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ObjectiveTo develop a high-quality rehabilitation major curriculum using the World Health Organization rehabilitation competency framework (RCF), to improve the level of traditional Chinese medicine (TCM) rehabilitation major, to meet the requirements of competency-based education development. MethodsThe competence requirements of rehabilitation professionals of higher traditional TCM colleges and universities were analyzed using the theory and method of RCF. ResultsThe competency structure of TCM rehabilitation talents based on RCF was built, and the curriculum setting of TCM rehabilitation based on RCF was proposed. According to the characteristics of the educational environment of colleges and universities, a competency model suitable for undergraduate-level TCM rehabilitation major was established. ConclusionThe theory and methods of RCF are of great significance for the construction of competency-based education system of TCM rehabilitation major. Based on RCF, this study constructs the basic and practical curriculum system of TCM rehabilitation at the undergraduate level to promote the training of applied talents in TCM rehabilitation.
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Objective To investigate the efficacy of acupuncture and rehabilitation therapy on lower limb motor function, and to explore a cortical mechanism using functional near infrared spectroscopy (fNIRS). Methods From December, 2020 to July, 2021, 24 stroke patients with lower limb motor dysfunction in our hospital were randomly divided into rehabilitation group (n = 12) and acupuncture-rehabilitation group (n = 12), and received routine rehabilitation training and acupuncture-rehabilitation intervention for four weeks, respectively. The control group included ten healthy subjects matched the patients. Before and after intervention, the lower limb motor function of the patients was assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), and all the subjects accepted fNIRS examination. The functional intensity and lateralization index (LI) of supplementary motor area (SMA), premotor cortex (PMC) and sensory motor cortex (SMC) were calculated based on oxygenated hemoglobin (HbO2). Results There was no significant difference in FMA-LE score between the rehabilitation group and the acupuncture-rehabilitation group before the intervention (P > 0.05). After four weeks of intervention, FMA-LE scores improved in both groups (t > 3.770, P 0.05). After intervention, the average functional connection increased in both groups (t > 2.178, P < 0.05), and the functional connection of the affected PMC of acupuncture-rehabilitation group increased (P < 0.05). The LI in SMC increased in the acupuncture-rehabilitation group (P < 0.05). There was a significant positive correlation between the change of functional connection of the affected PMC and the change of FMA-LE scores in the acupuncture-rehabilitation group (r = 0.579, P < 0.05). Conclusion Acupuncture with rehabilitation therapy can significantly improve the lower limb motor function and asymmetrical activation of SMC in stroke patients. The recovery of lower limb motor function may be related to the enhanced activation of affected PMC.
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Objective To investigate the effect of combining electroacupuncture with nerve mobilization to improve lower extremity motor function after sciatic nerve injury. And to document any changes in mRNA and protein expression of Ras-related C3 botoxin substrate 1. Methods 180 New Zealand rabbits were randomly divided into a normal control group, a model control group, an electroacupuncture group, a nerve mobilization group, and an elec-troacupuncture combined with nerve mobilization group, each of 36. Sciatic nerve injury was modelled using the clam-ping method in all except the normal control group. The control group had no intervention, while the nerve mobiliza-tion group, the electroacupuncture group and the combined group were treated with nerve mobilization, and/or elec-troacupuncture applied to the rabbit analogue of the jiaji acupoint. After 1, 2, and 4 weeks of treatment, toe reflex scores and modified Tarlov scores were used to assess any functional recovery. After 1, 2, and 4 weeks of treatment, 12 of the rabbits in each group were sacrificed and the sciatic nerve and the L4-L6 segments of the spinal cord were re-sected. The expression of Ras-related C3 botoxin substrate 1 mRNA and protein was detected using the polymerase chain reaction and western blotting. Results Sciatic nerve function and the expression of Ras-related C3 botoxin sub-strate 1 mRNA in the spinal cords and sciatic nerves of the three treatment groups were significantly higher than in the model control group at all three time points, but significantly lower than in the normal control group. The combined group′s results were significantly better than with electroacupuncture or nerve mobilization alone. After 1, 2, and 4 weeks of treatment, the average expression of Ras-related C3 botoxin substrate 1 protein in the spinal cords of the three treatment groups was significantly higher than the model control group′s average, but significantly lower than that of the normal control group at the same time point. After 1 week of treatment the average expression of Ras-related C3 botoxin substrate 1 protein in the spinal cords of the combined group was significantly higher than that in the group receiving electroacupuncture alone. After 2 and 4 weeks it was also significantly higher than the nerve mobilization group′s aver-age. After 1 week of treatment, the average expression of Ras-related C3 botoxin substrate 1 protein in the sciatic nerves of all three treatment groups was significantly lower than that of the control group. However, 1 and 3 weeks later the av-erage protein expression in the sciatic nerves was significantly higher than in the model control group, but significantly lower than in the normal control group at the same time points. The combined group′s average was then significantly higher than those of the groups receiving electroacupuncture or nerve mobilization alone at the same time point. Conclusion Nerve stimulation combined with electroacupuncture applied to the jiaji acupoint can promote the regener-ation of axons after sciatic nerve injury. The mechanism may be related to up-regulation of the Ras-related C3 botoxin substrate 1 gene and protein expression in the injured sciatic nerve and corresponding spinal cord segments.
