observational study was conducted with 34 AIS patients (aged 10-18 years) and an equal number of healthy age and sex-matched teenagers (normal group). We obtained the spinopelvic three-dimensional parameters and balance parameters simultaneously through the EOS imaging system and gait and center of pressure (CoP) characteristics using a plantar pressure measurement mat. Besides determining the intergroup differences in balance and gait parameters, multiple linear regression analyses were performed to identify any correlation between the static plantar pressure and radiographic parameters. Results: Compared to the normal group, the CoPx is lower, the CoP path length and 90% confidence ellipse area were significantly higher in AIS patients (AIS: -13.7 ± 5.7 mm, 147.4 ± 58.1 mm, 150.5 ± 62.8 mm2; normal: -7.0 ± 5.4 mm, 78.8 ± 32.0 mm, 92.1 ± 41.7 mm2, respectively), correlated with apical vertebra translation, sagittal pelvic tilt, and pelvis axial rotation, respectively. Moreover, AIS patients had a shorter stance phase (61.35 ± 0.97 s vs. 62.39 ± 1.09 s), a longer swing phase (38.66 ± 0.97 s vs. 37.62 ± 1.08 s), and smaller maximum pressure peaks in the gait cycle, especially on the left foot, as compared to healthy subjects. Moreover, the CoP trajectory in AIS patients was different from the latter, and changes in the bipedal trend were not consistent. Conclusion: The standing balance and gait characteristics of AIS patients are different from those of healthy subjects, as reflected in their three-dimensional spinopelvic radiographic parameters. Trial registration: The study protocol was registered with the Chinese Clinical Trial Registry (Number ChCTR1800018310) and the Human Subject Committee of Guangzhou Sport University (Number: 2018LCLL003).

Bioinformatics study of the potential therapeutic effects of ginsenoside Rf in reversing nonalcoholic fatty liver disease.

OBJECTIVE: Ginsenoside Rf, a tetracyclic triterpenoid only present in Panax ginseng, has been proven to relieve lipid metabolism and inflammatory reactions, which can be a potential treatment for nonalcoholic fatty liver disease (NAFLD). Therefore, this study aimed to reveal the underlying mechanisms of ginsenoside Rf in the treatment of early-stage NAFLD (NAFL) by using a bioinformatics method and biological experiments. METHODS: Target genes associated with NAFL were screened from the Gene Expression Omnibus (GEO) database, a database repository of high-throughput gene expression data and hybridization arrays, chips, and microarrays. Subsequently, gene set enrichment analysis was performed by using Gene Ontology enrichment analysis tool. Then, the binding capacity between ginsenoside Rf and NAFL-related targets was evaluated by molecular docking. Finally, the FFA-induced HepG2 cell model treated with ginsenoside Rf was adopted to verify the effect of ginsenoside Rf and the related mechanisms. RESULTS: There were 41 common differentially expressed genes in the GEO dataset. Gene Ontology and Reactome pathway enrichment analysis of the differentially expressed genes showed that many pathways could be related to the pathogenesis of NAFL, including those participating in the cytokine-mediated signaling pathway, G protein-coupled receptor signaling pathway, and response to lipopolysaccharide. Finally, the qRT-PCR analysis results indicated that ginsenoside Rf therapy could ameliorate the transcription of ANXA2, BAZ1A, DNMT3L and MMP9. CONCLUSION: Our research discovered the relevant mechanisms and basic pharmacological effects of ginsenoside Rf in the treatment of NAFL. These results might facilitate the development of ginsenoside Rf as an alternative medication for NAFL.

Influence of metatarsophalangeal joint stiffness on take-off performances and lower-limb biomechanics in jump manoeuvres.

