In this work,we intended to connect clinimetrics with holism in traditional Chinese medicine towards multidimensional assessment of post-stroke sequelae in real-world setting,as a bridge between inheritance and innova...In this work,we intended to connect clinimetrics with holism in traditional Chinese medicine towards multidimensional assessment of post-stroke sequelae in real-world setting,as a bridge between inheritance and innovation.Firstly,a systematic search of current evidence that supported integrated treatment of traditional Chinese and Western medicine for post-stroke sequelae sufferers was performed.Secondly,on the basis of available evidence,we presented couples of implications.Lastly,as psychosomatic perspective is one of the main academic paradigms of traditional Chinese medicine holism,we chiefly proposed comprehensive assessment for both motor and non-motor severities to probably match consonance with traditional Chinese medicine practice that treats psycho-/somatic-complains simultaneously.展开更多
Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but...Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.展开更多
BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their effi...BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.展开更多
The activation of the sirtuin1(SIRT1)/nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase 1(HO-1)pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing ...The activation of the sirtuin1(SIRT1)/nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase 1(HO-1)pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing reactive oxygen species(ROS)levels.Clinical trials have demonstrated that Zhongfeng Xingnao Liquid(ZFXN)ameliorates post-stroke cognitive impairment(PSCI).However,the underlying mechanism,particularly whether it involves protecting mitochondria and inhibiting apoptosis through the SIRT1/Nrf2/HO-1 pathway,remains unclear.This study employed an oxygen-glucose deprivation(OGD)cell model using SHSY5Y cells and induced PSCI in rats through modified bilateral carotid artery ligation(2VO).The effects of ZFXN on learning and memory,neuroprotective activity,mitochondrial function,oxidative stress,and the SIRT1/Nrf2/HO-1 pathway were evaluated both in vivo and in vitro.Results indicated that ZFXN significantly increased the B-cell lymphoma 2(Bcl2)/Bcl2-associated X(Bax)ratio,reduced terminal deoxynucleotidyl transferase-mediated d UTP nickend-labeling(TUNEL)+cells,and markedly improved cognition,synaptic plasticity,and neuronal function in the hippocampus and cortex.Furthermore,ZFXN exhibited potent antioxidant activity,evidenced by decreased ROS and malondialdehyde(MDA)content and increased superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH)levels.ZFXN also demonstrated considerable enhancement of mitochondrial membrane potential(MMP),Tom 20 fluorescence intensity,adenosine triphosphate(ATP)and energy charge(EC)levels,and mitochondrial complexⅠandⅢactivity,thereby inhibiting mitochondrial damage.Additionally,ZFXN significantly increased SIRT1 activity and elevated SIRT1,nuclear Nrf2,and HO-1 levels.Notably,these effects were substantially counteracted when SIRT1 was suppressed by the inhibitor EX-527 in vitro.In conclusion,ZFXN alleviates PSCI by activating the SIRT1/Nrf2/HO-1 pathway and preventing mitochondrial damage.展开更多
Post-stroke swallowing disorder is an important factor affecting the rehabilitation of stroke patients.There are many clinical treatment methods such as physical therapy and acupuncture.From the literature in recent y...Post-stroke swallowing disorder is an important factor affecting the rehabilitation of stroke patients.There are many clinical treatment methods such as physical therapy and acupuncture.From the literature in recent years,acupuncture points,acupuncture manipulation,acupuncture amount,combined with other treatment methods,and acupoint selection based on syndrome differentiation are reviewed.It is clinically proved that acupuncture is effective in treating stroke accompanied by swallowing disorder.Different acupuncture methods need to select different acupoints,and different doctors have different acupuncture techniques,which reflects the syndrome differentiation and treatment of traditional Chinese medicine.Summarizing the literature is convenient in guiding patients to select acupoints more precisely and easily in treatment.In the future,more patient samples,multiple clinical centers and more standardized controlled clinical trials will be adopted to find out the theoretical basis of traditional Chinese medicine for acupuncture treatment of post-stroke swallowing disorder and the specific effective acupoints in acupuncture treatment,so as to facilitate learning,communication,popularization and application in primary clinical practice.展开更多
BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic ...BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.METHODS Two hundred patients with chronic stroke admitted in over 7 years(January 2017 to January 2024),were enrolled and categorized into the PSD group(n=96)and the non-PSD(NPSD)group(n=104).Demographic characteristics,clinicopathological data,and biochemical indicators were collected and analyzed by univariate analysis.Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk.The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.RESULTS Compared with the NPSD group,the PSD group included a higher proportion of patients aged≥60 years,divorced/widowed,with an education level below senior high school,presenting with≥2 comorbidities,exhibiting severe neurological impairment,and having multiple lesions.Additionally,the PSD group showed significantly higher neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)than the NPSD group.After assigning values to significant predictors,multivariate analysis indicated that educational level(P=0.046),NLR(P<0.001),and PLR(P<0.001)were independently associated with PSD in patients with chronic stroke.The developed nomogram exhibited favorable discrimination performance.The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in lowand middle-risk categories.CONCLUSION Education level,NLR,and PLR independently contribute to PSD in patients with chronic stroke.The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90,presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.展开更多
Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this ...Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.展开更多
Post-stroke depression(PSD) is a common psychiatric complication affecting nearly one-third of stroke survivors, leading to increased disability, mortality, and cognitive decline. Traditional Chinese Medicine(TCM) has...Post-stroke depression(PSD) is a common psychiatric complication affecting nearly one-third of stroke survivors, leading to increased disability, mortality, and cognitive decline. Traditional Chinese Medicine(TCM) has proven effective in treating PSD through syndrome differentiation, yet existing animal models primarily reflect Western medical concepts and fail to incorporate the TCM principle of “同病异治”( treating the same disease with different methods). This paper provides a review of the current methods for constructing animal models of post-stroke depression(PSD) from the perspective of Traditional Chinese Medicine(TCM) syndrome differentiation and proposes multi-dimensional assessment indicators. By integrating TCM theories with modern biomedical techniques, this study offers a comprehensive framework for deepening the understanding of the pathogenesis and therapeutic evaluation of PSD. This approach not only contributes to advancing PSD research but also paves the way for innovative treatment strategies that combine traditional and modern medicine.展开更多
Post-stroke depression(PSD)is a prevalent but often underdiagnosed complication affecting stroke survivors,with significant implications for recovery and quality of life.Emerging evidence suggests that central obesity...Post-stroke depression(PSD)is a prevalent but often underdiagnosed complication affecting stroke survivors,with significant implications for recovery and quality of life.Emerging evidence suggests that central obesity,as measured by the weight-to-waist index(WWI),may play a crucial role in PSD risk and severity.Traditional obesity metrics,such as body mass index,may not accurately capture the impact of visceral fat distribution on neuropsychiatric outcomes.This letter highlights the growing recognition of WWI as a precise indicator of metabolic and inflammatory disturbances linked to post-stroke mental health.Integrating WWI into routine stroke rehabilitation assessments could facilitate early identification of high-risk patients and improve intervention strategies.Further research is needed to establish standardized WWI cutoff values and explore potential therapeutic targets for PSD prevention.展开更多
Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients wi...Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients with post-stroke pneumonia were investigated,and the number of cases was 60.These patients’diseases were consistent with the dialectical standards of traditional Chinese medicine(phlegm-heat obstructing lungs).The patients were randomly divided into a control group(30 cases,treated with antibiotics and symptomatic methods)and a treatment group(30 cases,treated with Xiaochaihu Decoction and Xiaoxianxiong Decoction on the basis of the control group).Various indicators were compared.Results:The total clinical effective rates were 93%and 80%in the treatment group and the control group,respectively,with statistical significance(P<0.05).The improvement of various clinical symptoms was compared,and the values in the treatment group were reduced,showing significance(P<0.05).Analysis of serum factor indicators showed that the overall trend of the treatment group was reduced,and the comparison between groups was below 0.05.Conclusion:Xiaochaihu Decoction combined with Xiaoxianxiong Decoction has a significant clinical effect in the treatment of post-stroke pneumonia(phlegm-heat obstructing lungs syndrome),which can reduce inflammatory reactions and has few adverse reactions,worthy of clinical application.展开更多
