BACKGROUND Increased blood urea nitrogen(BUN)levels have been demonstrated to be associated with broader metabolic disturbances and the incidence of type 2 diabetes(T2D),potentially playing a role in the development o...BACKGROUND Increased blood urea nitrogen(BUN)levels have been demonstrated to be associated with broader metabolic disturbances and the incidence of type 2 diabetes(T2D),potentially playing a role in the development of diabetic complications,including diabetic peripheral neuropathy.AIM To examine the relationship between BUN levels and peripheral nerve function in patients with T2D.METHODS This observational study involved the systematic recruitment of 585 patients with T2D for whom BUN levels and estimated glomerular filtration rate were measured.Electromyography was used to assess peripheral motor and sensory nerve function in all patients,and overall composite Z-scores were subsequently calculated for nerve latency,amplitude,and conduction velocity(NCV)across the median,ulnar,common peroneal,posterior tibial,superficial peroneal,and sural nerves.RESULTS Across the quartiles of BUN levels,the overall composite Z-score for latency(F=38.996,P for trend<0.001)showed a significant increasing trend,whereas the overall composite Z-scores for amplitude(F=50.972,P for trend<0.001)and NCV(F=30.636,P for trend<0.001)exhibited a significant decreasing trend.Moreover,the BUN levels were closely correlated with the latency,amplitude,and NCV of each peripheral nerve.Furthermore,multivariate linear regression analysis revealed that elevated BUN levels were linked to a higher overall composite Z-score for latency(β=0.166,t=3.864,P<0.001)and lower overall composite Z-scores for amplitude(β=-0.184,t=-4.577,P<0.001)and NCV(β=-0.117,t=-2.787,P=0.006)independent of the estimated glomerular filtration rate and other clinical covariates.Additionally,when the analysis was restricted to sensory or motor nerves,elevated BUN levels remained associated with sensory or motor peripheral nerve dysfunction.CONCLUSION Increased BUN levels were independently associated with compromised peripheral nerve function in patients with T2D.展开更多
Objective:It has been reported that local vibration therapy can benefit recovery after peripheral nerve injury,but the optimized parameters and effective mechanism were unclear.In the present study,we investigated the...Objective:It has been reported that local vibration therapy can benefit recovery after peripheral nerve injury,but the optimized parameters and effective mechanism were unclear.In the present study,we investigated the effect of local vibration therapy of different amplitudes on the recovery of nerve function in rats with sciatic nerve injury(SNI).Methods:Adult male Sprague-Dawley rats were subjected to SNI and then randomly divided into 5 groups:sham group,SNI group,SNI+A-1 mm group,SNI+A-2 mm group,and SNI+A-4 mm group(A refers to the amplitude;n=10 per group).Starting on the 7th day after model initiation,local vibration therapy was given for 21 consecutive days with a frequency of 10 Hz and an amplitude of 1,2 or 4 mm for 5 min.The sciatic function index(SFI)was assessed before surgery and on the 7th,14th,21st and 28th days after surgery.Tissues were harvested on the 28th day after surgery for morphological,immunofluorescence and Western blot analysis.Results:Compared with the SNI group,on the 28th day after surgery,the SFIs of the treatment groups were increased;the difference in the SNI+A-2 mm group was the most obvious(95%confidence interval[CI]:[5.86,27.09],P<0.001),and the cross-sectional areas of myocytes in all of the treatment groups were improved.The G-ratios in the SNI+A-1 mm group and SNI+A-2 mm group were reduced significantly(95%CI:[-0.12,-0.02],P=0.007;95%CI:[-0.15,-0.06],P<0.001).In addition,the expressions of S100 and nerve growth factor proteins in the treatment groups were increased;the phosphorylation expressions of ERK1/2 protein in the SNI+A-2 mm group and SNI+A-4 mm group were upregulated(95%CI:[0.03,0.96],P=0.038;95%CI:[0.01,0.94],P=0.047,respectively),and the phosphorylation expression of Akt in the SNI+A-1 mm group was upregulated(95%CI:[0.11,2.07],P=0.031).Conclusion:Local vibration therapy,especially with medium amplitude,was able to promote the recovery of nerve function in rats with SNI;this result was linked to the proliferation of Schwann cells and the activation of the ERK1/2 and Akt signaling pathways.展开更多
Objective This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging(MRI)for short-term postoperative facial nerve function ...Objective This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging(MRI)for short-term postoperative facial nerve function in patients with acoustic neuroma.Methods A total of 110 patients with acoustic neuroma who underwent surgery through the retrosigmoid sinus approach were included.Clinical data and raw features from four MRI sequences(T1-weighted,T2-weighted,T1-weighted contrast enhancement,and T2-weighted-Flair images)were analyzed.Spearman correlation analysis along with least absolute shrinkage and selection operator regression were used to screen combined clinical and radiomic features.Nomogram,machine learning,and convolutional neural network(CNN)models were constructed to predict the prognosis of facial nerve function on the seventh day after surgery.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate model performance.A total of 1050 radiomic parameters were extracted,from which 13 radiomic and 3 clinical features were selected.Results The CNN model performed best among all prediction models in the test set with an area under the curve(AUC)of 0.89(95%CI,0.84–0.91).Conclusion CNN modeling that combines clinical and multi-sequence MRI radiomic features provides excellent performance for predicting short-term facial nerve function after surgery in patients with acoustic neuroma.As such,CNN modeling may serve as a potential decision-making tool for neurosurgery.展开更多
BACKGROUND： Ultraviolet blood irradiation and oxygenation （UBIO） has obtained better clinical effect in treating acute cerebral infarction, but the mechanism underlying this effect remains unclear. OBJECTIVE： To o...BACKGROUND： Ultraviolet blood irradiation and oxygenation （UBIO） has obtained better clinical effect in treating acute cerebral infarction, but the mechanism underlying this effect remains unclear. OBJECTIVE： To observe the effect of UBIO on the nerve function and activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase activities on the red blood cell （RBC） membrane of patients with acute cerebral infarction. DESIGN： A randomized and controlled study.SETTING： Department of Neurology, Xiangfan Central Hospital.PARTICIPANTS： From January 2000 to December 2001, excluding those above 70 years old, 58 cases of 700 patients with acute cerebral infarction admitted in the Department of Neurology, Xiangfan Central Hospital, were recruited and divided into two groups according to the random number table： UBIO treated group （n=28）, including 17 males and 11 females, aged 40-68 years; and control group （n=30）, including 20 males and 10 females, aged 44-69 years. All the patients agreed to participate in the therapeutic program and detected items. The general informations were comparable without obvious differences between the two groups （P 〉 0.05）.METHODS： ① The patients in both groups received routine treatments, besides, those in the UBIO treated group were given UBIO treatment by using the XL-200 type therapeutic apparatus produced in Shijiazhuang, whose ultraviolet wave was set at 253.7 nm with the energy density of 0.568 J/m^2 per second, UBIO treatment started from the second day after admission, once every other day, with a single course consisting of 5-7 treatments. ② In the UBIO treated group, the venous blood was sampled before and after the first, third and the completion of the treatment course respectively, the venous blood was taken at each corresponding time point in the control group. After centrifugation of the blood at 10 000 rounds per minute, the RBC membrane was separated and then the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase were detected by means of phosphorus determination.