目的观察浮针疗法对老年患者全膝关节置换术(total knee arthroplasty,TKA)后早期康复及股直肌超声剪切波弹性成像指标的影响。方法纳入膝关节骨性关节炎(knee osteoarthritis,KOA)拟行TKA手术患者64例,按照随机数字表法分为治疗组(32例...目的观察浮针疗法对老年患者全膝关节置换术(total knee arthroplasty,TKA)后早期康复及股直肌超声剪切波弹性成像指标的影响。方法纳入膝关节骨性关节炎(knee osteoarthritis,KOA)拟行TKA手术患者64例,按照随机数字表法分为治疗组(32例)和对照组(32例)。两组均接受标准的围手术期治疗和康复运动,治疗组另予浮针疗法治疗。观察两组围术期膝关节疼痛视觉模拟量表(visual analog scale,VAS)评分、膝关节屈曲角度、美国特种外科医院(hospital for special surgery,HSS)评分、超声剪切波弹性成像指标(股直肌厚度、股直肌横截面积和剪切波速度)、血清C反应蛋白(C-reactive protein,CRP)水平。结果与对照组比较,治疗组术后静息及运动VAS评分均显著降低(P<0.05),且改善趋势更明显(交互效应P<0.05)。治疗组术后第1、3、5天膝关节屈曲角度和HSS评分均优于对照组(P<0.05)。超声弹性成像显示,术后第5天,治疗组发力状态下股直肌横截面积和剪切波速度较对照组提高(P<0.05),放松状态下股直肌厚度亦较对照组增加(P<0.05)。治疗组术后肌力恢复更快(P<0.05),术后第3、5天血清CRP水平低于对照组(P<0.05)。结论在围手术期治疗和康复运动基础上,浮针疗法治疗可有效缓解TKA患者术后早期疼痛,改善膝关节屈曲角度,提高股四头肌肌肉力量,从而改善膝关节功能,且促进炎性吸收。展开更多
Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microgl...Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.展开更多
文摘目的观察浮针疗法对老年患者全膝关节置换术(total knee arthroplasty,TKA)后早期康复及股直肌超声剪切波弹性成像指标的影响。方法纳入膝关节骨性关节炎(knee osteoarthritis,KOA)拟行TKA手术患者64例,按照随机数字表法分为治疗组(32例)和对照组(32例)。两组均接受标准的围手术期治疗和康复运动,治疗组另予浮针疗法治疗。观察两组围术期膝关节疼痛视觉模拟量表(visual analog scale,VAS)评分、膝关节屈曲角度、美国特种外科医院(hospital for special surgery,HSS)评分、超声剪切波弹性成像指标(股直肌厚度、股直肌横截面积和剪切波速度)、血清C反应蛋白(C-reactive protein,CRP)水平。结果与对照组比较,治疗组术后静息及运动VAS评分均显著降低(P<0.05),且改善趋势更明显(交互效应P<0.05)。治疗组术后第1、3、5天膝关节屈曲角度和HSS评分均优于对照组(P<0.05)。超声弹性成像显示,术后第5天,治疗组发力状态下股直肌横截面积和剪切波速度较对照组提高(P<0.05),放松状态下股直肌厚度亦较对照组增加(P<0.05)。治疗组术后肌力恢复更快(P<0.05),术后第3、5天血清CRP水平低于对照组(P<0.05)。结论在围手术期治疗和康复运动基础上,浮针疗法治疗可有效缓解TKA患者术后早期疼痛,改善膝关节屈曲角度,提高股四头肌肌肉力量,从而改善膝关节功能,且促进炎性吸收。
基金supported by the Natural Science Foundation of Yunnan Province,No.202401AS070086(to ZW)the National Key Research and Development Program of China,No.2018YFA0801403(to ZW)+1 种基金Yunnan Science and Technology Talent and Platform Plan,No.202105AC160041(to ZW)the Natural Science Foundation of China,No.31960120(to ZW)。
文摘Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.