In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Gi...In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Given the developmental disparity in this population,specific preoperative planning is an essential prerequisite for the success of THA procedures.In the review by Oommen et al,assessments of acetabular and femoral anatomic variations were fully described.However,spinal malalignment and stiffness are common in physical and radiological examinations and should be taken into careful consideration when planning surgical procedures.Poor outcomes of THA for patients with comorbid hip and spinopelvic pathologies have been widely reported,especially for hips with childhood disorder sequelae.Therefore,in this editorial,we would like to emphasize the need for a thorough hip-spine evaluation of patients with childhood hip disorder sequelae before THA.展开更多
BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains ina...BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.展开更多
Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Si...Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials （RCT） of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results Atotal of 23 RCTs （845 patients with post-stroke depression） were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI （0.11, 0.40）], but via susceptibility analysis （excluding low quality studies）, the differences were not statistically significant [SMD=-0.06, 95% CI （-0.37, 0.25）], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% Cl （0.19, 0.53）], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high- quality randomized controlled trials for further verification.展开更多
Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medicatio...Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medication group, 30 cases in each group. In comprehensive therapy group, electroacupuncture at temple-three-needle was mainly applied and Fluoxetine Hydrochloride capsule was taken by oral administration; in medication group, Fluoxetine Hydrochloride capsule was applied by oral administration. Functional Independent Measure （FIM） Scale and WHOQOL-BREF evaluation results before and after treatment were compared after 4 weeks treatment. Results Comparing with the FIM scores before treatment, the differences in the two groups were significant （both P0.01）, and the improvement in comprehensive therapy group （74.97±9.52） was superior to that in medication group （66.70±9.23） （P0.01）. Signif icant differences were presented statistically in comparison of index scores of WHOQOL-BREF before and after treatment in two groups （P0.05, P0.01）, and it in comprehensive therapy group was superior to that in medication group （P0.05, P0.01）. Conclusion Activities of daily life and quality of life of post-stroke depression can be significantly improved by electroacupuncture at temple-three-needle and oral administration of Fluoxetine Hydrochloride capsule.展开更多
This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized co...This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized controlled clinical trials （quasi-RCTs） will be searched from the following databases： the Cochrane Central Register of Controlled Trials （CENTRAL）, MEDLINE, EMBASE, China National Knowledge Infrastructure （CNKI）, Chinese Scientific Journal Database （VIP）, Wanfang Database, Chinese BioMedical Literature Database （CBM）. The Cochrane risk of bias tool will be used to assess the trials. No patients or their family will be bothered in this systematic review, so there is no need for the permission of institutional review board （IRB）. The completed systematic review will be published in a peer-reviewed journal.展开更多
Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized int...Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.展开更多