③ The nerve function was scored before and after treatment in both groups with European stroke scale, which included 13 items, the total score was 0-100 points, the higher the score, the better the nerve function. MAIN OUTCOME MEASURES ：①Score of European stroke scale before and after treatment in both groups.② Comparison of the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase on RBC membrane between the two groups before treatment and after the first, third and the completion of the treatment. RESULTS： All the 58 patients with cerebral infarction were involved in the analysis of results.① The score of European stroke scale had no obvious difference between the two groups [（49.31±11.48）, （50.58±12.63）, P 〉 0.05], and it was obviously higher in the UBIO treated group than in the control group after treatment [84.66±13.75）, （77.05±11.17）, P 〈 0.05].②The activity of K^＋-Na^＋-ATPase on RBC membrane in the UBIO treated group was significantly increased after the first and third treatment as compared with before treatment [（31.56±19.25）, （27.64±15.83）, （17.67±13.83）, P 〈 0.01], it was still higher after the completion of the treatment than before treatment without obvious difference [（20.86±14.53）, P 〉 0.05]. After the first and third treatment, it was obviously higher in the UBIO treated group than in the control group [19.31±11.88）, （17.44±10.42）, P 〈 0.01]. ③ In the UBIO treated group, Ca2^＋-Mg2^＋-ATPase activity on RBC membrane significantly increased after the first treatment and remained higher than the pre-treatment level throughout the treatment [（27.49±14.72）, （17.41±4.82）, P 〈 0.01]. The activity of Ca2^＋-Mg2^＋-ATPase on RBC membrane was markedly higher in the UBIO treated group than in the control group after after the first, third and the completion of treatment respectively [（24.83±12.88）, （17.70±5.69）; （28.08±13.44）, （16.32±5.29）; （17.42±6.04）, P〈 0.05-0.01]. CONCLUSION： The effect of UBIO treatment against acute cerebral infarction may be mediated by the increased K^＋-Na^＋ ATPase and Ca2^＋-Mg2^＋-ATPase activities on RBC membrane, which enhances the RBC transformation ability so as to lower RBC aggregation and correct high blood viscosity.展开更多
BACKGROUND: Pain and sensory disability are greatly affected by subjective factors, there are no quantitative indexes to evaluate cervical spondylotic radiculopathy(CSR). The judgment on clinical body examination and ...BACKGROUND: Pain and sensory disability are greatly affected by subjective factors, there are no quantitative indexes to evaluate cervical spondylotic radiculopathy(CSR). The judgment on clinical body examination and chief complaint always causes nonobjective results with great individual differences. Quantitative sensory testing (QST) can be used to judge the nerve function of fibril. The application of QST for the quantitative evaluation of peripheral nervous system disease needs to be further studied. OBJECTIVE: The cold-thermal sensation and pain of patients with CSR are quantitatively analyzed by using QST technology in order to evaluate the nerve function of fibril in patients with CSR. DESIGN: Case-control observation. SETTING: Pain Center of Beijing Hospital of Ministry of Health. PARTICIPANTS: Twenty patients with CSR, including 8 males and 12 females, aged from 33 to 70 years, who received treatment between January and April 2005 in Pain Center of Beijing Hospital of Ministry of Health were involved in CSR group. All the involved patients presented symptoms in unilateral upper extremity (left side 10 patients, right side 10 patients). They did not undergo physical therapy or nerve block therapy in 1 week before examination. Eight non-CSR patients who received treatment in Pain Center concurrently were involved in the control group (2 patients with trigeminal neuralgia, 4 with osteoarthrosis of knee joint and 2 with lumbar intervertebral disc protrusion), and another 12 healthy volunteers were involved. Four non-CSR patients and 12 healthy volunteers, 8 male and 12 female, were aged from 23 to 75 years. The informed consents were obtained from all the involved subjects. METHODS: The volar thresholds of cold sensation, thermal sensation, cryalgesia of thenar eminence of both upper extremities of all the subjects were examined separately by limit method with type TSA-Ⅱ temperature sensation analysator made by Medco Company (Israel). The subjects were pre-examined to be familiar with the method for sensory discrimination and affirmation. Thenar eminence vola of bilateral upper extremities were detected. The infrared detector of a semiconductor was contacted with skin. The infrared detector could be used to heat and cool skin. A group of cold-heat water circulation device was given electric current to produce temperature gradient, which was higher or lower than skin temperature. The initial temperature of infrared detector was 32 ℃, stimulation temperature was increased or decreased progressively at 1 ℃/s, and temperature change range was 0 to 50 ℃. In the first step, subjects pressed down the button to stop the stimulation when the temperature of infrared detector was decreased progressively until the subjects felt, and the threshold of cold sensation was obtained; In the second step, the threshold of thermal sensation was obtained when the temperature of infrared detector was increased progressively until the subjects felt; In the third step, the threshold of cryalgesia was obtained when the temperature of infrared detector was decreased progressively until subjects felt; and in the fourth step, the threshold of thermalgesia was obtained when the temperature of infrared detector was increased progressively until subjects felt. Each step was conducted 4 times and the mean threshold was obtained. Before each measurement, the temperature was made to rebound to the initial temperature and kept for 10 s. MAIN OUTCOME MEASURES: The thresholds of cold sensation, thermal sensation and cryalgesia, thermalgesia of thenar eminence vola of bilateral upper extremities of all the subjects. RESULTS: Twenty patients with CSR and 20 healthy subjects participated in the final results. ① In the CSR group, the threshold of cold sensation of affected side was lower than that of intact side [(29.00±1.26) ℃ vs.(30.00±1.06) ℃, P < 0.05], and the threshold of thermal sensation of affected side was higher than that of intact side [(35.04±0.87) ℃ vs. (34.14±0.99) ℃, P < 0.05]. There were no significant differences in the thresholds of cold and thermal sensation between affected side and intact side (P > 0.05). ②In the CSR group, the difference of threshold of cold sensation, thermal sensation, cryalgesia and thermalgesia between affected side and intact side was (-1.01±0.57), (0.89±0.39), (2.49±1.10) and (-1.62±0.86) ℃, respectively , the absolute value of which was higher than that of control group, respectively [(0.04±0.28),(0.05±0.26),(0.28±1.79),(0.17±1.10) ℃,P < 0.01]. In the CSR group, the threshold of cold sensation and thermalgesia of affected side was lower than that of intact side, respectively; and the threshold of thermal sensation and cryalgesia of affected side was higher than that of intact side, respectively. CONCLUSION: The superficial sensation of affected extremity of patients with CSR is lessened as compared with that of intact extremity. There are dysfunctions of small myelinated fiber (Aδ fiber) and demyelinated fiber (C fiber) in the affected-side extremity. QST, as a mean for quantitatively evaluating the function of Aδ fiber and C fiber, plays an objective evaluative role in the diagnosis and therapeutic effect observation of CSR.展开更多
