Application of Robot-assisted Upper Limb Rehabilitation for Stroke (review) / 中国康复理论与实践

Stroke would result in upper-limb dysfunction. Robot-assisted upper limb rehabilitation is applied in the rehabilitation training after stroke, mainly for intensive and repetitive specific task-oriented training to improve muscle strength and promote the isolated movement of upper limbs for the hemiplegics. However, it can do less for spasm and activities of daily living. It may be more effective combining with other therapies. Although the robots have the advantages of no fatigue, quantification, individualization and objective evaluation, there are also some disadvantages, such as incomplete training, inability to correct compensatory action and lack of empathy, etc. There is still a lack of high quality clinical research of large samples about robot-assisted upper limb rehabilitation, and frequency and time of the treatment is unclear.

Efficacy of Compound Wrist-hand Orthosis-assisted Therapy on Wrist-hand Dysfunction after Stroke / 中国康复理论与实践

Objective:To observe the efficacy of compound wrist-hand orthosis-assisted training on wrist-hand dysfunction in patients with convalescent stroke. Methods:From June, 2018 to December, 2019, 34 stroke patients in our hospital were randomly divided into control group (n = 17) and experimental group (n = 17). Both groups received basic treatment and routine occupational therapy, while the experimental group wore a compound wrist-hand orthosis during and after the daily occupational therapy. The occupational therapy was carried out 30 minutes a time, twice a day for 14 days, and the non-training time orthosis wearing was carried out cumulative five hours a day for 14 days. Before and after treatment, the Brunnstrom stage (upper limb and hand) and Fugl-Meyer Assessment (FMA) (wrist and hand) were used to assess the motor function of the upper limbs and hands, while the modified Ashworth Scale (MAS) and modified Barthel Index (MBI) were separately used to assess the wrist tension and activities of daily living. Results:Two cases dropped out in the control group. There was no significant difference in Brunnstrom stage, FMA score, MAS score, and MBI score between two groups before treatment (P > 0.05). After treatment, the scores of FMA and MBI significantly improved in both groups (|Z| > 3.420, P < 0.01), and the improvement was higher in the experimental group than in the control group (Z = -2.895, t = 4.331, P < 0.01); while, no significant difference was found in Brunnstrom stages and MAS score in both groups (P > 0.05). Conclusion:The compound wrist-hand orthosis-assisted therapy could improve the wrist-hand motor function and activities of daily living in patients with convalescent stroke.

Ultrasound-induced transdermal drug delivery to the stellate ganglion as a countermeasure to sub-health state / 中国组织工程研究

BACKGROUND:Stellate ganglion block is feasible for the patients in sub-health status,but it is invasive and the patient compliance is poor.OBJECTIVE:To investigate the clinical effectiveness of ultrasound-induced transdermal drug delivery for reducing the hyperactivity of the cervical sympathetic ganglia in the sub-health status.METHODS:Sixty-nine participants in sub-health state from different age levels and professions were recruited and were randomly divided into treatment (n=31) and control (n=38) groups.The treatment group underwent ultrasound-induced transdermal drug delivery to the cervical sympathetic ganglia,while the control group received psychological counseling on sub-health education and behavior intervention.All patients were assessed with Sub-Health Measurement Scale Version1.0,and the Medical Outcomes Study 36-Item Short-Form Health Survey prior to and post treatment,along with clinical curative effect assessment.RESULTS AND CONCLUSION:After treatment,29 participants in the treatment group were improved or recovered from sub-health,with an effective rate of 93.5％.Compared with the control group,the scores were significantly improved in the treatment group.To conclude,ultrasound-induced transdermal drug delivery to the stellate ganglion has a significant effect on sub-health state.