Although depression may affect patients＇ recovery and even their survival rate after stroke,it is often overlooked or inadequately managed.And data regarding the treatment efficacy and safety of fluoxetine in this se...Although depression may affect patients＇ recovery and even their survival rate after stroke,it is often overlooked or inadequately managed.And data regarding the treatment efficacy and safety of fluoxetine in this setting are inconsistent.We aimed to systematically assess those two indices in patients with post-stroke depression （PSD）.Through a systematic literature search in 10 biomedical databases,244 articles were first identified,through which we collected and evaluated a total of 600 patients identified from 11 RCTs.The meta-analysis with Revman software indicated that fluoxetine was more effective than placebo,the combined results of 9 RCTs showed that fluoxetine decreased the depression rating scale scores significantly compared with placebo,and the pooled weighted mean difference （WMD） was 0.44 （95% CI-0.03 to 0.92）.Moreover,time-dependent effects were also observed.No consistent evidence was found for its positive effects on the recovery of neurological impairments and improvements in activities of daily living （ADL）.Six studies reported rate of adverse effects in both fluoxetine groups and control groups and showed no significant difference between them （OR=0.03,95% CI-0.00 to 0.07）.This meta-analysis suggested that fluoxetine may be effective and safe for patients with PSD and it may have time-dependent effects.展开更多
Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-str...Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.展开更多
Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and expl...Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and explore the role of Danzhi decction in improving the blood stasis microenvironment of SPID.Methods:A three-dimensional(3D) co—culture system including human vascular endothelial cells(VECs),endometrial stromal cells and glandular epithelial cells was established in vitro and treated with Danzhi decoction,sterilized water and aspirin respectively.A Milliplex multifunctional liquid chip technique was used to measure the expression levels of vascular endothelial growth factor(VEGF)—A/C/D,fibroblast growth factor-1/2.angiopoietin-2.epidermal growth factor(EGF) HB-EGF,bone morphogenetic protein-9.endoglin.endothehn-l.granulocyte colony stimulating factor,hepatocyte growth factor,interleukin-8,follistatin.placenta growth factor and leptin.The location of angiogenesis factors was monitored by immunofluorescence labeling and confocal laser scanning microscope3 D reconstruction.Results:Endometrial stromal cells and glandular epithelial cells were isolated and primary cultured for establishing a 3D co-culture system.The levels of VEGF—A/C/D in Danzhi decoction group and aspirin group were significantly lower than those in mock group(P<0.05).while there was no significant difference between Danzhi decoction group and aspirin group(P>0.05).Furthermore,the alterative location of VEGF—A/C/D was observed in the cytoplasm of endometrial glandular epithelial cells.Conclusions:Danzhi decoction mav inhibit the expression of VEGF in the blood stasis microenvironment of SPID by targeting the cytoplasm of endometrial glandular epithelial cell.展开更多
AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic le...AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae(stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma(PS)and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic leakage.RESULTS: Structural sequelae after anastomotic leakage were identified in 29 patients(39.7%).Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio(OR) = 6.741; P = 0.017].Fourteen patients(17.7%) had permanent stoma during the follow-up period(median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma(OR = 0.751; P = 0.045).CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.展开更多
基金supported by Guangdong Medical Science Foundation(Grant No.A2020370A2021199)Guangdong Administration of Traditional Chinese Medicine Project(Grant No.20211328).
文摘In this work,we intended to connect clinimetrics with holism in traditional Chinese medicine towards multidimensional assessment of post-stroke sequelae in real-world setting,as a bridge between inheritance and innovation.Firstly,a systematic search of current evidence that supported integrated treatment of traditional Chinese and Western medicine for post-stroke sequelae sufferers was performed.Secondly,on the basis of available evidence,we presented couples of implications.Lastly,as psychosomatic perspective is one of the main academic paradigms of traditional Chinese medicine holism,we chiefly proposed comprehensive assessment for both motor and non-motor severities to probably match consonance with traditional Chinese medicine practice that treats psycho-/somatic-complains simultaneously.
基金Supported by Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040Nantong Young Medical Expert,No.46+2 种基金Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,and No.MSZ2024038Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD022,and No.KD2024KYJJZD289Nantong Municipal Health Commission Project,No.MSZ2023020.
文摘Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.
基金Supported by Open Project of Jiangsu Province Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Geriatric Diseases,No.202232.
文摘BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.