Objective： To explore the effect of electro-acupuncture and musk injection on recovery of injured sciatic nerve function in rats, so as to provide the experimental evidences for the promotion of peripheral nerve rege...Objective： To explore the effect of electro-acupuncture and musk injection on recovery of injured sciatic nerve function in rats, so as to provide the experimental evidences for the promotion of peripheral nerve regeneration by electro-acupuncture and musk injection. Methods： Following establishing rat model of sciatic nerve injury by operation, the rats were randomly divided into electro-acupuncture group, musk injection group, electro-acupuncture plus musk injection group and model group, then sciatic functional index （SFI） and motor nerve conduction velocity （MNCV） were measured after 4 weeks of treatment, 8 weeks of treatment and 12 weeks of treatment respectively to evaluate recovery of nerve function. Results： SFI and MNCV in electro-acupuncture group, musk injection group and electro-acupuncture plus musk injection group were improved more obviously than that in model group, with significant differences（P〈0.01, P〈0.05）. Conclusions： Both electro-acupuncture and musk injection could promote recovery of injured nerve function, and they had a certain synergetic effect and might be the effective methods in promoting recovery of injured peripheral nerve function.展开更多
To examine the effects of Cerebrolysin on the treatment of diabetic peripheral neuropathy, we first established a mouse model of type 2 diabetes mellitus by administering a high-glucose, high-fat diet and a single int...To examine the effects of Cerebrolysin on the treatment of diabetic peripheral neuropathy, we first established a mouse model of type 2 diabetes mellitus by administering a high-glucose, high-fat diet and a single intraperitoneal injection of streptozotocin. Mice defined as diabetic in this model were then treated with 1.80, 5.39 or 8.98 m L/kg of Cerebrolysin via intraperitoneal injections for 10 consecutive days. Our results demonstrated that the number, diameter and area of myelinated nerve fibers increased in the sciatic nerves of these mice after administration of Cerebrolysin. The results of several behavioral tests showed that Cerebrolysin dose-dependently increased the slope angle in the inclined plane test（indicating an improved ability to maintain body position）, prolonged tail-flick latency and foot-licking time（indicating enhanced sensitivity to thermal and chemical pain, respectively, and reduced pain thresholds）, and increased an index of sciatic nerve function in diabetic mice compared with those behavioral results in untreated diabetic mice. Taken together, the anatomical and functional results suggest that Cerebrolysin ameliorated peripheral neuropathy in a mouse model of type 2 diabetes mellitus.展开更多
Objective: To explore the therapeutic effect of Huoxue Tongmai capsule combined with edaravone right camphor on patients with acute cerebral infarction (Acute Cerebral Infarction) and the effect of combination therapy...Objective: To explore the therapeutic effect of Huoxue Tongmai capsule combined with edaravone right camphor on patients with acute cerebral infarction (Acute Cerebral Infarction) and the effect of combination therapy on serum inflammatory factors. Methods: In this study, 90 patients with acute cerebral infarction hospitalized in Zhuji People’s Hospital from December 2023 to December 2024 were selected and divided into two groups of 45 patients in each group. The control group used standard medical treatment, and the treatment group compared the changes of serum inflammatory factors IL-CRP, TNF-α, and Hcy with Huoxue Tongmai capsule for 7 days, 14 days and 30 days, and discussed the changes of the modified Rankin scale score (mRS) and National Institutes of Health Stroke Scale (NIHSS) score. Results: At 7 days, 14 days, and 30 days of treatment, the NIHSS score, mRS score, hs-CRP, IL-6, TNF-α, and Hcy levels were statistically significant (P α, and Hcy levels in the treatment group were significantly lower than those in the control group (P Conclusion: Patients with acute cerebral infarction received Huoxue Tongmai capsule combined with edaravone right camphor, which can reduce the inflammatory reaction, improve the nerve function and improve the prognosis.展开更多
More than half of stroke patients live with different levels of motor dysfunction after receiving routine rehabilitation treatments.Therefore,new rehabilitation technologies are urgently needed as auxiliary treatments...More than half of stroke patients live with different levels of motor dysfunction after receiving routine rehabilitation treatments.Therefore,new rehabilitation technologies are urgently needed as auxiliary treatments for motor rehabilitation.Based on routine rehabilitation treatments,a new intelligent rehabilitation platform has been developed for accurate evaluation of function and rehabilitation training.The emerging intelligent rehabilitation techniques can promote the development of motor function rehabilitation in terms of informatization,standardization,and intelligence.Traditional assessment methods are mostly subjective,depending on the experience and expertise of clinicians,and lack standardization and precision.It is therefore difficult to track functional changes during the rehabilitation process.Emerging intelligent rehabilitation techniques provide objective and accurate functional assessment for stroke patients that can promote improvement of clinical guidance for treatment.Artificial intelligence and neural networks play a critical role in intelligent rehabilitation.Multiple novel techniques,such as braincomputer interfaces,virtual reality,neural circuit-magnetic stimulation,and robot-assisted therapy,have been widely used in the clinic.This review summarizes the emerging intelligent rehabilitation techniques for the evaluation and treatment of motor dysfunction caused by nervous system diseases.展开更多
OBJECTIVE： There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell＇s palsy. Our previous studies found that observing the electrical respons...OBJECTIVE： There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell＇s palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell＇s palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell＇s palsy. METHODS： The facial nerve function of 68 patients with Bell＇s palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to find the relationship between electrical response and therapeutic effects or prognosis. RESULTS： Checking consistency between electrical response grading and House-Brackmann scale： Kappa value 0.028 （P = 0.578）. Correlation analysis： the two methods were correlated with the prognosis, and electrical response grading （rER = 0.789） was better than the House-Brackmann scale （rHB = 0.423）. CONCLUSION： Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.展开更多
Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Scien...Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we per-formed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduc-tion function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regener-ated potentials ifrst appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ‘ex-cellent’ and ‘good’ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The func-tional recovery of a transplanted nerve can be dynamically observed after the surgery.展开更多
We previously prepared nerve growth factor poly-lactide co-glycolid sustained-release microspheres to treat rat sciatic nerve injury using the small gap sleeve technique.Multiple growth factors play a synergistic role...We previously prepared nerve growth factor poly-lactide co-glycolid sustained-release microspheres to treat rat sciatic nerve injury using the small gap sleeve technique.Multiple growth factors play a synergistic role in promoting the repair of peripheral nerve injury;as a result,in this study,we added basic fibroblast growth factors to the microspheres to further promote nerve regeneration.First,in an in vitro biomimetic microenvironment,we developed and used a drug screening biomimetic microfluidic chip to screen the optimal combination of nerve growth factor/basic fibroblast growth factor to promote the regeneration of Schwann cells.We found that 22.56 ng/mL nerve growth factor combined with 4.29 ng/mL basic fibroblast growth factor exhibited optimal effects on the proliferation of primary rat Schwann cells.The successfully prepared nerve growth factor-basic fibroblast growth factor-poly-lactide-co-glycolid sustained-release microspheres were used to treat rat sciatic nerve transection injury using the small gap sleeve bridge technique.Compared with epithelium sutures and small gap sleeve bridging alone,the small gap sleeve bridging technique combined with drug-free sustained-release microspheres has a stronger effect on rat sciatic nerve transfection injury repair at the structural and functional level.展开更多