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@#Gut microbiota, as a "microbial organ" in human body, has important physiological functions and participates in regulating body's homeostasis and health. Exercise can improve metabolism and immune regulation of body by promoting the composition and structure of gut microbiota, and even affects interaction of the "microbiota-gut-brain axis". This article reviewed the effects of various functions of gut microbiota on body and relationship between gut microbiota and exercise.
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@# Intestinal flora plays an important role in the process of human health and disease conversion. It not only participates in a number of physiological processes in the host, but also affects the central nervous system (CNS) -related diseases, which may involve in neurotransmitter, immune, endocrine, metabolites, etc. Intestinal dysbacteriosis plays a role in the development of CNS diseases, such as ischemic brain injury, Parkinson's disease, Alzheimer's disease, multiple sclerosis, hepatic encephalopathy, and mental disorders, etc. Fecal microbes transplantation, exercise training, acupuncture and Tuina therapy can improve the intestinal flora balance, which may be potential for the treatment and prevention of some nervous system diseases.
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@#Objective To investigate the effect of acupuncture-rehabilitation therapy on the neurological function and the expression of cleaved-caspase-8, cleaved-caspase-3 and cellular inhibitor of apoptosis 1 (cIAP1) in ischemic penumbra of rats with cerebral ischemia. Methods A total of 90 male Sprague-Dawley rats were randomly divided into sham group, model group, acupuncture group, rehabilitation group and acupuncture-rehabilitation group. Each group was divided into three days, seven days and 14 days subgroups (n=6). The cerebral ischemia model was established with the modified Koizumi suture method. The sham group and the model group received no treatment. The acupuncture group received cluster needling of scalp acupuncture, the rehabilitation group received treadmill training, and the acupuncture-rehabilitation group received both acupuncture and treadmill training. Three days, seven days and 14 days after modeling, their neurological function was assessed with modified Neurological Severity Score (mNSS) and Rota-rod test, and the expression of cleaved-caspase-8, cleaved-caspase-3 and cIAP1 protein in cerebral ischemic penumbra were detected with Western blotting. Results Compared with the model group, the mNSS scores decreased, the retention time of Rota-rod test increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein decreased and the expression of cIAP1 protein increased in each treatment group at each time point (P<0.05). Compared with the other two treatment groups, the mNSS scores further decreased, the retention time further increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein further decreased, and the expression of cIAP1 protein further increased (P<0.05) seven days and 14 days after modeling in the acupuncture-rehabilitation group.Conclusion Acupuncture-rehabilitation therapy can improve the neurological function in rats with cerebral ischemia, that is better than the simple acupuncture or exercise, which may relate to the inhibition of caspase-8 and caspase-3 protein activation, and promotion of cIAP1 protein expression, to inhibit the apoptotic caspases cascade reaction.