基金supported by the Science&Technology Department of Sichuan Province(No.2019YFS0040)the Improvement Plan of“Xinglin Scholar”Scientific Research Talent,Chengdu University of Traditional Chinese Medicine(No.XKTD2022002)。
文摘The activation of the sirtuin1(SIRT1)/nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase 1(HO-1)pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing reactive oxygen species(ROS)levels.Clinical trials have demonstrated that Zhongfeng Xingnao Liquid(ZFXN)ameliorates post-stroke cognitive impairment(PSCI).However,the underlying mechanism,particularly whether it involves protecting mitochondria and inhibiting apoptosis through the SIRT1/Nrf2/HO-1 pathway,remains unclear.This study employed an oxygen-glucose deprivation(OGD)cell model using SHSY5Y cells and induced PSCI in rats through modified bilateral carotid artery ligation(2VO).The effects of ZFXN on learning and memory,neuroprotective activity,mitochondrial function,oxidative stress,and the SIRT1/Nrf2/HO-1 pathway were evaluated both in vivo and in vitro.Results indicated that ZFXN significantly increased the B-cell lymphoma 2(Bcl2)/Bcl2-associated X(Bax)ratio,reduced terminal deoxynucleotidyl transferase-mediated d UTP nickend-labeling(TUNEL)+cells,and markedly improved cognition,synaptic plasticity,and neuronal function in the hippocampus and cortex.Furthermore,ZFXN exhibited potent antioxidant activity,evidenced by decreased ROS and malondialdehyde(MDA)content and increased superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH)levels.ZFXN also demonstrated considerable enhancement of mitochondrial membrane potential(MMP),Tom 20 fluorescence intensity,adenosine triphosphate(ATP)and energy charge(EC)levels,and mitochondrial complexⅠandⅢactivity,thereby inhibiting mitochondrial damage.Additionally,ZFXN significantly increased SIRT1 activity and elevated SIRT1,nuclear Nrf2,and HO-1 levels.Notably,these effects were substantially counteracted when SIRT1 was suppressed by the inhibitor EX-527 in vitro.In conclusion,ZFXN alleviates PSCI by activating the SIRT1/Nrf2/HO-1 pathway and preventing mitochondrial damage.
基金Supported by Graduate Innovation Program of Bengbu Medical University(BYYCX1981).
文摘Post-stroke swallowing disorder is an important factor affecting the rehabilitation of stroke patients.There are many clinical treatment methods such as physical therapy and acupuncture.From the literature in recent years,acupuncture points,acupuncture manipulation,acupuncture amount,combined with other treatment methods,and acupoint selection based on syndrome differentiation are reviewed.It is clinically proved that acupuncture is effective in treating stroke accompanied by swallowing disorder.Different acupuncture methods need to select different acupoints,and different doctors have different acupuncture techniques,which reflects the syndrome differentiation and treatment of traditional Chinese medicine.Summarizing the literature is convenient in guiding patients to select acupoints more precisely and easily in treatment.In the future,more patient samples,multiple clinical centers and more standardized controlled clinical trials will be adopted to find out the theoretical basis of traditional Chinese medicine for acupuncture treatment of post-stroke swallowing disorder and the specific effective acupoints in acupuncture treatment,so as to facilitate learning,communication,popularization and application in primary clinical practice.
文摘BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.METHODS Two hundred patients with chronic stroke admitted in over 7 years(January 2017 to January 2024),were enrolled and categorized into the PSD group(n=96)and the non-PSD(NPSD)group(n=104).Demographic characteristics,clinicopathological data,and biochemical indicators were collected and analyzed by univariate analysis.Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk.The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.RESULTS Compared with the NPSD group,the PSD group included a higher proportion of patients aged≥60 years,divorced/widowed,with an education level below senior high school,presenting with≥2 comorbidities,exhibiting severe neurological impairment,and having multiple lesions.Additionally,the PSD group showed significantly higher neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)than the NPSD group.After assigning values to significant predictors,multivariate analysis indicated that educational level(P=0.046),NLR(P<0.001),and PLR(P<0.001)were independently associated with PSD in patients with chronic stroke.The developed nomogram exhibited favorable discrimination performance.The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in lowand middle-risk categories.CONCLUSION Education level,NLR,and PLR independently contribute to PSD in patients with chronic stroke.The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90,presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.
基金supported by the Chinese Medicine Development Fund,Hong Kong SAR,China(23B2/027A_R1)the National Natural Science Foundation of China(81704198).
文摘Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.
基金Jilin Provincial Department of Education,Grant/Award Number:JJKH20230958KJJilin Scientific and Technological Development Program,Grant/Award Number:YDZJ202401092ZYTS。
文摘Post-stroke depression(PSD) is a common psychiatric complication affecting nearly one-third of stroke survivors, leading to increased disability, mortality, and cognitive decline. Traditional Chinese Medicine(TCM) has proven effective in treating PSD through syndrome differentiation, yet existing animal models primarily reflect Western medical concepts and fail to incorporate the TCM principle of “同病异治”( treating the same disease with different methods). This paper provides a review of the current methods for constructing animal models of post-stroke depression(PSD) from the perspective of Traditional Chinese Medicine(TCM) syndrome differentiation and proposes multi-dimensional assessment indicators. By integrating TCM theories with modern biomedical techniques, this study offers a comprehensive framework for deepening the understanding of the pathogenesis and therapeutic evaluation of PSD. This approach not only contributes to advancing PSD research but also paves the way for innovative treatment strategies that combine traditional and modern medicine.