Although the local application of mitomycin C may prevent epidural adhesion after laminectomy, mitomycin C can induce neurotoxicity in optic and acoustic nerves at high concentrations. To determine the safe concentrat...Although the local application of mitomycin C may prevent epidural adhesion after laminectomy, mitomycin C can induce neurotoxicity in optic and acoustic nerves at high concentrations. To determine the safe concentration range for mitomycin C, cotton pads soaked with mitomycin C at different concentrations （0.1, 0.3, 0.5, and 0.7 mg/mL） were immediately applied for 5 minutes to the operation area of rats that had undergone laminectomy at L1. Rat sciatic nerves, instead of dorsal nerves, were used in this study. The results showed that mitomycin C at 0.1-0.5 mg/mL did not damage the structure and function of the sciatic nerve, while at 0.7 mg/mL, mitomycin C signiifcantly reduced the thickness of the sciatic nerve myelin sheath compared with lower concen-trations, though no functional change was found. These experimental ifndings indicate that the local application of mitomycin C at low concentrations is safe to prevent scar adhesion following laminectomy, but that mitomycin C at high concentrations （＆gt;0.7 mg/mL） has potential safety risks to peripheral nerve structures.展开更多
Aphasia is an acquired language disorder that is a common consequence of stroke.The pathogenesis of the disease is not fully understood,and as a result,current treatment options are not satisfactory.Here,we used blood...Aphasia is an acquired language disorder that is a common consequence of stroke.The pathogenesis of the disease is not fully understood,and as a result,current treatment options are not satisfactory.Here,we used blood oxygenation level-dependent functional magnetic resonance imaging to evaluate the activation of bilateral cortices in patients with Broca＇s aphasia 1 to 3 months after stroke.Our results showed that language expression was associated with multiple brain regions in which the right hemisphere participated in the generation of language.The activation areas in the left hemisphere of aphasia patients were significantly smaller compared with those in healthy adults.The activation frequency,volumes,and intensity in the regions related to language,such as the left inferior frontal gyrus（Broca＇s area）,the left superior temporal gyrus,and the right inferior frontal gyrus（the mirror region of Broca＇s area）,were lower in patients compared with healthy adults.In contrast,activation in the right superior temporal gyrus,the bilateral superior parietal lobule,and the left inferior temporal gyrus was stronger in patients compared with healthy controls.These results suggest that the right inferior frontal gyrus plays a role in the recovery of language function in the subacute stage of stroke-related aphasia by increasing the engagement of related brain areas.展开更多
Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor functio...Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method.Through a series of novel design concepts,including the integration of a detecting circuit and an analog-to-digital converter,a miniaturized functional electrical stimulation circuit technique,a low-power super-regeneration chip for wireless receiving,and two wearable armbands,a prototype system has been established with reduced size,power,and overall cost.Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects,the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy.Test results showed that wrist flexion/extension,hand grasp,and finger extension could be reproduced with high accuracy and low latency.This system can build a bridge of information transmission between healthy limbs and paralyzed limbs,effectively improve voluntary participation of hemiplegic patients,and elevate efficiency of rehabilitation training.展开更多
OBJECTIVE:To study the functional mechanism of Pingchuanning Decoction in treatment of airway remodeling in asthmatic rats.METHODS:Eighty healthy Wistar male rats were randomized into eight groups(n=10 rats each):Norm...OBJECTIVE:To study the functional mechanism of Pingchuanning Decoction in treatment of airway remodeling in asthmatic rats.METHODS:Eighty healthy Wistar male rats were randomized into eight groups(n=10 rats each):Normal group,Asthma model group,Dexamethasone group,Guilong Kechuanning group,Xiaoqinglong Decoction group,and Pingchuanning Decoction low-,middle-,and high-dose groups.The rats of all but the Normal group were made into asthma models through intraperitoneal injection and aerosol inhalation of ovalbumin.All treatments were administered at the first stimulation of asthma onset(third week of modeling),and the rats were killed after stimulating asthma attacks for 4 weeks.The general conditions of rats and pathomorphological changes of the lung tissues were observed.The expression of nerve growth factor(NGF) of the lung tissues was measured with immunohistochemical methods,and the content of Clara cell secretory protein(CCSP) mRNA was determined with RT-PCR.RESULTS:Compared with the Normal group,the contents of NGF and CCSP mRNA in the lung tissues of the Model group were significantly changed(P<0.01).Compared with the Model group,the indices of Pingchuanning Decoction and other treatment groups were improved to some extent(P<0.05 or P<0.01).CONCLUSIONS:Pathological changes of airway inflammation and remodeling were present in these rat asthma models.Pingchuanning Decoction had an intervention effect on these experimental models.Its functional mechanism may be related to multiple factors,including alleviation of airway inflammation,relief of bronchial smooth muscle spasm,and inhibition of airway remodeling.展开更多
Surgical accuracy has greatly improved with the advent of microsurgical techniques. However, complete functional recovery after peripheral nerve injury has not been achieved to date. The mechanisms hindering accurate ...Surgical accuracy has greatly improved with the advent of microsurgical techniques. However, complete functional recovery after peripheral nerve injury has not been achieved to date. The mechanisms hindering accurate regeneration of damaged axons after peripheral nerve injury are in urgent need of exploration. The present study was designed to explore the mechanisms of peripheral nerve regeneration after different types of injury. Femoral nerves of rats were injured by crushing or freezing. At 2, 3, 6, and 12 weeks after injury, axons were retrogradely labeled using 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate（Dil） and True Blue, and motor and sensory axons that had regenerated at the site of injury were counted. The number and percentage of Dil-labeled neurons in the anterior horn of the spinal cord increased over time. No significant differences were found in the number of labeled neurons between the freeze and crush injury groups at any time point. Our results confirmed that the accuracy of peripheral nerve regeneration increased with time, after both crush and freeze injury, and indicated that axonal regeneration accuracy was still satisfactory after freezing, despite the prolonged damage.展开更多
Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper li...Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.展开更多
