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Modified constraint-induced movement therapy enhances cortical plasticity in a rat model of traumatic brain injury:a resting-state functional MRI study

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Neural Regeneration Research 2023年第2期18卷 410-415页

作者： Cheng-Cheng Sun Yu-Wen Zhang Xiang-Xin Xing Qi Yang Ling-Yun Cao Yu-Feng Cheng Jing-Wang Zhao Shao-Ting Zhou Dan-Dan Cheng Ye Zhang Xu-Yun Hua He Wang Dong-Sheng Xu department of rehabilitation Tongji HospitalSchool of MedicineTongji UniversityShanghaiChina Institute of Science and Technology for Brain-Inspired Intelligence Fudan UniversityShanghaiChina Center of rehabilitation Medicine Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghaiChina Institute of rehabilitation Medicine School of Rehabilitation ScienceShanghai University of Traditional Chinese MedicineShanghaiChina Engineering Research Center of Traditional Chinese Medicine Intelligent rehabilitation Ministry of EducationShanghaiChina department of rehabilitation Shanghai East HospitalSchool of MedicineTongji UniversityShanghaiChina department of rehabilitation Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina department of rehabilitation Shanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina department of Traumatology and Orthopedics Yueyang HospitalShanghai University of Traditional Chinese MedicineShanghaiChina department of rehabilitation Yangzhi Rehabilitation HospitalTongji UniversityShanghaiChina Human Phenome Institute Fudan UniversityShanghaiChina Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence(Fudan University) Ministry of EducationShanghaiChina

Modified constraint-induced movement therapy(mCIMT)has shown beneficial effects on motor function improvement after brain injury,but the exact mechanism remains *** this study,amplitude of low frequency fluctuation(ALFF)metrics measured by resting-state functional magnetic resonance imaging was obtained to investigate the efficacy and mechanism of mCIMT in a control co rtical impact(CCI)rat model simulating traumatic brain *** 3 days after control co rtical impact model establishment,we found that the mean ALFF(mALFF)signals were decreased in the left motor cortex,somatosensory co rtex,insula cortex and the right motor co rtex,and were increased in the right corpus *** 3 weeks of an 8-hour daily mClMT treatment,the mALFF values were significantly increased in the bilateral hemispheres compared with those at 3 days *** mALFF signal valu es of left corpus callosum,left somatosensory cortex,right medial prefro ntal cortex,right motor co rtex,left postero dorsal hippocampus,left motor cortex,right corpus callosum,and right somatosensory cortex were increased in the mCIMT group compared with the control cortical impact ***,we identified brain regions with significantly decreased mALFF valu es at 3 days *** correlation coefficients with the right forelimb sliding score indicated that the improvement in motor function of the affected upper limb was associated with an increase in mALFF values in these brain *** findings suggest that functional co rtical plasticity changes after brain injury,and that mCIMT is an effective method to improve affected upper limb motor function by promoting bilateral hemispheric co rtical *** values correlate with behavio ral changes and can potentially be used as biomarkers to assess dynamic cortical plasticity after traumatic brain injury.

关键词： amplitude of low frequency fluctuation cortical plasticity functional magnetic resonance imaging modified constraint-induced movement therapy traumatic brain injury

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Possible effect of blonanserin on gambling disorder:A clinical study protocol and a case report

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World Journal of Clinical Cases 2021年第11期9卷 2469-2477页

作者： Akihiro Shiina Tadashi Hasegawa Masaomi Iyo Division of Medical treatment and rehabilitation Chiba University Center for Forensic Mental HealthChiba 260-8670Japan department of Psychiatry Chiba University HospitalChiba 260-8670Japan department of Psychiatry Chiba University Graduate School of MedicineChiba 260-8670Japan

BACKGROUND Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social *** several psychotherapeutic and pharmacological approaches have been used to treat gambling disorder,new treatment strategies are *** evidence suggests that dopamine D3 receptor plays a specific role in the brain reward *** To investigate if blonanserin,a dopamine D3 receptor antagonist,would be effective in reducing gambling impulses in patients with gambling *** We developed a study protocol to measure the efficacy and safety of blonanserin as a potential drug for gambling disorder,in which up to 12 mg/d of blonanserin was prescribed for 8 *** A 37-year-old female patient with gambling disorder,intellectual disability,and other physical diseases participated in the pilot *** case showed improvement of gambling symptoms without any ***,blonanserin was discontinued owing to excessive saliva *** This case suggests that blonanserin is potentially an effective treatment for patients with gambling disorder who resist standard therapies,but it also carries a risk of adverse effects. Further studies are needed to confirm the findings.

