Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in s...Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.展开更多
The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly f...The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.展开更多
Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration...Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.展开更多
BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recover...BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life.Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.AIM To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.METHODS This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital.Patients were randomly divided into two groups:Routine treatment group(n=60)and laser acupuncture intervention group(n=60).There were no significant statistical differences in baseline characteristics(age,gender,body mass index,appendicitis severity)between the two groups.The routine treatment group received standard postoperative care,while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care.Key observation indicators included time to first exhaust,time to first bowel movement,time to gastrointestinal function recovery,and postoperative complication rates.RESULTS Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group.Specifically,time to first exhaust was significantly shortened(intervention group:12.5±2.3 hours vs control group:18.7±3.1 hours,P<0.05),time to first bowel movement was earlier(intervention group:36.4±4.6 hours vs control group:48.2±5.7 hours,P<0.05),postoperative complication rate was significantly reduced(intervention group:8.3%vs control group:20.0%,P<0.05),postoperative pain score was significantly lower(intervention group:3.2±1.1 vs control group:4.7±1.5,P<0.05),and intestinal motility recovery was faster and more effective.CONCLUSION Laser acupuncture,as an auxiliary treatment method,can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy,reduce complications,and improve postoperative comfort.This technique has advantages such as minimal invasiveness,rapid recovery,and few side effects,making it worthy of further clinical promotion and application.展开更多
Objective:To investigate the effects of performance-linked early rehabilitation management model on the recovery of neurological function,motor function and activities of daily living in patients after intracerebral h...Objective:To investigate the effects of performance-linked early rehabilitation management model on the recovery of neurological function,motor function and activities of daily living in patients after intracerebral hemorrhage surgery.Methods:A randomized controlled trial design was adopted.A total of 120 patients after cerebral hemorrhage surgery admitted to our hospital from June 2023 to June 2024 were selected as the research subjects and were randomly divided into the experimental group and the control group,with 60 cases in each group according to the random number table method.The control group received routine postoperative care and rehabilitation guidance in neurosurgery,while the experimental group implemented an efficacy linkage early rehabilitation management model on the basis of routine care.Before the intervention,4 weeks after the intervention,and 12 weeks after the intervention,the National Institutes of Health Stroke Scale(NIHSS),the Fugl-Meyer Assessment of Motor Function(FMA),and the Barthel Index(BI)were used to assess the degree of neurological deficits,motor function,and activities of daily living in patients,respectively.Results:After 4 weeks and 12 weeks of intervention,the NIHSS scores of the experimental group[(8.5±2.1)points,(5.2±1.8)points]were significantly lower than those of the control group[(10.8±2.4)points,(7.9±2.2)points](P<0.01);FMA scores[(58.4±10.2)points,(78.6±12.4)points]and BI scores[(55.3±11.5)points,(72.8±13.2)points]were significantly higher than those of the control group[(45.2±9.8)points,(62.3±11.7)points;(42.1±10.6)points,(58.4±12.5)points](P<0.01).Conclusion:The performance-linked early rehabilitation management model can effectively promote the recovery of neurological and motor functions in patients after cerebral hemorrhage surgery and significantly improve their ability to take care of themselves in daily living.It is an efficient rehabilitation management strategy.展开更多
Quantifying the post-earthquake functional recovery of railway stations presents significant challenges.This paper first establishes a post-earthquake function calculation method for railway stations,encompassing the ...Quantifying the post-earthquake functional recovery of railway stations presents significant challenges.This paper first establishes a post-earthquake function calculation method for railway stations,encompassing the establishment of relationships between the station’s function and the damage state,function loss,and failure probability of components and professional equipment in each layer.Also,the“4 stages-6 sequences”post-earthquake repair method is present,taking into account the functional and structural characteristics of railway stations.Additionally,a novel piecewise function for the post-earthquake functional dynamic recovery of railway stations is developed.A case study is conducted on a typical railway station to demonstrate the analysis procedure.Results indicate that under fortification,rare,and extremely rare earthquake scenarios,the interlayer drift ratio(IDR)of the railway station were 1/276,1/143,and 1/52,respectively,and corresponding peak floor acceleration(PFA)were 6.31 m/s^(2),7.82 m/s^(2),and 8.57 m/s^(2),respectively.The post-earthquake function of the railway station was 93.21%,82.33%,and 64.16%of its initial function.The repair times were 6.66 days,18.65 days,and 37.42 days.The displacement-sensitive,non-structural components were identified as the most vulnerable to damage.And the first repair stage(R_(1))which was mainly used to repair structural components and non-structural transport components,accounted for the highest proportion of total repair time.展开更多
BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the imp...BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)protocols have emerged as a promising approach in perioperative care.This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition follo...BACKGROUND Enhanced recovery after surgery(ERAS)protocols have emerged as a promising approach in perioperative care.This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition following laparoscopic gastric cancer surgery.AIM To evaluate the impact of ERAS protocols on postoperative gastrointestinal function recovery and intestinal microbiota composition in patients undergoing laparoscopic gastric cancer surgery,and to identify factors associated with improved clinical outcomes and microbial diversity preservation.METHODS We conducted a retrospective analysis of 80 patients who underwent laparoscopic D2 gastrectomy,comparing ERAS(n=40)vs traditional care(n=40).Primary outcomes included postoperative gastrointestinal function recovery and complications.Intestinal microbiota was analyzed using 16S rRNA sequencing at multiple timepoints perioperatively.RESULTS ERAS patients demonstrated faster recovery of bowel function,with earlier return of bowel sounds(16.25±6.41 hours vs 22.3±6.49 hours),first flatus(23.95±6.02 hours vs 28.45±7.12 hours),and defecation(34.95±9.34 hours vs 48.1±15.64 hours),all P<0.05.Complication rates,including antibiotic-associated diarrhea and surgical site infections,were comparable between groups.Microbial diversity indices and probiotic populations showed better preservation in the ERAS group postoperatively(P<0.05),though neither group achieved complete restoration to preoperative levels at one month.CONCLUSION These results support tailoring ERAS protocols to prioritize gut microbiome resilience through early feeding and shortened antibiotic courses,with particular benefits for younger patients.展开更多
BACKGROUND Appendicitis is a common acute abdominal pain disorder.Laparoscopic appendectomy,a commonly used modality,is associated with less trauma and faster recovery than traditional open appendectomy.However,postop...BACKGROUND Appendicitis is a common acute abdominal pain disorder.Laparoscopic appendectomy,a commonly used modality,is associated with less trauma and faster recovery than traditional open appendectomy.However,postoperative recovery remains an important issue that affects rehabilitation quality and surgical results.AIM To explore the effects of rapid rehabilitation and surgical nursing care on gastrointestinal function recovery and sleep quality among patients undergoing laparoscopic appendectomy.METHODS A total of 120 patients who underwent laparoscopic appendectomy at our hospital between January 2019 and March 2024 and for whom complete clinical data were available were selected.Patients were randomly assigned to two groups(n=60 each)using the random number table method.The control group received routine nursing care,while the experimental group received rapid rehabilitation surgical nursing care;all patients continued to receive nursing care until discharge.The recovery of gastrointestinal function,length of hospital stay,complications,Pittsburgh sleep quality index,and nursing satisfaction were compared between groups.RESULTS Following the implementation of effective nursing measures,the times to bowel sound recovery,first exhaust,first defecation,and first feeding were notably shorter in the study vs control group(P<0.05).Additionally,the duration of the first postoperative activity and the length of hospital stay were significantly shorter in the study vs control group(P<0.05).Furthermore,the study group exhibited better sleep quality than the control group(P<0.05).The postoperative complication rate was significantly lower and the nursing satisfaction rate significantly higher in the study vs control group(P<0.05).CONCLUSION Rapid rehabilitation surgical nursing interventions provided to patients after laparoscopic appendectomy can accelerate their postoperative recovery,reduce the occurrence of complications,and improve their sleep quality and nursing satisfaction.展开更多