Following central nervous system injury, axonal sprouts form distal to the injury site and extend into the denervated area, reconstructing neural circuits through neural plasticity. How to facilitate this plasticity h...Following central nervous system injury, axonal sprouts form distal to the injury site and extend into the denervated area, reconstructing neural circuits through neural plasticity. How to facilitate this plasticity has become the key to the success of central nervous system repair. It remains controversial whether fine motor skill training contributes to the recovery of neurological function after spinal cord injury. Therefore, we established a rat model of unilateral corticospinal tract injury using a pyramidal tract cutting method. Horizontal ladder crawling and food ball grasping training procedures were conducted 2 weeks before injury and 3 days after injury. The neurological function of rat forelimbs was assessed at 1, 2, 3, 4, and 6 weeks after injury. Axon growth was observed with biotinylated dextran amine anterograde tracing in the healthy corticospinal tract of the denervated area at different time periods. Our results demonstrate that compared with untrained rats, functional recovery was better in the forelimbs and forepaws of trained rats. The number of axons and the expression of growth associated protein 43 were increased at the injury site 3 weeks after corticospinal tract injury. These findings confirm that fine motor skill training promotes central nervous system plasticity in spinal cord injury rats.展开更多
Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influen...Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored.We explored age-related brain network differences between ADHD patients and typically developing（TD） subjects using resting state f MRI（rs-f MRI） for three age groups of children,adolescents,and adults.We collected rs-f MRI data from 184 individuals（27 ADHD children and 31 TD children;32 ADHD adolescents and 32 TD adolescents;and 31 ADHD adults and 31 TD adults）.The Brainnetome Atlas was used to define nodes in the network analysis.We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality,a well-known measure of nodal centrality.The left middle temporal gyrus showed significant interaction effects between disease status（i.e.,ADHD or TD） and age（i.e.,child,adolescent,or adult）（P 0.001）.Additional regions were identified at a relaxed threshold（P 0.05）.Many of the identified regions（the left inferior frontal gyrus,the left middle temporal gyrus,and the left insular gyrus） were related to cognitive function.The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients.These findings contribute to better understand how brain function influences the symptoms of ADHD.展开更多
基金Supported by the Social Development Projects of Nantong,No.MS12019019,No.HS2022004 and No.MS2023083the Medical Research Project of the Jiangsu Health Commission,No.Z2022058the National Natural Science Foundation of China,No.32101027。
文摘BACKGROUND Increased blood urea nitrogen(BUN)levels have been demonstrated to be associated with broader metabolic disturbances and the incidence of type 2 diabetes(T2D),potentially playing a role in the development of diabetic complications,including diabetic peripheral neuropathy.AIM To examine the relationship between BUN levels and peripheral nerve function in patients with T2D.METHODS This observational study involved the systematic recruitment of 585 patients with T2D for whom BUN levels and estimated glomerular filtration rate were measured.Electromyography was used to assess peripheral motor and sensory nerve function in all patients,and overall composite Z-scores were subsequently calculated for nerve latency,amplitude,and conduction velocity(NCV)across the median,ulnar,common peroneal,posterior tibial,superficial peroneal,and sural nerves.RESULTS Across the quartiles of BUN levels,the overall composite Z-score for latency(F=38.996,P for trend<0.001)showed a significant increasing trend,whereas the overall composite Z-scores for amplitude(F=50.972,P for trend<0.001)and NCV(F=30.636,P for trend<0.001)exhibited a significant decreasing trend.Moreover,the BUN levels were closely correlated with the latency,amplitude,and NCV of each peripheral nerve.Furthermore,multivariate linear regression analysis revealed that elevated BUN levels were linked to a higher overall composite Z-score for latency(β=0.166,t=3.864,P<0.001)and lower overall composite Z-scores for amplitude(β=-0.184,t=-4.577,P<0.001)and NCV(β=-0.117,t=-2.787,P=0.006)independent of the estimated glomerular filtration rate and other clinical covariates.Additionally,when the analysis was restricted to sensory or motor nerves,elevated BUN levels remained associated with sensory or motor peripheral nerve dysfunction.CONCLUSION Increased BUN levels were independently associated with compromised peripheral nerve function in patients with T2D.
基金partially supported by research grants from the National Natural Science Funding of China(No.81603713)。
文摘Objective:It has been reported that local vibration therapy can benefit recovery after peripheral nerve injury,but the optimized parameters and effective mechanism were unclear.In the present study,we investigated the effect of local vibration therapy of different amplitudes on the recovery of nerve function in rats with sciatic nerve injury(SNI).Methods:Adult male Sprague-Dawley rats were subjected to SNI and then randomly divided into 5 groups:sham group,SNI group,SNI+A-1 mm group,SNI+A-2 mm group,and SNI+A-4 mm group(A refers to the amplitude;n=10 per group).Starting on the 7th day after model initiation,local vibration therapy was given for 21 consecutive days with a frequency of 10 Hz and an amplitude of 1,2 or 4 mm for 5 min.The sciatic function index(SFI)was assessed before surgery and on the 7th,14th,21st and 28th days after surgery.Tissues were harvested on the 28th day after surgery for morphological,immunofluorescence and Western blot analysis.Results:Compared with the SNI group,on the 28th day after surgery,the SFIs of the treatment groups were increased;the difference in the SNI+A-2 mm group was the most obvious(95%confidence interval[CI]:[5.86,27.09],P<0.001),and the cross-sectional areas of myocytes in all of the treatment groups were improved.The G-ratios in the SNI+A-1 mm group and SNI+A-2 mm group were reduced significantly(95%CI:[-0.12,-0.02],P=0.007;95%CI:[-0.15,-0.06],P<0.001).In addition,the expressions of S100 and nerve growth factor proteins in the treatment groups were increased;the phosphorylation expressions of ERK1/2 protein in the SNI+A-2 mm group and SNI+A-4 mm group were upregulated(95%CI:[0.03,0.96],P=0.038;95%CI:[0.01,0.94],P=0.047,respectively),and the phosphorylation expression of Akt in the SNI+A-1 mm group was upregulated(95%CI:[0.11,2.07],P=0.031).Conclusion:Local vibration therapy,especially with medium amplitude,was able to promote the recovery of nerve function in rats with SNI;this result was linked to the proliferation of Schwann cells and the activation of the ERK1/2 and Akt signaling pathways.
文摘Objective This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging(MRI)for short-term postoperative facial nerve function in patients with acoustic neuroma.Methods A total of 110 patients with acoustic neuroma who underwent surgery through the retrosigmoid sinus approach were included.Clinical data and raw features from four MRI sequences(T1-weighted,T2-weighted,T1-weighted contrast enhancement,and T2-weighted-Flair images)were analyzed.Spearman correlation analysis along with least absolute shrinkage and selection operator regression were used to screen combined clinical and radiomic features.Nomogram,machine learning,and convolutional neural network(CNN)models were constructed to predict the prognosis of facial nerve function on the seventh day after surgery.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate model performance.A total of 1050 radiomic parameters were extracted,from which 13 radiomic and 3 clinical features were selected.Results The CNN model performed best among all prediction models in the test set with an area under the curve(AUC)of 0.89(95%CI,0.84–0.91).Conclusion CNN modeling that combines clinical and multi-sequence MRI radiomic features provides excellent performance for predicting short-term facial nerve function after surgery in patients with acoustic neuroma.As such,CNN modeling may serve as a potential decision-making tool for neurosurgery.