Forefoot and toes are prominent regions for locomotion and individual metatarsophalangeal joint (MTPJ) stiffness may be linked to jump take-off mechanics and performances. However, little is known about the relationships between MTPJ stiffness and take-off related variables. This study examined the relationship between individual MTPJ stiffness and biomechanical variables under various vertical countermovement jumps (CMJ) conditions. We measured MTPJ stiffness on 21 male university basketball players and then asked them to perform jumps under single, consecutive and running CMJ conditions. Pearson's correlation coefficient was employed to examine the relationships between MTP passive stiffness and each jumping performance, ground reaction force (GRF) and joint kinematic and kinetic variables. The results indicated that MTPJ stiffness significantly correlated with maximum jump height (r = 0.49, moderate), peak take-off velocity (r = 0.47, moderate), peak take-off ankle plantarflexion moment (r = 0.68, strong), peak dorsiflexion moment (r = 0.60, strong) and peak take-off ankle power (r = 0.44, moderate) in consecutive CMJ. Only a moderate correlation between MTPJ stiffness and peak MTPJ extension take-off velocity (r = -0.46, moderate) was determined in a single CMJ. There were no significant correlations found in running CMJ conditions. These findings imply that higher MTPJ stiffness of participants was related to improved jump performances in consecutive jumps.

Effects of shoe collar height and arch-support orthosis on joint stability and loading during landing.

This study examined the effects of shoe collar height and foot orthosis on ground reaction force (GRF), ankle and knee mechanics during landing. Sixteen male university basketball players performed drop landing when wearing different shoes with collar height (high vs. low) and foot orthoses (arch-support vs. flat). Biomechanical variables included vertical peak GRF and joint angles and moments in sagittal and coronal planes were analysed with two-way ANOVA with repeated measures (α = 0.05). Results indicated that high-collar shoes had significantly smaller peak ankle dorsiflexion (P < 0.001), smaller ankle sagittal total RoM (P < 0.001), higher forefoot peak GRF (P = 0.009) and peak knee valgus moment (P < 0.001) compared with low-collar shoes. Wearing arch-support orthoses induced higher forefoot peak GRF (P < 0.001) but smaller ankle inversion moment (P = 0.001) compared to flat-orthoses. Furthermore, significant interactions between collar-height and orthosis were found only for initial ankle plantarflexion (P = 0.023) and knee flexion (P = 0.035), but not in any kinetics variables. The findings suggest increased collar height and arch-support orthoses appear to reduce the risks of ankle sprains during landing, but might increase loading at adjacent joints.

Biomimetic Hydrogels Loaded with Nanofibers Mediate Sustained Release of pDNA and Promote In Situ Bone Regeneration.

Polymer hydrogels are generally insufficient biomechanics, strong resistance to cell adhesion, and weak bioactivity which limits their application in bone tissue engineering considerably. In order to develop a bone tissue engineering material with both good mechanical properties, osteogenic and angiogenic activity. Nanofibers carrying DNA plasmid (pNF) are introduced to gelatin methacryloyl (GelMA) and thiolated chitosan (TCS) system for preparing a novel GelMA/TCS/pNF composite hydrogel with dual network structure. By characterization of the compressive measurements, the resulting composite scaffold shows greatly enhanced mechanical strength (0.53 MPa) and is not damaged after 20 cycles of compression. And the fabricated composite scaffold displays sustained release of bone morphogenetic protein-2 that can induce osteogenic differentiation and angiopoietin-1 that promotes vascularization. The cell experiment shows that this system can significantly promote MC3T3-E1 cell attachment, proliferation, as well as osteogenic-related and angiogenic-related genes expression of MC3T3-E1 cells. Moreover, the in vivo results show that the composite scaffold with activated gene fibers can significantly promote osteogenesis and vascularization leading to favorable capacity of bone regeneration, meaning that the resulting biomimetic composite hydrogel scaffolds are excellent candidates for bone repair materials.

PLLA/POSS Nanofibers Loaded with Multitargeted pANG Composite Nanoparticles for Promotion of Vascularization in Shear Flow.