BACKGROUND Esophageal cancer surgery is associated with a high risk of postoperative pulmonary complications,particularly pneumonia.Although conventional respiratory rehabilitation strategies–such as preoperative ins...BACKGROUND Esophageal cancer surgery is associated with a high risk of postoperative pulmonary complications,particularly pneumonia.Although conventional respiratory rehabilitation strategies–such as preoperative inspiratory muscle training–have demonstrated limited efficacy,the low-intensity traditional Chinese Qigong practice"Liuzijue"(Six-Character Formula)shows promise.However,robust clinical evidence supporting its use in patients undergoing esophagectomy remains lacking.AIM To evaluate the effects of early postoperative"Liuzijue"training on pulmonary function and pneumonia incidence following radical esophagectomy.METHODS This retrospective study included 306 patients who underwent esophagectomy.The control group(n=163)received standard care,consisting of abdominal breathing,incentive spirometry,and early ambulation.The intervention group(n=143)received the same standard care plus twice-daily"Liuzijue"training for 14 days.Primary outcomes were the incidence of pneumonia(defined by Centers for Disease Control and Prevention criteria)and changes(Δ)in forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),and maximum voluntary ventilation(MVV)from baseline to postoperative day 14.RESULTS The"Liuzijue"intervention was associated with a significantly lower incidence of pneumonia(11.9%vs 24.5%,P=0.005;relative risk=0.48).Significant improvements were observed inΔFVC(+502.1 mL vs+326.5 mL,P<0.001),ΔFEV_(1)(+701.7 mL vs+434.4 mL,P<0.001),andΔMVV(+19.4 L/minute vs+14.4 L/minute,P<0.001).Absolute FEV_(1) values on postoperative day 14 were higher in the intervention group(2270.8 mL vs 2066.1 mL,P=0.021),along with significantly lower Borg dyspnea/fatigue scores(P=0.045).No significant differences were observed in changes in diffusing capacity of the lung for carbon monoxide,total lung capacity,or 6-minute walk distance.CONCLUSION Early initiation of"Liuzijue"training after esophagectomy is associated with reduced pneumonia incidence and accelerated recovery of key pulmonary function parameters.These findings support the integration of"Liuzijue"into enhanced recovery after surgery protocols for esophageal cancer patients.展开更多
BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasi...BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasingly applied in clinical settings.However,the impact of this nursing model on patients undergoing laparoscopic cholecystectomy remains unclear.AIM To evaluate the effects of ERAS on postoperative gastrointestinal recovery and quality of life in patients undergoing laparoscopic cholecystectomy.METHODS This is a retrospective study design in which we collected clinical data from 120 patients who underwent laparoscopic cholecystectomy at our hospital.Patients were divided into a control group(n=60)and a study group(n=60)based on the type of nursing intervention.The control group received conventional care,while the study group received ERAS.We assessed gastrointestinal recovery,quality of life,and nursing satisfaction before and after the nursing interventions in both groups.RESULTS After nursing care,the gastrointestinal recovery times(time to bowel sounds return,time to flatus,time to first bowel movement,and time to first meal)in the study group were significantly shorter than those in the control group,with statistically significant differences between the two groups(P<0.05).Additionally,the quality of life in the study group was significantly higher than that in the control group(P<0.05).The nursing satisfaction in the study group was also significantly higher than that in the control group,with statistically significant differences between the two groups(P<0.05).CONCLUSION In summary,compared to conventional nursing,ERAS can more rapidly promote gastrointestinal recovery and improve the quality of life in patients after laparoscopic cholecystectomy.Further clinical application of this approach is warranted.展开更多
The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia ...The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.展开更多
Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery ...Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.展开更多
The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate ne...The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate neurogenesis and reconstruct cortical layers II to VI in non-neurogenic regions,such as the cortex,remains unknown.In this study,we implanted a hyaluronic acid collagen gel loaded with basic fibroblast growth factor into the motor cortex immediately following traumatic injury.Our findings reveal that this gel effectively stimulated the proliferation and migration of endogenous neural stem/progenitor cells,as well as their differentiation into mature and functionally integrated neurons.Importantly,these new neurons reconstructed the architecture of cortical layers II to VI,integrated into the existing neural circuitry,and ultimately led to improved brain function.These findings offer novel insight into potential clinical treatments for traumatic cerebral cortex injuries.展开更多
BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rate...BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.展开更多
Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this s...Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.展开更多