文摘BACKGROUND： Ultraviolet blood irradiation and oxygenation （UBIO） has obtained better clinical effect in treating acute cerebral infarction, but the mechanism underlying this effect remains unclear. OBJECTIVE： To observe the effect of UBIO on the nerve function and activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase activities on the red blood cell （RBC） membrane of patients with acute cerebral infarction. DESIGN： A randomized and controlled study.SETTING： Department of Neurology, Xiangfan Central Hospital.PARTICIPANTS： From January 2000 to December 2001, excluding those above 70 years old, 58 cases of 700 patients with acute cerebral infarction admitted in the Department of Neurology, Xiangfan Central Hospital, were recruited and divided into two groups according to the random number table： UBIO treated group （n=28）, including 17 males and 11 females, aged 40-68 years; and control group （n=30）, including 20 males and 10 females, aged 44-69 years. All the patients agreed to participate in the therapeutic program and detected items. The general informations were comparable without obvious differences between the two groups （P 〉 0.05）.METHODS： ① The patients in both groups received routine treatments, besides, those in the UBIO treated group were given UBIO treatment by using the XL-200 type therapeutic apparatus produced in Shijiazhuang, whose ultraviolet wave was set at 253.7 nm with the energy density of 0.568 J/m^2 per second, UBIO treatment started from the second day after admission, once every other day, with a single course consisting of 5-7 treatments. ② In the UBIO treated group, the venous blood was sampled before and after the first, third and the completion of the treatment course respectively, the venous blood was taken at each corresponding time point in the control group. After centrifugation of the blood at 10 000 rounds per minute, the RBC membrane was separated and then the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase were detected by means of phosphorus determination.③ The nerve function was scored before and after treatment in both groups with European stroke scale, which included 13 items, the total score was 0-100 points, the higher the score, the better the nerve function. MAIN OUTCOME MEASURES ：①Score of European stroke scale before and after treatment in both groups.② Comparison of the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase on RBC membrane between the two groups before treatment and after the first, third and the completion of the treatment. RESULTS： All the 58 patients with cerebral infarction were involved in the analysis of results.① The score of European stroke scale had no obvious difference between the two groups [（49.31±11.48）, （50.58±12.63）, P 〉 0.05], and it was obviously higher in the UBIO treated group than in the control group after treatment [84.66±13.75）, （77.05±11.17）, P 〈 0.05].②The activity of K^＋-Na^＋-ATPase on RBC membrane in the UBIO treated group was significantly increased after the first and third treatment as compared with before treatment [（31.56±19.25）, （27.64±15.83）, （17.67±13.83）, P 〈 0.01], it was still higher after the completion of the treatment than before treatment without obvious difference [（20.86±14.53）, P 〉 0.05]. After the first and third treatment, it was obviously higher in the UBIO treated group than in the control group [19.31±11.88）, （17.44±10.42）, P 〈 0.01]. ③ In the UBIO treated group, Ca2^＋-Mg2^＋-ATPase activity on RBC membrane significantly increased after the first treatment and remained higher than the pre-treatment level throughout the treatment [（27.49±14.72）, （17.41±4.82）, P 〈 0.01]. The activity of Ca2^＋-Mg2^＋-ATPase on RBC membrane was markedly higher in the UBIO treated group than in the control group after after the first, third and the completion of treatment respectively [（24.83±12.88）, （17.70±5.69）; （28.08±13.44）, （16.32±5.29）; （17.42±6.04）, P〈 0.05-0.01]. CONCLUSION： The effect of UBIO treatment against acute cerebral infarction may be mediated by the increased K^＋-Na^＋ ATPase and Ca2^＋-Mg2^＋-ATPase activities on RBC membrane, which enhances the RBC transformation ability so as to lower RBC aggregation and correct high blood viscosity.
文摘BACKGROUND: Pain and sensory disability are greatly affected by subjective factors, there are no quantitative indexes to evaluate cervical spondylotic radiculopathy(CSR). The judgment on clinical body examination and chief complaint always causes nonobjective results with great individual differences. Quantitative sensory testing (QST) can be used to judge the nerve function of fibril. The application of QST for the quantitative evaluation of peripheral nervous system disease needs to be further studied. OBJECTIVE: The cold-thermal sensation and pain of patients with CSR are quantitatively analyzed by using QST technology in order to evaluate the nerve function of fibril in patients with CSR. DESIGN: Case-control observation. SETTING: Pain Center of Beijing Hospital of Ministry of Health. PARTICIPANTS: Twenty patients with CSR, including 8 males and 12 females, aged from 33 to 70 years, who received treatment between January and April 2005 in Pain Center of Beijing Hospital of Ministry of Health were involved in CSR group. All the involved patients presented symptoms in unilateral upper extremity (left side 10 patients, right side 10 patients). They did not undergo physical therapy or nerve block therapy in 1 week before examination. Eight non-CSR patients who received treatment in Pain Center concurrently were involved in the control group (2 patients with trigeminal neuralgia, 4 with osteoarthrosis of knee joint and 2 with lumbar intervertebral disc protrusion), and another 12 healthy volunteers were involved. Four non-CSR patients and 12 healthy volunteers, 8 male and 12 female, were aged from 23 to 75 years. The informed consents were obtained from all the involved subjects. METHODS: The volar thresholds of cold sensation, thermal sensation, cryalgesia of thenar eminence of both upper extremities of all the subjects were examined separately by limit method with type TSA-Ⅱ temperature sensation analysator made by Medco Company (Israel). The subjects were pre-examined to be familiar with the method for sensory discrimination and affirmation. Thenar eminence vola of bilateral upper extremities were detected. The infrared detector of a semiconductor was contacted with skin. The infrared detector could be used to heat and cool skin. A group of cold-heat water circulation device was given electric current to produce temperature gradient, which was higher or lower than skin temperature. The initial temperature of infrared detector was 32 ℃, stimulation temperature was increased or decreased progressively at 1 ℃/s, and temperature change range was 0 to 50 ℃. In the first step, subjects pressed down the button to stop the stimulation when the temperature of infrared detector was decreased progressively until the subjects felt, and the threshold of cold sensation was obtained; In the second step, the threshold of thermal sensation was obtained when the temperature of infrared detector was increased progressively until the subjects felt; In the third step, the threshold of cryalgesia was obtained when the temperature of infrared detector was decreased progressively until subjects felt; and in the fourth step, the threshold of thermalgesia was obtained when the temperature of infrared detector was increased progressively until subjects felt. Each step was conducted 4 times and the mean threshold was obtained. Before each measurement, the temperature was made to rebound to the initial temperature and kept for 10 s. MAIN OUTCOME MEASURES: The thresholds of cold sensation, thermal sensation and cryalgesia, thermalgesia of thenar eminence vola of bilateral upper extremities of all the subjects. RESULTS: Twenty patients with CSR and 20 healthy subjects participated in the final results. ① In the CSR group, the threshold of cold sensation of affected side was lower than that of intact side [(29.00±1.26) ℃ vs.(30.00±1.06) ℃, P < 0.05], and the threshold of thermal sensation of affected side was higher than that of intact side [(35.04±0.87) ℃ vs. (34.14±0.99) ℃, P < 0.05]. There were no significant differences in the thresholds of cold and thermal sensation between affected side and intact side (P > 0.05). ②In the CSR group, the difference of threshold of cold sensation, thermal sensation, cryalgesia and thermalgesia between affected side and intact side was (-1.01±0.57), (0.89±0.39), (2.49±1.10) and (-1.62±0.86) ℃, respectively , the absolute value of which was higher than that of control group, respectively [(0.04±0.28),(0.05±0.26),(0.28±1.79),(0.17±1.10) ℃,P < 0.01]. In the CSR group, the threshold of cold sensation and thermalgesia of affected side was lower than that of intact side, respectively; and the threshold of thermal sensation and cryalgesia of affected side was higher than that of intact side, respectively. CONCLUSION: The superficial sensation of affected extremity of patients with CSR is lessened as compared with that of intact extremity. There are dysfunctions of small myelinated fiber (Aδ fiber) and demyelinated fiber (C fiber) in the affected-side extremity. QST, as a mean for quantitatively evaluating the function of Aδ fiber and C fiber, plays an objective evaluative role in the diagnosis and therapeutic effect observation of CSR.
文摘Objective： To explore the effect of electro-acupuncture and musk injection on recovery of injured sciatic nerve function in rats, so as to provide the experimental evidences for the promotion of peripheral nerve regeneration by electro-acupuncture and musk injection. Methods： Following establishing rat model of sciatic nerve injury by operation, the rats were randomly divided into electro-acupuncture group, musk injection group, electro-acupuncture plus musk injection group and model group, then sciatic functional index （SFI） and motor nerve conduction velocity （MNCV） were measured after 4 weeks of treatment, 8 weeks of treatment and 12 weeks of treatment respectively to evaluate recovery of nerve function. Results： SFI and MNCV in electro-acupuncture group, musk injection group and electro-acupuncture plus musk injection group were improved more obviously than that in model group, with significant differences（P〈0.01, P〈0.05）. Conclusions： Both electro-acupuncture and musk injection could promote recovery of injured nerve function, and they had a certain synergetic effect and might be the effective methods in promoting recovery of injured peripheral nerve function.
