Feasibility of Using a Portable MyotonPRO Device to Quantify the Elastic Properties of Skeletal Muscle.

BACKGROUND The aims of this study were to (1) calculate the correlation between different tensile force levels and corresponding muscle stiffness both in vitro and in vivo; (2) determine whether muscle stiffness assessed using a MyotonPRO myotonometer can be used to accurately estimate muscle activity level; and (3) evaluate the inter-operator reliability of MyotonPRO-based measurement in assessing biceps brachii muscle (BBM) stiffness. MATERIAL AND METHODS In Experiment I, muscle stiffness, as measured using the MyotonPRO, was obtained at 0 N, 2 N, 4 N, 6 N, 8 N, and 10 N of applied force on 6 fresh medial gastrocnemius muscle specimens. In Experiment II, 11 healthy subjects were recruited. BBM stiffness, assessed by the same device, was obtained at different tensile force levels, from 0 to 50% of maximal voluntary contraction (MVC). For the reliability test, the score for each subject was quantified by 2 operators (I and II), thrice, at 30-minute intervals on the same day. RESULTS A strong correlation was found between the different tensile force levels, which corresponded to muscle stiffness in vitro (r=0.71-0.95, all P<0.05). In vivo, muscle stiffness increased linearly with an increase of the tensile force levels from 0 to 50% of MVC (r=0.99, P=0.00) and there was a significant difference in BBM stiffness among the incremental isometric tasks (F [1.76, 17.60]=91.52, P=0.00). The inter-operator reliability for the measurement of BBM stiffness was good (ICC=0.86). CONCLUSIONS Our findings indicate that muscle stiffness measured using the MyotonPRO is strongly related to muscle activity level and that the MyotonPRO is a feasible tool for quantifying BBM stiffness as well as for quantifying changes in MVC levels.

Exercise for Neuropathic Pain: A Systematic Review and Expert Consensus.

Background: Neuropathic pain (NP), a severe and disruptive symptom following many diseases, normally restricts patients' physical functions and leads to anxiety and depression. As an economical and effective therapy, exercise may be helpful in NP management. However, few guidelines and reviews focused on exercise therapy for NP associated with specific diseases. The study aimed to summarize the effectiveness and efficacy of exercise for various diseases with NP supported by evidence, describe expert recommendations for NP from different causes, and inform policymakers of the guidelines. Design: A systematic review and expert consensus. Methods: A systematic search was conducted in PubMed. We included systematic review and meta-analysis, randomized controlled trials (RCTs), which assessed patients with NP. Studies involved exercise intervention and outcome included pain intensity at least. Physiotherapy Evidence Database and the Assessment of Multiple Systematic reviews tool were used to grade the quality assessment of the included RCTs and systematic reviews, respectively. The final grades of recommendation were based on strength of evidence and a consensus discussion of results of Delphi rounds by the Delphi consensus panel including 21 experts from the Chinese Association of Rehabilitation Medicine. Results: Eight systematic reviews and 21 RCTs fulfilled all of the inclusion criteria and were included, which were used to create the 10 evidence-based consensus statements. The 10 expert recommendations regarding exercise for NP symptoms were relevant to the following 10 different diseases: spinal cord injury, stroke, multiple sclerosis, Parkinson's disease, cervical radiculopathy, sciatica, diabetic neuropathy, chemotherapy-induced peripheral neuropathy, HIV/AIDS, and surgery, respectively. The exercise recommended in the expert consensus involved but was not limited to muscle stretching, strengthening/resistance exercise, aerobic exercise, motor control/stabilization training and mind-body exercise (Tai Chi and yoga). Conclusions: Based on the available evidence, exercise is helpful to alleviate NP intensity. Therefore, these expert consensuses recommend that proper exercise programs can be considered as an effective alternative treatment or complementary therapy for most patients with NP. The expert consensus provided medical staff and policymakers with applicable recommendations for the formulation of exercise prescription for NP. This consensus statement will require regular updates after five-ten years.

Objective Assessment of Regional Stiffness in Achilles Tendon in Different Ankle Joint Positions Using the MyotonPRO.