基金The New Professor Research Program of Korean Technology in 2025.
文摘Post-stroke depression(PSD)is a prevalent but often underdiagnosed complication affecting stroke survivors,with significant implications for recovery and quality of life.Emerging evidence suggests that central obesity,as measured by the weight-to-waist index(WWI),may play a crucial role in PSD risk and severity.Traditional obesity metrics,such as body mass index,may not accurately capture the impact of visceral fat distribution on neuropsychiatric outcomes.This letter highlights the growing recognition of WWI as a precise indicator of metabolic and inflammatory disturbances linked to post-stroke mental health.Integrating WWI into routine stroke rehabilitation assessments could facilitate early identification of high-risk patients and improve intervention strategies.Further research is needed to establish standardized WWI cutoff values and explore potential therapeutic targets for PSD prevention.
文摘Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients with post-stroke pneumonia were investigated,and the number of cases was 60.These patients’diseases were consistent with the dialectical standards of traditional Chinese medicine(phlegm-heat obstructing lungs).The patients were randomly divided into a control group(30 cases,treated with antibiotics and symptomatic methods)and a treatment group(30 cases,treated with Xiaochaihu Decoction and Xiaoxianxiong Decoction on the basis of the control group).Various indicators were compared.Results:The total clinical effective rates were 93%and 80%in the treatment group and the control group,respectively,with statistical significance(P<0.05).The improvement of various clinical symptoms was compared,and the values in the treatment group were reduced,showing significance(P<0.05).Analysis of serum factor indicators showed that the overall trend of the treatment group was reduced,and the comparison between groups was below 0.05.Conclusion:Xiaochaihu Decoction combined with Xiaoxianxiong Decoction has a significant clinical effect in the treatment of post-stroke pneumonia(phlegm-heat obstructing lungs syndrome),which can reduce inflammatory reactions and has few adverse reactions,worthy of clinical application.
文摘In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Given the developmental disparity in this population,specific preoperative planning is an essential prerequisite for the success of THA procedures.In the review by Oommen et al,assessments of acetabular and femoral anatomic variations were fully described.However,spinal malalignment and stiffness are common in physical and radiological examinations and should be taken into careful consideration when planning surgical procedures.Poor outcomes of THA for patients with comorbid hip and spinopelvic pathologies have been widely reported,especially for hips with childhood disorder sequelae.Therefore,in this editorial,we would like to emphasize the need for a thorough hip-spine evaluation of patients with childhood hip disorder sequelae before THA.
文摘BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.
基金Supported by Special Project for Practice Development of National TCM Clinical Research Bases:JDZX 2012154
文摘Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials （RCT） of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results Atotal of 23 RCTs （845 patients with post-stroke depression） were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI （0.11, 0.40）], but via susceptibility analysis （excluding low quality studies）, the differences were not statistically significant [SMD=-0.06, 95% CI （-0.37, 0.25）], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% Cl （0.19, 0.53）], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high- quality randomized controlled trials for further verification.
文摘Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medication group, 30 cases in each group. In comprehensive therapy group, electroacupuncture at temple-three-needle was mainly applied and Fluoxetine Hydrochloride capsule was taken by oral administration; in medication group, Fluoxetine Hydrochloride capsule was applied by oral administration. Functional Independent Measure （FIM） Scale and WHOQOL-BREF evaluation results before and after treatment were compared after 4 weeks treatment. Results Comparing with the FIM scores before treatment, the differences in the two groups were significant （both P0.01）, and the improvement in comprehensive therapy group （74.97±9.52） was superior to that in medication group （66.70±9.23） （P0.01）. Signif icant differences were presented statistically in comparison of index scores of WHOQOL-BREF before and after treatment in two groups （P0.05, P0.01）, and it in comprehensive therapy group was superior to that in medication group （P0.05, P0.01）. Conclusion Activities of daily life and quality of life of post-stroke depression can be significantly improved by electroacupuncture at temple-three-needle and oral administration of Fluoxetine Hydrochloride capsule.