文摘To examine the effects of Cerebrolysin on the treatment of diabetic peripheral neuropathy, we first established a mouse model of type 2 diabetes mellitus by administering a high-glucose, high-fat diet and a single intraperitoneal injection of streptozotocin. Mice defined as diabetic in this model were then treated with 1.80, 5.39 or 8.98 m L/kg of Cerebrolysin via intraperitoneal injections for 10 consecutive days. Our results demonstrated that the number, diameter and area of myelinated nerve fibers increased in the sciatic nerves of these mice after administration of Cerebrolysin. The results of several behavioral tests showed that Cerebrolysin dose-dependently increased the slope angle in the inclined plane test（indicating an improved ability to maintain body position）, prolonged tail-flick latency and foot-licking time（indicating enhanced sensitivity to thermal and chemical pain, respectively, and reduced pain thresholds）, and increased an index of sciatic nerve function in diabetic mice compared with those behavioral results in untreated diabetic mice. Taken together, the anatomical and functional results suggest that Cerebrolysin ameliorated peripheral neuropathy in a mouse model of type 2 diabetes mellitus.
文摘Objective: To explore the therapeutic effect of Huoxue Tongmai capsule combined with edaravone right camphor on patients with acute cerebral infarction (Acute Cerebral Infarction) and the effect of combination therapy on serum inflammatory factors. Methods: In this study, 90 patients with acute cerebral infarction hospitalized in Zhuji People’s Hospital from December 2023 to December 2024 were selected and divided into two groups of 45 patients in each group. The control group used standard medical treatment, and the treatment group compared the changes of serum inflammatory factors IL-CRP, TNF-α, and Hcy with Huoxue Tongmai capsule for 7 days, 14 days and 30 days, and discussed the changes of the modified Rankin scale score (mRS) and National Institutes of Health Stroke Scale (NIHSS) score. Results: At 7 days, 14 days, and 30 days of treatment, the NIHSS score, mRS score, hs-CRP, IL-6, TNF-α, and Hcy levels were statistically significant (P α, and Hcy levels in the treatment group were significantly lower than those in the control group (P Conclusion: Patients with acute cerebral infarction received Huoxue Tongmai capsule combined with edaravone right camphor, which can reduce the inflammatory reaction, improve the nerve function and improve the prognosis.
基金the National Key Research and Development Project of China,No.2020YFC2004200(to ZYL)the National Natural Science Foundation of China,Nos.61761166007(to ZYL),81772453(to DSX),81974358(to DSX),31771071(to ZYL)Fundamental Research Funds for Central Public Welfare Research Institutes,No.118009001000160001(to ZYL)。
文摘More than half of stroke patients live with different levels of motor dysfunction after receiving routine rehabilitation treatments.Therefore,new rehabilitation technologies are urgently needed as auxiliary treatments for motor rehabilitation.Based on routine rehabilitation treatments,a new intelligent rehabilitation platform has been developed for accurate evaluation of function and rehabilitation training.The emerging intelligent rehabilitation techniques can promote the development of motor function rehabilitation in terms of informatization,standardization,and intelligence.Traditional assessment methods are mostly subjective,depending on the experience and expertise of clinicians,and lack standardization and precision.It is therefore difficult to track functional changes during the rehabilitation process.Emerging intelligent rehabilitation techniques provide objective and accurate functional assessment for stroke patients that can promote improvement of clinical guidance for treatment.Artificial intelligence and neural networks play a critical role in intelligent rehabilitation.Multiple novel techniques,such as braincomputer interfaces,virtual reality,neural circuit-magnetic stimulation,and robot-assisted therapy,have been widely used in the clinic.This review summarizes the emerging intelligent rehabilitation techniques for the evaluation and treatment of motor dysfunction caused by nervous system diseases.
文摘OBJECTIVE： There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell＇s palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell＇s palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell＇s palsy. METHODS： The facial nerve function of 68 patients with Bell＇s palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to find the relationship between electrical response and therapeutic effects or prognosis. RESULTS： Checking consistency between electrical response grading and House-Brackmann scale： Kappa value 0.028 （P = 0.578）. Correlation analysis： the two methods were correlated with the prognosis, and electrical response grading （rER = 0.789） was better than the House-Brackmann scale （rHB = 0.423）. CONCLUSION： Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.
基金funded by the National High Technology Research and Development Program of China(863 Program),No.2008AA022400a grant from Science&Technology Department of Sichuan Province of China,No.2009JY0174
文摘Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we per-formed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduc-tion function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regener-ated potentials ifrst appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ‘ex-cellent’ and ‘good’ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The func-tional recovery of a transplanted nerve can be dynamically observed after the surgery.
基金supported by the National Key Research and Development Program of China, No. 2016YFC1101603 (to DYZ)the National Natural Science Foundation of China, Nos. 31640045 (to YHW), 81901251 (to ML)the Natural Science Foundation of Beijing of China, No. 7204323 (to ML)
文摘We previously prepared nerve growth factor poly-lactide co-glycolid sustained-release microspheres to treat rat sciatic nerve injury using the small gap sleeve technique.Multiple growth factors play a synergistic role in promoting the repair of peripheral nerve injury;as a result,in this study,we added basic fibroblast growth factors to the microspheres to further promote nerve regeneration.First,in an in vitro biomimetic microenvironment,we developed and used a drug screening biomimetic microfluidic chip to screen the optimal combination of nerve growth factor/basic fibroblast growth factor to promote the regeneration of Schwann cells.We found that 22.56 ng/mL nerve growth factor combined with 4.29 ng/mL basic fibroblast growth factor exhibited optimal effects on the proliferation of primary rat Schwann cells.The successfully prepared nerve growth factor-basic fibroblast growth factor-poly-lactide-co-glycolid sustained-release microspheres were used to treat rat sciatic nerve transection injury using the small gap sleeve bridge technique.Compared with epithelium sutures and small gap sleeve bridging alone,the small gap sleeve bridging technique combined with drug-free sustained-release microspheres has a stronger effect on rat sciatic nerve transfection injury repair at the structural and functional level.
基金supported by the National Natural Science Foundation of China,No.81171694,81201374,81371968,81371969a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Nature Science Foundation of Jiangsu Province No.BK2012718,BK2011844
文摘Although the local application of mitomycin C may prevent epidural adhesion after laminectomy, mitomycin C can induce neurotoxicity in optic and acoustic nerves at high concentrations. To determine the safe concentration range for mitomycin C, cotton pads soaked with mitomycin C at different concentrations （0.1, 0.3, 0.5, and 0.7 mg/mL） were immediately applied for 5 minutes to the operation area of rats that had undergone laminectomy at L1. Rat sciatic nerves, instead of dorsal nerves, were used in this study. The results showed that mitomycin C at 0.1-0.5 mg/mL did not damage the structure and function of the sciatic nerve, while at 0.7 mg/mL, mitomycin C signiifcantly reduced the thickness of the sciatic nerve myelin sheath compared with lower concen-trations, though no functional change was found. These experimental ifndings indicate that the local application of mitomycin C at low concentrations is safe to prevent scar adhesion following laminectomy, but that mitomycin C at high concentrations （＆gt;0.7 mg/mL） has potential safety risks to peripheral nerve structures.
