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Exercise-with-melatonin therapy improves sleep disorder and motor dysfunction in a rat model of ischemic stroke

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Neural Regeneration Research 2024年第6期19卷 1336-1343页

作者： Haitao Zhao Tong Zhang Haojie Zhang Yunlei Wang Lingna Cheng School of rehabilitation medicine Capital Medical University department of Neurological rehabilitation Beijing Bo'ai Hospital China Rehabilitation Research Center 3. School of Rehabilitation Medicine University of Health and Rehabilitation Sciences 4. Laboratory of Brain Injury Repair and Rehabilitation China Rehabilitation Science Institute

Exercise-with-melatonin therapy has complementary and synergistic effects on spinal cord injury and Alzheimer’s disease, but its effect on stroke is still poorly understood. In this study, we established a rat model of ischemic stroke by occluding the middle cerebral artery for 60 minutes. We treated the rats with exercise and melatonin therapy for 7 consecutive days. Results showed that exercise-with-melatonin therapy significantly prolonged sleep duration in the model rats, increased delta power values, and regularized delta power rhythm. Additionally, exercise-with-melatonin therapy improved coordination, endurance, and grip strength, as well as learning and memory abilities. At the same time, it led to higher hippocampal CA1 neuron activity and postsynaptic density thickness and lower expression of glutamate receptor 2 than did exercise or melatonin therapy alone. These findings suggest that exercise-withmelatonin therapy can alleviate sleep disorder and motor dysfunction by increasing glutamate receptor 2 protein expression and regulating hippocampal CA1 synaptic plasticity.

关键词： exercise glutamate receptor 2 hippocampus ischemic stroke learning melatonin memory sleep disorder synaptic plasticity

Effects of higher femoral tunnels on clinical outcomes,MRI,and second-look findings in double-bundle anterior cruciate ligament reconstruction with a minimal 5-year follow-up

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Chinese Medical Journal 2024年第4期137卷 465-472页

作者： Lin Lin Haijun Wang Jian Wang Yongjian Wang Yourong Chen Jiakuo Yu sports medicine department Beijing Key Laboratory of Sports InjuriesPeking University Third HospitalBeijing 100191China Peking University Institute of sports medicine Beijing 100191China

Background:To perform anatomical anterior cruciate ligament reconstruction(ACLR),tunnels should be placed relatively higher in the femoral anterior cruciate ligament(ACL)footprint based on the findings of direct and indirect femoral insertion.But the clinical results of higher femoral tunnels(HFT)in double-bundle ACLR(DB-ACLR)remain unclear.The purpose was to investigate the clinical results of HFT and lower femoral tunnels(LFT)in DB-ACLR.Methods:From September 2014 to February 2016,83 patients who underwent DB-ACLR and met the inclusion and exclusion criteria were divided into HFT-ACLR(group 1,n=37)and LFT-ACLR(group 2,n=46)according to the position of femoral tunnels.Preoperatively and at the final follow-up,clinical scores were evaluated with International Knee Documentation Committee(IKDC),Tegner activity,and Lysholm score.The stability of the knee was evaluated with KT-2000,Lachman test,and pivot-shift test.Cartilage degeneration grades of the International Cartilage Repair Society(ICRS)were evaluated on magnetic resonance imaging(MRI).Graft tension,continuity,and synovialization were evaluated by second-look arthroscopy.Return-to-sports was assessed at the final follow-up.Results:Significantly better improvement were found for KT-2000,Lachman test,and pivot-shift test postoperatively in group 1(P>0.05).Posterolateral bundles(PL)showed significantly better results in second-look arthroscopy regarding graft tension,continuity,and synovialization(P0.05).No statistically significant differences were found in IKDC subjective score,Tegner activity,and Lysholm score between the two groups.Higher return-to-sports rate was found in group 1 with 86.8%(32/37)vs.65.2%(30/46)in group 2(P=0.027).Conclusion:The HFT-ACLR group showed better stability results,better PL,and higher return-to-sports rate compared to the LFT-ACLR group.

