ABSTRACT
Objective:To explore the influences of Xingnao Tongdu acupuncture combined with Brunnstrom staging training on rehabilitation effect in stroke patients during recovery.Methods:According to random number table method, 82 patients with stroke during recovery who met inclusion criteria in Rehabilitation Medicine Department of the hospital were divided into control group (receiving routine rehabilitation training combined with Xingnao Tongdu acupuncture) and observation group (Brunnstrom staging training on basis of control group) between February 2020 and February 2021, 41 cases in each group. Both groups were continuously treated for 4 weeks. Before and after treatment, the severity of neurological deficits was evaluated by National Institute of Health Stroke Scale (NIHSS). The limb motor function was evaluated by Fugl-Meyer Assessment (FMA). The self-care ability was assessed by Barthel Index (BI). IL-6 was detected by ELISA. CRP level was detected by immunoturbidimetry. The WBC was detected by blood analyzer. The adverse reactions during treatment were observed. The clinical curative effect was evaluated.Results:There 40 cases in observation group and 41 cases in the control group were included into the statistics. The difference in total response rate between observation group and control group was not statistically significant [90.0% (36/40) vs. 75.6% (31/41)] ( χ2=2.93, P=0.087). After treatment, NIHSS score (6.65±1.79 vs. 8.71±2.61, t=4.13) in observation group was significantly lower than that of the control group ( P<0.01), while FMA score (69.56±9.64 vs. 61.77±10.33, t=3.51) and BI (73.72±8.34 vs. 65.86±7.36, t=4.50) were significantly higher than those in the control group ( P<0.01). The levels of serum IL-6 and CRP in observation group were significantly lower than those in the control group ( t values were 5.95, 5.61, respectively, all Ps<0.01). There were no adverse reactions in either group during treatment. Conclusion:The Xingnao Tongdu acupuncture combined with Brunnstrom staging training can improve rehabilitation effect and reduce levels of serum inflammatory cytokines in stroke patients during recovery.
ABSTRACT
Objective: To explore the causes and management of the complications in diabetic foot treated with tibial transverse transport (TTT). Methods: Between September 2015 and September 2019, 196 patients with diabetic foot were treated with TTT. There were 109 males and 87 females, with an average age of 67.6 years (range, 45-86 years). According to Wagner's classification, there were 124 cases of grade 3, 62 cases of grade 4, and 10 cases of grade 5; the course of disease was 1-12 months, with an average of 2.6 months. All patients underwent the minimally invasive tibial osteotomy. The osteotomy site was the middle and lower tibia in 62 cases and the middle and upper tibia in 134 cases. The area of osteotomy was 20 cm 2 in 83 cases and 7.5 cm 2 in 113 cases. The osteotomy block was moved back and forth once in 92 cases and twice in 104 cases. The complications were recorded, including secondary fracture at tibial osteotomy, skin necrosis in osteotomy area, and pin tract infection. Results: Among 196 patients, 41 cases (20.9%) had complications. Nine cases (4.6%) had secondary fracture at tibial osteotomy, among which 6 cases (9.6%) of middle and lower segment osteotomies and 3 cases (2.2%) of middle and upper segment osteotomies. The incidence between the patients with different osteotomy sites was significant ( χ2=5.354, P=0.021). The area of osteotomy was 20 cm 2 in 5 cases (6.0%) and 7.5 cm 2 in 4 cases (3.5%). There was no significant difference in the incidence between patients with different areas ( χ2=0.457, P=0.499). Skin necrosis occurred in the osteotomy area in 12 cases (6.1%), all of which were moved back and forth once. There was a significant difference in the incidence between patients who were treated with transport once and twice ( P=0.001). There were 18 cases (9.1%) with pin tract infection, including 12 cases (6.1%) with mild infection and 6 cases (3.0%) with severe infection. There was no significant difference in the incidence between the patients with mild and severe infections ( P=0.107). Conclusion: TTT is an effective method to treat diabetic foot, but there are complications such as secondary fracture at tibial osteotomy, skin necrosis in osteotomy area, and pin tract infection during transport. Preoperative evaluation of indication, standardization of osteotomy mode, size and position of osteotomy block, establishment of individualized removal plan, and strengthening of pin track nursing after operation can effectively reduce complications.
ABSTRACT
To investigate the effects of chemerin on helper T cells 9 (Th9)/regulatory T cells (Treg) in patients with psoriasis and the potential molecular mechanisms. Methods: Twenty-five patients with psoriasis and twenty healthy volunteers were selected for this study. CD4+ T cells were isolated from peripheral blood of samples by magnetic bead separation. The levels of chemerin and its receptor chemR23 were detected by real-time RT-PCR and ELISA. CD4+ T cells isolated from the healthy volunteers were treated with different concentrations of chemerin (50, 100, 150, 200 ng/mL), then cell viability was detected by MTT assay. The expression of inflammatory molecules and Th9/Treg were detected by ELISA and flow cytometry, respectively. Results: The expressions of chemerin and chemR23 in peripheral blood from patients with psoriasis were higher than those in healthy control (both P<0.05). The Th9/Treg was higher in patients with psoriasis than that in healthy control (P<0.05). After treating CD4+ T cells with 150 ng/mL of chemerin, the levels of IL-6, IL-9 and IL-17 were increased significantly (all P<0.05). Additionally, Th9/Treg was increased (P<0.05) and the cell balance was disrupt. However, the effects of chemerin on CD4+ T cells were reversed by silencing of chemR23 (all P<0.05). Conclusion: Chemerin may regulate the immune balance for Th9/Treg in CD4+ T cells from patients of psoriasis.