BACKGROUND Achilles tendinopathy commonly occurs in specific regions of the tendon, and Achilles tendon stiffness can be related to local pathological changes in the tendon. The MyotonPRO is a new handheld device that conveniently assesses stiffness of muscles and tendons. This study aimed to 1) evaluate the intra- and inter-rater reliability of stiffness measurements of the Achilles tendon at different ankle positions, 2) investigate the modulation of stiffness at different ankle joint angles, and 3) examine the differences between 2 regions of Achilles tendon stiffness. MATERIAL AND METHODS Thirty healthy young adults (15 men and 15 women) participated in this study. The regional Achilles tendon stiffness at 0 cm (AT-0) and 6 cm (AT-6) above the tendon insertion were evaluated by the MyotonPRO in the neutral position and 10° dorsiflexion of the ankle joint. Measurements of stiffness were taken by 2 raters on the first day and 5 days later. The stiffness data were compared by repeated measures analysis of variance (ANOVA). RESULTS The intra- and inter-rater reliability of stiffness measurements at AT-0 and AT-6 for each ankle position were good (all intraclass correlation coefficients >0.84). A significant modulation of Achilles tendon stiffness was obtained at different ankle joint angles (P<0.05). Stiffness at AT-0 was higher than at AT-6 (P<0.05) in both positions. CONCLUSIONS These results suggest the MyotonPRO reliably assessed Achilles tendon stiffness and monitors its modulation, and tendon stiffness increased with ankle dorsiflexion. Stiffness was also nonuniform along the length of the tendon.

Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia.

Stiffness is a valuable indicator of the functional capabilities of muscle-tendon-fascia. Twenty healthy subjects participated in this study in which the passive elastic properties of the medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus muscles (SOL), Achilles tendon (AT, at 0 cm, 3 cm and 6 cm proximal to the calcaneus tubercle, corresponding to AT0cm, AT3cm and AT6cm, respectively) and plantar fascia (PF) were quantified when their knee was fully extended or flexed to 90° using shear wave elastography at 25° of dorsiflexion (DF25°), 0° (neutral position) of flexion, and 50° of plantar flexion (PF50°) of the ankle joint. The stiffnesses of the AT, MG, LG, SOL and the fascia with the knee fully extended were significantly higher than those with the knee flexed to 90° (p < 0.05), while the stiffness of the PF showed the opposite relationship (p < 0.05). When the knee was fully extended, the stiffness was higher in the LG than in the MG at PF50° and 0° (p < 0.01), and it was higher in the MG than in the LG at DF25° (p = 0.009). Nevertheless, regardless of the knee angle, the stiffness decreased from AT3cm > AT0cm > AT6cm at PF50° and 0° (p < 0.001), while the stiffness decreased from AT0cm > AT3cm > AT6cm at DF25°. Regardless of the knee and ankle angles, the stiffness of the PF increased in a proximal-to-distal direction (p < 0.001). These insights can be used to gain a more intuitive understanding of the relationships between the elastic properties of the muscle-tendon unit and its function.

Paraffin therapy induces a decrease in the passive stiffness of gastrocnemius muscle belly and Achilles tendon: A randomized controlled trial.

BACKGROUND: The purposes of this study were to examine the feasibility of using the MyotonPRO digital palpation device in measuring the passive stiffness of gastrocnemius muscle belly and Achilles tendon; to determine between-days test-retest reliability of MyotonPRO; and to evaluate the acute effect of paraffin therapy on stiffness measurements in healthy participants. METHODS: It is a randomized controlled trial. Twenty healthy participants (male, n = 10; female, n = 10; total, n = 20) were recruited to evaluate the passive stiffness of gastrocnemius muscle belly and Achilles tendon. Dominant and nondominant legs were randomly divided into an experimental side (20 cases) and a control side (20 cases). The experimental side received 20 minutes of paraffin therapy. RESULTS: The stiffness of muscle and tendon in the experimental side decreased significantly after paraffin therapy (P < .01), whereas no significant differences in stiffness measurements were found in the control side (P > .05). The passive stiffness of muscle and tendon was positively correlated with the ankle from 30° plantar flexion to10° dorsiflexion for dominant legs. Between-days test-retest reliability in stiffness measurements was high or very high (ICCs were above 0.737). CONCLUSION: Paraffin therapy induces a decrease in the passive stiffness of gastrocnemius muscle belly and Achilles tendon. Furthermore, the MyotonPRO can reliably determine stiffness measurements.

Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain.

The objectives of this study were (1) to investigate the passive stiffness of the medial gastrocnemius (MG) and lateral gastrocnemius (LG) in patients with and without plantar fasciitis (PF), (2) to explore the correlation between gastrocnemius stiffness and plantar fascia thickness (PFT) as well as the intensity of pain in patients with PF, (3) to detect optimal cut-off points for stiffness of the MG and LG for identifying patients with PF. Forty patients (mean age = 51.1 years ± 12.9) participated in this study. The elastic properties of the MG and LG were quantified using shear wave elastography ultrasound. The thickness of the plantar fascia was measured by B-mode imaging. The intensity of pain was assessed using a visual analogue scale. The results showed that when the ankle was in the relaxed position, patients with PF had increased passive stiffness in the MG (P < 0.05) but not in the LG. Significant correlations were found between pain and the stiffness of the MG (middle, distal; all P-values < 0.05) and no correlation was observed between pain and PFT (P = 0.416). The initial cut-off point for the stiffness of the MG was 29.08 kPa when the ankle was in the relaxed position. The findings from the present study show that an increase in muscle stiffness is not the same in the individual muscles of the gastrocnemius muscle. Traditional treatment of the whole gastrocnemius muscle might not be targeted at the tight muscle.

[Invertebrate assemblage structure associated with key environmental factors in the Yangtze River Estuary, China.] / é•¿æ±Ÿå£æ— è„Šæ¤ŽåŠ¨ç‰©ç¾¤èšç‰¹å¾åŠå ¶ä¸ŽçŽ¯å¢ƒå› å­çš„å ³ç³».

Yangtze River Estuary plays a key role in linking the river and ocean ecosystems. Our understanding on its biodiversity and associated ecological processes remains poor, which is especially true for the invertebrate assemblage. Here, we investigated invertebrate assemblage pattern and associated environmental drivers based on four different seasonal comprehensive investigations across this region in 2014. A total of 35 species, belonging to 20 families, 10 orders and three phylums were identified. Crustaceans (19 species) and mollusks (13 species) were the taxa with higher richness. Dominant invertebrate included Palaemon gravieri, Crangon affinis, Ovalipes punctatus, Acetes chinensis, Portunus trituberculatus and Charybdis bimaculata. Total density and biomass was 4518.96 kN·km-2 and 173.09 kg·km-2 respectively, with the highest value in spring and the lowest in autumn. Biodiversity indices peaked in winter and spring and reached the lowest in summer. Invertebrate assemblage structure showed significant seasonal variation, appearing in a significant difference between the near-shore and the off-shore in spring, and between the northern-waters and southern-waters in other seasons. Results from ordination analysis showed that the spatial variation of invertebrate was mainly regulated by temperature and dissolved oxygen, whereas Chla and nutrient factors played key roles in driving the temporal community assemblage in this region.

Quantifying the Stiffness of Achilles Tendon: Intra- and Inter-Operator Reliability and the Effect of Ankle Joint Motion.

BACKGROUND The objectives of the present study were to examine the intra- and inter-operator reliability of the MyotonPRO device in quantifying the stiffness of the Achilles tendon and the device's ability to examine the modulation in stiffness of the Achilles tendon during ankle joint flexion. MATERIAL AND METHODS Twenty asymptomatic participants (10 males and 10 females; mean age: 25.0±3.1 years) were recruited for this study. The stiffness of the Achilles tendon was quantified using the MyotonPRO device. RESULTS The results revealed excellent intra- and inter-operator reliability for quantifying Achilles tendon stiffness with the ankle joint in a neutral position and detected a 13.9% increase in stiffness of the Achilles tendon between 0° and 30° of ankle joint flexion. The minimal detectable change (MDC) in tendon stiffness was 45 Newton/meter (N/m). CONCLUSIONS Our findings indicated that the MyotonPRO device is a feasible method to quantify the stiffness of the Achilles tendon and monitor its changes. Thus, it is an essential tool to use to examine the modulation in the stiffness of the Achilles tendon due to pathology or interventions for future studies.