关键词： Anterior cruciate ligament reconstruction Direct insertion Double bundle Second-look arthroscopy Femoral tunnel Anterior cruciate ligament rupture

Screening biomarkers for spinal cord injury using weighted gene co-expression network analysis and machine learning

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Neural Regeneration Research 2024年第12期19卷 2723-2734页

作者： Xiaolu Li Ye Yang Senming Xu Yuchang Gui Jianmin Chen Jianwen Xu department of rehabilitation medicine The First Affiliated Hospital of Guangxi Medical UniversityNanningGuangxi Zhuang Autonomous RegionChina department of rehabilitation medicine Guilin People’s HospitalGuilinGuangxi Zhuang Autonomous RegionChina department of rehabilitation medicine The First Affiliated Hospital of Fujian Medical UniversityFuzhouFujian ProvinceChina

Immune changes and inflammatory responses have been identified as central events in the pathological process of spinal co rd injury.They can greatly affect nerve regeneration and functional recovery.However,there is still limited understanding of the peripheral immune inflammato ry response in spinal cord inju ry.In this study.we obtained microRNA expression profiles from the peripheral blood of patients with spinal co rd injury using high-throughput sequencing.We also obtained the mRNA expression profile of spinal cord injury patients from the Gene Expression Omnibus(GEO)database(GSE151371).We identified 54 differentially expressed microRNAs and 1656 diffe rentially expressed genes using bioinformatics approaches.Functional enrichment analysis revealed that various common immune and inflammation-related signaling pathways,such as neutrophil extracellular trap formation pathway,T cell receptor signaling pathway,and nuclear factor-κB signal pathway,we re abnormally activated or inhibited in spinal cord inju ry patient samples.We applied an integrated strategy that combines weighted gene co-expression network analysis,LASSO logistic regression,and SVM-RFE algorithm and identified three biomarke rs associated with spinal cord injury:ANO10,BST1,and ZFP36L2.We verified the expression levels and diagnostic perfo rmance of these three genes in the original training dataset and clinical samples through the receiver operating characteristic curve.Quantitative polymerase chain reaction results showed that ANO20 and BST1 mRNA levels were increased and ZFP36L2 mRNA was decreased in the peripheral blood of spinal cord injury patients.We also constructed a small RNA-mRNA interaction network using Cytoscape.Additionally,we evaluated the proportion of 22 types of immune cells in the peripheral blood of spinal co rd injury patients using the CIBERSORT tool.The proportions of naive B cells,plasma cells,monocytes,and neutrophils were increased while the proportions of memory B cells,CD8^(+)T cells,resting natural killer cells,resti

关键词： bioinformatics analysis biomarker CIBERSORT GEO dataset LASSO miRNA-mRNA network RNA sequencing spinal cord injury SVM-RFE weighted gene co-expression network analysis

Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain:A prospective,multicenter randomized trial

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Journal of Integrative medicine 2024年第1期22卷 39-45页

作者： Jun-yan He Xiao-yu Tu Zi-fei Yin Hui Mu Ming-jun Luo Xing-yu Chen Wei-bin Cai Xue Zhao Can Peng Fan-fu Fang Can Lü Bai Li School of Traditional Chinese medicine Naval Medical UniversityShanghai 200433China department of rehabilitation medicine and Physiotherapy the First Affiliated Hospital of Naval Medical UniversityShanghai 200433China department of rehabilitation medicine and Training PLA 458 HospitalGuangzhou 510602Guangdong ProvinceChina No.3 Ward of Acupuncture rehabilitation department Guangdong Second Traditional Chinese Medicine HospitalGuangzhou 510095Guangdong ProvinceChina

Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in t

关键词： Chronic nonspecific low-back pain Traditional Chinese medicine Cupping and scraping therapy

Does ergogenic effect of caffeine supplementation depend on CYP1A2 genotypes? A systematic review with meta-analysis

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Journal of Sport and Health Science 2024年第4期13卷 499-508页

作者： Jieping Wang Luthfia Dewi Yundong Peng Chien-Wen Hou Yanmin Song Giancarlo Condello Laboratory of Exercise Biochemistry University of TaipeiTianmu CampusTaipei 11153China department of Emergency medicine National Clinical Research Center for Geriatric DisordersXiangya HospitalCentral South UniversityChangsha 410008China department of Nutrition Universitas Muhammadiyah SemarangSemarang 50273Indonesia School of sports medicine and rehabilitation Beijing Sport UniversityBeijing 10084China department of medicine and Surgery University of ParmaParma 43126Italy