基金supported by the Natural Science Foundation of Guangdong Province of China,No.2016A030313327the Science and Technology Planning Project of Guangzhou City of China,No.201607010185+1 种基金the Science and Technology Planning Project of Guangdong Province of China,No.2016A020215226the National Natural Science Foundation of China,No.81401869
文摘Aphasia is an acquired language disorder that is a common consequence of stroke.The pathogenesis of the disease is not fully understood,and as a result,current treatment options are not satisfactory.Here,we used blood oxygenation level-dependent functional magnetic resonance imaging to evaluate the activation of bilateral cortices in patients with Broca＇s aphasia 1 to 3 months after stroke.Our results showed that language expression was associated with multiple brain regions in which the right hemisphere participated in the generation of language.The activation areas in the left hemisphere of aphasia patients were significantly smaller compared with those in healthy adults.The activation frequency,volumes,and intensity in the regions related to language,such as the left inferior frontal gyrus（Broca＇s area）,the left superior temporal gyrus,and the right inferior frontal gyrus（the mirror region of Broca＇s area）,were lower in patients compared with healthy adults.In contrast,activation in the right superior temporal gyrus,the bilateral superior parietal lobule,and the left inferior temporal gyrus was stronger in patients compared with healthy controls.These results suggest that the right inferior frontal gyrus plays a role in the recovery of language function in the subacute stage of stroke-related aphasia by increasing the engagement of related brain areas.
基金supported by the National Natural Science Foundation of China,No.90307013,90707005,61534003the Science&Technology Pillar Program of Jiangsu Province in China,No.BE2013706
文摘Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method.Through a series of novel design concepts,including the integration of a detecting circuit and an analog-to-digital converter,a miniaturized functional electrical stimulation circuit technique,a low-power super-regeneration chip for wireless receiving,and two wearable armbands,a prototype system has been established with reduced size,power,and overall cost.Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects,the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy.Test results showed that wrist flexion/extension,hand grasp,and finger extension could be reproduced with high accuracy and low latency.This system can build a bridge of information transmission between healthy limbs and paralyzed limbs,effectively improve voluntary participation of hemiplegic patients,and elevate efficiency of rehabilitation training.
基金Supported by the National Natural Science Fund(No. 81173187)the Natural Science Fund of Anhui Province (No.11040606M217)
文摘OBJECTIVE:To study the functional mechanism of Pingchuanning Decoction in treatment of airway remodeling in asthmatic rats.METHODS:Eighty healthy Wistar male rats were randomized into eight groups(n=10 rats each):Normal group,Asthma model group,Dexamethasone group,Guilong Kechuanning group,Xiaoqinglong Decoction group,and Pingchuanning Decoction low-,middle-,and high-dose groups.The rats of all but the Normal group were made into asthma models through intraperitoneal injection and aerosol inhalation of ovalbumin.All treatments were administered at the first stimulation of asthma onset(third week of modeling),and the rats were killed after stimulating asthma attacks for 4 weeks.The general conditions of rats and pathomorphological changes of the lung tissues were observed.The expression of nerve growth factor(NGF) of the lung tissues was measured with immunohistochemical methods,and the content of Clara cell secretory protein(CCSP) mRNA was determined with RT-PCR.RESULTS:Compared with the Normal group,the contents of NGF and CCSP mRNA in the lung tissues of the Model group were significantly changed(P<0.01).Compared with the Model group,the indices of Pingchuanning Decoction and other treatment groups were improved to some extent(P<0.05 or P<0.01).CONCLUSIONS:Pathological changes of airway inflammation and remodeling were present in these rat asthma models.Pingchuanning Decoction had an intervention effect on these experimental models.Its functional mechanism may be related to multiple factors,including alleviation of airway inflammation,relief of bronchial smooth muscle spasm,and inhibition of airway remodeling.
基金supported by the National Natural Science Foundation of China,No.81360194a grant from the National Basic Research Program of China,No.2014CB542200
文摘Surgical accuracy has greatly improved with the advent of microsurgical techniques. However, complete functional recovery after peripheral nerve injury has not been achieved to date. The mechanisms hindering accurate regeneration of damaged axons after peripheral nerve injury are in urgent need of exploration. The present study was designed to explore the mechanisms of peripheral nerve regeneration after different types of injury. Femoral nerves of rats were injured by crushing or freezing. At 2, 3, 6, and 12 weeks after injury, axons were retrogradely labeled using 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate（Dil） and True Blue, and motor and sensory axons that had regenerated at the site of injury were counted. The number and percentage of Dil-labeled neurons in the anterior horn of the spinal cord increased over time. No significant differences were found in the number of labeled neurons between the freeze and crush injury groups at any time point. Our results confirmed that the accuracy of peripheral nerve regeneration increased with time, after both crush and freeze injury, and indicated that axonal regeneration accuracy was still satisfactory after freezing, despite the prolonged damage.
文摘Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.
基金supported by the National Natural Science Foundation of China,No.30972153
文摘Following central nervous system injury, axonal sprouts form distal to the injury site and extend into the denervated area, reconstructing neural circuits through neural plasticity. How to facilitate this plasticity has become the key to the success of central nervous system repair. It remains controversial whether fine motor skill training contributes to the recovery of neurological function after spinal cord injury. Therefore, we established a rat model of unilateral corticospinal tract injury using a pyramidal tract cutting method. Horizontal ladder crawling and food ball grasping training procedures were conducted 2 weeks before injury and 3 days after injury. The neurological function of rat forelimbs was assessed at 1, 2, 3, 4, and 6 weeks after injury. Axon growth was observed with biotinylated dextran amine anterograde tracing in the healthy corticospinal tract of the denervated area at different time periods. Our results demonstrate that compared with untrained rats, functional recovery was better in the forelimbs and forepaws of trained rats. The number of axons and the expression of growth associated protein 43 were increased at the injury site 3 weeks after corticospinal tract injury. These findings confirm that fine motor skill training promotes central nervous system plasticity in spinal cord injury rats.
基金supported by the Institute for Basic Science[grant No.IBS-R015-D1]the National Research Foundation of Korea(grant No.NRF-2016R1A2B4008545)
文摘Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored.We explored age-related brain network differences between ADHD patients and typically developing（TD） subjects using resting state f MRI（rs-f MRI） for three age groups of children,adolescents,and adults.We collected rs-f MRI data from 184 individuals（27 ADHD children and 31 TD children;32 ADHD adolescents and 32 TD adolescents;and 31 ADHD adults and 31 TD adults）.The Brainnetome Atlas was used to define nodes in the network analysis.We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality,a well-known measure of nodal centrality.The left middle temporal gyrus showed significant interaction effects between disease status（i.e.,ADHD or TD） and age（i.e.,child,adolescent,or adult）（P 0.001）.Additional regions were identified at a relaxed threshold（P 0.05）.Many of the identified regions（the left inferior frontal gyrus,the left middle temporal gyrus,and the left insular gyrus） were related to cognitive function.The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients.These findings contribute to better understand how brain function influences the symptoms of ADHD.