关键词： Blonanserin Gambling disorder Medication Clinical trial protocol D3 receptor Case report

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Effects of Interactive Dynamic Scalp Acupuncture on Motor Function and Gait of Lower Limbs after Stroke:A Multicenter,Randomized,Controlled Clinical Trial

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Chinese Journal of Integrative Medicine 2022年第6期28卷 483-491页

作者： ZHANG Shao-hua WANG Yu-long ZHANG Chun-xia ZHANG Chun-ping XIAO Peng LI Qian-feng LIANG Wei-rong PAN Xiao-hua ZHOU Ming-chao department of rehabilitation Dapeng New District Nan’ao People’s HospitalShenzhenGuangdong Province518121China department of rehabilitation Medicine Shenzhen Second People’s HospitalShenzhenGuangdong Province518037China department of rehabilitation Medicine Shenzhen Hospital of Guangzhou University of Chinese MedicineShenzhenGuangdong Province518034China

Objective:To evaluate the effects of interactive dynamic scalp acupuncture(IDSA),simple combination therapy(SCT),and traditional scalp acupuncture(TSA)on motor function and gait of the lower limbs in post-stroke hemiplegia ***:A total of 231 patients with post-stroke hemiplegia was randomly divided into IDSA(78 cases),SCT(78 cases),and TSA(75 cases)groups by a random number *** acupuncture(SA)and lower-limb robot training(LLRT)were both performed in the IDSA and SCT *** patients in the TSA group underwent SA and did not receive *** treatment was administered once daily and 6 times weekly for 8 continuous weeks,each session lasted for 30 *** primary outcome measures included Fugl-Meyer Assessment of the Lower Extremity(FMA-LE),Berg Balance Scale(BBS),Modified Barthel Index(MBI),and 6-min walking test(6 MWT).The secondary outcome measures included stride frequency(SF),stride length(SL),stride width(SW),affected side foot angle(ASFA),passive range of motion(PROM)of the affected hip(PROM-H),knee(PROM-K)and ankle(PROM-A)*** patients were evaluated before treatment,at 1-and 2-month treatment,and 1-,and 2-month follow-up visits,*** events during 2-month treatment were ***:Nineteen patients withdrew from the trial,with 8 in the IDSA group,5 in the SCT group,and 6 in the TSA *** FMA-LE,BBS,6 MWT and MBI scores in the IDSA group were significantly increased after 8-week treatment and2 follow-up visits compared with the SCT and TSA groups(Ptreatment,the grade distribution of BBS and MBI scores in the 3 groups were significantly improved at 1,2-month treatment and 2 follow-up visits(Ptreatment(Ptreatment(P<0.05)

关键词： interactive dynamic scalp acupuncture stroke dyskinesia lower extremity motor ability gait self-care capability randomized controlled clinical trial

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Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function,Depression,and Anxiety:A Multicenter,Randomized,Controlled Trial

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Chinese Journal of Integrative Medicine 2022年第2期28卷 106-115页

作者： ZHANG Shao-hua WANG Yu-long ZHANG Chun-xia ZHANG Chun-ping XIAO Peng LI Qian-feng LIANG Wei-rong PAN Xiao-hua ZHOU Ming-chao department of rehabilitation Medicine Dapeng New District Nan'ao People's HospitalShenzhenGuangdong Province(518121)China department of rehabilitation Medicine Shenzhen Second People's HospitalShenzhenGuangdong Province(518037)China department of rehabilitation Medicine Shenzhen Hospital of Guangzhou University of Chinese MedicineShenzhenGuangdong Province(518034)China