Background:The ergogenic effects of caffeine intake on exercise performance are well-established,even if differences exist among individuals in response to caffeine intake.The genetic variation of a specific gene,human cytochrome P450 enzyme 1A2(CYP1A2)(rs762551),may be one reason for this difference.This systematic review and meta-analysis aimed to comprehensively evaluate the influence of CYP1A2 gene types on athletes’exercise performance after caffeine intake.Methods:A literature search through 4 databases(Web of Science,PubMed,Scopus,and China National Knowledge Infrastructure)was conducted until March 2023.The effect size was expressed as the weighted mean difference(WMD)by calculating fixed effects meta-analysis if heterogeneity was not significant(I^(2)≤50%and p≥0.1).Subgroup analyses were performed based on AA and AC/CC genotype of CYP1A2.Results:The final number of studies meeting the inclusion criteria was 12(n=666 participants).The overall analysis showed that the cycling time trial significantly improved after caffeine intake(WMD=-0.48,95%confidence interval(95%CI):-0.83 to-0.13,p=0.007).In subgroup analyses,acute caffeine intake improved cycling time trial only in individuals with the A allele(WMD=-0.90,95%CI:-1.48 to-0.33,p=0.002),but not the C allele(WMD=-0.08,95%CI:-0.32 to 0.17,p=0.53).Caffeine supplementation did not influence the Wingate(WMD=8.07,95%CI:-22.04 to 38.18,p=0.60)or countermovement jump test(CMJ)performance(WMD=1.17,95%CI:-0.02 to 2.36,p=0.05),and these outcomes were not influenced by CYP1A2 genotype.Conclusion:Participants with the CYP1A2 genotype with A allele improved their cycling time trials after caffeine supplementation.However,compared to placebo,acute caffeine supplementation failed to increase the Wingate or CMJ performance,regardless of CYP1A2 genotype.

关键词： Countermovement jump test Endurance Ergogenic aid Gene polymorphism Wingate

Epidemiology of insertional and midportion Achilles tendinopathy in runners:A prospective cohort study

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Journal of Sport and Health Science 2024年第2期13卷 256-263页

作者： Wenbo Chen Kyra L.A.Cloosterman Sita M.A.Bierma-Zeinstra Marienke van Middelkoop Robert-Jan de Vos department of Orthopaedic Surgery and sports medicine Erasmus MC University Medical CenterRotterdam 3015GDthe Netherlands department of General Practice Erasmus MC University Medical CenterRotterdam 3015GDthe Netherlands department of sports medicine Huashan HospitalFudan UniversityShanghai 200040China

Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence and risk factors between insertional AT and midportion AT,though they are considered distinct.This study aimed to assess incidence and risk factors of AT based on data from a large prospective cohort.The secondary aim was to explore differences in risk factors between insertional and midportion AT.Methods:Participants were recruited from among registered runners at registration for running events.Questionnaires were completed at baseline,1 month before the event,1 week before the event,and 1 month after the event.Information concerning demographics,training load,registered events,and running-related injuries were collected at baseline.The follow-up questionnaires collected information about new injuries.A pain map was used to diagnose midportion and insertional AT.The primary outcome was the incidence of AT.Multivariable logistic regression analysis was applied to identify risk factors for the onset.Results:We included 3379 participants with a mean follow-up of 20.4 weeks.The incidence of AT was 4.2%.The proportion of insertional AT was 27.7%and of midportion AT was 63.8%;the remaining proportion was a combined type of insertional and midportion AT.Men had a significantly higher incidence(5%,95%confidence interval(95%CI):4.1%-6.0%)than women(2.8%,95%CI:2.0%-3.8%).AT in the past12 months was the most predominant risk factor for new-onset AT(odds ratio(OR)=6.47,95%CI:4.27-9.81).This was similar for both subcategories of AT(insertional:OR=5.45,95%CI:2.51-11.81;midportion:OR=6.96,95%CI:4.24-11.40).Participants registering for an event with a distance of 10/10.55 km were less likely to develop a new-onset AT(OR=0.59,95%CI:0.36-0.97)or midportion AT(OR=0.47,95%CI:0.23-0.93).Higher age had a significant negative association with insertional AT(OR=0.97,95%CI:0.94-1.00).Conclusion:The incidence of new-onset AT

关键词： Achilles tendon injury Incidence Risk factor Running-related injury

Efficacy of Daoyin combined with lower limb robot as a comprehensive rehabilitation intervention for stroke patients: a randomized controlled trial

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Journal of Traditional Chinese medicine 2024年第3期44卷 530-536页

