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ObjectiveTo investigate the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) combined with mirror therapy on upper limb motor function and cortical neurophysiological indicators in stroke patients with hemiplegia. MethodsSixty stroke patients who were admitted to Jinshan Hospital of Fudan University, from October, 2022 to March, 2023 were randomly assigned to control group (n = 15), rTMS group (n = 15), mirror therapy group (n = 15) and combined group (n = 15). All groups received routine medicine and rehabilitation. In addition, the control group received sham rTMS and sham mirror therapy, rTMS group received 1 Hz rTMS and sham mirror therapy, the mirror therapy group received sham rTMS and mirror therapy, and the combined group received 1Hz rTMS combined with mirror therapy, for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) were used to evaluate the motor function of the affected upper limb. The motor-evoked potential (MEP) amplitude and central motor conduction time (CMCT) of the affected cortex were measured using a transcranial magnetic stimulation device. ResultsAfter treatment, the scores of FMA-UE and ARAT, and the amplitude of MEP significantly improved in all groups (|t| > 3.854, P < 0.001), while the CMCT significantly shortened (t > 5.967, P < 0.001). Compared to the control group, rTMS group, the mirror therapy group and the combined group showed more significant improvement in the scores of FMA-UE and ARAT, and the amplitude of MEP, and shorter CMCT (P < 0.05). When compared to rTMS group and the mirror therapy group, the combined group showed more significant improvement the scores of FMA-UE and ARAT, and the amplitude of MEP, and shorter CMCT (P < 0.05). There was significant positive correlation of the scores of FMA-UE and ARAT with the amplitude of MEP, and negative correlation with the CMCT in all groups (R2 > 0.804, P < 0.001). ConclusionThe combination of 1 Hz rTMS and mirror therapy contributes to the post-stroke brain functional remodeling and facilitates upper limb motor recovery in stroke patients with hemiplegia.
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Objective:To explore how an enriched environment promotes synaptic remodeling in the hippocampus after cerebral ischemia.Methods:Among 60 clean, adult, male C57BL/6 mice, 16 were randomly selected into a sham operation group, while the remaining 44 underwent permanent left middle cerebral artery embolization. The 32 mice with successful modeling were randomly divided into a normal environment group and an enriched environment group, each of 16. The enriched environment group lived in an enriched environment for 28 days, while the other two groups were raised in normal conditions. The number of synapses in the CA3 area of the hippocampus was then measured using transmission electron microscopy, and the expression of Wnt7a, Dvl1, β-catenin, synaptophysin (SYN) and PSD-95 in the hippocampus were measured using western blotting.Results:Compared with the normal environment group, the average protein expression levels of Wnt7a, Dvl1, β-catenin, SYN and PSD-95 were all significantly higher in the enriched environment group. The number of synapses in the CA3 region of the enriched environment group was also significantly higher than in the normal environment group.Conclusion:An enriched environment can activate the Wnt7a-β-catenin-Dvl1 signaling pathway in the hippocampus after cerebral ischemia to promote synaptic remodeling, at least in mice.