In vitro prevascularization is particularly important for the clinical application of tissue engineering scaffolds that require vascularization. The principal challenge is simulating the dynamic in vivo environment to promote the continuous growth of blood vessels. In this study, two targeting polypeptides are linked to the two ends of an amphiphilic block copolymer, polyethyleneimine-b-poly(lactide-co-3(S)-methyl-morpholine-2,5-dione)-b-polyethyleneimine (PEI-PLMD-PEI), and self-assembled to form positively charged nanoparticles (NPs), which can bind to negatively charged pANG through electrostatic interactions; the polypeptides are finally loaded into PLLA/polyhedral oligomeric silsesquioxane (POSS) porous fibers to prepare untargeted nanofibers (unTFs), targeted porous nanofibers (TFBs), and targeted nanofiber bundles. The effects of the porous nanofibers on human umbilical vein endothelial cell (HUVEC) transfection, spreading, proliferation, morphology, and expression of related factors are investigated under the action of shear flow force. The results show that the PLLA/POSS nanofibers can maintain stable release of multitargeted NPs for nearly 45 days. Both the dual-targeted porous NPs and shear flow improve the pANG transfection efficiency and promote cell proliferation, and they have a good synergistic effect. These results provide a potential strategy for designing HUVEC-specific gene carriers and using shear flow to enhance endothelialization.

Systematic review and meta-analysis: Tai Chi for preventing falls in older adults.

OBJECTIVE: It remains unclear whether Tai Chi is effective for preventing falls in older adults. We undertook this systematic review to evaluate the preventive effect of Tai Chi by updating the latest trial evidence. DESIGN: Systematic review and meta-analysis. METHODS: The Cochrane Library, MEDLINE and EMBASE were searched up to February 2016 to identify randomised trials evaluating Tai Chi for preventing falls in older adults. We evaluated the risk of bias of included trials using the Cochrane Collaboration's tool. Results were combined using random effects meta-analysis. OUTCOME MEASURES: Number of fallers and rate of falls. RESULTS: 18 trials with 3824 participants were included. The Tai Chi group was associated with significantly lower chance of falling at least once (risk ratio (RR) 0.80, 95% CI 0.72 to 0.88) and rate of falls (incidence rate ratio (IRR) 0.69, 95% CI 0.60 to 0.80) than the control group. Subgroup analyses suggested that the preventive effect was likely to increase with exercise frequency (number of fallers: p=0.001; rate of falls: p=0.007) and Yang style Tai Chi was likely to be more effective than Sun style Tai Chi (number of fallers: p=0.01; rate of falls: p=0.001). The results might be influenced by publication bias as the funnel plots showed asymmetry. Sensitivity analyses by sample size, risk of bias and comorbidity showed no major influence on the primary results. CONCLUSIONS: Tai Chi is effective for preventing falls in older adults. The preventive effect is likely to increase with exercise frequency and Yang style Tai Chi seems to be more effective than Sun style Tai Chi.

Research protocol: effect of natural S-equol on blood pressure and vascular function--a six-month randomized controlled trial among equol non-producers of postmenopausal women with prehypertension or untreated stage 1 hypertension.

BACKGROUND: Although higher habitual soy intake is associated with lower blood pressure (BP) and stroke incidence, clinical trials using soy protein or isoflavones on cardiovascular risks yielded inconsistent results. The discrepancies are hypothesized to be due to the individuals' intestinal bacterial capacity to metabolite isoflavones daidzein into equol. Animal and in vitro studies have revealed that equol has stronger estrogen-like and anti-oxidative activity than isoflavones and possesses natriuretic and vasorelaxant properties which may play an important role in the prevention of hypertension. However, no clinical trial has examined the effect of equol on BP. We thus propose a 24-week randomized controlled trial to test the effectiveness of natural S-equol on BP and vascular function among equol non-producers. METHODS/DESIGN: This will be a 6-month double-blind, randomized, placebo-controlled trial among 207 non-equol producing postmenopausal women with prehypertension or early untreated hypertension. Eligible participants who have completed a 2-week run-in will be randomized to either one of the 3 groups: placebo group, low-equol group (10 mg/d) and high equol group (20 mg/d). The outcome measures will be conducted at baseline and at the end of the trial including 24 h ambulatory BP, endothelial function (by ultrasound determined brachial flow mediated dilation), arterial stiffness (by pulse wave analysis) and other cardiovascular risk factors (lipid profile, glycemic control and inflammatory biomarkers). Urinary isoflavones will be tested for compliance assessment. One way analysis of variance will be applied to compare the 6-month changes in ambulatory BP or parameters of vascular function among the 3 treatment groups. DISCUSSION: This study will be performed in community subjects. If the antihypertensive effect of equol is proven, the provision of natural equol to those high risk adults who are unable to produce equol will have enormous public health implications for the primary and secondary prevention of hypertension and cardiovascular diseases on a population basis. The research efforts will also have significant implications for industry in the provision of suitable soy products for the prevention of hypertension and its related complications. TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov with identifier of NCT02515682 .