Objective:To investigate the positive eff ect of mindfulness training and exercise therapy on functional recovery and quality of life in elderly patients with fractures of the lower back.Methods:Collection of medical ...Objective:To investigate the positive eff ect of mindfulness training and exercise therapy on functional recovery and quality of life in elderly patients with fractures of the lower back.Methods:Collection of medical records of patients with lumbar vertebral fractures in Suzhou Municipal Hospital(North District),60 patients underwent percutaneous vertebroplasty(PVP/PKP),they were divided into control and experimental groups according to a random number table,30 people per group;In addition to traditional care method,Also intervened with behavioural awareness training and exercise therapy,By comparing the Oswestry dysfunction index score(ODI),visual simulation score(VAS),ability of daily living score(ADL),quality of life score(SF-36),To evaluate the eff ectiveness of the intervention.Results:Before the intervention,the ODI,VAS,ADL,and SF-36 scores were basically the same,with no significant diff erence(P>0.05).After treatment,the ODI and VAS scores of the experimental group and the control group were signifi cantly lower,and the experimental group was significantly lower than the control group(P<0.05);the ADL scores of the experimental group were signifi cantly higher than those of the control group(P<0.05);their SF-36 quality of life scores in all dimensions were signifi cantly higher(P<0.05).Conclusion:Through the rehabilitation treatment method combining mindfulness behavior training and exercise intervention,it can eff ectively promote the functional recovery of osteoporotic lumbar fractures in the elderly,thus reducing their pain and improving their quality of life.展开更多
Resilience of residential buildings depends on the recovery process that follows the impact of natural hazards,such as tsunamis.In particular,the historical database from tsunamis that occurred in different Countries(...Resilience of residential buildings depends on the recovery process that follows the impact of natural hazards,such as tsunamis.In particular,the historical database from tsunamis that occurred in different Countries(Sri Lanka,Thailand,Indonesia,and Japan)have been considered.This study proposes a selection of the best-fitting models to assess the recovery process of tsunamis to derive a framework for resilience at geographical scales.Since the damage depends on the vulnerability of the buildings,several typologies have been considered.In addition,aggregations of different damage sources have been considered to propose comprehensive relationships.The definition of best-fitting recovery functions for different countries has been discussed to implement them in advanced platforms and calculate the resilience to tsunamis.展开更多
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
基金supported by the National Natural Science Foundation of China,Nos.82072165 and 82272256(both to XM)the Key Project of Xiangyang Central Hospital,No.2023YZ03(to RM)。
文摘Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.
基金supported by European Union Funding Programme,PNRR,No. 760058(to DMH)the UEFISCDI Project,No. PN-III-P4-IDPCE-2020-059(to APW)
文摘The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.
基金supported in part by NIH R01 NS100531,R01 NS103481NIH R21NS130241(to LD)+3 种基金Merit Review Award I01 BX002356,I01 BX003705 from the U.S.Department of Veterans AffairsIndiana Spinal Cord and Brain Injury Research Foundation(No.19919)Mari Hulman George Endowment Funds(to XMX)Indiana Spinal Cord&Brain Injury Research Fund from ISDH(to NKL and LD)。
文摘Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.
文摘BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life.Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.AIM To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.METHODS This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital.Patients were randomly divided into two groups:Routine treatment group(n=60)and laser acupuncture intervention group(n=60).There were no significant statistical differences in baseline characteristics(age,gender,body mass index,appendicitis severity)between the two groups.The routine treatment group received standard postoperative care,while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care.Key observation indicators included time to first exhaust,time to first bowel movement,time to gastrointestinal function recovery,and postoperative complication rates.RESULTS Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group.Specifically,time to first exhaust was significantly shortened(intervention group:12.5±2.3 hours vs control group:18.7±3.1 hours,P<0.05),time to first bowel movement was earlier(intervention group:36.4±4.6 hours vs control group:48.2±5.7 hours,P<0.05),postoperative complication rate was significantly reduced(intervention group:8.3%vs control group:20.0%,P<0.05),postoperative pain score was significantly lower(intervention group:3.2±1.1 vs control group:4.7±1.5,P<0.05),and intestinal motility recovery was faster and more effective.CONCLUSION Laser acupuncture,as an auxiliary treatment method,can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy,reduce complications,and improve postoperative comfort.This technique has advantages such as minimal invasiveness,rapid recovery,and few side effects,making it worthy of further clinical promotion and application.