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Objective To study the relationship between thyroid function and disease severity or insulin resistance in patients with type 2 diabetes.Methods A total of 500 patients with type 2 diabetes and 60 normal controls were enrolled in our study.Fasting blood free three iodine thyroid original thyroid hormones(FT3) and free amino acid(FT4),thyroid stimulating hormone(TSH),thyroid related antibodies(thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)) of two groups of selected objects were detected.In patients with type 2 diabetes group,blood insulin,glycated hemoglobin(HbA1c),and the determination of trace albumin urine creatinine(UCr) and (UMA) were assayed.Results FT3 and TSH of control group was (4.14±1.52) pmol/L,(2.10±1.33) mIU/L,but the level of case group was (4.53±0.72) pmol/L,(1.78±0.97) mIU/L respectively,the difference between case group and control group of serum FT3 and TSH were statistically significant(P=0.03,0.025).The serum FT3 significantly decreased in patients with high blood sugar,the difference between HbA1C>11% group(FT3=(3.76±0.78) pmol/l) and HbA1C≤7%(FT3=(4.37±0.78) pmol/l),7-9%(FT3=(4.24±0.62) pmol/l),9-11% (FT3=(4.36±1.68) pmol/l) groups were statistically significant(P=0.014,0.009,0.000).The higher urine MA/Cr,the more serum FT3 decreased,the difference between urine MA/Cr<30 mg/g group(FT3=(4.31±0.18) pmol/l) and 30 mg/g≤MA/Cr<300 mg/g(FT3=(4.00±0.79) pmol/l),MA/Cr≥300 mg/g (FT3=(3.50±0.76) pmol/l) groups were statistically significant(P=0.041,0.001).The differences between MA/Cr≥300 mg/g group and 30 mg/g≤MA/Cr<300 mg/g group was statistically significant(P=0.044).In addition,we found a correlation between serum TSH and insulin resistance index(HOMA-IR)(r=0.302,P=0.001).Conclusion As a sign of serious high blood sugar,it can predict the severity of diabetic nephropathy.There is intimate relationship of serum TSH and HOMA-IR.
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AIM: To investigate the effect of deoxycholic acid (DCA) on the energy metabolism in human normal colon epithelial NCM460 cells.METHODS: NCM460 cells was treated with DCA at 10, 30 and 100 μmol/L for 5 d, or DCA at 100 μmol/L for 3, 5 and 7 d.After treated with DCA at 100 μmol/L for 3 d, the cells were treated with resveratrol, the activator of sirtuin 3 (SIRT3), for the next 4 d.Adenosine triphosphate (ATP) production in the mitochondria and lactate acid level were detected.The protein expression of SIRT3 was determined by Western blot.RESULTS: DCA inhibited the ATP production, increased lactate acid level, and downregulated the protein expression of SIRT3 in a dose-and time-dependent manner.Resveratrol at 10 μmol/L reversed the effects of DCA on the NCM460 cells.CONCLUSION: DCA induces the dysfunction of energy metabolism in NCM460 cells, and the mechanism may be related with SIRT3.
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Objective To analyze the effects of physiotherapy and manual therapy on temporomandibular disorders (TMD). Methods 90 patients with TMD were randomly divided into the medicine group (group A, n=30), physiotherapy group (group B, n=30) and physiothera-py combined with manual therapy group (group C, n=30). They were assessed with Visual Analogue Scale (VAS) of pain, maximum active mouth opening and joint clicking (100%before treatment) before and 4 weeks after treatment. Results All the patients improved in the pain after treatment (P<0.01), while the group B also improved in the maximum active mouth opening (P<0.01), and the group C improved in all the assessments (P<0.001). The result of all the assessment ranked from better to worse were group C, group B and group A (P<0.001). Con-clusion Physiotherapy combined with manual therapy can improve the pain, the activity of mouth and joint clicking of TMD patients.
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Optic nerve is composed by the axonal of retinal ganglion cells,there are no Schwann cells around it,and optic nerve belongs to the central nervous,so it cannot regenerate when injuried. In 1985 So and Aguayo have made a success in peripheral nerve retinal transplant,which completely changes the concept that optic nerve injury cannot regenarate. Currently nerve injury recovry has following several methods: use of neurotrophic factor,such as nerve growth factor,ciliary neurotrophic factor and brain-derived neurotrophic factor,etc. These factors could promote the regeneration and repair of retinal ganglion cells; treatment of gene correction and gene regulation,by changing the expression of host gene,reduce the effect due to the disease,slow the progress of the disease course or provide protection against the disease; neural stem cell transplantatin and tissue-engineered Schwann cell transplantion. But these treatments are still at the stage of animal experiment,how timely and effctively reduce the apoptosis and increase the survival rate of ganglion cells,even further promote nerve regeneration and recovery,there is still not a perfect method so far.