作者： TIAN Haolin YANG Yuanbin ZHANG Hu ZHAO Wenjing ZHOU Jing TIAN Jingfeng HE Long LI Xuechao SHEN Qinxuan SHUAI Mei department of First rehabilitation Wangjing Hospital of China Academy of Chinese Medical Sciences department of rehabilitation Shunyi HospitalBeijing Traditional Chinese Medicine Hospital School of Biological Science and Medical Engineering Beihang University

OBJECTIVE: To assess the effectiveness of a comprehensive rehabilitation approach combining Traditional Chinese medicine Daoyin with lower limb robotics during the recovery phase of stroke patients.METHODS: Stroke patients meeting the specified criteria were randomly assigned to one of four groups using a random number table: Control group, Daoyin group, lower limb robot group(LLR group), and Daoyin and lower limb robot group(DLLR group). Each group received distinct treatments based on conventional rehabilitation training.The treatment duration spanned two weeks with two days of rest per week. Pre-and post-intervention assessments included various scales: Fugl-Meyer Assessment(FMA),Berg balance scale(BBS), Barthel index(BI), Fatigue Scale-14(FS-14), Pittsburgh sleep quality index(PSQI),Hamilton Anxiety Scale(HAMA), and Hamilton Depression Scale(HAMD).RESULTS: Statistically significant differences were observed in the lower limb function measured by FAM between the Control group(15 ± 5) and the DLLR group(18 ± 5)(P = 0.049). In the Barthel index, a statistically significant difference was noted between the Control group(54 ± 18) and the DLLR group(64 ± 11)(P = 0.041).Additionally, significant differences were found in the Berg balance scale between the Control group(21 ± 10)and the DLLR group(27 ± 8)(P = 0.024), as well as between the Control group(21 ± 10) and the LLR group(26 ± 10)(P = 0.048).CONCLUSION: The findings of this study suggest that the combined use of Daoyin and robotics not only enhances motor function in stroke patients but also has a positive impact on fatigue, sleep quality, and mood. This approach may offer a more effective rehabilitation strategy for stroke patients.

关键词： Daoyin lower limb robot randomized controlled trial rehabilitation stroke

Targeting oxidative stress with natural products: A novel strategy for esophageal cancer therapy

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 287-299页

作者： Fang Cao Han-Ling Zhang Cui Guo Xue-Liang Xu Qiang Yuan department of rehabilitation III Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina department of rehabilitation Chongqing Fuling District Maternal and Child Health HospitalChongqing 408000China department of rehabilitation Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina

Esophageal cancer(ESC)is a malignant tumor that originates from the mucosal epithelium of the esophagus and is part of the digestive tract.Although the exact pathogenesis of ESC has not been fully elucidated,excessive oxidative stress is an important characteristic that leads to the development of many cancers.Abnormal expression of several proteins and transcription factors contributes to oxidative stress in ESCs,which alters the growth and proliferation of ESCs and promotes their metastasis.Natural compounds,including alkaloids,terpenes,polyphenols,and xanthine compounds,can inhibit reactive oxygen species production in ESCs.These compounds reduce oxidative stress levels and subsequently inhibit the oc-currence and progression of ESC through the regulation of targets and pathways such as the cytokine interleukins 6 and 10,superoxide dismutase,the NF-+ACY-kappa+ADs-B/MAPK pathway,and the mammalian Nrf2/ARE target pathway.Thus,targeting tumor oxidative stress has become a key focus in anti-ESC therapy.This review discusses the potential of Natural products(NPs)for treating ESCs and summarizes the application prospects of oxidative stress as a new target for ESC treatment.The findings of this review provide a reference for drug development targeting ESCs.Nonetheless,further high-quality studies will be necessary to determine the clinical efficacy of these various NPs.

关键词： Oxidative stress Natural products Esophageal cancer Reactive oxygen species

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1377-1384页

作者： Chun-Yan Bai Wei Tian Qian Zhang department of rehabilitation medicine Beijing Aerospace General HospitalBeijing 100076China department of rehabilitation medicine People’s Hospital of HengshuiHengshui 053000Hebei ProvinceChina department of Internal medicine Hebei Academy of Chinese Medicine SciencesShijiazhuang 050000Hebei ProvinceChina

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

关键词： Chronic gastritis Liver-stomach disharmony Microcosmic syndrome differentiation Chinese herbal medicine Randomized controlled trial Microcosmic syndrome scores