[Chinese medicine formula 1 regulating immunity and anti-oxidation experiments in mice].

OBJECTIVE: To observe the effect of immunoregulation and anti-oxidation of Zhongyaofangji NO1 (ZYFJ). METHODS: 1. SPF BALB/C mice were randomly divided into control group (distilled water), positive control group (Broken Spore), ZYFJ low dose group (0.35 g/kg), middle dose group (0.70 g/kg) and high dose group (1.40 g/kg), with intragastric administration 1 time/d for 30d; The spleen and thymus index, ability of spleen lymphocyte proliferation, phagocytosing chicken red blood cell (CRBC) of abdominal macrophage cell, carbon clearance were investigated. 2. SPF BALB/C mice were divided into normal control group, model control group (D-galactose induced peroxidation damage), model plus ZYFJ low dose, middle dose and high dose group, model plus positive control group (Broken Spore), with drug administration 1 time/d for 30 d. SOD activity, MDA and LPO content in brain tissue were tested while Nrf2 [Nuclear factor (erythroi D-derived 2)-like 2] protein expression in brain tissue nucleus was tested by western blotting. RESULTS: The thymus index and spleen index in groups of ZYFJ high dose and positive control were higher than those in control group, the ability of lymphocyte proliferation and phagocytosis of macrophages were increased in all the other groups significantly compared with control group; The activity of SOD and Nrf2 protein expression level in brain tissue of model mice was increased, MDA and LPO contents were reduced in ZYFJ middle and high dose as well as positive control significantly, while the MDA content was reduced and Nrf2 protein was increased in low dose group. CONCLUSION: Appropriate dose of ZYFJ1 has good effect of immunoregulation, and plays a role of anti-oxidation probably by regulating Nrf2 protein expression in brain tissue and related signaling pathway.

[Study on antidepressant effect of kuanxinjieyutang combined aerobic exercise].

OBJECTIVE: To observe antidepressant effects of Kuanxinjieyutang (KXJYT), short-term aerobic exercise and their joint intervention and its possible mechanism. METHODS: Ninty-six SPF male KM mice were randomly divided into control group, imipramine, low dose (KXJYT 1.8 g crude drugs/kg bw/time/day), high dose (3.6 g crude drugs/kg bw/time/day), exercise group (swimming 30 min/times/day), joint group (low dose and swimming ), with 8 days intervention. The antidepressant effect was evaluated by forced swimming, tail suspension test and overhead cross maze test. After mice were killed, brain monoamine neurotransmitter levels of mice were detected by ELISA, and BDNF expression in brain was analyzed by Western blotting. RESULTS: High dose group showed antidepressant effect like imipramine while low dose didn't. Exercise group showed similar or better antidepressant effect than imipramine. Joint group showed better interaction antidepressant effect. Brain NE, DA of high dose group and brain NE, DA and 5-HT content of exercise group increased significantly, similar to imipramine. Brain NE,DA and 5-HT content of Joint group were significantly higher than those of imipramine. The protein expression of BDNF in brain was more in imipramine, high dose,exercise and joint groups than that of control group, sports group was higher than that of low dose and high dose group, joint group was obviously higher than other groups. CONCLUSION: Moderate KXJYT, short-term aerobic exercise and their joint intervention have obvious antidepressant effect on mild depression. Its mechanism may be related to increasing brain NE and 5-HT content, and inducing brain BDNF expression, which may affect the nerve regeneration and plasticity, improve cognitive function.