文摘Objective:To investigate the effects of performance-linked early rehabilitation management model on the recovery of neurological function,motor function and activities of daily living in patients after intracerebral hemorrhage surgery.Methods:A randomized controlled trial design was adopted.A total of 120 patients after cerebral hemorrhage surgery admitted to our hospital from June 2023 to June 2024 were selected as the research subjects and were randomly divided into the experimental group and the control group,with 60 cases in each group according to the random number table method.The control group received routine postoperative care and rehabilitation guidance in neurosurgery,while the experimental group implemented an efficacy linkage early rehabilitation management model on the basis of routine care.Before the intervention,4 weeks after the intervention,and 12 weeks after the intervention,the National Institutes of Health Stroke Scale(NIHSS),the Fugl-Meyer Assessment of Motor Function(FMA),and the Barthel Index(BI)were used to assess the degree of neurological deficits,motor function,and activities of daily living in patients,respectively.Results:After 4 weeks and 12 weeks of intervention,the NIHSS scores of the experimental group[(8.5±2.1)points,(5.2±1.8)points]were significantly lower than those of the control group[(10.8±2.4)points,(7.9±2.2)points](P<0.01);FMA scores[(58.4±10.2)points,(78.6±12.4)points]and BI scores[(55.3±11.5)points,(72.8±13.2)points]were significantly higher than those of the control group[(45.2±9.8)points,(62.3±11.7)points;(42.1±10.6)points,(58.4±12.5)points](P<0.01).Conclusion:The performance-linked early rehabilitation management model can effectively promote the recovery of neurological and motor functions in patients after cerebral hemorrhage surgery and significantly improve their ability to take care of themselves in daily living.It is an efficient rehabilitation management strategy.
基金National Natural Science Foundation of China under Grant No.52278534the Sichuan Provincial Natural Science Foundation of China under Grant No.2022NSFSC0423。
文摘Quantifying the post-earthquake functional recovery of railway stations presents significant challenges.This paper first establishes a post-earthquake function calculation method for railway stations,encompassing the establishment of relationships between the station’s function and the damage state,function loss,and failure probability of components and professional equipment in each layer.Also,the“4 stages-6 sequences”post-earthquake repair method is present,taking into account the functional and structural characteristics of railway stations.Additionally,a novel piecewise function for the post-earthquake functional dynamic recovery of railway stations is developed.A case study is conducted on a typical railway station to demonstrate the analysis procedure.Results indicate that under fortification,rare,and extremely rare earthquake scenarios,the interlayer drift ratio(IDR)of the railway station were 1/276,1/143,and 1/52,respectively,and corresponding peak floor acceleration(PFA)were 6.31 m/s^(2),7.82 m/s^(2),and 8.57 m/s^(2),respectively.The post-earthquake function of the railway station was 93.21%,82.33%,and 64.16%of its initial function.The repair times were 6.66 days,18.65 days,and 37.42 days.The displacement-sensitive,non-structural components were identified as the most vulnerable to damage.And the first repair stage(R_(1))which was mainly used to repair structural components and non-structural transport components,accounted for the highest proportion of total repair time.
文摘BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.
基金Supported by the Zhejiang Provincial Science and Technology Project for Traditional Chinese Medicine,No.2024ZL345.
文摘BACKGROUND Enhanced recovery after surgery(ERAS)protocols have emerged as a promising approach in perioperative care.This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition following laparoscopic gastric cancer surgery.AIM To evaluate the impact of ERAS protocols on postoperative gastrointestinal function recovery and intestinal microbiota composition in patients undergoing laparoscopic gastric cancer surgery,and to identify factors associated with improved clinical outcomes and microbial diversity preservation.METHODS We conducted a retrospective analysis of 80 patients who underwent laparoscopic D2 gastrectomy,comparing ERAS(n=40)vs traditional care(n=40).Primary outcomes included postoperative gastrointestinal function recovery and complications.Intestinal microbiota was analyzed using 16S rRNA sequencing at multiple timepoints perioperatively.RESULTS ERAS patients demonstrated faster recovery of bowel function,with earlier return of bowel sounds(16.25±6.41 hours vs 22.3±6.49 hours),first flatus(23.95±6.02 hours vs 28.45±7.12 hours),and defecation(34.95±9.34 hours vs 48.1±15.64 hours),all P<0.05.Complication rates,including antibiotic-associated diarrhea and surgical site infections,were comparable between groups.Microbial diversity indices and probiotic populations showed better preservation in the ERAS group postoperatively(P<0.05),though neither group achieved complete restoration to preoperative levels at one month.CONCLUSION These results support tailoring ERAS protocols to prioritize gut microbiome resilience through early feeding and shortened antibiotic courses,with particular benefits for younger patients.