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@#Objective To explore the effect and mechanism of exercise preconditioning on neurological deficits in rats after cerebral ischemia-reperfusion. Methods Thirty-six healthy Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and exercise preconditioning group (n=12). The latter two groups were occluded middle cerebral artery for 120 minutes and reperfused with modified suture method. The rats were evaluated with Longa's score two, twelve and 24 hours after reperfusion. The expression of mitochondrial ATP-sensitive potassium (mitoKATP) channel proteins inwardly rectifying potassium channel (Kir6.2) and sulphonylurea receptor 1 (SUR1) were detected with Western blotting and the cerebral cell apoptosis was detected with TUENL assay 24 hours after reperfusion. Results Compared with the model group, the Longa's score decreased in the exercise preconditioning group 24 hours after reperfusion (P<0.05), while the expression of Kir6.2 and SUR1 decreased (P<0.05), and TUNEL-positive cells decreased (P<0.05).Conclusion Exercise preconditioning may improve neurological function after cerebral ischemia-reperfusion, which may associate with inhibiting the expression of mitoKATP channel proteins and cell apoptosis.
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Objective To explore the effect of acupuncture-rehabilitation therapy on neurological function and expression of Flt-1 and Flk-1, members of vascular endothelial growth factor receptors, after permanent focal cerebral ischemia in rats. Methods Ninety male Sprague-Dawley rats were divided into five groups, namely sham group, model group, acupuncture group, rehabilitation group and acupunc-ture-rehabilitation group, and each group was further divided into 3-day, 7-day and 14-day subgroups, equally. Their middle cerebral arteries were occluded except those of sham group. The sham and model groups accepted no treatment, while the acupuncture group accepted clus-ter needling of scalp acupuncture, the rehabilitation group accepted treadmill training, and the acupuncture-rehabilitation group accepted both acupuncture and treadmill training. They were assessed with modified Neurologic Severity Score (mNSS) 3, 7 and 14 days after model-ing, while the expression of Flt-1 and Flk-1 were determined with Western blotting. Results The mNSS score reduced in all the treatment groups (P<0.05) compared with that of the model group at every time point, and was the least in the acupuncture-rehabilitation group (P<0.05) 7 and 14 days after modeling among the treatment groups. Meanwhile, the expression of Flt-1 and Flk-1 protein increased in all the treatment groups (P<0.05), and was the most in the acupuncture-rehabilitation group (P<0.05). Conclusion Acupuncture-rehabilitation thera-py can promote the neurological function recovery in rat with permanent focal cerebral ischemia, which may be associated with the continu-ous inducement of Flt-1, Flk-1 protein expression in ischemic penumbra cortex.
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Objective To investigate the effect of electroacupuncture (EA) pretreatment on neurological function, and the expression of Toll-like receptor 4 (TLR4) and nuclear factorκB (NF-κB) protein in ischemic penumbra after cerebral ischemia-reperfusion (CIR) injury. Methods A total of 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and EA group (n=12). The later two groups were occluded their right middle cerebral arteries for two hours and reperfused. The EA group was pretreated with EA at Baihui (GV20) for two weeks before modeling. They were assessed with modified Neurological Severity Scores (mNSS), the injury in ischemic brain was detected with HE staining, and the expression of TLR4 and NF-κB protein in ischemic penumbra were detected with Western blotting, 24 hours after reperfusion. Results The score of mNSS decreased (P<0.05), the injury of brain tissue ameliorated, and the expression of TLR4 and NF-κB decreased in ischemic penumbra (P<0.05) in EA group compared with those in the model group. Conclu-sion EA pretreatment can reduce the injury and improve the neurological function in rats after CIR by down-regulating the expression of TLR4 and NF-κB protein in ischemic penumbra.
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Objective To investigate the effect of electroacupuncture or exercise preconditioning on neurological function after focal ce-rebral infarction in rats and the possible mechanism. Methods A total of 24 male Sprague-Dawley rats were randomly divided into model group (n=6), sham group (n=6), exercise preconditioning group (n=6) and electroacupuncture preconditioning group (n=6). The model group and the sham group did not accept any treatment, while the exercise preconditioning group and the electroacupuncture precondition-ing group accepted treadmill training and electroacupuncture for two weeks, respectively. Their middle cerebral arteries were occluded with modified Longa's approach, except the sham group that was ligated the same arteries but did not result in infarction. They were evaluated with Neurologic Severity Scores (NSS) 24 hours after modeling, and the laminin expression in the ischemic area was detected with Western blotting. Results There was no neurological deficit in the sham group. The NSS was lower in both preconditioning groups than in the model group (P0.05). The expression of laminin was the most in the sham group, and was more in both preconditioning groups than in the model group (P0.05). Conclusion Preconditioning with exercise or electroacupuncture can both reduce the neurological deficits in rats after focal cerebral infarction, which may associate with the protection of laminin from inhibition in early stage.