Protective effect of bone marrow mesenchymal stem cell-derived microvesicles on glutamate injured PC12 cells / 中国实验血液学杂志

This study was aimed to investigate the protective effect of bone mesenchymal stem cell-derived microvesicles (BMMSC-MV) on glutamate injured PC12 cells so as to elucidate the mechanism of the neural damage repair. BMMSC were isolated and purified with density-gradient centrifugation method, BMMSC-MV were harvested from the supernatants of BMMSC by hypothermal ultracentrifugation method. The surface markers of BMMSC reacted against different antibodies were detected by flow cytometry. The morphology features of MV were observed under an electron microscope. Experiment was divided into three groups, one was a control group, and the other two were glutamate-injured group and co-culture group of BMMSC-MV and glutamate-damaged cells respectively. MTT test was used to evaluate the proliferative status of PC12 cells and the AnnexinV-FITC detecting kit and Hoechst33342 were used to detect the apoptosis of PC12 cells in different groups. The results showed that BMMSC isolated from rat bone marrow were highly positive for CD29, CD44 and negative for CD31, CD34 and CD45. The morphology of MV was round and the vesicles were homogenous in size. BMMSC-MV exhibited a protective effect on the excitotoxicity-injured PC12 cells, displaying increase of cell viability, decrease of Annexin-V/PI staining positive and nuclear condensed cells. It is concluded that BMMSC-MV can protect PC12 cells from glutamate-induced apoptosis, suggesting that BMMSC-MV may be a potential candidate for treatment of neurological diseases.This study provides the preliminary experimental and theoretical evidence for use of BMMSC-MV in treatment of neural excited damage.

Different frequencies of repetitive transcranial magnetic stimulation and rehabilitation of motor function in patients with cerebral infarction / 中华神经医学杂志

Objective To compare the effects of high and low frequencies of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation of motor function in patients with cerebral infarction. Methods From October 2010 to June 2011,60 patients with cerebral infarction undergoing treatment in our department were randomly assigned into 3 even groups. In addition to conventional medication and functional training for all patients,group A were given high frequency (3 Hz) rTMS once per day and 10 minutes per time for 14 days,group B low frequency (1 Hz) rTMS and group C sham stimulation in the same manner. The 3 groups were compared before and after stimulation in terms of motor function scores of Fugl-Meyer assessment (FMA),the Barthel index (BI),motion evoked potential (MEP) and central motion conduction time (CMCT). Results Before stimulation,there were no significant differences between the 3 groups in FMA,BI,MEP and CMCT (P ＞0.05),but significant significances were observed between the 3 groups after stimulation (P＜0.05) indicating that the motor functional recovery in groups A and B was significantly better than in group C. But there were no statistically significant differences between group A and group B in FMA,BI,MEP and CMCT (P＞0.05).Significant improvements were achieved in all 3 groups after rehabilitative treatment in FMA,BI,MEP and CMCT (P＜0.05). Conclusion Both high frequency rTMS and low frequency rTMS can promote motor functional recovery for patients with cerebral infarction, and their effects are not significantly different.

Effects of repetitive transcraniai magnetic stimulation on motor function of rats with acute spinal cord injury / 中华神经医学杂志

Objective To investigate the effects of repetitive transcraniai magnetic stimulation (rTMS) on rats with acute spinal cord injury (SCI). Methods Twenty-four SD rats were equally randomized into normal group, SCI control group, high-frequency rTMS group and low-frequency rTMS group (n=6). T10 spinal cord injury models were induced by weight-drop device. Twenty- four h after the success of model making, high-frequency rTMS group received 10 Hz threshold rTMS and low-frequency rTMS group received 1 Hz threshold rTMS once daily for a consecutive 4 w. SCI control group received sham stimulation. The scores of Basso Beatti and Bresnahan (BBB) locomotor rating scale were recorded 1, 3, 7,11, 14, 21 and 28 d after the success of model making. Motor evoked potential (MEP) was detected on the 14th and 28th d of injury. HE staining was employed to detect the changes of histomorphology and neurofilament (NF-200) protein was detected with immunofluorescence staining in the spinal cord injury lesion. Results The BBB scores in stimulation groups were significantly higher as compared with those in the SCI control groups (P<0.05); those in the high-frequency rTMS group were statistically higher than those in the low-frequency rTMS group(P<0.05). The MEP was shorter in the stimulation groups as compared with that in the other 2 groups (P0.05); that in the high-frequency rTMS group was statistically shorter than that in the low-frequency rTMS group (P<0.05). NF-200markers in the stimulation groups were significantly increased compared with those in the SCI control group (P<0.05); those in the high-frequency rTMS group were statistically higher than those in the low-frequency rTMS group (F<0.05). Conclusion The rTMS can improve the locomotor function of rats with spinal cord injury, resulting from the increased expression of NF-200. The obvious effects in the high-frequency rTMS group might relate to the regulation of cortex excitability.