A preventive injection of endothelial progenitor cells prolongs lifespan in stroke-prone spontaneously hypertensive rats.

There is a pressing need for new approaches to prevent stroke. Endothelial progenitor cells (EPCs) promote vascular repair and revascularization in the ischemic brain. The present study sought to evaluate whether preventive delivery of EPCs could prevent or protect against stroke. Stroke-prone spontaneously hypertensive rats (SHR-SP) received a single injection of EPCs, and their survival time was monitored. In addition, at 28 and/or 42 days after a single injection of EPCs, SHR-SP and mice were subjected to cerebral ischemia, and cerebral ischemic injury, local angiogenesis and in vivo EPC integration were determined. Other experiments examined the effects of EPC conditioned medium, and the distribution of donor EPCs taken from GFP transgenic mice. It was found that EPC-pretreated SHR-SP showed longer lifespans than untreated controls. A single preventive injection of EPCs could produce persistent protective effects against cerebral ischemic injury (lasting at least 42 days), and promote local angiogenesis in the ischemic brain, in two types of animals (SHR-SP and normotensive mice). EPCs of donor origin could be detected in the recipient peripheral blood, and integrated into the recipient ischemic brains. Furthermore, it was suggested that mouse EPCs might exert paracrine effects on cerebral ischemic injury in addition to their direct angiogenic effects. In conclusion, a single preventive injection of EPCs prolonged the lifespan of SHR-SP, and protected against cerebral ischemic injury for at least 7 weeks. It is implied that EPC injection might be a promising candidate for a preventive role in patients at high risk for stroke.

Preventive Cold Acclimation Augments the Reparative Function of Endothelial Progenitor Cells in Mice.

BACKGROUND/AIMS: Chronic cold exposure may increase energy expenditure and contribute to counteracting obesity, an important risk factor for cerebrocardiovascular diseases. This study sought to evaluate whether preventive cold acclimation before ischemia onset might be a promising option for preventing cerebral ischemic injury. METHODS: After a 14-day cold acclimation period, young and aged mice were subjected to permanent cerebral ischemia, and histological analyses and behavioral tests were performed. Mouse endothelial progenitor cells (EPCs) were isolated, their function and number were determined, and the effects of EPC transplantation on cerebral ischemic injury were investigated. RESULTS: Preventive cold acclimation before ischemia onset increased EPC function, promoted ischemic brain angiogenesis, protected against cerebral ischemic injury, and improved long-term stroke outcomes in young mice. In addition, transplanted EPCs from cold-exposed mice had a greater ability to reduce cerebral ischemic injury and promote local angiogenesis compared to those from control mice, and EPCs from donor animals could integrate into the recipient ischemic murine brain. Furthermore, transplanted EPCs might exert paracrine effects on cerebral ischemic injury, which could be improved by preventive cold acclimation. Moreover, preventive cold acclimation could also enhance EPC function, promote local angiogenesis, and protect against cerebral ischemic injury in aged mice. CONCLUSIONS: Preventive cold acclimation before ischemia onset improved long-term stroke outcomes in mice at least in part via promoting the reparative function of EPC. Our findings imply that a variable indoor environment with frequent cold exposure might benefit individuals at high risk for stroke.

Prolonged Fasting Improves Endothelial Progenitor Cell-Mediated Ischemic Angiogenesis in Mice.