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Objective To explore the effects of acupuncture-rehabilitation therapy on neurological function recovery and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway activation after permanent focal cerebral ischemia in rats. Methods Ninty male Sprague-Dawley rats were divided into five groups, namely sham group, model group, acupuncture group, rehabilitation group and acupunc-ture-rehabilitation group, and 18 in each group. Each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Their mid-dle cerebral arteries were occluded except those of sham group. The sham and model groups accepted no treatment, while the acupuncture group accepted cluster needling of scalp acupuncture, rehabilitation group accepted treadmill training, and the acupuncture-rehabilitation group accepted both acupuncture and treadmill training. They were assessed with modified Neurologic Severity Score (mNSS) 3, 7 and 14 days after modeling, while the expression of ERK1/2 and p-ERK1/2 were determined with Western blotting. Results The neurologic severi-ty score reduced in all three treatment groups (P<0.05) compared with that of the model group at every time point, and was the least in the acupuncture-rehabilitation group (P<0.05) 7 and 14 days after modeling among the treatment groups. Meanwhile, the expression of p-ERK1/2 increased in all three treatment groups (P<0.05), and was the most in the acupuncture-rehabilitation group (P<0.05), as well as the rate of (p- ERK1/2)/(ERK1/2) (P<0.05). Conclusion Acupuncture- rehabilitation therapy can promote the neurological function recovery, which may be associated with activation of ERK1/2 signaling pathway.
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Objective To observe the effect of cluster needling at scalp acupoints plus paraffin therapy on motor function in cerebral palsy patients.Method Forty eligible patients with spastic cerebral palsy were randomized into a control group and an experimental group, 20 cases in each group. The control group was intervened by cluster needling with long-time retaining of the needles plus Uyeda's approach and conventional rehabilitation trainings specifically for spastic cerebral palsy; the experimental group was intervened by paraffin therapy in addition to the treatment given to the control group. The interventions were conducted once a day, for a total of 8 weeks. The Gross Motor Function Measure-88 (GMFM-88) and Modified Ashworth Scale (MAS) were adopted to evaluate the motor function before and after the treatment.Result The GMFM-88 scores were significantly changed after the treatment in both groups (P0.05); there was a significant difference in comparing the MAS score between the two groups after the intervention (P<0.05).Conclusion On the basis of conventional rehabilitation trainings, cluster needling at scalp acupoints plus paraffin therapy can produce a significant efficacy in improving the muscular tension and motor function, and benefit the development of cerebral palsy patients.
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Objective To observe the effect of acupuncture plus rehabilitation on neurologic deficit and the expression of vascular endothelial growth factor (VEGF) protein in cortex on the infarction side in rats with focal cerebral infarction, and to explore the action mechanism of acupuncture plus rehabilitation in promoting the recovery of impaired function in rats.Method Ninety healthy male Sprague-Dawley (SD) rats were randomized into a model group, an acupuncture group, a rehabilitation group, an acupuncture-rehabilitation group, and a sham operation group, and the five groups were further divided into three subgroups, i.e. 3 d, 7 d, and 14 d subgroups, 6 rats in each subgroup. The modified Zea-Longa method was adopted to prepare the model of middle cerebral artery occlusion (MCAO) on theright side. Rats in the acupuncture group received simulant scalp-points cluster needling; the rehabilitation group was intervened by treadmill exercise; the acupuncture-rehabilitation group was intervened by scalp-points cluster needling plus treadmill exercise; the model group and sham operation group didn't receive any interventions. The modified Neurological Severity Score (mNSS) was adopted to evaluate the rat's neurologic deficit, and Western blotting was used to detect the expression of VEGF protein in cortex on the infarction side.Result Neurologic deficit wasn't found in rats in the sham operation group. After 3-day treatment, the mNSSs in the acupuncture group, rehabilitation group, and acupuncture-rehabilitation group were insignificantly different from the score in the model group (P>0.05), while the differences were statistically significant respectively after 7-day and 14-day treatment (P0.05). After 3-day treatment, the expression of VEGF protein in each treatment group was insignificantly different from that in the model group (P>0.05), while the expression of VEGF protein in each treatment group was significantly higher than that in the model group respectively after 7-day and 14-day treatment (P0.05).Conclusion Scalp-points cluster needling and rehabilitation both can improve the neurologic function in rat models of focal cerebral infarction, and enhance the expression of VEGF protein in infarction cortex, and the integration of acupuncture and rehabilitation can achieve a better result; the action mechanism is possibly related to the high expression of VEGF which can better promote the reconstruction and regeneration of the vessels in cerebral infarction area.