Objective:To compare the clinical effects of interactive dynamic scalp acupuncture(IDSA),simple combination therapy(SCT),and traditional scalp acupuncture(TSA)on cognitive function,depression and anxiety in patients with post-stroke cognitive ***:A total of 660 patients with post-stroke cognitive impairment who were admitted to 3 hospitals in Shenzhen City between May 2017 and May 2020 were recruited and randomly assigned to the IDSA(218 cases),SCT(222 cases)and TSA groups(220 cases)according to a random number *** the patients received conventional drug therapy for cerebral stroke and exercise rehabilitation *** acupuncture and computer-based cognitive training(CBCT)were performed simultaneously in the IDSA group,but separately in the morning and in the afternoon in the SCT *** patients in the TSA group underwent scalp acupuncture *** course of treatment was 8 *** treatment(M0),1(M1)and 2 months(M2)after treatment,as well as follow-up at 1(M3)and 2 months(M4),the cognitive function of patients was assessed using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MoCA)Scales;depression,anxiety,sleep quality,and self-care ability of patients were assessed using Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Rating Scale(HAMA),Pittsburgh Sleep Quality Index(PSQI),and Modified Barthel Index(MBI),*** this trial,all adverse events(AEs)were accurately ***:There were no significant differences in the MMSE,MoCA,HAMD,HAMA,PSQI,and MBI scores among the 3 groups at M0(all P>0.05).In the IDSA group,the MMSE,MoCA and MBI scores from M2 to M4 were significantly higher than those in the SCT and TSA groups,while the HAMD,HAMA and PSQI scores were significantly reduced(all P<0.01).The changes of all above scores(M2–M0,M4–M0)were significantly superior to those in the SCT and TSA groups(all P<0.01,except M4–M0 of HAMD).At M2,the severity of MMSE,HAMD,HAMA,PSQI and MBI

关键词： interactive dynamic scalp acupuncture stroke cognitive function depression anxiety randomized controlled trial Chinese medicine

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Therapeutic efficacy of acupuncture combined with neuromuscular joint facilitation in treatment of hemiplegic shoulder pain

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World Journal of Clinical Cases 2019年第23期7卷 3964-3970页

作者： Yan-Hui Wei De-Chao Du Ke Jiang department of rehabilitation Nanjing University of Chinese MedicineNanjing 210028Jiangsu ProvinceChina department of rehabilitation Nanjing Red Cross HospitalNanjing 210028Jiangsu ProvinceChina department of rehabilitation Physiotherapy Jiangsu Provincial Hospital of Integration of Chinese and Western MedicineNanjing 210028Jiangsu ProvinceChina

BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of *** a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical *** is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain *** to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with *** Forty patients with HSP were randomly divided into a treatment group and a control *** treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture *** patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the *** the clinical data were analyzed using SPSS 20.0 statistical *** There was no statistical difference in the general characteristics between the two *** the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(Ptreatment group than in the control group(P0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of *** combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with *** combination therapy is better than acupuncture ***,there is no significant difference in

关键词： Acupuncture Neuromuscular joint facilitation Hemiplegic shoulder pain Visual analogue scale Fugl-Meyer assessment Therapy

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Acupuncture treatment for Post-Stroke Dysphagia: An Update Meta-Analysis of Randomized Controlled Trials

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Chinese Journal of Integrative Medicine 2018年第9期24卷 686-695页

作者： LI Ling-xin DENG Kai QU Yun department of rehabilitation Medicine West China HospitalSichuan University department of Gastroenterology West China HospitalSichuan University

Objective： To explore the effectiveness and safety of acupuncture in patients with post-stroke dysphagia by an update meta-analysis. Methods： Potentially eligible RCTs aimed to evaluate the effects of acupuncture vs. non-acupuncture treatments, such as rehabilitation training or routine medication on the swallowing difficulty after stroke were searched from PubMed, Cochrane Library, China National Knowledge Infrastructure, and other database from the earliest record to June 2016. Patient demographics, regimens for acupuncture, type of controls, methods of randomization, and measurements of the clinical symptoms of dysphagia were retrieved. The relative risk （RR） and 95% confidence interval （CI） of effective rate of dysphagia was calculated after intervention performed following admission. Subgroup analyses and a meta- regression analysis were performed to describe the heterogeneity. Results： Twenty-nine RCTs comprising 2,190 patients were included. The included studies had a medium quality grade based on the Consolidated Standards of Reporting Trials （CONSORT） and Standards for Reporting Interventions in Clinical Trials of Acupuncture （STRICTA） checklist. Acupuncture therapy provided a higher effective rate compared with non- acupuncture treatments [RR=1.33, 95% confidence interval （CI）, 1.25 to 1.43]. Subgroup and meta-regression analyses suggested that acupuncture intensity and measurement method were main sources of heterogeneity and resulted in a significant difference for pooled effect size. No severe adverse events were documented in these RCTs. Conclusions： Our meta-analysis provides a new evidence supporting the efficacy and safety of acupuncture in treatment to post-stroke dysphagia in short-term compared with rehabilitation or medication. More high-quality and large-scale research studies are needed.