文摘BACKGROUND Appendicitis is a common acute abdominal pain disorder.Laparoscopic appendectomy,a commonly used modality,is associated with less trauma and faster recovery than traditional open appendectomy.However,postoperative recovery remains an important issue that affects rehabilitation quality and surgical results.AIM To explore the effects of rapid rehabilitation and surgical nursing care on gastrointestinal function recovery and sleep quality among patients undergoing laparoscopic appendectomy.METHODS A total of 120 patients who underwent laparoscopic appendectomy at our hospital between January 2019 and March 2024 and for whom complete clinical data were available were selected.Patients were randomly assigned to two groups(n=60 each)using the random number table method.The control group received routine nursing care,while the experimental group received rapid rehabilitation surgical nursing care;all patients continued to receive nursing care until discharge.The recovery of gastrointestinal function,length of hospital stay,complications,Pittsburgh sleep quality index,and nursing satisfaction were compared between groups.RESULTS Following the implementation of effective nursing measures,the times to bowel sound recovery,first exhaust,first defecation,and first feeding were notably shorter in the study vs control group(P<0.05).Additionally,the duration of the first postoperative activity and the length of hospital stay were significantly shorter in the study vs control group(P<0.05).Furthermore,the study group exhibited better sleep quality than the control group(P<0.05).The postoperative complication rate was significantly lower and the nursing satisfaction rate significantly higher in the study vs control group(P<0.05).CONCLUSION Rapid rehabilitation surgical nursing interventions provided to patients after laparoscopic appendectomy can accelerate their postoperative recovery,reduce the occurrence of complications,and improve their sleep quality and nursing satisfaction.
基金Supported by Xuhui District Health Commission,No.SHXH202214.
文摘BACKGROUND Esophageal cancer surgery is associated with a high risk of postoperative pulmonary complications,particularly pneumonia.Although conventional respiratory rehabilitation strategies–such as preoperative inspiratory muscle training–have demonstrated limited efficacy,the low-intensity traditional Chinese Qigong practice"Liuzijue"(Six-Character Formula)shows promise.However,robust clinical evidence supporting its use in patients undergoing esophagectomy remains lacking.AIM To evaluate the effects of early postoperative"Liuzijue"training on pulmonary function and pneumonia incidence following radical esophagectomy.METHODS This retrospective study included 306 patients who underwent esophagectomy.The control group(n=163)received standard care,consisting of abdominal breathing,incentive spirometry,and early ambulation.The intervention group(n=143)received the same standard care plus twice-daily"Liuzijue"training for 14 days.Primary outcomes were the incidence of pneumonia(defined by Centers for Disease Control and Prevention criteria)and changes(Δ)in forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),and maximum voluntary ventilation(MVV)from baseline to postoperative day 14.RESULTS The"Liuzijue"intervention was associated with a significantly lower incidence of pneumonia(11.9%vs 24.5%,P=0.005;relative risk=0.48).Significant improvements were observed inΔFVC(+502.1 mL vs+326.5 mL,P<0.001),ΔFEV_(1)(+701.7 mL vs+434.4 mL,P<0.001),andΔMVV(+19.4 L/minute vs+14.4 L/minute,P<0.001).Absolute FEV_(1) values on postoperative day 14 were higher in the intervention group(2270.8 mL vs 2066.1 mL,P=0.021),along with significantly lower Borg dyspnea/fatigue scores(P=0.045).No significant differences were observed in changes in diffusing capacity of the lung for carbon monoxide,total lung capacity,or 6-minute walk distance.CONCLUSION Early initiation of"Liuzijue"training after esophagectomy is associated with reduced pneumonia incidence and accelerated recovery of key pulmonary function parameters.These findings support the integration of"Liuzijue"into enhanced recovery after surgery protocols for esophageal cancer patients.