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<p><b>OBJECTIVE</b>To explore the effect of electroacupuncture(EA) preconditioning on cerebral infarct volume and the contents of TNF-α, IL-10 in serum of rats with cerebral ischemia-reperfusion injury.</p><p><b>METHODS</b>Thirty-six rats were randomly divided into a sham operation group, a model group and an EA preconditioning group, 12 rats in each group, which were further divided into 12 h and 24 h after reperfusion subgroups, 6 rats in each one. EA was used before model establishment for 2 weeks in the EA preconditioning group. The model of cerebral ischemia-reperfusion injury in rats was established with modified Longa suture method. 12 h and 24 h after reperfusion, the degree of neurological deficit was assessed by the modified behavioral scoring scale; the cerebral infarct volume was measured by TTC method and the contents of TNF-α, IL-10 in serum were detected by ELISA method.</p><p><b>RESULTS</b>Compared with the model group, the neurological severity scores in the EA preconditioning group significantly reduced 12 h and 24 h after reperfusion (both<0.05), the cerebral infarct volume in the EA preconditioning group significantly reduced 12 h and 24 h after reperfusion (both<0.05). Compared with the sham operation group, the serum TNF-α, IL-10 contents in the model group increased 12 h and 24 h after reperfusion (both<0.05). Compared with the model group, the serum TNF-α content reduced, while the serum IL-10 content increased in the EA preconditioning group 12 h after reperfusion (both<0.05). Compared with the model group, the serum TNF-α, IL-10 contents reduced in the EA preconditioning group 24 h after reperfusion (both<0.05).</p><p><b>CONCLUSION</b>EA preconditioning can improve neurological deficit, reduce cerebral infarct volume after cerebral ischemia-reperfusion injury in rats. The mechanism may be related to the regulation of EA on the dynamic balance between pro-inflammatory cytokine TNF-α and anti-inflammatory cytokine IL-10 in peripheral blood of cerebral ischemia-reperfusion injury in acute phase, thus alleviate acute cerebral ischemia-reperfusion inflammatory response.</p>
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Objective To explore the effect of Taijiquan on motor function and depression in patients with post-stroke depression. Meth-ods From January to October, 2015, 60 stroke patients with depression were randomly divided into control group (n=30) and Taijiquan group (n=30). Both groups accepted routine rehabilitation, while Taijiquan group accepted another training of six actions from simplified Taijiquan. They were assessed with Fugl-Meyer Assessment (FMA), Barthel Index (BI) and Hamilton Depression Rating Scale (HAMD) be-fore, and four and eight weeks after treatment. Results The scores of FMA and BI increased more in Taijiquan group than in the control group after treatment (t>2.351, P2.169, P<0.05). Conclusion Taijiquan can relieve the depression and improve the motor and activities of daily living in patients with post-stroke depression.