基金Supported by Beijing Chinese medicine inheritance of double hundred project
文摘This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized controlled clinical trials （quasi-RCTs） will be searched from the following databases： the Cochrane Central Register of Controlled Trials （CENTRAL）, MEDLINE, EMBASE, China National Knowledge Infrastructure （CNKI）, Chinese Scientific Journal Database （VIP）, Wanfang Database, Chinese BioMedical Literature Database （CBM）. The Cochrane risk of bias tool will be used to assess the trials. No patients or their family will be bothered in this systematic review, so there is no need for the permission of institutional review board （IRB）. The completed systematic review will be published in a peer-reviewed journal.
文摘Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.
文摘Although depression may affect patients＇ recovery and even their survival rate after stroke,it is often overlooked or inadequately managed.And data regarding the treatment efficacy and safety of fluoxetine in this setting are inconsistent.We aimed to systematically assess those two indices in patients with post-stroke depression （PSD）.Through a systematic literature search in 10 biomedical databases,244 articles were first identified,through which we collected and evaluated a total of 600 patients identified from 11 RCTs.The meta-analysis with Revman software indicated that fluoxetine was more effective than placebo,the combined results of 9 RCTs showed that fluoxetine decreased the depression rating scale scores significantly compared with placebo,and the pooled weighted mean difference （WMD） was 0.44 （95% CI-0.03 to 0.92）.Moreover,time-dependent effects were also observed.No consistent evidence was found for its positive effects on the recovery of neurological impairments and improvements in activities of daily living （ADL）.Six studies reported rate of adverse effects in both fluoxetine groups and control groups and showed no significant difference between them （OR=0.03,95% CI-0.00 to 0.07）.This meta-analysis suggested that fluoxetine may be effective and safe for patients with PSD and it may have time-dependent effects.
基金Supported by Hebei Administration of Traditional Chinese Medicine(2009180)
文摘Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.
基金supported by a grant from the National Natural Science Founlation of China(81373677)
文摘Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and explore the role of Danzhi decction in improving the blood stasis microenvironment of SPID.Methods:A three-dimensional(3D) co—culture system including human vascular endothelial cells(VECs),endometrial stromal cells and glandular epithelial cells was established in vitro and treated with Danzhi decoction,sterilized water and aspirin respectively.A Milliplex multifunctional liquid chip technique was used to measure the expression levels of vascular endothelial growth factor(VEGF)—A/C/D,fibroblast growth factor-1/2.angiopoietin-2.epidermal growth factor(EGF) HB-EGF,bone morphogenetic protein-9.endoglin.endothehn-l.granulocyte colony stimulating factor,hepatocyte growth factor,interleukin-8,follistatin.placenta growth factor and leptin.The location of angiogenesis factors was monitored by immunofluorescence labeling and confocal laser scanning microscope3 D reconstruction.Results:Endometrial stromal cells and glandular epithelial cells were isolated and primary cultured for establishing a 3D co-culture system.The levels of VEGF—A/C/D in Danzhi decoction group and aspirin group were significantly lower than those in mock group(P<0.05).while there was no significant difference between Danzhi decoction group and aspirin group(P>0.05).Furthermore,the alterative location of VEGF—A/C/D was observed in the cytoplasm of endometrial glandular epithelial cells.Conclusions:Danzhi decoction mav inhibit the expression of VEGF in the blood stasis microenvironment of SPID by targeting the cytoplasm of endometrial glandular epithelial cell.
文摘AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae(stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma(PS)and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic leakage.RESULTS: Structural sequelae after anastomotic leakage were identified in 29 patients(39.7%).Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio(OR) = 6.741; P = 0.017].Fourteen patients(17.7%) had permanent stoma during the follow-up period(median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma(OR = 0.751; P = 0.045).CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.