文摘BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasingly applied in clinical settings.However,the impact of this nursing model on patients undergoing laparoscopic cholecystectomy remains unclear.AIM To evaluate the effects of ERAS on postoperative gastrointestinal recovery and quality of life in patients undergoing laparoscopic cholecystectomy.METHODS This is a retrospective study design in which we collected clinical data from 120 patients who underwent laparoscopic cholecystectomy at our hospital.Patients were divided into a control group(n=60)and a study group(n=60)based on the type of nursing intervention.The control group received conventional care,while the study group received ERAS.We assessed gastrointestinal recovery,quality of life,and nursing satisfaction before and after the nursing interventions in both groups.RESULTS After nursing care,the gastrointestinal recovery times(time to bowel sounds return,time to flatus,time to first bowel movement,and time to first meal)in the study group were significantly shorter than those in the control group,with statistically significant differences between the two groups(P<0.05).Additionally,the quality of life in the study group was significantly higher than that in the control group(P<0.05).The nursing satisfaction in the study group was also significantly higher than that in the control group,with statistically significant differences between the two groups(P<0.05).CONCLUSION In summary,compared to conventional nursing,ERAS can more rapidly promote gastrointestinal recovery and improve the quality of life in patients after laparoscopic cholecystectomy.Further clinical application of this approach is warranted.
基金supported by the National Natural Science Foundation of China,Nos.82071387(to HT),81971172(to YW)the Natural Science Foundation of Zhejiang Province,China,No.LY22H090012(to HT)the Basic Research Project of Wenzhou City,China,No.Y20220923(to MZ)。
文摘The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.
基金supported by the NIH (R01NS103481, R01NS111776, and R01NS131489)Indiana Department of Health (ISDH58180)(all to WW)。
文摘Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.
基金supported by the National Natural Science Foundation of China,Nos.82272171(to ZY),82271403(to XL),81941011(to XL),31971279(to ZY),31730030(to XL)the Natural Science Foundation of Beijing,No.7222004(to HD).
文摘The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate neurogenesis and reconstruct cortical layers II to VI in non-neurogenic regions,such as the cortex,remains unknown.In this study,we implanted a hyaluronic acid collagen gel loaded with basic fibroblast growth factor into the motor cortex immediately following traumatic injury.Our findings reveal that this gel effectively stimulated the proliferation and migration of endogenous neural stem/progenitor cells,as well as their differentiation into mature and functionally integrated neurons.Importantly,these new neurons reconstructed the architecture of cortical layers II to VI,integrated into the existing neural circuitry,and ultimately led to improved brain function.These findings offer novel insight into potential clinical treatments for traumatic cerebral cortex injuries.
文摘BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.
基金the staff of UUTH for their support during data collection.
文摘Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.
文摘Objective:To investigate the positive eff ect of mindfulness training and exercise therapy on functional recovery and quality of life in elderly patients with fractures of the lower back.Methods:Collection of medical records of patients with lumbar vertebral fractures in Suzhou Municipal Hospital(North District),60 patients underwent percutaneous vertebroplasty(PVP/PKP),they were divided into control and experimental groups according to a random number table,30 people per group;In addition to traditional care method,Also intervened with behavioural awareness training and exercise therapy,By comparing the Oswestry dysfunction index score(ODI),visual simulation score(VAS),ability of daily living score(ADL),quality of life score(SF-36),To evaluate the eff ectiveness of the intervention.Results:Before the intervention,the ODI,VAS,ADL,and SF-36 scores were basically the same,with no significant diff erence(P>0.05).After treatment,the ODI and VAS scores of the experimental group and the control group were signifi cantly lower,and the experimental group was significantly lower than the control group(P<0.05);the ADL scores of the experimental group were signifi cantly higher than those of the control group(P<0.05);their SF-36 quality of life scores in all dimensions were signifi cantly higher(P<0.05).Conclusion:Through the rehabilitation treatment method combining mindfulness behavior training and exercise intervention,it can eff ectively promote the functional recovery of osteoporotic lumbar fractures in the elderly,thus reducing their pain and improving their quality of life.
文摘Resilience of residential buildings depends on the recovery process that follows the impact of natural hazards,such as tsunamis.In particular,the historical database from tsunamis that occurred in different Countries(Sri Lanka,Thailand,Indonesia,and Japan)have been considered.This study proposes a selection of the best-fitting models to assess the recovery process of tsunamis to derive a framework for resilience at geographical scales.Since the damage depends on the vulnerability of the buildings,several typologies have been considered.In addition,aggregations of different damage sources have been considered to propose comprehensive relationships.The definition of best-fitting recovery functions for different countries has been discussed to implement them in advanced platforms and calculate the resilience to tsunamis.