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ObjectiveTo investigate the clinical efficacy of acupuncture plus keritherapy for knee osteoarthritis.MethodForty patients with knee osteoarthritis meeting the inclusion criteria were allocated, using a random number table, to treatment and control groups, 20 cases each. The treatment group received acupuncture plus keritherapy and the control group, acupuncture. Treatment was given for four weeks. The clinical therapeutic effects were evaluated using the Visual Analogous Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in the two groups.ResultAfter four weeks of treatment,the VAS score and the WOMAC score decreased significantly in the treatment group of patients compared with the control group; there was a statistically significantdifference (P<0.05).ConclusionAcupuncture plus keritherapy can relieve pain around the knee and improve knee dysfunction in patients with knee osteoarthritis.
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Objective To investigate the effect of electro-acupuncture pretreatment on content of interleukin (IL)-1βand IL-6 in serum and ischemic penumbra, and apoptosis in ischemic penumbra in rats after cerebral ischemia-reperfusion injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12), and electro-acupuncture pretreatment group (n=12). The middle cerebral arteries were occluded for 120 minutes and reperfused. Twenty-four hours after reperfusion, the level of IL-1βand IL-6 in serum and brain tissue was detected with enzyme-linked immunosorbent, and apoptosis of ischemic penumbra was detected with TU-NEL. Results The content of IL-1βand IL-6 in the serum and brain tissue, and the number of TUNEL-positive cells decreased in the elec-tro-acupuncture pretreatment group compared with that in the model group (P<0.01). Conclusion Electro-acupuncture pretreatment may in-hibit inflammatory response and apoptosis in cerebral ischemia-reperfusion injury.
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Objective To explore the effect of cluster needling of scalp acupuncture combined with treadmill training on axonal regener-ation and expression of S-100 protein in rats with sciatic nerve injury. Methods Ninety male Sprague-Dawley rats were randomly divided in-to blank group, sham group, model group, treadmill group and cluster needling of scalp point combined with treadmill group (combination group), each group was further divided into 7, 14 and 21 days subgroups, with 6 rats in each subgroup. The sciatic nerve of rats was clamped in the model group, the treadmill group and the combination group. The sham group was subjected to the same surgical procedure with sciat-ic nerve exposure but without crush injury. Three days after modeling, the treadmill group was treated with treadmill training, and the combi-nation group was treated with cluster needling of scalp acupuncture and treadmill training, while the other groups were grabbed regularly, with no other intervention. The sciatic functional index (SFI) was tested, the condition of axon growth was observed with HE staining, and the expression of S-100 protein was examined with immunohistochemistry at each time point. Results At each time point, SFI was higher, the axon grew better, and the S-100 protein was higher expressed in the treadmill group and the combination group than in the model group (P<0.05), especially in the combination group (P<0.05). Conclusion Cluster needling of scalp acupuncture combined with treadmill training can accelerate the regeneration of axons and increase the expression of S-100 protein and improve sciatic function after sciatic nerve injury.
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@#Objective To explore the effect of exercise preconditioning on apoptosis and expression of P53 protein in ischemic penum-bra in rats after cerebral ischemia-reperfusion. Methods Thirty-six Sprague-Dawley rats were randomly divided into sham group, model group and exercise preconditioning group, with twelve rats in each group. The middle cerebral artery occlusion (MCAO) model was estab-lished with modified Longa's method. TUNEL method was used to observe the apoptosis of neural cells in the ischemic penumbra. Western blotting was used to detect the expression of P53 protein in the ischemic penumbra. Results Twenty-four hours after cerebral ischemia-reper-fusion, the number of TUNEL positive cells was more in the model group than in the sham group (P<0.01), and was less in the exercise pre-conditioning group than in the model group (P<0.01). The expression of P53 protein was higher in the model group than in the sham group (P<0.01), and was lower in the exercise preconditioning group than in the model group (P<0.01). Conclusion Exercise preconditioning coud down-regulate the expression of P53 protein in the ischemic penumbra, and inhibit the apoptosis of cortical cells.
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Hypoxic-ischemic brain damage is a serious complication of perinatal asphyxia. Enriched environment is the living condi-tions for the promotion of feeling, cognition and behavior. Enriched environment may promote the repairing of hypoxic-ischemic brain dam-age in term of praxiology, morphology and molecular biology, that enriched environment may regulate the secretion and release of various factors, and enhance synaptic plasticity, induce neuron regeneration, inhibit its apoptosis, and result in ethological and morphological recov-ery.