关键词： acupuncture dysphagia stroke systematic review meta-analysis randomized controlled trials

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Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing,China

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Neural Regeneration Research 2013年第25期8卷 2389-2398页

作者： Yi Zhu Bin Su Ning Li Hongzhu Jin Teaching and Research department of rehabilitation treatment Second Clinical MedicineNanjing University of Traditional Chinese Medicine Wuxi Tongren International rehabilitation Hospital department of rehabilitation Second Xiangya Hospital of Central South University Second Clinical Medicine Nanjing University of Traditional Chinese Medicine

We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.

关键词： neural regeneration brain injury hemiplegia post stroke shoulder pain adhesive capsulitis shoulder subluxation complex regional pain syndrome grants-supported paper neuroregeneration

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Essentials of thoracic outlet syndrome:A narrative review

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World Journal of Clinical Cases 2021年第21期9卷 5804-5811页

作者： Min Cheol Chang Du Hwan Kim department of rehabilitation Medicine College of MedicineYeungnam UniversityDaegu 42415South Korea department of Physical Medicine and rehabilitation College of MedicineChung-Ang UniversitySeoul 06973South Korea

Thoracic outlet syndrome(TOS)is a group of diverse disorders involving compression of the nerves and/or blood vessels in the thoracic outlet *** results in pain,numbness,paresthesia,and motor weakness in the affected upper *** reviewed the pathophysiology,clinical evaluation,differential diagnoses,and treatment of *** is usually classified into three types,neurogenic,venous,and arterial,according to the primarily affected *** true neurogenic and disputed TOS are considered neurogenic *** identifying the causative lesions is complex,detailed history taking and thorough clinical investigation are *** and imaging studies are helpful for excluding other possible disorders and confirming the diagnosis of true neurogenic *** existence of a disputed TOS remains *** physicians tend to be skeptical about the existence of disputed TOS,but thoracic surgeons argue that disputed TOS is *** who encounter patients with TOS need to understand its key features to avoid misdiagnosis and provide appropriate treatment.

关键词： Brachial plexus Diagnosis Review Thoracic outlet syndrome treatment Neuromuscular lesions

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Diffusion tensor imaging reveals brain structure changes in dogs after spinal cord injury

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Neural Regeneration Research 2023年第1期18卷 176-182页

作者： Chang-Bin Liu De-Gang Yang Jun Li Chuan Qin Xin Zhang Jun Liu Da-Peng Li Jian-Jun Li department of rehabilitation Medicine Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of Spinal and Neural Function Reconstruction China Rehabilitation Research CenterBeijingChina China rehabilitation Science Institute BeijingChina department of Neurosurgery Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain diffusion tensor imaging(DTI)parameters may change after spinal cord ***,the dynamic changes in DTI parameters remain *** established a Beagle dog model of T10 spinal cord contusion and performed DTI of the injured spinal *** found dynamic changes in DTI parameters in the cerebral peduncle,posterior limb of the internal capsule,pre-and postcentral gyri of the brain within 12 weeks after spinal cord *** then performed immunohistochemistry to detect the expression of neurofilament heavy polypeptide(axonal marker),glial fibrillary acidic protein(glial cell marker),and NeuN(neuronal marker).We found that these pathological changes were consistent with DTI parameter *** findings suggest that DTI can display brain structure changes after spinal cord injury.

关键词： spinal cord injury diffusion tensor imaging canines pathophysiology cerebrospinal structures corticospinal tract magnetic resonance imaging anisotropic fraction apparent dispersion coefficient

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Effectiveness of Different Orthoses on Joint Moments in Patients with Early Knee Osteoarthritis:Lateral Wedge Versus Valgus Knee Bracing

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Journal of Shanghai Jiaotong university(Science) 2012年第4期17卷 505-510页

作者：张旻瞿珮育冯美兰江澜沈晓艳马燕红白跃宏 department of rehabilitation the Sixth People's Hospital Affiliated to Shanghai Jiaotong University

The purpose of the study was to test the biomechanical differences between a lateral wedge and a valgus knee bracing on the knee joint moment during walking in patients with early stage of medial compartment knee osteoarthritis(OA).We conducted a crossover randomized design to compare gait parameters of 32 patients(with early stage medial compartment knee OA) in three different conditions during walking:with a custom-made lateral wedge of 5(in standard shoes),with a valgus knee bracing(in standard shoes),and with control condition(in standard shoes).Both two-orthose conditions showed decreased loading patterns(knee adduction moment and knee adduction angular impulse) on the knee joint in dynamic condition(statistic probability P treatment of early stage of knee OA.

关键词： gait biomechanics knee osteoarthritis orthose

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