BACKGROUND/AIMS: Prolonged fasting (PF) was shown to be of great potency to promote optimal health and reduce the risk of many chronic diseases. This study sought to determine the effect of PF on the endothelial progenitor cell (EPC)-mediated angiogenesis in the ischemic brain and cerebral ischemic injury in mice. METHODS: Mice were subjected to PF or periodic PF after cerebral ischemia, and histological analysis and behavioral tests were performed. Mouse EPCs were isolated and examined, and the effects of EPC transplantation on cerebral ischemic injury were investigated in mice. RESULTS: It was found that PF significantly increased the EPC functions and angiogenesis in the ischemic brain, and attenuated the cerebral ischemic injury in mice that was previously subjected to cerebral ischemia. Periodic PF might reduce cortical atrophy and improve long-term neurobehavioral outcomes after cerebral ischemia in mice. The eNOS and MnSOD expression and intracellular NO level were increased, and TSP-2 expression and intracellular O2- level were reduced in EPCs from PF-treated mice compared to control. In addition, transplanted EPCs might home into ischemic brain, and the EPCs from PF-treated mice had a stronger ability to promote angiogenesis in ischemic brain and reduce cerebral ischemic injury compared to the EPCs from control mice. The EPC-conditioned media from PF-treated mice exerted a stronger effect on cerebral ischemic injury reduction compared to that from control mice. CONCLUSION: Prolonged fasting promoted EPC-mediated ischemic angiogenesis and improved long-term stroke outcomes in mice. It is implied that prolonged fasting might potentially be an option to treat ischemic vascular diseases.

Investigating genetic characteristics of hepatitis B virus-associated and -non-associated hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is a primary liver malignancy that mainly occurs in patients with chronic liver disease and cirrhosis. Risk factors for HCC include hepatitis B virus (HBV) infection. However, the specific role of HBV infection in HCC development is not yet completely understood. In order to reveal the effects of HBV on HCC, we compare the genes of HCC patients infected with HBV with those who are not infected. METHODS: We encoded the genes of these two types of HCC in databases using enrichment scores of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway terms. A random forest algorithm was employed in order to distinguish these two types in the classifier, and a series of feature selection approaches was used in order to select their optimal features. Novel HBV-associated and -non-associated HCC genes were predicted, respectively, based on their optimal features in the classifier. A shortest-path algorithm was also employed in order to find all of the shortest-paths genes connecting the known related genes. RESULTS: A total of 54 different features between HBV-associated and -non-associated HCC genes were identified. In total, 1236 and 881 novel related genes were predicted for HBV-associated and -non-associated HCC, respectively. By integrating the predicted genes and shortest path genes in their gene interaction network, we identified 679 common genes involved in the two types of HCC. CONCLUSION: We identified the significantly different genetic features between two types of HCC. We also predicted related genes for the two types based on their specific features. Finally, we determined the common genes and features that were involved in both of these two types of HCC.

Design and high-level expression of a hybrid antimicrobial peptide LF15-CA8 in Escherichia coli.

Antimicrobial peptides (AMPs) have been paid considerable attention owing to their broad-spectrum antimicrobial activity and have great potential as novel antimicrobials. In this study, a novel hybrid peptide LF15-CA8 was designed on the basis of bovine lactoferricin (LfcinB) and cecropin A. The gene segment encoding LF15-CA8 was synthesized and cloned into pGEX-4T-BH to form pGEX-4T-LC1 containing one copy of the LF15-CA8 coding region. A series of recombinant vectors containing up to six multiple-copy LF15-CA8 coding regions, i.e., pGEX-4T-LCn (n = 1-6), were subsequently constructed, and used for transformation in Escherichia coli BL21(DE3). After induction with IPTG, pGEX-4T-LC1 and pGEX-4T-LC2 transformants successfully expressed fusion proteins GST-LF15-CA8 and GST-(LF15-CA8)2 in the form of inclusion bodies, respectively. The inclusion bodies were dissolved and the peptide was successfully released in 70 % formic acid in a single step. After purification, about 10.0 mg of the recombinant peptide LF15-CA8 with purity more than 97 % was obtained from 1 l of bacteria culture of pGEX-4T-LC2 transformants. LF15-CA8 caused an increase in antibacterial activity against Gram-positive bacterium (Staphylococcus aureus ATCC 25923) compared with the parent peptides and did not show obvious hemolytic activity against human erythrocytes in the range of effective antibacterial concentration. These results suggest that the peptide LF15-CA8 could be a promising candidate for therapeutic applications, and may lead to a cost-effective solution for the large-scale production of AMPs.